Wednesday, July 05, 2006

Carbohydrates - How Much is Too Much?

In the Lancet this week, researchers published a chilling finding - Diabetes confers an equivalent risk to ageing 15 years - in Relation between age and cardiovascular disease in men and women with diabetes compared with non-diabetic people: a population-based retrospective cohort study.

As reported in Forbes, "...the most striking numbers in the report involved life expectancy. People with type 2 diabetes who were also classified as being at moderate or high risk for cardiovascular disease died an average of about 18 years earlier than non-diabetics, the researchers found."

I don't know about you, but I find it disturbing that we now estimate one-third of adults in the United States have or at risk for type II diabetes and we're still making the same recommendations for diet that have done nothing to reverse, or even slow the ever-increasing incidence of the disease in the last thirty years.

Throughout the medical and scientific literature there is a wealth of data correlating glycemic control, and insulin and blood glucose levels, with cardiovascular disease. These findings are consistent in those with and without type II diabetes.

Back in 1988, the Paris Prospective Study, published in the International Journal of Obesity, found "The strength of the association of blood pressure to the risk was reduced when BMI increased. By contrast, the association of blood pressure to the risk remained linear when plasma insulin level rather than BMI was considered. Plasma insulin level was a more sensitive marker of CHD risk than glucose intolerance in the overweight group. Moreover, in this group, the relation to CHD mortality risk was stronger for plasma insulin level than for blood pressure."

In 1998, the Journal of Clinical Endocrinology & Metabolism published a study in which researchers concluded that "In conclusion, approximately one of every five healthy, nonobese subjects in the most insulin-resistant tertile, followed for approximately 5 yr, had a serious clinical event. These data highlight the importance of insulin resistance as a predictor of CVD."

In JAMA in April 2004, researchers published findings from subjects with normal glucose tolerance - a cohort of 234 men were investigated and the researchers concluded that "For patients with NGT and different extents of atherosclerotic disease, postload glycemia and HbA1c level are not equally distributed but are significantly higher in those with more severe disease. This suggests that the glycemic milieu correlates with the cardiovascular risk according to a linear model."

Let's not forget, earlier this year, a study was published after following 18,403 men for thirty-three years. The researchers found that ten years into the study, heart disease mortality started to increase at blood sugar levels above 95 mg/dl, but that those subjects with blood sugar levels below 95 mg/dl showed no increased risk for death from heart disease. After 33-years, the increased risk for heart disease started at blood glucose levels of 83mg/dL - with a linear increase in risk between 83mg/dL and 95mg/dL.

To date, not one study has been published with similar correlations to cholesterol levels.

In fact, the researchers in the above study measured cholesterol levels and found no significant difference in cholesterol levels between those subjects with normal blood sugar, those who were glucose intolerant, and those diagnoised with diabetes. Over thirty-three years it wasn't the cholesterol levels that mattered - it was blood sugars!

And here we are today, still preaching cholesterol, cholesterol, cholesterol; saturated fat, saturated fat, saturated fat as the only dietary means to reduce heart disease. Folks - it's not the cholesterol, and it's not the saturated fat - it's the blood sugars and resulting insulin resistance from years of excessive carbohydrate consumption!

Every single time you consume more carbohydrate than your body needs, it's excessive - and it's placing a burden on your metabolism to deal with the excess.

Just how long do you think your metabolism can keep humming along with too much blood sugar? How much time passes before repeated highs in blood sugars, and resulting highs in insulin, do damage to your cardiovascular system?

Don't fool yourself into thinking there are "good carbs" and "bad carbs" - there are only carbohydrates; some providing essential nutrients with a small amount of carbohydrate and others that are nutritionally bankrupt and/or providing too much carbohydrate-load to the body at one time. Both simple and complex carbohydrate is metabolized to glucose in the body - the former just faster than the latter.

Eating too many complex carbohydrates results in the same level of blood glucose as eating too many refined or simple carbohydrates - and both result in a higher demand for insulin to stablize blood sugars. Even the American Diabetes Association (ADA) acknowledges "[t]he total amount of carbohydrate consumed is a strong predictor of glycemic response."

