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Mayo Clinic misleads or, is it just innocent diabetes ignorance?

by Fred Hahn on March 18, 2010

Rummaging through my daughter’s school book sale yesterday, I spied and dug out a copy of the Mayo Clinic’s: The Essential Diabetes Guide 2010. I reached into my pocket, pulled out a buck and paid the friendly but frazzled public school volunteer.

Flipping through it, I paused at Chapter 3, Developing a Healthy Eating Plan. As I turned the pages, I was instantly inundated with loads of colorful pictures of the kinds of foods the Mayo Clinic thinks people with diabetes should be eating. What struck me as odd was that almost every picture was of a carbohydrate – fruits, pasta, muffins, salads, tacos shells, whole grain bread, tortillas, and cereals. I found this intellectually disturbing.

Last time I checked, diabetes was a condition of carbohydrate intolerance. Not fat or protein intolerance, carbohydrate intolerance. In fact, the Mayo Clinic agrees with this definition in their guide book. On pages 8&9 it states:

The term diabetes refers to a group of diseases that affect the way your body uses blood glucose, commonly called blood sugar. If you have diabetes – no matter what type – it means you have too much glucose in your blood although the reasons why may differ…If you have diabetes, this process doesn’t work properly. Instead of being transported into your cells, excess glucose builds up in your bloodstream…

Well, the main reason why a person would have too much blood glucose is if they ate too much carbohydrate. If you don’t eat carbohydrate, you can’t have too much blood glucose.

But hey, let’s not sweat the details.

Interestingly, there isn’t a separate chapter on the causes of diabetes. The guide book discusses what diabetes is, the different types, signs, symptoms, risks, dangers, etc. but gives scant mention as to the causes. While they describe the pathology in the “Types” section, there is no specific chapter on why you might have developed diabetes in the first place. I find this curious. You’d think this would be the most important chapter to people interested in learning about the disease.

There is enormous discussion on how a diabetic can’t deal with blood sugar without ever talking about why there is so much sugar in a diabetic’s blood. They make it seem as if it’s just there – as if a diabetic wakes up in the morning with her blood full of glucose which apparently lasts all day long. Are diabetics followed around by little sugar goblins carrying hypos filled with glucose who secretly inject them with it?

Let’s now investigate why a diabetic’s blood is aswirl with sugar.

Take a look at the Mayo Clinic’s Healthy Weight Pyramid:

2010-03-16-mayoclinicweightpyramid.jpg

The bottom of their pyramid is fruits and vegetables (carbohydrates) all of which convert to glucose (except for the fiber) once digested. And for these two food groups, they allow the diabetic to eat an unlimited quantity of them. In other words, if you’re a diabetic and you fancy eating an entire bag of grapes and a half dozen carrots, you go girl.

Above this is section is a smaller section they call ‘carbohydrates,’ as if fruits and vegetables are not carbohydrates but some other form of macro-nutrient. Why not say “grain?” Why the separation? (Seems sort of sneaky to me.) For this food group, you could choose to eat eight servings of pasta if you like. Eight servings of pure sugar that is.

A sweet pattern is emerging, yes?

Above this is protein and dairy. Dairy can, and often does, contain a good deal of carbohydrate especially low fat dairy products such as skimmed milk which is what the Mayo Clinic endorses. Skimmed milk is mostly sugar. Take a look at the label on the back of your skim or low fat milk right now. Ah heck, why bother taking the time. Here’s the label below:

2010-03-17-labelskimmilk.gif

As you can see, a cup of skim milk is really just a cup of sugar in disguise. There’s 12 grams of carbohydrates and 11 grams of sugar in a single cup. The normal amount of circulating blood glucose in the typical adult is about a teaspoon or about 4 grams. Eleven grams of ingested sugar is twofold more circulating glucose than is normal. For someone without diabetes this might be easy to handle, but for someone with diabetes, this is nasty.

And while protein can raise insulin levels, it does not raise blood sugar which is the real danger. In fact, research done by Frank Nuttal (the man who has probably done the most research on high protein diets) says that protein (and fat) has no effect on blood glucose concentration in non-diabetics and decreases blood glucose in diabetics because of an increased insulin response. From the study:

Dietary glucose strongly stimulates insulin secretion…Fats most likely have little or no effect on either glucose or insulin. Finally, reducing the glucose content of the diet and increasing the protein and fat content should reduce the postprandial plasma glucose concentration in people with diabetes.

