Archive for January, 2006

Low-Fat Diet Makes You Gain Fat

During the recent 2006 NMS Scientific Sessions in Brooklyn, New York, I had an opportunity to meet and discuss various research findings with Dr. Barry Sears, author of the Zone diet. One item we talked about was the recent JAMA publication that I wrote about earlier this month – JAMA Publishes Findings of Seven Year Low-Fat Diet Study – where I highlighted the increased risk from an increase in waist-hip ratios and waistline measurements in the study participants.

An even closer look at the results find something odd – over the seven years, even with the calorie restriction of both groups, neither had an appreciable weight loss. More startling, both groups experienced an increase in their waist hip ratio (WHR) due to an increase in the size of their waistline – a measure we now understand is important in assessing health risks.

This particular study was a “hot topic” of conversation amongst many of those in attendance at the conference because the results were so skewed by the media and within the press releases from JAMA.

Earlier this week, Dr. Sears issued a press release about this study – Lose Weight, Gain Fat on Low-Fat Diets? – where he rightfully points out that, “The women in the low-fat group were consuming 361 fewer calories per day during the study, Sears said, which means that they should have lost approximately three pounds per month as opposed to the actual two pounds lost in seven years.

“This suggests that a calorie is not a calorie when it comes to weight loss and even less so when it comes with an apparent long-term increase in body fat,” he said.”

From my conversations with Dr. Sears, it is this type of increase in body fat – even with no gain in body weight – that may provide the catalyst that increases inflammation in the body. Back in July I wrote about the insidious effects of low-level, chronic inflammation in the body in my article Death by Inflammation.

In that article, I pointed to the things that increase inflammation in the body and want to repeat them again:

There are a number of things that are found in the literature, and not surprisingly, all but two are associated with our dietary habits:

  • Advanced Glycation End (AGE) products, are formed when food is cooked at high temperatures. AGE’s are toxins in the body and some are now calling them “glycotoxins”. According to a Proceedings of the National Academy of Sciences study, consuming foods cooked at high temperature accelerates the glycation process, and the subsequent formation of advanced glycation end products. When you eat foods with AGE’s your body responds with inflammation to try to protect itself.
  • Sleep Deprivation. In 2002, researchers at the annual meeting of the Endocrine Society held in San Francisco reported that sleep deprivation markedly increases inflammatory cytokines. Getting a good night sleep allows your body time to build and repair tissue – a process that is inhibited during waking hours.
  • Damaged Fats. Oil starts to degrade upon heating and over a relatively short period of time, within 30-minutes, 4-hydroxy-trans-2-nonenal (HNE) begins to reach critical levels. HNE’s are toxic in the human body.
  • Trans-Fatty Acids. Man-made trans-fats are disruptive in the body since they are not natural and the body does not know what to do with them.
  • High Blood Sugars and/or Insulin Levels. It is well documented that high blood sugar and/or insulin levels produce inflammation in the body. Quite frankly, our bodies are simply not designed to handle the excessive amount of sugars we eat daily. Prolonged elevated insulin levels disrupt cellular metabolism and spread inflammation.
  • Nutrient Deficiency from any number of vitamins, minerals and elements along with essential fatty acids (specifically omega-3) and essential amino acids. When your body does not have all the ingredients it needs for health, it makes do with what it has for survival and makes compromises. In that compromise process, it also works to protect itself and inflammation is one result of a nutrient-poor diet.
  • Stress, an often over-looked component in chronic inflammation. When you are stressed, your body releases a number of hormones and chemicals to try to counteract the affects of the stress. Chronic stress means constant elevated levels of stress hormones and inflammation. Relaxation, meditation, exercise and simple general activity all help to reduce stress and thus reduce stress hormones in the body.

If you look carefully at the above list, every last item you control.

The most important factor you control is what you eat. The seven-year study published in JAMA is a testament to how a long-term low-fat diet, even with calorie restriction, increases body fat and thus, increases your risk for inflammation and poor health in the long-term.

