Posted on 01/12/2009 3:11:19 PM PST by truthandlife
Durham, NC - A Duke researcher says that despite the lack of a "gold-standard" clinical trial proving the benefits of a low-carb approach, he has seen enough in his own patients to know that, at least for some, a very low-carb approach can essentially reverse diabetes, without adversely affecting lipid profiles [1]. In his latest published research, Dr Eric C Westman (Duke University Medical Center, Durham, NC) and colleagues report that obese patients with type 2 diabetes randomized to a low-carbohydrate diet rather than a low-glycemic, reduced-calorie diet were more likely to experience improvements in glycemic control and, in some cases, patients were actually able to eliminate their diabetes medications and "reverse" their diabetes, at least as it is defined by hemoglobin A1c (HbA1c) level.
According to Westman, one of the novel aspects of this study was that patients in the low-carb group were maintained on what is typically considered the "induction phase" or "intensive" carbohydrate restriction of common low-carb diets. In the Atkins diet—and the Atkins Foundation funded this study—that induction phase means reducing carbs to <20 g per day for the first two weeks; in Westman et al's study, carbohydrate content was kept at <20 g for the entire six months of the study.
"Scientifically it's a no-brainer that the lower-carb diet affects the blood sugar better, because that's what physiology tells us," he told heartwire. "It's taught in Physiology 101 that what raises blood sugar is carbohydrates in the diet. There's no controversy about that. The question in the study is the degree to which changing the carbs in the diet affects type 2 diabetes."
Improvements in weight and glucose level
In all, investigators randomized 84 volunteers—mostly women—to either a ketogenic diet with <20 g of carbohydrates per day but no restriction on calories or to a calorie-reduced, low-glycemic-index diet (recommended calorie reduction of 500 kcal/day). Both groups attended regular clinic counseling sessions and were given nutritional supplements and recommendations for exercise: 30 minutes, at least three times per week.
At six months, more than 42% of patients had dropped out of the study, although both interventions had led to improvements in glycemic control as measured by HbA1c—the main outcome of the study. Strikingly, however, improvements in HbA1c, reductions in body weight, and improvements in HDL levels were significantly greater among participants randomized to the low-carb diet. Need for diabetes drugs, including insulin and/or oral drugs, was reduced or eliminated in more than 95% of people in the low-carb group as opposed to 62% in the low-glycemic-diet group, a statistically significant difference.
For lipid parameters, only HDL changes were significantly different between the two groups after adjustment for baseline differences, with improvements in HDL among the low-carb group being statistically greater—HDL levels were unchanged in the glycemic-index group. Both groups experienced significant improvements from baseline in VLDL and triglycerides.
To heartwire, Westman emphasized that there was a lot of variation in responses by lipid parameters to a diet that typically included more meat, cheese, and saturated fats. "I would say that we can allow a little increase in cholesterol if we're fixing diabetes," Westman said. "Diabetes is not a risk factor, it's a risk equivalent. I just don't understand the push-back, because we're not talking about raising or lowering LDL by 20 points, we're talking about fixing diabetes."
Mechanism of benefit
The authors point out that both weight loss and the reduced glycemic index contributed to the beneficial effects in the low-carb-diet group (since this diet also has a low glycemic index). But the higher impact of the low-carb diet in this study was likely driven by the lower carbohydrate intake, since the statistical significance of the different effect was maintained even after the researchers adjusted for weight loss.
"It is possible that the beneficial effect of 'low-glycemic' diets could be augmented by further reduction of the absolute amount of carbohydrate or by a reduction in caloric content," they write.
Asked to comment on the study for heartwire, Dr Robert Eckel (University of Colorado Health Sciences Center, Denver), who served on the nutrition committee of the AHA (which has long advocated fat restriction in the diet), pointed to information missing in the study, including details about the types of fat consumed and the reasons behind the high dropout rate.
Also commenting, diabetes researcher Dr Darren McGuire (UT Southwestern, Dallas, TX) called Westman et al's strategy "an intriguing concept."
"It's an interesting effect of HbA1c, but as we've all been so recently reminded, intervening on HbA1c is not the objective of diabetes management—the objective is to prevent micro- and macrovascular complications of the disease," McGuire told heartwire. "While some interventions that favorably affect HbA1c appear to reduce clinical risks, others do not and may cause harm. So, this diet intervention, fairly extreme in its nutritional composition and net metabolic effects above and beyond glucose metrics, just like any pharmaceutical intervention, requires evaluation over longer term and ideally in clinical-outcomes studies before one could endorse it on any scale. Most important, assessment of its clinical-outcomes effects, intermediate- and longer-term safety, and longer-term tolerability are all key questions remaining."
