Diabetes

[eytonxav]

Quote:

Originally Posted by FIRE'd@51 Just curious. If your A1c has been a steady 5.5, which is an average blood sugar of 112, and your fasting is around 110, it seems to me that you are probably not spiking very much after meals, unless your A1c is being distorted by "lows". Why do you think you need to further reduce your carbs?

I would like to see my FBS <100 and my A1C at 5.4 or less, which would be more or less normal, and you are correct, I do not spike that much after meals.

[ERD50]

Quote:

Originally Posted by rgarling The approved guidelines are 60% carbohydrate, 10% protein and 30% fat. That is 1200 calories of carbohydrates in a 2000 calorie diet, which is not a moderate amount. (80 teaspoons of sugar per day!)

Isn't that off by about a factor of two? I found this from the diabetes.org site:

About - MyFoodAdvisor™

Quote:

How much carb? A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on your activity level, your age and the medicines you take.

So 3 meals times ~ 50 gm times ~ 4 calories/gm = 600 calories from carbs.

It may turn out that is too much, I don't know. But it is half of your figure.

Quote:

Originally Posted by haha Quote: Because too much is bad, it doesn't follow that best is none. Your logic as usual is unassailable. If you should become diabetic, please follow your logic and report back to us.

His logic doesn't preclude that the best would be none, he only says it doesn't follow logically that it must be that the best is none. So following his logic means he could be open to less or none. If he became diabetic, I think he'd research it - I think he's just commenting on the logic is all.

-ERD50

[haha]

Quote:

Originally Posted by ERD50 His logic doesn't preclude that the best would be none, he only says it doesn't follow logically that it must be that the best is none. So following his logic means he could be open to less or none. If he became diabetic, I think he'd research it - I think he's just commenting on the logic is all. -ERD50

Well thank you, but I think that is what I was trying to say.

Ha

[rgarling]

Quote:

Originally Posted by ERD50 Isn't that off by about a factor of two? I found this from the diabetes.org site: About - MyFoodAdvisor™ So 3 meals times ~ 50 gm times ~ 4 calories/gm = 600 calories from carbs. It may turn out that is too much, I don't know. But it is half of your figure. ...

I provided the government's reference values for nutrition. Diabetes.org is apparently providing a low calorie entry point for meal design. I checked some of their recommended recipes and they seem to be targeting the 30:60:10 ratio (i.e. the reference values).

[TromboneAl]

Another news item on the national news last night about how the obesity epidemic keeps getting worse. It was followed by the standard advice of "eat less fat." So, more diabetes on the way.

Talk about a positive feedback loop!

[Blackwoodt]

I would also suggest reading Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs

Neal D. Barnard, M.D./ a Physicians Committee for Responsible Medicine (PCRM) site / Introducing Dr. Neal Barnard's Program for Reversing Diabetes

[rescueme]

Quote:

Originally Posted by TromboneAl Another news item on the national news last night about how the obesity epidemic keeps getting worse. It was followed by the standard advice of "eat less fat." So, more diabetes on the way.

And then some of us old pharts have the condition, not that it ran in our famlies, nor being obese, but having the "experience" of being saturated with TCDD much earlier in our lives ...

[Calgary_Girl]

Quote:

Originally Posted by Blackwoodt I would also suggest reading Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs Neal D. Barnard, M.D./ a Physicians Committee for Responsible Medicine (PCRM) site / Introducing Dr. Neal Barnard's Program for Reversing Diabetes

I'm going to go out on a limb here but I'm thinking that Dr. Barnard doesn't follow the "Dukan Diet"?

[Blackwoodt]

Quote:

Originally Posted by Calgary_Girl I'm going to go out on a limb here but I'm thinking that Dr. Barnard doesn't follow the "Dukan Diet"?

Too funny, you are so right! No, I don’t think Dr. Barnard would recommend the Dukan diet.

I’ve actually seen Dr. Barnard’s diet work. One of my old high school friends went on it for over 6 months. He lost over 30lbs, and no longer needed his diabetic medication.
Unfortunately he was a big meat eater, and could not stay on the diet. He’s since put back on all of the weight, and is back on his meds. I think since both of his parents
died at an early age with diabetes, he just accepts it to be his fate too.

[ERD50]

Quote:

Originally Posted by TromboneAl Another news item on the national news last night about how the obesity epidemic keeps getting worse. It was followed by the standard advice of "eat less fat." So, more diabetes on the way. Talk about a positive feedback loop!

I don't understand how you can phrase this in such black & white terms. Are you saying that Dean Ornish and this Dr Barnard became diabetic from their diets?

I'm not promoting their approaches, I just don't think it is a simple as you make it out to be.

We keep seeing studies that people seem to lose weight and improve their health on a variety of diets. Maybe it's the "Hawthorne Effect", and anybody who is actively monitoring what they eat does better, regardless of the method? I dunno.

Low carb... low fat... there seem to be success stories for each. The only thing I have not seen promoted is a diet rich in refined carbs. So I do limit those, and it's pretty easy for me even w/o any 'sugar substitutes'.

