Diabetes Nutrition BPR: Common sense

By pjain      Published June 11, 2019, 12:46 a.m. in blog Health   

Action Planning Realities

What is correct nutritional advice for diabetics

By going online, you can get lots of nutrition advice. The problem is that what you read one place often conflicts with information you see someplace else. Some of this has to do with how scientific studies are conducted and how the results can be reported or misreported. In the race for our attention, many sources will focus on sensational (but possibly flawed) studies or exaggerate the importance of a study to support a biased agenda. The result is misinformation, conflicting information, and a whole lot of confusion. https://www.diabetesfoodhub.org/articles/how-to-find-nutrition-advice-you-can-trust.html

Online Nutrition is hard and can be inappropriate - how to filter facts

Obviously not everything I run across online is good either.

EVEN DOCTORS ARE CONFUSED BY ADA etc guidelines.

Watch for Red Flags - Salesmanship, Qualifications and Biases

  • Salesmanship: Consider the intentions of your source. Does the source offer products for sale that may influence the information they present?

  • Bias, Unevenness? Is the information being presented in a sensational or “click-bait” manner? If so, it doesn’t necessarily mean the information is wrong, but it should probably be verified.

  • Unrealistic promises. If online source promises a quick fix or are too good to be true? But if your gut tell you that’s unlikely - then trust your gut instead.

What is the Scientific Basis? Ask YOUR OWN Questions

While unconventional approaches can work better than standard medical dogma sometimes, it is best to approach in a "verify" mode.

  • Qualifications over Celebrities: Do the authors have a background in science or nutrition?

    Instead of following the health advice of a celebrity with no nutrition training, base your choices on recommendations from credentialed experts such as dietitians (RD, RDN), diabetes educators (CDE), or doctors (MD, PhD).

  • Is the advice based on one or multiple well-cited studies? Science doesn’t completely turn over based on a single study. Evidence for an eating pattern or nutrition therapy builds as different researchers find similar results in similar studies with different subjects.

  • Are its scientific sources well cited. Does it discuss a study without giving any details or link to it? Without this information, there’s no way for you to check even the basics of when the study was published and if its conclusions are presented accurately.

  • Evaluate Design of Scientific studies - often lifestyle, nutrition and health studies are notoriously difficult to design, execute, and translate into practice, unlike well-trodden pharma studies.

a. What is Host Animal Target and Applicability?

Does the study involve humans, animals, or isolated cells? Animal and lab studies let scientists explore ideas for potential further research, but we can’t assume the results will be the same for humans in the real world. Even in human studies, you should take a closer look at what kinds of humans were studied: a 20-year old lean athlete may respond differently to a food or eating pattern than a 50-year old person with overweight and type 2 diabetes. Try to find out who was in the study and how these participants compare to the population at large (or yourself).

b. What kind of study is it? 1. “Systematic reviews” or “Metanalyses” are the most reliable studies, because they look at the results of several studies on the same topic and can draw stronger conclusions. 2. “Controlled but limited trials” set up an experiment where people are assigned to different groups and one particular aspect of their diet is changed, while all other factors are controlled. These trials are good at singling out cause-and-effect but are usually short term and involve a small number of participants, so we can’t necessarily assume the results apply to everyone. 3. "Large double-blind studies". These are the most reliable but often have limited variable eg use drug vs control.
4. “Observational studies” look at a larger population over a longer period of time and observe associations between eating habits and health outcomes, but they can’t always prove a cause-and-effect relationship.

c. Reevaluate study formulation for yourself!

What’s being compared? When a study finds that one eating pattern is associated with better health outcomes than another, pay attention to what it is being compared. For example, a healthful vegetarian diet is going to lead to better results when compared to a diet filled with fast food, but that doesn’t necessarily prove that a vegetarian diet is better than an equally healthful eating pattern that includes meat.

d. Draw your own conclusions - not rely on summation! - For nutritional often the construction can be invalid eg "use milk for high protein diet" - but milk products can cause autoimmune or irritate large intestine. Or perhaps the diet may be high protein but very low fiber countering the beneficial effects of a diet. So if study says keto high carb diets don't work - you should evaluate it more that milk proteins are not better not generic keto diet - as there are many different formulations of a particular diet.

e. Evaluate your significance!

