Can natural treatments "cure" or "treat" any disease?

According to current FDA policy, the answer is a flat "NO!"

No natural treatment, whether it be fish oil (as a nutritional supplement), l-arginine, vitamin D, magnesium, various flavonoids like theaflavin or resveratrol, can be declared to treat or cure any disease. That's why you see the evasive and vague wording on nutritional supplements, nutraceuticals, and various foods, like "Supports heart health" or "Supports healthy cholesterol". Claiming, for instance, that taking 6000 mg per day of a standard OTC fish will reduce triglycerides and stating so on the label of a supplement is unlawful and prosecutable.

Think what you will of Mr. Kevin Trudeau (author of Natural Cures They Don't Want You to Know About"): visionary, consumer advocate, David vs. the Goliath of the FDA and "Big Pharma", or huckster, scam artist, and one-time felon. But Trudeau got it right on one important issue: The FDA dictates what claims can be made to treat disease. On one of his ubiquitous informercials, Trudeau states:


"...the way the system works today, you have the Food and Drug Administration—the FDA, and you have the drug industry. They really work in tandem. Unfortunately, there’s an unholy alliance there. People don’t know that the majority of commissioners of the FDA, which allegedly regulates the drug industry, and the food industry—Food and Drug Administration, the commissioners of the FDA—the majority of them—go to work directly for the drug companies upon leaving the FDA and are paid millions and millions and millions of dollars. Now in any other format, that would be called bribery; that would be called a conflict of interest; that would be called payoffs. That’s exactly what’s happening right now. So what has occurred is the Food and Drug Administration is really working in tandem with the drug industry to protect their profits. Example: The Food and Drug Administration says that only a drug can diagnose, prevent, or cure any disease."


He goes on to say that

"...the Food and Drug Administration says only a drug--nothing else--can cure, prevent, or diagnose a disease. Therefore the Food and Drug Administration continues to call more and more and more things diseases. Therefore they eliminate all-natural remedies. No one can say what a natural remedy can do if it’s been classified as a disease. So Attention Deficit Disorder is now a disease. Therefore only a drug can cure, prevent, or diagnose it. Cancer is a disease. Acid reflux is now a disease. Obesity is now a disease."

(PLEASE do not construe this as an endorsement of Mr. Trudeau's overall opinions. But I do think he's right on this one point.)

The stated purpose of this restrictive policy is to protect the public. Indeed, in years past before protective legislation, ineffective and even poisonous products were commonly sold as therapeutic treatments. (Remember cocaine and morphine in cold remedies? Lead and other toxic agents were also common.) Unfortunately, a huge gap has emerged as clinical data accumulates that support the efficacy of nutritional treatments and other non-traditional methods to treat or alleviate diseases. Any disease, or anything construed as disease as Trudeau points out, can onlybe treated by a drug.

In the FDA's defense, they have made slow progress in allowing "claims" of benefits for several supplements and food substances, such as the beta-glucan of oat products, soy protein, and most recently barley (for cholesterol reduction). The scrutiny is quite thorough and the wording of the policy is quite specific. Regarding oat products, for instance, the policy states:

"FDA concluded that the beta-glucan soluble fiber of whole oats is the primary component responsible for the total and LDL blood cholesterol-lowering effects of diets that contain these whole oat-containing foods at appropriate levels. This conclusion is based on review of scientific evidence indicating a relationship between the soluble fiber in these whole oat-containing foods and a reduction in the
risk of coronary heart disease.

Food products eligible to bear the health claim include oat bran and rolled oats, such as oatmeal, and whole oat flour...To qualify for the health claim, the whole oat-containing food must provide at least 0.75 grams of soluble fiber per
serving. The amount of soluble fiber needed for an effect on cholesterol levels is about 3 grams per day."


(Source: FDA Talk Paper which can be viewed in its entirety at http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.)

In light of the boom in nutritional and non-traditional research that validate or refute efficacy, is such a policy still necessary? Or does it inhibit the open dissemination of information and result in a extraordinary monopolization of health treatment for the drug companies?

This debate will likely rage for the next two or more decades, particularly as drug companies are increasingly viewed as profit-seeking enterprises and more validation is gained by non-drug treatments.

For the moment, don't dismiss a "treatment" because it doesn't come by prescription. But don't reject a drugjust because it is a prescription. We need to strike a healthy, rational balance somewhere in between.

Can procedures alone keep you alive?

My days in the hospital remind me of what heart disease can be like when no preventive efforts are taken--what it used to be like even with my patients before taking a vigorous approach to prevention (though over 12 years ago).

Several cardiologists in my hospital, for instance, express skepticism that heart disease prevention works at all. Yes, they know about the statin cholesterol drug trials. But they claim that, given their experience with the power of coronary disease to overpower an individual's control, statin drugs are just "fluff". Coronary disease is a powerful process that can only begin to be harnessed with major procedures, i.e., a mechanical approach.

So these cardiologists routinely have their patients in the hospital, often once a year, sometimes more, for heart catheterization and "fixing" whatever requires fixing: balloon angioplasty, stents, various forms of atherectomy. Year in, year out, these patients return for their "maintenance" procedures. Their cardiologists maintain that this approach works. The patients go on eating what they like, taking little or no nutritional supplements, and medications prescribed by their primary care physicians for blood pressure, etc. But no real effort towards heart disease prevention beyond these minimal steps.

Can this work? Very little at-home, preventive efforts, but periodic "maintenance" procedures?

It can, perhaps, for a relatively short time of a few years, maybe up to 10 years. But it crumbles after this. The disease eventaully overwhelms the cardiologist's ability to stent or balloon this or that, since it has progressed and plaque has growth diffusely the entire period that maintenance procedures have been performed. In addition, acute illness still occurs with some frequency--in other words, plaque rupture is not affected just because there's a stent in the artery upstream or downstream.

Not to mention this can be misery on you and your life, with risk incurred during each procedure. It's also terribly expensive, with hospitalization easily costing $25,000-$50,000 or more each time. (Compare that to a $250 or so CT heart scan.)


As people become more aware of the potential tools for prevention of heart disease, fewer are willing to submit to the archaic and barbaric practice of "maintenance" heart procedures in lieu of prevention. But it still goes on. If you, or anybody you know, are on this pointless and doomed path, find a new doctor.




Bloodletting, another antiquated health practice

Support your local hospital: HAVE A HEART ATTACK!

I'm kidding, of course. But, in your hospital's secret agenda, that's not too far from the truth. Catastrophes lead to hospital procedures, which then yields major revenues.

Prevention, on the other hand, yields nothing for your hospital. No $8,000 to $12,000 for heart catheterization, several thousand more for a stent, $60,000-plus for a bypass, $25,000 or more for a defibrillator. In other words, prevention of heart attack and all its consequences deprive your hospital of a goldmine of revenue.

The doctors are all too often conspirators. I heard of yet another graphic example today. A man I didn't know called me out of the blue with a question. "I had a heart scan and I had a 'score' that I was told meant a moderate quantity of plaque in my arteries, a score of 157. My doctor said to ignore it. But I got another scan a year later and my score was 178. So I told this to my doctor and he said, 'Let's get you into the hospital. We'll set up a catheterization and then you'll get bypassed.' Of course, I was completely thrown off balance by this. Here I was thinking that the heart scan was showing that my prevention program needed improvement. But my doctor was talking about bypass surgery. Can you help? Does this sound right?"

No, this is absolutely not right. It's another tragedy like the many I hear about every day. Heart scans are, in fact, wonderfully helpful tools for prevention. This man was right: he felt great and the heart scan simply uncovered hidden plaque that should have triggered a conversation on how to prevent it from getting worse. But the doctor took it as a license to hustle the patient into the hospital. Ka-ching!

This sort of blatant money-generating behavior is far from rare. Don't become another victim of the cardiovascular money-making machine. Be alert, be skeptical, and question why. Of course, there are plenty of times when major heart procedures are necessary. But always insist on knowing the rationale behind such decisions, whether it's you or a loved one.

Hospitals contain experts in ILLNESS

Hospitals contain many experts in sickness. This seems obvious. But walk down the hallways of any hospital, and you'll quickly be convinced that hospitals contain almost no experts in health.

People (hospital staff, that is, not the patients) in hospitals are especially good at identifying and treating disease. They lack knowledge of health.

If your nurse is 100 lbs overweight and struggles to walk down the hall because of arthritis in both knees, would you entrust her with health advice?

If your doctor sits down in the cafeteria and eats his lunch of a ham sandwich with cheese on a bun, fried onion rings, and a milkshake and pastry, can you believe that he/she possesses any insight into health and nutrition?

If your physical therapist or cardiac rehabilitation counselor struggles nearly as much as you while climbing a single flight of stairs, can you accept their advice on how to regain your stamina and use exerise to full health advantage?

The answer to all these questions is, of course, no. Hospital staff are generally expert at dressing surgical wounds, stopping bleeding, identifying infections, and providing the support services for surgical and diagnostic procedures. In contrast, they are generally miserable at conveying genuine health advice. They certainly fall short in being examples of health themselves.

To hospitals and their staff, health is a temporary situation that persists only until you become ill. Illness is an inevitability in the hospital staff mindset. Health is a temporary state in between illnesses.

We need to shake off this perverse mentality. Health is the state of life that should dominate our practices and philosophies. Illness via the occasional catastrophe, e.g., broken leg from skiing, car accident, etc., is the province of hospitals. We should gravitate towards this philosphy and away from the over-reliance on hospitals that has come to dominate our present perceptions of health. Hospitals are not glamorous. They are, for the most part, profit-seeking businesses intent on portraying themselves as champions of health.

