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Medical Forum / Diseases and Disorders / Diabetes / October 2008Nice Quote, Good Paper
Academic nutrition experts like to believe that they have been engaged in prevention of chronic diseases since the mid-1950s with the publication of their government-sponsored dietary guidelines. These guidelines, based on the lipid hypothesis, ushered in an era of fat-phobia that is still with us today. Now, five decades after adoption of these guidelines as official nutrition policy, we have a generation of obese Americans, beset with chronic diseases. Not only have the guidelines failed to keep their promise of preventing cardiovascular diseases, but they may well have played a role in causing an exceptionally large increase in the incidence of lipid abnormalities, type II diabetes, andmetabolic syndrome. Low-Fat Diet and Chronic Disease Prevention: the Womens Health Initiative and Its Reception Alice Ottoboni, Ph.D. Fred Ottoboni, M.P.H., Ph.D. Journal of American Physicians and Surgeons Volume 12 Number 1 Spring 2007 http://www.jpands.org/jpands1201.htm >Academic nutrition experts like to believe that they have been >engaged in prevention of chronic diseases since the mid-1950s with [quoted text clipped - 18 lines] > >http://www.jpands.org/jpands1201.htm Great link - thanks. Worth browsing for other excellent papers on statins and the implications of the internet for the medical world. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Be Smart, Be Skeptical) dLife http://tinyurl.com/54get5 (Diabetes Diet Wars) > Now, five decades after > adoption of these guidelines as official nutrition policy, we have a > generation of obese Americans, beset with chronic diseases. Not > only have the guidelines failed to keep their promise of preventing > cardiovascular diseases, Even the "right" guidelines (approved by a.s.d) wouldn't prevent all the overeating & undermoving that has become so prevalent. bj >> Now, five decades after >> adoption of these guidelines as official nutrition policy, we have a [quoted text clipped - 5 lines] >overeating & undermoving that has become so prevalent. >bj It may not prevent it all, but actively bad guidelines are exacerbating the problem. And how do you know if it hasn't been tried? Until the ADA, AHA, USDA and the dieticians of the world use our guidelines that is just an unproven assumption. I would define our guidelines as eating a balanced (neither low-fat nor extreme low-carb), moderate-in-all-macronutrients diet with a minimum of 30 minutes daily exercise for non-diabetics and as that modifi9ed by test, test, test for diabetics. We certainly have enough examples here to refute your statement; as do the ADA forum members over the past few years and the members of several other forums I read. The examples I have seen here and on those forums of people who have changed their lives by following the '"right" guidelines (approved by a.s.d)' belie your statement. It's no wonder people give up and stop trying on official nutrition advice that has been repeatedly proven not to work. Some further quotes from the paper (note that "the intervention" was the low-fat diet): "It was concluded that among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year mean follow-up period." "Despite dietary changes, there was no evidence that the intervention reduced the risk of invasive colorectal cancer." "It was concluded that over a mean of 8.1 years, dietary intervention (reduced total fat intake and increased intake of vegetables, fruits, or grains) did not significantly reduce the risk of CHD, stroke, or CVDin postmenopausal women." "Medical education covers such a tremendously wide range and volume of information necessary to the diagnosis and treatment of disease that ancillary subjects such as nutrition are given only superficial treatment. Physicians rightfully have assumed that nutritional science can provide whatever information they require. Medical organizations must serve their members by demanding current, unbiased, accurate information from nutrition scientists. As patients look to their physicians for all manner of advice on health, including nutrition, physicians will ultimately be held responsible for errors. Physicians must also recognize that there is no drug that will cure a nutritional disease" That last sentence is one of the most important in the article. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Be Smart, Be Skeptical) dLife http://tinyurl.com/54get5 (Diabetes Diet Wars) >> Now, five decades after >> adoption of these guidelines as official nutrition policy, we have a [quoted text clipped - 4 lines] >Even the "right" guidelines (approved by a.s.d) wouldn't prevent all the >overeating & undermoving that has become so prevalent. Actually, it probably would go a long way towards it - because it's quite difficult to overeat low carb, at least if you're doing it paleo, and so you've generally got plenty of energy. CF Taubes... Michael Eades reckons you've got a 400 cal /day advantage low carbing. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.4% BMI 25 >>> Now, five decades after >>> adoption of these guidelines as official nutrition policy, we have a [quoted text clipped - 9 lines] >paleo, and so you've generally got plenty of energy. CF Taubes... >Michael Eades reckons you've got a 400 cal /day advantage low carbing. Works for me, I never had soooo little energy as when I was on the Healthy High Carb Low Fat Diet. Ten minutes waving the hedgetrimmer around and I had to lie down for an hour. Nowadays I work for an hour and break for ten minutes - then do another hour. My strong suspicion is that my BG was all over the place, which it no longer is. >>Even the "right" guidelines (approved by a.s.d) wouldn't prevent all >>the overeating & undermoving that has become so prevalent. [quoted text clipped - 7 lines] > D&E, 100ug thyroxine > Last A1c 5.4% BMI 25 I see my problem. I don't do low carb, therefore I don't adhere to the a.s.d. guidelines! However, I have been successful in controlling my diabetes. bj >>>Even the "right" guidelines (approved by a.s.d) wouldn't prevent all >>>the overeating & undermoving that has become so prevalent. [quoted text clipped - 12 lines] > >However, I have been successful in controlling my diabetes. No, the problem is that you and people like you are in a serious minority compared to people like us. I've met a few who actually do well with significantly more carbs than many of us can handle but only a few on any specific forum - and often outnumbered by the bullshitters. You appear to be genuine, so is Powerwalker on the ADA forum and a few others scattered around the place, but the vast majority of successfully controlled diabetics in all forums seem to be centred around the 50 - 100g range. Yet annoyingly the "professionals" try to foist the minority diet onto the majority for whom it doesn't work. >>>>Even the "right" guidelines (approved by a.s.d) wouldn't prevent all >>>>the overeating & undermoving that has become so prevalent. [quoted text clipped - 24 lines] > around the 50 - 100g range. Yet annoyingly the "professionals" try to > foist the minority diet onto the majority for whom it doesn't work. I don't think there have been a consideration of a person's metabolic rate in the control of diabetes. Like the some others, I don't do low carb but do low fat & low sodium (most times) & my bg is 95-104 pre while the after meal range from 112-125. Also dinner 4 times a week include 1 cup of cooked rice (real rice, not the minute stuff); yes I'm in the ethnic category that is prone to diabetes. I also do pasta & bread, both seem to be avoided by a.s.d. My 2001 a1c was 4.8 & my recent a1c was 4.7. In my younger days, I can lose 5 lbs if I skipped lunch once a week, which I quickly stopped doing that. Even at 50+ I would lose weight if I had a lunch of just a sandwich (not the submarine type with a large roll) & would have to have an extra steak during the week to regain my "ideal/desired" weight. Even now I found that I cannot skip lunch twice a week because classes are at the same time as I would lose weight; would snack before dinner & a south beach protein bar between classes. My bmi is around 28.5, a bit overweight by about 17 lbs of my "ideal". I believe that the added weight helps keep me somewhat healthy from colds & flu (last cold was in 1987 because of being "runned down"). Perhaps my theory is wrong even for me but it does work for me in my diabetes management without any drugs. Could the bg numbers be lower? probably, but my discerned comfortable "quality of life" would be lowered. >>>>>Even the "right" guidelines (approved by a.s.d) wouldn't prevent all >>>>>the overeating & undermoving that has become so prevalent. [quoted text clipped - 50 lines] >management without any drugs. Could the bg numbers be lower? probably, >but my discerned comfortable "quality of life" would be lowered. Yes good points, and this probably ties in with much of Taubes and others' theories on why calories of different types have different effects in different people. I simply can't eat those sorts of quantities of those sorts of things and have a metabolic rate above