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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
8/17/14 1:41 A

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I found the links given quite interesting. It was not clear to me, not having read the actual study, how "tighter blood sugar control" was achieved. Was it done by dietary changes or by medication changes? Given that cardiovascular risk factors are not just blood sugar but also stress (and a host of other factors), I find it conceivable, and I'm just guessing here, that being on a tighter blood sugar control program in a research setting may produce significant additional stress on participants. It is possible that someone who practices tighter control under their doctors supervision and with control over food choices, exercise, supplements etc. would have very different results. I don't know if that's the case, I'm just saying that there are a lot of factors that could increase risk in the "tighter control" arm of the study.
Concerning what constitutes a "normal" or "healthy" A1C level I suspect more and more that there are too many variables in A1C in too many people to rely on it exclusively. It makes more sense to me to have it be only one measurement and for doctors to test their patients daily fasting, post-prandial and other daily blood sugar levels and maybe also test fasting insulin.
Birgit

Edited by: HOUNDLOVER1 at: 8/17/2014 (01:41)
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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/16/14 8:09 P

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RUSSELL--
I have answered your question several times as to why someone with diabetes may have an A1C goal of 5.7, another person may have a goal of less than 7.0 and another person may have a goal of 9.0.

It is because "tighter control" for some people with diabetes can increase risk of disease and death. Do you understand the meaning of tighter control? Perhaps, this link will help you understand the concept and show you studies of where "tighter control" actually increased complications for some people with diabetes. This study was done on people with more advanced diabetes, but it provides links to other studies as well.

www.medpagetoday.com/Endocrinology/Diabete
s/25189

Notice that the researchers are not sure "why" tighter control did this for some of the subjects. But nevertheless, this is what happened.

Health care professionals use such studies to determine "safety measures" for clients---therefore avoiding complications. Sparkpeople also applies these safety measures.

Health Care professionals and doctors now use Patient Centered Care Plans. Each patient's needs are different, thus each care plan is different, thus each plan for the diabetic goals will be different. This is based on one's age, diabetes history, disease complications, lifestyle, medication needs etc, etc.

It is important to encourage every Sparkpeople member with diabetes to talk to their doctor and ask questions to determine their most effective and safe Patient Centered Care Plan. Talk to your doctor about the best A1C for you. The best eating plan for you. The best weight loss plan for you.
This is not a "Russell-Centered Care Plan." This is the Individual's Patient Centered Care Plan.

In many of your posts, you have told members to aim for a very specific A1C value. To follow a very specific diet. To test blood sugars in a very specific way. Yes---your posts were deleted. Since you are not the member's doctor, your recommendations were inappropriate and possibly dangerous. Please re-read the article that I linked to earlier in this thread. Do you see where "tighter control" increased complications for some people.

You do not get to say what is "successful" for others when it comes to the management of diabetes. You are not the individual. You are not the doctor. You can only encourage members to have these discussions with his/her doctor and health care team. The majority of health care professionals "greatly appreciate" the patient who asks questions and is actively involved in improving the quality of his/her life.

Becky
Your SP Registered Dietitian Nutritionist

PS---After I made this post, this article hit my list:

www.diabetesincontrol.com/index.php?option
=com_content&view=article&id=16753&cat
id=1&Itemid=17


It adds more confusion to the question about an appropriate A1C value for someone with diabetes. But it shows the importance of having discussions with one's doctor...as Sparkpeople has been emphasizing all along. Don't rely on this site or any other site or any individual for your lab result goals----talk to your doctor or health care provider regarding what is "most appropriate" for you.

Edited by: DIETITIANBECKY at: 8/16/2014 (20:33)
ALGEBRAGIRL Posts: 1,794
8/16/14 3:41 P

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Russell, I'm not diabetic and so I'm not sure what you're referring to. But I do wonder why you assume people aren't having meaningful conversations with their doctors, face to face, about their treatment and goals.

You wrote 'Personally, it scares me a little, when professional medical people feel threatened by simple questions, or more frequently, can't answer the questions. I think that is the real threat here'

Here? In the doctor's office - face to face - people do ask questions.

It comes down to advice, right, and direction, and goal setting. Wouldn't the doctor have to explain those things? So a useful takeaway would be, 'Ask your doctor.' You asked your doctor.

My doctor works out of a practice with 7 or 8 other doctors. Among them, they have several times the 'hundreds' you have spoken to. It's not a small population of patients.

You seem to paint a picture of doctors doing their jobs improperly. I don't think this is necessarily the case - as far as medications go, have you ever seen a diabetic go off medications without a doctor's advice? If the results are adverse, who is blamed, who has the liability?