Westman agreed, telling heartwire that he has a $50-million study written up and ready to go at Duke Clinical Research Institute but doubts it will ever be funded due to the entrenched attitudes about fat and the politics around food and agriculture.
"We're in the gray zone where the ultimate study that needs to be done is a randomized clinical trial, which I'm all for," he said. But in the meantime, he plans to continue using a low-carb strategy in his practice. "Should I increase the fat in the diet, which science has shown to not raise cholesterol, even though a lot of people believe that to be true? Yes, if it means I can take people off medicine and improve their glycemic control," he insists.
But he also emphasizes that the low-carb approach is just one of several approaches to helping obese patients with diabetes, and it's not for everyone. "I have some college professors who were in the study who said, this is like I was eating in Italy. . . . I love it. So for some it's a cinch. But for the average person who gets into our studies, it's not a cinch, and it does require behavioral changes. What we learned from this study and others is that this is intensive, and in our clinic we won't let anyone go longer than a month without coming in, and if they have any sort of trouble with this, we prefer seeing people every two weeks. Some people we see once a week."
The key point, Westman continues, is that diabetes is "fixable." That notion has already been demonstrated in the bariatric-surgery literature, he points out. "This is a noninvasive approach, it's not quite as fast, not as drastic, and not as risky as surgery, but it still really reconfirms that with diet and weight change, diabetes is reversible."
It's also cheap for patients, he points out. "I would think that today, in this economic climate, that we would want nonpharmacological alternatives," Westman said. "I made one man happy today because I reduced his insulin in half in one day, and he was spending a couple hundred dollars per month on insulin. Patients like the doctor who does this."
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Westman reports having no conflicts of interest. |
Yep, can't risk hurting Archer Daniels Midland's bottom line when there are elections looming. ;)
I’ve been on Atkins for 2 years, I’m 150 lbs lighter and no longer have high BP, am no longer pre-diabetic, and lost my cholesterol problem. I’m training for a 5K. All this with all-you-can-eat ribeyes. Low-carbing saved my life, deliciously, and made my family doctor a liar.
I call BS on this. With Type 2 Diabetes, the pancreas still produce insulin but the organs become less sensitive to the insulin the body produces. This causes more sugar to remain in the blood cells, giving the same symptoms of Type 1 Diabetes.
Reducing or eliminating carbs won't change the body's failure to use the insulin it produces - all it does is provide a smoke 'n mirrors effect to make it look qas though the Type 2 Diabetes has been "reversed". It hasn't.
I call BS on this. With Type 2 Diabetes, the pancreas still produce insulin but the organs become less sensitive to the insulin the body produces. This causes more sugar to remain in the blood cells, giving the same symptoms of Type 1 Diabetes.
Reducing or eliminating carbs won't change the body's failure to use the insulin it produces - all it does is provide a smoke 'n mirrors effect to make it look qas though the Type 2 Diabetes has been "reversed". It hasn't.
ping
Easier said than done. I prefer weigh watchers. I can eat what I want within moderation. It’s a slow process but I’m feeling good as I loose. I dropped really fast on the low carb diet but I felt sick the entire time. I also gained everything back, plus after I stopped.
(I am not trying to correct you with my post)
It depends on the carbs
google LOW GLYCEMIC DIET
carbs are not bad, excess carbs are bad, and carbs that break down fast and are high in concentration are bad
Plus I am going back on the Atkins diet. I allowed myself to be talked out of being on it. Only one that actually worked for me.
bump
well, I dont know about diabetes, but I do know a low gylcemic diet has brought several people I know off their insulin meds and no longer have diabetes
while no body works exactly like another, when you reduce the amount of simple sugars in the blood stream, you have less blood sugar: simple and true
I found the Atkins NO CARB 2 week period actually painful, and the low glycemic lifestyle helpful and easier
I just aint used to it, even after a year
I wish I didnt have so many life changes and could just stay to one thing/event in my life to deal with!
(I just found out I have a different issue regarding my health, one that explained why I always failed on diets so quickly, one that I honestly never thought of and one that I could NOT supplement my way out of or exercise or diet out of completly)
Way to go!!!!!
look up low glycemic diets and Glycemic Index
chose the veggies that are lowest in glycemic index and glycemic load
you can bet twice your points you can eat a bushellful of the low index/low load foods and not go over yur daily points! :)
Now, the side effects ~ if you already have low lipid levels, ain't no thang. At the same time I found that sticking to a less than 30g per day carb diet caused PAIN ~ you could find yourself dipping into hypoglycemia several times a day like I did. Letting it run up to 50g per day made it more tolerable.
