The ADA's Diabetes Thanksgiving Disaster
In recognition of November as Diabetes Awareness Month, we're publishing a series of Editorials that will bring real "awareness" to this very serious health problem which now affects 25% of the world's population. The story of how this easy-to-beat lifestyle condition has been allowed to become a global pandemic is nothing short of scandalous. I find it appalling that the food, drug, and medical industries -- along with our government -- are allowing diabetes to rage out of control because it represents a new source of tremendous revenue.
Thanksgiving is America's biggest food holiday. But for people with diabetes, prediabetes or other metabolic problems, it's one of the biggest food traps of the year.
Why? Because so many traditional Turkey Day dishes and desserts can wreak havoc on your blood sugar.
But my jaw really dropped when I looked at the website of the American Diabetes Association (ADA) and saw its "diabetes friendly" Thanksgiving menu. Yikes! It's truly a recipe for blood sugar disaster, featuring some decidedly "diabetes UNfriendly" dishes like mashed potatoes, maple syrup sweet potatoes, cranberry sauce, and gooey desserts including Pumpkin Pie with Maple Ginger Crust and Frozen Double Fudge Peanut Butter Pie.
These menu items will shoot up your blood sugar higher than fireworks on the Fourth of July. What were they thinking?
Pass the Diabetes, Please
I can tell you what the ADA wasn't thinking about: The Glycemic Index (GI). Their Thanksgiving side dishes and desserts rank high on the GI scale, a measure of how fast a food digests into blood sugar (also known as glucose). Developed by Dr. David J Jenkins in 1981, the GI scale determines which foods are good and bad for people with diabetes and other blood sugar problems.
You can be sure that chowing down on these ADA Thanksgiving goodies will send a diabetic rushing for the metformin or insulin syringe because they'll push blood sugar into the stratosphere. (Yet given the ADA's close ties with the diabetes drug industry, I sometimes wonder if this isn't their plan. More about this in a moment.)
Let the GI Be Your Guide
The GI Rating Scale goes from 1 to 100, with faster-digesting carbs showing higher numbers (white bread has a score of 100), and slower carbs coming in at 55 and under. The higher the score, the faster the food pushes up your blood sugar.
Whether a carbohydrate is "fast" or "slow" largely depends upon the amount of fiber it contains, because fiber slows its breakdown into glucose.
Slow-digesting carbohydrates (fiber-rich natural foods such as vegetables, beans, and whole grains) provide a steady supply of blood sugar to the body. Fast carbs (refined grains, processed food products, and "white" foods) launch a tidal wave of blood glucose, creating a kind of "sugar high" followed by sleepiness and more carbohydrate-cravings as glucose is cleared from the bloodstream.
High-GI Foods Make Diabetes Worse
Research clearly shows that eating low-GI foods significantly lowers your risk for developing both Type 2 diabetes and heart disease (the number one complication of diabetes). On the other hand, consuming high-GI foods that trigger repeated glycemic "spikes" actually encourage these health problems.
Based on this research, you'd think the ADA and its current Stop Diabetes® campaign would be telling everyone and his brother to eat more low-GI carb foods -- while cutting back on the high-GI refined carbs that send blood sugar skyrocketing, like mashed potatoes and pumpkin pie. But that's certainly not their message here.
"Why?" you might ask. Well, keep reading because I think I found the answer.
Fat Is Their Demon, Not Carbs
Despite the evidence (and there's a considerable amount of it), the ADA doesn't believe high-GI carbs cause or worsen diabetes. In fact, they don't even differentiate between a fast carb (high-GI) and a slow-carb (low-GI). To them "a carb is a carb." An apple is the same as table sugar.
And carbs aren't the enemy to ADA anyway. Dietary fat is the real bad guy, or so they believe, because it causes heart disease, the number one fatal complication of diabetes. So their solution is a low-fat diet.
What the ADA is really saying is that diabetes won't kill you, but heart disease will. Yet this completely disregards how diabetes -- even when blood sugar is controlled at levels doctors recommend -- slowly wastes and destroys the body, causing blindness ... nerve damage ... amputations ... and slow death. Not a pretty way to go.
Current research has moved way beyond this "fat causes heart disease" superstition. More than a dozen peer-reviewed studies published since 2003 show that a low-carb, high-fat diet is more effective at reducing overall heart disease risk than a high-carb, low-fat regimen.
The scientific explanation is that high levels of blood sugar and insulin are extremely inflammatory and damage artery linings, initiating the plaque-building process. Sugar, not dietary fat, is the real cause of heart disease.
