Are We Fighting the Wrong Battle in the Obesity War?

SanteMulberry

This is a link to an intriguing new "TED-Med" lecture by a prominent surgeon: http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html?utm_source=newsletter_weekly_2013-06-29&utm_campaign=newsletter_weekly&utm_medium=email&utm_content=talk_of_the_week_button


"As a young surgeon, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she needed a foot amputation. But years later, Attia received an unpleasant medical surprise that led him to wonder: is our understanding of diabetes right? Could the precursors to diabetes cause obesity, and not the other way around? A look at how assumptions may be leading us to wage the wrong medical war.

Both a surgeon and a self-experimenter, Peter Attia hopes to ease the diabetes epidemic by challenging what we think we know and improving the scientific rigor in nutrition and obesity research..."

Talk among yourselves--I'll be back later to comment.

mambagirl

Too much insulin floating around causes BOTH Diabetes and Obesity....So,eat less Carbs,Or exercise like mad to burn them off....But,what does the video say about this???/

SanteMulberry

Dr. Attia says that he always assumed that the conventional medical opinion was correct--that obesity was the cause of insulin resistance...until he got Type II diabetes himself (in spite of following the food pyramid to a T and exercising every day for several hours). He asks the question, "What if becoming obese is the better option that the body pursues rather than succumbing to Type II diabetes?" He isn't suggesting that there aren't serious ramifications from obesity itself, but that high carbohydrate consumption not only causes obesity but Type II diabetes and a host of other diseases.

This is what I have been saying here on the MFP forums-- for months--in spite of massive resistance from some people. Our bodies have a tough time coping with the "hyperglycemia" that results from a poor diet--one that is too rich in grain and sugar. We get addicted to high blood sugars and keep indulging in the poison that takes us there...until our bodies break down.

booksgiver

Interesting topic and while I have no medical knowledge to support it, I know that carbs from sugar, wheat and corn seem to always be my downfall as per dieting. I definitely have better self control if I avoid foods with those as primary ingredients. Thanks for this information.

SanteMulberry

You're welcome! It is important to note that Dr. Attia said that he bought the "conventional wisdom" that obesity is caused by eating too many calories and exercising too little. But habitual hyperglycemia leads to "food addiction" and sluggishness. I remember when my brother was acquiring Type II diabetes, that he used to shake if he didn't get his meals "on time". I remember thinking that this was abnormal. He got huge during that period as well, but I think his poor, high-carb diet caused both. He used to drink about a gallon of soday pop per day at that time. Also, he loved bread, cookies, doughnuts, desserts of all kinds, mashed potatoes, and some days would eat them exclusively. I think he got "addicted " to high blood sugars and then shook in reaction to falling blood sugars.

jennifershoo

I'm interested in this discussion. On my mom's side, they all have type 2 diabetes. They are all overweight except my grand-dad. He has aways been really thin and been active all of his life. He still got diabetes. So, I'm wondering why. My dad has always eaten tons of sugar (pies and desserts everyday), he's very active and thin. Not diabetic. So why would carbs affect some people and doesn't affect others?

(I haven't watched the video yet)

two_octopodes

Thank you so much for sharing this! I'm currently in school to become a physician assistant; both at school and in my clinical experiences so far, I've seen a huge amount of contempt and disgust thrown at obese/diabetic patients just like what this doctor described. Whether or not his theories pan out, I think there is a huge amount of value in reminding health care providers to treat patients as people, not blame them for their medical problems. This was a great Ted Talk- I'm going to share it with my classmates.

And in the interest of full disclosure, I found out about 2 weeks ago that I may have insulin resistance/prediabetes myself (I'm only 28 and overweight but not obese anymore) related to possible PCOS. Since then, I've panicked, blamed myself, cut way back on carbs, and felt deeply ashamed for becoming one of "those people" who are apparently fat enough to get sick. It was a breath of fresh air to watch this and know that there is a doc out there who would not judge me for having this condition.

