In the March issue of Diabetes Forecast Magazine, a publication of the American Diabetes Association, is an article that presents a fairly balanced review of various approaches to carb eating in the control of diabetes.
The article quotes Dr. B extensively. In support of low carb, it also quotes William Yancy MD as saying “Replacing carbs with protein and fat is a smart alternative” and researcher Mary Gannon, PhD as saying “Data would indicate that people with [type 2] diabetes, if the goal was glucose control, would be best off with a low-carb diet,”. It also doccuments studies showing Improved A1C and blood lipid profiles on low carb.
As if this wasn’t enough they then discuss the proposition that “saturated fat will kill you”. "Quoting Frank Nuttall, MD“ We really don’t have good evidence that saturated fat causes coronary heart disease. It can raise cholesterol levels, but whether that’s sufficient to raise the risk for coronary heart disease is not conclusive.” They then quote anti fat guru Dr. Neal Barnard presenting the opposite view.
Many veterans of the carb wars here on TuD have developed the attitude, eat whatever works for you, but please don’t quote a bunch of bogus facts attacking my way of eating. This article generally supports the idea that low carb is OK and it works for those who can stick with it.
So I guess we won’t have the ADA to kick around anymore. I must admit to feeling a little disoriented. Has the earth shifted on it’s axis? Is this a sign that the end of the world is upon us? At a minimum the base of the food pyramid seems to be turning to dust.
I also wonder how long it will take to filter down to the various heath care professionals, Dr.s CDE’s etc. It’s certainly a sea change.
I also note that in the 4th paragraph they list certain carby foods that provide important nutrients, Grains are absent from the list. This contradicts their previous position that grains were needed for their nutritional value.
I went to this website a while back for a list of essential nutrients found in grains. The first listed was carbs followed by thiamine, riboflavin, niacin, vitamin E, iron, magnesium, selenium and zinc.
I then did a search for dietary sources of all but carbs. I wrote them all down, but the list is rather repetitive. It includes meat, fish, eggs, veggies esp green leafy, nuts esp almonds, mushrooms, sunflower seeds, olives, avocados and dairy. Hmm… sounds like the Dr. B diet to me, its apparently also been known for some time.
I’ve never actually looked at their forum but do get the idea that they’re not interested on alternate points of view It sounds like you have engaged on some discussions over there in the past.
Im not real sure that this one article will turn the tide, but rather a milestone in the direction that the ADA may be going in. Although, Id like to say they are wising up, it still may be a while for them to accept anything but thier own methods.
Oh, and Ill bring the SF marshmallows for the roast!
Thanks for posting article! Sited reasons for not doing low carb are largely based on feelings:
1. “If someone told me you have diabetes but you can’t eat carbs, I’d be floored,” says Franz. “I would cry out in alarm and say, ‘But I deserve the right to eat healthfully, and I can keep my blood glucose in control by watching my portion sizes and, if necessary, taking medication.’ ”
Critics say that the low-carb diet is hard to stick to over time.
…carbs are an efficient source of energy. “Like gasoline powers a car, glucose powers your body,” says Neal Barnard, MD, adjunct associate professor of medicine at the George Washington University School of Medicine and author of Dr. Neal Barnard’s Program for Reversing Diabetes. “The idea that carbohydrate is a problem is, in my opinion, a mistaken one.”
First of all, keep in mind that what works for someone else may not necessarily work for you—and vice versa. You may need to experiment a bit to see how different methods affect your blood glucose levels. Consider making an appointment with a registered dietitian, who can review your individual needs and circumstances and help you tailor a nutrition plan that’s right for you. In the end, the best diet is the healthy one you’re able to follow.
My observations about above comments:
“I deserve the right”? Are we in first grade? When someone gets the diagnosis of T1 or T2 diabetes, somethings are going to change if you want to remain healthy. HARD WORK! I felt it was reckless to be told I needed to eat corn, mashed potatoes, bread all of which were on my hospital tray while learning to use insulin in those early days. Now that was a challenge!!!
I don’t need a critic to tell me low carb eating is hard. It is hard, but T1 diabetes is hard. Our brains are evolved enough to problem solve new challenges. For my personal study over the last 6 years, low carb eating provided a much more stable lifestyle with steady blood glucose numbers. Attempting to cover high carbs with insulin produced unnecessary chaos. I have the CGMS charts to prove it.
Carbs are efficient and a cheap food source, and that is good news and true for anyone without diabetes. High carbs can be dangerous, making undue stress on our bodies and at the very least tricky to deal with. While the body can convert carbs to energy, it can do the same with protein and fat.