When I walk down the halls of hospitals, I am shocked and ashamed at the extraordinary examples of ill-health presented by hospital staff. Yet they falsely paint themselves as experts in both illness and health. Don't believe it for a second.

Are there still unexplored causes of heart disease?

I met a woman today. She had her first heart attack at age 37. She just had her 2nd heart attack this morning, at age 40.

Several issues are surprising about her story. First, she's pre-menopausal. Heart attacks before menopause are unusual. We'll occasionally see women have a heart attack before or during menopausal years only if they're heavy smokers and/or they have had diabetes (either type I or type II) for many years. But this young woman had neither. She is slender and has never smoked.

Even more surprising are her basic lipid values: LDL cholesterol 35 mg/dl, HDL 150 mg/dl, triglycerides 317 mg/dl. This is a very unusual pattern.

Unfortunately, this is all developing acutely in the hospital. (I've just met her today--she's not a Track Your Plaquer!) Lipoprotein analysis would be extremely interesting. In particular, I'd like to see whether she has any other markers besides elevated triglycerides of a "post-prandial" abnormality, i.e., persistence of abnormal particles after eating. The high triglycerides make this quite likely.

If this proves true, the omega-3 fatty acids from fish oil will be a lifesaving treatment for her, since they dramatically reduce both triglycerides as well as persistent postprandial particles like intermediate-density lipoprotein (IDL). (Track Your Plaque Members: See the Special Report on Postprandial Abnormalities on the present home page at www.cureality.com for a more in-depth discussion of this fascinating collection of patterns that is just started to be explored.)

In the real world, especially acute care medicine, there's always a kicker: she speaks no English. Unfortunately, communicating the intricacies of a powerful program like ours that aims to identify all causes of heart disease, then corrects then and aims for coronary plaque regression, is difficult if not impossible.

I also do occasionally worry that, given this woman's extraordinary risk at a young age, and overall very unusual lipid patterns (HDL 150?!), if there are causes presently beyond our reach. We have to make use of the tools available to us for now.

Everything causes heart attack!

The media are presently gushing about a recent study that associates caffeine intake with heart attack.

CBS News: That cup of coffee you're craving might not be such a good idea. Research in the September issue of Epidemiology suggests coffee can trigger a heart attack within an hour in some people.


Some reporters and their quoted sources are musing about whether it's the caffeine, cream vs. other whiteners, time of day, interaction with other risk factors, etc.

My advice: Get a grip! How many relatively benign, every day factors in life can be blamed for dire health risks?

The problem with many of these studies is that they are cross-sectional. They do not enroll participants, then "treat" with coffee (or other substance in question) vs. placebo. In other words, it is not a randomized trial, the sort of trial necessary to prove a hypothesis. That's all that can be generated by a study like this one: a hypothesis.

Perhaps there's a bit of warning for the person with uncorrected lipids and lipoproteins, has no idea that they have extensive coronary plaque because they've never had a heart scan, and have a slovenly lifestyle. Maybe that person might have exaggerated risk from a cup of coffee.

But for us, involved and intensively addressing all causes of coronary plaque to the point of stabilizing or reducing it, coffee is likely a non-issue.

For more conversation on coffee and this report, go to the www.cureality.com home page.

Excessive Heart Procedures Makes New York Times Headline


One example of flagrant cardiac procedure excess has made New York Times headlines:


Heart Procedure Is Off the Charts in an Ohio City
The number of angioplasties performed in Elyria is so high that Medicare is starting to ask questions.

(The full article can be accessed through the New York Times website at http://www.nytimes.com/2006/08/18/business/18stent.html?pagewanted=2&ei=5094&en=b81be5f43f98a99b&hp&ex=1155960000&partner=homepage)



Cardiologists in little Elyria, Ohio, about a 30-minute drive west of Cleveland, do more coronary angioplasties and insert more stents than any other location in the U.S.--four times more than the national average, three times more than the Cleveland average. They perform even more than the recently-indicted cardiologist in Louisiana, who performed twice the national average of procedures.


The Times article, part of a series about financial incentives in medical care, provides a responsible and incredibly balanced report on the situation in Elyria. I have to give them credit, because from the eyes of a colleague (myself), this looks like blatant and extreme profiteering: "cathing for dollars".

I find it outrageous that this group of cardiologists claims that they have some special insight into heart care that justifies this extraordinary reliance on heart procedures. There's bound to be variation in practice patterns, but this is so outside the norm that I believe criminal behavior will be exposed. In fact, I believe that even the "norm", or average, rate of procedures is also excessive.

This is symptomatic of the perverse equation in heart disease care. If there's money to be made in major heart procedures, who wants to bother with prevention? Programs like the Track Your Plaque program present real potential to stop coronary heart disease in its tracks for many, if not most, participants--but don't expect to hear about it from your cardiologist. Don't expect to hear about it from the increasingly hospital-employed primary care physician.

Hopefully, media exposure like that in the New York Times is just the beginning of a public re-analysis of not only what's wrong with medicine today, but recognition of the tremendous power in preventive strategies when everyone stops being so enamored with hospital-based procedures. CT-based heart scanning that ignites your heart disease prevention program is your way to dodge the mainstream obsession with procedures.

More on "Bio-identical hormones" and Wyeth Pharmaceuticals

In October 2005, Wyeth petitioned the FDA, requesting that it completely ban the bioidentical alternatives that women have been using in ever-increasing numbers to achieve optimal hormone balance. With bioidentical replacement therapy clearly reducing its market share, Wyeth asked the FDA to outlaw all compounded bioidentical hormone formulations that compete with its own discredited drugs. If Wyeth is successful, then menopausal women will have no choice other than to take potentially life-threatening hormone drugs or to forgo hormone replacement therapy altogether, thus enduring the physically and emotionally debilitating effects of menopause-induced hormone depletion.

Dave Tuttle
Life Extension Magazine
August, 2006



For more commentary on Wyeth Pharmaceutical's outrageous and brazen petition to the FDA to bar prescription "bio-identical" hormones, i.e., hormones that are identical to natural human forms, read Life Extension's article, Health Freedom Under Attack!
Drugmaker Seeks to Deny Access to Bioidentical Hormones





This well-researched article is in the August, 2006 issue of Life Extension Magazine. The article can also be accessed online at http://www.lef.org/magazine/mag2006/aug2006_cover_attack_01.htm

or go to www.lef.org and click on the August, 2006 issue.

The author, Dave Tuttle, details the baseless arguments raised by Wyeth, a pathetic and amazingly selfish act in the name of protecting profits for Premarin, their prescription agent. It's bad enough to be selling this worthless drug. It's even worse--criminal, in my mind--to try to stamp out our right to have a physician write a prescription for a pharmacy to mix up hormones identical to that humans produce, individualized to our needs.

If you are as angry about this as I am, please go to the Life Extension online reprint that provides access to the International Academy of Compounding Pharmacists website to send the FDA an e-mail describing your opinion, or go to www.iacprx.org.

How accurate is LDL cholesterol?

Watch TV and you'd get the impression that the world revolves around LDL cholesterol: Commercials for Lipitor, Zetia, Vytorin, etc., all drugs to reduce cholesterol (total and LDL). Your doctor looks first and often only at LDL cholesterol.

If there's so much attention paid to LDL, how accurate is it? 100%? 90%? 80%?

Well, it varies widely. Occasionally, it's truly accurate, but most of the time it's miserably inaccurate . Every single day, I see people with LDL cholesterols that underestimates true (measured) LDL by 40%, 50%, and even over 100%. In other words, LDL cholesterol might be 120 mg/dl by the conventional method, but the genuine measured value might be 160 mg/dl, or even 240 mg/dl. It can be that far off--and it's not rare.

The converse can occasionally be true, though rarely in my experience: that conventional LDL overestimates true LDL. I saw someone in the office today like this, with a conventional LDL of 142 mg/dl but a true measured LDL of 115 mg/dl. I may see one or two more people like this the rest of this year.




Why is LDL so inaccurate? Several reasons:

--LDL in most labs is calculated, not measured. The "Friedewald calculation" derives LDL by substracting HDL and triglycerides (divided by 5) from total cholesterol. The higher triglycerides are, especially above 150 mg/dl, the more inaccurate the calculation becomes. As HDL drops below 50 mg/dl, this also introduces greater and greater inaccuracy.

--LDL particles vary in size. A more accurate representation and measure of LDL's dangers are therefore found in measures of LDL particle number , rather than a weight-based measure or calculation. LDL particle number can be measure as just that, LDL particle number (NMR), or as apoprotein B, the protein in LDL that occurs one apoB per LDL.

I liken conventionally calculated LDL cholesterol to a broken speedometer. You simply won't have an accurate measure of how fast you're going, though you may have a ballpark sense. But try telling that to the state patrol.

Or, as a cardiologist colleague said to me in a similar conversation about LDL: "Well, it's better than nothing!"

The lesson: If you're interested in plaque control, and control or reduction of heart scan score, you need a measured LDL, preferably LDL particle number by NMR or an apoprotein B. Another option is "direct" LDL.

Green tea: friend or faux?

The www.HealthCastle.com website is a helpful website on healthy eating that sends out a free newsletter. The content is all produced by licensed dietitions and nutritionists. Although I don't agree with everything said on the site, there's still some good information.

I'm a fan of green tea. Although I believe the effects are relatively modest (weight reduction, cholesterol reduction, anti-oxidation, etc., with theaflavin and/or green tea as a beverage,) they alerted me to the fact that the Lipton Green Tea product is one you should steer clear of. Here are their comments:



"More like Soft drink than Green Tea!With 200 calories, 13 teaspoons of added sugar and a long list of artificial ingredients, Lipton Iced Green Tea is more like a bottle of soft drink than tea, in our opinion."


