- advertisement -

Great article on Paleo

Discussion in 'Parents of Children with Type 1' started by Dave, Jan 8, 2014.

  1. Dave

    Dave Approved members

    Joined:
    Jun 19, 2013
    Messages:
    80
    https://myglu.org/articles/the-pale...mailer&utm_medium=email&utm_source=production

    GLU also has access to a really neat database where you can ask all kinds of questions. For example if you ask what percentage of kids have an a1c under 6, the database shows something like 1%. Using techniques like Ryan's (the above link) blood sugars can be normalized, a1c's drop dramatically and complications can be avoided (for example there are studies showing reduced cognition and children falling off their growth charts when they have elevated blood sugars - totally debunking the 'kids need carbs' argument - kids need normalized blood sugars!) Good luck and Aloha.
     
  2. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    The people at Glu are all adults. Not children.
     
  3. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    Good thing we intentionally keep my son's BGs high by feeding him a normal diet, then! He's 5'2" at 9 years old. He'd be a circus freak if we took your advice!

    Look, I've come to the conclusion that you must be a troll, because no one can be as stubborn and obtuse as you appear to be. At least I hope you are a troll, because putting a T1 child on the Paleo diet is seriously ****ed up, both with respect to that child's physical and mental health. But by all means, take "Ryan A's" advice over the advice of the ADA and the AMA and people who have actually, you know, done research on the subject. Aloha yourself, buddy.
     
    Last edited by a moderator: Jan 8, 2014
  4. MorgansDad

    MorgansDad Approved members

    Joined:
    Oct 13, 2011
    Messages:
    17
  5. funnygrl

    funnygrl Approved members

    Joined:
    Nov 2, 2005
    Messages:
    2,324
    I have to seriously question the validity of an article with such a bizarre statement like that. I love Glu, it's a great website, but "what the heck?" to this. Neanderthals did not have diabetes, obesity, and cancer because they lived to their 30's and had to work much harder to eat than us. They would have no idea if they had cancer because biopsies and microscopes and pathologists didn't exist. They'd have no way to know if they had diabetes because they'd just die. And it would be accepted. Because people died all the time. Because they lived to 35. If that. Any diet where you severely restrict your intake to a certain type of food will cause weight loss. There's been an article floating around lately where someone lost weight just eating McDonald's. When you cut out huge amounts of good you're bound to restrict caloric intake and lose weight, whether it's carbs, fats, or foods discovered after domestication.
     
  6. Jeff

    Jeff Founder, CWD

    Joined:
    Jun 1, 1995
    Messages:
    1,548
    Though I cannot find the citations at this moment, there is data looking at the impact of carbohydrate restriction on children, much of it from war and famine zones, and the results are not positive on the long term health of kids impacted.

    There are some very special circumstances in which kids are put on high fat, very low (or almost no) carbohydrates, including to treat epilepsy. There is however no data to support the use of severe carbohydrate restriction in kids with type 1 while they are still growing.

    Whether to restrict carbs as an adult is another matter altogether, with data supporting both sides of that argument.
     
  7. Dave

    Dave Approved members

    Joined:
    Jun 19, 2013
    Messages:
    80
    The GLU site has database access that does have a1c records for thousands of children. You can put a conditional into the database and search for a1cs in kids.

    We can agree to disagree with carbs from fruits - if I feed my child a banana and watch his g4 output, I am astonished how unhealthy the result is - but I suspect many parents on this site are giving kids lots and lots of empty calories - flour, sugar, juice. These do not 'help a child grow', they merely raise blood sugar.

    I suspect these third world children do not have a high calorie diet rich in good fats and protein as well as good vegetable carbohydrates. Fortunately we have access to all kinds of food that folks in the third world do not.

    You can call me a troll, I am merely pleading with folks to reconsider their child's high refined carbohydrate diets. Diabetes at its fundamental level is a disease of carbohydrate intolerance. High blood sugars lead to complications. A1cs even in the 6's are virtually guaranteed to lead to complications, and not necessarily later in life. Nothing I am saying is incorrect, these things are well known. If you are feeding your child lucky charms, chips, juice boxes and setting your child to bed at high numbers, you are doing it wrong. This is not a popular opinion, I realize that, but I think this site supports all points of views and I hope I can help others.
     
  8. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    Dave, you're obviously one of those know it all guys so I won't bother arguing with your solution - I will however tell you that you aren't even doing "it" yet. You think you are: you've got the technology and the dx and the prescriptions, but dude, you are just playing. "It" doesn't even come into play in a year, or even two. You're watching Sesame Street right now. When you're really doing "it", "it" will be more akin to reading Ulysses.
     