I guess the Mayo Clinic missed the memo. (Hat tip to Gary Taubes for bringing this to my attention.)

Near the top of the Mayo Clinic’s pyramid is fats – a critical macronutrient that does not increase blood glucose in the least. Fat is a veritable macronutrient savior for diabetics, if ever there was one. But for some reason the Mayo Clinic warns the diabetic to limit fats (even though there is no scientific evidence to warrant such a recommendation) in favor of carbohydrates – the macronutrient that increases blood glucose the most. (Pardon me while I go and scratch my head for an hour on this one.)

At the top of the pyramid is sweets – meaning pure sugar. That the Mayo Clinic would include sweets at all in their “healthy” food pyramid is very odd indeed. Imagine creating a “body health pyramid” and putting cigarettes at the top. “Limit to 1-2 servings daily.” ‘Nuff said on that.

So if you add it all up, we see that the Mayo Clinic, who tells us that diabetes is a problem of too much blood glucose (which we now know is caused by the ingestion of carbohydrates), suggests that the diabetic eat most of her calories as – drum roll please – carbohydrates! Rather than a dietary solution to diabetes, wouldn’t this instead be how one might cause it (type 2 specifically)?

Let us now take a moment of silence to honor the fallen diabetics who have succumbed to such a brilliant plan.

*

But I don’t find this situation funny at all, any more than you do. That’s why I wrote this post.

OK moving on. Let’s take a closer look as to what might be causing this deadly disconnect. I mean, surely the Mayo Clinic is made up of honest, caring people who want this terrible disease stopped dead in it’s tracks, right?

On page 9, the Mayo Clinic guide states:

When the level of insulin in your blood is high, such as after a meal,…

Something seems to be missing here, right? A word, perhaps? After a meal? After a meal of what pray tell? A meal of sausage? Nope. A meal of eggs cooked in pure lard? No. After a meal of – you guessed it – carbohydrate. Why the omission of the word carbohydrate? Here’s why.

On page 35, under the heading “What’s Healthy Eating?” we find a section called “Carbohydrates: The Foundation.” The foundation. See? Now we’re getting somewhere. Since the Mayo Clinic suggests that up to 65% of your calories should come from carbohydrates, it’s no wonder a diabetics blood sugar is “high after a meal…”

Had they said: “When the level of insulin in your blood is high, such as after a carbohydrate rich meal…” I’d venture to say that everyone would get it and type 2 diabetes would all but vanish from the Earth in a matter of months.

The Dietary Reference Intakes known as the DRI’s, generated by The Institute of Medicine, state the following:

The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed.

Zero means none. Zippo. Nada. Given this and knowing that diabetes is a disorder of glucose intolerance, how then, or rather, why then does the Mayo Clinic recommend that a diabetic eat so much carbohydrate when nary a gram is necessary at all?

So there you have it. And though this post has been a touch flippant here and there, please don’t take this information lightly. In the time it took you to read this, someone’s grandmother lost her eyesight and someone’s father lost his feet to diabetes. And all because no professional told them to severely limit their carbohydrate intake. On the contrary, grandma and dad were told to fill their bellies with them.

One has to wonder – does the Mayo Clinic want this country to be free of diabetes or riddled with it?

To sum up:

  • Diabetes is a condition of carbohydrate (blood glucose) intolerance
  • Carbohydrate is the food source that converts to glucose in your blood
  • Carbohydrate is not a necessary nutrient so long as adequate fat and protein are eaten
  • Fat and protein do not increase blood glucose (nor does fat contribute to heart disease)

Now, as a diabetic, what do you think you should be eating? As a non-diabetic wanting to avoid getting diabetes, what do you think you should be eating as well?

And if you are a diabetic, once you adopt a diet that is low in carbohydrate, you may no longer need your glucometer – or your medications.

What sorts of health care solutions is President Obama looking for? This sort I think.

