When weight loss is the goal, most diets restrict calories. It is a
relatively simple concept--a person can lose weight by taking in fewer
calories than he or she expends. But does it matter where the calories
come from? It might, according to findings from a small study published
in the December 2005 issue of the medical journal Diabetes Care.
Researchers at the Jean Mayer USDA Human Nutrition Research Center on
Aging at Tufts University discovered that a diet's overall "glycemic
load" may be an important determinant of weight loss, but only for some
people.
Senior author Susan Roberts, PhD, director of the Energy Metabolism
Laboratory at the Center says, "Our results suggest that in the future
there may be a way to predict who will do best on a low glycemic load
diet." The key, they have found, may be in knowing a person's level of
insulin secretion.
"Insulin is a hormone that is important in glucose (sugar) metabolism,"
explains senior author Andrew Greenberg, MD, director of the Obesity
and Metabolism Laboratory at the Center. "The regulation of body weight
is, at least in part, influenced by how much insulin a person secretes
in response to a load of glucose, as well as by how sensitive that
person is to insulin's glucose-lowering effects."
"In our study," says first author Anastassios Pittas, MD, assistant
professor at Tufts University School of Medicine, "everyone lost some
weight as a result of restricting calories, but people who had high
levels of insulin secretion and ate a diet with a low glycemic load
lost the most weight."
As part of the ongoing Comprehensive Assessment of Long-term Effects of
Reducing Intake of Energy (CALERIE) trial at Tufts, the authors studied
32 healthy overweight adults on a reduced-calorie diet for 6 months.
Half of the subjects were randomly assigned to a low glycemic load
diet, and the other half followed a diet with a high glycemic load.
"A food's glycemic load is a relative measure of how much carbohydrate
is in the diet and how quickly that food is converted in the body to
blood sugar. Foods with lower numbers typically have a greater
proportion of protein and fat, which usually result in a smaller rise
in blood glucose following a meal. Examples of low glycemic load foods
include salads with oil and vinegar dressing, high fat granola cereal,
and most fresh fruits and vegetables. Glycemic load may not be the
'be-all, end-all' of weight-loss diets for everyone," says Roberts, who
is also a professor at the Friedman School of Nutrition Science and
Policy at Tufts, "but it significantly enhanced weight loss in our
high-insulin-secreting subjects."
"Our findings may eventually have implications for individualizing
weight-loss diets," says Roberts. "We need to confirm our results with
further studies of larger groups of subjects first, but measuring
insulin secretion might be a simple way to target dietary
recommendations that help enhance successful weight loss." Greenberg,
who is also an assistant professor at the Friedman School, notes that
"only when we have completed these future studies can we determine
whether these tests will be useful for making recommendations for the
general public."
Pittas AG, Das SK, Hajduk, CL, Golden J, Saltzman E, Stark PC,
Greenberg AS, Roberts SB. Diabetes Care, (December) 2005; 28:
2939-2941. "A Low-Glycemic Load Diet Facilitates Greater Weight Loss in
Overweight Adults With High Insulin Secretion but Not in Overweight
Adults With Low Insulin Secretion in the CALERIE Trial."
That's the artificial problem they're suffering from, that they want
to be able to make recommendations to the general public. It may be
the case that the nutritional biochemistry of the general public is
too diverse for general recommendations to be safe enough for all.
For diabetics, pre-diabetics, etc. there is a simple answer to this
problem: get a BG meter and avoid the foods which spike your BG.
Wait a minute! That involves allowing patients to make their own
decisions about how to treat their illness! That's the beginning of a
very slippery slope involving a very important matter of medical
principle!
--
Chris Malcolm c...@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]
The concerns arise more from skepticism about efficacy rather than about
safety.
> For diabetics, pre-diabetics, etc. there is a simple answer to this
> problem: get a BG meter and avoid the foods which spike your BG.
From a cardiovascular perspective, BG spikes are not as bad as prolonged
periods of modest BG elevations (i.e. fasting BG of 150-200 mg/dL with
max of 250 mg/dL is less optimal than fasting BG of 100-150 mg/dL with
max of 250 mg/dl in the form of transient post-prandial "spikes")
> Wait a minute! That involves allowing patients to make their own
> decisions about how to treat their illness! That's the beginning of a
> very slippery slope involving a very important matter of medical
> principle!
