Atkins Diabetes Surprise

[nobimbo]

Atkins diabetes surprise
23 May 2005
By NIKKI MACDONALD

The controversial high-fat Atkins diet helps patients with diabetes lose weight and control the disease, a landmark Wellington Hospital study has found.


Twelve overweight patients with type 2 diabetes, brought on by diet and lifestyle, lost an average of almost 10 kilograms – more than 8 per cent of their total body weight – after six months on a modified Atkins diet. Medical debate has raged for more than a decade over the merits of the Atkins diet, which strictly limits carbohydrate intake.

The study found glucose tolerance improved significantly – a "really good result" indicating better diabetes control that could delay or stop the development of serious complications such as eye, kidney and nerve disease.

The research is only the second study of its kind. Lead researcher and endocrinologist Jeremy Krebs was extremely surprised by the findings.

"When I went into it, with no published studies, I was expecting we would see it would be harmful. I was not surprised people were able to lose weight, but the health parameters all improved more than I expected."

The study comprised 14 participants aged between 35 and 62, who weighed 82kg to 130kg. Two dropped out. For the first two weeks participants were restricted to up to 20 grams of carbohydrate a day – equivalent to one piece of bread. After two weeks, the limit on carbohydrates was gradually increased.

The aim was to lose weight in the first three months and maintain it in the second half of the study.

The diet was a slightly modified version of Atkins, aiming to avoid "bad" saturated fats and eat more mono and polyunsaturated fats.

Weight and waist measurements steadily decreased during the six months, from an average of 120kg to 110.3kg, and 126.2 centimetres to 117.7cm. Individual weight changes ranged from a 1kg gain to a 17kg loss.

Average levels of bad cholesterol went up, but less than expected, and the increase was largely cancelled out by an increase in good cholesterol, Dr Krebs said. One of the biggest concerns – that the diet would increase protein leakage, an indicator of kidney problems – proved unfounded.

Though the results were encouraging, the study was only a short pilot and a longer investigation was needed to prove long-term benefits.

It was the weight loss rather than the diet that was beneficial, but the Atkins diet was easier to keep to because it did not leave people feeling hungry, he said. Without counting calories, patients cut their energy intake about a third, just by cutting carbohydrates.

However, a high-fat diet was safe only if people were losing weight, Dr Krebs said. One participant "just did not get it". He increased his protein and fat intake without reducing carbohydrates, gaining 1kg and worsening his health.

Otago University professor of nutrition Jim Mann said the study results were interesting but he was "really nervous" about the suggestion the study endorsed the diet.

"It does not prove anything. When someone loses weight by whatever means their diabetes will improve, that's been known for 50 to 60 years."

When the weight loss stopped, the high-fat diet was likely to increase cholesterol and increase insulin resistance, causing the patient's diabetes to worsen, he said.

http://www.stuff.co.nz/stuff/0,2106,3288465a7144,00.html

[nobimbo]

Diabetes Study Results No Surprise To People Doing Low-Carb
Jimmy Moore
May 22, 2005


Well, well, looky what we found here today: "Atkins diabetes surprise"

It seems a new study released by the London-based Wellington Hospital finds that low-carb programs such as the Atkins diet can and does help people with diabetes lose weight and overcome their disease.

Surprise, surprise, surprise (in my best Gomer Pyle impression!). Actually, it's not a real surprise to people who are livin' la vida low-carb. While I am thankful I do not have diabetes, I have heard from so many of my low-carb friends who are diabetic about the wonderful results they have seen in improving their condition tremendously because of the low-carb lifestyle.

In fact, an entire book of research on the subject of doing low-carb for diabetes patients was released late last year called Atkins Diabetes Revolution. There is a wealth of information in that book that complements the findings of this new research.



In only the second such study of its kind, doctors examined twelve overweight diabetic patients between the ages of 35 and 62 and put them on a low-carb eating lifestyle for six months. Over that time, the study participants lost an incredible 8 percent of their total body weight and saw a noticably dramatic difference in their glucose tolerance.

Researchers admit this was a "really good result" from the Atkins program regarding diabetes. In fact, Jeremy Krebs, who served as the head of this study, was overwhelmed by the positive improvements in the diabetes patients they examined.

"When I went into it, with no published studies, I was expecting we would see [the low-carb diet] would be harmful. I was not surprised people were able to lose weight, but the health parameters all improved more than I expected."