that of a snail on valium. Do you think I haven't tried? <G> My weight never changed over years, I always had a BMI around 21 - 22 (except it went down to about 18.5 when I had gallstones) UNTIL I was put on the High Carb Low Fat Diet. Now after severely dropping the carbs and adding back the fat my BMI is back there again and without the carbs I have several orders of magnitude MORE energy. So I freely admit I have weird genes. You have a different kind of weird <G> In the end the secret is to eat as many carbs as YOU can metabolise without excess BG, excess lipids etc. It just seems that the majority do better on far fewer carbs than the experts say we should need, and that relates not only to diabetes but to obesity and cardiovascular risk, all of which have been mushrooming on the Heart Healthy diet. > Yes good points, and this probably ties in with much of Taubes and > others' theories on why calories of different types have different [quoted text clipped - 18 lines] > that relates not only to diabetes but to obesity and cardiovascular > risk, all of which have been mushrooming on the Heart Healthy diet. Good points bj and Trink! While I know there are generalities for good health--like eat enough Vitamin C to prevent scurvy--it seems silly to me to presume that humans are like robots and if you feed them all the same way, you'll get the same result, not only in objective health, but in quality of life. While your way of eating, bj, would make feel totally lousy (my metabolism is more like yours Trink) I wouldn't presume to tell you to do something that is going to make you feel bad, especially since your numbers are acceptable. I couldn't handle the amount of exercise you do either, and while I think exercise is important, I'd have to beat you with broom if you tried to make me do it. ;-) So bj, I promise not to make you eat too many veggies, if you promise not to make me exercise as much as you do! ;-)  SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 > So bj, I promise not to make you eat too many veggies, if you promise > not to make me exercise as much as you do! ;-) Sounds like a good deal. I don't exercise as much as some people seem to think I do, it's just that some of it is fairly vigorous -- not that my running speed is anything special, about middlin' for a woman my age who does roadraces. I may improve next year, though, I go into a new 5-year age group! Looking forward to that! :-) bj > not that my running speed is anything special, about > middlin' for a woman my age who does roadraces. But much, much faster than those of either gender who don't do roadraces:-) Like me. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Be Smart, Be Skeptical) dLife http://tinyurl.com/54get5 (Diabetes Diet Wars) >> not that my running speed is anything special, about >> middlin' for a woman my age who does roadraces. [quoted text clipped - 3 lines] > > Like me. Well, I do always say that no matter how slow we are at the back-of-the-pack, we're still ahead of the people who aren't there (& don't do something else, activity-wise -- & I don't mean those who for one reason or another can't or are very limited in what they can do). I'm certainly ahead of what I used to be before I got diabetes & had to shape up. :-) I took up roadracing for the variety, instead of always going around my own neighborhood, even though I do have loops in different directions to choose from. Then it took on a life of its own; now I'm as likely to keep up my training so my racing will go halfway decently! I get quilts made from the T-shirts that you get at a lot of events. Years from now they'll look good in my nursing-home-room -- I don't have a "power wall" of photos with prominent people. :-) bj >I get quilts made from the T-shirts that you get at a lot of events. >Years from now they'll look good in my nursing-home-room -- I don't have >a "power wall" of photos with prominent people. :-) ROFL! There's a darn good idea, I'm going to pass that on to my sister, who's a road-racer with a huge collection of running T-shirts. