Category: Diabetes

Wheat Belly Book Review

By , September 6, 2011

Wheat Belly

About the Author

Dr. William Davis is a practicing cardiologist in Milwaukee, WI with over 25 years of experience treating patients. Dr. Davis has impressive credentials: he is a graduate of St. Louis University School of Medicine and the Ohio State University Hospitals, with additional training in advanced cardiac catheterization techniques and coronary angioplasty at the Case-Western Reserve University system in Cleveland. But along the way, Dr. Davis discovered that his heart patients had a host of other problems, including obesity, gout, GERD, IBS, celiac disease, unexplained rashes and other mystifying symptoms.

There is no one as certain of the truth as a scientist cloistered in academia, performing tests on cells in a petri dish, or a researcher running computer programs to find patterns in data. While doctors share the same training in the scientific method they also live in the real world, and they often see their patients reacting very differently than popular studies and national dietary standards describe.

Dr. Davis’ Journey

Like many other medical doctors, Dr. Davis found that low carb diets were most effective in lowering his patient’s weight and improving lipid panel results. But he is aware of the exceptions, where a person’s genetic makeup can require a different approach. It is this relentless pursuit of truth and frank discussion of exceptions that makes his Track Your Plaque / Heart Scan Blog so valuable.

Dr. Davis noted his patients had dramatic improvements in other health issues after restricting carbohydrates. After thousands of years of eating carbohydrates, why would the last 50 years see such a dramatic increase in GERD, pre-diabetes, type 2 diabetes, obesity and celiac disease? Not satisfied with simply knowing the facts, Dr. Davis sought the cause of the rapid increase.

Wheat Belly

His new book, Wheat Belly provides his answer: wheat. Yes, that golden grain, enshrined in our mythology and patriotic songs, is killing us. But humans have eaten wheat for thousands of years.

So why has this seemingly benign plant that sustained generations of humans suddenly turned on us? For one thing, it is not the same grain our forebears ground into their daily bread. Wheat naturally evolved to only a modest degree over the centuries, but it has changed dramatically in the past fifty years under the influence of agricultural scientists.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 13.

About Wheat Belly, the Book

Eminently readable, Wheat Belly is written in a conversational style, suitable for any audience. Extensive footnotes are gathered together in the References section at the end of the book, where they don’t interfere with the text. Sidebars include fascinating details; patient success stories, insights into heirloom wheat, etc.

The book is just under 300 pages, divided into three main sections:

  • Wheat, The Unhealthy Whole Grain
  • Wheat and its Head-to-Toe Destruction of Health
  • Say Goodbye to Wheat

The first section gives the history of wheat, from the heirloom wheat mentioned in the Bible (einkorn, gathered by semi-nomadic tribes such as the Natufians as far back as 8500 BCE) to the modern, genetically altered variety created by aggressive cross breeding in the past 50 years.

Differences between the wheat of the Natufians and what we call wheat in the twenty-first century would be evident to the naked eye. Original einkorn and emmer wheat were “hulled” forms, in which the seeds clung tightly to the stem. Modern wheats are “naked” forms, in which the seeds depart from the stem more readily, a characteristic that makes threshing (separating the edible grain from the inedible chaff) easier and more efficient, determined by mutations at the Q and Tg (tenacious glume) genes . . . But other differences are even more obvious.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 21.
Note: the ellipsis indicates I removed a reference to a study mentioned previously in the text.

The differences in modern and ancient wheat is more than “skin deep”. On the glycemic index, whole wheat bread exceeds table sugar, scoring 72 versus sugar’s 59 on the scale. Because the carbohydrates in modern wheat are so easily digestible, eating whole grain results in the same blood sugar impact as an equivalent amount of highly processed flour. White bread, with less of the whole wheat grain, comes in at 70. A Snickers candy bar comes in lower, with a glycemic index of 41.

Interestingly, Dr. Davis’ self-experiment with baking bread showed his own blood sugar rise from 84 mg/dl to 110 mg/dl with 4 ounces of bread made with einkorn wheat. He also baked bread with modern wheat, keeping all other ingredients the same, and consumed the same four ounces. His blood sugar shot up from 84 mg/dl to 167 mg/dl.

