Diabetes and Carbohydrates

[r-marie]

Now that I have you guys together, I'd like to round this thread out with a question that has been buggin me ever since I joined this forum.
What about Dr. Richard Bernstein? Nobody ever mentions him! A diabetic 1 since the age of 12...wasn't expected to live very long, went through agony for years trying many different diets. If nothing else, his description in the introduction to his book is a fascinating account of what a diabetic had to go through in those days: http://www.diabetes-book.com/book/mylife.shtml

"Back in the 1940s, which were very much still the “dark ages” of diabetes treatment, I had to sterilize my needles and glass syringes by boiling them every day, and sharpen my needles with an abrasive stone. I used a test tube and an alcohol lamp (flame) to test my urine for sugar. Many of the tools the diabetic can take for granted today
were scarcely dreamed of back then — there was no such thing as a rapid, finger-stick blood sugar–measuring device, nor disposable insulin syringes....." Makes you thankful to have that modern little gadget (glucose meter) doesn't it?

When I was looking around for a way to reduce my IR, I did read about Dr. Bernstein's approach. It sounded very pursuasive - except I was never big on eating lots of meat and bacon etc. I was more attracted to the lighter side like McDougall's. But I too had my doubts about such a high carb intake.

I was also impressed to find out that Dr. Bernstein was an engineer who after much suffering and searching happened to discover a way to treat his own diabetes. And when he did and noone listened to him or was willing to publish his papers HE WENT TO MEDICAL SCHOOL AND BECAME AN ENDOCRONOLIGIST - an MD at the age of 45!!!

I believe he is now 73 and has been successfully treating other diabetics both 1 and 2 in his own practice for many years.

My question has always been why is he still alive on years of low-carb high fat diet? Is he just one of the exceptions? Just lucky? Or is he exceptionally adept at monitoring his condition and making necessary/timely adjustments? It's something that has been bothering me as his diet goes totally against what we learn here and elsewhere. Do any of you have an answer?

r-marie

[r-marie]

Thank you, Geoffrey, for your honest and thoughtful answer. I can tell that you too have been wrestling with this question. And you have the actual experience of having tried it. I guess there is no real answer; it's what works for YOU. It IS scary though how many more toxins you take in eating high-fat low-carb in this age of chemical additives and liberal use of antibiotics and growth hormones, etc. in raising animals. I'm glad MdDougall works for me as I naturally like and tolerate his suggested foods so much more.

r-marie

[Steve]

Good luck Big Bear. I hope you find health and happiness. You can always consider plant based sometime in the future.
Geoffrey and Marie,
You guys should know better. OK, my belief in low Fat, high carb is a bit of a religion. I am very certain that the McDougall program has saved my health. And my Mom's to boot, even though she was 80 something before starting.
How do you get around the damage to kidneys, cardiovascular system, bone loss, cancer promotion? If you think there is a master combination of meat and fat that will promote health, good luck. Maybe if you add a few vitamins every thing will be fine.
The McDougall program is based on the evidence of billions of people living healthy on a predominately plant based diet. Geoff mentioned the Inuit folks not having available foliage. Well there are not billions or even millions of Inuit. I wonder how many are living on the traditional diet? It is a very harsh environment. They have adapted, but I believe I read that those on the traditional diet have a high incidence of osteoporosis. And that is after many generations selecting for this type of environment. So, if we were playing a game of poker, I would say I see your Inuit and raise you a billion Chinese.

Steve

[JeffN]

What about Dr. Richard Bernstein? Nobody ever mentions him!

...

I believe he is now 73 and has been successfully treating other diabetics both 1 and 2 in his own practice for many years.

The reason that he is not discussed by me is because of the issue of "Burden of Proof."

He has no data to support his claims and/or program outside of those generic studies that similar programs use, that have been discussed here.

If you can post the data showing the effectiveness of his program, I would be glad to comment on it.


In Health
Jeff

[Chumly]

I just don't get the fascination with eating fat. To me it is very unappetizing, especially in it's refined form or when it's say fat cut off from a piece of steak. I was cutting fat off steak and removing skin from chicken as a child just because it grossed me out so much. I much prefer the taste of crisp raw vegetable and fruit or beans and sweet potatoes to fat. As far as it "works" for other people, you can survive on it, but I'd much rather eat something that has a proven track record in the healthiest, longest living populations in the world. That is a plant-based diet. It has been years since I researched it, but the Inuit and Masai have a drastically lower life expectancy than Okinowans, if I remember correctly.

