MD’s Argument … Part 3 11


Frederick Allen

This is the last post of three dealing with an online discussion I’ve had with Dr. Dean Jenkins, unless new, original points are made.

If you missed the first two posts, here are the links :

First, Dissecting an MDs ADA Minion Argument

Second,  Dissecting an MD’s Argument Part II

Note:  Below is the doctor’s reply, uninterrupted. My reply follows.

 

—————-

Just found this!   Thanks Steve for summarising the discussion.

I’ve replied in the Google+ thread already and that is public too. https://plus.google.com/107432884544968913388/posts/U9dBe8g7prS

The Frederick Allen diet was designed to keep people with Type 1 diabetes alive before the discovery of insulin. It worked. He was famous for it and it had low carbs. (A)

You asked a specific question about the nutritional composition of the diet and I couldn’t be exact about the conversion of percentage calories to grams of carbohydrate. You got me there. Fair enough.

Just to be clear people with Type 1 diabetes require insulin and should continue to take it.  (B)

The discussion we are having about high carb vs. low carb diets is for people with Type 2 diabetes and whether the diet and lifestyle regime that works for you could work for others. Yes it can – but not everybody will be able or willing to do so. I’d argue that many, perhaps the majority, would not be willing to do so and that is not because their dietitians or physicians are encouraging them to eat carbs and take more medication it is because they find changing their diet difficult. (C)

My belief on ‘normality’ is that there should be no difference in the diet of people with or without diabetes. We should all be on a ‘healthy’ diet – whatever that is and there is much debate on it. (D)

Keep up the advocacy for diabetes! BTW maybe you should label me a “DiabetesUK” minion as I’m not in theUSalthough I sometimes go to theADAmeetings.

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My Comment Reply

 

This discussion all began because you posted an article that was pro-vegetarian diet for diabetics.

I asked you if you knew of any vegan diabetics weaning off drugs and insulin with normal blood sugar….because I was interested in talking to them.

7 days later and after changing the subject and evading the question … you finally admit that you did not know of a single vegan diabetic who had normal blood sugar and who had weaned off drugs and insulin.

Point A:   When you originally posted about “The Fredrick Allen Diet”… you completely mis-characterized it. You stated the patients were wasting a way due to it being low in carbs.  Your quote,

” It involved very, very low carbohydrate diets that left patients alive but on the brink of starvation.”

NOW you state that ‘it worked’, I’m glad you now see the benefits of a low carb meal plan. … however…

Previously, when you stated that the ‘low carb diet’ was  keeping patients on the ‘brink of starvation’, you some how missed the fact that it was also a calorie restricted diet.  No where in your commentary did you mention this. Convenient when arguing against a low carb diet.

Prolonged calorie restriction can lead to ‘wasting away’… I’ve been on a very low carb meal plan for two years now… and I THRIVE. I definitely do NOT waste away but I eat the plenty of protein and fats.

 

Point B:  I am WELL aware that Type 1 Diabetics require insulin… that’s why they are Type 1.  You must be aware that the High Carb Meal Plan has many Type 2 Diabetics requiring Insulin as well.

Point C :     So you claim that many will not go ‘low carb Paleo’ ….

“…because they find changing their diet difficult.”

You made this same point numerous times as if it proves your point… and as if I am arguing this point.

FOR THE 3rd time: we are in agreement that most will not go low carb paleo.  Where we differ is on the Why and What to do about it.

 

The Why?


1) It’s because vast majority of diabetics never hear about Low Carb Paleo.  So you seem to want to play GOD and decide that NO ONE gets to hear about it because some won’t do it???

Can I play that game and decide that since some patients will not survive surgery… let’s end all surgeries? … I think not.

2) When they ARE told about Low Carb Paleo,  it’s ridiculed as being short term solution, not a long term option.

Or it’s stated that it’s not healthy, lacking grains/fiber etc…

Lastly, they are told Low Carb Paleo is damaging to the heart, with all the saturated fats clogging the arteries.

There are others. But you get the point.

3) The 3rd main reason most will not do it?  Not only is their so called “Diabetes Educator” not going to support them but neither is Oprah, Dr. Oz, their doctor, their nurse, their best friend, their pastor, their dentist … NO one.

THERE IS NO SUPPORT…every one ridicules it.

SO, given the utter lack of support, I agree:  many will not go low carb …today.

And why is there NO support?

Because people in the ‘Medical Industry’ continue to push a grain based, high carb meal plan that only benefits the Medical Industry (more customers), Big Pharma (more drug sales) and Big Agra Biz (Monsanto, PepsiCo, Coca Cola, etc)

WILL YOU be part of the solution???

What to do about it?

1) Your Solution:  hide low carb paleo  from all… since all will not do it.

2) My Solution:  tell ALL about low carb paleo  FIRST… and support those who can’t … pushing them to lower carbs gradually.

