Wheat elimination starts you powerfully on the path to reversing diabetes. We’ve seen it many times and it continues to develop in people who kiss their bagels, pretzels, and processed foods booby-trapped with wheat and grains goodbye.
But, as diabetics become less diabetic–a process that can occur VERY quickly, often within days of removing all wheat and grain products from their diet–but they are taking insulin or certain diabetes drugs, there is potential for hypoglycemia or low blood sugar. Low blood sugar from diabetes drugs can be dangerous and should be avoided at all costs. (Imagine if a non-diabetic started administering insulin or blood sugar-reducing drugs–it would result in a mess.)
Unfortunately, you cannot always rely on your doctor. Most physicians are unschooled in how to cure diabetes and therefore how to manage the hypoglycemia that may develop on your way to cure. (They are very good at CAUSING diabetes, however, prescribing diets like “An 1800-calorie American Diabetes Association Diet,” a typical dietary order in the hospital that RAISES blood sugar.) It is nonetheless important to at least discuss your questions with your doctor. (If you encounter resistance, get a new doctor, preferably one in functional medicine who is more apt to understand nutrition and biochemistry.)
So I reprint a section I wrote for the Wheat Belly Cookbook that details some of the important issues to be aware of if you are diabetic on insulin or diabetes drugs and remove wheat from your diet:
“There is not a shred of evidence that sugar, per se, has anything to do with getting diabetes.”
Richard Kahn, PhD
Recently retired Chief Scientific & Medical Officer
American Diabetes Association
Dr. Kahn’s comment echoes conventional thinking on diabetes: Eat all the grains and candy you want . . . just be sure to talk to your doctor about diabetes medications.
If you eat foods that increase blood sugar, it increases your need for diabetes medications. If you reduce or eliminate foods that increase blood sugar, then it decreases your need for diabetes medications. The equation for most people with adult, or type 2, diabetes, is really that simple.
But several precautions are necessary if you are diabetic and are taking certain diabetes drugs. The potential danger is hypoglycemia, low blood sugars (e.g., less than 70 mg/dl) . . . as well as the uninformed objections of many doctors who have come to believe that diabetes is incurable, irreversible, and a diagnosis for life.
Some medications, such as metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and acarbose (Precose), rarely if ever result in hypoglycemia when taken by themselves. They are effective for preventing blood sugar rises, but tend to not generate blood sugar lows.
However, other medications, especially glyburide (DiaBeta, Micronase), glipizide (Glucotrol), glimepiride (Amaryl), and various insulin preparations can cause severe and dangerous hypoglycemia if taken while reducing or eliminating wheat and carbohydrates. For this reason, many people eliminate these oral drugs or slash insulin doses by 50% at the start, even if it means some temporary increase in blood sugars. The key is to avoid hypoglycemia as you consume less food that increases blood sugar, even if it means higher near-term blood sugars.
Other medications, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), exenatide (Byetta) and liraglutide (Victoza) usually do not result in hypoglycemia but occasionally can, especially if taken in combination with other diabetes drugs.
Because of the complexity of these responses, you should ideally work with a healthcare provider adept at navigating these issues as you become less and less diabetic. Problem: Most doctors and diabetes educators have no idea whatsoever how to do this, as they will tell you that, once you have diabetes, you will always have it and trying to get rid of it is fruitless and foolhardy (to the appreciative applause of the diabetes drug industry). So don’t be surprised if you are left on your own. At the very least, you want to check to see if your doctor will work with you and, if not, at least try and find another who will. Also, frequent monitoring of blood sugars is essential. I tell my patients on the path to becoming non-diabetic that high blood sugars (though maintained below 200 mg/dl) are preferable to low blood sugars (below 100 mg/dl) in this transition period. If, for instance, you are obtaining blood sugars in the morning (fasting) of 100 mg/dl, it is time to further reduce or eliminate a medication, such as glipizide or Lantus insulin taken at bedtime.
