Anyone dissatisfied with the current Dietary Guidelines for Americans (DGA) can sign a petition at http://tinyurl.com/lfygzne.
The goal of the petition is not to mandate any one dietary philosophy over another, but rather to have a committee of nonstakeholders evaluate current guidelines. "The DGA implies consensus in a field that is highly controversial," says the petition.
It would be nice if dieticians weren't locked into a one-size-fits all diet approach.
If this is a duplication, I apologize. I thought I'd posted, but it never appeared.
Thanks for posting this gretchen!
"It would be nice if dieticians weren't locked into a one-size-fits all diet approach."
I think this is the crux of my disagreement with the current dietary guidelines. I have no doubt that eating as the current guidelines suggest is good for some people. I spent many years as a pre-diabetic and undiagnosed T2 generally following the guidelines. I thought I was doing myself a favor by drinking OJ with lunch everyday. I thought I was loading up with vitamins and minerals but didn't realize they came with a boatload of fast acting carbs my body could not safely metabolize. Ditto "healthy whole grains and legumes" both of which were a key part of my diet.
At my urging my daughter started testing following carby meals and found she was spiking to unacceptable levels. She cut out most of the same fast acting carbs I do with the exception of modest amounts of legumes. If she was following the guidelines I have no doubt she would eventually wind up with full blown T2 like me. Instead her a1C is 5.1 and holding steady.
I might add she is very lucky to have a PCP who gets it. No talk of being cured, instead she says she will be fine as long as she low carbs, but go back to the dietary guidelines and she will eventually wind up with T2.
I always urge T2s new to tuD to "Eat to Your Meter". Actually this is a piece of advice that much of the population should follow, instead of the dietary guidelines. I realize this is a pipe dream given the phobia many have of sticking their fingers and also that many are very resistant to changing their diet, especially cutting out or restricting fast acting carbs. Still I think following this one piece of advice would go a long ways toward stopping the current epidemic of T2.
Badmoon, I agree with you. But it always takes time for new approaches to become mainstream. I estimate about 10 years. I think the superlow carb diet I'm on and many people with full-blown diabetes need will never become mainstream. But if we can stop the idea that orange juice and pasta are healthy, we will have made progress.
I tried to introduce my mother to a lower-carb way of eating, and she said she felt so much better. But then she returned to eating oatmeal for breakfast, with orange juice. If I pointed out those were carby foods, she'd say, "But I thought orange juice was so healthy." It's difficult to change ingrained ways of thinking.
Re nondiabetics eating to a meter, I agree that's ideal although a pipe dream. I have type 2 in the family (3 Dx'd so far), but even so, they're not interested in even annual testing after a carby meal. "My doctor takes care of that" or "Why worry about a disease you may never get?" So if those at high risk aren't willing to test, those with no indications of risk probably wouldn't be.
I have to be honest, I'm not sure I can sign the petition. Why? Because as far as I am concerned, the current government system for establishing these guidelines is hopelessly corrupt. Would I trust USDA to select "fact finding experts" to develop guidelines that only considers the health of Americans? No. The USDA (and probably HHS as well) would select experts that protect their "constituents." And those constituents include businesses and corporations who have interests in direct conflict with the health of Americans.
These guidelines should be taken away from those organizations. They should be developed in a transparent and scientific way. There should be driven primarily by non-biased work from organizations like the National Academy of Science. And every panel member should be required to fully disclose all their conflicts of interest and be required to be free of substantial conflicts that compromise their ability to weigh in without corrupting the entire process.
So I'm not sure I can sign as even if the government does everything the petition asks that would still leave things totally corrupt and royally messed up. I just don't trust the system anymore.
Brian, I understand your point, and it's legitimate.
One of my favorite quotes concerning this is from Margret Mead “It is easier to change a man's religion than to change his diet.” From time to time several CDE's have commented here that almost none of their patients are interested in carb restriction when it is presented as a diet option. Your experience with your Mother and other relatives is hardly unique. I'm thankful I had better luck with my daughter.
I agree superlow carb will never be mainstream, I just wish it would be presented as an option to newly diagnosed T2's. I am lucky, in a way, in that I spent 6 days in the hospital on diagnosis. Diabetes was killing me and so a head in the sand approach was not an option. The ADA diet I was given by the hospital dietician was a spectacular failure as was the glycemic index approach. Low carb worked so well, along with medication etc., that it was obvious what my path forward should be.
Contrast this with the experience of a coworker who was diagnosed a few years ago. He was given metformin and told to watch sweets. No explanation of the fact that starch is really a sweet, as far as your body is concerned, because it is swiftly converted into glucose and hits your blood stream hard and heavy. At checkups he was told he was doing fine.
Suddenly last checkup he was told his condition had deteriorated and his medication would have to be changed. He had a look of betrayal in his eyes when he told me because he thought he was doing everything right. I could have predicted this outcome because I saw the starchy meals he continued to eat. My advice has been roundly ignored because it contradicts what his Doc is telling him, and the Doc is the expert not me. Fair enough, I just wish his Doc was giving him more realistic advice and options. If he chooses another path fine, it's a free country, but in his mind low carb is not really at option because it doesn't come from his Doc.
