Feinman To Warshaw: How Healthy Is A Diabetes Diet That Requires Medication?

Dr. Feinman tells Warshaw what she can do with her high-carb advice

One of the most controversial debates within the diabetic community right now is around the subject of carbohydrate-restricted diets as a means for naturally controlling blood sugar levels and insulin production (we can thank Men's Health columnist Adam Campbell for writing this outstanding column about it in late 2006 to get the ball rolling). It's a fascinating subject since so much research is pointing to livin' la vida low-carb as an excellent way to tame and virtually "cure" diabetes naturally without the use of drugs or insulin in many patients. It truly is a miracle for diabetics!

Nevertheless, the so-called "experts" in the field of diabetes are none too pleased with all this talk about low-carb diets because they do not give this way of eating any credence whatsoever as a legitimate nutritional approach for taking on diabetes, especially the ever-growing Type 2. One such leader in the anti-low-carb movement happening within diabetes circles is author, nutritionist, and diabetes educator Hope Warshaw.

I've previously blogged about Warshaw when she went head-to-head with low-carb diabetes champion Dr. Richard Bernstein on dLife last year. Warshaw is deeply entrenched in the politics and talking points of the American Diabetes Association (ADA), so it's not surprising she would write a short but to the point column like "Why You Don't Want To Go Low Carb Or Vegan" in a major diabetes publication like Diabetes Health.

Her key reasons for opposing livin' la vida low-carb for diabetics is this:

- It's too "extreme" a "fad" diet to be taken seriously
- It's not appropriate over the long-term
- You can't stick with it and maintain your weight on it
- Blood glucose levels do not return to "normal" after meals
- Carbohydrate is necessary for a healthy diet
- A low-fat, low-calorie diet is more effective

We also learn from this "Diabetes Mine" blog interview with Warshaw that she believes that diabetes control is "not about carb restriction," but rather eating lots and lots of fruits and vegetables as part of a high-fiber, low-fat, low-calorie diet. Does this include sugary fruits like bananas and raisins as well as starchy vegetables like white potatoes (which a recent ADA report found some startling statistics about regarding typical American consumption), hmmm?

Interestingly, despite including a vegan diet among those to avoid in the title of her column, Warshaw mentioned it a grand total of ONE time compared with EIGHT references to "low-carb" in the six-paragraph article. Can you say obsessive? Sure looks that way!

While most diabetes professionals who read this predictable missive from Warshaw a couple of months back no doubt grinned and nodded their head in complete agreement with all of her conclusions about the low-carb lifestyle for diabetics, at least one did not. His name is Dr. Richard Feinman from the SUNY Downstate Medical Center in Brooklyn, New York who serves as Editor-In-Chief of the scientific journal Nutrition & Metabolism.

I've previously interviewed Dr. Feinman at my blog and he has a rather unique perspective as it relates to helping diabetics beat their disease with as few medical interventions as possible by using a low-carbohydrate treatment option. He has been on the front line of this debate on behalf of the science regarding carbohydrate-restriction for diabetics and has seemed to step it up a bit in 2007.

To directly rebut everything Warshaw wrote in her column, Dr. Feinman penned his response entitled "Low Carbohydrate Diets: Why You Don't Want the 'Experts' to Tell You What to Eat" which brilliantly laid out and explained why low-carb diets are not only appropriate for diabetics, but actually preferred for those patients desiring to end their dependence on drugs and insulin.

Please go read the entire column which was published this week in Diabetes Health, but here are my favorite points that Dr. Feinman makes:

- Low-carb diets control glucose metabolism problems
- Encouraging carb consumption for diabetics is ridiculous
- High-carb diets demand the use of more medications and insulin
- Eating carbs WILL raise blood glucose levels
- My favorite: How healthy is a diabetes diet that requires medication?
- Reducing medication should be a sign of improvement for diabetics
- Diabetes is a metabolic disease that require a metabolic response
- There is no biological need for carbohydrate
- Glucose can be supplied to the brain through gluconeogenesis
- The obesity and diabetes epidemics caused by high-carb, low-fat diet
- More carbs in the diet means worse weight and health control
- If the low-carb diet were a diabetes drug, it'd be the hottest seller
- Compliance is a problem with ALL diets, not just low-carb
- Eating candy and taking insulin is really bad advice
- Diabetes control should be left to the patient's personal choice

That pretty much sums it up and Dr. Feinman should get a medal for making his points so clearly and succinctly with all the references and evidence to back up everything he wrote in that response. THANK YOU for being one of the few who "gets it," Dr. Feinman. We need more brave researchers and medical professionals who have seen the positive impact of low-carb diets on diabetes to step up like you did.

Dr. Feinman is not all alone on this. Dr. Eric Westman from Duke University and Dr. Mary C. Vernon from the University of Kansas are also outspoken practitioners who have seen changes happen to patients with their own eyes day in and day out.

It's funny how these so-called "experts" like Ms. Warshaw are trying desperately to ignore the findings of people like Drs. Feinman, Westman, and Vernon, but the word is starting to spread among diabetics. Patients are curious about getting off their medications and insulin if at all possible and livin' la vida low-carb is opening that door of opportunity.

Something tells me we're gonna keep hearing positive reports about how low-carb is providing beneficial results to diabetics helping more and more of them reduce or eliminate their need for prescription medications in the coming years. When that happens, do you think folks like Ms. Warshaw will be singing a different tune?

Doo-dah, doo-dah! :D