Dr. Sears is convinced that inflammation is at the root of many of our health ills – so convinced he founded the Inflammation Research Foundation that is “dedicated and committed to providing resources and funds for both education and medical research projects on the use of highly effective nutritional approaches for the treatment of chronic diseases associated with inflammation in adults and children.”

While I don’t think the Zone diet is the “cure all” or appropriate for everyone, it does have merit and is supported by evidence as one more dietary approach to consider for the long-term if your goal isn’t simply weight loss, but also includes health gains in the long-term!

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January 31, 2006 at 3:03 pm Leave a comment

JAMA: Atkins, Ornish, Weight Watchers & Zone – One-Year Comparison

Yesterday I pointed out the weight loss discrepancies, based on calorie intake of participants following various diets in a study published earlier this month in JAMA – Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction.

When viewed solely from a “calorie in – calorie out” perspective the results suggest that calorie intake alone is not the single determinant of weight loss. This is something I’ve been saying for years and still remain surprised when, at the end of a study where weight loss does not jibe with calorie intake, researchers fail to question why! They are quick to state weight loss that is aligned with calorie intake, which is almost always from a short-term period – so why ignore the question of why, over time, “calories in-calorie out” fails to produce predictable weight loss?

That’s just one question I have.

Another is why didn’t the researchers in this study make it clear that none of the groups followed over the year were able to follow the rules of their diet? And, why didn’t they acknowledge that even during the initial intensive start period, where education and support were provided, the groups couldn’t follow the “rules” of each diet?

For example, those assigned to the Ornish diet were supposed to limit fat intake to just 10% of their calories, yet consumed 17% of their calories from fat during the first two months of the study. By the end of one-year the group was averaging 31.6% of their calories from fat. This group was clearly not following the Ornish diet!

Nor did the group assigned the Atkins diet actually follow the Atkins diet rules. If they had followed the rules, at the end of month one they would have consumed just 30g of carbohydrate as part of their diet, and just 50g of carbohydrate by the end of month two. Instead, during this two month period of education & support, this group consumed an average of 68g of carbohydrate in month one and 137g of carbohydrate in month two.

Hello! This group was not following the low-carb Atkins diet!

In fact, none of the groups got the macronutrient ratios of their diets right. Those on Ornish and Zone ate way too much fat for their diet; those on Weight Watchers ate too much fat with too little carbohydrate; and those on Atkins ate too much carbohydrate with too little protein.

If nothing else this study tells us one thing – how to waste time and research money.

Those conducting this study failed to properly educate their participants and encourage adherence to the dietary rules of each plan. They did have ample opportunity to do so in the first eight weeks of the study and from their own data it is obvious they didn’t accomplish such an important part of the process required to start and follow a dietary approach – basic education of their participants. So, at the end of one-year this study tells us nothing and was nothing more than a waste of research dollars.

January 31, 2006 at 2:22 pm 1 comment

Atkins, Ornish, Weight Watchers & Zone Study – a Waste of Time

A study was published in JAMA – Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction – a couple of weeks ago, before I was in major “conference prep mode” that I wanted to write about. It was published around the same time as the study – Low-Fat Dietary Pattern and Weight Change Over 7 Years – that I’ve previously written about. Interestingly, this comparison study received little, if any, media attention.

Now that the 2006 NMS Scientific Sessions are complete and I’ve had a mini-vacation to relax a bit, it’s time to get back to the business of analyzing some research!

As I read through the study data, something interesting popped out – none of the participants, in seems, were able to actually follow the rules of the diet they were assigned to follow. That tidbit, in and of itself, is another article.

For now, I’d like to concentrate on something much more intriguing that comes to light when you look at the actual calorie intakes and compare that to the weight loss numbers.

The first clue that something is “just not right” is found it what is not said – there is no statement or acknowledgement that the weight loss experienced by participants is accounted for by the calorie restriction each diet imposed.