SanteMulberry

I'm interested in this discussion. On my mom's side, they all have type 2 diabetes. They are all overweight except my grand-dad. He has aways been really thin and been active all of his life. He still got diabetes. So, I'm wondering why. My dad has always eaten tons of sugar (pies and desserts everyday), he's very active and thin. Not diabetic. So why would carbs affect some people and doesn't affect others?

(I haven't watched the video yet)

The really interesting point that Dr. Attia makes is that there are a number of normal weight individuals with insulin resistance. And that there are a lot of obese people who do not have insulin resistance. There is some exciting research going on in the area of Type II and obesity (and all the rest of the "metabolic syndrome").

SanteMulberry

Thank you so much for sharing this! I'm currently in school to become a physician assistant; both at school and in my clinical experiences so far, I've seen a huge amount of contempt and disgust thrown at obese/diabetic patients just like what this doctor described. Whether or not his theories pan out, I think there is a huge amount of value in reminding health care providers to treat patients as people, not blame them for their medical problems. This was a great Ted Talk- I'm going to share it with my classmates.

And in the interest of full disclosure, I found out about 2 weeks ago that I may have insulin resistance/prediabetes myself (I'm only 28 and overweight but not obese anymore) related to possible PCOS. Since then, I've panicked, blamed myself, cut way back on carbs, and felt deeply ashamed for becoming one of "those people" who are apparently fat enough to get sick. It was a breath of fresh air to watch this and know that there is a doc out there who would not judge me for having this condition.

I'm glad you liked it. Have you looked at "estrogen dominance"? I had all the symptoms of PCOS for many years. I have had an easier time losing weight since I started on bio-identical progesterone therapy. Since estrogen raises blood sugar, could it be part of the picture here? Progesterone lowers blood sugar and enhances the metabolism. Estrogen partially blocks the uptake of iodine (which is often in short supply anyway) and that is another problem from the thyroid dysfunction that inadequate iodine causes.

brower47

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

SanteMulberry

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

brower47

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

SanteMulberry

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

That is correct that "calorie surpluses" create hyperglycemia (no matter the source of the calories). But (and I think this is key) high carbohydrates diets accelerate blood sugar further AND faster than a diet that emphasizes a higher level of proteins and fats. I never said that it wasn't important to limit total calories (I always stay within my calorie allotment) but the calorie-mix is what is key to avoiding the blood sugar and insulin spikes that make the diet easy to maintain. The body "views" hyperglycemia as an "emergency" and moves very quickly with high levels of insulin to "hammer down" the blood sugar (which then becomes a vicious cycle of carbs->high insulin->more carbs-> more insulin, until either the insulin making mechanism breaks down or insulin resistance develops (or both). There is already a lot of research demonstrating this effect. A doctor and his research team at the University of Colorado (Richard J. Johnson) produced "metabolic syndrome" in a large majority of normal-weight men in TWO WEEKS when they followed a very high carbohydrate diet that was particularly rich in sugars.

hookilau

Check out bloodsugar101.com and click on 'the patterns in which diabetes develops'.

This is not new news, just news that folks have been slow to embrace.

If you've read Dr. Richard K. Bernstein's book 'Diabetes Solution' or Jenny Rhul's 'Blood Sugar 101, what they don't tell you about diabetes, you will gain a FIRM grasp on what's wrong with the USDA's food pyramid, and how to manage this disease from people who actually have it.

My mom's a nurse, and after being diagnosed with T2, I had to educate HER about how to manage it. I'm still surprising her every day it seems :huh: as her fall back position is her training as opposed to the newer guidelines.

Due to the shame that's surrounded this disease, I had no idea (until I was diagnosed & family started spilling) that of my paternal grandmother's 5 children, 3 currently have it, 1 recently died from complications related to it & the other remains silent.

Had I been aware of the genetic link & how much my chances had increased to having full blown diabetes after having gestational diabetes, I may have been able to stay 'pre-diabetic'.

hookilau

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

Just to add to the complications, having gestational diabetes also increases the chances greatly of developing T2, if I remember the statistics properly, it's something like 30%.