Dr. Davis provides more detail on the genetic differences that carry unknown effects including the increase in chromosomes from 14 to 42.

Wheat and Modern Health

After establishing why modern wheat is different, Dr. Davis lists the health impact this new, genetically modified food product has introduced. First among impacts is the addictive property of modern wheat, and how it stimulates hunger. Then an extensive treatment of each health condition:

  • Obesity
  • Celiac Disease
  • Diabetes and Insulin Resistance
  • Acid Reflux and Stomach pH
  • Cataracts, Wrinkles, and the aging process
  • Heart Disease
  • Wheat’s effect on the brain
  • Acne, rashes and other skin problems
Note: I have reworded the actual chapter titles to reflect the contents.

Each chapter in this section includes footnotes to studies, as well as examples from Dr. Davis’ practice. Each topic is fully developed, and written in an easy-to-read style without excessive medical terminology (Dr. Davis explains the medical terms he does use).

Practical Application of Wheat Elimination

In the third section, Dr. Davis deconstructs the modern “eat healthy whole grains” advice. If you eliminate all wheat, do you end up with vitamin and mineral deficiency? Not if you follow his basic (and very easy) guidelines. Dr. Davis comments on the true effect of eliminating wheat:

Let me describe a typical person with wheat deficiency: slender, flat tummy, low triglycerides, high HDL (“good”) cholesterol, normal blood sugar, normal blood pressure, high energy, good sleep, normal bowel function.

William Davis, MD, Wheat Belly, (New York: Rodale Inc., 2011), 188.

The book devotes 37 pages to Dr. Davis’ simple method for eliminating wheat and replacing it with unlimited vegetables, raw nuts, grass fed beef, chicken and fish, and other whole, nutritious foods. He departs from the usual low carb / paleo prescription to warn about eating too much processed meat, with its chemical soup of seasoning, nitrates and other potentially harmful chemicals. And, a special note is made regarding the proliferation of “gluten free” products that substitute fructose and “chemical soup” in place of wheat that may still pose health risks. Instead, Dr. Davis provides a variety of great wheat free recipes to provide an insight into managing a diet without wheat, introducing wonderful variety and enjoying the journey.

My Conclusions

I am by nature a skeptical person, but my personal experience with low carb dieting led me to believe, long before I discovered Dr. Davis’ blog, that I may have a “hidden” wheat allergy. After suffering from painful GERD for over a decade, I noted a rapid decrease in symptoms when I started a low carb diet. My GERD does not return when I have the occasional indulgence of ice cream while on a cruise, but comes back with a vengeance when I consume wheat products. My personal experience is not scientific proof, of course, any more than the sidebar stories of dramatic cures are scientific proof in Wheat Belly.

I suspect I will still eat bacon and other processed meats, and I don’t share the enthusiasm for grass fed organic beef and free range chickens and eggs. But those quibbles aside, Dr. Davis’ clinical experience, supported by his scientific research as revealed in 16 pages of references, make a powerful argument that I find hard to refute.

It is easy to do your own experiment; there are no adverse health effects to eliminating wheat and eating according to Dr. Davis’ easy prescription. Two weeks is usually sufficient to notice differences in some conditions. I can heartily recommend Wheat Belly as a practical guide to seeing if you also have a “hidden” wheat allergy.

Resources

Other Reviews:
Book Review: Wheat Belly, by Tom Naughton at Fathead.
Review: Wheat Belly by Dr.William Davis, by Dana Carpender at Hold the Toast.
Wheat Belly Book Review, by Joe Lindley at Stop Craving Sugar.

Dr. Davis’ Blogs:
Track Your Plaque / Heart Scan Blog
Wheat Belly Blog

Disclaimer: Dr. Davis provided a complimentary review copy of the book, but did not attach any editorial restrictions to the review.

Leptin Resistance

By , April 7, 2011

What is Leptin?

