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ALGEBRAGIRL Posts: 1,925
8/12/14 3:49 P

Sometimes a drug is the only thing that can save your life!

HOUNDLOVER1 Posts: 8,869
8/12/14 1:59 P

Rick,
this statement of yours really caught my attention:
" The problem is that big pharma will always look to do that by finding a pill or shot. The assumption is the patient will do nothing to improve their own health. Mostly, that assumption is right."
It is true in my opinion but I'm not giving up on changing it because the continuation of our health care system (or should I say sick care system) depends on finding less expensive and more powerful alternatives and motivating people by giving them far more hope than big pharma can give. But having said that, sometimes only drugs can help.
Birgit


Edited by: HOUNDLOVER1 at: 8/12/2014 (14:00)
ALGEBRAGIRL Posts: 1,925
8/12/14 12:53 P

What's unusual for me is that I have type 2 diabetes in my family and my second child was large (over 10 lbs at birth) which prompted a Glucose Tolerance Test (you drink a really sweet measured beverage and they test your glucose at intervals for a few hours).

My results were fine.

I am a 'nearly-vegetarian' (that's a lotta carbs - I eat meat at one meal a week, Bill Clinton style) and I've seen my fasting blood sugar drop steadily on this way of eating - so no 'one size fits all here'! No concern from my doctor about going too low because my A1C is in the normal range.

I think hypoglycemia would be the source of a 'too low' A1C and that's why I wonder what the lowest range could be. Hyoglycemia is serious.



RICKTHEBIKER SparkPoints: (698)
Fitness Minutes: (435)
Posts: 21
8/12/14 12:46 P

I am a little late to this discussion.

1. Russell, you are my God! As I sit here eating my chicken salad and wonder why anyone would ever want to ruin it with carby croutons, I will start thinking about the fat and protein I will put on top of veggies for dinner.

2. Eelpie, I work for big pharma. The main goal of big pharma is to save lives and make people healthier. The founder of my particular big pharma even stated once that if you make good drugs and cure disease that profits will naturally follow. The problem is that big pharma will always look to do that by finding a pill or shot. The assumption is the patient will do nothing to improve their own health. Mostly, that assumption is right.

HOUNDLOVER1 Posts: 8,869
8/12/14 12:11 P

I wanted to add something I only implied below. Maybe there is not an absolute A1C number that is perfect for everybody. Maybe the current research just indicates that generally speaking, we should get our A1C as low as "reasonably possible" and that would then have to be defined by each patient and their doctor. It seems that there is possibly a fair amount of damage to our bodies at A1C levels that the American Diabetes Association considers normal or pre-diabetic and unfortunately I have experienced some of them. Now that my levels are lower my memory is much better and my vision is better as well as my ocular migraines being a thing of the past. Also, I have been able to gain a significant amount of muscle with the same strength training regime I had before.
Birgit

Edited by: HOUNDLOVER1 at: 8/12/2014 (12:12)
ALGEBRAGIRL Posts: 1,925
8/12/14 12:01 P

I'm surprised there is no research for A1C that is too low.

Diabetes,org says, of the A1C number, 'It is reported as the percent of hemoglobin molecules that has glucose attached.'

Is it possible, I wonder, to have no glucose attached?

JUSTEATREALFOOD Posts: 2,352
8/12/14 11:43 A

I'm similar to you Brigit in that grains and high glycemic fruits and vegetables send my blood sugars through the roof. I have cut way back on those things but haven't cut them completely. I have a family history of diabetes and my A1C was 6.5 at my last appointment which my doctor thought was too high. I'm working on getting that number down for my next appointment.

HOUNDLOVER1 Posts: 8,869
8/12/14 11:21 A

Becky,
I think you are right that it is not possible to make a general recommendation what the ideal A1C level is for everybody as there are many factors to consider. Some people are willing to go to extremes (or at least what others perceive as such) to make life style changes that optimize their blood sugar for their preferred lifestyle. For me giving up whole grains, legumes, starchy veggies, milk and all but small amounts of fruit and yogurt was comparatively much easier than controlling my blood sugar with metformin or similar drugs. For someone else eating a very low-carb diet may not be feasible or make them satisfied with their food choices.
I have so far not found any research indicating that there is an A1c level that is too low and there is significant evidence that many non-diabetic people have A1c levels in the 4's.
And then, A1c only gives the average, it is quite possible to have a "normal" A1c and have huge fluctuations in blood sugar that are very dangerous. For me this would happen all the time when eaten high-carb foods like whole grains, legumes or even have a big glass of milk or a big serving of fruit.
Now my blood sugar levels never go below 70 and never go above 120.
Birgit

Edited by: HOUNDLOVER1 at: 8/12/2014 (11:50)
DIETITIANBECKY Posts: 27,860
8/12/14 8:07 A

You are correct about the studies using the older adult.
I also found this in many other studies on the topic.

So while blood sugar is a lab value that should be monitored at your annual visit with your doctor---I don't think there is enough research evidence to make a recommendation that an A1C of 5.2 should be the recommendation for all.

This is a big stretch based on current research evidence. Remember too that recommendations are made when many, many studies conducted on the same population, show the same result.

Rest assured, people can still safely consume healthy carbohydrates: fruits, starchy veggies, milk, yogurt, beans, lentils, whole grains----using a healthy carb range with 45-65% of calories coming from carbs. No need to fear these type carbs when part of a health-promoting diet and lifestyle.