I wish I knew that when I was preggers with my now 17 yr old son. They thought my bg was high & then decided it was nothing to worry about :huh: Ever since that pregnancy, I'd not been able to get back down to my pre-pregnancy weight. I also believe this is when my insulin resistance began as the weight slowly started to come on despite all efforts to the contrary.

NormInv

Starvation improves life expectancy. We're studying mortality patterns in the past and there was some group of people in a remote location of the world who saw an increase in life expectancy because they were not getting enough to eat.

chatogal

thank you for such and interesting thread. I work as a midwife. We have a lot of women who get gestational diabetes...we explain to them that because they have acquired diabetes during their pregnancy (even tho fine in non pregnant state) they are more likely to develop type II diabetes as they get older...and believe me, it is not just the obese people who develop this condition (although it is DEFINETLY a percursor).

AbsoluteNG

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

brower47

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

Weird, since my mom still tests her blood sugar several times a day and no longer gets the spikes. I guess the saying "never use absolutes" applies here.

AbsoluteNG

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

Weird, since my mom still tests her blood sugar several times a day and no longer gets the spikes. I guess the saying "never use absolutes" applies here.

That's because your mom isn't eating cake, donuts, icecream, or candy. A truly normal person can eat those foods and never see a spike above 140 glucose. Give your mom cake and do a postmeal test exactly like they do at the doctors office and you will see a spike above 140, guarantee. Postmeal spikes should be tested every 30 mins after the first bite for 2 hours in order to find the highest spike.

etoiles_argentees

Eliminating water and driving up sugar levels to deal with cold. Coincidence that those most likely to have the propensity (genetic) for diabetes are people descended from the places most ravaged by the sudden onset of the ace age? Might be that diabetes helped them survive the Younger Dryas. Who knows.

I'll listen to the Attia thing before I say anything else.

Sorry, not listening. "Gary Taubes and Peter Attia, the co-founders of the non-profit organization Nutrition Science Initiative"

brower47

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

Weird, since my mom still tests her blood sugar several times a day and no longer gets the spikes. I guess the saying "never use absolutes" applies here.

That's because your mom isn't eating cake, donuts, icecream, or candy. A truly normal person can eat those foods and never see a spike above 140 glucose. Give your mom cake and do a postmeal test exactly like they do at the doctors office and you will see a spike above 140, guarantee. Postmeal spikes should be tested every 30 mins after the first bite for 2 hours in order to find the highest spike.

I stated in the post that she changed only the quantity of her foods, not the composition. When I last visited, she tested her blood levels after having a pasta meal at Olive Garden and a shared (three ways) apple carmel desert topped with vanilla ice cream.

I'd never heard that you could NEVER reverse the pre diabetic state and after reading your post I wanted to know if my mother was a special snowflake. It turns out she's not.

From: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

"Can insulin resistance and prediabetes be reversed?
Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.
The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."

It goes more in depth but I didn't want to do a huge copy pasta.

tootoop224

Good info. Thanks for posting. My takeaway is, that like most things, this is a complex issue, with more than one simple answer.

Also, curious how he gained 40 lbs. following the food pyramid "to a t", and working out 4-5 hours EVERY DAY.

AbsoluteNG

I stated in the post that she changed only the quantity of her foods, not the composition. When I last visited, she tested her blood levels after having a pasta meal at Olive Garden and a shared (three ways) apple carmel desert topped with vanilla ice cream.

I'd never heard that you could NEVER reverse the pre diabetic state and after reading your post I wanted to know if my mother was a special snowflake. It turns out she's not.

From: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

"Can insulin resistance and prediabetes be reversed?
Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.
The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."

It goes more in depth but I didn't want to do a huge copy pasta.

