Semantics.

The ADA has specific Medical Nutrition Therapy (MNT) guidelines published....it is the foundation of dietary recommendations made to those with diabetes. It may not be called the "ADA Diet" anymore, but it remains the ADA's nutritional guideline for diet in those at risk for or diagnosed with diabetes.

You may want to take a peek at their bookstore - rich with books of ADA published book on how to eat with diabetes, with titles like "The Diabetes Food & Nutrition Bible," "Cooking With the Diabetic Chef," "Guide to Healthy Restaurant Eating," "Dr. Buynak's 1-2-3 Diabetes Diet," "Brand Name Diabetic Meals In Minutes".........amazing some of the books they'll place their logo on!

Thanks, Angeline. I pride myself on being skeptical - which is not the same as cynical.

If I may add my prospective from a time when polio was a parents nightmare - and my sister had it. Back then there was the "March of Dimes" dedicated to finding a cure/prevention of polio. Well a vaccine was found and polio is just a word to many people. Did the "March of Dimes" organization close up it's doors and go away with the satisfaction of having gotten the job done? NO! They found a new cause, worthy enough, do not misunderstand what I am saying, to champion and they kept on as an organization.

All these types of organizations take on a life of their own, be it the Heart Asso., American Cancer Society, or what ever. And like any other (living) organism their self preservation is instinctive. So Regina has a valid point that cannot be ignored, the ADA is probably as much concerned with its own existence as it is about anything else at a subconscious level especially. Hidden agendas (self preservation in the case of the ADA) are often a BAD thing and can even be oblivious to the parties involved, as Regina has implied. SAD!

Your explanation for their mulishness has caused a paradigm shift in my own thinking. To embrace low carb they will have to accept they have been wrong for 20 years, and that they have been dispensing bad, even dangerous advice. It takes a very special kind of person to do that. I think most people can't do it. They will have to find some kind of compromise they can live with. In fact I think they have. Diets don’t work, let's just medicate people. Low carb doesn't work because no one can stick to it. Doesn't that sound like someone who is desperately trying to convince himself? They aren't lying to us, they are lying to themselves. The naked truth is just too scary.



I can only see two things happening, either they will wake up one of these days and "discover" low carb, or they will make themselves so thoroughly irrelevant, they will never recover.

I can only hope that a younger generation, that isn’t so firmly entrenched in current dogma, will change the situation.

No! The sponsors might be doing so, for all I know. However, we have no actual proof showing that is what's happening. Criticism is warranted, it's always warranted, but unfounded accusations strike me as pointless.

I figure that falls under a form of dogmatism. Some people have said "corrupt" and this kind of thing might be what they mean, a subtle form of corruption.

Certainly. All those things are essentially enemies of good science, and of progress.

You've done a lot more work than I have done.
But since the ADA focuses on diabetes-related research, not low-carb-related research, their database is different from yours, except where they overlap.

I can easily believe that. I'm not even diabetic and I wouldn't eat their diet.

My point was that they cannot make the studies happen in the first place. So, if they don't think there is enough data yet, they can't make more data happen.
We want to see lots of long-term study data on low-carb diets tested on diabetics, Type II in particular. The ADA can't just decide they want that and make a study happen, at least not as I understand it. They could only have one come along and award money to it. They don't commission studies for their own proposals, that I know of. They just accept grant requests and dole out the money they raise.
And sometimes special money gifts to the ADA are earmarked for certain types of studies, which narrows the ADA's options further.
They do review non-ADA-funded research. Their website offers the ADA-funded database and also external resources.

Then that "A" grade is way, way mysterious.

I still can't see it. When the ADA says there needs to be more data on low-carb diets, so they don't recommend them, I don't see how they can be blamed when patients decide to try it on their own.
I mean, how many people come to this board saying that they're "doing Atkins" who clearly have not read the book? Who is liable for whatever they do to themselves if they are eating something weird? I don't know, badly-prepared fugu for every meal, or something?

I would like to see a low-carb guideline, too. It would probably be for Type II only, and with a caveat about kidney disease, yadda yadda.

Yes, but the link I provided mentioned a hospital "1800-calorie ADA diet" that bore no apparent relation to the actual ADA. Some things claim to be "the ADA Diet" that are not, it just seemed worth mentioning.

Things their logo is officially on, for sale on their site, are presumably a close match to their current recommendations. I'm sure I wouldn't want any of 'em.

