Medicating the Unborn

      90 Comments on Medicating the Unborn

Just when I think the medical profession can’t sink any lower, it digs a trench a climbs in.

My previous post was about a new study claiming that surgery reverses diabetes more effectively than diet and drugs – the only problem, of course, was that the diet was the American Diabetes Association’s high-carbohydrate diet.  The study was set up to produce a better outcome for surgery.  That’s sinking pretty low.

Now here’s the new low:  Researchers are giving a diabetes drug to pregnant women, essentially drugging their unborn babies, in an attempt to prevent the babies from becoming obese.  Here are some quotes from an article in the U.K. Daily Mail:

In a world first, dangerously overweight mothers-to-be in four British cities have started taking a diabetes drug during their pregnancy. The doctors behind the controversial NHS trial say that obesity among pregnant women is reaching epidemic proportions and they need to act now to protect the health of tomorrow’s children.

Yes, they do need to act now.  They could start by telling pregnant women that the Eat Well Plate (the UK’s version of our USDA Food Plate) is a crock of @#$%.  Here’s what the official Eat Well site recommends:

  • Plenty of fruit and vegetables
  • Plenty of potatoes, bread, rice, pasta and other starchy foods
  • Some milk and dairy foods
  • Some meat, fish, eggs, beans and other non-dairy sources of protein
  • Just a small amount of foods and drinks high in fat and/or sugar

So you’re an obese, insulin-resistant British mom-to-be, and you follow the Eat Well guidelines by eating plenty of fruit, plenty of starchy foods, and just a bit of meat and dairy.  Great.  You just sent your blood sugar through the roof.

I swear, every time I see these government goofballs put fat and sugar into the same category, I want to kidnap two of them, stuff a pound of sugar down one’s throat and a pound of lard down the other’s, then have them compare notes on the effects.  They might notice a slight difference.

However, there is likely to be unease about resorting to medication in pregnancy for a problem that can be treated through changes in diet and exercise.

Yes, this problem can be treated through changes in diet.  But not if the diet consists of plenty of fruit and plenty of potatoes, bread, rice, pasta and other starchy foods.

If the strategy is a success, the treatment could be in widespread use in as little as five years, with tens of thousands of overweight but otherwise healthy mothers-to-be drugged each year.

This will be a boon not just for the pharmaceutical industry, but for the paper industry as well.  Doctors will be going through prescription pads like crazy.

The Daily Mail recently revealed the rise of the ‘sumo baby’, with the number of newborns weighing more than 11lb soaring by 50 per cent over the last four years.

Remember the days when a big baby was considered a healthy baby?  Not anymore.  Now more and more babies are big because they’ve already been biochemically programmed to become obese.

The trial involves 400 pregnant women in Liverpool, Coventry, Sheffield and Edinburgh. They have started taking metformin, which has been safely used by diabetics for decades and is cleared for the treatment of diabetes in pregnancy. It costs just pence per tablet.

Okay, maybe not a huge boon to the pharmaceutical industry.  But tens of thousands of prescriptions will still add up to a tidy profit.

The study aims to exploit the ability of metformin to lower levels of the hormone insulin in the bloodstream. Obese women make more insulin than other mothers-to-be and this leads to a greater nutrition supply reaching the baby. It is hoped that lowering levels of insulin will reduce the supply and so cut the odds of babies being born obese.

What, they’re blaming high levels of insulin?  No, no, no .. insulin has nothing to do with becoming obese.  Just ask all those people who are calling Gary Taubes an idiot on their blogs.  The problem here is food reward.  The moms are eating too much palatable food, so their babies are sitting there in the womb thinking, “Dang, that’s good stuff!  Salty, sweet, fatty … delicious!  I’m going to open the spigot on my feeding tube and have another couple of servings!”

Study leader Professor Jane Norman of Edinburgh University said: ‘One of the challenges is that many women feel perfectly healthy but there is very good evidence that women who are obese have an increased risk of pregnancy problems and their babies are at risk, and we’d like to reduce that risk.’

Addressing concerns about unborn babies being medicated for a problem that many would say could be treated by diet and exercise, she said: ‘I absolutely support the improvement of diet and encouraging exercise. ‘But we are increasingly faced with women who start their pregnancy obese. Saying at that stage to eat less and exercise more is not particularly helpful.’

No, we shouldn’t be telling pregnant women to eat less.  We should be telling them to eat differently.  We should be telling them to adopt a diet that doesn’t pump their unborn babies full of insulin.  Giving pregnant women a drug to beat down their glucose and insulin levels when switching to a low-carb, high-fat diet will accomplish the same goal is just nuts.

 

p.s. — I apologize for going all day without checking comments.  I was juggling projects and just now got around to it.

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90 thoughts on “Medicating the Unborn

  1. js290

    Food reward is a specious explanation of the Conservation of Energy, which as a Law of Science must absolutely hold true, but is often confused as a cause rather than correctly as an effect. People who still talk about energy balance as it relates to metabolism obviously do not understand science nor do they offer any useful insights into metabolism.

    Exactly. We don’t explain an overflowing toilet by saying it’s taking in more water than it’s flushing out.

