Diet Debate
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In his first book he says that his (very low carb, high fat diet) is absolutely the best diet there is for diabetes. In his 1981 book he says, "I get spectacular results in reducing or eliminating insulin by instituting a low carbohydrate diet."
Then he says:
"Unfortunately, the control is not always for a lifetime, for some diabetics seem to "adjust" (quotation marks his) to the new regimen after a while and spill sugar again--meaning that they need insulin again."
"Since blood sugar control by diet is far preferable to blood sugar control by insulin, any vacation from insulin and its potential side effects may well help to prolong a diabetics life span"
In other words, he is saying his diet will control sugar for a time and this is better than nothing. But what is really happening here? I think that because of the high fat, blood sugar is lowered but insulin resistance is building up. This is what he calls "adjusting" to his diet. He gives several test levels after people are on his diet among which is cholesterol dropping from 245 to 225. Nothing to write home about. He also says his patients lost weight.
His non overweight patients went on the meat and millet diet. Now it is very unusual for type two's to not be overweight. So it seems to me that when his diabetic patients lost weight, their blood sugars rose (they "adjusted") to his diet and he put them on the meat and millet diet. Very strange. Usually when diabetics lose weight their blood sugars improve. But his patients got worse.
On page 275 he describes his meat and millet diet.
"This diet is the best blood-sugar-controlling diet I have been able to devise for the patient who cannot afford to be on a weight losing regimen. It affords many of the advantages of a high ratio of complex (starch) to simple (sugar) carbohydrates .....And it provides the added benefit of a high fiber intake"
"The meat and millet diet is not a ketogenic diet......you won't lose weight either" he says, but I have to remind all that most people on the weight loss registry have used a low fat higher carb diet.
to be continued
Dolores
He says the main thrust is restriction of refined carbs and sugars and replacing them with whole vegetables and GRAINS. But his original diet has already replaced the sugars and refined carbs and also the whole grains and starchy vegetables.
1. He says this diet works because it stabilizes sugars and that the natural fiber of unrefined carbs has been shown to have a blood sugar stabilizing effect. (his words)
2. His diet decreases insulin response and that the most favorable response to a given amount of insulin comes from complex carbs. (his words)
3.It provides fiber, vitamins and minerals inherent in whole carb sources. (his words)
Rules of the meat and millet diet. Unrestricted meat, fish, fowl, eggs, cheese.
The millet group includes all whole vegetables and whole grains . Emphasis should be on the most starch-containing group of vegetables. Therefore the best choices include millet, buckwheat, oats, groats, grits, bulgar,couscous,barley, brown rice, wheat and rice bran. Potatoes, yams and legumes are acceptable. Less starchy vegetables are also a part of the diet he says.
Foods in controlled quantities, fruits, milk and dairy, cheese and cream. Fats and oils permitted in moderate proportions. Best choices are cold pressed oils. Worst are margarine and hydrogenated oils, coconut oil, shortening and lard. Butter and Mayo are permitted. Stone ground whole wheat breads and cereals are permitted.
He says--note that the total quantity of carbohydrate is unrestricted (page 278). On page 41 he has a chart group 1 of which contain the carbs you may eat without restriction on the meat and millet diet--all vegetables,all whole grains,all whole cereals,nuts, seeds, legumes and greens.
So, it seems to me that Atkin's diabetic patients didn't do so well on a diet which one might intuitively expect to be a good diet for diabetics (a ketogenic almost no carb diet), but on a diet more like the standard american diet without the refined and processed carbs--lots of meat, fish, eggs, cheese etc. Which looks like for diabetics, even the SAD without any refined or processed foods controls sugars in the long run better than the original atkins diet.
Remember also that Atkins said that if you are going to have a glucose tolerance test to go off his regular ketogenic diet for a week before the test. Otherwise you will test diabetic. So I guess his aim was to fool the test.