Leptin is a hormone released by fat cells that helps regulate hunger. And it may hold the key to why a low carb / paleo diet works for so many people.

Role of Leptin in Hunger Signals

Leptin and Hunger
(Click Image to Enlarge)

Success on a low carb / paleo diet is often attributed to “never feeling hungry”, an effect not seen on other diets. People point to the satiating aspects of fat or protein in eliminating hunger, but dieters may be suffering from a rarely diagnosed condition called leptin resistance that is corrected by the low carb diet.

Leptin circulates through the bloodstream in an amount directly proportional to the amount of fat you have. In theory, the more leptin you have circulating the less you will eat, because it signals that you have enough stored energy for all your metabolic processes. When leptin levels dip, it signals the brain that you are hungry.

So, that means fat people should never be hungry, right? Not so fast, grasshopper.

Resistance is Futile

Most low carbers are familiar with the concept of insulin resistance in those with type two diabetes and metabolic syndrome. In a healthy individual, insulin signals the cells that glucose is available, and the cells respond and allow the glucose to enter the cell (if they need the energy). Insulin resistance is a condition where the cells become resistant to the effects of insulin, requiring more and more insulin to deal with blood sugar levels. If a regular cell opens the door to a gentle knock, the insulin resistant cells respond only to ferocious pounding on the door with a battering-ram’s worth of insulin. The pancreas, which produces insulin, cannot keep up with the demand for more and more insulin, and dangerously high levels of blood glucose result.

A similar thing happens with leptin resistance, but through a different mechanism. There’s no shortage of leptin in an otherwise healthy obese person, and the fat cells never grow tired of producing it. But the circulating leptin is blocked and cannot turn off the hunger signal. The fat person remains hungry. And hungry people eat.

What Causes Leptin Resistance?

Some have theorized that dietary fat and blood glucose levels interfere with leptin. While there is a link between leptin resistance and the levels of fat circulating in the blood (triglycerides), eating dietary fat doesn’t seem to have an effect. Recent evidence showing a diet high in fructose contributes to leptin resistance adds to the growing body of evidence against high levels of fructose in the diet. The amount of fat in the diet did not matter; leptin resistance peaked with the high fructose diet, and reversed itself to normal levels when the rats ate a sugar free diet, no matter how much fat they had. Lucky rats.

We know that leptin signals our brain that enough energy is present, and the body does not need any more food. Leptin is able to cross the “blood brain barrier” (BBB) to do this. The BBB is a protective system of small capillaries that protects the brain from most chemicals but allows the important ones through. It works like a filter. So what causes the curious case of leptin resistance, where this essential hormone is blocked by the BBB? As Dr. Mike Eades explains:

Research done a couple of years ago in St. Louis and in Japan pinpointed the problem. Triglycerides – fat circulating in the blood – interrupts the passage of leptin across the BBB. If trigylcerides are high, which they are in most obese people, then, basically, they block the movement of leptin into the brain. So, leptin levels are elevated in the blood, and triglycerides keep the leptin from getting to where it needs to get to shut off hunger.

One Solution

Controlling trigylceride levels can reverse leptin resistance. In my own experience, hunger evaporated on my low carb diet as my triglycerides fell from 344 to 105. Before that, I was often hungry, even after eating past the feeling of fullness and often to discomfort. On my low fat diet 15 years before, I was miserable because I was always hungry. But that, as they say, is a personal testimony and not a scientific finding. Too bad I’m not a rat.

The easiest way for most people to lower triglyceride levels is to adopt a very low carb diet (less than 50 grams of carbohydrate per day), then transition to a moderate carb diet devoid of most grains. Niacin and fish oil have also proven to be effective in many people, even those with genetic reasons for high triglycerides (familial hypertriglyceridemia). I combine all three approaches, and have found the eliminating any one of those results in my triglycerides rising again. Management of triglycerides in this way is done in concert with a physician and blood tests. Those with chronic health problems should check with their doctors first, of course, especially those with reduced liver or kidney function, or those suffering from conditions such as gout that require specific diets.

