Science or Social?

So if you want to join the growing ranks of people who are becoming diabetic, now the largest epidemic of chronic disease ever witnessed in the history of the world, here’s what you do:

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Loss Leader said:

A lot of this is nonsense. I think the best predictor of pre-diabetes is belly fat.

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You can find a number of roadmaps to accomplish this lifestyle. The American Diabetes Association and the U. S. Dietary Guidelines for Americans have excellent programs for raising blood sugars. And don’t read nasty books like Wheat Belly that could actually harm the profit-making potential of grains and drugs. After all, the American Diabetes Association, the American Heart Association, and the Academy of Nutrition and Dietetics are industry-friendly, happily accepting generous donations from Big Food companies like Coca Cola and Kellogg’s and Big Pharma companies like Pfizer and AstraZeneca. Make yourself a type 2 diabetic and watch their stock prices rise!

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Skeptical Greg said:

Of course he's selling books, but is he wrong?

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All you have to do is show that people don't get healthy and reverse type 2 diabetes by following his guidelines..

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Are there other ways to get healthy? Sure.. But it won't be by following the advice from the institutions he decries?

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Why are they credible authorities when American health is in the crapper?

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Davis is an unlikely warrior. He was a cardiologist in Milwaukee, trying to lose a few pounds to help fight his type 2 diabetes. He never conducted any of his own scientific studies, but found that after cutting wheat from his diet, his blood sugar levels were significantly reduced and his extra weight melted away.

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Yoni Freedhoff, a family doctor and diet expert who runs a nutrition clinic in Ottawa, says the eating guidelines touted in Wheat Belly are similar to other carb-free diets that get results by dramatically reducing the carbohydrates and calories people eat.

He argues that the difference here is Davis, not any miracle cure: "This just took it to another level with a very charismatic doctor, who has a presentation that to me is reminiscent of an evangelical preacher. You know, with ‘You can be healed,’ and away you go. And I think…it’s what people want to hear. We want to believe in magic."

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Cut your fat intake — Because it leaves you unsatiated and hungry, you will be left with cravings and the loss of resolve to consume healthy foods, making those chips and cookies irresistible. Celebrate with Frito Lay and Oreos!

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Food macronutrients and satiety
Classic satiety research has typically looked at the physiological effects of food ingredients in isolation while holding all other contributors to satiety constant. This important work has highlighted that two foods of equal energy may have distinct effects on satiety if their macronutrient compositions differ. For example, women whose diet was modified to be high in protein and carbohydrate for a day reported higher levels of satiety compared to another day when the principle energy source of their diet was fat, despite the diets being matched for energy content (Westerterp-Plantenga, Rolland, Wilson, & Westerterp, 1999). The idea of a hierarchy of satiating effects of macronutrients in the order of protein > carbohydrate > fat (Blundell & Macdiarmid, 1997) goes some way to explain why not all calories will have the same impact on satiety, and has been hugely influential in the development of enhanced satiety foods. Nowadays, for many people, “high protein” is synonymous with feeling full and is central to most satiety claims in the appetite management food market. Protein has taken centre stage as the high satiety food constitute because of considerable experimental and real-world research indicating that increasing the protein composition of the diet without changing net energy can lead to enhanced feelings of satiety (Paddon-Jones et al., 2008). Possible physiological mechanisms underlying this effect include diet induced thermogenesis (Halton & Hu, 2004) and gastrointestinal hormonal signalling (Veldhorst et al., 2008), while two recent studies indicated that the sensory experience of ingesting protein is also important (Bertenshaw et al., 2013, Masic and Yeomans, 2013). Randomized trials of high protein diets on weight management provide evidence that these types of eating plans can support longer-term weight loss (e.g.Leidy et al., 2007, Skov et al., 1999, Weigle et al., 2005) and potentially aid future weight maintenance (Due et al., 2004, Westerterp-Plantenga et al., 2004). In the laboratory the satiating effects of high protein foods or meals have been compared to iso-energetic lower protein counterparts, typically using “preload” methodology where the measure of satiety is post-consumption subjective ratings of appetite and/or food intake. The majority of these types of studies indicate that high protein foods deliver better satiety than energy matched foods with lower levels of protein (e.g.Astbury et al., 2010, Bertenshaw et al., 2009, Booth et al., 1970, Fischer et al., 2004, Hill and Blundell, 1986, Rolls et al., 1988, Teff et al., 1989), though this not always reported (de Graaf et al., 1992, Vozzo et al., 2003). Overall this body of literature indicates that increasing the protein content of a food is an effective way to deliver enhanced satiety to the consumer, but manipulating the macronutrient content of a food while keeping energy constant means it is difficult to be certain whether these effects are due to the superior satiating effect of protein, the reduction of less satiating nutrients carbohydrate and fat, or a combination of both of these. Moreover, it is not known whether these effects are maintained after repeat experience; for these reasons EFSA are yet to approve claims based on a general protein effect (European Commission, 2007, European Commission, 2012).

