The Joslin Diabetes
Center in Boston is “the world’s largest diabetes research center, diabetes clinic,
and provider of diabetes education,”
according to Wikipedia. It came as no surprise, therefore, when on February 8,
2012 Joslin shot back at comments made by Richard Kahn, Ph.D., former
Chief Scientific and Medical Officer of the American Diabetes Association. The comments were made at a briefing
for public health advocates and diabetes researchers regarding his February 7,
2012 article, “Confronting the Growing Diabetes Crisis,” in the journal Health Affairs.
Dr. Kahn controversial
statement was, “Even though weight loss can prevent or delay the onset of
diabetes, the failure of patients to maintain weight loss beyond an average of
four years makes diabetes prevention
programs ‘a waste of resources,’
The health system should focus instead on reducing
the likelihood of complications once patients have been diagnosed with
diabetes.” (Emphasis added by me.)
Joslin’s rebuttal was given by Edward S. Horton,
MD, Professor of Medicine at Harvard Medical School (with which Joslin is
affiliated), and past President of the American
Diabetes Association. He said that Joslin had extensive “experience with
innovative weight management programs [that showed] that patients can maintain
healthy weight levels well past four years.” “There is a legacy,” he added, “for
the initial weight loss even if people cannot maintain it. The 10-year follow
up of the patients who completed the diabetes prevention program showed that
people who initially lost weight continued to develop diabetes at a lower
rate over 10 years than those who did not lose weight, even if they
gained part of that weight back.”
This internecine battle of former ADA officers demonstrates
clearly that overweight and obesity is a big problem, as well as the surest
predictor of incipient Type 2 diabetes. Further, it clearly identifies losing
weight as the first line of defense against “developing diabetes at a lower
rate” and “the likelihood of complications.”
Type 2 diabetes is also associated with a multiple
Diseases of Civilization (CVD, CHD, stroke, Alzheimer’s and some cancers). A recent NY
Times story reported, “Researchers found diabetes was associated with a
higher overall risk for colon, rectal and liver cancers among both men and
women. In women, diabetes was most strongly associated with a higher risk of
stomach, anal and endometrial cancers. In men, diabetes was most likely to
raise risk for pancreatic and bladder cancers. So, there’s wide recognition for
the benefits of “developing diabetes at a lower rate” and avoiding “the
likelihood of complications.”
The battle also illustrates the difficulty of
losing weight and keeping it off. Even Harvard Medical School’s defenders of
Joslin’s programs, in remarks posted in Public
Health and Policy (issue 612) one day after Dr. Kahn’s controversial
statement, appear to disagree. Enrique Caballero, M. D., said, “Not having a full answer on what to do
in the long term does not mean that efforts to identify these strategies and
translate them to clinical practice model should be abandoned.”
On the other hand, Martin Abrahamson, M. D.,
Chief Medical Officer at Joslin Diabetes Center and an Associate Professor of
Medicine at Harvard Medical School, said, “Since
we know which weight management programs will work in the fight against
obesity, the challenge is to find ways to implement them in communities, which
we at Joslin are working hard to do” (emphasis added in both quotes).
The problem is that Joslin’s “innovative” weight
management programs are not innovative. Joslin and Harvard still cling to the
Diet-Heart or Lipid Hypothesis promulgated by Ancel Keys in the early 1960’s and
later the American Heart Association: Saturated fat and dietary cholesterol are
bad for you. Although increasingly recognized as unproven, this hypothesis still
dominates in the medical establishment and suffuses public health policy.
Until this “corrupt
bargain” is broken, our health will continue to decline as rates of obesity,
Type 2 diabetes and “the likelihood of complications” all rise. The Low-Carb,
High-Fat Way of Eating advocated here is a solution. Be aware, though, that it
is an heretical guide to easy weight loss (without hunger),
remission
of
Type 2 diabetes, and avoidance of the dreaded
complications. Your doctor will really like the results of all your
blood tests too.
No comments:
Post a Comment