The "Fat-Free Fallacy:" Is It Obesity's Great Enabler?

This article was originally published in Diabetes Health in April, 2008.

| Dec 25, 2008

Obesity in the United States is increasing in epidemic proportions. This is true in children as well as adults. It's estimated that the healthcare costs associated with obesity and its related complications will exceed $130 billion this year.

If something is not done to stem this burgeoning tide of obesity, then the healthcare system that we know will soon crumble.

Why are we seeing this dramatic increase in childhood obesity? It is certainly true that children are not as active as they were 30 or 40 years ago. Television, video games and computers can entertain kids 24 hours a day. Parents are often relying on technology to babysit their children and are not spending as much time outdoors with them exercising or just playing.

Is this the only reason for the surge in obesity? As a pediatrician who specializes in childhood obesity, I see many children who are very active but they are also massively overweight. What about these children? I believe many of these children are victims of what I like to call the "fat-free fallacy."

Scapegoating Fat Backfires

In 1977 the U.S. Department of Public Health issued a statement encouraging Americans to eat less fat. In 1988 the U.S. Surgeon General recommended that we restrict our consumption of dietary fat. The assumption was that as we eat less fat the thinner we would become. The multi-billion-dollar food industry was quick to jump on the bandwagon. The race was on to produce fat-free everything. If food didn't have fat then it was OK to eat as much as you wanted.

Americans consumed more fat-free foods in the 90's than the previous three decades combined. This fat-free philosophy is exactly why we are becoming so obese as a society. Obviously if fat were the problem, then obesity would have decreased during this time. Instead, obesity did not decrease but skyrocketed to unprecedented levels.

But fat is not bad for you. Being fat is. The two are not related! Fat actually helps to satisfy our appetites and keeps us from eating too much or too often. Fat is also an important flavoring for food.

I, too, was a victim of this fat-free fallacy. I had been taught (brainwashed) that in order to lose weight we must eat less fat. I was a huge proponent of cutting back fat intake and watching total calories. I recommended at least 30 to 45 minutes of vigorous exercise daily.

I knew that it was very hard to lose weight. I didn't push overweight children to lose weight, thinking that if they could just maintain their current weight as they grew that would be significant progress. I felt like I was doing a good job. I believed whole-heartedly that I was explaining to these children the correct way to lose weight.

An Eye-Opening Study

In the late 1990's, a first-year pediatric resident physician at Marshall University did a required research project in which he looked at about 100 children whom I had counseled about weight loss. The results were astonishing to me. Not only did these children not lose weight or even slow down their weight gain, most gained weight at the same rate and some even faster.

The results did not lie. All of this time and energy that I had been spending to help children lose weight had been a waste of time. It just didn't work. A low-fat diet only worked for about one out of every 25 patients. Was this the best we could do?

I was determined to succeed. I began to look at other ways to lose weight. A third-year medical student at the time asked me about using a high-protein, carbohydrate-restricted diet for weight loss. At the time I knew very little about approach. This was not something that was taught in medical school. I couldn't believe that this would be successful or that it could be good for you, so I was very skeptical. How could eating high-fat foods not be bad for you? This is what I learned in textbooks from professors in medical school.

However, I still could not ignore the facts. We had cut back our fat intake and yet we were becoming fatter as a nation.

Low Carbs Make a Case

I researched and relearned the physiology and biochemistry behind low-carb diets. As I began to take a closer look, my findings were not what I expected. It all came back to insulin. Insulin is what causes fat storage. Insulin is what drives weight gain. Insulin is what is secreted when we eat carbohydrates. Insulin is one of the most powerful and efficient substances that our body uses to control the use, distribution and storage of energy. Insulin is essential for life. Without insulin, we would quickly waste away and perish. Just ask the teenager with type I diabetes who has been hospitalized for diabetic ketoacidosis because of not taking his or her insulin.

Let's look at what happens after a meal that is high in carbohydrates. Carbohydrates are broken down into thousands of molecules of glucose that are quickly absorbed through our small intestines into our bloodstream. Our body has the ability to monitor this rapid rise in blood sugar and quickly secretes insulin to counterbalance this. This is true if we do not have diabetes. Our nervous system keeps our blood glucose levels very steady no matter what we eat. These values almost never get above 120 or less then 70mg/dl. This is true whether we eat a meal that consists of pure sugar, a meal loaded with complex carbohydrates, a meal consisting of only protein or fat, or when we have fasted for two or three days. Almost all of our cells use glucose for energy.

Our bodies are extremely efficient energy machines. Only a small part of what we eat is actually used or needed by the muscles or other cells for energy. If these energy-using cells do not need any extra energy what happens to the majority of the glucose that we ingest? Insulin converts a portion of that glucose to another starch, called glycogen. Glycogen is stored in the liver and can maintain our blood sugar levels in the normal range for several hours after a meal. This is why we do not have to eat continuously. Glycogen can quickly be converted to glucose whenever glucose is not readily available in the bloodstream.

Why Low-Fat Diets Don't Work

What about the rest of the glucose? Where does it go after a meal? Herein lies the answer to why most low-fat diets do not work. The extra glucose is converted to fat. Fat is our main storage area for energy. Let me say this again: insulin promotes the production and storage of fat. That's right, even without eating fat our body produces fat from sugar.

Insulin is an extremely efficient hormone. It is the master hormone of our metabolic system. Its most important function may be the control and maintenance of our blood sugar, but insulin performs a myriad of other activities. In the appropriate amount, insulin keeps the metabolic system running smoothly and everything in balance.

However, in great excess it becomes a dangerous hormone wreaking havoc through the body. Mountains of scientific evidence implicate insulin as the primary cause or significant risk factor for high blood pressure, heart disease, arteriosclerosis and high cholesterol. It may also have a causative role in type 2 diabetes.

With type 2 diabetes our body needs extra insulin to help to maintain our blood sugar. The insulin that is available just does not work as well and we become resistant to its effects.

With type 1 diabetes we have a little different story. Our body can no longer make the insulin that we need therefore we have to take manufactured insulin to maintain our blood sugar. More carbs equals more insulin.

Teenage girls with diabetes know that insulin causes them to gain weight. Many recent studies have shown that in order to keep from gaining weight a very high percentage of teenagers with diabetes omit their insulin. We cannot continue to allow this to happen. This leads to uncontrolled diabetes and horrible long-term complications.

More Protein = Greater Insulin Control

So, how can we control our insulin requirements? The key to good blood sugar control, the key to weight loss and the key to lowering our insulin secretion is very simple. Eat fewer carbohydrates and eat more protein.

Protein keeps us from being hungry. A meal high in protein stays with us a lot longer than a meal high in carbohydrate content, which is quickly absorbed and does not satisfy our appetite as long. When we eat protein our body does not need as much insulin. Our blood sugar values are much steadier and we do not have the wide fluctuations that we see with high carbohydrate foods. This dietary approach works whether you have diabetes or not. It is perfect for anyone who is overweight or has type 2 diabetes. Type 1 people with diabetes can benefit by improved blood sugar values and lower insulin requirements.