' Doctor's do not have a way to get people below a 5.7 A1C without medication. '
According to my doctor, weight loss (through calorie reduction) is the first step. This came up in a discussion of type 2 diabetes in my family - my father has it and eats mainly fruits and vegetables, is healthy for an 82-year-old, and is of average build.

If a doctor make the diagnosis of diabetes, it's in your medical records. He addresses that with medication because it's a known condition and there are known medications to help control that. He would be ethically in trouble if, diagnosing diabetes, he said to the patient, 'Go home and lose weight' and that was the treatment. If I'm wrong about that advice being the incorrect response, let me know.

Weight Watchers meetings have the face-to-face advantage of people losing weight and their doctors reducing or taking them off medications. I'm not pushing WW, the Spark People diet works the same way in that it reduces calories with some sense of nutritional balance in mind. I mention it because it's the benefit of losing weight that it shows in your health. Not to mention the fact that it is a 'now' thing - it works now as long as you control your diet now.

So, check on that 'no way without medication' thing. A doctor's way to surely address a known condition is to give medication. That's what he or she can do - but losing weight (which can be more difficult) is what a patient can do. However they reduce calories, the weight will come off.





Edited by: ALGEBRAGIRL at: 8/16/2014 (17:17)
RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
8/16/14 2:45 P

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Thanks for the reply about blood sugar control.

As far as my high BP, they do have goals, and the goals for me, are the same as they are for a healthy person, not elevated. Yes, they may be ecstatic if my BP is 135/80, because it is better than 180/125, however they don't set up any mediocre goals... 120/70 is still my goal, the same as it is for you. So while there are varying degrees of success, just like in weight loss, we should have an ultimate goal.

As far as I can tell from personal experience the #1 risk of lowering blood sugars is low blood sugars, No one is suggesting that a person just lower blood sugars without their doctor being made aware, and ready to adjust medications. I am just asking why a diabetic's goal wouldn't be the same as yours, barring health complications that make a 7.0 A1C healthier.

I am not suggesting anyone follow any diet, or aim for any A1C level. I am merely asking for clarification of what is normal, since there are so many ranges if one checks online. Dr. Bernstein recommends 4.2-4.6 A1C, which I find impossible so far. Still, I ask a lot of questions here at SP, and while I do get my questions answered at times, it is always with an insinuation that somehow I am making a statement, or have suggested some advice contrary to what is common advice.

Asking why a diabetic shouldn't aim for the same goal you do, is simply a question, not a suggestion that people aim for lower blood sugars, or a specific target. I think most people when faced with a challenge, set goals, with an ultimate goal at the end, and to do so, it needs to be defined. This would be determined with your doctor, and I haven't suggested otherwise. Funny thing is, my doctor has no goal other than " below 6.5 ".

I have talked to hundreds of diabetics, and not one has ever been given advice other than below 6.5, or 7.0. Not one person told to aim for 5.7 A1C, or lower, and to aim for NO medications. Obviously, this is possible for some, so why is no one trying? Are they ALL incapable of doing this? Do they all have issues that require them to not aim for anything below 6.5?

As you noted, I have other major health complications, so my diabetes was low on their list of areas of concern. Many of the people I know are people who are 30-40 years of age, who have been diagnosed with diabetes, and nothing else, except extra weight. Surely one of them would go see a doctor, and get the advice to aim for " below 5.7 "

If people knew what normal was, I think they would go to their doctor and ask why their goal is 7.0, and not whatever number is possible. Maybe some have complications prohibiting lower blood sugars, and that is why you question your doctor, but with the knowledge that 7.0 or 6.5 is NOT normal, many diabetics hear they are 6.8, and consider it a success, and not a milestone. They have no next goal. They are not attempting to go any lower, because no one told them it was possible.

What would be the harm, if every diabetic walked into their next doctor's appointment, and asked why their goal wasn't the same as yours is? Or if getting off diabetes meds was possible? Surely these questions could simply be answered. When did questioning things become harmful?

Personally, it scares me a little, when professional medical people feel threatened by simple questions, or more frequently, can't answer the questions. I think that is the real threat here. Doctor's do not have a way to get people below a 5.7 A1C without medication. To prevent having to admit they have no plan, they have lowered the bar.

I look forward to the day that I talk to a diabetic, whose doctor has told them.. aim for below 5.7, and let's get you off those diabetes meds, but I doubt that is going to happen anytime soon.



"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

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ALGEBRAGIRL Posts: 1,794
8/16/14 1:46 P

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Russell, I think she was referring to the need for documentation and verification. That's present in scientific papers. There are plenty of studies out there for all kinds of diets.

