“Nuts!” to the Nutty Diabetes “Expert”

A reader of this blog wrote to Hope Warshaw, author of the “eat your carbs and take your drugs” article in Diabetes Health that was the subject of my last post.  I didn’t see his original email to her, but he did forward me her response.  Here’s the opening:

Rather than throwing stones and continually citing Richard Bernstein, MD, who as far as I know has only written consumer books and not published one research paper on his recommendations, or discussing your own experience of one, how about providing/discussing citations of well conducted long term research studies in people with type 1 and type 2 diabetes (or even prevention trials) who more successfully manage glycemia, lipids and blood pressure and eat healthfully on an intake of carbohydrate below 40% of total calories.

I see … the reader has successfully managed his diabetes with diet, but we can simply dismiss that evidence because it’s an “experience of one.”  Ms. Warshaw apparently is convinced the reader is the only diabetic in the world who found a low-carb diet beneficial.  Therefore her advice to eat a high-carb diet is still correct.

Riiiight … except we already know it’s not an “experience of one.”  I quoted some comments diabetics posted on the Diabetes Health site regarding Ms. Warshaw’s article in my previous post.  Here are a few more:

I set out on a low carbohydrate diet and within 6 months had normal blood sugar, normal blood pressure and lost over 100 pounds. People don’t need more drugs and bad dietary advice. I think we have all see the rising rates of obesity and diabetes and you are not helping the situation. If you really want to stop the rise, tell people the truth. Low Carbohydrate diets normalize blood sugar.

As a physician with pre-diabetes I am appalled that a high carbohydrate diet continues to be promoted. I am 56 years old. For the past 5 years I have maintained normal fasting blood sugars on a low carb diet.

I have been eating low carb for almost 1 year now and my diet includes lots of non stachy vegetables, fruits(strawberries, blueberries, raspberries), lean meats, eggs, nuts and some low carb desserts occasionally. My A1C is 5.6 and I have accomplished this by diet/exercise alone.

I am a type I diabetic and I know for a fact what 45-65% of calories as carbs can do to my BG… This is absurd and border-line dangerous statement from some “best-selling author.”

On Facebook and in other corners of the blogosphere, a lot of people are complaining that they also left comments on the article, but those comments never showed up.  Perhaps Diabetes Health isn’t interested in letting the world see how many diabetics disagree with their house expert.  Whatever the explanation for the blocked comments, it’s clear that many, many people have successfully managed their diabetes by doing the opposite of what Ms. Warshaw recommends.  It’s not an “experience of one.”

Ms. Warshaw continued in her reply:

And instead of reading top line messages in resources like myplate.gov, dig into the research based information in the Dietary Guidelines Advisory Committee Report, 2010. Here’s the link: http://www.cnpp.usda.gov/DGAs2010-DGACReport.htm

A couple of quotes from the Carbohydrate Chapter:

The Institute of Medicine (IOM) (2002) set an acceptable macronutrient distribution range (AMDR) for carbohydrates of 45 to 65 percent of total calories. Thus, current dietary guidance recommends consumption of carbohydrate-containing foods, including vegetables, fruits, grains, nuts and seeds, and milk products. Carbohydrate foods are an important source of fiber and other nutrients.

Well, there you have it:  Ms. Warshaw’s dietary recommendations for diabetics must be correct because the USDA and other experts say so.  No other proof needed  — which is a rather odd position for her to take, considering how she ended her reply:

No need to write back unless you’ve got well conducted published research studies to share.

So we’ve got someone who is supposedly interested in helping diabetics, but arrogantly dismisses comments from actual diabetics who’ve achieved normal blood sugar through a low-carb diet.  You’d think she would find all those “experience of one” stories intriguing and look into the matter a little more.

Banging my head on my desk didn’t diminish my annoyance with Ms. Warshaw’s reply to the reader, so this morning I wrote to her myself:

———————————————————

Dear Ms. Warshaw –

I’ve been following your responses to people who questioned your advice to diabetics to consume a high-carbohydrate diet.  Those responses boil down to two arguments:

1.  I’m right because the USDA Dietary Guidelines say I’m right.
2.  Show me the long-term clinical studies proving carbohydrate restriction is effective for diabetics, or shut up and leave me alone.

