Frustrated with idiots

[FarmerD]

Why the ADA Really Opposes Low Carb Diets
“While agreeing that carbohydrate restriction helps people with type 2 diabetes control their blood sugar, ADA spokesman Nathaniel G. Clark, MD, tells WebMD that the ADA does not recommend very low-carb diets because patients find them too restrictive. ‘We want to promote a diet that people can live with long-term,’ says Clark, who is vice president of clinical affairs and youth strategies for the ADA. ‘People who go on very low carbohydrate diets generally aren't able to stick with them for long periods of time.’"http://livinlavidalocarb.blogspot.com/2 ... -into.html
The above is quite possibly the stupidest advice I have ever seen.  The ADA is essentially saying that low carb diet work great for diabetics but we don’t recommend them.  The ADA dieticians always recommended to me a practically vegetarian diet, featuring very low fat diet of salads with no dressing, steamed vegetables with no salt or butter or sauce, lots of sugary fruit along with tons of “healthy”? whole grains.  It’s easier to stick to this kind of diet? In any event, this diet is guaranteed to raise your glucose levels.

Think about the following:
• The ADA adamantly opposed patients access to blood glucose meters until 1980
• The ADA recommends blood glucose levels for diabetics up to three times the levels of non-diabetic people even though it’s well known that complications from diabetes begin occurring at any level above normal
• ADA says it’s OK to substitute sugar for starches since both raise blood glucose the same.  see http://www.diabetes.org/diabetes-myths.jsp

The ADA was originally formed as a trade group for doctors that treat diabetic patients.  In my opinion, it still is. 
- Dr Richard K. Bernstein 

[FarmerD]

EM2,
Convincing a diabetic to ignore mainstream medicine is like convincing a boglehead that perhaps there is a better approach to investing than "the Boglehead way."  I try not to push my beliefs on anybody.  I may mention the PP to people but I don't press the issue if they aren't interested. Same way with diabetics.  I have to admit I do a slow burn at luncheons where I see diabetics eating piles of rice, whole wheat bagels, fruit, etc

For the most part, I like John Bogle, I just keep the following in mind:

Do not ever trust an expert, even me, if what they say does not agree with your own understanding and common sense.
-the Buddha

[Lone Wolf]

Thanks so much for bringing this up. I never talk about this with anyone since nobody would be able to understand my eating 70-80% of calories as fat.  At 70, I'm in way, way better health than I was twenty years ago.  And I have none of the common physical problems of my age cohort.

Wow, what a percentage!  What kind of foods do you consume to achieve 80% calories from fat?  (I'm a high protein - moderate carb - moderate fat eater, myself.)

Congratulations on your great results.

[bigamish]

Speaking as an academically-oriented animal physiologist, I am not sure that current dietary dogma is all big Pharmas fault.  Just as much blame should be placed on academic inertia.  Decades of repeating the same dietary advice has created an environment where suggesting alternatives to the norm, in spite of compelling peer-reviewed evidence, is often met with hostility.  Thankfully, accumulated evidence is starting to change the perceptions on what healthy diet is.  Science can be wrong, but given enough time it is self-correcting.

I have quietly supported "low-carb" diets as a viable dietary alternative for years because peer-reviewed evidence published in top-flight medical journals suggest that something compelling is going on here.  When asked by my advanced students about the subject, I explain my contrarian views w/ literature references to back it up.  However, I never openly preach for being perceived as a whack-a-doodle.  When asked to review the physiology chapters in intro biology textbooks I still frequently see incorrect blanket statements made about the folly of "low-carb" diets, & I point the editors to the abundance of studies that contradict these stated views (ala Farmer D's bullet list).  However, to date none of the publishers I have worked with ever made modifications based on my suggestions. (see scientific inertia comment above)

FarmerD describes one way of eating specific to Type I diabetics, but non-diabetics can see profound health benefits by eating "low-carb" or whole foods with a low glycemic index & glycemic load.  The key is keeping blood insulin at stable homeostatic levels.  Bottom line, prolonged elevated insulin levels stimulates fat deposition as well as a plethora of other bad side effects.  Sadly, the modern western diet encourages this kind of blood chemistry, which is evidenced by skyrocketing obesity rates.