Things are changing slowly in part because of the DOC. There are too many stories of success, here and on other boards, in treating T2 using carb restriction to be ignored. Unfortunately it will be many years before it filters down to the Docs on the front lines.
I totally agree with BadMoonT2. For many years I too followed the dietary guidelines put out by our government. When told to eat Low GI because I was pre-diabetic (which I did not believe) I found I was already eating in such a way so decided to add more bread to my diet as it is so stressed as important in Low GI diets. Bingo, I am now T2. I am not American, so will not be signing the petition.
I'm seeing more and more new T2s being advised to cut carbs, but it's by no means universal. One CDE said they had to prescribe ADA diet or they'd lose their license. When she was Dx'd T2, a friend showed her food logs to a dietician, who said, "You need to eat more bread."
Luckily my friend dumped the dietician and went low carb.
As older docs retire and younger ones start practice, I think we'll see more emphasis on cutting carbs.
I've stopped trying to convert people I meet as the response is what you're getting: "But my *doctor* says starch is good."
"As older docs retire and younger ones start practice, I think we'll see more emphasis on cutting carbs."
I wish I could share your optimism. I truly do. But the average medical school still spends only a few days on diabetes, out of a 4 year program, and most of what is taught was laid down anywhere from 10 to 30 years ago and is formulaic and superficial.
Your story about the CDE who was threatened with license revocation for failing to advocate one particular diet to everyone is extremely disturbing. That sounds like a huge lawsuit just waiting to happen.
i live in spain and am a type 1. i am lowish carbing, about 70 or 100 a day. all of my carbs are leafy greens, nonstarchy veg and full fat yogurt, very little fruit (sadly) and squares of dark chocolate. when i showed the dietician who worked with my endo my log of food, she said i need to eat bread. i told her if there was a magic ingredient in bread that would cure me i would eat it.
the cdes at the diabetes day unit at the hospital are also horrified at my diet, saying that im going to pay for it when im older-not as much as id pay if i were eating to ada standards. i am beginning to enjoy the looks on their faces when i tell them what i eat!
funnily enough, my endo and the big deal diabetes specialist at the hospital had ABSOLUTELY NOTHING negative to say about my low carbing! the diabetes specialist said it may actually be prolonging my beta cell function...
"i am beginning to enjoy the looks on their faces when i tell them what i eat!"
Me too:-)
My PCP who is the only Doc I see is also OK with my diet, I think he beleives in results above all else.
The friend who was told to eat more bread turned out to be T1, but she controlled for about 6 years without insulin on a LC diet.
Back it up. How was your friend a type 1 for 6 years without insulin? If so, how the heck did she live? Or am I not understanding what you're saying? Unless she was literally eating nothing it doesn't work that way at all.
I'm not sure what to think about the nutrition guidelines because low carb made me feel absolutely horrible and gave me less blood sugar control (my a1c was 7.2% before I started insulin and back to my normal diet and now I have had a 6% and 5.5% a1c on a less restrictive diet of around 150-200 carbs) but I wouldn't listen to government guidelines I'd listen to what works for my body when I eat it and how it makes me feel over anything so this also doesn't matter to me in general.
There's a piece of information missing here. Someone who really has Type 1 diabetes will not live 6 years without exogenous insulin. Not in this reality.
My friend is actually LADA, originally Dx'd as T2, and that can move a lot slower than classic T1. Some sources say 3 to 12 years to insulin dependence. I think of it as a subset of T1, but some people call it type 1.5. She was 60 when Dx'd.
I agree you should do what works for you. I also don't give a hoot about govt guidelines for myself. The problem is that a lot of physicians who don't know much about nutrition will use govt guidelines to tell their patients what they should be eating.
It can take a long time for your body to adapt to low carb, and some people do feel terrible before they adapt. I didn't go from standard American diet to LC, but reduced carbs slowly, so I never had any problems.
David, See reply to Sensorium. I should have been clearer.
Ah yes. LADA has different (and highly variable) behavior. That was the missing bit.
I should probably clarify more. My friend was Dx'd T2 in 1996, the same as me, so we compared notes. In 1996, antibody testing was not common, and a lot of GPs hadn't heard of LADA.
I was overweight when Dx'd (no longer). She was thin. Metformin did nothing for her, but it helped me. The most interesting (to me) difference was that if we fasted for a day, my BGs would go up 10 or 20 points in the morning, and then they'd go down and stay at about 80 all day. Her BGs would go up and keep going up until she ate something.
By the time she asked for insulin, the antibody tests probably wouldn't have been accurate. The assumption was that she was LADA, but no proof. Her C-peptide was low. Some real T2s end up insulin-dependent, and there may be a continuum between fast-onset classic T1, LADA, and T2, or there may be significant differences. Many T2s have antibodies, just not a lot.
My friend is now over 80 and her A1cs are usually about 4.8 without a lot of lows.
I have pondered long and hard over that "continuum" concept too. I am T2 with hardly any c-pep left (just a trace). Without insulin I would be in dire straits -- I just wish I had gone in and demanded it ten years sooner than I did. Never mind, ancient history.
I don't know that we'll every fully understand the distinctions between types -- certainly won't happen in my lifetime. I continue to subscribe to what Bernstein says (paraphrasing): I don't care what type I am, or someone else is. What matters is what you can do about it.