Appealing to the authority of the USDA — whose mission is to sell the grains our government subsidizes — isn’t proof of anything.  As you may already know, one member of the committee that wrote those guidelines has already stated publicly that the guidelines aren’t based on good science.  I read the entire, mind-numbingly dense, stupefying, often-contradictory report myself, and I agree:  the guidelines aren’t based on anything resembling solid science.  So let’s set those aside and deal with actual science.

Here are links to just a few of the clinical studies that demonstrated the effectiveness of low-carbohydrate diets for managing diabetes:

The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The Low-Carbohydrate Ketogenic Diet group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03), body weight (-11.1 kg vs. -6.9 kg, p = 0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p < 0.001) compared to the LGID group.  Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p < 0.01).

A low-carbohydrate, ketogenic diet to treat type 2 diabetes

The Low-Carbohydrate Ketogenic Diet improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants. Because the LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.

Utility of a short-term 25% carbohydrate diet on improving glycemic control in type 2 diabetes mellitus

Compared to baseline diet, after 8 weeks of a 25% carbohydrate diet, subjects showed significantly improved glycemia as evidenced by fasting blood glucose values (p<0.005) and hemoglobin A1c levels (p<0.05). Those previously treated with oral hypoglycemic agents showed, in addition, a significant decrease in weight and diastolic blood pressure despite the discontinuation of the oral agent. When then placed on a 55% carbohydrate diet, the hemoglobin A1c rose significantly over the ensuing next 12 weeks (p<0.05).

Yes, I know:  you asked for long-term studies.  As far as I can tell from my online research, there are few if any controlled clinical studies of dietary interventions that have lasted more than a year or perhaps two at most.  So you appear to be asking your critics to quote the results of studies that have never been conducted.

But I’m clearly mistaken about that.  You obviously have access to a long list of multi-year clinical studies on carbohydrate-restricted diets.  I know this because of what you wrote in your article in Diabetes Health:

“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.”

Since you’ve examined countless such studies, could you please provide me a list of, say, a dozen references to clinical studies in which subjects adhered to a carbohydrate-restricted diet for more than a year, but failed to achieve improved glucose control compared to a control group?  If you could point me to studies matching that description that lasted five or ten years, that would be super.  I’d like to share them with my readers.  Then we’ll all understand exactly how countless studies failed to show any long-term superiority of carbohydrate restriction for glucose control.

Also, given that you don’t like anyone to promote dietary advice that isn’t backed up by long-term clinical studies, could you please provide a list of multi-year clinical studies in which a diet of 45-65% carbohydrates produced superior glucose control and lower A1c when compared to a control group, or – better yet – when compared to a group in which carbohydrate was restricted to less than 40%?  The diabetics among my readership especially would love to see the scientific basis for your advice — after all, their lives depend on it.

Best regards,
Tom Naughton
Writer/Director “Fat Head: you’ve been fed a load of bologna”

———————————————————

I haven’t received a reply.

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200 thoughts on ““Nuts!” to the Nutty Diabetes “Expert”

  1. Beth

    Thanks for writing this message. I appreciate that you have taken on baiting the bear in the den. 🙂

    Beth

    I don’t think the bear wants anything to do the rest of us.

    Reply
  2. kat

    good stuff, Tom. agree with you and all replies.

    any chance the drug companies want to make money off this? ha. no.. that can’t be it. they CARE about people over profits, right?

    kat

    They certainly aren’t interested in discovering if diet will work instead.

    Reply
  3. Ailu

    I posted this comment on the editor’s response, but don’t know if it’ll be approved, so posting here as well:

    Honestly, I was one of those people who thought low-carb didn’t work for me. But when I first tried low-carb I did it low-carb AND low-fat, being paranoid of fat due to conventional wisdom. No wonder I was miserable. I bet the majority of people who try low-carb and fail likely give up for the same reason. Or another reason – it takes about 2 weeks for your body to adjust to burning fat instead of carbs. I was never told that, either. Had I known both these things, I would have started and been successful living low-carb a lot sooner. All I can say, is when I finally overcame these issues and went low-carb, my severe reactive hypoglycemia finally went away for good. Out of all the diets I tried, it was the only one that was successful in eliminating it.(My blood stats are excellent now too.)