Dolores
Thank you for taking the trouble to find it and transcribe it here. I am sur[prized because I never heard of this even though I was following Dr. Atkins publications and got a few copies of his books on the garage sales. But not that one. Clearly, neither his original diet from his first book nor the one you found in his second book are very high fat diet. On a very high fat diet there is simply not enough raw material to synthesize glucose even in an insulin resistant diabetic. In my opinion (only opinion, not a proof) gradual deterioration on an Atkins #1 diet could only have happened if a diabetic patient was consuming too much protein! Glucose can be synthesized out of the following macronutrients:
1) starch (100%)
2) table sugar - sucrose (50%, the other 50% turns to fructose which is worse)
3) Protein (about 50%)
In addition:
4) Fat - the glyceride base of a fatty molecule can be converted not to glucose but to other by products (diacetic acid) that require insuline to metabolize. Howver that amount of insiulin is much smaller than for the 1,2 and 3 above. About a few %.
I think that his problem with the diet #1 necessitating his diet #2 tweak are most likely the result of his unrestricted protein - meat recommendation! Had he restricted protein to 10-20% of calories (or 1g/kg body/day) and beefed up the animal fat to over 70% like Kwasniewski's Optimal Diet , he would never have had any problems.
I think it was worth discussing it. It is not a proof but I think it does bring us closer towards the truth. I found in my experience to have learned more from other people's mistakes than from their successes.
Best regards and thank you,
Stan
Are you saying that because of the mechanism you described, a high animal protein diet is more conducive of diabetes than a high carbohydrate diet? His patients' diet eventually produced high blood sugars on high protein (if this was happening, why wasn't it noticed right away instead of after several months?) So
switching to grains and starchy vegetables, according to atkins, lowers blood sugars.
I do not agree with your analysis. I think if the problem was protein causing synthesis of blood sugars it would have shown up on their monitors as high blood sugars right away not after several months. And you will notice that on his meat and millet diet he still permits unrestricted meat, cheese and eggs. The only thing he is doing is adding complex carbs.
No matter how you slice it and how much protein Atkins dieters eat, it is still a very high fat diet. I think the diet produced insulin resistance. I say this because it seems that if a lot of protein is producing synthesis of sugar, this would be noticed right away when using a blood sugar monitor. However, insulin resistance, from eating lots of fat, would not raise sugars right away but would, over time make people insulin resistant.
Another odd thing is the fact that when t2 diabetics lose weight, their blood sugars drop and get much lower. However, when Atkins' patients lost weight their blood sugars went so high that he had to put them back on insulin. Very strange.
Dolores
Fat does not cause permanent insulin resistance. Under normal circumstance, it only does it while you eat it, not a few hors afterwards. Even if I eat lots of fat, I can have 100g of carbs on the next day (though I rarely do).
My body WAS insulin resistant intitially on the high fat diet, but I was able to increase my occasional consumption of carbs way above my initial 50g level, gradually over time. In the first year I could not exceed 25g of carbs (1 beer) without suffering a massive headache. Gradually after a couple of years my body recovered its usual flexibility and I am able to eat occasionally up to about 100g of carbs as vegetable, fruit and my two favored "truly essential macronutrients" - ice cream and chocolate.

For me a high fat low carb diet wasn't a road from bad to worse, it was from bad to normal!
I suspect that the reason behind Atkins diet #1 delayed (not immediate) blood glucose deterioration among some patient was his allowance to up the carbs after his initial induction stage. Some patients probably took it too liberaly and coupled with the then much stronger fatophobia than nowadays, may have resulted in overconsumtion of lean protein and carbs.
In my experience on the high fat, which is probably representative to many middle-aged adults ( 43 at that time) , my hormonal imbalance involving insulin resistance, with hypoglycemia and poor glucose regulation persisted throughout the first 1.5 year! Atkins induction period (6m ?) was probably not long enough for people with metabolic syndrome and with diabetes! It certainly was not long enough for me. In the first 1.5 years I could only tolerate 25g of carbs! Which was not a huge problem but I just had to remember to be strict. Whenever I ate more, even 50g would cause me a headache especially if I simultaneously exceeded protein as well! For example, I remember a massive headache I got from a plate full of salmon with potatoes!
