Thank you for your article, and especially for the link to the full text. I had been trying to get that for days but could only read the very brief abstract up until now.
Now to read it all; being a meta-analysis, the time-consuming part will be reading the cites. So much to read, so little time :-)
Of course, for you and I and most of the pro-active diabetics I know this is just science catching up with the knowledge we have gained the hard way from personal experience, usually despite stern warnings about clogged arteries from our medical and dietary advisors.
I am regular visitor to this site and have been folowing some of your recommendations.
This question is a bit off-topic. I was wondering if I could get some insight from this group here on one of the symptoms I am having.
I have been Pre Diabetic for close to 7 years. My last two A1Cs are 5.8 (Oct) and 5.5 ( december 21st). My goal is to keep it less than 6.
However, for the last few months I suddenly have new sensation on my tongue - My tongue tip always seems to be burnt. I don't feel it in the mornings but as the day goes it gets obvious. My blood sugars are normal during this time.
Is this diabetes related? or am I dealing with some thing else. Any body else feel it here.
My doctor has not been great help.
I am a type 2 diagnosed in 1983; since my last surgery for cancer, unrelated totally to diabetes, the surgery, the tip of my tongue and even a bit back burns. However, I have neuropathy, both from diabetes and fibro, am familiar with this burning. I would not call an A1c of 5.8 prediabetic; I think you have to admit you have gone over the line and stiffen up your treatment. My last A1c was 5.6, definitely not in the pre diabetic range. If you can't get help from your present physician, get another. The B vitamins, btw, are good for nerve problems, you might want to try them. But I think if you tighten up your A1c to no higher than 5.5 you can forestall any further problems with your tongue, and with the B vitamins maybe get rid of this burning sensation. Some of us develop complications at A1c levels lower than in others.
Good luck, Helen
My husband had a sensation of burning on the tip of his tongue and also numb toes. He is not diabetic. Turned out he had pernicious anaemia. This is due to a failure to absorb vitamin B 12. This is an autoimmune condition. It is worth knowing that metformin, often prescribed for diabetics, can also cause impaired absorption of vit b 12 and so can give you similar symptoms. With metformin the condition is reversible if you reduce the dose of metformin or stop it. You can get diagnosed with a simple blood test.
I am a family medicine doctor. I agree that you may have a B12 deficiency. That has to be replaced either SUBLINGUAL (under the tongue) OR INJECTION. Check your B-12 and folic acid levels in your blood, you can order that yourself at many labs, or have your doctor order it. This should be done BEFORE you start supplementing B-12 or you can't know for sure. If we have B-12 deficiency it means we can no longer absorb it from the stomach no matter how much we swallow, so it has to go directly into the blood and tissue, either under the tongue (thin tissue, lots of veins) or by a shot.
Anyone with a sore tongue or periperal neuropathy should have their B-12 (and folic acid) checked. Many people get those changes years before B-12 deficiency causes anemia, and it can affect behavior, too. I have found many cases by doing a B-12 level on people who's behavior is changing, odd or vaguely annoying. They and their families often thank me once they start treating it because their thinking gets back to normal. If it is not treated it can cause permanent brain and nerve damage. Serious business. B-12 deficiency ALWAYS requires a lifetime of B-12 supplement sublingual or by injection. ALWAYS!
Saturated fat, carbohydrate, and cardiovascular disease
If you enjoyed the meta analysis this paper is in the same vein.
The link came from Stephan's Wholehealthsource where there are some more details and comments.
It is a terrible misconception that fats are dangerous and carbohydrates are darlings.
Based on my continued literature review and personal experimentations, hyperglycemia has at least five dangerous roles on our health: (1) Inflammatory and Proinflammatory; (2) Prothrombotic (blood clot formation); (3) Arteriosclerotic and Atherosclerotic; (4) Vasoconstrictive or Hypertensive; and (5) Pro-glycation. The most important link that the mainstream medicine has missed is the relationship between digestible carbohydrates and blood glucose level. This is why medicine has not been able to prevent and treat diabetes mellitus.
To understand how carbohydrates, not fats, impact the cardiovascular system, please visit
"Postprandial hyperglycemia as an etiological factor in vascular failure." by Koichi Node, M.D. and Teruo Inoue, M.D..