    It’ll probably never show up, but good response.

    Reply
  4. Nick

    Tom,

    BTW….here are some of comments coming from fellow Diabetics on a Forum I post on….

    #1:
    What are Hope Warshaw’s qualifications?

    Is she a doctor? NO!
    Is she a medical professional? NO!
    Is she a diabetic? NO!

    She’s a dietician who has no clue about diabetes.

    Why would any of us care what she thinks?

    #2
    This Hope Warsaw is a CDE. I remember meeting another CDE sometime ago and she recommended the same thing, that carb consumption should be 50% of our calorie intake. Those CDEs read the same text book, go to the same school, take the same test, and got the same diploma. Unless a CDE himself/herself is a diabetic, they have no idea whatsoever what is going on in real diabetic life. They simply memorize what they read and quote it to you. I met this CDE in this diabetic group meeting. She was the speaker. She gave each of us a handout and started reading through it. I remember half way through I asked her why does certain thing had to be done certain way. I kept an open mind and asked her very nicely, but she became aggitated…. CDEs are extremely helpful when I was first diagnosed and had absolutely no idea about this disease, but within a few weeks they are completely obsolete…. I wouldn’t waste any more time with CDEs lol

    So it’s a bunch of rote learning without any understanding. Figures.

    Reply
  5. Firebird

    “She’s a dietician who has no clue about diabetes.”

    A friend of mine is a nutritionist, and HE knows more about diabetes.

    There are good ones and bad ones. The good ones don’t just parrot what they’re told; they read the literature and think for themselves.

    Reply
  6. Verimius

    Ms Warshaw is like a member of the Catholic hierarchy in the sixteenth century, while you and the low-carb community are busily nailing theses to her door!

    Good analogy.

    Reply
  7. Nick

    Tom,

    BTW….here are some of comments coming from fellow Diabetics on a Forum I post on….

    #1:
    What are Hope Warshaw’s qualifications?

    Is she a doctor? NO!
    Is she a medical professional? NO!
    Is she a diabetic? NO!

    She’s a dietician who has no clue about diabetes.

    Why would any of us care what she thinks?

    #2
    This Hope Warsaw is a CDE. I remember meeting another CDE sometime ago and she recommended the same thing, that carb consumption should be 50% of our calorie intake. Those CDEs read the same text book, go to the same school, take the same test, and got the same diploma. Unless a CDE himself/herself is a diabetic, they have no idea whatsoever what is going on in real diabetic life. They simply memorize what they read and quote it to you. I met this CDE in this diabetic group meeting. She was the speaker. She gave each of us a handout and started reading through it. I remember half way through I asked her why does certain thing had to be done certain way. I kept an open mind and asked her very nicely, but she became aggitated…. CDEs are extremely helpful when I was first diagnosed and had absolutely no idea about this disease, but within a few weeks they are completely obsolete…. I wouldn’t waste any more time with CDEs lol

    So it’s a bunch of rote learning without any understanding. Figures.

    Reply
  8. Firebird

    “She’s a dietician who has no clue about diabetes.”

    A friend of mine is a nutritionist, and HE knows more about diabetes.

    There are good ones and bad ones. The good ones don’t just parrot what they’re told; they read the literature and think for themselves.

    Reply
  9. Verimius

    Ms Warshaw is like a member of the Catholic hierarchy in the sixteenth century, while you and the low-carb community are busily nailing theses to her door!

    Good analogy.

    Reply
  10. Adrienne Larocque, Healthy Nat

    Tom, as usual you have hit the nail squarely on the head! Keep up the great work!

    Thank you.

    Reply
  11. Goober

    Great post Tom! I just wish I could convince my diabetic friends to go low carb. They look at me like I’m an alien when I suggest it. For years their doctors have told them to eat low fat. It is criminal.

    Maybe Dr. Bernstein’s book would open their eyes.

    Reply
  12. Nina

    I love the complaint that Bernstein hasn’t published robust findings. He tried and tried and tried and tried, but was rejected. That’s the reason he went off to train as a doctor.