The Lipton website lists the ingredients:

Water, high fructose corn syrup, citric acid, green tea, sodium hexametaphosphate, ascorbic acid (to protect flavor), honey, natural flavors, phosphoric acid, sodium benzoate (preserves freshness), potassium sorbate (preserves freshness), calcium disodium edta (to protect flavor), caramel color, tallow 5, blue1.

An 8 oz serving yields 21 grams of sugar. If you drink the full 20 oz. bottle (not hard to do!), that yields 52.5 grams of sugar! You will also notice that the second ingredient listed after water is high fructose corn syrup. This ingredient, you may recall, causes triglycerides to skyrocket, causes an insatiable sweet tooth, and is a probable contributor to obesity and diabetes.

In their defense, the Lipton people do also offer a sugar-free alternative without the excessive sweeteners and empty calories.

Do the Lipton products offer the same kind of benefits from green tea catechins (flavonoids) offered by freshly brewed teas? This product has not been formally tested by an independent lab to my knowledge, though, in general, commercially prepared and bottled teas tend to have dramatically less catechin/flavonoid content compared to brewed. (The USDA website provides access to an extraordinary collection of flavonoid food content at their USDA Database for the Flavonoid Content of Selected Foods - 2003. You'll find it at http://www.ars.usda.gov/Services/docs.htm?docid=6231.)

I think the HealthCastle people got it right: Brew your own, making sure to steep for at least 3 minutes. Alternatively, a green tea or theaflavin supplement provides many of the benefits. (Theaflavin has been used in trials at doses of 375 to 900 mg per day.) An in-depth report on green tea will be coming in a future Special Report on the www.cureality.com Membership website.
The Westman Diet

The Westman Diet

Dr. Eric Westman has been a vocal proponent of carbohydrate restriction to gain control over diabetes, as have Drs. Richard Bernstein, Mary Vernon, Richard Feinman, and Jeff Volek.

Several studies over the years have demonstrated that reductions in carbohydrate content of the diet yield reductions in weight and HbA1c (glycated hemoglobin, a reflection of average blood glucose over the preceding 60-90 days).

Among the more important recent clinical studies is a small experience from Duke University's Dr. Eric Westman. In this study, obese type 2 diabetics reduced carbohydrate intake to 20 grams per day or less: no wheat, oats, cornstarch, or sugars. Participants ate nuts, cheese, meats, eggs, and non-starchy vegetables.

After 6 months, average weight loss was 24.4 lbs, BMI was reduced from 37.8 to 34.4. At the end of the study, 95% of participants on this severe carbohydrate restriction reduced or eliminated their diabetes medications.

That was only after 6 months. Note that the ending BMI was still quite well into the obese range. Imagine what another 6-12 months would do, or achieving BMI somewhere closer to ideal.

Curiously, this idea of severe low-carbohydrate restriction to cure or minimize diabetes is not new. Sir William Osler, one of the founders of Johns Hopkins Hospital and author of the longstanding authoritative text, Principles and Practice of Medicine, advocated an diet identical to Dr. Westman's diet. So did Dr. Frederick Banting, discoverer of the pancreatic extract, insulin, to treat childhood diabetics. Before insulin, Banting and his colleagues at the University of Toronto used carbohydrate elimination (less than 10 g per day) to prolong the lives of children with diabetes.

This lesson was also learned many times during war time, when staples like bread were unavailable. The Siege of Paris in 1870 yielded cures for diabetes in many (or at least they stopped passing urine that tasted--yes, tasted--sweet and attracted flies), only to have it recur after the siege was over.

These are lessons we will have to relearn. As long as the American Diabetes Association and most physicians continue to advocate a diet of reduced fat, increased carbohydrate that includes plenty of "healthy whole grains," diabetics will continue to be diabetics, taking their insulin and multiple medications while developing neuropathy (nervous system degeneration), nephropathy (kidney disease and failure), atherosclerosis and heart attack, cataracts, and die 8 to 10 years earlier than non-diabetics.

All the while, we've had the combined wisdom from antiquity onwards: Carbohydrates cause diabetes; elimination of carbohydrates cures diabetes.

(This applies, of course, only to adult overweight type 2 diabetics, not type 1 or some of the other variants.)

Comments (71) -

  • Kris @ Health Blog

    3/26/2011 7:20:19 PM |

    It is absolutely ridiculous that doctors don't understand how to cure diabetes with a low-carb diet.

    This is just really basic biochem 101, carbs release insulin, and prolonged excess insulin causes insulin resistance, then diabetes.

    This seems so simple that almost anyone with any small knowledge of biology should understand it, yet the main diabetes experts in the world don't.

    I sometimes wonder if the "experts" don't want to give out simple solutions, since then half of them will eventually be unemployed and they won't be experts anymore. Kind of like how the oil companies obviously don't want us to invent renewable energy sources.

  • Anonymous

    3/26/2011 7:47:36 PM |

    Dr. Davis, just to nitpick for clarity,

    I'm assuming in the second paragraph "reductions in weight loss and HbA1c" is really meant to read "reductions in weight and HbA1c".

  • Jenny

    3/26/2011 8:31:26 PM |

    Sadly, what the studies show is that when these low carb weight
    loss studies are continued past six months, invariably the weight loss stops dead for most participants.

    This is true even in studies where the researchers tested for ketones in urine to ensure that people were eating what they said they were eating. The six month prolonged (and often permanent) stall is a repeatable low carb diet phenomenon.

    My own polls among the low carb community verify this finding. Most people with diabetes will report they easily drop 15-20% of starting weight on a low carb diet but after that weight loss often comes to a complete halt even in my sample population which was made up of people with diabetes who had continued to maintain A1cs in the 5% range.

    There are some lucky people for whom this won't be true, but they are a minority and tend to be male.

    Since they are enthusiastic and vocal you tend to run into them online. The people whose experience is more typical tend to blame themselves and keep quiet.  

    The real benefit of low carb dieting is in how it controls blood sugar. That effect will persist.

    But long term diets of all types, including the low carb diet, downregulate the metabolism in ways that make it progressively harder to lose weight.

    The big problem with posts like this one is that they raise false expectations--if you do well the first six months, a year later wow! That kind of false expectations eventually lead to frustration, feelings of failure, self-blame and almost inevitably diet failure and regain.

    I can't tell you how many people I've seen posting on online support groups who did well for those first six months but ended up crashing off their diets a year later because they couldn't lose any more weight.

    So after 13 years of observing people dieting with the low carb diet, I'm convinced that it's best to start the diet because of the blood sugar benefits--not with the dream of reaching what is all too often an unrealistic weight goal.

    Figure that you'll lose 15-20% of your starting weight (you'll lose more if you are very heavy). Maybe you will be one of the small number of lucky people who do much better, in which case it will be a lovely surprise.

    That way, you won't end up blowing off the diet once weight loss stops at a level where you still are much heavier than you had hoped to be.

  • justdoinglife

    3/26/2011 10:47:22 PM |

    The economics are not right for doctors to cure diseases. Healthy people do not come back until the next disease. Such is life. Doctor should only be paid for cures, when one exists.

    We need to take charge of our own health and stop eating sugar, grains, manufactured oils and eatable products. Get a bit of exercise most days, and live a bit.

    but what do I know

  • Susan

    3/27/2011 12:14:55 AM |

    My perception:  I live in the "Deep South", home of the most obese people in the world.  The frustration for many health care professionals is in the unwillingness of patients to significantly change their diet.  It seems culturally mandated for many people to eat a certain way.  I fear that most obese people in the south would rather take medications than adhere to a diet such as this.  We can hardly blame the health care industry for this.

  • Anonymous

    3/27/2011 1:12:07 AM |

    But what about the normal weight relatively young (41) type two diabetic?  (BMI 24)  Could I lose 20 pounds to be model slim?  Yeah. And I do eat low carb, although not 10 gram low carb.  And I have gotten my Hba1c to 5.4.  But, my insulin is crazy high, I hit 90 at my last glucose challenge.  I think it would be a big help if we acknowledged that diabetes is a SYMPTOM of a variety of related but not identical diseases.  Not everyone ate their way to diabetes, and while diet can totally help control symptoms, for me neither maintaining a proper weight nor controlling my carbs has solved the underlying problem, which seems to be a severe insulin resistance.

  • Might-o'chondri-AL

    3/27/2011 1:38:24 AM |

    Might Jenny's observation and Nigel's study reference be reconciled somewhat ? I'll tag on my disclaimer of being unqualified to judge low carb or specific diets; since I've never struggled with weight or diabetes, and am not a doctor.

    The study Nigel linked was done with all Kuwaiti subjects. In that country co-sanguinity in marriage is practised by +/- 54.3 % of Kuwaitis. And 1 in 5 are reported to be diabetic.

    The data is very admirable; my suggestion is that the data trend may not exactly transfer to a modern Caucasian population; which is essentially interbred from migration and war (rape). This may be why Jenny sees a +/- 6 month plateau among her respondents and the co-sanguine Kuwaitis saw changes continue for a year +.

    Genetic poly-morphisms influence fasting glucose (GCK, G6PC2 and MTNR1B), are implicated in Hb1Ac, triglyceride levels, HDL levels & so on. That said, I personally would try the low carb approach if I was diabetic.

  • Might-o'chondri-AL

    3/27/2011 1:47:27 AM |

    edit my previous text to read  "... cross-bred from migration ...." instead of inter-bred.