Chris, most physicians understand their role to be that of medical
advisors for patients so that the decision making has been the
responsibility of each respective patient. That is certainly how the
diabetic 2PD-OMER Approach is structured:
http://www.HeartMDPhD.com/wtloss.asp
Would be more than happy to "glow" and chat about this and other things
like cardiology, diabetes and nutrition that interest those following
this thread here during the next on-line chat(12/15/05) from 6 to 7 pm
EST:
For those who are put off by the signature, my advance apologies for how
the LORD has reshaped me:
In Christ's love always,
Andrew
http://tinyurl.com/b6xwk
>> > Researchers at the Jean Mayer USDA Human Nutrition Research Center on
>> > Aging at Tufts University discovered that a diet's overall "glycemic
>> > load" may be an important determinant of weight loss, but only for some
>> > people.
>>
>> > Senior author Susan Roberts, PhD, director of the Energy Metabolism
>> > Laboratory at the Center says, "Our results suggest that in the future
>> > there may be a way to predict who will do best on a low glycemic load
>> > diet." The key, they have found, may be in knowing a person's level of
>> > insulin secretion.
[snip]
>> > "In our study," says first author Anastassios Pittas, MD, assistant
>> > professor at Tufts University School of Medicine, "everyone lost some
>> > weight as a result of restricting calories, but people who had high
>> > levels of insulin secretion and ate a diet with a low glycemic load
>> > lost the most weight."
[snip}
>> > "Our findings may eventually have implications for individualizing
>> > weight-loss diets," says Roberts. "We need to confirm our results with
>> > further studies of larger groups of subjects first, but measuring
>> > insulin secretion might be a simple way to target dietary
>> > recommendations that help enhance successful weight loss." Greenberg,
>> > who is also an assistant professor at the Friedman School, notes that
>> > "only when we have completed these future studies can we determine
>> > whether these tests will be useful for making recommendations for the
>> > general public."
>> That's the artificial problem they're suffering from, that they want
>> to be able to make recommendations to the general public. It may be
>> the case that the nutritional biochemistry of the general public is
>> too diverse for general recommendations to be safe enough for all.
> The concerns arise more from skepticism about efficacy rather than about
> safety.
Fair enough, but not that it still may be impossible to discover an
efficacious recommendation to the general public, if it so happens
that the general public consists of subgroups of people with
considerably different kinds of nutritional biochemistry. My general
impression from a number or recent research reports is that suggestive
evidence is accumulating that this in fact is the case, e.g. the
distinction between those with insulin resistance and those without.
>> For diabetics, pre-diabetics, etc. there is a simple answer to this
>> problem: get a BG meter and avoid the foods which spike your BG.
> From a cardiovascular perspective, BG spikes are not as bad as prolonged
> periods of modest BG elevations (i.e. fasting BG of 150-200 mg/dL with
> max of 250 mg/dL is less optimal than fasting BG of 100-150 mg/dL with
> max of 250 mg/dl in the form of transient post-prandial "spikes")
You're quite right, but there is also accumulating suggestive evidence
that if you want to stop the progression of diabetic complications it
may be necessary not only to bring down prolonged modest BG
elevations, but also transient high prost-prandial BG spikes. In other
words, while BG spikes are not as bad as modest prolonged elevations,
they're still bad enough to damage you, although more slowly than
prolonged modest elevations.
>> Wait a minute! That involves allowing patients to make their own
>> decisions about how to treat their illness! That's the beginning of a
>> very slippery slope involving a very important matter of medical
>> principle!
> Chris, most physicians understand their role to be that of medical
> advisors for patients so that the decision making has been the
> responsibility of each respective patient.