    Bingo. Publication bias is a huge problem in the scientific journals that deal with nutrition and health.

    Reply
  13. MedPhyzz

    Well done, Tom.
    Amazingly my comment was included at the end of that article. (SubstanceX)
    I guess if one million people wrote to Hope Warshaw and told her they had cured their diabetes with a low-carb diet, she would arrogantly and patronisingly dismiss them all and tell them that their ‘experience of one’ meant nothing. The only way you can get the qualifications that she has got is to be a parrot with no brain who can repeat the same nonsense over and over again. But she thinks it gives her a licence to be arrogant and superior while giving advice that will kill. Makes me wanna spit! Grrrr!!

    Anyone who falls on back on the USDA as a source doesn’t understand science.

    Reply
  14. Adrienne Larocque, Healthy Nation Coalition

    Tom, as usual you have hit the nail squarely on the head! Keep up the great work!

    Thank you.

    Reply
  15. Goober

    Great post Tom! I just wish I could convince my diabetic friends to go low carb. They look at me like I’m an alien when I suggest it. For years their doctors have told them to eat low fat. It is criminal.

    Maybe Dr. Bernstein’s book would open their eyes.

    Reply
  16. Sam Elowitch

    Isn’t it maddening how ignorance is so often the handmaiden of arrogance?

    I say it all the time: I don’t get riled when people are ignorant, and I can usually stand it when people are arrogant. But when ignorant people are arrogant, that sets me off.

    Reply
  17. Nina

    I love the complaint that Bernstein hasn’t published robust findings. He tried and tried and tried and tried, but was rejected. That’s the reason he went off to train as a doctor.

    Bingo. Publication bias is a huge problem in the scientific journals that deal with nutrition and health.

    Reply
  18. MedPhyzz

    Well done, Tom.
    Amazingly my comment was included at the end of that article. (SubstanceX)
    I guess if one million people wrote to Hope Warshaw and told her they had cured their diabetes with a low-carb diet, she would arrogantly and patronisingly dismiss them all and tell them that their ‘experience of one’ meant nothing. The only way you can get the qualifications that she has got is to be a parrot with no brain who can repeat the same nonsense over and over again. But she thinks it gives her a licence to be arrogant and superior while giving advice that will kill. Makes me wanna spit! Grrrr!!

    Anyone who falls on back on the USDA as a source doesn’t understand science.

    Reply
  19. Sam Elowitch

    Isn’t it maddening how ignorance is so often the handmaiden of arrogance?

    I say it all the time: I don’t get riled when people are ignorant, and I can usually stand it when people are arrogant. But when ignorant people are arrogant, that sets me off.

    Reply
  20. LaurieLM

    Longitudinal studies: Maybe these are not clinical, only field studies, but they are ‘natural’ (by default, unintended) experiments and the last one I mention is the longest.

    Since the 1980’s and McGovern, low-fat, low-calorie, high-carb, semi-vegetarian.

    Since the 1970’s the commodification of HFCS and hydrogenated palm-kernal oil and altered coconut oil.

    1950’s invention of CAFOs and factory farming.

    Since the turn of the 20 th century, vegetable oils created to be drying agents for paint, putty and varnish industry, gain a hold in Crisco, margarines and touted to this day for their health benefits.

    ~130 years ago, vegetarians Post and Kellogg gave us breakfast cereals.

    ~5000 years ago give or take, the invention of bread.

    ~10,000 years ago the beneficial, but also risky discovery of agriculture.

    ~10 – 5 million years ago the exploitation of the miracle molecule cholesterol and it’s positive motive effect on the evolution of the human brain.

    ~ 1 billion to 750 million years ago beginning evolution of animals by the proto-animal discovery of proto-cholesterol. Up to that point, bacteria, fungi and plants predominated- none of which had or have to this day- cholesterol, nervous systems, brains. Nor do they have skeletons, muscles nor do they move or think.

    Grains, sugars, cereals and man-made vegetable oils have no place in the human diet. There is no nutritional requirement for any of it to any human. We CAN process that stuff, but eating any of it, even one gram, replaces, displaces, is instead of the nutrition we need for robust health and higher order, high-performance, excellent brain function. Animal fat, cholesterol and animal protein is all that is required.