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.4% BMI 25 >>I get quilts made from the T-shirts that you get at a lot of events. >>Years from now they'll look good in my nursing-home-room -- I don't >>have a "power wall" of photos with prominent people. :-) > > ROFL! There's a darn good idea, I'm going to pass that on to my > sister, who's a road-racer with a huge collection of running T-shirts. It's not cheap, but if there's someone (or a group) who needs a Big Gift Idea it's a good opportunity. My mother gives me a "quilt voucher" & then repays me the cost of whatever I get. (You can get them in all sizes.) There are several companies who do this as a business (I've been using campusquilts.com) & you (or she) can find ads in various racing rags. If she does marathons, there may also be booths at the packet-pickup/expos. If you end up with too many quilts to sleep under, you can always hang them on the wall, the way they used to with tapestries in the Very Old Days. :-) bj >> So bj, I promise not to make you eat too many veggies, if you promise >> not to make me exercise as much as you do! ;-) [quoted text clipped - 5 lines] > 5-year age group! Looking forward to that! :-) > bj I'm always envious of people who can run in marathons. I've never been much of runner--even when I tried to improve. :-) SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 >>> So bj, I promise not to make you eat too many veggies, if you >>> promise [quoted text clipped - 11 lines] > I'm always envious of people who can run in marathons. I've never > been much of runner--even when I tried to improve. :-) Well, you certainly don't have to envy me -- I've never done a marathon, doubt I ever will, & don't even think I'll be able to work up to another 10miler or half-marathon (though I do keep hoping I can work it out, going downhill at my age is not a good sign for running improvement....) bj >>>> So bj, I promise not to make you eat too many veggies, if you promise >>>> not to make me exercise as much as you do! ;-) [quoted text clipped - 14 lines] > downhill at my age is not a good sign for running improvement....) > bj LOL! In my book a 10 miler is two marathons! ;-) So if it's not an impertinent question, how old are you, bj? I'm 99% sure you are older than I am--I'm 44. SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 >>> I'm always envious of people who can run in marathons. I've never >>> been much of runner--even when I tried to improve. :-) >> Well, you certainly don't have to envy me -- I've never done a >> marathon, doubt I ever will, & don't even think I'll be able to work >> up to another 10miler or half-marathon (though I do keep hoping I can >> work it out, going downhill at my age is not a good sign for running >> improvement....) >> bj > LOL! In my book a 10 miler is two marathons! ;-) > > So if it's not an impertinent question, how old are you, bj? I'm 99% > sure you are older than I am--I'm 44. Child! :-) I'm not a boomer I was a WWII baby & so was my little brother. I've just filed for Medicare. At least, and at last (first time in ~40 years), I'll be in a group insurance program (with a *big* lobbying group defending it) & not feel so vulnerable & out there on my own as an individual. It'll cost less too! bj >>>> I'm always envious of people who can run in marathons. I've never been >>>> much of runner--even when I tried to improve. :-) [quoted text clipped - 18 lines] > individual. It'll cost less too! > bj LOL! Hey, I'm always glad when someone in this group gets good health insurance at a reasonable cost! It's such a struggle for so many. (And I'm going to leave it at that because I feel a rant coming on.) Of course, you keep running those road races, and you may not have much use for your Medicare. ;-) SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 > "bgl" <bjones44@verizon.net> wrote in message >> I'm not a boomer I was a WWII baby & so was my little brother. >> [quoted text clipped - 3 lines] >> individual. It'll cost less too! >> bj > LOL! Hey, I'm always glad when someone in this group gets good health > insurance at a reasonable cost! It's such a struggle for so many. In Scotland we get free doctor's visits and hospital treatment etc on the NHS. but we have to pay a token amount for having a prescription filled by the pharmacist. Unless you have one of number of chronic conditions like diabetes in which case all your prescriptions are free of charge too. They also regard being over 65 as a chronic health condition, and give all prescriptions free to the over-65s. SignatureChris Malcolm, IPAB, School of Informatics, Informatics Forum, 10 Crichton Street, Edinburgh EH8 9AB >> "bgl" <bjones44@verizon.net> wrote in message > [quoted text clipped - 16 lines] > of charge too. They also regard being over 65 as a chronic health > condition, and give all prescriptions free to the over-65s. Go ahead, rub it in, Chris. ;-) SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 >>> LOL! Hey, I'm always glad when someone in this group gets good health >>> insurance at a reasonable cost! It's such a struggle for so many. [quoted text clipped - 5 lines] >> of charge