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  #1   ^
Old Sun, May-25-08, 13:39
Feinman Feinman is offline
 
Plan: My own
Stats: 208/180/165 Male 70 inches
BF:
Progress:
Default Carbohydrate Restriction and Diabetes

Of possible interest to readers, are three papers recently published in Nutrition & Metabolism (available without subscription):

1. Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, Gleed A, Jacobs DB, Larson G, Lustig RH et al: Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond) 2008, 5(1):9.

http://www.nutritionandmetabolism.c...43-7075-5-9.pdf

2. Westman EC, Vernon MC: Has carbohydrate-restriction been forgotten as a treatment for diabetes mellitus? A perspective on the ACCORD study design. Nutr Metab (Lond) 2008, 5:10.

http://www.nutritionandmetabolism.c...3-7075-5-10.pdf

3. Nielsen JV, Joensson EA: Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up. Nutr Metab (Lond) 2008, 5(1):14.

http://www.nutritionandmetabolism.c...3-7075-5-14.pdf

In Accurso, et al. 24 authors lay out the positive effects of carbohydrate restriction. Meant as a rebuttal to the American Diabetes Association 2008 Nutritional Guidelines which damned low-carbohydrate diets with faint praise, it provides the underlying biochemistry for carbohydrate restriction. Nielsen, et al. shows the persistent benefits of such a diet at 44 months and Westman et al. provides a likely explanations of the unexpected deaths in the ACCORD study.
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  #2   ^
Old Sun, May-25-08, 14:47
Hutchinson's Avatar
Hutchinson Hutchinson is offline
Registered Member
Posts: 2,886
 
Plan: Dr Dahlqvist's
Stats: 205/152/160 Male 69
BF:
Progress: 118%
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Thanks for those.
I'm glad to see the name Annika Dahlqvist among the authors of Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome:

I came upon her blog and because it looked so straightforward I thought this is simple enough for me to manage. I'm now 3st lighter so as well as being grateful to Gary Taubes for planting the idea I'm also pleased that Annika Dahlqvist made it sound easy enough for me to put into practice.

I haven't read them all yet but the first paper is in fact surprisingly readable for lay people like me who generally find medical scientific papers quite difficult to understand. It would be better if all papers were written in such accessible language.

Here is a sample paragraph for those who are usually intimidated by such papers
"There is reluctance to make recommendations for low carbohydrate diets on the grounds that people will not follow them but compliance and efficacy of dietary recommendations are separate phenomena. In fact, all recommendations are specifically intended to be different from average consumption and it is sensibly the purpose of health agencies to encourage conformance to the best therapies."
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  #3   ^
Old Sun, May-25-08, 15:37
lowcarbUgh's Avatar
lowcarbUgh lowcarbUgh is offline
Dazed and Confused
Posts: 2,927
 
Plan: South Beach
Stats: 170/132/135 Female 5'10
BF:
Progress: 109%
Location: Flip-flop, FL
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I don't think older diabetic patients would balk at a diet that includes fillet mignon and bernaise, crab legs with butter instead of the low-fat, calorie-controlled offerings that nutritionists push on the unsuspecting newly-diagnosed type 2 diabetic.

I think the young type 1, who is pumping and bolusing for carbs, would balk at the restrictions, until they got older and it became increasingly more difficult to control their BG levels.

The current ADA recommendations are pure rubbish, but they are probably are an improvement over the old "exchange" system, which was so restrictive that hardly anyone complied with it.

The problem with Berstein's diet, and I have adapted it to my needs, is that it has some elements of the old exchange system where you must eat X grams of CHO and X ounces of PRO at every breakfast, lunch and dinner. I sometimes find that hard to deal with. And it is 30 grams of CHO per day for life, with no fruits or grains, ever.

Atkins works better for life because of OWL, but this is like induction forever, with the addition of moderate alcohol and nasty Wasa High Fiber or G/G Crispbread crackers. There are much better alternatives from netrition.com for bread-like wraps, pancakes and such that have the same number of net carbs as those cardboard crackers.