    Reply
  2. Davida

    I am type 2 diabetic and take metformin sometimes (right now I’m taking the herbal version, because it is a known galactogogue.) I have elevated blood sugar often even when I eat very low carb….not NEARLY as high as when I eat “normal”, but still elevated. Metformin seems to act in two ways: to make the cells more sensitive to insulin and to slow the creation of glucagon. It also reduces fatty liver. It normalized my hormones enough so that I got pregnant after 15 years without pregnancy due to PCOS. It did not work like that when I was eating a “diabetic’s” diet, but only when going low carb (low carb by itself did not work either…it wasn’t til the two were put together that things started straightening out.) If there are some diabetic/obese women who just cannot seem to change their diet at first metformin may be able to help til they are able to. It isn’t without risks… B12 deficiency is common, and if a person’s digestive system doesn’t do well on it, it can lead to other deficiencies. It can be a tool if there are multiple issues going on, etc. It should not, however, be pushed to every overweight pregnant woman out there, like statins are to….well, everyone. I’m not sure exactly how strong the link to superhuge babies is with obesity either. Is it a “slight increase”, “moderate increase”, or “major increase” in the numbers of huge babies born to overweight mothers? I would be considered obese, as would my sister. My one-year-old was 6 lbs 10 oz, and that was included the extra weight from iv fluids used in the c-section. My sister’s 4 month old was 7 1/2 lbs. Anectdotal, i know, but I know of many more overweight women with low and normal weight babies. Pushing drugs may just stress the women out….

    Some people need the drugs, no matter what diet they’re on. But drugs should always be the last resort.

    Reply
  3. Katy

    I was overweight when I discovered I was pregnant in 1975, and decided to eliminate starchy foods, bread, etc., and just eat protein, vegetables, milk, and some fruit. At the hospital prior to delivery, I weighed what I did when 9 months earlier. Three days later at home, I had lost 25 lbs., and had a healthy baby girl. I understand the mandate to not “diet” when pregnant, but as you said, overweight women can eat differently and have healthful outcomes. Also, chronic low blood sugar can damage the baby’s brain.

    Pregnant women shouldn’t have to go hungry. They just need the right diet — and so does the baby.

    Reply
  4. gollum

    A German poster at

    http://www.dasgelbeforum.de.org/forum_entry.php?id=252463

    claims pregnant women are being aggressively checked for gestational diabetes and if they fail the OGTT, put on near-starvation diet [That’s my term, not his – the usual whole bread, veggies, tiny amounts of meat etc., rationed, not ad lib!] and failing that, insulin. Goal to keep birth weight down [literally]. Poster is not sure how to see good motive behind this. Poster mentions doctors being evasive/defensive to critical questions (literally, “blocking”).

    Well, it is certainly nice that they are actually checking for gestation diabetes – I mean, I was literally born fat (by sight and documented weight), and no one seemed to care (though I do not know whether g.d. was tested for), though there were certainly lots of “fattie” and “exercise more” comments; gee thank you.

    However, strict dieting while pregnant – I mean, you certainly can imagine my comment; and with the insulin, I am not sure whether that fixes more than it damages; would have to look up fetal metabolism but the insulin is acting on the fetus too, right?

    That’s nuts. With the right diet, there’s no need for pregnant women to go hungry.

    Reply
  5. Joey

    Oh man, that’s just sick. Now the pharmaceutical industry is trying to get people on a lifetime of meds before they’re even born!

    By the way, Tom, I get the feeling that you’re pretty adverse to fruit. What gives? I eat a lot of fruit, especially during spring and summertime but I never have a problem with it. From time to time I live only on fruit and it just gives me a lot of energy without getting cravings or energy dips.

    Some fruit in the diet is good. But if you’re insulin resistant and filling up your plate with fruit (which the government goofs put in the same category as vegetables) and starches, it’s just too much glucose-producing food.

    Reply
  6. Sahanya

    You are so right. I am pregnant, I got pregnancy diabetes and I changed my diet to a low-carb diet AGAINST the recommondations of the doctors.

    Every time I have an apointment with the doctors, which is every 3 weeks, I have to fight/argue with them. On the one hand they have to admit that my blood values are excellent, but on the other hand they critizize my diet and constantly tell me to eat more carbohydrates!

    They are telling me that I will get fat, although fact is that I lost a total of 2 kg during my pregnancy so far and Im now in my 32 week!

    I feel excellent and will stick to a low-carb diet also after the pregnancy. I´m not obese but overweight, so I hope to loose those remaining extrakilos.

    It´s a shame that a lot of doctors are so ignorant and I´m glad I´m in the situation to inform myself.

    How’s that for logic? Your results are great, but we want you to stop doing what’s producing those results.

    Reply
  7. js290

    Food reward is a specious explanation of the Conservation of Energy, which as a Law of Science must absolutely hold true, but is often confused as a cause rather than correctly as an effect. People who still talk about energy balance as it relates to metabolism obviously do not understand science nor do they offer any useful insights into metabolism.

    Exactly. We don’t explain an overflowing toilet by saying it’s taking in more water than it’s flushing out.

