12:11:34 Sun, 18 Apr 2004sci.med.nutrition
Moosh
at "Moosh
" <
[email protected]> writes:
>On Thu, 15 Apr 2004 10:55:07 +0100, Martin Thompson
><
[email protected]> posted:
>
>>That is right, I believe. These dentition changes are
>>suspects in the extinction of some of the pre-human lines,
>>as those that depended on eating many more grass seeds and
>>the like are thought to have had survival problems when
>>the climate changed, whereas our line, with its more
>>generalist adaptation, was able and willing to eat more
>>meat instead.
>>>Climate change where, though. The world is a pretty
>>>big place.
>>
>>At that time, primarily Africa.
>
>And the climate there then was glacial?
>
No:
http://www.eurekalert.org/pub_releases/2003-11/gsoa-
gr0102703.php
"Boulder, Colo.- Scientists at the Geological Society of
America annual meeting in Seattle next week are taking a
comprehensive new look at drivers of human evolution. It now
appears that climate variability during the Plio-Pleistocene
(approximately 6 million years in duration) played a hugely
important role. Astronomically controlled climate forcing on
scales ranging from 20,000 to 100,000 years down to El
Niños (5-7 years) made a highly unpredictable environment
in which generalists with intelligence, language, and
creativity were best able to adapt. "
My point is that in Africa there was a continuous shift from
forest to grassland and back over time, with *regions*
migrating over thousands of years, deserts appearing and
disappearing, and so on. Some animals, too specialist, will
have had problems keeping up.
More details are here:
http://www.columbia.edu/cu/record/archives/vol21/vol21_iss7-
/record2107.24 .html
"Analyzing ocean sediments off the African coast, Peter
deMenocal, a Lamont-Doherty paleoclimatologist, reported in
the Oct. 6 issue of Science that the continent suffered
cycles of colder, drier climate about 2.8 million, 1.7
million and 1 million years ago. The three periods coincide
with major steps in human evolution as documented by the
fossil record. The evidence strongly suggests that shifting
environmental conditions contributed to the extinction of
some human ancestors while other, more adaptable, species
survived."
The article goes on to give details. It is quite short and
is worth a quick read.
>>>Which line was adapted to only eating seeds? I thought
>>>most prehuman dentition was pretty generalist.
>>>
>>
>>No, there were some robust australopithecine lines adapted
>>to eating vegetable matter:
>
>But not vegetable matter only? That's my point. I thought
>they all had faily generalist dentition.
>
Apparently not, in the case of these Australopithecines.
Perhaps they ate other things too, but it may have been too
hard for them to adapt their lifestyles more in that
direction when the pressure was on. We can only speculate,
of course.
>>Well, we still have our molars. But there is evidence that
>>our species did go through a near-extinction, because our
>>genetic variety is less than would be expected otherwise.
>
>WRT dentition?
>
No, in general, AIUI. But diet could have been a factor:
AIUI the reason has yet to be discovered. Speculation again.
>>>Fifty years ago, maybe, but now we know it's just too
>>>many calories. If you get fat on a low carb diet, you
>>>will get DM2 if you have the genetic predisposition.
>>>
>>
>>I'm not sure about this. Being fat is a risk factor, but
>>if the fat person's insulin resistance nevertheless is not
>>causing high blood glucose levels because the person is
>>not eating that many fast carbohydrates, it would not
>>exhaust their beta cells (which produce the insulin) and
>>diabetes type 2 as such wouldn't manifest.
>
>And how rare is this? Are you talking about before or after
>DM has established itself?
>
I'm talking about before, in normal people. Many normal
people have some insulin resistance: indeed there is a
smooth and uninterrupted continuum of insulin resistance
levels in the population from those who have very little, to
those who have so much that their blood glucose levels are
chronically high. Some of the latter go on to be diagnosed
as "glucose intolerant" or, later, if and when their beta
cells are giving out, as
DM2.
As most people are eating a lot of carbohydrates (more
starchy and sugary ones than is necessary IMO), and as no
analysis of their relative dietary habits has been
undertaken as far as I know (but I will search), it is hard
to tell if I am correct in my guess about this. I will let
you know what I turn up.
I have turned up this so far:
http://216.239.53.104/search?q=cache:1IIlvi2nIncJ:www.rosed-
alemetabolics. com/Speech1996.pdf+Rosedale+insulin+glycerol&hl=en&ie=UTF-
8 [[
"I just came across a very interesting article. This is from
THE AMERIAN JOURNAL OF CLINICAL NUTRITION, January 1996.
This is by Dr. Benji Kings and Eric Riktor, of The
University of Copenhagen, in Denmark. This is a very
important study. What they did is, they measured insulin
response to eating a high glycemic index, or a low glycemic
index diet. They fed people a diet that is very typical of
American diet. They kept the carbohydrate content actually a
bit lower that we eat, and we have been recommended a very
high carbohydrate diet.
/snip/
What you will see, is that after three days, the insulin
response in the high glycemic index foods was quite a bit
more than in the low glycemic index. It is predictable;
after breakfast, if you eat a high glycemic index with more
simple sugars, it is going to raise your blood sugar faster,
and it should lead to greater insulin response. Same thing
after lunch, and even more so, high glycemic index/low
glycemic index, big difference. High glycemic led to much
more insulin. After 30 days on this diet, they note almost
the same. After lunch, there is also a narrowing. They also
measured insulin resistance via something called the
euglycemic clamp method, which is a very accurate way of
measuring insulin resistance. Let’s see what they found.
