I was writing another blog, on another matter, when someone sent me an email containing a petition signed by over two hundred Canadian doctors.
Re: Canada’s Food Guide Consultation
From: Group of concerned Canadian Physicians and Allied Health Care providers
For the past 35+ years, Canadians have been urged to follow the Canadian Dietary Guidelines. During this time, there has been a sharp increase in nutrition-related diseases, particularly obesity and diabetes.
We are especially concerned with the dramatic increase in the rates of childhood obesity and diabetes. In 1980, 15% of Canadian school-aged children were overweight or obese. Remarkably, this number more than doubled to 31% in 2011; 12% of children met the criteria for obesity in the same reporting period. This has resulted in a population with a high burden of disease, causing both individual suffering, and resulting in health care systems which are approaching their financial breaking points. The guidelines have not been based on the best and most current science, and significant change is needed.
What exactly is insulin resistance? One of insulin’s jobs is to help move glucose from the blood into the cells for energy. When blood glucose remains elevated despite normal or high levels of insulin, this is called insulin resistance. The cells are resisting insulin’s pleas to take up glucose. But why is this happening? What causes insulin resistance?
The current paradigm of understanding insulin resistance is the ‘lock and key’ model. The hormone insulin acts upon a cell surface receptor to do its job. The insulin receptor is like a lock keeping the gates to the cell closed. Insulin is like the proper key. When inserted, the gate opens to let glucose from the blood inside the cell for energy. Once you remove the key (insulin), the gate closes back up and blood glucose can no longer enter the cell.
During the phenomenon of insulin resistance, we imagine that the lock and key no longer fit together very well. The key (insulin) only partially opens the lock (receptor) and not very easily. Glucose cannot pass through the gate normally, and as a result, less gets into the cell. The blood glucose piles up outside the gate, becoming detectable as the clinical diagnosis of type 2 diabetes is made.
Science can’t prove it and the industry denies it, but Gary Taubes is convinced that the sweet stuff kills.
“I hope that when you have read this book I shall have convinced you that sugar is really dangerous,” wrote John Yudkin in his foghorn-sounding treatise on nutrition from 1972, Pure, White and Deadly. Sugar’s rapid rise to prominence in the Western diet, starting in the mid-19th century, had coincided with a sudden outbreak of heart disease, diabetes, and obesity. Yudkin, one of the United Kingdom’s most prominent nutritionists at the time, believed that one had caused the other.
Then, as now, there was no decisive test of his idea—no perfect way to make the case that sugar kills. It’s practically impossible to run randomized, controlled experiments on human diets over many years, so the brief against sugar, like the case against any other single foodstuff, must be drawn from less reliable forms of testimony: long-term correlations, animal experiments, evolutionary claims, and expert judgments.
This is big: nearly 200 doctors and allied health practitioners in Canada have signed an Open Letter to their government calling for urgent, radical reform of nutrition guidelines to include low-carb diets.
They say that authorities told Canadians to follow guidelines for nearly 40 years. During that time, nutrition-related diseases, such as obesity, diabetes and heart disease, increased sharply. The doctors are also concerned about sharp increases in childhood obesity and diabetes rates.
They say that the evidence does not support conventional low-fat dietary advice. In fact, they say it worsens heart-disease risk factors. They say that those responsible must be free to compile dietary guidelines without food and drug industry influence. They want the guidelines to promote low-carb diets as “at least one safe, effective intervention” for people with obesity, diabetes and heart disease.
At heart, the letter’s signatories call for mainstream medical advice to include low-carb, healthy-natural-fat. Here’s more of these doctors’ powerful challenge to orthodoxy.
This past fall, Gary Taubes took his wife and two sons on a trip to a wildlife preserve in Sonoma County, California, the kind of place where guests learn firsthand about the species of the Serengeti. They slept in tents and spent the day among giraffes, zebras, antelope, and the like. One morning, Taubes and his boys awoke early. “It was 50 degrees out — freezing by our standards,” he recalls. “I took the kids to breakfast, and” — his face takes on a pained expression — “how can I not give them hot chocolate?”
For most parents, indulging the kids with some cocoa would pose no dilemma. But Taubes, one of America’s leading and most strident nutrition writers, is no ordinary father. His new book, The Case Against Sugar, seems destined to strike fear into the hearts of children everywhere. Taubes’ argument is simple: Sugar is likely poison, and it’s what is making our country fat. And not just fat but sick. So don’t eat it. Ever.
When I was a medical student at McGill in the late 1970s, we learned a straightforward explanation for the cause of Type 2 diabetes, the most common form of diabetes in adults, accounting for about 90 per cent of all diabetes cases. We were told the insulin resistance responsible for Type 2 diabetes was caused by high levels of insulin. Hyperinsulinemia–increased insulin levels in the blood–was said to “downregulate” insulin receptors, making cells with those receptors less responsive to the insulin message. From a physiology point of view, this makes perfect sense. It’s analogous to the development of tolerance that can happen with regular heroin use when a person no longer responds to the drug in the way they did initially.
Sometime in the 1980s this explanation for the cause of insulin resistance was abandoned. Instead, the medical community adopted a new theory that insulin resistance comes first, and is behind high insulin levels in Type 2 diabetes. To overcome insulin resistance, the pancreas secretes larger-than-normal amounts of insulin, resulting in so-called “reactive hyperinsulinemia.” The cause of this insulin resistance is never clearly explained, although obesity, chronic inflammation, and genes are all said to contribute.