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Re: La Puma: low carb when on meds?

Posted by drjohnlapumamd on February 12, 2003, at 22:10:04

In reply to La Puma: low carb when on meds?, posted by jflange on February 11, 2003, at 22:44:19

Gee---there's a lot here. But I'll try.
A moderately low carb approach (30-45% of calories) works in diabetics because their insulin doesn't work well, and because there is often some degree of insuling resistance. Not all carbs are created or metabolized equally, however. What's important is glycemic load, not glycemic index, as the latter is a research tool that has gotcha-appeal popularized by the Sugar Busters people first, and man-handled by others later.

Glycemic load is the glycemic index of a carb multiplied by the number of grams of carbs ingested. Glycemic index is calculated, in the laboratory, as your blood sugar response to 100 grams of any particular food, administered in isolation. But we don't eat foods in isolation--we usually eat them with other foods. Adding fat to any particular carb will modify its glycemic index, and ultimately, its glycemic load---and your insulin and cortisol responses.

Enough pathophys. If you have gained weight, especially around the middle, and have an elevated waist to hip ratio (over 0.8 in women, and 1.0 in men), there's a good chance you have metabolic syndrome if your blood pressure or triglycerides or blood sugar is also high. And metabolic syndrome patients are often insulin resistant and do in fact benefit from lower carb intakes.

However, the rest of Atkins (and Somers and Heller and Schwarzbein and others) is likely to be atherogenic---i.e., cause vascular disease, include heart attacks, stroke, impotence and premature wrinkling of the skin. Protein should not come primarily from animal sources, as they suggest, but from fish and vegetable sources. Fat should be unsaturated not saturated or hydrogentated---nothing makes your cholesterol levels go up faster than weight gain, saturaged and trans fats.

So, yes, lower carb than we have been eating seems right---no one ever lost weight and kept it off with sugar or Snackwells or Twinkies. But don't reverse the mistake of the 80s and substitute fat for's just as lethal.




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