Atkins diet combats diabetes says NZ study

It's increasingly dismissed as a fad - but a New Zealand and world-first study into the effect of the Atkins diet on diabetes indicates people not only lose weight, their life-threatening illness improves as well.

Ten overweight diabetic New Zealanders have for the past four months been eating rich fatty food as part of a Wellington Hospital study into the controversial diet.

Until now, nothing scientific has been known about the effect of the popular protein and fat-rich diet on type-2 diabetes, a deadly disease that strikes particularly at Maori, who have the second highest diabetes rate in the world.

One in three adult Maori are diagnosed with the disease, which can lead to blindness, limb amputations and death.

Usually diabetics are recommended the traditional low-fat diet to control their illness but the Wellington study may change all that - and it is set to gain international scientific attention.

Four months ago, endocrinologist Jeremy Krebs chose subjects with an average weight of 120 kilograms.

Since then:

Grace, 38, has stopped taking insulin, halved her daily diabetes medication and the weight is falling off. All the while she enjoys rich meals, including fat sirloin steaks dribbled in blue cheese sauce.

Louise, 54, whose grandmother went blind and had both legs amputated because of diabetes, has lost 15kg and now has a blood sugar level of about six - a normal level for non-diabetics. Before the study her level was 17.

Fred, 44, is training for a 160km bike race in two weeks' time. After being "hungry for 40 years", he says he hasn't experienced a hunger pang in four months.

The group say their blood pressure has been reduced, their good cholesterol raised and the bad lowered, their energy has skyrocketed, and their lives have been dramatically changed. The diet they follow is strictly Atkins: Carbohydrates are almost eliminated and protein and fat are allowed. Though, because it is hospital-controlled, the group is encouraged to replace as much saturated fat with the safer mono and polyunsaturated fats, and to include lots of nutrient-rich green vegetables.

Three times during the study, each person spends a day at the hospital subjected to five-hours of scientific tests including glucose tolerance, blood pressure and kidney function, as well as measurements of their weight and body composition.

Dr Krebs says provisional results - the study is not due to finish for another four weeks - show the effects of the diet on the 10 were beneficial for their diabetes.

But he was sceptical that the type of food they were eating was making the difference.

"I think what we're going to conclude is that it's weight loss that counts and how you achieve it doesn't really matter that much."

Popular opinion holds that the Atkins diet works by forcing the body to consume stored fats because there is no available carbohydrate to burn.

But Dr Krebs believes the diet, like all others, works only by reducing the overall energy intake.

Eventually, he hopes to find the funding necessary to extend the study beyond a year to provide another world-first - the only scientific research into the long-term effects of the Atkins diet.

Source: THE HERALD ON SUNDAY

Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes

Diabetes 53:2375-2382, 2004
© 2004 by the American Diabetes Association, Inc.

Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes
Mary C. Gannon1,2,3, and Frank Q. Nuttall1,3

1 Metabolic Research Laboratory and the Section of Endocrinology, Metabolism and Nutrition, Department of Veterans Affairs Medical Center, Minneapolis, Minnesota
2 Department of Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota
3 Department of Medicine, University of Minnesota, Minneapolis, Minnesota

There has been interest in the effect of various types and amounts of dietary carbohydrates and proteins on blood glucose. On the basis of our previous data, we designed a high-protein/low-carbohydrate, weight-maintaining, nonketogenic diet. Its effect on glucose control in people with untreated type 2 diabetes was determined. We refer to this as a low-biologically-available-glucose (LoBAG) diet. Eight men were studied using a randomized 5-week crossover design with a 5-week washout period. The carbohydrate:protein:fat ratio of the control diet was 55:15:30. The test diet ratio was 20:30:50. Plasma and urinary ß-hydroxybutyrate were similar on both diets. The mean 24-h integrated serum glucose at the end of the control and LoBAG diets was 198 and 126 mg/dl, respectively. The percentage of glycohemoglobin was 9.8 ± 0.5 and 7.6 ± 0.3, respectively. It was still decreasing at the end of the LoBAG diet. Thus, the final calculated glycohemoglobin was estimated to be ~6.3–5.4%. Serum insulin was decreased, and plasma glucagon was increased. Serum cholesterol was unchanged. Thus, a LoBAG diet ingested for 5 weeks dramatically reduced the circulating glucose concentration in people with untreated type 2 diabetes. Potentially, this could be a patient-empowering way to ameliorate hyperglycemia without pharmacological intervention. The long-term effects of such a diet remain to be determined.