Why? Let’s find out…

This study was over a period of one year and there were some extreme calorie fluctuations thorughout. Each group was assessed at “baseline” and then at 1-month, 2-months, 6-months and one-year. The findings provide the first insight into just how extreme the calorie swings and creeps were in each diet:

So, what’s wrong with this picture?

Well, first of all it’s highly unlikely that a group of 200+ pound people are consuming just around 2000-calories a day at baseline and sport a BMI of 35 on average! So, that’s our first clue that the study has what is called a “reporting bias” caused by those participating under-reporting their actual food intake at the start of the study.

But, let’s pretend that is really all they were eating, OK?

Now look at just how significantly calories were restricted on some of the diets. The folks in the Zone managed to reduce calorie intake over the first month by 642-calories a day, then in month two they managed to keep calories reduced by 625-calories a day below their baseline start calorie intake, followed by an average of 173-calories less a day in months 3-4-5-and-6 and an astounding 302-calories fewer over the last six months.

So, where’s the 32-pound weight loss expected with such a calorie restriction? Why did these folks manage just 7.04-pounds of weight loss? Was this just a phenomenon of those in the Zone?

Not exactly. In fact, all groups had calorie restrictions that should have resulted in greater weight loss. The calorie restriction of the Ornish group should have resulted in 23.76-pounds of weight lost, in the Weight Watchers group a weight loss of 30.78-pounds should have been realized and in the Atkins group, the expected weight loss should have been 5.4-pounds.

Whoa!

Hold on a second.

The Atkins group, even though they were obviously not really following a “low-carb” diet, should have had a predictable weight loss of 5.4-pounds and lost 4.6-pounds? That’s mighty close to the expected weight loss, especially when we compare how poorly the other groups did when compared with their calorie restriction!

What prevented the other groups from not losing the weight they should have based on the Calorie Theory (calories in versus calories out)?

Call me crazy, but 1300, 1400, heck even 1600-calories a day is simply too few calories for someone weighing an average of 220-pounds with an average BMI of 35. After reviewing the amount of carbohydrate consumed by those supposedly following Atkins, I’m not surprised they lost just 4.6-pounds in a year – they were eating too many carbs to effectively burn body fat!

But, they were eating more calories each day – enough to support weight loss without throwing their metabolism into “starvation mode” where the body thinks it is in a famine and really conserves energy rather than burn it. I would wager that if they’d actually followed Atkins – actually kept their carbohydrate intake at levels recommended by Atkins – they would have seen some impressive weight loss! Too bad the researchers didn’t make sure each group actually was following the plan assigned during the first two months where support and intensive education was part of the design protocol.

January 31, 2006 at 1:25 am Leave a comment

My Brain Hurts!

To say my “brain hurts” from all the data presented this past weekend at the 2006 NMS Scientific Sessions: Nutritional & Metabolic Aspects of Carbohydrate Restriction is an understatment! I was blown away by the data presented by dozens researchers and clinicians along with the posters on display that highlighted findings from soon-to-be or recently published research findings from more than a dozen others!

As I sit here this morning, I am left wondering where to begin to tell you all about this incredible weekend of learning, made possible not only by those in the trenches of scientific inquiry and investigation who presented data, but also the dozens of scientific & medical experts who were attending the conference too!

Each presentation truly deserves its own time – from the opening presentation that provided the general overview of carbohydrate restricted diets as a potential therapeutic model for a number of metabolic disorders and detailed where the evidence stands along with how important the future research is, to the complicated presentations that detailed various aspects of the dietary approach from animal models to the highly specific role of genetics, macronutrients, micronutrients, thermogenesis, activity and more.

This is important stuff!

What’s more important is writing about it in a way that a non-scientific person will understand – and that is something that I will be trying to do in the coming weeks as I review my notes and write about the presentations and posters in a style I hope will bring the science to you, my readers, in an easy-to-digest manner.

I have a feeling I won’t be the only one writing about this conference – other sites you may want to read and bookmark for future reference include Drs. Mike & Mary Dan Eades and Jimmy Moore – who have blogs and were in attendance too!