Becky

Edited by: DIETITIANBECKY at: 8/12/2014 (08:24)
ALGEBRAGIRL Posts: 1,925
8/12/14 7:59 A

Becky, I notice that the studies you cite seem to focus on the elderly (59 years up). No complaints, just noting that.

DIETITIANBECKY Posts: 27,860
8/12/14 7:54 A

Birgit--
Thanks!
Here are the links to the studies:

www.ncbi.nlm.nih.gov/pubmed/?term=Hammer%2
C+Hemaglobin+A1C%2C+fasting+glucose+an
d+future+risk+of+depression%2C+2011


www.ncbi.nlm.nih.gov/pubmed/?term=Enzinge%
2C+Risk+Factors+for+progressions+of+Br
ain+Atrophy%2C+2005


Of course we only have access to the abstract. While the studies do show a correlation between elevated A1C and a decrease in brain health----I can not tell if there really is a recommendation for 5.2. That's a "very specific" number from such preliminary research. I think the best take away is that it demonstrates another reason to maintain a healthy lifestyle, have annual check ups with your doctor and maintain "healthy" blood sugar control.

Thanks Again--
Becky

HOUNDLOVER1 Posts: 8,869
8/12/14 1:12 A

Becky,
here is a quote from the book "Brain Grain", followed by the reference.
chapter 4 "Not a fruitful Union", page 116

"It is well documented that glycated hemoglobin is a powerful risk factor for diabetes but it's also been correlated with risk for stroke, coronary heart disease, and death from other illnesses...
We now have evidence to show that elevated hemoglobin A1C is associated with changes in brain size. In one particularly profound study published in the journal "Neurology", researchers looking at MRIs to determine which lab test correlated best with brain atrophy found that the hemoglobin A1C demonstrated the ost powerful relationship. When comparing the degree of brain tissue loss in those individuals with the lowest hemoglobin A1C (4.4to 5.2) to those having the highest hemoglobin A1c (5.9 to 9.0), the brain loss in those individuals with the highest hemoglobin A1C was almost doubled during the six-year period..."
There is also a chart on page 117 of the book that shows 4 categories of A1C levels and corresponding increased % of annual brain loss with the first category of A1C between 4.4-5.2 and % of annual brain loss around 0.250, second category of A1c between 5.3-5.5 and % of annual brain loss around 0.375, the third category of A1C between 5.6-6.8 and % of annual brain loss around 0.425 and the last category of A1c betwen 5.9-9 and annual % of brain loss at around 0.48
The study that Dr. Perlmutter refers to is this one:
C.Enzinger, et al, "Risk Factors for Progression of Brain Atrophy in Aging: Six-year Follow-up of Normal Subjects," Neurology 64,no.10 (May 24,2005): 1704-11.

There is also a paragraph connecting higher A1c levels with an increase in depression.
This is the reference given:
M.Hamer, et al, "Haemoglobin A1c, Fasting Glucose and Future Risk of Elevated Depressive Symptoms over 2 Years of Follow-up in the English Longitudinal Study of Ageing," Psychological Medicine 41, no.9 (September 2011):1889-96

I will now take a look at the pubmed reports that you shared.

Birgit

P.S. I completely agree that tighter blood sugar control for people who are on diabetes medication and/or insulin can be risky and needs to decided together with a knowledgeable physician to avoid dangerous blood sugar lows.

Edited by: HOUNDLOVER1 at: 8/12/2014 (01:46)
DIETITIANBECKY Posts: 27,860
8/11/14 9:28 P

Dear HOUNDLOVER--
I became more curious after your post about recent research in the area of A1C values and dementia, brain health, etc.

And as one would expect, out of range A1C values does elevate risk. (nothing surprising there). But I could not find any study/studies providing evidence of a 5.2

Here are 2 of the interesting reports:
www.ncbi.nlm.nih.gov/pubmed/24652830

www.ncbi.nlm.nih.gov/pubmed/18267013

Let me know if you find something.

Becky
Your SP Registered Dietitian

DIETITIANBECKY Posts: 27,860
8/11/14 9:02 P

I was under the impression that the most recent posting was in response to WILMA---who stated she had a recent diagnosis of diabetes. Therefore I think I referenced the A1C value I provided of 7.0 as being for someone who has that medical diagnosis.

For more on A1C testing, diagnosis, and variations, this link is excellent:
diabetes.niddk.nih.gov/dm/pubs/A1CTest/>

It may be a good idea to save the link for it does help as a reference to assure that one is sharing guidelines that are within line with the medical protocols for diabetes management.

Becky
Your SP Registered Dietitian

Edited by: DIETITIANBECKY at: 8/11/2014 (21:07)
ALGEBRAGIRL Posts: 1,925
8/11/14 8:09 P

Just a reality check... the 'web' is not a doctor!

RUSSELL_40 Posts: 16,826
8/11/14 7:26 P

Becky, while we know the recommendations for diabetics, we were discussing what is normal.

Surely your doctor does not have below 7.0 as a goal for you, so what is normal? I can get 10 different answers on the web.

DIETITIANBECKY Posts: 27,860
8/11/14 4:21 P

Birgit--
So glad your doctor and you are happy with your A1C; but this does not mean it is an appropriate goal for everyone with diabetes. Once again---everyone with diabetes should be determining their goal with their health provider.

