American Diabetes Association On Low Carb Diets

[NicoleC1971]

Just picked this up on Diabetes Daily (a low carb site) on what the ADA thinks of vlcd for type 2 and type 1 kids
https://www.diabetesdaily.com/blog/very-low-carbohydrate-diets-for-diabetes-ada-2018-580309/

 

[Guzzler]

Low Carb Low Sat Fat. It bears no resemblance to the diet I am on so if they speak of LDLc then this should be made absolutely clear at the outset. Neither of these diets would appeal to me but I know that a zero sat fat plus low carb approach would appeal to those with metabolic syndrome and who are vegetarian or vegan.
It begs the questions of why keep holding onto the sat fat/heart health dogma and why the surprise (if there was any) at the drop out rate. What is it that I am missing? The article mentions LCHF but then compares one diet polar opposite to a diet that is similar to LCHF but with a striking difference. Maybe I need another hour's sleep.

 

[kokhongw]

ADA has been resistant and dismissive of the low carb approach for decades...unlikely that their stakeholders will be in a hurry to change their stance. The FUD against low carb will continue...

 

[NicoleC1971]

But at least this is an RCT and findings like this can legitimise this approach so that clinicians don't feel wary of prescribing it or other low carb varieties of diet for fear of being sued for not practising evidence based medicine.
ADA is very conservative but even they can't hold out forever!

 

[Guzzler]

But at least this is an RCT and findings like this can legitimise this approach so that clinicians don't feel wary of prescribing it or other low carb varieties of diet for fear of being sued for not practising evidence based medicine.
ADA is very conservative but even they can't hold out forever!

Having thought about it it strikes me thus:

We did tests on red haired people and blonde haired people and here are the results for the auburn haired people.

 

[Tannith]

Low Carb Low Sat Fat. It bears no resemblance to the diet I am on so if they speak of LDLc then this should be made absolutely clear at the outset. Neither of these diets would appeal to me but I know that a zero sat fat plus low carb approach would appeal to those with metabolic syndrome and who are vegetarian or vegan.
It begs the questions of why keep holding onto the sat fat/heart health dogma and why the surprise (if there was any) at the drop out rate. What is it that I am missing? The article mentions LCHF but then compares one diet polar opposite to a diet that is similar to LCHF but with a striking difference. Maybe I need another hour's sleep.

Why does low carb high fat have to be high sat fat? Why can't it be high monounsaturated fat like the mediterranean diet?

 

[bulkbiker]

Why does low carb high fat have to be high sat fat? Why can't it be high monounsaturated fat like the mediterranean diet?

Why not? The fear of sat fat is now seen to be unfounded so why not enjoy those things that have been viewed as "bad" for many years. No one is forcing you to eat it.
I think @Guzzler was saying it was not their way of eating not that their's was the only way.

 

[kokhongw]

Why does low carb high fat have to be high sat fat? Why can't it be high monounsaturated fat like the mediterranean diet?

Of course it can be...but would that not end up to be a highly restrictive diet with missing nutrients? One of mainstream dietitians/nutritionists pet argument...that makes an excellent diet...unsubstainable AND unhealthy for the long term...

But by embracing and including saturated fats...our food horizon is greatly expanded...

 

[Guzzler]

Why does low carb high fat have to be high sat fat? Why can't it be high monounsaturated fat like the mediterranean diet?

It can!

 

[Tannith]

http://care.diabetesjournals.org/content/36/11/3821.full They appear to be keeping to the 2013 guidelines in their new 2016 guidelines
http://care.diabetesjournals.org/content/36/11/3821.full

 

[bulkbiker]

http://care.diabetesjournals.org/content/36/11/3821.full They appear to be keeping to the 2013 guidelines in their new 2016 guidelines
http://care.diabetesjournals.org/content/36/11/3821.full

No surprises there then..

 

[kokhongw]

http://care.diabetesjournals.org/content/36/11/3821.full They appear to be keeping to the 2013 guidelines in their new 2016 guidelines
http://care.diabetesjournals.org/content/36/11/3821.full

It actually all boils down to the argument that saturated fats purpotedly increases CVD risks. Yet after decades of studies and hundreds of millions of lives at stake...

Saturated fat, dietary cholesterol, and trans fat

• The amount of dietary saturated fat, cholesterol, and trans fat recommended for people with diabetes is the same as that recommended for the general population. (C)

Few research studies have explored the relationship between the amount of SFA in the diet and glycemic control and CVD risk in people with diabetes. A systematic review by Wheeler et al. found just one small 3-week study that compared a low-SFA diet (8% of total kcal) versus a high-SFA diet (17% of total kcal) and found no significant difference in glycemic control and most CVD risk measures (88,186).

