What is evidence?

[hanadr]

I have written already on the latest scare about the dangers of the low carb diet. I've also corresponded with David Mendosa on the subject. He pointed out something, which ,in my original anger, I'd missed.
The low carb diet was a 20% carb on a 500 calorie deficit diet. If an average calorie count is 2,500 per day for men and 2,000 per day for women, the deficit of 500 calories would amount to 2,000 for men and 1,500 for women participants.
I've done a few sums on this and got the following results.
Men participating in this so-called low carb diet were probably eating about 100 carbs per day and women about 75. NOT what most of us would call LOW, in fact nearer Cugila's MODERATE
In addition, The study lasted 8 weeks, which is not long enough for the metabolism to adapt properly to the low carb lifestyle.
I also picked up the following phrase in the abstract. My italics
>>may imply a negative effect of low-carbohydrate diets on vascular risk.<<
I tried to send my comments to the doctor involved in the study and so far haven't found an mail that works. I may have to resort to snail mail, which in my experience DOESN'T usually get answered.
I'd like to find whqat mechanism is postulated to explain why an unnatural food is so essential to health.

 

[catherinecherub]

Hana what would be your reaction if you came across and eight week study that sang the praises of low carbing. Would you rubbish that too?
These studies are not positive proof of anything, they are studies and as such have to be viewed with caution.
The best way to manage our diabetes is with an individual approach and frequent testing at the onset. Sometimes it only takes portion control and many are successful doing just that. There is no right or wrong way.

Catherine.

 

[wallycorker]

Hana,

As far as I'm concerned evidence is what I see happens to me.

Anything else - such as something that I read - is just another spot on the graph. If I'm interested in the idea in the reading matter and think that it might be applicable to me then I'll test it out. If I think it works then I'll use it on me.

At present, I'm testing out reducing my carbohydrate intake lower to see whether I can control my HbA1c below 5%. That came about because of something that you triggered Hana coupled with something that Mitch said to me on the Low-Carbohydrate Forum. If it works I'll use it! Initial results are very promising indeed - so far, I've had an amazing week with blood glucose levels!

Best wishes - John

 

[noblehead]

That's quite right Catherine,

It would seem that there is a minority of low-carbers that are really defensive whenever a article is published that may question the merits of a low-carb diet. It leaves one to wonder why this is so? Why on earth do they go to such extreme measures to find some evidence that may counteract what has been written!

Regardless of any study published, I would be more than happy to reap the rewards of a diet that benefited my health overall; good diabetes control and cholesterol etc. It really isn't important how you achieve good control, as long as you are healthy and comfortable with the diet you happen to follow i.e low-carb, moderate carbs or a conventional diet that includes all foods.

For the record, as many know I eat moderate carbs 100-120g, sometimes a little more on special occasions. :wink:

Regards

Nigel

 

[IanD]

... It would seem that there is a minority of low-carbers that are really defensive whenever a article is published that may question the merits of a low-carb diet. It leaves one to wonder why this is so? Why on earth do they go to such extreme measures to find some evidence that may counteract what has been written!
.....

Why are we defensive? Because such studies are used by dietitians, including DUK, to advise against any carb reduction.

The latest DUK "Healthy eating for T2" recommends a daily consumption of carbs of up to 42 tablespoons of cooked rice, or 14 slices of bread. (About 200 - 300 g carbs & 1000 - 1400 cals.)

The same publication insists on high carb consumption, despite the fact that carbs are converted to blood glucose, because, "glucose from carb is essential to the body, especially the brain."

There seems to be a campaign to rubbish reduced carb, despite the success of those who practise such a diet. We have to speak up for the health of those deceived by the official propaganda. Including myself.

 

[hanadr]

I wouldn't think highly of any study on diet that runs for only 8 weeks, unless It were the weight loss graph of its participants 8) . The Jorgen Nielson study has data over 44 months :shock:
I and many other people have found that low carb has improved our health and definitely improved our BG control. I don't like being told it MIGHT be dangerous, when I've already been doing it for far longer than the sudy, with NO ill effects.( ANd so have Loads of people.
The other thing about SHORT studies is that they inevitably find very little difference in weight loss between dietary patterns. Longer studies are able to take account of the Rate of Attrition( dropout) which tends to be very high in lowcal/low fat diets.