Michael

[JeffN]

It has been years since I researched it, but the Inuit and Masai have a drastically lower life expectancy than Okinowans, if I remember correctly.

Correct.

The Masai get atherosclerosis but their incredible high activity levels (I believe one paper showed they get more activity/exercise in one day than most Americans get in a week), which people often forget about when they go on these high fat diets confers them "some" (but not total) protection.

In Health
Jeff

[r-marie]

The reason that he is not discussed by me is because of the issue of "Burden of Proof."

He has no data to support his claims and/or program outside of those generic studies that similar programs use, that have been discussed here.

If you can post the data showing the effectiveness of his program, I would be glad to comment on it.


In Health
Jeff

Jeff, please understand I'm not trying to be argumentative - just more clarity on this controversy.

So, I guess it's mostly 'luck'? He was in bad shape for so many years. The fact that he contained his diabetes 1 successfully with a restrictive low-carb high-fat diet and is still healthy (apparently) and is having success in his own practice seems to fly in the face of high-carb proponets, re both heart disease and diabetes. BUT I have not researched him enough to know whether the data he's put out is peer reviewed and credible - and don't want to take the time to find out since his eating style is WAY too restrictive and unappetizing to ME. I've found a much better alternative in the McD eating plan, which works very well for my body and taste buds.

Thanks for taking the time to answer this.

r-marie

[r-marie]

I just don't get the fascination with eating fat.

Michael

I understand what you're saying, but please note that this is in relationship to blood sugar control.

r-marie

[JeffN]

Greetings,

Jeff, please understand I'm not trying to be argumentative

Neither am I.

just more clarity on this controversy.

Me too. Hence, the "burden of proof" (let alone any proof).

How do you know any of what he says is true?

Where is the evidence?

Nathan Pritikin did the exact same thing and now has over 100 studies spanning over 30 years documenting what he said. So did Walter Kempner, MD and he has over 20 studies spanning several decades. etc etc

It is just like in Law. Many people make many claims about man other people. He did this. She did that. He said this. He said that. And they all say they have "proof."

But, in order for their claim to have any "weight" they must take their claim to court and once there, prove their claim using evidence. And, our court system, that we have all agreed to, has a standard on the quality of the evidence in order for it to be admissible and a standard on the burden of proof that both parties must try to meet to win their case.

In our court, the court of science, the evidence is peer reviewed published studies and the burden of proof is based on such evidence and the quantity and quality of it.

I am just trying to help people understand this issue which is a key point so we can raise the standard and the quality of the debate/discussion.

Or, do you have a better standard for us to use to help provide more clarity on the situation?

Thanks for taking the time to answer this.

You are welcome.

In Health
Jeff

[ida]

bigbear,

i agree that diet is a very individual thing and i applaud you for doing research and making a decision. it shows that you are opened minded which is great. i am a former atkins dieter...i did my research years ago, read all the low carb gurus (atkins, eades, schwarzbein, bowden etc) and compared their books to the high carb gurus (macdougal, ornish, barnard etc) and i also believed that the low carb guys made the most sense. i spent two years on atkins...i lost 25 pounds and my health. for the first 8 months i felt amazing...and then slowly my body began to stop functioning. my thinking became cloudy and unfocused, my energy faded, my weight loss reversed, my emotions became unstable, i had serious constiptation, my always low blood pressure became elevated, i began to get frequent colds, allergies, heart palpitations, muscle spasms etc. i refused to believe it was my low carb diet...but it was. i switched from atkins to low fat vegetarian (with some fish/poultry/olive oil on occasion!) and within 3 days every issue i noted above began to disappear. i've been eating this way for quite some time now and i've never felt better.

if at any point low carb ceases to work i hope you will remember this website and try this out. i wish you nothing but health and success on whatever plan works best for you!

[Rjay]

One problem with peer reviewed evidence in support of the fat and meat only diet (some may call this a true/real Paleo diet) is that a group of sufficient numbers probably cannot be identified for study. I experience, every day, how few people out there eat like me. I have no big problem sticking with a low fat whole food plant diet but I don't know, and have not met, anyone who eats only meat and fat. (talk about alone at a party)

Curously, I wonder how long a person could live at the extremes of eating nothing but rice (or only potatoes) compared to a person eating nothing but fat and meat. I suspect that in both cases survival would continue for a significant period of time.

