just high insoluable fiber? some soluable fiber is absorbed as carbohydrate, but in the absolute absense, it is hard to say.
You clearly feel strongly about this issue. Here is my quick observation having a different view. Fred Hahn, who has written several exercise books, but no diet books comes to a forum and declares that the ADA and ADtA is giving cr*p dietary advice and diabetics should be given low carb dietary advice and in particular use very low carb diet. Immediately, he is personally attacked, accused of selling books and/or himself (apparently related to some old history) and an immediate “flame war” ensues.
Nobody really disagrees with the suggestion that diabetics (particularly t2 which is where the discussion took place) generally do very well on low carb diets.
What really struck me was that the discussion became a series of personal attacks rather than an objective discussion of the matters. I think we have a duty the community to discuss contradictory opinions in an objective manner. That is the only way to divine the truth. The power of social networking is that through a broad and open discussion, the truth shall become clear. It won’t be revealed in a “flame war.”
Your link is actually to a side skirmish, you may want to change it.
Your point about Allen’s diet not making much different is certainly true, but you have to realize that Allen actually increased the carbs and reduced the calories over Naunyn’s treatment. From Clinical Diabetes Mellitus: A Problem-Oriented Approach, pg 16 on the historical perspective,
Naunyn (99), developed the hypothesis that “glucose underutilization” caused diabetes. He prescribed a carbohydrate-free (high-fat) diet, and noted a decrease in glucosuria.
In light of that, it is not surprising that there was little difference.
What is really surprising is why a starvation diet did better than a carb-free/zero carb diet. That is the real question. I have two theories. The first theory is that protein still remains as a source of glucose in a zero carb diet and hence overeating of protein caused DKA and diabetic coma/death. The second theory is that starvation actually forced metabolism changes and ensured constant ketosis and hence avoided DKA, …
I'm glad you found the info. I thought I had linked!
I've had a look at the skirmish on the other forum, glad it was of use.
I noticed the discussion about when people were aware that there was more than one type of diabetes. The French doctors Lancereaux and Bourchadat referred to le diabete maigre and le diabete gras (still sometimes used today). Lancereaux was the first to use it in a publication in 1888. Obviously this was long before insulin and theories of insulin resistance so was a crude diferentiation
One of these is characterized by its sudden onset, striking clinical manifestations and, above all, by weight loss and the accompanying pancreatic lesions: this type we call thin diabetes or pancreatic diabetes. We have also described another very characteristic form. This is more common than the first, is often inherited, is accompanied at onset by obesity and does not show pancreatic lesions. Its symptoms are few; its progression is slow and chronic; it is a syndrome often associated with other morbid circumstances. We call this type fat diabetes or constitutional diabetes
http://www.diabetologia-journal.org/webpages/covers/2005/november.html
Lacereaux and Bourchadat independently developed restrictive diets. Looking back through the history of diabetes, it is clear that US and Canadian researchers often had a total lack of awareness of work in Europe and a number of key "discoveries" were reported and recognized in North America, even though some of these "discoveries" had already been made in Europe.
A classic description of this history of this era can also be found in "Joslin's Diabetes Mellitus," an expensive book, but which has portions that can be read on-line. I find the "skirmish" in the other forum really confusing. The history actually repeatedly confirms the seemingly "obvious" observation that carbohydrate restriction improves glycemic outcomes and in fact can was used before insulin to keep people alive with "some" success.
Thanks for posting this. Many forget that very low carb diet was the only treatment before insulin was discovered and it only prolonged life for Type 1 children by 1.5 years maximum, in most cases.
Thanks, this is an important observation. Actually, before treatment, type 1 children generally only survived a few months after diagnosis and usually succumbed to diabetic coma (DKA). According to the Joslin summary, the Naunyn treatment (VLC/high-fat) enabled children under 10 to survive an average of 1.5 years and with the Allen treatment (VLC, starvation), those same kids survived an average of 2.9 years. Elizabeth Hughes survived nearly four years on the Allen diet, although she was a teenager.
We often forget that the discussion of restrictive diets has a long history. After the discovery of insulin, Joslin still advocated for a restrictive diet, and by the 1940's and 50's waves of surviving diabetics came through the medical system with complications. Joslin and others argued that restrictive diets helped with blood sugar control, but the medical system rose up against those suggestions and advocated the "free diet." The ADA creation in 1940 in a large part was driven by this controversy, which obviously remains to this day. An early premise of the ADA was that patients should just go about their lives as though they did not have diabetes, and that the medical system should support that strategy.