Overall the conference provided invaluable insight into the role of dietary carbohydrate restriction and made it clear this isn’t just an alternative approach for weight loss. The evidence supports the idea that carbohydrate restriction has a much more important role as a tool for dietary management of a number of metabolic disorders that include diabetes, metabolic syndrome and the like. Hopefully, in the coming days I’ll get started with the various presentations and writing about the research and data presented!

January 24, 2006 at 4:25 pm 2 comments

Can we Cure Type II Diabetes?

I’ve received a number of emails since my article, Diabetics Must Demand Accountability from the ADA on Monday – with the vast majority thanking me for taking a strong stand on the issue.

All of the emails were not, however, singing my praises. In fact, about 30% were critical of the article or me personally and ran the gamut from ‘if you don’t have diabetes, you simply can not understand how important the ADA is to those of us who do’ to ‘you’re an idiot of you think the ADA is withholding a cure’ to ‘a high fat diet is deadly to those with diabetes, you obviously don’t know the research even though you claim you do.’

First, let me say that I do think the American Diabetes Association (ADA) should be important to those with diabetes, and even those with pre-diabetes or metabolic syndrome. Because of their prominent and trusted role in the lives of those with diabetes, they should be held accountable for the progress, or lack thereof, made in finding a cure. And that was the point of my article – hold the organization, that is the leading health authority for the disease, to a high standard and expect progressive improvements in your health not simply better medical management techniques.

That isn’t to say those medical interventions are not important – they are and they save lives. What they do not do is stop the progressive damage within the body – they only slow it down. Such treatments should not be viewed as the best we can do or the best we can hope for when the research data shows that there are natural, dietary interventions that may hold the key to finding a cure for Type II Diabetes!

Dare I say we may already have that key?

But, before we can consider the idea that a cure for Type II Diabetes is possible, we must first have a working definition of of “cure.”

Some will argue that there is no cure because diabetes is a lifelong, progressive, chronic disease and even if you can somehow manage it, even without medication, it does not change the fact you still have diabetes.

There are others though, with definition of “cure” from other diseases and conditions where the term “cure” is applied who hold that, if by definition you’re considered diabetic when you are placed on medications to manage the condition, then you are no longer a diabetic if you are able to eliminate the need for medication through whatever means – diet, exercise, etc. – and do not present symptoms that meet the definition of diabetes.

For the purpose of this article, let’s start to consider “cure” as you no longer meet the strict definitions established for a diagnosis of diabetes and no longer require medication to control blood sugars and/or insulin.

I think it is also important to have a good definition, one that cannot be considered too “loose,” so let’s also consider the multitude of complications associated with diabetes that increase risk for other problems like cardiovascular disease – so, let’s make our definition of “cure” five-fold:

improvement in fasting blood sugars to a level that indicates one is no longer meeting the criteria to be diagnoised as “diabetic”
AND
improvement in post-prandia glycemia & insulin secretion so that medication is no longer necessary and one is no longer meeting the critera to be diagnoised as “diabetic”
AND
normalized HBA1C levels so one is no longer meeting the criteria to be diagnoised as “diabetic”
AND
improvement in dyslipidemia
AND
elimination of oral medication and/or insulin injections

So, then – can we cure type-II diabetes?

If various research studies investigating dietary interventions are correct, and we even use the strict definition we have above, than yes, we can cure diabetes.

First, the problem – a low fat, high carbohydrate diet in combination with regular exercise is the traditional recommendation for treating diabetes. Compliance with these lifestyle modifications is less than satisfactory, however, and a high carbohydrate diet raises postprandial plasma glucose and insulin secretion, thereby increasing risk of CVD, hypertension, dyslipidemia, obesity and diabetes.