Okay, so now we've convinced a doctor that the low-carb lifestyle does actually have health benefits besides losing weight. While most universally accept it as a way to lose weight (although, most of them would say "temporarily"), it's been like pulling teeth to get these doctors to see the long-term health benefits to their patients. And when a patient has diabetes, the results are even more promising!

Study participants only ate 20 carbs during the first two weeks, just as the Atkins program prescribes during their Induction phase, with a gradual increase in carbohydrates over the subsequent weeks. Again, this mimicks Phase 2 (Ongoing Weight Loss) of the Atkins plan. The study researchers wanted their patients to lose weight in the first three months and then maintain it for the next three months.

The only change the researchers made to the traditional Atkins diet is they did not allow the study participants to eat any saturated fat, but rather monounsaturated and polyunsaturated fats.

They called this a "modified" Atkins eating plan, but really it's not. Contrary to popular belief, not everyone who does the low-carb lifestyle tries to gorge themselves on sticks of butter, a pound of bacon a day and other such saturated fats. Most of us eat healthy fats, like the ones found in nuts, to help us get the fat we need on our low-carb plan. While there is absolutely nothing wrong with eating saturated fat on low-carb, most experienced long-time low-carbers learn to moderate their intake and cut back on it naturally.

Other interesting results from the study include a marked increase in the HDL "good" cholesterol levels in almost every patient. Additionally, Krebs said despite repeated warnings from his colleagues in the medical community about possible kidney problems from eating too much protein on a low-carb lifestyle, his observations led him to believe that was simply not a major concern. He also credited the low-carb approach for giving study participants a way of eating that helped them to feel full and satisfied without having to count calories and yet still lose weight.

WOO HOO! Can we get this guy to start lecturing doctors about the healthy alternative low-carb offers? Man, if doctors would just listen to what one of their own is saying, we could overcome this negative barrier regarding low-carb. Sadly, it will take a lot more studies like this before medical "experts" change their already-made-up-mind about what to think about low-carb.

Interestingly, Krebs said one of the study participants "just did not get" the Atkins diet and on his own decided, in addition to eating more protein and fat, that he was going to keep on eating the same amount of carbs that he always had. Talk about a recipe for disaster! Needless to say, he was the only patient to actually GAIN weight and make his health get even worse than it was before the study began.

What an idiot! Did he really expect to lose weight on a steady diet of protein, fat AND carbs?! It simply amazes me when people stray away from the plan thinking they know better about how to do it than a silly book. Just a small word of advice: DON'T DO THAT!

At the end of the story, a so-called health and nutrition expert responded to the study results with the same vile hatred and disdain for the Atkins lifestyle that we hear all the time in the media: "It does not prove anything. When someone loses weight by whatever means their diabetes will improve, that's been known for 50 to 60 years," adding that the diabetes problems will return if the patients continue with the low-carb lifestyle after the study they will see an increase in their cholesterol and insulin resistance.

See what I mean? Despite an incredibly positive story about the low-carb lifestyle, medical professionals are still going to scoff at any beneficial factors associated with it. It goes against everything they've ever known about health and nutrition. And by golly they're gonna protect their precious little reputations so they don't have to admit they were WRONG! It may not be today, or tomorrow or even next week or next year. But someday these same doctors who have been lambasting the low-carb lifestyle will be saying mea culpa to their patients when they realize just how wrong they were about livin' la vida low-carb.

http://www.scheadlines.com/article.asp?colid=2126

[Dodger]

Well said by Jimmy Moore.

[mio1996]

Not perfectly said though, Dodger. I like Jimmy Moore, but this statement really got me:

Most of us eat healthy fats, like the ones found in nuts, to help us get the fat we need on our low-carb plan. While there is absolutely nothing wrong with eating saturated fat on low-carb, most experienced long-time low-carbers learn to moderate their intake and cut back on it naturally.

Unfortunately, Jimmy is still slightly on the wrong side here regarding fats. Maybe he has read much of the new PC literature put out by that adulterous organization, Atkins Nutritionals, who is slowly working to destroy the healthfulness and effectiveness of the Atkins Nutritional Approach. They are promoting frankenfoods at a never beforeseen level and are leaning a little away from the truth that saturated fats are healthy. Anyone wanting to embark on the wonderful journey that is the Atkins lifestyle would do well to stick with DANDR or the original 1972 DADR rather than what that organization is publishing now!

The poor doc must be rolling in his grave as we speak!

