August 15, 2011

Does the High Fat Diet Cause Diabetes? No, But The Onslaught of Bad Research Is Making Me Burn Out.

I've received a torrent of mail about the study recently published in NATURE which claims that eating a "high fat diet" damages beta cells and causes diabetes.

You can read a summary here:

Science Daily: How a High Fat Diet Causes Diabetes

I don't have access to the full article, but I have read (and commented on) dozens of other articles that purport to show that "high fat diets" cause diabetes. And, I have also written at length about the problem of confusing rodent diabetes with human diabetes. Folks, wake up. This was a rodent study!

In every case, the "high fat diet" used in rodent studies is the rodent equivalent of eating a burger with fries and a milkshake. I.e. it's a diet very high in fats, but also very high in carbohydrates--and often that carbohydrate comes in the form of high fructose corn syrup.

In addition, as I've mentioned dozens of times before, rodent metabolisms are very different from human metabolisms because rodents are adapted to eat a very different kind of diet. Rodent diabetes is not human diabetes. "Cures" for diabetic rodents almost never work in humans. Drugs that are safe in rodents harm people.

There is very little research looking into human/rodent differences because rodent research has become a huge specialty in medical research and eliminating reliance on rodent studies would put a lot of very highly paid medical research lab heads out of work. Since it is precisely these highly paid heads of rodent labs who make up the committees who decide who gets research funding, the system is self-perpetuating. Rodent research, no matter how flawed and irrelevant breeds more rodent research.

But that rodent research is not only flawed, it's dangerous. A very rare--and very relevant--study about rodent-human differences was published recently (with almost no mention in the press) and it underlines what I'm talking about.

It found that, in the words of the chief researcher, "...the difference in gene expression between the mouse and the human is very very large." And concluded that the potassium channels acted upon by sulfonylurea drugs are found in completely different places in rodent hearts than they are in human hearts, which means that a drug that is safe for rodents would cause "fatal arrhythmias" in humans. (Which they do. Glipizide, glibenclamide, etc. raise the risk of dying of heart disease over time.)

Science Daily: Human Hearts Respond Differently Than Mouse Hearts to Two Cardiovascular Drugs.

But I can post as much here as I want about flawed studies. It doesn't help. Because the people who read these posts on my blog about misleading research are the people who are already aware of why the research is flawed. It's a classic case of "preaching to the converted."

Analysis of my blog's stats makes it clear that the people who read these kinds of articles are a very small minority of those who read this blog. Almost all the traffic to this blog goes to articles that discuss commonly prescribed drugs and tests. They answer common questions people have who are newly diagnosed. Few who visit this site to find answers to that kind of question read anything but a single post. In short, by now it's clear that the many hours I spend tracking down the details that might offer counterarguments to misleading medical headline news is wasted.

So what it comes down to is this. I can't single-handedly, in my spare time, and for free, counteract the toxic effects an entire medical research establishment funded by multi-billionaire predatory drug companies and backed by armies of doctors who get paid hundreds of thousands of dollars a year to, supposedly, take care of people with diabetes.

Over the last six years I've posted dozens of posts just like this one, many much more detailed, but all pointing out basic flaws and citing other studies that make it very clear that eating carbohydrates is what raises blood sugars, not fats. And that high blood sugars are what cause diabetic complications in humans, not eating fats. I've put an average of 3 hours into each post. Sometimes more. I've answered hundreds of comments and emails from people who read the blog posts and want to know more.

Meanwhile, the misinformation that shapes diabetes treatment gets louder and louder. So it's time for some of the rest of you to get active. If you want things to change, you are going to have to write letters to newspapers and journals, confront doctors, call your TV station, and band together with other people with diabetes to change the way that people with diabetes are treated. If you don't do this, nothing will change, no matter how elegantly I dissect research publications.

There's enough material on this blog by now that a person who wanted to understand any of these new studies could easily apply what has already been explained and do their own analysis. There's plenty you could print out and show your doctor if you took the time.

As far as what I'm going to do it's this. I am done wasting my very limited time reading and commenting on flawed studies. From now on, the only studies I'm going to put time into describing are those that come up with new information that can actually help people with diabetes improve their health.

Such studies are very rare. Please do not email me links to the studies that appear each week "proving" stupid stuff that any reader of this blog and the main Blood Sugar 101 Website knows is bullshit.

Gloria Steinem said something brilliant, reported last week, which sums up exactly how I feel right now.

