Sunday, July 31, 2016

Type 2 Diabetes, a Dietary Disease #339: Low Carb? “It’s not a diet,” I blurted.

Those in the know – the cognoscenti – know that eating Low Carb, or Very Low Carb, is not a diet; it’s a Way of Eating  (WOE). And in the parlance of the medical establishment (skewed to my purpose), it’s a lifestyle change.
It’s also true that if you make this lifestyle change – that is, follow this WOE – you will lose weight, but that’s a secondary or “side” effect. Of course, you might make this change with the purpose of losing weight (as my doctor suggested I do), but even if that’s your primary motive, the effect on your general health, in many respects beyond weight loss, will be a much broader benefit than the lost weight: e.g., lipids (cholesterol), blood pressure (hypertension), and inflammation markers like hsCRP.
It’s worth noting, however, that in “prescribing” Very Low Carb (VLC) my doctor didn’t know this. He must have had an inkling though because as he walked me down the hall to schedule my next appointment, he put his hand on my shoulder and said, “Dan, this might even help your diabetes!” I was morbidly obese and had been a diagnosed Type 2 diabetic for 16 years. That was 14 years and 140 pounds ago. And within a day of starting VLC, I had a hypo. I called him and he took me off the 3rd oral med that I had just started. The next day, after another hypo, he cut the other two “maxed out” oral meds in half, and a few days later he had to cut them in half again.
So I guess it’s fair to say the Very Low Carb WOE did help my diabetes, as my doctor thought it might – even though that was NOT the reason either he put me on it or I agreed to do it. We both wanted me to lose weight – he because he thought (wrongly) that obesity was a “risk factor” and possibly a “cause” of type 2 diabetes. In point of fact, as many doctors and others “in the know” now understand, insulin resistance, the condition that leads to Type 2 diabetes, is what causes obesity, as I’ll explain in a moment.
If it makes sense to you that eating low carb is a safe and effective way to lose weight, as is now generally accepted by most “establishment” medical researchers, clinicians, food writers, pundits and TV personalities, doesn’t it make sense that eating a high carb diet is how that weight got on our bodies in the first place? Surely you’ve heard it; it’s been reported ad nauseum. And everyone knows how they fatten feed-lot beef; they feed them corn from a trough for weeks on end! So, why does our government still push a high carb diet on everyone – one size fits all – even the overweight, obese, insulin resistant, pre-diabetic and Type 2s among us?!!!
If you’re genetically predisposed, a diet very high in carbohydrates (say 60%, the amount on which the % Daily Value is based on the USDA’s Nutrition Facts panel), especially carbs that are refined and thus “pre-digested,” leads to overload on the liver and on insulin receptors on the surface of cells that take up the glucose. The overload results in backup which results in resistance (in the destination cells) and conversion (in the liver).
The pancreas responds by secreting more insulin to help the destination cells take up the glucose, producing thus an elevated level of insulin circulating in the blood. In the liver, when it’s full of glucose (glycogen in the storage form), it makes fat. And when the brain gets the signal that there’s an elevated level of insulin circulating (to help the resistant cells take up the glucose it is transporting), it gets the message that it doesn’t need to break down body fat for fuel. It can run on all that glucose “going around.”
Eventually, with all that insulin circulating, the glucose gets taken up and your blood sugar crashes. Your body now needs, indeed craves, more fuel to maintain a steady energy state (homeostasis). But with your insulin still elevated, the signal to break down body fat for fuel is blocked, so your body tells you to eat. Your chance to burn body fat is lost. When you then eat or drink to satisfy your hunger, this overloads your already full liver, which converts the carbs to fat (de novo lipogenesis).
If you’re lucky, you’ll just get fatter; you won’t get non-alcoholic fatty liver disease (NAFLD).

No comments:

Post a Comment