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    Old 10-23-2004, 01:04 PM   #16
    ZippyDawg
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Arizona, you make a distinction between refined carbohydrates and carbohydrates but most people do not think of cereals, grains like corn and rice and starches like potatoes as refined carbs but they have a higher glycemic index and load then table sugar (sucrose) does. They provide large amounts of fast acting sugars and small amounts of nutrients and fiber which can easily be obtained from low-carb green leafy vegetables without the sugar.

    You should eliminate all trans-fats and fast acting high glycemic index/load carbohydrate foods like:

    Table sugar, corn syrup, milk, honey, cakes, cookies, cereals, grains, breads, chips, pies, donuts, baked goods, muffins, bagels, pasta, flour, potatoes, corn, rice, oats, most fruits etc.

    Replace them with slow acting low glycemic index/load and/or high fiber carbohydrates, nuts and green leafy vegetables (preferably raw) and fruits like:

    Green beans, peppers, avocados, spinach, broccoli, cauliflower, olives, tomatoes, zucchini, arugula, alfalfa sprouts, asparagus, Chinese cabbage, collard greens, cucumber, eggplant, endive, escarole, fennel, garlic, parsley, kale, lettuce, celery, radicchio, Swiss chard, turnip greens, watercress, snow pea pods, Brussels sprouts, blueberries, raspberries, black berries, strawberries, grape fruit, almonds, filberts, hazel nuts, pecans, pistachios, sunflower seeds, pumpkin seeds, walnuts, live culture (5 or more) yogurt etc.

    There is no reason you can’t eat a variety of nutritious high fiber slow acting carbohydrates on a low-carb diet. Add in some fats from olive oil, fatty fish, butter, ½& ½ (or cream) and protein/fat from meats, chicken, pork and eggs. If you’re concerned with the intake of saturated fats simply eat less of them and eat more olive oil and fatty fish. Don’t eliminate eggs from your diet. They are probably the most nutritionally complete food you can eat on any diet.

    Last edited by ZippyDawg; 10-23-2004 at 01:06 PM.

     
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    Old 10-23-2004, 01:48 PM   #17
    ARIZONA73
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    ZippyDawg,

    I understand what you're saying, and I pretty much agree. Foods such as rice, potatoes, and corn may not be classified as refined carbohydrates, but they still have a rather high glycemic index. In the absence of refined carbohydrates, I suspect that these vegetables may not be as much of a concern. You see what so many people eat, as well as I do. I believe that there is a tendency for many people to consume large quantities of refined carbohydrates. Why? Because they're nice and sweet and taste good, so people become addicted to them. Donuts, cakes, pastries, sodas, candies, bagels, and so many other refined white flour products. All junk. People are simply overloading themselves with excessive quantities of refined carbohydrates. Considering that, the addition of high glycemic foods like rice, corn, and potatoes can certainly add fuel to the fire. But, as I said, in the absence of our high intake of refined carbohydrates, I would suspect that these other natural foods would not pose nearly as much of a problem.

     
    Old 10-23-2004, 05:11 PM   #18
    ZippyDawg
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Quote:
    Originally Posted by ARIZONA73
    ZippyDawg,

    People are simply overloading themselves with excessive quantities of refined carbohydrates. Considering that, the addition of high glycemic foods like rice, corn, and potatoes can certainly add fuel to the fire. But, as I said, in the absence of our high intake of refined carbohydrates, I would suspect that these other natural foods would not pose nearly as much of a problem.
    Ahh, but here’s where the "magic" comes in. If you want to lose weight or maintain your weight loss you still can only eat very small amounts of corn, rice, potatoes, pasta etc. and not take in excess calories. A portion of cooked rice is 1/3 to 1/2 cup. Who could eat such a tiny portion and be satisfied?

    Take a medium sized potato for another example.

