nermal

You live in a different America than I do? Food manufacturers and advertizers making low fat hight carb crap?
You mean the "Big Rice Mac"? Or "Tony's Tasty Potato Pizza"? How about "Oscar Meyer's Corn Plant Sweepin's Hot Dogs"?

No, it's those damn Baked Lay's Potato Chips you're talking about, right? Those are the culprits making us all fat! Damn our government for passing those off on us instead of the healthy grease-on-your-fingers ruffled potato chips and the wonderful see-through-the-greasy-wrapper fish sticks. Damn those low fat foods! Damn them all! That's exactly why the Chinese have been so obese all these years.

Ed

Nuno Figueira

Ketoacidosis only happens in total absence of insulin and in healthy people who don't suffer from insulin dependent diabetes ketoacidosis can't happen because the small insulin secretion caused by fats and protein is enough to keep you out of it.

I chalenge you to present ONE single piece of peer reviewed evidence showing a case of ketoacidosis resulting from a low carb diet. Even in prolonged starvation periods it's unlikely to be a problem.

Dune

I never said that it is a certainty to occur- I stated that it is a possibilty and needs to be monitored. PLUS diabetics USE THE low carb diet, so it is a valid concern for them.
I have had to help treat a patient with this condition. I am not going to post the chart, sorry.
Ketoacidosis can occur even with small amounts of insulin present. NOT the total absense of insulin, diabetics still often produce a small amount of insulin.

Nuno Figueira

Well, it's not a valid concern for healthy individuals so please be more accurate in the future and explain things properly.

Ketoacidosis doesn't have a place in the possible concerns against a low carb diet.

JGL53

Just some curious questions, since you apparently are a practicing clinical pharmacist, and I'm retired now - plus most of my career was either as an fraud investigator or as an administrator:

Do you see many diabetics who are chosing to go on low carb to control their diabetes - even against physicians's advice?

Are you seeing any diabetics actually being put on a low carb diet by their physician?

Without asking you to reveal any great details or confidential patient information (which you wouldn't do anyway), what is your personal overall evalutation of a low carb diet effects (positives and/or negatives) on the patients you see that have or are presently on low carb?

Dune

-Well, it's not a valid concern for healthy individuals so please be more accurate in the future and explain things properly. -

Yes it does. I have concern for any possible deadly condition, common or unlikey

-Ketoacidosis doesn't have a place in the possible concerns against a low carb diet.-
Is that your medical opinion?
.
Again- I had a patient who develped the conditions so dont attempt to tell me what is and isnt a valid health concern.
Plus- many diabetics are non diagnosed or borderline- and this could be VERY dangerous for them- since many patients do not consult their physician before attempting this diet. Plus there are other conditions that may be exascerbatated by an alteration in pH. Not everyone is as healthy as you seem to think they are.

Jgl53-
I have seen diabetic patients both attempt the diet without physicains advice (many are under the impression that it will "cure" their diabetes) and a couple of FNPs and NPs (and one MD) put diabetics on the low carb diet.
So far as I can tell, the low carb diet seems just fine so long as you monitor the ketones and otherwise work with a physician. I have had pateints gain remarkable results very quickly. I am unsure how many of them will do in the long run, but we shall see. Plus there is the patient who went overboard and developed the ketoacidosis. There has been a few other problems associated with decreased pH, serum albumin and some kidney function issues- but these patients had some problems before.
The CHD aspect still seems somewhat shakey to me, but anything that helps patients loose weight is a valuable tool. I think overall, I would say I have guarded good outlook. I just dont think it is any better than any diet so far, just a little quicker.
My major concern is the hype about it being free from any danger, can cure diabetes and is cardioprotective.

JGL53

If you are planning to try to break into professioanal comedy, Ed,
I recommend you don't give up your day job - just yet.

Let me see if I can analyze this in more detail so you won't get the urge to go back into your unfunny sarcasm routine:

A few decades back, before the great American obesity epidemic, the government 'recommended' reducing fat in the diet to below thirty per cent, and to eat 6 to 10 servings of starchy food daily. The government pyramid actually lists sugar up at the top as something one should limit.

But the government actually never pushed -or even mentioned - that fact much afterward - they just harped on reducing fat.

The food manufacturors subsequently produced food that the government 'recommended' - low fat food. And advertizing convinced people to eat fat free cookies, low fat pop tarts, reduced fat cheese and sour cream, non-fat milk, etc. Even candy was advertized as "fat free' - and all this was touted as 'heart healthy'.

The lay public got the message, chowed down on such crap and tried to avoid dietary fat as much as possible. But they didn't do such a good job of it, as you noted.

They tried to eat less red meat and eggs and butter, because they were told these were full of unhealthy saturated fat. But they fell of the wagon a lot, because it's hard to turn down such foods. Plus, they thought eating margarine was healthy, not understanding it was a fat with as many calories as butter. They thought eating french fries that were fried in vegetable oil was ok - hey, it was vegetable, not animal fat.

They ate loads of processed, refined, prepared, ready to eat crap, some of which is low fat, but much of which is loaded with hydrogenated vegetable oil. But this was supposed to be healthy, because it wasn't that horrible saturated animal fat.

I recently read a newspaper article (so it MUST be true) that a study shows that Americans eat about the same amount of fat today as they did five, ten. or twenty years ago. It's just that less of it is animal and more of it is vegetable oil, a lot of which is the unhealthly (as we now know) hydrogenated kind.

The study showed (allegedly) that our obesity epidemic actually comes from an extra average consumption of several hundred calories per day - in sugary soft drinks and sugary/starchy processed prepared foods.

So people have been eating a combination of unhealthy fats PLUS a ton more of sugar and refined starch. It's a double whammy.

But of course, as previously mentioned, this is all layed out in great detail in this (in)famous article:

http://www.lowcarb.ca/articlesb/article344.html

JGL53

Fair enough, my man. Certainly, many comparison studies need to be done.

Are you familiar with this study?

http://www.pslgroup.com/dg/10786a.htm

I know this study can be criticized (uh, Godot - how's it going, dude?) because of the small number of participants, but let me ask this: Are there any studies in existence that show the same or better results with the ADA recommended diet, as compared to Atkins or some other dietary plan?

Dune

I agree that the current food reccomendations by the ADA are, um, well....how do you put this lightly- misinformed, shall we say.
I would never propose to argue otherwise.

I havent been convinced the low-carb is any better than other dieting methods such as low fat, or low calorie yet.
But if adkins is what you like- spiffy. But, (like with all things) watch for the possible dangers. Dont be reactionary about them, but be aware.

The study is interesting, and mentions a very important fact about the acidosis- I like that. So the question is would these diabetics seen the same results by loosing the same amount of weight with another diet?

JGL53-
Administrator and fraud investigator? Man, those must have been rough jobs. I dont think you could pay me enough! I have almost more than I can handle manager wise with techs and the like! My hat is off to you!:notworthy

Nuno Figueira

Again I want to leave clear that ketoacidosis ONLY happens in insulin dependednt diabetics, rarely on alcoholics and after extreme and prolonged periods of starvation, but even then usually doesn't happen to a significant degree.

Ketoacidosis is not a concern for healthy individuals.