Thanks for the link but I already know what it says but there is some misconceptions into the wording and the way some people understand it. It is possible for a prediabetic to manage their glucose levels to look like a normal person and that's what they mean by reversible, but what damage has already occurred in the body due to the prediabetic conditions will always be there. Any prediabetic who tests after 2 hours of eating will easily be under 140 glucose because their Phase 2 Insulin response is working perfectly fine but not Phase 1 Insulin Response. Prediabetics no longer have a Phase 1 Insulin Response and if your mom would test 30 mins after eating that icecream and pasta, she will see spikes above 140. Testing every 30 mins after the first bite of a meal is how they do a postmeal glucose test at the doctors office and the brochure you get in the mail that says you can still eat carbs as long as you test 2 hours after eating, has a lot to do with politics.

hookilau

http://www.mayoclinic.com/health/hyperinsulinemia/HQ00896

Just to add that this is a complicated issue with many diversions as to the why and then the proper course of managing the problem.

There are so many different possible reasons for increased blood glucose...

shannashannabobana

He asks the question, "What if becoming obese is the better option that the body pursues rather than succumbing to Type II diabetes?"

I heard somebody mention this the other day. I think this is a very interesting line of study and I like that somebody is looking at things a different way. We'll see what the studies show...

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant

It's kind of the same with heart disease/cholesterol/high blood pressure, etc.. People generally link them with overweight/obesity, but there are tons of people with terrible cholesterol who are thin, and people overweight with great numbers. Same as blood pressure. There are some linkages, and there is some element of genetics (a huge piece, imo), but there is also WHAT you eat (not just how much) and exercise - although if you exercise too much (marathoners) that can go in the other direction.

SanteMulberry

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

Interesting. I notice that when I have a particularly "carby" meal (and I don't eat a lot of them) that I start to get sleepy, shortly after---no matter how well-rested I am--unless I make a point of walking for at least 15 minutes after the meal. When I was diagnosed as having "metabolic syndrome" a little over three years ago, I became determined to "reverse" it. And even though I am no longer running high B.P. or high blood glucose, I have no doubt that I would be right back where I started (or worse) if I went back to eating the high grain/carb diet recommended by our government. :grumble:

SanteMulberry

Perhaps, like breast cancer, certain genetic lines are more susceptible to type II than others. Perhaps, if members from those same genetic lines allow themselves to become overweight or obese, they increase that risk of developing the disease to an even greater degree.

This does not change the fact that weight gain, certain metabolic issues aside, is caused my an over consumption of calories regardless of the source of those calories.

I'm guessing the good surgeon has a family history of diabetes and his unfortunate genetics are more to blame (if not solely) for his current medical condition. If he'd been overweight he probably would have developed it sooner.

I think what he is challenging is the conventional medical "wisdom" that obesity causes Type II. He cited the fact that there are a number of people who are of normal weight and are still insulin resistant. He feels that insulin resistance causes both obesity and Type II--that obesity is actually the "healthier" response to "hyperglycemia". At just 40 pounds overweight, he probably was not obese (he seems fairly tall). He might have been "over-fat" but he believes that both conditions were caused by an unwise diet that emphasized carbohydrates (the former "food pyramid" calls for 6 servings of bread or other grain products---waaay too many carbohydrates for the average adult). Sugary foods are the other source of hyperglycemia. The average person eats approximately 500 calories in sugar every day. Dr. Attia said that he also exercised 3 to 4 hours per day--and all the while, he was gaining weight and developing insulin resistance. When he changed his diet, he lost the body fat and the insulin resistance. Just because obesity is correlated with Type II does not mean that it causes Type II. Correlation does not equal causation.

He's using himself as an anecdotal case so I'll use my mom as an anecdotal rebuttal. She was overweight, less so than him by a 20 pounds, and developed insulin resistance and was called pre diabetic. She didn't change her diet in terms of composition, she changed it in terms of quantity. She lost the weight and she is no longer insulin resistant or pre diabetic. She gained weight, not because of hyperglycemia (she didn't have it until the resistance started) but because she ate at a calorie surplus.