    Baked russet potato (starch) medium size 5.5 oz is 44 carbs and is composed of 91% sugar molecules, 8% protein and less then 1% fat. The rest is water, trace vitamins/minerals and a small amount of fiber and other non-digestible material. It has a caloric content of 145 calories and a GI of 111 and a GL of 24. For reference purposes 1.75 oz of table sugar (sucrose) has a GI of 65 and a GL of 6.5

    Compared to:

    Broccoli (green leafy vegetable) 3 cups of broccoli is only 60 calories, 11 carbs and a GI of 15 and a GL of 3. In addition it is packed with nutrients not available in a potato, has twice the protein content and provides so much bulk you won't have much room to eat much of anything else.

    In the laboratory carbohydrates and proteins have 4 calories per gram and fat has 9 calories per gram. There is new research that suggests although protein has an equal amount of calories per gram and fat has more then double the amount of calories per gram when they are metabolized in the human digestive system they don't have the same impact as an equivalent amount of carbohydrates. What this means is you can eat more calories of protein and fat and actually consume "less" calories then an equivalent amount of carbohydrates. A calorie is a calorie may not be true anymore. We do need more research in this area though.

    Another advantage of replacing calories from carbohydrates with calories from fat and proteins is the “hunger” factor. It takes much longer to digest fat and protein so you don’t get hungry between meals and reach for the calorie laden snacks. A byproduct of burning fat also suppresses your appetite as well. This is important in losing/maintaining weight loss because at the end of the day you will have consumed less calories.

    The bottom line is we all need to find what works best for each of us irrespective of these silly “diet” labels and misinformation that special interest groups are “feeding” all of us.

     
    Old 10-23-2004, 07:58 PM   #19
    ARIZONA73
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    ZippyDawg,

    Again, I would tend to agree with you. But still, in the absence of refined carbohydrates, who is going to eat corn, rice, and potatoes everyday? I know I don't. I would most surely substitute other vegetables, such as the low-glycemic ones that you mentioned. That way, by eating them on a rotating basis, they really shouldn't present too much of a problem. But, as you said, we are all different, so we must adjust accordingly.

     
    Old 10-24-2004, 05:41 AM   #20
    zip2play
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    It seems eminently clear then: the ketogenic diet is VERY useful for obese epileptic chiildren in CERTAIN wings of Johns Hopkins. I KNEW it was good for something!


    But then, I guess you eventually wind up with a pile of old epileptics with heart disease? A conundrum indeed.
    On the other hand, maybe it's not a very huge population to worry about.

    Last edited by zip2play; 10-24-2004 at 06:22 AM.

     
    Old 10-24-2004, 12:42 PM   #21
    ZippyDawg
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Low-Carb Guru Weighs In On Controversy
    DIABETES INTERVIEW 28 MARCH 2004

    I struggle to understand why you are publishing information recommending low or no-carb meals for people with diabetes.

    As someone who has taken insulin for 29 years, I would expect you most of all to understand the relationship between carbohydrate and insulin. I have to fight this confusion with my patients on a regular basis. Do you not agree that people with type 1 diabetes who take insulin are at high risk of hypoglycemia and ketoacidosis when they deplete carbohydrate from their meals? What happened to the knowledge that carbohydrate is our body's primary fuel source as well as B vitamins and fiber?

    I truly wish that we would stop confusing our diabetes population by giving them so much conflicting information. Many of my patients are advised to avoid carbohydrate to promote "weight loss" by most of our primary care and family practitioner physicians. Unfortunately, many of them are also on long acting insulin or sulfonylureas. These patients will be causing hypoglycemia and possible ketosis by following their physicians advise.

    Also, many dietitians who read your publication will not agree with Joy
    ****'s "point of view.” My request to you is to stop publishing articles that contain controversial, unproven, and possibly harmful advice. Let's give people clear, concise, proven, and recommended guidelines from health organizations with credibility, shall we?

    Diane Schafer, LDN,RD,CDE

    P.S. I thought we all knew by now that diets don’t work.

    We asked Richard Bernstein, MD, FACE, FACN, CWS, of the New York Diabetes Center in Mamaroneck, New York, to respond to Diane Schafer’s letter:

    I was present in the late 1940s when the American Diabetes Association (ADA) first recommended a high-carbohydrate diet. At that time, it was believed that the long-term complications of diabetes were due to the high cholesterol levels so common to people with diabetes. It was assumed that this was a consequence of dietary fat and that by dramatically reducing fat and substituting large amounts of carbohydrate, these complications would be avoided.