I have seen hundreds of children actually lose weight with our plan. Eight and nine year old kids have lost 40 to 50 pounds. Obviously, the health benefits are tremendous, but the greatest improvement is what we see with self-esteem. Children's energy and blood pressure improve, and their lipid profiles universally improve. Before-and-after pictures of these successful children can be viewed on our website

In general, the fewer carbohydrates we eat the better. However, we should get a minimum of 30 grams of carbohydrates per day. The standard approach of 60 to 75 grams of carbohydrates per meal and 30 grams per snack is way too much. If you do not want to restrict carbs to 30 grams per day, then somewhere between 60 to 100 grams per day will still allow for weight loss if it is combined with exercise.

Remember: Eat all the protein you desire. Do not worry about where the protein comes from or how it is prepared. People who eat more protein end up eating fewer total calories. Protein keeps us from being hungry and satisfies our appetite more than any other macronutrient. This is the key for successful weight loss. It is hard to lose weight if you are hungry all the time.

Dr. Bailes is a pediatrician at Marshall University in Huntington, W. Va. He has developed a successful weight loss program in his book, No More Fat Kids: A Pediatrician's Guide for Safe and Effective Weight Loss. It is available at

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Categories: Blood Glucose, Blood Sugar, Diabetes, Diabetes, Diets, Food, Insulin, Losing weight, Professional Issues, Type 1 Issues, Type 2 Issues

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Posted by kheuserRD on 21 February 2008

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. Isn't it calories that make you gain weight?

Posted by catman on 21 February 2008

The process Dr, Bailes refers to wherein glucose is converted to fat is basic chemistry that one can find an explanation for in any college textbook. This raises the issue of the legal obligation surrounding disclosure.

The promotion by health care professionals, including dieticians and nutritionists, of diets low in fat as the preferred method for maintaining or even losing excess body weight is by default associated with a diet high in carbohydrates. There are two issues here that involve disclosure. First, no requirement for carbohydrate has ever been established in human nutrition. In order to put any recommendation for the inclusion of carbohydrate in the diet in the proper perspective the absence of any requirement in human nutrition should be disclosed. Omitting this important fact implies that recommendations for carbohydrates are based on an established requirement in human nutrition where in fact none exists. In the absence of such disclosure it can be argued that recommendations for the inclusion of carbohydrates in the human diet are misleading and deceptive.

The same argument can be applied to recommendations for low fat diets. Recommendations for low fact diets imply that being low in fat such diets will not contribute to the accumulation of excess body fat. While this may true be indirectly for carbohydrate it is not true in the ultimate outcome which is really what matters. A low fat diet that invariably must be associated with a diet high carbohydrates can and will result in the conversion of excess sugars derived from carbohydrates to body fat. This is an indisputable scientific fact that should be disclosed with any recommendation to consume a diet low in fat. The absence of such disclosure implies that low fat foods can be eaten with impunity and without incurring risk of accumulating excess body fat. As with carbohydrates, it can be argued that in the absence of such disclosure, recommendations for low fat diets are misleading and deceptive.

The facts of the rising rates of obesity, gross obesity and now the emerging trend of super obesity with BMIs in the 50-60 range stand as stark evidence that low fat diets do result in the avoidance of excess body fat.

The nail in the coffin of the low fat, high carbohydrate recommendations is that it can be argued that the proponents of such dietary advice being professionals in the field should have known or at the very least ought to have known that such recommendations would result in an epidemic of obesity and the associated health problems. The stage appears set for a torrent of class action lawsuits. All that awaits is the entry of the lawyers.

Posted by catman on 21 February 2008

kheuserRD on 21 February 2008

"From a dietitian's perspective, 30 grams of carbs doesn't allow for much."

Based on what? Considering the requirement for carbohydrate in human nutrition is zero, 30 grams seems more than adequate. What this amount doesn't allow for is the inhibition of fat burning caused by excessive insulin levels. Nor does it allow for or contribute to excessive hunger or excessive eating.

On a similar vein there is no requirement in human nutrition for dietary fiber.

Posted by Anonymous on 21 February 2008

Not all fats are equal. Recommended low fat diets don't take into account that we need essential fatty acids from omega 3 & 6 fats that are beneficial to health. People on low fat diets tend to control all fats. My son had very dry skin & tried all sorts of cream etc but now he has fish oil high in omega 3 his skin has improved dramtically & now has the softest skin ever. He also has type 1 & I believe that since diagnosis we were always advised to follow carbo diet portions/counting etc but always felt "feeding the insulin", now we go alot on his appetite & his control has improved so much. What an interesting article defiently food for thought.

Posted by Anonymous on 21 February 2008

Seems to me the fat belly people are genetically way more efficient at storing fat, and less carbohydrates is definitely way to go for them.

Posted by catman on 21 February 2008

Correction to my earlier post. Obviousl,y I meant to state:

"The facts of the rising rates of obesity, gross obesity and now the emerging trend of super obesity with BMIs in the 50-60 range stand as stark evidence that low fat diets do not result in the avoidance of the accumulation excess body fat but cause or contribute to it."

Posted by Emma on 21 February 2008

I have been type 1 for over thirty years and the only time I have been in decent control was when I cut down on the carbs. My BMI is 20 and my hba1c is below 6.

Fat free products just mean more carbs and sugar because the food industry has to compensate for the taste, but hey, it sells. Then we get the government stamped, very official food pyramid which says the largest part of our diet should be grains and starch - is it any wonder more and more people are waddling around and draining the health care system? (But don't worry, all the big industries are making tons of money from your ill health).

Most galling of all is so called "professionals" (and I have met a few in my time), giving out "advice" or diet sheets promoting a one plan fits all high carb, low fat eating "guidelines"; and well, see you in three months' time, but it's your fault if you come back fatter and less healthy.

Please... the evidence/research is out there and tons of people (Diabetic or not) have benefitted from a low carb diet. Read Dr. Bernstein's book "Diabetes in Control", he explains all the ins and outs of carbs and its effect on diabetics, and he is living proof that it works.

Posted by bdebruler on 21 February 2008

I'm waiting for the Low carb craze to die down myself. Let me know when the moderation in all food groups fad starts, I might just be a vocal supporter of that.

Just because your body doesn't absolutely need carbs to survive, doesn't mean they shouldn't be a part of your diet, (meaning what you eat on a regular basis, not what you restrict yourself to occasionally).

We have evolved with the ability to eat a variety of foods. Our saliva contains an enzyme (amylase) that rapidly breaks down starch into sugar. There is nothing wrong with eating carbohydrates... in moderation. The problem is that our society doesn't really know what moderation means anymore, all you need to do is go to your typical restaurant and look at the portion sizes for proof.