Source: American Diabetes Association

What You Don’t Know About Blood Sugar

Conventional Medicine’s Interpretation
Of Fasting Glucose Blood Tests

70-109 mg/dL . . . . . . . . .Normal glucose tolerance
110-125 mg/dL. . . . . . . . .Impaired fasting glucose (prediabetes)
126+ mg/dL . . . . . . . . . . .Probable diabetes

Life Extension’s
Fasting Glucose Guidelines

70-85 mg/dL . . . . . . . . . Optimal (no glucose intolerance)
86-99 mg/dL . . . . . . . . . Borderline impaired fasting glucose
100+ mg/dL . . . . . . . . . .Probable prediabetes

Full article: LEF

Fructose, weight gain, and the insulin resistance syndrome

American Journal of Clinical Nutrition, Vol. 76, No. 5, 911-922, November 2002
© 2002 American Society for Clinical Nutrition

Sharon S Elliott, Nancy L Keim, Judith S Stern, Karen Teff and Peter J Havel

From the Department of Nutrition, University of California, Davis (SSE, JSS, and PJH); the US Department of Agriculture Western Human Nutrition Research Center, Davis, CA (NLK); and the Monell Chemical Senses Institute and the University of Pennsylvania, Philadelphia (KT).

This review explores whether fructose consumption might be a contributing factor to the development of obesity and the accompanying metabolic abnormalities observed in the insulin resistance syndrome. The per capita disappearance data for fructose from the combined consumption of sucrose and high-fructose corn syrup have increased by 26%, from 64 g/d in 1970 to 81 g/d in 1997. Both plasma insulin and leptin act in the central nervous system in the long-term regulation of energy homeostasis. Because fructose does not stimulate insulin secretion from pancreatic ß cells, the consumption of foods and beverages containing fructose produces smaller postprandial insulin excursions than does consumption of glucose-containing carbohydrate. Because leptin production is regulated by insulin responses to meals, fructose consumption also reduces circulating leptin concentrations. The combined effects of lowered circulating leptin and insulin in individuals who consume diets that are high in dietary fructose could therefore increase the likelihood of weight gain and its associated metabolic sequelae. In addition, fructose, compared with glucose, is preferentially metabolized to lipid in the liver. Fructose consumption induces insulin resistance, impaired glucose tolerance, hyperinsulinemia, hypertriacylglycerolemia, and hypertension in animal models. The data in humans are less clear. Although there are existing data on the metabolic and endocrine effects of dietary fructose that suggest that increased consumption of fructose may be detrimental in terms of body weight and adiposity and the metabolic indexes associated with the insulin resistance syndrome, much more research is needed to fully understand the metabolic effect of dietary fructose in humans.

Why Diabetics Should Avoid High Carbohydrate Diets

*American Diabetes Association's Bizarre Message to Diabetics: "A High Carbohydrate Diet Will Raise Your Blood Sugar - But You Should Eat it Anyway!"*

By Anthony Colpo.

March 28, 2004.

Among the influential mainstream proponents of low-fat nutrition is the American Diabetes Association who, for years, has recommended that diabetics consume a high-carbohydrate diet.

Never mind that diabetes is an illness characterized by glucose intolerance; that is, an inability to efficiently metabolize dietary carbohydrates which, regardless of their source (complex, simple, high-glycemic, low-glycemic, high-fiber, low-fiber) are ultimately broken down into glucose inside the body. In healthy individuals with optimal glycemic control, much of this glucose will be channeled into the muscles (and to a lesser extent, the liver), where it will be stored as glycogen. This stored glycogen can later be used as fuel for muscular effort.

In healthy individuals, the transport of glucose from the blood into the muscles is largely mediated by insulin, a hormone secreted by the pancreas. By removing glucose from the bloodstream into muscles, insulin helps keep blood sugar levels in a tightly-controlled range. This is important, because both low and high blood sugar levels have a number of adverse physiological consequences, and epidemiological studies have uncovered a higher risk of cardiovascular and all-cause mortality for individuals with hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose).(Bjornholt JV)(Wei M)

In full-blown diabetics, a lack of sufficient insulin output by the pancreas leads to chronically elevated high blood sugar levels. The resultant hyperglycemia dramatically increases glycation, a process in which protein and sugar molecules in the body "cross-link", forming what are known as advanced glycation end-products (AGEs). Glycation is a process to which none of us are immune, but it can be reduced by avoiding high-glycemic load diets and by minimizing our intake of overcooked, highly-browned foods.

Glycation damages our organs and tissues and, along with free radical damage, is considered a major contributor to the aging process. It is no coincidence that diabetics typically have significantly-shortened lifespans compared to non-diabetics, along with a far higher prevalence of heart disease, cancer, kidney disease, amputation, and blindness.

Listen to the ADA - and watch your blood sugar go up!

Recently, I received a copy of a highly-informative and soon-to-be-published review on popular low-carbohydrate diet books, which had kindly been forwarded to me by its author. As I scanned through the review, my eyes nearly popped out after reading the following quote, attributed to the American Diabetes Association:

"The message today: Eat more starches! It is healthiest for everyone to eat more whole grains, beans, and starchy vegetables such as peas, corn, potatoes and winter squash. Starches are good for you because they have very little fat, saturated fat, or cholesterol. They are packed with vitamins, minerals, and fiber. Yes, foods with carbohydrate -- starches, vegetables, fruits, and dairy products -- will raise your blood glucose more quickly than meats and fats, but they are the healthiest foods for you. Your doctor may need to adjust your medications when you eat more carbohydrates. You may need to increase your activity level or try spacing carbohydrates throughout the day."

