Just Read: Cutting Carbs Curbs Kilos, Cholesterol, Blood Pressure – And Maybe Not in that Order

2019.03.10 Low Carb Denver, Denver, CO, USA 00598
2019.03.10 Low Carb Denver, Denver, CO, USA 00598 (View on Flickr.com)

We’re now in the era of diabetes reversal. Why don’t more doctors know?

Tip for fellow physicians: Question the statement “low carbohydrate diets work only in the short term.”

Many of the often-quoted studies about diet and health are surprisingly short term. Perhaps most notably, the widely cited DASH diet [25] to lower blood pressure, referenced in every hypertension guideline, was a six-week study in 412 people. In our own study, the subjects were happy to continue the dietary change for an average of two years (so far).cite>Unwin, Tobin, Murray, Delon, Brady. Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care. Int J Environ Res Public Health [Internet]. 2019 Jul 26;16(15):2680.

Hallberg, et. al further pointed out that this question (of low carb diets) is often posed in the background of bias.

See: Just Read: Guidelines for Creating Guidelines: Dissecting American Diabetes Association Nutrition and Eating Pattern Guidelines.

Just Read: Guidelines for Creating Guidelines: Dissecting American Diabetes Association Nutrition and Eating Pattern Guidelines

One thing they/we can do is follow the work of Dr. David Unwin (@LowCarbGP) in the UK. He was involved in the creation of the Royal College of General Practice Course on Diabetes Reveral and the Low GI Diet that I took. There’s no comparable course available from the United States’ based American Academy of Family Physicians (@AAFP).

See: Just Completed: RCGP e-learning Course: Type 2 diabetes and the low GI diet, comparing to my ABFM educational experience

This paper covers Unwin’s experience as a GP (equivalent to the United States’ family medicine specialist) enrolling patients in his practice in a low carbohydrate diet program, including 19% of his type 2 diabetic patients.

An investigation into the impact of a low-carbohydrate diet on BP, weight, and lipid profile in ‘real world’ general practice. A total of 154 patients with type 2 diabetes or impaired glucose tolerance were recruited into a pragmatic, observational cohort study in primary care. The effects of a low carbohydrate diet, sustained for an average of two years, on cardiovascular risk factors were examined. Results showed significant and substantial reductions in BP (mean reduction of systolic BP 10.9 mmHg and diastolic BP of 6.3 mmHg) and mean weight reduction of 9.5 Kg, together with marked improvement in lipids. This occurred despite a 20% reduction in BP medications. This novel, cheap, and highly effective dietary modification offers hope that a low-carbohydrate diet is sustainable and effective in improving BP, weight, and lipidsUnwin, Tobin, Murray, Delon, Brady. Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care. Int J Environ Res Public Health [Internet]. 2019 Jul 26;16(15):2680.

The paper includes an exploration of the possible mechanisms for hypertension in the setting of hyperinsulinemia, yet another connection of chronic illness and chronic hyperglycemia, which has been steadily rising in the United States, seemingly unnoticed by the medical profession.

2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452
2018.05.29 Low Carbohydrate Meetup, Washington, DC USA 452 (View on Flickr.com)

Perhaps weight is a symptom, not the problem…

This is not a randomized controlled trial and involves patients who voluntarily signed up for the intervention. However/and the results are biologically plausable, and the converse has not been shown in studies that I know of – that a low carbohydrate diet increases blood pressure. If I’m wrong, I welcome references in the comments.

The Standard Norwood Surgery Low-Carbohydrate Diet

The work of Unwin has been enshrined by UK’s NICE (@NICEcomms), which has officially endorsed the infographics he created to help people understand the impact of their diet on blood sugar.

See: Sugar Equivalent Infographics Courtesy Of Dr David Unwin – Public Health Collaboration

Reference

Unwin, Tobin, Murray, Delon, Brady. Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care. Int J Environ Res Public Health [Internet]. 2019 Jul 26;16(15):2680.

The article (and this blog post) is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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