“what works for someone else may not necessarily work for you—and vice versa” If this statement means that people prefer to live their lives differently, then I agree. I have a T1 D nephew who is non-compliant and at 40 looks pretty bad. It doesn’t ‘work’ for him to manage his diabetes. The variable is our technique and determination. I discussed this with my endocrinologist, because on the forums you read people saying all sorts of things. He said if any type 1 did my routine, they would have the same results. It is science, not virtue. I looked at those who were having success and found Bernstein.
When we continue to give people a pass that their diabetes is more special/difficult than others it can become somewhat misleading. Attitudes, personal situations and resources differ…how supported we feel, how overwhelmed or confident we feel are all important variables. Feelings are how we respond to science. The science is neutral. Bernstein’s findings have been useful to the scientific management of my diabetes. It works, every time. I don’t have to hope it works. I don’t have to pray it works (although I do pray). I don’t have to stand on my head for it to work. I don’t have to wait for a consortium like ADA to tell me it works. It works on a good day or a bad day. It speaks for itself. That said, because new people are being diagnosed every day and looking for help every day, I wish this information were more mainstream, saving people from the pitfalls of feelings and loss of good time.
BTW, I just heard that the recent earthquake in Japan has shifted the planet’s axis nearly 4 inches.
I do hope low carb becomes more mainstream. Not as the only way, but as a viable option. I think it’s good that they are acknowledging that it is safe. Lots of solid research has been done since the Atkins diet craze and they all seem to agree, it’s in fact a healthy way to eat.
I think the ready availability of blood glucose meters, which give the individual the ability to see the effect of various foods, combined with the communication revolution of the web, has changed things dramatically. We can see what is working for others, test it on ourselves, and then share the results.
Visit any diabetes forum and you will find many individuals having success by reducing carbs. In a way I think the ADA is just acknowledging this simple fact. And by the way, this is not rocket science. Our bodies have damaged carbohydrate metabolic systems, the obvious response is to limit the thing causing the problem. For insulin users Dr. B’s law of small numbers is powerful and reliable because it is simple.
I have to be honest. I do not trust the ADA. I consider them hopelessly corrupt and anything that comes out of their mouths must be assumed to be corporate spin and to be an attempt at manipulating us. For years, they advocated high carb diets. Then as the evidence became overwhelming, they shifted strategies to create a “front” organization for their recommendations (American Dietitic Association (ADtA)). All the same people just went propagated the same stuff over at the ADtA, putting the ADtA forward as independent experts. Yet they clearly are not, it is exactly the same people as before and all under the same control of the “cabal” First the ADA "accepted’ low carb diets as a way of losing weight.
And now, they “entertain” the position that low carb diets can be used to manage glycemia. It is a scam, when it comes down to it, they won’t take a position, they will “never” endorse a low carb diet, nor any other diet directly, they will defer to their “front” organization, the ADtA. In this way, they can avoid criticism while still controlling things. And do understand, the ADtA is still all focused on their “message” that carbs are essential nutrients and you must have 45-60% of calories from carbs. And if you have any question about exactly where the ADA lies on this matter, read carefully the “spinmeiester” Hope Warshaw, spokeswoman for the ADA on this article. Note her use of classic “talking points” and choices of words. This stuff is no doubt the result of many $$$ spent on marketting and public relations in order to deflect the truth. Consider the title “Great Carb Debate – Can Glucose Control and Healthy Eating Coexist?” Who in the world would suggest that high blood sugars reflect healthy eating? Well apparently, Hope Warshaw and the ADA.
‘Fool me once, shame on you; fool me twice, shame on me’
Well I readily admit to being a glass half full kind of guy. Having said that, money is a very powerful motivator and individuals and organizations who view themselves as experts have a tough time admitting they were wrong. Human nature is unchanging and so the pace of change is often glacial. The counter revolutionaries may well stage a counter attack, and who knows how that will play out.
I decided to go back to the article and review the comments at the bottom of the page. The usual cast of characters make an appearance. There’s the bacon and hamburger will kill you person, as well as the T1 who gets 70% of their calories from carbs and wonders what all the fuss is about.
The overwhelming majority, however, seem to be T2s who advocate the eat to your meter approach and also mention something along the lines of YMMV. Most of them seem to have found they have a problem with carbs and have reduced them to whatever extent is necessary for them to meet their goals.
But these T2’s are web literate and motivated. I still worry about those, probably the vast majority, who do not fit this mold. Insulin users have their own set of challenges, many seem to get bad advice with the inevitable bad results.
