As the Allies were advancing in December of 1944, the Germans launched a massive counter-attack in what became known as the Battle of the Bulge.  The 101st Airborne Division was sent to hold the town of Bastogne, a vital transportation hub the Germans desperately wanted.  The “Screaming Eagles” were surrounded, out-numbered, short on ammunition, and freezing in their summer uniforms.  But when the German commander demanded their surrender, U.S. general Anthony McAuliffe sent a one-word reply:  “Nuts!” The Screaming Eagles dug in and held the town.

The Grains-and-Drugs Axis is in full counter-attack mode.  The USDA Dietary Guidelines call for greater restrictions on fat and more whole grains in our diets.  The new My Plate tells us to fill 25% of our plates with grains.  And now the dimwits at Diabetes Health magazine -– which reaches hundreds of thousands of diabetics -– are telling people with  blood-sugar issues to eat even more carbohydrates.

That advice comes in the form of an article titled Type 2 Diabetes: From Old Dogmas to New Realities.  There’s no subtitle, but there should be, and it should read:  Just give up and take your drugs, dangit!

In the last decade, dramatic changes have occurred in our understanding of the onset and progression of prediabetes. Lightning speed changes have also occurred regarding the therapies available to achieve optimal blood glucose control. Even with all of this change, however, many old dogmas hang on. It’s time to be aware of the new realities. In this article,  I focus on two common old dogmas and the new realities.

Old Dogma: Losing weight will make blood glucose levels plummet no matter how long you have had type 2 diabetes.

New Reality: Research shows that the greatest impact of weight loss on blood glucose is in the first few months and years after diagnosis… Once insulin production is on a dwindling course (particularly after 10 years with type 2), weight loss has less impact on glucose control.

The reality is that if blood glucose is out of control, it’s time to progress to blood glucose-lowering medication(s), because it’s doubtful that weight loss alone will get and keep blood glucose under control. Today, most experts, including the American Diabetes Association and American Association of Clinical Endocrinologists, agree that people with type 2 should start on a blood glucose-lowering medication that decreases insulin resistance–the core problem in type 2–at diagnosis.

Got that?  The people whose livelihood depends on writing prescriptions for drugs agree that you need drugs, so take your drugs.  I agree that weight loss alone won’t lower high blood sugar -– I’ve known some skinny type 2 diabetics –- but that doesn’t mean a change in diet can’t do the trick.  It just has to be the right kind of diet, one that won’t jack up your blood sugar in the first place.

Speaking of diet …

Old Dogma: People with type 2 diabetes should follow a low carbohydrate diet.

New Reality: Nutrition recommendations for people with type 2 diabetes from the American Diabetes Association and other health authorities echo the recently unveiled U.S. 2010 Dietary Guidelines for carbohydrate: about 45 to 65 percent of calories. (Americans currently eat about 45 to 50 percent of calories as carbohydrate–not a “high carb” intake.)

Countless research studies do not show long term (greater than six months to a year) benefit of low carb diets on blood glucose, weight control, or blood fats. People with type 2 diabetes, like the general public, should lighten up on added sugars and sweets (yes, they’re carbohydrate). They should eat sufficient amounts of fruits, vegetables, whole grains, and low fat dairy foods–all healthy sources of carbohydrate.

Well, there you have it:  the USDA and other (ahem, ahem) health authorities recommend we get 45 to 65 percent of our calories from carbohydrates, so it must be true.  We consume a higher proportion of carbohydrates now than we did 30 years ago, the rate of type 2 diabetes has skyrocketed during that same period, so what this proves is that we should eat even more carbohydrates.

As for those “countless studies” that didn’t show low-carb diets improving glucose control beyond six months to a year, there’s a reason for that:  most dietary studies last six months to a year.  So we can interpret that statement as “countless studies failed to show any benefit after the study ended and we stopped tracking the benefits.”  Over and over, we see medical authorities warning that we don’t know the long-term effects of low-carbohydrate diets.  Right … because the long-term clinical studies haven’t been conducted.

But there are plenty of doctors out there — Dr. Richard Bernstein, Dr. Mary Vernon, Dr. Steve Parker, Dr. James Carlson, to name just a few — who do know the long-term effects of a low-carbohydrate diet for their diabetic patients.  Those effects include weight loss, lower fasting glucose, reduced reliance on drugs, and even a complete reversal of diabetic symptoms in some cases.

A few people commenting on the Diabetes Health article have had the same experience:

Respectfully, this column is not helpful to diabetics and probably dangerous. I am going on 6 years of eating 30-35 carbs/day. My A1c has been in the “non-diabetic” range ever since I went this route and I feel better than I have in years.

