Yes, the high carbohydrate advice is
slowing, but it is still not ending. With the Academy of Nutrition
and Dietetics being a puppet of Big Food, it will take more than a
few people advocating for the healthiness of low carbohydrates for
people with type 2 diabetes to move the dial.
Dr. Osama Hamdy, Medical Director,
Obesity Clinical Program, Director of Inpatient Diabetes Management
at Joslin Diabetes Center, Assistant Professor of Medicine at Harvard
Medical School does say that a low carbohydrate diet is beneficial
for people with diabetes. We need more medical professionals saying
this and pointing out that the Dietary Guidelines produced every five
years for the USDA and HHS are based on weak scientific evidence.
The guidelines were started in 1977,
when the Select Committee On Nutrition and Human Needs of the US
Senate chaired by Senator George McGovern recommended that people
increase their carbohydrate intake to 55 to 60 percent of the total
caloric intake, while reducing fat consumption from approximately 40
percent to 30 percent of the total daily calories. The aims of these
recommendations were to reduce health care costs and maximize the
quality of life of Americans.
The proposed cost saving was predicted
to result from the possible reduction in the incidence of heart
disease, cancer, as well as other killer diseases. Despite
controversy, the United States Department of Agriculture (USDA)
created in 1980 a food pyramid representing the optimal number of
servings to be eaten each day from each of the basic food groups.
Carbohydrates were placed at the base of the pyramid (making up the
largest portion of caloric intake, 6 to 11 servings per day), and
fats were placed at the tip of the pyramid to show that they should
be “used sparingly.”
As we all know now, these
recommendations turned out to be the opposite of what the USDA
expected. What has been aptly described as a “national nutritional
experiment” contributed to the increased prevalence of obesity.
And, contrary to the main aims of the recommendations, the prevalence
of type 2 diabetes and cardiovascular disease went up significantly.
What happened should have been
expected. An increase in carbohydrate intake results in an increased
insulin response to carbohydrates, which through its fat-storage
promoting action increases obesity. And, it has been shown, that
accumulation of fat inside the belly (visceral fat) is associated
with chronic inflammation that is directly related to type 2 diabetes
and heart attacks.
The problem is especially severe for
people who already have type 2 diabetes. We know today that
increasing the carbohydrate load in the diabetes diet increases what
is called glucose toxicity and consequently increases insulin
resistance, triglycerides level and reduces beneficial
HDL-cholesterol.
Now that we are past the history, Dr.
Hamdy isn't really for low carbohydrate food plans. He only
advocates a small reduction from 55 to 60% to 40 to 45% which is only
a quarter reduction instead of much lower that was advocated by Drs.
Elliot P. Joslin and Fredrick Allen, the fathers of diabetes science,
successfully treated their patients diagnosed with fatty diabetes
(later known as type 2 diabetes) with a diet very low in
carbohydrates. Bold is my emphasis.
How Dr. Hamdy considers this much of a
reduction leaves me wondering why he even makes that statement. I
also have to wonder where he found the information that most medical
societies have departed from the recommendation of high carbohydrates
intake. A few, yes, and they still believe in low fat which is also
harmful and makes for slow weight loss.
Dr. Hamdy is more right when he writes
- “Unfortunately, many healthcare providers and dietitians
across the nation still recommend high carbohydrate intake for
patients with diabetes, a recommendation that may harm their patients
and contribute to increasing obesity and worsen diabetes control and
consequently increase the chance of developing diabetes
complications.” He may as well be writing about his position
of high carbohydrates
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