Moreover, the current epidemic of diabetes and obesity has been, over the past three decades, accompanied by a significant decrease in fat consumption and an increase in carbohydrate consumption. This apparent failure of the traditional diet, from a public health point of view, indicates that alternative dietary approaches are needed. Because carbohydrate is the major secretagogue of insulin, some form of carbohydrate restriction is a prima facie candidate for dietary control of diabetes with the potential to reverse the condition and perhaps cure type II diabetes.

A study published in 2004 – Glycemic optimization may reduce lipid peroxidation independent of weight and blood lipid changes in Type 2 diabetes mellitus – in the journal, Diabetes Nutrition & Metabolism, showed great promise for the standard ADA recommendations. The data showed some improvements in those following the diet for 8-weeks and is often cited as “proof” the recommendation for a low-fat, high-carbohydrate diet works.

But, if we use our definition of “cure” above, does the data support the idea that this type of dietary approach will lead to one being “cured” of their diabetic condition?

Let’s see…did this dietary approach result in:

Fasting Blood Sugar improvement? Yes
Improvement in post-prandia glycemia & insulin secretion? Not measured
Improvement in HBA1C? Yes
Improvement in dyslipidemia? No
Elimination of Medications? No

By our strict definition for “cure” bove, this dietary approach will not lead to one being cured of diabetes. The improvements above will most certainly slow the progress of the complications, and may even require less medication, but the individual with diabetes following this diet will not see a cure and will be left to continue with “medical management” of their disease and hope the worst long-term complications can be delayed as long as possible.

What about other studies? Surely the literature has something within that gives us hope.

Well, back in 1992, a study published – Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM – in the journal Diabetes, provided some very intriguing data. Researchers confined subjects to a metabolic ward for 3-weeks during each diet to ensure compliance with the dietary interventions to compare the standard ADA diet with a diet much lower in carbohydrate. Each subject was crossed-over to the other diet for three-weeks to compare effects. The two diets provided the same calories and fiber, but had significant differences in their effect.

This study did not look at all parameters we’ve used in our definition for cure, but something very alarming did happen to those following the high-carbohydrate diet – their cholesterol was significantly impacted by the high-carb diet! The high-carb diet resulted in a 27.5% increase in triglycerides and a similar increase in VLDL cholesterol and an 11% decrease in HDL. For cholesterol levels the high-carb diet was a disaster!

Are there other studies that might show improvements that meet the strict definition of cure we’ve established?

In 1994 a study – Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus – was published in JAMA. In this 8-week study, researchers investigated the difference between a high-carbohydrate diet compared with a lower carbohydrate, high-monounsaturated fat diet. Again, the high-carbohydrate diet was disasterous as it resulted in increased fasting plasma triglyceride levels and very low-density lipoprotein cholesterol levels by 24% and 23% respectively, and increased daylong plasma triglyceride, glucose, and insulin values by 10%, 12%, and 9%, respectively. Plasma total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels remained unchanged. The effects on plasma glucose, insulin, and triglyceride levels persisted for 14 weeks after the diet was abandon.

These last two studies were done 12-years ago and during the time since, the ADA has remained staunch in it’s high-carbohydrate, low-fat recommendation. Twelve years ago, we had the start of some very compelling data that suggested we continue to study a dietary approach that was lower in carbohydrate as a dietary intervention for those with Type II Diabetes.

So what happened?

Well, if we look through the literature, we find that researchers often adjusted their study design and rarely compared the high-carbohydrate diet to a lower carbohydrate diet again until 1998, when a study – Utility of a Short-Term 25% Carbohydrate Diet on Improving Glycemic Control in Type 2 Diabetes Mellitus – was published in the Journal of the American College of Nutrition. While this was another short-term study, this one did look at a number of items from our definition above.

The data from the study provides some insight into what effect a lower carbohydrate diet had with regard to:

Fasting Blood Sugar improvement? Yes
Improvement in post-prandia glycemia & insulin secretion? Yes
Improvement in HBA1C? Yes
Improvement in dyslipidemia? Not measured
Elimination of Medications? Yes

The researchers noted that “In those subjects on sulfonylurea therapy, the improved glycemia was achieved despite discontinuation of the oral hypoglycemic agent. “

This is our first glimmer of hope in the literature that diet alone may indeed hold the key to cure. One would think the above results would have sparked a renewed interest in researching comparitive studies of high-carbohydrate versus low-carbohydrate diets for diabetics?

