Diabetes Self-Management Blog

Have you gotten caught up in the royal wedding fever surrounding Kate and Will’s upcoming nuptials? Imagine if you’re the bride, or even the mother of the bride. You have to look good for the big day. After all, Queen Elizabeth and some two thousand people will be there, not to mention the millions watching you on television. You gotta look good. So, enter the Dukan diet, France’s version of the Atkins diet. Rumor has it that Kate Middleton and her mother are “on” the Dukan diet in preparation for the wedding on April 29. Not to mention that Jennifer Lopez and Gisele Bundchen are avid followers, too.

The Dukan diet was created by French physician Dr. Pierre Dukan, a nutritionist who specializes in food behavior. This diet is so popular that his book has been translated into 14 languages and is sold in over 32 countries. And when you read “2 Steps to Lose the Weight, 2 Steps to Keep it Off Forever” on the book cover, you can’t help but be curious. So what is this diet all about?

Dukan Diet: The Basics
What makes this diet “special” is that not only is it a low-carb diet, it also promises you that you really can eat as much as you like…once you get through the various stages, that is. There are four stages, or phases, in the Dukan Diet. Here’s how they break down:

  • Phase I (the “Attack” Phase). Here’s when you load up on protein, including lean meat, poultry, fish, eggs, low-fat dairy, and offal (liver and tongue!). There’s no limit on the amount of protein you can eat. You supplement about 1.5 tablespoons of oat bran each day. No starchy foods or fruit are allowed. Typically, this phase lasts for 5 days (you should lose about 7 pounds), but may last longer the more weight there is to lose.
  • Phase II (the “Cruise” Phase). This is the time when you alternate between all-protein days and protein days supplemented with non-starchy vegetables (tomatoes, lettuce, radishes, mushrooms, carrots, etc.). No potatoes, corn, carrots, or peas. You “cruise” along in this phase until you reach your goal weight. You should be losing weight at a rate of roughly 2 pounds per week.
  • Phase III (the “Consolidation” Phase). This is when you’re allowed to introduce those previously off-limits foods, such as pasta, potatoes, and bread, but in limited amounts — and not every day. Your body is supposedly adapting and learning how to digest carbohydrate. This phase is designed to prevent compulsive eating and help you gain self-control. This is the high-risk phase, when people are likely to regain the weight that they’ve lost. The formula for staying in this phase is five days for every pound that you’ve lost.
  • Phase IV (the “Definitive Stabilization” Phase). Now you can eat what you want (except no sugar and never any sweets) for the whole week…except for one day. One day a week (preferably a Thursday), you eat just protein, as you did when you were in the Attack Phase. Oh, you also eat three tablespoons of oat bran per day, too. Why oat bran? According to Dr. Dukan, oat bran interferes with the body’s ability to absorb sugar due to its chromium content (?), it lowers cholesterol (true), and it helps with digestion (true). Because of its absorbent properties, the oat bran will stick to everything around it and lower the calorie content of your food (not quite sure about that claim!). Phase IV is lifelong, by the way. And you’ll supposedly keep the weight off for good if you follow the rules.

What else can you eat on this diet? Spices, vinegar, nonnutritive sweeteners, and sugar-free gum. And you should take a multivitamin with minerals. Exercise is a big part of the plan. Dr. Dukan recommends walking for at least 20 minutes each day.

The Down and Dirty on the Dukan Diet
Will you lose weight on the Dukan Diet? Most likely, yes. The main reason for weight loss with this plan is that 1) you initially lose “water weight” thanks to cutting out carbs and 2) the plan is fairly low in calories (how much “offal” can one eat?). Any time you slash calories, you generally lose weight.

Possible side effects include dry mouth, bad breath, constipation, and fatigue. The Dukan Diet isn’t specifically for people with diabetes, but if someone with diabetes were to follow this, there’s also the risk of low blood glucose (hypoglycemia) among those who take insulin or certain types of diabetes pills.

The diet itself isn’t nutritionally balanced as it eliminates or at least severely restricts several foods groups, including fruit. The British Dietetic Association and France’s National Agency for Food, Environmental and Work Health Safety have given this diet a thumbs down.

As with most fad diets, there isn’t the evidence to back up the claim that weight loss can be maintained, particularly long-term. Is it harmful to follow for a short period of time? Probably not, unless the side effects become bothersome. Do you see yourself eating this way indefinitely? Maybe. Is this another Atkins-type of diet, repurposed? Very likely. Is this the best diet for the future Queen of England to be following? That remains to be seen.

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Comments
  1. There are many flaws in your analysis of the Dukan Diet, mostly because you believe the conventional wisdom for diabetics. It’s true that diabetics need to beware of low blood sugar. However, the answer isn’t in continuing to eat carbs when you have diabetes. Why continue eating the thing that causes your diabetes (carbs), only to pump insulin when you eat them? With the help of their insulin meds, diabetics can be weaned off of carbs into a low- or zero-carb lifestyle, thus eventually needing little to no insulin… ever. Please research the paleo, Dukan, and low-carb lifestyles and talk to diabetics who have practically cured their condition with these new options. The faulty science preaching that low-carb and animal foods are killing us is quickly being dismissed in the past year. The media is trying to hold on to the conventional wisdom that grains are good for us by throwing around headlines like “red meat kills, science finds”. When you look at the article they cited and look at the DATA ITSELF (NOT THE AUTHOR’S WRITTEN CONCLUSION), we find that the data DOES NOT show that meat kills. A study has never been done with MEAT ALONE… it’s always studied with meat and grains being consumed together. There is evidence now that it’s the grains that is causing the inflammation that causes the Type II Diabetes, Heart Disease, etc., instead of the hamburger meat. Please, please listen to the other side of the story instead of blindly listening the ADA’s recommendations. ‘Critical thinking’ is the saving grace for us all who suffer.

    Posted by Emm |
  2. If you don’t mind me adding: most of the weight lost at the beginning of a low-carb diet is, yes, just extra water weight. I don’t know why people say this is negative. Grains cause us to carry around unnecessary water reserves (inflammation), and a low-carb diet fixes that :)

    Posted by Emm |
  3. Hi Emm,

    Thanks for your comments. Just to clarify, I don’t “blindly” listen to ADA’s recommendations. What I aim to present in all of my postings, as much as I am able, are evidence-based guidelines and practices that are supported by a number of organizations and health institutions, including, but not limited to, ADA, Harvard School of Public Health, American Cancer Society, Academy of Nutrition and Dietetics, American Heart Association, and the World Health Organization, to name a few. I have no doubt that diets like Dukan and Paleo help people manage their blood glucose. However, the research doesn’t support long-term effectiveness or safety of either of these diets. As a dietitian, however, my job is to promote healthful eating for the whole person, not just the “diabetes part” of that person. Any diet that severely restricts or eliminates an entire food group has the potential to be nutritionally unbalanced. And those that promote rapid weight loss are generally not healthful, as muscle mass, not fat mass, tends to be lost along with fluid and electrolytes. To address your point about whole grains causing inflammation, again, the evidence (from credible, peer-reviewed journals) does not support this claim. On the contrary, a sizable amount of evidence (including research done by Dean Ornish and Neal Barnard) indicate that whole (not refined) grains, along with fruits and vegetables, have an anti-inflammtory effect, thus likely protecting against heart disease, Type 2 diabetes, and cancer. Interestingly, a study was released today indicating that people with Type 2 diabetes who follow a low-carb, high-fat diet have higher levels of endotoxins than those not on a low-carb diet. Endotoxins may raise the risk of heart disease and inflammation.

    Posted by acampbell |

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