Kudos to FarmerD for his health improvement.  Keep milking that glucagon hormonal pathway!

[Jan Van]

Are we back to paleo diets? 

[cabronjames]

wow on the diabetes story.

imho independent personal critical thinking is a vital life skill, & it's not necessarily tought by one's parents or education (even graduate university level education).

[FarmerD]

Speaking as an academically-oriented animal physiologist,

For some reason, I have found vets (or animal physiologists) to be very open minded.  They seem to have a little more horse sense (sorry, bad pun!) than most doctors I know.  You may want to check out Dr Bernstein's diabetes forum.  I've seen lots of vets posting there discussing research findings there on the low carb diet.   

Yes, low carb diets raise HDL and lower Triglycerides for everyone, not just diabetics. 

[Gumby]

Yes, low carb diets raise HDL and lower Triglycerides for everyone, not just diabetics.

Fascinating stuff...

Wikipedia has a whole section about this approach with diabetes:

http://en.wikipedia.org/wiki/Low-carbohydrate_diet

Also saying...

Apart from obesity, low-carbohydrate diets are used as treatments for some other conditions, notably diabetes[5][6][7][8] and epilepsy,[9][10][11] but also for chronic fatigue syndrome (see ketosis) and polycystic ovarian syndrome.

The article covers a lot of the various opinions from major medical organizations as well as the controversies.

[Coffee]

on the low carb diet.    

Yes, low carb diets raise HDL and lower Triglycerides for everyone, not just diabetics.  

No, they do not.  

I tested Atkins and a couple of other low carb variations on myself, and my cholesterol numbers shot up to dangerously high levels.  

I've also seen plenty of people who have followed a Vegan diet and have lost weight, lowered their cholesterol, avoided diabetes and have regained their health.  

Advocates of the low carb diet never want to admit this, in the same way that Bogleheads don't want to admit the PP may be a better way.

Yes-- low carb works.  On everyone? No it does not.

I think there is an anti-establishment arrogance by some of the posters on this thread that is alarming.  

I am completely invested in the PP... in both my retirement account and my regular investment account.  I've lived a very non-conformist lifestyle: I am married, but have chosen not to have kids.  I've lived in four different countries and I have reinvented myself and my career, countless times... to the dismay of my more traditional minded friends and family.  So, I'm not exactly the poster child for 'the establishment'.

But I'll be the first to admit: What I think is the one true path may not be.  I could be wrong.  We all could be wrong.  Even though we all know the PP is the way to go, sometimes even the best laid plans...

Keep an open mind, folks.

[bigamish]

I've also seen plenty of people who have followed a Vegan diet and have lost weight, lowered their cholesterol, avoided diabetes and have regained their health.  

[snip]

Yes-- low carb works.  On everyone? No it does not.

Agreed on both counts.  

Caveman low-carb (i.e., early phase Atkins-style), although it gets great results for many, is detrimental to the blood parameters of a statistically significant minority.  Baseline blood tests are absolutely recommended to make sure a person does not fall into the danger group.  If they do, other options should be pursued.  Be aware that as a Type I diabetic, FarmerD has to take pretty extreme measures of carb exclusion to get results he is looking for.  Definitely not for everyone, and for him the pluses outweigh the medication minuses.  As with investing, practice due diligence and pursue the options that work best for you.

Vegan can be great too, so long as one keeps primarily to whole foods that don't encourage rapid glucose uptake into the blood.  In fact, one could argue that veganism/vegetarianism is a type of low-carb diet when done properly.  Again, any eating plan that moderates the insulin response has the potential to get good blood and body weight results, and one often has to experiment with different styles to find a plan that is suitable with a person's metabolic nuances.  This last point completely jives with the majority of the modern literature on the subject, much of which is presented in mainstream advanced physiology textbooks I use.  This is why I find it so odd that there is often reflexive resistance to this style of food intake among many nutritionists.