    Reply
  8. Davida

    I am type 2 diabetic and take metformin sometimes (right now I’m taking the herbal version, because it is a known galactogogue.) I have elevated blood sugar often even when I eat very low carb….not NEARLY as high as when I eat “normal”, but still elevated. Metformin seems to act in two ways: to make the cells more sensitive to insulin and to slow the creation of glucagon. It also reduces fatty liver. It normalized my hormones enough so that I got pregnant after 15 years without pregnancy due to PCOS. It did not work like that when I was eating a “diabetic’s” diet, but only when going low carb (low carb by itself did not work either…it wasn’t til the two were put together that things started straightening out.) If there are some diabetic/obese women who just cannot seem to change their diet at first metformin may be able to help til they are able to. It isn’t without risks… B12 deficiency is common, and if a person’s digestive system doesn’t do well on it, it can lead to other deficiencies. It can be a tool if there are multiple issues going on, etc. It should not, however, be pushed to every overweight pregnant woman out there, like statins are to….well, everyone. I’m not sure exactly how strong the link to superhuge babies is with obesity either. Is it a “slight increase”, “moderate increase”, or “major increase” in the numbers of huge babies born to overweight mothers? I would be considered obese, as would my sister. My one-year-old was 6 lbs 10 oz, and that was included the extra weight from iv fluids used in the c-section. My sister’s 4 month old was 7 1/2 lbs. Anectdotal, i know, but I know of many more overweight women with low and normal weight babies. Pushing drugs may just stress the women out….

    Some people need the drugs, no matter what diet they’re on. But drugs should always be the last resort.

    Reply
  9. Katy

    I was overweight when I discovered I was pregnant in 1975, and decided to eliminate starchy foods, bread, etc., and just eat protein, vegetables, milk, and some fruit. At the hospital prior to delivery, I weighed what I did when 9 months earlier. Three days later at home, I had lost 25 lbs., and had a healthy baby girl. I understand the mandate to not “diet” when pregnant, but as you said, overweight women can eat differently and have healthful outcomes. Also, chronic low blood sugar can damage the baby’s brain.

    Pregnant women shouldn’t have to go hungry. They just need the right diet — and so does the baby.

    Reply
  10. Tammy

    Tom – I commend you for all your work. I see articles like this pretty much everyday too and all I can do is shake my head. Sometimes it seems pretty overwhelming. Thanks Again !!

    Reply
  11. Auntie M

    Sigh. I’m one of the people who needs to take metformin at the beginning of a pregnancy because of my PCOS. I took it in the first trimester, while eating my low carb menu and doing insulin shots, because my body goes nuts when I’m pregnant. With PCOS, the miscarriage rate is about 70% for women who don’t take metformin. At least that’s according to my endocrinologist. They didn’t seem to want me on it after the first trimester, though. One of the docs said it was “probably” fine, but I was under good sugar control, so I didn’t need it.

    Reply
  12. Auntie M

    Also, I’m sick of being maligned by the medical community for my weight as though I’m fat on purpose. I’m overweight BECAUSE of my insulin resistance, not the other way around. I was in my late 20s before I discovered that the high-carb, low-fat way was making me sick. I’m still fighting to fix those problems at age 37.

    I swear the word “obese” was written on my medical discharge papers after my baby was born at least three times, but “diabetes”, “high blood pressure”, and “preeclampsia” were mentioned once each, and PCOS wasn’t even on there. Cart before the horse, anyone?

    They definitely get the cause-and-effect backwards.

    Reply
  13. Mike P.

    My wife, who is completely normal in terms of health and fitness, got gestational diabetes during the pregnancy of our second son. She met with the nutritionist to learn how to test her blood sugar, how to eat an ADA diet, etc. She goes home, eats the diet, tracks her food, her blood sugar skyrockets, and she can’t maintain the blood sugar levels recommended by the nutritionist. We were not Paleo/Primal/LC at the time, but I was in the middle of reading the Primal Blueprint and GCBC. A week or two of uncontrollable blood sugar is enough to order up insulin shots for a pregnant mother. My wife was über-determined to not take insulin shots. So she started looking at her food log and figuring out what foods raised her blood sugar and which ones didn’t. By this time, I’m all on board for a Primal lifestyle. Having gone through that personal experience, she was on board too. The sad thing is that when she showed the nutritionist the diet log and the resulting good blood sugar numbers, the nutritionist was upset she wasn’t following the diet. So my wife continued to eat what she knew would work and just lied to the nutritionist for the remainder of the pregnancy. Subsequently, our son has a metabolism off the charts. He is only 2, but he eats almost as much as our 5 yr old, has endless energy, and is lean. He is programmed for a lean body because of how my wife ate during the pregnancy.

    Sorry for the long comment but this story hit home for me. It’s scary what new “treatments” doctors are coming up with. What ever happened to preventative medicine?

    Keep up the great work Tom!

    Mike

    No apologies necessary for the long comment. It’s a compelling story.

    Reply
  14. Anne

    “I swear, every time I see these government goofballs put fat and sugar into the same category, I want to kidnap two of them, stuff a pound of sugar down one’s throat and a pound of lard down the other’s, then have them compare notes on the effects. They might notice a slight difference.”

    Note to all govt bureaucrats – If two of your “friends” mysteriously disappear after the release of some stupid nutritional study, you know where to look. 😉

    ((It made me laugh as I’ve thought the exact same thing many times!))

    I hope a couple of USDA bureaucrats don’t disappear anytime soon. I’d be a suspect.

    Reply
  15. Isabel

    I do have to say, that metformin’s impact on insulin resistance allows many women with Poly Cystic Ovarian Syndrome to become pregnant. I had been taking Metformin for years (for the PCOS, not diabetes) when I became pregnant with my second child. I continued to take it during my pregnancy because I acquired gestational diabetes and was able to manage the GD with the metformin and a low carb diet of about 100 carbs per day. I lost 20 lbs during my pregnancy and never had to take any insulin. My daughter weighed the same as my older son did at birth, but I can definitely see a difference in her physical structure. While my son has been ‘chunky’ all his life (I suspect that I had GD during his development, which was uncontrolled by either medication or diet), my daugher is much slimmer.