But that 'plenty' number pales in comparison to the 'I know someone who...' stories.

'By that standard, the only way of knowing a diet worked, would be if you did it yourself. '

That's not true in the competitive world of science, where data is questioned and methods are questioned.

'So by your criteria, no diet on Earth can be proven to work. '

The diet to eat fewer calories than you expend has been proven to work. There have yet to be any demonstrations to the contrary (barring hormonal aspects that would disqualify you) - and I wish there were. If you want to put yourself on cable TV (it's inexpensive, FREE, on local cable, who are always looking to find something to fill in time) and have witnesses round the clock -that means sleeping on camera - for even what passes for 'long-term' in some studies (a month, say), you can demonstrate the opposite of that. You will have to have medical supervision, to say the least, and very accurate recording and measuring. You will sign a lot of wavers, have your lawyer draw up some papers to absolve anyone of any liability in your 'experiment' of one, and you of course, pay for the extensive medical testing yourself that would follow - I guarantee that the bill will be in the tens of thousands (judging from the cost of a single copper assay I had when I requested a screening....)

'I live with myself 24/7, know what I eat, and my doctors have run a multitude of tests upon me ( although I did not do the tests myself, so there is still a measure of doubt, obviously ). The other 7 billion people on this Earth are impossible for me to judge according to your standards, so therefore, no one can say any diet works, except for the one they follow, and we have no idea if it works for anyone else either.'

I wanted to make the point before - and I should have - that a 'multitude of tests' is very expensive. Depending on your insurance and your deductible, unless you are a modern medical miracle, or participating in a study where you live in a metabolic chamber or on a metabolic ward in an environment where exhaustive tests are run and someone else foots the bill - and they would not cover everything, there aren't multitudes of tests that cover every or even most aspects of health. You'd have to be very rich indeed.

'I wonder if you think Becky Hand has patients held for this purpose, making sure to verify that what she is repeating is true? ' I don't think she needs to, do you? She's a professional in her field, it's not 'I know someone who said...'

Edited by: ALGEBRAGIRL at: 8/16/2014 (14:12)
RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
8/16/14 1:32 P

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By your standard of proof Love4Kitties, no diet can be proven to work. Even those who lose weight and are healthy on the SP diet can't be proven to be healthy, or what they are actually eating, so no one could then say that this diet works either.

In person, most of the people I would say were at a perfect weight, tended to get there naturally, and did not eat any exceptionally nutritional diet, and certainly I have never met ANY person following the 50/20/30 diet, who was at a perfect weight.

I expect that you have ZERO people that you have met in person, performed a multitude of tests upon, and watched 24/7 to know what they were eating. By that standard, the only way of knowing a diet worked, would be if you did it yourself.

I live with myself 24/7, know what I eat, and my doctors have run a multitude of tests upon me ( although I did not do the tests myself, so there is still a measure of doubt, obviously ). The other 7 billion people on this Earth are impossible for me to judge according to your standards, so therefore, no one can say any diet works, except for the one they follow, and we have no idea if it works for anyone else either.

So by your criteria, no diet on Earth can be proven to work. You would have to have yourself a pet human, to prove anything to you, one you kept secluded, fed, and performed tests on, and then no one would listen to you anyways, because you would be arrested for kidnapping, and your results would probably be tossed away, since you are of questionable character.

I wonder if you think Becky Hand has patients held for this purpose, making sure to verify that what she is repeating is true? Otherwise, I am sure you tell her all the time that she has no way of knowing what she says is true.

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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LOVE4KITTIES's Photo LOVE4KITTIES Posts: 1,929
8/16/14 12:48 P

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'I am aware of one person who used to be on the low-carb team who ate nothing but meat and occasional cheese for years. She was very healthy and definitely at perfect weight."

Actually, you have no real way of knowing what this person was actually eating (unless you were watching her 24 hours per day), if she was healthy (unless you are her doctor, and even then, you might not know unless you ran a multitude of tests) or even if she was at a good weight (unless you met her in person).

ETA...yes, I am talking about documentation and verification. I mean...we're talking about an individual who is self-reporting on the internet (of all places) and who is eating (or saying s/he eats) an extreme and very limited diet... Personally, I'm not going to take someone's word for it that they are perfectly healthy when they are eating a diet like that.

