Re: Nutrition Recommendations and Interventions for Diabetes-2006
- From: "Kurt" <kurtwheeling1965@xxxxxxxxxxx>
- Date: 2 Sep 2006 09:44:31 -0700
Peter C 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.
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.
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.
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. IF they stuck to
it.
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.
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.
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 ).
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 ?
IMO low carbing by T2s is an aspect of Denial - a means to avoid medication
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.
I agree with most of what you say here Peter and thanks for taking the
time to say it. Most of the people in this newsgroup are not typical
diabetics and a couple I suspect aren't diabetics at all. What I see
reported here are people who seem to have found what works for them and
because of that they have attained good control, some even report that
they have attained perfect control. And that's where the problems
begin when it comes to arguing. By nature, we all have a need to
justify our choices in life by insisting that since we have come to
those choices through much personal research it rules out all the
alternatives. I see a lot of that going on in here. Most will say
they become loud and aggressive because of the "newbies" that wander in
here and it is a mission of mercy. For a few that may be true, but for
most I think it is a need to puff their chest out and proclaim to all
that "I'm the King of the World."
As far as the ADA goes, there will never be a day of peace in here
because there are some that are convinced that there is some kind of
conspiracy going on and the recommendations they make are based on
skulduggery and politics. Joslin gets a bit of a break, but even a lot
of what they say is way out of line with some in here who think that
there way is better for diabetics. When I first came here I was amazed
at the amount of bashing that went on day after day about any kind of
medical establishment. I found it hard to believe that some people
would be so vicious about it. I've since learned that a few had some
terrible experiences when they were first diagnosed and felt that they
got short changed to a dangerous point. I sympathize with those people
and truly understand why they sought alternatives to control their
diabetes.
There is room here for many diverse opinions and opposing views. Why
not, we are all individuals and therefore we are not going to
necessarily find methods that work for others to work for ourselves.
The ADA puts out general information for the general public. There is
no way they are going to know how to fine tune those recommendations
for each diabetic, but I don't doubt for a minute that they have come
up with those recommendations sincerely and with great thought about
them from people who have a much higher degree of knowledge about
diabetes than anyone I've ever read in here. So, I advise everyone
to do what they do, but be careful about thinking it's the best and
only way. The minute the ADA is mentioned here it incurs the wrath of
many and the support of few. The anti-ADA message gets out loud and
strong in here and I often feel that isn't good enough for some.
They would be happy to squelch any support of that organization.
Sorry for the long winded response. I've said all of these things
before and will no doubt say them again because, dammit, I'm the King
of the World! :)
Best,
Kurt
.
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