She said, "The danger of the Internet is cocooning with the like-minded on line -- of sending an email or twitter and confusing that with action -- while the real corporate and military and government centers of power go right on."

People with diabetes need to stop reading things that they agree with and start confronting those centers of power if they want anything to change. Reading elegant articles here might make you feel good, but to change anything you will have to take action. I've already given you hundreds of thousands of words worth of ammunition. Now use it.



41 comments:

LeonRover said...

Hi Jenny

1) It's those headline sub-editors at Science Daily - again.

2) It takes an amount of reading of the article to deduce that the researchers have identified a mechanism (pathway) which interrupts GSIS once one already Type II diabetic, and advances one to along the path to full pancreatic failure.

3) It identifies the culprit as palmitic acid.

4) However, there no narrative concerning how a high fat diet in humans may eventually lead to the presence of high blood levels of palmitic acid.

5) The use of the word Cause is therefore highly pejorative.

Jenny said...

Leon Rover,

This study was being reported with that headline all over the media. Google News has it today.

Was any of this study conducted in humans? It looked like it was all rodent from what I could see. Though admittedly I only could read the summaries.

Angelyne said...

I hear ya Jenny. It's like trying to empty the sea with a cup.

But every time you post, I learn something new. This time it was about rodent research.

That's why I keep coming back here.

Jenny said...

I have written extensively about rodent research on the blog in the past.

Here

Here

and elsewhere. Site Google "rodent research" to find more. Or "in mice"

Denise said...

Brava! Thank you, ma'am, may I have another?

As a reader whose emails you have graciously answered, I thank you for what you have contributed to my life, and my understanding of my Type 2 diabetes, completely controlled through diet and without medications.

You are right, it is time to act.

Anna said...

Glad I finished reading your post. I was all set to send you the full text paper (my husband has access).

And you are very right about the flies in the ointment, I mean the flaws in the system.

Natalie said...

Dear one, I can hear your frustration loud and clear. But I do want you to know that I have read nearly every article and blog on the site, and I have learned a lot from them, and I can't tell you how much I appreciate your labor of love. Please choose to write on what you think is most valuable to us, but keep on writing, OK?

Jenny said...

Natalie, It's people like you who make it worthwhile. Thanks for the kind words.

Jenny said...

Angelyne added the following link to her earlier post, which is worth reading.

http://rdfeinman.wordpress.com/2011/08/15/the-office-of-research-integrity-conference-and-the-crisis-in-nutrition/

Jan Blawat said...

I have your blog linked to mine because several of my relatives are diabetic. Some have died because they followed their doctors' orders religiously, and I'm trying to help the ones who remain see the light. I make myself a pest all the time and use your site as reference. The hardest thing is to influence the medical people I have to deal with, though. They don't want to read anything a mere patient recommends. But I'm trying. Thanks for all your work.

Caleb Murdock said...

Jenny, I think that you shouldn't blame your readers for not doing more. Everybody has a lot on their plate. Also, in every area of our lives, there is misinformation being distributed, and you can't fight it all. You've chosen to get involved in the subject of diabetes, even to the extent of writing a book (which I have), and you are responsible for your choice. To then turn around and blame your readers in frustration serves no useful purpose. Personally, the topics that interest me most are the environment, social justice and religion. Because I've become a diabetic in my 50's doesn't mean that I can now be a diabetes crusader. I do what I can, including an article on my own blog, talking to my doctor, posting on forums, and writing angry notes to the ADA, dLife and an occasional media outlet, but I can only do so much without rededicating my life. Progress in any area of human knowledge comes slowly. Human beings seem intent on finding a consensus on every topic, yet the consensus that we arrive at is rarely accurate. Beyond speaking up in whatever way I can (and have the time for), there is no way to stop that.

Lila said...

I echo Natalie's sentiments.

I have full access to the article and the first thing I scanned for was whether it was high fat-high carb. But it is very dense and full of jargon and I couldn't find the answer.

This week there has also been an equally stupid paper in the American Journal of Clinical Nutrition, claiming that two slices of bacon a day increases T2 risk by 50 percent...

Jenny said...

If I remember correctly, the bacon study finds an association. Like most nutritionist studies it's probably from a questionnaire and they don't ask what people ate WITH the bacon. Like, say pancakes or waffles and syrup, and homefries.

heckelmeister said...

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The problem is, you have no way to track what happens after we read your Diabetes Updates. You don't know how many times I have pointed my dietician, endocrinologist, and friends to the Diabetes Update site (not just Blood Sugar 101). We *are* carrying your message! If only there were a way for you to know it in real time... Please don't stop!!