    I agree that a mother’s insulin and glucose levels during pregnancy can impact their child’s predisposition for insulin resistance and obesity, but I disagree with giving metformin to healthy mothers. Rather, I think that women should lose the mindset that they can gain 40, 50 or 100 lbs during pregnancy. They are not only setting them selves up to never lose the additional weight, but they are impacting their child’s health. Also, huge weight gain during pregnancy will almost certainly guarantee undiagnosed and untreated GD in the last few months of pregnancy. What I would like to see is a study showing weight gain during pregnancy compared to the childs weight at birth, 2yrs old, 10 yrs old, etc…

    I was lucky to have a great gestational endocrinologist who did not endorse the “eat carbs, take insulin” strategy that the ADA seems to recommend. I followed a strict diet, ate according to my meter (glucose levels 7 times a day!), and learned exactly what a low carb diet can do for my body.
    Yes, my weight goes up and down, but I have managed to lose 100 lbs and can keep it off as long as I stay on a low carb diet. I am now off the metformin (A1c of 5.3), but I already know that I will resume it when I want to get pregnant again.

    Some people need metformin, even if they’re on a low-carb diet. But the drugs-first mentality drives me nuts. It should be a low-carb diet first, then drugs if and only if eliminating the foods that spike glucose levels isn’t enough.

    Reply
  16. gollum

    A German poster at

    http://www.dasgelbeforum.de.org/forum_entry.php?id=252463

    claims pregnant women are being aggressively checked for gestational diabetes and if they fail the OGTT, put on near-starvation diet [That’s my term, not his – the usual whole bread, veggies, tiny amounts of meat etc., rationed, not ad lib!] and failing that, insulin. Goal to keep birth weight down [literally]. Poster is not sure how to see good motive behind this. Poster mentions doctors being evasive/defensive to critical questions (literally, “blocking”).

    Well, it is certainly nice that they are actually checking for gestation diabetes – I mean, I was literally born fat (by sight and documented weight), and no one seemed to care (though I do not know whether g.d. was tested for), though there were certainly lots of “fattie” and “exercise more” comments; gee thank you.

    However, strict dieting while pregnant – I mean, you certainly can imagine my comment; and with the insulin, I am not sure whether that fixes more than it damages; would have to look up fetal metabolism but the insulin is acting on the fetus too, right?

    That’s nuts. With the right diet, there’s no need for pregnant women to go hungry.

    Reply
  17. Joey

    Oh man, that’s just sick. Now the pharmaceutical industry is trying to get people on a lifetime of meds before they’re even born!

    By the way, Tom, I get the feeling that you’re pretty adverse to fruit. What gives? I eat a lot of fruit, especially during spring and summertime but I never have a problem with it. From time to time I live only on fruit and it just gives me a lot of energy without getting cravings or energy dips.

    Some fruit in the diet is good. But if you’re insulin resistant and filling up your plate with fruit (which the government goofs put in the same category as vegetables) and starches, it’s just too much glucose-producing food.

    Reply
  18. Sahanya

    You are so right. I am pregnant, I got pregnancy diabetes and I changed my diet to a low-carb diet AGAINST the recommondations of the doctors.

    Every time I have an apointment with the doctors, which is every 3 weeks, I have to fight/argue with them. On the one hand they have to admit that my blood values are excellent, but on the other hand they critizize my diet and constantly tell me to eat more carbohydrates!

    They are telling me that I will get fat, although fact is that I lost a total of 2 kg during my pregnancy so far and Im now in my 32 week!

    I feel excellent and will stick to a low-carb diet also after the pregnancy. I´m not obese but overweight, so I hope to loose those remaining extrakilos.

    It´s a shame that a lot of doctors are so ignorant and I´m glad I´m in the situation to inform myself.

    How’s that for logic? Your results are great, but we want you to stop doing what’s producing those results.

    Reply
  19. NM

    I enjoyed your swipe at those who attack Taubes and think that “palatability” and “food reward” explain everything. Those who think that it explains anything need to look up the logical meaning of “begging the question”: another word for “hyper-palatable” is “insatiaitng”, if you think about it. And what is it about sweet, simple carbs in particular that makes them just so constantly palatable without ever *satisfying* said palate? In the end, the proponents of food reward simply say that palatable food is rewarding because it is palatable. Gee. Thanks.

    Even if Taubes’s thesis has gaps and needs refining, at least it is a thesis that doesn’t simply chase its own tail!

    I don’t doubt that certain combinations of flavors encourage us to eat more — that’s what food-industry scientists are paid to figure out — but some people are assuming that if palatability explains some cases of over-eating, it must be the whole ball of wax when it comes to obesity. As Dr. Lustig pointed out when I interviewed him, gluttony can’t explain the rise in the number of obese babies.

    Reply
  20. Beowulf

    It’s amazing how entrenched the LF dogma is, as is the “Healthy Whole Grains” mantra. They are valued by the medical system to the point that adhering to that regimen is more important that actual health.

    They just can’t shake the belief that fat is bad for us, so therefore our diets should be mostly carbohydrates.

    Reply
  21. Tammy

    Tom – I commend you for all your work. I see articles like this pretty much everyday too and all I can do is shake my head. Sometimes it seems pretty overwhelming. Thanks Again !!

    Reply
  22. bigmyc

    But ah…’taking’ drugs when a proper (natural) diet will do even better IS nuts.
    ‘Prescribing’ drugs when a proper diet will do even better is profitable.