"Carbohydrate-restricted Diet for The Therapeutic Paradigm" by Robert Su, Pharm.B., M.D.
And for more of my writings, please visit www.carbohydratescankill.com.
Dear Mr. Mendosa:
You are very welcome, Sir.
I appreciate very much that you have found the way to manage your blood sugar without the need of insulin or medication. This is the way that every diabetic should do. Restricting carbohydrates is not only for controlling the diabetic conditions but also for preventing deterioration of most, if not all, of the diseases, which are a result of hyperglycemia/inflammation. Besides, this approach is the best measure for reducing the skyrocketing health care cost.
Please keep up your excellent work!
Best regards,
Robert
I would like to go on a low carb diet to control my type 2 diabetes, however when I did, it severly affected my kidneys adversely. Before going on a low carb diet, my kidneys were absolutely fine. It took 1 1/2 years for my kidneys to recover from my low carb diet. No kidding. Why is the adverse kidney affect on some diabetics on a low carb diet never honestly addressed or even admitted to? All you ever hear is denial that it could ever occur. I love Dr. Richard K. Bernstein and what he has and is doing for diabetes. I also think Atkins is a good diet, but I cannot deny that this actually happened to me, and I have no doubt that it happens to others. I would like to go on a low carb diet, but not at the cost of my kidneys. I've got a friend on Kidney dialysis. Trust me, it's not something you want to have to deal with on a daily basis if you don't have to. I just don't get why it works for others, but not me. The whole kidney thing was more scary to me than the day I found out I had diabetes. Anybody else out there ever have this happen to them?
I believe that you are not kidding. Generally, people who go on "low-carbohydrate diets" are likely taking "low-carbohydrate-high-protein diets." It means taking proteins at more than 35% of his daily calories or 200 grams a day. Diabetic patients with kidney involvement have to be careful in pushing so many proteins, which burden the kidneys for excreting nitrogen metabolites. Thus, the diseased kidneys are unable to handle them and will fail. Unfortunately, many people are still afraid of taking more fats in place of carbohydrates, because the misconception of the relationship between fat and cardiovascular risks persists. Could you share with us the amount of proteins you took when you went on "low-carb" diet?
Thank you very much.
Robert Su, Pharm.B., M.D.
Some people go on a high-protein diet when they go low-carb. And too much protein is indeed suspected in some cases to lead to kidney problems.
But a low-carb diet is not at all necessarily a high-protein diet. It IS necessarily a high-fat diet, because we can get the fuel that our bodies need only from carbohydrates or fats (well, we can get the fuel from the breakdown of the protein in our body, but that is an unhealthy way). Were you consuming much more than the 56 grams of good quality protein per day that men need or the 46 grams and that most adult women need, according to the Food and Nutrition Board of the Institute of Medicine? That is a surprisingly small amount, and most Americans get considerably more than that no matter what diet they follow.
Best regards,
David
First of all, please let me correct the typo error: " Unfortunately, many people are still afraid of taking more fats in place of carbohydrates, because misconception of the relationship between fat and cardiovascular risks persists."
Second of all, 200 grams of daily protein intake is the maximum, based of 35% of daily calories of 2,500 for a man. Nevertheless, this is not a recommendation.
Many advices for weight loss program suggest "low-carb-high-protein" diets that is not healthy, although proteins generate only 3 Kcal, not 4 Kcal, when they are converted for energy source.
Robert
01/27/10
I went on the Kimkins Diet, specifically Kimmer's Experiment.
When I emailed "Kimmer," about my kidney problem, she denied
that such a thing could possibly happen from her diet and that
I must have had kidney problems beforehand. It did happen from
her diet, and I didn't have any kidney problems before going on
her diet. As to the exact amount of protein I was eating each
day, I really don't remember. I just followed her Kimmer Experiment
diet.
I am not familiar with the Kimkins Diet, and cannot comment on it. Although studies showed improvement in the kidney functions of the diabetic patients after they were on "low carb" diets, I do believe diabetic patients should be carefully about replacing carbohydrates with too many proteins.