Initially, blood glucose and plasma insulin concentrations
were lower during part of the day with the low glycemic
index than the high glycemic index diet, but after 30 days
of the diet, glucose and plasma insulin were not
significantly lower with the low glycemic index than the
high glycemic index. With time, some adaptation to the low
glycemic index diet took place, resulting in a more rapid
and larger insulin response. This adaptation can also
reflect decreased insulin sensitivity. There were small but
significant differences between the high glycemic index and
low glycemic diets in insulin action at high insulin
concentration. In the opposite direction, one would expect
the high glycemic index diet to result in low insulin
sensitivity. They did expect the high glycemic index diet to
lead to greater insulin resistance. This was not the case.
“In conclusion, the present study shows that the type of
carbohydrate in an ordinary western diet influences whole
body insulin action. When total carbohydrate intake provides
46% of energy, then insulin action at a high plasma
concentration is lower (insulin action is lower, insulin
resistance is higher), when the carbohydrates are primarily
slowly absorbable, lower on the glycemic index. This may be
related to generally higher plasma fatty acid concentration
when the carbohydrates are slowly absorbable.†Things get
really confusing now. Due to the complex low glycemic index
diet, it may show that it actually increases insulin
resistance. ]] "
It appears to be saying that carbohydrates, of any type,
raise insulin resistance in normal people (and presumably
diabetics).
The lecturer also says:
Ancient civilizations ate a high complex carbohydrate diet,
much as is recommended by the powers that be today and
suffered a high incidence of obesity and coronary disease,
much as our Western populations do today:
"The diet that the Egyptians ate, and the diet that is
currently recommended, is a high-carbohydrate diet. Now,
their diet was a very high complex carbohydrate diet; there
was nothing refined at all about it, yet they were not very
healthy. This is uniformly found in ancient cultures."
and
"I would also like to take a look at the Eskimos. The
Eskimos eat a diet that for most people would be considered
horrendous. Anywhere between 70 to 90% of the calories
derived in Eskimo diets are from fat, depending on the
season. Sometimes they will eat a high-protein diet, high
protein or fat. They eat very little carbohydrates. In
wintertime, they eat no carbohydrates. Coronary disease is
almost unknown; so is diabetes. Look it up!"
The entire lecture is quite long (about 28 pages on
printout) but you might like to browse through it a bit and
see what you think.
>>Thus a fat person eating Atkins-style would *probably* not
>>develop the condition. Mind you, they might have a job
>>staying fat if they ate that way. Heh.
>
>What's hard about eating hypercalorically?
>
I guess it is possible.
However, most people on low
carbohydrate diets tend to eat hypocalorically, at least for
a while. One study I read of was of two groups of dieters,
low fat and low carb, who were allowed to eat as much as
they liked of the foods they were allowed. The low carb
people ate significantly fewer calories and lost more weight
during the study. This contradicts other research which
indicates that protein and fat are less satisfying to hunger
than carbohydrates, however, so it is all up in the air at
the moment. Getting some proper, well-thought-out research
done seems to be a real problem in this area. Maybe all
research is as half-baked, I don't know.
>>>Seems to be grains (small seeds) on any continent that
>>>man has dispersed to.
>>>
>>
>>I have a list of where the main food crops were
>>domesticated and when, from Jared Diamond's "Guns, Germs
>>and Steel":
>>
>>Independent Origins of Domestication: Southwest Asia -
>>wheat, pea, olive, 8500BC China - rice, millet, by 7500BC
>>Mesoamerica - corn, beans, squash, by 3500BC
>>Andes/Amazonia - potato, manioc, by 3500BC Eastern US -
>>sunflower, goosefoot, 2500BC Sahel - sorghum, African
>>rice, by 5000BC Tropical W.Africa - African yams, oil
>>palm, by 3000BC Ethiopia - coffee, teff, date not
>>established New Guinea - sugar cane, banana, 7000BC?
>>
>>Local Domestication following Arrival of Founder Crops
>>from Elsewhere: Western Europe - poppy, oat, 6000-3500BC
>>Indus Valley - sesame, eggplant, 7000BC Egypt - sycamore
>>fig, chufa, 6000BC
>>
>>Most large-seeded grass species flourished originally in
>>the Mediterranean climate zone. Here is a chart of the 56
>>heaviest seeded species, whose grain weight ranged from
>>10mg to 40mg (about 10 times the median for all grass
>>species). These species represent about 1% of all grass
>>species:
>>
>>Area and Number of Species West Asia, Europe, North Africa
>>33 (of which 32 are from the Mediterranean climate zone
>>and the remaining 1 is from England) East Asia 6 Sub-
>>Saharan Africa 4 Americas -
>>- North America 4
>>- Mesoamerica 5
>>- South America 2
>>
>>Mediterranean climate zones are basically the Med,
>>California, Chile, South Africa and SW Australia.
>
>As I said. I didn't notice amaranth mentioned here.
>
My point is that these plants were very localised until
quite recent times (the last 8500 years or so). This means
that their impact will have been local, indeed almost
entirely restricted to the Mediterranean region (especially
perhaps the fertile crescent where Babylon eventually
emerged) but we are talking about the entire species. Only
after that, selective breeding, trade and so on appears to
have improved the species for human purposes and spread them
around the world. And, because their impact is both local
and recent in evolutionary terms, only the most immediate
evolutionary impacts from eating them will have had time to
operate fully.