Edited by: LOVE4KITTIES at: 8/17/2014 (08:53)

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ALGEBRAGIRL Posts: 1,794
8/16/14 11:59 A

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I have looked at ketogenic diets for epilepsy. I found one study that showed one person who was on a ketogenic diet (for epilepsy) long term.

www.ncbi.nlm.nih.gov/pubmed/17560509

I don't think it was a no-carbohydrate, just a very very low carbohydrate diet. It was also started in childhood. It was one person.

'I am aware of one person who used to be on the low-carb team who ate nothing but meat and occasional cheese for years. She was very healthy and definitely at perfect weight. No idea if that would work for everyone, though.' Well, according to the abstract, there would be a possible side-effect in that she would suffer from poor growth. That person should be able to document how she only ate meat and occasional cheese. Then she could be person number two (although 'for years' doesn't really match this kid!) And she would be worthy of medical study.

Now, I have one long-term ketogenic diet on record with medical scrutiny and one 'I know a person who knows a person who said... ' It's not quite the same.

That abstract was really not a study. Not an experiment on that kid. Just a report.

Edited by: ALGEBRAGIRL at: 8/16/2014 (12:06)
HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
8/15/14 1:12 A

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There are some very low-carb, almost no-carb diets in use for therapeutic purposes to treat epilepsy (Johns Hopkins has a program) and also for treating certain cancers which looks promising (most cancer cells need a fair amount of glucose to grow and survive).

I am aware of one person who used to be on the low-carb team who ate nothing but meat and occasional cheese for years. She was very healthy and definitely at perfect weight. No idea if that would work for everyone, though. I think there is a huge difference between consuming animal products from pasture-fed animals versus CAFO (factory-farmed). The latter don't eat a natural diet but grains (mostly wheat and corn) and soy, usually from GMO sources, and don't get vitamins and minerals nor phytonutrients so you won't find enough of those micronutrients in their eggs, milk and meat, either. Pasture-fed may be a different story, but to expensive to us exclusively for most people.
Even given that our body can produce some types of fat (and store it) eating low-fat may make it quite hard to absorb essential fat-soluble vitamins and other nutrients.
The rock stars of vegetarian fats are nuts and avocado, all very tasty, but, again, quite pricey. Sure wish our government would subsidize these super-healthy foods instead of GMO crops like corn, soy and canola.


Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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ALGEBRAGIRL Posts: 1,794
8/14/14 6:40 P

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If plants contain fat (they do, in varying small amounts), do you need to eat any kind of fat other than the fat contained in plants?

The elimination of carbohydrate is an interesting idea - in theory. Or at least according to the one person who I could find that even posited that idea.



ajcn.nutrition.org/content/75/5/951.2.long


'In addition, the essentiality of some nutrients is species-specific; therefore, these studies do not provide convincing evidence that elimination of dietary carbohydrate is safe in humans '

Also, 'Few contemporary human cultures eat low-carbohydrate diets, but the traditional Eskimo diet is very low (≈50 g/d) in carbohydrate (2). It is possible that if more humans consumed diets severely restricted in carbohydrate, a carbohydrate deficiency syndrome might become apparent. '

No kidding.

We're not talking about 'severely restricted,' we're talking about 'elimination' of carbohydrate.


'When carbohydrates are eliminated from the diet, there is a risk that intakes of vitamins, minerals, and perhaps yet unidentified beneficial nutrients provided by carbohydrate-rich foodstuffs (eg, fiber) will be inadequate. There are case reports of extreme dieters who probably developed deficiencies. One dieter who only ate cheese, meat, and eggs (no vegetables) was reported to have developed thiamine-deficient optic neuropathy (14). Another dieter may have developed a relapse of acute variegate porphyria (15). However, most of the current low-carbohydrate, weight-reducing diets advocate the consumption of low-carbohydrate vegetables and vitamin supplements. '

'Although there is certainly no evidence from which to conclude that extreme restriction of dietary carbohydrate is harmless, I was surprised to find that there is similarly little evidence to conclude that extreme restriction of carbohydrate is harmful. In fact, the consequential breakdown of fat as a result of carbohydrate restriction may be beneficial in the treatment of obesity (7). Perhaps it is time to carefully examine the issue of whether carbohydrate is an essential component of human nutrition.'

Little evidence because you would have to use human subjects, longer-term than the usual 'I gotta lose weight somehow' diet and the controlled conditions would definitely be difficult to manage. Even the Eskimos eat some carbohydrate.

And again, there was no recommendation to eliminate fat from the diet. There are plenty of studies showing the effects of very low fat dieting (not no fat) but they suffer from the same limitations as any dietary study (mentioned above) longer term.

The effects you would want to look at wouldn't be obesity (reducing calories will show you that). It would be a daunting task to see the effects on renal function, cancer, etc.

