Diabetics continue to be misinformed regarding healthy eating

I was giving a presentation last night to a group of individuals of Indian sub-continent extraction. As a group, south Asians appear to be particularly prone to cardiovascular disease and type 2 diabetes. And judging by the expanded waistlines in the audience, this group were no difference. Part of my presentation focused on the potential hazards of carb-rich foods such as rice and chappatis in the development of abdominal obesity, heart disease and type 2 diabetes. I made point that a lower-carb diet is the, generally, the way to go for those wanting to lose fat and reduce their risk of these health issues.

One of the foods I recommended is nuts. Nuts are a highly nutritious food. A recent study found that those including nuts in their diet had generally more nutritious diets with regards to key nutrients including magnesium and potassium [1]. Nut-eating appears to be particularly beneficial for diabetics, and is associated with a reduced risk of heart disease. And, despite being rammed full of fat, nuts are not fattening.

After the presentation, I lost count of the number of people who came up to me to express how surprised (and pleased) to learn that nuts were ‘on the menu’. All had been advised not to eat them on accouint of their calorific nature. The people I spoke to were also, it seems, please to have been exposed to ‘the other side’ regarding healthy eating and disease prevention. Notably, among them were several type 2 diabetics. Without exception, each of these told me that they had been strenuously encouraged to eat a low fat, carbohydrate rich diet.

Just to ram home the points I’d made in my presentation, I asked each one of them (rhetorically), what type of foods diabetics have difficulty handling metabolically (carbohydrate). I then asked whether it made sense for them to base their diets on the very food type their bodies cannot handle. If high blood sugar is the hallmark of diabetes, why base the diet on foods that tend to raise blood sugar substantially? I also mentioned some studies that demonstrate that low-carb diets bring significant benefits for diabetics.

My impression was that again, without exception, these diabetics ‘got it’. Some of them asked how come something so wrong (diabetics should eat lots of carbohydrate) could become established as fact. Part of the reason, I explained, relates to the fact that if something gets repeated long enough and often enough, it becomes ‘fact’. At one point, for example, it was ‘fact’ that the world was flat. Now we know better. The problem is, I think, that even in the face of good evidence and common sense to the contrary, many health professionals continue to maintain that diabetics should eat a diet rich in the very foods that appear to do them most harm.

References:

1. O’Neil CD, et al. Tree nut consumption improves nutrient intake and diet quality in US adults: an analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2004. Asia Pac J Clin Nutr, 2010;19(1):142-50

18 Responses to Diabetics continue to be misinformed regarding healthy eating

  1. Nigeepoo 30 April 2010 at 12:35 pm #

    Did you mention Vitamin D?
    I think that a high percentage of south Asians living in the UK have hypovitaminosis D, which is strongly associated with impaired insulin sensitivity and beta cell function.

  2. Dr John Briffa 30 April 2010 at 4:55 pm #

    Nigeepoo

    I did indeed talk about vitamin D! And thanks for drawing our attention to this important issue.

  3. Dan 30 April 2010 at 5:15 pm #

    I’m a type 2 and in diabetes education, I was told to eat low fat, high “complex” carb diet with 15g carb servings. I soon wised up to the idea that they were telling me to do what I was doing before. That approach resulted in years of morbid obesity and type 2 diabetes. I have been on low carb ever since.

    It’s just become dogma. Everyone “knows” that fat is bad and that you should get most of your calories from carbs. And, since diabetics are more prone to heart disease, avoiding fat is especially important, which means more carbs. Yeah Right.

  4. Jennifer 30 April 2010 at 7:18 pm #

    Thanks, Dr. Briffa. I’ve been saying this for years. It’s unbelievable! I think a lot of these big diabetic associations and big Pharma have a stake in keeping people with diabetes ill. It is a modern day crime in my opinion. At least give people the option of a low-carb diet. I have heard the cop-out excuse that people will not be able to do it long term. Let them at least try and many will do it long term for the sake of their health. Those that don’t will have to rely on medication and perhaps declining health in their old age. Give people the choice and let them make informed decisions instead of making a bad decision for the masses right up front.

  5. Fiona 30 April 2010 at 7:41 pm #

    I once urged a Type-2 Diabetic friend to go on a low carb diet – she lost 2 stone and her consultant was delighted with her. However, the nutritionist became very angry with her and told her that she must eat two slices of bread with every meal! She subsequently went back to eating low-fat, high-carb and has put back all the weight, and more…

  6. Debbie 30 April 2010 at 9:15 pm #

    Dr. John,

    Can you comment on the lopsidedness of Omega 6 to Omega 3 in good-for-you nuts like walnuts? Don’t we want to steer clear of O6s?