Posted by Anonymous on 21 February 2008

Re: "Just because your body doesn't absolutely need carbs to survive, doesn't mean they shouldn't be a part of your diet"

That may be true but not if you have diabetes.

Posted by Bates Estabrooks on 22 February 2008


Please, please , please read "Good Calories, Bad Calories" by Gary Taubes (NY times bestseller/#257 top seller on Amazon). He makes an incredibly detailed, sourced and convincing argument for the fallacy of "low fat" diets and for the risk of obesity associated with carbs. and thus, insulin.

It's a long, challenging, read, but well worth it; for diabetics or otherwise.

Posted by kheuserRD on 22 February 2008

By all means I do not support the low fat, or any othe diet fads - they don't work. Behavior/Lifestyle Habits play a major role in obesity. I am a firm supporter of healthy food choices from all food groups and daily physical activity. I am well aware of the chemistry behind carbohydrae metabolism. I do not disagree that reducing carbohydrates will help reduce blood glucose levels. I have also seen people lose weight with a low carb diet - on the same note I've seen people gain weight back if they follow the same diet and start eating carbs again. The concerns I expressed in my previous post are how are children of such a young age meeting their nutrient requirements for calcium or other vitamins and minerals present in foods such as milk or fruit and some carbohydrate containing vegetables if such extreme restrictions are being made. Were these children monitored for any nutritional deficiencies or have the long term effects of following such a diet been studied when such a diet was started at such a young age.
Even if there are no recommendations for fiber - diets rich in fiber are associated with prevention of many diseases.

Posted by Anonymous on 22 February 2008

What catman said! Absolutely right!

Posted by Anonymous on 22 February 2008

The problem with diet articles, pro or con, is that they look at a single issue and nutrition is far more complex than that. Increases in US consumption of low fat foods is irrelevent to this argument, because the consumers have not been identified; are they already fat and just maintaining? Or are kids getting fat while limiting themselves to low fat foods?

Healthy weight is about proper caloric intake, balanced by activity level and nutritious foods, including some fat, some carb and some protein from quality sources, including vitamins and minerals. Stress is probably bad. HFCS is probably a contributor. And worst of all, since trying to figure out what is OK to eat is so upsetting, I think I'll race downtown to get a double Whopper with cheese, fries and large Coke.
-Super size me....

Posted by bdebruler on 22 February 2008

anonymous said:
That may be true but not if you have diabetes.

Well, I have diabetes (Type I for ~19 years), and I am in good control.

Posted by Anonymous on 23 February 2008

"kheuserRD: 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."

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

3 small celery stalks with 2 tablespoons almond butter

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

hard boiled egg

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

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

The above meets and exceeds recommendations for children for calcium, iron, vitamins A, C, D, E, K, B-6, B-12, Folate, Thiamin, Riboflavin, Phosporus, Magnesium, Zinc, Selenium, Niacin and Copper......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?

Posted by Anonymous on 23 February 2008

"The concerns I expressed in my previous post are how are children of such a young age meeting their nutrient requirements for calcium or other vitamins and minerals present in foods such as milk or fruit and some carbohydrate containing vegetables if such extreme restrictions are being made. Were these children monitored for any nutritional deficiencies or have the long term effects of following such a diet been studied when such a diet was started at such a young age. Even if there are no recommendations for fiber - diets rich in fiber are associated with prevention of many diseases."

You're assuming one needs milk, grains and other foods often limited on low-carb to meet nutrient requirements. Have you ever looked at the nutrient profile of a menu you recommend to ensure it meets all nutrient requirements for vitamins, minerals, amino acids and essential fatty acids? You might be surprised when you realize the menus you're recommending are nutritionally deficient! Low-carb menus, where fiber is not included in the total for the daily carbs, does meet and even exceed nutrient recommendations for children. If and when you're able to put together a day's menu that can do that with your phiolosophy that it's all good and moderation in everything, post it here for readers to see and analyze, OK?

Posted by npm on 23 February 2008

"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."

Sure it does! I eat more veggies now on my low carb diet than I ever did back when I ate carbs. Total carbs are usually calculated by subtracting indigestible fiber carbs from total carbs. Non-starchy veggies are mostly fiber and water and they're a huge component of a low carb way of eating. Plus they're full of fiber.

Dairy? Last time I checked cheese was a low carb food, and greek (full-fat) yogurt is too. Also, if you let yogurt (or kefir) ferment long enough the bacteria digest the milk sugars, lowering the carbohydrates.

But there are also plenty of low carb veggies that contain calcium like broccoli and spinach.

Posted by catman on 23 February 2008

Good one npm.

I also urge everyone to read 'Good Calories, Bad Calories' by Gary Taubes. And while you are at it read some basic books on physiology and biochemistry. Chemistry and biochemistry are based on science as evidenced by predictable, consistent outcomes.

With reference to carbohydrate consumption, once insulin levels have exceeded a specific threshhold any excess glucose is converted to belly fat. The only point of contention is the threshhold at which this will occur. It is thought to be somewhere around 60 grams of carbs per day. But it varies from person to person. In some it will be higher, in others it will be lower. But the one thing that can be stated for certain is that there is a threshhold above which fat burning will be inhibited by insulin levels and excess glucose will be converted to belly fat.

In my opinion, recommending a diet with more than 60 grams of carbs and not warning of the existence of this threshhold and the consequences of exceeding it is at the very least textbook negligence. The fact that no party has been sued yet for offering such advice does not mean that this will not happen. I think it probable that the Courts may see even an greater legal exposure in this regard for health care professionals. All this is just my opinion of course. But if the current epidemic of obesity, which has now mushroomed into an epidemic of super obesity and the related complications of diabetes and coronary heart disease, continues unabated (which all signs indicate that it will), we may soon find out whether my read of the situation is right.

To those who argue that not gaining weight on a high carb diet means that carbs can be consumed without consequence I recommend that they consider consulting a doctor (if they can find one) who knows about protocols to determine whether good blood glucose control is present and insluin levels are within ideal limits. I for one ate enourmous amounts of carbs for most of my life and was skinny as a bean pole until 10 years ago. But when I was skinny my insulin levels were astronomically high. And this is a very bad thing. However, if tests at regular intervals show that insulin levels are within ideal limits you may ineed be able to tolerate large amounts of carbs. But that still doesn;t necessarily mean that you are deriving any special benefit from such consumption.

Fiber? There is no established requirement for fiber in human nutrition. Fiber is especially irrelevant if one is on a low carb diet. Would the next person who cites a need for fiber in human nutrition please provide a scientific reference that will actually withstand the scrutiny of the criteria to be classified as 'science' as opposed to being merely 'science fiction' or 'non-science'.

Posted by Ladybird on 24 February 2008

I totally agree with bdebruler. No fads for me!