In fact, consumption of dietary fat has decreased in the US since the 1960s, while heart disease has been steadily on the rise. What has kept pace with heart disease is our consumption of sugar (now up to 150 pounds per American per year!) and refined carbohydrates.
According to Jeff Volek, Ph.D., R.D., a nutrition researcher at the University of Connecticut. "Research shows that replacing carbohydrates with saturated fat has a beneficial effect on cardiovascular health (because) a low-carbohydrate diet ... increases (the body's) ability to burn the incoming dietary fat."
Dietary Fat Actually Fights Diabetes
Here's more proof: Before the discovery of insulin, the leading treatment for diabetes was a high-fat, low-carb diet. Dr. Elliott Proctor Joslin, M.D., a Harvard- and Yale-educated physician, relied on it more than a century ago to successfully sustain dozens of diabetic patients -- including his own mother. His treatment? A diet made of 70% fat and just 10% carbohydrates.
And then there are the Greenland Eskimos, who before the introduction of the Western-style high-carb diet, had the lowest incidence of heart disease and diabetes on earth. They ate fat and protein almost exclusively -- and only about three percent carbohydrates. So much for dietary fat causing heart disease. So much for dietary fat causing heart disease.
The problem is, if you're cutting back on fat, you have to make up the calorie difference somewhere else. And in the ADA's view, that "somewhere else" should be carbohydrate foods. Hence, its official pro-carb, anti-fat position.
But we've already seen how mistaken this approach is dating back the 1980s, the decade of "low-fat mania." Then, food manufacturers cranked out thousands of low-fat foods, replacing their fat content with sugar and other sweeteners such as high fructose corn syrup. That fad diet started our current obesity/diabetes boom.
Apparently, the ADA was asleep for the whole decade, because they still maintain that our diabetes and obesity woes stem from consuming too much dietary fat -- even though fat consumption declined significantly over the past 30 years. But carbohydrate consumption (and I'm not talking about fruit, vegetables, and whole grains) has been steadily increasing.
Why The ADA Favors a High-Carb Diet
Reflecting their fat phobia, the ADA recommends that up to 65% of a diabetic's daily calories come from carbohydrates. And they don't differentiate between a slow-carb the fast-carb. Instead, they want you to simply "count carbs" no matter what kind of carbs they are.
You see, in the ADA universe, a 1/2 cup of oatmeal or black beans counts the same as two cookies or 1/4 serving of French fries -- even though these foods have very different effects on your blood sugar as indicated by their GI ratings. Cookies and French fries will spike your blood glucose, while oatmeal and beans will stabilize it.
If you have diabetes or prediabetes, eating high-GI foods (like those on the ADA Thanksgiving dinner menu, for example) will send you running for your medications. Low-GI foods, on the other hand, usually allow your doctor to lower your dose -- or withdraw them completely.
Reducing High GI Carbs Reverses Type 2 Diabetes
When my diabetes patients reduce the high-GI carbs in their diet and replace them with fiber-rich carbs such as vegetables, beans, and whole grains, we see significant reductions in their blood sugar and insulin levels -- so much so that we're able to completely discontinue their medications.
Not only does this type of eating normalize blood sugar, but replacing refined carbs with protein, fiber, and healthy fats, usually results in a reduction of overall calories which translates into weight loss without any "dieting" whatsoever. And I'm not the only clinician who is seeing this.
We also have plenty of solid clinical evidence dating back at least 30 years which shows that simple dietary changes are enough to help diabetics become drug-free...
- In 1982, nutritional researcher Kerin O'Dea reversed severe Type 2 diabetes in Australian aboriginal males simply by getting them off refined carbohydrates and into a more active lifestyle. Their markers for diabetes and heart disease were completely gone -- and not a drop of medication or insulin was required.
- In 1984, the journal Diabetes published a study from the University of Vermont College of Medicine showing that lifestyle modifications successfully reversed the insulin resistance that is the precursor to (and underlying cause of) Type 2 diabetes.
- Researchers at the UCLA School of Medicine found that 50% of Type 2 patients in their study were able to reverse their diabetes in just three weeks by making small changes in their diet and adding moderate exercise. "The study shows ... that Type 2 diabetes and metabolic syndrome can be reversed solely through lifestyle changes," according to lead researcher Dr. Christian K. Roberts.
- In 2001, the largest study ever conducted, researchers found that diet and lifestyle modifications were twice as effective as the leading drug, metformin (Glucophage), in preventing prediabetes from turning into full-blown Type 2.