As a point of information, I engage in a near-vegetarian whole-foods style eating preference.  Ironic, as many of my old college buddies have suggested that I could suck a veal cutlet through a straw if needed.  Aside from the health benefits, there are four main reasons I do this: (1) the described style of eating is more compatible with that of Mrs. Amish, (2) the extra low GI carbs I take in are needed for the high-intensity-interval-training I regularly engage in, (3) I can eat a *ridiculous* volume of food with minimal calorie input if I pick my shots right, and (4) the last 10 years of academics took a serious toll on my body...as a physiologist it was time to start practicing my own advice like I did in my 20s and early 30s.

@FarmerD: Although I am not a vet, I do study animals...primarily amphibians and reptiles.  So basically I chose a field that required a similar level of academic training to that of a doctor or vet, but had the worst possible comparative income potential.  Color me silly.  :D

[stone]

Bigamish "the extra low GI carbs I take in are needed for the high-intensity-interval-training I regularly engage in"

I guess exersize is a critical part of what the "western lifestyle" misses and, with plenty of exersize, the body can deal much better with whatever diet you're on (Farmer D is in a special situation because he has type 1 diabetes). "Primitive" people seem to be able to avoid western lifestyle diseases on  a diverse variety of diets. Some pre-colonial Australians in the mountains ate nothing but grubs all winter. That was an almost entirely fat diet, likewise with the eskimo diet. Other people mainly gathered sago and so mainly ate starch. I guess one thing they had in common is that they didn't eat too much calories and had ample exersize. I read something about the body's molecular reaction to brief oxygen shortage (such as from intense exersize)  showing that it linked in to controls preventing obesity, type2 diabetes etc. What shocked me is that the authors did not say that this indicated that doctors might recommend that people should run up the stairs. Instead they said that this opened up avenues for designing drugs that would molecularly mimic the body's response to running up the stairs.

[bigamish]

Stone, you are absolutely correct regarding exercise & western diet.  

Exercise is part of the whole picture, and regularly and intelligently applied, can stave off all sorts of lifestyle diseases, much like proper diet can.  However from a pure calorie in/out perspective, diet trumps exercise by a fair margin.  The damage I can do by eating an entire large meat-lovers pizza in one sitting (done it many times in the past) will take days to recover from if I depend on exercise alone for calorie burn.

Were I forced to choose proper diet *or* exercise solely to manage blood chemistry and weight, I'd choose proper diet every time because you get more bang for the buck (per unit effort), so to speak.  However, if you can also fit in a intelligently-designed exercise plan (I like high-intensity-interval training supplemented by calisthenics) you can turn the clock back decades physiologically, as well as physically, given enough time and persistence.  

I believe the exercise research you may be referring to is based on the seminal study by Izumi Tabata, et al. in 1996.  It has changed the field of exercise physiology in profound ways.  For those interested in reading the original study, the citation is:

Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max.  Medicine and Science in Sports and Exercise (1996) 28, 1327-1330

A great layman's description of this, and other related areas of promising exercise-related research can be found on the Clarence Bass website (http://cbass.com/).  Don't be thrown by the fact that he is a lawyer by training who is a hard-core body builder.  The guy knows his stuff, has a very rational mind, and I suspect he would fit in well on this site.

[stone]

Bigamish, I think the article that I came across was:
http://www.jci.org/articles/view/35846
I work alongside people who work on hypoxia and that's how I came across it.

[Lone Wolf]

A great layman's description of this, and other related areas of promising exercise-related research can be found on the Clarence Bass website (http://cbass.com/).  Don't be thrown by the fact that he is a lawyer by training who is a hard-core body builder.  The guy knows his stuff, has a very rational mind, and I suspect he would fit in well on this site.

Strongly agreed.  Clarence Bass is the man.  Very knowledgeable, open-minded guy and has stayed strong, freakishly ripped and very healthy into his 70s.  Amazing what a rich diet filled with healthy foods, strength training, and a lot of low-impact activity will do for a person.

[stone]

Is the PP an investment strategy that appeals on the whole to the freakishly ripped?