    I really enjoy your posts and LOVE the cucumber kim chi! Found Korean cucumbers in an Asian mart last summer and made a lot :)

    Keep up the good work.

  7. A.A 30 April 2010 at 9:15 pm #

    Please can you publish the food that diabetics,type 2, can eat.I like nuts,but recently my doctor told me that nuts are gaining me weight cos the oil from them make you eat more!I would like to know which food is safe to eat,without getting high bs and doesn’t make you gain weight. Thanks

  8. Sue Bedford 30 April 2010 at 10:33 pm #

    When I was a student nurse back in the late 70s, I distinctly remember being taught that diabetics should reduce starchy carbohydrates. Therefore, I was surprised when I became a Practice Nurse in 2001 to discover that my colleagues were saying the exact opposite. It just didn’t make sense.

    The problem is not helped by the fact that study days on Diabetes management are funded and, in many cases, organised by Pharmaceutical companies who provide their own staff to do the training!

    Thankfully, I have “seen the light”, undertaken a diploma in nutrition and now work as an independent nurse.

  9. Margaret Wilde 1 May 2010 at 7:06 pm #

    @A.A

    I don’t know which sort of nuts you have been eating, but if they are salted nuts and if they have caused you weight gain, then it is the SALT that is likely to have caused the weight gain, by way of fluid retention, and that if the nuts have caused you to eat more, then the blame for that also lies with the salt, because salt is somewhat addictive and we tend to find salty food more ‘moreish’ than unsalted food.

  10. Joanne Unleashed 2 May 2010 at 1:22 pm #

    I told my diabetic friend about the low-carb paleolithic diet. He has been obese his whole life. He adopted my suggestions and lost 60 pounds and reduced his insulin medication. He’s over 60 years old, and he told me he’s at a weight he hasn’t seen since he was a teenager. He says the low-carb diet completely changed his life.

    It’s just infuriating that our medical establishment continues to advise all people to eat a low-fat, high-carb diet. How stupid can you be?

  11. Donald G 2 May 2010 at 11:38 pm #

    Dr Briffa:

    How much difference does it make to ones health if one eats complex carbohydrates rather than simple ones? Are the former not broken down into the latter by the body?

  12. Tim Gwynne 4 May 2010 at 2:47 pm #

    Norman Mailer coined the word “factoid” which he defined as “facts which have no existence before appearing in a magazine or newspaper”. Oliver Rackham has interpreted this to be “a lie universally held to be true”.

  13. simona 6 May 2010 at 12:10 pm #

    AA
    check Jenny Ruhl’s site and blog. Lots of information. Get dr. Bernstein’s book.

    http://www.phlaunt.com/diabetes/sp2index.php

    My mother has had T2DM for 20 years almost and it’s extremely sad and frustrating to watch her deteriorate, lose her sight, put on even more weight despite the low fat low calorie diet. She’s living a miserable life of deprivation and worrying and has a very poor blood sugar control with loads of dangerous hypos. Do you think her doctors care about her? She is only 67.

  14. Bob 11 May 2010 at 10:01 pm #

    Sue Bedford.
    You are quite right.
    Until 1982 the recommended diet for diabetics was one low in carbohydrates.
    But because this by default meant a higher fat intake, and diabetics were prone to heart disease, dietary advice was changed to one of a low fat, higher carb diet in line with the new anti-fat theory that had gained widespread support at that time.

  15. Sheryl Blystone 27 May 2010 at 11:08 pm #

    I am a well informed personal trainer/nutritionist/speaker and I work in EMS as well. I am horrified at how hospitals and nursing homes advocate a “2000 calorie diabetic diet” to most patients. This is actually a high carb, low fat and protein diet. The very diet that made them sick and dying…?? It’s malpractice..

  16. jo 16 September 2010 at 2:01 am #

    I am a newly diagnosed T2 diabetic, learning how to control my blood glucose and insulin. I am *incensed* by what I am being taught in the education seminars. SB is right: malpractice.

    I am profoundly grateful that there are alternative ways to educate myself. Without blogs like this one, I would not have the confidence to go against accepted wisdom to put together a way of eating that works for me.

    Thank you

  17. Michael Hines 17 March 2011 at 7:10 pm #

    Hi there,

    Great post on healthy eating. I am glad that you discussed how important nuts are in this article. As you said, people think that nuts have high calories and are saturated with fat.

    I am sure after reading this, You have changed a lot of people’s minds.

    Thank you and I will be sure to come back for more advice.

    Michael

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