I enjoy all types of foods, in moderation. To not to eat a whole type of food, like carbs, I feel as a Type 2, is missing out on nutrition, which we, as diabetics need as as much of as anyone else. Having said that, I am on low carbs, whole wheat and veggies as well as non fat/low fat dairy foods. I don't want to miss out on the nutrients, which are in every food.

Dr Bailes has written an article which, ofcourse, is very much in, defending the "High fat and Protein" diet. But how much fat is good/necessary for the child and the adult? I'm sure the answer will be different. Is he talking about basically a meat diet/ Atkins style, sure with the veggies included? Can there not be too much fat/protein for the diabetic? What is really a "low fat" diet? Does anybody know?

Dr Bailes hasn't differentiated between the "good" and "bad" fats in this article, which, we all know is very important.

Veggies are low carbs and also fiber. Whether needed for human nutrition or not, as somebody else said, should we all stop eating something, just because it may not be essential for us? Is that the only criteria for eating anything? Should there be no enjoyment left for diabetics at all, like fruit? And I do eat fruit, which is fiber, sure, in moderation. What is life about in the end? Just eating only the essentials? Ofcourse, if all diabetics felt like that, maybe that would "cure" a lot of us Type 2's straight away!

I can say for myself, since I have suffered from chronic constipation, only eating enough fiber has helped me. But maybe other people can survive without fiber, I know I can't.

I'm not on diabetic meds and my A1c now is 5.7 and am trying to get lower, ofcourse. So yes, am quite happy with my eating ways!

Posted by Anonymous on 25 February 2008

Sounds like more Atkins BS.

Posted by Anonymous on 25 February 2008

Medical and health institutions are all institutional dictatorships. All dictatorships, of whatever kind, are dysfunctional. Their aim is to preserve themselves and their ideology. Hence our present problems. Democratise the institutional dictatorships. Give every patient a vote: Does your medical treatment work, Yes or No? If we'd had this insitutional democratisation, we'd have known decades ago that the high carb, low fat ideology is a fraud - and a death sentence.

Posted by Anonymous on 25 February 2008

Your right - I guess if you eat a 6-8 ounces of cheese or 12 cups of broccoli everyday a 9 yr old child can get the recommended 1300mg of calcium.

Posted by Anonymous on 25 February 2008

The idea that low carb diets are fad diets is simply wrong. The high carb diets that have been promoted for the last 40 or so years are the fad diets. Unfortunately, promotion of the high carb diets started before the science (at least, in America) was fully understood.

Going back about 100+ years, the first diet book for losing weight promoted a low carb diet. The author was Mr. Banting and his book was very successful. In fact, his name, banting, became to mean dieting in England.

And, of course, we all evolved from hunter-gathers, which were all low carb eaters. Eating more carbs only began about 10,000 years ago. The amount of carbs in the Western diet has increased pretty steadily since. Where now we have huge fruits, extremely refined grains, sugars of all types, etc. So, my opinion is that the high carb diets are the fad diets.

BTW, I've been a Type 1 for 40+ years and have been low carbing for 3 years. My A1c's are 5.5 or less and my lipids have allowed me to get off of statins. And I lost 40 pounds without even trying to lose them.

Posted by Ladybird on 26 February 2008

I think most of us over here do agree that low carbs is the way to do it, I certainly do. Is a 1/4 bowl of fruit/s,though, high carbs? I personally don't think so, BUT we should eat only what suits us as individuals. We all may be diabetics, but cannot eat all the same way. 1/4 bowl of fruit may not suit somebody else the way it does me. Some people may not be able to eat fruit at all, but if we can, why not in moderation, they have a lot of multi- nutrients which we do need.

I've lost 30 lbs eating the way I do and doing well. I eat only two slices of whole grains/at most times rye and pumpernickel during the day, avoid it at night. And I eat it with "good" fats, peanut butter. I would call that "moderation".

There is no doubt that diabetics have had a bad deal from the ADA, which has been supporting the high carbs for so many years till now, but does it mean that we should not see/understand that we are missing out on so much by leaving out whole foods? It's called the balancing act and each of us have to find how much of what, we can fit in "safely" into our various lifestyles.

And what about vegetarians like me, who are on low carbs "diets" also? Why do we only think of meat as the only healthy low carbs diet? And I have only become a vegetarian over the last 15 years or so, seeing that this way of eating was the only one what really suited me. That doesn't mean at all that I'm saying other diabetics should not meat. Only that we are all different people and should eat what suits us - but whatever it may be, it should be low carbs for sure!

Good for you with an A1c of 5.5!

Posted by Ladybird on 26 February 2008

"The stage appears set for a torrent of class action lawsuits. All that awaits is the entry of the lawyers."

First of all I loved that comment of yours, Catman!! A brave comment!! I, myself have never followed the advice of ADA from day one that I was diagnosed with diabetes but have been wondering since they came out with their "approval" finally of low carbs, how those who have been following the high carbs style for years would be feeling now. Full of anger, I can imagine, and that thousands of doctors around the world had let this go without too much debate, besides people like Dr Bernstein, Dr N. Barnard and many other brave professionals.

I, for one, and am sure, all the other contributers on this forum, would be also interested in you throwing opening your ideas on insulin response and resistance for us to consider and comment on.

Posted by Ladybird on 26 February 2008

And ofcourse, on other key issues of diabetes!

Posted by Anonymous on 26 February 2008

Ladybird, your post reminds me of a similar discussion on another forum. One gentleman had tried low carb (less than 60 gr per day) and did not enjoy it even though he was able to reduce his meds to almost nothing. He loved his doughnuts, pizza and desserts. So, he decided that he would go on insulin and keep eating his carbs. Totally his choice, which he did fully understanding his opinions and possible outcomes.

My thought was Good for Him. Its his body and his life. He got a lot of grief from the other bloggers, but to me he made an informed choice and seemed to enjoy it. So, that's just fine.

I agree with Catman that its the people and especially those doctors and medical professionals that don't disclose the facts about foods that need to be .... sued? Does anyone know a lawyer?

BTW, Catman, I'm hoping to see your comments about Phase 1 insulin release.

Posted by catman on 26 February 2008

Ladybird, my argument is not with those such as yourself who appear to have come to terms with the fact that care needs to be exercised when carbohydrates are included in one's diet. Instead, my argument is with those who use misinformation and disinformation to promote their agenda for low fat, high carbohydrate diets. In particular I take exception to those who promote such a diet in combination with a robust array of pharmaceutical agents in a treatment protocol that amounts to pouring gasoline on a fire as the treatment of choice for diabetics.

Judging by the comments on this forum there are enough knowledgeable, intelligent contributors to engage in a productive, objective discussion of some of the key aspects of diabetes such as the processes of phase 1 insulin response and the mechanism of insulin resistance. If those such as yourself are willing I have a few ideas I would like to throw open for consideration and comment.