STG said...

Jenny,

I am prediabetic and my HbA1C is too high. Your website is getting me focused and helping me make more dietary changes, so I don't have to take medication. I am currently experimenting, so I don't know the outcome. At this point in time, I am trying to learn and understand as much as possible about my broken metabolism. I am reading everything at Blood Sugar 101 and have bookmarked every study on the website. I intend to read and reflect on every study you posted. I am also going to buy your book. Your are a gifted writer and educator. I really value your time investment in creating such an informative website. Please keep it up--analysis of studies included!

Lucy said...

Thank YOU SO MUCH for every word you have ever written. Thank you for your research and for your passion to put forth what is true and right in the midst of ri'diculousness (which, unfortunately so many believe without researching for themselves...AARGH!!!!).

This site provides so much information that is VITAL to someone who is looking for answers (especially when first diagnosed w/diabetes). Thanks you (again).

Jenny said...

Hecklemeister,

I'm NOT going to stop. I'm just not going to put my energy into trying to counteract the never-ending barrage of depressingly similar, poorly designed or misleading studies that keep coming up.

Anne said...

I am glad to hear that you are not giving up your blogging. I appreciate all the hard work and time you have put into this site and the Blood Sugar 101 pages. Whenever I meet a person with diabetes, these sites are the first place I send them. Your information has been invaluable to me and so many others. I can understand getting burned out on all the bad studies that get the sensational headlines.

Karen said...

Jenny I thank you for all your work you do. I thank you for the emails you have answered. I thank you for putting the articles into a language I can understand. I fight with my Dr and tell her things I learn here. If anyone can tell me how to go farther I sure will! Karen

Caleb Murdock said...

Heckelmeister makes a good point. I view you as an expert in this field. Do you know how many times I have said in one of my forums posts, "Jenny Ruhl says ..."? I mention you constantly, so your message is getting around. It may not be getting to the researchers, though -- and it never WILL because you are not a doctor or a researcher yourself. That's just the way it goes. Your efforts need to be directed at diabetics. You are helping the "people" directly. If you are not changing the medical status quo, well, look how long Bernstein has been trying to do that with only limited success. You throw your pearls of wisdom to the world, and you can't be certain where they will land. You can't worry about that.

You've helped me in several crucial respects. Most notably, it was a post on your blog that turned me on to regular insulin. By injecting R insulin just to cover my post-prandial highs, my fasting numbers have fallen into place, and I expect to have an A1c of about 6 at my next doctor visit. Since then, I have repeatedly talked about the value of R insulin on the forum. So you see, your pearls of wisdom are getting around!

Ventura Bill said...

Wow Jenny!

I can feel the frustration in your words. I have had my Endocrinologist ask me where I got the crazy ideas about wanting to stay below 140 with my sugars. When I tried to tell him, he cut me off and said he perhaps was not the right Doctor for me. He said if I was under 7 a1c then I was well controlled. I am currently looking for someone else for treatment.

I am over 71 and probably won't be around overly long but I still would like to feel better during what time I have left. Your site and book as well as Dr. Bernstein's book have been very informative to me and I hope to keep seeing your wisdom posted.

Bill Londree

rdfeinman said...

This was a very good post although I would second people who tell you not to lose heart. There are many who are trying to do what you say, my own group, Nutrition & Metabolism, for one, http://www.nmsociety.org. We do have trouble getting everybody together as a cohesive force, however and are open to suggestions on mechanisms, (meet-ups, volunteers ?).

I have not read the Nature paper but I would add a couple of points:
1. Rodents are even different from each other. Some strains of mice get fat and insulin resistant on high fat diets, even if there is very low carbohydrate. Humans do not unless there is high carbohydrate.
2. As for palmitic acid, in humans high palmitic acid (that is, saturated fat) in the diet may actually reduce palmitic acid in the blood compared to a high carbohydrate with much less saturated fat. How is that possible? That's what metabolism does. I will describe experiments from Jeff Volek's lab in upcoming blog post. Carbohydrate can be turned to fatty acid and the immediate product is palmitic acid.
3. Rodent research can be very valuable because we have so much information about the underlying biochemistry. So researchers are partly to blame for not always making clear what the relation to humans is but one of the comments pointed out that I am making the case at a conference that they have a responsibility in seeing that the press not exaggerate the meaning of their results.
4. In some sense, rodent research can be valuable for showing what doesn't happen in humans in response, for example, to high fat. The regulatory systems are frequently the same but have different control mechanisms but again the relations have to be made. In fairness, many cell biologists have little knowledge of nutrition and assume that the party line about high fat is correct but are open to new ideas.

