What Is the Nutritional Answer to Diabetes

Earlier in this chapter I pointed out that I have yet to see a study that showed that a high carbohydrate level in a diet is more helpful to diabetics than is Atkins. But I didn't tell you why. Even though the controlled carbohydrate approach was the standard diabetic therapy until 1950, the ADA abandoned it without ever doing a single test comparing it with a controlled carbohydrate eating plan that followed the Atkins approach.

Most studies that have been conducted were done with diets too high in carbohydrates to be consistent with the controlled carbohydrate approach that is Atkins.

Here is a small sample of the research done over the last seven or eight years. In the mid-1990s, researchers began to compare the effects of high monounsaturated-fat diets with the effects of high-carbohydrate diets in diabetic patients. A study by Dr. Abhimanyu Garg at the University of Texas Southwestern Medical Center showed that compared with the high-fat diet, the high-carbohydrate diet increased risk factors for heart disease-in the form of triglyceride levels and VLDL (very-low density lipoprotein) cholesterol levels-by twenty-four and twenty-three percent respectively. The high-carb diet also increased glucose and insulin levels by ten and twelve percent. The numbers are less impressive than we usually see in our clinical practice because, in the high-fat diet studied, the level of carbohydrate consumed wasn't low enough to trigger lipolysis.

In a somewhat similar Australian study, researchers noted that "the currently recommended high-carbohydrate, low-fat diet" produces unfavorable effects on both glucose levels and cholesterol levels in people with mild and severe cases of diabetes. By 1996, researchers at the University of Rochester in New York were testing a high-ketogenic, very low-calorie diet in comparison with a low-ketogenic, very low-calorie diet for diabetics. The high-ketogenic diet turned out to be considerably more effective in controlling blood-sugar levels.

All these studies indicate the superiority of almost any form of carbohydrate control over regimens comprising up to fifty-five percent carbohydrate foods. In Chapter 27, I'm going to show you in detail how formidable the evidence has become to indicate that the control of carbohydrates is not only heart-safe but also heart-protective. This is crucial to the diabetes question, for diabetes is a major risk factor for heart disease. Indeed, it's fair to say that if you have diabetes, you may also have heart disease. The damage done to the cardiovascular system by high insulin levels over decades is tremendous. Combine that damage with the health problems of being overweight and having high blood pressure, and you have what has become a new buzzword in medicine: Syndrome X. Turn to Chapter 27 for a thorough discussion.

The study closest to evaluating the effects of a controlled carbohydrate approach such as Atkins to diabetes control was done at Sansum Medical Research Foundation. There, diabetic subjects were put on a dietary regimen that contained only twenty-five percent carbohydrate for eight weeks. They were then switched to a regimen that contained fifty-five percent carbohydrate for another eight weeks. On the controlled carbohydrate segment, the subjects' glucose values improved, their diastolic blood pressure went down and they lost weight. When they were placed on the high-carbohydrate segment, one of the indicators for diabetes got worse and none of the improvements seen on the controlled carbohydrate segment occurred.

Appropriate research in which the level of carbohydrate intake results in lipolysis, as compared to a higher intake of carbohydrates, is finally in progress (although not yet published). When these studies are published, the evidence that the standard dietary approach to diabetes should be changed will undoubtedly be compelling. The fact that by controlling carbohydrate intake one controls glucose and insulin is hardly surprising. When you add to this the fact that a controlled carbohydrate nutritional approach is outstandingly effective at decreasing the risk factors for heart disease, the medical world needs only to exert common sense and a little courage to overturn the standard clinical approach that has been so harmful to so many people for so many decades.

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