Resisting Resistance

Humans are adapted to eat a certain diet, and in terms of adaptation, the modern agricultural era is a blip on the radar screen. We simply haven’t had time to adapt to large quantities of grain and other carbohydrates in our diets. The inexpensive access to readily available carbohydrates is new, barely 10,000 years old, and our biological machinery is not able to handle it. That’s the philosophical framework under girding the modern low carb / paleo diet movement. The rise of leptin resistance is just one more metabolic condition that supports the effectiveness of a low carb / paleo lifestyle.

Other Resources

MegaSearch: Leptin Resistance

Heart Scan Blog: Niacin

Heart Scan Blog: Fish Oil

Conquer Diabetes and Prediabetes

By , March 17, 2011

Dr. Steve Parker is a leading expert on the Mediterranean diet. With two decades experience treating patients with diabetes, pre-diabetes and metabolic syndrome, Dr. Parker has developed a modified version of the Mediterranean diet. His new book Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet provides a comprehensive overview of the diet.

Dr. Parker is no stranger to the low carb lifestyle, and has seen dramatic health improvement from it in some of his patients. His low-carb Mediterranean diet is an attempt to marry the heart-healthy benefits of the traditional Mediterranean diet, with its emphasis on natural foods, omega-3 rich olive oil and plenty of complex carbs, with the superior blood sugar control and weight loss of a low carbohydrate lifestyle.

How can these two diets, seemingly incompatible, come together without compromising both? I was concerned that Dr. Parker might give a pass to “complex carbs” in the same way the American Diabetic Association does. But he doesn’t mince any words about carbohydrates:

We’ve done an atrocious job for type 2 diabetics and prediabetics.

We’ve recommended they eat precisely what their bodies can’t handle: carbohydrates. We’ve urged them to take poison: carbohydrates. We’ve cooperated with the drug companies to encourage diabetics to eat foods that increase drug company profits: carbohydrates.

Dr. Parker relates that how, over the past 10 years, the medical literature and his clinical experience has led to a change in his thinking, and better treatment of his patients.

The book is a medium format, 5.5″ x 9″, quality paperback with 216 pages. It is economically priced at $16.95. The last 26 pages are devoted to a list of print and on-line resources, an annotated bibliography complete with URLs to medical journal articles, and a five page index.



Dr. Parker’s low-carb Mediterranean diet follows a familiar pattern: a very low carb starting phase called the Ketogenic Mediterranean Diet (KMD), and a maintenance phase dubbed the Low-Carb Mediterranean Diet (LCMD). He includes a week of meals suitable for the KMD, with a list of additional foods that can be added, slowly, once weight loss and blood sugar levels are in control.

What is different about Dr. Parker’s book? He includes a robust list of drugs and possible interactions during the ketogenic phase of the diet. Other specific recommendations for diabetics, such as the chapter devoted to the dangers of hypoglycemia, are a must read for someone looking to control blood sugar via diet. And I found the book eminently readable. Dr. Parker writes in a conversational style, explaining terms in a way that does not come across as condescending.

His chapter on “Daily Life with Low-Carb Eating” addresses several issues, including “cheating”. What do you do when presented with that Cinnabon you can’t resist? His answer is surprising, but workable. If you must indulge, compensate by replacing a meal with the treat, adding extra exercise or medication, or reverting to the KMD diet for a few days after. While purists will insist they never cheat, I did exactly this on a recent European cruise, and came back weighing less than when we set sail. (As Dr. Parker points out, you have to know your limits; just as a reformed alcoholic never tastes alcohol again, some “carbohydrate addicts” can’t afford to cheat.)

Dr. Parker’s easy approach to developing a reasonable exercise program might get me started in that direction. (Niacin, taken to help lower my triglyceride levels, also increases insulin resistance, and the antidote for that is exercise.) I loathe exercise, but Dr. Parker’s no-nonsense approach to the subject may get me walking in the evenings.