Reeling in disbelief at the stupidity of such advice, I visited the ADA website (March 28, 2004), and sure enough, in an article titled The Diabetes Food Pyramid: Starches, were the very words you see printed above.

The complete lack of logic in the ADA's statement is absolutely mind-boggling. We are simultaneously told that "Yes, foods with carbohydrate -- starches, vegetables, fruits, and dairy products -- will raise your blood glucose more quickly than meats and fats" - a situation to be avoided at all costs by diabetics - but that these high-carbohydrate foods "are the healthiest" for diabetics. How can that be?

The consequences of the ADA's enthusiastic call to "Eat more starches!" are alluded to in the sentence that states: "Your doctor may need to adjust your medications when you eat more carbohydrates." Yes, if your blood sugar rises from eating more carbohydrates, your doctor will indeed need to adjust your diabetic medication dosage - upwards!

The ADA article also states that: "You may need to increase your activity level or try spacing carbohydrates throughout the day", further acknowledging the deleterious glycemic effects of increased carbohydrate intake.

Why in blazes is America's premier diabetes organization recommending a diet that will raise blood sugar levels and necessitate increases in blood-sugar lowering drugs? And, even worse, why are they actively discouraging diabetics from trying the very diets that have been shown repeatedly to improve glycemic control? I'm talking about carbohydrate-reduced diets. Take the following quote:

"Currently some controversy about carbohydrates is raging due to a few new diet books. These books encourage a low carbohydrate, high protein and moderate fat intake. These diets are not in synch with the American Diabetes Association nutrition recommendations, which are based on years of research and clinical experience."

The ADA is 100% correct that low-carb diets are not in synch with their own recommendations; given the highly erroneous and counterproductive nature of the ADA recommendations, this cannot be considered anything but a virtue!

The ADA claims that their nutrition recommendations "...are based on years of research and clinical experience". If they are implying that science supports their guidelines as being beneficial to diabetics, nothing could be further from the truth. As we shall now discuss, numerous studies show that high-carbohydrate diets can markedly worsen glycemic control in both diabetic and even non-diabetic individuals. Reduced-carbohydrate diets, on the other hand, can bring about dramatic improvements in glycemic control.

What the Research Shows

When Type 2 diabetics were placed on a low carbohydrate diet (25% carbohydrate) for 8 weeks, they experienced significant improvements in glycemic control, as reflected by decreases in both fasting blood glucose and hemoglobin A1c, a measurement that reflects the average blood sugar level over the previous 3 months or so. Nineteen of the patients had been taking oral diabetic drugs prior to the onset of the study; all were able to discontinue the use of these drugs during the study. However, when the patients were switched to a 55% carbohydrate diet - similar to that recommended by the ADA - their blood glucose control and hemoglobin A1c measurements significantly deteriorated. (Gutierrez et al. 1998)

Similar results were noted in a 1987 study which also compared higher and lower carbohydrate intakes in Type 2 diabetics. In this study, one of the diets contained 20 percent protein, 20 percent fat, and 60 percent carbohydrate, again similar to that recommended by the ADA. The other contained 20 percent protein, 40 percent fat, and 40 percent carbohydrate. Unfavorable glucose and insulin responses, and significantly greater 24-hour urinary glucose excretion, were observed when subjects followed the high carbohydrate diet. (Coulston et al. 1987)

A 1994 edition of the Journal of the American Medical Association reported how Type 2 diabetics consumed a 40% carbohydrate, 45% fat diet for 6-14 weeks, and a 55% carbohydrate, 30% fat diet for another 6-14 weeks in a randomized crossover fashion. The high carbohydrate diet increased daylong blood glucose and insulin values by 10%. (Garg et al. 1994)

Yet another study with Type 2 diabetics showed that raising the dietary carbohydrate content by a mere 10%, from 40% to 50%, resulted in a significant increase in both post-meal blood glucose and insulin concentrations. (Sestoft et al. 1985)

Finally, researchers from the University of Minnesota recently found that Type 2 diabetics consuming a 30 percent protein, 30 percent fat, and 40 percent carbohydrate diet (a macronutrient ratio similar to that prescribed in Dr. Barry Sear's Zone Diet), showed significantly lower blood glucose levels after meals and greater reductions in glycated hemoglobin levels than those following a 15 percent protein, 30 percent fat, and 55 percent carbohydrate diet. (Gannon et al.)

Type 2 diabetics are not the only folks who experience improvements in blood sugar metabolism when carbohydrate intake is restricted. A recent study compared the effects of three different diets in healthy volunteers; 1) zero fat, high carbohydrate, 2) moderate fat, moderate carbohydrate, and 3) high fat, low carbohydrate. Researchers observed significantly lower insulin concentrations on the high fat, low carbohydrate diet. In addition, those on the high fat, low carbohydrate diet burnt more fat and less glucose for fuel. (Bisschop et al. 2001)

To be fair, high carbohydrate diets can lead to improvements in blood sugar and insulin function if caloric intake is restricted to the point where fat loss occurs, but the ADA does not include this important pre-requisite in their dietary guidelines.

