Was: Another link for carbohydrate information
On 19 Feb 2007 12:14:27 GMT, Chris Malcolm
<cam@holyrood.ed.ac.uk> wrote, replying to Kurt:
>>> only if you dont count the millions in research in the last 20 years.
>>> they did invest 18 million in 1999 and 40 million in research in the real
>>> 2005 alone.
>
>It's the next step after that which they've failed to take, which is
>to update the pages of general advice on their web site to reflect the
>results of that research.
Lets look at ADA-funded research for a moment.
It's not just a matter of updating web-sites correctly. It
can also be a matter of deliberate obfuscation and failing
to highlight unpopular results. Some of us get accused of
"ADA-hating" here. That would be really silly, to "hate"
such an important support organisation for diabetics - but
no organisation should be immune from criticism and
scrutiny. As an organisation becomes bigger and more likely
to affect the daily lives of those it supports such scrutiny
becomes not only necessary but critically essential.
I make no apologies for the length - I believe this to be
important. There are two aspects - important ADA-funded
dietary research and the possibility of deliberately
misleading comment on unpopular results for the funder.
There are several examples, but I'll choose Mary C Gannon's
research as illustrative.
A couple of years ago the ADA had a page on Mary C Gannon,
giving her background and qualifications and showing the
research that she was about to do. It was a complimentary
and interesting page, one of several featuring various
researchers.
That page disappeared about the time her 2004 paper on LoBAG
appeared:
http://diabetes.diabetesjournals.org...ract/53/9/2375
The abstract said, in part:
"On the basis of our previous data, we designed a
high-protein/low-carbohydrate, weight-maintaining,
nonketogenic diet. Its effect on glucose control in people
with untreated type 2 diabetes was determined. We refer to
this as a low-biologically-available-glucose (LoBAG) diet.
<snip>
Thus, a LoBAG diet ingested for 5 weeks dramatically reduced
the circulating glucose concentration in people with
untreated type 2 diabetes. Potentially, this could be a
patient-empowering way to ameliorate hyperglycemia without
pharmacological intervention. The long-term effects of such
a diet remain to be determined."
It was a study on a small population, obviously a pilot, so
further study was needed.
A search for "Gannon" of the ADA web-site finds few
references now, apart from LoBAG, simply inclusions in
lists:
The grants review committee:
http://www.diabetes.org/uedocuments/...sMarch2006.pdf
the 2004 and 2005 Research awards:
http://www.diabetes.org/uedocuments/...sBookFINAL.pdf http://www.diabetes.org/uedocuments/Research.pdf
The LoBAG gets a mention:
http://tinyurl.com/22oqtl or
http://www.diabetes.org/diabetes-res...otein-diet.jsp
But that's not the paper. Instead it is an ADA "summary"
titled "The Effects of a High-Protein, Low-Carb Diet".
It does include a url link, not to the original paper but to
a follow-up.
The concluding statement in that abstract is:
"The lack of negative effects, improved glucose control, and
a positive nitrogen balance suggest beneficial effects for
subjects with type 2 diabetes mellitus at risk for loss of
lean body mass."
Since then she, usually together Frank Q. Nuttall and fellow
researchers, has published further papers following on from
the inital LoBAG paper:
LoBAG30 (the number refers to the carb%)
http://ajpendo.physiology.org/cgi/co...act/291/4/E786
"Overall, the lack of negative effects, the improved glucose
control, and the positive nitrogen balance suggest such a
diet will be beneficial for older subjects with type 2
diabetes."
And lately (I may start a separate thread on this one,
possibly we've already discussed it?):
http://www.pubmedcentral.nih.gov/art...?artid=1475800
Control of blood glucose in type 2 diabetes without weight
loss by modification of diet composition
"Results
We determined that, of the carbohydrates present in the
diet, absorbed glucose is largely responsible for the
food-induced increase in blood glucose concentration. We
also determined that dietary protein increases
insulin
secretion and lowers blood glucose. Fat does not
significantly affect blood glucose, but can affect insulin
secretion and modify the absorption of carbohydrates. Based
on these data, we tested the efficacy of diets with various
protein:carbohydrate:fat ratios for 5 weeks on blood glucose
control in people with untreated type 2 diabetes. The
results were compared to those obtained in the same subjects
after 5 weeks on a control diet with a
protein:carbohydrate:fat ratio of 15:55:30. A 30:40:30 ratio
diet resulted in a moderate but significant decrease in
24-hour integrated glucose area and % total glycohemoglobin
(%tGHb). A 30:20:50 ratio diet resulted in a 38% decrease in
24-hour glucose area, a reduction in fasting glucose to near
normal and a decrease in %tGHb from 9.8% to 7.6%. The
response to a 30:30:40 ratio diet was similar.
Conclusion
Altering the diet composition could be a patient-empowering
method of improving the hyperglycemia of type 2 diabetes
without weight loss or pharmacologic intervention."
If you've read this far, you may have come to the same
conclusion as I did in reading Gannon's papers. This
ADA-funded research would seem to show some significant
benefits for diabetics by reducing the carb proportion of
diets without any negative consequences discovered to date.
Further study is definitely needed - but the results are
sufficiently different to those promoted by the ADA that one
would think some enthusiasm for that research would be
evident in the ADA report.
So, go back and read the ADA report again. I know you didn't
click on the link the first time, so here it is again:
http://www.diabetes.org/diabetes-res...otein-diet.jsp
And this is what they stated are the implications of the
study:
"The amount of fat and carbohydrates in a person's diet does
not appear to have an effect on metabolism. Increasing the
levels of protein in a person's diet causes changes in the
body that are not well understood and need more research."
And that's the positive bit.
Hang on - what happened to improved glucose control?
Patient-empowering? Reduction in fasting glucose to near
normal? A drop in A1c?
Where is the ADA report on that latest paper?
I can see no other way to view that "summary" than as a
deliberate attempt to bury the results. I sincerely hope
that I am wrong, and I'll be happy to eat humble pie and
apologise if anyone can advise me that the ADA are diverting
serious funding to Gannon, Nuttall et al to expand the study
into a major one to follow up such a promising line of
research.
I'm ever the optimist - but always the skeptic.
Cheers, Alan, T2, Australia.
d&e,
metformin 1000mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/
latest: Epidaurus
Another link for carbohydrate information 
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