[Dodger]

For an article on low-carbing in the popular press, Jimmy's statements were in the top 10% for being accurate. It is impossible for us low-carbers on this web site to agree with each other 100% on what is best.

I do wish the original study had followed the Atkins philosophy on saturated fats, rather than limiting them. I think that saturated fats are better for humans than the vegetable based polyunsaturates that have become the fashion, but reducing the carbs is far more important in overall health.

[Kristine]

The controversial high-fat Atkins diet helps patients with diabetes lose weight and control the disease, a landmark Wellington Hospital study has found.

Surprise! :idea: :idea:

[VALEWIS]

Yes, a brave researcher needs to do a long term LC study in which sat fats are allowed ad libitum..and to see if type 2 diabetes control and good HDL/tri's results are maintained despite the sat fat intake.

This needs doing. Perhaps the dairy industry might get behind such a study.

Val

[Lisa N]

I do wish the original study had followed the Atkins philosophy on saturated fats, rather than limiting them. I think that saturated fats are better for humans than the vegetable based polyunsaturates that have become the fashion, but reducing the carbs is far more important in overall health.

Mike, I also wish that they had included a control group that also lost weight using the standard diabetic protocol so that the effects of weight loss on blood sugar control and lipid profiles could have been better compared. I have a very strong hunch that weight loss in and of itself would not have produced the same positive changes or in the same degree that weight loss and low carb produced.

[VALEWIS]

Lisa, this is a good point. It would perhaps finally end this entrenched belief that just losing weight was the key factor.

Val

[mcsblues]

The diet was a slightly modified version of Atkins, aiming to avoid "bad" saturated fats and eat more mono and polyunsaturated fats.
It still amazes me that any "scientist" can do a prolonged and no doubt expensive study into the efficacy and safety of anything (in this case the Atkins approach to drug free glycaemic control for diabetes) - and then deciding not to actually study what this entails.

Sure it might require some courage to fully explore all the ramifications - but then studying the (crazy) Atkins approach (particularly when you don't believe it will work!) requires this anyway. And to compound this lack of simple scientific rigor, as Lisa points out - where is the control group?? (rolleyes)

It would be nice to see how much more the CHD risk factors would have been improved by replacing the no doubt processed vegetable oil sources of polyunsaturated fats with healthy saturated fats. Now THAT would have surprised him! :)

Cheers,

Malcolm

[ironaddict]

Hi,

This was done in a local hospital, and as well as the article in the Dominion Post this morning, there was a segment on a current affairs show last night. I have mixed feelings about it. There was the usual slagging of the Atkins approach by a low-fat zealot nutrition professor, and footage of sizzling butter and bacon. On the other hand, they also showed one of the subjects making herself an enormous salad, and showed that in the period of the study she'd progressed from lying on the sofa in a coma-like state to competing in triathlons and teaching exercise classes.

But what is coming across overwhelmingly is that they just don't want to accept their own findings in the study. In the paper there was material that wasn't in the online version posted above. They printed case studies of three of the subjects, and these included information that directly contradicted the doctors' conclusions. For instance, they're saying that improvements in blood sugar numbers are solely because of the weight loss, and nothing to do with the composition of the diet. But right there in one of the case studies, one of the subjects says that her blood sugar went from stratospheric to normal within the first two days. Clearly not the result of weight loss.

The worst of it is that they're recommending that it be used as a short term method of quick weight loss, followed by a return to low fat/high carb. Could anything be more potentially harmful than that recommendation?

Cheers, IA

[VALEWIS]

The following has some bearing on this discussion?

Val

The Degree of Fat Saturation Does Not Alter Glycemic, Insulinemic or Satiety Responses to a Starchy Staple in Healthy Men
Caroline G. MacIntosh, Susanna H. A. Holt and Jennie C. Brand-Miller1

Human Nutrition Unit, School of Molecular and Microbial Biosciences, The University of Sydney, NSW 2006, Australia


