Diabetes and Carbohydrates

[TanneryGulch]

... all of the vast studies that completely contradicted the ones you happen to pick out.

My point was not to directly dispute the studies you cited.

I see.

the evidence speaks for itself even without the scientific studies.

Yep, just as it does for the Book of Mormon, the Roswell aliens, chelation therapy...

So far on Atkins (less than 2 weeks) I have lost 12 lbs, dropped my bp by 8-10 points both systolic and diastolic, my bg has not gone above 130 (checking 5-7 times daily) and normalized fasting bg is 94....without medication...dispute that!

Easy. Glycogen depletion accounts for almost all the weight loss. There's probably some genuine weight loss, too, from the caloric restriction that happens automatically at first when you eliminate whole categories of food. Of course your BG has fallen when you haven't eaten carbs for over a week. IOW, it proves nothing about the long-term healthfulness of the diet.

[TanneryGulch]

... the real problem is combining high fat and carb

Then explain all those starch-phobic ETLers avoiding/reversing T2D and CVD on macros like 50/35/15 from nuts, fruit, beans, and greens (in that order). (Some will even add a tsp or two of oil before they'll touch the dreaded grains. )

The open question is the very long term effects of eating the high fat/low carb version. And it must be added that eating that way REQUIRES being scrupulous about not getting too much protein causing osteoporosis; not consuming fat soluble, high on the food chain, environmental organic pollutants (PCB's, pesticides, etc) causing cancer and endocrine disruption; not consuming high on food chain heavy metals causing all sorts of metabolic and endocrine and cognitive disruption.

That would indeed be an open question if the epidemiology weren't crystal clear: there's no such thing as a long-lived population on high-fat. The Taubesites can wank about how the crusted-over coronaries of the Masai and Eskimos managed not to infarct before their deaths at the ripe old age of 47, but I'm not interested. Also, I don't buy their "grass-fed / pesticide-free" hobbyhorse. The rural Chinese Campbell studied (assuming we can believe his findings) weren't eating factory-farmed. Neither were the Scandinavians when Keys did his study, etc. The Masai certainly weren't. Aside from the issue of fatty acid ratios, I think they're generalizing from studies showing small increases in risk from long-term occupational exposure (like guys who spray the stuff for a living). But if you know of data showing a benefit of eating grass-fed meat and milk, I'm interested.

[bigbear]

There's probably some genuine weight loss, too, from the caloric restriction that happens automatically at first when you eliminate whole categories of food. Of course your BG has fallen when you haven't eaten carbs for over a week. IOW, it proves nothing about the long-term healthfulness of the diet.


Em..amigo...this is the diet that eliminated whole categories of food..I would recommend you read the phase 3 and 4 of Atkins..nothing is eliminated..just controlled...How much meat, fish, dairy, nuts, oils, cheese, etc, etc etc have you been eating..who really is eliminating categories of food.....besides..I am an alien Mormon on chelation therapy....

[TanneryGulch]

That was 50% CHO : 35% FAT : 15% PRO

However, looking at it again, I clearly have PRO too high; more realistic would be something like 56:33:11. Still, the point stands: it's neither <15% nor >70% FAT, yet it doesn't seem to be killing them.

[MariusA]

Very interesting topic with a rapid evolution, loved TanneryGulch's arguments and humor, but I understand bigbear's reaction. You all bombarded him with evidence supporting a totally opposite way of eating, very brutally said that a whole plant based diet is the only diet for him.

Bigbear follow the Atkins diet, with all it's restrictions, and then if you're not satisfied, after several months, try the McDougall diet, with the same adherence. Those numbers you said got better on your diet, get a lot better on the McDougall diet and a lot faster, with small restrictions.

Now I like to point out some things that you have to consider:

1. This diet you try now should become permanent, untill you die, because when you get the results you cannot revert to the one that got you here in the first place. Think about this, it is very important.

2. If you don't process your food using special machines, I mean removing parts from your food, then eating the way you eat now is bad for your health. You simply cannot separate the fat from protein, they come in a "package", carbohydrates from protein/fat you can, regarding the percentage of calories you get from a food. Too much protein destroys your kidneys, everybody knows this. Again think about this, carbohydrates versus fat and protein.

3. The brain uses 20% of the daily energy to function in the form of glucose. Muscles use glucose to function, I mean the basic chemical reactions to produce energy for movement require glucose. Scheletal muscles, heart muscle, internal organs muscles etc. Now why must you eat fat and protein to get your glucose when you can eat carbohydrates. The number of chemical reactions needed to obtain glucose from fat, let alone protein, is greater than from carbohydrates. I don't know if you know something called Occam's razor, the simple explanation or way is the correct one. So why choose the long way when there is a short way.