I greatly admire Dr. Berstein, but he has, and advocates, an almost robotic discipline that I don't think it realistic for the vast majority of people, even the highly motivated ones.
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  #4   ^
Old Sun, May-25-08, 15:40
rightnow's Avatar
rightnow rightnow is offline
Every moment is NOW.
Posts: 23,064
 
Plan: LC (ketogenic)
Stats: 520/381/280 Female 66 inches
BF: Why yes it is.
Progress: 58%
Location: Ozarks USA
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I think that a genuine addiction to grains may be present in today's society that might not have been 40 years ago, and this might present complications for dietary adherence. Genuine lowcarb (especially minus grains) can deal with that addiction, if it exists, but but moderate carb programs that emphasize 'whole grains' are likely to be close to impossible for a good chunk of population to follow.
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  #5   ^
Old Mon, May-26-08, 19:48
Daryl's Avatar
Daryl Daryl is offline
Senior Member
Posts: 7,427
 
Plan: ZC
Stats: 260/222/170 Male 5-10
BF:Huh?
Progress: 42%
Location: Texas
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Quote:
Originally Posted by Feinman
Of possible interest to readers, are three papers recently published in Nutrition & Metabolism (available without subscription):

1. Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, Gleed A, Jacobs DB, Larson G, Lustig RH et al: Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond) 2008, 5(1):9.

http://www.nutritionandmetabolism.c...43-7075-5-9.pdf

2. Westman EC, Vernon MC: Has carbohydrate-restriction been forgotten as a treatment for diabetes mellitus? A perspective on the ACCORD study design. Nutr Metab (Lond) 2008, 5:10.

http://www.nutritionandmetabolism.c...3-7075-5-10.pdf

3. Nielsen JV, Joensson EA: Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up. Nutr Metab (Lond) 2008, 5(1):14.

http://www.nutritionandmetabolism.c...3-7075-5-14.pdf

In Accurso, et al. 24 authors lay out the positive effects of carbohydrate restriction. Meant as a rebuttal to the American Diabetes Association 2008 Nutritional Guidelines which damned low-carbohydrate diets with faint praise, it provides the underlying biochemistry for carbohydrate restriction. Nielsen, et al. shows the persistent benefits of such a diet at 44 months and Westman et al. provides a likely explanations of the unexpected deaths in the ACCORD study.


Hmm, are you by chance Prof Feinman? If so, thank you for your work!
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  #6   ^
Old Mon, May-26-08, 21:13
Zei Zei is offline
Senior Member
Posts: 1,596
 
Plan: Carb reduction in general
Stats: 230/185/180 Female 5 ft 9 in
BF:
Progress: 90%
Location: Texas
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Mission low carb tortillas have either 4 (wheat) or 5 (white) grams net carbs per tortilla, lots of fiber and are available at common stores like Wal-Mart rather than needing to shop at a specialty place. They taste good. They do contain wheat, though, for those trying to avoid it.
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  #7   ^
Old Tue, May-27-08, 12:42
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,830
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
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Quote:
pumping and bolusing for carbs
LOL! When I first read that I was thinking... is this a new way of saying "pining for..."? then I thought a bit and realized what it was.
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  #8   ^
Old Tue, May-27-08, 12:45
lowcarbUgh's Avatar
lowcarbUgh lowcarbUgh is offline
Dazed and Confused
Posts: 2,927
 
Plan: South Beach
Stats: 170/132/135 Female 5'10
BF:
Progress: 109%
Location: Flip-flop, FL
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Quote:
Originally Posted by Nancy LC
LOL! When I first read that I was thinking... is this a new way of saying "pining for..."? then I thought a bit and realized what it was.


LOL! Right. I forget that not everyone realizes that pumping means using an insulin pump and bolusing is pumping extra insulin for extra carbs.

Many diabetics are not overweight and I don't see them cheerfully adopting this diet while they can bolus and achieve numbers that are "good enough," but not necessarily normal. There is little societal support for this WOE and it is just another thing to set one apart from normal, and this is particularly important for kids and teens with diabetes.

-------
Susan
LC'ing for juvenile-onset diabetes (30+ years and no complications!)

