It's a Type 2 Life
It's a Type 2 Life

San Francisco Bay Area resident Patrick Totty writes about his experiences living with type 2 diabetes

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The Fat Lady Is Singing

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We’ve all had the experience where experts say something is good for us only to find out later that they’ve changed their minds.

Coffee is bad for you; now it’s good for you.

Multivitamins are good for you; now they’re unnecessary.

Glopping on high SPF sunscreen is good for you; now exposing your unprotected skin for a few minutes daily to direct sunlight is good for getting your vitamin D quotient.

Even more disconcerting is when we realize that what we are told directly contradicts our personal experience.

One arena where this is becoming obvious is the controversy over low-fat versus low-carb diets. For years diabetics have been told to adhere to low-fat diets while still eating fairly high amounts of carbohydrates. The experts have told us that fat intake is the major culprit in the development of heart disease. The reasoning goes that since people with diabetes run an increased risk of cardiovascular disease, they should be especially careful about dietary fat.

If fat is truly bad for you, the advice makes sense. But if fat turns out not to be a cause of cardiovascular problems, why do diabetics who are on low-fat diets continue to run a real risk of getting heart disease?

The answer, says an increasing number of researchers, is carbohydrates. Simply put, carbs lead to excessive blood glucose in diabetics. High blood sugars create inflammation, which damages organs and the cardiovascular system. 

For now, the orthodoxy that says fat is bad holds sway, at least at official association and organizational levels. But in the understories of the diabetes community, expert opinion is being increasingly doubted. 

A few months ago in a diabetes publication I occasionally contribute to, a certified diabetes educator wrote that low-carb diets had no real value and that there was no scientific evidence to support recommending them. The response from readers was astonishing: Out of several dozen replies to her statement, only one supported her. The rest came from articulate type 1s and 2s who vehemently differed with her official take on low-carb diets.

I know that anecdotal evidence does not prove or disprove a scientific theory. Still, when people who’ve had diabetes for a long time, and who have diligently and thoughtfully experimented with different approaches for managing it, tell us that the experts have it wrong, it’s worth a listen.

Even the American Diabetes Association acknowledged in 2008, after years of supporting low-fat diets, that for some people low-carb diets work best for weight loss and lowered A1c’s. It wasn’t the breakthrough moment that low-carb advocates were hoping for, but it was an important acknowledgement that real-life experience confirms that low-carb works for many people.

The battle is on. You are going to see more about this controversy as the low-carb side sharpens its message and builds its chorus of expert voices.

Perhaps the best place to start looking into the low-carb/low-fat controversy is with “Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease.” Published in 2007 by science writer Gary Taubes, this book has done more than any other to set the stage for a radical re-examination of the theory that high fat intake is a factor in obesity, diabetes, and cardiovascular problems.

Closer in time is this recent newspaper article about a Swedish study showing that type 2 patients on a low-carb/high-fat/high-protein diet achieved better blood sugar control than patients on the conventional low-fat diet advocated by Swedish health authorities.

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About the Author

Bay Area resident Patrick Totty was diagnosed with type 2 diabetes in July, 2003.

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