The legendary humorist Mark Twain once said: “The truth is easy to kill but a lie well told is immortal.” The lie, or rather, the innocently ignorant fib the Mayo Clinic is telling diabetics is that you need to flood your blood with sugar in order to manage your diabetes. I’m sure once they release their old ideas and see the error of their ways, they’ll apologize to the American people and start recommending a low carbohydrate/sugar diet. They’ll have to or it could (and should) be considered a form of ‘malpractice.’

I think we now know the true dietary road to rid ourselves of this terrible disease. If I have helped even one person cure their diabetes with this post, I have done my job. Hopefully, I will have helped an entire nation. (But if this comes to pass, it’s no thanks to me…it’s thanks to science.) Please share this post with anyone you know who is diabetic. It will save their eyes, their limbs and perhaps their life.

For more information, please visit the Nutrition and Metabolism Society.

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I've been involved in exercise ever since I became a member of The Charles Atlas Club when I was 10 years old. In 1998, I founded and established Serious Strength on the Upper West Side of NYC. My clients include kids, seniors (and everyone in between), top CEOs, celebrities, bestselling authors, journalists and TV personalities.
my book. my Gym.

in Current Affairs, Health/Fitness, Nutrition · 28 comments

{ 1 trackback }

Stuff I have been reading this week- Sherzy.com
March 19, 2010 at 11:33 AM

{ 27 comments… read them below or add one }

Kim Eidson March 18, 2010 at 7:17 PM

Well written Fred! Particularly helpful for those Type II diabetics out there who can truly make a difference in their health and longevity by finding a provider who truly understands the disease and the fact that sugar is sugar no matter how you package it.

Fred Hahn March 18, 2010 at 7:25 PM

Thanks Kim. I hope people listen.

Kab March 19, 2010 at 12:39 AM

Thank you for a great post, Fred. I’ve said it before and I’ll say it again, if not for people like you willing to buck the these misguided organizations, diabetics like me would be dead. Many of them are… and many more will die before they begin hearing the truth about their condition and what to do about it.

Whenever I try to advise a fellow diabetic to eat fewer carbs, eat more meat and especially more fat, (as you know, based on my own success without any meds) I inevitably hear the same reason they refuse to change from a high-carb to a low-carb diet: “My doctor says I need to limit red meat, especially pork… I have to eat low-fat”. No mention at all about the carbs which they seem to believe they can eat quite freely even when I tell them that those are the foods that turn to glucose that cause their post-meal numbers to go above 140 sometimes as high as 200 … WITH meds! Nothing I can say deters them; they believe their doctors and that is that.

Worst of all they believe that the only reason their numbers are high is due to the “fact” that diabetes always “progresses and there is nothing that can stop it”; that eventually it will worsen all by itself no matter what. They always seem to be letting my contradicting information (although in my opinion, I would think it’s hopeful) go in one ear and out the other. I have never understood this very common disinterest (in LC and its enormous success) among diabetics. I was never like that — I searched out answers like a hound-dog when I first realized how bad my situation was. So it leaves me bewildered and I walk away wondering how much longer they’ll be around… or how much of them will still be around by the time they die. I do agree — what these organizations are doing is malpractice… no, actually it’s criminal or should be. They are committing murder by the millions. They are despicable.

Fred Hahn March 19, 2010 at 8:07 AM

Well it’s a grass roots effort. One by one we educate and hopefully a positive virus is spread.

Even if it were true that eating fat leads to heart disease, why diabetics are more afraid of heart disease (something they more than likely don’t have) then they are of diabetes – something they already DO HAVE is completely and utterly beyond me.

It’s sad that doctors don’t keep up on the nutritional literature. I know they can’t read everything but the idea that eating fat leads to heart disease is SO yesterdays news.

Gracie March 19, 2010 at 8:56 AM

I too am appalled that diabetics are not told to limit their carbs. I control my type 2 by keeping at 20 or less net carbs a day. And have a wonderful life. Too many people are losing body parts to consume their pasta. For me twinkies or toes is an easy pick.
Hugs,
G

Fred Hahn March 19, 2010 at 12:05 PM

That’s funny Gracie. Twinkies or toes. I should have titled the blog that!

