Doctor's Diary: the dietary advice that caused a diabetes catastrophe

Sensible people take no notice of expert advice about what they should or should not eat, secure in the knowledge that the latest fad will eventually be shown to be false. There is, however, one group for whom that advice, first promulgated exactly 35 years ago, has proved disastrous. Maturity onset (or Type 2) diabetes is, as all know, a condition of carbohydrate intolerance where either the pancreas produces insufficient insulin for the body’s needs, or the tissues are resistant to its action. Either way, the body’s metabolism can no longer utilise the sugars in carbohydrate-based foods, the levels of glucose in the blood rise and the unused energy laid down as fat.

Thus, historically, those with Type 2 were advised to restrict the amount of bread, pasta, potatoes etc consumed in favour of meat and dairy products. This dietary regime combined with weight loss was often sufficient to restore their blood sugar levels to normal. Then, back in 1982, an alliance of influential nutritionists and epidemiologists reversed this logical advice on the grounds that meat and dairy products contain wicked saturated fats that push up the cholesterol, causing tens of thousands of premature deaths from a heart attack.

Those with Type 2 are particularly prone to heart disease and so it was decreed that they too should abjure meat and dairy products, eat lots of “healthy” fruit and carbohydrates instead and take pills to control their blood sugar. Consequently, since then the prevalence of Type 2 has increased threefold – many of whom being overweight have considerable difficulty in controlling their condition – and the cost of treating diabetes has soared. A catastrophe indeed.

Since the exoneration of saturated fat from causing heart disease, wiser counsels are beginning to prevail. While it is understandable that those responsible are reluctant to admit they might have been wrong, the pressure group Diabetes UK that initiated those dietary changes three decades ago has recently and, without fanfare, changed the advice on its website from commending “5-to-14 portions of starchy foods a day” to “you may need to reduce your carb intake”.

http://www.telegraph.co.uk/

Graham