Any diabetic who wants to better understand the details of becoming non-diabetic would also benefit from knowing about the resources of Dr. Richard Bernstein, author of The Diabetes Solution. More information can be found at http://www.diabetes-book.com. The critical issue here is to understand that many people with diabetes have been told that they have an incurable condition for a lifetime and that a diet rich in “healthy whole grains” is essential—-advice that ensures you remain diabetic. Do the opposite─-eliminate “healthy whole grains,” especially the most dangerous grain of all, wheat─-and limit other carbohydrates, including non-wheat grains like millet, corn, and oats, and diabetes unwinds itself with reduced fasting blood sugars and HbA1c in the majority.
More recently, the American Diabetes Association’s Chief Scientific & Medical Officer, Dr. Richard Kahn, added, “Diabetes prevention is a waste of resources.” Why, think of all the money that could instead go to pharmaceutical research and marketing!
How do you respond to this articles from Forks Over Knives?
http://www.forksoverknives.com/the-smoke-and-mirrors-behind-wheat-belly-and-grain-brain/
William Telgheder wrote: «How do you respond to this articles from Forks Over Knives?»
It wasn’t worth responding to when it was written 2 years ago, and still isn’t, but if you insist…
McDougall is a vegan zealot – that’s as in: the principle (veganism) is more important than any goals (such as health) that it might be pretending to serve. Whatever the question, the answer is vegan. You probably know this.
The article is ostensibly about both the original Wheat Belly book, and Perlmutter’s Grain Brain, but it’s not clear that he fully read them.
It starts out by bringing Atkins into the discussion for some reason, then launches with a vacant appeal to authorities not in evidence:
McD: “…well-informed people have come to understand … that eating an animal-based, high-fat, low-carbohydrate diet is wrong.”
The word “wrong” is also ambiguously loaded, perhaps intentionally. I avoid it myself. When I mean mistaken, I say mistaken.
McD: “They have learned that following this eating pattern causes epidemic diseases,…”
I think he meant pandemic, but it’s consistent with the carelessness so far.
McD: “…including type-2 diabetes, coronary heart disease, and common cancers;…”
The problem here, of course is that Wheat Belly reverses T2D, arrests if not reverses CVD, and so far hasn’t resulted in a cancer pandemic (on the contrary, it appears to be quite protective).
McD: “…and that the livestock industry is at the root of climate change.”
Hello? The books ostensibly under review are warning about grains, advocate a very low carb, high specific fat, moderate protein diet; counseling organic pastured where one chooses to consume animal products. Neither is endorsing the current CAFO livestock industry, which does indeed have major environmental and sustainability problems (as does industrial agriculture). Guilt by random grasping at straws, I suppose.
McD: “If you believe these authors, then what is left to eat in order to meet your energy requirements? Meat, dairy, fish, and eggs (the original Atkins Diet).”
Actually, you can follow WB (and probably GB) as a vegetarian. The WB book says so. I’ve even written an article on how. But that would be an inconvenient fact that doesn’t fit the apparent agenda here.
He then goes on to cite some science that he claims debunks low carb. The main problem is that these didn’t isolate for LCHF (low-carb high-fat), but for the favored vegan straw man (LCHP: low-carb high-protein). Neither WB nor GB advocate LCHP. Other confounding factors abound.
The first is a meta-analysis of the Nurses’ Health Study and Health Professionals’ Follow-up Studies, both based on annually-recollected self-reported dietary records. I suggest reading the paper and see if you can make any sense of it. There is precious little actual data.
The second paper admits right at the outset: “Objective To study the long term consequences of low carbohydrate diets, generally characterised by concomitant increases in protein intake, on cardiovascular health.”
Ditto for the third paper, also a meta-analysis: “A growing body of evidence has suggested that low-carbohydrate diets and their combination with high-protein diets are effective in weight loss.”
These papers might be evidence for the massive problems in what passes for nutrition science, but not much else. If there were some real controlled trials of LCHF to look at, that would be another matter. But if those existed, nusi.org wouldn’t need run any (which are underway now).
McD: “Exaggerating the Truth about Inflammation” – the very title tacitly admits that carbs cause inflammation (and in the case of grains, it’s more than just the sugars). There are some cites that are non-dispositive on the topic. There is a cite to Ornish, because of course there is. Dr. Davis has ample personal and professional experience with the real-world consequences of the Ornish approach to CVD.
Lots of chatter about CRP. Wheat Belly encourages people to get tested for hsCRP. Target is 0 to 1.0 mg/L, which is ⅓ of consensus “normal”. It would be very interesting to compare a random sample of WB followers to a random sample of vegans on a number of such metrics.