Kab March 19, 2010 at 1:42 PM

“Even if it were true that eating fat leads to heart disease, why diabetics are more afraid of heart disease (something they more than likely don’t have) then they are of diabetes – something they already DO HAVE is completely and utterly beyond me.”

Fred, I’ve so often wondered this as well. But, I would guess that it’s because of the fat phobia that has overtaken the medical world for the last 40+ years. Too bad it was all based on a few people’s anti-fat and/or anti-meat agendas a long time ago; personal agendas that have unfortunately been supported (with our tax money) by our own government. It led us down the primrose path promising an end to heart disease but our national health has gotten worse and hasn’t stopped worsening. I’ve never seen so many obese (often sickly and on multiple meds) people in my life and grossly obese at that. It’s astounding. And all these poor people are told is “Don’t eat so much, limit your red meats, stay away from saturated fats altogether, eat plenty of fruits, vegetables, and whole grains and …. EXERCISE!” Can you imagine being 300+ pounds and told to exercise to lose weight?! I’d think my doctor had lost his mind… and I’d be right!

Even though obesity is terribly unhealthy in itself, in my opinion, the worst, most tragic consequence of these unfounded, scientifically unsupported ideologies is the death and damage to those with potential glucose problems (and apparently there are millions) it has left in its wake. While they show not one symptom of heart disease ( “high” cholesterol is NOT a symptom and has even been shown to be a totally unreliable “risk factor”), these medical practitioners are directing their diabetic patients to “lower their cholesterol” by eating a high-carb diet to which their diabetes (an actual, real, totally observable disease NOW) naturally responds by progressing. What else could happen under such inept management? They are increasing their Insulin Resistance (the reason almost all T2s develop diabetes) by keeping their blood soaked in sugar and thereby killing their beta-cells. I only have a BA in psychology, not exactly in the medical field yet, I understand this. How hard is this to comprehend for someone with a medical degree?

As far as doctors not being able to read everything… I suppose so but diabetes is so common a disease that we have every right to expect that every doctor be up on the latest about it. So many lives depend on it. However, I honestly believe it isn’t ignorance but their own biases that keep them behind the times. As you are so aware, there are basically three camps concerning “healthy” diets: low-fat, low-carb, and the “balanced” diet, an ambiguous term for those who cannot or will not decide which end of the diet spectrum is better. When you get down to it, among these misguidING professionals, it’s all about individual philosophy rather than truth.

Kab March 19, 2010 at 1:54 PM

Correction: After stating, “As you are so aware, there are basically three camps concerning “healthy” diets: low-fat, low-carb, and the “balanced” diet, an ambiguous term for those who cannot or will not decide which end of the diet spectrum is better.”, I meant to add:

Among these, only the low-carb can show evidence for the ability to lower glucose among diabetics without being on a starvation diet. Advising a diabetic to use the low-fat or balanced diet is irresponsible based on the clearly observable effect they have on blood glucose …. When you get down to it, among those misguidING professionals, it’s all about individual philosophy rather than truth.

Now it makes sense! lol

Gracie March 19, 2010 at 6:40 PM

Fred, that’s one of my tag lines, feel free to use it whenever you want!
Hugs,
G

Jenny March 20, 2010 at 10:36 AM

While I agree with the vast majority of what you said I do have to disagree with how you’ve grouped fruit and veggies into the same category has grains and agree with Mayo’s separation of them. As a diabetic I have found that I can eat 50-80 grams of carbs for a meal as long as they are fruit/veggie based and I will suffer little to no impact on my blood sugar. Now if that is a 40 grams of carbs from bread, pasta, etc my blood sugar sky rockets out of control….I suppose this can lead to the conclusion that fruit/veggies aren’t bad for diabetics but I prefer to send the message to my other diabetic friends that you should test, test, test, test your BS in order to see what works for you and that what your Dr or other sources of medical information are telling you might not work for you.

Fred Hahn March 20, 2010 at 10:45 AM

Hi Jenny –

I think you misunderstand. The Mayo Clinic separates them out of the carbohydrate category. Vegetables, fruits and grains are ALL carbs. I agree that veggies are the #1 go to carb and fruits are #2 with grains as the absolute worst food choice for diabetics. I was not suggesting nor did I say that people should not eat veggies.