  • Stargazey

    3/27/2011 4:38:41 AM |

    Just personal experience here, but I'm a postmenopausal female and have lost 35% of my starting weight by doing low-carb. I've maintained that loss for four years. My BMI is 21.0.

    For me, the key to reaching goal was the realization that eventually calories start to count. Low-carb has a natural appetite-limiting effect, but it is not a perfect tool. For people like me who have rather robust appetites, it becomes necessary to keep track of carbs for health and calories for weight loss and weight maintenance.

    I wish low-carb weight loss were as quick and easy as Dr. Atkins made it out to be, but it's not. Prescription drugs, thyroid issues and exercise all factor into the equation, but after a certain amount of weight has been lost on low-carb, the sad fact has to be faced: calories count.

  • Peter

    3/27/2011 1:27:27 PM |

    I just read the article on the front page of the American Diabetic Association website where they compared the benefits of a low carb vs. low fat diet for diabetics, and they said the big advantage of the low carb diet was you can reduce or eliminate insulin.  It seems like this idea is getting more and more respect from mainstream medicine.

  • Gretchen

    3/27/2011 3:33:59 PM |

    I agree with Jenny that it's cruel to promise people that their diabetes will be "cured" by ANY treatment, including drugs, diet, exercise, or a combination of the above.

    It sets up unrealistic goals and is equivalent to the nurse who tells obese people that if they'd just lose 10 pounds their diabetes would "go away."

    It's simply not true. Type 2 diabetes is caused by faulty insulin-producing beta cells as well as insulin resistance, and that is often genetic.

    Some people in very early stages of diabetes, when they're still producing a lot of insulin, can return to near-normal blood sugar levels with various regimens. Low carbing is one.

    But if those people resume eating carbs, their blood sugars will go into diabetic ranges. They're not cured. They're just well controlled.

    I have type 2 and I'm on a LC diet to control blood sugar, but I also take metformin and inject a basal insulin once a day or my blood sugars will be higher (I'm not comfortable with fasting or premeal numbers over 100, which they can be without the insulin).

    I was diagnosed in late stage of type 2, and nothing we know about today will bring my beta cells back.

    Please don't promise people false cures.

  • Geoffrey Levens

    3/27/2011 4:05:14 PM |

    Anon posted "But what about the normal weight relatively young (41) type two diabetic? (BMI 24) Could I lose 20 pounds to be model slim? Yeah. And I do eat low carb, although not 10 gram low carb. And I have gotten my Hba1c to 5.4. But, my insulin is crazy high, I hit 90 at my last glucose challenge."

    Just sounds like insulin resistance to me.  Some causes are transient fat in blood stream from high fat meals (In my experience in my body, saturated fat is more of a culprit than unsaturated by a very large measure), excess body fat and lack of muscle (lots of people are what I call "skinny fat").  Low carb diet, in one sense bypasses the problem since w/ low carb you don't produce much blood sugar load at once so the insulin resistance makes little difference.

  • Geoffrey Levens

    3/27/2011 4:10:26 PM |

    I had fairly high postprandial readings (175-180's at one hour) and rising A1c.  Low carb per Bernstein made me feel terrible and worse the longer I did it though it did lower my sugar readings dramatically.  Now I eat a very high carb diet and about 30% fat (from whole, raw, seeds and nuts) but all the carbs are in high fiber veg and fruits and beans (with their resistant starch component)(occasional starchy veg and rarely whole grains NOT flour) and my one hour postprandials are in low 120's to teens and my most recent A1c was 4.7

  • Lori Miller

    3/27/2011 4:49:39 PM |

    My mother is a type 2, overweight diabetic. She's been helped tremendously by Dr. Davis's advice to eat low-carb and avoid wheat. But even on a VLC diet, her fasting blood sugar is typically in the 120s. Her diabetes was uncontrolled for 20 years, and her blood sugar was wonky for probably most of her adult life. She's never going to be back to normal.

  • LifeCoachAndy

    3/27/2011 6:05:26 PM |

    Excerpt, ' Experiments described in the medical literature have tested the effects of high-fat diets on insulin intolerance. In one study, healthy young medical students were fed a very high fat diet containing egg yolks, heavy cream, and butter, and within two days all of the students had blood sugar levels high enough to be labeled diabetic.1 Complex carbohydrates have been shown to have the opposite effect.

    Again I am not saying that low fat diet will work for everyone, but I think it worth trying, expecially if low car dose not work.

  • LifeCoachAndy

    3/27/2011 6:11:06 PM |

    Sorry my previous post was not posted so do it again,
    I think what people dont understand, that fat reduces insulin sensitivity and effectiveness, so when glucose and fat present inthe blood stream need much more insulin to maintain glucose homeostasis, and in many people even hyperinsulinaemia cannot compensate. Listen a few interviews with Dr. Delgado, dr. McDougle they explain it more clearly. When you keep your fat intake under 10%, the insulin is much more sensitive , sure you need to eat whole grain, proper carbs, and not junk cereals, breatds etc.
    However, low carb diet works when people restict carbs, so they are able to maintai low blood glucose,  but once they consume more carbs,  blood sugar goes sky high.

    Moreover, in some studies, has been shown, that when people eat fat diet, even pure sugar does not cause glucose spikes, as it is immediately regulated by insulin. , here i do not advocate eating sugar.
    Another study Hollenbeck C, Doner CC, Williams RA, Reaven GM. The effects of variations in percent of naturally occurring complex and simple carbohydrates on plasma glucose and insulin response in individuals with non-insulin dependent diabetes mellitus. Diabetes 1985; 34:151.

  • Darrell D.

    3/27/2011 8:48:06 PM |

    http://www.joe-cannon.com/home/wp/can-type-ii-diabetes-be-cured/comment-page-1/#comment-1394

    "I make the bold statement that type II diabetes can be cured because I care and I desperately want people to know the facts about type II diabetes that few people appear to have ever been told. I want people to know:

    "1. Type II diabetes will go away -and stay away – in most people who take care of their health.

    "2. Most people don’t have to get type II diabetes. Most type II diabetes is environmental  (eating too much and exercising too little).

    "3. Losing a little weight and getting some exercise every day – even 20 minutes a day – can make profound changes not only on type II diabetes, but how long that diabetic lives."

    Apparently Joe Cannon, personal trainer, whom I quote, believes most type 2s can be cured. Through 12 years of diabetes, type 2, I have exercised by ass off. I went from the typical ADA advice which didn't work for several years, to following Protein Power which brought management, to Dr. Berstein, which brought more and better management but didn't cure it. Found Dr. Davis's web site about 2 years ago and have been reading every post, becoming increasing radical in my approach. Dropped the steel cuts oats, added niacin, fish oil, you name it, I did it. Just ordered Dr. Ron Rosedale Diet because he says  diabetes can be cured in most cases. Okay, which radical approach is going to cure diabetes? I am one of your readers that is taking your words in your blog as a personal challenge. And I'm taking the personal trainer to task as well. I expect to be cured in six months (and am devoting six months to do that!) I expect you to continue to give fabuous advice, and as your experiment of one, I expect this to happen. I now have adopted the theme: "Diabetes is the Terminator"--it canot be reasoned with, doesn't show pity, and absolutely will not stop until you are dead!" Sorry if I sound desperate, but some of us are taking your words to heart!

  • Anonymous

    3/27/2011 10:49:45 PM |

    Type 2 diabetes will rise and rise until people stop overeating. I see it around me everyday. Obese friends/relatives. For the last 20 years I'v watched them live an unhealthy lifestyle. Now it is catching up on them. One relative, age 48 type 2 diabetic, and one friend diagnosed last year. Age 52. Both have not changed their diet since diagnosis. Each carries an average of 60 extra pounds.
    They were given nutritional guidance from a dietician, and I gave them websites to check out. Neither is interested in changing their lifestyle.

    They refuse to change. Period. I'm sure there are thousands more like them out there......

  • Might-o'chondri-AL

    3/28/2011 3:51:02 AM |

    Fat is not all the same or always acting as we think. An unusual poly-petptide in the intestine is upregulated by fat; and it follows a diurnal rhythm (inactive at night).

    After "fasting" in response to
    the first meal the body synthesizes bile acids for digestion of fat intake. When their litocholic and chono-de-oxy-cholic acids hit the small intestine they
    interact with bile's Farnesoid X Receptor. This  upregulates Fibroblast Growth Factor 19 (FGF 19) in the intestines.

    FGF 19 cycle is at maximum 1.5 to 2 hours after the post-prandial bile production kicked off; and bile synthesis had largely came on and abated. If the breakfast had no fat content then FGF 19's "on" trigger of specific bile acids can be low.

    FGF 19 for it's part acts somewhat like a hormone; it integrates into a feed back loop. Humans have at least 22 different types of FGF with distinct action.

    FGF 19 acts in turn to upregulate the anti-diabetic protein Insulin-like Growth Factor BP2. So there is less insulin resistance and blood glucose levels drop.

    FGF 19 accelerates adaptive thermogenesis by  upregulating Uncoupling Protein 1 (UCP 1); the mitochondria energy gets "spilled" as heat. This makes the metabolic rate go higher and fatty acids are oxidized for energy.

    Weight gain from fat is, in this scenario, less; but mostly from less liver cell fat. There is increased fatty acid oxidation burning for useful energy, since the mitochondria energy supply shifted from ATP delivery.

  • revelo

    3/28/2011 4:05:23 AM |

    "Carbohydrates cause diabetes; elimination of carbohydrates cures diabetes."

    "Type 2 diabetes will rise and rise until people stop overeating."