It was not until I started a low carbohydrate diet that my blood glucose numbers fell. They fell rapidly and have been easy to maintain under such a diet.

I had awful lipids and blood sugar control on a low fat/high carb diet. Now that I have switched to a lower carb diet – all my numbers are superb.

Ordinary people get it, even if the supposed experts don’t.  As for the  experts at the American Diabetes Association, here are a few points from their own literature:

  • Your digestive system turns carbohydrates into sugar quickly and easily
  • Carbohydrate is the food that most influences blood glucose levels
  • The more carbs you eat, the higher your blood glucose goes
  • The higher your blood glucose, the more insulin you need to move the sugar into your cells
  • The Food Pyramid is an easy way to remember the healthiest way to eat.
  • At the bottom of the pyramid are bread, cereal, rice and pasta.  These foods contain mostly carbohydrates.
  • You need six to eight servings of these foods per day

Head.  Bang.  On.  Desk.

You’d think someone writing up those guidelines might spot the contradiction.  But the contradiction is less surprising when you look at a short list of who provides the ADA with its funding:

  • Abbott Pharmaceuticals
  • Amylin Pharmaceuticals
  • AstraZeneca
  • Eli Lilly and Company
  • GlaxoSmithKline
  • Merck & Co.
  • Pfizer Inc.
  • Cadbury Schweppes (candy/soda maker)
  • Kraft Foods
  • J.D. Smucker Company
  • General Mills

From what I read online, the publisher of Diabetes Health also sells medical devices and started the magazine to promote its products.  Like I always say, follow the money.

It’s time for those of us who don’t want more diabetics to be killed by bad advice to stand up and say “Nuts!” to the commanders of the Grains-and-Drugs Axis.  If you know a diabetic, give him or her a copy of Dr. Bernstein’s Diabetes Solution or Dr. Steve Parker’s Conquer Diabetes and Prediabetes.  Point your family and friends to books and blogs that educate people about what causes type 2 diabetes and how to avoid it.

Then join the Nutrition and Metabolism Society, one of the few organizations dedicated to fighting bad nutrition science with good nutrition science.  By joining NMS at any membership level –  from $10 on up — you will be supporting the kind of research that’s necessary to overcome years of misinformation promoted by the USDA and ADA.

Think of it as providing badly-needed weapons for the Screaming Eagles of nutrition research.  They’re surrounded, but they won’t give up.  And they will win the battle.

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61 Responses to “Stand Up And Say “Nuts!””
  1. Katy says:

    Nadia talks about “options” but if you go to the ADA website and search “low carb,” the first result is a recipe for low fat corn bread made with fake eggs and skim milk! And then the cognitive dissonance continues:

    “A key message for people with diabetes is “Carbs Count.” Foods high in carbs (carbohydrates) — bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas, sweets — raise your blood glucose levels the most. [Yep!]

    For many people, having 3 or 4 servings of a carb choice at each meal and 1 or 2 servings at snacks is about right. [WHAT??] Keep an eye on your total number of servings. For example, if you choose to have dessert, cut back on potatoes.”

    HOW can anyone make any sense out of this advice?

    That’s an impossible task. We can’t make the illogical logical.

  2. Jim Anderson says:

    There’s a report out today from the Trust for America’s Health (TFAH), saying, in effect, America is fatter than ever. In the past year, obesity rates have increased in 16 states and not declined in any state. The press release notes that 32 states now have diabetes rates above 8 percent. The TFAH suggests that the food and beverage industry (that is, the high-carb junk-food industry) voluntarily scale back its advertising aimed at kids. I’m not a fan of unrestrained capitalism, but I am a realist, and I know an appeal like that won’t work. It’s like asking a lion not to eat a nice, fat fawn. What will work is everybody telling the “industry” what to do with the crap it pushes. Basically, standing up and saying, Nuts!

    Agreed, it’s education that will change our eating habits, not mandates or bans on advertising.

  3. Mark says:

    Here’s a little interesting loop-of-income fact. I’m sure it wasn’t part of the master planned, but hey, nothing wrong with increasing the bottom line!

    -American Heart Association recommends more grains in your diet.
    -Grains don’t help so of course they also recommend statins.
    -Pharma maka money.
    -New indications are that statins increase chance of Diabetes.
    [ citation: http://well.blogs.nytimes.com/2011/06/21/cholesterol-drugs-linked-with-diabetes-risk/ ]
    -Yay! More insulin drugs!

    However, Dr. Steven Nissan doesn’t find this clinically important and, after all, we must trust him. He is the chairman of cardiology at the country’s number 1 rated hospital, The Cleveland Clinic. Wow. Well then I gotta go with him! Oh wait…what’s this? Hmmm, he is also a consultant with the drug companies! Eh, nevermind. He doesn’t get paid. He just requires them to give money to charity. Hey, isn’t the American Heart Association a charity?