Whenever it's extremely difficult to show a large population that lives with a restriction - because they lived years ago, in a different era or milieu where scientists did not have a hand in observing a large number of people and measuring to modern standards, or when the population is small and lives in a vastly different environment from most of the world, you've got a problem.



www.ncbi.nlm.nih.gov/pubmed/9145438

'Our great ape cousins may derive 30% or more of their dietary calories from colonic uptake of short-chain fatty acids (SCFAs) generated in the colon. The metabolic effects of dietary carbohydrate entering the colon are many and include laxation, the growth of the fecal biomass, nitrogen entrapment and SCFA generation. These SCFAs in turn may nourish mucosal cells, spare glutamine utilization, enhance hepatic gluconeogenesis and lipogenesis and possibly influence renal handling of uric acid. The health implications are significant in terms of modifying risk factors for disease and disease prevention and justify interest in the metabolic effects of non-absorbable sugars such as lactulose.'

I'm mainly interested in the gut microbiota and colorectal cancers, as I've said before.

'assuming all other vitamins and minerals are also eaten. '
That's a lotta supplements. I'm guessing there's a real market for devising complete enteral nutrition - sure enough, there is! And parenteral nutrition (intravenous). I'll also hazard a guess that carbohydrates are included in that mix.

Totally agree with the 'animals store extra calories as fat' thing. Eat more than you burn and you do get fat.

Edited by: ALGEBRAGIRL at: 8/14/2014 (19:40)
RICKTHEBIKER SparkPoints: (698)
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8/14/14 4:58 P

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Um, biochemist here....the body most definitely makes fat from other things. That is what happens when you eat too much sugar or starch. Try overeating honey and bread sometime and see if it doesn't turn into fat right where you don't want it. The starch is broken down to sugar. The sugar is broken down during glycolysis (literally meaning breaking of sugar) and turned into the first component of fatty acid synthesis....making fat. Proteins can be broken down into this first fatty acid synthesis component, too. We store some sugars, but animals mostly store extra calories that come in all forms as fat!

Now, what we can't do is make essential fatty acids. The kind of fatty acids we make is pretty simple and really is just storage of calories. There are certain essential fatty acids that we can only get from our diet. And a small amount of it has to come from animal sources!. Super strict vegans get these very essential (but only in very small amounts) of fats from the bug parts found in the spices we eat! Essentially, you can't survive on a 0% fat diet.

Technically, there are no essential carbohydrates that we actually have to eat. Our body can make all the carbs we need from fat and protein. I wouldn't recommend it, but you could survive on a 0% carbohydrate diet; assuming all other vitamins and minerals are also eaten. I sure wouldn't want to by your colon, however!

Edited by: RICKTHEBIKER at: 8/14/2014 (16:59)
You can't make an omelet without breaking some eggs.....yummy. yummy, omelet!


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ALGEBRAGIRL Posts: 1,794
8/14/14 1:06 P

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Becky, I think it may have been regarding fiber and SCFAs. And the text (it was probably in some study- no, not probably, it was, so I have to search) did not say anything about eliminating dietary fats from the diet, or recommend anything of the kind! I've been looking for the text since I wrote that, because it has to be some study where the text was free (otherwise, I wouldn't have been reading it).

As I was looking, what I saw was a lot about how microbiota in the gut changes and this changes with diet and also with weight loss. For example, in obese people vs lean people.

My interest - and why I was even there in those studies - was about gut microbiota, fiber, and colorectal cancers.

I'm not so interested in cholesterol myself.

But I think that by differentiating essential fatty acids from SCFA (short term fatty acids) in the gut (produced by fermentation) that is where you have cleared it up for me.

Low-fat vegan is about as low as you go, when it comes to dietary fat - that I know of. But, plants already contain fat.

Edited by: ALGEBRAGIRL at: 8/14/2014 (13:34)
DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/14/14 12:53 P

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Might you have been reading about cholesterol; not fat.
You do need to have fat in your diet. Your body needs the essential fatty acids. These can not be produced by the body. There are several conditions caused by a fatty acid deficiency.

Becky
Your SP Registered Dietitian

JUSTEATREALFOOD's Photo JUSTEATREALFOOD Posts: 1,447
8/14/14 12:45 P

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I know the body makes cholesterol if you don't eat it because it is essential for every cell in the body. But I don't believe body can make it's own fat though.

JERF - Just Eat Real Food

I'm a Certified Personal Trainer.

