Diabetes advice going low-carb

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The American Diabetes Association (ADA) has long advised a high carbohydrate diet which seems counterintuitive given diabetes is a condition of high blood sugar and carbohydrates more than any other nutrient cause blood sugar to rise. 

In response to the ADA’s stance, many of us who live with and write about diabetes complain about such advice, and personally follow low-carb diets. As do I. 

I used to scratch my head wondering why the ADA would so tirelessly recommend eating a lot of carbs until I read sufficient literature that they feared people were eating too much fat and fat caused heart attacks (not my belief), the greatest cause of death for people with type 2 diabetes. Thus, they wanted people to give up their fat and thinking there was no other way, they pushed them to eat more carbs.

This too kind of stuns me as I eat a low carb diet and haven’t replaced carb with more fat, I just eat sensibly – a bit of steel cut oatmeal most mornings with nuts, seeds, a few berries and Greek plain yogurt, other days cottage cheese, eggs or a protein shake. For lunch a salad with veg and grilled chicken and for dinner fish and veg mostly and snack on a bit of cheese, handful of nuts, piece of dark chocolate. 

So, I’m glad to see in the last several months the ADA finally seems to be coming ’round to advising PWDs lower their carb intake, and it’s making its way into the general advice on diabetes management. 

In today’s DiabetesInControl is one such article. Here are the highlights: 

  • Dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels.
  • During the epidemic of obesity and type 2 diabetes, caloric increases have been due almost entirely to increased carbohydrates.
  • Benefits of dietary carbohydrate restriction do not require weight loss.
  • Studies show that carbohydrate restriction is the best intervention for weight loss.
  • Adherence to a low-carb diet in people with type 2 diabetics is at least as good as adherence to any other dietary interventions and is frequently significantly better.
  • Replacement of carbohydrate with protein is generally beneficial.
  • Dietary total and saturated fat do not correlate with risk of cardiovascular disease.
  • Plasma saturated fatty acids are controlled by dietary carbohydrates more than dietary lipids.
  • The best predictor of microvascular and to a lesser extent, macrovascular complications in patients with type 2 diabetes, is glycemic control (HbA1c).
  • Dietary carbohydrate restriction is the most effective method of reducing serum triglycerides and increasing HDL.
  • Patients with type 2 diabetes on carbohydrate restricted diets reduce and frequently eliminate medication and type 1 diabetics require less insulin.
  • Intensive glucose lowering by dietary carbohydrate restriction has no side effects comparable to the effects of intensive pharmacologic treatment.

Full article here.

The Big Fat Surprise uncovers a big fat lie: fat is not the enemy

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I’ve long thought our reverence for a low and no fat diet has failed us. Just look around. Ever since the US government began pushing more carbs and less fat, and food manufacturers all but wiped full fat products off the shelf, as a nation we’ve grown fatter than ever.

Now, The Big Fat Surprise uncovers 9 years worth of investigation by its journalist author, Nina Teicholz, tracing how one man – Ancel Keys – convinced food experts, scientists, researchers the government and the American public that saturated fat was the devil – and changed our diet. 

Keys massaged much of his research to fit his notion that fat and red meat was our downfall. Study after study was faulty and wrongfully reported. Keys also liked being the persuasive savior and his charisma filled a room until all were convinced.  

I am two-thirds of the way through the book so I can’t tell you if we will find at the end the Big Truth, but I do believe sugar and carbs have increased our waistline, not fat, and the sooner we drop those containers of skim milk and no fat fruit yogurt and add some eggs, red meat and cheese back into our diet, the better off we’ll be. 

Unfortunately as pointed out in the book, the studies that contradict the merit of low-fat eating, you don’t read or hear about. Because they fly in the face of 30 years of our adopted “wisdom” they never get published. And, I know from marketing, if you hear something often enough you think it’s true whether it is or not.  

Here are a few snippets from the Wall Street Journal review:

In the great morality play of modern diet, the angels, we have been told by a host of experts, favor egg-white omelets and skimmed milk, while the devil gorges on red meat cooked in butter. For 50 years we have been warned to fight the good fight on dietary fats if we want to stay healthy. In “The Big Fat Surprise,” as one might guess from the title, Nina Teicholz plays the devil’s advocate—convincingly.

when skeptics, including the National Academies of Science, weighed in on Keys’s impoverished data, and on related claims that multiplied over the succeeding years, the media attacked the skeptics, heedless of statistical reasoning. Meanwhile, the food industry—apart from the protesting cattle and dairy lobbies—happily ministered to the new dietary wisdom. Government agencies weighed in with dietary guidelines that emphasized carbs and vegetables and warned that red meat was something one could only risk eating a few times a month. And when this miserable diet, shorn of taste, wearied its adherents, as it so often did, the pharmaceutical industry stepped in, offering drugs to lower cholesterol.

Read the book and judge for yourself.