High protein food products invariably contain other energy-yielding nutrients, usually both carbohydrate and fat. Therefore, in order to optimise high satiety products the carbohydrate-to-fat ratio should also be considered. Protein's position at the top of the satiety hierarchy is fairly well accepted but the order of carbohydrate and fat is often disputed, with this debate further complicated by variability in glycaemic responses to carbohydrate ingestion which can influence satiety signalling (Brand-Miller, Holt, Pawlak, & McMillan, 2002). With regard to satiety, the low-fat rhetoric of recent years seems justified: consuming more energy from carbohydrate than fat has been linked to reduced risk of being overweight or obese (Astrup et al., 2000, Gaesser, 2007), the implication being that high carbohydrate foods are more satiating than those that are high in fat. In free-feeding experiments when people are offered a range of high fat foods they tend to consume more energy than when they are offered high carbohydrate foods (Blundell, Green, & Burley, 1994), a phenomenon termed high fat hyperphagia or passive over consumption (Blundell & Tremblay, 1995). Importantly, this fat-related increased intake of energy does not lead to increased sensations of satiety (Blundell & Macdiarmid, 1997). In the laboratory, studies have found that high fat preloads are less satiating than energy matched high carbohydrate versions (e.g.Cotton et al., 1994, Holt, 1999, Robinson et al., 2005), though not in every case (e.g. de Graaf et al., 1992, Rolls et al., 1994). These mixed findings might be due to between study differences in participants characteristics (Chambers & Yeomans, 2011), and preload ingredients (Rolls & Bell, 1999). One particularly important property of fat is that per gram it delivers more than double the energy of carbohydrate and protein. The prevailing view is that fat's high energy density per unit weight largely accounts for its low satiety value (Blundell and Macdiarmid, 1997, Rolls and Bell, 1999). A high fat food will often be smaller in weight (and volume) than a high carbohydrate food of similar energy and this difference may affect the timing of the processing of the nutrients in the gut (Karhunen, Juvonen, Huotari, Purhonen, & Herzig, 2008) and also consumer beliefs about the likely consequence of consuming that food. That is, people tend to believe a small serving of food will not be enough to satisfy their hunger regardless of the energy it contains (Rolls, Drewnowski, & Ledikwe, 2005) and these satiety expectations are thought to play a key role in eating behaviour (Brunstrom, Shakeshaft, & Scott-Samuel, 2008).

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Although the effects of dietary fat and carbohydrate on satiety are well documented, little is known about the impact of these macronutrients on food hedonics. We examined the effects of ad libitum and isoenergetic meals varying in fat and carbohydrate on satiety, energy intake and food hedonics. In all, sixty-five overweight and obese individuals (BMI=30·9 (sd 3·8) kg/m2) completed two separate test meal days in a randomised order in which they consumed high-fat/low-carbohydrate (HFLC) or low-fat/high-carbohydrate (LFHC) foods. Satiety was measured using subjective appetite ratings to calculate the satiety quotient. Satiation was assessed by intake at ad libitum meals. Hedonic measures of explicit liking (subjective ratings) and implicit wanting (speed of forced choice) for an array of HFLC and LFHC foods were also tested before and after isoenergetic HFLC and LFHC meals. The satiety quotient was greater after ad libitum and isoenergetic meals during the LFHC condition compared with the HFLC condition (P=0·006 and P=0·001, respectively), whereas ad libitum energy intake was lower in the LFHC condition (P<0·001). Importantly, the LFHC meal also reduced explicit liking (P<0·001) and implicit wanting (P=0·011) for HFLC foods compared with the isoenergetic HFLC meal, which failed to suppress the hedonic appeal of subsequent HFLC foods. Therefore, when coupled with increased satiety and lower energy intake, the greater suppression of hedonic appeal for high-fat food seen with LFHC foods provides a further mechanism for why these foods promote better short-term appetite control than HFLC foods.

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Consume high-glycemic index foods — By “high,” I mean any food with a greater than zero or single-digit glycemic index, such as grains and sugars. Also eat more “low-” and “moderate-” glycemic index foods, because they raise your blood sugar to high levels, too!

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“There have been debates for literally the whole history of diabetes about which kind of diet is best,” said Dr. C. Ronald Kahn, chief academic officer at Joslin, and no relation to Dr. Richard Kahn. But, he said, “the answer isn’t so straightforward.”

