March 2, 2015
Is the High Carbohydrates Era Finally Ending?
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