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Wednesday 21 May 2014

Life With Type 2: Science Catches Up to Our Experiences

Scientists will tell you that they don't consider anecdotes-personal stories about something-to be evidence that establishes a fact. Say you have 10 people swear they've been abducted by aliens, and all of their descriptions of the kidnappers match. That still wouldn't be enough for scientists to declare that aliens are real. 
It would take other types of evidence, not just word of mouth, for the actual existence of aliens to be accepted as a plausible explanation for people's reported disappearances.
But personal experience does count for something, even if only to later inspire or goad scientists into investigating a phenomenon.  For example, take fat and carbohydrates. Mosttype 2s reading this (type 1s, too) will tell you from personal experience that the main source of their high blood sugar levels and weight gains is the consumption of too many carbohydrates. Yet their anecdotal observations about the clear relationship between carbs and type 2 symptoms have been dismissed for years by the diabetes establishment.
We've been told over and over that carbs are essential to our health, and that we can safely consume them as long as we eat complex forms that take the body longer to convert into sugar. We've also been told over and over, for more than 50 years now, that the main reason for eating carbs is to avoid eating fat, which we've been assured is the culprit behind cardiovascular disease.
Now the evidence is mounting that the fat-is-bad mantra is part of a myth built on bad science and a misperception of what it was that was causing the alarming increase in heart disease that medical experts began seeing in the 1950s.
That myth busting is at the heart of devastating takedown of the naughty fat school that appeared May 2 in the Wall Street Journal's "The Saturday Essay." Its headline read: "The Questionable Link Between Saturated Fat and Heart Disease-Are butter, cheese and steak really bad for you? The dubious science behind the anti-fat crusade."
The writer, Nina Teicholz, offers a 2,000-word analysis of how the public got manipulated into thinking that fat consumption was the main offender behind the spike in cardiovascular diseases. She tears into the flaws in the original research, including statistical samples that were too small and a failure to look at cultures (such as the French) where fat consumption was high yet incidences heart disease were relatively low.
At almost the same time as Teicholz's piece, the Toronto Star ran a short item on a Swedish study of 61 type 2 patients that was published recently in the Annals of Medicine. The patients were divided into two groups, one of which ate a low-carb diet while the other ate a low-fat diet. At study's end, though both groups had lost weight, the low-carb group showed substantially lower levels of inflammation than the low-fat group.
Inflammation, which diabetes delivers in spades, is a major factor in heart disease. If fat is the bad boy pop science says it is, then a low-carb diet, having to rely more on fat and protein for nutrition, would seemingly invite inflammation. But it didn't.  
Admittedly, a 61-person sample is very small, and you can't build a major conclusion on it. But the Swedish study joins the growing number of other studies that seem to exonerate fat and push suspicion increasingly onto carbohydrates.
We are seeing the end of a very long slog for people who've been pointing out carbs as the major perps in heart disease. One of them, Dr. Richard K. Bernstein, has been out shouting "truth to power" for years now. At first many dismissed him as a cantankerous outlier who had a grudge against the diabetes establishment. However, many people who sensed that the advice they were getting was off kilter began following Dr. Bernstein's advice, which in a nutshell was, stay away from carbs and don't worry so much about saturated fats.
As thousands of people started doing exactly that, the anecdotal evidence favoring low-carb diets began piling up. Eventually, the pressure from those testimonies led to further research on the question of carbohydrates in the diabetic diet.
So, yes, the stories we tell each other about type 2 don't carry much scientific weight. But they do have weight, nonetheless, however miniscule. And that weight adds up, to the point that somebody like a Dr. Bernstein or a science writer like Gary Taubes decides to test the conventional wisdom. If he can stick to his guns and persuasively make his case, he eventually becomes the focus of a "cloud of witnesses" who can vouch for what he's saying. When that happens, perceptions shift and the world for us type 2s becomes a different place.
Graham

3 comments:

Galina L. said...

I believe it is why most registered dietitians dismiss Dr. Bernstein's theory - his books are grounded in clinical experience, not in a scientific research. As far as I remember, is was what Hope Warsaw said in her interview which I happened to read a while ago.

Almond said...

The paradigm is shifting.... Better late than never, I suppose.

JanKnitz said...

It's often easier to tell your doctor you are following the Diabetic Associations low fat, high carb diet than tell them what you are really doing to keep your diabetes under control. But that just perpetuates the myth that the prescribed diet works. I think it's time for us to at least let our doctors know that our good results come from doing the opposite of what we are told.