    Well, at least as a charity, they only want to help and are completely transparent in their reports and have no confidential or proprietary information they wouldn’t share. What would they have to hide?

    “American Heart Association Ethics Policy…Fraud…Disclosing confidential and proprietary information to outside parties.”

    Okay, I don’t know. That’s probably a standard legal stamp, but I’m really getting to the point to where I don’t know who to trust anymore!

    I don’t think it’s big conspiracy. I think they’re examples of something the economist Milton Friedman once said: people have an inexhaustible capacity to believe that whatever is in their own interest is also in the interest of society as a whole.

  4. kat says:

    I just happened to run across an article http://shine.yahoo.com/channel/health/5-foods-that-keep-you-thin-2507875/?pg=2#comments while the article itself is not bad, you have to wonder about some of the really stupid commenters LOL. I’ll give you one example which really cracked me up. he makes almonds sound like they’re arsenic or something LOL:

    Posted by Chris 1 hour 17 minutes ago

    Almonds are VERY dangerous if you’re looking to lose weight. When they say eat a handful… they mean like 6 – 10 tops. Eat any more and you’re sliding down hill fast. Just stay away from the almonds completely. If you like almonds, substitute your milk for almond milk.

    Oh my … I hope Chris isn’t a nutritionist.

  5. LaurieLM says:

    Good Carbs, Bad Carbs (no such difference- they’re all BAD)
    from the Dr Sears that’s not our Dr Al Sears (thanks James Birdsall for this quote)

    “But before you reach for the carbs in a candy bar, take some time to learn about sugar and other kinds of carbs. Over-processed, factory-made sugars and starches have given carbohydrates a bad reputation. Once you understand which carbs are best for your body…….”.

    ‘healthywholegrains’ are “over-processed, factory-made”. Wheat seeds are inedible coming off the plant. The wars over oil have to be fought to fuel supply
    the plows, combines and harvesters that desertify millions of acres of aerable land per year, pesticides and herbicides come from oil and have to be sprayed on these monocrop cereal grain agricultural nightmare plants. The irrigating of these same fields is an ecologic, environmental disaster and the harvesting and then the over-processing needed to make inedible individual seeds sort of table ready, that you need a whole huge concentration of just to make a little bread, is just the begining of the ‘factory-made’ process, and this is continued AFTER the seeds have been grown- see above.
    Processing requires, grinding, fumigating, transporting, storing, bleaching, pressurizing, additional fuel oil, fractionating, baking, packaging etc etc etc.

    Cereal grains, ‘healthywholegrains’ are ‘over-processed, factory-made’ incarnate.

    Grains = health food is one of the most successful con jobs ever.

  6. Steve says:

    Hi Tom – would you be willing to post a link to a source for ADA funding? I can’t find anything on their website that indicates their funding coming from most of the companies you listed, but I’d like to point out the hypocrisy to some people I know who are following the ADA’s ‘advice’.

    http://www.diabetes.org/assets/pdfs/2008-revenues-received-by-ada.pdf
    http://lists.essential.org/pipermail/corp-focus/2005/000204.html

  7. Laurie says:

    Great post, Tom.
    Thanks for the laughs – they’ve been in short supply since Hope’s article was published! :)

    We’ve got to laugh. If we lose our sense of humor, they win.

  8. Dan says:

    I’ve heard what she’s saying for the last 5 years since getting type 2 diabetes. It’s nothing new. She was saying the same thing when she debated Dr. Bernstein on dLife several years ago. The stardard dietary dogma for diabetics is low fat high carb, just as it is for everyone else. I had to find the “dogma” of low carb on my own.

    I check out Diabetes Health every week and, while is does have nonsense like this, the also have articles on low carb and allow for open discussion on the subject. That’s the best you can expect in the current medical-dietary environment. Not everyone at Diabetes Health is a dimwit.

    That’s good to know.

  9. Bruce says:

    Tom and/or his panel of experts must have a huge financial investment in the meat/agribusiness industries or the fast food industry or both. It is also very obvious that he hates the very idea of regulating these industries. I feel sorry for the people who really do want to lead healthier lives who are fooled into following this low carb eating bullshit. It is so incredibly unhealthy. Do yourselves a favor, learn how poisoned and toxic commercially produced meat, dairy and eggs are. Agribusiness has more federal government protection than almost any other industry except perhaps the banking, energy, chemical, and pharmaceutical industries of course. By the way, grains are not the only substitute for meat. There’s also vegetables, fruits, beans, nuts, seeds, berries… Oh and if you really have to have meat, get organic meat, or raise and feed a steer yourself or best of all, shoot a deer or elk or bison. At least those won’t be teaming with chemical toxins and the animal won’t have lead a life of complete torture and misery before its death.