    Stupid slogans like the above just confuse what is already a complex issue. To reiterate what has been said so many time, we have plenty of evidence of societies where carbs make up 65% or more of daily calories, but those societies show little obesity, diabetes, or heart disease, and they show long-life expectancy. The Japanese are a fine example of a developed society which eats a carb-based diet, and refined carbs at that, but doesn't have a diabetes epidemic. Clearly, carbs is NOT the problem.

    And just as clearly, plenty of fat type II diabetics want to lose weight, but they can't. It is perfectly realistic to ask people to suffer hunger for a few months while getting down to normal weight. What is not realistic is asking them to suffer for the rest of their lives. So the real question is, why is causing people to have such huge appetites? And that is not an easy question to answer.

    I grew up in the 1960's and everyone then was eating plenty of refined wheat, sugar and partially-hydrogenated vegetable oils, but people weren't fat like they are nowadays. Perhaps the manufacturers of processed foods have simply gotten much better at arranging fat, sugar and salt so as to make food irresistible. Perhaps it is a cultural thing: the same media brainwashing that has everyone wanting to supersize their house (McMansions) and car (SUV's) has them wanting to supersize their bodies as well. Perhaps the tendency towards obesity started after WWII, when food finally became cheap, and it simply took several generations for people to get accustomed to the idea of eating as much as they want, instead of treating food like something valuable not to be wasted. (Ever heard the expression "puts meat on the table?" Yes, there really was a time when an hour of labor at minimum wage didn't buy that much meat.)

    If there is a magic bullet to the diabetes epidemic, it will have to do with appetite suppression. My impression, based on my own experiences and observations of people around me, is that low-fat/high-carb is more effective in the long-run at curbing appetite than low-carb/high-fat, at least for most people. In other words, the convention wisdom is right.

  • Might-o'chondri-AL

    3/28/2011 5:37:28 AM |

    Japan obesity (BMI > 30 kg/m2) in 1990 - 1994  was nationally 3%. Japan statistic then for the overweight (BMI = 25 - 29 kg/m2) was 24% of men and 20% of women.

    Adults were over weight 4 times more than they were in 1960 statistics; and mostly in the rural population. The 1994 school children (age 6 to 14) had 5 - 11 % obesity.

    Data is from my notes (source was a Japanese translation) and I haven't looked up current statistics. Those 1994 obese school kids are all adults now
    of course.

    A recent analysis suggests that the lowest rate of death in East Asians (Japan, China, Korea) is for those with BMI of 22.6 to 27.5. This is similar to the European Prospective Studies Collaboration data of BMI = 23 - 27 as having least death risk in Caucasians.  

    In obese East Asians with BMI >35the risk of death was 1.5 times greater. However, those with a BMI of 15, or less, saw their risk factor go up by 2.8 times. In those with super low BMI the theory is underlying co-morbidity is involved, like respiratory disease.

  • Might-o'chondri-AL

    3/28/2011 6:26:37 AM |

    Coconut (like Doc's header image) has a  long 12:0 chain of lauric acid in it's fat that contributes to food satiety. It upregulates Glucagon-like Peptide 1 (GLP 1) release in the intestines.

    GLP1 is secreted in the endocrino-cyte "L" cells and is one of the hormone group called incretins; some GLP is also active in the brain. GLP 1 inhibits gastric secretion, gastric emptying and digestive secretion from the pancreas.

    It does enhance the release of insulin, which in this scenario
    (GLP 1 activated) occurs in the context of slowed digestion; so blood sugar drops in real time. GLP 1 also stymies the release of glycogen (stored liver glucose) and the body is driven to burn something else.

    GLP 1 does not provoke hypo-glycemia; the body burns it's fatty acids to run on. In fact if the individual does NOT graze between meals the satiation potential of coconut oil can work for up to 1.5 days worth of meals.

    It seems coconut's lauric acid fat works on GLP 1 with a timed phase that also kicks in +/- 3 hours after a meal. This has the affect of getting some insulin out to sweep away the blood glucose and force the body to burn fatty acids.

    Coconut's effect was greater than that of other fats; like milk fat, linoleic acid,stearic acid and oleic acid. Palm oil is more similarly satiating to coconut oil than other those other fats.

    I detail this as a suggestion how dieters can keep the weight they lost off. Read Doc's old posts and you will see his objection to "grazing" food between meals; it supplants the GLP 1 surge benefits.

    Here is a closing observation to amplify what others have infered. When western packaged foods switched out of palm and coconut oil shoppers lost the strongest activators of GLP1. Obesity from over eating got worse as we snacked up calories that sneak up on the waistline.

  • justdoinglife

    3/28/2011 7:43:52 AM |

    It is normal for people to overeat when food is readily available. That is a biological characteristic that has aided survival. We live in a time of excess. We need to learn to live normal in a abnormal world.

    I try to do that by avoiding sugar, grain, manufactured oils and other eatable products.

    but what do I know

  • Stargazey

    3/28/2011 2:07:25 PM |

    Might-o'chondri-AL, thanks for that mini-treatise on coconut oil. Lately I have been eating two tablespoons of coconut oil for breakfast as part of my weight maintenance program. I have noticed that the coconut oil is able to produce satiety as well as lower my blood sugar, but I had no idea why it worked.

  • Anonymous

    3/28/2011 2:39:14 PM |

    Some folks are very sensitive.  Control is probably a better word than cure, but the message is the same.  Low carb helps many folks with their blood sugar which is what seems to be so damaging.  It almost seems as though some cannot see beyond their own world views ("it isn't anyone's fault other than some medical-industrial complex", paraphrasing) when presented with evidence that INDIVIDUALS can help themselves, though some choose not to.

  • Lyford

    3/28/2011 3:40:49 PM |

    "Cure" implies that you no longer have diabetes, that you can eat whatever whenever and maintain normal blood sugars.  For almost everyone diagnosed as diabetic, that's not ever going to happen.  

    Diabetes -> High blood sugar -> complications

    You cannot change condition one - if you're diabetic, you're diabetic.  You can't really do much with link two - high blood sugar is going to cause complications in everyone who isn't killed by something else first.  But many type 2 diabetics can break link 1 and maintain normal blood sugars by limiting (or effectively eliminating) the amount of carbohydrate in their diets.

    But "cure" is definitely the wrong word to use.

  • Helen

    3/28/2011 9:39:20 PM |

    This is an interesting discussion.  Like "Anonymous" who is a young diabetic with a BMI of 24, I didn't eat my way into diabetes, and if I could eat my way out of it, I would have by now.  

    To M-Al and proponents of both low-carb and low-fat approaches, my experience tells me that type II diabetes is definitely NOT one disease, and (I'm getting to be a broken record on this forum I'm afraid) therefore the best regimen for control won't be the same for each person.  I do believe that many diabetics benefit from low-carb, and some from low-fat.  I suspect you will find refugees from one diet in the forums of the other - e.g., people for whom one alternative didn't work.

    One thing you probably can't do as a diabetic is eat both fats and carbs. And diabetes is so complex - a research article I read said that many diabetics seem to have disturbed lipid *and* carbohydrate metabolisms.  So where do you go from there?  Plus, you just dump sugar from your liver for no good reason, regardless.  This is why many diabetics (most?) will need to add medications to their diet and exercise routines.

    To commenters saying things like, "I know why there's diabetes - everyone's eating too much":

    Look at all of us: we're on a health blog.  We all have in common an unusual interest in health matters.  The fact that some people not reading this blog do not want to change their habits doesn't make it okay to blame diabetics for their disease.   Easy for you to say if it hasn't happened to you.

  • Gabriella Kadar

    3/28/2011 11:07:45 PM |

    What people do not take into consideration is that blood glucose is not dependant solely on dietary intake.  The liver dumps glucose into the blood stream in response to catecholamines.  Beta cells do not respond to endogenously produced glucose.  Glucose not utilized by the brain and the skeletal muscles will circulate for long periods of time.

  • Might-o'chondri-AL

    3/29/2011 12:34:52 AM |

    Hi Helen,
    Me, for my part, am just trying to examine the science of what Doc says works. It intrigues me, as do your comments.

    Whatever the causes of insulin resistance it starts unnoticed. The pancreas cells that should respond to circulating glucose go awry.

    Beta cells don't polarize their
    mitochondria membranes in the "normal" response to blood sugar (for many reasons, as you say).The Potassium ( K+) Channel is ruled by ATP and is unable to perform it's K+ channel function; it closes up for those people. (Mitochondria in other tissue can still be functioning normally.)

    So that Beta cell's mitochondrial
    Calcium ( Ca++) Channel gets a disorganized electrical charge. The Ca++ can't reach the triggering level the islet
    cell needs to put out insulin.

    A rhythmic swinging of Ca++ between the cell's mitochondria and that cell's cytoplasm (interior) is what sustains "normal" insulin activity. Why this happens, when and to whom is as you say  variable.

    First comes that pancreatic
    islet Beta cell mal-function, which instigates body's
    insulin resistance and then that
    individual shows symptom of hyper-glycemia (high blood sugar). If that kind of Beta cells' mitochondria mis-step (detailed above)is happening when someone's body tries
    to respond to blood glucose Doc's carbohydrate restriction is logical (to me).

    Insulin resistance apparently starts for adults long before blood glucose tests indicate
    even "pre-diabetes"; by age 60 +/-  1 in 5 will become Type II diabetic in the U.S.A. It seems with age our Beta cell mitochondria get out of whack and what we got away with in youth is not going to last forever.