Interesting observation re Allen vs. Naunyn. Got the stats from "Cheating Destiny."
I looked at the history of diabetes timeline on dLife -- diabetes was recognized in ancient times in both Egypt and India -- and they even distinguished between young, thin diabetics and older, fat diabetics, and said the older ones lived longer. World communication in those times was non-existent, and the Europeans weren't ready for that information anyway, but I found it interesting that Type 2 was indeed present in ancient times, and is NOT the product of modern obesity "epidemics".
Type 2's lived significantly longer, but still succumbed to infection or coma.
Before anyone recommends to a mother or caretaker of a child with Type 1 that they put that child on a low carb diet, this post will remind them that was treatment before insulin was discovered. These children were allowed 30 grams of carbohydrate a day, which is somewhat akin to Dr. Bernstein's recommendations. So it is a very dangerous recommendation. Hopefully, the mother has a pedi endo who will stop this nonsense in its tracks but there are those who may come on line from other countries who do not have proper medical access. Adults can go as low carb as they wish. Children cannot without endangering their health and should not.
I think this is a reflection on today's low carb diets in a most poignant way. The people on those diets had a very poor quality of life. I've tried low carb and found it to result in a very low A1c, but a crappy way to live. I now eat more carbs, manage my insulin very carefully, and have the energy and fitness to live a very active lifestyle. You gotta have lots of carbs if you're going to run a race, climb a mountain, cut a pile of firewood, play a soccer tournament, waterski all day...and on and on. I think low carb, particularly for T1's, is a throwback to the dark ages - as the starvation diet alludes to.
Joe, I agree with you. For younger, more active people the higher carb diet is good. You can "burn off" those carbs easily with that kind of activity. I am 71 and have arthritis. I walk a lot, but that is my only activity. I don't need more than 150 carbs per day. If I go higher, without increased activity, I gain weight.
It seems like the very low carb (I don't think 150 is 'low' as much as 'reasonable' or 'sensible' BTW...) strategy it would very easily sort of work to turn people into a potted plants, sitting on the couch and being happy their BG didn't fluctuate very much. Small doses of insulin but no energy. As it is, I will talk about eating garbage and like to let 'er rip but serving sizes are very important and I watch both my weight and my BG a lot. Being low is good but I think being in the middle is a much better long-term prospect?
That is a huge leap. My question is, why with more than 100 years of evidence, does the ADA/ADtA still refuse to even "suggest" that lowering carbs can result in better blood sugar control. For a look at how Dr. B's principles have been applied to a child, the link to Dr. Kathatrine Morrison's regime for her child demonstrates normalized blood sugar control with 100-150g of carbs. I would hardly call her regime dangerous.
From reading Breakthrough, it seems that many of Allen's patients ate 'thrice-boiled vegetables' (to remove all carbs from them) and eggs. At one point in the book, they talk about how at Allen's Physiatric Institute the cooks invented many many many ways to serve eggs, because it was a staple of the diet. It does mention that Elizabeth Hughes got to eat half an orange, etc. sometimes so it appears fruit played a very SMALL role as well. At the end it did say she hadn't had bread, rice, pasta, or potatoes in about 3-4 years, which aligns with our ideas of 'starchy foods wreak havoc for diabetics'.
Couldn't VLC stunt a child's growth, at least to some degree?
Richard, this is exactly my point. You are on a low carb diet and from what I have read, you had improved blood sugar control and health when you lowered your carbs. This is lower than recommended by the ADA/ADtA for your age.
I never experienced energy problems or brain fog on very low carb, and I use my head for a living. But I spent the time to adapt to the diet and really did very low carb. People should make their own betary choices, but my big peeve is that the ADA/ADtA perpetuates a lie. They should either do their job or get out of the way of setting public nutrition policy.
Diabetics on all the many D sites I visit are saying the same thing, they agree with you, and I do too. It is sad though that many newbies trust the ADA advice and follow it to the letter. I think they eventually get the message by reading what we say in the forums, but how about the millios who never vist an online forum? Misinformation begets poor diabetes health.
Honestly, I dunno what you're talking about... I have a TON of energy... I am more active now, on low carb, than I ever was trying to eat an ADA diet on 150 or more carbs. I'm not an "athlete" by any means, but I doubt a regular every day common person could even keep up with me, right now.