- A Duke University Medical School study found that when Type 2 diabetics reduced their consumption of glycemic carbohydrates, they achieved better blood sugar control. After just six months, 95% of the participants were able to reduce or completely eliminate their diabetes medications. "It's simple," says Eric Westman, MD and lead author of the study. "If you cut out the carbohydrates, your blood sugar goes down, and you lose weight, which lowers your blood sugar even further. It's a one-two punch."
- Another Duke Medical School study in 2005 found that diabetic patients who reduced their consumption of high-GI carbs were able to significantly reduce their medication or discontinue it altogether.
So why does the ADA cast a blind eye to this well-published research (much of it is in their archives!) and continue to recommend a high-carb/low-fat diet?
Because Drugs Are Part of the ADA "Diet"
While these lifestyle modifications are easy to adopt, the ADA continually portrays them as "extreme." And from what I can tell, their blindness has more to do with medical politics (another way of saying "money") than real science.
The ADA maintains that drug treatment, not food, is best for controlling blood sugar. And while it may pay lip service to the benefits of "diet and exercise," its official position (published in August 2006) advises doctors to immediately start new Type 2 patients on metformin, a drug that slows the liver's production of glucose. These guidelines never give "diet and exercise" a chance.
Instead of advising new diabetics to first restrict low-GI carbohydrates, most physicians simply prescribe enough medication to cover the patients' carb consumption. And once drugs are started, conventional doctors continue them for life.
"What's the Hurry?"
Another good question. My hunch is the answer lies in the cozy relationship the ADA has with the diabetes drug industry (which provides the lion's share of its funding). Metformin, for instance, is the most widely prescribed diabetes drug in the world, with total sales topping one billion dollars in 2005. (We'll take a closer look at this relationship in a moment.)
"Metformin is insurance for people who aren't following their diet and exercise plan," stated Dr. John Buse of the ADA. But Dr. Buse's explanation doesn't jibe with the ADA's official physician guidelines to prescribe metformin immediately.
"They're contradicting themselves," says Richard Feinman, Ph.D., director of the Nutrition & Metabolism Society and a biochemistry professor. "They want diabetics to take medication to lower their blood sugar, but recommend a diet that has the opposite effect."
What's Really Behind The ADA's High-Carb Position?
Again, it's politics -- this time, food.
In addition to the "contributions" it receives from manufacturers of diabetes drugs and supplies, the ADA is supported by giant food companies. Its Seal of Approval essentially has been for sale since the ADA was founded. And it still is.
It recently signed a $1.2 million deal with the candy conglomerate Cadbury, whose products will now qualify for ADA endorsement. Kraft Foods had a four-year, $1 million deal which allowed the ADA logo to appear on such products as SnackWell's cookies, Post Raisin Bran, Cream of Wheat cereal, and Sugar-Free Jell-O.
According to the New York Times, it costs a minimum of $500,000 to even qualify for the ADA seal. (Yes, you are paying attention: All these processed foods actually are high-GI and spike blood sugar!)
According to Marion Nestlé, PhD and professor of Nutrition, Food Studies and Public Health at New York University and author of Food Politics: How the Food Industry Influences Nutrition and Health, ADA research co-sponsorships also influence the outcome of the supposedly "unbiased" studies in favor of the food product being tested.
The ADA certainly knows which side of its bread the butter is on...
In an article published November 25, 2006 ("In Diabetes Fight, Raising Cash and Keeping Trust"), the Times reports that the ADA received more than $23 million worth of contributions in a single year from the food and pharmaceutical industries combined.
While the lion's share of the ADA's $200 million-plus budget is spent promoting "treatments" (in other words, drugs), very little goes toward prevention, patient education, and real public awareness campaigns. So much for "stopping" diabetes.
Inside the ADA's Inner Circle
The ADA's relationship with Big Pharma dates back to 1940 when it was founded with a $1 million gift from the drug maker Eli Lilly. Twice in the past decade, the ADA's 12-member Executive Committee has been headed by former top executives of drug or medical equipment companies.
Far from being a public interest non-profit, the ADA is an “old boy” network of ex-executives from the drug and food industry, plus biased medical “experts” who have direct ties to diabetes drug companies and supplies. Salaries are large and the perks are many.
The ADA's links to these special interests make it hard to trust that it is objective and impartial in its dietary and treatment recommendations.
Pharmaceutical companies sell $15 billion worth of diabetes drugs in the US each year, and the ADA is a lynchpin of their marketing strategy. Drug companies routinely advertise to doctors in ADA journals and announce new medicines at ADA conventions. US doctors usually take the ADA pronouncements as gospel.
And ADA drug endorsements don't come cheap.