    Genetic, epi-genetic and age are part of the disease progression; diabetes is a process, not a static condition over time. Abnormal Beta cell workings can lead to improper protein structure of the insulin molecule itself.

    This afflicts the Endoplasmic Reticulum (ER)where proteins are supposed to be appropriately folded. The erroneous protein configurations trigger the cell to "opt" for pre-programmed death (apoptosis, kind of like cell "suicide").

    That apoptosis is what eventually
    causes the diminished number of Beta cells in Type II diabetes.
    Early on Type II diabetics are not neccessarily suffering from dying Beta cells, or even always shrunken (atrophied) ones.

    Once the Type II diabetic's Beta cells die, then they suffer irreversable insulin insufficiency. That person has no response to hyper-glycemia and again Doc's regimen makes sense (and,I think he alluded to
    adding prescription diabetes drugs in certain individual cases).

  • Dr. William Davis

    3/29/2011 1:29:59 AM |

    Anon about typo: Thanks for catching that. Now fixed.

  • Dr. William Davis

    3/29/2011 1:33:27 AM |

    Hi, Jenny--

    Thanks, as always, for your insights.

    However, I am witnessing something different. I see 30, 40, 70, 80, 100 lbs of weight loss, followed by profound reversals of diabetes and all its associated measures.

    I suspect that many of the people you are talking to are not really following the diet that has the potential, in most diabetics but not in all as you well know, to completely reverse diabetes. It is a matter of the intensity of diet, the long-term commitment, and knowing what feedback tools to monitor.

  • Dr. William Davis

    3/29/2011 1:33:49 AM |

    Just doing--

    Well said!

  • Dr. William Davis

    3/29/2011 1:36:24 AM |

    Gretchen--

    Same response as that to Jenny.

    I was diabetic 20 years ago. No longer. I have a long list of former diabetics. It ain't that tough.

    There are indeed people who are physiologically incapable of reversing or ending diabetes. Jenny's LADA, for instance, can only be minimized, not completely reversed.

    But, as much as I respect the opinions of both of you very sophisticated ladies, I disagree with you on this issue. In fact, I would crudely estimate that 70-80% of all current diabetics, with the proper insight and information, can completely rid themselves of diabetes. This is no false hope.

  • Dr. William Davis

    3/29/2011 1:42:12 AM |

    Revelo--

    You are venturing very close to my Zero Tolerance Policy for rude behavior. Nonetheless, you often have insightful comments, so I'll let this one pass.

    Having done this in many patients, I can tell you it works in many, perhaps most, thought not all. There are too many paths to this place called diabetes, variable residual beta cell function, variable leptin status, variable adiponectin status, varying apo E status, etc. to allow 100% generalizations.

    The important lesson here is that MANY people, me included, who can kiss diabetes goodbye.

    Incidentally, I made myself diabetic 20 years ago eating low-fat, high- carb while jogging 5 miles a day.

  • Rick

    3/29/2011 1:54:54 AM |

    Another typo? About the paper you link to, is about a "small experience" or a "small experiment"?

  • Stargazey

    3/29/2011 2:40:14 AM |

    Just to be argumentative Smile

    Dr. Davis, if you are no longer diabetic, how could you start with a blood sugar of 84 mg/dl, eat 4 ounces of whole wheat bread, and then have a blood sugar of 167 mg/dl one hour later?

    In search of wheat: Einkorn and blood sugar

    I'm not a physician, but a postprandial blood sugar of 167 might indicate that your diabetes has not been cured.

  • PJNOIR

    3/29/2011 7:27:14 AM |

    after losing 70 lbs, even at 6:2 225 lbs, I was still in the Obese category.  I am not a bigbfan of one size fits all number ranges.  

    btw:  funny how it is the last ten lbs as if the number is the same. most low crabbers lie about their REAL carb intake.. We forget how quickly they add up.  


    Calories do NOT count.

    better the last ten is harder than the first fifty.

  • PJNOIR

    3/29/2011 7:35:36 AM |

    GRAND control but no cure.

  • Gretchen

    3/29/2011 1:29:19 PM |

    'I see 30, 40, 70, 80, 100 lbs of weight loss, followed by profound reversals of diabetes and all its associated measures."

    Dr Davis, with all due respect, if I lost 100 pounds, I'd weigh 20 pounds, which doesn't sound very appealing to me.

    As I noted, *people who are diagnosed in early stages of diabetes when they're still producing a lot of insulin* can go into remission with any kind of weight loss diet. These are the patients you're seeing.

    But they're not CURED. If they regain the weight, they'll have the same problems again.

    And people who aren't grossly overweight when diagnosed can't even go into remission by reducing carbs and giving up wheat. There are many many reports of this on the discussion boards and the anger the patients feel because medical people promised them something that didn't happen. They lose faith in doctors and try all kinds of alternative treatments, some of which could be dangerous.

    I think it's fine to tell patients that they MAY find that the weight loss puts them into remission. But to tell them that any diet will cure their diabetes is cruel, IMHO.

    If you had diabetes 20 years ago, then you still have it. Nondiabetics can be grossly overweight and maintain normal blood sugar levels. Some very obese people aren't even very insulin resistant.

    Human physiology is complex, and simplistic slogans (it used to be "fat makes you fat") are misleading.

    (BTW, Jenny is MODY, not LADA).

  • Gretchen

    3/29/2011 3:06:24 PM |

    I thought of an analogy: Someone is alcoholic. He gets counseling and gives up alcohol. Is he no longer alcoholic?

    I don't think so. Nonalcoholics can have one or two drinks and stop. He can't. He's controlled, but not cured.

    A lot of this controversy involves definitions. If you define "diabetes" as an A1c in the 4s, which is found in truly healthy young people, then if you get your A1c down that low with diet, you're not diabetic.

    But if you define diabetes as an inability to eat a lot of carbohydrate without going over 120 mg/dL, then you could have a low A1c on a low-carb diet and still be diabetic.

    Here are some quotes from lists from people who tested nondiabetic relatives:

    "My non-diabetic husband has never tested above 4.7 (85) and I've tested him a few times 1 and 2 hrs after amazing carb loads - 200g plus in 1 meal. Once after a Christmas dinner with 2 desserts (one dessert was sugar pie) and once after a pasta+white bread+dessert meal. After gigantic amounts of pancakes and gobs of maple syrup. He stays pretty much rock-steady."

    "I took my glucometer down for Thanksgiving and tested everyone an hour and two hours after the big meal with potatoes and pies etc. My brother in law's BG was only 82!"  and "I did the same thing with my siblings...including a sister who is close to 400 pounds. She was 84, my other sis who is about 220 lb was 75 and my brother who is thin was 100."

    It's not just weight.

    I don't like to argue about this, because I think you're doing a lot of good by urging people to cut carbs. But I think we need to face facts. Weight is an important factor, but not the primary cause of diabetes.

  • Anonymous

    3/29/2011 3:45:45 PM |

    I think that Grtchen's comment sums it up well. Dr Davis is a cardiologist. He also has a strong interest in nutrition and its impact on cardiovascular health. He is not an endocrinologist. And this shows in many of his comments regarding diabetes.

  • semsons.group

    3/29/2011 5:11:37 PM |

    Stargazey,

      I'm not diabetic, neither my wife, both of use can get 170 mg/dl after a vegetable sandwich with white bread. So, from my perspective your comment does not make much sense.

  • Alex

    3/29/2011 6:23:02 PM |

    Seems to me that low carb with elimination of grains and fructose would be a necessity for anybody with impaired glucose tolerance or diabetes.  Depending on how bad your insulin sensitivity is, you may have to switch from saturated fat to mono-unsaturated as well.  Add an hour a day of physical activity and I expect a significant percentage of diabetics/prediabetics will be off their meds.  The others will hopefully at least stabilize and not get worse.  Are they "cured"?  Not exactly...they still can't eat all that sugary stuff we all like to eat.
    But here's how I look at it.  Maybe they were never "sick" to begin with.  Maybe they were just poisoning themselves with foods they were never adapted to eat. After prolonged and sustained exposure to these poisons they got sick. Remove the poison and they no longer have the "disease" of diabetes.  I wonder what percentage of diabetics this definition of "disease" might apply to?

  • rhc

    3/29/2011 6:53:47 PM |

    @GeoffreyLevens
    I would be interested in how much exercise you do along with your diet to keep your bloodsuger (and A1C) that low.

  • PJNOIR

    3/29/2011 8:28:06 PM |

    exercise has little positive effect on blood sugar in the short term, in fact, in early efforts to control my numbers without meds, exercise would increase BS numbers after excerise. But in the long term, as a means to repair the body, it is very positive with diet.

  • Anonymous

    3/29/2011 9:17:43 PM |

    I find that exercise is a significant way to control blood sugar level. For me, a 30-min brisk walk (breathing hard at end) will reduce a 150+ blood sugar to under 125 mg/dL.
    I have found that the time of day for exercise is important. Physiologically we release glucose from liver glycogen prior to and on wake-up, preping our metabolism for activity so to speak. With increasing insulin resistance blood sugar will rise from the released glucose. Blood sugar is controlled by the insulin release in nondiabetics. Diabetics and the insulin resistant, can verify this with a series of fasting morning sugar checks, say on rising every 20 mins for an hour. By the way, this is known as the "dawn effect". For diabetics, the effect seems to be compounded with rigorous morning exercise. Exercise later in the day does not seem cause a problem. I had to go low carb (reducing stored hepatic glycogen) to reduce this natural response.
    This is my experience, and I am a DMT2. Be curious to hear about impact of exercise from you non-diabetic types.

    semsons.group: You may not consider yourself a "diabetic" but hitting a one-hour postprandial blood sugar of 170 after eating a sandwich is not healthy. Increased postprandial blood sugar levels is a sign of possible insulin resistance and a prediabetic condition.
    Continuous glucose monitoring studies show that for healthy individuals blood sugar rarely rises over 130 mg/dL and then only briefly during a 24-hour period. It is generally beleieved that blood sugar levels over 140 mg/dL are harmful.