No diabetic can tolerate grains or starch. Forget about individuality when it comes to this. A diabetic must stick to a VLC diet and refrain from grains altogether. That’s the cold hard fact of a diabetic life. Even if you’re not a diabetic grains should be avoided like the proverbial plague. They have no place in the human diet. Thanks for reading and commenting!

Jake March 20, 2010 at 12:31 PM

There is a huge disconnect between the successful diabetes patients and the diabetes treatment establishment.

Not only are successful diabetes patients ignoring what their doctors are telling them. They are laughing at the doctors’ advice to eat a high carb, low fat diet.

It is amazing to me how the diabetes treatment establishment can ignore the low carb revolution that is growing by leaps and bounds every day. Perhaps they see their livelihoods being threatened. And they probably are.

Auburn March 20, 2010 at 2:38 PM

I wonder how correct your fat doesn’t effect insulin position is. See the following article:
American Journal of Clinical Nutrition, Vol. 88, No. 3, 638-644, September 2008
© 2008 American Society for Nutrition

——————————————————————————–

ORIGINAL RESEARCH COMMUNICATION

Distinctive postprandial modulation of β cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids1,2,3,4
Sergio López1, Beatriz Bermúdez1, Yolanda M Pacheco1, José Villar1, Rocío Abia1 and Francisco JG Muriana1

Fred Hahn March 20, 2010 at 5:22 PM

Fat alone does not increase blood glucose. In the study you cited (here’s the fill text version):

http://www.ajcn.org/cgi/reprint/88/3/638

fat was mixed with carbohydrate. You either didn’t read the study or don’t realize that the deleterious effects of fat are ONLY seen in the presence of carbohydrate. Don’t y’all forget that now!

Fred Hahn March 20, 2010 at 5:23 PM

Oops left out the section:

“The subjects then ingested, within 15 min, a fat-rich
meal consisting of dietary fat [50 g/m2 body surface area of
butter, refined olive oil (ROO), high-palmitic sunflower oil
(HPSO) or a mixture of vegetable and fish oils (VEFO) along
with a portion of plain pasta (30 g/m2 body surface area), one
slice of brown bread, and one container of skim yogurt].”

Samantha Smith March 23, 2010 at 6:12 AM

Just happen to come across your website and have learned a lot. I’m taking care of my diabetic parents and these are all very helpful information.

Audley March 23, 2010 at 2:09 PM

Also check out the American Diabetes Assocation(diabetes.org) guidelines for food. They tell you if you plan correctly, that eating occasional sugar treats is OK for diabetics, or you don’t have to give up grains and sugar. (???? really?)
Goes back to an older post when I mentioned my diabetic doctor selling cookies at a holiday craft fair, telling me the same thing.
Like Jenny, I can eat a fair amount of veggies and some fruit, they don’t bother my blood sugars, but those grains…….another story.
Thanks again Fred for your posts. I’m sure your clients get this in person.

Fred Hahn March 23, 2010 at 3:08 PM

Samantha – Glad I could be of help.

Audley – Ditto. Some of my clients get it some don’t. Some people seem to like wo wallow in despair. You tell them there is a pretty simple solution to their diabetes and they say “I don’t know. My doctors says….” They don’t want to think for themselves. So sad.

Dustin M. March 24, 2010 at 6:04 PM

That is some great information that you dug up about diabetes and carbs. My brother is diabetic and will definitely forward this onto him also and how this plays an important factor in health.

Fred Hahn March 24, 2010 at 8:26 PM

Dustin – Glad I could be of service. I wish your brother well and if he allows science to be a candle in the dark for him, he will be well.

Eleanor M March 26, 2010 at 5:19 AM

I’m from the UK, so I’m not that familiar with the Mayo Clinic. But my Mum is diabetic (type II) and she’s been told by the nutrionist that she ‘needs to eat complex carbohydrate to mop up the sugar in her bloodstream’.

Seriously.

