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Where Is The ‘Hope’ For Diabetics, Ms. Warshaw?

One of the things I try really hard to avoid doing at my blog is making the subject of my criticisms the people and personalities involved rather than the issue at hand. But in the case of registered dietitian and self-proclaimed diabetes “expert” Hope Warshaw, I have to make an exception because she has crossed the line into causing more harm than good with her irresponsible advice for people living with Type 2 diabetes. As my buddy Steve Cooksey from the “Diabetes Warrior” blog so succinctly put it at the beginning of an April 2011 post about her, “Has any ADA Minion harmed as many people as Hope Warshaw?” The pure arrogance and condescension this woman puts on full display every time she writes or speaks about what is best for diabetics to control their disease is sickening. And when you bring up the subject of low-carbohydrate nutrition for Type 2 diabetics to naturally controlling blood sugar and insulin levels with little to no drug therapy, the woman seems to lose all sense of rationality and civility. In fact, I’d dare say she’s downright clueless for being touted as a top “educator” on behalf of the principles promoted by the American Diabetes Association–the leading advocate for diabetes education in the United States. They ought to be ashamed of themselves for associating themselves with the reckless views this lady is espousing.

The social networking sites and blogosphere lit up like a Christmas tree last week when a top diabetes magazine published a column by Warshaw about the supposed “new realities” of living with Type 2 diabetes. It appeared in the June 28, 2011 issue of Diabetes Health and was titled Type 2 Diabetes: From Old Dogmas to New Realities – Part 2. In that column, Warshaw explained that we know more about treating and controlling Type 2 diabetes now than just a decade ago and that these “new realities” have replaced the “old dogmas” about how to best deal with this disease. She focused specifically on the “two most common old dogmas” and why she believes they’re no longer relevant. The first one was about losing weight to bring blood sugar down which she says has been trumped by the use of medications from the get-go for people with diabetes. As if that were bad enough, you’re not gonna believe what the second one was. Try not to bang your head against the wall too hard as you read this:

Old Dogma: People with type 2 diabetes should follow a low carbohydrate diet.

New Reality: Nutrition recommendations for people with type 2 diabetes from the American Diabetes Association and other health authorities echo the recently unveiled U.S. 2010 Dietary Guidelines (1/31/11) for carbohydrate: about 45 to 65 percent of calories. (Americans currently eat about 45 to 50 percent of calories as carbohydrate–not a “high carb” intake.)

Countless research studies do not show long term (greater than six months to a year) benefit of low carb diets on blood glucose, weight control, or blood fats. People with type 2 diabetes, like the general public, should lighten up on added sugars and sweets (yes, they’re carbohydrate). They should eat sufficient amounts of fruits, vegetables, whole grains, and low fat dairy foods–all healthy sources of carbohydrate.

Bottom line: The most important new reality for prediabetes and type 2 diabetes is: Take action as early as possible after diagnosis. Don’t delay, don’t deny. Get and keep your blood glucose, blood pressure, and blood cholesterol into recommended target zones.

Ummm, really Ms. Warshaw? Has it come to this now after all we’ve learned in the past decade from people like Dr. Richard Bernstein, Gary Taubes and others about what impacts blood sugar? To paraphrase a famous line from the 1992 U.S. presidential campaign, “It’s the carbs, stupid!” Anyone who thinks Type 2 diabetics should NOT be lowering their carbohydrate intake shows an obvious ignorance about the carb connection to blood sugar. Here are some cold hard facts and stark “realities” that Hope Warshaw needs to learn if she’s going to continue spouting information for people living with Type 2 diabetes:

  • The 2010 Dietary Guidelines is not based on science
  • A diet consisting of 45% or more carbohydrate IS a “high-carb diet”
  • Research from Gardner, Shai, Foster and others has proven low-carb
  • Low-carb diets effectively control blood sugars
  • Encouraging carb consumption for diabetics makes the disease worse
  • Sugary fruits, starchy veggies, and whole grains increase blood sugars
  • Any food that spikes blood sugar cannot be described as “healthy”
  • Low-fat dairy contains more lactose that will raise blood sugars
  • High-carb diets demand the use of more medications and insulin
  • Eating carbohydrates WILL raise blood glucose levels
  • Eating carbohydrates WILL require medication
  • Reducing medication should be a sign of improvement for diabetics
  • Diabetes is a metabolic disease that require a metabolic response
  • There is no biological need for carbohydrate, especially for diabetics
  • Glucose can be supplied to the body through gluconeogenesis
  • The diabetes epidemic has been made worse by the high-carb, low-fat diet
  • If the low-carb diet was a diabetes drug, it’d rake in billions annually