McD: “Animal Foods, Not Plant Foods, Cause Inflammation” – cites among other things a sloppy European study on red meat vs. whole grains, which didn’t even define what “red meat” was. It might be buried in some supplementary materials, but the usual dodge in such papers is to fail to isolate for things like processed meats or even hamburgers with the buns included, and also to take no steps to de-confound the fact that meat eaters, being rebellious to government guidelines, tend to include people who are careless about their entire diet, whereas whole grain eaters, thinking they are being cautious, tend to be cautious the rest of entire diet and lifestyle.
There are also various cites to whole grain studies, and indeed whole grains beat refined grains. What’s prominently absent is any no-grain arms or cohorts.
McD actually relies on the “cholesterol hypothesis”. Wow.
McD: “Relevant to the argument that inflammation is not the underlying cause of obesity and disease is the fact that treating inflammation with powerful anti-inflammatory medications does not favorably change the course and progression of the disease.”
That’s a straw man. WB does not identify inflammation as the underlying cause of obesity.
McD: “Using Celiac Disease to Demonize All Carbohydrates for All People” – another straw man (actually a small gang of them).
McD: “The main take-away that readers will get from Grain Brain is that grains and other starchy foods are the cause of type-2 diabetes, Alzheimer’s disease, obesity, and most of the other chronic health problems suffered in the Western world.”
Silver star for reading comprehension. It would be gold, but he didn’t mention the co-starring role of sugars in T2D.
McD: “The truth is that people with type-2 diabetes are ill with many disorders of the body and brain. But grains and other starchy vegetables do not cause type-2 diabetes. The Western diet, loaded with meat, fat, and empty calories, makes people overweight and diabetic.”
That dogma, which of course must be uttered, as if in prayer, is killing vegans in huge numbers.
McD: “Regardless of the effects on blood sugar, the underlying animal-based, low-grain, low-starchy-vegetable diet consisting of those very foods recommended in the books Wheat Belly and Grain Brain, is the major reason people with type-2 diabetes are so sick with heart and other diseases.”
Ignore your blood sugar? At your peril, folks. So all of you WB followers that have completely reversed your T2D – what you are going to trust, McDougall’s cherry-picked junk science, or your own lyin’ glucose meter?
Missing from the critique entirely are a number of WB and GB topics, principally fats and brain effects. For example, how to get enough DHA&EPA from plant sources, with any kind of ancestral rationale, is a huge problem for vegetarian dogma, so the dogmatics avoid the topic when they can, and try to deprecate it when they can’t.
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re: McD actually relies on the “cholesterol hypothesis”. Wow.
It has been revealed this week that the second of two landmark studies that were used to prop up the early cholesterol hypothesis, the Minnesota Coronary Experiment (MCE, 1966-1973), has been found to have, umm, “neglected” to publish back then that their raw data actually show that reducing cholesterol increases the risk of death.
This archeology was done by the same team that previously discovered similar gaming in the Sydney Diet Heart Study (SDHS, 1966-73).
In both cases, saturated fat was replaced by vegetable oil high in Omega 6 linoleic acid (the polyunsaturated fat that is pervasive in modern grain and seed oils such as soybean, corn, sunflower, peanut and canola).
What the recovered data from these trials actually tell us is:
☯ dietary saturated fat and cholesterol are not the cause of heart disease
☠ excess dietary Omega 6 linoleic acid is a health disaster
which is entirely upside down from the official advice we are getting from governments, doctor’s unions, national affliction associations and vegetarian advocates.
Dr. Malcolm Kendrick has links to papers in his remarks today on this mess:
https://drmalcolmkendrick.org/2016/04/13/greater-cholesterol-lowering-increases-the-risk-of-death/
You should do a face reveal Bob Niland. People want to see the face of wisdom.
D wrote: «You should do a face reveal Bob Niland.»
It’s on my list, probably later this month.
…gotta look into how Gravatar works…
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Maybe Dr. Richard Kahn was trying to become the “Ancel Keys” of the diabetes world. Glad to see that his status is “recently retired” from the ADA. Not to say his replacement will be any better.