    The idiot circus has no shortage of clowns in the medical/health field but those ringleaders know exactly what is up. You could go ahead and group them with the “conscientious non-cognizants” of Wall Street, Pesticide manufacturers, Military Contractors, Grain and Soy Agro and the like, et al.

    Reply
  23. Joe Lindley

    Great article Tom! While agreeing with what you say, my question is for the obese mother-to-be that either refuses to diet/exercise or who is forced into the high carb diet mentioned here that won’t work. Is it better for her to take the Metformin? We are focused on the overarching diet issue, but what about those pregnant women who are going to go to term with gestational diabetes?

    In that case, they probably need the drug. But if pregnant women were told to avoid sugars and starches, a lot fewer would develop diabetes.

    Reply
  24. Jen

    In general it is a bad idea to hand out drugs indiscriminately, but metformin is quite possibly one of the most beneficial and least dangerous drugs in existence. At least it will partially mitigate the effects of the unhealthy diet prescribed along with it.

    Sure, some people need metformin. But if we dumped the high-carb diets first, far fewer people would need a drug.

    Reply
  25. Cor Aquilonis

    Yeah, right; hyper-palatability is crap. Compare my last night’s dinner of homemade-from-scratch cocktail shrimp and cocktail sauce (less than 1T, from homemade low-sugar ketchup), plus wedge salad with Roquefort dressing and strawberries and cream with what I used to eat before low carb: veggie pizza, vegetables, chips and sweets.

    I assure you, last night’s dinner was far more palatable than the high carb meal, yet I was able to be far more satisfied on fewer calories, and felt better after eating it. I think your term of “insatiating” is far more useful and descriptive than “hyper-palatable.”

    PS – I got “Nourishing Traditions” by Sally Fallon after you mentioned it on your blog, and thank you for the tip! It’s where I got the ketchup recipe – I will never have store ketchup again. Homemade is so, so tastier.

    I believe the food reward idea makes sense in that some foods — sugar and wheat, for example — produce a cocaine-like effect in the brain. But I don’t believe mere palatability causes over-eating. Like you, I enjoy delicious meals without feeling any desire to stuff myself.

    Reply
  26. Joe Dokes

    Finally ordered Fat Head and your other DVDs and watched Fat Head with my wife. My wife was / is a constant yo-yo dieter (of course she was following traditional low fat high carb diets).

    At the end of the movie my wife exclaimed, “This is the exact opposite of everything I’ve ever heard.” I responded, “Yeah and that’s why you haven’t been able to lose weight and keep it off.”

    By the way, I liked the movie, not much new information to me as I’m a frequent reader of your blog and have read Taube’s GCBC. The absolute best part was when you went back to your doctor and had your weight and cholesterol checked. The incredulous look on his face when your cholesterol and weight numbers were lower.

    I think the look on his face, and the fact that he couldn’t believe the results showed how much education needs to take place. The above post also shows the level of education that needs to take place. Recommending a high carbohydrate diet to a diabetic is criminal.

    Keep up the good work.

    Regards,

    Joe Dokes

    The doctor’s reaction was priceless. So glad we caught that on camera.

    Reply
  27. Auntie M

    Sigh. I’m one of the people who needs to take metformin at the beginning of a pregnancy because of my PCOS. I took it in the first trimester, while eating my low carb menu and doing insulin shots, because my body goes nuts when I’m pregnant. With PCOS, the miscarriage rate is about 70% for women who don’t take metformin. At least that’s according to my endocrinologist. They didn’t seem to want me on it after the first trimester, though. One of the docs said it was “probably” fine, but I was under good sugar control, so I didn’t need it.

    Reply
  28. Auntie M

    Also, I’m sick of being maligned by the medical community for my weight as though I’m fat on purpose. I’m overweight BECAUSE of my insulin resistance, not the other way around. I was in my late 20s before I discovered that the high-carb, low-fat way was making me sick. I’m still fighting to fix those problems at age 37.

    I swear the word “obese” was written on my medical discharge papers after my baby was born at least three times, but “diabetes”, “high blood pressure”, and “preeclampsia” were mentioned once each, and PCOS wasn’t even on there. Cart before the horse, anyone?

    They definitely get the cause-and-effect backwards.

    Reply
  29. Dave, RN

    Wow. Lots of PCOS here. Google “PCOS and iodine”. You probably don’t have enough iodine in your body. All those halides (flouride and bromine) in our water and bread displace iodine. Used to be that each slice of bread had 100 mcg of iodine, until they substituted bromine (basically a poison) for the iodine. Lots of bromine in hair coloring as well.
    It’s a big subject. I think the book “Iodine, Why You Need it and Can’t Live Without It” is as important as “Good Calories, Bad Calories”, or “The Primal BluePrint”. Or “FateHead” even. 🙂
    Look at it enough and you’ll get as disgusted at the iodine issue as you do with other Conventional Wisdom issues. Maybe more so.

    Reply
  30. Mike P.