    The meat/agribusiness industry? What’s that, exactly? Idiots like Hope Warshaw tell people to eat less meat and more grains. I’m pretty sure the grain industry favors that advice, while the meat industry doesn’t. That would lead a logical person to conclude that there’s no such thing as some combined meat/agribusiness industry.

    As for low-carb being incredibly unhealthy, what are you basing that on? Your own opinion? The science certainly doesn’t back you up.

  10. Bruce says:

    Dude, the majority of the grains grown in this country are fed to the livestock raised in this country for slaughter. The beef, pork and poultry are force fed a feed of mostly corn and soy.
    Agribusiness = Perdue, Smithfield Farms, Cargill, Monsanto, just to name a few.
    As far as the science. My opinion has NOTHING to do with it. And the majority of the real science does back it up. Human anatomy and physiology of the digestive system and cellular metabolism in particular muscle cell metabolism which is where most of the food is used.
    What’s the point of this discussion? Prove to me and the rest of the world that you don’t make a single dime from the meat or fast food industry and then maybe you can be taken seriously.

    First off, genius, if you had two synapses capable of firing in unison to form a logical thought, you’d know it’s impossible to prove a negative. Prove to you and the rest of the world that I don’t take money from the fast-food industry, seriously? First prove to me that you don’t take money from PETA. Then prove to me and the rest of the world that you don’t watch child pornography. Then prove to me and the rest of the world that you don’t capture frogs and torture them. When you prove all that, then maybe I’ll take you seriously … idiot.

    Second, if you actually read this blog now and then, you’d know I believe livestock should be raised on grass, not grains. The fact that livestock are fed grains doesn’t mean the meat industry and the grain industry are the same industry, any more than it means Exxon and Toyota are the same industry. If the meat industry and the grain industry are the same industry and they’re paying me off, the grain side of the industry must feel they’re getting a lousy return on their investment, since I’m constantly telling my readership to stop eating grains and to buy grass-fed meat whenever possible.

    Third, I’ve now spent four years examining the real science … dozens of books and more studies than I can count. The real science says restricting carbohydrates is beneficial, especially for diabetics and pre-diabetics. Dietary fat is not and never was the problem. Not even the former anti-fat hysterics at Harvard’s nutrition department believe what you do anymore.

    Fourth, the point of this discussion is that you showed up here and spouted your uninformed opinions. If the discussion now seems pointless to you (which it surely is), you are free to quit wasting your typing fingers and my time.

  11. Gwen says:

    Here is a sample menu suggested by the site “Diabetes UK”. Needless to say I was horrified!

    Breakfast
    • Small glass of fruit juice or a portion of fruit (see below for what’s a portion)
    • 4 tablespoons of muesli or 4 tablespoons of porridge oats or 2 weetabix or 2 shredded wheat or 6 tablespoons of other cereal with 200mls semi-skimmed/skimmed milk
    or
    2 slices of toast or 2 crumpets or 1 bagel or 1 muffin with 2 teaspoons of sunflower or olive oil spread and 2 teaspoons jam/marmalade/honey
    Lunch
    • Sandwich made with 2 slices bread or 1 bread roll or 1 pitta or 1 tortilla/wrap or 4 crispbreads with salad and
    • 2-3 oz (60 – 85g) of cooked meat/poultry or vegetarian alternative or 4 – 5 oz (120 – 140g) tuna/sardines/mackerel or 3 1/2 oz (100g) cooked prawns or 2 boiled eggs and
    • 2 teaspoons low fat mayonnaise
    • with 2 teaspoons of sunflower or olive oil spread
    Dinner
    • 6 tablespoons pasta/cous-cous/noodles or 4 tablespoons easy cook rice/basmati rice/bulgar wheat or 4 egg sized potatoes
    • with 6 tablepsoons vegetables or large portion of salad with low calorie dressing
    • 2-3 oz (60 – 85g) of meat/poultry or 4 – 5 oz (120 – 140g) fish or 2 eggs or vegetarian alternative or 3 tablespoons pulses, beans or lentils
    • Dessert: 1 low fat or diet yogurt
    Additional daily milk allowance
    • 1/3 pint (200mls) milk
    Snacks
    • 2 portions fruit. 1 portion = 1 banana, apple, orange, pear.1 slice of a large fruit like melon or mango. 2 small fruit such as plums or apricots handful of grapes, cherries or berries. 1 tablespoon of dried fruit.

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