The study is here:
Elevated Triglycerides Correlate with Progression of Diabetic NeuropathyTimothy D. Wiggin et al. Diabetes. May 1, 2009, doi: 10.2337/db08-1771
What the researchers found here was nothing all that remarkable. it was:
In this cohort of participants with mild/moderate DN [diabetic neuropathy], elevated triglycerides correlated with MFD [nerve myelinated fiber density]loss independent of disease duration, age, diabetes control or other variables. These data support the evolving concept that hyperlipidemia is instrumental in the progression of DN.Where the science gets bad is in how the researchers interpret their finding.
From Science News we read that a lead researcher on the study had this to say:
"Aggressive treatment can be very beneficial to patients in terms of their neuropathy," says Feldman, who is also director of the A. Alfred Taubman Medical Research Institute and director of the Juvenile Diabetes Research Foundation Center at U-M for the study of complications in diabetes.But wait! High triglycerides are NOT produced by eating "harmful fats." They are produced by eating excess carbohydrate. Lower your carbohydrate intake for even a month and you'll see your triglyceride levels plummet no matter how much fat you eat.
People can reduce blood triglyceride levels with the same measures that reduce cholesterol levels: by avoiding harmful fats in the diet and exercising regularly. [emphasis mine]
So what this study actually found is not more proof of the dangers of eating a high fat diet. What we have is instead more proof that diabetic complications are a associated with the excess consumption of carbohydrates. Which makes total sense since when people with diabetes eat excess carbohydrates they not only get high triglycerides, they get high blood sugars.
DUH.
You can lower your fat intake all you want and exercise daily, but if you are a person with diabetes whose blood sugars are running higher than normal because you are eating more carbs than your body can burn you are going to have blood sugars at least reaching the pre-diabetic level after meals, the level where solid research has proven diabetic neuropathy begins to occur, if not at frankly diabetic levels.
Is the neuropathy caused by the high triglycerides? Probably not. It's probably caused by the high glucose levels in your blood stream that clog your tiny capillaries and starve nerve fibers.
So what this study probably "proved" is only that high triglycerides are a marker for the elevated carbohydrate intake that produces the high blood sugars that cause neuropathy.
If you want to lower your triglycerides, lower your carbs. Eat all the fat you want. Your triglycerides will plummet. Metformin also helps lower triglycerides, possibly because it blocks the processes in the liver that convert carbohydrate to triglycerides.
The fact that the people who peer reviewed this article--and the researchers who conducted it--do not seem to understand that carbohydrate intake correlates directly to triglyceride level is very troubling. Once again we see a religious belief--that eating fat is bad--translate into poor science--the belief that lowering fat intake will lower blood fats.
It is understandable that scientists might have believed this back in the days when poor quality research, spun by important research divas shaped medical belief, as has been so brilliantly documented in Gary Taubes's book, Good Calories, Bad Calories.
But this is 2009, not 1989 and if these people had been paying any attention at all to dietary research they should have known of the connection between carbohydrate intake and triglyceride levels.
But they don't, so you can be sure that doctors will now be urged to force their diabetic patients into low fat diets to prevent complications. And thousands of thousands of people will end up with precisely the complications they were trying to avoid as they eat their "healthy" diets of Cheerios, bananas, pasta, whole grain bread and fat free starchy sauces.
Don't be fooled. You do want to keep your triglycerides low. The lab sheets suggest under 150 mt/dl is normal, but you will do a lot better to get them under 100. And the way most of us do that is to eat diets that are modestly carb restricted--i.e. under 120 grams of carbs a day, or whatever amount of carbohydrates it takes to keep your blood sugars in the safe, normal range.
To learn how to lower your blood sugars visit this page: How To Lower Your Blood Sugar
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Jenny,
ReplyDeleteThanks for getting this one to us. In my opinion, the scientific/medical/pharma companies are playing with the lives of the people just for filling their coffers. I wish these fraudsters are put behind bars for their misleading and errornous interpretation.
Thanks
Venkat
Jenny I am new to your blog but not to diabetes being a T2 for about 8 years diagnosed.
ReplyDeleteThanks for the information and I wish my DH would try low carb for his heart disease but he goes along with what the Dr tells him...sigh
It makes you wonder if Sears is offering Doctorate degrees now.
ReplyDeleteWhen I followed the AHA recommended low fat diet, I watched my triglycerides soar to over 300. Now that I have cut carbs to control my blood glucose and eat all the fat I want, my triglycerides are 85. I am not on any lipid lowering medications.
ReplyDeleteMakes you wonder what these "medical researchers" have been smoking. :)
ReplyDeleteThere is little incentive for scientists to broaden their perspective beyond their immediate research report or grant proposal and to try to understand the bigger picture. I found academic research very discouraging for that reason. I wanted to see the big picture, but there is no reward and no career path for that approach. So people are busy trying to get funding, manage their labs, teach, and achieve notariety in their own little niche and they sometimes don't see the relevance to other fields or they don't even understand the basic physiology of the system they are working in. Hence there is lots of bad research cluttering up the literature and cited selectively by other people doing bad research, IMO.
ReplyDeleteThanks for pointing these errors out at least so that the uneducated and inexpert don't get misled (though those who should know better don't).
Cynthia
Partly on topic, if you look at the arguing here
ReplyDeletehttp://www.drbriffa.com/blog/2008/06/25/why-might-a-leading-diabetes-charity-offer-dietary-advice-that-is-likely-to-increase-the-need-for-medication/
you'll be disappointed for sure.
I followed on to here
http://paynowlivelater.blogspot.com/2008/07/are-we-underrating-anecdotal.html
and then here
http://nhsblogdoc.blogspot.com/2008/06/has-dr-john-briffa-taken-leave-of-his.html
Scarcely believable :( These are Medical Professionals. They have probably never seen a diabetic with an A1c in the fives let alone normalised lipids. They depend on "evidence" from papers such as the above. They have no "evidence" that people can do any better simply because not enough papers are financed or published studying the opposite.
At least we have sources such as here which find the decent science and criticise the dross, would that they were so lucky :(
In my own humble opinion, one reason so many doctors have "never seen a diabetic with a 5% A1c" is that if you show up with one they'll tell you that you aren't diabetic.
ReplyDeleteMy doctors have often responded to me by acting as if I was somehow fantasizing that I had diabetes. No amount of explaining that my blood sugars were due to eating no more than 50 g of carbs a day could get through.
My endo has seen high blood sugars fresh from the lab as I had to screw up my blood sugar to convince her I wasn't a fantasist. The rest of them, I've given up on.