    Of course, I honestly believe Hope Warshaw knows all of this and is simply saying what needs to be said so she can keep her cushy position as a bona fide diabetes “expert.” But the gig is almost up and there will be a heavy price to pay to her reputation as Type 2 diabetics realize they have been lied to. Perhaps Warshaw honestly believes in her heart of hearts that the answer to treating diabetes is indeed more and more medication. Yet it would seem to me that if there were a way to control blood sugar levels, lower A1c numbers, and get this disease under control WITHOUT medication, why wouldn’t you shout it from the rooftops and to everyone dealing with Type 2 diabetes? It’s rather conspicuous that Warshaw would describe a low-carb diet as “old dogma” and replace it with her “new reality” recommendation of more carbohydrates which will then require more medications to cover up. Am I missing something here? Cue the Twilight Zone music and Rod Serling.

    Hope Warshaw has been at this nonsensical promotion of high-carb, low-fat approach for a while and is proud of it too. She is a big believer in the carbohydrate recommendations in the 2010 Dietary Guidelines while ignoring the countless success stories of Type 2 diabetics who have cut the carbs and experienced superior blood sugar control. Wanna good laugh at just how far off the deep end Warshaw has become? Check out this classic debate she had with the legendary low-carb physician and genuine diabetes expert Dr. Richard Bernstein in September 2006 on dLife:


    http://youtu.be/3PZno7Nkuuw

    As I stated earlier, the blogosphere has been going berserk over Warshaw’s column with so many people chiming in about how insane it is for a diabetes leader to be telling people with Type 2 diabetes to eat MORE carbohydrates while taking higher doses of medications to cover it up. Here are just a few examples of the passionate outrage that has been floating around out there:

    - Laurie Cagnassola
    - Fred Hahn
    - Ramona Denton
    - TuDiabetes
    - Diabetes Forum
    - Inner Carnivore
    - Tom Naughton
    - April Smith

    Do you think comments like any of these shared in the columns above made it through the editorial desk at Diabetes Health? Actually not at all. Well, not publicly anyway. But they did get the comments and they heard them loud and clear in many “strongly worded” responses from people in the low-carb community according to Publisher/Editor-In-Chief/Founder of the magazine named Nadia Al-Samarrie. Rather than addressing the concerns raised by low-carbers who have controlled their diabetes through a healthy high-fat, moderate protein, low-carb diet, Al-Samarrie instead simply circled the wagons around Hope Warshaw in a snippy response article published today entitled “Righteous About a Diabetes Diet” where she defended Warshaw’s promotion of more carbohydrates for people with Type 2 diabetes. UGH! Ironically, she uses her defense and promotion of Dr. Bernstein and the late, great Dr. Robert C. Atkins two decades ago as proof they do not have a bias against low-carb nutrition for people with diabetes.

    While that may be true that Diabetes Health defended low-carb previously, that was then and this is now. Al-Samarrie said they ran Warshaw’s column because “we believe that people could benefit from it.” Riddle me this Batman: How will Type 2 diabetics being told to consume more than half of their calories in the form of carbohydrates which will raise their blood glucose levels to the degree that they’ll need to take medications and insulin to bring them back down again actually “benefit” from this advice, Ms. Al-Samarrie? That doesn’t make any sense at all. While I agree there is no one-size-fits-all diet for most people trying to lose weight, diabetes is a whole different creature altogether. It is by very definition a disease of carbohydrate intolerance. Thus, low-carb diets don’t just become a simple choice in order to best control diabetes. They are an absolute necessity!

    Rather than calming the firestorm that began when Warshaw published her original column last week, Al-Samarrie has instead just poured a big bucket of gasoline on it with this ridiculous response. It’s unfortunate she chose to take the tone she did to some genuinely serious concerns brought up by those of us who espouse carbohydrate-restricted nutrition for best controlling diabetes. Perhaps hearing from a few more of my readers who have had experience trying the Warshaw methodology of consuming more and more carbohydrates while taking medications only to see their disease get worse and worse can share with the Diabetes Health editorial staff how livin’ la vida low-carb has changed their lives forever by bringing their blood sugar numbers and A1c levels down, lowered or eliminated their need for diabetes medications and insulin, and gave them their life back. You can contact Nadia Al-Samarrie directly at editor@diabeteshealth.com or by leaving a comment at their Contact Us page. LET YOUR VOICE BE HEARD! Feel free to post your feedback for Diabetes Health in the comments section below.