More can be said, but I think others before me have done this.

Again, try Atkin's, see if it works, if not try McDougall, with the same adherence. This is the most objective I can be.

We don't want to harm you, we just try to save you the time, effort, money, health issues etc. . But if you do try the other side of the story the choice is yours.

[bigbear]

What will destroy my kidneys and many other organs is bg spikes from eating too many carbohydrates..It matters not what anyone on this site says, the facts are just that, facts. I can eat fats and proteins and my sugar is normal. Eat a potato, brown rice, popcorn, oatmeal, cereal, bread etc etc..wham, spike..my meter doesn't lie and neither does my body. bdb..

[SactoBob]

I really think you are on to something there, and perhaps you should publish. There must have been a mistake in Dr. Barnard's tightly controlled crossover study that proved conclusively that his diet did better than any other that has been published.

Maybe they all faked the data - perhaps they don't care about taking people off their diabetes meds - so long as it makes them rich and famous. You must be correct.

And Dr. McDougall isn't too bright - he probably forgot that carbs can spike blood sugar. Probably my lab tests are in error and I shouldn't have been taken off my medication, and there are many more in that boat. Insulin sensitivity is probably not much of a factor.

Now that you have persuaded us that you know more about this than the people we formerly had confidence in, would you please keep your previous promise and stop posting. Why not move to another site and we will follow your lead there.

Thanks

[TanneryGulch]

You all bombarded him with evidence supporting a totally opposite way of eating, very brutally said that a whole plant based diet is the only diet for him.

No, that is not what I am saying. I'm not even arguing for McDougall. I am saying that the physiological rationale for low-carb (high-fat) is bulls##t. Their assumptions about how the body works haven't withstood experimental scrutiny. Bigbear came into this thread preaching, "This diet can't work for a diabetic because I know my meter, and boyyy, if I eat a potato..." etc., and I tried to give an inkling (based on my admittedly very limited knowledge) why this is simplistic and myopic. Of course glucose and insulin should run in the favorable range over the long-run, but (1) it's not like those are the only (or even the most important) measures of health; (2) it's not true that the only (or even the best) way to achieve this is by eating high-fat.

Again, try Atkin's, see if it works, if not try McDougall, with the same adherence. This is the most objective I can be.

On what basis should one determine whether it "works"? Weight loss? Ease of compliance? Biomarkers? (Which?)

I'm reminded of Agatston's diet (or the later Atkins Bigbear referred to). You start on the strict Phase 1 (keto) and lose 10 lbs (of glycogen/water) in the first 45 minutes. Awesome! You intend to soldier on with your cheese omelets and Ketostix, because you've extrapolated the weight loss and concluded that you'll hit your ideal weight by 10 o'clock tonight, but you're getting those 'carb cravings'. Damn. So you proceed into Phase 2 and up the carbs a bit, still eating gobs of 'lean protein' and 'healthy fat'. Weight jumps on reintroduction of carbs (muscle/liver glycogen repletion), and that scares you, but it seems to stabilize (phew!) and proceed slowly downward. Finally you reach a happy place weight-wise (or more likely, throw your hands up from your periodic carb binges) and proceed to 'Phase 3, Maintenance', which is really 'eat whatever you want.' Weight goes right back up. You conclude: it's the damn carbs; back to Phase 1. This repeats for a few cycles until you conclude that you're genetically 'carb-sensitive.' "I just can't handle carbs. I know how my body responds."

Just an example of how the "objective" self-experimentation you recommend could easily "prove" a conclusion that's totally spurious.

Why am I on one about this? Because this stupidity is hurting people -- including people I know personally and care about.

[TanneryGulch]

What will destroy my kidneys and many other organs is bg spikes from eating too many carbohydrates..It matters not what anyone on this site says, the facts are just that, facts. I can eat fats and proteins and my sugar is normal. Eat a potato, brown rice, popcorn, oatmeal, cereal, bread etc etc..wham, spike..my meter doesn't lie and neither does my body. bdb..

LOL, I wrote my last post without having seen this one, yet I anticipated you almost verbatim. I already explained the fallacy in this, so stop repeating yourself. And the diabetic complications you refer to take years of chronic hyperglycemia to develop.

... Dr. Barnard's tightly controlled crossover study that proved conclusively that his diet did better than any other that has been published.