    My wife, who is completely normal in terms of health and fitness, got gestational diabetes during the pregnancy of our second son. She met with the nutritionist to learn how to test her blood sugar, how to eat an ADA diet, etc. She goes home, eats the diet, tracks her food, her blood sugar skyrockets, and she can’t maintain the blood sugar levels recommended by the nutritionist. We were not Paleo/Primal/LC at the time, but I was in the middle of reading the Primal Blueprint and GCBC. A week or two of uncontrollable blood sugar is enough to order up insulin shots for a pregnant mother. My wife was über-determined to not take insulin shots. So she started looking at her food log and figuring out what foods raised her blood sugar and which ones didn’t. By this time, I’m all on board for a Primal lifestyle. Having gone through that personal experience, she was on board too. The sad thing is that when she showed the nutritionist the diet log and the resulting good blood sugar numbers, the nutritionist was upset she wasn’t following the diet. So my wife continued to eat what she knew would work and just lied to the nutritionist for the remainder of the pregnancy. Subsequently, our son has a metabolism off the charts. He is only 2, but he eats almost as much as our 5 yr old, has endless energy, and is lean. He is programmed for a lean body because of how my wife ate during the pregnancy.

    Sorry for the long comment but this story hit home for me. It’s scary what new “treatments” doctors are coming up with. What ever happened to preventative medicine?

    Keep up the great work Tom!

    Mike

    No apologies necessary for the long comment. It’s a compelling story.

    Reply
  31. Brad C. Hodson

    Really? Shooting pregnant women full of drugs is preferable to having them eat less suagr? Wow. And I thought we had already seen the bottom level of idiocy. It seems like the “experts” are armed with shovels and continuously dig deeper to find a new low.

    My wife is pregnant and is taking her glucose screening test today. She’s been nervous about how someone who never eats sugar or bread will react to a sudden shot of 50 grams of sugar on an empty stomach. How does that actually reflect the way her body normally processes insulin? (She’s written about it on her blog at http://theprimalsophisticate.com/2012/04/05/glucose/).

    I’m prepared for them to falsely tell her she has gestational diabetes and then for us to smugly to ignore the dietary guidelines she’s given over a plate of bacon.

    Do whatever you have to do.

    Reply
  32. Anne

    “I swear, every time I see these government goofballs put fat and sugar into the same category, I want to kidnap two of them, stuff a pound of sugar down one’s throat and a pound of lard down the other’s, then have them compare notes on the effects. They might notice a slight difference.”

    Note to all govt bureaucrats – If two of your “friends” mysteriously disappear after the release of some stupid nutritional study, you know where to look. 😉

    ((It made me laugh as I’ve thought the exact same thing many times!))

    I hope a couple of USDA bureaucrats don’t disappear anytime soon. I’d be a suspect.

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  33. Isabel

    I do have to say, that metformin’s impact on insulin resistance allows many women with Poly Cystic Ovarian Syndrome to become pregnant. I had been taking Metformin for years (for the PCOS, not diabetes) when I became pregnant with my second child. I continued to take it during my pregnancy because I acquired gestational diabetes and was able to manage the GD with the metformin and a low carb diet of about 100 carbs per day. I lost 20 lbs during my pregnancy and never had to take any insulin. My daughter weighed the same as my older son did at birth, but I can definitely see a difference in her physical structure. While my son has been ‘chunky’ all his life (I suspect that I had GD during his development, which was uncontrolled by either medication or diet), my daugher is much slimmer.

    I agree that a mother’s insulin and glucose levels during pregnancy can impact their child’s predisposition for insulin resistance and obesity, but I disagree with giving metformin to healthy mothers. Rather, I think that women should lose the mindset that they can gain 40, 50 or 100 lbs during pregnancy. They are not only setting them selves up to never lose the additional weight, but they are impacting their child’s health. Also, huge weight gain during pregnancy will almost certainly guarantee undiagnosed and untreated GD in the last few months of pregnancy. What I would like to see is a study showing weight gain during pregnancy compared to the childs weight at birth, 2yrs old, 10 yrs old, etc…

    I was lucky to have a great gestational endocrinologist who did not endorse the “eat carbs, take insulin” strategy that the ADA seems to recommend. I followed a strict diet, ate according to my meter (glucose levels 7 times a day!), and learned exactly what a low carb diet can do for my body.
    Yes, my weight goes up and down, but I have managed to lose 100 lbs and can keep it off as long as I stay on a low carb diet. I am now off the metformin (A1c of 5.3), but I already know that I will resume it when I want to get pregnant again.

    Some people need metformin, even if they’re on a low-carb diet. But the drugs-first mentality drives me nuts. It should be a low-carb diet first, then drugs if and only if eliminating the foods that spike glucose levels isn’t enough.

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  34. Jana

    This news article was so annoying. I couldn’t believe how stupid their ideas are. All I could think of was that back at the turn of the 20th century, Lou Gehrig was born at 14 lbs. if you look at pictures of him he is thin. Having a heavy baby at birth does not condemn them to a life of obesity. What people eat after they are born is a greater determining factor. Are they trying to kill the human race with their idiotic ideas?

    It depends on why they’re born big. If babies are born big because they were exposed to high levels of insulin in the womb, that is a problem. They’re being programmed to be fat.

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  35. JFlaminio

    So, is this implication that large babies will become obese children? My last one was a whopping 9 1/2 pounds (at least, it felt whopping to me), and eleven years later is tall, slim and wants to run cross-country in the fall. Is a large baby now considered a bad thing?

    Insulin acts as a growth hormone, among other functions. If babies are being born at 10+ pounds because they’ve been exposed to high levels of insulin in the womb, they can be born with insulin resistance already developing.

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  36. Rachel

    I also applaud your mentioning this whole anti-Taubes thing online. It’s been quite depressing to see. Why has the carbs/insulin hypothesis been declared dead so summarily, by so many? I missed the memo, clearly.