I'm not a doctor or dietitian. I'm just a real whole foods nutrition nerd.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

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Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


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ALGEBRAGIRL Posts: 1,794
8/14/14 10:55 A

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That's why I was asking about the lower limit. I'm not sure 'the lower the better.' And I think Becky cleared that up - saying that it is something to discuss with your doctor or qualified professional.

Interesting thing I read recently, somewhere - that if you don't eat fat, your body manufactures it. You don't actually need dietary fat, using that logic. Except it's not real logic, if you get my drift. There are so many benefits to the very many components of a diet that finding what you 'don't need' isn't exactly the point.

And the place where I read that (don't remember where, but I know it wasn't a book, a blog or a diet website - it was in the text of a study or some such thing) was relating how fat is manufactured in the gut, from non-fat sources. Yeah, so? It still doesn't follow that you don't 'need' fat. But that is the danger in evaluating foods and diets.

A1C is a blood test, not a mathematical average (although I think it correlates well) - just thought I'd repeat that. It's that definition given by diabetes.org.

Edited by: ALGEBRAGIRL at: 8/14/2014 (12:12)
RICKTHEBIKER SparkPoints: (698)
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8/14/14 10:33 A

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It may have been mentioned before, but I would like to point out something about A1C hemoglobin. There is nothing magical about hemoglobin and health with respect to glycosylation. It is a biomarker. The damage that high glucose does is to other body parts and included glycosylation of artery walls resulting in damage to vision, blood flow and such as well as messing with the regulation of fat cells, muscle cells, kidneys and anything else that requires tight glucose regulation to work properly. A1C is just a way of measuring the average monthly glucose levels that might be doing all those bad things completely independent to what hemoglobin is doing.

In general, glucose in the blood is toxic. Like, causes everything from arteriosclerosis to skin wrinkles toxic. Unfortunately, glucose in the blood is also essential! So essential that even people who eat absolutely no carbohydrates at all still have their liver make glucose to release into the blood (gluconeogenesis). That sucks, but that also means that the lower the A1C the better...but what is considered 'good' A1C numbers is going to be different for each person based on their medical situation.

You can't make an omelet without breaking some eggs.....yummy. yummy, omelet!


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
8/14/14 12:19 A

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It seems to me that for anyone with higher blood sugar levels, whether officially diagnosed with diabetes or pre-diabetes or not, should do all the research they can and ask lots of questions when talking to their health care provider. I never want to stop learning about things that may improve my health in the future. There are so many new scientific findings in the area of metabolic health every year it is too much to expect for doctors to keep up with everything for every disease. I would not make decisions without my doctor's approval but I would sure do my own research and then share it with her. My physician is very open-minded and willing to think outside the box. I'm very thankful to have found her.
Birgit

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/13/14 9:12 P

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For folks with diabetes, getting below an A1C of 7.0 is the "gold standard" because the research shows "super wonderful" health improvements in so many areas and decreases risk factors in the areas you mention: eye health, nerve damage, blood circulation, kidney function, heart health, etc. etc.

Now the next step of taking an A1C even lower could be OK for some with diabetes, for others it would not be appropriate. So that is why the discussion must take place regarding A1C target with one's health care providers. Pursing tighter control for many could be dangerous. It could bring about even more diabetes complications and some research even shows an increase in death rate with tighter control.

So discovering the desired A1C for each individual is a discussion to be had by the person and his/her health care team. Only the health care team can see the big picture. There are many things that will go into this decision including ones age, medical history, medical complications, diabetes history, other lab data, personal choice, personal food preferences, personal exercise goal, cultural preferences, etc. etc.

Notice too in the article that I linked to---that there are some folks with diabetes that even the "lower than 7.0" mark is inappropriate. And a higher goal will be determined. I refer you to the article for more info on this.

Bottom line, you have every right to have the discussion with your health care team to determine the A1C that is best for you. And I encourage that discussion to take place.

This site, our experts and members are permitted to share the standard guidelines as outlined in the article.

Planting the idea to any Sparkpeople member with diabetes that they should aim for tighter control with their A1C than is indicated in the standard guidelines is not permitted. Why you may ask? Because no member or expert on this site has the qualifications, the medical data or knowledge to make that decision. This can only be accomplished through a complete medical and nutrition assessment. And making the suggestion that one should aim for a lower A1C could be dangerous or deadly.


There are many criteria that can be used to measure "success" with diabetes management. So let's encourage all SP members to have discussions with their health care team regarding their personal goals and to assure that their goals are realistic and safely obtainable based on their medical history and needs. Examples include: lowering of body weight, achieving a lower than 7.0 A1C, being off insulin and only using oral meds, being off all medication for diabetes... For each person the goals will be different. Talk to your doctor.