Posted by Ladybird on 27 February 2008

Dear Anonymous on the 26th Feb,

I don't understand why my post should remind you of the gentleman who didn't enjoy his low carbs way of eating and went back to his donuts, pizzas and desserts. I've made it very clear that I'm on a low carbs lifestyle and actually do enjoy it. I stopped the donuts, pizzas and desserts a long time ago but yes, do enjoy my 1/4 bowl of fruits twice a day, which to me, personally is not high carbs.

I don't think you read either of my two posts carefully.

I think, most of us on this forum are eager to learn from each other and thus bother to write on it. Some of us have well controlled diabetes, others are struggling, all are wanting to learn more, thus we read the learned articles over here.

It's tough to have diabetes and tougher to be able to control it, many of us other handicaps also, it's not just one thing.

I did also say that I, for one would love to read Catman's opinions on this subject. We are all different people and will disagree with each other, which is absolutely fine, but let's also read each other's posts more carefully please.

I'm a Type 2, neither on insulin or any diabetic meds, although, my own doc had tried to put me on them on day one itself. I decided to do it, with a lifestyle change and have pretty much succeeded. But it's a life long effort, as we all know, every day, we, even who are well controlled have to continue to be very careful not to go back to our bad old ways. My taste buds have changed over these last couple of years, by the way, things have become so sweet, that even a bite of dessert becomes sickingly sweet!

By all means, mention your gentleman friend who didn't enjoy his low carbs ways, but let's be clear, I love my new lifestyle, specially my new figure!! There are even good "side effects" of some things.

And we do know, let's be frank there are many diabetics, who'd rather be on the meds rather than stop eating certain foods or get off the couch.

And, ofcourse, I agree with you and Catman that, for sure, it's the health professionals who have let them be this way by not being emphatic about changing their ways.

Posted by catman on 27 February 2008

Ladybird "I love my new lifestyle, specially my new figure!! There are even good "side effects" of some things."

Ditto. In 3 years I have gone from a 39+ inch waist to a 32 inch waist. I recently had to buy a whole new ward robe. The only place I can find clothes that fit me now is in young men's specialty shops. The other downside I have experienced on low carb is the lose of my taste for desserts. My favorite dessert is now frozen raspberries with organic whip cream.

When I get time later today or tomorrow I would like to start a discussion thread on the latest research on insulin resistance (IR) that suggests that cells develop IR as a defense against high concentrations of glucose in the blood stream derived from excess glucose from dietary sources. To me this reads 'carbohydrates'. But the researchers only make reference to 'excessive nutrients'. Hmmm, I wonder why?

There are those who point to the presence of such things as starch digesting enzymes as proof that humans are designed to ingest carbs. The question in my mind is "how much carbs and how often should they be consumed". I have done lots of research and lots of critical thinking on this issue. My tentative conclusion (which I will argue in support of) is that humans are not designed to ingest significant amounts of carbs, that we may get away with consuming lots of carbs for short periods of time but that there are mechanisms that will come into play such as IR to protect the human system from glucose toxicity.

While it may be convenient to think of diseases like T2 diabetes as a breakdown in the human system I see this situation is being the best case solution the body can come up with to address excessive carb consumption. Those who get the message and drastically reduce their carbs (as I have done) usually address the issue by doing what needs to be done. In other words, we listened to our bodies, got the message, and responded appropriately. For the most part, those who choose to ignore what their body is trying to tell them don't do very well.

What I am trying to do is understand how my body is attempting to address my dietary indiscretions.

Posted by Anonymous on 28 February 2008

I'm sorry Ladybird that my post implied something that you do not do. That was not my intention. My logic in writing what I did was that you had researched low carb dieting or what you may call a very low carb dieting and then arrived at a diet that suited you. Excellent! The doughnut man did the same thing but he went completely away from even a medium carb diet, which was totally his choice.

We may be having a bit of a problem with our semantics. To me a low carb diet does not include whole wheat bread or pasta, low fat milk or cheese nor a 1/4 cup of fruit. Maybe I should call my definition very low carb. Anyway, without getting to much into this, I think that we are in much more agreement than not.

Catman thanks for your post and the article at Salk Inst. Once I get a chance to read the article, I'll comment.

Posted by Ladybird on 29 February 2008

Catman and bird54, all this is fascinating!

Bird54, I read most of your interchange between Nicholas Gracey on the postings under the Insulin article, am going to be looking up the readings also. Catman, your idea of the insulin dump is very interesting. It does make a lot of sense.

Posted by Anonymous on 29 February 2008

Should we get calcium from milk or from cheese? Let's look at the data:

100 grams (about half a cup) of lowfat (1%) milk has 123 mg of calcium. 100 grams of boiled spinach, 146 grams. 100 grams (about four ounces) of cheddar has 721 mg of calcium. 100 grams of parmesan, 1253 mg. (all from the USDA online database).

What about carbs? The milk has about 5 grams of lactose, spinach about 5 grams (some of it fiber), the cheddar about 1 gram of carbs (probably lactic acid, which I think the body can't use), and the parmesan about 3 carbs.

If you don't like dairy and hate spinach, 100 grams of sardines has 382 mg of calcium, and 100 grams of canned salmon, about 250 mg. Other fish have less calcium, probably because these canned fish include the bones.

My conclusion: don't believe the dairy-farmer milk lobby: there's lots of ways to get more calcium. On the other hand, making cheese takes lots of milk, so perhaps eating cheese can only help to support your local dairy producer.

Posted by Ladybird on 1 March 2008

Love fish and also the Omega 3's in it( and in nuts etc.) are almost some of the most "miraculous" nutrients ( besides the calcium) that are available to us. We all know that finally the medical community, (the alternate studies have been advocating it for years now) is coming out for the Omega 3's, one of the best agents to work as against inflammation, which is the cause of most of our diseases, heart problems, arthiritis and some people feel also diabetes.

Cod liver Oil, some people say is even better than other fish oils, since it has also Vit. D. I switched to Cod liver Oil, a few months ago. It's available in lemon, mint, etc flavours now and doesn't taste horrible anymore!

Posted by catman on 1 March 2008

As someone who excels at problem-solving it has been my consistent observation that the probability is great that what the majority believe is either dead wrong or seriously flawed. In view of this my preferred strategy is to start with a clean sheet of paper and with no preconceived notions. Then I start creating a fabric of the structure of the issue at hand by adding information that I have a very high confidence in as fact. What begins to emerge is a matrix of separate islands of fact with void space in between. If sufficient relevant factual information can be assembled this way a point is eventually reached where possible relationships can be hypothesized between the islands of fact. These are tried for fit to see if they result in a logical understanding of the issue.

In my view insufficient factual information has been gathered to date to understand how type II diabetes emerges in a person. So treatment protocols with the exception of the law of low numbers amount to nothing more guesswork.

One of the first assumptions I question is the prevailing concept of normal blood glucose. I think traditional medicine is on some other planet here or even in a different time warp.