I'll consider your hypothesis when there's been a large scale, long term study done on it. Until then, it's all just anecdotal (the surgeon and my mom). Just because this guy has a hypothesis that coincides with your personal views on food, does not make it anything more than an untested, unreviewed hypothesis.

And just to clarify, at 40 pounds overweight, I was clinically obese. The surgeon probably was too.

Once you become prediabetic, you are always prediabetic. All you can do is manage your condition in keeping your glucose levels low. You can never again eat carbs without seeing a postmeal spike above 140.

Weird, since my mom still tests her blood sugar several times a day and no longer gets the spikes. I guess the saying "never use absolutes" applies here.

That's because your mom isn't eating cake, donuts, icecream, or candy. A truly normal person can eat those foods and never see a spike above 140 glucose. Give your mom cake and do a postmeal test exactly like they do at the doctors office and you will see a spike above 140, guarantee. Postmeal spikes should be tested every 30 mins after the first bite for 2 hours in order to find the highest spike.

I stated in the post that she changed only the quantity of her foods, not the composition. When I last visited, she tested her blood levels after having a pasta meal at Olive Garden and a shared (three ways) apple carmel desert topped with vanilla ice cream.

I'd never heard that you could NEVER reverse the pre diabetic state and after reading your post I wanted to know if my mother was a special snowflake. It turns out she's not.

From: http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

"Can insulin resistance and prediabetes be reversed?
Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.
The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."

It goes more in depth but I didn't want to do a huge copy pasta.

The only thing is, that is government propaganda (they are still pushing the low-fat agenda, for some reason). I participated in the DPP and I rejected their low-fat diet (the participants were told that grain and sugar didn't matter--just keeping the fat and calories low). I kept to my own healthy lower carb diet and made no attempt to restrict fat (though I was easily able to stay below my calorie-allotment). I was the ONLY one in my class of 28 people who made not only my weight goal (lost 14 pounds during the course of the program) AND my waist-measurement goal, but I am the only one who still is running normal B.P. and blood glucose (they did a re-check in our group at 3 months after the initial program).

CysterWigs

Great video. And to add to the discussion:

Diabetes and pre-diabetes can be reversed. I mean, it happens all the time for people who've undergone WLS. I don't think that this disproves the supposition that IR/Metabolic Syndrome cause weight gain. I think we need to stop thinking in such a black and white fashion about such complicated and little understood body mechanisms. It makes a lot of sense that both could be possible...because both totally happen in real life. (Fat people can become IR/pre-diabetic, and diabetic, and people of normal weight can become IR and eventually obese.) I also don't think it's just a matter of what people are eating, though that may greatly exacerbate matters.

etoiles_argentees

He asks the question, "What if becoming obese is the better option that the body pursues rather than succumbing to Type II diabetes?"

I heard somebody mention this the other day. I think this is a very interesting line of study and I like that somebody is looking at things a different way. We'll see what the studies show...

The studies will show whatever Taubes and crew want them to show.

Sorry, not listening. "Gary Taubes and Peter Attia, the co-founders of the non-profit organization Nutrition Science Initiative"

SanteMulberry

He asks the question, "What if becoming obese is the better option that the body pursues rather than succumbing to Type II diabetes?"

I heard somebody mention this the other day. I think this is a very interesting line of study and I like that somebody is looking at things a different way. We'll see what the studies show...

The studies will show whatever Taubes and crew want them to show.

Sorry, not listening. "Gary Taubes and Peter Attia, the co-founders of the non-profit organization Nutrition Science Initiative"

Peter Attia is a respected physician, medical researcher and surgeon. It is pretty arrogant to dismiss him just because he is voicing an opinion that is not popular with you and others here. What medical credentials do YOU have? Here is just a small part of Peter Attia's:

" While he was studying mechanical engineering as an undergrad, a personal experience led him to discover his passion for medicine. He enrolled at Stanford Medical School, and went on to a residency in general surgery at Johns Hopkins Hospital and a post-doctoral fellowship at the National Cancer Institute..."

Ante up?