 

[cugila]

I'm intrigued by Hana's comment, " why an unnatural food is so essential to health."

Simple carbohydrates, which are found in fruits and dairy products are more easily digested by the body. They are also often found in processed, refined foods such as white sugar, pastas, and white bread.
What's unnatural about fruit and dairy products ?

Complex carbohydrates, which take longer for the body to digest, are most commonly found in vegetables (cellulose), whole grain breads and pasta, brown rice, and legumes. Foods with unrefined grains, such as brown rice, retain complex carbs, unlike refined grains, such as white rice. This is because the refining process removes some of the grain’s fibre and nutrients.
What's unnatural about Veggies, bread, pasta, brown rice etc ?

I would also like to know who decided that my intake of carbs is moderate, as I used to consume around 300g daily I think it is low, I am consuming between 60 - 90g most days. I consider anything below that to be 'ultra low'. Who decided all this....Dr Bernstein perhaps....? it is only because of previous spats on here that we all started using the term 'reduced.'

As for IanD's comment,
"There seems to be a campaign to rubbish reduced carb, despite the success of those who practise such a diet. We have to speak up for the health of those deceived by the official propaganda. Including myself."

I could have written some of that myself, because I reduce carbs and have had good results, however I don't low carb (officially) but use the GI/GL method to control my Bg well. A different method that is also successful, it works well for me. There are people who can obviously control their Diabetes well without reducing any carbs. If it works for them then as far as I am concerned that is great, I don't feel I need to convert them to my way of thinking and get everybody low carbing or low GI/GL

I just want to give people a choice in what they do without being jumped on. I want DUK to put alternatives, not just one way as at present. Whatever suits you is best. I don't want to achieve non Diabetic numbers either. I am happy keeping to normal levels, so long as I am healthy and my lifestyle is good, why should I beat myself up because I don't fit into a category.

As for research studies, they are all just some facts and figures we can look at, digest, ignore, question, assimilate or throw in the bin. I am sure we all have reservations about many of the studies, however long they may have been. My beef is with the fact that people quote these studies as if they are facts....posting links that are again supposed to be facts.....no they're not. They are ideas mostly, which needs to be proven. Until then we all can make our own minds up and believe whatever parts of them that we want. A choice.

I don't eat many eggs, fact. I don't eat high fats, fact. That is my choice and I am happy with it. I did my own research and I believe who I want. So, whether you high carb/low carb/lowGI/lowGL
paleo or whatever. Let's just let people who don't, make their own minds up and let members decide for themselves what is rubbish and what is not. We don't need to preach to anybody or rubbish valid research.

I also believe we should direct our efforts at the people who are advocating we eat plenty of starchy carbs....trouble is without valid evidence, it just 'aint gonna' change any time soon !!

 

[IanD]

Let's just let people who don't, make their own minds up and let members decide for themselves what is rubbish and what is not. We don't need to preach to anybody or rubbish valid research.

I also believe we should direct our efforts at the people who are advocating we eat plenty of starchy carbs....trouble is without valid evidence, it just 'aint gonna' change any time soon !!

The trouble is, Cugila, that newly diagnosed diabetics are NOT given the info that will enable them to choose a reduced carb diet. They are warned against it. Threatened with brain malfunction if they don't base their diet around 300 g carbs daily. (Presumably premature alzheimer's.)

I started reduced carb because of crippling leg muscle pains. My mobility & tennis playing were restored, but I still have the problem in the background. I am considering giving up tennis until the spring as I have leg discomfort afterwards, to have a thorough rest, though I shall continue with the gym, where I have more control of how much I do. I need to keep active. A Baroque music group meets on Tuesdays (my winter tennis evening) so I shall join them.

We HAVE TO campaign in the interests of diabetics everywhere, & flag up misleading "research."

What is research evidence? Controlled long-term tests on people. People's experience. Why should OUR experience be discounted :?:

 

[cugila]

Ian.

