Re Diabetes UK

[sugarless sue]

So is the incidence of chronic heart disease in the Inuit pre westernisation or post ?After all their diet has changed significantly with so called civilisation!

 

[Dr H]

It was taken during the 20s when people decided to experiment with low-carb dieting. So if you assume that it takes years to build up to CHD then you're looking at a lifetime of their pre-westerization diet. With westernization, the rates of CHD have apparently dropped (I haven't found any specific figures or any particularly reliable resources). It may be due to the increase in westernization they have access to better healthcare and education.

 

[red]

"Also, even if you do keep your bg levels down low, you can still get complications. That's what annoys me about the NHS and Diabetes UK."

j.......... C........ what is the point of trying then?

 

[graham64]

In several native populations, a shift away from traditional lifestyles and diets is associated with an increased prevalence of risk factors for CVD,

http://www.ajcn.org/cgi/content/full/ajcn;74/4/464

Graham

 

[marphil]

Yes, I do realise that good blood sugars do help us to keep well but when things go wrong like getting used to an insulin and having side effects (which I did i.e. humalog etc.,levemir didn;t suit me for quite a while and I thought I was to blame. Also it is not so easy to keep good balance if suffering from another condition. I have now been changed back to porcine and am so much better and have better blood sugar results. I still say that Diabetes.co.uk is much better.

 

[timo2]

In time the brain reduces its glucose requirements from 120g to 40g per day.

Now, I'm no expert and don't claim to be. But a brain that should be running on 120g, only running on 40g, that doesn't seem to me to be a good thing long term.

The 40g minimum (adequately generated without the need for dietary carbohydrate) is only for those regions of the brain which cannot utilize ketone bodies for fuel.

Therefore, the brain doesn't actually need 120g glucose at all, but that's the amount it will use if available.

 

[Dillinger]

However, the eskimos live on high fat diets and it's their diets that most modern low-carb diets are modelled on. They have far higher rates of chronic heart disease than normal, but that could be genetic or have other environmental factors.

From Graham's posted link:

"The traditional Inuit diet, which is rich in n-3 fatty acids, is probably responsible for the low mortality rate from ischemic heart disease in this population."

Thar she blows... as us whalers say

This point is also brought up a lot in the Gary Taubes book that 'traditional' non western diets display a marked absence of CVD and other 'western' associated disease, it is only when these populations 'modernise' their diets that the problems start to roll in.

I don't think that the inuit diet is the model for Atkins etc., though; it is just used as an example that it was possible as previously there had been a paucity of studies looking at those diets.

Good point by the way Sue - I hadn't taken into account protein; so in fact we have a low to moderate level of dietary carbohyrdate, protein, plus glucoyneogenesis to provide essential glucose; that 40g a day sounds very manageable.

Dillinger

 

[Aadrgon]

In response to Graham's post. Two people doesn't make for conclusive evidence. However, a whole population living on low-carb diets having higher rate of chronic heart disease carries some weight. Whether or not it is down to the diet or other factors.

http://www.second-opinions.co.uk/cholesterol_myth_2.html

Suggests there is no relationship between a high fat diet and CHD

 

[Celtic.Piskie]

I'm sceptical of a lot of these claims of the inuits etc having wonderful health before they 'modernised' their diets.
How would we know?
As far as i know, and i could be mistaken, there are no figure correlating earlier inuit deaths from heart disease, cancer etc.
So how are we to know that they haven't always had this level of heart disease etc.
Type 2 diabetes is a problem as well, seeing as an awful lot more people are diagnosed with it, and it might neverhave been a problem in their society, so no need to diagnose it.
I just thik a lot of these figures could be down to awareness, and not diet.

 

[Dillinger]

As far as i know, and i could be mistaken, there are no figure correlating earlier inuit deaths from heart disease, cancer etc.

Hello,

I'm afraid you are mistaken - here is a good overview of this very point from The American Journal of Clinical Nutrition http://www.ajcn.org/cgi/content/full/81/2/341, which is well worth reading.