Over time, this rollercoaster of high blood sugars, demand for more insulin to reduce blood sugars within a tight range of normal and increasing insulin resistance is damaging to not only the metabolism, but to cardiovascular health. At some point, the body simply has to make compromises when it is assaulted day in and day out by foods that damage its ability to function properly.

The food you choose to eat has a direct and lasting effect on how well your body functions - eat the wrong foods repeatedly and your body and metabolism will be damaged over time. Consume foods that optimize your metabolic function while nourishing your body, and your body will thank you with good health.

Good health is the default human condition - when you find yourself in an unhealthy state, it's time to assess where you can make improvements to enhance your well-being to restore good health. Our bodies are designed for good health - it's the normal state we are supposed to enjoy each day! Yet, too many of us accept poor health as normal and convince ourselves that it's just part of life.

You do not have to accept poor health as your fate.

There are simple modifications one can make to their diet to increase essential nutrient intake and reduce the damaging effects of high blood sugars and insulin. Creating a health enhancing diet starts with eliminating the excessive carbohydrate from your diet - this type of diet is built on our knowledge of the athrogenic effects of high blood sugars and insulin in the body.

In May of this year researchers published the study, The atherogenic potential of dietary carbohydrate, and concluded "High-carbohydrate diets, particularly in the form of high-glycemic index carbohydrate, have the ability to directly induce atherosclerosis. Based on anthropologic facts, the reason for these dietary-induced, insulin-mediated, atherogenic metabolic perturbations are suggested to be an insufficient adaptation to starch and sugars during human evolution. Restriction of insulinogenic food (starch and sugars) may help to prevent the development of atherosclerosis, one of the most common and costliest human diseases."

The first step is to lay the foundation of nutrients we know are critical for good health - amino acids, fatty acids and vitamins, minerals and trace elements. These essential nutrients are provided by meats, poultry, fish, game, eggs, nuts, seeds, fats/oils, fruits, legumes and non-starchy vegetables.

That's it - we don't need any grains for health, and certainly don't need any refined or processed foods.

But, we like them.

They taste good.

And, we've built our entire dietary recommendations around them - established grains as the foundation of our diet rather than nutrient-dense foods. Today, we're paying the price for our dietary myths - we're eating excessive carbohydrate and thus, consuming too many calories and getting too fat because of the metabolic rollercoster caused by what we eat. In the process, we're watching our children suffer with type II diabetes, increasing our dependance on pharmaceutical solutions to our ills and accepting poor health as somehow normal when we age.

With so many "experts" claiming that low-carb and/or controlled-carb diets are unhealthy, it's difficult to consider their health redeeming benefits. But, a number researchers have published data that supports such a dietary approach as a way to reduce weight, stabilize blood sugars, reduce insulin resistance, reduce HbA1C levels, improve blood pressure and even improve cholesterol. These studies are consistently ignored and dismissed while the established low-fat dogma persists and our health continues to decline.

The only word that describes our current situation in the United States is "crisis" - we are in a national health crisis today and rather than base recommendations on clear data, we're seeing the leading health authorities dig in their heels and repeat the dietary advice I believe is directly contributing to our declining health.

It isn't all that difficult to understand that when you tell a population to reduce total fat and strictly limit saturated fat and cholesterol they're going to eat more carbohydrate to compensate for the calories lost by limiting protein and fat.

Take that to the next step, and it's not that difficult to understand that shifting consumption of calories to more carbohydrate stimulates more insulin to control higher blood sugars that result from consumption of more carbohydrate. The unintended consequence being that hunger is triggered more often with highs and lows in blood sugar and insulin triggering hunger more often, leading to an increase in calories eaten each day, leading to consumption of more carbohydrates - exacerbating a vicious cycle in the metabolism: the more carbohydrate consumed, the more hunger is triggered, the more calories consumed, the higher blood sugars, the more insulin demanded, the more cells ignore the insulin, the fatter one gets as excess glucose must be shuttled from the blood and is deposited in body fat, the sicker one gets.