Because this utter rubbish is coming from her doctor and health officials, she won’t listen to me (passionate believer in LC lifestyle with first hand experience)… still, I’m stubborn. I’ll have another go when she comes down to visit next…

Amy Dungan March 29, 2010 at 11:53 AM

Great article Fred! I know too many people struggling to manage their diabetes because of bad advice. And since fat and low-carb diets in general have gotten so much bad press over the years, most of these people refuse to listen to me. I keep hoping someday something will click with them and they will give it a try. I’ll pass this post along and hopefully it will help open a few eyes.

Fred Hahn March 29, 2010 at 12:09 PM

Eleanor, after she eats the grains, take her blood sugar reading. Show her what the grains do! Then feed her a piece of steak. Take another reading. Viola!

Rob April 25, 2010 at 2:50 PM

If you’re eating a low carb diet, you aren’t getting enough nutrition. Fruits and vegetables are on the unlimited list for a reason – we need them for our bodies to properly work. The part of the pyramid about grains, dairy, and sweets should be removed. You don’t get diabetes from eating raw things full of nutrients. You get diabetes from eating shitty carbohydrates devoid of nutrition.

Like your glycogen levels being restored? Carbs do it best by far. Eat more fruits and veggies. Eat less meat. You will never get a sugar crash from fruit.

Richard Feinman May 9, 2010 at 2:26 PM

A fruit is not a vegetable. When I took a poll of the low-carbers forums, I found that the biggest change for most people was substantial increase in vegetables and substantial decrease in fruit. On average, per 100 grams, fruits have more calories, more carbohydrates, less potassium, fewer antioxidants and less fiber than vegetables. A fruit is not a vegetable. This seems pretty basic. If the experts at the Mayo Clinic don’t think this is important, you may have basis for your concern.

The paper (available without subscription): http://www.nutritionj.com/content/pdf/1475-2891-5-26.pdf

Fred Hahn May 9, 2010 at 2:41 PM

Rob you said:

“If you’re eating a low carb diet, you aren’t getting enough nutrition. ”

This statement is odd and is unfounded. As I mentioned in the article, The DRI’s are quite clear on this issue. Do you have research to counter what the National Academy of Sciences has found?

“Fruits and vegetables are on the unlimited list for a reason – we need them for our bodies to properly work. ”

Tell that to the Inuit, the Masai, and dozens of other cultures that rarely if ever ate plant matter.

“The part of the pyramid about grains, dairy, and sweets should be removed”

I agree – to a point.

“You don’t get diabetes from eating raw things full of nutrients. You get diabetes from eating shitty carbohydrates devoid of nutrition.”

Sort of.

“Like your glycogen levels being restored? Carbs do it best by far. Eat more fruits and veggies. Eat less meat. You will never get a sugar crash from fruit.”

Are you a vegetarian?

Scott August 13, 2010 at 10:06 AM

Hello Fred,

I found your blog after finally being diagnosed with glucose intolerance. During the past year (prior to my ‘official’ diagnosis) I did several ‘low-carb’ experiments to see if they would help with the problems I’ve had over the past decade or so (skin lesions, and joint swelling/muscle pain, among others). The results were encouraging to say the least. However, I have a couple of questions that I hope you won’t mind answering:

1) What’s the secret to feeling ‘full’ when eating this way? After about 4 days, I was so hungry I couldn’t stand it. It seemed that no matter how much I ate, I was always ready for more an hour later. Are there food choices along these lines that are key to having that ‘full’ feeling?

2) I seem to be different than many people I read about in that I am NOT overweight (though I was when I first began making diet/lifestyle changes 4 years ago). Currently, I weigh just under 130, and stand 5′8″ w/ a small frame (down from nearly 200 lbs in 2006). I’m afraid of losing any more weight, and would actually like to put on 10-15 lbs. Tips?

3) I have basically eliminated sweets and refined carbohydrates, but still eat things like steel-cut oatmeal. I was under the impression that this might be acceptable due to the fiber slowing down how quickly the body gets to the actual carbs, but after reading your blog, I’m questioning myself… Also eating dairy products like unsweetened yougurt or ricota cheese, which seemed to both be low in sugar and carbs? Again, I’m confused.

I realize there’s alot of back story here that may keep you from giving a complete answer, but I would be grateful for anything you’d be willing to share.

Thanks

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