 

Lastly  (for part C) : You sadly state that many will not go low carb paleo …

“because they find changing their diet difficult.”

And to that claim I’ll say:

1) Any diet change is difficult.  We ALL resist change.

2) Following the ADA, high carb  meal plan is difficult too… few even follow it!

Do you know why?

It’s like telling an alcoholic to only drink a six pack… the addiction NEVER ENDS!

You can NOT eat high carb foods, such as grains, pasta, cereals, legumes,  breads, cakes and cookies and BREAK  the addiction.

3)  How do you know how many COULD do it if they had the support of doctors, friends, TV docs and the medical industry???

And what if ONLY one person changed their lives… but what if it was YOUR mother, daughter, son or YOU.

Still… you seem to want to play God… and to decide that since most won’t do Low Carb Paleo … let’s keep it a  secret.

 

Point D :  … not sure what you are thinking here my friend.

a)    You  said…. “…there should be no difference in the diet of people with or without diabetes. “

Really?

… so you are going to play God and decide that people should not know there is a way to eat that will reduce drugs and insulin???

Are you serious???

I’ve heard similar statements in the past from so called “Certified Diabetes Educators”  like Hope Warshaw … but I expected more from you.

… I’m guessing your ‘one diet’ for diabetics would be ‘wholesome whole grains’, soy beans, rice, breads, cereals, pasta, potato,  beets, etc?  If you think we have an epidemic of obesity and diabetes now???  Wait until this ‘diet’ goes ‘world wide’.

… what a coincidence that ‘your diet for all’ also just happens to be the diet that increases drugs and insulin usage…

It also just happens to be the diet that keeps them coming back for more ‘diabetic services’.

I agree, people with diabetes should be able to eat foods that raise their blood sugar and that require an increase in drugs and insulin to keep them alive…  However  they DESERVE a right to know that there is a BETTER WAY!!!!

Type 2 Diabetics deserve to know that MOST can wean off of all drugs and insulin entirely… all can reduce drugs and insulin.   Potentially BEING FREE from daily insulin shots and drugs that cause other health problems.

Type 1 Diabetics deserve to know that they CAN greatly reduce the soaring highs and crashing lows associated with a high carb meal plan.   They TOO can reduce drugs and insulin usage.

Other Resources

- where you can learn about TRUE diabetes care.

Dr. Bernstein – Click Here for a post on a true diabetes educator… his book, “The Diabetes Solution“…  He’s a 70+ year old, Type 1 Diabetic with normal kidney function etc.

Dr. BG’s Blog .  The only Certified Diabetes Educator I read and heed….and she’s a PhD!

There are so many reasons a low carb meal plan is preferred,  pancreas beta cell preservation is certainly one.  Why ‘over work’ the pancreas causing beta cell burn out??? Even Type 1’s …

http://www.sciencedaily.com/releases/2010/06/100614102008.htm

Excellent Video from Robb Wolf – giving Paleo Overview - Robb Wolf is author of “Paleo Solution

 Type 1 Diabetic… radiologist Podcast with Jimmy Moore

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11 thoughts on “MD’s Argument … Part 3

  • Dean Jenkins

    Below is a comment from Dr. Jenkins. I’ve commented ‘inline’ in bold and quotes.

    ————-
    Steve thanks for your comments.

    However, you’re making the debate more complicated than it needs to be and splitting my responses across your blog, my blog, Storify and Google+ just makes it more confusing still. I’ll restrict myself to just answering here if that’s OK.

    In his opening statement he’s blaming me for making it ‘confusing’… by splitting responses etc. I only post on Google+ and my blog… I have nothing to do with his “Storify” page nor his blog. I only posted here so a wider audience can see the ‘mindset’ of a diabetes professional. I certainly apologize if the posts on GooglePlus and this Blog are confusing… luckily my brain is ketone powered. :)

    To answer your specific points:

    A – Frederick Allen’s patients were on the brink of starvation not because they were on a very low carbohydrate diet or because of the very moderate calorie restriction they were on (1750 calories / day) but because they were in diabetic ketoacidosis. They had no insulin (because they were Type 1 diabetics). The wards were described as “famine wards” because the patients looked so dreadfully thin not because they were being starved. They were on very low carbohydrate diets (fact) and it kept them alive (fact) because they didn’t become even more hyperglycaemic (fact) and they were very thin because they lacked insulin (fact) and the best treatment for them later when insulin was discovered (fact).

    No one is disputing the facts above…you continue to re-state facts that are not being debated, as if that bolstered your argument.

    I merely pointed out that you MIS-characterized the diet… you conveniently left out ‘calorie restriction’ when you described the diet…YOU DID THAT.