  • Dr. William Davis

    3/29/2011 10:19:17 PM |

    I use the term "cure" loosely. "Latent" would be a better term.

    Personally, I run HbA1cs of around 4.7%, fasting glucose below 90 mg/dl, and postprandial glucoses of less than 100 mg/dl. In other words, no diabetes.

    However, if I have whole grain bread, cookies, and pretzels, I will be fully diabetic in short order, especially if I gain weight.

    I've seen this played out many, many times.

  • Stargazey

    3/29/2011 11:26:16 PM |

    Thanks, Dr. Davis. I suspected that might be the case.

    On a related topic, semsons.group and his wife may wish to avoid vegetable sandwiches with white bread.

  • Gretchen

    3/30/2011 1:01:46 AM |

    Dr Davis, thanks for clarifying your terminology. The reason I'm so adamant about avoiding the word "cure" is the following.

    I knew a man who was Dx'd with type 2. He did all the right things and got his BGs into normal ranges. So he thought he was cured and stopped testing. Nondiabetics don't test, and he was cured and nondiabetic, right?

    Then he had a piece of cake for his birthday. It was pretty good. Soon he was having cake every Sunday. Then every day. Then he forgot about the diet altogether. He was cured, right?

    One day he noticed he was thirsty all the time and decided to test. His BG was in the 400s or 500s. He wasn't worried. He knew what to do and went back to the diet that "cured" him before.

    Only this time it didn't work. He'd burned out his beta cells with high glucose. And he had to start injecting insulin.

    If instead of being told he was cured, he'd been told he was in remission but still had to be careful, he might have tested and discovered the problems before they were irreversible.

    This also illustrates the benefit of early diagnosis. If you wait too long, the condition may become irreversible no matter how strict your diet.

  • Lori Miller

    3/30/2011 1:59:12 AM |

    A difference between Dr. Davis's patients and typical low-carb dieters is that the patients may be taking more supplements of the right kind. There's a whole school of thought that overweight is caused by lack of nutrients, especially minerals. I believe that whacking out the empty, carby calories is important, but I also believe you need vitamins and minerals to metabolize fat--including your own fat. It's often forgotten that Dr. Atkins recommended supplements, and even wrote a book on the subject.

    In some studies I've seen, low-carb dieters were allowed, over time, to go back to eating more and more carb. (I'm sure this happens sometimes in real life, too.) Naturally, they stopped losing weight.

  • Anonymous

    3/30/2011 2:39:32 AM |

    Has anyone used supplements like lipoic acid ? (The R version is supposedly superior). It is used in Germany as a treatment in diabetes.

  • Anonymous

    3/30/2011 4:19:26 AM |

    Revelo: No, my comments are not stupid. I have yet to see a Type 2 diabetic within their normal weight range, AND eating healthy. I am surrounded by fat relatives/co-workers who live on highly processed boxed packaged foods, morning, day, and night at home and work place.  

    Myself and only 2 others bring our lunch to work from home, the rest on a daily basis eat out at Taco bell, Burger King, Pizza Hut, MsDonalds, etc. Now imagine doing this again for dinner??

    How much more can your body take of this diet before you become a DIABETIC?? I see it day in and day out before my eyes people eating themselves into Type II Diabetes.

  • Megaera

    3/30/2011 4:37:09 AM |

    Interesting: when Jenny points out that a theory applied doesn't actually work, the response isn't, "hm, perhaps the theory isn't right..." it's, "Well, then you have to be doing it wrong."  So, if I go on a rigorously-applied low-carb diet (no grains of any kind, no vegetable starches, limited fruits, no juices, fats being animal and EVOO only, and I STILL don't lose even a single pound despite cycling 20+ miles per day, Dr. Davis will unblushingly inform me that it's my fault, it's not that there's something wrong with the theory.  This is the case, by the way -- been doing this as a test since January. FWIW, my blood sugar, which before January, was typically 80 or so in the morning is now 120+, as often as not.  I'm not impressed with the results of this "health" approach, which hasn't changed even one of my health issues for the better, and appears to have worsened several rather significantly.

  • PJNOIR

    3/30/2011 12:15:09 PM |

    Meg:  Not a single pound?   Then something is very unusual.  Many of us know Jenny and her work and are familiar with her POVs. But not a single pound and claims of worse health leaves many of us speechless, What in the world would one expect to hear on an internet forum?  


    Annom-  I have used R  acid large doses twice a day. I cannot say that it worked by itself. I stopped when money got tight and didn't start again. It was a part of many things I was doing at a time when I was having my best results away from using any meds. I am thinking of going back to it and a few other things.

    As for exercise, only heavy lifting, strength training had any effect on my BS numbers on the short term. Walks and aerobics increased the numbers.  Type II is different for all of us. My best numbers are when I wake up and at night. go figure.

  • Helen

    3/30/2011 1:15:56 PM |

    To Anonymous, who said:

    "Revelo: No, my comments are not stupid. I have yet to see a Type 2 diabetic within their normal weight range, AND eating healthy. I am surrounded by fat relatives/co-workers who live on highly processed boxed packaged foods, morning, day, and night at home and work place."

    Well, then you have yet to meet me.  And my father-in-law.  Your tone is very judgmental and your comments uninformed.  About 1/4 of type II diabetics are not overweight.  I have always eaten healthfully - people are always commenting on it, and now they say, "Diabetes - you?"

    On the other hand, most obese people do not have diabetes, even though they may have other health problems.  Diabetes can be triggered by a poor diet and overweight, which lead to insulin resistance, but you have to have other, usually genetic, risk factors to develop diabetes.

  • Gretchen

    3/30/2011 1:16:01 PM |

    Anonymous, I once gave a talk to a local diabetes group. What really impressed me was that there were very few obese people in the audience. One man with a "beer belly," but most were post middle age women, not skinny, but not fat. Some were thin.

    I find it sad when people blame the victims. I think it's a form of self-protection. "Well, I don't do those things, so I'll never get disease X."

    I know a lot of people with diabetes who eat healthy diets, but I live in a rural area where most of us have vegetable gardens and some raise animals for meat as I used to.

    When you work in an urban area where everyone else in the office goes to fast food places for meals (I once noticed there was nothing but fast food available in the Harvard Medical School area and I wondered if they were trying to drum up business), it's difficult to be different, especially if you're the only one. Lots of peer pressure. People hate "holier than thou" eaters.

    I recently heard a talk on obesity by Jeffrey Friedman, who discovered leptin. He said many people think obesity is caused by gluttony and sloth, adding that "this view is mostly espoused by thin people." He thinks genetics has a very large role.

    Anonymous, have some compassion and have the courage to use your real name.

  • Helen

    3/30/2011 1:17:05 PM |

    Megeara, I have had a similar experience, although I did lose weight on low-carb.  It may be that this diet simply isn't compatible with your particular genetic profile and how you handle lipids and carbs.  Try some other approaches, keep checking your blood sugar, and see what works best for you.

    By the way, I find that supplemental fish oil and also vitamin C drive my blood sugar up.  (Both of these personal experience were backed up by research, I discovered.)  Check out if any supplements you are taking might be driving your numbers up.

  • Stargazey

    3/30/2011 1:41:24 PM |

    Megaera--just a thought--are you doing anything close to zero-carb? For some reason, in people over 50 a zero-carb diet can cause elevated blood sugar.

    I tried a zero-carb diet a couple of years ago, thinking it would help me lose weight and stave off diabetes. Instead, I gained weight and my fasting blood sugars went above 100 mg/dl for the first time in my life. I surveyed a bunch of people at my blog and found that those over 50 had similar experiences. (Google: Stargazey Observations on Protein Intake, if you want to read about it.)

  • CarbSane

    3/30/2011 3:28:04 PM |

    I tend to agree with what Stargazey is getting at here and Dr. Davis has since rephrased:  VLC is not a cure for diabetes.  VLC is clearly one way of managing one of the major symptoms implicated in health risks associated with diabetes (e.g. hyperglycemia -> glycation).  

    However, eating VLC does not cure diabetes, which at its core is pancreatic beta cell dysfunction.  Indeed it seems it can exacerbate the dysfunction as illustrated by the anecdotal evidence (don't like it but we have no real studies on this that I am aware of) that long term low carbers become more and more sensitive to any carb in the diet = worsening glycemic control.  

    A normal person can handle quite the glucose excursion and mounts an appropriate insulin response to handle it.  A diabetic cannot handle this, and neither can VLC'ers or the advice to carb up with 150g/day for several days in advance of an OGTT would not be circulating around the web.

    Can diabetes be cured?  Well, apparently yes.  I'm not suggesting gastric bypass surgery, but the remission rate - as in cessation of meds and "passing" an OGTT - is remarkable in morbidly obese diabetics undergoing the procedure.  In the 80-85% range in a matter of days/weeks prior to significant weight loss.  

    This tells me that our beta cells are remarkably more resilient than we give them credit for - we're talking some of the most deranged metabolisms snapping back to "normal" relatively quickly.

    In the short run, especially in IR obese and with weight loss, low carb generally seems to be a more successful approach.  But long term, more moderate approaches with higher carb and lower fat intake seem to be better, especially once compliance is taken to account.  