I found another personal benefit. While not diabetic, I do struggle with blood sugar control, and have been diagnosed with metabolic syndrome (now abated with low carb living). We often get stuck in our choice of foods, and simply removing carbs from our standard diet can get boring. Dr. Parker notes that the popularity of the standard Mediterranean diet includes the benefit of both taste and variety. Adopting a low carb Mediterranean diet approach could introduce some variety to what has become a routine diet. And as my wife tells me, variety in everything in life, except partners, is a good thing.

Disclaimer: Dr. Parker provided a complimentary review copy of the book, but did not attach any editorial restrictions to the review. Low Carb Daily is also listed as an on-line resource in the Resources section of the book.

Greate Diabetes Resource

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By , March 7, 2010

Another great resource for those with type I or II diabetes, LADA diabetes or low carb dieters interested in the peer-reviewed research is created and maintained by Janet “Jenny” Ruhl at http://www.phlaunt.com, and is called “Blood Sugar 101.”

Jenny explains the reason the site exists:

After losing 30 pounds with a low carb diet, I have maintained that weight for many years. My current BMI is within the normal range for my height. At one point I exercised daily for a year and got my body fat down to 24%, which put me into the “Fitness” category for a woman my age. Despite what my doctors had told me, weight loss and intense fitness didn’t do a thing for my blood sugars, which got worse.

This raised my curiosity. I started tracking through the research articles available for free on the web. (many of them, now, alas, are no longer free, but I was lucky that I started my research back in 2004 when they were.)

The information I found, much of it differing dramatically from what doctors were telling patients about what caused diabetes and how it should be treated, became the kernel of this web site. My goal was to answer these questions: What do scientists actually know about Type 2 diabetes? Why do doctors miss diabetes diagnoses until long after people already have diabetic complications? And what blood sugar levels are truly low enough to prevent further damage to the organs and beta cells?

The site is a treasure trove of information. While Low Carb Age attempts to provide the latest news chronicling the end of the low fat craze, Jenny’s site provides a wide and expansive view of the research spanning back decades. Under the general heading of blood sugar control, Jenny ventures into nearly every area a low carb dieter is concerned about. The site is extensive enough to have been put out in book format:



Jenny maintains a blog also at Diabetes Update where new information is presented.

Both the blog and the Blood Sugar 101 website are highly recommended.

American Heart Assoc & Low Carb

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By , December 4, 2009

The American Heart Association is now recommending a lower carb diet for prevention of cardiovascular heart disease, heralding the beginning of the Low Carb Age!

A new study, recently presented at the American Heart Association annual meeting in Orlando, FL, tested the effect of a low fat verses moderate fat diet. The low fat diet contained 20 percent of calories from fat, 65 percent from carbs and 15 percent from protein (this is the standard low fat diet that has been recommended for years). The “moderate fat diet” increases fat, and to keep the calories consistent, lowers the carbohydrate contribution. The moderate fat diet in the study has 40 percent of the calories from fat, 45 percent from carbohydrate and 15 percent protein. HealthDay, from the National Institutes of Health, quotes the AHA:

“This is a good study that essentially confirms that the current recommendations are appropriate,” said Alice Lichtenstein, a spokeswoman for the American Heart Association (AHA). “Since 2000, the AHA has been recommending not a low-fat diet, but one that is low in saturated fats and trans fatty acids.”

People with metabolic syndrome are glucose-intolerant, meaning they can’t process blood sugar well. Low-fat, high-carbohydrate diets exacerbate this condition, Lichtenstein explained.

The study is explained in more detail on our Diabetes and Metabolic Syndrome research page. The conclusion of the study gives the bottom line:

Conclusions: This is the first study to examine the effects of low fat vs. moderate fat diet in MetS. MF compared to LF diet improves the atherogenic dyslipidemia of MetS. MF diet is a preferable dietary intervention in people with MetS to improve CVD risk.