I am not sure I have read the research indicating that everyone with diabetes should have an A1C below 5.2 to prevent brain shrinkage. Can you share the actual study??? Remember too, that is should be a study on humans, not rodents. If you can not locate the human control study, it is probably best to alter your post. We don't want to plant misinformation.


In fact there are several studies showing that "tighter blood sugar control" for people with diabetes can be more dangerous and increase disease risk. Therefore, as I said earlier---this is a discussion one should have with their doctor!!! This is not the information that should be coming from members on this site. We (members and experts) are not able to determine this medical need.

Becky
Your SP Registered Dietitian Nutritionist

HOUNDLOVER1 Posts: 8,869
8/11/14 4:08 P

Dr. Perlmutter describes in his book "Grain Brain" (and references it from studies printed in the Journal of Neurology) that any A1c level over 5.2 increases the risk of brain shrinkage (and diseases like Alzheimer's, dementia etc.) significantly.
I've been able to lower my A1c to 5.3 now and will not stop until it's below that.
Birgit

DIETITIANBECKY Posts: 27,860
8/11/14 4:08 P

WILMA--
How did your visit go today.
Is there anything that I can do to help you.
Would using our Sparkpeople Diabetes Center help?
We have many tools, resources, meal plans and informational articles.
Let me know if you need the steps to use this tool.

Becky
Your SP Registered Dietitian

DIETITIANBECKY Posts: 27,860
8/11/14 4:04 P

For someone with the diagnosis of diabetes, the standard medical recommendation for an A1C is.....less than 7.0

However....your doctor may set your target A1C to be slightly different based on your diabetes history and overall health. What is a safe A1C goal for one person with diabetes may not be safe or appropriate for another person with diabetes. So please confirm with your doctor or Certified Diabetes Educator the A1C goal that is best for your overall medical care.

Becky
Your SP Registered Dietitian

ALGEBRAGIRL Posts: 1,925
8/11/14 9:14 A

Hmmm. I guess I'll have to ask my doctor to clarify that range. When it comes to choosing between an answer from my own doctor and a website, I think I'll choose the former. Even though I do like Webmd, by the way!

ALGEBRAGIRL Posts: 1,925
8/11/14 8:45 A

4-6.2% is the normal range for A1C. That's what's printed on my lab report (mine is 5.4%). Whatever the doctor's own value is doesn't affect hers!

Edited by: ALGEBRAGIRL at: 8/11/2014 (08:45)
ALGEBRAGIRL Posts: 1,925
8/11/14 8:07 A

Wilmac, you say you're seeing a doctor (yesterday?): that is where you will get the information you need! Especially since you want to deal with this in a 'safe and healthy way.' Good luck!

Edited by: ALGEBRAGIRL at: 8/11/2014 (08:08)
WILMAC8 SparkPoints: (1,529)
Fitness Minutes: (0)
Posts: 16
8/11/14 7:05 A

Hi I would like to know more. I have just been diagnosed with type 2 diabetes have had a go at reading do's and dont's in recipe books for diabetes and have ended up giving myself a serious sugar head today has taken me till lunch time to feel half way normal LOL. Its where to start that is the thing. I have been told this can be controlled with diet seeing doc this afternoon but want to do this and loose weight in a safe and healthy way

HOUNDLOVER1 Posts: 8,869
4/27/14 9:45 P

Kdarden,
sounds like you are doing great with diet and exercise. Feel free to join us on the low-carb team on Spark. emoticon
Birgit

KDARDEN7 Posts: 3
4/27/14 7:09 P

Through diet and exercise I have kept off over 200 pounds and have stopped insulin, glucophage and metformin. Eating a low glycemic diet rich in fish, chicken, veggies and fruit has helped me begin the journey to lose the last 50 pounds. Exercise 3 days a week at the gym combined with 3 days of general yard work including a push mower has my blood glucose averaging 107. I will get the A1C in May but Jan was 6.1 down from 7.2. Diabetes can be controlled by diet and exercise if you are type 2!

RUSSELL_40 Posts: 16,826
4/27/14 6:58 P

I just can't get to the point where i consider tomatoes and onions a cheat Hawk...lol.

HAWKTHREE SparkPoints: (32,331)
Fitness Minutes: (14,667)
Posts: 1,070
4/27/14 1:08 P

@russell_40
I cheat with the tomatoes and onions. Not badly but sometimes a soup just needs them.

JUSTEATREALFOOD Posts: 2,352
4/27/14 6:53 A

Russell that book is very cool, I bookmarked it :)

RUSSELL_40 Posts: 16,826
4/27/14 6:34 A

I found the part where Becky talked about local fruit/produce being suggested to be very interesting. Some low carbers tend to aim for meat and eggs, but many other aim to increase veggies, nuts, cheeses, fruits, and seeds etc.

As some people get further along in the diet, they start to narrow it down even more to " eat locally, or eat " grass fed beef ". which personally, I would find hard to afford, and being from Michigan, would limit my fruit intake severely..lol. We had snow 2 weeks ago.

So sometimes we need to note that more lenient versions of what we would suggest might be more helpful. I tried Dr. Berstein's diet for example, after recently getting my HgbA1c down to 5.0,without any meds, and found it way to strict. I like tomatoes, and onions, and not so much many of the vegetables he allows. I am super happy for you HAWKTHREE, and glad it worked for you, but I guess I will just have to be happy with a 5.0, and not be able to get to 4.2 , like I wanted to.