    If you want to support an organization that actually cares about sharing the science supporting the use of carbohydrate-restriction for people with Type 2 diabetes, then you should consider becoming a member of The Nutrition & Metabolism Society (NMS) (check out the new and improved web site which I’ll be sharing more about with you soon). For a nominal donation as little as $10 for a Consumer Membership, you can help NMS combat this kind of conventional wisdom idiocy espoused by Diabetes Health by spreading what the real scientific evidence is showing about this remarkably healthy, delicious and nutritious way of eating. If we ever hope to take on the ADA and other low-carb antagonist groups, then we need to unite our voices behind organizations who will stand up for nutritional truths. That’s what NMS is all about. THANK YOU for your support!

    • Teri Fout

      I especially like the comment she makes in the video–”the research shows low carb diets don’t work”. Really Ms Warshaw? Could you please post which research you’er referring to?

      Its hard to believe she could write that article with a straight face. I say folllow the money…I bet she’s getting some compensation from Big Pharma for that sort of drivel. If she isn’t, she’s even dumber than the article indicates.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Prolly.

    • http://philosophyofweightmanagement.blogspot.com/ fred

      Who is paying her? Tom just told us where ADA money comes from. If it was from the same sources, she would be unemployed if she said low carb.

      More of the oldest profession.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Sickening.

    • Brenda Nolen

      Through a low carb way of eating I am now off all Type 2 diabetes meds. I’d love to hear her explain that away, especially since I’ve only lost 10 pounds and am very over weight. It took about 4 months for me stabilize my blood sugars by strictly eating low carb.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Yay Brenda!!!

      • William

        She would say that you’re atypical. Most people can’t live with such an “unpalatable” diet.

    • Jennifer Peacock

      Yet it would seem to me that if there were a way to control blood sugar levels, lower A1c numbers, and get this disease under control WITHOUT medication, why wouldn’t you shout it from the rooftops and to everyone dealing with Type 2 diabetes?

      Um…MONEY.

      Big Pharma and all the people from all these medical associations don’t make money from people who use diet and exercise to relieve, treat, cure diseases.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        True. But there’s that pesky Hippocratic oath thingy.

      • http://www.livecollarfree.com/ James Schipper

        Always follow the money. This woman is nothing more than a paid shill/salesperson. Go to the ADA website and look at their sponsors http://www.diabetes.org/donate/sponsor/our-corporate-supporters.html

        Every penny in her life comes directly from pharma and food companies. She recommends eating carbs from her bosses, then drugs from her other bosses to try to mask the damage from the carbs. Disgusting and criminal.

        They name the top-level supporters after Banting, who discovered insulin. But he is a distant relative of William Banting, who recommended a low-carb diet to control weight and diabetes LOL

        • http://www.livinlavidalowcarb.com Jimmy Moore

          Ironic eh?

        • http://mytotalgymtransformation.com Eric Schmitz

          The fact that they claim and use Banting’s name makes my blood seethe.

    • http://alternefit.wordpress.com Rachel

      You know, Jimmy, my husband is a diabetic…and has been talking about wanting to contribute to some diabetes charities…but he doesn’t want to give his hard earned money to people that promote sick care for diabetics…he suddenly came to the realization the other day…he said “You know, why would these places and people try to even cure diabetics when they are making so much money off of it…it would be putting themselves out of business.” I said to him, “You are right…that is why you do your research and give charity to places like Nutrition and Metabolism Society, Weston A. Price Foundation, or the Diabetes Warrior…there are many out there that are looking out for the health and well-being of the people…not their finances!” I bring this up because I think Hope Warshaw is out to keep her pocketbook healthy…not the people…along with the American Diabetes Association and many others…it is such a shame that they get such promotion with their ill advice and harmful ideas! I do hope that people like hope will eventually fall so that the public can truly be on the way to wellness! Keep spreading the good word! I will too!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        You nailed it Rachel!

    • Rich Trippeer

      As a type 2 diabetic that is finally beating the disease thanks to low carb, this makes me really, REALLY angry. She is literally killing people.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        That’s putting it nicely.

