Diabetes Solution Revised and Updated 2007
HOW DID THE COMMONLY PRESCRIBED HIGH-CARBOHYDRATE DIET COME ABOUT?
If, like me, you’ve had diabetes for a while, you’ve probably been told to cut way down on your dietary intake of fat, protein, and salt, and to eat lots of complex carbohydrate. You may even still read this advice in publications circulated to diabetic patients.
Why is such advice being promulgated, when the major cause of such diabetic complications as heart disease, kidney disease, high blood pressure, and blindness is high blood sugar?
When I first developed diabetes, in 1946, little was known about why this disease, even when treated, caused early death and such distressing complications. Prior to the availability of insulin, about twenty-five years earlier, people with type 1 diabetes usually died within a few months of diagnosis. Their lives could be prolonged somewhat with a diet that was very low in carbohydrate and usually high in fat. Most sufferers from the milder type 2 diabetes survived on this type of diet, without supplemental medication. When I became diabetic, oral hypoglycemic agents were not available, and many people were still following very low carbohydrate, high-fat diets. It was at about this time that diets very high in saturated fats, with resultant high serum cholesterol levels, were experimentally shown to correlate with blood vessel and heart disease in animals. It was promptly assumed by many physicians that the then-known complications of diabetes, most of which related to abnormalities of large or small blood vessels, were caused by the high-fat diets. I and many other diabetics were therefore treated with a high-carbohydrate, low-fat diet. This new diet was adopted in the mid-1940s by the American Diabetes Association (ADA), the New York Heart Association, and eventually by the American Heart Association (AHA) and other groups around the world. On the new diet, most of us had much higher serum cholesterol and triglyceride levels, and still developed the grave long-term complications of diabetes. Seemingly unaware of the importance of blood sugar control, the ADA raised the recommended carbohydrate content from 40 to 50 percent of calories, and then more recently to 60 percent. The ADA’s most recent guidelines have backed off by vaguely stating that some diabetics may do better with less carbohydrate.
Next feature: Recent Developments Regarding Risk Factors for Heart Disease
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