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Medical guidelines don’t include a diet low in carbohydrates

nytimes.com

121–130 of 185 posts

Re: Medical guidelines don’t include a diet low in carbohydrates

#121
post #111

Earlier quoted context omitted.

I get annoyed when people stop a discussion dead in its tracks by asking for references like this, especially when they can easily look it up themselves if they actually cared about the answer rather than winning. If you think about it, any molecule that isn't sugar but tastes like sugar will have a similar molecular shape to sugar. Hmmmm I wonder if this will fit into receptors in other places in the body, not just…

> If you think about it, any molecule that isn't sugar but tastes like sugar will have a similar molecular shape to sugar. I'm going to go out on a limb here and propose that you may not be a professional medicinal chemist. Many theories conveniently support your position. Of course, many theories conveniently support the other side. How can we objectively determine who is right? Well, let's look at (among many, many…

> sucralose (Stevia)

s/Stevia/Splenda/ (stevia is entirely different from sucralose).

Re: Medical guidelines don’t include a diet low in carbohydrates

#122
post #116

I've been on a low carb diet since June. I've lost 30 pounds and my high blood pressure is now gone (I read 97/63 last week). My glucose went from 134 mg/do to 96 in 2 months. A1C from 6.5% to 5.5%. Now normal again. If you've been diagnosed with type 2 diabetes you should try a very low carb diet before anything else. It really seems to work.

> If you've been diagnosed with type 2 diabetes you should try a very low carb diet before anything else. What do you mean by "very low"? One year ago I lowered carbs, with a target of a maximum of 40% of daily calories from carbs. Results: 120 pounds lost, A1C from 8.1% (on Metformin and Actos) to 5.2% (no Actos, Metformin dose cut in half, and would not be surprised if my doctor suggests cutting it further when I s…

I wouldn't say that 174g is low carb.

On Keto, for example, low carb is Your personal macros will be dependent on your exercise levels, BMI, and calorie intake though.

Re: Medical guidelines don’t include a diet low in carbohydrates

#123
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

The ADA does a lot of dumb stuff and rightfully gets a good amount of stick for it, but you have to remember that they are also having to optimize for a population that is overwhelmingly less educated and financially insolvent.

If you are educated and/or wealthy with diabetes[0], the odds are you have a good endocrinologist and/or are disciplined about diet and exercise. In these cases, given you're not an extreme case, your diet is largely based on consistency. It's not necessarily low or high carb diets (although the extremes obviously create complications), it's about keeping your insulin input consistent. This means you have to keep your "carb" (diabetes isn't all about carbs, but they are the biggest factor in your diet) to exercise ratio relatively consistent, so those that exercise a lot or have high metabolisms often still have high carb diets after diagnosis. The real killer with people who have the wherewithal to manage their diabetes is blood glucose swings, and the swings to the low end are quite a bit more dangerous than those to the high end. You have much less wiggle room for "lows"... using general numbers, a "healthy" blood glucose reading is ~120, a low is 200. While that difference may seem small, a reading of 40 is much more dangerous than a reading of 220, as 40 presents a decent risk of loss of consciousness and other very serious, immediate complications while 220 may cause some long term damage if not controlled but mostly manifests as mental fatigue or irritability. To drive my point home, a reading of 400 is very bad, but quite fixable without professional medical help. A score of 30 or below is serious cause for an itchy 911 trigger finger, and might mean death if the patient has already lost consciousness.

All this is to say: Even in the best case, low carb diets are only for diabetics with a very good A1C and highly controlled and managed diet/exercise/insulin ratios.

Now consider that the vast majority of people with diabetes (see footnote again) are poor, genetically predisposed to obesity, and uneducated. Asking them to manage their diabetes in the first place is hard enough, much less asking them to make substantial lifestyle changes to eat healthily. These people are going to have high carb diets whether they like it or not. Given the dangers of lows on top of this, the responsible thing is to keep them consistent, recommend higher carb diets, and just hope you can help them manage their condition in other ways to the point of maybe not having limbs amputated, losing their sight, or dying at a middle age.

Most of all, though, this is a huge testament to how poorly we're taking care of the diabetes epidemic (yes, it's an epidemic) sweeping our nation. You can point to socio-economic issues, political issues, ecological issues, and so on, but the end result is we are abandoning and failing millions of people with a serious, chronic illness. Organizations like JDRF and the ADA do have serious problems, but at the end of the day they have very few avenues to actually affect change while the root causes still exist. Thus we end up managing symptoms and trying to minimize damage. Sad state all around.

[0] I'm going to blur the line a bit between Type 1 and 2 here. Of course, it's important to note that treatment and management varies wildly between the two but there are good general rules of thumb that apply to both, so i'll stick to those in order to make my point simpler

Re: Medical guidelines don’t include a diet low in carbohydrates

#124
post #63
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

Of course they are. People continuing to get diabetes is how they get funding for their organization.