    • Dave

      Looks like the Empresses aren’t wearing any clothes! I don’t know which is worse, Hope’s article or Nadia’s pathetic defense of it! The level of carbs that Ms. Warshaw is promoting is higher than what the average American consumes (up to 65%)! BTW, the comment that I submitted hasn’t yet been published (and I doubt that it will).

      • http://www.livinlavidalowcarb.com Jimmy Moore

        The gig is up…it’s only a matter of time.

    • Anne

      Hope is a consultant for some food and nutrition companies http://www.hopewarshaw.com/services

      I will add my name to the long list of people who can lower blood glucose very nicely with a low carb diet. I use my glucometer as my guide. Her advice will help only the pharmaceutical companies and doctors who treat diabetic complications.

      I worked in an eye clinic for many years. The patients with type 2 diabetes would come in with horrible complications. I don’t think I remember any one saying their A1C was under 7. Actually, many had never heard of an A1C. If they checked their blood sugar they said they were told to check only upon awakening and before bed. Never after eating. With advice like that, no wonder they had so many complications. These are people who had seen diabetic educators too.

    • http://reemancini@san.rr.com Marie

      Two points. First, the “no long term results” arguement always kills me. If low carb eating produces such improved results in six months to a year, why would it not continue? IOW, they act as if at the end of a year all of a sudden horrible, evil things would happen to a body if continuing to eat low carb.

      Second, I wonder if either of these women would let a loved one, spouse or child, who suffered from diabetes, eat 45% (or more) of their daily diet in carbs.
      “Go ahead, honey, eat more bread. I have your insulin shot ready.”

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Awesome points!

    • http://www.fatthenfitnow.com Joe Leonardi

      It would seem to me that her continued employment and income comes from more and more people being “treated” for type II diabetes; so if that is the case then it would seem to be in her financial interest to push more and more people to stay type II diabetics. I’m just sayin’!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Yep

    • marilynb

      To quote Tom Naughton, “Head. Bang. On. Desk.”

      • http://www.lchf.com Katarina wikholm

        That is such an awesome expression. Being mindful both of head and desk, my personal equivalent response is Hyperventilating. In. Paper. Bag.

        • http://www.livinlavidalowcarb.com Jimmy Moore

          Hs ha!!!

    • PhilM

      My comment on Hope’s article seems to have been censored!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Yep!

    • tam

      As a first step, potatoes, bread, and cereal should be tread as what most people think butter or sugar should be treated as. Some very low percent of the diet.

    • Stephanie Urban

      Shame, shame! But then why do people fall for it? When you know that it hasn’t worked for you in the past, why would a diabetic listen to this? What because she works for ADA? Love of money can’t possibly the root of all evil, can it? Time to wake up, folks. Thanks for keeping up the fight!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        People are very trusting of authority figures.

    • Peter Silverman

      If you eat less carbs, you’ll have less blood sugar. But that’s different than whether you’re also affecting the insulin resistance or how your pancreas functions, which have to with the disease itself. And it’s not clear to me that those things are actually improving. In their new book, Volek and Phinney seem to be saying if you stop eating low carb, within hours or days your insulin resistance is back to what it was. So it kind of sounds like you’re not actually affecting the disease process by eating low carb, though eating low carb may still be a good idea even if it’s not curing you. Anyone: please let me know if I’m wrong, I’d rather be eating right than blogging right.

      • Rich Trippeer

        You are absolutely right, Peter. I have diabetes. I can never eat sweets and have them affect me the same way they would affect a non-diabetic. That said, a low carb diet allows me to to achieve normal blood sugars, which is of the highest importance. Diabetes is a word. People don’t die from diabetes – they die from complications due to diabetes, which can be abated with a low carb diet.

    • Jim T.

      Not to sound like a defender of what Ms. Warshaw wrote, but I checked the web sites of the Canadian, British, Irish, Australian, New Zealand, and French diabetes associations, and their dietary advice appeared to be basically the same.

      Group-think and intellectual laziness (which go hand-in-hand) can be more pernicious than outright willful corruption, and more difficult to overcome. It is likely that the members of the diabetes establishments in the English-speaking countries read the same journals (and peer-review each other’s articles), and go to the same conferences, and are personally acquainted with each other, and wind up thinking the same thoughts. This happens in many fields. Is Ms. Warshaw that much worse than the rest of her colleagues?

