On the other hand.....

Public Health Nutr. 2007 Oct;10(10A):1164-72.
Inflammation, obesity and comorbidities: the role of diet.

The adipocyte metabolism has been shown to change during the fat enlargement
process associated to obesity. Several procoagulant proteins such as
plasminogen activator inhibitor type 1, tissue factor or factor VII and also
inducible nitric oxide synthase show higher expression in adipose tissue of
obese people in comparison to lean. This overexpression could explain at
least a part of the atherogenic and cardiovascular risk associated with
obesity. In addition to cytokine secretion, many other features have been
observed to be common to adipocyte and monocyte/macrophage lines: for
example, phagocytic and microbicidal activities, and possibly a cellular
plasticity of adipose precursors. Overweight and obesity are associated with
an increased risk of such metabolic abnormalities as dyslipidemia,
hypertension or type 2 diabetes mellitus and cardiovascular diseases, common
features of the metabolic syndrome. Initially, insulin resistance or
hyperinsulinemia was suggested as the origin of these abnormalities. More
recent studies indicate that adipokynes have an important role in
obesity-associated metabolic complications, and suggest that chronically
elevated local or systemic concentrations of adipokynes contribute to the
development of complications associated with obesity and metabolic syndrome.
Considering all the evidence relating to diet and inflammation, the best
diet for protecting against the metabolic derangements associated with
obesity and metabolic syndrome would be high in fibre-rich cereals, fruit,
vegetables, fish, virgin olive oil and nuts; moderate in wine; and low in
meat, processed meat foods and trans-fatty acids.

PMID: 17903326

hmmm
getting mor and more depressed
Gys

This doesn't read like any new research...but it does read like a review
made of old out-of-date literature made authors who have a bias.

I'm still only skimming, but one of their references really
stood out. It's also included in their comparison "table 2":
"21.    Gannon MC, Nuttall FQ. Effect of a high-protein,
low-carbohydrate diet on blood glucose control in people
with type 2 diabetes. Diabetes. 2004;53(9):2375-2382."

You would usually presume references are included to support
the researchers position. One really has to wonder if they
read this one. I know we both have; just to remind you of
the conclusions to that one:

"In summary, a LoBAG diet can dramatically reduce the 24-h
integrated glucose concentration and consequently the
percentage of glycohemoglobin in people with type 2
diabetes. These positive results occur without a significant
change in serum lipids, except for a significant decrease in
triacylglycerol concentration."

For reference, you can find it here:
http://diabetes.diabetesjournals.org/cgi/content/full/53/9/2375

I will be fascinated to see if Nuttall or Gannon respond to
this "paper" which has conclusions diametrically opposed to
their own but claims to be using their work as a reference.
One glaring misrepresentation is: "In seven studies, LDL-C
increased significantly after carbohydrate restriction.
13,14,17,21,24,38,40"

Please let us know if they do.

This also makes me wonder what we'll find if we take the
time to read the other references. One criticism of the
LoBAg studies was their small size and short duration. A
quick glance shows many of the others in table 2 to have
exactly the same problem.

I could find no indication of the funding source for this
work, apart from "The authors have indicated no
relationships to disclose relating to the content of this
article."

I'm definitely not going to be rushing out to buy packets of
cereal or pasta based on this:-)

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Psyllium, Fibre, Muesli and Nuts

That's certainly true. That is why in following my carb-restricted
diet I drink more and exercise more, as a result of which I'm gaining
metabolically active muscle tissue, and in general have improved in
health since diagnosis of diabetes, and am still improving.

That's true too, which is why I'm not going to discontinue my diet. I
deliberately devised it from the start as a diet I could live with for
the rest of my life. I've now followed it for nearly two years, and it
shows all the signs of being a successful lifestyle adaptation.

That's true to. Fortunately the measures I've taken to avoid the other
risks they mention have also reduced my circulating LDL-C levels, and
have also, in the judgment of my doctor, reduced my CVD risk. As
someone already at least one heart attack down that's a risk factor I
take very seriously.

That's true. Fortunately I'm either lucky or the other measures I've
taken to avoid the other problems seem to have gifted me with renal
function which is better than usual for my age.

I have unusually strong bones for my age. Even so, just as a
precaution, I include in my exercising stuff designed to strengthen
bones as well as muscles. I'm considering making myself a punch bag to
get some good heavy impacts in the arms and upper body. I think
carbohydrate might make a good filling material :-)

Fortunately the amount of walking I do, plus my high consumption of
fibrous vegetables, has given me enviably healthy bowel function.

It's so encouraging to read such a long list of problems that I'm
successfully avoiding!

