Sunday, 11 January 2009

Diabetes diet - high carb or low carb?

Today I was in a health food shop buying flax seeds to make my usual low carb bread. Just out of interest, I asked the assistant whether the Daily Mail's recent series about the 'All-new Atkins Diet' had increased the number of people asking about the Atkins Diet. Her answer was that she was totally against low carb diets. She then said that she was a diabetic, and therefore needs her carbs! A lady of considerable weight shall we say, I thought this unlikely. I mentioned that there is a lot of evidence now that diabetics get better control on a low rather than high carb diet, but she was obviously unwilling to be convinced. Another customer came along, so I was unable to suggest she look at some of the information about low carb diets in diabetes on my website.

In view of the increasing evidence to the contrary, when are Diabetes UK, the American Diabetes Association and other diabetes care organisations and health professionals going to stop telling diabetics that high carb is the only safe diet for them?

The trouble is, it takes many years for long-held beliefs to change in medical and government health advice circles. This is especially the case where these beliefs are constantly reinforced by the drug companies and agricultural and food manufacturing industries, who have much to lose should healthy eating advice change from the status quo.

Nutritional medicine experts such as Dr Richard Bernstein, Dr Robert Atkins and Weston Price have long maintained that type 2 diabetics can often be cured and taken off their diabetes medications completely by following a low carb diet, but they have largely been ignored by mainstream medicine. Now, however, the weight of scientific evidence is fast becoming overwhelming. Although this is unlikely to translate into official changes in dietary advice for diabetics for some time to come, many diabetics may now feel there is sufficient information on the issues around low fat versus low carb diets for them to make their own informed choice about the diet they should follow. It is important, though, to carry out any changes in diet in consultation with your doctor, as you may need to reduce or even stop your insulin or other diabetes medications.

If you or someone you know is diabetic, particularly type 2, and you want to know more about recent advances in understanding about using low carb diets in diabetes, the Nutrition and Metabolism Society website is a good source to start with, particularly the section on low carb diets and diabetes, the recent research and presentations pages, and the Nutrition & Metabolism Journal review article on low carb diets in type 2 diabetes and metabolic syndrome.

Remember: it's your body, and your right to make an informed decision on how to deal with your diabetes. Challenging what your doctor or other sources of dietary advice say and seeking out the information you need can be daunting. But perhaps the following might help spur you into action:

Dr Bernstein, diabetes doctor and a diabetic himself, writes in Diabetes Health of his belief that the only way to keep insulin levels down and blood sugars normal is to reduce fast-acting carbs such as bread, pasta and sugar. He says that the American Diabetes Association does not support this approach because they maintain that 'diabetics are either too stupid or lazy to follow it'. He also suggests there is another institutional problem with normalising blood sugars via a low carb diet: doctors' fears of having a patient die from hypoglycemia, for which they could be sued. So doctors might prefer to keep their patients' blood sugars unnaturally high. If they die of heart attacks, or of other disease, as often happens, they won't get sued for that.

Dr Mary Vernon, co-athor of 'Atkins Diabetes Revolution' says on her website that she used to tell her diabetes patients what she had been told to tell them in medical school but it wasn't helping. This made her wonder whether the advice was wrong, so she went back and looked at the biochemistry. This reminded her of a fact which has long been known, but which often gets forgotten. Insulin's primary job is to store fat and block fat burning. What her patients were doing on their high carb diets was to make large amounts of insulin, store fat very effectively and gain weight hand over fist. So she started advising them to eat low carb and they lost weight and improved their blood sugar levels tremendously. The news got around and soon she started getting referrals from other physicians whenever they had patients with metabolic problems.

A low carbing diabetic who contacted me recently told me: 'I get so cross that all my current ills are due to the high carb low fat diets that the doctors had me following. I followed them to the letter but my diabetes etc got steadily worse with all the nasty complications. Every time I had a blood test I was told I was not in control, I told them I followed the eating plans their nutritionalist gave me but they just basically called me a liar! Now I am low carbing and suddenly the blood test that shows how well your control is over a 12 week period came back at 6, it seems 5 to 7 is normal. I told them I am low carbing and proud of it and the nurse shocked me to the core by saying "I thought so, it is the only way you could get those results!". So they do know it works but they still push the high carb low fat diets!'

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