-ERD50

[TromboneAl]

Quote:

Originally Posted by ERD50 Low carb... low fat... there seem to be success stories for each. The only thing I have not seen promoted is a diet rich in refined carbs. So I do limit those, and it's pretty easy for me even w/o any 'sugar substitutes'. -ERD50

What I've bolded may be exactly the reason that there are success stories for each. Here's a quote from Taubes' Why We Get Fat book.

Why Diets Succeed and Fail


The simple answer to the question of why we get fat is that carbohydrates make us so; protein and fat do not. But if this is the case, why do we all know people who have gone on low-fat diets and lost weight? Low-fat diets, after all, are relatively high in carbohydrates, so shouldn’t these fail for all the people who try them?

Most of us know people who say they lost significant weight after joining Weight Watchers or Jenny Craig, after reading Skinny Bitch or French Women Don’t Get Fat, or following the very low-fat diet prescribed by Dean Ornish in Eat More, Weigh Less. When researchers test the effectiveness of diets in clinical trials, like the Stanford University A TO Z Trial that I’ll discuss shortly, they’ll invariably find that a few subjects do indeed lose considerable weight following low-fat diets. Doesn’t this mean that some of us get fat because we eat carbohydrates and get lean again when we don’t, but for others, avoiding fat is the answer?

The simple answer is probably not. The more likely explanation is that any diet that succeeds does so because the dieter restricts fattening carbohydrates, whether by explicit instruction or not. To put it simply, those who lose fat on a diet do so because of what they are not eating—the fattening carbohydrates—not because of what they are eating.

Whenever we go on any serious weight-loss regimen, whether a diet or an exercise program, we invariably make a few consistent changes to what we eat, regardless of the instructions we’re given. Specifically, we rid the diet of the most fattening of the carbohydrates, because these are the easiest to eliminate and the most obviously inappropriate if we’re trying to get in shape. We stop drinking beer, for instance, or at least we drink less, or drink light beer instead. We might think of this as cutting calories, but the calories we’re cutting are carbohydrates, and, more important, they’re liquid, refined carbohydrates, which are exceedingly fattening.

We’ll stop drinking caloric sodas—Coca-Cola, Pepsi, Dr Pepper—and replace them with either water or diet sodas. In doing so, we’re not just removing the liquid carbohydrates that constitute the calories but the fructose, which is specifically responsible for making the sodas sweet. The same is true of fruit juices. An easy change in any diet is to replace fruit juices with water. We’ll get rid of candy bars, desserts, donuts, and cinnamon buns. Again, we’ll perceive this as calorie cutting—and maybe even a way to cut fat, which it can be—but we’re also cutting carbohydrates, specifically fructose. (Even the very low-fat diet made famous by Dean Ornish restricts all refined carbohydrates, including sugar, white rice, and white flour.* This alone could explain any benefits that result.) Starches like potatoes and rice, refined carbohydrates like bread and pasta, will often be replaced by green vegetables, salads, or at least whole grains, because we’ve been told for the past few decades to eat more fiber and to eat foods that are less energy-dense.

If we try to cut any significant number of calories from our diet, we’ll be cutting the total amount of carbohydrates we consume as well. This is just arithmetic. If we cut all the calories we consume by half, for instance, then we’re cutting the carbohydrates by half, too. And because carbohydrates constitute the largest proportion of calories in our diet, these will see the greatest absolute reduction. Even if our goal is to cut fat calories, we’ll find it exceedingly difficult to cut more than a few hundred calories a day by reducing fat, and so we’ll have to eat fewer carbohydrates as well. Low-fat diets that also cut calories will cut carbohydrates by as much or more.*

Simply put, any time we try to diet by any of the conventional methods, and any time we decide to “eat healthy” as it’s currently defined, we will remove the most fattening carbohydrates from the diet and some portion of total carbohydrates as well. And if we lose fat, this will almost assuredly be the reason why. (This is the opposite of what happens, by the way, when food producers make low-fat products. They remove a little of the fat and its calories, but then replace it with carbohydrates. In the case of low-fat yogurt, for instance, they replace much of the fat removed with high-fructose corn syrup. We think we’re eating a heart-healthy, low-fat snack that will lead to weight loss. Instead, we get fatter because of the added carbohydrates and fructose.)

The same is likely to be true for those who swear they lost their excess pounds by taking up regular exercise. Rare are the people who begin running or swimming or doing aerobics five times a week to slim down but don’t make any changes in what they eat. Rather, they cut down their beer and soda consumption, reduce their sweets, and maybe even try to replace starches with green vegetables.

When calorie-restricted diets fail, as they typically do (and the same can be said of exercise programs), the reason is that they restrict something other than the foods that make us fat. They restrict fat and protein, which have no long-term effect on insulin and fat deposition but are required for energy and for the rebuilding of cells and tissues.

[Nemo2]

I'm of the opinion that most/all of those who lose substantial amounts of weight and then regain it, fail to recognize that they are not embarking on a limited time frame 'diet', but are, or should be, making lifetime behavioral changes.

The notion that you diet until you've reached a goal, and then it's back to 'business as usual' is nonsensical & unworkable.