I think we should be studying what to eat to treat diabetes a lot more, but right now, mostly we have questions. They need to be answered. Then we can make changes. That will take time.

I recently came across a 1917 Diabetic cookbook that I found interesting, and kind of wonder how we have come from a Berstein-like diet.. 76 % fat/ 7 % carbs/17% protein, to where we are today. On page 148, they list 9 days meal plans, and they do include bread, and fruit, but still very low carb.

archive.org/details/diabeticcookeryr00oppe
iala


Maybe it is because we not have medicines, and Insulin, as well as blood sugar meters, but shouldn't we at least explore the idea of treating diabetes with diet?

If nothing else, the link is interactive, and interesting, so I thought some here might enjoy it. I found the link on Mark's Daily Apple, but decided to get it from a secondary source, and this is the California Digital Library, which is probably where Mr. Sisson got it..lol.

The section on bread/cakes makes the low carber in me weep a little, but it is low carb bread, and I think most people would struggle to make it. Plus, I think other than the macronutrient ratios being similar to Bernstein's diet, there are difference between this diabetic menu, and low carb as we would do it today ( Atkins/Paleo etc ).

I'm guessing that with meds, we now are able to eat more carbs, and keep low blood sugars, the question always is, how many carbs, and does one want to take meds, just so they can eat more carbs? I'm sure that varies by the individual, so while low carb may be one form f treatment for diabetes, maybe another person might be willing to take a small dose of Insulin, if it allows them to have brown rice, or bananas.

I don't think low carb represents the diet plan all diabetics should follow, but actually represents the bottom end, and there is a scale, based on what a person is willing to cut, or how much medicine they are willing to take to enjoy their favorite foods, such as yogurt. So a plan with 15 grams a day can work, and so can a plan with 150 grams... You would just probably need some medications if you are at the top end, and less as you move down in carb consumption.

My only concern with higher carb, is that I tended to eat trigger foods, and have more low blood sugars as I rebounded, or had some Insulin created by my pancreas, when it decided to actually work.

Sorry for the long post, but I find this very interesting, since I have had success, but realize that there are other ways to achieve it, and diabetics who choose to eat 150 grams a day need to have success too, and many have done this, so hope that this becomes more of a discussion, like on this thread.

Edited by: RUSSELL_40 at: 4/27/2014 (06:52)
HAWKTHREE SparkPoints: (32,331)
Fitness Minutes: (14,667)
Posts: 1,070
4/25/14 10:02 P

@russell_40

Diabetes is genetic in our family. Lots of hypoglycemia and some Type 1. Loads of diabetic pregnancies. Children born larger than 10 pounds.

I was exempt from fasting due to hypoglycemia. Had diabetic pregnancies and in 2000, I was officially diabetic Type 2.

My doctor wisely steered me to Dr. Bernstein's diabetes research and recommendations.

I am medication free and have been since 2000.

I had anesthesia this summer and my BG went whacko for a couple of days. From asking other diabetics or their family members, anesthesia can do this.

HOUNDLOVER1 Posts: 8,869
4/25/14 1:38 P

I do agree that people end up eating the SAD diet because what they are eating is not satisfying them. This needs to be considered. The cause could be either that their bodies aren't getting enough nutrients of some sort (macro or micro) or that something they are eating is addictive. It could also be both together. We know that sugar, for instance, is addictive to many people and changes the mineral balance in our body.
As far as responsibility, I believe we are only responsible for our own personal food choices and the information we give to other people. Just because I eat a particular type of diet and someone else does it incorrectly I am not at all responsible for what that person does unless I have taught them wrong. Almost any correct information can be misunderstood and/or misinterpreted. Sometimes it is the fault of the person who passed on the information, sometimes it is nobody's fault, and sometimes it's the fault of the person who misinterpreted the information.
Professionals of course have a higher level of responsibility and professional ethics than the average person needs to follow. But we all have a moral responsibility to do no harm and to help others.
The other problem is that it does not help to put people into categories (low-carb, low-fat), because most people don't fit neatly. I'm 95% very low-carb but also eat organic, 90% local, 75% vegetarian, gluten-free, 3% at fast food restaurants, 80% humanely raised animal products, 60% raw etc.
I don't have too much in common with many people who eat in all these different ways.

I often hear people complain that it is so difficult to decide how to eat because there is so much conflicting information out there. This is true, but it is true in any area of life. Think about dealing with finances, buying or maintaining a home, raising kids, finding a good job/career, knowing if and who to vote for etc., these things all need a lot of learning/education to navigate for most adults. Having finished high school is adequate preparation for most people to learn about all these things on their own if they really put their mind to it.
We have the choice to be our own best advocates and research well what to eat or we can leave it up to the "experts" to tell us what to do. The experts are not always right, they can just explain their beliefs better. We should listen to their input but ultimately we owe it to ourselves to learn what we need to know to lead fulfilled lives.
This goes for what we put in our mouth, too. Learning why we do what we do is empowering, even if we make some mistakes in the process, and we all do.

Birgit

Edited by: HOUNDLOVER1 at: 4/25/2014 (13:40)
EELPIE Posts: 2,700
4/25/14 1:30 P

hmmm...here's a question:

Could big Pharma be influencing any of this?

RUSSELL_40 Posts: 16,826
4/25/14 1:21 P

I recently watched a video where a guy said that if you were designing a diet to keep blood sugars low, you would look at how each macronutrient affected blood sugar.