To quote just one element from the conclusion - "in the United States and most Western countries, diet-related chronic diseases represent the single largest cause of morbidity and mortality. These diseases are epidemic in contemporary Westernized populations and typically afflict 50–65% of the adult population, yet they are rare or nonexistent in hunter-gatherers and other less Westernized people."

There are arguments as to what causes the increase in these chronic diseases and over the last 50 years or so saturated fats have been held up as the culprits (the above study acknowledges that there may be a number of causes) however read this very good essay by Gary Taubes that started him on the path he has taken in laying the blame for diet-related chronic disease at carbohydrate's door. An excellent essay.

http://www.nytimes.com/2002/07/07/magaz ... gewanted=1

All the best

Dillinger

 

[Aadrgon]

Thanks Dillinger - two very interesting articles

 

[hanadr]

Dr H
since BG for a non-diabetic is about 4.7, anything above that is high. I don't mean above DUK guidelines, I mean above normal. Not many diabetics, even with insulin use can keep to a Bg around 5 and eat high carb foods.
I certainly can't and I'm usually VERY careful ( not an insulin user though)
Running Bgs consistently in the 6s and 7s as the medics advise isn't controlling diabetes. It's just reducing the BG level to that which someone deamed doable.

 

[LizzieP]

Interesting thread. Bit confused on the below, though:

since BG for a non-diabetic is about 4.7, anything above that is high. I don't mean above DUK guidelines, I mean above normal. Not many diabetics, even with insulin use can keep to a Bg around 5 and eat high carb foods.
I certainly can't and I'm usually VERY careful ( not an insulin user though)
Running Bgs consistently in the 6s and 7s as the medics advise isn't controlling diabetes. It's just reducing the BG level to that which someone deamed doable.

Might be worth clarifying if the BGs referred to here are HbA1C or every day readings from a meter. If your average day to day readings come out at say 6.2mmol/l, then your HbA1C would be 5.3. If your average BG readings day to day are 7mmol/l then your HBA1C would be 5.7. At least, that is my understanding.

 

[kegstore]

...presumably the only good reason for the new HbA1c scale, that it's way off what we're used to reading? But I'm not sure how users of the mg/dl scale for daily measurement feel...

I would think a day-to-day reading of less than 7 mmol/l for any diabetic an excellent figure, not sure what other hoops we're supposed to jump through in the attainment of "good control"?

 

[phoenix]

There are arguments as to what causes the increase in these chronic diseases and over the last 50 years or so saturated fats have been held up as the culprits (the above study acknowledges that there may be a number of causes)

I find this an interesting topic (but we seem to have diverted slighly from yesterdays topic in the same thread, of glucose and the brain and also another strand about blood glucose levels at the same time.... very confusing!)

There are many reasons given why the typical US model cited in the paper is extremely unhealthy. I couldn't find any evidence (only implication) to show that more primitive societies were free from chronic disease
Even if we accept the theory that there was less chronic disease the paper gives no support to a diet high in saturated fat suggesting that the fat of hunted animals was lower in saturated fats athan meat today with MUFAS and PUFAS constituting the largest precentage of game meat

Diets of primitive peoples varied and whilst there are some societies that through necessity (and extreme climate) ate diets extremely high in fat, there others for which carbohydrate was a staple.
This is an editorial written at the time of Cordains 2000 paper.
Hunter Gather diets, a different perspective http://www.ajcn.org/cgi/content/ful...b9f7700327ed310ed2c31e28&keytype2=tf_ipsecsha
The Author, discusses a variety of diets including the much cited Inuit but also the !kung with 33% animal sources and 67% plant foods, the Hazda of Tanzania with who consume 'the bulk of their diet as wild plants, the Aka who rely on wild tubers, Australian aborigines eating wild fruits and millet and groups in Papua New Guinea with sago as a staple.She also notes some possible problems with Cordains data . For example, the possibility that the contribution of the female 'gatherer' has been undervalued.
She also notes that Humans have evolved from higher primates which whilst not avoiding meat were strongly herbiverous

