Madely Health Headlines Commentary for October 15, 2009

Source:

Big Fat Diet a recipe for good health: Doctor

Additional comment:

There are several flaws in the arguments presented by Dr. Jay Wortman with respect to cause and effect but he is to be commended as well for his anthropological insight by matching diet to genetic adaptation.

This population has adapted to its environment over thousands of years. These foods are a reintroduction of normalcy for them; a return to the traditional diets that served them well. The North American junk foods that have invaded their dietary regimen has injected excess calories and subsequent weight gain. This is evident in many First Nations communities where obesity and diabetes are common and exceed general population rates.

There is no indication in the article if the study was published; important it the peer-review process. We are then left with only observational data. The effect of this diet could be compared to other low carbohydrate diets in the medical literature if it were published and allow further critical appraisal. Would this diet have similar outcomes for other cultures and ethnic backgrounds?

The study did not look at long-term compliance; a major issue with strict dietary regimens. Compliance becomes an issue when junk foods that were introduced into this population remain available.

As mentioned, peer-review would examine the data collected and the results of the study and questioned this claim,

“Within weeks of giving up sweet, starchy foods, Wadhams lost 19 pounds and went off the diabetes medications he had been swallowing for years”

Dr. Yoni Feedhoff, author of one the best science blogs about weight management, diet, misleading food benefit claims, and food science, provides this analysis of the claim:

“The weight reportedly lost rapidly may well have been real, but not impressive.  Meaning that when someone goes on a low-carb diet (which is of course what Dr.Wortman promotes), two things happen.  Firstly their body depletes itself of its glycogen stores (primarily from liver and muscle) which make up the roughly 24 hrs worth of stored carbohydrates the body has on hand.  Glycogen is stored along with a great deal of water so utilization mobilizes the water which of course gets excreted.  This can easily affect a 5-10 lb weight loss in a single week.  Couple that with ketosis which causes increased urination and voila – rapid weight loss.”

Hence the need for peer-review and published data.

The article goes on to state,

“He says the Canadian Diabetes Association, which sets guidelines for doctors and nurses treating the two million diabetics across the country, needs to wake up to the benefits of eating more fat and eliminating carbohydrate-rich foods like pop, pasta and potatoes.

“This diet should be offered as a valid option,” says Wortman, who describes Type 2 diabetes as an “intolerance” to carbohydrates that are loaded into many modern foods.

This statement is correct from the perspective of reducing calories, not because of eating more fat. Weight loss is a result of a deficit of calories. However given the limited scope of this study and its population-specific nature, one cannot draw any conclusions on the effect it would have on people of different genetic backgrounds.

Dr. Freedhoff adds,

“Regarding the benefits of a low-carb diet for diabetics – I don’t entirely disagree.  Low-carb diets are often quite satiating due to the fact that they’re much higher in protein and fat.  Consequently people on ad-libitum low carb diets like Atkins’ and Jay’s will consume fewer calories due to being less hungry.  The issue I take with low carb dieting is the fact that for the vast majority of folks, they’re not sustained in which cases the results are just another big fat diet.”