Published on June 28, 2011, in Diabetes Health Magazine: Type 2 Diabetes: From Old Dogmas to New Realities – Part 2, by Hope Warshaw, MMSc, RD, CDE.
This very short article would seem to indicate that following a low-carb diet is “old dogma” and that some kind of “new reality” has provided a wiser course of action.
The wiser course of action seems to be not to try diet and exercise as a means to control Type 2 Diabetes, but to keep carbohydrate intake high, and start taking dangerous medications to combat insulin resistance as quickly as possible after your blood sugar problems are diagnosed.
Wow. I’m almost speechless.
I think her advice is bad, bad, BAD!
I’m neither a scientist nor a medical professional of any kind, so I’m going to say – officially – that this is “just my personal opinion.” That said, there are plenty of scientists, medical professionals and plain old smart people, who agree with me. I read their blogs, so I know they’re out there.
I could pick apart almost every sentence of this article, but I’m not going to bother. That would be tedious for both of us. What I will do, is attack her citation of LARGE and COUNTLESS studies that support her conclusion that low-carb diets don’t offer any long-term benefits to type 2 diabetics, because I believe they most certainly do.
In her article, Ms. Warshaw references:
“Nutrition recommendations …”
“Large studies have shown that …”
“Countless research studies do not show long term benefit …”
Citing LARGE and COUNTLESS studies sounds so impressive. Yet she fails to actually quote ONE STUDY that truly supports her conclusion that diabetics need to eat so many carbohydrates to manage their diabetes.
If you have read the fine print of even ONE nutritional study, you probably know that there are large and countless problems with them.
Here are just a few, off the top of my head:
1. Real, controlled nutritional studies are terribly expensive, and most people don’t even do them. This would be a study in which the food of the participants is really controlled, by making them live in a controlled environment, and measuring all their food. Terribly expensive.
2. To really prove anything with a nutritional study, you have to control all variables, other than the thing you want to study, to make sure that those don’t interfere with the outcomes.
For example, if you’re testing something related to carbohydrate intake… FAT intake must not be a variable. Protein intake must not be a variable. Smoking status. Physical activity. Everybody in your study must have matching levels of fat and protein intake, smoking status and physical activity, and ever other thing you can think of. Otherwise you cannot prove that the CARBS were the determining factor. It could have been something else. We call this a confounding variable.
3. The other kind of nutritional studies, the cheaper kind, is called an observational study. Most nutritional studies – by far – are observational studies. And, here’s the big, fat FACT about observational studies: THEY DON’T PROVE ANYTHING!
Observational studies are properly used to identify relationships that would be interesting to study further. Sometimes, the people conducting the studies will say different things are LINKED, or that there is a CORRELATION.
There is a well-known statistical correlation between smoking tobacco and lung cancer. This means that where tobacco smoking is observed, lung cancer is also observed. It doesn’t say which causes which. And it doesn’t tell you if there is another variable involved, which maybe causes both. This is one that is so well known that it doesn’t really prove my point, because everybody (including you) already believes that smoking causes cancer.
How about this? Over the past 200 years the number of pirates has diminished. Over the same period of time, marketing surveys have determined that the amount of fun people are having has also diminished. In fact, statistically, the amount of fun people are having is directly correlated to the number of pirates there are. So, if we want to have more fun, more of us should become pirates…
This example shows how absurd that is. Just because two things exist together doesn’t mean one causes the other. It really doesn’t. Don’t let politicians or pseudo scientists fool you into thinking that low-carb diets cause poor health based on observational nutritional studies that can’t prove anything.
4. Finally, my last point – off the top of my head – is to attack the data gathering techniques of observational studies. I know that sounds a little jargon-y, but here’s what I mean.
Have you ever taken a survey or filled out a questionnaire? Of course. We all have. Many observational studies use questionnaires to gather their data.
How accurate are the data collected on these questionnaires? Your guess is as good as mine. But we are only guessing. And the people filling them out are probably doing a lot of guessing, too! Some multi-year studies provide their study subjects with an annual questionnaire.
Do you remember what you ate a year ago? A month ago? Yesterday?
How accurate can they possibly be?
For a really great presentation on how to tell what you can (and can’t) tell from nutritional studies, check out Science For Smart People on Tom Naughton’s Fat Head Blog. It is both informative and entertaining!
As Tom would say: “You’ve been fed a load of bologna!”
Support The Metabolism Society in their efforts to support better nutritional studies and exploiting the full therapeutic potential of carbohydrate-restricted diets.
The Metabolism Society is dedicated to addressing the problems of obesity, diabetes & cardiovascular disease through public awareness and education. The Society believes specifically that the therapeutic potential of carbohydrate-restricted diets for the treatment of these diseases is under-investigated and under-utilized. The Society seeks to support research in this area. Our mission is to improve current nutritional guidelines and to see that sound scientific information is provided for the public.
Lovin’ it Low Carb
Ramona Denton