[ERD50]

Quote:

Originally Posted by TromboneAl What I've bolded may be exactly the reason that there are success stories for each. Here's a quote from Taubes' Why We Get Fat book.[INDENT] Why Diets Succeed and Fail ...

Taubes makes an awful lot of suppositions and chains them together there. And I'm pretty sure that the studies I linked earlier (in another thread) monitored the ratio of carbs and all that, and people lost about the same amount of weight on a variety of diets. It just doesn't add up for me.

But we've been through that circle before, so I'll stop now, I've got nothing new to add. I still think your recent unequivocal statement that cutting fat = increased diabetes is worded far too strongly - if it were true, Ornish would be in a diabetic coma (exaggerated for effect).

-ERD50

[rgarling]

Quote:

Originally Posted by ERD50 ... and people lost about the same amount of weight on a variety of diets. It just doesn't add up for me. ... -ERD50

You can lose weight on any diet, but recent studies show higher compliance and better health results with low carb diets vs low fat diets. Humans vary in insulin sensitivity by a factor of ~6, and insulin sensitivity is the primary thing that determines how someone's body will respond to an infusion of carbohydrate.

In the end, it is very easy to limit carbohydrate intake so you can experience what this means to you. For most people (~70%) limiting carbohydrate intake will improve health.

[haha]

Quote:

Originally Posted by rgarling You can lose weight on any diet, but recent studies show higher compliance and better health results with low carb diets vs low fat diets. Humans vary in insulin sensitivity by a factor of ~6, and insulin sensitivity is the primary thing that determines how someone's body will respond to an infusion of carbohydrate. In the end, it is very easy to limit carbohydrate intake so you can experience what this means to you. For most people (~70%) limiting carbohydrate intake will improve health.

I agree with this viewpoint.

I think one thing that sometimes gets forgotten is that everything gets more important in a high calorie, food aplenty environment. If people's belts are approaching their backbones because it is hard to get enough to eat, carbs are likely not much of a problem. But as soon as that belt starts moving forward they can become so for many people.

Ha

[ERD50]

Quote:

Originally Posted by rgarling You can lose weight on any diet, but recent studies show higher compliance and better health results with low carb diets vs low fat diets. Humans vary in insulin sensitivity by a factor of ~6, and insulin sensitivity is the primary thing that determines how someone's body will respond to an infusion of carbohydrate. In the end, it is very easy to limit carbohydrate intake so you can experience what this means to you. For most people (~70%) limiting carbohydrate intake will improve health.

That's a much more balanced viewpoint, IMO. IIRC, the results in favor of low carb were pretty slight, but they were there.

Whether it is 'very easy to limit carbohydrate intake' - I guess it is an individual thing. I know plenty of people who went whole-hog into the low-carb thing, got a religious kind of fervor about it, and were not able to stick to it and lose weight (they couldn't stick to other diets either, to be fair). These low carb books have been on best seller lists and got plenty of press, yet obesity rates still rise. So I'm not sure it's all that easy. But it may be relatively easy for some.

In another thread, I think haha said something to the effect that this is all very complex and inter-related and likely genetics play into what works for one versus another, and that we will probably all be dead before it is well understood. That may very well be true.

I never bought into the "low fat" craze, and now we seem to be getting data that 'good fats' aren't the devil they were made out to be. So until I feel we have better data, I'm a little skeptical of any diet that cuts down a major food group that drastically. The exception for me being limiting refined carbs - I haven't seen any support for those, can't recall any serious 'eat a pound of table sugar at each meal and lose weight!' promotions.


-ERD50

[harley]

The Donut Diet Review | How It works, Pros/Cons, In-Depth Reviews

[Calgary_Girl]

Quote:

Originally Posted by ERD50 So until I feel we have better data, I'm a little skeptical of any diet that cuts down a major food group that drastically. -ERD50

I agree with this completely. This is part of the reason that I can't hop onto the Dukan Diet bandwagon. Any plan that requires you to cut out entire food groups raises a red flag with me.

[rgarling]

Quote:

Originally Posted by ERD50 .... So until I feel we have better data, I'm a little skeptical of any diet that cuts down a major food group that drastically. The exception for me being limiting refined carbs - I haven't seen any support for those, can't recall any serious 'eat a pound of table sugar at each meal and lose weight!' promotions. -ERD50

As far as your body is concerned, there is little difference between what are called 'good' carbs and 'refined' carbs. They both spike your blood sugar, however, there is a slight slowing of absorption with the good carbs. Read this blog entry about a guy's experiment of one with a glucose meter: Fat Head » Hope Warshaw’s Pepsi Challenge

By the way, for people who really want to see how their body reacts to carbs, buy a glucose meter and check for yourself. You will probably be surprised. If you do this, you want to eat in such a way to keep your blood glucose below 140 at the spike. To do that you will likely have to cut way back on carbs.

[FIRE'd@51]

I think Dr. Richard Bernstein (in the book I cited above) said it best when he said "eating fat does not make you fat any more than eating tomatoes makes you red". IMO, much of this is socio-economic. Low-carb diets (which tend to be high-protein) are considerably more expensive than low-fat, high-carb diets.