Thanks so much! That site is hilarious. I need to buy some of their products for my husband.
Since none of their quotes seem attributed to anyone, does this mean they are theirs?

We really ought to have a low carb wiki setup to store all these wonderful references to studies.

I have subscribed to this thread! Thanks, Regina!

I think it means it's either theirs or that no one has ever copyrighted it.

May 16th, 2005.

Sorry for the Big McLargeHuge post, but I did put some real time and effort into this.
So read it!



Thanks for the info. I thought you meant decades-long studies on patients, as in long-term study data, but this is still interesting.

So, I have taken some time today to dig into these cites, and find the text. I don't have time to read all of them, so I've just picked a few out. First I just highlighted a section and was picking titles out of that, then I broadened and picked some because the titles sounded relevant, or interesting to me personally (like the Bantu one). Everything I picked is listed.

I would like to invite other readers of this thread to do the same, and pick out some titles to look up. If you find the text online, please provide a link to it.

A high-carb, modified-fat diet may therefore have an advantage over a low-carb diet? The high carb was 203 g and the low carb was 150 g! High carb for newly-diagnosed diabetics improves insulin sensitivity!?
This openly contradicts your pro-low-carb position. This is not evidence of th good health of low-carb diets. Are you sure you wanted to cite this?

I can't find the article via the journal site, and anyway I don't speak Spanish (or Portuguese) but I'm game to run it through Babelfish. I don't think the online archive goes back far enough, though. I can't find the author's name in the list.
"Contraindications" means that the study found reasons NOT to use low-carb diets in certain diabetics, anyway. That sounds like it doesn't support your assertions, but I'm willing to read it. Do you have translated text available?

This one's in Polish, and I can't find the text - I don't know Polish enough to even find an online host for the journal. You have read this? Where did you find it?
But I do have to say, the author is not an MD and is a proponent of "balneotherapy" so I'm not sure how seriously I should take her anyway. I will try to be open-minded.

I can't find the full text online. The archive only appears to go back to 2004. There isn't an abstract either. What did this say?

This was a scanned-in PDF so I could not select text, but here's a snapshot of the summary:



That study is about elevated blood lipids on low-carb! It doesn't say low-carb shouldn't be used, but that the 'hazards' should be considered.
It mildly contradicts your position, certainly doesn't support it.

This is mildly positive in that it indicates something about how high carb intake can lead to higher blood lipids. However, it was a short (one-week) study, looking for a specific pancreatic action, and it shows correlation, not causation.
This at least starts to support your assertions. However, it was published in the ADA's own journal. Can it be said they are 'withholding' this evidence?

This sounds positive, about fast changes in triglycerides and cholesterol. But the abstract provided doesn't say much, and I can't find the full text as the online archive only goes back to 1994. Also, 'Hautarzt' is 'skin doctor.' This is from a dermatology journal (xanthomas are fatty skin deposits). This does sound interesting in the realm of blood lipids, but it's hard to draw any strong conclusions without knowing how long the study was ('short time' and 'few days' indicate it may have been short), how low-carb the diet was, and so on.

This is a good read. It's not a study, but a review of data. She thinks we should update dietary recommendations based on science, but concludes that more research is needed before recommending low-carb across the board. It also mentions 'realistic anticipated level of compliance,' which is something we've mentioned in the thread. It's dated 2006. So that actually supports what the ADA says: more research is needed.
I wouldn't say it supports your assertions.

Can't find the text - online archive only goes back to 2002. You have the text?

There's no really good short text to quote, but this study found in favor of a higher-carb, high-fiber diet compared to a lower-carb, lower-fiber one, because it lowers fasting blood plasma glucose over 2-3 weeks. The low-carb diet wasn't very low-carb, around 30% of diet (high was 60% of diet).
This contradicts your pro-low-carb position.

All I can get online is the abstract, so let me know if the text provides more interesting details. Based on the abstract, this one does sound very good, though. In people who have high triglycerides, a very high carb diet with lots of sucrose makes them worse. This was a 15-day study, that is not very long-term.
Also, this says nothing about going particularly low-carb for positive effect, it merely indicates negative results from going very high-carb with a certain amount of sucrose in the daily diet. This does not go very far in supporting your position, but it's on the positive side.

One more makes a dozen:
High carbohydrate diets may be beneficial in the management of certain diabetic patients?!

This is another scanned document, so here's a GIF from the summary:


This certainly doesn't agree with the position you're taking.