[bigamish]

Bigamish, I think the article that I came across was:
http://www.jci.org/articles/view/35846
I work alongside people who work on hypoxia and that's how I came across it.

Very cool.  

I wrongly assumed from your post that you were describing the role of O2 consumption/lactate influences on skeletal and cardiac muscle physiology (hence the Tabata reference)...very interesting that hypoxia can influence pancreatic function as well.  Makes sense that there might be a connection between the two, but it wouldn't have been my first guess.

[Lone Wolf]

Is the PP an investment strategy that appeals on the whole to the freakishly ripped?

Unquestionably.  It's crucial that we all look our best in our leather chaps if this investment strategy is to have any credibility.

[bigamish]

Is the PP an investment strategy that appeals on the whole to the freakishly ripped?

Sadly, I am living evidence to the contrary...but at least I still have my chaps!

[FarmerD]

on the low carb diet.    

Yes, low carb diets raise HDL and lower Triglycerides for everyone, not just diabetics.  

No, they do not.  

I tested Atkins and a couple of other low carb variations on myself, and my cholesterol numbers shot up to dangerously high levels.  

My comment that “Yes, low carb diets raise HDL and lower Triglycerides for everyone, not just diabetics”? seems to have bothered people.  Let me clarify.  I did not say a low carb diet reduces ALL risk factors for heart disease.  There are many other proposed risk factors.  It is possible a low carb diet could possibly increase some other risk factor.  For example, for some people a low carb diet may increase your LDL cholesterol.  Some consider that an important risk factor, others disagree. 

The idea that low carb diets raise HDL and lower triglycerides is a well accepted idea in medical research.  I have never seen a study that concludes otherwise. I'm sure some people could be outliers in this respect. Rather than list a ton of studies, here’s some quotes:
“A low-carb diet will bring triglycerides down 100 per cent of the time (and that's regardless of whether or not you lose much weight on the diet). You read that right. Not 90 percent, not 95%, but 100 percent of the time. There are very, very few strategies in nutrition that have 100 percent success rate, but when it comes to lowering triglycerides, low-carb diets do in fact have that enviable track record.”?
http://www.jonnybowden.com/2009/01/trig ... -know.html

“Two of the most consistent results when a person first reduces carbohydrates are a dramatic drop in triglycerides and an increase in HDL ("good") cholesterol. These changes are so dependable that Dr. Vernon (President of the American Bariatric Association) calls them the "hallmark of carbohydrate restriction", and advised the doctors at the conference that they could use these two measures to inform them as to whether their patients were indeed following a low carb diet.”?
http://lowcarbdiets.about.com/od/predia ... erview.htm

Even vegetarian guru Dr Dean Ornish freely admits a low carb diet raises HDL and lowers triglycerides but he doesn’t think this is very important. 

[Liz L.]

Ever since my husband was diagnosed with cancer of the esophagus (one of the scarier in terms of survival rate) six years ago, I've spent a lot of time researching health and diet.

I was most influenced by reading Anticancer by David Servan-Schreiber, which emphasizes the benefits of a vegetable-oriented diet. (The Paleo diet also interests me, but for now we have no easy access to pastured, as opposed to grain-fed, meat.)

Before my research, I suspected that sugar was bad for you. Now I believe it is terrible. The big surprise was figuring out how awful grains--all of 'em, not just white flour--are. "Healthy whole grains" is pure marketing fiction, I now believe.

I am also very into Omega-threes, and so we eat a lot of wild salmon, and take fish-oil supplements. That was another surprise, how bad farmed fish is for you. On this front, I was influenced by reading The Queen of Fats: Why Omega-3s Were Removed from the Western Diet.

So we eat: lots of vegetables; some fruit; some meat and chicken (will be more when Whole Foods opens here and we can get the good stuff); plenty of olive oil and butter (but no corn or soybean oil, which are bad news). We drink water, wine, coffee and green tea; no soft drinks ever.

I'm excited to find others here who have concluded that the standard American diet is a disaster that considerably ups your odds of dying unpleasantly from one of the big three (cancer, heart disease, stroke).