Goals that may be appropriate for one member may be completely inappropriate for another. A goal that you wish to personally set, may not be important to another member. What motivates one member, may not be a motivation to another.

I know that you have also shared numerous times with our members that you have congestive heart failure and high blood pressure. These are also conditions where "desired medical outcomes" are somewhat different than for someone who does not have the condition. I am sure you are aware of this. These are also disease conditions where medication is sometimes needed to assist with control, where weight loss can help with control, where diet and exercise can bring about health improvement. A person works with their doctor to determine the best medical management possible when establishing goals to reduce health risk. Remember..... Diabetes management is no different.

Becky
Your SP Registered Dietitian





Edited by: DIETITIANBECKY at: 8/14/2014 (07:21)
RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
8/13/14 8:03 P

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Becky, i was responding to Algebragirl, who said normal was 4-6.2 on her medical paperwork. Your link says below 5.7. I was asking so I could compare advice given to diabetics to advice given to non-diabetics.

For me, I was of the opinion that if my A1C was higher than normal, there would be damage possible to me, because of elevated glucose levels, so I was wondering how much higher the recommendation was for diabetics than it is for non-diabetics.

If I take your link, then a non-diabetic should be at 5.7 or below, but a diabetic is supposed to only get below 7.0, or if the doctor is hopeful, 6.5.

That variance is what puzzles me. If 5.7 is normal ( I think it is high ), then why shouldn't the goal of diabetics be 5.7, without meds? Why do we aim so low? Is it to achieve a higher " success " percentage.

My concern is that once they achieve a 7.0 A1C, they will think they just need to maintain. No one told me that 7.0 was still high. Why would our goal be high blood sugar. It seems to me that they set the goal low, because they either doubt the patient's ability to get much below that level, or be willing to stick to a proper diet long enough to get below 5.7.

Of course, at 5.0, I technically am still withing their guidelines.. below 7.0, but people focus on this number. They have no idea what 6.5, or 7.0 means. It is just a number to them. My brother is ecstatic because his is 6.8. As far as he is concerned, everything is peachy. He thinks his blood sugars are normal now. They think anything below 7.0 is safe. that they are no longer in danger of amputations, blindness, kidney disease etc.

If 7.0 is safer than 9.0, how much safer is 5.0? Is 7.0 a point where the dangers are so low that doctors are happy with it? Or are there no benefits to being much below 6.5-7.0?

I'm kind of wondering if staying below 5.4 A1C for the past few years is a waste, without any health benefits as far as diabetic complications. I've talked to so many low carb diabetics here on SP, and they seem to all end up around 5.0-5.5. If it is so easy to get to this level, and there are health benefits from a lower A1C, shouldn't we at least explore the possibility that diabetics could have normal blood sugars without medication?

"We can't solve our problems with the same thinking we used when we created them "

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“Whether you think you can, or you think you can't--you're right.”

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ALGEBRAGIRL Posts: 1,794
8/12/14 8:58 P

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Yes - there was a study about anemia and A1C results:

www.ncbi.nlm.nih.gov/pubmed/24199163

HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
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I found this little video to explain A1C testing and levels in general. It does not go into great detail but is very understandable so I thought I'd pass it on.
It is mentioned in the video that there is some controversy about what constitutes a normal A1C level and how reliable the test is. One variable is obviously how long someone's Hemoglobin cells live, if they live longer than in the average person the A1C test would read higher, if they live shorter, it would read lower than daily average blood sugar readings by comparison. There are also genetic conditions of abnormal red blood cells in which A1C testing can not be used.
https://www.khanacademy.org/science/health
-and-medicine/endocrinology-and-diabet
es/v/a1c-levels

Khan academy has a whole series on the topic of blood sugar and endocrine health and it may be worth watching as an intro to the topic.

Birgit

Edited by: HOUNDLOVER1 at: 8/12/2014 (18:52)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

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ALGEBRAGIRL Posts: 1,794
8/12/14 6:02 P

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That's why I said:
'Diabetes,org says, of the A1C number, 'It is reported as the percent of hemoglobin molecules that has glucose attached.''

I'm wondering what little amount of hemoglobin molecules with glucose attached you can have - the A1C number is the result of a blood test. What if the result was 1%, for example? If you hadn't any symptoms (hypoglycemia leads to dizziness, etc.- actually, it can lead to a coma and eventually death!), wouldn't it be worrisome?

I'm just surprised there's no low threshold to test for.


