Discussion Board

Knowing that Dr McDougall has his STARCH SOLUTION book coming out next month, I thought it may be impt to comment on this blog entry by Dr Fuhrman. Where he states those eating white rice have greater incidence of type 2 diabetes. He reports of numbers greater in Asia than USA. "Worldwide prevalence of diabetes in adults is about 6%, and Asian countries have somewhat higher rates (9% in China and Korea, and 11% in Japan).2,3 This is interesting to consider. In spite of considerable more overweight and obesity in the USA, and our dangerous diet, there is considerable more diabetes in China, Korea and Japan. This is mostly because of white rice."

Most damning is the statement from the blog "Similarly, a recent U.S. study found a link between starch consumption and breast cancer recurrence." He also states "Substituting 1 serving of whole grains per day with potatoes was estimated to increase diabetes risk by 30%." Then in BOLD font he says "Let’s make it clear: white rice, white flour products, and white potatoes are foods that should not be central in our diets".

Please help us understand these studies Dr Fuhrman is referring to in relation to the consistent teaching of Dr McDougall and yourself. We know that the McDougall plan is a starch based diet and Dr McDougall is a champion for potatoes. Im afraid people may be confused after reading this, especially after we have learned that we should be eating a starch based diet.

Here is Joel's post

Summary:
Over 20 million people in the United States (about 8% of the population) have type 2 diabetes.1 Worldwide prevalence of diabetes in adults is about 6%, and Asian countries have somewhat higher rates (9% in China and Korea, and 11%...

View the entire entry:
http://www.diseaseproof.com/archives/di ... -risk.html


Thank you.
Tom

Dr. McDougall addresses this in his current newsletter:

White Rice and Diabetes

White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review by Emily Hu, published in the March 16, 2012 issue of the British Medical Journal, found, “Higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes, especially in Asian (Chinese and Japanese) populations.”1 This report involved a collection of studies (a meta-analysis) that reported risk estimates for type 2 diabetes, by rice intake levels.

Comments: Confounding, the presence of another hidden variable, is of particular concern in this study because socioeconomic status is both a risk factor for type 2 diabetes and a predictor of rice consumption in Asian and Western populations.2 In other words, within a particular population (say in China or Japan), those who eat more white rice are also the wealthier people who eat more meat, oil, refined food, etc. Poorer people purchase less white rice and less rich food (they also work physically harder), and as a result, they are trimmer with little chance of developing type 2 diabetes—a condition directly resulting from obesity.

Worldwide, the populations with the lowest rates of diabetes are those that eat the most rice and other starches; type 2 diabetes is all but unknown in rural Asia, Africa, Mexico, and Peru, where a high-carbohydrate diet is the cultural norm.3-6 Some of the highest rates of obesity and diabetes are, however, found among people of Hispanic, Native American, Polynesian, and African descent—but not because of their genetic make up or the starch-based diets of their distant ancestors. These ethnic groups became fat and sick when they adopted a high-fat, high-protein Western diet.7

I recommend people eat whole-grain (brown) rice, but I do not consider white rice a deal-breaker. Because of social status (refined people eat refined rice) and lack of availability, many people tell me they cannot eat brown rice. I understand. When you are out and about, and all you can find is a Chinese restaurant for lunch, and you are given a choice of white rice to fill your hungry belly, or fried pork, go with the white rice.

1) Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012 Mar 15;344:e1454. doi: 10.1136/bmj.e1454.

2) Neal B. White rice and risk of type 2 diabetes. BMJ. 2012 Mar 15;344:e2021. doi: 10.1136/bmj.e2021.

3) Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care. 2011 Jun;34(6):1249-57.

4) Janket SJ, Manson JE, Sesso H, Buring JE, Liu S. A prospective study of sugar intake and risk of type 2 diabetes in women. Diabetes Care. 2003 Apr;26(4):1008-15.

5) Kitagawa T. Increased incidence of non-insulin dependent diabetes mellitus among Japanese schoolchildren correlates with an increased intake of animal protein and fat. Clin Pediatr (Phila). 1998 Feb;37(2):111-5.

6) Llanos G. Diabetes in the Americas. Bull Pan Am Health Organ. 1994 Dec;28(4):285-301.

7) Egede LE, Dagogo-Jack S. Epidemiology of type 2 diabetes: focus on ethnic minorities. Med Clin North Am. 2005 Sep;89(5):949-75, viii.

Kate

Sounds like Dr. Fuhrman has starch envy to me.

or perhaps book envy.

oh, Dr. Fuhrman...eyes rolling.

Sorry, I just couldn't resist.

p.s. Re Dr. F's stance on potatoes: Ask Dr.Fuhrman about the resistant starch in potatoes, especially room temperature or cold potato salad (nonfat of course). Resistant starch is prevalent in potatoes, and the cooler they are, the more the starch is released...resistant starch being the new hoopla substance that so many studies have linked to weight loss, improved metabolic syndrome and better health in general.

In fact there's some books out on resistant starch: The Carb Lover's Diet, etc. resistant starch...found in starches! is a good thing.