    There’s no doubt in my mind that some foods are addictive; they create the desire to eat more of such foods, in some people. Seems to me a huge leap from that to “…and that’s what makes us fat!”. Show me your working!

    As for obese pregnant women, I’ve no idea how to get the Department of Health or the NHS to change dietary advice, but I can tell you this- the NHS webpages allow comments, and last time I checked every single comment on the diet advice page took issue with the EatWell Plate, the lipid hypothesis and the energy balance theory of obesity. The truth will out! 🙂

    That’s why I believe the Wisdom of Crowds effect will turn things around. Supposed experts post the same old advice and they get slammed in comments.

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  37. Bex

    This is horrific but I’m having difficulty working out who’s making money out of this. The drugs cost pennies and pregnant women get free prescriptions so the NHS will spend a fortune it can ill afford. It’s still scary though…..

    The makers of metformin will certainly make money, if not a fortune.

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  38. NM

    I enjoyed your swipe at those who attack Taubes and think that “palatability” and “food reward” explain everything. Those who think that it explains anything need to look up the logical meaning of “begging the question”: another word for “hyper-palatable” is “insatiaitng”, if you think about it. And what is it about sweet, simple carbs in particular that makes them just so constantly palatable without ever *satisfying* said palate? In the end, the proponents of food reward simply say that palatable food is rewarding because it is palatable. Gee. Thanks.

    Even if Taubes’s thesis has gaps and needs refining, at least it is a thesis that doesn’t simply chase its own tail!

    I don’t doubt that certain combinations of flavors encourage us to eat more — that’s what food-industry scientists are paid to figure out — but some people are assuming that if palatability explains some cases of over-eating, it must be the whole ball of wax when it comes to obesity. As Dr. Lustig pointed out when I interviewed him, gluttony can’t explain the rise in the number of obese babies.

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  39. Beowulf

    It’s amazing how entrenched the LF dogma is, as is the “Healthy Whole Grains” mantra. They are valued by the medical system to the point that adhering to that regimen is more important that actual health.

    They just can’t shake the belief that fat is bad for us, so therefore our diets should be mostly carbohydrates.

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  40. bigmyc

    But ah…’taking’ drugs when a proper (natural) diet will do even better IS nuts.
    ‘Prescribing’ drugs when a proper diet will do even better is profitable.

    The idiot circus has no shortage of clowns in the medical/health field but those ringleaders know exactly what is up. You could go ahead and group them with the “conscientious non-cognizants” of Wall Street, Pesticide manufacturers, Military Contractors, Grain and Soy Agro and the like, et al.

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  41. Joe Lindley

    Great article Tom! While agreeing with what you say, my question is for the obese mother-to-be that either refuses to diet/exercise or who is forced into the high carb diet mentioned here that won’t work. Is it better for her to take the Metformin? We are focused on the overarching diet issue, but what about those pregnant women who are going to go to term with gestational diabetes?

    In that case, they probably need the drug. But if pregnant women were told to avoid sugars and starches, a lot fewer would develop diabetes.

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  42. Jen

    In general it is a bad idea to hand out drugs indiscriminately, but metformin is quite possibly one of the most beneficial and least dangerous drugs in existence. At least it will partially mitigate the effects of the unhealthy diet prescribed along with it.

    Sure, some people need metformin. But if we dumped the high-carb diets first, far fewer people would need a drug.

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  43. Cor Aquilonis

    Yeah, right; hyper-palatability is crap. Compare my last night’s dinner of homemade-from-scratch cocktail shrimp and cocktail sauce (less than 1T, from homemade low-sugar ketchup), plus wedge salad with Roquefort dressing and strawberries and cream with what I used to eat before low carb: veggie pizza, vegetables, chips and sweets.

    I assure you, last night’s dinner was far more palatable than the high carb meal, yet I was able to be far more satisfied on fewer calories, and felt better after eating it. I think your term of “insatiating” is far more useful and descriptive than “hyper-palatable.”

    PS – I got “Nourishing Traditions” by Sally Fallon after you mentioned it on your blog, and thank you for the tip! It’s where I got the ketchup recipe – I will never have store ketchup again. Homemade is so, so tastier.

    I believe the food reward idea makes sense in that some foods — sugar and wheat, for example — produce a cocaine-like effect in the brain. But I don’t believe mere palatability causes over-eating. Like you, I enjoy delicious meals without feeling any desire to stuff myself.

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  44. Joe Dokes

    Finally ordered Fat Head and your other DVDs and watched Fat Head with my wife. My wife was / is a constant yo-yo dieter (of course she was following traditional low fat high carb diets).

    At the end of the movie my wife exclaimed, “This is the exact opposite of everything I’ve ever heard.” I responded, “Yeah and that’s why you haven’t been able to lose weight and keep it off.”

    By the way, I liked the movie, not much new information to me as I’m a frequent reader of your blog and have read Taube’s GCBC. The absolute best part was when you went back to your doctor and had your weight and cholesterol checked. The incredulous look on his face when your cholesterol and weight numbers were lower.

    I think the look on his face, and the fact that he couldn’t believe the results showed how much education needs to take place. The above post also shows the level of education that needs to take place. Recommending a high carbohydrate diet to a diabetic is criminal.

    Keep up the good work.

    Regards,

    Joe Dokes

    The doctor’s reaction was priceless. So glad we caught that on camera.