    Reply
  21. guinea pig

    Hi Tom
    I have to say i this blog is amazing and your documentary really helped me take a second look at low carb after trying and failing atkins previously after doing it wrong(i didnt eat enough fat and didnt eat often enough so my blood sugar fell very low and i gave up).

    Correct me if im wrong but i think i found another article in diabetes health from 2007 which promotes low carb and is the exact opposite of the article by warshaw.Here’s the link:

    http://www.diabeteshealth.com/read/2007/04/24/5143/why-eating-too-many-carbs-makes-you-fat/

    Well, let’s give them credit for airing different views.

    Reply
  22. Homer

    This kind of sort of relates. So at the hospital I work at we serve different patients, different diets. For diabetics we give them varying amounts of carbohydrates per meal (45g to 80g per meal) based on their weight and insulin use (interesting thinking there). This logic is based on this stupid graph that assumes all diabetics should be on oral treatments day in day out (our hospital uses primarily metformin). So they have this “basal rate” of anti-diabetic medication, and if the meals result in higher blood sugar, (the range we use is 80 to 180 so above 180 and you get some insulin) then we give them an extra shot of insulin on top of the “scheduled” doses. We don’t alter their diet, we just give them more medication.

    For “cardiac” patients they are given a “cardiac” food tray. This means no saturated fat, no cholesterol, and very low fat in general (lunch and dinner comes with a low sodium V8, ha!). So now this is where is gets interesting.

    Our hospital recently released a journal article accessing program that sums up the general consensus of the medical journals about what is evidence-based practice. This is a fantastic idea in practice but contradictory science rears its ugly head.

    The section on diet says, “There is no evidence to suggest that diets high in fat and cholesterol cause cardiac disease. Evidence suggests that high carbohydrate/low fat diets can lead to lower HDL and higher triglycerides.” So why are we giving the patients a “cardiac” food tray that is high in carbs, low in fat? I asked the dieticians, and they demanded to see where I saw that. So I showed them(mind you this is information everyone at the hospital should be reviewing), low and behold they had no answer. So I continued reading through our journal article summaries.

    Next came the section on saturated fat (here is where it gets contradictory and just plain dumb). Suddenly in the saturated fat section, “A diet high in fat, primarily saturated fat, can cause cardiac disease.” Wait, one paragraph ago it said the opposite. Two journal articles were cited, one was a paper on feeding rats saturated fat, I skipped that one entirely, second was an article from the New England Journal of medicine that gave different diets to different individuals. As I was reading through the journal article, I saw that they increased the amount of carbohydrates in the diet by the same caloric amount of the type of fat given. How in the hell could this possibly prove anything? They are altering two different macronutrients???? Well as I read further, I found a section where they increased the amount of animal fat but nothing else, guess what was found? “Animal fat seems to have no adverse effects on cardiac health markers. HDL was increased, LDL remained the same or increased by a statistically insignificant amount, and triglycerides lowered.” So why would they conclude in their paper that saturated fats are bad. I found two reasons.

    They based this “adverse” outcome on the patients that increased both saturated fat and carbohydrates. The other is much more subtle. They lumped together saturated fats and trans fats because (their reasoning, not mine) “they usually occur together in foods and the results were statistically insignificant if saturated fat was tested on its own”. What. The. Hell. I thought I would share this bizarre experience. Keep fighting the fight Tom! Can’t wait for a book by you.

    Don’t go looking for consistency in those guidelines. You’ll end up banging your head on your desk.

    Reply
  23. LaurieLM

    Longitudinal studies: Maybe these are not clinical, only field studies, but they are ‘natural’ (by default, unintended) experiments and the last one I mention is the longest.

    Since the 1980’s and McGovern, low-fat, low-calorie, high-carb, semi-vegetarian.

    Since the 1970’s the commodification of HFCS and hydrogenated palm-kernal oil and altered coconut oil.

    1950’s invention of CAFOs and factory farming.

    Since the turn of the 20 th century, vegetable oils created to be drying agents for paint, putty and varnish industry, gain a hold in Crisco, margarines and touted to this day for their health benefits.

