Why is type 2 more common in Mediterranean countries?

A disease of affluence indeed. That is what "they" really mean when they blame it on obesity. I was jst thinking about that the other day when I visited a very new branch of a well nown dept store which boasted the largest food hall I have ever seen.

To my surprise it was almost impossble to find any food on sale which was no covered in breadcrumbs or bater or wrapped in pastry. If this is the case in a "quality " foood sore - and his was also reflected in the menu in the restaurant- hen what hope is there for the others?

How are people even to know hat this is a bad idea? Ah well , if it proves impossible to change eating abits the next step will have to be to encourage them to die early so they don't have ime to develop this and other conditons......

Unfortunately diabetes can quickly become a disease of poverty too once "Big Food" companies expand their markets into developing countries. It's now happening in Mexico, South America, China, India. Once Coke and frankenfoods are sold at ridiculously low prices to very poor people, the mothers get hugely overweight while the children have stunted growth, with all suffering from serious malnutrition - and with teenagers getting given gastric bypass surgery to cure them (happening in Mexio as we speak).

It's hard not to become discouraged by the society we live in.

Many thanks, Stephen for your erudite reply. So I assume that those who advocate that all starchy carbs are incompatible with the human digestive system are perhaps mistaken? Leaving aside that issue, this thread appears to be indicating that while the Med diet is not so good for diabetes, it is not necessarily bad for other health issues such as cardiac health,for which it is recommended.

Regards

Doug

It was low birth weight children in India that were at risk of diabetes when they were older.

borofergie said:

Osidge said:

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots (cassava, yams) and cereals - i.e. carbohydrates. Given the comments made about carbohydrates and, occasionally, on our bodies inability to deal with them, as we were not made to eat them, I wonder why those from Benin don't have a huge problem with diabetes? The world is a mystery.

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75% of the population of Benin lives in poverty (defined as living on less than $2 per day).
47% of the population of Benin live in extreme poverty (defined as living on less than $1.25)
The average life expectancy is 59.
Before 1980, less than 30% of the population had access to primary healthcare.
Benin is the 19th poorest country in the world (judged by % of people on <$2 a day)
(Mali, which has the second lowest incidence, is the 13th poorest country in the world).

1. Since most of the population is living in poverty, you wouldn't expect that the overconsumption of anything (including carbohydrates) is an issue.
2. Starchy roots such as cassave and yams are part of our ancestral diet, and are generally much less harmful than refined carbohydrates such as cereal grains and sugar. Among the Paleo community these are generally referred to as "safe starches".
3. Many people don't live long enough for diabetes to be a problem.
4. Given the level of poverty and healthcare, it is unlikely that the diabetes estimates are very accurate.

Diabetes is a disease of affluence. It rarely manifests itself among the poor and hungry.

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Plus, if you are dirt poor, you can't afford to go to the doctor to get diagnosed. There could be many undiagnosed DBs (as there apparently are in the UK)

Osidge said:

Many thanks, Stephen for your erudite reply. So I assume that those who advocate that all starchy carbs are incompatible with the human digestive system are perhaps mistaken? Leaving aside that issue, this thread appears to be indicating that while the Med diet is not so good for diabetes, it is not necessarily bad for other health issues such as cardiac health,for which it is recommended.

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Doug,

I don't think that anyone has seriously suggested that the human digestion system is incompatible with all starchy carbs. In fact it's easy to demonstrate that this is not the case, since most non-metabolically deranged people can eat potatoes without a problem.

I think that it's generally acknowleged that refined carbohydrates (from grains and sugar) are the main cause of metabolic syndrome. I think there is lots of evidence that root vegetables and tubers are a significant source of carbohydrate in indiginous populations (such as the Kitavans), and are part of our ancestral diet (although some populations thrive without any, such as the inuit). Without eating grains or sugar it is very difficult to get over half of your calories from carbohydrates: on a 3000kcal diet you'd have to eat about 1.75kg, which is about 20 medium sized sweet potatoes. It's difficult to see how that could be a practical or sustainable diet for a pre-agricultural population.