    There never were, and still have never been, any studies supporting this hypothesis. So if anything is “un-proven,” it is the ADA hypothesis. Except for a brief change of mind in 1975-76, it wasn’t until the Diabetes Control and Complications Trial terminated that the ADA acknowledged that the real culprit might be high blood sugars.

    More recently, studies comparing high- and low-carbohydrate diets have finally been performed and show that low-carbohydrate diets reduce both blood sugars (HbA1c) and conventional cardiac risk factors. A number of these studies were actually published in ADA research journals such as Diabetes Care.

    In spite of this, probably because of a rigid adherence to tradition, the ADA
    continued to raise carbohydrate guidelines and even now recommends the
    use of rapid-acting carbohydrate such table sugar, bread, potatoes, pasta, etc..
    The new but unproven ADA hypothesis is that people with diabetes can keep
    blood sugars normal by covering large amounts of carbohydrate with “industrial” doses of insulin.

    This never worked for me (I’ve had diabetes for 58 years) or for my thousands of patients. The reasons for this include the following:

    1) We can never know the exact carbohydrate content of a meal. In the United States, labeling laws permit an error of +/- 20 percent of the carbohydrate content of a serving. For a typical ADA meal containing 150 grams of carbohydrate, the uncertainty is +/- 30 grams. One gram of carbohydrate will typically raise the blood sugar of a type 1 person by 5 mg/dl for a net uncertainty of +/- 150 mg/dl. Carbohydrate estimates in books are even more uncertain.


    2) John P. Bantle, MD, professor of medicine, division of diabetes, endocrinology and metabolism at the University of Minnesota Medical School, demonstrated that for a given individual from day to day, the uncertainty of insulin absorption from typical ADA megadoses varies from +/-29 percent to +/- 39 percent. He further showed that the timing of action of these large doses is likewise highly variable.

    Thus, it is the high-carbohydrate diets covered by megadoses of insulin that increase the likelihood of hypoglycemia. In the 20 plus years that I have been in practice, only five of my patients have had severe hypoglycemia causing loss of consciousness. Two of these people were eating excessive amounts of carbohydrate and three made major mistakes such as taking the wrong type of insulin. I’m sure this is a far cry from the incidence of severe hypoglycmia among patients of highcarbohydrate practitioners.

    The ADA’s designation of high blood sugar—an A1C of 7% (corresponding to
    an average blood glucose of 170 mg/dl) when non-diabetics whom I have tested show about 4.2-4.8%—attests to its lack of interest in blood-sugar normalization.

    This may further explain the ADA failure to give up on its high-carbohydrate
    diet. This likelihood is also supported by ADA opposition to blood glucose
    self monitoring (BGSM) for 14 years—from 1969 when I first demonstrated
    it to their president until 1983 when pressure from patients became overwhelming. To this day, the ADA opposes BGSM for the 90 percent of people with diabetes who don’t take insulin. As a result, Medicare will not pay for BGSM for this 90 percent.

    Doesn’t this suggest that all of us with diabetes have an “orphan” disease without strong organized support for our well being? If some readers still consider this subject “controversial,” they should log on to the Internet ([url]www.***********[/url] and [url]www.**********[/url]) and search at these sites for my book “Diabetes Solution” to read what hundreds of ****** readers over the years have been saying about the lifesaving effects of their new low-carb diets.

    Remember, however, that lowering dietary carbohydrate without drastically
    lowering insulin doses and doses of other blood-sugar lowering medications
    can cause severe hypoglycemia. Diabetes Interview asked Joy **** to
    write a low-carbohydrate column for an obvious reason—it is essential to the
    best thing that can be offered to us short of a cure—normal blood sugars.

    Richard K. Bernstein, MD, FACE, FACN, CWS
    New York Diabetes Center
    Mamaroneck, New York

    Last edited by ZippyDawg; 10-24-2004 at 12:46 PM.