You would eat the most of the macro that didn't move blood sugar much, if at all ... FAT

Then you would eat a moderate amount of the macro that had moderate effect on blood sugar.. PROTEIN

An you would eat very little of the macro that spiked you blood sugar, and choose these selection based on their individual ability to spike blood sugars... CARBOHYDRATES.

This just makes sense to me. The problem I always had with diabetes counseling is that they could never answer how eating 45% carbs could help me attain normal blood sugars, without meds. What is the reasoning behind eating so many carbs? Especially when higher carb levels lead to higher glucose levels, and the need for medication to offset this.


On the other hand, I am always reading about how they do a study, but can't really prove that diabetes is helped by low carb. On my own, with no guidance whatsoever besides DANDR, I figured it out, and got rid of meds, and have 5.0-5.4 HgbA1c's for 3 years now.

Meanwhile a bunch of scientists can't get together, and come up with a study that would answer this question once and for all. Why don't the people supporting low carb, ask the critics what criteria they would need to follow to make their study accepted.

They would need enough participants to make the study worthwhile, with enough leeway to compensate for quitters. Then they would have to pick a set of acceptable foods, and a carb level for the diabetics to follow, like 50 g a day. Since a HgbA1c is a 3 month average, have the participants log their meals for 3 straight months, with a test at the start, and another 3 months later.

I just get so tired about hearing this study says low carb may be a benefit to diabetics. How about we start by getting everyone to agree that a 50 g a day carb diet will significantly lower blood sugars , and A1c ( by doing an accepted study ), and then work on what level we actually need to stick to, to see positive results. We see some improvement from the " diabetic " diet, so 120 grams would have some extra benefit, and 100 g even more ( theoretically ). So at what point could they get off meds, and have blood sugars be 80-110?

Low carb = high fat. We may eat slightly more protein, or not, but it isn't enough to make up for all the carbs you cut, so fat has to be what makes up those calories. Then it is just a matter of how much saturated/unsaturated fat you choose to consume. Personally, I don't care what kind of fat I consume, just make sure it is 60-75%.

I guess it always comes back to why would I eat foods that spike my blood sugars, and force me to take meds? Maybe my goal is wrong? get off meds/ have normal blood sugars? If so, what is the goal, and how best to achieve that?

Wasting time doing studies that just get ignored for various reasons doesn't make any sense. There has to be some guidelines to what a study would need to entail to be beyond reproach. Follow those guidelines, and prove this once and for all.

EELPIE Posts: 2,700
4/25/14 10:00 A

I do not have diabetes, and I do moderate carb intake - slow carb is my style...but I can talk about saturated fat and how it has helped me.

It works for me. Not a ton of it - and I'm not talking deep fried food...I'm just talking normal saturated fat.

Yesterday I experimented with barley (OMG I have a new love in my life). I had it with sour cream, hot sauce and red pepper flakes. Wow.

Anyway..so I lost half a pound over night.. .on a diet that included a
*huge* dollop of sour cream.

Anyway, so for me, fat is not the enemy that it is portrayed to be.

RUSSELL_40 Posts: 16,826
4/25/14 9:49 A

Becky, I have no doubt that your personal clients are well tended to, and even those handled by most dietitians, but most people do not see a dietitian. Maybe with Obamacare that will increase, since a little nutrition now could prevent a lot of unhealthiness later.

S.A.D. has nothing in common with what I will call the low fat diet a doctor would recommend today. I agree on that, but while the 22 year old college kid scarfing down soft tacos knows he is eating poorly, many other people do not, because they don't eat at McDonald's every day. They consider themselves to be eating healthy, even though they are 50 lbs. overweight.

Without all the help of a dietitian, they only hear " fat is bad ". I talk to people daily who tell me how low in fat their diet is. No mention of calories, or any other macronutrients. They have come to fear fat, and food manufacturers have seized upon that, and while the low fat diet ( 30 % ) has also changed in the past 40-45 years as you have noted, the S.A.D. has also changed immensely. New foods have been invented.

You may note that there is a huge difference between a plate with 50 % veggies, 3-4 ozs. lean meat cooked in a Tbsp. of olive oil, and a serving or two of brown rice, and what people eat on the S.A.D. The problem is that for many people, up to 8 p.m., they think they ate a wonderful menu, following the low fat diet. For these people what they think of as the low fat diet, becomes the S.A.D. at 10 p.m., when they run out and buy 3 double cheeseburgers, Fritos, and a liter of Pepsi. They do this because they are starving on the " low fat diet ".

If I go on the theory that the low fat diet is healthy, then we have to admit something went terribly wrong in it's implementation. We are approaching 70 % overweight as a country. These are horrible results. While some of these people are just eating junk food, most of them think they are doing their best to follow the diet the government recommends. They are eating the cereal, milk, veggies, bread, pasta, lean meat, and salads, and think their diet is very healthy. They would not consider themselves to be on the S.A.D. yet have the same weight problems. They consider themselves to be on a low fat diet, but just "cheat " a little.

