Re: Nutrition Recommendations and Interventions for Diabetes-2006
- From: Alan S <loralweightandcarbs@xxxxxxxxxxxxxxx>
- Date: Sat, 02 Sep 2006 14:31:17 GMT
On Sat, 02 Sep 2006 10:07:53 GMT, "Peter C"
<peterc_2003@xxxxxxxxxx> wrote:
"Alan S" <loralweightandcarbs@xxxxxxxxxxxxxxx> wrote in message
news:8bmhf29mldhp4mte0phm1v5a928g1s3uhd@xxxxxxxxxx
On Fri, 1 Sep 2006 12:14:37 -0700, "Sarah"
<sarahpa1980@xxxxxxxxx> wrote:
So, the real guidelines published in 2006 by the ADA for
dieticians are:
Fat: 25-35%, including <7% saturated and 0% trans-fat.
Protein: ~10%
Carbohydrates: 55-65%, not less than 130gm daily.
So Alan if your figs are correct the charge that the AdA/Diabetes Uk are
recommending High carb/low fat diets that don't work just won't stick. Your
figs ( presumably for percentage of calories derived from each food group )
are neither high carb nor low fat.
Don't presume - read the document. And they are not my
figures - those are from the document. And by comparison
with Joslin they are high carb, low fat and low protein.
From your question I take it that you do not consider 55-65%carbs as high, or 25-35% fat/10% protein as low? Personally,
I have no idea of the threshold which determines high and
low - but the Joslin recommendations are certainly lower in
carbs(40%) and higher in fat(30-35%) and higher in
protein(20-30%). Would you agree that Joslin is a reputable
source of diabetes information?
What is your source for your definitions?
This is from the Joslin web-site:
http://joslin.org/managing_your_diabetes_3231.asp
"The Basics
The biggest difference between the USDA’s guidelines and
Joslin’s is the recommendation of fewer carbohydrates and
more protein in the diet, as recent studies have shown that
this helps people eat less and lose weight.
The following are Joslin’s guideline essentials (shown as
approximate percents of daily calories):
"Carbohydrate: 40 percent from carbohydrates, including at
least 20-35 grams of fiber. Best carbohydrate/high-fiber
sources: fresh vegetables, fruits, beans and whole-grain
foods. Eat less of these carbs: pasta, white bread, white
potatoes and sugary cereals.
Protein: 20-30 percent from protein (unless you have kidney
disease). Best protein sources: fish, skinless chicken or
turkey, nonfat or low-fat dairy products, tofu and legumes
(beans and peas).
Fat: 30-35 percent from fat (mostly mono- and
polyunsaturated fats). Best fat sources: olive oil, canola
oil, nuts, seeds and fatty fish like salmon. "
The other point which makes all these interminable lowcarb versus Ada diet
arguments so tiresome is that nobody seems to be discussing diet in CONTEXT.
Well, actually, we do. Does the ADA? The NHS/DUK? DA?
Good control is a judicious mix of diet/exercise/medication/insulin.
You
cannot say this or that diet is right/wrong in limbo without considering
what stage the diabetic is at and what mix of those elements they are using.
That much we agree on.
For the average T2 on max metformin and another oral anti-hypoglycemic drug
( such as a TZD or a sulf ) and healthy exercise the diet you summarised out
of the ADA recommendations should, IMO, pose no problems.
As you said, in your opinion. But why should they need to go
to max metformin and another med - if they don't need to. I
have no problem with necessary meds. But if the diabetic can
modify lifestyle to achieve the aim - why not investigate
and approve those lifestyle changes which many people (not
just here) have shown can work. Incidentally, nobody here
has mentioned gastro-intestinal discomfort from eating less
carbs; I cannot say the same for those discussing increasing
metformin.
IF they stuck to it.
Big proviso. The same one that the ADA uses to justify meds
in lieu of lifestyle treatments.
It seems to me that the whole of the low carb arguments against the standard
ADA diet are based on a non-sequitur - "I tried the standard diet and my
numbers were wrong therefore the diet is wrong".
They never seem to consider
the possibility that the diet is right but their diabetes is more advanced
and more serious than they think it is.
Well, mine wasn't. I can't speak for others.
I believe most T2s are several stages behind where they should be on the
medication ladder. As Oldal says probably half of T2s should be on insulin
injections. Shock, Horror !!!
I personally do not believe that any diagnosed T2 should be put onto/told to
try D&E ONLY at the start - everyone should start on metformin. They should
start on the recommneded diet, metformin and exercise and if there are
problems with that they should walk up through the standard pathway of
treatment increasing the quantity and quality of the meds. They should not
go "backwards" to low carbing.
You have a lot of beliefs in there. My beliefs are
different. But we are discussing medical matters here, not
theology. Where is your supporting evidence for these
statements of faith?
As Jenny said on asduk recently there is a general anti-meds ambience on the
support groups as a far as T2s are concerned.
That's unfortunate and may be one of the factors which drives newbies away.
( As well as all the unpleasant anti-ADA ranting ).
I keep seeing lots of IMO, I believe, may - I have no doubt
that you believe all this - but I have no idea why you
believe it. Some valid support please.
OK, low carbing will work for an overweight newbie but it is essentially
avoiding the central issue which faces T2s. The ADa recommendations at least
have the merit of putting the problem facing T2s centre stage but they
expect T2s to be handling it with a god mix of those elements outlined
earlier - diet/exercise/medication/insulin. And of course low carbing is a
stunt you can only pull off once - what you going to do when your figs
continue to deteriorate with progression ?
A stunt? You're not really serious? I don't low-carb, I
low-spike; that's also what I recommend. There are probably
days I eat higher carb than you. But if I needed to I could
safely eat at the lower end of my carb input for the rest of
my life. And what am I going to do if I continue to
deteriorate? Add the meds of course, as I have, and ramp
them up as needed - but later and less than I would have if
I had started on max metformin four years ago.
IMO low carbing by T2s is an aspect of Denial - a means to avoid medicationThere it is again - IMO. OK Peter - I respect your right to
and insulin and to avoid the ultimate admission that they have an incurable
disease. There also seems to be an enormous amount of control freakery in
the t" low carb fraternity. And of course Testing is a Godsend to
obsessive-cumpulsive personalities.
express your opinion.
But that last comment is just plain nonsense. Testing is a
godsend to diabetics who wish to lead long and
complication-free lives.
Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
--
Everything in Moderation - Except Laughter.
.
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