Amaranth is not a grass, as far as I know. Nevertheless, to
deal with your point, it is native to the North American
continent around Cape Cod to the Carolinas and so will have
had little impact until domestication as well. This happened
after about 7000BC and possibly around 3000BC (my source is
ambiguous):
http://uk.encarta.msn.com/encyclopedia_761570777/Native_Ame-
ricans.html
>>>Sorry I must have missed the passage above where it was
>>>shown that grains in the diets were suboptimal.
>>>
>>
>>I mean where it is saying that they lack cancer-
>>preventative phytochemicals, and so on.
>
>So does meat. But we are talking addition, not
>substitution, I thought.
>
Addition is OK up to the point of hypercaloric eating... I
don't argue with that particularly. But as I mentioned
above, I would like to see some research on the impact of
such carbohydrates on insulin resistance levels. That would
answer our questions properly, I think. Best of all would be
if this was also correlated to the subjects' BMI or body fat
% or some other general measure of their fitness level.
>>>The passage you refer to, I think talks about replacing
>>>one goup of foods with another, and any understanding of
>>>diet in those times will show that new foods were ADDED
>>>to existing subsistence diets to the benefit of the
>>>balance of the nutrition. Not substituted.
>>>
>>
>>Well, it depends, doesn't it? One can only eat so much and
>>if one fills up with grains, other vegetables won't seem
>>so palatable.
>
>Food was rarely plentiful.
>
It is clear from human physiology that what you say is most
likely correct: we have several mechanisms (hormone systems)
for raising blood glucose levels, but only one (hormone
system) for bringing it down: insulin. The implication is
that raising blood glucose levels was more of an issue for
much of our evolutionary history since Nature has seen fit
to provide a number of paths to achieve it. Furthermore, the
one path that operates in the other direction has all sorts
of non-optimal side-effects which evolution clearly hasn't
had time to eliminate yet.
>>Bingeing is natural for humans, but still many of us stop
>>eating when we are full. And, if you have a whole bunch of
>>readily available grains to hand, why would you spend
>>hours rummaging about in the forest for a few leaves and
>>roots as well, or risk your life to go after a wild boar
>>or whatever?
>
>So where did this readily available grain come from. All
>foods were hard to get and in generally short supply.
>
You are claiming that we ate lots of grains, aren't you? I
am suggesting that this was unlikely until domestication.
>>>And as much fruit and vegetables would be eaten as they
>>>could get hold of. Again substitution does not occur on a
>>>near starvation diet. They eat everything they can get
>>>hold of.
>>>
>>
>>Up to a certain point.
>
>Well this was the general state of affairs.
>
OK, but some grains does not equal a lot of grains (that's
my guess).
>>>>>Depends what you mean by "lots". I've never seen any
>>>>>recommendations to eat hypercalorically, have you? A
>>>>>60% carb, 20% fat, 20% protein for an active adult is
>>>>>fine. Is this what you mean by "lots"? (40:30:30 for
>>>>>sedentary individuals on much less calories)
>>>>>
<snip>
>>
>>As I mentioned above, DM2 would probably not manifest, in
>>my opinion, if blood glucose levels were kept low enough,
>>which could be achieved with a low carbohydrate/slow
>>carbohydrate style of diet.
>
>Rubbish. Normal blood glucose levels are within a narrow
>range. Eat anything and it rises slightly, produces
>satiation, and any excess is stored. Makes little
>difference what you eat on a wholefood diet.
>
I agree that a wholefood diet would be much less problematic
(but see my quote about the ancient Egyptians and about the
effects even of slow carbohydrates above), but a normal diet
these days doesn't contain many wholefoods, in fact, and
that could be part of the problem I am complaining about.
The diet that is generally recommended (not apparently by
you) includes too many fast and medium-speed carbohydrates
(bread, pasta, rice, potato). Slow ones from vegetables
(other than certain root vegetables) and salads seem to
present little problem. The diet you are arguing for may
well be satisfactory in this respect. Without testing it
directly, it is hard to know, but it sounds OK to me,
*provided* the carbohydrates are not released into the
bloodstream too rapidly (because this will be when blood
glucose spikes and insulin surges will be created, which, I
maintain, lead to the problems in the long run). If you
agree with this, then we may well be arguing the same thing
as each other.
On the other hand, the study quoted above suggests that all
carbs may be bad. The lecturer also says,
"There are 50 or so essential nutrients in the human body.
We’ve got vitamins, minerals, water, oxygen, amino acids,
and essential fatty acids. There are no carbohydrates on
that list. Why should we advocate a diet that the majority
of which is a totally nonessential nutrient. Decrease
carbohydrates, and a good fat diet lowers blood sugar,
lowers cholesterol, lowers triglycerides, and it leads to
low degenerative diseases. All of these quotes actually
show that."
Agree?
>>Overeating is of course possible on such a diet, but is
>>also less likely in those prone to DM2 since that style of
>>eating seems to satisfy hunger better (in them). But,
>>eating lots of carbohydrates stresses the beta cells of
>>those fat and insulin resistant people.
>
>Only when they have developed insulin resistance by eating
>too much and exercising too little.