Jack said...

Perhaps you underestimate the good
you perpetrate :)

I've made a practice of noting the
references you often provide, and
taking them along to Endo appt's at
the VA - To provide to the earnest
young (& not so young) docs who tell
me my A1C (5.x %) is too low, and
blandish the drug-of-the-month as a
"safe" alternative to Insulin.

And, occasionally, I detect some interest...

Anna said...

For those who still pay attention to media coverage of research studies, I highly recommend a great (often hilarious) video now posted on YouTube of a lecture given by Tom Naughton on the Low Carb cruise last year. It's titled Science for Smart People and it really explains in laymen's terms everything media consumers need to know about those headlines about science and studies.

YouTube of course is free for those who have high speed internet access, but CDs of the lecture are also available for a very reasonable price on Tom's website. Great for sharing with others. http://www.fathead-movie.com/

http://www.youtube.com/watch?v=y1RXvBveht0

Kevin La said...

http://www.diabetologia-journal.org/Lim.pdf

What do you think about this article?

Jenny said...

Kevin, This is the dangerous 600 calorie a day starvation diet that I already blogged about HERE.

You can get the identical results by cutting carbs without starving yourself.

Gretchen said...

The Nature study on "high fat diet" used mice but also human cells in culture.

I've blogged about it at Health Central (http://www.healthcentral.com/diabetes/c/all/?ic=4027) but they haven't posted it yet.

Jenny said...

Cells in culture is a huge step away from cells in a human body where nutrients are delivered to the cells by physiological means, not poured on them.

Dr. Feinman already addressed the issue of how eating fat changes the concentration of palmitic fat in the blood stream.

Gretchen said...

I know cells in culture are different from in vivo. But someone asked if it was all rodent research, and no one else had responded to that.

Pia said...

Hi!
Check ingredients for this high fat diet, I say no wonder...

"Mice were provided either a standard diet (16.4% protein, 73.1% carbohydrates and 10.5% fat with 4.07 kcal g−1; D12329, Research Diets) or a high-fat diet (16.4% protein, 25.5% carbohydrates and 58.0% fat with 5.56 kcal g−1", "D12331, Research Diets".

D12331:
Casein, 80 Mesh
DL-Methionine
Maltodextrin 10
Corn Starch
Sucrose
Soybean Oil
Coconut Oil, Hydrogenated
Mineral Mix S10001
Sodium Bicarbonate
Potassium Citrate, 1 H2O
Vitamin Mix V10001
Choline Bitartrate
FD&C Red Dye #40

High Fat Research Diet #D12331 http://t.co/RiGPlL3

Pathway to diabetes through attenuation of pancreatic beta cell glycosylation and glucose transport
http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2414.html

Villa Priscilla said...

Dear Jenny,
Because I TRUST YOU and your research and your remarkable ability to read, glean, and summarize medical and scientific research and studies, I do not read most of the articles. I have tried a couple of them, but, they are too confusing for me. This is what distinguishes you for me. It is your willingness to provide and include your sources, usually peer reviewed, which underscores your integrity and the information you provide on this blog.

When I make references to your blog and/or Blood Sugar 101 I ALWAYS.....ALWAYS....say "She bases her information on peer reviewed scientific studies, AND she includes a link to the study. She does not just opine. Her information is based in medical and scientific research, not just opinion."

That being said if it is time to make some changes, I find change is usually a good thing!

As with your other faithful followers I am filled with gratitude and thanks for all that your research and writing has done for me. Because of you I drove two hours north to Plattsburgh, NY, on Thursday, to hear a lecture by Dr. Silvio Inzucchi. He is at Yale, Professor/Medicine/Endocrinology and Director of Yale Diabetes Center. I would NEVER have considered going to this 1 hour lecture in the past. YOU PUT ME ON THIS PATH. And it really is bc of your documented research that I have grown to trust and respect what you convey. You gave me the wake up call to question, monitor, and decide how I want to proceed with my T2 diabetes.

More thanks,
Priscilla

Jenny said...

Priscilla, Thanks for your very kind words. So many of the responses here have been very heartening. It is a tough to strike a balance between doing things that apparently do help people and getting burnt out on how many people out there seem to be working assiduously, and with huge financial resources at harming them, often for profit.