We must understand that when one is diagnosed with diabetes mellitus, he has had repeated or chronic postprandial hyperglycemia for some time and about 40-60% of his pancreatic beta-cells are damaged or dead. During the period before the diagnosis is made, repeated or chronic postprandial hyperglycemia has already assaulted his blood vessels of the kidneys and retina as well as other parts of the cardiovascular system. This is the reason why many patients have had symptoms of the cardiovascular system before they are diagnosed with diabetes mellitus, or vice versa. This is a serious flaw in recognizing how hyperglycemia attacks our body. Thus, I would not be surprised, if you had had some ill-impacts by hyperglycemia on your kidneys before your were diagnosed with DM. Thus, diabetic patients should be careful when taking in too many proteins.
For your reference, please review my comment, "Carbohydrate-restricted Diet for The Therapeutic Paradigm", on an article, "Postprandial hyperglycemia as an etiological factor in vascular failure."
Robert Su, Pharm.B., M.D.
Thank you so much for your reply. I did try a Vegan diet for two years,
but the beans and many other carbs did affect my blood sugar adversely.
I am currently trying a high fat, adequate protein, very low carb diet. It seems to be working for me blood sugar-wise so far, but I can't say I've lost any weight yet like others claim that they have. Perhaps that will come in the future though. Before I read this article, I was afraid to do too much fat due to the low-fat campaign over the past several years. I also read somewhere that fat coats your cells so that insulin can't get the glucose into them and that's why diabetics, like me, are so very insulin resistent. In any case, I'm trying the high fat diet right now to see where it takes me.
Great Article, David. Isn't this a strange coincidence
William Banting , Father of the low Carbohydrate Diet and Frederick Banting, co-discover of insulin . Seehttp://www.westonaprice.org/William-Banting-Father-of-the-Low-Carbohydrate-Diet
Does this new research make any reference to cholesterol levels which are meant to be correlated with eating saturated fat? - and are also correlated with pressure from doctors to take statin drugs...
The whole cholesterol "issue" has been largely overblown, to the benefit of the pharma companies and certain doctors. At first, the warnings were about high total cholesterol. This was adjusted to differentiate between "good" cholesterol (HDL) and "bad" cholesterol (LDL). Newest incarnation of the paradigm: risk depends on the size distribution of HDL and LDL particles (to understand how quickly the medical establishment has bought into the latest, note that the VAP test is covered by insurance in the US).
Cholesterol is essential for the production of steroid hormones, for the stabilization of cell membranes, for the production of myelin sheaths around neurons, and many other things. The body makes it because it needs it. Low cholesterol levels increase the risk for hemorrhagic stroke, depression and violent behaviour. The standard American diet (a.k.a., SAD) recommended by the health-care establishment (I would call it "sickness-care") is largely responsible for the current epidemics of overweight/obesity and Type II diabetes.
The key to being healthy is to eat food that has been little altered from how it started out. That means meat, poultry, fish, eggs and plants (preferably vegetables and nuts). Processed foods, including grains, contain little in the way of nutrients and are high in diabetogenic compounds.
You posted a very common but interesting question. Please review an article, "A Holistic View: Lowering Cholesterol Level Is Not The Top Priority For Health', in "What's New, Doc?" at www.carbohydratescankill.com. It is posted in three parts on November 25, December 2, and December 9, 2009.
I hope this is helpful.
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I believe it's appropriate to compile a list of publications initially in two categories; biased and unbiased, supported if possible by statistics. A biased publication is after all a threat to knowledge and when the knowledge relates to health it is a threat to life. A biased publication carries with it the seeds of it's own destruction but a little hurry-up assistance may be warranted, as it is with the publicizing of hazardous products.
Speaking about the flip-flop results in the publications, there are two problems, one is ghostwriting and the other is the game of statistics. I have been critical of them and encouraged others to not take the conclusion of one article seriously but to read many articles like I have been doing before drawing your own conclusion.
For your references, please visit my articles, "Medical Ghostwriting" and "We Could Fool Ourselves in The Game Of Statistics: Are Foods High In Glycemic Index and Glycemic Load Linked To The Risk of Pancreatic Cancer?" in "What's New, Doc?" at www.carbohydratescankill.com
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Thanks for asking. Not long ago I report on my experience of counting calories, etc. That's at http://www.healthcentral.com/diabetes/c/17/92183/counting-eat
My diet keeps changing in its details. But it remains firmly low-carb. Here is what I eat this month:
My breakfast starts with two glasses of Greens First. I wrote about them at http://www.healthcentral.com/diabetes/c/17/67280/drink-veggies . I buy Greens First from Amazon.com.
