Carb Scare Tactics

About Diabetes.com ^ | July 08, 2003 | Paula Ford-Martin

[Nov3]

Carb Scare Tactics

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July 08, 2003

Carb Scare Tactics
U.S. News and World Report has an article in their upcoming issue (7/14/03) entitled: "The Diabetes Diet Wars: The nutrition advice given to most diabetics might be killing them" that discusses the great carb debate - again. Headlines like this really rub me the wrong way, especially for those who are newly diagnosed and may read this piece. The article does touch on some interesting points in the ADA nutrition guidelines vs. low-carb debate, but unfortunately leaves out critical information. Begin rant here...

Here's the letter I wrote to the U.S. News editor in response to the piece:

To the Editor:

I found the headline "The nutrition advice given to most diabetics might be killing them" on your "Diabetes Diet Wars" piece to be irresponsible and alarmist. While I agree that the current dietary recommendations from the ADA deserve re-evaluation in light of the recent NEJM studies on low-carb diets and weight loss in type 2 diabetes (which were vaguely referenced in your article), the current guidelines are a far cry from killing anybody. Given that the consumers who are actively digging for diabetes information online and in their bookstores are often those who are newly diagnosed as type 2 and completely overwhelmed (I know, I get email from hundreds each month), this type of fear-mongering headline is uncalled for and designed not to inform but to cause panic.

Diabetes is very much an individual disease, and I believe the ADA emphatically recognizes that when they state in their technical review on the subject that a primary goal of medical nutritional therapy should be: "To address individual nutritional needs, taking into consideration personal and cultural preferences and lifestyle while respecting the individual’s wishes and willingness to change." In other words, while the ADA does issue evidence-based clinical practice recommendations for carbohydrate intake (and the key phrase is *evidence-based* - meaning based on the current body of knowledge from controlled scientific studies and subject to future change as knowledge evolves), these are only guidelines.

Your article also fails to address several critical points of the debate. You quote Frank Vinicor of the CDC speaking to how high protein intake (a feature of popular low-carb diets) cannot harm anyone with healthy kidneys. This is absolutely correct, but your reporter fails to mention that diabetes is the number one cause of chronic kidney failure in America. Many people with diabetes *do* have existing renal impairment, and forcing their kidneys to process extra protein makes the problem worse.

There's also the matter of carb quality versus carb quantity (otherwise known as the glycemic index, or GI), which should play a necessary role in this debate. A baked potato, for example, will raise blood glucose levels much higher and faster than a portion of fiber dense whole grain bread, even if the portions given have equal amounts of carbohydrates gram for gram. If anything, there should be a push towards including GI basics on smart carb choices in diabetes medical nutrition therapy. The ADA currently acknowledges the possible utility of the GI, but stops well short of endorsing it, citing a lack of current scientific evidence on long-term success, plus the supposed complexity of the method. In a world of exchange lists, carb counting, and blood glucose testing, however, the GI seems to be just a little more math for a much larger reward.

Finally, exercise is an absolutely essential component of any treatment plan for type 2 diabetes. Exercise lowers blood glucose levels, improves heart health (cardiovascular disease is a major complication of diabetes), and improves overall well being. Inactivity is sometimes, though not always, the cause for a seemingly ineffective diet plan.

Respectfully,
Paula Ford-Martin

*****************
About Diabetes
Editor and Content Producer
diabetes.guide@about.com
http://diabetes.about.com

[EggsAckley]

>>A$$hole$.<<

Funny and appropriate that you would spell that with all those dollar signs, because, isn't THAT ($$$) what it's ALL about!?! LOL!

[EggsAckley]

Oh, BTW Mr.3, THANK YOU for posting about this of late. It's very important, and we're all learning and getting fired up over it. Don't stop!!

[Nov3]

The spate of diabetes is downright scary. There are other factors but diet is the main cause. Beyond diet there is a tie with the autoimmune problems that seen to be rampant in our society.

[EggsAckley]

As a matter of fact, if you decide to set up a *ping* list on this topic, sign me up!
~</:o)

[AAABEST]

God bless! I'm very happy for you.

