The Obvious isn't Always Obvious...

"Relinquishing My Mental Frustrations"

I have this crazy hobby, or maybe obsession.  

I read anything and everything related to nutrition.  I mean everything....Research, Diet Books, Blogs, you name I read it.

I read it with a pair of Diabetic Glasses on, looking for ways to improve my health(and others) I have written posts about food, and controversial topics like What's Up with the Food Guide and Pro Carb vs. Low Carb so one could say I am a little biased in my opinion.

I am now trying to figure out why so many in the medical profession (at least the ones I meet)tend to not agree with reducing the carbs.  So I started looking into what knowledge the General Practitioner gets regarding Nutrition. 

I asked a brand new, wet behind the ears Resident or Family Doc in Training how much education he received in the area of nutrition during his medical degree.  His response was, "Hardly Any" 

Hmmmmm. So I decided to pull a Medical Physiology Textbook written by Guyton from the shelf to have a look at what these doctors review in terms of Insulin Metabolism, and the storage of Macronutriants, like Carbohydrate, Protein, and fat.  Thinking, there must be a profound reason we are offering the general public a guideline to consume a diet that contains 65% carbohydrate. So I flip it to the pertinent section. And read the following:

In time, the insulin plays an important role in storing the excess energy substances.  In the case of excess carbohydrate, it causes these to be stored as glycogen mainly in the liver and muscles.  It causes fat storage in the adipose tissue.  Also, all the excess carbohydrate that cannot be stored as glycogen are converted under the stimulus of insulin into fats also stored in the adipose tissue

Okay, so they are taught in medical physiology that insulin is the main stimulus for fat storage. So I ask myself, what causes increased levels of insulin in the human body?

Excess Carbohydrate causes an increase in blood glucose, which in turn cause an increase in insulin which in turn gets stored as fat.  Apparently most of the world has missed this point.

Okay, I also read from the same text, now this is for those interested in how to up the fat burning engine in your body, which definitely includes me. 

All aspects of fat breakdown and use are greatly enhanced in the absence of insulin

Short quote. Now in the complete absence we'd be dead, so I guess what this Medical text is suggesting is that in cases of reduced insulin levels, we set our metabolism up to burn more fat then if we have higher levels.

So as I read this from a Medical Text Book on Physiology, that Doctors use to reference, I question how the hell we can in good conscious tell people to increase their insulin levels beyond capacity, when basic Insulin Metabolic Theory indicate the outcome of doing so?

What's my point?

Well, I guess I don't understand why the obvious isn't noted, and practiced. Perhaps it's the "Hardly Any" training some groups of health professionals receive in the area of nutrition. However, even the Professionals that are trained in the area of nutrition still encourage this high carbohydrate approach.

Who knows.

Trev 

Source:

Textbook of Medical Physiology, Guyton, Arthur C.8th Edition, WB Saunders Company, 1991. pp. 858-859. 

Sunday Night Summary

AKA the Day was too busy to write an original blog.

On a positive note, my 6 year old type 1 came up to me tonight while shopping in the bread section of the local grocery store and said "Dad I think I am low" Now most parents would probably be "Oh crap" and interpret this as a failure. Not I, I was happy, oh my, was I happy!  Why, well if you've read the post, "My Kid Can't Feel Her Lows" you'd know.  I immediately asked her how she knew she was low and she told me, "I can feel shaky and funny in my legs" I said," that is how daddy feels too when he is low"  Then I positively reinforced her coming to tell me, and gave her a bag of mini-eggs, I know I should pay first but this was a medical emergency.  So to me I can rest a little easier and know that she is capable of feeling and articulating when she is having a low blood sugar.  Huge relief! Hurray for the low response, yippee for the adrenaline!

Well it has been a good week in the Posting department.

Number 1 on the list: Pro Carb or Low Carb

Number 2: Have Your Cake and Eat it Too

Number 3: Timing is Everything

Thanks to all for your comments!  It is encouraging and supportive.

Cheers!

Trev

Pro Carb or Low Carb?

I must say, the debate is on!  I am not an extremist, as I believe in moderation but a popular topic in the field of diabetes, especially diabetes and weight loss is, as the title depicts, should we eat high carb, low fat, or low carb, high protein, mod fat.  What should we eat?

I am reading a book at the moment called Living Low Carb, great book!  The author Jonny Bowden compares all the low carb diets on the market. His writing style is witty, fun, and makes complicated biochemistry seem interesting, seriously, definitely worth a read! 

The author uses an analogy to clearly display how silly the current stance is for most health care providers, dietitians and associations that place huge emphasis on how carbs are absolutely essential for a healthy diet.


I love Mr Bowden's illustration:

He talks about a time he was lecturing to a large group.  He tells the group that he going to divide them in half. He explains that they are going to be stranded on a deserted island. The first half will be given only carbohydrate to survive on, and the second half will be given protein and fat but zero carbohydrate.  Then, he asks the audience who will be alive in 12 months.

The answer, backed by research  according to his literature review,  is the group that consumed protein and fat . This claim begs the question; are we being told to consume so much bloody carbohydrate when it's not essential for our survival. So I did my own lit search, not a google search but an actual lit search.

I do believe Mr Bowden and the Low Carb crew may be onto something.

The first study article written by Dyson, P and colleagues  in Diabetic Medicine took 13 Type 2 diabetics and 13 non-diabetic subjects. They were randomly placed on a low carb diet (less then 40 gms per day) or the usual diet recommended by the UK diabetes association.  They were assessed monthly for three months.  Guess what the results were?  Those assigned to the low carb eating plan, lost more weight but had minimal changes to lipids and A1C levels.  "The diet was equally effective in those with and without diabetes.
So onto the next study"  Okay good info, interesting.....

Another study done by Shai, Iris R.D and colleagues in the New England Journal of Medicine compared weight loss with three mainstream diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. What did they find?

When they randomly assigned 322 moderately obese subjects to one of the three group they concluded that:
"Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions."

Clear as mud right, so what they are telling us is that a lower Carb higher healthy fat diet may be a good alternative compared to the 60-75 % high carb diets normally recommended to us battling the big D. 
Okay, moving on......

The last study authored by  Brinkworth and colleagues in Diabetologia  randomly assigned 66 obese subjects to either a low carb (40 % carb/30% protein)or high carb(55% carb/15% protein) diet.  The results were "A high-protein weight-reduction diet may in the long term have a more favourable cardiovascular risk profile than a low-protein diet with similar weight reduction in people with Type 2 diabetes."

So you can loose weight, increase the good fat HDL, with no apparent adverse effect?  Sounds good!

After reading the books, doing a bit of a lit review(not an exhaustive one).  I try to remain unbiased, but the evidence is mounting in favour of a reduced carbohydrate way of eating.  I know that the more carb I consume, the more insulin I need, the hungrier I am, the bigger my waist gets and most importantly the sugars are way harder to control. 

Are you pro carb or low carb or somewhere in between?

Trev

Sources:
Dyson, P. A.; Beatty, S.; Matthews, D. R.(2007). A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects, Diabetic Medicine. 24(12):1430-1435.

Shai, Iris R.D et al.(2008).  Weight Loss with a Low Carbohydrate, Mediterranean, or Low-Fat Diet,

Brinkworth, G. D. 1; Noakes, M. 1; Parker, B. 1; Foster, P. 1; Clifton, P. M. (2004).
Long-term effects o advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with Type 2 diabetes: one-year follow-up of a randomised trial, Diabetologia. 47(10):1677-1686.New England Journal of Medicine. 359(3):229-241.