The further a society drifts from the truth, the more it will hate those who speak it. ... In a time of deceit, telling the truth is a revolutionary act. George Orwell

Wednesday, August 13, 2008

Carbohydrates and Diabetes

Response for TG (on McDougall forum)

http://www.drmcdougall.com/forums/viewtopic.php?t=8095&postdays=0&postorder=asc&start=0

I know you have studied this issue and you did notice that your glucose response is dependent on the carbohydrate load (primarily) while other factors such as the presence of fat may only modulate the insulin sensitivity somewhat but it is not the main factor. The main factor is the total glycemic load ( GL = GI * mass of carbs ).

Typically, our insulin response is equal to about 10 insulin units per every 100g of carbohydrate (GL). It is as simple as that and no amount of wiggling or waving by vegan followers with their refined versus natural theories; potatoes versus rice versus sweet potateoes etc., is going to change this.

Your blood glucose post-prandial peaks at 140mg/dl are on the higher limit of the normal (on a high carbohydrate diet) and probably indicate that your insulin secretion may be insufficient (as I wrote before check against dm t1) or that your tissue became insulin resistant (metabolic syndrome).

Insulin resistance depends on the amount of fat you consume with the carbohydrates but important is also that you allow a time of metabolic rest in between the meals. This is the period when the body wants to switch from burning glucose to burning lipids (from body fat) and ketone bodies.

Preventing the appearance of such a cycle of rest in-between the meals, through frequent snacking may be one of the culprit behind the metabolic syndrome.


There are two ways of preventing metabolic syndrome:

1) Eat low fat high carbohydrate natural low glycemic food (vegetarianism is not necessary and probably not even relevant) and make long breaks between the meals to allow for the ketogenic cycle in between the meals

2) Eat a low carbohydrate high ANIMAL fat meals. Avoid polyunsaturated oils and transfats! In this case snacking in between the meals is not harmful as long as it is with fat only, not with carbohydrates (the reason is that fatty snacks do not break the ketogenic "resting" cycle).

Both styles of eating 1 or 2 will result in low average insulin level in between the meals, and will protect you against the chronic diseases associated with the metabolic syndrome such as CHD, cancer and autoimmune. Such disease are associated with the elevated insulin level rather than with the glucose itself. Kidney failure however, is related to glucose peaks since every time it exceeds 160mg/dl, it forces kidneys to excrete glucose. Other risk factors have different causes. For example diabetic neuropathy (and retinal damage) is probably more associated with fructose leakage to the bloodstream than with glucose.

If you decide to follow (2) then do not try to avoid fat. The more fat (animal, saturated and monounsaturated) the better it works. There is absolutely no need to worry about the heart disease since it is the insulin, not fat, in particular not animal fat, that seems to be the main growth promoter for arterial plaque and arteriosclerosis. For example, see R.W. Stout http://www.ptbo.igs.net/~stanb/Lancet_Stout_pg_702.pdf and http://www.ptbo.igs.net/~stanb/Lancet_Stout_pg_467.pdf

Besides if what I am saying were wrong and McDougall's crowd were right, I wouldn't be typing it. I would be dead. Over in the last 9 years I have been consuming about 150g (to 200g) of butter, cream or pork lard every day. If you read this message it means it's true! :)

Stan (Heretic)

3 comments :

Stan (Heretic) said...

Re: 1 ( http://www.ajcn.org/cgi/content/abstract/66/5/1264 )

Not so! They fed them 1000kJ test meals (240kcal) which is only 10% of the normal average daily intake. That means that 90% of the time they were eating their normal high carbohydrate meals. Thus this study cannot possibly be relevant to low carb high fat diets like Atkins etc. The results can only tell you about the effect on some selected food items under the high carbohydrate nutrition model. Still the results are quite favorable towards increased fat and meat consumption, for example if you look at the Table 2 (under "protein-rich foods"), Figure 2 (see "eggs" to "fish" group) or Figure 4 (the "FAT g/serving" graph).

Re 2:

Because they probably are not aware of that!

It is important to allow the body rest in the lipid-burning or ketogenic mode in between the high carb meals, in my personal opinion. Most vegan promoters would disagree, however the selection of their food discourages frequent snacking or makes it less attractive. That's why it may be achieving the same purpose implicitly. After all how often do you feel like eating vegetables? Snacking is easy on high sugar items or high fat items (like nuts), but veggies aren't that attractive to bother.



-----------------------------------

TG wrote:

Thanks again for your interest in my case. I don't see what's so incendiary about your response that you couldn't just post it. Couple of questions:

1. Are you sure of what you said about insulin response being a linear function of carb load? Surely you're familiar with this study, where e.g. beef was as insulinogenic as an isocaloric serving of brown rice: http://www.ajcn.org/cgi/content/abstract/66/5/1264
I believe this study undermines an essential premise of low-carb (certainly Atkins wrote that carbs => insulin => bad stuff), but perhaps I misunderstood.

2. If the fasting between meals is critical on high-carb (I don't doubt that it's beneficial, based on Fuhrman), why isn't it stressed by any of the low-fat gurus, and why aren't all the Esselstyn and Ornish subjects dead from diabetic complications?

We should talk investing sometime, too, as that's another of my hobbies. :)

Gyan said...

Can we eat fat with carbs provided it is saturated?.
Like bread with butter or vegetables fried in ghee?.
Along with no-snacking?.

Stan (Heretic) said...

Hi Gyan,

Welcome and thanks for posting!

I doubt if you could get away with that, even with saturated fat. I think the "forbidden zone" of 35-45% fat by calories can be tolerated (my guess) by very young people and on low caloric diets or for a short time. The reason is biochemical: our metabolic and digestive pathways for fats and carbohydrates are separated in space (our digestive tract) and in time (our daily cycle, see my newer post). Peter posted a good article on his blog about that issue. Bottom line is that fat+carbs at the same time and in equal calories = trouble. Whether we can tolerate it alternatively, say one day carbs next day fat or similiar ideas, I generally do not know. I do know that my body would object!

Regards,
Stan