Yesterday I learned of a recent blog post by the Joslin Diabetes Center regarding my ADA Diabetes Spectrum article on the benefits of a whole-foods-based, low-carbohydrate diet for people with diabetes. (It's still not accessible to the public, but it should be within the next couple of months). While I appreciated the few positive remarks, I was disappointed by the overall message that we need grains and starchy vegetables in order to have a balanced, nutritious diet that people can follow indefinitely. First of all, the recommendations I made were for a carbohydrate amount considerably higher than I currently follow or think is necessary for many people. While I don't have the time or inclination to go point by point over every statement made, there are a few things I'd like to address: 1. Grains and/or starchy vegetables are not necessary to ensure adequate micronutrient intake. The post included my table containing a sample day's menus and nutrient analysis for select vitamins and minerals. Space considerations did not permit me to list additional nutrients or calorie counts (I originally submitted four tables with different menus and calorie counts but was told I could choose only one). Fortunately, I still had the complete nutritional analysis for this day on FitDay (impressive, as this was a whole year ago) and found that it exceeded or came close to the RDA for the micronutrients in question:
Thiamin: 81% Riboflavin: 164% Niacin: 173% Yes, the day was a little low on thiamin. Pork is the best source of thiamin, but I'm not necessarily suggesting people eat it every day. However, by slightly increasing the amount of nuts or animal protein, a person would easily meet the RDA . Also, consider the 10 Best Sources of Thiamin. Not a grain or starchy vegetable among them! 2. The fat content of this menu may be "elevated beyond the culinary comfort of most Americans," but that doesn't mean it is unhealthy or that a higher-fat diet would be difficult to adapt to. I've discussed the issue of dietary fat in a previous blog post, and I have several references in my Diabetes Spectrum article regarding the lack of evidence that a high-fat diet contributes to heart disease or has other detrimental effects on health; on the contrary, such a diet may have a beneficial effect on lipid profiles and markers of inflammation. I believe a person with diabetes or metabolic syndrome following a "healthy, low-fat diet" that includes a breakfast such as a bowl of cereal with a banana and skim milk would achieve better blood sugar control and experience increased satiety by switching to the breakfast in the menu above and eating similar high-fat, moderate-protein, low-carb meals on a daily basis. This can be a very luxurious and satisfying way of eating. 3. Some people may find low carb difficult to stick to, but that doesn't mean it shouldn't be offered as an option for those who are interested in following it. There is a well-known study indicating that a carb-restricted diet can be sustained over two years, but most studies are of much shorter duration. Unfortunately, the most difficult part of low carb is often at the beginning, when a person becomes adapted to using fat rather than glucose as a primary fuel source. There are many examples online of low-carb adherents -- including doctors, nurses, dietitians, and other healthcare professionals -- who have experienced great improvements in glycemic control and/or weight and find this way of eating enjoyable, energizing, and sustainable. I am one of them, and I will continue to advocate carbohydrate restriction as an alternative to the low-fat diet, higher-carbohydrate diets currently promoted by the majority of nutrition professionals.
24 Comments
Barb
3/9/2013 11:54:15 pm
I am so glad I found your link on fb .
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Linda Roberts
3/10/2013 12:22:35 am
It is going to take a very long time for the tide to finally change. The "low fat" mantra is too totally ingrained in the American psyche.
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3/10/2013 01:54:13 am
Thanks so much for sharing your fantastic results, Linda! So glad to hear success stories like yours.
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Good for you, Franziska. I know you will stick to your guns. You had the courage to enter their "den of iniquity" (a little strong, perhaps), and I admire your commitment to continuing to do what you know is best. Isn't it ironic that you modified your program somewhat, perhaps in the hope of gaining their acceptance and approval, and all they could do was pick at the corners and the details that publication did not allow you to include. Don't be discouraged. You (and all of those who think as you do) have a growing audience. Frankly, I think they must feel threatened (and maybe even confused by the thought that they may be wrong!)
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3/10/2013 09:10:26 am
Dan, thank you so much for your feedback and continued support. It can be hard to keep speaking out when the voice of opposition comes from esteemed organizations like Joslin, but I can't back down when I know how beneficial low carb can be from personal experience and that of others.
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I know what you mean about Joslin, but their orientation stems from helping Type 1s, for whom a major object is to avoid hypos, so they are 'conservative.' Of course, Dr. Richard K. Bernstein wrote the book, literally, on how to do that using his concept of "small numbers." Have you read his "Diabetes Solution"?
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3/10/2013 09:38:58 pm
Yes, I've read Diabetes Solution and refer to it regularly. Essential reading for anyone interested in achieving great BG control with low carb.
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Linda B
3/10/2013 09:48:11 am
You are my hero!!
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3/10/2013 09:46:59 pm
Well put, Franziska. I agree with you.
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3/10/2013 11:10:54 pm
Thanks, Steve. Agree that not always meeting 100% of the RDA for a vitamin or mineral isn't a big deal. I just wanted to demonstrate that starchy carbs aren't required, as needs can be met very well with low-carb foods.
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3/10/2013 11:01:44 pm
Franziska, I am sickened every time the latest addition of Dietetics Today (UK) comes through my door!! It is little more than an advert for Kellogg's... totally disheartening.
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3/10/2013 11:21:28 pm
Thanks, Melanie. Agree that it's really hard to admit that you may have been giving less-than-helpful advice to people for years. I have to remind myself that I didn't always hold these beliefs and looked unfavorably at Atkins and other low-carb diets because I was taught they were unhealthy and unsustainable. It's very encouraging to find out that open-minded RDs like you are also questioning standard dietary recommendations.
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3/12/2013 03:01:02 pm
Just wanted to let you know I left a comment at the Joslin blog and they were gracious to publish it:
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3/12/2013 10:49:54 pm
Thanks so much, Steve. Appreciate your response, and happy to see that it was published.
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Gerri
3/12/2013 04:07:20 pm
I also applaud your honesty & integrity. Takes moxie to say the emperor has no clothes on. Weary, so weary, of hearing about the alleged deficiencies of LC & the praises sung of grains. Yes, that entire food group should be eliminated. The weak Joslin acknowledgement LC may be beneficial for some, followed by it's something most can't adhere to, is infuriating. Thank you, Joslin, ADA, CDA, et al, for gate-keeping & assuming what people can & cannot do.
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3/12/2013 10:55:23 pm
Thank you very much for your comments and support, Gerri. I'm actually pretty optimistic about low carb being considered a realistic option in the near future but completely understand your frustration. Appreciate your continued support.
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Terry
3/19/2013 04:33:54 am
Franziska,
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3/19/2013 05:47:06 am
Terry,
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3/29/2013 11:39:42 am
Hi Franziska,
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3/29/2013 09:53:55 pm
Thanks so much, Bill! That's my goal: to offer low carb as the best option for anyone with diabetes, metabolic syndrome, PCOS, and other conditions without fear of reprimand.
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Rick
4/18/2014 05:33:46 am
I hope you don’t mind me responding to your older blogs……they are new to me. I just sent your link to 2 more people. Anyway,
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4/18/2014 07:38:53 am
Of course I don't mind, Rick. I appreciate your interest and support. Thanks for your comments and your insight.
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