This paper, published 2 years ago (I’m still catching up), is a peer-reviewed listicle which presents 12 points of evidence challenging the conventional treatment approach of high-carbohydrate, low-fat diets for people with diabetes.
12 Points of Evidence
And…it’s all here. The 12 points are laid out logically so I don’t need to repeat them. Some of the key questions that people have are answered here:
- What’s the definition of a low carbohydrate diet?
- Is the diabetes-reversing effect of this diet based on weight loss alone? (no)
- Why does an increase in fat intake actually decrease circulating triglycerides (you aren’t what you eat, you are what your body does with what you eat) and improve lipid profiles?
- Is saturated fat bad for you? (the evidence has not shown this to be the case)
The most salient feature of both diseases (Type 1 and 2 diabetes) is hyperglycemia and the intuitive idea that reducing carbohydrate would amelio- rate this symptom is borne out by experiment with no significant exceptions…The ascendancy of the low-fat paradigm meant that the fat that would replace the carbohydrate that was removed was now perceived as a greater threat, admittedly long term, than the immediate benefit from improvement in glycemia.
A key question that’s also asked and answered is which diet is really unconventional? Is the low-fat diet or the low-carb diet. If you look at the history of diabetes management pre-insulin (carbohydrate restriction, see: Just Read: Diabetic Cookery, Rebecca Oppenheimer, 1917 (!) ) or the evidence behind changing dietary recommendations in 1977 to favor carbohydrates over fat (not there), the unconventional treatment is probably the high carbohydrate diet.
Several (not all) of authors declare potential conflicts. In this exploration these sections are really important to read:
RDF wrote the original draft and incorporated changes and corrections from the other authors. All authors approved the final manuscript. AA is con- sultant/member of advisory boards for the Dutch Beer Knowledge Institute, NL, Global Dairy Platform, USA, Jenny Craig, USA, McCain Foods Limited, USA, McDonald’s, USA, and Gerson Lehrman Group, USA (ad hoc consultant for clients). He is recipient of honoraria and travel grants as speaker for a wide range of Danish and international concerns. He has conducted research funded by a number of organizations with interests in the food production and marketing sector. RDF writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation. EJF has received grant support from the Veronica and Robert C. Atkins Foundation. TK sits on an advisory board for Eli Lilly and gives lectures for Lilly about the diabetic diet. NW has written popular-audience books on low-carbohydrate diets and is a consultant and promoter for Leberfasten/Hepafast, a specific low-carbohydrate meal replacement program. JW is on the Scientific Advisory Board of Atkins Nutritionals Inc. with paid retainer, honoraria, and travel costs. None of the other authors have anything to declare.
Interestingly, several of these should lend to a conclusion that the status-quo high-carbohydrate, low-fat diet is beneficial, some the other way around. A recent paper in JAMA addressed this issue: John P. A. Ioannidis, John F. Trepanowski. Disclosures in Nutrition Research: Why It Is Different. JAMA. Published online December 07, 2017.
Because this is so important, I’m experimenting here by posting a link to other reactions to the paper (thank you social media!)
h/t @JeffStanleyMD for the link to the paper.
Another question I’ve had for myself, is about the sustainability, from an environmental perspective, of a LCHF diet, because climate change is a threat to human health and increases health disparities among vulnerable populations. I’ll post on that next.