Diabetes and Carbohydrates

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Postby rlandis » Tue Mar 03, 2009 10:05 am

Rjay wrote:Oh, I get it... The initial poster and bigbear are just playing a little game.


Whoa, Nellie!!!!! I'm the initial poster. Why are you getting on my case. All I did was aska question. I'm doing the MWL program, and I'm doing well on it, for the few days I've completed. I was only curious about the effect of high carbs on Type II, and was seeking advice about continuing meds, or not.

What's with the hostility?
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Postby JeffN » Tue Mar 03, 2009 10:25 am

While I appreciate the debate/discussion, and the references to other material, the answers to all the questions raised are in the links provided in my original email.

This included detailed discussions on the carbohydrate issues and why not all high carb diets are the same and why this program is effective, information on Dr Barnard's study, his book, and also discussions on the research from the Pritikin and other centers on which diets are the most effective to getting someone of their medications and reversing the disease, and not just the markers of the disease. There is even a link with the full story of someone else in this forum who had the same concerns/oppositions about carbohydrates and this diet and what happened over several months of applying the program and their success.

It is quite a bit of reading, but the disease is not going to get better or go away over night, so if someone is truly exploring something, then it is up to them to put the effort in to be able to make an informed choice.


So, in case anyone missed it... :)

For those of you who are new, it is understandable that this program may not make sense to you and may be different than the information you are hearing or have heard before from health professionals.

You are asking some "big" questions that have no simple answer. However, while there is no simple "sound bite" answer to all your questions, this website and this forum is loaded with free information on this topic.

My recommendation is for you to begin to read the main website and the this forum and both have been organized to help you do this.

I would recommend you start here..

http://drmcdougall.com/med_hot_diabetes.html

In addition, while there is no "Diabetes" hot topic in this forum (Which I will soon fix), here are some discussion in this forum that will be of benefit to you.

Diabetes
http://drmcdougall.com/forums/viewtopic.php?t=6321
http://drmcdougall.com/forums/viewtopic.php?t=10136
http://drmcdougall.com/forums/viewtopic.php?t=6969
http://drmcdougall.com/forums/viewtopic.php?t=7671
http://drmcdougall.com/forums/viewtopic.php?t=8615
http://drmcdougall.com/forums/viewtopic.php?t=9455

Calorie Density, Weight Loss, BMI, How Much To Eat
http://www.drmcdougall.com/forums/viewtopic.php?t=6032
http://www.drmcdougall.com/forums/viewtopic.php?t=6916

Intact Whole Grains vs Refined Processed Grains
http://www.drmcdougall.com/forums/viewtopic.php?t=6045
http://www.drmcdougall.com/forums/viewtopic.php?t=6512
http://www.drmcdougall.com/forums/viewtopic.php?t=6122

Sugars, Agave, Honey, Stevia, Etc
http://www.drmcdougall.com/forums/viewtopic.php?t=5666

Take some time and begin to read and understand the information. Then if you have a more specific question, let me know.

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JeffN..Is there anything McDougall didn't author himself..

Postby bigbear » Tue Mar 03, 2009 10:40 am

Jeff..Pardon my skepticism, but I would like to read something that wasn't written by Dr Mcdougall himself or someone on this forum. Can you direct me to where the clinical evidence and peer reviews are located. I would just like to see other doctors/medical groups that agree with this method of eating.

ncyg46-Dr Atkins had a lot to do with not only food companies switching to natural fats as opposed to trans fats, but also with the gov mandating that trans-fats be labeled as such...small steps but it is at least a step. He also had a lot to do with getting the standard food pyramid changed. It is not perfect but better than what it was.
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Postby Adrienne » Tue Mar 03, 2009 10:43 am

The following article about the efficacy of high-carb. vegan diets for type 2 diabetes appeared a few weeks ago in The Globe and Mail, Canada's largest-circulation newspaper. Some of you may find it helpful/interesting.

http://www.theglobeandmail.com/servlet/ ... columnists
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Adrienne

Postby bigbear » Tue Mar 03, 2009 10:51 am

I will check it out..thanks.. bb..
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Re: JeffN..Is there anything McDougall didn't author himself

Postby JeffN » Tue Mar 03, 2009 11:02 am

bigbear wrote:Jeff..Pardon my skepticism, but I would like to read something that wasn't written by Dr Mcdougall himself or someone on this forum. Can you direct me to where the clinical evidence and peer reviews are located. I would just like to see other doctors/medical groups that agree with this method of eating. .