Well, it didn’t happen.

But in 2004, we do find a study – Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes – published in the journal, Diabetes, that again does compare the high-carbohydrate diet with a low-carbohydrate diet. Again, the results are compelling for the low carbohydrate diet:

Fasting Blood Sugar Improvement? Yes
Improvement in post-prandia glycemia & insulin secretion? Yes
Improvement in HBA1C? Yes
Improvement in dyslipidemia? Yes
Elimination of Medications? Not stated

Unfortunately this study did not tell us if those within the study were able to eliminate their medication or not with the dietary intervention.

A study last year gave us data from a Swedish research team – Lasting improvement of hyperglycaemia and bodyweight: low-carbohydrate diet in type 2 diabetes–a brief report – published in the journal, Upsala Journal of Medical Sciences. In this study, researchers found that in their type II diabetic subjects following a low-carbohydrate diet for six months resulted in:

Fasting Blood Sugar improvement? Yes
Improvement in post-prandia glycemia & insulin secretion? Yes
Improvement in HBA1C? Yes
Improvement in dyslipidemia? Not Measured
Elimination of Medications? Yes

And, get this – while this study was just six months, the researchers noted that the improvements persisted in the six months following the end of the study! That’s ONE YEAR of measurable, real metabolic improvement in study participants who had diabetes and through diet alone were able to eliminate their medications!

Then we have, from the Annals of Medicine a study published last year, Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. This study was short-term, included a very limited number of participants but was conducted within a metabolic ward to specifically measure food intake accurately. The researchers findings included:

Fasting Blood Sugar improvement? Yes
Improvement in post-prandia glycemia & insulin secretion? Yes
Improvement in HBA1C? Not Measured
Improvement in dyslipidemia? Yes
Elimination of Medications? Yes

The researchers again noted that the low-carb diet affected “markedly improved glycemic control and insulin sensitivity.”

Here we have three studies since 1994 – a period of twelve years – that show elimination of medications of those with Type II Diabetes. Yet, in tweleve years we still have NO long-term study data because we have no longer term studies done specifically using this dietary intervetion to actually see if reducing carbohydrate has a lasting effect in those previously diagnoised with diabetes who, by participating in a study, were able to eliminate their medications because of a low-carb diet!

The above studies are publically available, so the ADA is well aware of them. Even if, in the last twelve years they wanted to remain cautious in their recommendations – totally understandable – why in the world have they not committed funding to a large, well-controlled, long-term study to investigate the long term effect of a carbohydrate restricted diet?

The last twelve years has been lost to us for data collection – it’s gone, time we cannot get back. The ADA knows the data about a low-fat, high-carbohydrate diet does not hold promise for a cure. They have no idea what a low-carbohydrate diet can do because they simply will not commit to investigating the dietary approach for long-term data.

They are supposed to be the leading healthcare organization for those with diabetes! Why are they dismissing this potential key to the cure?

January 13, 2006 at 3:08 pm 3 comments

Diabetics Must Demand Accountability from the ADA

Earlier today, the New York Times ran the heartbreaking story, Diabetes and Its Awful Toll Quietly Emerge as a Crisis, about the “epidemic” of diabetes in New York City and its progressive, deadly destruction in those afflicted. This isn’t just a New York story, but a snapshot of the future in American that deserves our efforts to ensure we are doing all we can, as a nation, to end what is truly a devastating epidemic. (If the NYT link requires registration, try the reprint of the article at the Amherst Times)

The author paints the bleak reality of diabetes:

Diabetics are two to four times more likely than others to develop heart disease or have a stroke, and three times more likely to die of complications from flu or pneumonia, according to the Centers for Disease Control. Most diabetics suffer nervous-system damage and poor circulation, which can lead to amputations of toes, feet and entire legs; even a tiny cut on the foot can lead to gangrene because it will not be seen or felt.