Easy there, Trigger. It showed that he beat the ADA diet somewhat. (NB: The control group also lost weight and improved their A1Cs, and some reduced their meds, too.) Here's the paper: http://care.diabetesjournals.org/cgi/co ... /29/8/1777

I'd never use phrases like "tightly controlled" and "proved conclusively" in the context of diet studies. Thanks for the chuckle, though.

However, Bigbear, this paper is great reading for you. I want you to explain why the high-carb group didn't go blind and keel over from those meter spikes (which DON'T LIE!!!) and saw their A1Cs improve while adding almost 50g/day of carbs and eating more total calories than controls.

[bigbear]

Ok, you guys win, I am going out right after work and getting a 50lb bag of rice and a jumbo size box of spaghetti and I am gonna have a hay day...I can gorge myself on all that good for me carbohydrates until it comes out my ears and then I can sit back and go into a diabetic comatose..that sounds like a great idea. I am so glad that I have learned so much from you guys..thanks for the stellar advice..

Just so you do know..I do not eat "lots of fats" or "high fat" or anything of the such. Tannery thinks he knows so much about atkins, it sounds like he was a failure and wants to take it out on everyone who is successful on it. Have fun and I do hope that you are healthy. I have found out what I needed. Sacto, you get your wish. I am through..

[MariusA]

No one can revert to SAD but you can go from high fat/low carb to low fat/high carb with little difficulty. It takes a couple weeks for the metabolism to adjust and then you are fine. The real danger is in the middle where you get inflammation and glycation of proteins and tissue damage etc.

What I was trying to say is that he has to change his diet forever, not only until things get better, because if he reverts his diet he will become sick again.

Also not true. You can easily eat much more fat than protein without special machines other than a sharp knife to trim the meat. You just do the opposite of what most folks do and you buy the fattiest cuts and maybe even then give part of the meat to the dog and you eat all the fat.

Yes, you can easily eat more fat than protein and even only fat as you said, but you can't eat only that way, you'll just won't be satisfied. With the fat comes the extra protein. And keeping it simple, the extra protein damages your kidneys along with demineralization of bones etc.

No, that is not what I am saying. I'm not even arguing for McDougall. I am saying that the physiological rationale for low-carb (high-fat) is bulls##t. Their assumptions about how the body works haven't withstood experimental scrutiny. Bigbear came into this thread preaching, "This diet can't work for a diabetic because I know my meter, and boyyy, if I eat a potato..." etc., and I tried to give an inkling (based on my admittedly very limited knowledge) why this is simplistic and myopic. Of course glucose and insulin should run in the favorable range over the long-run, but (1) it's not like those are the only (or even the most important) measures of health; (2) it's not true that the only (or even the best) way to achieve this is by eating high-fat.

bigbear doesn't seem to get this. He's a meat lover, he's been eating this way all his life, it is very hard to change old habits that make you feel good. Only life threatening situations make people change their habits and that's what's killing me, that you cannot get it through their thick skulls that SAD is bad for their health.

On what basis should one determine whether it "works"? Weight loss? Ease of compliance? Biomarkers? (Which?)

So far on Atkins (less than 2 weeks) I have lost 12 lbs, dropped my bp by 8-10 points both systolic and diastolic, my bg has not gone above 130 (checking 5-7 times daily) and normalized fasting bg is 94....without medication...dispute that!

I guess personal experience. If bigbear believes that is which is best for him, then it's his choice, although someone here said that he's been on the Atkins diet, did well in the beginning, but things got bad in the long run.

[SactoBob]

I do consider Dr. Barnard's study conclusive and very tightly controlled compared to other diet studies. There was a lot of follow up. They did not simply trust the participants to comply, and they were carefully educated and interviewed many times.

What weighed heaviest to me was the crossover aspect of the study. The plant food group did markedly better than the ADA group (which also improved). But what was conclusive to me was the next study, where the plant food group went to ADA and the ADA group went to plant food. I.e. they traded diets for the second part of the study. And they traded results.

The former ADA group got better when they moved to plant food and the former plant food group got worse when they went ADA. Dr. Barnard had trouble getting some of the former plant fooders to stay ADA.

To the extent that there may have been some deviance from instructions, I believe that the crossover aspect of the study allowed for that. It seems statistically unlikely that adherence changed abruptly over the course of the crossover.