Last edited by lowcarbUgh : Tue, May-27-08 at 12:59.
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  #9   ^
Old Sun, Jun-01-08, 08:56
alisbabe's Avatar
alisbabe alisbabe is offline
Senior Member
Posts: 997
 
Plan: high fat paleo
Stats: 238/215/165 Female 5foot 7inches
BF:yes
Progress: 32%
Location: UK
Default Low-carb diets for overweight diabetics

http://www.thenews.com.pk/daily_detail.asp?id=115982

Quote:
Sunday, June 01, 2008
Overweight people with type 2 diabetes can keep their weight and blood sugar under control in the long term by following a low-carbohydrate diet.

Researchers from Sweden previously reported superior weight loss and glucose control over a 22-month period among 16 obese patients with diabetes who followed a low-carbohydrate diet compared with 15 similar patients following a diet containing 55 to 60 percent of energy from carbohydrates.

In their current study they reported 44 months of follow up data. Of the 16 patients, five had retained or reduced bodyweight since the 22 months point and all but one have lower weight at 44 months than at start. Furthermore, glucose levels dropped soon after starting the diet and have stayed down over the 44 months period.

The participants in the study limited their carbohydrate intake to 20 percent of total calories. The most significant effect of this low-carb diet is the absence of hunger. The consequent reduction in food intake allows the body to use its own stores of fat for fuel, which results in weight reduction. Moreover, avoiding starch-rich bread, pasta, potatoes, rice, and breakfast cereals, and limiting carbohydrate intake to 80 to 90 grams a day primarily from vegetables, salad, and crisp bread, also minimises the glucose spikes that make it necessary for people with diabetes to take insulinn.

The findings advise obese patients with type 2 diabetes to follow a 20 per dent carbohydrate diet with some caloric restriction for a lasting effect on bodyweight and glycaemic control. The study appeared in journal the, Nutrition and Metabolism.


Also:

http://7thspace.com/headlines/28204..._follow_up.html

Quote:
Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up.

Low-carbohydrate diets, due to their potent antihyperglycemic effect, are an intuitively attractive approach to the management of obese patients with type 2 diabetes. We previously reported that a 20% carbohydrate diet was significantly superior to a 55-60 % carbohydrate diet with regard to bodyweight and glycemic control in 2 groups of obese diabetes patients observed closely over 6 months (intervention group, n = 16; controls, n=15) and we reported maintenance of these gains after 22 months.

The present study documents the degree to which these changes were preserved in the low-carbohydrate group after 44 months observation time, without close follow-up. In addition, we assessed the performance of the two thirds of control patients from the high-carbohydrate diet group that had changed to a low-carbohydrate diet after the initial 6 month observation period.

We report cardiovascular outcome for the low-carbohydrate group as well as the control patients who did not change to a low-carbohydrate diet.MethodRetrospective follow-up of previously studied subjects on a low carbohydrate diet.

Results: The mean bodyweight at the start of the initial study was 100.6+/-14.7 kg. At six months it was 89.2+/- 14.3 kg.

From 6 to 22 months, mean bodyweight had increased by 2.7+/- 4.2 kg to an average of 92.0 +/- 14.0 kg. At 44 months average weight has increased from baseline g to 93.1+/- 14.5 kg.

Of the sixteen patients, five have retained or reduced bodyweight since the 22 month point and all but one have lower weight at 44 months than at start. The initial mean HbA1c was 8.0 +/- 1.5 %.

After 6, 12 and 22 months,HbA1c was 6.1+/- 1.0 %, 7.0 +/- 1.3 % and 6.9 +/- 1.1 % respectively. After 44 months mean HbA1c is 6.8 +/- 1.3 %.

Of the 23 patients who have used a low-carbohydrate diet and for whom we have long-term data, two have suffered a cardiovascular event while four of the six controls who never changed diet have suffered several cardiovascular events.

Conclusion: Advice to obese patients with type 2 diabetes to follow a 20 % carbohydrate diet with some caloric restriction has lasting effects on bodyweight and glycemic control.
Author: Jorgen V Nielsen and Eva A Joensson
Credits/Source: Nutrition &Metabolism 2008, 5:14

Published on: 2008-05-22
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  #10   ^
Old Sun, Jun-01-08, 14:44
Wifezilla's Avatar
Wifezilla Wifezilla is offline
Senior Member
Posts: 4,367
 
Plan: I'm a Barry Girl
Stats: 250/208/190 Female 72
BF:
Progress: 70%
Location: Colorado
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Woo hoo! The good news is spreading ;D
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