Whew. What the heck does that mean? Here’s a layman’s plain English translation:

This is the first study to examine the effects of low fat vs. a moderate fat diet with lower carbohydrates in patients with metabolic syndrome. The moderate fat diet compared to the low fat diet improves the heart disease related risks of various blood fats (VLDL, LDL, triglycerides, etc.) in people with metabolic syndrome. The moderate fat diet is therefore a better diet for people with metabolic syndrome.

Health Day goes on to quote other experts:

Experts familiar with the study aren’t surprised by the findings. “This sort of falls within the boundaries of what we used to call the Atkins diet, which was a high-lipid and low-carb diet. Normally this kind of diet suppresses appetite, improves diabetes,” said Dr. Alfred Bove, president of the American College of Cardiology. “This diet looks like it does a good job of altering the negative metabolic effects of early diabetes or high carbohydrate stimulation,” he said.

“Much of this we’ve known before, but the idea is that a moderate-fat diet is something most people can tolerate,” Bove said. “It probably affects the way insulin is released because if you have a lot of carbohydrates in the diet, you tend to generate a lot of insulin, and insulin is the hormone that lowers blood sugar,” Bove explained. “In addition to lowering blood sugar, it also increases appetite so a lot of people on high-carb diets are restimulated to eat more.”

Preventable, yet “Encouraged”

By , November 30, 2009

Stunning statistics from a study published in the December issue of Diabetes Care, as reported by Health Day News:

The number of people with diabetes in the United States is expected to double over the next 25 years, a new study predicts.

That would bring the total by 2034 to about 44.1 million people with the disease, up from 23.7 million today.

At the same time, the cost of treating people with diabetes will triple, the study also warns, rising from an estimated $113 billion in 2009 to $336 billion in 2034.

The increase is from adult onset, or type II diabetes. Health Day attributes the increase to obesity:

Factors driving the increase in diabetes cases include the aging population and continued high rates of obesity, both of which are risk factors for type 2 diabetes, in which the body does not produce enough insulin or the cells don’t use it correctly. In the study, the researchers assumed that the obesity rate would remain relatively stable, topping out at about 30 percent in the next decade and then declining slightly to about 27 percent in 2033.

The problem is that the official stance towards this problem has little hope of solving the underlying issue: our addiction to carbohydrates. While the general consensus is that people would not be diabetic if they lost weight, telling people to lose weight has proven to be a dismal failure. The reason is that very few people will starve themselves voluntarily.

The standard American diet is one rich in refined, processed foods (i.e., carbs). The “optimum” diet recommended by nutritionists is one that is low in dietary fat and eschews refined, processed foods in favor of “complex carbohydrates, such as whole grains, cereal, rice, pasta, potatoes, dry beans, carrots and corn”, with calorie reduction necessary to lose weight. It doesn’t work because you are always hungry on that diet.

Hungry people eat. And if they eat “complex carbs” that are “low in fat” they never feel sated, and will never stop eating.

Try this experiment … go to the sugar bowl and spoon out a scoop of sugar onto the counter. Then another. And another. Keep going, and when you have 22 spoonfuls of sugar on the counter, you have the average American’s intake of sugar. But what if you cut out all the added sugar found in soft drinks, cookies, candy and other snacks (even low fat ones)?

If you follow the various guidelines by the USDA, American Heart Association, et. al., you’ll limit fat to 20% of your dietary intake, and get adequate protein, making up the rest of your diet with those complex carbohydrates. Let’s take an example of a 2,000 calorie diet, and see how that works out in grams of each micro nutrient:

  • Fat, 44g at 9 calories each = 20% of calories
  • Protein, 100g at 4 calories each = 20% of calories
  • Carbohydrates, 300g at 4 calories each = 60% of calories

Carbohydrates turn to sugar (glucose) in your gut in a very short time, within 2 to 4 hours. Even “complex carbs” turn to sugar.

Spoon out another 75 teaspoons of sugar onto your counter. That is the amount you are asking your body to metabolize when you eat 300g of carbohydrates per day.

