You won’t know until you try it, suggests dietitian Melanie Thomassian. These are some of the diagnoses that may respond positively: irritable bowel syndrome (IBS), Crohns disease, and gastroesophageal reflux disease (GERD).
Very low-carb diets also help GERD.
I’ve written before about the low FODMAPs diet and irritable bowel syndrome. The low FODMAPs diet essentially involves limiting the delivery of particular carbohydrates to your intestinal bacteria.
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…according to a report in MedPageToday. Type 2 diabetes is linked to higher incidence of several cancers: liver, pancreas, uterus, colo-rectal, breast, and bladder. On a brighter note, diabetics have lower risk of prostate cancer. Diabetes is also associated with higher risk of heart disease.
I’m still not convinced that severe sodium restriction is necessary or even possible for most people
The American Heart Association has published guidelines aiming to reduce premature death and illness caused by cardiovascular diseases such as heart attacks, high blood pressure, and strokes.
The guidelines focus on seven factors critical to cardiovascular health:
Using data from the Atherosclerosis Risk In Communities study (almost two decades’ follow-up), researchers found that those who maintained goals for six or seven of the American Heart Association critical factors had a 51% lower risk of cancer compared with those meeting no goals.
For detailed information about the specific goals, click here.
As you might expect, I was curious about what the American Heart Association considered a heart-healthy diet. I quote the AHA summary:
The recommendation for the definition of the dietary goals and metric, therefore, is as follows: “In the context of a diet that is appropriate in energy balance, pursuing an overall dietary pattern that is consistent with a DASH [Dietary Approaches to Stop Hypertension]-type eating plan, including but not limited to:
Intake goals are expressed for a 2000-kcal diet and should be scaled accordingly for other levels of caloric intake. For example, ≤ 450 calories per week represents only up to one quarter of discretionary calories (as recommended) coming from any types of sugar intake for a 2000-kcal diet.
Diet recommendations are more complicated than that; read the full report for details. Only 5% of study participants ate the “ideal diet.” The AHA-recommended diet may have too many carbohydrates for some diabetics. The Mediterranean diet easily meets four out of five of those diet goals; you’d have to be extremely careful to reach the sodium goal on most any diet.
Cardiovascular diseases and cancer are among the top causes of death in Western societies. Adhering to the guidelines above may kill two birds with one stone.
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![MPj04384870000[1]](https://diabeticmediterraneandiet.files.wordpress.com/2010/03/mpj043848700001.jpg)
A recent Swedish study suggests that low-carbohydrate/high protein diets increase the risk of cardiovascular disease in women. I’m not convinced, but will keep an eye on future developments. This is a critical issue since many women eat low-carb/high protein for weight loss and management.
Researchers followed 43,000 women, 30-49 years of age at enrollment, over the course of 16 years. In that span, they had 1270 cardiovascular events: ischemic heart disease (heart attacks and blocked heart arteries), strokes, subarachnoid hemorrhages, and peripheral arterial disease. Food consumption was estimated from a questionnaire filled out by study participants at the time of enrollment (and never repeated).
In practical terms, … a 20 gram decrease in daily carbohydrate intake and a 5 gram increase in daily protein intake would correspond to a 5% increase in the overall risk of cardiovascular disease.
So What?
To their credit, the researchers note that a similar analysis of the Women’s Health Study in the U.S. found no such linkage between cardiovascular disease and low-carb/high protein eating.
The results are questionably reliable since diet was only assessed once during the entire 16-year span.
I’m certain the investigators had access to overall death rates. Why didn’t they bother to report those? Your guess is as good as mine. Even if low-carb/high protein eating increases the rate of cardiovascular events, it’s entirely possible that overall deaths could be lower, the same, or higher than average. That’s important information.
I don’t want to get too far into the weeds here, but must point out that the type of carbohydrate consumed is probably important. For instance, easily digested carbs that raise blood sugar higher than other carbs are associated with increased heart disease in women. “Bad carbs” in this respect would be simple sugars and refined grains.
In a 2004 study, higher carbohydrate consumption was linked to progression of blocked heart arteries in postmenopausal women.
It’s complicated.
