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
- Eli Lilly and Company
- 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.