[AAABEST]

I know you make fun of these threads, but you will be converted. </ bodysnatcher>

[freethinkingman]

I have researched different diets quite a bit before settling on the Atkins type "Schwartzbein Diet" . She is a doctor that has put many diabetics on the high protien/good fat diet.

I personally have lost 20 since the new year and that is not even sticking rigidly to the diet. I just cut out bread, chips, coke and other sweets and eat more meat and dairy.

After reading her book I can't see how anyone can refute the evidence, everyone knows how the body treats carbs (like sugar) whats left to debate?

[Nachum]

Good luck with your impending operation.

There are a number of things have proven tough to give up for me. Diet Coke was one. I am a major addict. I stick to green tea and water these days.

[Mr. Jeeves]

There are a number of things have proven tough to give up for me. Diet Coke was one.

No need to give cola up entirely. Try Diet-Rite cola. No aspartame, no calories, no carbs and it tastes pretty good.

[upchuck]

Just wondering, why did you give up Diet Coke? I'm on a sort of modified Atkins. I avoid most carbs, giving into a piece of pizza or some microwave popcorn once a week or so. I try to be good :)

[jacquej]

Hey!!! Thanks for the tip!!! I am gonna try it! I love wine, always thought red would give me headaches, so avoided it... But, have read that the red wines are better than the white for health...

And, I trust Freepers more than any others!!!

Cut the carbs, guys... that means, no cereals, no breads, no taters, no rice, no pasta, no sodas, no sugar, and no aspatame... prolly no artificial sweeeners of any kind.

I know, wah... grow alpine strawberries in pots on balconies, you know?

It works, and once you get past the first month, and decide it is life-long, it really isn't bad... but you won't know till you make the commitment.

Get your GP to do the blood tests before you start, then get them taken after you have done it for about 3 months with NO CHEATING! Let us all know what your results are...

[not_apathetic_anymore]

Well... I'm still losing on Atkins (without giving up Diet Coke) more slowly than at first, but the trend is still down. For more reasons than Atkins, the Diet Coke should go. But, giving up carbs was all I could do...I couldn't give up the DC as well. I figure when I hit a plateau and stop losing that's when I'll be forced into the final Atkins step.

[sinkspur]

Might I suggest, in starting out, that you go for a Gamay Beaujolais, or even one of the generic red table wines? They're a bit lighter.

Some people do get headaches from the sulfites in red wine, so start light and see what it does.

Whatever you do, stay away from Lambruscos and white zinfandels. As much sugar as whites.

[pubmom]

It is frustrating to be a family member of a diabetic (in-law)who was given that type of advice. They will follow the dr's advice even if they feel lousy all the time.

A big beef of mine is that it was recommended he use margarine instead of butter. Trans fats are rotten for everyone, not just diabetics.

Is his health better by following dr's orders? He needed a hearth cath last year and is heavier now than he's ever been.

[Xenalyte]

Do you take Synthroid? Xena's Mom does (thanks to having her head X-rayed in the late '50s for an acne treatment, of all things, which killed her thyroid gland), and when she tried to quit taking it several years back, she couldn't get out of bed. She felt just fine, except for having zero energy. Weird.

[Xenalyte]

That's right . . . blame the hooch. ;)

The good part about Atkins is that it lets me have tons of what I love - beef and cheese and wine. The bad part is that the only beer I can have is Michelob Ultra. I think my views on this near-beer have been amply covered on FR.

But hell, if it gets that extra inch or two off my stomach and hinder, I am SO there.

[Xenalyte]

Just the meat and the cheese, or anything else? Actually, a good Omaha Steaks burger with some kickazz Swiss on it sounds VERY yummy.

[Xenalyte]

Sounds like you're doing the same thing I'm doing. No Krispy Kremes are killing me, but it will all be worth it when I (at nearly six feet) can fit into my size sixes and eights.

[Xenalyte]

Speaking for myself alone, I have no problems with red. White always gives me a headache, and I'm not headache-prone.

Plus, red is just plain better with all the red meat.

[EggsAckley]

Adele Davis did N0T recommend a high carb diet. She was the pioneer in the low carb regime, and she insprired Atkins. I followed her low carb diet; I know.