If we want to engage in a constructive dialog we need to maintain focus. The subject we started under was low carb. But posters are heading all over the map now.

Posted by catman on 3 March 2008

I will partially answer my own question with a hypothesis.

Exogenous glucose (and associated sugars) is different from endogenous glucose derived from gluconeogenesis. In other words, glucose is not necessarily glucose in the way body deals with it. Endogenous glucose is relatively benign in that it presents little danger of toxicity to the cells because production is tightly regulated.

But exogenous glucose can not be regulated in the same manner that endogenous glucose is. The main difference between exogenous and endogenous glucose is first phase insulin response with the insulin dump which equates with a fire suppression system. The insulin dump acts as the first line of defense in attempting to blunt the impact of a toxic load of exogenous glucose. To the best of my knowledge the management of endogenous glucose does not involve for does it require a first phase insulin response.

If two very different glucose management systems are present this issue seems to have
escaped everyone or ate least the significance of it has escaped everyone.

Does anyone wish to comment either for or against my hypothesis?

Posted by catman on 3 March 2008

Good opening island bird54!

I assume you read the article on the Salk site summarizing the paper on IR. After stating that excessive nutrients (glucose) evokes IR as a cellular defense mechanism the authors then propose developing drugs to coax more glucose into the cells. Given our island I don't think it is necessary for me to comment on how I view this proposal.

If indeed cells possess a defense mechanism to protect against excessive glucose transfer the question I have is why does it seem take so long for IR to become established? Does anyone know if there is a fixed metabolic hierarchy for dealing with glucose and other sugars? Put another way, is the first option cellular uptake of glucose including the maximizing glycogen reserves with the last option being the conversion of excess glucose to fat?

I assume some of you are familiar with principles of neural science. It seems reasonable to assume that there is some adaptive options for dealing with excess glucose derived from exogenous sources. If so, the probability is great there would be limits to such options.

Does anyone have an island to offer on the above?

Posted by catman on 4 March 2008

For some reason my first post on 3 March posted twice.

Here's another island. Somewhere I came across a paper on study where non-diabetic subjects who had been on a low carbohydrate diet for a long time were given a glucose tolerance test (GTT). The results were then compared to subjects on a high carbohydrate diet who were given the same GTT. Surprisingly, those on the low carbohydrate diet showed a poor tolerance to the glucose load. Put another way, the results showed the low carb group as diabetic while the high carb group showed good tolerance for the glucose load.

I believe this result has significance for my hypothesis of the existence of 2 separate glucose management systems or at least 2 separate BG management strategies.

Does anyone care to offer an opinion of the significance of the GTT test results? The interpretation of the authors of the study is that carbohydrate somehow enhances BG management. My opinion is that this interpretation plumbs new depths of absurdity.

I will give you a hint of what I think it may mean. If the insulin dump in the first phase insulin response is the body's first line of defense against excess exogenous glucose/sugar loads what would happen if this defense is partially overwhelmed by the size of the glucose/sugar load? In other words, what is the next logical line of defense?

Posted by Anonymous on 4 March 2008

Fat Free MEANS carbohydrate........and carbohydrate means FAT. I've been on a high fat, high protein diet for two months. I have lost 20 lbs., did not have to starve in the process. I have also LOWERED my LDL to 42. My overall cholesterol is 102. It's the carbohydrate folks.....and therein lies the problem. Grocery stores and tv commercials are filled with high carb ads.

Posted by catman on 5 March 2008

Hi bird54,
Sorry, I don't have time to chase down the reference. I have a massive library of material that I would have to go through to locate it. Maybe later. What I can tell you is that the authors of this study concluded that carbohydrate enhanced BG management in the human body. Considering that the human requirement for exogenous glucose and associated sugars is ZERO, I think not!

Interesting stuff on LoveDiabetes. Unfortunately for the unsuspecting diabetics who actually 'trust the system' diabetes is a large and lucrative business. Just imagine yourself as a side of prime rib or filet that sells for much more per pound than stewing beef and you will get a bit of an idea of how you look to the pharmaceutical industry compared to a non-diabetic person.
More stuff later.

Posted by bird54 on 5 March 2008

Hi catman—
The status quo at Lovediabetes is in turmoil. The glucose sensitive Islanders are revolting at the thought that catman is bird54 in jungle disguise--

Sarah wrote:
P.S. What's really alarming is that there is a good chance that Gracey/Bird54/and the new "Catman" reference are all the same person...posting on 3 different but overlapping "styles"….When you have to actually create people to support your claims...

Sarah wrote:
P.S. IF "Catman" IS Bird54, "he" makes an interesting claim...he speaks of being thin but having high levels of insulin/insulin resistance. He also says he ate "enormous" amounts of carbs...much like how Bird54 said she was thin and "ate like a horse". Funny, eating excess carbs (particularily high glycemic) raises insulin levels, creates insulin resistance, and later leads to weight gain and Type 2 diabetes. Diet is a KNOWN cause for T2. And poor diet choices can come before weight gain…So Bird54/Catman just has your run of the mill diet (self) induced Type 2 diabetes, even though she claims she was thin and ate healthy...funny...

What do you make of these cocoNUT comments?

Posted by bird54 on 5 March 2008

Catman said, “One of the first assumptions I question is the prevailing concept of normal blood glucose. I think traditional medicine is on some other planet here or even in a different time warp.”

Below is an interesting twist on the concept of “normal blood glucose”--

Posted by catman on 5 March 2008

Bird 54, I am not sure where the people on allies voice are coming from. But when someone talks about IF not working and says they ate "only an orange and some grapes" I know that I am not on the same page as them.

My position is that the whole premise of what constitutes normal blood glucose and BG management is based on a high carb diet. Therefor, the current thinking of what is normal BG is patently absurd. The only macro nutrients we require are protein and fat. This does not mean that we are not able to consume some amount of carbs. What it does mean is that we do not require exogenous glucose. So normal BG should be based on a strict diet containing only protein and fat. Once the normal BG baseline has been established carbs can be added and the adaptive process will become obvious. It will of necessity involve an up-regulation of insulin and, depending on the carb load and frequency of the load, a decline in the effectiveness of the phase 1 insulin dump. Continued consumption of significant carb loads will establish an escalating cycle of up-regulation of insulin and declining insulin dump efficiency for reasons that should be obvious.

This is the subject that I would like to have a dialog on with others. But at the end of the day, if no one is interested I could care less.

Posted by Ladybird on 9 March 2008

Catman and Bird54, this is not to say, we, other posters would not like to read the interesting scientific "conversations" the two of are reading BUT let's not close off the conversation with other posters who may like to add/or just butt in with a comment of theirs.

We've all outgrown the strict school system where no other topics were allowed to be discussed.

I have asked Bird54, who she/he is since she has signed off with N. Gracey's block. Most of us usually sign off with our own "names" and since she/he herself brought up the topic of mixed identities from

I have looked up Salk Institute's articles and they are certainly very interesting.