    ~130 years ago, vegetarians Post and Kellogg gave us breakfast cereals.

    ~5000 years ago give or take, the invention of bread.

    ~10,000 years ago the beneficial, but also risky discovery of agriculture.

    ~10 – 5 million years ago the exploitation of the miracle molecule cholesterol and it’s positive motive effect on the evolution of the human brain.

    ~ 1 billion to 750 million years ago beginning evolution of animals by the proto-animal discovery of proto-cholesterol. Up to that point, bacteria, fungi and plants predominated- none of which had or have to this day- cholesterol, nervous systems, brains. Nor do they have skeletons, muscles nor do they move or think.

    Grains, sugars, cereals and man-made vegetable oils have no place in the human diet. There is no nutritional requirement for any of it to any human. We CAN process that stuff, but eating any of it, even one gram, replaces, displaces, is instead of the nutrition we need for robust health and higher order, high-performance, excellent brain function. Animal fat, cholesterol and animal protein is all that is required.

    Reply
  24. guinea pig

    Hi Tom
    I have to say i this blog is amazing and your documentary really helped me take a second look at low carb after trying and failing atkins previously after doing it wrong(i didnt eat enough fat and didnt eat often enough so my blood sugar fell very low and i gave up).

    Correct me if im wrong but i think i found another article in diabetes health from 2007 which promotes low carb and is the exact opposite of the article by warshaw.Here’s the link:

    http://www.diabeteshealth.com/read/2007/04/24/5143/why-eating-too-many-carbs-makes-you-fat/

    Well, let’s give them credit for airing different views.

    Reply
  25. Tim

    Tom, if you bang your head against your desk any more, you’ll get one hell of a splitting headache! 😉

    The good news is lent my doctor Fat Head and he didn’t totally dismiss it. He agrees that high carbs are bad but still doesn’t recommend high fat intake.

    Some progress at least 🙂

    It’s a start.

    Reply
  26. Homer

    This kind of sort of relates. So at the hospital I work at we serve different patients, different diets. For diabetics we give them varying amounts of carbohydrates per meal (45g to 80g per meal) based on their weight and insulin use (interesting thinking there). This logic is based on this stupid graph that assumes all diabetics should be on oral treatments day in day out (our hospital uses primarily metformin). So they have this “basal rate” of anti-diabetic medication, and if the meals result in higher blood sugar, (the range we use is 80 to 180 so above 180 and you get some insulin) then we give them an extra shot of insulin on top of the “scheduled” doses. We don’t alter their diet, we just give them more medication.

    For “cardiac” patients they are given a “cardiac” food tray. This means no saturated fat, no cholesterol, and very low fat in general (lunch and dinner comes with a low sodium V8, ha!). So now this is where is gets interesting.

    Our hospital recently released a journal article accessing program that sums up the general consensus of the medical journals about what is evidence-based practice. This is a fantastic idea in practice but contradictory science rears its ugly head.

    The section on diet says, “There is no evidence to suggest that diets high in fat and cholesterol cause cardiac disease. Evidence suggests that high carbohydrate/low fat diets can lead to lower HDL and higher triglycerides.” So why are we giving the patients a “cardiac” food tray that is high in carbs, low in fat? I asked the dieticians, and they demanded to see where I saw that. So I showed them(mind you this is information everyone at the hospital should be reviewing), low and behold they had no answer. So I continued reading through our journal article summaries.

    Next came the section on saturated fat (here is where it gets contradictory and just plain dumb). Suddenly in the saturated fat section, “A diet high in fat, primarily saturated fat, can cause cardiac disease.” Wait, one paragraph ago it said the opposite. Two journal articles were cited, one was a paper on feeding rats saturated fat, I skipped that one entirely, second was an article from the New England Journal of medicine that gave different diets to different individuals. As I was reading through the journal article, I saw that they increased the amount of carbohydrates in the diet by the same caloric amount of the type of fat given. How in the hell could this possibly prove anything? They are altering two different macronutrients???? Well as I read further, I found a section where they increased the amount of animal fat but nothing else, guess what was found? “Animal fat seems to have no adverse effects on cardiac health markers. HDL was increased, LDL remained the same or increased by a statistically insignificant amount, and triglycerides lowered.” So why would they conclude in their paper that saturated fats are bad. I found two reasons.