I think this forum has a great reputation for informing new members and even some 'oldies' what can help reduce their Bg levels and also improve their health. An International reputation, so the word is spreading far and wide. This is the little acorn Ian, watch it grow and send shoots around the World. Changing opinions everywhere, tentacles reaching out. So if you can't change DUK from within, help spread the word here and watch it gradually seep in to DUK when they read it in Africa, UAE, Australia, Egypt, Israel, USA, Germany, Spain, Crete, Cyprus, etc everywhere we have new members. The word will spread.

We have to be tolerant. It is well documented by the amount of members who join and say, "what great information we are reading on here, I never knew that, etc etc". So the information is certainly going out from here and always will. I am one of the first to criticise DUK for their dietary stance, unfortunately as they say, we are p***ing in the wind !

I applaud you and Hana for being active in seeking to change the status quo, I know it must be a hard slog. The entrenched opinions, the head in the sand brigade. We are stuck with them I'm afraid as far as DUK and a lot of the NHS are concerned. Having said that there are the green shoots of change appearing here and there.

My Practice Nurse was a firm believer of all things DUK, then she went on a course to become the Practice Diabetic Nurse. Well, I don't know where she got her information but it is pretty much what we give out here....reduce those carbs..... :shock: No high fats though, I'm happy with that bit.
I got her to go over it twice because I couldn't believe what I was hearing. She has looked at this website and thinks it's great, thinks the advice given out is great. What a sea change that was !

So my view is, still attack the DUK mantra - yes. The NHS mantra - yes. But let's not return to rubbishing stuff a non low carber posts, just because research doesn't fit in with your views (not you personally Ian ) It is so predictable as to what will happen and when. I think we have grown a lot since that all came to pass. People have moved on to pastures new and there is a more tolerant approach here.

We are not going back to open warfare over diet matters again.

Edited.
& flag up misleading "research."
Interesting.....WHO decides what is misleading or not....... :?:

 

[catherinecherub]

This unnatural foods intrigues me and I would consider that a McDonalds Burger, Fish fingers etc... are unnatural foods and yet I have seen people on this forum advocate that a burger from this source is fine as long as you throw the bun away because that lowers the carb content.
A homemade burger may be fine if you mince some steak and add an egg and some seasoning but not from McDonalds as the saturated fat and salt content alone is something to worry about. If you eat the cheese burger then that adds even more preservatives. When did fish ever have fingers that could be eaten? These are all what I would class as processed foods and not what anyone needs to be healthy.
Perhaps someone would care to clarify what unnatural foods are. My interpretation of this is processed.
If we are going to give mixed information then we only have ourselves to blame if things do not progress as we would like.

 

[phoenix]

>>may imply a negative effect of low-carbohydrate diets on vascular risk.<<
I tried to send my comments to the doctor involved in the study and so far haven't found an mail that works. I may have to resort to snail mail, which in my experience DOESN'T usually get answered.
I'd like to find whqat mechanism is postulated to explain why an unnatural food is so essential to health.

To go back to the original post.
Evidence is just that, you may consider it, compare it with other evidence, replicate the test to see if the result is consistent etc. Any result over such a short time would have to be qualified by words such as suggest, may, possible etc.
So why did he say this? I assume that you have no more access to the full text than I.
I assume that they assessed the arterial stiffness of the subjects at the start and end of the trial. (using pulse wave analysis) At the end those on the lower fat diet had a significant decrease in arterial stiffness, those on the lower carb diet a non significant increase. From what I can gather, and I'm no expert, increased arterial stiffness has been shown to predict cardiovascular events so any increase may indicate a negative effect of the low carb diet. It could also be due to something else,( it could be an artifice caused by something in the randomisation, it might not be the problem as the test itself might not be valid or the problem might resolve itself on a longer trial ... that's open for discussion, and further research and thats one of reasons for publishing results in a reputable peer reviewed journal.

Incidently you might be able to measure your own level of arterial stiffness, it's apparently correlated with peoples flexibility as demonstrated with the sit and reach test!
I too would like to know what unnatural food is!