In support of a diet like Dr. Hallberg’s, there is one recent short-term study, by Kevin Hall of the National Institute of Diabetes and Digestive and Kidney Diseases and his colleagues, involving 17 overweight and obese men, none of whom had diabetes. They stayed in a clinical center where they ate carefully controlled diets. The researchers asked what would happen if calories were kept constant but the carbohydrate composition of a diet varied from high to very low. The answer was that insulin secretion dropped 50 percent with the very low carbohydrate diet, meaning that much less insulin was required to maintain normal blood glucose levels.

“Since diabetes results when the body can’t produce enough insulin, perhaps it is a good idea to reduce the amount of insulin it needs by eating very-low-carbohydrate diets,” Dr. Hall said.

Some longer-term studies, though, failed to show that low-carbohydrate diets benefited glucose control.

Even if diets are effective in the short term, Dr. Hall said, “the difficulty is adhering to the diet over the long term.”

In an analysis of weight loss diets (not specifically for diabetics) published this summer, he and Yoni Freedhoff of the University of Ottawa wrote: “Diet adherence is so challenging that it is poor even in short-term studies where all food is provided. When diets are prescribed, adherence is likely to diminish over the long term despite self-reports to the contrary.”

But short-term studies of just a few weeks, which constitute the bulk of the diet studies, can be misleading, said Dr. C. Ronald Kahn.

“In the short term, the low-carbohydrate diet sometimes does better on glycemic control,” he said. “But as time progresses, the difference mostly disappears. What counts is which diet helps most with long-term weight loss. ”

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It is impossible, Dr. Hamdy said, to separate weight loss from the diet’s effects on diabetes because people following such a diet — which limits but does not forbid things like breads, pasta and rice — also lose weight.

But multiple studies have found that when it comes to weight loss — the only proven way to help with blood sugar control over the long term — there is no difference among diets that restrict calories, fat or carbohydrates.

Experts like Dr. David Nathan, the director of the diabetes center and clinical research center at Massachusetts General Hospital and a professor of medicine at Harvard Medical School, advise dieting for people with diabetes. But, he said, “when we advise people to be on diets, the major goal is to lose weight.”

What matters the most for controlling diabetes, Dr. Nathan said, “is how much weight you lose.”

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Apart from this lowering of HbA1c over the short term, there is no superiority of low-carbohydrate diets in terms of glycemic control, weight, or LDL cholesterol.

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The glycemic index (GI) has been proposed as a way in which to categorize carbohydrate foods as those that are rapidly absorbed (high GI) or more slowly absorbed (low GI) on the basis of the postingestion glucose area under the curve. Several recent studies suggested that diets that have a low GI may improve insulin sensitivity (20) and that consuming a low GI diet may be associated with a lower risk for type 2 diabetes (11, 12). Other studies have not shown a relationship between GI and risk for diabetes (13). In a recent, carefully done interventional study, Kiens was unable to show any benefit to insulin sensitivity of a low GI diet as measured by the gold standard method, the euglycemic hyperinsulinemic clamp [reviewed in (3)].

Intake of dietary fat, particularly saturated fat, appears to be associated with insulin resistance in animals (23) and humans (21) and may predispose to the development of diabetes (10). It seems prudent at this time to advocate increased fiber consumption. Resistant starch or low GI diets may ultimately prove to have beneficial effects at some stage in the development of type 2 diabetes, but this remains controversial. Although simple sugars appear to cause insulin resistance in rats, adverse effects in humans have not been demonstrated conclusively. Future studies should use appropriate doses of these nutrients fed over moderate periods of time to populations presumed to be the most susceptible to their effects. These populations might be the young in the case of simple sugars and those with preexisting insulin resistance in the case of complex carbohydrate and fiber. Clear relationships may not emerge until it is possible to obtain a more accurate phenotype or even genotype of subjects because genetic heterogeneity likely underlies the heterogeneous response to these diets.

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Although there are some clinical data to support a modest benefit of low GI and GL diets in the management of diabetes (5, 6), in the nondiabetic population the evidence is mixed (7). Meta-analysis of prospective studies supports a positive association between high GI diets and increased chronic disease risk (8), but data from randomized clinical trials indicate an inconsistent relation between dietary GI and GL values and insulin sensitivity (9), cardiovascular disease (8, 10), weight loss (11, 12), and cancer (13, 14). Some of this discrepancy in the literature has been attributed to methodologic issues with its measurement (15–18).