2003 The American Society for Nutritional Sciences J. Nutr. 133:2577-2580, August 2003



ABSTRACT


Inclusion of fat reduces the glycemic response to a carbohydate meal, although the effect of different types of fat on glycemic, insulinemic and satiety responses is unclear. Ten healthy men received 50-g carbohydrate portions of mashed potato with isoenergetic amounts of butter (saturated fatty acid), Sunola oil (monounsaturated fatty acid) or sunflower oil (PUFA) and two 50-g glucose loads on separate days. Capillary blood was collected at regular intervals for 2 h. Satiety ratings were assessed by use of a rating scale. The glycemic index (GI), insulin index (II) and satiety index (SI) scores were calculated. Energy intakes from a meal consumed ad libitum at 2 h and for the remainder of the day were quantified. The GI values ranged from 68 ± 8 to 74 ± 10 and the II values ranged from 113 ± 10 to 122 ± 17, but there was no effect of fat type. SI scores and subsequent energy intake did not differ among the test meals. Substitution of unsaturated fats for saturated fatty acids had no acute benefits on postprandial glycemia, insulin demand or short-term satiety in young men.

[K Walt]

Yes, a brave researcher needs to do a long term LC study in which sat fats are allowed ad libitum..and to see if type 2 diabetes control and good HDL/tri's results are maintained despite the sat fat intake.

This needs doing. Perhaps the dairy industry might get behind such a study.

Val

Been done.
http://www.diabetenet.com/L-dg-dispatch-endo-99.htm
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12113629&query_hl=1

[TBoneMitch]

It is amazing that these researchers do not even understand the whys and hows that low carbing works to improve glycemic profiles independently of weight loss?
To twist a quote by the researcher, it has been known for 50-60 years that lc will improve blood sugar by itself, and much more than low fat high carb will.

I corroborate IronAddict's feelings that it takes quite a degree of arrogance to stare at your own results and not accept them.

[Meow]

If they actually acknowleged that lc is good for diabetics, they would probably lose tons of research money. The almighty dollar is more important than a person's health any day. :rolleyes:

Correct me if I'm wrong, but wasn't Atkins originally started for diabetics?

[ironaddict]

To twist a quote by the researcher, it has been known for 50-60 years that lc will improve blood sugar by itself, and much more than low fat high carb will.

I corroborate IronAddict's feelings that it takes quite a degree of arrogance to stare at your own results and not accept them.

Hi,

It's a natural human thing to hang on to your beliefs, even when they're contradicted by evidence, but you can't do that and call yourself a scientist.

Another thing they're saying is that they can't draw definite conclusions from this study as it was only a short-term pilot experiment, which is a fair comment. But I'd hope that in the long term follow-up study that they're planning, they're more honest and open-minded in interpreting the data.

Cheers, IA

[Lisa N]

Correct me if I'm wrong, but wasn't Atkins originally started for diabetics?

Nope. Dr. Atkins was a cardiologist and developed the diet for his heart patients because he noted the significant improvement in lipid profiles while following a low carb approach. Weight loss is also considered important in lowering cardiac risk and his approach accomplished that as well.
IMO, the fact that it improves cardiac profiles because of the insulin lowering effects of the diet shows that the two problems have a common root cause. ;)

[kmct10]

Well, halleluiah. Another stunning revelation, quickly buried under cover of night like a dirty secret. One researcher's eyes opened, three million to go.

One participant "didn't get it" - how common this problem is.

"Otago University professor of nutrition Jim Mann said...he was "really nervous" about the suggestion the study endorsed the diet." !

I love this glimpse of total honesty...he was not so much nervous about the results as the risk to his professional reputation. I can smell his insecurity from here.

Let's keep the heat on.

[Melanie2]

When the weight loss stopped, the high-fat diet was likely to increase cholesterol and increase insulin resistance, causing the patient's diabetes to worsen, he said.

Gee, all along I thought it was the sugar and carbs that caused the insulin resistance. huh?

[Turtle2003]

See what I mean? Despite an incredibly positive story about the low-carb lifestyle, medical professionals are still going to scoff at any beneficial factors associated with it. It goes against everything they've ever known about health and nutrition. And by golly they're gonna protect their precious little reputations so they don't have to admit they were WRONG! It may not be today, or tomorrow or even next week or next year. But someday these same doctors who have been lambasting the low-carb lifestyle will be saying mea culpa to their patients when they realize just how wrong they were about livin' la vida low-carb.

I think it was Einstein who said something about the only way to change some people's minds is to wait for them to die. :lol:

[kmct10]

"Dr. Atkins was a cardiologist and developed the diet for his heart patients because he noted the significant improvement in lipid profiles while following a low carb approach." Lisa N

Not only that, but he first came across the concept in JAMA, a mainstream medical journal. As TBoneMitch pointed out above, LC has been common knowledge for decades, though it never got formally explained or verified. During the 50's and 60's every average person knew that the most unhealthy thing about the Western diet was our predilection for "dessert and candy bars".

