CategoryCarbohydrate

T2 Diabetes Reversal

Dr Robert Szabo, Melbourne GP and founding partner of The Low Carb Clinic, tweeted the results of one of his diabetic patients who went low carb in April — blood tests in November showed him to no longer be diabetic.

The circled values on the right show a HbA1c (Haemoglobin A1c) value of 12.3 in March of this year (6.5 or higher is diabetic). By July it was 6.8, and on November 2 it was 5.9.

No more diabetes, no medications, only a change in diet.

Keto flu

Some people who start a low carb diet experience what’s called the “keto flu” or the “induction flu” in the first few days while the body is adapting to burning ketones instead of glucose. You can think of it as kind of a carbohydrate withdrawal.

The common symptoms are:

  • headaches
  • nausea
  • upset stomach
  • Lack of mental clarity (brain fog)
  • sleepiness
  • fatigue

Many people have reported good results in minimizing these symptoms by doing the following.

  • Drink plenty of water throughout the day
  • Increase your electrolytes (sodium, magnesium, potassium). Initial weight loss in ketosis is mostly water, so the loss of retained water will also result in a loss of electrolytes. Adding more salt to your food can help, as well as magnesium and potassium supplements or by eating foods that are rich in these minerals. Another helpful approach is consuming salty chicken or beef broth during this period.
  • Eat more fat — cheese, avocados, fatty meat, sour cream, coconut oil, olive oil, butter, heavy cream in coffee
  • Minimize protein. The body can convert protein into glucose if you eat very much, and this can stall the transition into ketosis

I did not experience this in 2013 when I went on the ketogenic diet, but my 15 year old son had a couple of days in June where he felt crummy. This was about 3-4 days into the switch to removing carbs from his diet. It passed quickly and then he felt really good with a lot more energy.

In any case, do some research on this and decide for yourself how to prepare for the transition. You might even do a gradual reduction of carbs rather than diving in all at once.

Bariatric surgery

Bariatric Surgery or Better Diet?Great article at the New York Times by Dr Sarah Hallberg and Osama Hamdy.

Rather than cutting on perfectly healthy organs to deal with weight loss, why not use a dietary approach on a dietary problem: cut out the foods that contribute to obesity.

Excerpt from the article:

It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.

Once a fad diet, the safety and efficacy of the low-carb diet have now been verified in more than 40 clinical trials on thousands of subjects. Given that the government projects that one in three Americans (and one in two of those of Hispanic origin) will be given a diagnosis of diabetes by 2050, it’s time to give this diet a closer look.

When someone has diabetes, he can no longer produce sufficient insulin to process glucose (sugar) in the blood. To lower glucose levels, diabetics need to increase insulin, either by taking medication that increases their own endogenous production or by injecting insulin directly. A patient with diabetes can be on four or five different medications to control blood glucose, with an annual price tag of thousands of dollars.

Yet there’s another, more effective way to lower glucose levels: Eat less of it.

Macronutrients & Obesity: 1971-2000

From DietDoctor.com — a look at the change of macronutrient composition in our diet from 1971 to 2000. As we transitioned to the recommended low fat approach our carbohydrate intake increased dramatically. It had to, because there are only three macronutrients: carbs, protein, and fat. If you restrict fat you will by default consume more carbohydrate-rich foods.

The LCHF approach flips this to reduce carbs (sugars, starches, grains) and increase the fat content. The typical result of this is healthy weight loss as well as improvements in several metabolic markers like HDL, triglycerides, blood pressure, and insulin sensitivity.

macros-1971-2000

Another look at macronutrients and associated effects from this study.

macros-1971-2008

Exercise

There are many good reasons to exercise. Muscle strength, improved bone density, cardiovascular health, optimal metabolic function, reducing risk of stroke and heart disease and T2 diabetes and dementia — the list is long. Exercise energizes and makes you feel great. But exercise is not a great weight loss strategy. You can lose weight with exercise, but (1) you have to work really hard at it, and (2) the weight tends to come off very slowly.

The best way to burn off excess body fat is by reducing consumption of sugar and refined carbohydrates. The reason is that carbohydrates drive up blood sugar (glucose), which stimulates the secretion of insulin. Insulin is the fat storage hormone. If the excess glucose is not used for energy, insulin moves it into the fat cells to be used for energy later. But if we keep eating the carbs and glucose levels remain high, the stored fat is never metabolized for energy — so the fat cells remain. You cannot outrun a bad diet.

A low carb / ketogenic diet causes the body to transform from burning sugar for energy to burning fat. It works.

exercise

Fat vs Carbs

The traditional “balanced diet” may be way out of whack. To fight obesity and diabetes, doctors and nutritionists are embracing diets that were once called fads.