Women with diabetes are at higher risk for complications in pregnancy, including miscarriages and birth defects. Men run a higher risk of impotence. Young adults have twice the chance of getting gum disease and losing teeth.

And people with Type 2 are often hounded by parallel problems – high blood pressure and high cholesterol, among others – brought on not by the diabetes, but by the behavior that led to it, or by genetics.

Dr. Monica Sweeney, medical director of the Bedford-Stuyvesant Family Health Center, offered an analogy: “It’s like bad kids. If you have one bad kid, not so bad. Two bad kids, it’s worse. Put five bad kids together and it’s unmanageable. Diabetes is like five bad kids together. You want to scream.”

The outlook, at best, is bleak:

Diabetes has no cure. It is progressive and often fatal, and while the patient lives, the welter of medical complications it sets off can attack every major organ.

[…]

The health care system is good at dispensing pills and opening up bodies, and with diabetes it had better be, because it has proved ineffectual at stopping the disease. People typically have it for 7 to 10 years before it is even diagnosed, and by that time it will often have begun to set off grievous consequences. Thus, most treatment is simply triage, doctors coping with the poisonous complications of patients who return again and again.

No cure and treatment that is, at best, basic triage to cope with the complications as they happen and a management plan that leads only down the path to progressive degeneration.

Is this the best we can do?

Of course not – but it is the best the American Diabetes Association (ADA) wants you to believe we have.

Interestingly, when this story broke this morning, I was working on a piece about the latest ADA position statement, Standards of Medical Care in Diabetes–2006, since this year’s publication had extensive revision to the section Medical Nutrition Therapy (MNT). I was following the reference trail to understand how they decided that:

Low-carbohydrate diets (restricting total carbohydrate to <130 g/day) are not recommended in the management of diabetes. (E) The “E” noted after the statement indicates this recommendation is based on “expert opinion.” A cleaver double-speak for “there is no research evidence available for us to present that proves low-carb diets are bad for those with diabetes.” For decades, the ADA has maintained that diabetics need carbohydrate in their diet – the very macronutrient that aggravates and complicates their condition – and recommends 45-65% of their total calories each day come from carbohydrate. What boggles my mind is how we as a nation continue to put up with such a counter-intuitive, illogical, obviously flawed recommendation!

Let me be clear here – excessive carbohydrate is the very thing that destroys a T2 diabetic’s endocrine system and metabolism permanently – so there is no reversal and only progressive degeneration of the whole body from within if the diabetic continues to eat excessive carbohydrate each day. What is excessive carbohydrate? ANY level of carbohydrate beyond what your body can tolerate, effectively metabolize and use as energy!

Rather than acknowledge this fact, the ADA continues to promote the idea that “management” of the progressive degeneration is the only way to go and the only treatment that is “effective.”

Rather than disappoint the diabetic and tell them to face the facts and stop eating cakes, candy, cookies, pastries and such, the ADA tells those with diabetes that “sugar can be a part of your diet” and even publishes recipes for their convenience, while telling them to monitor blood sugars and keep popping pills or injecting insulin as directed.

Rather than tell a diabetic the TRUTH – that their own research shows that it doesn’t matter what type of carbohydrate is eaten, if the total non-fiber intake remains the same, regardless of source, they all stimulate high blood sugars – they lull the diabetic into thinking that somehow “complex” carbohydrates offer some magic protection against blood sugar rising too high.

Rather than tell the diabetic there is certainty they will progressively decline in health if they do not stop eating excessive amounts of foods that turn into glucose, they tell them to continue eating a high carbohydrate diet and progressively increase medications and then “manage” the other complications – high blood pressure, high cholesterol, high triglycerides, renal failure, etc. – with a multitude of more medical interventions.