Every bit of information you will read anywhere has some bias to it. Even the actual published studies have bias. Your job, which you seem to say you are actively involved in, is to read and explore the information and make your mind up based on what you read. The only point I am making is you can't really dismiss something if you don't take the time to understand it.

Now, if you take the time to read the links you will see all the outside references to the studies and discussions of the studies and the physiology and biochemistry discussed.

My comment above about the other "outside" material is because most of it is just someone else's opinion. I recommend people read original source material and not public and lay interpretations of it. You will also find that one of the posted links is my disagreement with one of the programs and/or books others have recommended to you.

I am here of my own free will, volunteer to be here and have no vested interest in which diet you follow. I teach nutritional biochemistry and science, not dogma. I teach at several Universities and Colleges and also am faculty for the Florida Academy of Family Physicians. I have no hidden agenda other than to help you understand the science and how best to apply it to your personal situation.

Before beginning to work with Dr Mcdougall, I spent 10 years at another center where I worked with over 15,000 patients, most of them with metabolic syndrome and/or diabetes. Most all felt exactly like you do, yet within 3 weeks, all saw significant improvement and 80% of them with Type 2 diabetes were off their oral medications and 40% of those with Type 2 no longer had to take inslulin and 5 year follow ups showed they stayed that way. In addition, in those with metabolic syndrome, within 2 weeks over half of them could no longer be diagnosed with metabolic syndrome. All of this, is published in the leading medical journals.

In addition, you will often find my comments to anyone in your shoes, to do what they feel is right. I make no effort to debate or convert anyone.

I also recommend that this information is for the individual themselves and not for them to use to debate or try to convert their friends and families. As I have said, read the information and you have any specific questions, let me know.

I wish you the best.

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Adrienne

Postby bigbear » Tue Mar 03, 2009 11:05 am

well, that was counterproductive...while perusing the authors website, I found this little tidbit...

http://lesliebeck.com/page.php?id=2622&type=art
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Thanks for your time and commentary

Postby bigbear » Tue Mar 03, 2009 11:10 am

Jeff, I appreciate your candor and will take what you say under advisement. I will look at the links you posted (have already checked several of them out). At this point I will quit posting until I have come to a decision and have some kind of results to post. Again..thanks and have a great day..big bear..
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The Leslie Beck Article

Postby SactoBob » Tue Mar 03, 2009 11:22 am

There really isn't much question that a person can lower their blood sugar by eating low carb. The diet she discusses in the article does, however have a lot vegetables in it. Maybe she doesn't count those as carbs.

But the question is - what is the optimum overall diet. Diabetes is a single disease, at least in my opinion. It is one facet of a larger disease. It goes along with obesity, heart disease, high bp and metabolic syndrome. Virtually nobody dies of high blood sugar. Heart disease in public enemy number one.

On that score, if you are researching that issue, please check out Dr. Caldwell Esselstyn at his website
www.heartattackproof.com

He has followed some very sick people on this diet for over 20 years. These folks were basically sent home to die because there was nothing more that could be done for them. Now, many years later, almost all of them are doing great and have reversed their heart disease.

As Jeff says, you have to make up your own mind. The problem is that there is a lot of conflicting information out there. In my case, it was easy. Dr. Esselstyn and Dr. Ornish are the only docs who have demonstrated long term reversal of the heart disease. The fact that I am off my bp meds and diabetes meds and have lost weight is a nice bonus.

Ask your doc whether he believes you have heart disease - his answer could surprise you.
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Postby Plumerias » Tue Mar 03, 2009 12:19 pm

rlandis,

Neither DH nor I are diabetic, but we have friends and loved ones who are/and or are headed that way, so it is of interest to us.