Sometimes I just have to step back, because too much negativity (and there is so much to be negative about in the world today) keeps one from being productive.

Patricia said...

Dear Jenny,

So much I'd like to say but will keep it brief. October 2010 I stopped eating all sugar, starch, grains. Blood draw 1 month later showed a1c of 7.0. Eight months after that, a1c was 5.2 - NO MEDS. 

Your research, reporting, and advice taught me what I needed to do. THANK YOU. 

Shawn said...

Jenny,

A little background - I had gone back to school after having been a software engineer for about a decade and, a year after starting back to school, discovered I was diabetic. My first A1C was 12.1% at 38 years old. I have learned a great deal here and my last A1C (less than 2 years later) was 6.1%. Still a ways to go, but the improvements due in great part to what I learned here. I have found information other places, but your efforts have definitely helped me.

I wouldn't get too wound up in site viewing statistics. I don't think they tell you everything. How many doctor's have learned something indirectly through patients? Not to mention, it is not hyperbole to say that your information, and the work you put into conveying very technical information in an understandable manner, has literally saved lives. How much effort is that worth?

As the late Paul Harvey would say - and now for the rest of the story...What I went back to school for is to work on a PhD in Biomedical Sciences in a molecular biology based program. So one of your regular readers is, in fact, in training to be one of the scientists that performs those studies. Even the supposed experts, like many of my professors, are taken in by the constant blare of misleading and incorrect general media headlines. I have made quite a few of them, and many of my classmates, aware of the poor quality of research that goes on and have changed their minds about what they thought they knew. I only check the site about once a month or so to catch up so I bet the sites statistics really miss out on how much impact you really have.

Not only that, I think you do a fantastic job critiquing a paper and I've learned a thing or two about how to critically read the literature as well, so thank you for that too.

Shawn

Jenny said...

Shawn,

Thanks for a very inspiring post!

Lone Stewart said...

Hi Jenny

Your blog is even reaching across the pond to Denmark, where I have been working as a nurse for 29 years. I have certainly been re-educated on diabetes, and nutrition in general, via your writing.
So thank you - and keep up the good work - if you can.

Anna said...

Denise Minger (of deconstructing The China Study fame) has posted her analysis of this paper over at Mark Sisson's Mark's Daily Apple blog:

www.marksdailyapple.com/does-a-high-fat-diet-cause-type-2-diabetes/

Newell Wright said...

Jenny: I only check your update site about once per month but it (and your other two diabetes/low carb sites)is very influential and has very literally changed and saved my life. My blood sugars are near normal, I convinced my doctor to switch me from Janumet to Metformin, my HbA1C fell two whole points in three months (from 8.1 to 6.1--I am hoping for a lower reading the next time I get it checked), and my blood pressure normalized.

I like to tell people I have learned more about diabetes control from a romance novelist than from any M.D., R.D., Ph.D. I have ever met. In fact, I wrote about your hard-hitting information on my blog (http://lowcarbwisdom.blogspot.com/2011/08/where-do-you-get-your-low-carb.html).

All of this is to say, Thank You, for the huge influence you have had on my life (which I expect to be longer, now that the type II diabetes is effectively in remission). Know that what you write is read and appreciated, and that we do spread the word. I may not comment often, but I do read and forward your information on to others.

Jenny said...

Shawn, What wonderful progress.

I do have to point out that I've been a diabetes wonk for a lot longer than I've been a romance novelist. That was a hobby that rather unexpectedly took off. The Diabetes was an exercise in saving my own life.

forinfo said...

Jenny - you have done so much to help people with diabetes and it is impossible to criticise your decision to wind back how much time and effort you put into this. You are right that the information you have already made available is enough to help anyone who is sufficiently motivated to get a good understanding of diabetes issues.

Is there any hope that you might be able still to update and perhaps even do a sequel to your diabetes book as a way of keeping your immensely helpful and empowering perspective on diabetes current and available? I am perhaps naively assuming that a book every few years might be more manageable than a constantly updated website and blog....

I consider Blood Sugar 101 to be the bible on type 2 diabetes management and push it to people and doctors whenever it is relevant.

Many, many thanks

Jenny said...

Forinfo,

The web site has been updated whenever I find something that makes would benefit site visitors and I've been posting all the updates on a second blog which you can find here:

Updates to Blood Sugar 101

I would update the book version if there had been any breakthroughs that would change the usefulness of the book, but there really haven't been. There's been a lot of research that backs up things the book explains, a few new drugs that are in the same families as drugs that the book discusses, but nothing significant.

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