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Algebragirl,
you are so lucky that you could pass the OGTT. I won't even take it as I suspect that my pancreas function is low enough that my blood sugar would be in the several hundreds, just not worth causing so much damage to my body. My doctor recommended against this test for this reason.
A1C gives an average blood sugar over the period of the last 3 months. Dangerously low blood sugars are typically the result of high blood sugars earlier (where the pancreas overreacted by releasing more insulin than necessary after eating a high-carb meal) or the result of taking medication and/or insulin that lowers blood sugar. They could not be chronic or the person would not be able to function or even stay alive. Therefore as far as low blood sugars it is the daily levels to watch out for.
Birgit

Edited by: HOUNDLOVER1 at: 8/12/2014 (17:47)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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ALGEBRAGIRL Posts: 1,794
8/12/14 3:49 P

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

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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)
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BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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ALGEBRAGIRL Posts: 1,794
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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)
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8/12/14 12:46 P

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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.

You can't make an omelet without breaking some eggs.....yummy. yummy, omelet!


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
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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)
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BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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ALGEBRAGIRL Posts: 1,794
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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?

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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.

JERF - Just Eat Real Food

I'm a Certified Personal Trainer.

I'm not a doctor or dietitian. I'm just a real whole foods nutrition nerd.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
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Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
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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)
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BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/12/14 8:07 A

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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: 1,794
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Becky, I notice that the studies you cite seem to focus on the elderly (59 years up). No complaints, just noting that.

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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

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8/12/14 1:12 A

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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)
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BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/11/14 9:28 P

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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's Photo DIETITIANBECKY Posts: 26,699
8/11/14 9:02 P

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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: 1,794
8/11/14 8:09 P

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

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

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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.

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

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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

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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

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
8/11/14 4:08 P

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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

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8/11/14 4:04 P

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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: 1,794
8/11/14 9:14 A

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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: 1,794
8/11/14 8:45 A

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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: 1,794
8/11/14 8:07 A

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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)
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8/11/14 7:05 A

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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

Each day has new challenges, may I rise to each one as it presents itself to me.


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
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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

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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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!



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

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

"We can't solve our problems with the same thinking we used when we created them "

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“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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

Life needs balance


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

JERF - Just Eat Real Food

I'm a Certified Personal Trainer.

I'm not a doctor or dietitian. I'm just a real whole foods nutrition nerd.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
37 years old
2 kids

Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


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

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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)
"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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HAWKTHREE's Photo HAWKTHREE SparkPoints: (25,919)
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4/25/14 10:02 P

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@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.

Life needs balance


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
4/25/14 1:38 P

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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)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

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EELPIE's Photo EELPIE Posts: 2,669
4/25/14 1:30 P

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hmmm...here's a question:

Could big Pharma be influencing any of this?

The best exercise in the world is to bend down and help someone up.


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RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
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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.

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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EELPIE's Photo EELPIE Posts: 2,669
4/25/14 10:00 A

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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.

The best exercise in the world is to bend down and help someone up.


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

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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?








"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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JUSTEATREALFOOD's Photo JUSTEATREALFOOD Posts: 1,447
4/25/14 8:44 A

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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.

JERF - Just Eat Real Food

I'm a Certified Personal Trainer.

I'm not a doctor or dietitian. I'm just a real whole foods nutrition nerd.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
37 years old
2 kids

Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
4/25/14 8:03 A

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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's Photo RUSSELL_40 Posts: 16,826
4/25/14 2:02 A

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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.



"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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

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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?



"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,699
4/24/14 8:25 P

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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's Photo HOUNDLOVER1 Posts: 8,381
4/24/14 11:48 A

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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

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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

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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)
"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
4/22/14 5:41 P

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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)
You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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RUSSELL_40's Photo RUSSELL_40 Posts: 16,826
4/22/14 8:25 A

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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 ).

"We can't solve our problems with the same thinking we used when we created them "

- Albert Einstein

“Whether you think you can, or you think you can't--you're right.”

- Henry Ford


 current weight: 179.6 
 
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262.5
213.25
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JUSTEATREALFOOD's Photo JUSTEATREALFOOD Posts: 1,447
4/22/14 8:08 A

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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.
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"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)
JERF - Just Eat Real Food

I'm a Certified Personal Trainer.

I'm not a doctor or dietitian. I'm just a real whole foods nutrition nerd.

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
37 years old
2 kids

Keeping my blood sugar levels low on my high fat/ low carb/ moderate protein diet.


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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,381
4/21/14 8:35 P

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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

You can talk to God all you want and that's great, but the changes happen when you start listening to him.

BE THE CHANGE YOU WANT TO SEE IN OTHERS.




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16
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