[MediumTex]

As I recall in reading about grains somewhere, the theory about them being bad for you is based upon the idea that grains trigger inflammation responses in humans just as something like poison ivy does, though in much more subtle ways.

This defense mechanism is supposed to make us not want to eat them, but rather than paying attention to this warning sign, we have instead cultivated these grains on a massive scale and when the various inflammation-related illnesses pop up, we just treat them with creams, steroids and other anti-inflammation remedies.

Anyone have any more information on this line of thinking?

[FarmerD]

As I recall in reading about grains somewhere, the theory about them being bad for you is based upon the idea that grains trigger inflammation responses in humans just as something like poison ivy does, though in much more subtle ways.

This defense mechanism is supposed to make us not want to eat them, but rather than paying attention to this warning sign, we have instead cultivated these grains on a massive scale and when the various inflammation-related illnesses pop up, we just treat them with creams, steroids and other anti-inflammation remedies.

Anyone have any more information on this line of thinking?

Medium Tex,
Check out the Dr William Davis's blog (Heartscan Blog).  He's constantly harped on wheat for the past 2 years or so on his blog and has just written a book on the subject called "Wheatbelly"
http://www.trackyourplaque.com/blog/category/wheat

[FarmerD]

Before my research, I suspected that sugar was bad for you. Now I believe it is terrible. The big surprise was figuring out how awful grains--all of 'em, not just white flour--are. "Healthy whole grains" is pure marketing fiction, I now believe.

I am also very into Omega-threes, and so we eat a lot of wild salmon, and take fish-oil supplements. That was another surprise, how bad farmed fish is for you. On this front, I was influenced by reading The Queen of Fats: Why Omega-3s Were Removed from the Western Diet.

So we eat: lots of vegetables; some fruit; some meat and chicken (will be more when Whole Foods opens here and we can get the good stuff); plenty of olive oil and butter (but no corn or soybean oil, which are bad news). We drink water, wine, coffee and green tea; no soft drinks ever.

I'm excited to find others here who have concluded that the standard American diet is a disaster that considerably ups your odds of dying unpleasantly from one of the big three (cancer, heart disease, stroke).

Liz,
After I did my research I came to the same conclusion as you.  Your diet sounds like a duplicate of mine.   

[stone]

Bigamish, one of the hypoxia people just reminded me that the article I was actually thinking of was:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893150/

It ends with "In conclusion, our data clearly show that the oxygen sensor FIH regulates respiration, energy balance, and lipid metabolism. They also demonstrate a novel role for neuronal FIH in regulation of body mass, energy expenditure and insulin sensitivity. Thus, FIH is a ready target for broad-spectrum pharmacological inhibition of hydroxylase activation, and in particular FIH-specific inhibitors (Banerji et al., 2005; Nagel, et al., 2010). Our data indicate that such inhibitors, especially those able to inhibit FIH function in neurons, might have significant therapeutic potential in reducing body weight and increasing insulin sensitivity."

Basically they leap to "kerrrrchiiingg  great way to make a drug that will keep you lithe and alive so long as you take it every week" rather than simply pointing out that you could get the same effect from running up the stairs.

[bigamish]

"Healthy whole grains" is pure marketing fiction, I now believe.

As it is depicted on the front of cereal boxes and bags of chips, absolutely.  However the form of the grain makes all the difference.  A beneficial whole grain should be as close to it's non-pulverized form as possible.  As examples, oat groats, kamut berries, bulgur wheat (all in whole form) are generally fine because it is tough to break down the hulls in the digestive system, thus blood sugar never really spikes to a significant degree.  I use all three of these to make my pail of whole grain & low GI fruit gruel every morning.  I need to cook the grains in a rice cooker in advance though.  When these grains are pulverized into a powdered form, much of this benefit is lost.  Of course that doesn't stop marketers from touting their whole grain goodness anyway.  

Bottom line, foods made with whole grains should be chunky and dense to reap their benefits.  If you are eating whole grains in their proper form with regularity, your toilet should hate you.