Furthermore, when calorie-reduced low-fat, high-carbohydrate regimens are directly compared with similarly-restricted low carbohydrate diets, the latter are still shown to be more effective in terms of glycemic control. (Baba et al. 199)Brehm et al. 2003)(Lewis et al. 1977)(Volek et al. 2002)(Layman et al. 2003)(Farnsworth et al. 2003)(Heilbronn et al. 1999)(Jeppesen et al. 1997)(Gumbiner et al. 1996)(Golay et al. 1996)(Piatti et al. 1994)(Rabast et al. 1979)(Fujita et al. 1975)

Finally, while calorie-restriction may help mitigate the harmful glycemic effects of high carbohydrate diets, what happens when diabetic individuals eventually return to maintenance-calorie intakes? If the studies comparing maintenance-calorie high- and low-carb diets that we discussed above are any indication, the result will be steadily deteriorating glucose tolerance.

Conclusion

The research leaves little doubt as to what diabetics can expect from the American Diabetes Association's bizarre "a-high-carbohydrate-diet-will-raise-your-blood sugar-but-you-should-eat it-anyway" message: worsening glycemic control! Because it is poor glycemic control that causes the health problems that befall diabetics - not imaginary villains like saturated fat or cholesterol - diabetics would be very wise to disregard the contradictory, incoherent, and scientifically baseless recommendations of the ADA.

References

Bjornholt JV, et al. Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men. Diabetes Care, 1999; 22: 45-49.

Wei M, et al. Low Fasting Plasma Glucose Level as a Predictor of Cardiovascular Disease and All-Cause Mortality. Circulation, May, 2000; 101: 2047-2052.

Gutierrez M, et al. Utility of a Short-Term 25% Carbohydrate Diet on Improving Glycemic Control in Type 2 Diabetes Mellitus. Journal of the American College of Nutrition, 1998; 17 (6): 595-600.

Coulston AM, et al. Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. American Journal of Medicine, 1987 Feb; 82 (2): 213-20.

Garg A, et al. Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. Journal of the American Medical Association, 1994; 271: 1421-1428.

Sestoft L, et al. High-carbohydrate, low-fat diet: effect on lipid and carbohydrate metabolism, GIP and insulin secretion in diabetics. Danish Medical Bulletin. 1985 Mar; 32 (1): 64-69.

Gannon MC, et al. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. American Journal of Clinical Nutrition, 2003; 78: 734-741.

Bisschop PH, et al. Dietary fat content alters insulin-mediated glucose metabolism in healthy men. American Journal of Clinical Nutrition, 2001; 73: 554-559.

Baba NH, et al. High Protein vs High Carbohydrate Hypoenergetic Diet for the Treatment of Obese Hyperinsulinemic Subjects. International Journal of Obesity, 1999; 11: 1202-1206.

Brehm BJ, et al., A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. The Journal of Clinical Endocrinology and Metabolism, 2003; 88 (4): 1617-1623.

Lewis SB, et al. Effect of Diet Composition on Metabolic Adaptations to Hypocaloric Nutrition: Comparison of High Carbohydrate and High Fat Isocaloric Diets. The American Journal of Clinical Nutrition, 1977; 30 (2): 160-170.

Volek JS, et al. Body Composition and Hormonal responses to a Carbohydrate Restricted Diet. Metabolism, 51(7), 2002, pages 864-870.

Layman DK, et al. Increased Dietary Protein Modifies Glucose and Insulin Homeostasis in Adult Women during Weight Loss. The Journal of Nutrition, 2003; 133 (2): 405-410.

Farnsworth E, et al. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. American Journal of Clinical Nutrition, July 2003; 78: 31-39.

Heilbronn LK, et al. Effect of Energy Restriction, Weight Loss, and Diet Composition on Plasma Lipids and Glucose in Patients With Type 2 Diabetes. Diabetes Care, 1999; 22 (6): 889-895.

Jeppesen J, et al. Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. The American Journal of Clinical Nutrition, 1997; 65 : 1027-1033.

B Gumbiner, et al. Effects of diet composition and ketosis on glycemia during very-low- energy-diet therapy in obese patients with non-insulin-dependent diabetes mellitus. The American Journal of Clinical Nutrition, 1996; 63: 110-115.

Golay A, et al. Similar weight loss with low- or high-carbohydrate diets. The American Journal of Clinical Nutrition, 1996; 63: 174-178.

Piatti PM, et al. Hypocaloric high protein diet improves glucose oxidation and spares lean body mass. Comparison to hypocaloric high-CHO diet. Metabolism, Dec. 1994; 43 (12): 1481-1487.

Rabast U, et al. Dietetic treatment of obesity with low and high carbohydrate diets: Comparitive studies and clinical results. International Journal of Obesity, 3 (3), 1979, pages 201-211.

Fujita Y, et al. Basal and postprotein insulin and glucagon levels during a high and low carbohydrate intake and their relationships to plasma triglycerides. Diabetes, 1975; 24 (6): 552-558.

Source: theomnivore.com
Re-published with permission

Diabetes without Complications!