    They based this “adverse” outcome on the patients that increased both saturated fat and carbohydrates. The other is much more subtle. They lumped together saturated fats and trans fats because (their reasoning, not mine) “they usually occur together in foods and the results were statistically insignificant if saturated fat was tested on its own”. What. The. Hell. I thought I would share this bizarre experience. Keep fighting the fight Tom! Can’t wait for a book by you.

    Don’t go looking for consistency in those guidelines. You’ll end up banging your head on your desk.

    Reply
  27. Tim

    Tom, if you bang your head against your desk any more, you’ll get one hell of a splitting headache! 😉

    The good news is lent my doctor Fat Head and he didn’t totally dismiss it. He agrees that high carbs are bad but still doesn’t recommend high fat intake.

    Some progress at least 🙂

    It’s a start.

    Reply
  28. Peggy Holloway

    How about just having her read every study referenced in “GCBC,” “Why we get fat,” and the Phinney/Volek “The Art and Science of Low-Carbohydrate Living?”
    That should give her plenty of reading material.

    She doesn’t need those … she’s got the USDA recommendations to back her up.

    Reply
  29. Peggy Holloway

    How about just having her read every study referenced in “GCBC,” “Why we get fat,” and the Phinney/Volek “The Art and Science of Low-Carbohydrate Living?”
    That should give her plenty of reading material.

    She doesn’t need those … she’s got the USDA recommendations to back her up.

    Reply
  30. Ketotic

    In case you are interested in more scientific literature on the subject:

    More than 2 years:

    http://www.ncbi.nlm.nih.gov/pubmed/16652223

    http://www.ncbi.nlm.nih.gov/pubmed/17447017

    Ketogenic Diet vs. Low fat + Orlistat:

    http://www.ncbi.nlm.nih.gov/pubmed/20101008

    Even with 30% of carbs:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923629/?report=abstract

    More research:

    http://www.ncbi.nlm.nih.gov/pubmed/21688989

    Always interested in more research. Thanks for the links.

    Reply
  31. Dave P

    Well played sir !!! Nice tactic ……….. if my evidence is rubbish, please show me yours 🙂
    Maybe there arnt any long term studies (possibly cos they dont want them ) but might it not be a good idea to record how long peeps have been on this lifestyle ….. successfully !!
    For me its since Feb 2007, when i was almost 20 stone ( again ) and looking at going onto insulin. Now almost 3.5stone lighter and holding close to normal blood sugars .

    Sorry to say havnt seen the film yet but it is on the “to do” list

    No worries. You’ll see the film sometime.

    Reply
  32. Ketotic

    In case you are interested in more scientific literature on the subject:

    More than 2 years:

    http://www.ncbi.nlm.nih.gov/pubmed/16652223

    http://www.ncbi.nlm.nih.gov/pubmed/17447017

    Ketogenic Diet vs. Low fat + Orlistat:

    http://www.ncbi.nlm.nih.gov/pubmed/20101008

    Even with 30% of carbs:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923629/?report=abstract

    More research:

    http://www.ncbi.nlm.nih.gov/pubmed/21688989

    Always interested in more research. Thanks for the links.

    Reply
  33. Dave P

    Well played sir !!! Nice tactic ……….. if my evidence is rubbish, please show me yours 🙂
    Maybe there arnt any long term studies (possibly cos they dont want them ) but might it not be a good idea to record how long peeps have been on this lifestyle ….. successfully !!
    For me its since Feb 2007, when i was almost 20 stone ( again ) and looking at going onto insulin. Now almost 3.5stone lighter and holding close to normal blood sugars .

    Sorry to say havnt seen the film yet but it is on the “to do” list

    No worries. You’ll see the film sometime.

    Reply
  34. Scott

    And then I see this article on my RSS Feeds today

    FDA warns about new diabetes pill risks: http://www.msnbc.msn.com/id/43768077/ns/health-diabetes/

    The drugs sound more damaging than the disease! What enrages me more though is the recommendation that the government take kids away from their families because the kid is obese … yet, the kids are obese because the parents have done what the government TOLD THEM TO DO! http://www.upnorthlive.com/news/story.aspx?id=640419

    The drug is worse than the disease … sounds like statins.