Here’s a layman’s explanation of what is happening: The body needs sugar to run, but if it can’t use it in a very short time, it is stored as fat. Blood sugar spikes in 2 to 4 hours after eating carbs, and the body reacts by releasing insulin to drive the sugar into the cells so they can use it for energy. If the cells have enough, they refuse insulin’s prompting, and the sugar is stored as fat. As you abuse this system by overloading it with sugar, the cells become more and more resistant to insulin, and the body sends out more and more. When the sugar is pushed into fat cells, your blood sugar level drops, and hunger returns even though you ate only a few hours ago. So you eat again, and start the process all over again (if you eat a diet “rich in complex carbohydrates”). Sound familiar?

The emphasis on low fat, high carbohydrate diets has caused our expanding waistlines, and emphasizing that people should continue to eat this way but reduce calorie intake is counter intuitive. Survival depends on getting enough to eat, and your body will betray you if it thinks it is starving.

A better approach is to limit carbohydrates to about 1/3 of all calories if you are at your goal weight and otherwise healthy. For a 2,000 calorie diet, that’s about 167 grams of carbs. The rest of your calories can come from fat and protein. It is best to calculate your minimum protein requirement, usually calculated at about a half gram per pound of lean body weight. “Lean body weight” is your weight minus your fat (take your body fat percentage times your weight, and deduct that from your total weight to get your “lean body weight”). The book The Protein Power Lifeplan has this approach as a “maintenance diet”, and people can tolerate it for life … because you don’t get hungry.

And if you need to get to your goal weight, the first phase of the diet can help you do that without getting hungry. You can short-circuit the vicious cycle of carb intake, insulin response, fat storage and premature hunger by eating a diet that is tuned to your needs.

BMI and the “Obesity Epidemic”

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By , November 24, 2009

Tom Naughton deconstructs the “obesity epidemic” at his blog Fat Head:

But what I found most interesting was the data on who’s “overweight” and by how much. Here are the numbers:

  • More than 50 pounds overweight: 6%
  • 21-50 pounds overweight: 17%
  • 11-20 pounds overweight: 15%
  • 1-10 pounds overweight: 24%
  • At ideal weight: 18%
  • 1-10 pounds underweight: 7%
  • 11-20 pounds underweight: 3%
  • More than 20 pounds underweight: 1%
  • Undesignated: 9%

As we noted in our post Does Being Overweight Harm Your Health, all-cause mortality studies show that you have a 17% less chance of dying if you are in the “overweight” BMI (as compared to being “normal weight”). Even being “obese” was statistically even with being “normal weight” in these studies. The absolute worse thing you can do is be “underweight”, with a stunning 73% greater risk of dying than a “normal” weight person.

We have also noted our belief that individuals have to assess their own health needs and identify their individual risk factors, rather than focusing on a “society wide goal”. If your risk factors lean more towards developing diabetes II, then controlling blood sugar levels may be more important than being within 10 pounds of some goal weight. And as McNaughton notes, adult onset diabetes is at epidemic levels:

A different Gallup poll underscores another point I made in the film: there is a genuine epidemic out there, and it’s called diabetes. More than 11% percent of Americans adults have diabetes now, and more than 90% of those have type 2 diabetes, which is mostly preventable. The rate has more than doubled in the last decade alone. Among senior citizens, the numbers are even more harrowing: nearly one-quarter have diabetes. Just think of all the physical damage that’s causing. And even those numbers don’t count the pre-diabetics.

Nutritionists tend to focus on the weight end of the scale (so to speak), but they are missing the point. You can’t push a string. People are overweight because of their blood sugar levels (i.e., hyperinsulinemia, insulin resistance and related disorders leading to diabetes). They are not suffering from high blood sugar levels because of their weight. As Naughton sums it up:

The constant drumbeat about the obesity epidemic and the emphasis on losing weight is sending the wrong message. We need to tell people to get their blood sugar checked and keep it under control with the proper diet. If we do that, the 10 pounds will take care of itself. And if it doesn’t, well … so what? A bit of belly won’t kill you if it’s not the result of high blood sugar.

If your blood sugar is elevated, the way to get it under control is by adopting a low carb eating lifestyle. You will lose weight, but the most important thing is that you will live longer. And living longer is the goal.

