The Hypocritic Oath

Would You Like Carbs With That?

Posted in Uncategorized by trinkwasser on August 3, 2009

William Davis has come up with some good lines here.

If a doctor told their patient “you are allergic to penicillin so you must take more penicillin to control your allergy levels” they would be disciplined.

In Diabetes World, if the same doctor did NOT tell their patient “you are intolerant to carbohydrates so you must eat more carbohydrates to control your glucose level” they would be equally likely to be disciplined.

What’s wrong with this picture?

So just how many carbs do you actually NEED to eat?

Eric Westman reckons none at all.

However this can be hard to achieve, and it may also lead to short term problems (“Atkins Flu”) while adapting, and plausibly to longer term problems, for example it becomes difficult for me to fine tune my BG and prevent reactive hypoglycemia and reactive liver dumps without using some carbs as part of the control system. But then not everyone has my freaky genes.

Michael Eades decribes the system well. This is non-obvious until it is pointed out to you (well OK it was not obvious to me!) there is a constant shuffling of glucose in and out of store to maintain BG within a very tight range in “normal” people, and they are little affected either by huge dietary carb doses or excessive exercise.

This system goes out of balance early in the diabetes progression. Many diabetics find they suffer from Dawn Phenomenon. I tend not to do this, but my BG will tend to go high with exercise in the morning, whereas in the afternoon it will tend to drop low with the same level of exertion. Alan also has a take on this.

Now I’ve found that this is much less likely to happen since I reduced my carbs to a level where I am predominantly fuelling myself on fats, and where most of the glucose I require is generated from protein. But on balance I do better with some carbs.

If you look at food labels you will often find they do not list an RDA for carbs at all. Or if they do it will be in the range of 225 – 300 g/day. This is the sort of level taken as standard by numerous organisations whose recommendations are supposed to improve your health.

Is it working? Well look at the increase in Type 2 diabetes and other cardiovascular diseases, and obesity, and correlate them with the increase in carbohydrate consumption and the concurrent reduction in saturated fat consumption and the answer has to be no.

Mark Sisson has a pretty good take on the subject.

Lyle McDonald isn’t far off either.

Due to my genes and (probably) the amount of damage I have done to myself during the high carb years, I need to be one step down on his continuum, I work most efficiently on around 50 – 100 g/day, preferably around the lower end, and predominantly from non-grain sources.

Many people (either with different gene sets or more damage) do better at even lower levels, like Bernstein or Atkins Induction. Also, depending on insulin resistance and other factors, the level of carb input may vary significantly throughout the day.

By testing my BG I have ascertained that my limits are around 15 g at breakfast, increasing to around 30g and on occasion 50 g or more (depending what they are diluted with) by evening. Many diabetics have an even steeper slope, from 5 g or less at breakfast to possibly 100 g in the evening while remaining euglycemic.

Just because I can eat those quantities doen’t mean that I necessarily do.

Benefits not only accrue from avoiding carbs but from what you replace them with. Protein, lots of healthy saturated fat, hordes of non-starchy vegetables, nuts, cheese, monounsaturated fats, Omega 3s from fish and Real Meat, and a major reduction in Omega 6 processed vegetable oils . . . all things with much more nutrition per volume and fewer harmful contents.

In my case this has not only served to reduce my BG largely to nondiabetic levels but to reduce the variation, improve my energy which was similarly erratic due to the BG shifts, and leave me more capable of going longer on less food without recourse to snacks. My blood pressure also improved, though this is beginning to worsen again FIVE YEARS later, during which time I have failed to succumb to the immediate dangers I was warned of, such as heart attacks, scurvy, rickets etc. It has more than doubled my HDL and reduced my trigs to 10% of what they were. It has slightly increased my LDL but then the particles are larger fluffier and more beneficial judging by the other numbers, so that’s a small price to pay for all the major improvements.

These improvements are commonplace, and not only for diabetics. Some people can also reduce their LDL cholesterol which I don’t appear to have succeeded in, so perhaps I am one of the people for whom statins are indicated. Some people have continued such improvements for 20 or more years.

One person reports having had no “diabetic progression” in 39 years, mainly because he was originally placed on a low carb diet, and his doctors unaccountably failed to change this. Nice doctors. As opposed to NICE doctors.

I tend to believe that perhaps reducing your carbs to the lowest level you can get away with on a long term basis is better than trying to see how many you can eat.

Now, would you like carbs with that?


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