End of the High Carb Era?

Some of you may recall Osama Hamdy came and gave us a live interview last July. His recent book and his appearances last year gave a T2 treatment plan that focused on 45% of calories from carbs and restricted fat and calories. However he has recently published a paper entitled "Nutrition Revolution—The End of the High Carbohydrates Era for Diabetes Prevention and Management" in which he he suggest "Over the last few years, strong evidence suggest reducing carbohydrates intake for patients with type 2 diabetes to less than 40%." And he further says "The era of high carbohydrates came to an end."

What do you think?

Honestly, I am proof… T2/for 25 yrs…just got off ADA plans…endo set me straight on carbs in September…my A1c was 9.3…went low carb…no more than 45 a day…now A1c is 5.4… I now do not need my daytime insulin as long as i stay on this 45c a day…BS day readings hover around +|- 90…i am thrilled…stopping the insulin and carb abuse…am over 75…all in my life are overjoyed with me…I still test…then grin!

The idea that there was ever an era where any diabetic should consume a *high* carb diet kind of blows my mind. I don't agree with Bernstein about everything, but it is kind of remarkable how slowly the conventional wisdom shifts.

My workout buddies aim for 40/40/20 or 50/30/20 and seem to get pretty good results when they hit it!

What took them so long?

I think the medical profession including the advocate orgs like the ADA, AADE, AACE, and the dietitians, to name just a few, all owe us a large apology. The first rule in medicine is to do no harm. They have flagrantly, deliberately, and in a sustained fashion violated that ethic.

And it's not over yet. Many professionals hang on to their outdated ideas even as many studies and a heap of anecdotal evidence piles up.

sandy, that is awesome!

Is that carbs/protein/fat?

Protein/ Carbs/ Fat. They refer to the 50/30/20 target as the "fat shredder" and also have had some interesting discussions about "zig zagging" where you go back and forth between the 50/30/20 and 40/40/20 every other day to kind of goose your results. I've dabbled in it but end up having to eat cans of tuna, 2-3 chicken breasts or 2x protein shakes/ day to hit 50% protein and am not that into it.

I probably naturally eat about 25-30 % protein. I'd have to supplement to increase that percentage. Ideally, I'd like to get my nutrition from real foods only.

An increased protein percentage would also increase my total daily dose of insulin. Since cutting back my carb consumption to 30 grams/day, my TDD of insulin has fallen to 27-28 units/day. It's been 25 or 30 years since I've taken so little insulin. I've taken as high as 80 units/day.

In the future, I think hyperinsulemia may be tagged as contributory to things like heart disease. I don't think that medical conclusion will happen before I depart, so I'll just have to bet on my hunch.

I have a hunch your hunch about hyperinsulemia is on target. I really have nothing to back it up, though, except intuition.

The frontier of science is always uncertain. But we must live now as best we can. That's when I conclude n=1 findings as "good enough."

Congratulations, Sandy, on the dramatic turn around!

The science behind low carb is solid, add to that testimonials like yours and it becomes increasingly difficult for the old advocates of the carb happy diet to go on promoting their unhealthy diet.

The nice thing is that the results are instantaneous, I knew with the first finger stick, after my first low carb meal that this was the way for me to go.

I have problems with formulas in general as they are often too simplistic and one-size-fits-all, but I'm actually confused by this one. Since there are only the three categories, I assume that all vegetables are considered carbs. But a diet consisting of 30 or 40% fresh vegies definitely would have different results than a diet consisting of 30-40% pasta, cereal and rice!Am I missing something?

Ok I'm convinced, but then again I already was.

You aren't missing anything. At least the theory "there" is that it doesn't matter what makes the numbers,it's just you step back and look at whatever you've eaten and the macronutrient ratios to see where you're at...

Veggies would be whatever the veggies are. If you can find some protein/ fat veggies, you get some protein/ fat out of them. There's other "rules" that they bandy about, "don't eat anything white" [pasta, bread, potatoes...] but even with stuff like that, you can work it in if you eat, whatever, 5 servings of tofu, etc. to jack your protein up. I like it because it's a different game than BG but is still fun.

No, I don't think we are at the end of the high carb era.
I think we are at the beginning of an era where limiting your carbohydrates is not scoffed at by all the professionals. Limiting carbohydrates in the long run is hard, at least for me. I've been doing it for seven years though.

It requires planning ahead, and a fair amount of effort. It's going to take a while, and be slowly adopted in my opinion. We are fighting more than 50 years of "eat lower fat" propaganda.

We are just barely mainstream.
I have hopes, just limited expectations.


It should be at an end - but it remains to be seen how long it takes to become generally accepted at a population level and implemented.

At least the mainstream medical field is finally understanding that low carb is a viable way of eating (and not just for persons with diabetes).


I get away with very little insulin when I eat low carb (avoid grains & flours, sweetened foods, most fruit), though I don't really 'count' carbs. If I ate the amounts of carbs 'recommended' not only would I be severely obese, I would need to be mainlining insulin and my blood sugars would probably be swinging wildly.

I don't think the mainstream medical community is finally understanding that low carb eating is a viable way to eat. The article you cite is not authored by "mainstream medical professionals." Dr. Bernstein is one of the authors and he has been marginalized by every mainstream medical organization for years.

I think the low-carb high-fat way of eating is slowly gaining ground at the edges of the medical mainstream. The American Diabetes Association and the Academy of Nutrition and Dietetics, while begrudgingly moderating their positions a little, seemingly refuse to own their decades of misinformation and medical malfeasance. They bought into the low fat high carb bandwagon that stormed this country since the '60s and led to exploding rates of heart disease, diabetes, and obesity.

Excellent comment.

Why high carb nee - high energy diets have been allowed to exist is beyond belief. Human body is a chemical machine and energy balance is critical.

The human body was not designed or built many moons ago to be a virtual huge energy dump.

In fact the system was designed to grab and save all available calories - liquid energy in case of shortages.

Blood sugar/glucose regulation is really a storage issue whereby extra calories not stored in skeletal muscles or burned get saved as fat. If that fills up (yes it is finite; the human body will back it up in the blood system.

The human body was not designed with a throw away system that could bypass excess glucose out of the system to prevent damage.

Today we now have drugs that enable kidneys throwing away excess glucose to
overcome the kidneys proclivity for grabbing glucose in urine and stuffing back in blood system.

The science on type 2 diabetes is disgraceful and simply ignores actual
chemistry. Talk about the dark ages.

I had mentioned our discussion of carbohydrate restriction for diabetes. Available without charge at http://bit.ly/1tyFh89. I had discussed this with Brian when Hamdy was here. He is in receipt of that paper and he sent me an email describing how the original Joslin diet was the same as the Atkins diet. I asked him to comment on our paper and why his paper in Lancet said people couldn't stay on the diet even though we had presented evidence. He stopped answering. It is heartening to see that he is now willing to take small steps to admit mistakes but not citing our work seems unethical to me.

In any case, I have tried to describe the "end of the era" in my book "The World Turned Upside Down. The Second Low Carbohydrate Revolution." You can see excerpts at http://bit.ly/1zH5e7P. There are some practical difficulties at Amazon but I will sign your copy if you order at http://nmsdocs.com.

I am happy to answer questions or comments here or at the FB discussion: https://www.facebook.com/groups/TWTUD/