And though I amuse you, I can probably read the studies and make some sense of them. My degree from UC is in bio science with honors, I interned as a medical scientist for a year and became licensed and have worked years in the hospital lab in bacteriology, biochemistry, hematology, etc. My law work has been very heavily involved with medical issues. But I am happy if my opinions amuse you. You may not find that crossover study as conclusive as I do, but what other theory explains the superiority of the plant food diet, and the reversal of the effect when the cohorts were reversed? Do you have some particular credentials that you would like to share?

If you could offer a theory based on fact, I, and I am sure Dr. Barnard, would be willing to consider it. I know of no study which would impeach Dr. Barnard's study, and it is important that his study beat the "gold" standard of the ADA diet.

Dr. McDougall's and Nathan Pritikin's results are not the randomized and tightly controlled studies, but confirm the benefit of this diet for type 2 diabetes. I am unaware of a single study which does not show benefit of this diet in the treatment of type 2 diabetes, or heart disease, of which a type 2 diagnosis is considered fully equivalent to.

If the Atkins people could do such a study with better results, it would definitely change my opinion. But that is not the way I would bet . . . or the way I am betting (with my health).

Finally, would you please stop baiting bigbear. Do you really think you will convince him of anything? Do you think he will give you the last word? Do you want to give him a platform to ridicule what we are doing here? He has promised to go. Please give him the last word and let him go.

[Nettie]

Ok, you guys win, I am going out right after work and getting a 50lb bag of rice and a jumbo size box of spaghetti and I am gonna have a hay day...

Make sure it's brown rice and whole wheat spaghetti.

Nettie

[SactoBob]

If you wanted to compare the whole plant food diet with the Atkins, a crossover study would be the best. I think that the ADA diet was selected because that is what is generally recommended by physicians. I think it still is the standard.

When I was diagnosed with type 2, that is what was prescribed to me. They sent my wife and I to a dietician who explained it all. It was very complicated, and even though my health was threatened, I could not follow it well.

As far as I did follow the diet, it helped some, but I kept drifting away from it. I could not even think of getting off my meds with my execution of that diet, and it seemed like a lot of work for little payback.

The beauty of the crossover diet is that it compensates for so many variables. The only thing that changed in the crossover was the diet. Any errors in the randomization of the cohort, or the level of adherence or exercise etc. should not be a factor. The only thing that varied was the diet in the crossover, and the results speak for themselves.

I personally don't see much value in a crossover with the Atkins diet. It is such a dangerous diet that not many knowledgeable people, and no physicians I know, recommend it for treatment of type 2. The Atkins people should finance a study against the ADA diet if they want to prove their case. As far as I know, they have no such studies, nor any long term studies such as those by Dr. Esselstyn, or any population studies such as the China Study.

I personally don't think it is a lot of value to shoot down the Atkins straw man. I can't see how anybody who looks at the available data could consider it a healthy diet or a proven diet in any way. If good data does exist, I would look at it. But the results I have achieved with Dr. McDougall here are hard to ignore. When so many things - really everything - gets so much better, it is hard to believe that I am going in the wrong direction.

I really don't see type 2 diabetes as a separate disease, but rather a manifestation of a single progressive disease. Obesity -> Elevated BP and cholesterol -> Type 2 -> metabolic syndrome -> heart disease -> heart attack or stroke or neuropathy -> death.

I was glad that I was able to break that cycle with the help of some great people like Dr. Esselstyn and Dr. McDougall.

[SactoBob]

I really don't think that most docs even give it much thought. Once a protocol is established as the standard of care, it is prescribed without further analysis.

I just had my follow up appt. with my internist, who is interested in my case and my results. We discussed the follow up tests ordered by my cardiologists, and whether I would have a bypass if I failed those test badly.

I said probably not, since I am experiencing no pain, and since the procedure did not treat the disease and offered no real benefit of longevity or protection for heart attack. He thought that the procedure did provide these benefits (from what the heart surgeons told him) and I told him that my research indicated otherwise - that it provided only marginal protection for small subsets (for stable angina). He is going to check that out.

But he said that he was really concerned if what I said was true, since he routinely followed what he believed to be the standard of care by referring patients to the cardiac surgeons for CABG. He said that he would probably be drummed out of his group if instead prescribed my program to his patients.

But more interesting is that he mentioned that a physician in his group had similar symptoms to what I was experiencing, and was not a candidate for surgery and did not want the meds. He told the doc about how well I was doing. That doc called, and he and wife is coming over for dinner tonight for an Esselstyn meal. He is checking out this site, and Dr. E's and Veg Soc Hawaii.

I think that is how people are going learn more about this program, and that is the sort of thing we should be focusing on rather than arguing with people who don't want to how how well this program works regardless of the facts.