    Here is what you originally said…

    “The Frederick Allen diet was used for the treatment of Type 1 Diabetes before the discover of insulin in 1922. It involved very, very low carbohydrate diets that left patients alive but on the brink of starvation.
    Not to be recommended! Insulin is much more effective.”

    YOUR charactarization would leave ANYONE with the opinion that Very Low Carb Diets will leave people on the brink of starvation… because that’s what you said.

    I think you saw ‘low carb’ and ‘starvation’ in the same sentence and assumed one caused the other and it was a criticism of the modern-day debate on low carbs – it was not.


    … when you say “very low carb diets that left patients alive but on the brink of starvation” … you are saying …
    “very low carb diets that left patients alive but on the brink of starvation”… LOL!!! Why did I ever think you meant… “very low carb diets that left patients alive but on the brink of starvation”???

    Maybe ‘starvation’ was the wrong word but that is how it has been described since the 1920s.

    Now you are passing blame onto someone else… As I have noted NUMEROUS TIMES … the Allen Diet is also described as “calorie restricted”. I imagine it’s been described that way since the 1920′s too. …but you left that out.

    Dean… you only gave half the story… you made it appear that very low carb diets had people on the brink of starvation…. NOTHING you can say will change that.

    Perhaps ‘weight loss due to lack of insulin’ would be a better way of explaining it. ‘Starvation’ is a derogatory term (like ‘wall of shame’ and ‘minion’ ;-) ).

    Regarding the ADA Minion comment… stop promoting a drug first policy. Stop promoting a meal plan that causes more drug and insulin usage… and I will not use that term…for you.

    Had you mentioned the calorie restriction and/or had you explained that T1′s by their very nature ‘waste away’ pre-insulin… had you TOLD the whole story instead only saying “very low carb diets that left patients alive but on the brink of starvation” … this would not have been an issue.

    B – I needed to make the point about not advising Type 1 diabetics to stop their insulin! Many younger diabetics do just that – avoid their insulin and it can be a dangerous game and it has nothing to do with their diet.


    Thanks for stating the obvious… in a comment where you are debating me… as if that was under dispute. Again, stating facts that are not disputed does not bolster your argument.

    Weekly I am accused of telling diabetics or others to ‘not take drugs or insulin’ … I have never said that and never will.

    What I do say is , “DO NOT TAKE DRUGS NEEDLESSLY!”

    I advocate PROPER blood sugar control and for Type 1′s that ALWAYS involves insulin.

    I’m not sure about your comment about high carb diets in Type 2 diabetes. I agree if people with Type 2 diabetes eat too much carbohydrate they will need more treatment but some will need insulin anyway. Type 2 diabetes is actually a collective term for a whole load of different conditions whose end point is diabetes.

    When Type 2 diabetics continue to eat a high carb meal plan, they lose pancreas function over time and eventually require insulin…. they too become insulin dependent. When your body metabolizes glucose improperly … requiring it to generate more and more insulin to handle a high carb meal plan over works the pancreas.

    C – I think this is the crux of our debate and I’m really prepared to listen. No honestly I am. Do you think it would be possible to create a “patient information leaflet” that we could both agree to? Is that a challenge? It would present the existing advice on diet which I shared on Storify ( http://storify.com/dean_jenkins/low-carb-diets-and-diabetes ) AND offer the low-carb diet that you and others follow as an option. I agree they are safe. There is evidence to show it. There is insufficient evidence of long term efficacy (in my view) for recommending them as first choice to all. That’s not to say that they could be A choice.

    If the offer still stands… of course. I do what I do to help people, especially those that suffer inflammatory neolithic diseases such as diabetes.

    Regarding your first choice comment… that’s up to you, including the resources I’ve already provided, there is more than enough information there.

    D – I just don’t think there should be a ‘diabetic’ diet as such. We should all avoid excesses diabetic or not. My reading of the evidence is that whatever diet induces the weight loss (Atkins, palaeolithic, Mediterranean, low-GI, vegetarian, vegan or whatever) seems to work in preventing diabetes and in reducing the requirements for treatment.


    This was a previous comment… “…there should be no difference in the diet of people with or without diabetes. “, this is totally indefensible in my view. That’s like saying, we should promote alcoholics being able to drink like everyone else. It’s a coddling, enabling mentality that causes untold harm and suffering to millions per day… YOU KNOW… you see it.

    Having said that… The number 1 thing I tell people? Control Blood Sugar! That is the key! A sub 6 A1C is doable for all diabetics, I know… I’ve seen T1′s and T2′s do it. Preferably DRUG & Insulin FREE! (obviously T1′s will need insulin)

    I have seen others duplicate my ‘normal blood sugar for non-diabetics’… BUT I’ve only seen it done eating ‘low carb paleo’. No one else I know has done it eating a higher carb inflammatory meal plan.