Maybe that's only 12 pulled out of what, 250 or so? So, that's nearly 5% and I tried to somewhat randomize my choices. Out of this random-ish sample:

• Five seem to contradict your position (as I understand it)
• Three seem to support your position, out of which
  • One was published by the ADA themselves (so they are not 'withholding' it)
  • One was a dermatology study (and no full text yet)
  • One merely said not to eat lots of sugar
• Four I was unable to read (I'd be happy to if I can get the text)

I was going on the assumption you had evaluated these things you cited. But now I'm not so sure...have you read them? Especially these ones in remote foreign journals!

I think that your comment
is on track. I know I am not competent to read much more than the abstracts. BUT as the following entries in Dr. Mike Eades blog indicate, the abstracts are often written to "pass the censors" and do NOT truly reflect the data in the study.


Because of his blogs, such as these, and the massive research shown by the bibliography for Protein Power Lifeplan (over 400 cites), I have total faith in Dr. Eades and by extrapolation also in Regina since her blogs track so closely with Mike’s.

Oh, so you think I'm a cherry-picker? LOL

Nope, sorry to disappoint - the citations are positive, neutral and negative for findings.

See, that's the thing with evidence-based medicine standards - you take the good and the bad and take it all to review and weigh it all in coming to a determination. You don't just pick one or two that support your postion - you take them all and see what happens when they're all considered.



If you're firmly of the belief that elevating lipids is hazardous in and of itself and don't look beyond a number, to perhaps the particle size changes, TC:HDL ratios, triglycerides, etc., then you're stuck in the diet-heart hypothesis and unable to open up the question "is this really an increased risk when all other factors are improving?"



Every last one of them? Nope.....but most of them, yes - a good number are references in my dissertation. And "remote" foreign journals are available at medical school and research university libraries with translation into english if needed.

You biggest mistake - going by just the abstract....far too often the abstract is out-of-synch with the data within the full-text. I've seen it way too often and never, ever go by just an abstract (even if it's positive) these days!

Lastly, my position isn't "pro low-carb" --- it's pro-science....right now the science is pointing toward carbohydrate restriction (which isn't always as low as, say, Atkins) and while you maintain that because the ADA publishes studies and abstracts in their journals, they're not "withholding" the information.....on one level you're right, but on another you're wrong......they have a duty and obligation to disclose it beyond their journals (which are paid access) to the public and healthcare providers in their position statements accurately.

As it is now, they're taking the position that even though the data is strong and suggestive of benefit, no one is going to do it anyway, therefore they are not going to make a recommendation for it.

That's disingenous and dangerous - with patients out there on medications who may decide to do low-carb on their own with little or no guidance or monitoring it is a disaster in the making. Physicians need a clear guideline that takes them through the dietary approach, the medication reductions, the monitoring involved and what to watch for along the way.

By not taking this critical step, the ADA is setting the stage for a potential train-wreck that can be prevented by simply documenting the protocol. They're also leaving themselves open to huge liability issues in the future, as more data emerges and someone with diabetes is told, in no uncertain terms, the ADA says not to do low-carb.....and they don't.....they follow the ADA recommendations and lose an arm or a leg.....and then find out they might have had a different outcome IF their healthcare team were given another option.

It's a balancing act - what do you recommend, what do you say to avoid.....what to issue cautionous guidelines for......it is this last one, cautious guideline that is what the ADA needs to be doing and they're not.

Thanks Larry!

I missed responding to this while I was writing my big bloated post:

They are refusing to disclose it? Or maybe they don't assign the evidence that much weight?

Are you expecting me to defend the ADA's dietary recommendations? I have said that I don't like 'em much, except that I have said they will be better than what some people are eating. Which is pretty faint praise.

I agree, they don't appear to be providing info about what studies they mean. That "A" grade is mysterious. I think they are saying that there is A-grade evidence that nondiabetic individuals with pre-existing cardiovascular disease benefit from low limits of saturated fat (because of the lowering of LDL and yadda yadda). Quite possibly they are adopting the rating straight from the AHA's rating of a study or group of studies? I'm not really interested digging around in the AHA info just for purposes of this discussion, though, especially considering that I'm not interested in defending the ADA's dietary stuff in the first place.

I get the idea that you feel the ADA and/or AHA is inconsistently applying their evidence standards. Proving that would take a very major meta-analysis effort. Is that the kind of thing you're working on, with all the data you've assembled?

In any case, again, we're talking about wanting the ADA to look again at lower carb than what they recommend, and I totally agree. I just don't see anyone providing the least bit of proof that they are presenting false information to please their sponsors.

Actually, I think we had a simple misunderstanding. Let's review.

You said: "...there is LONG-TERM DATA......and it clearly points to carbohydrate restriction."

I said: "What long-term data are you referring to? Where is the data on low-carb diets that goes back decades? Do you mean patients of Dr.Bernstein (et al.)? Have epidemiological studies been done on them?"