    Reply
  45. Dave, RN

    Wow. Lots of PCOS here. Google “PCOS and iodine”. You probably don’t have enough iodine in your body. All those halides (flouride and bromine) in our water and bread displace iodine. Used to be that each slice of bread had 100 mcg of iodine, until they substituted bromine (basically a poison) for the iodine. Lots of bromine in hair coloring as well.
    It’s a big subject. I think the book “Iodine, Why You Need it and Can’t Live Without It” is as important as “Good Calories, Bad Calories”, or “The Primal BluePrint”. Or “FateHead” even. 🙂
    Look at it enough and you’ll get as disgusted at the iodine issue as you do with other Conventional Wisdom issues. Maybe more so.

    Reply
  46. Brad C. Hodson

    Really? Shooting pregnant women full of drugs is preferable to having them eat less suagr? Wow. And I thought we had already seen the bottom level of idiocy. It seems like the “experts” are armed with shovels and continuously dig deeper to find a new low.

    My wife is pregnant and is taking her glucose screening test today. She’s been nervous about how someone who never eats sugar or bread will react to a sudden shot of 50 grams of sugar on an empty stomach. How does that actually reflect the way her body normally processes insulin? (She’s written about it on her blog at http://theprimalsophisticate.com/2012/04/05/glucose/).

    I’m prepared for them to falsely tell her she has gestational diabetes and then for us to smugly to ignore the dietary guidelines she’s given over a plate of bacon.

    Do whatever you have to do.

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  47. Helen

    Hi Tom, here in Australia I was one of many Mums with Gestational Diabetes who took metformin as part of a study. I was happy to do it after receiving the terrible diet info from the dieticians in my previous GD pregnancies and having to take massive doses of insulin instead. It makes me sad to think of the effects of all that insulin and the hypos I had the last time I was on it were quite scary. I happily signed up for the metformin to be able to reduce the amount of insulin dosage they were pushing on me. (multiple injections per day – why did I listen to them?)
    My last pregnancy, I was able to take Metformin alone with no insulin at all. Why? because I ignored the dieticians advice and ate more good fats and avoided many high GI carbs. That was before I discovered LC and Paleo. I figured this out for myself.
    I was assured that Metformin doesn’t cross the placental barrier. The effects were on my side, and decreased the high blood sugar affecting the babies growth.
    With my first few GD pregnancies, I was controlled by diet alone. I never understood why they pushed eating low fat when it was clear by my self monitoring that my blood sugar levels were much better eating fatty things. I remember being scolded by the dietician for eating a whole punnet of strawberries one day (though I was really craving a chocolate bar). I’m not stupid, I looked up the carbs and compared them to how many were in an apple and made a decision that as a special treat I”d rather eat a pile of strawberries instead of an apple. I was made to feel like a greedy pig. It was probably at that point I stopped listening to what they had to say.
    Having had GD so many times, becoming progressively worse each time (7 pregnancies), there was an extremely high risk of developing type 2 diabetes, and so it was, just over a year ago, I was on the cusp of doing so, with some debilitating symptoms, when I took action. I ignored the standard medical advice and started low carb with great results.

    You were lectured for eating strawberries? By some nutritionist who probably thinks whole grains are fabulous? Sheesh!

    Reply
  48. Janknitz

    I am another woman with PCOS who took Metformin, in this case AGAINST my OB’s recommendation. First, let me say I had PCOS from the beginning of puberty when I was very thin, and I grew up where the water was NOT flouridated. I grew up on a tropical island, ate a lot of seafood and seaweed, so I highly doubt iodine deficiency was my problem. I believe there is a genetic connection here, as my mother had all the symptoms as well, though never diagnosed. Obesity does not cause the majority of PCOS either, though many women with PCOS will eventually become obese.

    I had to go through multiple In Vitro procedures to conceive my first child. This was 20 years ago, before the metabolic causes of PCOS were known. 8 years later I began following a low carb diet and taking Metformin to treat my PCOS. I was 40 at the time and laughed when the endocrinologist suggested I could get pregnant–I had been infertile all my life. The big laugh came 6 months later, when I found myself pregnant (unplanned, but very much wanted!).

    I did a lot of research. What I learned is that there was an enormous risk of miscarriage in the SECOND trimester for women with PCOS because of the insulin resistance issues. Placental blood clots were common, leading to fetal demise. Some doctors were studying whether or not continuing Metformin during pregnancy would prevent that. I joined an observational study against my OB’s recommendation and I took Metformin throughout the pregnancy while still eating a fairly low carb diet (I was advised to stay out of ketosis). The result was a normal, healthy pregnancy and baby.

    Would I have had a normal, healthy pregnancy and baby without the Metformin? We’ll never know. But I felt in my heart this was the right decision for me and my baby. My first IVF pregnancy was supported with all sorts of monitoring and treatment–I was left on my own for the second pregnancy and had to make this decision myself (my husband really didn’t understand all this, but trusted me to make the right decision). I knew there were risks involved (at that time, Metformin was still classified as a Class C teratogen), but for me, the benefits outweighed the risks.

    I agree that pregnant women should be counseled to follow an appropriate fairly low carb, high fat diet for optimal fetal health, and not simply put on Metformin as a first line of intervention. But I don’t agree that a blanket condemnation of the use of Metformin in pregnancy is appropriate. There are some instances when it may make a lot of sense for a pregnant woman to take it.

    I’m not against people who need metformin taking it. I’m against drugs being used as the treatment of choice when a change in diet would do the job for many women.

    Reply

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