Jonathan Christie

"I'm 52. I've been insulin-dependent since I was 38 but my glycosylated hemoglobin and blood chemistry are normal, so I see no reason why diabetics should develop complications or suffer a shortened life expectancy. I lost confidence in the medical prescription, and now I keep my own counsel about my diabetes and go to doctors for needles, Humalog insulin and tests. Years of self-experimentation - some of which I wouldn't repeat - have taught me what works best for me. I felt lost when I was diagnosed, and I hope this site may ease a trying time and provide some solutions for others who suddenly find themselves diabetic...

This site is dedicated to diabetes and diabetics, Type I and Type II, insulin-dependent (IDDM) and non-insulin dependent (NIDDM), at risk for diabetic complications from poor diabetic control such as kidney disease, overweight, high blood pressure and cholesterol, coronary heart disease and heart attacks, neuropathy, retinopathy and blindness, and leg ulcers with their attendant risk of gangrene and amputation. It is for those with brittle diabetes, Somogyi reactions or the "dawn phenomenon" who suffer emotional distress, anxiety or despair over their abnormal Glycosylated Hemoglobin Tests. And for those who feel hopeless about achieving good control, avoiding insulin reactions, hyperglycemia and hypoglycemia. To all of you, I say there is hope: I'm insulin-dependent, but my risk for complications is almost zero on a low carbohydrate, ketogenic diet without sugar, refined carbohydrates or starches. My Lifescan meter gives my average blood sugar as 102 mg%, and Ketostix tell me I'm in mild ketosis. I eat food I like and I feel good, so it can be done."

Site link: survivediabetes.com

ENDO 99: Diabetics Improve Health With Very High-Fat, Low Carb Diet

Doctor's Guide
June 15, 1999

By Cameron Johnston
Special to DG News

SAN DIEGO, CA -- June 15, 1999 -- A very high-fat, low-carbohydrate diet has been shown to have astounding effects in helping type 2 diabetics lose weight and improve their blood lipid profiles.

The results of three studies involving such a diet, which is similar to, but has a few key differences from the famous "Dr. Atkins Diet", were presented today at the annual meeting of the Endocrine Society.

Dr. James Hays, an endocrinologist and director of the Limestone Medical Center in Wilmington, DE, admitted that the concept of a high-fat diet in people who are already at higher risk of cardiovascular disease might seem incongruous. Nonetheless, this study of 157 men and women with type 2 diabetes showed an impressive benefit in body mass index (BMI) triglycerides, HDL, LDL and HbA1c.

Most people are encouraged to reduce the amount of fat in their diets,
particularly saturated fats, and diabetics in particular are advised to reduce their overall caloric intake, Dr. Hays explained in an interview in San Diego during the conference.

Whereas a normal diet would be in the order of 1800 to 2100 calories, with 60 percent of calories coming from carbohydrates and 30 percent from fat, patients in this diet were restricted to 1800 calories per day and were encouraged to get 50 percent of their caloric intake from fat, and just 20 percent from carbohydrates. The balance of 30 percent would come from proteins.

A whopping 90 percent of the fat content in their diets was saturated fat, compared with just 10 percent that was monounsaturated fat.

"I think this is at least worth considering for any diabetic," Dr. Hays said in an interview. "The thing many diabetics coming into the office don't realize is that other forms of carbohydrates will increase their sugars, too. Dieticians will point them toward complex carbohydrates ... oatmeal and whole wheat bread, but we have to deliver the message that these are carbohydrates that increase blood sugars, too."

Higher-fat diets, on the other hand, seem to make the person feel full faster so they eat less; higher-fat diets also tend to reduce postprandial hypoglycemia so the patients feel better after eating.

"Every diabetic comes home from the doctor with instructions as to what their diet should consist of, but they're not getting the information from dieticians about what complex carbohydrates they should eat," Dr. Hays said.

"The important thing here is no ketosis. We absolutely don't want people to
become ketotic, and so we said they had to have so many exchanges of fresh
fruits and vegetables and we specified the ones they could eat."

They were able to eat all the meat and cheese they wanted, but as for
carbohydrates, they are restricted to eating unprocessed foods, mainly fresh
fruit and vegetables, he added.

Subjects recruited into the study (84 men, 73 women) were all type 2 diabetics and were required to undergo a standard American Diabetes Association modified diet for one full year before entry into the trial.
Over the course of one year, the subjects achieved a mean decline in total
cholesterol of between 231 and 190 mg/dl. Triglycerides declined from 229 to
182 mg/dl.

Low-density lipoproteins (LDL cholesterol) fell from 133 to 105 mg/dl, while HDL increased from 44 to 47 mg/dl.

HbA1c, which at the start of the study averaged 3.34 percent above normal,
declined to the point that at one year, the mean was just 0.96 percent above
normal.

The average weight loss among subjects in the study was in the order of 40
pounds, Dr. Hays said.

By the end of the one-year study, he added, 90 percent of the patients had
achieved ADA (American Diabetes Association) targets for HbA1c, HDL, LDL and
triglycerides.