>
Well, discounting the above study for now, I am wondering
what the impact of fast carbohydrates is on normal people:
does it add to their insulin resistance too? I think it does
since even normal people's insulin resistance spans a range
of values. And yes, quantity and exercise levels will impact
this too. I suppose I am saying that there is a third
factor: caloric input and exercise are the first two, and
type of food eaten may be the third. After all, a person
*could* get all their calories and nutrition from coca-cola,
a slab of meat, some fibre (maybe from linseed) and some
multivitamin/mineral tablets, just about. But would it be
good for them?
>>You might say that such people are not "normal" but they
>>were until they started eating according to what our
>>society provides them with.
>
>Well they should resist eating too much energy. I know this
>is often difficult when so many high calorie convenience
>foods are as close as the refrigerator, but I'm not
>interested in the how, but the what to
>do.
>
Me too. The how comes once we have decided what's right in
the first place.
I think it is worth mentioning that some people may find
it harder to resist the extra calories than others for
physiological reasons: many diabetics, and indeed non-
diabetics that I know personally, report that sweet and
starchy foods make them feel hungry again a couple of
hours later.
>>They didn't start out overweight (some DM2's were never
>>overweight, but their problem may be caused in other ways
>>and might best be called DM3 whatever that may be).
>
>And the overweight (fat) is always caused by eating too
>many calories.
>
Except in people with other metabolic problems, but we are
not talking about them.
Fat is caused by eating too many calories, I agree. I am
saying that the choice of how to input calories (which foods
to eat) may make this process easier or more difficult for
people to manage. I think you might agree that caloric
maintenance would be easier to manage on a wholefood diet
than on a high starch low fat diet, for example. Also, once
insulin resistance has set in, unstable blood glucose levels
can result in stronger hunger impulses.
>>Exercise would help too, in that it would help keep
>>insulin resistance down.
>
>Exactly.
>
>>So, yes, overeating is partly to blame, but it is
>>overeating carbohydrates in particular that is the trigger
>>for the problem in those people.
>
>No! Only when they have overeaten calories in the past and
>developed
>DM2.
>
I don't think it comes down just to calories, as I have
mentioned above: the speed of the conversion of food into
blood glucose is critical in the development of diabetes in
normal people, in my view. Therefore, it is not just that
they may be eating too many calories (although this does
seem to be a factor in *most* but not all cases), but that
the calories are being provided in an unsuitable form.
It surely must make a big difference to a person's body if
their calories reach the bloodstream in 20 minutes or spread
over 3 hours. They may end up in the same place (burned or
stored), but how they get there and the amount of stress
they apply to the body in the meantime will be different.
>>Up until that point, they are "normal" and are given
>>"normal" advice. It is the wrong advice for them. In my
>>opinion.
>
>They are never given the advice to eat too much energy.
Agreed. It is the form of the energy supply that I am
querying.
>If they do and develop DM2, they then have to cope with it
>by reducing calorie consumption, restricting carbs and
>increasing exercsie.
>
I agree - although that is not what is advised in most
places, it seems.
>>Defining "normal" is tricky, since if you stress *any*
>>"normal" person enough, something will break down
>>somewhere, eventually.
>
>Yes, so everyone should eat eucalorically. Remember I'm
>only talking about the what to do, not the how to do. I
>realise the immense difficulties in achieving this.
>
Cool. I don't think many would differ with you on the
desired level of caloric input. But as to what foods to
eat... that is where the problems arise. And then, as you
imply, we have all the psychological and social impediments
to good eating as well.
>> I am saying that the advice to eat 40-60% carbs perhaps
>> needs to be reconsidered as it is stressing too many
>> "normal" people and contributing to the development of
>> metabolic breakdown in them.
>
>No it is not! It is the overeating and overweight and not
>exercising and the genetic predisposition to develop this
>disease. I've seen no evidence that 60% carb calories in a
>very active normal weight human stresses anything. Now if
>he sits on his ass, keeps eating all those calories and
>gets fat, THAT'S stressing him.
>
Yes, activity levels certainly need to be taken into
account. But if people are sedentary, they should be advised
to eat appropriately for their lifestyle, don't you think?
Sure, they should be advised to change their lifestyle too -
and they are, ad nauseam, but who listens to constant
nagging? We all have our own problems already without
listening to some holier-than-thou doctor pontificating
about our lives. Nagging doesn't work. Advice appropriate to
the individual *might* go further. But this is beyond the
scope of the discussion.
>>They are not diabetic until they are. Up to then, they are
>>"normal".
>
>Yes, and will remain so until they stress themselves by
>eating too much and getting fat and not exercising.
>
>>>>But plates full of pasta, rice, bread and so on were
>>>>clearly the wrong way to eat, although it is still
>>>>widely advised.
>>>
>>>By whom, though. Yes I've seen some diabetes association
>>>websites with what appears to be ridiculous advice, but
>>>all the diabetes clinics and diabetologists here
>>>certainly don't give the advice I've seen from UK and US.
>>>So what was your carb percentage while you were an
>>>undiagnosed diabetic? Carbs are to be avoided by
>>>diabetics (DM2) but that does not mean they caused it.
>>>Excess calories is the dietary cause.
>>>
>>
>>I ate a lot of meat and rice and pasta and bread and not
>>much in the way of fruit and vegetables or salads.
>>Probably in the region of 50-60% carbs. Hard to say. It
>>was reasonably balanced by Western standards and I didn't
>>suffer from any obvious lack of nutrition that I know of.