When I was 360, I ate pretty close to what my interpretation of what was healthy 80 % of the time. Mostly my binges were at night, and the next morning, I would eat healthy again. I don't think the S.A.D. is something people eat all day long. It is what happens when a person is trying to eat a low fat diet, and finds themselves with cravings at lunch, or late at night, and succumbs to what they perceive as hunger.They may only be " off plan " for an hour a day, but in that hour, they turn that low fat diet into the S.A.D. I would wager that most people eating the S.A.D. would say they follow the government recommended diet if you asked them. So we either have the fact that it doesn't work for 70 % of them, or that they are doing it improperly. If a diet gets sabotaged, or is unable to be followed by a person, it is still part of
that diet. It resulted from attempting to spread an idea to the populace, and like a high school rumor has been diluted, and warped to not be anything close to what was intended, but you can't just take your negative results, and say they are a different diet.

Just like the people eating Atkins bars/shakes/meals and not losing a lb. who gets counted as a low carber, you need to address the health concerns of these people who have been labeled as people who follow the S.A.D., but consider themselves to be following a healthy low fat diet, that the government recommended, and wondering why it isn't working.

The S.A.D. is just a poorly implemented version of the low fat diet. I don't say this to say " NaNaNANaNaNa.. your diet failed ". I say it to point out that those who seem to have been cast off as people following a different diet, think of themselves as following the diet the government recommends. They need to be put back on track. The difference between what is intended, and what gets eaten, needs to be pointed out, and switched back.

This is nobody's fault, except, of course, the food manufacturers, but something is wrong, and I don't hear anyone coming up with any corrections. This is aside from other diets. I am talking about people who believe in the low fat diet.. the majority. Maybe they are happening in face-to-face meetings between clients/dietitians, but the average person is trying to piece together random dietary factoids, and fashion a diet they think follows what the government recommends, and are failing, and ending up eating the S.A.D.

If 70 % of people had another health issue, we wouldn't sit around trying to explain why they had it, but would focus on fixing it. I would be interested in reading an SP article about what has changed over the past 20 years. There are daily " studies " released it seems, but what has really changed over the years. As a dietitian, what changes have you had to implement due to new studies, or ideas?

I know you probably just think of me as being argumentative, but I am serious. If the implementation is just being handled poorly, then we need to do a better job of clarifying how to do the government diet. Since a majority of people follow, or try to follow it, increasing the success rate of this diet helps more people than if I was to say switch to a low carb diet, or eat vegan. With so much information coming out, has the advice changed that much in the past 20 years, or despite all the buzz about parts of our diet, nothing has really changed in the past 20 years?








JUSTEATREALFOOD Posts: 2,352
4/25/14 8:44 A

I think that a big part of how we ended up with the SAD comes from the belief that bottom line calories in, calories out is all that matters. In that world three teaspoons of sugar are healthier than a grapefruit.

tomduhamel.com/advertising-gold/2013/09/ma
rketing-gold-kinda-sugar/


Calories are important but I believe the emphasis should be on eating real food, especially vegetables and fruits, not just calories. Eating less calories of a diet that is highly processed and nutrient poor isn't going to make you healthier.

I very much agree the food industry can turn any healthy food into an unhealthy food.

DIETITIANBECKY Posts: 27,860
4/25/14 8:03 A

I think it is important to understand "how" we got to our current food consumption patterns. That's food history. But it is also important to stop blaming the diet education from the 1970's for todays nutritional concerns. That was 45 years ago. I was 8 years old. Recommendations and counseling techniques have changed drastically.

Today it is "so much more" than 50/30/20.
Today it is so much more individualized.
Finding out about a person's lifestyle, personal desires and goals, cultural and religious preferences, financial situation, family situation, health concerns, educational abilities, etc, etc.

I don't have 1 client who thinks they can eat in a healthy fashion by going to McDonalds 24/7. But they will ask what might be the "better choices" when they do go and how to fit their restaurant visits into their individualized plan.

Today's nutrition message really is about finding out where the person is currently and moving them forward towards better health. It is no longer an "eat this- avoid all that" type approach.

I encourage all "eating approaches" to be very careful of the message they are sending. (This we have learned from past experience) This goes for low carb diets, paleo diet, clean eating diets, gluten free diets, really everyone. For you can easily see how the food industry can turn any "popular approach" into a less than ideal food at the grocery story. For example: gluten free cookies, 100-calories snack packs, Atkins frozen meals (loaded with salt), organic potato chips. WTH (what the heck)!

FYI...I was just at this meeting that the speaker was pushing for the usage of more local produce and saying how we should "only" use foods that come within a 50 mile radius. Good concept but this got me VERY concerned. I thought of my mother (age 93) who reports that when she was a child she only had a banana and orange, once a year, on Christmas---they were too expensive and not available at other times (not grown locally in the mid-west). This is exactly what would happen if I really only ate foods within a 50 mile radius of my home. We need to be realistic! People really need to be thinking of the impact of their message. And that goes for all of us here at Sparkpeople too!

have a great day--
Becky
Your SP Registered Dietitian

Edited by: DIETITIANBECKY at: 4/25/2014 (08:06)
RUSSELL_40 Posts: 16,826
4/25/14 2:02 A

S.A.D. is the unfortunate result of saying fat was bad. They replaced the fat with stuff that was bad, and as long as it said " low fat ", it was okay.

As a low carber, I often read about people just eating meat, butter and eggs, and not consuming fruits, vegetables, nuts, seeds, or legumes at all, or in very small quantities. They have latched on to the meat and eggs in butter concept of low carb, and while it is not what is intended when one suggests low carb, we can't just say.. those people don't count as low carbers.