Even among juvenile diabetics, he said, they might not be overweight and they might have more or less normal lipid levels, but when they are on this kind of diet it is possible to treat them with lower doses of insulin and make their lives a little safer, he said.

As for the response from cardiologists who see a high-fat diet as anathema to what they have been instructing their patients for years now, Dr. Hays said he has three cardiologist patients who are now on the diet.

"If you have a diet that results in weight loss, lower cholesterol, and a better lipid profile, eventually, everybody will be eating that way. It's going to come whether we like it or not."

Source: pslgroup.com

Diabetes diet war | The nutrition advice given to most diabetics might be killing them

By Dara Mayers
The bible says "make starches the star." That's the Diabetes Food and Nutrition Bible, published by the American Diabetes Association. "Grains, beans, and starchy vegetables form the foundation of the Diabetes Food Pyramid. The message is to eat more of these foods than of any of the other food groups." For 17 million Americans with diabetes, diet is a crucial part of treatment, And what the ADA bible preaches, many doctors, nutritionists, and patients believe.

But what if the ADA's high-starch diet--another way of saying high-carbohydrate--is not healthy for people with diabetes but harmful to them instead?

This possibility is now the source of heated debate in the diabetes community. It is "the most controversial aspect of diabetes treatment today," says Scott King, editor-in-chief of Diabetes Interview magazine. How controversial? "Malpractice!" is how physician and diabetes specialist Lois Jovanovic, chief scientific officer of the Sansum Medical Research Institute in Santa Barbara, Calif., describes conventional high-carb nutrition advice.

Carb consequences. These arguments are more intense than the nutrition wars over low-carb, Robert Atkins-like diets taking place in mainstream culture. For people with diabetes, the battle is about more than waistlines. As far as bodies are concerned, carbohydrates equal sugar. And complications from Type I and Type II diabetes, which are caused by high blood-sugar levels, include amputation, heart disease, blindness, and kidney failure. Often they are lethal. The illness is not necessarily a disaster, because people with diabetes who maintain close to normal blood sugar can effectively avoid these problems. A number of doctors and people with diabetes, however, believe the high-carb diet is a recipe for trouble.

"There are a number of myths surrounding diet and diabetes, and much of what is still considered sensible nutritional advice for diabetics can over the long run be fatal. I know, because it almost killed me," writes physician Richard Bernstein in his book Diabetes Solution. Bernstein, a Type I, or insulin-dependent, diabetic for the past 57 years, has been at war with the medical establishment since the 1970s. At that time, his failing health caused him to wonder why someone whose body couldn't process carbs--which are chains of sugar molecules--was repeatedly being told to eat a lot of them. Should people with diabetes be eating a diet that is, essentially, 50 percent to 60 percent sugar?

The reason, historically, has been fear of fat and the cardiovascular problems that plague diabetics. As the cholesterol-fat-heart-disease links moved doctors to recommend a low-fat diet, the amount of carbohydrates recommended for diabetics gradually increased to fill the void. In 1994, the ADA stated that people with diabetes could eat anything, including sugar itself. "There is no longer a diabetic diet. People with diabetes eat the exact same foods as anyone else," says Nathaniel Clark, national vice president for clinical affairs at the ADA. "We do not believe there is any harm in eating carbohydrates."

Bernstein does. He prescribes an extremely low carbohydrate diet--approximately 30 grams of carbs over three meals for diabetics to achieve normal blood-glucose readings round-the-clock. "In my experience," he says, "the ADA diet does not work for anyone."

He's not alone. "Diabetes is a disease of `carbohydrate intolerance.' Thus, meal plans should minimize carbohydrates because people with diabetes do not tolerate carbs," says Sansum's Jovanovic. She prescribes food considerably lower in carbohydrates than does the ADA.

Some patients are discovering low-carb benefits for themselves. Nancy Humeniuk, a 70-year-old retiree and Type II diabetic from Monterey, Tenn., was put on the ADA diet under the direction of a diabetes educator. "While I was following the diet, my blood-glucose levels were completely out of control," Humeniuk says. "They told me I was being noncompliant--but I was following the diet exactly. I was scared." After three months, Humeniuk switched to low carb. "Within three days of going low carb, my blood sugars were normal. And they have been for the past six years." Her cholesterol profile is also very good. "My doctor told me that whatever I was doing, I should keep it up," she says.

The ADA, however, remains firm in its stance. "A diet that is very low in carbohydrates is significantly higher in protein and in fat, and there are specific risks to people with diabetes from high-protein diets in regard to kidney disease and from high-fat diets in regard to cardiovascular disease," Clark says. The ADA is far from alone in its position. "We recommend that 45 to 60 percent of calories come from carbs," says Karen Chalmers, director of nutrition services at the Joslin Diabetes Center in Boston.

