Tuesday, April 08, 2008

Time for Critical Appraisal

Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

Current nutritional approaches to metabolism syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is based on the accepted idea that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These positive effects of carbohydrate restriction do not require weight loss. Finally, the point is re-iterated that carbohydrate restriction improves all of the features of metabolic syndrome.

Anthony Accurso
Richard K Bernstein
Annika Dahlqvist
Boris Draznin
Richard D Feinman
Eugene J Fine
Amy Gleed
David B Jacobs
Gabriel Larson
Robert H Lustig
Anssi H Manninen
Samy I McFarlane
Katharine Morrison
Jorgen VESTI Nielsen
Uffe Ravnskov
Karl S Roth
Ricardo Silvestre
James R Sowers
Ralph Sundberg
Jeff S Volek
Eric C Westman
Richard J Wood
Jay Wortman
Mary C Vernon

Full-Text PDF


You'll note the above list includes two individuals that I've recently posted about, Dr. Annika Dahlqvist and Dr. Katharine Morrison, along with a number of individuals you all know from their books, published studies and commitment to the science of carbohydrate restriction.

They're all members of the Nutrition & Metabolism Society, an organization committed to "providing research, information and education in the application of fundamental science to nutrition. The Society is particularly dedicated to the incorporation of biochemical metabolism to problems of obesity, diabetes and cardiovascular disease."

If you haven't done so, you can join today - membership helps NMS in the "promotion of scientific information in an environment where such information is not adequately supported by government and private health agencies. "


  1. Patty3:23 PM

    Is nutrition & metabolism planning to go before congress and make a stink?

  2. Kyle Cramer3:24 PM

    I'd like to join, but what benefit do I get if I'm not a doctor?

  3. Anonymous3:40 PM

    Thank you to all who wrote it and worked on it. Those of us with diabetes, who eat low-carb, are grateful to you all.

  4. Comment from Dr. Feinman of NMS:

    Patty: NMS is approaching congress with the problem although it is appropriate for you yourself to discuss this with your elected officials. It is reasonable to ask for congressional hearings or NIH conferences in which the minority opinion is heard. People who understand the potential of carbohydrate restriction (the authors of the paper, for example) should be represented on the panels who make recommendations. You can write to the ADA as well.

    However, you should be constructive and collegial. I would not assume that any particular person is opposed to your point of view. There are traditional, conservative people who I think have undue influence on policy but these are big organizations and most physicians want to help their patient and may not be in concert with these committees. Also, many practitioners simply don't have the relevant information. We want them to accept a minority voice and we don’t really want to fight with them.

    Richard Feinman

  5. Comment from Dr. Feinman of NMS:

    Kyle Cramer: the benefit you get is that your voice may be heard. When NMS talks to a congressman, if we can say we have even 200 members who are committed to at least joining at $ 25 (this is still not a trivial amount of money for most of us), then we have much more likelihood of being listened to. Same goes for having a voice with the media. Most of all, the benefit is that we will try to post information, answer questions and do the things you think will bring out real scientific information. It is important to note that not all the authors of our articles are low carb advocates. They really want what the title says: a serious appraisal of the science.

    Richard Feinman

  6. Joined - hope my membership helps. Tell them to keep up the good work, and thank you!