Just trying to envision the fear and misery in the eyes of those test subjects they limited to 20g per day ~ did they do this in Pakistan again? You can do everything there!
The problem is that there is just about nothing you can eat that doesn’t have carbs. I have been diabetic since 1995 and been through untold hours of classes and consultations about diabetes.
Each of us is different and our bodies respond differently to different treatment regimens. The bottom line is that diabetes is a progressive disease. It is not curable and the best that can be hoped for is to manage it until it finally consumes it’s host.
I had a 950 C.F.M. Holley on my '67 Camaro and turned 12.7 in the quarter mile! It was a great "excess" Carb!
All kidding aside, Race....I excluded what I call "Burps" from my diet and lost 55 lbs in 5 months. I lowered my triglycerides down to a great level and my good cholesterol skyrocketed and my bad cholesterol plummeted. In addition....I felt great and ate everything else I could put my hands on......and a lot of it!
Bread
Rice
Pasta
Potato
Sugar
BRPPS!
Congratulations, that’s an astounding feat.
Yeah I know. Here's something that might be interesting to keep an eye on
http://www.freerepublic.com/focus/f-news/2163183/posts
“Fixable”? Well...yes and no. Type two diabetes comes in several varieties from genectics, insulin insensitivity to eating too many carbs for the pancreas to compensate (producing a glucose surplus....ie: a man has a pancreas that produces enough insulin for a 200 pound person, yet he eats like a 250 pound man).
I have several relatives (including immediate family who were pre-diabetic or early type two) who have gone off their meds because of diet, weight loss, exercise, and supplements. BUT, lets be honest....”reversable” or “fixable” needs caveats. The proper term is that the condition is “under control”. So long as you stay in the proper lifestle, you’re okay. Also, as you get older you might have to go back on the meds eventually.
Only twice have I lost weight in my life.
1. When I ran away from home with a chick. Bad choice as I starved for like a month. However, I lost 20 pounds in 3 weeks.
2. Cut out carbs. Lost 30 pounds in 6 months.
Breakthroughs: Diabetes, Alzheimer’s, Obesity & Depression
Recent new science has revealed common metabolic relationships between T2 Diabetes, Alzheimer’s, Obesity, and Depression. New science makes it possible to lower total body serum glucose by up to 70%, in less than an hour. The benefits from rapidly increasing the upload of glucose and amino acids into skeletal muscles cells are considerable. It becomes possible to:
(1) increase muscle mass, brain function, energy levels, workloads and weight loss,
(2) reduce depression and carbohydrate craving,
(3) restore normal sleep patterns and fat balances (lipids).
Even Minor Defects In The Modern American Diet Cause Disease
The U.S. Surgeon General and the World Health Organization concluded that 60 to 70% of degenerative diseases (such as cancer, heart disease, strokes and diabetes) are caused by unhealthy diets. The American epidemic of Diabetes, Alzheimer’s, Depression and Obesity proves beyond any reasonable doubt that many Americans do not structure their diets in a way that controls their weight and reduces their risk for disease. Modern science has identified very important diet modifications that help in weight loss and reduce the risk of disease. These “diet modifications” do not mean transforming the Modern American diet into that of a vegan Buddhist monk. It is critical, however, to accurately identify the most destructive aspects of the Modern American diet and the appropriate remedies. Americans consume large amounts of sugar and have higher rates of disease than humans who consume almost no sugar. Americans consume very low levels of omega-3 fatty acids and have higher rates of disease than humans who consume 6-12 grams of omega-3 fatty acids per day. A recent study on omega-3 fatty acids concluded that it reduced the incidence of sudden cardiac death by 45%.
How Does The Modern American Diet Cause Disease?
Four out of ten of American adults between the ages of 40 and 70 are presently pre-diabetic. Three out of ten of Hispanic-American children now become pre-diabetic by age 12. The Modern American Diet (excessive sugar and minimal omega-3 fatty acids) contributes to diabetes and disrupts the way normal human bodies manage eating patterns and energy utilization. These disruptions in energy utilization in diabetics are associated with:
(1) reduction in total energy uptake into muscle cells,
(2) reduction of total energy oxidized in muscle cells,
(3) reduction of protein synthesis in muscle cells (loss of muscle mass),
(4) reduction of leptin sensitivity, food satiety, and food portion control,
(5) reduction in brain function and brain serotonin levels (causing increased anxiety),
(6) increases in body fat as the liver converts glucose back into fatty acids.
Good Science Suggests That We Need To Modify The Modern American Diet!