Thing is, I thought you meant "there are specific long-term studies on carbohydrate restriction that clearly point to using it for diabetes patients." But you meant something more like "all of the years of dietary studies that focus on carbohydrates cumulatively point to carb restriction for diabetes patients."

I suppose it came off as if I was asking you to 'cherry-pick,' then. If that's bad manners, I apologize.

For some patients, though, it could be a 'hazard' as they say. Just yet another factor.

I figured you had read all that stuff, but when I looked those up and found they were extremely hard to find, it just didn't seem as likely. I also figured if you had the translated text handy, you might be willing to share it. I mean, I've spent a lot of time on this thread, in a good-faith effort to understand the points being made, but I can't commit the kind of time it takes to visit some research libraries just for an online discussion at the moment.

I picked twelve things. I could have ignored the one that I only had the abstract for, but I figured clearly labeling it was enough.

The two things I linked to weren't just in their journal, but specifically mentioned on their free web site.
The old pricey journal paradigm may be shifting towards a more open-source system, which is great. But interpreting the studies is still an important service the ADA should perform - I agree. Although they can hardly present everything.

Isn't there some data that shows people stay on more moderate diets longer? So they may have a point.

I can't really agree with that. Diabetes patients on medication may also be convinced by a chiropractor that adjusting their subluxations has cured them, go off their meds, and start drinking three Frappuccinos a day. The ADA doesn't tell them not to.

I'd like to see them produce a protocol, too, for something lower than 130g/day but higher than 60g/day. Hopefully it's just a matter of time and maybe some more data.

Incidentally, couldn't they genuinely have come to a different conclusion from yours (and mine, but mine is based on less)? I know you've looked into how they rate evidence, but it is a very large pool of data we're talking about.

Liability is an interesting point. I almost wonder if it is working against progress here - the country is WAY more litigous now than it was in the 1980s when these recommendations started. A major reversal in favor of lower carb and higher fat...I wonder if that would seem to expose them to lawsuits?

I would be happy to see the ADA come out with some low-carb recommendations, as in below 130g/day, and I think it would be a responsible thing to do.
I'm just not interested in claims they are selling out, corrupt, criminal, etc. without some real evidence that it's true. The fact people on this thread don't like the macronutrient ratio the ADA recommends and don't like their sponsors either doesn't mean their sponsors are dictating the diet they recommend.

Actually, not just the abstracts. He goes much farther than that.

Here he is talking about problems with the peer review system:

Here he talks about reporting bias:

Here he talks about how drug-company funding twists studies:

Here he is agreeing that most current published studies are false (I included what he's quoting this time, also):


Here he discusses a pretty bad study result:


Here, he explains how the authors of another study are either ignorant of how the statistics work, or dishonest:


They do both make the point about how critical reading of studies is crucial. Although Dr.Eades makes you wonder if there are any reliable studies at all, to read!

What's your point, Ysabella? Is it that we should be nicer to the ADA because they're doing the best they can? Regina has shown beyond a shadow of a doubt that the science behind carbohydrate restriction is very clear. To be most charitable to the ADA is to understand that there is a paradigm shift going on in medical science that is killing off the lipid hypothesis. As in all paradigm shifts, many will cling to the weakening paradigm as long as possible because something in that paradigm supports what people need to believe about themselves.

When you suggest that Mike Eades work makes you wonder whether ther are any reliable studies at all, the answer is that looking at those studies from the point of view of the new paradigm reveals the flaws caused by the old paradigm biases. But good science is uncovering the flaws, not simply adherence to a new paradigm. The fact that good science supports the new paradigm shows that we are moving in the right direction.

One need not allege a conspiracy between the ADA and the drug companies to understand the ADA as a bad actor. The informational environment within which people make choices about diet and treatment is corrupt. The ADA is a player in causing and maintaining that corruption. The consequences of that corruption is that people are being denied information that could save their lives.

The victory of a new paradigm is not automatic. It must be struggled for by those who have come to understand it. Taking on the ADA of any other institution that supports the lipid hyothesis could be a part of that struggle.

Ysabella:

With all the rambling I can't stay clear what you disagree with.

Are you saying that low carbing does not work?

Are you saying that low carb patients have not been studied for decades?

Are you saying that the average person on a low carb diet lipid profiles are not better than a regular diet?

Are you saying that the ADA, FDA, AMA, etc are telling people to switch to the low carb diet?

You doubt the power of LC?

Diabetics who begin induction level LC had better modify their medication dosages the day they start.

Unfortunately many physicians aren't aware of this, and the ADA might look into it, if they had diabetic patients' best interests at heart.