Any diet will be either misunderstood, or warped into unhealthy versions, and just like low carbers can't divorce themselves from the idea that the guy eating 2 lbs. of meat thinks he is on the same diet as I am, neither can the government divorce themselves from the fact that the S.A.D. is an offshoot of the recommended diet, and now is a majority of dieters " following " that plan.

Talk to anyone supposedly following your plan, and they will tell you all about the healthy foods they can get at McDonald's. Many actually stick to 50/20/30, but in a way that is terribly unhealthy.

You came up with a plan, which may be healthy if done correctly, but you have to accept blame when someone trying to follow your plan decided that the food on your plan sucks, and invents Hot Pockets, or Chicken McNuggets. Or if they eat the way you intend, but are starving at 10 p.m., and go eat 5000 calories at Taco Bell. If your diet caused the binges, then those binges are a result of your diet.

As a result of the diet created in the 1970's, we cut fat, and had to make food taste better by adding sugar/salt. Was this intended? Of course not. They want you to eat lean meat and fresh veggies, but without the idea that low fat foods made us healthy, we wouldn't have low-fat twinkies, or people who think they are healthy.

S.A.D is the result of the low fat fad diet, and while we can point out that it isn't done as intended, it is the result. We told everybody fat was bad, and acted amazed when huge companies figured out that food did not need to be healthy, just LOW FAT. That is the problem with government. They never figure out the obvious. What else would food manufacturers do, besides come up with low fat foods?

It is one of the reasons that I am leery of low carb becoming mainstream. I wish people could do the diet, and benefit from it, yet I am worried that if food manufactureres start think anything without carbs is good, they will invent low carb franken-foods.

So I sympathize with you bemoaning the fact that your low fat diet has been hijacked, and totally made into a diet bearing little resemblance to the original, but I think it was the only possible outcome. It is why people following the S.A.D. think they are eating healthy. They think they are following your diet.

S.A.D. is a direct result of the low fat craze.



RUSSELL_40 Posts: 16,826
4/25/14 1:10 A

That is the problem Birgit. If we accept that saturated fats aren't so bad, what then? Without a plan to incorporate that new information into a better plan, what are you going to do? Just say eat saturated fats? That could be unhealthy.

They will say that saturated fats are okay, but in what circumstances? It comes across as a license to consume vast quantities of saturated fats, without concern for the rest of your diet.

It's kind of like saying that driving 20 m.p.h. faster isn't dangerous. If that happens to be 20-40 m.p.h, it may be true. If it is 120-140, it may be very dangerous.

Are there any new guidelines on how much saturated fats you should consume, or with what food it is okay to eat it with? Or is it unlimited, and I can just eat it on any diet, without consequences?

Dr. Oz says he was wrong. Congrats!.. so what is right? I am not sure he knows. An idea he believed in was proven, at least to him, to be false, but he doesn't have a new philosophy. He just ran out and told people he was wrong.

If he isn't confused, he should share what he thinks we should do with this information, because I think most people are confused. Hearing that saturated fat is okay doesn't explain to me how that should affect my diet at all. Has dietary advice changed at all because of this, and if it would change, how so?



DIETITIANBECKY Posts: 27,860
4/24/14 8:25 P

Most doctors and dietitians that I know are "not" confused. We continue to use current research evidence to help patients and clients create healthy meal plans to prevent disease as well as improve overall health. As new research reveals better treatment options we implement them into our nutrition therapy. I am sure recommendations will continue to change as we learn more and more through research.

I consider the SAD (standard American diet) diet to include an excessive amount of calories, excessive amount of fat, refined carbohydrates, and loaded with salt. It contains too few fruits and veggies, too little fiber. It is filled with foods like: deep fried meats, sauce covered ribs, pastries, sweets, sugary drinks and cereals. I honestly don't know one doctor or dietitian who is suggesting the SAD as a healthy diet for anyone.

Becky
Your SP Registered Dietitian

HOUNDLOVER1 Posts: 8,869
4/24/14 11:48 A

To their credit, they did mention in the Dr. Oz show that saturated fat plus high-carb does not work, but it was certainly easy to miss. It would have been much better if they had taken a whole program and gone in-depth on how to do this right, including lots of helpful resources that have links to the research. I can only hope that this will happen in the future as Dr. Oz is watched by so many millions who consider him their health-care guru.
Birgit

RUSSELL_40 Posts: 16,826
4/24/14 11:04 A

A lot of people are changing their tune. Hard to keep preaching that X works, when so many are getting healthier while supposedly eating such an " unhealthy " diet, instead of eating X. The results after 40 years are woeful, and even if you think the diet works, you still need to address the increases in obesity, cancer, diabetes, and heart disease, even if the cause is that no one follows the diet. All that matters is the result.

If a diet helps you maintain a healthy weight, and improves health in the tests your doctor prescribes, then it is healthy. If not, then the diet is unhealthy. I think 70 % overweight speaks for itself. Time for a new solution for those not seeing good results ( 70 % of America ).

I think most doctors and dietitians are confused mostly. What they think will work hasn't, and while you and I, Birgit, have an idea of what a better plan might be, they don't. All they know is the current plan isn't working. They are lost. So they can see that saturated fats aren't as big an issue as they believed, but what do they prescribe?