The only way to stop that cycle is to stop feeding it - reduce demand for insulin by reducing blood sugars created by excessive carbohydrate intake. An amazing thing happens when one reduces their intake of carbohydrate - they typically reduce calorie intake without specifically trying to create a calorie deficit or count calories; their blood sugars stabilize, their insulin levels stabilize, their cholesterol levels improve; their blood pressure normalizes and they lose weight.

The leading medical organizations and government agencies call this an unbalanced diet and an unhealthy way to eat.

What do you call it?

8 comments:

  1. Great post Regina . How does what you have referenced tie in to the research that Dr. Mike Eades talked about in;
    http://www.proteinpower.com/drmike/archives/2006/04/lowcarb_caveat.html

    Is it that high but steady blood glucose has lower over all insulin levels - reduced production? - while the up and down levels would indicate high levels of insulin at times. Then the high insulin levels fit the research you are talking about.

    Can you tie the two together?
    Thanks,
    Larry

    ReplyDelete
  2. I call it getting my life back!

    ReplyDelete
  3. Very interesting. In the past I tried Atkins but found the lack of fruit and vegetables restricting. I did lose lots of weight but regained it all afterwards.
    I've had success with keeping to low gi foods but do find I have problems with my digestion. I just wonder if it will improve..

    ReplyDelete
  4. great post, im particular well done on the link between sugar and cardiovascular mortality. I can't wait to feed this the people who tell me low carb is going to kill me soon with cardiac arrest... ha!

    Thanks for researching all this very much needed information and providing it to the public for free.

    ReplyDelete
  5. It is written a little too technically, but the gist of what I get from the post is that the higher ones fasting insulin levels which are primarily a funtion of excessive carbohydrate intake, especially from consunption of sugars and refined grains, the greater one's risk for heart disease and diabetes. In my family, my paternal grandfather ran a bakery. All of the male children (6 in all including my father) had coronary and/or circulatory events; heart disease, stroke, phlebitis in their 40's and 50's. Also, a friend who did some work at the Hershey chocolate plant in Pennsylvania noticed a high rate of obesity and early mortality among the workers there. It makes me wonder if any of the epidemiologists have attempted to correlate carbohydrate consunption with rates of heart disease, stroke, and possibly cancer. My own research showed a 98% and 99% correlations between increases in grain and sweetener consumption respectively and obesity/overweight rates using USDA and HHS statistics from 1975 to 1997.

    Another item about the Forbes article is that not only is life expectancy apparently shorten by 18 yrs but the quality of life decreases, e.g. amputated toes, kidney failure and all the other multiple complications of diabetes.

    Finally to Angela, while the Atkins and similar diets like Protein Power and South Beach restrict consumption of fruits especially in the 1st phase, consumption of non starchy vegetables like cauliflower, broccoli, etc. is virtually unlimited. If you haven't read the Atkins book(s), do so before you try the diet again. They should be available in most libraries. Thanks for the time and space to comment.

    ReplyDelete
  6. I now eat a much bigger & i must admit tastier variety of vegetables on Atkins than I ever did in my high carb days. I also eat a fair bit of seasonal lower carb fruits - remember when you couldn't get the summer fruits all year round??? I wonder at the problems now created by being able to get all fruits all year round now - where has the balance gone?
    I find I don't miss potatoes or rice or pasta at all.
    Excessive sugar in all it's forms is the major health problem of our times & there is a list somewhere on the web that boasts some 140 odd diseases that are caused or worsened by sugar consumption. It's main problem being the hampering of the immune system & it's ability to make the blood thicken & become sticky. A bit like making toffee !! Most people will acknowledge that sugar rots your teeth but they fail to realise that is it also rots everything else in your body over time. No wonder some people call it white death!!

    ReplyDelete
  7. 1. "In the general American population, approximately one-third are obese, while more than two-thirds are overweight." --http://health.dailynewscentral.com/content/view/0002364/31/. That's more than 3/3rds there!!?
    2. or maybe they are eating the atkins-approved bacon and steaks and they think that's eating healthy!!

    ReplyDelete
  8. Anonymous2:14 PM

    Hi you dont seem to have answered the question how much is too much. There are so many variations with the GI diet from 25 to 50% of the diet ??? Which one is correct?

    ReplyDelete