 

[catherinecherub]

The sit and reach test for arterial flexibility as mentioned by phoenix,

http://www.the-aps.org/press/releases/09/41.htm

 

[hanadr]

Catherine,
I can sit on an exercise ball and bend down to grasp my toes perfectly easily. In fact I can reach in any direction whilst sitting on the ball.
As to unnatural foods
I think the starches are more unnatural than the burge or the fish in the fish finer. I could, if I wished, eat raw beef or raw fish. I am not equipped to digest raw cereal.
that's what i mean by unnatural.
My late father was very intelligent, but totally eccentric. If you offered him a "modern " food( for exaple "Instant Whip") and he didn't like the look of it, he'd insist it was made from coal.
It would probably take as much processsing to make grains digestible as coal.
Hana

 

[catherinecherub]

This article explains about the digestion of all carbs, including complex ones.

http://recipes.howstuffworks.com/food2.htm

I disagree that complex carbs are unnatural.

 

[carlos]

my own personal view witch we all have but has worked for me is that a low carb diet does work to a certain degree but because of the high fat protein it impacts more on the bs after the two hours after nearly twelve month i like many of you have tried to find a diet witch suits me and this has included a reduction in carbs i have reintruduced certain foods and taken certain foods out but i feel a reduction in carbs does work to a certain degree its what works for you at end of day gd look to everybody at end of the day its your choice and your desicion

 

[veggienft]

.
Hanadr, I was wondering about the efficacy of predicting artery disease among non-artery disease patients by measuring vessel "stiffness".

Also........ Two things cause insulin release, blood sugar and blood endorphin. Ag proteins, especially cereal grain proteins, mimic blood endorphin. They do this using immune mechanisms, so grain reactions can dwarf bad effects from sugar. You can cut back on ingested sugar, but if you fail to cut out cereal grains, you still have a massive problem.

http://jcem.endojournals.org/cgi/conten ... t/49/4/649

An unscrupulous researcher could artificially produce autoimmune results by switching "carbs" to cereal grain. I'm not claiming these researchers stacked the deck, just that they might have. We've certainly seen massive examples of scientific fraud lately.
..

 

[IanD]

I think we could get a research paper published from diabetes.co.uk forum members which would provide long term evidence on the effects of reduced carb.

A questionaire would be something like:

• Diabetes type
  year diagnosed
  HbA1c/weight year by year
  Other measurements year by year
  Year reduced carb diet commenced
  Complications & year they began
  effect of reduced carb on complications
  etc

This would collate the experience of contributors.

 

[hanadr]

Good idea Ian!
Veggie
I have seen a paper by an endocrinologist which purports to demonstrate the benefits of a high carb diet in diabetes.
It does nothing of the sort, since it takes Fibre and digestible carbs as one unit!!!!!! and the HbA1cs recorded are around 10.
You don't have to be unscrupulous, just unknowing or careless.
Hana
Ps
I'm all in favour of a high fibre diet.

 

[sugarless sue]

I think we could get a research paper published from diabetes.co.uk forum members which would provide long term evidence on the effects of reduced carb.

A questionaire would be something like:

• Diabetes type
  year diagnosed
  HbA1c/weight year by year
  Other measurements year by year
  Year reduced carb diet commenced
  Complications & year they began
  effect of reduced carb on complications
  etc

This would collate the experience of contributors.

To be perfectly honest Ian, I do not see that this could be possible. There would be no control over what was written and the paper would have to rely on the total honesty of those replying. It would be very easy to 'massage' the results to show any positive conclusion that was wanted.

 

[IanD]

I had a long chat with a young lady in the scienceinfo dept at DUK this morning.

Particularly about the T2 Healthy Eating booklet & brain function. She has no research information on the efficacy of a low carb diet on diabetes, so they have to provide the agreed line on diet. She insisted that the brain can only get its glucose from carbs, but had to concede that it gets it through the blood, & that the liver dump can provide.

She said there is a debate about low carb, but NOT within DUK. Only people phoning in & advocating reduced carb! Such info is not "scientific" & peoples' experience is scientifically useless.

I suggested DUK survey Balance readers (along the lines above) but they couldn't finance it & again it wouldn't be "scientifically valid."

She has promised to send me the scientific data, & I promised to review it ....

She also promised to follow up the source of the daily allowance of the equivalent of 42 tbs rice. I did suggest that that recommendation was a result of brain damage from a high carb diet....