The current issue of Performance Menu, a journal devoted to hard core nutrition and strength training, has an interview with Yours Truly.
A sample:
Many of our readers are coaches and trainers and are constantly facing a scenario of working with a type 2 diabetic or pre-diabetic. What are your basic guidelines for introducing a nutrition and exercise program? What have you found to be a safe rate of carbohydrate restriction in the type 2 diabetic? Do drugs such as Glucophage and Avandia increase the likelihood of an event of hypoglycemia or ketoacidosis?
MRE: In my medical experience I’ve found that with type 2 diabetics, the more carbohydrate restriction the better. We usually start diabetic patients on diets containing about 30 grams of available carbohydrate per day. When I first started treating diabetic patients with these low-carbohydrate diets I really pussy footed around with it. I would put these patients on the diet and wait to see what happened with their blood sugars. If they were on an oral hypoglycemic drug I found out in a hurry because their blood sugars cratered. After a couple of these experiences I began taking these patients completely off all oral meds when starting the diet. I watched them closely and would add a small amount of an oral agent back in if sugars didn’t respond, which wasn’t very often. Most patients, if they followed the program as they should, never had to go back on the meds. I went up this learning curve before the advent of metformin (Glucophage). Once metformin came along, it was the only medication I ever used in type 2 diabetics. To this day I have never used Avandia. I use Metformin only if I can’t get a patient’s blood sugar controlled with diet alone. I’ve never had a problem with ketoacidosis or with lactic acidosis with metformin.
I’ve set it up so that readers of this blog can download the issue of Performance Menu containing the entire interview free.
Click here, then request issue #22. You might want to consider subscribing because the journal is full of interesting info on diet and training written from a Paleolithic perspective. And it’s very reasonably priced. I read every issue.
Enjoy
Robb Wolf, the publisher, arranged a debate between Loren Cordain and T.
Colin Campbell, author of The China Study
Thank you very much! Great interview in one of my favorite mags.
Hi Connie–
My pleasure. Glad you enjoyed it.
Best–
MRE
Can’t wait to hear the debate between Cordain and Campbell!!
HI Sue–
I’ll get it up as soon as I get my hands on it.
Best–
MRE
Nice interview Dr. Eades. I’m a regular reader of the PM and advise everyone to get a subscription…you can’t beat the price for 12 issues of top notch material.
Hi Scott–
I agree. It’s well worth the bucks for the PM info.
Best–
MRE
Thanks for the pointer to the magazine interview — I read the prior article on sleep, including the reference to Lights Out, which I’ve never read — but now I want to!
Hi Francis–
Lights Out is a pretty good book. The Paleolithic version of a good night’s sleep.
Cheers–
MRE
and what an attractive young man you are; though for a man of 26 you don’t look so good !
Hmmm. I think you’ve got your numbers reversed. I’m way closer to 62 (though not there yet) than I am to 26.
Cheers–
MRE
Yep, what a treat that was! My favorite blogger in my favorite mag. 🙂
Can’t wait for Cordain vs. Campbell. The China study was stupid anyway, just another epidemiological waste of time and expenses. Ever read Anthony Colpo’s response to the China Study? He rips Campbell a good one too. He doesn’t have it up for free anymore, but you can but it for 5 bucks at http://www.lulu.com/content/411584. His “best of the omnivore” is 200+ pages long of material from his old blog. It also includes a debate with Cordain on the saturated fat issue. Good stuff.
Keep fighting the good fight.
Neal
Hi Neal–
Thanks for the kind words. I’ll post the debate as soon as I get it.
The saturated-fat debate between Cordain and Colpo wasn’t really a debate per se. It was a debate with Cordain in absentia. One of Colpo’s readers asked him what he (Colpo) thought of Cordain’s stance on saturated fat. Colpo answered, then the reader took his (Colpo’s answer) and asked Cordain about it. Cordain replied, whereupon the reader went back to Colpo and said: Cordain says so and so, what do you say about that? So it wasn’t really a debate between the two of them. The deck was sort of stacked in Colpo’s favor because Cordain didn’t realize that he was even in a debate. I’ve asked Loren about it, and he tells me that he doesn’t really even know who Anthony Colpo is or anything about him. He (Cordain) has never read the so-called debate. So I don’t know if the debate would have come out the same had Colpo and Cordain gone at it head to head instead of through an intermediary with one party not knowing he was even in a debate.