>
>Why we are discussing your personal problems defeats me,
>but if you insist. What was your weight when diagnosed and
>what exercise did you take, and what is the cause of your
>DM2 ? If you don't wish to answer these personal questions,
>I completely understand, I don't like asking them, but
>answers are necesary to shed light on the points you make.
>
My weight began to increase from about the age of 20 (i.e.,
after I had left home and started feeding myself instead of
eating what I was given). When diagnosed I was probably
about 12kg overweight, and my weight fluctuated between
about that and maybe 20kg overweight. By moderating my food
intake as much as I could stand, I was able to bring my
weight down to the lower end of that range for most of the
time. I didn't exercise because at the time the advice I was
given was minimal (I think I was expected to know all about
glucose intolerance and DM by telepathy). My first dietician
gave advice that I've not heard elsewhere from the UK health
service and told me to limit my carbs to 20g per meal (later
ones have given me the stupid advice I've told you about
before). I did limit my carbs but not very successfully as I
did not appreciate the dangers (not having been told: it was
a case of, so my blood sugars will be too high, so what?).
Once I learned about it for myself, and began to get
gradually stronger and stronger symptoms, I looked about for
a way of tackling the most likely-looking cause, my weight
(even though I suspected and still suspect that there may be
more to the overeating than meets the eye,
D.N., it may in turn be caused by some other disorder - or a
too carby diet, of course). Luckily I discovered Atkins
and read his book. I could see right away that the diet
was too strict for me, so I followed his "Maintenance
Phase" basically by limiting myself to around 20g of
carbs per meal as my first dietician had advised, and as
Dr Atkins stated, I feel no excessive hunger eating that
way: it was always the carbs that triggered the
excessive hunger, it seems. I now also go to the gym for
a couple of hours of cardio and resistance exercise
every third day. My stats are currently:
height: 167.5cm weight: 63kg body fat: 22% blood pressure:
110/68 Total cholesterol: 6
LDL: 4.23 HDL: 1.5 Trigs: 0.6
Mostly OK - got to work on the LDL for now. Trouble is,
different sources say different things about how to get that
down. Low fat, high fat, yada yada yada. All I can say is,
the low carb approach has worked and I will need to be
cautious about tinkering with it because I don't want to
break it! I am thinking that as my body fat % continues to
decrease (I am still losing weight, I think - not sure: I
may have reached equilibrium. I won't know for a couple of
months until I see what happens) the LDL may go down anyway.
>>>I wonder if thay have somehow confused what is reasonable
>>>advice for type 1 with type 2.
>>>
>>
>>Don't know. It just seems stupid to me. But that's
>>human nature.
>
>I don't think it is, really. I think folk genuinely want
>to do the right thing, they just get misled and perpetuate
>the errors.
>
I agree most want to do the right thing - as long as they
can avoid thinking for themselves too.
>>>It's certainly NOT given universally here. Can you cite
>>>an example of this? Do they not avise seeing a doctor if
>>>you are ill? They do here. They routinely test people for
>>>blood sugar levels.
>>>
>>
>>An example in Australia? How about this from the
>>International Diabetes Instutute in Australia:
>>
>>
http://www.acrn.com.au/factsheets/Healthy%20food%20for%20-
>>healthy%20living.pdf
>
>Sorry, I've never heard of the "International Diabetes
>Institute". Sounds sus to me.
>
>>On page two, it says to eat things like bread and
>>breakfast cereals, rice and pasta. Although it then goes
>>on to talk of slow acting carbohydrates, any diabetic who
>>measures his or her body's response to the foods suggested
>>will quickly discover that it makes very little
>>difference: the peak comes after 45-85 minutes instead of
>>after 15-30 minutes, and may be a little lower, but it is
>>still far too high for anything but a tiny portion (such
>>as one slice of wholemeal/bran or similar grainy bread). I
>>believe it is close to impossible to eat as they suggest
>>and maintain safe blood glucose levels, without taking
>>extra medication - which medication is unnecessary if the
>>unnecessary starchy and sugary carbs are simply left out
>>or replaced with nutritious salads and vegetables.
>
>I agree.
>
>>On page 5 they give a sample day's meal.
>>
>>Breakfast - Oats (slow carbs but I find even 25g (about an
>>ounce) puts me near the top of my range for a safe blood
>>glucose level within an hour and I am healthier than most:
>>most diabetics would find the same or worse. Low fat milk
>>contains more carbs per unit weight than full-fat milk as
>>well and the lack of fat means that a) the carbs are not
>>slowed down and b) the calcium is not absorbed so
>>effectively by the body); banana slices (the worst fruit
>>of them all for raising sugar levels - half a medium-sized
>>banana is the absolute maximum a typical diabetic can
>>tolerate without medication); wholegrain toast (yet more
>>carbs but at least they say only 1 slice - on its own that
>>would be OK). Some margarine (no mention of the dangers of
>>trans fats). Some veg - no complaints there. This would
>>add up to about 3 times a safe level of carbohydrates if
>>the dieter kept to small portions such as I've suggested.
>>
>>Lunch - 1 wholegrain sandwich (two slices of bread is too
>>much); mayo, tuna, salad (fine); fruit (with all that
>>bread?); low-fat yoghurt (low-fat yoghurt usually has more
>>carbohydrates than the standard stuff as sugar is often
>>added to help with the flavour. One 125g tub of yoghurt
>>usually has a full dose of carbohydrates for a meal by
>>itself). So here, they are advising the person eat enough
>>carbohydrates to put them maybe 4 times over a safe limit.