When medical research finally went looking for a formal explanation for "heart disease", they completely ignored this common sense dietary connection and focused solely on the SYMPTOM, that is fat in the arteries, in the process utterly obscuring the role of sugar.

Hence, the entire theoretical basis of the low-fat theory is: if we are too FAT, it must be because we are eating too much FAT - problem solved! It became a political crusade, and the unquestionable low-fat dogma was born. Unfortunately, it has caused little or no health improvement in anyone.

It is mind-boggling that forty years later, medical science STILL does not grasp any connection between glucose and metabolic syndrome, even though the data for low-fat is virtually NON-EXISTENT and the data for LC is relatively OVERWHELMING. So we see the bizarre and pernicious nature of blind beaurocratic and cultural group-think. Group-think is the very worst aspect of modern mass-culture. Dissent from politically correct theories is simply not allowed.

"I think it was Einstein who said something about the only way to change some people's minds is to wait for them to die. " Turtle2003

Unfortunately, that is no joke, and true in many academic fields. But what does not kill you DOES make you stronger. Let's not be discouraged by the ignorance of those in power. The plain facts are overwhelmingly on our side! On a strictly scientific basis, this is one battle we can't possibly lose.

[rbednarski]

Not only that, but he first came across the concept in JAMA, a mainstream medical journal. As TBoneMitch pointed out above, LC has been common knowledge for decades, though it never got formally explained or verified. During the 50's and 60's every average person knew that the most unhealthy thing about the Western diet was our predilection for "dessert and candy bars".


They also knew that the way to lose weight was to cut down on starches. I'm old enough to remember when the "diet plate" in many restaurants consisted of a hamburger patty and some cottage cheese - anathema to the current low-fat cult but spot on for people who understand Dr. Atkins.

Rich

[rbednarski]

Mike, I also wish that they had included a control group that also lost weight using the standard diabetic protocol so that the effects of weight loss on blood sugar control and lipid profiles could have been better compared. I have a very strong hunch that weight loss in and of itself would not have produced the same positive changes or in the same degree that weight loss and low carb produced.

The problem is that they probably couldn't find people who could get that kind of weight loss on the standard diabetic protocol.

Rich

[rbednarski]

Otago University professor of nutrition Jim Mann said the study results were interesting but he was "really nervous" about the suggestion the study endorsed the diet.

"It does not prove anything. When someone loses weight by whatever means their diabetes will improve, that's been known for 50 to 60 years."

When the weight loss stopped, the high-fat diet was likely to increase cholesterol and increase insulin resistance, causing the patient's diabetes to worsen, he said.

http://www.stuff.co.nz/stuff/0,2106,3288465a7144,00.html

Anyone want to bet that he doesn't have any actual data to back up what he thinks is likely to happen?

Rich

[Dodger]

I'm old enough to remember when the "diet plate" in many restaurants consisted of a hamburger patty and some cottage cheese

How could you forget the piece of iceberg lettuce that the cottage cheese sat on?

[VALEWIS]

Or the slice of tinned peach on top of the cottage cheese?

Val

[dannysk]

Correct me if I'm wrong, but wasn't Atkins originally started for diabetics?

Not Atkins, but low-carb was started in the early 19th century by a French doctor as a cure for diabetes. The side effect was weight loss.
An English doctor who heard these lectures recommended it to Banting as a weight loss regimen. And the rest, as they say, is history.

danny

[TBoneMitch]

I think you may be right, Dannysk, and that physiologist's name was Claude Bernard. He discovered the role of the liver in producing glucose even in the absence of carbohydrates in the diet and concluded that carbs were dietarily non essential.

[CindySue48]

Way back in the 70's, when I was in school, weight gain was a SYMPTOM of type 2 diabetes. Now it's considered a cause.

Back then we also treated patients with a fairly strict diet of limited carbs of all kinds, but especially sugar. Following the proper diet, with or without meds, usually resulted in pretty good control of bs. Patinets that didn't have good control were usually found to be non-compliant with their diet. But of course, they didn't know anything back then....after all, look at how many people didn't NEED meds back then!

[Marge]

All I know is when I follow Atkin's principles in his book my blood sugar and everything else improves dramatically. My eating habits get better and I snack less. Hallajuh. Amen.