How meaningful was the difference? Scientists talk about whether results are “statistically significant,” meaning the results probably didn’t happen just by chance or accident. However, results that are statistically significant may not always be clinically significant or make a meaningful difference in your health. A food or diet might result in better weight loss than another in a two-month study but turn out no better in a longer-term study. Talk with your healthcare provider or diabetes educator about whether results of a study would likely make a meaningful difference in your health.

Assemble your own Collection of Trustworthy Sources

Rather than entering your nutrition questions in a general search engine, identify sources you trust to deliver information that’s been evaluated for quality and shared in a big-picture context.

Bookmark non-profit, academic, or government sites (they usually end in .org, .edu, or .gov) These typically reference the studies they discuss and cover the potential limitations of a study.

Suggested sources - should be taken with a pinch of skepticism also - American Diabetes Association - Academy of Nutrition and Dietetics - National Institutes of Health. - WebMD - Healthline

How does it apply to Me?

Finally, when looking for nutrition advice online, the most important question to ask is: Is this advice realistic for you? It’s true that if you want to change your health, you will need to change your behavior. But extreme changes and restrictions are unnecessary and unlikely to stick. If the advice is something you can’t stick with long-term, then it’s probably not good advice. Changes don’t need to be big to make a difference in health. Small adjustments in eating habits add up over time and can make a meaningful difference in managing your diabetes.

SRC

Action Plans

It’s enticing to think you could make one eating change and shed 10 years’ weight gain in a month, or take a supplement to offset a slew of unhealthy eating habits.

1 Fix REALLY Shitty diets - first - 90% of Diabetes control

Experience in my family with diabetes--with those w/raging cases and those who kept/keep it at bay through effort--tells me that at least in our cases, 90+% of the effort needs to be diet

But of course..... and you've certainly never read a different message coming from my keyboard, have you? To repeat myself yet again... you can't outtrain a craptaculous diet. Exercise done right, however has a big part to play in maximising dietary interventions. One of the undisputed effects of exercise.... both acute and long term....is an increase in insulin sensitivity (even without weight loss) It's great that you can currently manage your diabetic issues with diet alone but .....as you've read on the H&N board.... that control takes the form of eating down to what your compromised pancreas can handle, not improving the organ's efficiency.....or your insulin sensitivity. As the pancreas continues to fail, it's not usually feasible to eat less and less.

2a Reduce Sugars in Diet

A lot of prediabetics have fixed their (>110 fasting sugars) simply by going off habituated sugar sodas and lattes.

Americans have a love/hate relationship with sugar. We eat a lot of it—an average of about 17 teaspoons on a given day per person, according to data from the National Health and Nutrition Examination Survey. But 77 percent of people in a survey from the International Food Information Council said they are trying to limit or avoid sugar.

The sugar in question is added sugars—those that are added to foods, not the sugars found naturally in fruit, milk, yogurt, and some vegetables. Both our consumption levels and the medical evidence suggest good reasons for cutting back on added sugars. In excess, they may increase the risk for obesity, type 2 diabetes, heart disease, and other health problems.

But you don’t have to remove every granule of added sugar in order to help your health, says Ellen Klosz, a Consumer Reports’ nutritionist. The recommendations for the maximum daily amount you should have vary depending on which agency you go with, but none say you have to set your goal at zero added sugars.

2b Go Low Carb

as in low carb (esp avoiding sugar and grains). Lowish calorie (esp avoiding unhealthy fats & not going overboard on protein either) and exercise help, too, but not nearly as much as low carb.

3 Intermittent Fast - esp Dinner

4 Low Calorie Load <350 calorie meals

5 Keto diets - for omnivores

The keto WOE has been a far better treatment for my T2 diabetes than medications. I used to have an A1c of 7.3 while using insulin and metformin. Since starting keto over 2 years ago, it's been as low as 5.2 without any diabetes medications.

My mom is also a T2 diabetic and just started keto recently. She takes repaglinide and struggled to keep blood sugar in the 140's. Many times since starting keto, she's had measurements under 100. She's cut back on the repaglinide and is still seeing low numbers.

6 Protein plant diets


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