>>
>>Dinner - stirfry (excellent choice, but
served with
>>basmati rice (how much? The don't say. Two tablespoons is
>>as much as most diabetics could tolerate without
>>medication: hardly worth the bother.) Then let's add some
>>fruit and some yoghurt/ice cream again. See above for
>>comments on that. Well a typical serving of such a meal,
>>with a minimum dosage of rice, would be maybe 2-4 times
>>over a safe level. If I took their portion control advice
>>to heart (i.e., none) and had the traditional 3" thick
>>ring of rice around my stir fry, I would probably be
>>eating a good 10 times too many carbs. For some diabetics,
>>they would risk Diabetic KetoAcidosis (DKA) after eating
>>such a meal (this is a medical emergency requiring
>>immediate medical treatment).
>>
>>Snacks - if this poor dieter ever manages to get their
>>blood glucose levels down to a safe level, they can ruin
>>it again by eating plenty of fruit, fruit salad, fruit
>>snacks, wholegrain bread, creamed corn, low fat yoghurt,
>>fruit bread, toasted muffin and fruit spread, plain
>>popcorn or low fat milkshakes. OK, to be fair, apart from
>>the muffin with fruit spread, a *small* portion of the
>>rest (e.g., 1 piece of fruit (not a banana)) might be OK
>>depending on the individual.
>>
>>I find, and many other diabetics who measure their glucose
>>levels concur, that around 20-30g of carbohydrates is
>>about the maximum I can take without my blood glucose
>>levels going above 8 after 1 hour and 6.5 after two hours
>>(the normal acceptable levels). This quantity varies
>>according to activity, time of day, and the individual,
>>but the dietary advice given here doesn't even come close.
>>
>>I think I'll e-mail the above to them as a question. Heh.
>>I'll let you know what they reply. Their web site is
>>
http://www.diabetes.com.au/home.htm
>>
>>Right. I've posted it to one of their forums (which appear
>>to have been hacked).
>
>How do you mean "hacked"?
>
>Yes this International thing seems to be what the Oz
>diabetes mob are linking to. I wonder who did that?
>
>I'll be interested in any reply, but I'm suspicious that
>you mightn't get through to anyone but a webmaster.
>
The forums all have the title "hacked" and some of the other
pages on the site are not working properly. I think the site
may have been sabotaged. My post has not appeared in the
forum that I posted it to, and the site feedback page is one
of the ones that is not working... <sigh>.
<snip>
>>
>>But diabetics are ex-normal, healthy adults.
>
>Yes. They have damaged themselves by becoming overweight
>and not exercising enough.
>
>Most sick folk are ex-normal
>
>>The advice didn't work for them.
>
>They didn't follow it by not eating eucalorically.
>
>>Maybe they were eating wrongly, but maybe they weren't.
>
>Most were eating too much energy.
>
>>To say they must have been eating wrongly is asserting
>>what has to be proved.
>
>As most gained weight, there is clear evidence that they
>did not follow the advice.
>
OK, I agree with that. However, I still want to take into
consideration the choice of foods eaten. If, as I and other
people seem to find, a carbohydrate-rich diet increases
hunger feelings a couple of hours after eating, then the
overeating, while true, is not the real cause: it is the
type of food eaten. It is as if they are taking a hunger-
enhancing drug then being blamed for eating too much. It is
true, but it is not the fundamental cause: it is a symptom
of the cause (the hunger-enhancing carbs).
>>I am suggesting that DM2 can be triggered by following
>>this advice, in normal healthy people (who have a
>>predisposition to the disease).
>
>Without gaining weight? Only in a very small minority who
>probably have a different disease.
>
With gaining weight (ignoring the unexplained minority
pending evidence). Because the weight gain is a symptom
of overeating, caused in turn by an improper diet (too
many carbs).
Of course, people can eat too much fat and protein too, but
that seems to be harder to do in practice than eating too
many carbs for the body to handle, despite the fact that fat
is much more calorie dense: the body seems to handle it
better (witness the Eskimos referred to earlier). This is
doubly strange as research indicates that carbs are more hunger-
satisfying than the other two. I suspect the research is
wrong and a more careful study will find otherwise: I am not
the only one who finds it turns out this way: pose the
question on alt.support.diabetes.uk or alt.support.diabetes
and you will find many who concur (and a few who don't -
people differ a lot).
>>You might say that they are not normal because they have
>>this predisposition, but I would say that that is a poor
>>defence of the theory: it works, except when it doesn't
>>work. Anyone it doesn't work with isn't "normal" somehow.
>>But that defence makes the theory unfalsifiable: it
>>becomes non-scientific right there.
>
>No. They are normal. Except that they cant cope with excess
>weight and underactivity. So if they never do this, they
>likely won't ever have a problem.
>
>>>>Do you see the distinction I am making there?
>>>
>>>Yes, you are confusing dietary advice for the normal
>>>population as applying to all sick people as well.
>>>
>>
>>Nope. Pre-diabetics are not sick people - yet.
>
>Some argue that there is no such thing as "pre-diabetes".
>But if you mean overweight, with hypertension and fat
>metabolism abnormalities and insulin resistance, they are
>no longer normal.
>
Correct: they could be suffering from carb-poisoning! Heh.
