By Duane Graveline, M.D., M.P.H.
The high carbohydrate / low fat diet of the past fifty years has left us with a massive ongoing epidemic of obesity and type-2 diabetes yet those agencies responsible for this incredible nutritional "faux pas" are still denying their role.
Instead of admitting they have made a gross error in judgment these past many decades, they have taken the position of sniping at every attempt being made by responsible leaders to get this country's diet back on track and have become the principle perpetrators of the myth that carbohydrate restriction is harmful.
On the one hand, doctors were taught in biochemistry that consumption of fat and protein placed minimal demands on the pancreas for insulin production yet at the same time and in the very same educational institutions they were instructed to use the standard diabetic diet with its emphasis on ample carbohydrates in the form of bread, potatoes, pasta and rice.All of these refined carbohydrates placed heavy demands on insulin secretion.
Even today, some fifty years later, I can vividly recall my surprise at these conflicting lectures but as a fledgling doctor could not even conceive the thought of challenging traditional medical concepts. Now there is a growing trend among diabetes specialists to restrict carbohydrates in their patients' diet because it works. Not only does it work but it works far better than fifty years of traditional diabetes treatment.
All of these refined carbohydrates placed heavy demands on insulin secretion. Even today, some fifty years later, I can vividly recall my surprise at these conflicting lectures but as a fledgling doctor could not even conceive the thought of challenging traditional medical concepts.
Now there is a growing trend among diabetes specialists to restrict carbohydrates in their patients' diet because it works. Not only does it work but it works far better than fifty years of traditional diabetes treatment.
The man who ushered in the world's most effective weight loss diet was a 19th century English carpenter and undertaker by the name of William Banting. Grossly obese with large umbilical hernia and diabetes Banting had almost run out of time in 1863 when he met Dr. William Harvey who took control of his life.
Harvey had just returned from a medical symposium in Paris where he had been introduced to entirely new concepts about diet and health. Banting was to be his first patient to try the new radical concepts concerning weight reduction and diabetes management.
On this low carbohydrate diet Banting went on the live another two decades but his diet died very prematurely. The medical community was unable to accept such a radical departure from traditional health care. The Banting diet was not to emerge from hibernation.
It was almost 100 years before a thoroughly frustrated (now Doctor) Richard Bernstein, an insulin diabetic since childhood, tired of following the advice of the American Heart Association , the American Diabetes Association and the American Dietetic Association.
Instead, he put himself on Banting’s life-saving carbo-restrictive diet that immediately brought his diabetes under control. This saved his life and allowed him to promote the proper treatment of diabetes in society today as a medical specialist.
Dr. Staffan Lindeberg of the Department of Medicine, University of Lund, Sweden, was another who threw off contemporary shackles on diabetes control to achieve remarkable success using his paleolithic diet to treat patients with type II diabetes.
He normalized the glucose tolerance of all 14 of his volunteers in 12 weeks.
He compared his paleolithic ('Old Stone Age') diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; with the consensus (Mediterranean-like) diet based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines.
The literature is now replete with the success stories of others who are now actively promoting carbo-restrictive diets in diabetes treatment.
If I were suddenly back in business as a doctor, all my diabetic patients would be on rigid carbo-restrictive diets. By this I mean at least 75% of daily calories would come from fats and proteins. Type 2 diabetics are telling us their ability to metabolize carbohydrates is failing. Whether they have concurrent metabolic syndrome as well with excessive girth, elevated blood pressure and elevated triglycerides, carbohydrates are their enemy.
The proper diet will help with weight loss. Diabetes pills do nothing more than give these people the delusion they can eat normally. They cannot! The drug companies are making millions convincing these people they should be taking their pills and following their glucose levels closely. Instead they must follow a tight diet. Once they fail that, their pancreas is exhausted and insulin is mandatory.
When I read of the accomplishments of such medical scientists as Bernstein, himself a juvenile diabetic, who as a young non-professional had to take his diabetes treatment into his own hands to save his life, I am filled with shame at how inadequate treatment standards have been.
Bernstein later went to medical school in mid-life; primarily so that having an MD his studies could be published in medical journals and he could better inform other doctors. This is a sad commentary of the reality of challenging orthodoxy.
As you review these diets you will observe how very basic they are, even primitive, for to eat in this manner is to regress, nutritionally speaking, 10,000 years to the time before our encounter with agriculture and the preponderance of carbohydrate in our diet.
We humans think of ourselves as highly evolved - the epitome of the evolutionary process yet our metabolic system is unchanged from our primitive ancestors. A carbohydrate restrictive diet is natural for us, the one to which we are best adapted physiologically.
No more than 40-50% of our daily caloric intake should be from carbohydrates and it should be from the complex variety and for fats we must return to the natural fats that were the foundation of the American diet five decades ago.
We also should remember that our strongest antagonists in what I chose to call "back to basics" diet will be the food industry for there is relatively little profit in basic foods. I fondly remember the words of Doctor Paul Dudley White, cardiologist to the presidents back in the mid-fifties.
When pressed to support the politically motivated "prudent" diet of fat and cholesterol restriction he replied, "See here, I began my practice as a cardiologist in 1921 and never saw a myocardial infarction (heart attack) patient until 1928."
Back in the days before 1920 when heart attacks were relatively rare, the fats were butter, whole milk and lard, and I think we would all benefit from the kind of diet that we had when no one had ever heard of corn oil.
Today most people have forgotten all about Dr. Dudley White and his prophetic words of advice. If Dudley White had been in control of our dietary destiny then, cardiovascular disease would probably not be the immense problem it is today.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor
Updated May 2016