Perhaps these are the opposite ends of a human metabolic mechanism allowing both these extremes to ensure survival, in repoductive good health, either way? It may never be known because the group(s) will probably never be able to be composed numerically to be comprable.

Just a thought.

[JeffN]

One problem with peer reviewed evidence in support of the fat and meat only diet (some may call this a true/real Paleo diet) is that a group of sufficient numbers probably cannot be identified for study..

There are actually many studies on many exotic and rare diets and exotic and rare populations.

In fact, there are over 25 published peer-reviewed studies on the raw food diet, and Dr. Loren Cordain has published several on the Paleo diet and we have several on the Masai, etc, etc.

In spite of its flaws and criticisms, the peer-reviewed published system is still the best system we have. And, if we are not going to use the system because of its flaws, we can't just go and use any system, but we have to recommend and use a system that is "better" and has less flaws then the one we are criticizing.



In Health
Jeff

[r-marie]

What about Dr. Richard Bernstein? Nobody ever mentions him!

The reason that he is not discussed by me is because of the issue of "Burden of Proof."

He has no data to support his claims and/or program outside of those generic studies that similar programs use, that have been discussed here.

If you can post the data showing the effectiveness of his program, I would be glad to comment on it.

In Health
Jeff

Jeff, I decided to take up your challenge after all and started googling. There are 2 parts to my answer to you: References by Dr. Bernstein himself and those from other sites.

1. As luck would have it I immediately came upon an interview with Dr. Bernstein at this blog: http://livinlavidalocarb.blogspot.com/2 ... ks-to.html

As I was reading through the interview it soon became apparent to me that Dr. Bernstein relies heavily on his own experience - feedback and testimonials from his own patients – and readers at amazon.com – as well as copius reading of scientific publications and studies (which he does not reference individually).

At the top of the following article about normal blood sugar at http://www.diabetesincontrol.com/result ... ticle=6202 there is this statement: "Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., FCCWS is convinced from his personal experience, from the experiences of his patients, and from reading the scientific literature, that people with normal blood sugars do not develop the long-term complications of diabetes. Learn what your patients can expect when they fix their blood glucose."

It's a little out of context since it addresses complications of blood sugar but still shows how he values his own results - without official controlled studies. (the blue emphasis is mine)

The site http://www.diabetesincontrol.com/catego ... recordID=2
lists many of Dr. Bernstein’s articles most of them being updates to his book The Diet Revolution.


2. Related links to low-carb diet sites from various/other sources:
The following link lists a variety of links to articles, scientific papers, forums and support groups http://www.nmsociety.org/LowCarbDietLinks.aspx
I am in the process of reading some from these but there are two obstables for me personally: 1) Many of the scientific sites only list the abstract and prevent me from accessing the whole article unless I pay a fee, and 2) Since I am untrained in comparing/interpreting scientific data I would probably not recognize the many pitfalls, untruths, contradictions, etc. someone like Jeff would pick out fairly easily.

I will not post anything more on this subject as I fear it may not be appropriate to do so on a McDougall sponsored forum. I apologize if I’ve already overstepped my boundaries by posting this. But I just wanted to let Jeff know I’m listening.
And others can make up their own mind.

Thanks for everything
r-marie

[TanneryGulch]

I decided to give atkins a try. Primarily because it fits with my lifestyle

Irrelevant. Shooting up heroin may "fit with my lifestyle"; that doesn't mean it's healthful.

I read his book and it makes sense to me.

No offense intended, but it "makes sense to you" because you're not aware of the reasons why it's crap. The Ptolemaic model of the universe, the phlogiston theory of combustion, and miasma and evil-spirit theories of disease all "made sense" to people too. (And in the latter case, many, many people were hurt as a result.) A few examples:


- Low-carbers claim that insulin is needed to store dietary fat as body fat. Actually, the most potent stimulator of triacylglycerol esterification in adipose tissue is acylation-stimulating protein (ASP), and it works just great in the absence of insulin. http://www.ncbi.nlm.nih.gov/pubmed/8492712 Guess what the primary regulator of ASP is? Dietary fat (chylomicrons). http://www.ncbi.nlm.nih.gov/pubmed/9694837 The body isn't that "stupid." Eat a caloric surplus, even with zero carbs, and the fat you eat is the fat you wear.


