momof4 wrote:Hi Jeff,
You wrote earlier to slugmom:
We can discuss the Barnard study on the GI at a later point but the GI was not the relevant issue to the success of the program in the study. It was the principles I mentioned above.
I'm sorry to bring the GI topic back up, but I'm wanting to recommend Dr Barnard's program to my friend w/Type 2 Diabetes, but this seems to be an area where he and Dr McDougall disagree (I've also recommended Dr McDougall to her, so I don't want to her getting conflicting advice). The PCRM website is full of resources for diabetics, but they keep bringing up the GI. My friend said that she knows potatoes raise her blood sugar, but when I looked at Dr McDougall's newsletter on GI, potatoes are basically the same as brown rice--so what's the deal with potatoes? I haven't asked her if she eats them with the skin, so would that make the difference (because of the fiber, I assume)?
The rest of his recommendations look good, and it's nice to have something tailored to diabetes--but the GI focus, esp. since it seems other groups discredit the idea, is puzzling.
Greetings
I think it is great that Dr Barnard has published work on the "vegan" diet, the "GI" and diabetes. I have a lot of respect for the work he does.
However, in my opinion, of which I have discussed with him, I do not beleive the "factors" that made his program effective were either it being "vegan" or what he called "low GI" and in the discussion part of the study, this is mentioned.
In regard to vegan, we have discussed this issue many times here. So, vegan can be healthy and unhealthy so "vegan" is not the issue, but the factors that made it a "healthy" vegan diet.
Well, basically, it is the same with the GI/GL, of which we have discussed here and also there are 2 newsletters at my website where I go into more detail. There are many foods that are low GI that are healthy and many foods that are low GI that are VERY unhealthy, so in and of itself, so a "low GI" does not always point to healthy foods or which foods that will help with diabetes. I can easily create for you a low GI diet that is not healthy nor will it help with diabetes.
Plus, the whole concept is very confusing for most people and several randomized controlled trials have shown it to be ineffective for both weight control and blood sugar. So, why focus on it? Let's spend out time and energy focusing on what really matters and what really works. Diabetes is not caused by high GI foods or non vegan foods or diets. We need to address the causes and not the symptoms (blood sugar). GI focuses on the symptoms.
If you read my newsletter, you will find a summary of recommendations, which, when reviewed, are about identical to the MWL program, which I think is the best approach for someone with Diabetes. And, it is easy to understand and follow. No fancy concepts, or indexes to try and understand that in the end, do not work.
You can read the newsletters here..
http://jeffnovick.com/RD/Articles/Entri ... vels..htmlAnd here are the recommendations..
-Follow an unrefined, unprocessed, high carbohydrate, lower fat, very high fiber, and plant based diet for weight loss and for better health. Such a diet is based on fresh fruits, fresh vegetables, “intact” whole grains, starchy vegetables and legumes. It is not only very healthy; it is also very effective for weight loss, diabetes and heart disease. It is low in calorie density so you can fill up without overeating and not worry about being hungry. In addition, it is very high in nutrient density, so you will be optimizing your nutrient intake at the same time.
-Do not be afraid of carbohydrates but understand that all carbohydrates are NOT EQUAL. Forget the GI/GL or whether they are complex or simple. That is all too complex. Instead, choose carbohydrates that are intact, unrefined and unprocessed. Period. Choose whole kernel corn over corn flakes or corn chips. Choose brown rice over white rice or rice crackers.
-Aim for a fiber intake of at least 50 grams a day from whole foods. If it makes it easier, focus on getting at least 17 grams of fiber at each meal, based on 3 meals a day. If you follow the diet recommended above, this will be easy.
-While increasing fiber, focus on the foods that tend to be higher in soluble fiber for improved blood sugar, insulin sensitivity and lipid levels. These foods are beans, yams, oats, barley and berries. These foods are easy to remember by using the acronym BYOB & B. (We give new meaning to life’s acronyms!) (Beans are the best for this)
-Do not be misled by diets, food choices, or packaged products that are recommended for weight loss, diabetes, heart disease and/or cancer based on the glycemic index or the glycemic load. The GI and the GL is not only extremely confusing, but they are also misleading and have little if any benefit to you. It is much simpler to just choose foods based on the principles I described above.
I will add in...
- be active for at least 45-60 minutes, 5-6 days a week.
In regard to why you will occasionally hear "good news" about the GI/GL...
The situation is similar to news/media reports about "low fat" diets. We know, almost without exception, when the "low fat" diet gets a bad review or results in a study, it is because it is either not really a low fat diet and/or it is a diet that is based on refined and processed foods.
Same with GI/GL.. Whenever you hear a report about how good the GI/GL is, most all the time, it is because the low GI/GL foods were from the healthy selection of available GI/GL foods. The benefit was not from the low GI/GL but because the foods that happen to have a low GI/GL were also "Healthier" foods.
A few decades ago, mainland Japan ate a very high GI diet that was also low in fat, and diabetes was rare. Now, they eat a diet higher in fat and lower in GI and Diabetes is rising. Same with the Pima Indians in the Sierra Madre mountains vs the ones in the Arizona.
Diabetes Care. 2005 Sep;28(9):2123-9.
Influence of glycemic index/load on glycemic response, appetite, and food intake in healthy humans.
"RESEARCH DESIGN AND METHODS: Thirty-nine healthy adults consumed only low- or only high-GI foods ad libitum in the laboratory for 8 days in either high (three foods per meal)- or low (one food per meal)-variety conditions. Glucose and insulin concentrations as well as appetitive sensations were determined before and for 2 h following breakfast and lunch on days 1 and 8. Energy intake was monitored daily.
RESULTS: There were no significant differences in plasma glucose or insulin responses, appetitive ratings, or food intake between treatments.
CONCLUSIONS: These data indicate that the differential glycemic response of foods tested in isolation under fixed time are not preserved under conditions of chronic ad libitum consumption of mixed meals."
At the last center I worked, in 10 years I saw over 25K people with about 2/3 to 3/4s of them with diabetes. About 80% on average, were able to get off their medications in about 2 weeks. Most of them were able to eventually achieve "normal" fasting levels, in the range of 70-100, with many between 70-90. This work is published in several major medical journals. We never focused on or taught the GI/GL.
I don't think you (or anyone else) should either.
In Health
Jeff