There is of course, Dr. McDougall's work, to which Jeff has provided many links, which I now have to check out myself. Drs. Esselstyn and Ornish have also been discussed.

Check it out Neal Barnard's studies and books on his website, www.pcrm.org. Personally both of us found his explanations (on a variety of topics) to be easy to understand. If you get a chance to hear him in person, do so, he's lots of fun.

Another option not yet mentioned is Brenda Davis, RD, of Canada. She too did diabetes research and has published a book on the subject. www.brendadavisrd.com. I checked the Vegetarian Summerfest schedule and Brenda is schedule to speak there in July if that might be of interest to you. Her diabetes studies were conducted in the Marshall Islands, where the diet is actually worse than SAD and diabetes is so widespread as to be "normal".
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Postby rlandis » Tue Mar 03, 2009 2:42 pm

Plumerias wrote:rlandis,

Neither DH nor I are diabetic, but we have friends and loved ones who are/and or are headed that way, so it is of interest to us.

There is of course, Dr. McDougall's work, to which Jeff has provided many links, which I now have to check out myself. Drs. Esselstyn and Ornish have also been discussed.

Check it out Neal Barnard's studies and books on his website, www.pcrm.org. Personally both of us found his explanations (on a variety of topics) to be easy to understand. If you get a chance to hear him in person, do so, he's lots of fun.

Another option not yet mentioned is Brenda Davis, RD, of Canada. She too did diabetes research and has published a book on the subject. www.brendadavisrd.com. I checked the Vegetarian Summerfest schedule and Brenda is schedule to speak there in July if that might be of interest to you. Her diabetes studies were conducted in the Marshall Islands, where the diet is actually worse than SAD and diabetes is so widespread as to be "normal".


Thanks for all the info. I'll be doing a lot of reading over the next few days.

Regards,
Richard
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Brenda Davis lecture

Postby SactoBob » Tue Mar 03, 2009 2:49 pm

Brenda Davis also has a recent lecture posted on the Vegetarian Society of Hawaii website. It is a good one, about her experience with the Marshall Islanders and their diabetes problem.
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Postby CarolWL » Tue Mar 03, 2009 4:32 pm

Bigbear, I completely understand your hesitation. In my adulthood, I have been around the block and back again on what makes a healthful diet. For more than 20 years, I have written about nutrition as it relates to heart disease and diabetes, including articles (and books) about Atkins diets, McDougall and Ornish, ADA diets, the food pyramid, raw food, the whole shebang. The McDougall diet is a whole 'nother animal (sorry about the pun), and I don't think it can be compared in any way to anything you've tried before.

I admire you for researching and even more for coming into the McDougall forum, especially when you're not sure it's the Real Deal. Takes guts.

Some years ago, I attended one of the McDougall seminars as research for a magazine article. In 6 days, I lost 6 pounds and my cholesterol level dropped 14 points. But even more impressive: I saw how people with heart disease and diabetes greatly reduced their meds or even went off their meds entirely, some after only 2 or 3 days. None of the diabetics were passing out or going into diabetic shock. They were walking 2 miles a day and going off their meds while eating only carbs.

(BTW, when a McDougaller says "carbs," we mean whole grains and whole foods, not white bagels or bread or pasta. We don't mean instant oatmeal with milk and sugar. We don't mean "whole grain" Cheerios. Of course those things spike glucose; how could they not? Fiber is what keeps the glucose at an even keel, so when we say "carbs," we mean beans, vegetables, fruit, bulgur, brown rice, old-fashioned oats, et al.)

I would encourage you to try the McDougall diet for 10 days. Just 10 days. You may find if you feel bad, it may just be because you need to decrease your meds, not increase them.

Whatever you decide, best of luck to you. And the best of health.
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Postby TanneryGulch » Wed Mar 04, 2009 2:02 pm

Bigbear,

Great question. Something else to consider, and perhaps Jeff or someone will jump in and correct me if I have the science wrong:

Although insulin does lower blood sugar, that isn't its primary function and it's simplistic to think of it that way. Its job is to control the uptake of all macronutrients circulating in the blood by the liver and peripheral tissues of the body (skeletal muscle, body fat). When insulin is high, it's telling the body to take whatever is in the blood and store it: glucose (glycogen synthesis), fatty acids (esterification into triglycerides in adipocytes), and amino acids (protein synthesis in muscle fibers -- in fact, experiments have shown that protein can stimulate insulin as much carbs or even more, although somewhat differently). Type-2 diabetics have body-wide resistance to the action of insulin. The physiology of this is complicated and somewhat controversial but Barnard's diabetes book gives a simple illustration.