“PEOPLE have told me what I do is dangerous. They have walked away from me at meetings,” says David Unwin, a doctor practicing in Southport, UK. Unwin suggests to his patients with type 2 diabetes or who want to lose weight that they do the opposite of what official health advice recommends. He advises them to stop counting calories, eat high-fat foods – including saturated fats – and avoid carbohydrates, namely sugar and starch. Telling people to avoid sugar is uncontroversial; the rest is medical heresy.

But crazy as it sounds, Unwin has found that most of his diabetes patients who follow this advice are getting their blood sugar back under control, and that some are coming off medication they have relied on for years. Those who are overweight are slimming down.

This might seem like just another controversial fad diet, but a growing number of researchers, doctors and nutritionists around the world are backing it, and reporting their findings in peer-reviewed medical journals. Last month, the National Obesity Forum, a UK body for health professionals involved in weight management, made headlines when it overhauled its advice, telling people to ditch calorie-counting, low-fat foods and carbs in favor of fats.

Source: New Scientist

fat-carbs

Doubling saturated fat in diet does not increase saturated fat in blood

New research links diabetes, heart disease risk to diet high in carbohydrate — not fat.

Doubling or even nearly tripling saturated fat in the diet does not drive up total levels of saturated fat in the blood, according to a controlled diet study. However, increasing levels of carbohydrates in the diet during the study promoted a steady increase in the blood of a fatty acid linked to an elevated risk for diabetes and heart disease.

The finding “challenges the conventional wisdom that has demonized saturated fat and extends our knowledge of why dietary saturated fat doesn’t correlate with disease,” said senior author Jeff Volek, a professor of human sciences at The Ohio State University.

“When you consume a very low-carb diet your body preferentially burns saturated fat,” Volek said. “We had people eat 2 times more saturated fat than they had been eating before entering the study, yet when we measured saturated fat in their blood, it went down in the majority of people. Other traditional risk markers improved, as well.”

Source article at  Ohio State University News site.

Research findings at the PLOS ONE Journal.

1917 Diabetes Cookbook

In 1917 Rebecca Oppenheimer published “Diabetic cookery; recipes and menus” which described what was already known about the optimal diet for diabetics — more butter, olive oil, meats, cheeses, eggs, and healthy fats (low in carbohydrates), and less sugar, starch, bread, pasta, and other foods that raise blood sugar (due to high carbohydrate content).

This is essentially a low carb / high fat (LCHF) diet, which not only helps diabetics to reduce their blood glucose, but is also effective for weight loss and other metabolic conditions.

The book can be found online at Archive.org and you can download it in PDF format here.

Here are pages 12 and 13 from the book.

Diabetic Cookery

Insulin

Insulin is a hormone secreted by the pancreas in response to elevated levels of glucose (blood sugar). Its function is to move the glucose into the body’s cells to be used for energy. Insulin is also the fat storage hormone — excess glucose that is not burned as energy or stored in the cells as glycogen will be converted into adipose tissue (fat). See the Insulin-Fat Connection by Dr Richard Bernstein.

Insulin Resistance

Insulin resistance is a condition in which the body’s cells fail to respond to the normal actions of the insulin. The body produces insulin, but the cells in the body become resistant to it and are unable to use it as effectively, leading to hyperglycemia (excess blood sugar). Beta cells in the pancreas subsequently increase their production of insulin, further contributing to hyperinsulinemia (excess insulin in the blood). This often remains undetected and can result in Type 2 Diabetes.

For a good overview of insulin resistance, obesity, and Type 2 diabetes, see Dr Sarah Hallberg’s TEDx talk below, titled Reversing Type 2 diabetes starts with ignoring the guidelines.

Dr Hallberg is the Medical Director of an obesity clinic in Indiana, and she says that the American Diabetes Association’s recommendations to eat 45-60 grams of carbohydrate per meal is making patients worse — carbs raise blood sugar, and that is exactly what T2 diabetics need to avoid. As Hallberg points out, “Diabetes is a state of carbohydrate toxicity. Insulin resistance is a state of carbohydrate intolerance.”

Chris Froome cut carbs & won the Tour de France

Chris Froome just won his third Tour de France title in four years.

“His success can be put down to a massive loss in weight, helping to explain his improvement from also-ran to Tour de France winner,” William Fotheringham at The Guardian noted.

“The engine was there all along,” Jeroen Swart, a sports physician and exercise physiologist at the University of Cape Town, told Richard Moore for Esquire. “He just lost the fat.”

As Froome told Kimmage: “In the Vuelta that year (2011), I think my muscles were probably lighter. I was quite gangly. You wouldn’t look at me and say, ‘That’s someone who’s strong.’ Whereas now, my diet is a lot more protein based. I’ve cut back on carbs completely but I’m not losing muscle.”

See the post at Business Insider.

Chris Froome