Having said all that, I can tell you that my opinion on the saturated fat issue is much more in line with Anthony Colpo’s (in fact, I suspect it is identical) than it is with Loren Cordain’s. And I have had one-on-one, face-to-face debates with Loren on the issue, and neither one of us has changed positions. We simply agree to disagree on this one issue since we are totally in sync on virtually everything else.
Cheers–
MRE
it was a joke Sir , supposedly !
So was my reply!
Cheers–
MRE
I keep trying to get my Dad to try low-carb. The only thing he knows is he’s supposed to avoid sugar. he has no idea how much hidden sugar is in stuff, nor that starch turns into a sugar once eaten. He’s type 2 and getting worse all the time – he on a hefty dose of insulin and has a wound that won’t heal. he just doesn’t get it and at 83 I’m not sure he ever will. He ate all the low-fat, high-carb stuff my sister served while we were there for Thanksgiving. But hey – he thinks since he takes insulin it’s okay.
*sigh* Sis eats general low-fat, Mom’s on Weight Watchers, and Dad is a type 2 diabetic who doesn’t have a clue how to eat right. I’m the lone low-carber.
Hi Victoria–
Sad to say, your father’s situation is all too common. Far too many doctors take care of their diabetic patients by putting them on large doses of insulin then encourage them to eat carbs so that their blood sugars don’t plummet. In my opinion, it’s malpractice.
I wish you luck
MRE
I just read the
Cordain/Campbell “Protein Debate”. I recommend it for Cordain’s concise writeup on the evolutionary/archaeological evidence in favor of a high-protein diet. Read Campbell’s stuff for a chuckle, and a good illustration of why nutrition science and the accompanying public policy is such a screwup. A few highlights:
Cordain’s paper contains no less than 134 references, and his rebuttal to Campbell contains another 30. Campbell, in support of a low protein, low fat, diet provides, uh, let me count, ZERO citations. He manages a few in his rebuttal to Cordain, but a couple of those are to himself, and only one that I saw appeared to be a peer-reviewed article. He makes some fairly bold statements, like “overwhelming findings on the adverse health effects of dietary protein” and “remarkable healing effects now being routinely accomplished by my clinician colleagues”, again with no citations to supporting peer-reviewed literature.
Campbell’s stance appears to be largely one of “because I said so”. The first sentence in his rebuttal is “My critique of Professor Loren Cordain’s proposition almost entirely depends on my philosophy of nutrition”; as opposed, say, to evidence gathered via the scientific method? In fact, he goes so far as to argue in favor of what is essentially sloppy research in nutrition science. The point Campbell is trying (badly) to make is that making precise measurements of the components of a complex system may do little to increase your understanding of it’s overall behavior (look no further than cholesterol research for a good example of “missing the forest for the trees”). But the fact that complex systems often exhibit the “gestalt” of emergent behaviors does not mean we throw the scientific method out the window in favor of “holistic” hand-waving and arguing about whose bullsh*t “philosophy” is superior.
BTW, Campbell isn’t just some wacko off the street. He’s the “Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry” at Cornell University. So he’s clearly convinced more than a few people that his “philosophy” constitutes sound science.
Cordain, while largely very thorough, fails to follow his own advice that “the data must speak for itself” to avoid “prejudice introduced by charismatic personalities, faulty human judgment and preconceived biases” when it comes to the issue of saturated fat and cholesterol. In particular, he cites the “atherogenic effect of saturated fat”, while providing no references to studies demonstrating said effect. I find this surprising, and illustrative of the dogmatic strength of the lipid hypothesis, even in the mind of an otherwise strongly rational and methodical scientist.
Dave
Hi Dave–
Terrific analysis. I’m going to post it as it is on the regular blog.
Thanks–
MRE