The cost in human suffering and health care dollars is already unbearable and will certainly get worse if we do not alter this trend line. The challenge is to encourage a transition from the obesity-causing diet to a diet that burns fat more readily (thermogenic diet). A blizzard of misinformation and advertising quackery has rendered millions of Americans “blind” to the benefits of valid diet-related science. The ever present mantra: “Eat Less & Exercise More” has failed to produce durable weight loss in millions of Americans because it does not give Americans the details essential in making informed food selections that promote healthy weight loss. Healthy and durable weight loss must incorporate good science on how to attain greater appetite satisfaction from less food consumption without losing muscle mass. This can be accomplished with ingredients that cause more glucose and amino acids to be uploaded by the skeletal muscle cells and the reduction of glucagon signaling action. Informed food selections which cause more glucose and amino acids to be uploaded by the skeletal muscle cells should be the primary objective of any organized attempt to prevent T2 Diabetes, Alzheimer’s, Depression & Obesity. Some diet plans do not include sufficient protein and can produce temporary weight loss where 30% of the weight loss is in the form of lean muscle mass. As soon as the starvation diet is suspended, a rapid weight gain results from the starvation-adjusted metabolism.
Can Average Americans Reduce Their Risk For Disease With Minor Diet Modifications?
Absolutely! Omega-3 fatty acids can reduce the incidence of sudden cardiac death by 45%.
Vitamin D3 has been shown to reduce the risk of breast cancer by 77%, juvenile diabetes by 80% and heart disease by 50%. Americans are smart enough to modify their diets and reduce their risks for disease if they can be introduced to valid diet-related science.
Who Are The Significant People To Promote This Information?
The majority of medical school classes are focused on pharmaceutical and surgical remedies. Very few practicing physicians show any interest in learning about diet-related remedies. The reason for this lack of interest is obvious: how much money can you charge some one for telling them to eat less, exercise more and lose weight?
The Diabetes Prevention Project is a non-profit group dedicated to the reducing the symptoms of people suffering from T2 Diabetes, Alzheimer’s, Obesity, and Depression . The Diabetes Prevention Project is recruiting individuals and groups that share our purpose. A partial list of offerings and ideas are as follows:
(1) Free T2 Diabetes Diet & Exercise Model for T2 Diabetics and their physicians.
(2) Free glucose testing kit links.
(3) Free Juvenile Obesity Prevention Plans for Schools.
(4) Pooling of resources for clinical trials on diet solutions and degenerative disease.
(5) A “twelve step” style mentoring process for distributing diet solutions.
Are You One Of The Significant People?
If you would like to contribute time, good ideas, or money to any of these concepts, please communicate the nature of your interest. We welcome your participation.
Good for you sir, more power to you.
I've never been overweight, but have gone on Atkins to reduce body fat and make fitness/training more efficient. I don't want to use the term "miracle diet" because it's so cliche, but the Atkins diet is something of one. It literally changes your physiology.
The "7 food group pyramid" is a defunct 1950s lie which continues to poison people with processed carbs and refined sugars that have no nutritional value whatsoever. All sugars and carbs do is make people who consume them fat and tired.
Actually, I'm suprised that the majority of the medical and scientific community hasn't figured out (or won't admit) that cows eat no meat whatsoever - yet are one of the fattest animals in existence. Predatory mammals eat nothing but meat yet are all generally lean and strong.
The body doesn't turn FAT into FAT. The body can't turn fat into fat. The body turns excess SUGARS and CARBS into FAT.
DUH!
I’ve heard that Co-Q10 is a good diabetic suppliment to take.
You sound as if you've tried everything else - try Atkins.
After a month PM me.
After 2 weeks on Atkins, I honestly felt like I had just woke up, fully, for the first time in 15 years. It was as though sweets, breads, spuds, and all that was a dulling drug, like natural depressants. It’s hard to explain it, but low-carber’s generally know what I mean.
You are rigth but as long as they get their extra weight off the diabetes will stay at bay.
I am type one and am on a carb counting regimen. If I could live on a diet of no carbs I’d probably never have to take any medication. Unfortuantely there are few things that are carb free.
You are never supposed to stop the low carbs on a low carb diet. It is a lifestyle not a diet.
So instead of eating steak & potatoes, I should eat steak & steak instead? I can live with that.
I think I’ll have the Spam, Spam, Spam, Spam, eggs, and Spam.
Godh don’t have such a bad attitude about it! I’ve been diabetic for nearly 40 yearsand so far so good. At 48 I’m in better health then a lot of others my age.
Too big a carb on an engine will drown it and not run well.
Dual 1300 CFM 4-bbls on a 289 that only goes to church on Sunday will never run well.
A single bore on a 454 designed to redline at 10,000 will not have much power.