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In summary, our data indicate substantial variability in GI value determinations for white bread despite the use of standardized methodology and multiple testing in a large number of healthy volunteers. The high degree of variability demonstrates that there is potential to misclassify foods into the 3 commonly used GI categories (low, medium, and high), which would result in the inability to distinguish between foods, thus invalidating the practical applicability of the GI value. Additionally, our results indicate that the variability was explained in part by differences in baseline HbA1c and insulin index, suggesting that longer-term glycemic control and insulin response, even in normoglycemic individuals, affect the GI value. The impact of these findings on GI estimates and subsequent associations with chronic disease risk needs to be considered.

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Consume modern wheat — Because the gliadin protein yields opiate peptides that stimulate appetite and increase calorie intake by 400-800 calories per day, every day, making you want more to eat all throughout the day, paving the road to a wonderful and proud collection of visceral fat.

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Joe Schwarcz, a chemist at McGill University dedicated to demystifying science and debunking big claims, says, "This is one of these arguments that has one smidgen of scientific fact to it, which is then exploded into a whole blob of nonsense."

Schwarcz says he hasn’t seen any evidence that wheat has addictive properties, as Davis claims in his book. Schwarcz also says "opioid peptides" are produced when some foods are digested. But just because they can bind to opiate receptors in the brain doesn’t mean they produce a morphine-like effect.

"If we’re going to say that wheat is addictive," Schwarcz explains, "it’s along the line that people like foods that have wheat in them. It’s not a physical addiction."

It appears that Davis based this claim mainly on one study of rat brains, done on dead rats in 1979. The fifth estate could not locate any study on humans that conclusively proves wheat is addictive.

Davis also links wheat to mental illness such as schizophrenia. But the study he based his research on was conducted in 1966, and after almost 50 years of research, no one consulted by the fifth estate could point to any definitive study that specifically links wheat to schizophrenia.

What about Davis’s claim that today’s wheat is not wheat at all, but a "modern creation of genetics research"?

Researchers at the University of Saskatchewan have been studying the genetic profiles of 37 varieties of wheat grown in Canada since the 1800s, to discover if wheat’s basic protein structure has been altered in any way.

Wheat geneticist Dr. Ravi Chabbar is heading up the Saskatchewan project and is paid to advise the grain industry, but this particular project is being funded by the federal government.

Dr. Chabbar says that over time, wheat has been modified to produce high-yield crops. But when it comes to wheat’s proteins – gluten and gliadins – the basic structure of "ancient" and modern wheat is the same.

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Listen to your doctor’s advice to not supplement vitamin D or supplement at low-dose and be content with a 25-hydroxy vitamin D level of 30 ng/ml, the level you would have with minimal sun exposure and no consumption of animal organs. Ignore the fact that healthy, young, sun-exposed people typically have 25-hydroxy vitamin D levels of 70, 80, or 90 ng/ml. And ask your doctor to take the less effective, non-human form of vitamin D available by prescription!

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Dear USA, we’ll help you, but you don’t really think that nutrition plays any role and keep talking about counting calories – which doesn’t work. I’ll go to NYC and New Jersey later this month to tell you about our research. HELP IS ON THE WAY.
Arne V. Astrup, (Facebook, Oct. 13, 2018)

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Council for a Strong America is a national, bipartisan nonprofit that unites five organizations comprised of law enforcement leaders, retired admirals and generals, business executives, pastors, and prominent coaches and athletes who promote solutions that ensure our next generation of Americans will be citizen-ready.
Unhealthy and Unprepared: National security depends on promoting healthy lifestyles from an early age (Council for a Strong America, October 2018)

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71 percent of youth between the ages of 17 and 24 would not meet the military’s core eligibility requirements. Obesity is one of the largest medical disqualifiers.

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dann said:

A leading Danish researcher in the field of nutrition is in the USA right now to talk about why simply counting calories doesn't work:




Arne Astrup is the leader of the Department of Nutrition, Exercise and Sports Institute of Sports Medicine at the University of Copenhagen - and I'm pretty sure that he doesn't see wheat as a problem - at all!

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Many of your papers tackle the debate of fat versus carbohydrates in diets, such as whether or not the Atkins diet fad really is beneficial and whether or not carbohydrates are really bad for people's diets. On what side of the issue has your research led you to be? Is there an ideal diet to maintain a healthy weight?

We have shown that all calories are not equal because they exert different effects on satiety, and changes in the diet composition can therefore lead to spontaneous changes in body weight through changes in caloric intake.

Our paper "Randomized trial on protein vs. carbohydrate in ad libitum fat reduced diet for the treatment of obesity," (Skov AR, et al., International Journal of Obesity 23[5]: 528-36, May 1999) was the first randomized trial to show that the stronger satiating power of protein leads to greater weight loss during ad libitum intake of a diet providing 25% of calories from protein (versus 12 % protein).

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Tsukasa Buddha said:

I'll get there.

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I need to cut myself off here.

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