Many people trying to lose weight or manage blood sugar instinctively cut out white rice and fruit, embracing low-carb or even ketogenic diets laden with fatty meats like steak, pork belly, and trotters. The assumption: no carbs means no glucose spike, so it must be healthy. But according to Hong Kong weight management physician Dr. Xiao Jiejian, this extreme dietary approach can backfire dramatically, causing glycated hemoglobin levels to rise and pancreatic function to deteriorate. In a recent social media post, the doctor shared real-world cases and introduced a groundbreaking concept from UK researchers that is reshaping how we understand diabetes.
The Case of the Worsening Numbers
Dr. Xiao reports that many elderly patients, following well-intentioned advice to “eat less starch,” swap out rice and fruit for braised pork trotters, fatty ribeye, and five-flower pork. They strictly avoid carbohydrates, believing they have unlocked the secret to health. Yet when they return for a follow-up six months later, the results are alarming: their glycated hemoglobin—a key blood sugar marker—has not dropped but increased, and their pancreatic function has notably declined. The problem, explains Dr. Xiao, is not a lack of effort but a fundamental misunderstanding of what actually drives insulin resistance.
The Real Villain: Saturated Fat That “Buries” the Pancreas
The medical community has long focused on sugar and starch as dietary enemies. However, Dr. Xiao warns that the hidden danger in many low-carb regimens is saturated fat, abundant in red meat, processed meat, and fatty cuts. Rather than simply raising calorie intake, these fats tend to accumulate around two critical metabolic organs: the pancreas and the liver. When fat builds up around the pancreas, it physically impairs its function, much like piling debris around a 24-hour power plant until it can no longer cool itself or work properly. The result: the pancreas effectively goes on strike, leading to worsening blood sugar control even when carbohydrate intake is low.
Personal Fat Threshold: Why Being Thin Is No Guarantee
One of the most common misconceptions is that only overweight individuals develop type 2 diabetes. Dr. Xiao cites the work of Professor Roy Taylor (Newcastle University) and Professor Rury Holman (University of Oxford), who introduced the concept of a personal fat threshold. This theory posits that everyone has a maximum amount of fat their body can store safely in subcutaneous fat tissue. Once that limit is exceeded, excess fat begins to deposit where it shouldn’t—namely in the liver and pancreas. Crucially, this threshold varies from person to person and has no direct relationship with BMI. Some individuals who appear lean may have a very low threshold, making them paradoxically more vulnerable to visceral fat accumulation and metabolic dysfunction when they eat a high-fat diet, compared to a heavier person with a higher tolerance.
Three Practical Steps to Reduce Visceral Fat and Improve Blood Sugar
Since the core issue is fat surrounding the pancreas, the solution is to reduce that visceral fat. Dr. Xiao offers three evidence-based strategies:
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Change your eating order. Consume protein first, then vegetables, and leave starchy carbs like rice or noodles until the end of the meal. Research shows that simply rearranging the sequence can slash post-meal blood sugar by 36.7% at the 60-minute mark.
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Move for 15 minutes after meals. Sitting down or lying down after eating is common, but even a gentle walk speeds up muscle contraction. Active muscles pull glucose from the bloodstream for energy without needing insulin, lowering blood sugar by 30 to 50 mg/dL.
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Build muscle mass. Muscle acts as a reservoir for glucose. Dr. Xiao recommends simple resistance exercises twice a week, such as bodyweight squats or modified push-ups. A larger “storage warehouse” means less sugar remains in circulation and less fat accumulates around internal organs.
A Critical Caution for Those on Medication
Dr. Xiao emphasizes that anyone currently taking diabetes medication or insulin should never stop or reduce their medication without consulting their doctor. Combining dietary changes and exercise with existing treatments can cause blood sugar to drop too quickly, leading to dangerous hypoglycemia. Patients should first implement lifestyle adjustments, monitor their blood sugar regularly, and then discuss gradual medication reductions with their physician during follow-up visits.
A New Perspective on Diabetes Management
This insight from Dr. Xiao and the research teams in the UK challenges the popular low-carb dogma that equates all carbohydrates with harm. While refined sugars and starches certainly disrupt blood sugar, overemphasis on fatty animal products may be inadvertently causing pancreatic damage through visceral fat accumulation. Instead of eliminating entire food groups, the focus should shift to the quality and distribution of fats and carbohydrates, along with simple lifestyle habits that improve metabolic flexibility. For anyone struggling with blood sugar or weight, seeking personalized guidance from a medical professional remains the safest route to lasting health.