This blog post really irked me... I got so stressed out about the white potatoes/diabetes connection, because I'm feeding my kids all these white potatoes don't you know (as if I'm not stressed out enough about daring to throw some food in a blender on occasion apparently damaging their endothelium although I missed out on finding out how that's possible so it will forever remain a questionable mystery) and then I tried to find out more on this potato worry what that was based on but the link only took me to a newsletter I couldn't read, so I had to just be stressed unaware yet again, so I searched for the source and all I could come up with is this http://www.ajcn.org/content/83/2/284.full which really frustrated me because I so aced my engineering statistics course some 20 years ago or so, so this all should be easily understandable for me, right? except it isn't... I have some vague recollection that this one point something with p values should have some meaning for me, but it doesn't, it doesn't help that they insist at some point that bmi had no impact and then later say when they factored out the bmi those with lower bmis didn't have the risk factor that those with higher bmis did (which if you look at the tables we are talking over 30 bmi) and even that is minimal, so I really don't get what all the fuss is about (and somehow I missed where they come up with their servings per day value and how it relates to an actual potato because at one point they are talking about .79 servings and another it's 2 potatoes, but the part where they talk about .07servings/day I start to think I have no idea what they are talking about because a point zero seven can't possibly be a real serving measurement, can it? what's that, like I breathed in the steam from boiling a potato or something? Maybe they mean one potato every two weeks I guess? ... I mean they don't make this easy do they?), but anyways (oh, gosh and now I'm just noticing they claim that adjusting for several things, including whole grains made no difference in risk, so isn't this in conflict with the suggestion that subbing potatoes for a serving of grains increased risk??)... my takeaway ends up being this oh and this conclusion but just in case that isn't good enough I'm going with the fact that I like to parboil my potatoes to have on hand and apparently, ... the glycemic index being the very tenuous thread upon which this crazy white potato is evil is a hangin'

Ugh! So in summary, diseaseproof had me all worried that despite my eschewing the SAD I was still yet leading my children down a sure path to diabetes when in truth they'd only have to worry about white potatoes if they were very obese and eating the unhealthy western diet and even then it would be the least of their worries... or am I missing something?

Dr.Fuhrman shows us why nutritional recommendations
Change time after time. The point is most people eat
So many wrong foods that they forget it is the combination
Of the bad foods that leads to disease not a particular food.
Consider he typical overeating, unwise Person. They have
Animal products 2 to 3 times a day, and refined carbs at every
Meal. They develop acne and oh yeah blame the dairy.

A little of dairy wont kill you, a little of refined carbs wont give
You diabetes or heart disease, but when you combine them and
Make them the majority of your calories you are in deep trouble.

Panamanians have always had rice as the basis of their diet. There are many very elderly Panamanians who are in amazing shape. Not uncommon for them to live well into their nineties and one hundreds. However, many of their children and grandchildren are obese and diabetes is epidemic. I can assure you it's not the rice or other starches doing it. It's all the junk food from up north. Soft drinks, chips, candy...you know the list. Also meat and oil is now more affordable for many and frying is the preferred method of cooking. More sedentary jobs versus working on the farm has also contributed to the problem.
In my opinion, starches do not cause diabetes. Obesity is the culprit. Eating potatoes allowed me to lose 50 pounds and get myself OFF the list for future diabetes.

How come people like me and you can see this but dieticians like Fuhrman
Don't? So if it's obesity (i fully agree) then it's the excess
Calories that are the problem. It's easy to consume excess
Calories when foods are processed, making them digest much
Faster so the individual feels hungry and eats more.

It's so disturbing how studies are twisted to reflect different agendas. Surely, Fuhrman can see the obvious confounding factors. If this was a recent study, then, of course, the wealthier asians are also eating McDonald's and plenty of meat products along with their white rice. But where was their diabetes before westernization?

The other study just says "starches", which could mean any refined starch, like the refined white bread you put your greazy burger between. It doesn't mean rice or potatoes. These women getting breast cancer are not eating the complex starches we are.

Ugghh. You really have to learn how to read between this BS, which is apparently too difficult for some of these researchers.

It's not the rice, stupid!

It makes sense to me that a diet whole foods, plants, and fruit is the absolute best choice. The argument in the health community over white rice and white potatoes, I have determined, is counterproductive. I know in my gut they are good foods and will not be swayed by the egos that want to argue too fine a point. I believe Dr. Mcdougall is correct in his campaign for starches, not because I believe blindly what I read, but because I have spent nearly every waking hour since my "conversion" reading and studying this way of life and way of eating.

The leaders in this "plant-based" world should realize how easy it is to be confused by the tons of information we have available. Of course the Asian numbers don't take into account all the "real" culprits of type II diabetes. It is much more sensational to blame the rice.

Whole food, plant based is the simplest, most effective WOE that exists, white potatoes and white rice included!

I just found my new signature!

Fact is that most of us haven't touched white rice in years. Dr. McDougall doesn't recommend it either--it's a fallback for those who won't eat this way otherwise. Brown rice is, of course, GREATLY preferable.

Ditto bread. The only bread recommended on the regular plan is whole wheat w/ no added oil. And many of us rarely if ever eat it.

And Dr. F is just dead wrong on taters. We all know THAT.

Thanks for a very good summary!

Summer, thanks for your analysis--I was an English major a million years ago, and I'm an accountant now, so all that gobbledygook just slides through my brain!

The thing that I notice in so many of the studies, and is highlighted by this quote from above:

White potatoes and french fries...Apparently no one has bothered to isolate the actual white potato for any studies? How are french fries and potato chips synonymous with potatoes? Using that concept, then salads topped with the American restaurant-sized serving of blue cheese dressing counts as a vegetable, and the effects of eating them like that must be considered. Broccoli smothered in cheese sauce is a vegetable, What is the effect of that? How did they manage to isolate potato-product consumption out of all of the food the population was eating?