• If there is a consensus in the Paleo community, it's that about 150g of carbohydrate is about as much as a non-athlete's liver can handle per day, without dumping the excess out as fat (or much worse).
• I can't prove it, but I'm fairly sure that even if we did get 50% calories from root veg and tubers, but never ate grains or sugar, then the incidence of diabetes would be very low.
• For most non-metabolically deranged people I don't think there are many good arguments for eat much less than 150g a day of carbohydrate.
• Most T2 diabetics are unable to handle significant quantities of tubers and root veg, without suffering hyperglycemia (without the aid of medication more powerful than metformin).
• From an evolutionary perspective, I think that the range 50 to 150g is the most sensible, even for most T2 diabetics.

So in conclusion, if you are not metabolically deranged, then "safe starches" are probably good for you in reasonable quantities. If you are a (NID) T2 diabetic, then it's probably a bad idea to base your diet around too many starchy carbs.

If I can improve my insulin sensitivity, I want to introduce more sweet potatoes into my diet, mainly because I can't think of anything more delicious.

Osidge said:

Many thanks, Stephen for your erudite reply. So I assume that those who advocate that all starchy carbs are incompatible with the human digestive system are perhaps mistaken?

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As you know all of us who try to do an essentially diet led approach encourage each other to use what ever method works best for them regardless of our individual choices. .

Osidge said:

while the Med diet is not so good for diabetes

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Actually Doug the classic Med diet is a pretty good choice for a T2 as its carbohydrate restricted. Its why, for example, low carb high fat Sweden's government recommends it as one of a number of suitable choices for T2's SPECIFICALLY because they believe it is preferable to the standard 50% carb regime we get advocated. Try downloading and reading Kost Vid Diabetes. I can think of one active T2 poster on this forum who reported excellent results with a correctly formulated Med diet as he said it was actually very good GI/GL wise.


It is far more likely that its the corruption of the Med countries classic diet by the introduction of high sugar, high carb, high processed foods in recent decades that has caused of problems being reported in my opinion Doug. A similar issue is being reported in Norway. In that regard the Med countries problems with the incidence of T2 are no different to those that have or are occurring in a lot countries regardless of their wealth.

Osidge said:

So I assume that those who advocate that all starchy carbs are incompatible with the human digestive system are perhaps mistaken?

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Isn't that an ad hominem comment :angel: ? I don't think anyone, even the loony low-carbers like Borofergie and er, me, have ever said all starchy carbs are incompatible with the human digestive system. There are quality and quantity issues that come into play of course, but it's a different thing to say they should be carefully controlled and reduced.

Dillinger

Fraddycat said:

borofergie said:

Osidge said:

It is interesting to see the low incidence of diabetes in Benin where the diet is based on starchy roots (cassava, yams) and cereals - i.e. carbohydrates. Given the comments made about carbohydrates and, occasionally, on our bodies inability to deal with them, as we were not made to eat them, I wonder why those from Benin don't have a huge problem with diabetes? The world is a mystery.

Click to expand...

75% of the population of Benin lives in poverty (defined as living on less than $2 per day).
47% of the population of Benin live in extreme poverty (defined as living on less than $1.25)
The average life expectancy is 59.
Before 1980, less than 30% of the population had access to primary healthcare.
Benin is the 19th poorest country in the world (judged by % of people on <$2 a day)
(Mali, which has the second lowest incidence, is the 13th poorest country in the world).

1. Since most of the population is living in poverty, you wouldn't expect that the overconsumption of anything (including carbohydrates) is an issue.
2. Starchy roots such as cassave and yams are part of our ancestral diet, and are generally much less harmful than refined carbohydrates such as cereal grains and sugar. Among the Paleo community these are generally referred to as "safe starches".
3. Many people don't live long enough for diabetes to be a problem.
4. Given the level of poverty and healthcare, it is unlikely that the diabetes estimates are very accurate.

Diabetes is a disease of affluence. It rarely manifests itself among the poor and hungry.

Click to expand...

Plus, if you are dirt poor, you can't afford to go to the doctor to get diagnosed. There could be many undiagnosed DBs (as there apparently are in the UK)

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I don't think diabetes is a disease of affluence at all. It's a disease of what's 'sold' to us as 'good food and healthy eating'.