too. They also regard being over 65 as a chronic health >> condition, and give all prescriptions free to the over-65s. > Go ahead, rub it in, Chris. ;-) Ok. As a pensioner I also get a free bus pass which takes me all over Scotland :-) SignatureChris Malcolm >>>> LOL! Hey, I'm always glad when someone in this group gets good health >>>> insurance at a reasonable cost! It's such a struggle for so many. [quoted text clipped - 10 lines] > Ok. As a pensioner I also get a free bus pass which takes me all over > Scotland :-) Whack! Whack! LOL! :-) Ahem..., it's only envy. SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 > LOL! Hey, I'm always glad when someone in this group gets good health > insurance at a reasonable cost! It's such a struggle for so many. > (And I'm going to leave it at that because I feel a rant coming on.) > Of course, you keep running those road races, and you may not have > much use for your Medicare. ;-) Unfortunately diabetes isn't my only expensive health problem. Maybe not even my most expensive, just the most day-to-day nuisance. The periodic checkups to see if my cancer has returned or metsticized can cost big bucks, although the daily meds are dirt cheap. :-) The last major checkup I had 2 years ago was $2600+ & I just had another go last week. (I have a feeling something's missing in my sums or my records; it was more in '03 & '04.) That doesn't include any further imaging or testing, which I also need this time to check on a "ghost" on my nuclear scan, & I still have a noodgie in my neck that may or may not be doing anything & needs to be watched. <sigh> The extras in '03 added quite a bit to the tab. Medicare is gonna *love* me! BCBS is going to be dancing in the aisles. bj >> LOL! Hey, I'm always glad when someone in this group gets good health >> insurance at a reasonable cost! It's such a struggle for so many. [quoted text clipped - 17 lines] > Medicare is gonna *love* me! BCBS is going to be dancing in the aisles. > bj Well, Medicare if far more efficient in cost of adminstration. so it can afford you. ;-) SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 : >> LOL! Hey, I'm always glad when someone in this group gets good health : >> insurance at a reasonable cost! It's such a struggle for so many. [quoted text clipped - 17 lines] : > Medicare is gonna *love* me! BCBS is going to be dancing in the aisles. : > bj : Well, Medicare if far more efficient in cost of adminstration. so it can : afford you. ;-) Don't forget to get secondary insurance to cover the 20% co-pays. With your conditions that could amount to real money!. Wendy > : > Medicare is gonna *love* me! BCBS is going to be dancing in the > aisles. > : > bj > Don't forget to get secondary insurance to cover the 20% co-pays. > With your conditions that could amount to real money!. Oh believe me, I'm doing my homework on Medicare, Medi-gap, Medi-drug, & Medi-anything else that seems appropriate. :-) I not only have a stack of reading material from companies that I called, I'm getting more from companies I didn't call. Just like AARP, they know when you're turning the Magic Age. Good brain activity, I suppose. At least you can change the 'gap & 'drug plans each year -- the important thing is to sign up for *something* during the initial enrollment period so you don't pay a monthly penalty forever. bj : >>Even the "right" guidelines (approved by a.s.d) wouldn't prevent all : >>the overeating & undermoving that has become so prevalent. [quoted text clipped - 7 lines] : > D&E, 100ug thyroxine : > Last A1c 5.4% BMI 25 : I see my problem. I don't do low carb, therefore I don't adhere to the : a.s.d. guidelines! : However, I have been successful in controlling my diabetes. : bj You alway say that you don't do low carb. Just how much carb do you eat? Is it like odinary non-diabetics with cereal and toast for breakfast, sandwich and french fries for lunch maybe with some fruit an dcookies and meat, potaotes, veg,, often starcy, bread adn fruit and cake foor cookies for dessert, as well as sugar in your coffee? Many diabetics continue to eat almost that way, maybe not havign the cookies or both toast and cereal at breakfast. Many of us are not wildly low carb here, but do use moderation. Are you claiming that you do not? Wendy > : I see my problem. I don't do low carb, therefore I don't adhere to > the a.s.d. guidelines! [quoted text clipped - 14 lines] > low carb here, but do use moderation. Are you claiming that you do > not? There's a lot of territory between moderation and low-carb. I'm way over the 50-100g/day that many here mention, & I've never