If diabetics could carry around a little meter that measured not only glucose but also the levels of fat (triglycerides, non-esterified fatty acids) circulating in their bloodstream after a meal, they might be in for a shock. Likewise if they had a blood insulin meter. That low-carb, high-protein/fat meal that so neatly controls your blood sugar is provoking a monstrous insulin release and most likely leaving your bloodstream sludged with fat for many hours afterward. You just don't have a way of measuring it. But it's there, just the same -- chylomicrons and VLDLs, and then into LDLs, all lingering the bloodstream for hours, inhibiting the dilation of the arteries, oxidizing and sticking to the walls. This is at least as potent a contributor to the vascular damage that kills diabetics as the high blood sugars.

(BTW, if you do want to confirm this, fast for 8-10 hours and then get an AtheroTech VAP test and look at the "remnant lipoproteins" section, especially intermediate-density lipoprotein (IDL). In a normal person, that number should be ZERO in fasting serum -- all the fat from your last meal should have been tucked away hours ago.)

In general, people become insulin resistant because they're too fat. (And McDougall and others have argued that this is an adaptation designed by evolution.) So to solve the main problem, pretty much any non-retarded diet plus strenuous exercise will help immensely. Notice that everybody on The Biggest Loser starts out diabetic and ends up non-diabetic, despite not eating as healthfully as McD/Jeff recommend.

But there's more to it than body fatness. They showed clear back in the 1920s that you can induce diabetic blood sugars in normal subjects within days by feeding them a diet very high in total and saturated fat. (Note that they couldn't have packed on more than a pound or two of body fat in that time.) Now, at that point the low-carb idiots would tell the hapless subjects that they were diabetic for life, "carb-sensitive" or similar nonsense, and that their only salvation is to restrict carbs and eat to their meters religiously. Conversely, guests at McDougall, Pritikin, and similar programs see their blood sugars revert to normal or near-normal within days by cutting dietary fat back to 20-30g/day or less. This is well in advance of any significant weight loss. So what's going on? Essentially, the constant influx of fat "gums up" the insulin receptors all over the body. (Again, see Barnard's book.) So the moderate ADA diet is the perfect "one-two punch" to keep you diabetic, which is why both low- and high-carb diets usually outperform it. (On low-carb, you're still extremely resistant to glucose uptake -- and the more enlightened low-carbers like those in Heretic's camp will admit this -- but you're never eating enough carbs at a time to raise blood sugar much.)

So "eat to your meter" is a misleading and myopic strategy, guaranteed to fail. I know this goes totally against the ADA advice to watch the postprandials carefully, "learn how different foods affect you," etc. They're wrong. Whatever diet a diabetic chooses to pursue, the numbers to watch are (1) the bathroom scale and (2) fasting sugar.

Hope this helps.
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So here's the deal..

Postby bigbear » Thu Mar 05, 2009 7:52 pm

I decided to give atkins a try. Primarily because it fits with my lifestyle and also I read his book and it makes sense to me. I did less than a month ago have all my labs done so I will be able to compare the cholesterol, HDL, LDL, Triglycerides..along with my A1c and BP. I have been on it for 6 days...I am no longer on any diabetic meds. Had to stop taking them as my blood glucose was getting too low. I also was able to cut my omneoprazale dosage in half. That med is for GERD. Physically I must say I have a lot more energy and really feel quite well. I will go with this for now and see the results, go back to my dr and have all my labs done again to see if I have negatively affected any of them. Nice side effect is I have dropped 9 lbs. I do realize that some of that is water weight so I am not under any illusions. I will not post anything else until I am on this eating plan for long enough to see real results and get my labs done. Thanks..Bigbear..
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