But eating carbs with meals is what poor people have always been encouraged to eat to eke out the protein, which was usually the most expensive item on the plate.

I can remember my Mum trying to make a cooked chicken last 3 days for a family of 4 back in the late 50's. We'd have roast chicken dinner on Sunday, chicken pie on Monday, chicken soup on Tuesday etc. Carbs like bread and potatoes and carrot and swede were the cheaper foods and they bulked out the plate. My Dad was disabled not long after I was born so Mum was the breadwinner and women's wages then were well below what a male would earn so money was tight. We didn't starve, we ate well compared to some of my friends who came from bigger families, who I often saw eating 'jam or sugar butties' one after the other when they were hungry. A butty is a sandwich in Liverpool. We'd be playing in the street and my friends would run in for a sugar butty to keep them going until bedtime. Bread and jam and sugar was, for those families, a way of staving off the hunger. It was also quick and easy to prepare, didn't cost anything in gas or electric and filled the kids up quickly. I remember asking my Mum for a sugar butty and she tutted and said I wouldn't like it even if she gave it to me. I was encouraged to eat bread but not to fill myself up on it. But I thought I was deprived because my friends had neverending access to sugar butties! I once had a taste of my friends sugar butty and yuuuuuuuuuuk my Mum was right. It was horrible doughy sliced white bread laced with Echo margarine with a liberal layer of white sugar on it. God it was awful.

Today I don't think we have the sugar butties but we do have more candy bars and biscuits available to fill up on. We have Pound Shops full of the stuff all going cheap and we still use carbs to bulk out our plates so that we have less room for protein - we've been encouraged to eat the 'healthy baked potato' topped with a bit of cheese or tuna, or the 'healthy pasta meal' that you can't find the cheese in. I'd rather have 1.5 portions of the usual protein and a good sauce, than the portion of potatoes. And the thing is - it's cheaper because I'm satisfied, what I don't spend on bread and cakes is spent on more protein and fats and I don't need the snacks between meals.

GraceK said:

I don't think diabetes is a disease of affluence at all. It's a disease of what's 'sold' to us as 'good food and healthy eating'.

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I didn't mean "affluence" in a Western sense, I meant that, if you live in a poor country, on the edge of malnutrition, then you are less likely to suffer from something like diabetes.

I wanted to say, diabetes is "a disease of civilisation", but I didn't want to imply that Africans are somehow "not civilised" (in fact the reverse is true, I'm sure elements of their culture are far superior to the mess that we have made in the West.

Dillinger said:

Isn't that an ad hominem comment :angel: ?

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Doh, being a dumb T2 whose brain is addled through lack of carbs I don't know what that means.

It would appear to mean that I am not allowed to be critical of someone elses posts anymore.

At the expense of being accused of stating the bleedin' obvious

Modern wheat is not wheat, and is not the same as out predecessors ate. No evolutionary changes here in humans, but changes in the food itself!!!

http://preventdisease.com/news/12/011612_Modern-Wheat-Really-Isnt-Wheat-At-All.shtml
as a starting point, then google.

Before we discuss carbs, we need to think about and address the constituents of the main carb eaten all over the world - modified "wheat" and the damage it is causing.

Just like we address the modified hydrogenated fats we eat, and the damage that causes.

xyzzy said:

Dillinger said:

Isn't that an ad hominem comment :angel: ?

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Doh, being a dumb T2 whose brain is addled through lack of carbs I don't know what that means.

It would appear to mean that I am not allowed to be critical of someone elses posts anymore.

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Quick grab a biscuit! It means literally 'attacking the man' not the argument, but also would apply to attacking other points/positions which are also not the argument in question; another brand of that stategy is the straw man argument where you construct a point of view that the other side done't actually hold and attack that. My favourite 'fake argument' attack though, and one which pretty much always signals that the person using it is wrong, is the 'slippery slope' argument; if we give an inch they'll take a mile type thing, or if you reduce carbohydrates you'll only eat cheese and so on.

Indy51 said:

Unfortunately diabetes can quickly become a disease of poverty too once "Big Food" companies expand their markets into developing countries. It's now happening in Mexico, South America, China, India. Once Coke and frankenfoods are sold at ridiculously low prices to very poor people, the mothers get hugely overweight while the children have stunted growth, with all suffering from serious malnutrition - and with teenagers getting given gastric bypass surgery to cure them (happening in Mexio as we speak).