Anyway the guideline ends up more like a legal document to cover stakeholders from being sued...

We know for certain that saturated fats does not spike glucose. Even vegans like Dr Greger and friends now admits that it undoubtedly flatline glucose. We see this all the time.

So the contentious part for saturated fats is how much does it actually raise our CVD risks? Or does it really raises our CVD risks? That is why those who finally went ketogenic would actually have gone thru a whole lot of research to overcome this mental fence that has been set to cage us over the decades.

Eventually I decided to pick the diet that gives me a flatline glucose and by extension lowered insulin load, even if it comes along with purported CVD risks...

 

[kokhongw]

And before I forget...if we worry about saturated fats...we can simply choose to fast....

But then again ADA has another set of purported risks of fasting and no RCT to warrant recommending fasting as a solution for T2D ... dada dada dada...

My conclusion just about 3 year ago was that overcoming our misguided fear of fats and fasting remains....the key to achieving and maintaining T2D remission...

 

[lindisfel]

It depends how low carb they are! Apparently for saturated fat to be ok it is no good eating carbs much at all or so one of the low carb gurus Phinney points out. It does cause atherosclerosis when taking with carbs.
Olive oil a monounsaturate, is fine.
D.

 

[Tannith]

Why not? The fear of sat fat is now seen to be unfounded so why not enjoy those things that have been viewed as "bad" for many years. No one is forcing you to eat it.
I think @Guzzler was saying it was not their way of eating not that their's was the only way.

What if that's a con? I'm a cynic. I can't see how much good and bad LDL I have in my arteries. So I reckon its best to keep my LDL as low as possible so I shall have as little of the bad sort as possible.

 

[Guzzler]

What if that's a con? I'm a cynic. I can't see how much good and bad LDL I have in my arteries. So I reckon its best to keep my LDL as low as possible so I shall have as little of the bad sort as possible.

You mean like the con Ancel Keys pulled with his cherry picked results that led people to fear sat fat in the first place?

 

[Tannith]

It depends how low carb they are! Apparently for saturated fat to be ok it is no good eating carbs much at all or so one of the low carb gurus Phinney points out. It does cause atherosclerosis when taking with carbs.
Olive oil a monounsaturate, is fine.
D.

"
Evidence from large prospective cohort studies, clinical trials, and a systematic review of RCTs indicate that high-MUFA diets are associated with improved glycemic control and improved CVD risk or risk factors (70,169–171). The intake of MUFA-rich foods as a component of the Mediterranean-style eating pattern has been studied extensively over the last decade. Six published RCTs that included individuals with type 2 diabetes reported improved glycemic control and/or blood lipids when MUFA was substituted for carbohydrate and/or saturated fats (70,72,83,100,108,172). However, some of the studies also included caloric restriction, which may have contributed to improvements in glycemic control or blood lipids (100,108).

In 2011, the Evidence Analysis Library (EAL) of the Academy of Nutrition and Dietetics found strong evidence that dietary MUFAs are associated with improvements in blood lipids based on 13 studies including participants with and without diabetes. According to the EAL, 5% energy replacement of saturated fatty acid (SFA) with MUFA improves insulin responsiveness in insulin-resistant and type 2 diabetic subjects (173)."http://care.diabetesjournals.org/content/36/11/3821.full

 

[bulkbiker]

What if that's a con? I'm a cynic. I can't see how much good and bad LDL I have in my arteries. So I reckon its best to keep my LDL as low as possible so I shall have as little of the bad sort as possible.

What if what is a con - that sat fat isn't bad for us?
Why would a food that mankind has eaten for thousands of years suddenly become bad for us since 1972?
As for LDL I think lots of "good" is probably better than a bit of "bad" assuming that there is any "bad" as its all conjecture anyway.
If you want to keep it low then good for you... I just hope you don't use drugs to do it. All drugs have side effects whether you notice them or not.

 

[bulkbiker]

Why does low carb high fat have to be high sat fat? Why can't it be high monounsaturated fat like the mediterranean diet?

You may or may not have seen the conclusions of the Swiss Re conference hosted by the BMJ and Swiss Re
Prof Taylor was there along with Prof Lean

'Together with Mozaffarian during the final remarks, they also agreed that there was insufficient evidence to continue with caps on saturated fats. (BMJ Editor) Godlee called this an "emerging consensus" and added that it was "quite a big thing to have gotten wrong"'

 

[Tannith]

The DASH diet recommends no more than 6% of calories from sat fat. The pritikin diet red meat no more than once a month and zero dairy, American heart association and British Heart Foundation and other reputable diets 10% cals from sat fats. They can't ALL be wrong.