>>>It is for normal healthy people. Where on Earth do you
>>>get the idea that it is advised for sick people as well,
>>>and why should healthy folk have restricted diets coz you
>>>can't differentiate?
>>>
>>
>>They can decide for themselves what to eat, taking into
>>account the risks and family history, expert advice and
>>so on, if they like. But I am talking about normal people
>>- some of whom will go on to get diabetes if they eat
>>this way.
>
>No, only if they become overweight.
>
Yes, but eating this way will cause them to become
overweight because the carbs make them too hungry to be able
to eat a eucaloric diet (I strongly suspect).
>>After they get diabetes, I accept that the label "normal"
>>no longer applies in this respect. But it *does* apply
>>beforehand, I maintain.
>
>If they stay normal weight, they will remain normal
>(healthy).
>
Correct, but impossible on the normal Western diet for many
people, it seems.
>>>>and it is a mistake for our medical professionals to
>>>>promote it as if it were.
>>>
>>>Were what?
>>
>>Universally applicable.
>
>But they don't as far as I've observed. They advocate it
>for normal folk, and if you are overweight pre DM2 and or
>frankly DM2, they advocate other regimes, from my
>observations.
>
Nope, they advocate the same regime (witness the various
sites I have shown you).
>>And anyway, as I have shown with that dietary advice from
>>Australia, they are knowingly handing it out to diabetics
>>as well.
>
>The original site is linking to that International
>nonsense. I wonder why and who the international mob are.
>Some diabetic associations are rather political, I believe.
>Not sure how closely one should follow their advice. I
>would certainly take the advice of a diabetologist in one
>of our major teaching hospitals were I ever to need such.
>
Me too: except that now I prefer to research it for myself,
think for myself, and test it on myself. I can tell within a
short period of time what works and what doesn't. So-called
"experts" seem to be of little use to me, given the advice
I've (mostly) been given.
>>>I think you are imagining things. We have dietary advice
>>>for the general healthy population, and if you are
>>>coeliac, you modify it, if you are allergic to certain
>>>foods, you modify it, and if you are DM2 you modify it. I
>>>thought this would be fairly obvious, but perhaps not.
>>>
>>
>>It is obvious to me; I wonder why it isn't obvious
>>to medical professionals who are advising diabetics
>>how to eat.
>
>Are you sure it is medical professionals doing this?
>I wonder.
>
Oh, certainly. Doctors, Nurses, the National Health Service
leaflets I've been given, NHS dieticians, the lot.
>>And, why it isn't obvious to them that the advice is
>>apparently contributing to the causes of the disease in
>>the first place.
>
>Well it isn't sorry. It is contrary to good treatment once
>it has developed, but the only dietary "cause" for DM2 is
>overeating calories, from all the reading I've done.
>
Read that link I posted early in this (long, long) reply
(the one about the Egyptians and all that). It is only a
lecture, and lacks proper references and links (and is also
long), but it contains much food for thought.
Overeating calories is a symptom, I maintain. A symptom of
eating the wrong sorts of foods, which in turn causes the
eating of too much food.
>>The term "dietary deficiency" is yours. I am thinking more
>>in terms of malnutrition.
>
>Malnutrition seems to cover a wide variety of problems. You
>claimed that 60% of Westerners had an "unbalanced" diet,
>which means they must have some dietary deficiency. I
>merely asked you what that was.
>
No, to me an unbalanced diet is a form of malnutrition (bad
nutrition). So too many carbs = malnutrition. Too much food
= malnutrition. It is a surplus, not a deficiency, except
that the diet can be thought of as deficient in moderation
I suppose.
>>>>>>So for me, a "standard model diet" is the same idea in
>>>>>>nutrition: the diet generally accepted by experts as
>>>>>>being what is to be recommended. The model is (or
>>>>>>should be) subject to change based on evidence.
>>>>>
>>>>>So what is this "standard" diet?
>>>>>
>>>>
>>>>40-60% carbs, 20-30% protein, 20-30% fat.
>>>
>>>Strange for a standard? A wide range?
>>>
>>
>>It is the standard advice given. Yes?
>
>But not a standard diet. OK, just standard advice.
>
Um... OK.
>>>What about 39% carb, 31% protein and 30% fat? Would this
>>>be non-standard? Or 61% carb, 19% fat and 20% protein?
>>>Non-standard again?
>>>
>>
>>Looks OK to me, but...
>>
>>It is outside the range of standard advice given by
>>medical professionals. So, by definition, it is non-
>>standard. *That* is how I'm using the term "standard".
>
>So it's non-standard, but OK? I purposely picked numbers
>just outisde the range you cite, and well within the
>measurement errors of diet planning. Sorry, to me a
>"standard" diet is a specific amount of specific things. So
>we'll just have to agree to disagree on this one.
>
OK.
>>>And who is it standard for? There are an infinite number
>>>of diets that this range could contain. Again, strange
>>>standard.
>>>
>>
>>No, not who is it standard for, but whose standard
>>advice is it?
>
>OK, advice is standard, not the diet.
>
>>>>Heh... see above. It is what the medical profession is
>>>>advocating, as far as I know. That is, it is their
>>>>"standard model".
>>>
>>>What is? They give a wide range and advocate variety
>>>and balance and moderate regular exercise as far as
>>>I've seen.
>>>
>>
>>Still it is standard advice, is it not?
>
>Yep. Advice, not diet.