      Mr. Moore, would you consider asking her to be interviewed on your podcast? Your courtesy, and your ability to separate disagreement about an issue from the person promoting it, are exceptional. You would give her a fair chance to reply to your objections to her stance; your listeners can judge whether her replies are convincing. If it is possible to decrease the heat and increase the light, then some good would come of it. If she declines the opportunity, well, that would tell us something too.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Jim, I have asked her and would indeed give her a chance to speak. No response from her.

        • Alan

          Not surprising really, after all the heat over the last few days I imagine she will be keeping her head very low indeed. Not that she will be missed, we don’t need any more ignorant articles like that.

    • http://www.low-carb-news.blogspot.com Jennifer Eloff

      Really shocking! As far as Diabetes Health is concerned – don’t even get me started. Somebody there is not ethical at all and they treated me appallingly. My husband was up in arms. See, I worked for them for a period of time (for no money, just PR) but a new editor was hired and he was pro low-fat/higher carb. They put Marlene Koch (low fat/high carb/Splenda cookbook author)in my place without even giving me notice. The first I saw was a spread by Marlene in the new magazine. At the same time in the previous issue, they published several of my recipes without giving me credit at all – so no money and no PR either! Talk about adding insult to injury! Anyway, needless to say I completely lost respect for that magazine as they try to sit on the fence re low-fat or low-carb and so they deserve to be shot from both sides!!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        That’s terrible Jennifer.

    • vladex

      Low carb diet could maybe lessen the symptoms of the diabetes but could never really cure it as it is related to cortisol dysregulation which brings blood sugar up without any carbs. This is done so to give the brain uninterupted access to glucose in times of stress.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Never said low-carb would cure diabetes….but it does for all intents and purposes keep it under control as if you never had the disease.

    • Dan (aka Renegadediabetic)

      I’ve heard what she’s saying for the last 5 years since getting type 2 diabetes. It’s nothing new. She was saying the same thing when she debated Dr. Bernstein on dLife several years ago.

      The stardard dietary dogma for diabetics is low fat high carb, just as it is for everyone else. I can’t beleive she called low carb “old dogma.” What a crock. I had to find the “dogma” of low carb on my own.

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Is it the old old dogma or the new old dogma that makes the new dogma the old dogma? Is everyone thoroughly confused yet? That is the intended purpose of this Warshaw woman.

    • http://ingredients-mp.blogspot.com/ pjnoir

      Unfortunately I find most diabetics unwilling try a low carb diet as a way to control their diabetes and why not have the bread sticks and huge plate of pasta when you have a stick of Lantus in your purse or shirt pocket? Diabetes does NOT kill, like cancer does- it acts as a surrogate and allows other ghastly diseases to do the work. I’ve been on a low carb diet for a little over two years now and it dawned on me that besides dropping a lot of weight and getting my blood sugars under control- I lost about ten years of old age- try that with your drugs Warshaw!

    • http://plate-by-plate.com Penny

      I’m chiming in a bit late but thought it was important to point something out. Yes I completely agree that low carb is the way to go for diabetics but controling blood sugar levels is extemely important to prevent diabetic complications. This might mean using oral medication and even insulin.

      Every time your blood sugar levels are elevated for more than 2 hours it begins to damage the body. I think I remember reading a study somewhere that said small capilary damage took place in even less time than that but I’m not 100% sure. Small vessel damage contributes to many of the complications that diabetics experience so the quicker you control blood sugar levels the better. Following a low carb diet makes it easier to get levels under control versus a high carb diet such as the one recommended by the ADA. But some type of medication may be very important to help even if you follow a low carb diet. This ended up being the case for my mother.

      As a nurse with 18 years of med-surgical and long term care experience the effects I’ve seen from diabetic complications have made me rethink my career choice. I’ve recently returned to college to become a registered dietitian and plan to specialize in treating diabetics. Family and friends have asked why I don’t become a nurse practitioner since they make more money. Personally, I’d rather try to solve some of the terrible things I’ve seen than pass out antibiotics and cholesterol medication. And no….I will NOT be telling my patients to get 45 to 65% of their calories from carbs. This will be one dietitian who will be telling them low carb is the way to go!

      • http://www.livinlavidalowcarb.com Jimmy Moore

        Here here Penny!

    • http://www.diabetes-warrior.net/ Steve Cooksey

      Well said Jimmy.   Though we see signs of the “low carb” and “paleo” becoming more and more popular … it will not benefit the vast majority of diabetics until we can break the money ties of Big Pharma and Large Food Businesses …  and thanks for the ‘link love’. :)