Man, oh man. If only more doctors would stand up and make this statement:
I’m sorry for what the medical establishment has done to people with diabetes. We’ve done an atrocious job for type 2 diabetics and prediabetics.
We’ve recommended they eat precisely what their bodies can’t handle: carbohydrates. We’ve urged them to take poison: carbohydrates. We’ve cooperated with the drug companies to encourage diabetics to eat foods that increase drug company profits: carbohydrates.
Much of the medical establishment’s damage to diabetics has been done innocently, unknowingly. Rank and file physicians, dieticians and nutritionists put blind faith in their instructors, scientific journal editors, and time-honored and tenured thought-leaders. Our unquestioning faith has hurt people with diabetes and prediabetes.
Those are the opening paragraphs from Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet, by Dr. Steve Parker. I’ve been recommending Dr. Bernstein’s Diabetes Solution to anyone who asks me about diet and diabetes, and I’ll continue to do so. But now I’ll recommend this book as well.
I read quite a few books on nutrition and health, but only urge other people to read those that meet at least one of two criteria:
- Is the information important and not readily available in other books? (Good Calories, Bad Calories falls into this category. It’s a tough read, but you won’t find a lot of the information Gary Taubes presents anywhere else.)
- Is the information important and presented in a manner that passes my “Aunt Martha” test? That is, could we hand this book to our overweight, pre-diabetic, frustrated-with-Weight-Watchers Aunt Martha and reasonably expect that she’d read it and understand it?
Conquer Diabetes & Prediabetes passes the Aunt Martha test with flying colors. The entire book consists of 190 pages (a sizable chunk of which is taken up by meal plans), so the size of it won’t scare anyone off. Better yet, Dr. Parker avoids medical mumbo-jumbo and explains diabetes, blood sugar levels, and how carbohydrates affect blood sugar levels in language that’s easy to understand.
As anyone who reads this blog knows, I lost my automatic respect for anyone with an MD or PhD once I began doing research for Fat Head. Too much bad advice and too many lousy studies have been produced by people with impressive credentials. As Thomas Sowell (I think) once wrote, credentialed ignorance is still ignorance. I now ignore the post-graduate degrees and judge what I’m reading based on logic and evidence.
But that’s me. Like it or not, Aunt Martha and Uncle Joe are more likely to listen to a doctor. I have friends and relatives who couldn’t quite believe that statins haven’t been shown to reduce heart disease among women, the elderly, or men who don’t have existing heart disease until I handed them books written by Malcolm Kendrick (MD) and Uffe Ravsnkov (MD, PhD). When Aunt Martha’s doctor or dietician is telling her she needs to stick to a low-fat, high-carb diet to treat her type 2 diabetes, it can only help to have a book written by a doctor who points out exactly why that advice is just plain wrong. That’s what Dr. Parker does in Conquer Diabetes and Prediabetes.
Although I’m not a diabetic and don’t take any prescription drugs, I was pleased to see the book includes a chapter that lists the drugs prescribed to diabetics and explains exactly what they are, how they work, why they’re prescribed, and what side-effects they may produce. If Aunt Martha is taking Metformin simply because her doctor said she needs it to keep her blood sugar under control, it would be nice if she actually understood what Metformin does:
Metformin decreases glucose output by the liver. The liver produces glucose (sugar) either by breaking down glycogen stored there or by manufacturing glucose from smaller molecules and atoms. The liver then kicks the glucose into the bloodstream for use by other tissues. Insulin inhibits this function of the liver, thereby keeping blood sugar levels from getting too high. Metformin improves the effectiveness of insulin in suppressing sugar production. In other words, it works primarily by decreasing the liver’s production of glucose.
Of course, Dr. Parker’s goal is to control high blood sugar with diet, not drugs – or at least with a lower dose of drugs. Back in the day, that’s exactly how doctors treated diabetes: with a change in diet.
In 1797, Dr. John Rollo (a surgeon in the British Royal Artillery) published a book entitled An Account of Two Cases of the Diabetes Mellitus. He discussed his experience treating a diabetic Army officer, Captain Meredith, with a high-fat, high-meat, low-carbohydrate diet. Mind you, this was an era devoid of effective drugs therapies for diabetics.