The Banting Circle Elite is the ADA's highest level of "recognition" for companies that develop diabetes medicines and devices -- and a contribution of $1,000,000 will get almost anyone in. For that, the honored company receives ADA sponsorship, grants, advertising in its publications and the right to exhibit at the Annual Scientific Sessions and/or the Annual Advanced Postgraduate Course (giving them access to the ADA's membership of influential doctors, researchers, and promising medical students).
Companies who contribute at least $500,000 are merely recognized at the Banting Circle level, but membership at both levels reads like a Who's Who of the diabetes industry.
Diabetes Is Worth a Trillion Dollars a Year
Last year, the world spent nearly $400 billion on diabetes, with 99% of that going for treatments -- and the rest (1%) for prevention.
I find this shocking and incomprehensible because prevention is the best "cure" we have. And diabetes, unlike some of our really tough medical challenges such as AIDS and antibiotic-resistant bacteria, is utterly preventable and curable.
As Jim suggested in last week’s article if the ADA and the medical community were really serious about stopping diabetes, they could succeed in a single generation.
But they don't seem to be the collective will, despite all the faux public concern. Let me tell you why I think the motivation isn't there...
By the end of this decade, we'll be spending $1 trillion globally on diabetes every year. That's a lot of glucose monitors ... test strips ... drugs and insulin ... lab tests ... doctor visits ... hospital stays ... research grants ... and medical procedures for heart attacks, vision loss, and amputations.
Diabetes Has Become a Huge "Industry"
Call me cynical, but there's far more money in treating diabetes than curing it. Just imagine all the jobs and revenue that would disappear if diabetes suddenly went away.
Which is why, I believe, the ADA still hasn't found a cure, despite the billions of research dollars spent to find one. Diabetes continues to rage out-of-control, year after year. In the words of the ADA's director, Tom Czajak: "Diabetes is a disease that right now has no cure."
But he's dead wrong.
The cure for diabetes is right under our noses and our feet.
A Thanksgiving Dinner You Can Really Be Thankful For
For starters, you can say no to the ADA's "diabetes unfriendly" Thanksgiving menu and prepare this Diabetes-Healing Thanksgiving Dinner from MyHealingKitchen.com, instead. It's low-GI ... blood sugar-friendly...and absolutely scrumptious.
Here are some other suggestions to make your Thanksgiving celebration more healing and healthy...
Start your day with a walk. There's going to be a lot on your schedule -- so you probably won't get to exercise today. Claim the early morning for yourself and get out in nature. As you inhale the fall air, breathe in the goodness of the world ... and exhale your love and appreciation for life itself. You won't be alive forever, so seize the day.
Get off your bum. Football will be on the TV around-the-clock, but you don't have to watch game after game. Instead, toss a football with your grandchildren or take them on a hike. Remember, they won't be little for long -- so enjoy them while you can.
Go easy on the booze. Promise yourself you'll stay clearheaded so you can enjoy the people around you and the memories you'll be creating. Dilute your beverages with club soda and nurse them. Get your buzz from love, not booze.
Snack healthy. Keep a platter of raw veggies and your favorite low-cal dip handy. Or munch some nuts ... crunch and apple ... smear peanut butter on celery sticks ...enjoy a bite or two of artisanal cheese. Most people overeat at dinner because they're ravenous. Keep your hunger in check by snacking moderately throughout the day.
Have seconds. Before you fill your plate, give yourself permission to go back for more and take a smaller first portion. You may be surprised to find this initial amount will be enough.
Eat slowly. Thanksgiving isn't really about the food -- it's about the people you're with. The family you love. The new little ones and the dearly departed elders. Put your fork down frequently and enjoy the conversation. You may find it more nourishing than what's on your plate.
Take an after-dinner stroll. After the guests are gone and the cleanup is over, take your sweetie by the hand and go for a leisurely walk outdoors. Appreciate the moment and your togetherness, either in conversation or meditative silence. You'll never have this exact same time again, so cherish it.
Have a Happy, Healing Holiday!
About the author
Meet Dr. Stefan Ripich, ND, ANP. While modern medicine is failing miserably to stem the spread of diabetes, Dr. Ripich is achieving 100% success in getting his patients completely OFF diabetes meds and related drugs — and back on the road to a healthy, normal life.
His groundbreaking book, The 30-Day Diabetes Cure, is the first day-by-day, step-by-step guide to reversing Type 2 diabetes and prediabetes, while showing people with Type 1 how to dramatically reduce their insulin dose.
In both cases, Dr. Ripich has been able to virtually eliminate his patients’ risk of deadly diabetic complications, such as heart attack (which is responsible for 75% of all diabetes-related deaths).