Kewl! I said the same thing myself on August 31: "There is a danger that an organization can become more interested in furthering the glory of the organization itself than furthering the organization's stated goals."

More than 20 years. I was just reading an interview with Dr.Bernstein where he was talking about that. He said the ADA was recommending high-carb diets back in the 1940s. That was the cutting-edge idea at the time because of the heart disease connection and so on.
We have been discussing their possible "dogmatism" all through the thread.

I suppose. But, I think it's counter-productive to treat the ADA as some kind of monolith. It is made up of a lot of people, and people can change their minds.
It's possible something has gone wrong and the ADA system for evaluating studies is no longer responding to new science as it should, but maybe it's just going to take more data and they will finally recommend low-carb, at least for some diabetics.

I don't know about the relative ages of the ADA's board members. Maybe more young doctors on the board would help make a difference? I've read that younger doctors are usually more active about reading new science, and more open to it.

Since low carb research has been going on for over one hundred years -- how much has the ADA done to promote it?

William Bantings from mid 1800s
Weston A Price from 1930s
Dr Atkins from 1970s
Dr Bernstein from ?

Plus countless other doctors researching pre type 2 diabetes, syndrome X, metabolic syndrome, and other health topics regarding low carb diets and supplements for optimum health.

All these doctors had one thing in common -- nutrition plays a huge role in our health -- and is the only true cure for type 2 diabetes.

I think that many doctors agree that if you find the cure to type 2 diabetes then you have found the root cause of 80% of todays health problems. We know what that cure is -- but "health experts", including the ADA, say the exact opposite.

My understanding is that the ADA has not only done little to help with this reasearch -- but promoted the exact opposite - heavy intake of starches !(see article I sited above)

To this day -- I don't see or hear the ADA standing on the mountain top yelling out loud "high glycemic foods are as bad, or worse, for your health than smoking, drugs, and alcohol. Everybody needs to start a low carb diet immediately and then read everything they can on pre type 2 diabetes, Syndrome X, and metabolic syndrome".

If the ADA has changed their ways is so great today -- why are hundreds of thousands of type 2 diabetics and "health experts" -- still anti low carbing?

If the ADA was so great they would have been the leader on low carb research and would be knocking on every door in America to make sure that everyone knew the risks of eating high glycemic foods.

You may be surprised - my dissertation is on the multi-faceted, massive endocrine failure in diabetes.

The point you're missing is that they ignore the data from studies specifically investigating carbohydrate restriction in those with insulin resistance or diabetes. If you look at their references in the MNT position, they use studies that are not only "stale" (older), they use ones that didn't focus on IR, IFG, IGT or diabetes. They're out there, in the literature, yet those sitting on the writing panel did not use them to support their position that carbohydrate restriction should be avoided - why?

Why not point to the studies?

Oh, that's right, they don't support the ADA position - so rather than use that data they'll omit it and leave it as carbohydrate restricted diets are not beneficial for diabetics.

Here's the thing with evidence based medicine standards - when someone or a group makes an assertion, and claims it is based on the data, they're expected to cite the studies. In this case, they cite nothing that supports their position that a carbohydrate restricted diet should be avoided.

IF their position was valid, the data would easily stand behind their position - they can't cite studies where the data (not the interpretation of the data) brings to the surface the problems they suggest as reason to avoid carbohydrate restriction.

Actually how they grade evidence is clearly outlined in their position statements:

An "A" grade is earned when studies are:

Clear evidence from well-conducted, generalizable, randomized controlled trials that are adequately powered including:
• Evidence from a well-conducted multicenter trial
• Evidence from a meta-analysis that incorporated quality ratings in the analysis
• Compelling nonexperimental evidence, i.e., "all or none" rule developed by Center for Evidence Based Medicine at Oxford
Supportive evidence from well-conducted randomized controlled trials that are adequately powered including:
• Evidence from a well-conducted trial at one or more institutions
• Evidence from a meta-analysis that incorporated quality ratings in the analysis

So my assertion remains - they're grade of "A" for the recomendation to reduce intake of saturated fat to less than 7% of energy is NOT from studies that meet their grading criteria....

My bottom line is that I believe that almost all type 2 diabetes can be cured with a low carb diet and I feel that it is criminal the the ADA warns people not to follow one.

I believe it's such a simple concept that low carb prevents/cures diabetes, that I have to assume that this is all about the money. And then there are all the studies/evidence pointing to low carb.
And....well, up here diabetics are told they can have bananas and porridge for breakfast with skim milk, the evilest of all milks
What can I say?