" humans come from an ancestral lineage in which plant foods traditionally have served as the primary source of energy (14, 15). All else being equal, digestible carbohydrates are the most expedient way for humans to obtain glucose, the preferred fuel for the anthropoid brain and one source of glycogen. Humans are quick to appreciate the value of reliable energy-providing staples and will work hard to ensure a steady supply of them"


In a short letter, http://www.ajcn.org/cgi/content/full/73/2/353
Alexander Walker agrees with Cordain that that there is less chronic disease in the remaining hunter gatherer populations but goes on to say:

this relative freedom from degenerative diseases is equally characteristic of all of the numerous rural pastoral societies in Africa, which, until very recently, have been accustomed almost wholly to diets with a relatively low contribution to energy by fat of 15–20%

Walker goes on to suggest two features that may have a strong bearing on this 'very high levels of everyday physical activity and low levels of smoking, especially among women.'

Finally he suggests that rather than looking for answers in primitive societies it would be better to study the lifestyle of certain modern Western populations noting that the CHD mortality rate in Spain is 1/5 that of Poland and in New Mexico, half that of New York.

 

[Marky74]

Dr H
since BG for a non-diabetic is about 4.7, anything above that is high. I don't mean above DUK guidelines, I mean above normal. Not many diabetics, even with insulin use can keep to a Bg around 5 and eat high carb foods.
I certainly can't and I'm usually VERY careful ( not an insulin user though)
Running Bgs consistently in the 6s and 7s as the medics advise isn't controlling diabetes. It's just reducing the BG level to that which someone deamed doable.

Under 7 sounds like control to me.. mine is currntly about 5.5 to 6... It was around 4.5 but I wanted to raise it so I was at less a risk of a Hypo..

 

[inwales]

As a type 2 diagnosed with BG of 17 several weeks ago, I am getting in the 5s now, I never thought I would get control so quickly.

So it is do-able!

 

[copepod]

Re: Innuit death rates
A very small study of nearly 200 20th century headstones in graveyards in Nanortalik, South Greenland was carried out by members of the Lichenometry Fire (group) of BSES South Greenland 1992 expedition.
This found average life expectancy of 48 years for males and 62 years for females, although this was skewed by infant mortality twice as high in females as males. Many deaths, particularly males, were caused by fishing / boating accidents, indicated by deaths occuring on the same day, and higher numbers of deaths in light months than dark months (Dec & Jan). So, from this small study, it is difficult to infer that innuit diet protected against disease.
Report published as "Demongraphic information from graveyards in Nanotalik, south Greenland", by Basil Davis, pages 152 - 154, in British Schools Exploring Society report 1992 - 1993, ISBN 0521-1573.

 

[lionrampant]

I'm not sure how this went from the efficacy (or lack thereof) of Diabetes UK to Eskimo mortality, but... er...

Anyway, the problem with DUK is that they seem to be obsessed with a) type 2, and b) avoiding any discussion of leading edge developments like the plague. Have they ever even mentioned c-peptide or campaigned on it? What about real-time blood monitoring? Bio-engineered treatments?

Don't get me wrong, I remember when they were the BDA - and had some clout. The people were dedicated and really fought to make sure diabetics weren't discriminated against and tried to improve front-line and secondary care standards. Right now, that process seems to be stagnating (and not just due to any deficiency in DUK's behaviour). :?

 

[graham64]

This is from 1958 by Richard MacKarness, it makes a very interesting read.

In other words, Eskimos stay slim on a high-fat diet, but as soon as they start eating starch and sugar they get fat.The European brings obesity to the Eskimo in addition to his other "gifts" of
civilisation

http://www.ourcivilisation.com/fat/chap3.htm