I absolutely love this way to start the day! Much better than the two cups of coffee I used to start the day with. I don't drink any coffee or alcohol now. I stopped drinking both of them to help control my headaches, which are now gone. Instead, I often drink Pero, sometimes with a little Scharffen Berger unsweetened cocoa powder and stevia added) or herbal tea.
When I wrote the article about Greens First, I hadn't experimented much with it. But now I make it with carbonated water that I make from filtered tap water and a Soda Club carbonator. I really enjoy the fizz. I used to add protein powder, but now I know that I get more protein than I need anyway.
I usually drink two more big glasses of carbonated water in the morning and two more in the afternoon. Got to stay hydrated!
Then, a half hour or so after my first breakfast I sometimes eat two egg that I poach in my microwave with a little egg poacher I got from Target. I spice up the eggs with salt ("Real Salt" is the best salt I can find), a little hot sauce (my favorite is Tapatío, which doesn't have any vinegar) , and a little summer savory. I also sprinkle on some chia seeds (see http://www.healthcentral.com/diabetes/c/17/17801/chia-seeds/ ).
Lunch is a salad, which I make with a flaxseed oil and vinegar dressing (with cloves of garlic and a little Dijon mustard). Lots of greens, starting with spinach (or sometime romaine lettuce) and including arugula whenever I can get it at Whole Foods. Sometimes other cruciferous greens like watercress.
BroccoSprouts are essential (see http://www.healthcentral.com/diabetes/c/17/60926/broccosprouts ). I often now eat some broccoli flowers in my salad, even though I wrote on my website that I didn't (my diet keeps changing!). Sometimes cauliflower, and just recently I added some raw cabbage.
Often a can of VitalChoice.com sardines or mackerel or salmon or albacore tuna -- all packed in water, not oil (they have the best -- by far!). Sometimes I will add anchovies (which I have only found packed in olive oil, not water) or kippers. I add a few capers and powdered lemon to the fish for flavor.
Sometimes green peppers or red ones for a dash of color (even though the red ones are a bit higher in carbs).
Sometimes a little cucumber and/or daikon radish.
Chia seeds on top.
Dinner is usually fish or sometimes a chicken leg (skinned) that I simmer on the stove top for an hour (I simmer 6 or 8 at a time) or grass-fed beef, especially ground beef. When I cook fish I bake it on a wood cooking plank. Fish is the best for Omega 3 oil, and it tastes wonderful with salt, pepper, powdered lemon (see http://www.healthcentral.com/diabetes/c/17/1589/true-lemonade/ ), capers, and chia seeds.
Sometimes I will have one of my favorite low-carb veggies with (or for) dinner. Like an artichoke with low-fat mayo or okra with butter or a butter substitute that has no trans-fats.
My favorite snack is an avocado wrapped in toasting nori, a sea vegetable. Sometimes I will snack instead on Oikos Greek yogurt, low-carb turkey jerky, or an extra glass of Greens First.
When I use sweetener, it is always SweetLeaf stevia from Wisdom Brands. About the only time I use a sweetener is in my tea.
When I am on a hike at lunch time, my usual lunch will be one or two cans of sardines from VitalChoice.com.
I don't take any prescription medicine for diabetes or anything else. But I do take some supplements. The only supplements that I take that I can unequivocally recommend are vitamin D3 (I take 10,000 IU per day, which is higher than the 5,000 IU per day that most experts on vitamin D recommend (and much higher than the 400 IU in the government's RDA) and fish or krill (see http://www.healthcentral.com/diabetes/c/17/20232/krill-oil ) oil.
Not a lot to eat! No wonder I have been able to lose half my body weight. But I very, very seldom get hungry at all. And all of my food is delicious and healthy (very low-carb and well balanced toward the anti-inflammatory Omega-3 and away from the pro-inflammatory Omega-6 fats). At least it is delicious to me. Everybody is different, but I hope this gives you some good ideas.
Best regards,
David
01/27/10
Gosh, this is great! Thanks so much for your current food info.