PS: I figure Swedish diet doctor Andreas Eenfeldt would have some great comments on this study, but can’t find them at his blog.
Reference: Lagiou, Pagona, et al. Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study. British Medical Journal, June 26, 2012. doi: 10.1136/bmj.e4026
Filed under Carbohydrate, coronary heart disease, Heart Disease, Protein
Jimmy Moore has posted a podcast interview with internist Luan Pho, who thinks that the right diet can help reduce or eliminate usage of diabetic drugs. I’m sure involves type 2 diabetes, not type 1. I haven’t listened to the podcast, but you may want to.
-Steve
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Animal-based low-carb diets are linked to higher death rates, according to a recent study in the Annals of Internal Medicine. On the other hand, a vegetable-based low-carb diet was associated with a lower mortality rate, especially from cardiovascular disease.
As always, “association is not causation.”
It’s just a matter of time before someone asks me, “Haven’t you heard that low-carb diets cause premature death?” So I figured I’d better take a close look at the new research by Fung and associates.
It’s pretty weak and unconvincing. I have little to add to the cautious editorial by William Yancy, Matthew Maciejewski, and Kevin Schulman published in the same issue of Annals.
The study at hand was observational over many years, using data from the massive Nurses’ Health Study and Health Professionals’ Follow-up Study. To find the putative differences in mortality, the researchers had to compare the participants eating the most extreme diets. The 80% of study participants eating in between the extremes were neutral in terms of death rates.
They report that “…the overall low-carbohydrate diet score was only weakly associated with all-cause mortality.” Furthermore,
These results suggest that the health effects of a low-carbohydrate diet may depend on the type of protein and fat, and a diet that includes mostly vegetable sources of protein and fat is preferable to a diet with mostly animal sources of protein and fat.
In case you’re wondering, all these low-carb diets derived between 35 and 42% of energy (total calories) from carbohydrate, with an average of 37%. Anecdotally, many committed low-carbers chronically derive 20% of calories form carbohydrate (100 g of carb out of 2,000 calories/day). The average American eats 250 g of carb daily, 50-60% of total calories.
Yancy et al point out that “Fung and coworkers did not show a clear dose-response relationship in that there was not a clear progression of risk moving up or down the diet deciles.” If animal proteins and fats are lethal, you’d expect to see some dose-response relationship, with more deaths as animal consumption gradually increases over the deciles.
The Fung study is suggestive but certainly not definitive. Anyone predisposed to dietarycaution who wants to eat lower-carb might benefit from eating fewer animal sources of protein and fat, and more vegetable sources. Fung leaves it entirely up to you to figure out how to do that. Compared to an animal-based low-carb diet, the healthier low-carb diet must subsitute more low-carb vegetables and higher-fat plants like nuts, seeds, seed oils and olive oil, and avocadoes, for example. What are higher-protein plants? Legumes?
You can see how much protein and fat are in your favorite vegetables at the USDA Nutrient Database.
The gist of Fung’s study dovetails with the health benefits linked to low-meat diets such as traditional Mediterranean and DASH. On the other hand, if an animal-based low-carb diet helps keep a bad excess weight problem under control, it too may by healthier than the standard American diet.
See the Yancy editorial for a much more detailed and cogent analysis. As is so often the case, “additional studies are needed.”
Reference: Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, & Hu FB (2010). Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Annals of internal medicine, 153 (5), 289-98 PMID: 20820038
Filed under Carbohydrate, coronary heart disease, Vegetables
In 1797, Dr. John Rollo—a surgeon in the British Royal Artillery—published a book entitled An Account of Two Cases of the Diabetes Mellitus. He discussed his experience treating two diabetic Army officers with a high-fat, high-meat, low-carbohydrate diet. Mind you, this was an era devoid of effective drug therapies for diabetes.
The soldiers apparently had type 2 diabetes rather than type 1.
In at least one of the cases, the diet led to loss of excess weight (original weight 232 pounds or 105 kg), elimination of symptoms, and reversal of elevated blood and urine sugars.
Read more about this and other characters in the history of diabetes in”Diabetes Detectives,” an article in Dartmouth Medicine, Winter 2008 edition, by Lee Witters, M.D., et al.
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Diabetic Mediterranean Diet 