It's hard not to become discouraged by the society we live in.

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Brilliant post. I watched a youtube documentary recently about all of this, and Mexico which used to have a very healthy diet, is now to all intents and purposes another America. Between starchy carbs, GM foods and McDonalds, there is just no hope for the country.

Cuba which lost vast supplies of oil when the USSR collapsed, found it's people hungry, so rather than just sit back, cooperatives of small farms began to spring up, even in Havana. The people by sheer hard work and dedication are almost self sufficient in a lot of foods, but because it is mainly locally grown produce, are back to a healthy diet.

In the Punjab in India, the bread (or perhaps rice) bowl of India, is also teetering on the edge. The soil has been depleted of nutrients and the water table is shrinking on average by 20 feet per year. Prosperous farmers are now having to look at how they will continue to feed India, as it's forecast that the soil and water crisis peak in around 10 years.

Countries like Kenya are having vast tracts of land hired by countries like Qatar so it can grow crops to feed its own people, while millions of Kenyans starve. Masai tribes are losing tribal land to these agreements, and they are unable to graze their cattle, so their own people will starve.

The Senegal people are having their seas plundered by European fishing vessels, taking millions of tons of fish, that belong to the local fishermen. Agreement that were once in place to protect fish stocks for locals have broken down and fish factory boats just ride roughshod over the locals.

The Mediterranean countries, along with many other countries including the UK may well find that we have to change the way we eat. Going back to seasonal produce, locally produced food and less of the processed ****. While many will wail and moan, it could end up making may countries a hell of a lot healthier.

There are big differences between areas within the Med countries that have high rates of diabetes.
This is from a paper Diabetes in Northern Med countries.

significantly higher prevalence rates in urban rather than rural environments within the same country. Comparisons of migrant populations living in rural and urban settings in the same country also show an excess of diabetes in urban communities.

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One of the highest levels is in Portugal which also has one of the lowest minimum salaries in Europe (and sadly things may get worse for people with D . when I was trying to find more info on the country I found a recent forum post elsewhere said that the government was no longer to fund strips or needles for any people with D)

Dillinger said:

My favourite 'fake argument' attack though, and one which pretty much always signals that the person using it is wrong, is the 'slippery slope' argument; if we give an inch they'll take a mile type thing, or if you reduce carbohydrates you'll only eat cheese and so on.

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<borofergie stands in the corner looking shifty, and pretends not to eat a diet consisting only of meat>

If we're playing that game then mine is ...

Dillinger said:

where you construct a point of view that the other side done't actually hold and attack that.

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sounds familiar ... in the context that everyone one who does LC is a fanatic and wants everyone else to be a fanatic too when nothing could be further from the truth.

xyzzy said:

sounds familiar ... in the context that everyone one who does LC is a fanatic and wants everyone else to only be a fanatic too when nothing could be further from the truth.

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<borofergie skulks further into the corner, and begins to look even shiftier>

borofergie said:

xyzzy said:

sounds familiar ... in the context that everyone one who does LC is a fanatic and wants everyone else to only be a fanatic too when nothing could be further from the truth.

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<borofergie skulks further into the corner, and begins to look even shiftier>

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<Def decides it may be better and safer to hide behind Stephen.>

Just one point. I wouldn't call myself a fanatic, I KNOW LC works, and I recommend it here to people asking for advice. However I also say people have to chose for themselves. I love Primal eating, Stephen does Paleo, Paleo is just a tad to hardcore for me, but he accepts my choice, I accept his, I also accept anyone else has a mind of their own. Sometimes I read posts and shrug my shoulders but that is about as far as my 'fanaticism goes.

I've never thought of anyone here as being 'fanatical' about their diet - we've all found different ways to eat to suit our diabetes and some of us, including me, are absolutely gobsmacked at the difference our particular diet has made to our overall health and so we can't help but enthuse about it. That doesn't mean we're advising others that it's the ONLY WAY to eat, it's just ONE OF THE GOOD WAYS to eat. I would have thought readers would have the sense to realise that was the case.