I know your diet keeps changing, that's why I asked for the latest. Mine keeps
changing too. I WILL get this down pat. I've never eaten a sardine
in my life, but I'm going to order some and try them out. I'll also go over
your referenced URLs. This is so helpful. I can't thank you enough.
Dear Mr. Mendosa,
Thank you for suggesting Greens First as a breakfast drink. (I didn't know what was safe to eat for breakfast anymore)! I will definitely check into purchasing this product. Although, I am encouraged to read that you approve of flax seed oil (with the addition of vinegar or lemon) as a salad dressing, I read on an earlier post that you felt the ratio of Omega 6 to Omega 3 in flax seed was not beneficial for us diabetics. So what do you suggest?
Also, if I am daily taking 2 Tbls. of good quality Cod Liver Oil, will this help balance out the Omega 6 overload? Per your recommendation I would like to take Vitamin D3. Can you recommend a quality brand? There are so many to choose from!
One more thing - Are fresh peaches acceptable in my low sugar, low carb diet?
Thank you for sharing your wisdom.
Dear Renae,
Flax seed oil has about the BEST ratio of omega 3:6!
I don't recommend cod liver oil -- too much vitamin A, which can give you an overdose. Much better is fish oil (Carlson's is a reliable brand) or krill oil (all brands come from the same source).
I have used the NOW brand of vitamin D3 for years and have had my level tested. It's right where the dose that I take indicates it should be.
One peach per day can be accommodated on a low carb diet. Do check how many carbs that it has an cut back otherwise for that meal.
Best regards,
David
I'm a T2 diabetic who is VERY weight loss resistant. I have been keeping fairly good control of the T2( A1c in the 5% Range) and lost some weight, but I want to improve. I have found that the only thing that works is Atkins' Fat Fast.
Atkins has been demonised, but he wrote about the beneficial effects of a low carb diet on Blood pressure, a long time ago. And now we have a new study which has found the same.
The Fat Fast contains saturated fats in cheese.
Your summary of this article completely misrepresents the authors conclusions.
Contrary to asserting that saturated fat is unrelated to cardiovascular disease (CVC), in the abstract published on the American Journal of Clinical Nutrition website, the authors clearly state: "...substitution of dietary polyunsaturated fat for saturated fat has been shown to lower CVD risk, [but] there are few epidemiologic or clinical trial data to support a benefit of replacing saturated fat with carbohydrate." In other words, the data show that the effects of reducing saturated fat depend on the food that replaces it. Polyunsaturated fat produces clearly demonstrable benefits, but simple carbs apparently do not.
This answers a few questions many of us have had. The native Americans of the north traditionally had a diet rich in whale blubber. The French eat lots of butter & duck fat both groups have extreemly low rates of heart disease. We Americans suffer a very high rate of heart disease and are only now getting off the trans-fat wagon. So is that the cardiovascular bugaboo ? Trans-fats, sedentary life style, and simply over eating ?
This is another example of the misuse of statistics in science; it is
very difficult to get an article published, unless it is to uphold a
"politically correct" position, and difficult even then, unless it has a
"statistically significant" result.
Statistical significance and practical significance are related in a given
experiment, but not too much. The point of the cited paper is that there
is NOT a significant difference between saturated fat consumption and
the effect on cardiovascular problems. The absence of a statistically
significant result, and the sufficiently large sample size, does show that
it is very likely that practical significance is absent.
Statistical procedures form a body of religious activities in the sciences,
and these procedures have assumptions which are not always met. This
is one case of an important result which seems not to get published.
I think we all agree that hyperglycemia,especially when it is chronic, is terribly damaging to our vascular system. As a practicing diabetes educator for the past nearly twenty years, I have found that the most effective dietary approach for my patients' glycemic management and cardiac health has been following a balanced diet that is low glycemic. There are too ways to to work through a low glycemic meal plan: minimal carbs - this approach focuses on the quantity of carbs consumed; or low glycemic carbohydrate choices, which focuses on the quality of carbs (low GI carbs "trickle" glucose into the bloodstream, while high GI carbs cause a "gush" of glucose into the bloodstream). I haven't found a better, more sustainable diet plan to date that works better.
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Thank you for this timely article. Now I will not worry so much when my body is craving some fat. No, I won't pig out, but I will enjoy fat a lot more knowing that it is helping with low carb and heart healthy as well.
Bob