Nobody is terribly surprised that Food Network star Paula Deen has diabetes, but the interesting thing is how many people assume that she has developed diabetes from overindulging in fat and sugar, and that the real culprit is fat. Her son has a new show called “Not Mama’s Cooking” where he “makes over” Paula’s recipes, often by lowering the fat and increasing the carbs. Sigh . . .
Those of us who have read books like Gary Taubes Good Calories, Bad Calories, and who have paid attention to the latest research which shows that fats, formerly thought to be the major contributor to obesity and disease, is NOT the culprit. We believe that the carbohydrates in Paula’s diet of choice—all the carbohydrates—are a major factor in her diabetes. (Genetics may play a part as well, but it’s the carbs that cause the genetic predisposition to turn on the diabetes “switch”.)
Marion Nestle, of Food Politics, posits, in today’s San Francisco Chronicle Food Matters column, has yet another theory of why Paula Deen and many others develop Diabetes Type II–because they are overweight. Nestle points out that 85% of people who develop diabetes type II are obese, therefore, she concludes, that must be the cause.
She doesn’t quite manage to state what might cause Diabetes Type II in the other 15% of individuals who are not obese, although she does give a passing nod to “genetics”.
And to Nestle, the prevention for Diabetes Type II is simple. Lose weight by eating less and moving more. She urges that old balanced diet—one where carbohydrates are “balanced” with the fat and the protein. She particularly recommends against cutting back on carbohydrates alone.
ZZZZZZZZZZZ, same old, same old!
I wonder about people who believe that this is the simple answer to this 21st century diabetes scourge. Presumably the word is out. Everyone who doesn’t live under a rock has heard the conventional wisdom–eat less and move more and you won’t get fat, or if you do, that’s the secret to losing the excess weight. What puzzles me most is that people who think losing weight is that simple must think that EVERY obese person has not tried that, or at least not tried that “hard enough”.
How can they believe that? I can almost guarantee that every single overweight person has tried at least one (and often many) calorie reducing diet and has exercised “more”. Some people complain that their obesity developed while they were exercising religiously and following a low calorie, whole grain diet.
News Flash: Eat less move more does NOT work. If it did work, if it was that simple, why do you think we all got so fat? The answer, is obvious–we are all a bunch of stupid and lazy slobs. What else could explain the obesity epidemic if the solution is so simple.????
Nestle touches on the issue of insulin resistance, but states that insulin resistance is a consequence of obesity. She fails to recognize that insulin resistance can (and probably does, in most instances, as posited by Gary Taubes) CAUSE obesity, not the other way around. Many people are insulin resistant though still very thin. Dr. Mary Vernon refers to these people as “metabolically obese” even when their bodies are not (yet) overweight. Poor diet is certainly one reason for insulin resistance, genetics may also play a role. In any case, it’s clear that insulin resistance may be the precursor to obesity, not the other way around.
In my case, for example, I have a condition called “Polycystic Ovarian Syndrome” (PCOS), which we now know is a metabolic condition, the hallmark of which is insulin resistance. I was a terribly thin child (a lousy eater) and thin young adult (with an abysmal diet!). Nevertheless, I had PCOS, so that even in the very beginning when there was not an ounce of fat on my body, my menstrual cycles were severely impacted (1 to 2 periods per year, no ovulation, infertility). I weighed 110 pounds soaking wet when I got married, and we underwent three YEARS of infertility treatments before I could conceive my first child through in vitro fertilization. The hormone treatments for infertility made me pack on the pounds so that I came out of all that treatment after my first child was born 70 pounds heavier and continued to gain from there. Appalled, of course I tried to rein in my diet by eliminating fats, eating plenty of vegetables and whole grains, and adopting various exercise programs. Yet I grew more and more obese.
In the year 1999, I read about the new theory that PCOS was tied to insulin resistance and that a low carb diet coupled with the oral diabetic drug Metformin was helping people normalize their metabolisms and in some cases, even conceive naturally. I was lucky to secure a referral to a great endocrinologist who understood all of this. He put me on Metformin , which is an insulin sensitizing drug, and advised me to follow a low carb diet outlined in the book by Michael and Mary Dan Eades called Protein Power. The weight practically flew off, even though I was eating a delicious diet consisting of plenty of FAT and protein–butter and heavy cream daily. And, to my utter surprise (and great delight) I got pregnant with my second child “naturally”.
Insulin resistance caused my PCOS, not the other way around. By lowering my carbohydrates and increasing the fats, my insulin resistance decreased. The PCOS symptoms abated. I lost weight, and was able to conceive.
Nestle doesn’t get the dietary connection to insulin resistance. She blames insulin resistance on weight, and erroneously concludes that weight loss will improve insulin resistance (I was just as insulin resistant at 110 lbs as I am at 220).
And how does Nestle propose that someone lose weight to improve insulin resistance and manage Type II Diabetes? “Dietary advice for type 2 diabetes is the same as advice for everyone else: Eat a wide variety of relatively unprocessed foods, especially vegetables, fruits and whole grains, and don’t consume too much junk food or too many sugary beverages.
Scientists may argue endlessly about the relative importance of calories, sugars and refined carbohydrates in the diets of people with type 2 diabetes, but everyone agrees that eating less of all three would help resolve symptoms.”
Well, Scientists may argue, but a growing number of clinicians like the Eades, Atkins, Vernon, Westman, Rosedale, Pescatore, Davis, and many others agree that carbohydrates DO matter and they see the results every day in their clinics. Reducing carbs controls insulin resistance. Their obese and diabetic patients lose weight, improve their lipid profiles, and are able to get off their diabetes medication. They also can get off blood pressure medications, statins, and proton pump inhibitors, simply by reducing dietary intake of carbohydrates AND increasing fat.
Nestle says that “some people” who follow her advice to eat less, move more will “still need medications.” What she fails to recognize is that a whole lot fewer of them will need any medication at all if they reduce the carbohydrates in the diet and stop eating grain. And to do that successfully, protein and especially FAT must increase. “Balancing” carbohydrates is ludicrous and ineffective. Carbs must come down, fat must come up. Calories tend to take care of themselves when insulin resistance is minimized so that the body can absorb nutrients properly while shedding excess fat.
Nestle understands that diet is key, even if she doesn’t get what type of diet is effective. She states that she was a speaker at an ADA conference and she was one of only two speakers at the entire conference addressing diet at all, the other speaker was sponsored by Coca Cola and speaking about sugar (!?!–let’s give the fox the keys to the henhouse!). Nestle gets the fact that the big pharma sponsorship of the ADA is a huge conflict of interest. But unless and until she understands that reducing carbohydrate consumption is the key to treating insulin resistance and preventing or reversing diabetes, her advice is nothing more than the conventional wisdom that simply does not work.