I do hope so. There are certainly a lot who do. But you can't read
this newsgroup without noticing that there is certainly a significant
number of doctors who react with dismay to the idea that patients
should be given some responsibility for dosage adjustment, etc.. In my
own UK NHS experience, whenever I've changed medical group practice
I've selected a new practice with a particularly good reputation, but
I've nevertheless had to work my way through a few doctors before I
found one that wasn't upset by how much I wanted to know, how much I
did know, and how much I wanted to take my own decisions based on them
helping me to become as fully informed as I thought necessary.
I'm not talking about a mild reluctance. I'm talking about doctors who
far example would refuse to tell me what my blood pressure was, and
would simply go on insisting that all I needed to know was that it was
"ok for my age".
> That is certainly how the
> diabetic 2PD-OMER Approach is structured:
> http://www.HeartMDPhD.com/wtloss.asp
Yes, I would agree, and as I've posted in the past, I've discovered by
expriment that with my typical kind of diet, 2lbs is about the
threshold for me above which I gain weight and below which I lose it.
I'm sure, however, that you can recall a number of doctors disagreeing
with your diet on the grounds that a member of the public couldn't be
trusted not to eat 2lbs of ice cream and think they were following
your diet.
Time will tell.
> >> For diabetics, pre-diabetics, etc. there is a simple answer to this
> >> problem: get a BG meter and avoid the foods which spike your BG.
>
> > From a cardiovascular perspective, BG spikes are not as bad as prolonged
> > periods of modest BG elevations (i.e. fasting BG of 150-200 mg/dL with
> > max of 250 mg/dL is less optimal than fasting BG of 100-150 mg/dL with
> > max of 250 mg/dl in the form of transient post-prandial "spikes")
>
> You're quite right, but there is also accumulating suggestive evidence
> that if you want to stop the progression of diabetic complications it
> may be necessary not only to bring down prolonged modest BG
> elevations, but also transient high prost-prandial BG spikes. In other
> words, while BG spikes are not as bad as modest prolonged elevations,
> they're still bad enough to damage you, although more slowly than
> prolonged modest elevations.
Those spikes would be addressed by lowering insulin resistance with
weight loss +/- exercise.
> >> Wait a minute! That involves allowing patients to make their own
> >> decisions about how to treat their illness! That's the beginning of a
> >> very slippery slope involving a very important matter of medical
> >> principle!
>
> > Chris, most physicians understand their role to be that of medical
> > advisors for patients so that the decision making has been the
> > responsibility of each respective patient.
>
> I do hope so. There are certainly a lot who do. But you can't read
> this newsgroup without noticing that there is certainly a significant
> number of doctors who react with dismay to the idea that patients
> should be given some responsibility for dosage adjustment, etc.. In my
> own UK NHS experience, whenever I've changed medical group practice
> I've selected a new practice with a particularly good reputation, but
> I've nevertheless had to work my way through a few doctors before I
> found one that wasn't upset by how much I wanted to know, how much I
> did know, and how much I wanted to take my own decisions based on them
> helping me to become as fully informed as I thought necessary.
>
> I'm not talking about a mild reluctance. I'm talking about doctors who
> far example would refuse to tell me what my blood pressure was, and
> would simply go on insisting that all I needed to know was that it was
> "ok for my age".
Sorry you have encountered those in my profession who would covet the
LORD's power.
> > That is certainly how the
> > diabetic 2PD-OMER Approach is structured:
>
> > http://www.HeartMDPhD.com/wtloss.asp
>
> Yes, I would agree, and as I've posted in the past, I've discovered by
> expriment that with my typical kind of diet, 2lbs is about the
> threshold for me above which I gain weight and below which I lose it.
>
> I'm sure, however, that you can recall a number of doctors disagreeing
> with your diet on the grounds that a member of the public couldn't be
> trusted not to eat 2lbs of ice cream and think they were following
> your diet.
Those would be the doctors that covet the LORD's power :-)
Would be more than happy to "glow" and chat about this and other things
like cardiology, diabetes and nutrition that interest those following
this thread here during the next on-line chat (12/22/05) from 6 to 7 pm
EST:
For those who are put off by the signature, my advance apologies for how
the LORD has reshaped me:
Many Christmas blessings,
Andrew
http://tinyurl.com/b6xwk