"Healthy fats." Scientific evidence supporting the low-carb approach has been thin. But some recent studies have refuted the idea that an Atkins-like diet increases cholesterol, or lipid, problems. "Our data would suggest that you don't get a negative lipid pattern with the Atkins diet," says James Hill, director of the Center for Human Nutrition at the University of Colorado, where a recent study compared the Atkins diet with a standard low-fat, high-carb diet. Cholesterol levels in the Atkins dieters were actually better after a year. Frank Hu, associate professor of nutrition and epidemiology at the Harvard School of Public Health, also believes that lower-carb diets are beneficial to some people with diabetes. He is careful to point out, however, that carbohydrates should be replaced with "healthy fats," such as the mono- and polyunsaturated fats found in olive oil, nuts, and avocados.

The kidney-disease claim is also disputed. "There is no evidence that in an otherwise healthy person with diabetes eating protein causes kidney disease," says Frank Vinicor, director of diabetes research at the Centers for Disease Control and Prevention.

Some people hope that the new data will have an impact. "The ADA is responsive to new scientific data and is likely to incorporate this information into new dietary guidelines with a lower proportion of carbohydrates," says ADA board member Barbara Kahn, a physician and diabetes expert at Harvard Medical School. Kahn has seen how difficult it is for people with diabetes to gain control while following current recommendations, so she is pushing for changes. Still, the ADA Web site and all of its literature continue to tell people with diabetes and the thousands of medical professionals who treat them to make starches "the centerpiece of the meal." Revising a bible is never easy, so it may be quite some time before this bit of medical gospel sees real change.

Meal plans
Dinner duel

Low-carb Diabetes Solution fare really differs from the standard advice for diabetics.

"DIABETES SOLUTION" DINNER

Steak 4-6 oz.
Cooked broccoli 2/3 cup
Salad w/dressing 1 cup

AMERICAN DIABETES ASSOCIATION DINNER

Pasta w/vinaigrette dressing 1 cup
Fish 3.5 oz.
Granola bar
Banana

Source: usnews.com

bantransfats.com

"BanTransFats.com, Inc. is a non-profit corporation based in California. Our goal is the reduction and elimination of trans fats from all food products. Our founder is Stephen Joseph, a lawyer based in San Francisco, who is originally from Britain. Our principal consultant is Mary Enig, Ph.D. She is widely regarded as one of the world's foremost authorities on trans fats.

There are four kinds of fats: saturated fat, trans fat, monounsaturated fat, and polyunsaturated fat. Trans fat is the most dangerous.

Many British food products contain trans fat, including Digestive biscuits. It's not just in biscuits. It's in all kinds of foods, even some "health" foods. If you see the words "hydrogenated" or "partially hydrogenated" in the ingredients, the product contains trans fat.

Recent medical research has shown that trans fat causes significant and serious lowering of HDL (good) cholesterol and a significant and serious increase in LDL (bad) cholesterol; major clogging of arteries; type 2 diabetes; and other serious health problems."

Full article, further information and links on the subject: bantransfats.com

Increased Dietary Protein Modifies Glucose and Insulin Homeostasis in Adult Women during Weight Loss

"This study demonstrates that consumption of a diet with increased protein and a reduced CHO/protein ratio stabilizes blood glucose during nonabsorptive periods and reduces the postprandial insulin response."

The American Society for Nutritional Sciences J. Nutr. 133:405-410, February 2003

Source: nutrition.org

Fat that may benefit Diabetics reduces weight, blood sugar

"COLUMBUS, Ohio – Supplementing the diet with a certain fatty acid may lead to better weight control and disease management in diabetics, a new study suggests.

Diabetics who added an essential fatty acid called conjugated linoleic acid (CLA) to their diets had lower body mass as well as lower blood sugar levels by the end of the eight-week study. Hyperglycemia, or high blood sugar, is a hallmark of diabetes.

Researchers also found that higher levels of this fatty acid in the bloodstream meant lower levels of leptin, a hormone thought to regulate fat levels. Scientists think that high leptin levels may play a role in obesity, one of the biggest risk factors for adult-onset diabetes."

Full article: Ohio State University

May be possible to stay slim and eat what you want

"The researchers, headed by C. Ronald Kahn at the Joslin Diabetes Center, reported on their experiments with mice that have been genetically altered to have no insulin receptor in fat. These so-called FIRKO mice were able to eat all they wanted and remain lean. In fact, even when they were stimulated to overeat, they failed to gain any extra weight. What's even more important is that these mice live longer than brother/sister controls that ate the same amount of food but did not have this genetic knockout."

Full article: Harvard Gazette

A human time bomb

By Jerome Burne
A 35-40in waist means greater risk of diabetes and stroke

ANTONY WORRALL THOMPSON, the celebrity chef, has been worrying about his waist. It is a bit more than 40in (101cm), which means that he is at risk of a newly identified disorder that is causing concern among health experts. The condition already affects 25-30 per cent of the population and, if left untreated, can lead to diabetes, heart disease and stroke. It has also been linked with poor memory and a shrunken hippocampus — the area of the brain involved in memory formation.
Worrall Thompson is the face of a new campaign to “measure your mate”, which aims to raise awareness about the condition, known as insulin resistance syndrome (IRS). If your mate — or any male who lets you wrap a tape measure around them — measures more than 40in, they are at risk of IRS. The red-light figure for women is 35in.