Swap the two and you're in business.
Each engine has certain carb requirements to run well.
Each metabolism does too.
I’ve lost over 60 pounds since I went on the “Hunter/Gatherer” diet.
When I am on the diet, my BS is normal to slightly elevated, even in the morning when I get up. When I am off the diet, my BS is over 200 most of the time.
Yep lots of protein and little carbs. Have 2 steaks, the salad, and skip the potato and roll.
Interesting. I have high triglycerides and low HDL (LDL’s not too bad) and am currently on fenofibrate to treat it - no major side effects from it, at least - but still haven’t achieved as much as would be ideal. Even when exercising like crazy and following the recommended low-fat diet as best as I could, as well as taking the fenofibrate, I still only managed to get my triglycerides under control, but my HDL stayed rather low. I don’t know if I can live the low-carb lifestyle, though. I’m not a starchaholic, but I do like fries, bread, pasta/noodles, etc. I can probably give up the sweet stuff most easily. Do you still eat fruit?
My husband does very well on a low carb life style. I don't. WW works better for me. I can still eat healthy but splurge occasionally for something I'm craving.
No, no, no please don't just settle for this belief. Read Dr. Bernstein's Diabetes Diet Solution. Diabetes does NOT have to be progressive. Bernstein himself is Type I, and he has had it since the mid 1940s (he is elderly now) and is still going strong. And it is becoming clear that Type II is reverslble with either bariatric surgery or the low-carb lifestyle.
Type I is not reversable, but is definitely controllable, and the need for medication can be reduced. Type Is need a doc who will work carefully with them, though, to carefully monitor their decreasing need for meds and lower their meds gradually as the low-carb diet diminishes their need for the meds. Many docs will not do this because they believe as you have stated above.
My testimony is that low carbs for 6 months did not have a significant effect.
The only way for me to lower my BS from `150 to 130 or so is to exercise every day. Sweat does it.
Yes, I agree with you. I have experienced something of the same effect. I have presently fallen off of the low-carb wagon, though and need to get right back on. When low-carbing, I sleep better, my stomach upsets disappear, and my stiff finger joints on awakening are not stiff, but normal and flexible for the first time in years. Weird, huh!
Try fish oil (Omega3). That was the recommendation from my doctor. I have the same problem with my tryglycerides and HDL.
ping
for later
That sounds like my story! I lost 40 lbs low carbing and felt better than I have in years. Energy, not stiff in the morning, etc. My new year's resolution was to get back to low carb.
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I also spent my whole earlier life believing that I was “not a morning person” and would drag around for about an hour after I awoke before I felt human. Getting ready for an early workday for 24 years was not much fun for me at all. When I am doing low-carb, I tend to wake up pretty bright and chipper when I open my eyes so maybe the “not a morning person” thing has a nutritional cause, too.
I’ve observed two types of metabolisms within my circle of friends and work associates. All of which were dedicated to getting healthy and stuck to their respective diet approaches and exercised.
All (side note):
Consuming high cholesterol foods does not give you high cholesterol, that is a myth. Unless of course you are a couch potato and then the body decides to store it for you.
Most men and some women:
Low-carb, high fat (good fat) and exercise is the key to controlling your blood pressure and “bad” cholesterol
Muscle cannot be built without protein and you need fat in your diet to provide the fuel for exercise. Low carb is without a doubt the way to go. All low fat diet’s do is rob your engine of the fuel it needs to build lean mass. The more lean mass you have the easier it is to stay lean.
For you, try this “lifestyle” book: Natural Hormonal Enhancement by Rob Faign
Some women, very few men:
If you are in this group your genetics require a different approach. Low fat, low calorie diet consisting mainly of veggies. Get your protein from a high quality source like whey isolate or small premium cuts of meat.
Exercise is a requirement and high aerobic activity is what your body needs. People in this group have difficulty in building lean mass which robs them of high fat burning potential. Aerobic activity is the furnace substitute but if you can manage to build mass you’ll be that much better off.
This group of people should be studied as I found very few people land in this category. Not sure what their propensity for diabetes or other ailments is but they do not seem to respond well to low carb dieting.
For this group try (or some variant): Skinny B!tch (yes I know, not my title) by Kim Barnouin and Rory Freedman
I didn’t feel good on Atkins either.
I’ve been doing a different low carb/high protein diet that makes me feel good.
I follow the David Kirsch books - and the approach is different enough to make me feel much better.
“The only way for me to lower my BS from `150 to 130 or so is to exercise every day.”
Yes the revolutionary and amazing new diet;
“Eat Less, Move More”
So simple anyone can do it.
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