even thought about doing an Atkins induction type of diet. I'd say that 150g/day would be a low-average on a not-overly active day, & I may be underestimating some of my carbo-servings. I didn't eat your "ordinary non-diabetic" meals when I *was* non-diabetic! Too much, yes, but not the pattern you mention. Nor do I drink coffee -- although when I have had some it has been with plenty of sugar & hopefully cream to make it tolerable -- & I drink my tea straight. I do still eat cookies & ice cream & bread/crackers & cereal on a regular, usually daily basis. I'm not much of a veggie eater. I (try to) do better than I used to pre-dx, & I eat less & move more than the pre-dm years when I got lazy & inattentive. No ice cream or other dairy right now, though, because of a special (non-dm) test-prep diet (I hope to be back to "normal" by the weekend if the tests come out ok) -- but I'm eating more cereal & bread instead. And feeling even less like veggies than usual due to the conditions of the testing. bj : "W. Baker" <wbaker@panix.com> wrote in message : There's a lot of territory between moderation and low-carb. I'm way over : the 50-100g/day that many here mention, & I've never even thought about : doing an Atkins induction type of diet. I'd say that 150g/day would be a : low-average on a not-overly active day, & I may be underestimating some : of my carbo-servings. : I didn't eat your "ordinary non-diabetic" meals when I *was* : non-diabetic! Too much, yes, but not the pattern you mention. Nor do I : drink coffee -- although when I have had some it has been with plenty of : sugar & hopefully cream to make it tolerable -- & I drink my tea : straight. : I do still eat cookies & ice cream & bread/crackers & cereal on a : regular, usually daily basis. I'm not much of a veggie eater. I (try to) : do better than I used to pre-dx, & I eat less & move more than the : pre-dm years when I got lazy & inattentive. : No ice cream or other dairy right now, though, because of a special : (non-dm) test-prep diet (I hope to be back to "normal" by the weekend if : the tests come out ok) -- but I'm eating more cereal & bread instead. : And feeling even less like veggies than usual due to the conditions of : the testing. : bj thanks, you do eat quite a few more carbs than I caan handle, but then I can't run o even do a ton of walking. for me, the lowercarb approach with medication keeps me in a good number area. I was amazed, during the olympics, to read wwhat michael Phelps are in a day during the racing season. He had to really stuff on carbs to keep up with his heavy athletic schedule. I was wondering aobut your diet, as you so often mentin tht you don't do low caarb. Wendy > : There's a lot of territory between moderation and low-carb. I'm way > over the 50-100g/day that many here mention, & I've never even thought [quoted text clipped - 8 lines] > during the racing season. He had to really stuff on carbs to keep up > with his heavy athletic schedule. During the Tour de France broadcasts they also talk about how much the cyclists have to take in while they're on the road, not even counting what they eat before & after each day's ride. High-level athletes need an astounding number of calories! Not that I'm "high level" but I'm moderately active on a regular basis. Besides, earning my treats keeps me motivated to get out the door! Bg control aside, I've also kept my weight stable since the initial post-dx weight loss due to taking control, paying attention, & getting back to at least reasonable amounts of regular exercise, which I'd gotten really sloppy about. Maybe I'd have staved of dm longer if I hadn't gotten so....lazy....about it all. > I was wondering aobut your diet, as you so often mentin tht you don't > do low caarb. Not that I'm *against* it if that's what you want to do. But I can't abide the amount of veggies that it would require to keep me full. Bleagh. :-) I have compromised by using medication (currently Januvia, love that stuff!) so that I can eat pretty much on a normal pattern -- for several years I ate the same amount of carbs I do now but spread out more -- I usually didn't have an actual whole-meal-at-once. I got tired of that routine; doctor agreed to my request; I used Prandin for a while (~3yrs I think) before switching to Januvia. I've gotten a *little* sloppy lately, so I had an A1c run along with some other totally unrelated tests being done today. It'll either be sigh-of-relief (that it isn't worse, despite some of my recent meter readings) or whap-in-the-face (*shape up!*). bj |
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