I think saturated fats can be a problem with certain diets, especially a high carb diet, so if all you know is that saturated fats aren't that bad, and that is all you change, it could still be dangerous. You need to change the entire diet, not just saturated fats, and until they get that, they will do shows about how saturated fats may not be so bad. However, they aren't ready to suggest another type of diet.

I think that the current S.A.D. is already high in saturated fats, and combined with carbs, causes us to overeat, and become obese. Changing where you get these saturated fats from matters. I just think that a doctor or dietitian will be reluctant to suggest that anyone should increase their saturated fats, until they have a complete diet to suggest along with that idea.

My biggest problem is with those who are still saying that a diet that caused 70 % overweight, is a good diet. I can understand those who haven't found an alternative diet to recommend, but those who aren't looking for a better alternative, baffle me. They should be trying to help the 70 % who this diet doesn't work for. One diet won't work for everyone, so use this 50/20/30 for those 30 % who do well on it, and for those who don't do well, at least start looking for an alternative. First though, one needs to admit that there is a problem with current thinking, and I find this encouraging. It will be a while before we see other diets being suggested, or the idea that the 50/20/30 diet only works for 30 % of Americans, and is not a good option for the other 70 %.

In everything else, we judge things by results, why not diet? Especially for diabetics.

Edited by: RUSSELL_40 at: 4/24/2014 (11:04)
HOUNDLOVER1 Posts: 8,869
4/22/14 5:41 P

I was surprised when I saw that Dr. Oz talked about saturated fat on his program from 4/17 in a very different light, saying that natural saturated fats are not the demon they were once believed to be but may actually be helpful. He made it very clear that what he used to think was wrong.
www.youtube.com/watch?v=6t6T0l14-n4 part 1
www.youtube.com/watch?v=4FdpWvA3v3Y part 2

Birgit

Edited by: HOUNDLOVER1 at: 4/22/2014 (17:45)
RUSSELL_40 Posts: 16,826
4/22/14 8:25 A

I remember when I did my diabetic training class, and they told us to cut down to 150 grams of carbs a day to improve blood sugars. This was out of 1800 calories for me, so 33%, but for some, it was 50% ( 1200 calories ).

I decided to ask a question. " If cutting carbs by 50 % is good, and helps improve blood sugars, why not cut it in half again, and see better results ". The instructor actually yelled at me.

Seven years later I started low carb at 20 g a day, and within 1 year was off all my meds. In those 7 years, I had high blood sugars, neuropathy in my foot, worsening vision, and damage to 21 teeth, 3 which had to be removed, after one fell out. My diabetes was around before I found out at 28 years of age ( it was 526 mg/dl 1st test ). Still, at the time of this class, I had almost no damage from the disease. What if they had been open to low carb diets that were even lower that what they were suggesting?

I might have all my teeth, better vision, as well as no numbness in my right foot. It is nice to see that their goal is shifting to actual blood sugar control, and they are finding that it is possible to get patients into the 80-110 mg/dl range, instead of being happy when they get a 132 reading, like it was a great accomplishment.

Diabetics today are literally taking medication to offset what they eat, and just by adjusting what they eat, they need less medication, if any at all. We should aim for results, and if a person can maintain 80-110 mg/dl while eating 300 grams of carbs, that is awesome. However, if not, they should be working to see what foods they can eat to accomplish this, not just following a set goal if they don't get the results they want.

If you don't eat enough carbs to raise blood sugars above 120, then you don't need meds at all. So the focus should be on quantity, AND quality of the carbs we eat, and not on medication to offset the damage we are doing to ourselves. First, we should stop doing what caused us to become diabetic.( Type II ).

JUSTEATREALFOOD Posts: 2,352
4/22/14 8:08 A

It was a great article. I re-blogged it on my page :)

I found this bit particularly interesting.

-------------------------

"After carbohydrates were recognized as the macronutrient primarily responsible for increasing blood glucose, severe restriction was used to manage hyperglycemia before the discovery of insulin in 1922.4 Until the early 1970s, a lower-carbohydrate, higher-fat diet was considered appropriate for nutritional management of diabetes.5 In 1980, the first set of Dietary Guidelines for Americans included recommendations to adopt an eating pattern lower in fat to prevent chronic health conditions such as diabetes, cardiovascular disease (CVD), and hypertension.6 Although these guidelines state that they “do not apply to people who need special diets because of diseases or conditions,” many clinicians began recommending lower-fat eating patterns, and people with diabetes began adopting them."

-------------------------

I've always wondered why my type 2 diabetic father has been prescribed and following a low fat, low protein (2 oz per meal) diet. That only leaves carbohydrates for him to fill up on, the very thing that is slowly killing him. It just doesn't make any sense to me at all.


I really liked this bit too.
------------------------

"Low-carbohydrate diets are often disparaged for providing inadequate calcium, folate, vitamin C, and fiber. The sample menu in Table 1 demonstrates that this criticism is unwarranted because these nutrients can exceed the RDA or adequate intake (AI) amounts without reliance on fortified foods or supplementation."




Edited by: JUSTEATREALFOOD at: 4/22/2014 (08:13)
HOUNDLOVER1 Posts: 8,869
4/21/14 8:35 P

Diabetes Spectrum is a publication by the American Diabetes Association. This article gives an interesting update on the recommendations for eating with diabetes and pre-diabetes.

spectrum.diabetesjournals.org/content/25/4
/238.full?sid=205120d8-8d95-4c3c-aed7-
3bbd4bcea55f


Birgit

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