Vitamin D Improves Insulin Response

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By , October 12, 2009

Diabetics and many people diagnosed as “pre-diabetics” may be helped by vitamin D supplementation, according to a new study previewed in our Diabetes Research Page.

Unlike studies that look at populations and try to determine the underlying factors for a certain health aspect, this study is a true randomized, double-blind study. One group of 42 insulin-resistant women were given 4000 IU of vitamin D3 and another group of 39 were given a placebo. As is standard in this type of study, neither the women or their doctors knew if they were getting the vitamin or the placebo. To further refine the study, all of the women were south Asian, to try and account for any racial or ethnic differences in the way the vitamin might be metabolized. The trial lasted 6 months, with direct testing of insulin levels.

The study will be published soon; the link above is to the synopsis and “preview” of the study’s results. The conclusion of the researchers is that supplementing vitamin D levels improved insulin resistance and made the cells more sensitive to insulin without affecting the pancreas’ insulin secretion (that’s a good thing). In addition, they didn’t note any change in overall lipid profile (cholesterol, triglycerides, etc.) or high sensitivity C-reactive protein, a measure of inflammation associated by some researchers with increased risk of coronary heart disease. Another good thing!

Diabetics should consult with their physician to see if supplementing with vitamin D can be a part of their treatment. If the vitamin D response is the same as found in this study, it may be possible to reduce of the amount of insulin needed daily.

Monday Round-up

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By , September 7, 2009

Tom Naughton of the Fat Head Blog has another funny article, this time about low carb enthusiast Jimmy Moore and his surprising cholesterol numbers. In the post, he talks about the worldwide study of average cholesterol rate and heart disease. This short video shows the concept (and Tom expands on it quite a bit in his blog piece):

Laura Dolson at Low Carb Diets takes a look at a new study in the Annuals of Internal Medicine comparing a semi-low carb Mediterranean-style diet with a low fat diet. Oh, the study calls it “low carb” but as Laura points out, getting 50% of your calories from carbs is not low carb in the same sense as a Protein Power or Atkins diet.

What was the outcome? Well, as the diets weren’t extremely different, it’s not surprising that in most ways there wasn’t a huge difference. Both groups lost and kept off a relatively small amount of weight, averaging 7-8 pounds by the end of the study. (This is interesting in an of itself, as the participants reported that they continued on their low-calorie diets.) Additionally, on average the participants had (mostly small) improvements in most of the markers they were looking for in the study – markers of blood glucose control and heart disease risk. But on each one of those markers (there were 13 in all) the lower-carb Mediterranean group had more improvement. And on perhaps the most important marker of all – how many participants required medications for diabetes, there was a huge difference. By the end of the study, 70% of the people on the low-fat diet were taking diabetes medication, whereas only 44% of the people on the lower-carb were.

The study would have been more interesting if they had included a third group, a real low carb, higher fat diet utilizing the same type of fats as a Mediterranean-style diet (olive oil, saturated fats, etc.)

Low Carb Diets – Evidence Mounts

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By , August 6, 2009

We added a few more links to our Research Pages, including two new studies showing that a low carb diet works better than the traditional low fat diet for metabolic syndrome (scroll to bottom for the section on metabolic syndrome).

I found these studies through a column that is good, but not great. The LA Examiner online has an article about low carb diets and CHD (coronary heart disease). The studies they link to regarding inflammation at the Cleveland Clinic do not mention high carbohydrate diets at all. It is a bit misleading; the author states categorically that inflammation is caused by several factors including “over consumption of processed carbohydrates”, and then links to the Cleveland Clinic article. But I cannot find that sentiment on any of the Cleveland Clinic’s linked pages; they advocate the low fat, high complex carbohydrate diet instead.

The article is valuable for the links to other studies and resources that do connect a low carb diet to reduced inflammation. If the reader checked the Cleveland Clinic source and went no further, he would have to conclude the author is incorrect and may dismiss the article. So check out the other links and information provided.

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