Saturday, June 17, 2006

ADA Acknowledges Low-Carb Diets Help Control Blood Sugar

In an interesting twist this week, in an updated WedMD article, American Diabetes Association spokesman Nathaniel G. Clark, MD acknowledged in an interview that carbohydrate restricted diets help people with type II diabetes control blood sugar.

In previous articles, I've stated evidence-based medicine must be the gold standard used for making for recommendations; I've pointed to the consensus driven, dogmatic position of the ADA; and I've stated in no uncertain terms that the ADA must be held accountable for the health harming position, based on opinion not data, it takes.

Now the excuse from the ADA is that they do not recommend controlling carbohydrate because patients find them too restrictive. "We want to promote a diet that people can live with long-term," says Clark, who is vice president of clinical affairs and youth strategies for the ADA. "People who go on very low carbohydrate diets generally aren't able to stick with them for long periods of time."

The WebMD update was prompted by the publication of Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycemic control during 22 months follow-up, in the peer-reviewed journal, Nutrition & Metabolism.

The study started as a six month study to compare the effect of a low-carb or low-fat diet in those with type II diabetes. The original study data was published in 2005. In the present study, the researchers wanted to determine to what degree the changes among the 16 patients in the low-carbohydrate diet group at 6-months were preserved or changed 22 months after start, even without close follow-up. They also noted that 2/3 of the original low-fat group modified their diet after the study term and also showed improvement after making the dietary change. At the 22-month mark it was concluded that the improvements found at six months had a lasting effect on both body weight and glycemic control.

Noteworthy is that this is the first "long-term" study - one that didn't even include intensive follow-up and tracking for compliance - at almost two years. Without dietary counseling those who experienced the dramatic improvements stuck with the diet - even the majority of those subjected to the low-fat diet saw the results in the group following the low-carb diet and jumped at the chance to follow a low-carb diet and experienced the improvements too in the period between six months and twenty-two months.

So, it's now difficult for the ADA to say there's no data. What they're doing now is changing their tune - patients don't want to follow the diet, it's too hard.

Again we see the ADA purposely avoiding evidence-based medicine standards.

Quite frankly, it doesn't matter if a patient can or will follow the dietary protocol the evidence shows is superior to the current recommendations. Evidence-based medicine demands these findings be not just acknowledged in an interview, but presented to the patient as a line of defense in their management of the disease.

It's nothing but pure arrogance for the ADA to arbitrarily decide that it will not fully disclose the benefits of a carbohydrate restricted diet, as shown by the evidence, to patients because it feels patients won't want to follow the diet.

Since when does the ADA or any other medical organization decide what a patient wants?

Those with type II diabetes, those with pre-diabetes, and those at risk for developing insulin resistance which will lead to diabetes must be given all the facts so they can make a decision based on the full data available - anything less fails the standard of informed consent.

This study shows that individuals, when given an opportunity to experience the health changing effects of carbohydrate restriction, stick with it for the long-term. And who wouldn't? Just imagine what their health would be today if they never enrolled in the study and never were given the information about how to properly follow a carbohydrate restricted diet - they'd be progressively deteriorating!

Instead, their improvements are persisting - because they chose to continue eating a carbohydrate restricted diet.

It's time the ADA takes the evidence-based approach seriously and abandons this notion they know what a patient wants.

At the end of the day, you'll be hard pressed to find a majority of those with diabetes willingly opting for more medication and progressive deterioration rather than just give up the bread, pasta, rice and potatoes!


  1. Thanks for linking to that interesting article in Nutrition & Metabolism. The authors report that three "episodes of cardiovascular disease" occurred among the 5 patients in the control group who stuck with the high-carbohydrate diet, while none occurred among the 23 patients who continued or switched to the low-carbohydrate diet (p < 0.03.)

    It’s a bit chilling to consider this finding in light of what it suggests about the magnitude of the harm done by the standard "diabetic diet" and medications.

  2. Regina,
    I realize this post is almost a month old, but I just found your blog and would like to make an observation.
    I have Low-carbed for over 2 years now and have had striking health benefits. For that reason alone, I would never go back to eating starches and sugar.
    In regard to what the ADA says about people not being able to stick with a low-carb diet, I get questioned often: "Wasn't it hard to give up bread and potatoes? I couldn't do it, I am sure." Also, people with diabetes claim they could NEVER give up those things. My reply to them is usually: "I thought the same way until AFTER I did it." You don't know what you can or can't do until you try. If the personal benefit is enough, sticking with it isn't a problem. Unfortunately for them, some people do prefer to stay sick.

    I love your blog by the way!

  3. I had gestational diabetes with all of my pregnancies; and struggle with following the rules of the ADA; only to feel like a failure. During another episode of 'nutrition' classes, they had several magazines geared for diabetics and many articles on low carb success. I told my doctor that I didn't want any medication...he was goin to place me on three; one to control my blood sugar, one for cholesterol, and another for high blood pressure? not sure about the last one. I also informed him that I was going low carb, he supported my decision, giving me a year to try it my way as long as I met with him monthly with lab work every three months. He was thrilled with my progress and my results! I lost 70 lbs, I gave up sugar and processed carbs. My sugars are in the normal range, my cholesterol is better than ever with decrease in the bad and an increase in the good. I always read about low-carb being water loss! Give me a break! Anyway, as far as 'never being able to do that'. You do what you have to do for your health and quality of life.
    Awesome article! Thanks!

  4. Anonymous7:48 PM

    Thank you for exposing this issue! I was diagnosed with gest. diabetes two weeks ago and put on a "diet" that consisted of eating 250 grams of high-glycemic carbs per day including white rice, pasta, waffles and pancakes. At the time of diagnosis, I was borderline with only my morning number being higher than they wanted. Their diet caused my morning number to go up 15 points, and then continue to go up 3-5 points each morning. And my previously normal day-time readings also went up by 5-10 points. I got sick, and was stressed to the point of borderline high blood pressure because they told me they would put me on insulin and also give insulin to my newborn when she arrives in July. Instinctively, I knew this "diet" of theirs was bad news. So I did the research and took myself off their stupid diet and went controlled-carb like I was with my first pregnancy. Know what? My morning numbers dropped 30 points in one night. I haven't reached their 100 yet, but my #s are going down each day. Since all of the "literature" they diabetic center gave me was published by insulin companies, I have to believe that the reason the ADA and diabetes counselors don't back away from this high-carb diet because they are sponsored by the pharmaceutical companies.

  5. Thank you for writing this post. I have used it on my blog with a link to your blog and am a new subscriber.

  6. Anonymous10:17 PM

    Until this country addresses the addiction of carbs, including sugar, as something very real we are going to get fatter and more diseaded w/ diabetes.
    Sadly, in the same way most nutritionists are just lobbyists for the food co.'s and big pharma, the ADA is now like a sleazy war profiteer. Why would they put themselves out of biz?

  7. Its a very beneficial article of Low-Carb diets to Control Blood Sugar.

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