- On that basis, Atkins claims a "metabolic advantage" of dietary fat and that excess carbs turn to body fat. Actually there is a metabolic advantage -- in favor of carbs. First of all, de novo lipogenesis is an inefficient process that wastes about 1/4 of the energy. http://www.ajcn.org/cgi/reprint/62/1/19 Secondly, it basically doesn't happen in humans, at least with starch. (Fructose is different.) Your body will overstuff its glycogen stores and crank up thermogenesis before it will convert a gram of glucose to fat. See this study, where they fed subjects 2000 calories in a single meal:

http://www.ncbi.nlm.nih.gov/pubmed/6755166
The data imply that: (1) The capacity for glycogen storage in man in larger than generally believed, and (2) Fat synthesis from CHO will not exceed fat oxidation after one high-carbohydrate meal, even if it is uncommonly large. When a single high-carbohydrate meal is consumed, dietary CHO merely has the effect of reducing the rate of fat oxidation. These findings challenge the common perception that conversion of CHO to fat is an important pathway for the retention of dietary energy and for the accumulation of body fat.


- They simplistically assume that insulin response equals glycemic response. They also like to claim that mixing protein/fat with carbs blunts the insulin release, keeping it in a "Zone." Sorry, but that's been tested too:

http://www.ajcn.org/cgi/reprint/66/5/1264
Within each food group, there was a wide range of insulin responses, despite similarities in nutrient composition. The important Western staples, bread and potato, were among the most insulinogenic foods. Similarly, the highly refined bakery products and snack foods induced substantially more insulin secretion per kilojoule or per gram of food than did the other test foods. In contrast, pasta, oatmeal porridge, and All-Bran cereal produced relatively low insulin responses, despite their high carbohydrate contents. Carbohydrate was quantitatively the major macronutrient for most foods. Thus, it is not surprising that we observed a strong correlation between GSs and ISs (r = 0.70, P < 0.001). However, some protein and fat-rich foods (eggs, beef, fish, lentils, cheese, cake, and doughnuts) induced as much insulin secretion as did some carbohydrate-rich foods (eg, beef was equal to brown rice and fish was equal to grain bread). As hypothesized, several foods with similar GSs had disparate ISs (eg, ice cream and yogurt, brown rice and baked beans, cake and apples, and doughnuts and brown pasta).


- They claim that chronic high-carb diets make you insulin resistant. I already addressed that. Also, Jeff has cited the data showing fasting insulin dropping like a rock on high-carb diets.

... and on and on...

[JeffN]

Greetings,

Most all of the links above are to pages of articles that he wrote and are not published in peer reviewed medical journals. They are just articles expressing his opinions that he has self published at his website that he makes to look like published medical articles. It does not make them good or bad, just not reliable and credible without being able to document what he is saying, of which, the burden is on him.

I am in the process of reading some from these but there are two obstables for me personally: 1) Many of the scientific sites only list the abstract and prevent me from accessing the whole article unless I pay a fee,

You are welcome to post the citation here (as others do) and I can see if I have access to the article and/or if it has been discussed here already. In addition, you can also search the title of the citation in google and see if someone else has posted the full article on the internet, which is a common occurrence.

Since I am untrained in comparing/interpreting scientific data I would probably not recognize the many pitfalls, untruths, contradictions, etc. someone like Jeff would pick out fairly easily.

Part of my goal here is to help people understand the data for themselves so they do not continually get misled by misinformation.

I will not post anything more on this subject as I fear it may not be appropriate to do so on a McDougall sponsored forum. I apologize if I’ve already overstepped my boundaries by posting this. But I just wanted to let Jeff know I’m listening.

You are welcome to continue to post on the topic, but the only think I am asking is to post citations and/or studies from peer reviewed published medical journals. Anyone can say anything about anything on the internet and the internet if full of people and MDs making health claims about their program, but few if any, have any "real" data to support their claims.

The best resource for accessing peer-reviewed published data on the internet is the National Library of Medicine which can be accessed at www.pubmed.gov

In the 10-Day Program, Dr McDougall actually spend one lecture on this very topic, including the importance of finding accurate info and how and where to do it.

As a result, many other forum members have taken on this challenge and we have had some great discussions on the data.

And others can make up their own mind

I agree. I just want them to have accurate and reliable data. See the recent discussion on Going Nuts Again, where someone thought they had and were acting on accurate and reliable data because it came from a popular MD they knew. However, upon close analysis, we find the data to support the claims did not exist at all.

Thanks for everything

You are welcome!

In Health
Jeff