>
>>All I'm saying is perhaps the wide range isn't wide
>>enough.
>
>Perhaps not, does it matter, so long as the diet is
>balanced, wholefood, varied and eaten eucalorically with a
>garnish of regular moderate exercise
>
>>>>Yes. People can be motivated in other ways though. For
>>>>example, I feel good about eating in a way that controls
>>>>my diabetes because exercising that control boosts my
>>>>self-esteem when I see the good results it brings.
>>>
>>>Yep, controlling a disease so it's impact on your future
>>>health is minimised is surely a satisfying goal.
>>>
>>>>Comfort bingeing is bad for self-esteem and causes a self-
>>>>reinforcing downward spiral:
>>>
>>>Advice I've seen is to not beat yourself up over
>>>occasional lapses.
>>>
>>
>>Quite so - nor even frequent lapses. But most people
>>are not trained in the thought processes required to
>>avoid doing this, and de-motivate themselves severely
>>as a result.
>
>A niche for a good dietition, I would think. Most are
>apparently (42 Noisey) woeful in America. I've met a few
>here and they seem to vary. Like nurses. Some are better
>than the docs and some just turn up for the pay. Most of
>our medical practitoners are not like this. Mostly
>dedicated professionals. Perhaps due to our education
>system, or our health system, just our social more's at
>the moment
>
>>>>You just said it:
>>>>>Yes, normal folk should derive from ~40 to ~60% of
>>>>>their energy from carbs in wholefoods. Depending on
>>>>>activity levels.
>>>
>>>And where did I say this was describing "balanced"?
>>>
>>
>>You're making a distinction I am not understanding - or I
>>am making one you are not understanding.
>>
>>You appear to be saying two associated things: 1) that
>>people should eat a balanced diet, i.e., one that meets
>>their nutritional needs; 2) people should eat 40-60%
>>carbs, 20-30% protein, 20-30% fat.
>
>Yes, depending on the activity levels. They are not
>associated. I don't know where this comes from.
>
>>The implication is that number 1 equals number 2. Yes? No?
>
>No.
>
>>If no, then why advocate 2 as well as 1?
>
>Because there are some folk who seem to think that less
>than ten percent carb calories is fine. It ain't. Sure if
>you are ill with DM2.
>
Why isn't it OK? A handful of vitamin/mineral tablets could
take up the slack. And look at those Eskimos.
>>>>A moderate approach is sensible, but people are looking
>>>>for quick fixes and not for new ways of eating
>>>>(lifestyle changes). Hence, they don't do the right
>>>>thing. Their doctors do not seem to be explaining it to
>>>>them; or they aren't getting the message anyway.
>>>
>>>So you want to change the facts to accommodate this?
>>>
>>
>>Nope. I figure out for myself what is best for me. Other
>>people may do as they please, but I'd prefer it if they'd
>>listen to me.
>
>And your advice for DM2 is jolly good, except for your
>small confusion about the cause
>
LOL.
>>>>I think the evidence available suggests that over 95% of
>>>>low-fat dieters fail.
>>>
>>>Do you mean low calorie dieters?
>>>
>>
>>Not really. Low calorie diets work temporarily if people
>>can stick to them. But diets in general are a waste of
>>time: it is a WOE, a lifestyle, that makes a lasting
>>difference. I find it strange that so many people don't
>>seem to realise this.
>
>I put it down to the instant-gratification, quick-fix, magic-
>bullet scapegoat (have I covered all the cliche's here?)
>attitude of the young
Some good basic nutritional
>education in schools would help. I imagine that "home
>economics" courses will be as old fashioned as when my
>sister learned how to iron with a flat iron on the open
>fire with waxed paper apparently and this was decades after
>these things had turned into musreum objects.
>
>>>I believe the figures for failed attempts at any diet are
>>>similar.
>>>
>>>>No doubt a lot of Atkins dieters fail too.
>>>
>>>About the same, after a year, I believe.
>>>
>>
>>No doubt, when treated as a temporary fix instead of as a
>>lifestyle.
>
>I've just heard recently several medical experts claim that
>they wouldn't adopt the Atkins diet as a WOE until its long-
>term safety has been assured. They came to the conclusion
>after finding NO calories excreted as ketone in the urine
>and NO calories extra needed to digest
>it. Atkins dieters just eat less calories coz the extra
> protein not, the fat or low carb reduces their apetite.
> Interesting. I heard that years ago here I believe.
> Lyle McDonald IIRC.
>
Hmm... Lyle knows a lot about that sort of thing. I wonder
if the data has changed since then.
>>>> As you say below, it is a WOE that is needed, not a short-
>>>> term diet.
>>>
>>>Yep, and your WOE is going to be radically different from
>>>healthy adult humans.
>>>
>>
>>It is, but it would probably be healthier for a "normal"
>>person even than the "normal" diet I used to eat, in my
>>opinion. Although I didn't eat enough fruit and vegetables
>>probably.
>
>Still need to know what your weight, exercise status and
>actual diagnosis were
>
>
Diagnosed glucose intolerant at first (when the 20g advice
was given) then a few years later DM2.
--
Martin Thompson
[email protected] (use "martin" not
"bin") London, UK Home Page:
http://www.tucana.demon.co.uk
Web Shop:
http://buy.at/tucana Mobile Phone Ring Tones:
http://www.ringamoby.com
"Everything I do and say with anyone makes a difference."
Gita Bellin