IRS, which is also known as metabolic syndrome, glucose intolerance and Syndrome X, has been dubbed a “medical time bomb” because it could lead to an explosion of disease in years to come. And not only among those facing midlife spread. Derriford Hospital in Plymouth last month reported that 30 per cent of 300 children between the ages of 5 and 16 were showing signs of it. Diabetes now affects about 4 per cent of the population.

The key to all this is the way that your body handles glucose. Until recently this was considered a specialised medical problem reserved for diabetics. But this comforting division is an illusion; our sedentary lifestyle, coupled with a taste for sugar and refined carbohydrates, is playing havoc with the subtle balance between glucose and insulin in our bloodstreams.

Refined carbohydrates are dangerous in the long term because they are too easily digested. The body turns all carbohydrates into glucose, which is then released into the blood. But while wholefoods, such as pulses, fruit and most vegetables, are broken down over several hours, providing a steady trickle of glucose, a sugar-laden fizzy drink, for instance, produces a glucose spike — a sudden rise, followed by an equally dramatic fall. An occasional sugar spike is no big deal; but day after day, over many years, it can be deadly. As glucose levels rise, your body releases insulin to mop it up. After years of glucose peaks, the extra amounts of insulin have a diminishing effect. IRS then develops — a pre-diabetic state with high levels of both insulin and glucose circulating in your blood. The result, among other things, is that hard-to-shift spare tyre around the middle and damage to blood vessels and the heart.

In America the syndrome has been recognised as a medical condition, officially defined as having three or more of five conditions: abdominal obesity, high triglycerides (damaging fats) in the bloodstream, low levels of the good LDL cholesterol, high blood pressure and high glucose.

In sufferers, this can translate to feeling sluggish most of the time, nervousness, being in a low mood for no good reason, strong cravings for white bread and pastries, bingeing on chocolates or sweet snacks more than three times a week, using caffeinated drinks to stay alert and exercising fewer than three times a week.

We, too, need to recognise the condition, says Giancarlo Viberti, professor of diabetes and metabolic medicine at Guy’s Hospital. “At the moment someone who shows up in a doctor’s surgery with those symptoms probably would not be spotted as being at risk of heart disease and diabetes. By the time they are diagnosed as diabetic, 50 per cent of sufferers already have signs of damaged blood vessels.”

So what can be done? Experts such as Viberti agree that the best course of action is dieting to lose weight and taking 30 minutes of daily exercise, such as a brisk walk. But because diets are notoriously hard to stick to, the medical profession also favours a pharmaceutical approach, with weight-loss drugs such as Xenical (which prevents fats from being absorbed from your gut), and “early and intensive intervention with a combination of drugs” for diabetes. This means drugs to reduce insulin production (metformin), plus ones to increase insulin sensitivity (glitazones). Reducing hypertension with beta blockers is not advised since they make insulin resistance worse.

It is not an approach that finds favour with Sandra Lees, a former IRS suffer who “cured” herself with a change of diet and supplements. She has now become an energetic campaigner for the nutritional approach, working with Dr Ann de Wees Allen, the chief of biomedical research at the Glycemic Research Institute in Washington. “Just cutting calories or going on a low-fat diet is unlikely to do any good,” Lees says. “Most low-fat products are loaded with sugar, for a start.”

Instead Lees stuck to a low-glycaemic diet, ie, one made up of foods that don’t raise blood sugar levels. Broadly, that means going for foods such as sausages, beans, porridge and wholegrain pasta, and avoiding the likes of bagels, cornflakes, bananas and beetroot. One of the UK’s supermarkets already has a range of low-glycaemic foods in the pipeline.

This approach also involves the use of various supplements. High glucose and insulin levels, for instance, increase the amount of damaging free radicals in the bloodstream, which means that your body needs more antioxidants, such as vitamins C and E. Another antioxidant, alpha lipoic acid, has been found to lower glucose levels, while magnesium improves the way that the body handles excess glucose.

Such an approach is controversial and doesn’t have the backing of large-scale studies; but evidence for a nutritional approach to what is, after all, a nutritional problem, is coming in. A study published earlier this year in The Journal of Nutrition reported that adding an essential fatty acid called conjugated linoleic acid (CLA) to the diet of diabetics lowered their blood sugar levels by five time more than a placebo. Those on CLA also lost weight.

Source: Times Online

The correct way to treat diabetes

The numbers of people contracting diabetes is increasing rapidly all over the industrialised world. Children are now getting Type-2 diabetes, which normally only affects people over the age of forty. Something has gone drastically wrong. This series of papers looks at the reasons for this phenomenon, shows how conventional medicine is making the situation worse, and presents practical advice for both the treatment and prevention of diabetes.

The introduction and Parts 1 to 6 are mainly concerned with adult onset or Type-2 diabetes. Most of the advice and, certainly, the general principles are common to both types of diabetes. But as there are significant differences with between Type-2 and Type-1, Part 7 looks at other factors that affect those with Type-1.

Full articles: Second Opinions - Barry Groves, PhD