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Readers Exchange Opinions on Whether Low-Carb Diets Can Hurt Children


Apr 28, 2008

(Editor’s Note: When we recently published “The ‘Fat-Free Fallacy’: Is It Obesity's Great Enabler?” on our website (#5658 in the search feature), it generated dozens of spirited responses. Two of them, reprinted below, struck us as representative of the differing opinions people hold on the topic.)

Low-carb diet proponents would say that the real culprit in this hamburger is the bun, not the meat.

Does Low-Carb Cheat Young Children of Their Needs?

KheurserRD wrote us to say, “From a dietitian's perspective, 30 grams of carbs doesn't allow for much. It would not allow for the recommended amounts of milk/milk equivalents or fruit a child needs. Not to mention the lack of fiber. Whatever happened to balance, portion control, physical activity, and eating within your calorie needs? ...If such extreme restrictions are being made, how can very young children meet their requirements for calcium and other vitamins and minerals present in milk or fruit and some carbohydrate-containing vegetables?  Were these children monitored for nutritional deficiencies, or have the long-term effects of such a diet been studied when the diet was started at such a young age? Even if there are no recommendations for fiber, diets rich in fiber are associated with the prevention of many diseases.”

So, What Exactly Is Wrong?

An anonymous reader responded to kheuserRD’s statement that 30 grams of carbs “doesn’t allow for much” by writing, “The [following diet] meets and exceeds recommendations for children for calcium, iron, vitamins A, C, D, E, K, B-6 and B-12, folate, thiamin, riboflavin, phosphorus, magnesium, zinc, selenium, niacin, and copper, and provides complete and adequate protein (amino acids) and omega-6 and omega-3. So, what exactly is wrong with a carbohydrate-restricted approach for children again?”

Breakfast
1 egg with 1/4 cup spinach and 1-ounce cheddar omelet
1/4 cup blueberries
3 medium slices of tomato
water
1 teaspoon cod liver oil

Snack
3 small celery stalks with 2 tablespoons almond butter

Lunch
2-ounce ham + 1-ounce cheddar
3/4 cup cooked spinach
1/4 cup strawberries + 1/4 cup blueberries and 1/2 cup plain yogurt
homemade iced tea with lemon slice

Snack
Hard-boiled egg

Dinner
2-ounces white roasted chicken
1/2 cup cooked broccoli
water

Total carbs = 43g
Fiber = 13g
Net carbs = 30g

Does DH's Left Hand Know What Its Right Hand is Doing?

Editor:

What a disconnect and what a disappointment!  On page 32 of your February/March issue, there is a warning that Byetta can cause acute pancreatitis. Then, on page 36, there is an interview with a representative of Amylin Pharmaceuticals, which manufactures Byetta, extolling Byetta’s virtues in an interview with Scott King. I hope your magazine wasn't bought off by a paid ad for a medication that can cause serious side effects. I expect better from Diabetes Health.

Marcyl Seidscher
San Mateo, CA

(Editor’s Reply: Marcyl, thank you for your attentive reading. We hope you’ll see that we are committed to covering both the good and the bad aspects of Byetta. The truth is that Byetta has been closely connected with a few cases (30) of pancreatitis, and we duly reported it. We made no attempt to soft-pedal or hide that news.

But the truth is also that in thousands of cases, Byetta has produced some astonishing results, including lowered A1c’s and notable weight loss and appetite control. Investment expert David Kliff, highly respected for his forthright, play-no-favorites advice, recently said, “When you keep in mind how rare even 30 reported cases are in comparison with the number of people who are taking Byetta, this is a non-issue. There are more than 700,000 patients using Byetta, and 30 reports of pancreatitis. That’s 0.00428 percent, or 1 case per 23,364 patients. That’s rare.”

We printed reports on both aspects of Byetta because we know that printing only negative reports about the drug would be just as biased as printing only good news about it. If we had been bought off by an ad, we would have never run the article you read on page 32.  We want to thank you for holding us to a high standard and hope that this will assure you that we hold ourselves to it, too.)

Readers Sound Off:

“My sister was put on Byetta in spite of the fact that she has had two operations for bowel obstruction. When she became very ill, even her doctor could not believe how bad she looked when she went in. After he took her off the Byetta, and she improved, he ended up dismissing her as a patient. Byetta may be a good medicine for a lot of people, but those who have intestinal problems should not be on it, and a lot of them do not know that.”

“Excellent and reassuring reply from the Editor.”

“Speaking as a diabetes educator and type 1 for 30+ years, Byetta is a godsend to 99 percent of patients who use it. The astounding results, including decreased appetite, no longer obsessing about food, and [reducing] the fear of long-term complications because of elevated A1c’s, have improved the quality of life for hundreds of thousands of those who suffer with this complex disease. To make a sweeping judgment based upon the rarity of acute pancreatitis [is like throwing] the baby out with the bath water! Just yesterday I learned that a man who had just started Byetta one month ago had reduced his A1c from 8.8% to 7.4% and had a 10-pound weight loss. He was so grateful for how he felt that when he learned his new drug insurance plan would not pay for his new Byetta prescription, he paid $280 out of pocket because he did not want to live without it.”

“I’ve been on Byetta for one year now with no outward signs of pancreatitis. However, I agree with the writer regarding your magazine’s two articles. Studies with 25, 50, or 75 people never seem to be an accurate test of a product. I usually disregard any such studies, and maybe you should consider not reporting them either.”

“Readers should be reminded that all drugs have risk of side effects, some common and some rare (such as pancreatitis). Drug manufacturers know this and so do physicians, and thus patients are made aware of all possibilities. We know that there is always a risk of getting in a car accident every time we get in a car, but we still use this mode of transportation despite its risks. The same goes for pharmacologic management of diseases.”


Categories: A1c Test, Diabetes, Diabetes, Diets, Food, Letters to the Editor, Losing weight, Low Carb



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Apr 28, 2008

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