This is seriously messed up.

As I said in another comment, these organizations have serious problems that need remedying but they have almost no control over the underlying root causes of the US' diabetes epidemic. I wouldn't necessarily argue against a problem with leadership and a focus on fundraising, but there are thousands of people who work under these organizations who often give up promising careers and their own time and money to make a real difference in communities that are outright ravaged by diabetes. Focusing on orgs like JDRF and the ADA as the "bad guy" only exacerbates the obsession with managing the symptoms as opposed to dealing with the underlying causes (mostly socio economic, political, and ecological in my personal opinion).

If you really want to focus on organizations, lets talk about the FDA and the outright corruption and thievery between Medicare/Medicaid and insurance companies. In the medical industry "diabetes" is a codeword for "huge profits from captive, disadvantaged markets" and until we start addressing those issues no amount of reform in 3rd party orgs will do anything.

Re: Medical guidelines don’t include a diet low in carbohydrates

#125

Earlier quoted context omitted.

The Inuit did pretty well on a diet of whale blubber, so I doubt that fat is a problem. The Italians and French are pretty healthy, and they don't skimp on fats either. However, I do agree that we should all eat more fresh produce.

The French don't skimp on baguettes (= evil heavily processed white bread) either. There's no silver bullet.

Something tells me that the French baguettes don't have as much HFCS as the ones around here....

Re: Medical guidelines don’t include a diet low in carbohydrates

#126
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

Why people drink diet soda? If someone cares about his sugar intake, why not skip the soda and drink some water? It also amazes me how people associate some dishes to sodas. For example, at lunch with my colleagues (I'm in France), I observed that when they eat a pizza or a burger, they order a soda. But if they eat a salad, they order a bottle of water! (I don't like sodas so my opinion is probably oriented)

Personal preference is pretty easy to assume whenever you question why your opinion on something isn't universal.

Re: Medical guidelines don’t include a diet low in carbohydrates

#127
post #42
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

> I don't have diabetes and the doctors say my blood sugar control is very good I don't understand what this means for a non-diabetic. Are they measuring your A1c? How are you "controlling" your blood sugar? Secondly, even if you're not building fat your body still needs insulin.

I have some risk factors for diabetes (which I'm doing my best to minimize/eliminate/control) so my doctor had me get my blood sugar tested a few times. It always came back with results that looked good and at least to him weren't worth investigating further.

Re: Medical guidelines don’t include a diet low in carbohydrates

#128
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

Why people drink diet soda? If someone cares about his sugar intake, why not skip the soda and drink some water? It also amazes me how people associate some dishes to sodas. For example, at lunch with my colleagues (I'm in France), I observed that when they eat a pizza or a burger, they order a soda. But if they eat a salad, they order a bottle of water! (I don't like sodas so my opinion is probably oriented)

I haven't had soda more than (once every year or so) for several years now, other than as a mixer in cocktails.

It's still delicious. Water is still disgusting. I don't drink diet soda because it tastes terrible. Stevia sodas taste worse. But I'd be ecstatic if there was a drink which tasted like soda without the negative effects.

So, yeah, I'm confused over what led you to write your first line given your last line. It's because it's utterly delicious to many of us.

Re: Medical guidelines don’t include a diet low in carbohydrates

#129
post #21

Whether or not you believe in low/no carbs for everyday health, it is uniquely horrifying that the Diabetes association is promoting a high carb diet. Having recently made changes to my own eating, which still includes carbs but at a much less extreme amount, I'm amazed at the differences. I don't have diabetes and the doctors say my blood sugar control is very good, but the energy differences I feel before and after…

Why people drink diet soda? If someone cares about his sugar intake, why not skip the soda and drink some water? It also amazes me how people associate some dishes to sodas. For example, at lunch with my colleagues (I'm in France), I observed that when they eat a pizza or a burger, they order a soda. But if they eat a salad, they order a bottle of water! (I don't like sodas so my opinion is probably oriented)

I haven't had soda more than (once every year or so) for several years now, other than as a mixer in cocktails.

It's still delicious. Water is still disgusting. I don't drink diet soda because it tastes terrible. Stevia sodas taste worse. But I'd be ecstatic if there was a drink which tasted like soda without the negative effects.

So, yeah, I'm confused over what led you to write your first line given your last line. It's because it's utterly delicious to many of us.

Re: Medical guidelines don’t include a diet low in carbohydrates

#130
post #32

Earlier quoted context omitted.

I strongly disagree with this: > Pretty much any diet which is free of anything should be avoided. For the couple of years, I've been trying various elimination diets so that I can see what effects particular foods and food groups have on me. Even if I had ended up with exactly the same diet, it would have been worth doing, as I learned a lot about my body and my relationship with food. As it happens, though, I want…

Good for you, want to try it without a link to a commercial diet?

It started out non-commercial, and all their recommendations are available on their site. I've never given them any money, and you are welcome to do the same.
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