    I am NOT saying it can’t be done… I just have not seen it. I would LOVE to see it. That’s why I originally asked you about a vegan doing it… I really want to know if it can be done.

    People should NOT take drugs so they can eat cakes, cookies, cereals, breads and pasta. There are many who have damaged organs who took Januvia, Byetta and Actos who would agree. There are many who have died due to hyperglycemia…who can’t agree but I’m sure they would if they could.

    I do sincerely appreciate the opportunity for this exchange…. I’m sure it’s been irritating for you at times… as it has been for me.

  • Dean Jenkins

    Steve said “7 days later and after changing the subject and evading the question … you finally admit that you [Dean Jenkins] did not know of a single vegan diabetic who had normal blood sugar and who had weaned off drugs and insulin.”

    Actually I didn’t say that. I said I knew several vegetarians who had lived a long and largely complication-free life with Type 2 diabetes. Some were on insulin some were not. None of them were obese. None of them were vegans.

    I personally think that their success was due to the conscientious choices they made of their diet and in particular their calorie control keeping them at a normal weight. I feel it had less to do with the exact composition of their diet.

    ——————
    My Reply – Steve Cooksey

    Dr. Jenkins is stating that I misrepresented his statements…. he’s wrong.

    Doctor Jenkins… you REALLY need to go back and read your own statements before claiming that I was in error…. YOU ARE WASTING MY TIME with deceptions.

    After 7 days of wrangling and deception you …. finally admit…

    “I have not seen a Type 2 diabetic on treatment with oral meds and insulin who has managed to wean themselves off all medication with a vegan meal plan.”

    As you can clearly see… I stated the truth… and once again you are changing the story. That’s called deception… deceit. It’s happened too many times in our discussion. :(

  • Dean Jenkins

    … my point is I didn’t ‘only’ say that.

    ———
    My Reply – Steve Cooksey

    Dr. Jenkins… that’s not what you said. You said … and I quote, “Actually I didn’t say that.“… and YOU CLEARLY DID.

    Had you truly meant that you didn’t ‘only’ say that… then you should have stated that.

    Correcting what you said and what you meant to say is becoming tiresome… and time consuming. I am not a mind reader. You accused me of misrepresenting what you said… I clearly did not.

  • Dean Jenkins

    Actually I’m quite enjoying the exchange and greatly appreciate your patience!

    I accept the comment about the Frederick Allen diet was sloppy and misleading. The very, very low carbohydrate diet was an essential aspect of the treatment.

    “The Frederick Allen diet was used for the treatment of Type 1 Diabetes before the discover of insulin in 1922. It involved very, very low carbohydrate diets that left patients alive but on the brink of starvation. Not to be recommended! Insulin is much more effective.”

    I accept also that my comment “Actually I didn’t say that” was also sloppy and not (don’t laugh) what I meant to say.

    That’s all very good and apologetic but you’ve now raised another issue on HbA1c target in diabetes which I can’t let lie! I disagree that all people with diabetes should aim for a HbA1c of less than 6%. This would warrant a part 4 I’m sure as it has been an enormous debate in the diabetes world for the past few years. For those who don’t require any medication that will cause hypoglycaemia then I’d agree with you. However, those that are on sulphonylureas or insulin are at risk of hypoglycaemia and the harm that it can cause. For some, especially the elderly and those with ischaemic heart disease, they should have more relaxed HbA1c targets.

    • Steve Cooksey Post author

      I sincerely appreciate this comment… I hope I have not been too ‘out of line’. When you deal with this everyday… the misinformation spewed by the ADA and AADE .. it becomes very frustrating.

      And I will admit that I may have misspoken… may have. :) Often I get sloppy too and use ‘always’ and ‘never’ in the heat of battle.

      However, insulin dependence by itself is no reason to not suggest a sub 6 as a goal, a target. I know several Type 1 who have achieved this.

      Regarding suphonylureas… the goal would be to reduce blood sugars, weaning off those drugs.

      However, most diabetics on diabetes drugs and/or insulin AND eats a high carb meal plan will have soaring highs and crashing lows… given the nature of the beast. Much (not all) of that goes away when the carb range is in the 30g per day range. Obviously for T1′s there are other factors including pump malfunctions etc etc.

      I am willing to listen to an alternative views.

  • HeatherMcD

    Steve, although I am firmly in your low-carb camp, I just want to express my appreciation to Dean Jenkins for keeping the discourse so civil. Unfortunately, many blogs about this topic resort to flaming, and I appreciate a calm, civil discussion. Keep up the good work on your blog.

    • Steve Cooksey Post author

      Heather,

      I absolutely appreciate his willingness to discuss his point of view. If we can explore why ‘we’ think and act certain ways… ‘we’ can all learn from them.

      I will admit that I cross the line at times…

      Thank you for reading my blog and for commenting. If there is a topic you would like the blog to explore… please let me know.