Rather than providing uncomplicated recommendations for weight loss – the single most effective non-pharmacological option available – they continue to promote the idea no one is smart enough to plan their meals without a “professional registered dietitian” at the wheel, directing what to eat, when to eat and how to prepare foods. Their menus are too often nutritionally deficient, too low in calories and too difficult to follow for the long-term – is it any wonder the majority of type II diabetics are still obese?

Rather than admit their dietary recommendations are contributing to the progressive degeneration of those with diabetes, they remain staunch that this type of “treatment” is the best we have.

Can you tell I’m just a bit disgusted by this being considered the “standard” treatment for someone with diabetes?

I hope everyone reading this today is ANGRY! If you’re diabetic, pre-diabetic, have a family member or friend, co-worker or someone else you care about that is diabetic or pre-diabetic – you should be angry!

It is time we, as a nation, start to DEMAND accountability from the leading health organizations, trusted by the nation to provide timely, relevant, evidence-based recommendations for the treatment of diabetes!

The ADA survives because we, as a nation, are not demanding they be accountable to every diabetic out there who has followed their recommendations and still are declining each day. The ADA continuing to promote the idea of managing the disease symptoms and progressive complications is NOT good enough anymore.

Only an aggressive campaign that openly and honestly reviews every last piece of scientific data available and comprehensively details exactly what metabolic and/or endocrine improvement is seen with each option will be an acceptable start.

You see, the drugs and other medical interventions do not provide metabolic and/or endocrine system improvement – they just make you feel better while you’re body continues to degenerate and self-destruct inside.

Do you want treatment to just mask your slow death or do you want real improvement in how your body systems function each day? The ADA is giving you the former – scientific research data already holds the latter.

The ADA tells you this scientifically supported approach is unbalanced and will lead to kidney damage, heart attacks, high cholesterol and other health problems. The ADA just refuses to accept it works and continues to tell you to ignore it, dismiss it and forget trying it since it is unhealthy.

It’s called carbohydrate restriction – the fastest, most effective dietary treatment to reduce or eliminate your dependence on medications to control your blood sugars, reduce your weight and thus increase your insulin sensitivity. All of which are real, measurable improvements within your body and not just “medication induced” improvements that do nothing to stop the progressive complications you are facing in the long-term!

Type II Diabetics, ask yourself, do you want to have to take medication every day for the rest of your life and progressively add more and more as the years go by? No? Well…

Demand the ADA begin to tell you the truth about restricting carbohydrate in your diet!

Demand the ADA begin to give you actual IMPROVEMENT in, not just medical management of, your metabolism, endocrine system and thus, your diabetes!

January 10, 2006 at 3:39 am 3 comments

Censor Scientific Findings?

Last month I wrote about the scathing editorial in the journal Nature that called into question the integrity of Dr. Manny Noakes and Dr. Peter Clifton, authors of the CSIRO Total Wellbeing Diet, in The Emperor has no Clothes.

Well, it seems raising concern, heck even outright attack on these two researchers, in a scientific journal wasn’t enough. As reported in Questions raised over CSIRO diet – a nutritionist, Rosemary Stanton, and a medico, John Tickell, have taken their concerns to the government of Australia and requested that the Prime Minister, John Howard, review the diet.

The pair wrote to Mr Howard, saying the high meat content in the diet contravenes the government’s own dietary advice.

Whoa!

A book isn’t aligned with government dietary guidelines and therefore is subject to review by the government?

Do these two concerned healthcare professionals understand they are asking their government to censor a book? Not only that, they’re asking the government to censor its own scientific findings that were the foundation of the book.

CSIRO is a government agency in Australia. Dr. Noakes and Dr. Clifton are researchers at CSIRO and had approval from that agency to write the book!

Since when are findings, from scientific studies – eight years worth of data – that are contrary to current belief up for censorship?

This is just the beginning of what I believe is going to be a concerted effort to suppress scientific inquiry into dietary approaches that contradict various government recommendations both here and abroad. Such attempts to censor what researchers study, find, conclude and write about is outrageous.

January 8, 2006 at 2:20 pm Leave a comment

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