Posted by Ladybird on 10 March 2008

Bird54 hi again,

I think you should read carefully what I've written, it wasn't really negative.

I also believe in being positive, otherwise, I'd not have lost 30 lbs in a year with the handicap of having a spinal surgery, which hampers any heavy exercising and be having an A1c of under 6 without being on meds. You and I've had a conversation before.

You didn't answer my question of why you were signing with N. Gracey's blog under your name or are you just supporting him?

The other thing I mentioned in my post was stopping the conversation by not letting other posters giving their own comments/opinions on the subject or only commenting in low carbs. That is not fair, this is an open forum for all of us, most of us are diabetics and interested in writing about our experiences with diabetes.

I already told you that I'd read the very interesting exchange between you and N. Gracey; it just happened about a couple of months ago, right? So in a couple of months you've become a total believer in his theories and they've already started to work for you?

If they have, that's great. I'm happy for you. I've made a purposeful lifestyle change, determined not to be on meds and have read as much as I can about diabetes to be able to help educate/myself myself about it. Everyone over here is not so lucky to be able to do that and have to be either on meds or insulin or both.

Everyone over here may not have read as much as somebody else, so may not understand about diabetes as much as, say, you. Over here, where we exchange ideas, I think it is not fair to promise "cures". Some people try things without discussing it before hand with their own doctors, these diabetics can land up in dangerous situations.

I, myself would not even dream of trying to have just one meal a day. Although, not on meds, I feel low, if I don't eat at regular intervals and having just one meal a day will land me in real trouble.

I wrote above, that there is not just one CORRECT way of doing things. Many times in my various postings under various articles, I've written that we are all individuals, what may suit one person may not suit another. It is not right to keep on insisting, as you did, the last time we had a conversation, that a meat diet was the best way to go for a diabetic. Or that nobody should eat whole grains. They may not suit you, which is fine, but they may suit somebody else. Or that we should all be on one meal a day.

Many people, as well as diabetic educators have written, that a varied diet may be the better way to go, what suits that individual in MODERATION. Small portions mean small glucose highs. BUT, ofcourse, if you're agreeing with N. Gracey, you feel that the highs are good for the diabetic, they "protect" him/her, if I've understood correctly. That goes completely against the conventional wisdom but if you want to believe that it's fine. All, I'm repeating is that could be very dangerous for most diabetics and thus should not be advocated so strongly by you or promised as a cure.

Water is a great thing, but even too much water can be bad for some individuals.

Ofcourse, I didn't bring N. Gracey into this conversation, you did. I've not commented up to now on anyone of his postings since I just don't want to get in to any arguments/discussions with him, where he asks me to give him evidence for everything I say.
I'm going on my own experiences, that's the only thing I can talk about with conviction.
I've done it and I've done it this way. That's all. And I plan to continue to do it my way, since it's working for me; it may not work for somebody else.

Since you brought up the discussion of the mixed up identities, I asked you why you had signed off with N. Gracey's blog under your name. One would usually sign off with our own blogs - if we have one- under our name.

Sure, only by being positive, every single day can a diabetic survive and it's a struggle for each one of us, however we do it.

Good luck to you!

Posted by Anonymous on 29 April 2008

"The recommended dietary allowance (RDA) for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat"-Diabetes Care.1:S61-S78, 2008

And, also as a diabetic, I was told to change to low fat or nonfat food options, but not to increase my carb intake beyond what was recommended by the ADA. I am doing fine with my BG. It's all about balance and not overeating.

Posted by Anonymous on 2 May 2008

"My conclusion: don't believe the dairy-farmer milk lobby: there's lots of ways to get more calcium."

I agree it is possible to meet calcium needs without drinking milk, but your evidence is possibly misleading. So me present it in a more realistic perspective.

From the USDA Nutrition Database

You wrote:
"100g spinach = 146 g and 100 g milk = 123 mg."

I don't weigh my food. Here is the information in more layman terms:
1 cup spinach, cooked, boiled,drained = 241 mg Calcium (not how I like my spinach but it's a great amount of calcium - however, this would be about 5 bunches raw).

And I applaud families that include these vegetables on a daily basis.

1 cup 2% low fat milk = 285 mg.
8 oz container plain yogurt = 415 mg (by the way, to follow up on another person's comment, the live active cultures may "digest" the lactose, but the carbohydrate will still be there, albeit in another form, when you eat it).

While it is possible to take in adequate calcium from nondairy sources, it is more difficult and takes more planning. I would also like to point out that the higher the protein intake, the higher the phosphorous intake which pulls calcium out of bones which is lost in the urine - increasing risk for renal stones and osteoporosis. I can acknowledge that recent animal & limited human studies are showing mixed results on this topic - so the evidence is in both directs. But there is enough available that still causes me to recommend avoiding phosphorous containing sodas (of course regular soda is pure junk) and the importance of more fruits & vegetables instead of snacking on chicken legs.

The operative issue isn not "low carb" or "high carb", it should be the right amount of carbs for your individual body. But also the right amout of calories.

When someone is trying to lose weight, the calories (energy intake) is key, and going on a low fat diet doesn't mean unlimited carbs. "High" is just a relative term meaning "compared to the percentage of calories coming from fat or protein, the carbohydrates are contributing more". Same goes with "low" (compared to the relative contribution of calories from fat or protein, the amount coming from carbohydrate is lower).

Please don't put a blanket blame on any entity or profession when you are angry about medical or nutritional advice with which you don't agree.

Standards of Medical Care for Diabetes are reviewed and updated with scientific evidence every year.

This includes Nutrition Recommendations.

Thank you.

Pediatric Dietitian & Diabetes Educator

Posted by Anonymous on 25 July 2008

Dr. Bailes is my childrens pediatrician and I have taken his book and applied it to our families diet. We all eat between 30-50 grams of carbs a day and as much protein as we like and only eat 1200 calories a day. We don't snack as often and we feel better. We don't buy soda the kids are offered one glass of juice & milk a day. The rest of the time they drink water. We have lost weight and feel great.

It is a lifestyle is not a diet. I have tried all the other fade diets and I gained more weight. I wanted my kids to have a lifestyle that would keep them healthy.

Posted by Anonymous on 30 July 2008

Anonymous on 29 April 2008 "The recommended dietary allowance (RDA) for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat"-Diabetes Care.1:S61-S78, 2008

Boy if i followed that requirement i would have all kinds of problems blindness, amputee, ect... Each must find his/her own level which safely keeps their bg under control. i would rejoice at 30 cabs a day, but i have major problems dealing with 10 or less. we are individuals. educate youself, and find your level, because your bg is in your hands alone.

Posted by Anonymous on 15 August 2008

From another anonymous user:

The U.S. government’s Food Guide Pyramid is supposedly based on a mountain of scientific data that supports its recommendations regarding diet and healthy living. With such a departure from these recommendations, I assume that the children on “high-fat, high-protein” diets are routinely monitored for plasma levels of CRP and homocysteine.