    (In Westman, after randomized assignments of 97 participants, 10 of those who drew the LCKD diet didn't show up to do the study, while only 3 of the LGID did.  So they started with 38 and 46 respectively.  Of these 5 KD's dropped out for refusal/dissatisfa41%ction with the diet while only 2 dropped out of GI diet.  17 total dropped from each group.  So from assignment to completion,  27/48 = 56% of screened recruits effectively dropped the LCKD while only 20/49 = 41% dropped out of LGID.  This can definitely impact results.  And the post-6 month rebound is common in longer term studies.)

    The results in the 2 year Shai study for example:  http://carbsanity.blogspot.com/2010/09/shai-and-diabetes.html

    Nuttal's group has achieved some excellent results absent weight loss with their LoBAG diets - high protein (30%) with 20,30 or 40% carb splitting the 70% baby with fat.  http://carbsanity.blogspot.com/2010/09/lobag-diets-for-treatment-of-type-ii.html

    I think Dr. Davis is an example of what Dr. Dansinger (who treats diabetics with a relatively low carb but less extreme version than others) refers to as a "carb cripple".

  • Anonymous

    3/30/2011 3:46:40 PM |

    I use the antioxidant R-lipoic acid as a supplement.
    Daily:  3x 200mg R-Lipoic Acid
    1x 1000 mg Evening Primrose Oil
    1x 1000 mcg Biotin
    As suggested by Richard Bernstein in his book, “Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars.” The Evening Primrose Oil provides gamma-linolenic acid (GLA) that is believed to increase the effectiveness of the lipoic acid effect. The biotin replaces the body’s supply consumed in the lipoic reaction.
    The R-isomer is believed to be better utilized than the S-isomer.
    In Germany, R-lipoic acid is used to relieve diabetic peripheral neuropathy, however, the supplement is given intravenously.

    I can not say that it has improved my blood sugar control but I continue to use it more as a “universal antioxidant”, and because of Bernstein’s endorsement. R Bernstein, a type 1 diabetic, is an endocrinologist and one of the original proponents for the use of at-home meters for measuring blood sugar levels in diabetics. He is one of the very early supporters of low carbs for blood sugar control in diabetics. He is in his 70s.

    I am a type 2 diabetic on metformin and low-carbs, maintaining HbA1cs at the low-end of 5%.

    For supplements this is the most expensive one I take. I go back and forth between the Doctors Best and Life Extension products, whatever is cheaper on Amazon at the time.

    Perhaps Jenny/Blood Sugar 101 can add a few more comments …

  • Might-o'chondri-AL

    3/30/2011 6:48:26 PM |

    Very interesting to me here, thanks everyone. Beta cells, in human adults, have their individual life span; they are not replaced from stem cells.

    A few at a time, of the already differentiated, Beta cells duplicate themselves. New ones form and in the absence of hyper-glycemia (high blood sugar) can become larger than their progenitors.

    This might explain how Doc gets latency, CarbSane suggest a "snapping" back, and why standard carbohydrate intake does not always induce diabetes. Each Beta cell has more than one mitochondria in order to sustain it's insulin role.

    Another commentator mentions that as some Type II diabetics age they (diabetics) do better off the low carbohydrate diet. Maybe the very slow time which Beta cells self-duplicate in has reached a good formation (in those individuals) and best to  "use it, or lose it".

    A low carb period gives fresh Beta cells enough of a break from high blood sugar then they can become large. Then that co-hort of Beta cells can follow the "normal" response; which is to get larger in response to  insulin demand from blood sugar (ex: when middle age Type II diabetic does "better" off of a strict low carb diet).

    What stops Beta cell self-duplication in Type I diabetes is the auto-immune T cell "attack". The immune system stymies regeneration.

    In Type II diabetes the inability to prevent toxic exposure side effects can be what impedes Beta cell self-duplication. Distorted  down-stream signal pathways can affect the transcription of a "fledgeling" Beta cell's replication of it's actin cyto-skeleton .

  • Stargazey

    3/30/2011 8:51:34 PM |

    Might-o'chondri-AL, if you don't mind my asking, where do you get all your information? Are you a graduate student, perhaps?

  • Might-o'chondri-AL

    3/30/2011 10:29:42 PM |

    Hi Stargzy,
    I'm "semi-retired" 60 year old who hopes to avoid degeneration as I age. I've been investigating how to live well for over 40 years. Doc's blog appeals to me because he has clinical cases to draw on and good input from his readers.

    When I first began looking into things maintaining health the science was much different. I am just trying to organize my thoughts on contemporary research to preserve my mental capacity.

  • CarbSane

    3/31/2011 12:43:28 PM |

    In the Westman study, it bears noting that the gender and racial make-up of the "completers" - which is all that counts for comparisons - varies considerably between the diet study groups:
    LKCD:  67% female, 67% white, 24% African-American
    LGID:  79% female, 45% white, 52% African-American

    On the "carbohydrates cause diabetes" front, I remain unconvinced.  When one looks at populations who are most susceptible to developing the disease, what does they tell us?  The traditional Pima ate an 80% carb diet and had low diabesity.  Expose to SAD - rates soar.  Japanese in Japan eating traditional diet with lots of rice = low diabesity rates.  Expose to SAD = rates soar.  The SAD is lower in carb by % (generally comes in at 40-45% carb for "usual" diet in studies) than the traditional diets.  So how can we say that carbs cause diabetes?

  • Helen

    3/31/2011 3:53:49 PM |

    I tried to post this before, but it got lost.  

    A question for Dr. Davis:  When you got diabetic blood sugars on a "healthy, whole grain" diet, were you supplementing with niacin and fish oil, which you recommend on your site?  I'm curious, because both are associated with impaired glucose tolerance in type II diabetics, and I have seen the effects of fish oil on my own glucose control.  There's a theory I've read that, while niacin has cardiovascular benefits, which is why you recommend it, food fortification with niacin may be in part responsible for increased rates of diabetes.  

    Is it possible that niacin is beneficial with low-carb, but deleterious with high-carb?

  • revelo

    3/31/2011 5:29:51 PM |

    Sorry for that comment above.

    Afghans (people of Afghanistan) eat a wheat based diet. In fact, wheat bread is almost the entire diet of many of them (and they suffer from iodine deficiency and other problems as a result). But they have little obesity, little diabetes, no problems with insulin-resistance:

    http://maisonneuve.org/pressroom/article/2010/nov/15/the-diseases-affluence/

    Things are more complicated than simply "carbs = bad".

  • Might-o'chondri-AL

    3/31/2011 11:03:59 PM |

    Hi Helen,
    Niacin induces vaso-dilation ("flush") from the action of prostaglandins on capillaries Prostaglandins are made from the lipids stashed in our membranes.

    This is how fish oil DHA/EPA (n-3) and poly-unsaturated vegetable oil (n-6) are involved; these can form Arachidonic Acid (AA)for making prostaglandins. Aspirin (salicylic acid) works as an anti-inflammatory because it blocks the AA pathway engendering prostaglandins.

    1876 salicylate was known to decrease diabetic's glucose in their urine. A modern study showed injected salicylate restored acute (ie: 1st) insulin response to glucose in
    10 out of 12 Type II diabetics who were administered prostaglandin.

    For the 2nd insulin phase, with a few gr. glucose challenge, 12 out of 12 Type II diabetics had a 4x increase in their 2nd insulin response (ie: with a
    salicylate booster before glucose administered and having those prostaglandins they got to start the test.)Prostaglandins,
    in Type II diabetics, interfere with insulin response; in the controls the prostaglandins did not blunt the 1st nor the 2nd insulin "pulse" put out.

    Women (some) "flush" from effect of prostaglandins at lower concentrations (ie: less niacin)than men (some). This is believed to be related to estrogen levels; suggesting that
    post-menopausal women should review their original pre-menopausal niacin dose.

    Doc specificly stated no one should take more than 1,500 mg. niacin without medical supervision (ex: liver enzymes
    that monitor inflammation
    tests). Diabetics who see their blood sugar worsen and/or liver
    tests worsen while taking niacin, might be able to find their individual dose that does not induce levels of prostaglandins interfering with insulin phases 1 and/or 2.
    Aspirin, as a salicylate, could be an additional way to block AA (thus prostaglandins)and foster timely insulin secretion for glucose clearance.

  • LifeCoachAndy

    4/2/2011 9:04:52 AM |

    Another latest study showed that carbs and fats do not mix well and results into high blood sugar. YOu need to read the full studyy, to see the whole picture. healthy subjects were given hig fat meal (only fat) in the morning and their glucose and insulin remained at the fasting level for the next 5 hours. Then they were given coffee or nothing and then did glucose challenge. Sugar shut sky high (10 mmol/l ~180sh). Coffein further increases glucose.

    This study again demonstrates that fat even after many outs of eating got negative effect on glucose. If if you eat low carb diet thats ok, but like most peole eat 30-40% energy from fat that leads to disaster.
    'An Oral Lipid Challenge and Acute Intake of Caffeinated Coffee Additively Decrease Glucose Tolerance in Healthy Men ' http://jn.nutrition.org/content/early/2011/02/23/jn.110.132761.abstract

    THis give some explanation why low fat diet work on some ppl.
    Also emaging what wouldve happen if this study was done with diabetics.

  • Might-o'chondri-AL

    4/2/2011 4:28:38 PM |

    Hi L/C/Andy,
    Is it more likely that caffeine's classic effect on the adrenals, causing the liver to naturally put glycogen (sugar storage molecule)into circulation, is the reason blood glucose "surged" after coffee? I admit to not having read the study, so this is speculation.

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