I’m with Bea, I just wish it would become a little more mainstream, so people can deal with their condition effectivly and get on with their lives.
Whats interesting about this is Dr. B’s recent call for action. In his Feb teleseminar, he called on us folks to try to bring this way of control to the mainstream. He is in his 70s now and wont be able to keep this up forever. Intersting time for the ADA to start questioning low carb.
Im a T1 for 25 years and this (last 6 mo of low carb) is the first time Ive ever been under tight control. All thanks to the Dr. B way (and TuD). I fully agree with the sediments YDMV and dont really try to push the diet on folks. The funny thing is the results speak for themselves (my BGs). If we did have some soft of main stream push, I figure it would help tons of T1/T2s.
When it comes down to it, we are allergic to carbs, you only beat that with abstinence, exercise, or medication. The ADA pushes the medication route and so far I havent seen it work a whole lot. Do I think they are going to suddenly do whats right for folks? No. Would their approval and support help spread the Bernstein way" You betcha.
You really have to rail against the mainstream to live low carb and most folks dont like to do that. Also, you have to subscribe to the notion that fat wont kill you and thats really a very new (old) idea. Can your average T1 who thinks they can cover everything with meds (and it told so) or T2 who “knows” fat will kill them really change to fallow this route? I dont think so. Not unless there is a seal of approval from upstairs or a main stream push. Because right now, its just a crazy diet fad (south beach, atkins, etc) unless you see BG results. Heck, look at Bernstein himself, hes been pushing this for how many years?
Well, if you really want to push for change you need to get into the belly of the beast. And I have to tell you it smells in there. You can join presentdiabetes.com and present these alternative views. Hope Warshaw sits with her disciples and self reinforces here message to the group. Read up on the ADtA and USDA dietary guidelines and make your voice heard, but be prepared for a long battle. It is a long way up the hill in the fight against stupidity. You can try to join the ADA forum, but it is a highly dysfunctional group with essentially no interaction with policy and education making bodies at the ADA. Attend the ADA Food and Nutrition Expo in San Diego in Sept and make your voice heard.
If I sound frustrated, I am. But I will continue to make my voice heard. I am ‘tolerated’ at presentdiabetes, but I am not liked. I am “barely tolerated” at the ADA forums.
People dont like someone with opposing views who can lay out facts and might know what they are talking about. That would mean they have to accept that they could be wrong.
Im not really sure that using brute force is called for in this case. Bernstein has been at the ADA for 30 years, with no sign of acceptance (other than this write up questioning low carb). So, Im not sure practitioners like us will persuade the ADA to stop listening to money for a moment. Possibly local groups is the way to go. Initially small support groups to help us all along the path.
Unfortunately, Bernstein hasnt created a medical team that is putting out books / publications to promote the management style. That would be beneficial. Rather hes gone at it (essentially) alone. So, when he bows out a large void will be left with no one to speak of with such accomplishments to fill the void. Only us who fallow the management style are left to speak.
I looked out the window to see if pigs were flying. They aren’t, but I’m still cautiously, very cautiously, optimistic.
I’m with bsc that I have to wonder what they’re up to. Power only yields what it must to survive. I’d like to think that the ADA is attempting to become more progressive, but they’re an inert organization, like any institutionalized entity, bowing before the big bucks who fund them. There may be some chipping away of the high carb pedestal for them to even acknowledge low carb.
Change will be glacial. We’ve witnessed firsthand the carb wars that rival any heated political discussion. I was floored the first time I saw the defensiveness. The misinformation.was less surprising. Propaganda is propaganda.
I’ll never forget an exchange I had with a CDE Tu member. She admitted that lowering carbs was a viable route, but withheld this info from patients. Her reasons were typical patronizing gate-keeping assumptions. Patients shouldn’t be told because they’re not going to change, it’s all CDE’s can do to get them to make minor dietary adjustments let alone low carb, they’ll fail, patients don’t want to hear this type of recommendation, blah, blah. I challenged her that patients shouldn’t be treated as children, that all options should be presented for them to decide & that what she did was a huge disservice. Ooo, I was jumped on by other members.
I’m sorry I forget to put the Hope Warshaw blog link in my last post. I am in constant debate with the staff of my local diabetes center. There is a new director and they attempted to direct a recent support group discussion on diet, but had to back down.
What is most alarming is I am actually active over in the presentdiabetes forum and yesterday my post critical of the ADA’s failure to recognize long-term low carb diets as appropiate for diabetics was yanked. This essentially confirms what I suspected about this “debate.” It is not a debate or discussion, it is a public relations strategy.
It sounds like you have engaged on some discussions over there in the past.