    Reply
  35. Scott

    And then I see this article on my RSS Feeds today

    FDA warns about new diabetes pill risks: http://www.msnbc.msn.com/id/43768077/ns/health-diabetes/

    The drugs sound more damaging than the disease! What enrages me more though is the recommendation that the government take kids away from their families because the kid is obese … yet, the kids are obese because the parents have done what the government TOLD THEM TO DO! http://www.upnorthlive.com/news/story.aspx?id=640419

    The drug is worse than the disease … sounds like statins.

    Reply
  36. Walter B

    Replying to Scott (July 15)

    Hey, perhaps the child would be better off would be parents aware enough not to take advice (especially nutritional advice) from the government.

    Reply
  37. Walter B

    Replying to Scott (July 15)

    Hey, perhaps the child would be better off would be parents aware enough not to take advice (especially nutritional advice) from the government.

    Reply
  38. Derek

    Tom, whats the deal with cooking with Peanut Oil? is it as bad as all the other proccessed oils? and how about Olive Oil? thanks.

    Olive oil and peanut oils are natural oils that don’t require chemical extraction. According to Dr. Mary Enig, author of “Know Your Fats,” it’s best to avoid consuming large quantities of peanut oil because it can produce inflammation. But it’s fine in smaller quantities.

    Reply
  39. Derek

    Tom, whats the deal with cooking with Peanut Oil? is it as bad as all the other proccessed oils? and how about Olive Oil? thanks.

    Olive oil and peanut oils are natural oils that don’t require chemical extraction. According to Dr. Mary Enig, author of “Know Your Fats,” it’s best to avoid consuming large quantities of peanut oil because it can produce inflammation. But it’s fine in smaller quantities.

    Reply
  40. Rebecca Foxworth

    Hmmm. Who publishes “Diabetes Health”? I don’t remember what diabetes magazine was given to me when I was diagnosed as gestational diabetic years ago, I only remember that it was published by Eli Lilly. I remember thinking at the time, “Why would a company that makes gazillions off diabetes medicines and insulin publish a magazine helping people control their diabetes through diet?” Turns out they didn’t.

    Follow the money.

    Reply
  41. Rebecca Foxworth

    Hmmm. Who publishes “Diabetes Health”? I don’t remember what diabetes magazine was given to me when I was diagnosed as gestational diabetic years ago, I only remember that it was published by Eli Lilly. I remember thinking at the time, “Why would a company that makes gazillions off diabetes medicines and insulin publish a magazine helping people control their diabetes through diet?” Turns out they didn’t.

    Follow the money.

    Reply
  42. Patrick Narkinsky

    I know this is an old thread, but I wonder whether Ms. Warshaw has responded to this study, published in Nutrition in July.

    Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base.
    http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext

    The authors (including Dr. B) provide a comprehensive set of references to peer-reviewed studies supporting each of their twelve points. Maybe I’ll email her and ask. 🙂

    Reply
  43. Patrick Narkinsky

    I know this is an old thread, but I wonder whether Ms. Warshaw has responded to this study, published in Nutrition in July.

    Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base.
    http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext

    The authors (including Dr. B) provide a comprehensive set of references to peer-reviewed studies supporting each of their twelve points. Maybe I’ll email her and ask. 🙂

    Reply
  44. Rachel

    Tom,

    You picked up on some of the VERY things I pointed out too! I totally agree with you, and I also provided my own resources for low-carb effectiveness in combatting diabetes! I also pointed out that serious flaw of hers in which she did not cite any of those “countless studies” and did not back up her “facts”! I just get so annoyed at things like this…the logical fallacies in her article were numerous and could contribute to dangerous situations! You can visit my response on my blog if you want (since my comments didn’t make it on her article either!): http://alternefit.wordpress.com/2011/07/07/credit-where-credit-is-due-and-discredit-where-it-is-due-as-well/

    Good piece, but in my browser the paragraphs are breaking at odd places.

    Reply

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