That's a terrible list of possible problems of low-carbing. Since I'm
far from beling alone in having avoided them all, and thereby have
been able to reap the benefits of low carbing for a T2, and that I did
so by following the advice and education I've got here, it would seem
to be a good idea for physicians caring for T2 diabetics to consider
asd as a useful educational resource whose ideas may help at least
some of their diabetic patients to benefit from low-carbing without
any of those risks.

I don't quite get why glycogen depletion is seen as risky.

And I *really* don't get how eating sufficient protein puts one at risk
for losing lean body mass.  Seems to me it's quite the opposite.

The Protein Sparing Modified Fast is a medical diet invented
specifically to allow doctors to have patients lose weight rapidly when
their life is at immediate risk and the whole point of it is that
sufficient protein spares lean body mass being lost.

Not discontinuing it solves that problem.  I've never seen a published
low-carb diet that didn't have a maintenance phase, so someone doing one
ought to be doing it for life.

The renal function thing is a known urban legend.  Protein leaks from
the kidneys when they're broken, that doesn't *cause* them to be broken.
 It's a symptom, not a cause.

Ketosis happens any time fat is burnt at a significant clip, any weight
loss diet is going to produce ketones whether it's low-fat, low-carb or
just generally low-calorie.  If it works, fat is burnt; if fat is burnt
at a good clip, ketones are produced.

OK, we've only got the conclusion not the reasoning, but most of what I
see in the conclusions is flatout wrong.

Which isn't too surprising since they began by asking the wrong
question... should T2s go low-carb for weight loss?

My answer is... no.  Rather, they should go low-carb for bg control, to
protect their hearts, their kidneys, their eyes, their limbs, their
lives.  Losing weight just isn't nearly as significant as controlling bg.

I'm the last person here who would advise anyone to follow a low-carb
diet,  But the problem with this study/article is that it deals with
extreme low-carbing and seems to define it as being around 20 grams
per day.  There are only a couple of people in this newsgroup that I
think follow a dangergously low carb diet like that.  However, there
are many many people in the general population who believe that low
carb diets are like that...cut out all carbohydrates and eat all the
fatty food you want.  In that case, then someone would have medical
problems if they followed it long term.

Here is what the article describes low carb eating to be:

"Many of the most popular low-carbohydrate diets, also known as
ketogenic diets, focus on consuming animal-based foods and suggest
limiting intake of fruits, vegetables, and complex carbohydrates, not
just simple carbohydrates (see Table 1). Saturated fat content in most
cases is more than the current recommendations for disease prevention.
And, in view of the limited food choices, adequate micronutrient
consumption is often corrected with supplements."

From what I read in here, most of the low-carbers don't limit their
intake of low carb vegetables and get lots of important nutrients from
them

This article illustrates the frustration I have within this newsgroup
regarding people who jump on newbies and push them towards a low carb
diet, a few of them do so in a very heavy handed way.  Even here in
a.s.d. I have yet to see a specific definition of what low-carb means
in terms of the amount of carbs per day.  It is all over the place.
And therein lies the rub...it will be different for everyone.  I'm
labeled a "high carber" yet I eat around 150 grams a day, which is
much "lower carb" than the average person eats.

That is why it behooves all people with diabetes to work with
professional medical people IN PERSON to determine what is right for
them. If someone were to plan their diet based on what they are told
in a Usenet newsgroup then they may misinterpret, or in some cases be
misinformed.

An important factor that most studies fail to address is the activity
level of the participants.  Having a daily exercise routine, even a
moderate one, greatly affects the carb level that can be tolerated.
If you sit in front of the computer all day long and don't get "up,
up, and away" as Tom says then it's going to be a lot harder to
consume many carbs or calories without a negative effect.

Kurt

Very complicated stuff, Gys....

When I had that 2 month gout problem, one of my docs suggested it may be due
to too much protein in my diet... In a way, I think he was at least
partially right. The balance of our metabolisms is very delicate, and in
diabetics, especially prone to imbalance.

Lately, I have conciously been eating a few more carbs, of the more complex
and low glycmic variety.... Balance is so important.

Lucky for me,  I seem to have turned the corner for now.

Will, T2

"GysdeJongh" <jongh711@planet.nl> wrote in message news:4747f068$0$25501

Lol, I'd like to know what their test subjects have been eating. I have been
on a low carb diet for 7 years. I am never constipated, or even remotely
like it, never dehydrated, I don't eat "high" protein, my bone density tests
are always exactly right for my age, my kidneys and thyroid are working
perfectly and I still qualify for Mensa. Some people are such dicks. Oh, and
the bit about having fat problems when you cease the diet... ceasing a type
2 diabetes diet would be when you are cured or dead...