Posted by volleyball on 21 August 2008

HLBrewer, I wish to commend you for responding so well to the article that the topic is suppose to be on. While the thoughts of others may very true, it seems to fail to consider the target, growing children. The metabolism of growing people is different than when the growth stops. I see no mention of this in Taubes book even though he acknowledges that underweight children of obese parents over the age of 25.
Low carb, high carb, low fat, high fat are not really numbers defined. And a way they should not be. We are all different and the best approach is what works for us. If you eat high carb and are healthy, it is right for you, if high fat makes you healthy, then that is right for you.
For kids in general, I do think there carb be proportional. But lower than it is today. 30 gram carbs to a 40 lbs. kid is a lot more than to a 100 lbs. kid. A less active kid should lean towards lean protein and healthy fats, an active child can handle more carbs to fuel them and their activities. I think the percentage of fat in milk should go from full fat to 2% in the teen years. I would limit juices unless they are sole made up of the juice they portray, no apple or grape juice in it unless it is apple or grape juice.
We need to extremely limit corn syrup and especially HFCS. Limit foods with the first ingrediant being enriched flour. Parents need to limit what comes into their household.
I don't see the huge lack of activity from the last 40 years. I remember that 40 years ago that was being said about that time. Perception and reality really are different. But as some challenge fat and carb myths, they readily accept activity myths.
The lower your fat intake was/is sound advice. The problem is the consumer demand for low fat to taste like higher fat and the industry willing to give them what they want. They trade 1 issue for another and say ti is better because there is no warning out there.
I did laugh hard when I heard about getting lawyers involved. That was just too funny. That would be like Columbus suing Europe for saying the world was flat. It was scientific fact until it was disproven just like anything else. 20 years from now we may have a new concensus about food.

Posted by RDMelinda on 25 August 2008

This is the strangest thread I have ever read.

If you look back when LOWER-fat was first recommended there was no such thing as fat-free cookies. The only fat-free item at the store was Skim Milk. When population studies were done it was determined that Americans were eating ~40% of calories from fat. The rate of heart disease was high and it was determined that closer to 30% of calories from fat would produce a lower rate of heart disease. If food manufacturers had never made fat-free everything, the hypothesis would have been realized, because to eat less fat one would have had to eat whole fruits, vegetables, lean meats and a few whole grains. But when fat-free everything started flooding the stores, Americans took it to mean they could eat as much as they wanted....that was NEVER recommended by any health professional anywhere. I had to spend hours of time explaining to patients that the serving size on a fat-free pastry was only 1/13 of the pastry and how many calories and how much sugar was added, and that we were not meant to switch out veggies and fruits for fat-free pastry! But I'm not on Oprah so I had an audience of one person at a time. So all this blaming health care professionals is crazy. People were not meant to have unlimited amounts of anything! Any food can be a problem if it is super-sized.

The American mind seems to go to extremes. If less fat is good, none must be better. Professionals were recommending a 25% reduction in fat intake, not 100% reduction!

As for the food pyramid, if anyone ever bothered to actually learn about it, it recommended 6-11 servings of grains per day...and that was an average for the whole population of Americans, fat, thin, athletic, couch potato, 4 ft 11 to 7 ft, male, female. Even then we would customize it to each individual patient. A tall, athletic, active, thin male can easily burn off 11 servings of grains a day with no problem. He might even be able to burn off more depending on his activity level and muscle mass. Remember, carbohydrates are just supposed to provide fuel so that protein can provide for protein needs (muscle, enzymes, etc.). Look at the amount of calories Michael Phelps can eat! Is he not fit and healthy? But of course a shorter, less active woman who needs to lose weight would need less, and she could eat six servings of grains and still lose weight. Six servings is only 1 cup cooked steel cut oats, 2 slices of 100% whole grain bread, and 2/3 cup brown rice! That's breakfast, lunch and dinner! She could still have 2-3 servings of fruit for snacks, but a serving is only the size of a tennis ball (not the California softball size varieties of fruit...those are 2 servings for one peach). She could still include 2-3 (measuring) cups of fat-free milk (no need for extra saturated fat) and with the recommended 6 oz. of chicken/fish/turkey/lean meat/tofu/peanut butter/egg whites and 2 1/2 cups plus of non-starchy veggies with some heart-healthy fat still be under 1400 calories with a full complement of vitamins and minerals + phytonutrients.

By the way, Registered Dietitians do use software to analyze meal plans and take into consideration the needs of the individual in each and every case. We also have to be able to flex a plan around a whole host of health problems and allergies/intolerances a person may experience as well as shift-work, family dynamics, economic situation, etc. We look at the whole person and work WITH him/her to come up with a workable plan. We don't blame the patient...we try to problem-solve together. We look at populations who enjoy good health and determine what nutrition components contributed to that good health and longevity and try to help our patients achieve those goals. We look at more than blood sugars. We consider heart health, cancer risk, and GI health and function as well.

I don't know about other professionals, but I am not a part of some dictatorship. I don't get kickbacks from drug companies. I work in a hospital and in a clinic where I do my part to help patients. I could leave this low-paying job to write some fad book with a quasi-scientific hook and maybe make a mint, but I have to sleep at night, and that is more important. And at the end of my life I can look back and be proud that I helped people. I don't know what professionals you all have run into that have made you so jaded. Physicians sometimes pass on nutrition information that is not 100% accurate because they have such a short time with patients and try to encapsulate a huge topic like nutrition into a 10-second sound bite. They also have one whole nutrition class in med school. But if you have run into Registered Dietitians who have given you bad advice I'm surprised. I have had one person tell me that I told her to eat six times per day and she was mad because eating 3 times a day works better for her. However, she never came back to talk to me about it. I talk to people about trying a strategy and testing blood sugars to evaluate how the strategy is working. Nutrition is not black and white. There is more than one strategy, and sometimes it's like have to try it, see if it works, and if not, adjust the dose or try another strategy. That is the one thing that we agree on...that we are all individuals.

By the way, your arguments that fiber is not necessary floor me. If you have ever had constipation you should know better! If you worry about heart health and colon cancer, you would never say those things. How can you ignore epidemiologic studies? I have a strong family history of colon cancer and early MIs and you could not pay me to eliminate fiber-rich foods from my diet. I am not going to get all my fiber from grains, I will get some from fruit, some from vegetables and some from whole grains.

Thank you, volleyball, for the comment about Columbus suing Europe. Nutrition is an evolving science, and it always has been. But some things remain constant: balance, moderation and variety. Those things will always apply no matter what catman wants to argue about.

In the end, the low-carb high-carb terminology may have gotten us into this debate. We should all be eating, medium-carb, medium-protein, medium-fat diets and moving our sorry selves like nature intended. The rest is just semantics!

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