Technically my capacity to consume carbs became in that initial period much reduced than before on the high carb diet, therefore technically you could argue that I had "deteriorated" from being insulin resistant to being virtually a diabetic! However, that is purely of academic interest (i.e of useless value) because I RARELY exceeded those 25g of carbs/day, and when I did stuck to those 25g I had absolutely no problem and my health continued improving. That 25g limit didn't bother or worry me at all! For example my intestinal sensitivities and dry eyes syndrome went away with weeks. My mild angina begun gradually abate and I was feeling stronger and more energetic with every passing months. That was the story of the first 1.5 years. Most Atkins patients I guess - would probably bail out during that stage, not understanding why they suddenly feel much worse the moment they add "little" bit more carbs after Atkins unfortunate recommendation!
The second stage of my adaptation to my high fat nutrition occured after 1.5 years. My mild angina completely disappeared, and I discovered that I am no longer carbohydrate intolerant!
I remember how surprized I was when after eating two full bowls of strawberries I did not get any sensations! I no longer would get a headache after drinking wine and especially beer.
I discovered that I occasionally could eat a dinner plate of a rice dish and - nothing happend!
It was also at that time when I broke a rib and discovered that it took only 2 weeks to heal! When I broke it once before it too 4 weeks. It was at that time I also discovered that my broken molar filling didn't deteriorate as expected (I am a chicken if it comes to dealing with dentists...). Eventually I broke that molar tooth in half on a nut, it was around 2002. This is year 2010 and it is still broken in half, didn't decay since, and covered/sealed itself in some kind of new enamel.
Regards,
Stan
2.Leave it to a man to say 43 is middle aged. We women become middle aged when we start collecting social security.
Saying that you technically made yourself diabetic is exactly what pritikin reported in his books from studies he cited. It was also interesting that on the high fat diet, adding just a bit extra carbs caused headaches. Maybe what was happening was that your blood sugar rose very high and your insulin rose very high in response. On the diabetes support groups, I noticed that members who eschew carbs and do eat meat, cheese, eggs and peanut butter report that even small amounts of carbs make their blood sugars rise too high. Some won't even use balsamic vinegar. Most of these are on meds. I am not. Yet I eat lots of carbs and my blood sugar is fine.
I give you an A for persistence in hanging in there for 1.5 years while experiencing angina. I find I get chest pain if I eat a lot of fat, but if I do eat fat and get chest pain, I get religion again and quickly go back to my regular diet.
Naturally, after the 1.5 years you put your diet through the beer test. And the broken rib test. Some people go through life without ever getting a broken rib but you broke a rib twice. So I picture you having a secret life of being either a crash test dummy or a subway decoy. Do you wear a mask and cape?
EG had a test which showed his carotid arteries cleared up (I think it was in about two years after switching to less grains, more greens and nuts). Your angina cleared up in 1.5 years on a high fat diet. If I were rich, I would donate money to get you an IMT.
I am going to take a leaf from your book and speculate. The only way we will know if I am right is to donate your body to science. You can do it now or later. I propose that you have turned yourself into a Masai! I believe the latest on them is that they have atherosclerosis but they have compensated by expanded arteries. So maybe by persisting with a high fat, low carb, low meat diet (like the Masai), your arteries have expanded. (Wow--speculation--I think I have a talent for it)
Best, Dolores
P.S. Do you use a blood sugar monitor to check you blood sugars?
Sorry, I don't buy it. One cannot "spill" what is not there! If his patient really restricted carbohydrates (50g/day) then they would have had no sugar left to "spill"! The fact that they did need insulin means that they were reverting back to eating more carbs or consuming way too much meat or both.
Regards,
H.
Dolores
I am not really advocating a diet change to you. or anyone. It's up to you.
Best regards,
Heretic
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