Rollo’s diet led to loss of excess weight, elimination of symptoms such as frequent urination, and reversal of elevated blood and urine sugars. This makes Dr. Rollo the original low-carb diet doctor. Many of the leading proponents of low-carb eating over the last two centuries – whether for diet or weight loss – have been physicians.
My, how things have changed. Now you have medical organizations accusing doctors who prescribe low-carb diets of being quacks and perhaps engaging in mass murder. I guess that’s why, in a the middle of an excellent book explaining the causes of high blood sugar and how a change in diet can help, Dr. Parker had to include the standard disclaimer that the information he’s presenting shouldn’t be construed as medical advice or medical care.
I’d suggest placing a similar disclaimer on the wall next to most doctors’ medical-school diplomas: Warning! None of the dietary advice offered in this office as treatment for diabetes or other diseases should be construed as effective medical care.
The middle chapters detail the diet Dr. Parker recommends, which is actually two diets: a ketogenic Mediterranean diet intended to be followed for several weeks, followed by a low-carb Mediterranean diet for life.
Personally, I don’t think there’s anything magical about a low-carb Mediterranean diet that makes it a better choice than any other low-carb diet that emphasizes whole foods. On the other hand, The Mediterranean Diet has been promoted so heavily in the media as a life-saver, perhaps the label will help sell a low-carb diet to people who would otherwise dismiss it as “that crazy Atkins thing.”
As for the standard Mediterranean diet that’s usually recommended, Dr. Parker spells out his objections:
The Mediterranean diet poses a problem for people with diabetes and prediabetes. It’s relatively high in carbohydrates, which tend to raise blood sugars too high. The result could be diabetic complications or the need for more and more diabetic medications with unknown long-term side effects.
And a couple of pages later:
Diabetics and prediabetics -– plus many folks with metabolic syndrome -– must remember that their bodies do not, and cannot, handle dietary carbs in a normal, healthy fashion. In a way, carbs are toxic to them. Toxicity may lead to amputations, blindness, kidney failure, nerve damage, poor circulation, frequent infections, premature heart attacks and death.
That’s why Dr. Parker created ketogenic and low-carb versions of a Mediterranean diet. The purpose of the ketogenic phase, he explains, is to lower blood sugar, reduce chronically elevated insulin (or reduce the need for insulin), and re-condition the metabolism to more easily burn fat for fuel. Many of his patients enjoy the renewed sense of health, weight loss, and better blood-sugar control so much, they decide to remain in the ketogenic phase permanently.
For those who prefer to include more carbs in their diets once the blood-sugar issues are under control, Dr. Parker explains how to slowly re-introduce some extra fruits, nuts, legumes, dairy products and whole grains in the low-carb phase, which is intended to last for life.
After the chapters on how to follow the diets at home, there are chapters on how to eat out and how to deal with cheating –- which is okay once in awhile. The doctor even admits to indulging in cinnamon buns a couple of times per year. That’s pretty much how I handle my love of pizza; I give in on very rare occasions. (Since this is St. Patrick’s Day, I’ll give in to my love of Guinness later tonight.)
There’s also a chapter on exercise that explains what it does and doesn’t accomplish:
Exercise is overrated as a pathway to major weight loss. Sure, a physically inactive young man with only five or 10 pounds to lose might be able to do it simply by starting an exercise program. That doesn’t work nearly as well for women. The problem is that exercise stimulates appetite, so any calories burned by exercise tend to be counteracted by increased food consumption.
On the other hand, exercise is important for diabetics and prediabetics in two respects: 1) it helps in avoidance of overweight, especially after weight loss, and 2) it helps control blood sugar levels by improving insulin resistance, perhaps even bypassing it.
Exercise is good for your health. That’s why I exercise, even though I don’t believe it’s much of a weight-loss treatment. But it may serve, at least in part, as a diabetes treatment.
However, as Dr. Parker emphasizes, type 2 diabetes is first and foremost a blood-sugar problem, and diet affects blood sugar more than anything else. That’s why this is a book that diabetics — and those who want to avoid joining their ranks — need to read.