     
    Old 10-24-2004, 04:17 PM   #22
    JacquelineL
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    I have Dr Berstein's book and have a lot of respect for what he says. It seems like the ADA is not doing a good job in promoting the health of diabetics. I didn't know that they were actually discouraging blood monitoring in type 2 diabetics. That doesn't make any sense.

     
    Old 10-24-2004, 05:25 PM   #23
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Quote:
    Originally Posted by zip2play
    It seems eminently clear then: the ketogenic diet is VERY useful for obese epileptic chiildren in CERTAIN wings of Johns Hopkins. I KNEW it was good for something!


    But then, I guess you eventually wind up with a pile of old epileptics with heart disease? A conundrum indeed.
    Why would you associate a ketogenic diet with heart disease?
    __________________
    The tragedy of science is the slaying of a beautiful hypothesis by an ugly fact. T H Huxley

     
    Old 10-25-2004, 07:23 AM   #24
    zip2play
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    All the good research that I've come across has convinced me that a high fat diet, especially an 80% fat diet (ketogenic) is damaging to the heart.
    The "ketogenic diet" may have some limited use in treating pediatric epileptics in an institutional setting, but it has no safe useful function for adults with or without epilepsy.

    It's use in treating diabetics I leave to the experts, perhaps trading one coronary risk (high blood sugar) factor for another (steady high levels of blood fat) might be beneficial on a case by case basis. Before insulin, it was the ONLY treatment for Juvenile Diabetes.

    Of course anyone is free to choose any diet formulation he believes is beneficial, from O% fat to 100%, low carb or high carb, no protein to ONLY protein depending on the diet book he last read...book sales stimulate the economy...and so do the medical and funerary industries.
    Skoal!

    Last edited by zip2play; 10-25-2004 at 07:38 AM.

     
    Old 10-25-2004, 10:35 AM   #25
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Quote:
    Originally Posted by zip2play
    All the good research that I've come across has convinced me that a high fat diet, especially an 80% fat diet (ketogenic) is damaging to the heart.
    Could you point me to some of that research. I would like to read it. Did the research you came across distinquish between natural forms of fat like that found in animal products and processed forms of fat like liquid and partially hydrogenated vegetable oils?

    Quote:
    Originally Posted by zip2play
    The "ketogenic diet" may have some limited use in treating pediatric epileptics in an institutional setting, but it has no safe useful function for adults with or without epilepsy.
    Well, quite a few bodybuilders would disagree. The cyclic ketogenic diet or "CKD" has been around for quite a few years as a way for bodybuilders to cut the bodyfat to very low levels. A good reference on the subject is "The Ketogenic Diet" by Lyle McDonald.

    Also, Dr. Richard K. Bernstein, M.D., has successfully used a ketogenic or near-ketogenic diet for himself (a Type I diabetic for 58+ years) as well as his thousands of diabetic patients. I believe that he would also have to disagree with your assertion that "it has no safe useful function for adults with or without epilepsy."
    __________________
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    Old 10-26-2004, 05:40 AM   #26
    zip2play
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Arkie,

    I'm sure you can find the research pointing to the links between a high animam diet diet and heart disease quite easily if you would look for it. I've given up on trying to proscelitize to those who pray at the Church of Atkins.

     
    Old 10-26-2004, 07:45 AM   #27
    ZippyDawg
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    Re: Dangers of High-Protein, Low Carb - Diabetes

    Quote:
    Originally Posted by zip2play
    It's use in treating diabetics I leave to the experts, perhaps trading one coronary risk (high blood sugar) factor for another (steady high levels of blood fat) might be beneficial on a case by case basis. Before insulin, it was the ONLY treatment for Juvenile Diabetes.
    Low carbohydrate diets reduce the "blood fat" in circulation because the fat is burned for energy and any excess is excreted by the kidneys vs. glucose that is converted to triglycerides and stored as saturated fat in adipose tissue.

    The dietary intake of fat or the stored fat is converted to ketone bodies by the liver. They are either burned or excreted because the body doesn't have a mechanism to convert them back to triglycerides.

     
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