  9. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    But your problem is you aren't pleading. You get up on your high horse and lecture us on how to learn how to scramble eggs because it's what you think is the magic pill for us all. You don't appreciate others points of view, you chastise us for what we chose for our kids.

    You are new to this, year one is always tough. It's great that you have your son under such fantastic control. I'm curious as to how old he is. My daughter is 12, going through puberty and is like every other kid. We've taught her and her sister to make wise food choices, but she's not under our thumbs 24x7, so there are times when she doesn't make the best decisions. Do I worry and think "Oh my God, my kid is going to die because she ate refined sugar, flour and processed foods? She's going to loose her leg or need a kidney transplant by the time she's 21 because she ate a bowl of Lucky Charms on July 7, 2006?" No, I don't. 90% of the time she makes good choices. We try not to keep "fun" food in the house, but there are times we do. Do we curl up into a ball in fear because her BG went to 300? No. Are we concerned? Yes. But, we make sure her diet is well balanced and she exercises daily 90% of the time. Combined with visiting the endo 4+ times a year, I feel fairly confident that my child will live well past the cavemen.
     
  10. Jeff

    Jeff Founder, CWD

    Joined:
    Jun 1, 1995
    Messages:
    1,548
    Can you please provide citations to the data which support your claim that A1cs in the 6s are "virtually guaranteed to lead to complications"? Is that what your child's diabetes team is telling you?

    Based on all I have learned in the past 24+ years being involved in type 1 diabetes, I would argue that you are misinformed. The data show a continuing decline in complications beginning approximately around 1980, when home glucose monitoring became available. In fact, good data from Scandinavia, where countries have excellent registries, shows a dramatic decline in compilations, especially in kidney issues.

    Other studies, particularly analyses of the Pittsburgh Epidemiology of Diabetes Complications Study, show dramatic increases in average lifespan for people with type 1 diabetes -- in fact, rates of increase that dwarf gains seen for the the average American and which have led to what can certainly be argued is a normal life span for young people with type 1 diabetes today.

    And all of this has been accomplished without A1cs in the 5s, as you seem to seek to achieve. (The only group for whom such low A1cs is sought is women who are pregnant or planning to become pregnant.)

    I would argue that the science today shows that complications are not inevitable and are becoming rare and will be rarer still for young people with type 1 diabetes -- if they remain involved in their care. And by involved I do not mean an A1c in the 5s, but rather that checking blood sugar often matters (T1D Exchange data), pre-bolusing for meals matters a lot (20 minutes pre meal at least; see http://www.ncbi.nlm.nih.gov/pubmed/20151766), blousing for every meal (especially breakfast), pumps and sensors make a difference, be open to non-insulin adjunctive therapy (GLP-1 agonists, SGLT-2 inhibitors [both off-label in type 1, and I realize there is debate about these]), and finding support is critically important to success.

    And that doesn't even take into account the incredible progress being made on closing the loop, which will provide very good control and a dramatic reduction in the risk of hypoglycemia -- the limiting factor on tight control for anyone past their honeymoon period.

    Just a couple of studies to read that illustrate the changing landscape of complications:

    Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease
    http://www.ncbi.nlm.nih.gov/pubmed/16505502
    (Compare to pre-1980, when, according to a noted pediatric endo, the risk of developing kidney disease with 10-20 years of diagnosis was roughly 50%)

    In the absence of renal disease, 20 year mortality risk in type 1 diabetes is comparable to that of the general population: a report from the Pittsburgh Epidemiology of Diabetes Complications Study.
    (With study above as background, this study is all the more interesting)
    http://www.ncbi.nlm.nih.gov/pubmed/20665208

    Improvements in the life expectancy of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications study cohort
    (This is especially interesting if you extrapolate the data to today from their end point of 1980)
    http://www.ncbi.nlm.nih.gov/pubmed/22851572
     
  11. emm142

    emm142 Approved members

    Joined:
    Sep 7, 2008
    Messages:
    6,883
    Not really replying to this, just wanted to say thanks for the laugh.

    I think it's sort of problematic to look at data from children exposed to war and famine and draw conclusions about children who are raised in nonviolent environments with plentiful access to fat and protein. Evidence of the ketogenic diet in childhood epilepsy seems really good to me, and in that case the value of minimising brain damage and other lack of functionality (due to seizures) really outweighs any potential health risk (which, to be frank, seem pretty low). Given that some children with type 1 have regular seizures or don't function well due to severe and recurrent low blood sugars or DKA, to be honest I think there are some cases where a very low carb, paleo diet might be helpful.


    However, such a diet would only work if absolutely everybody involved was 100% on board. It goes against the common diet for most of the modern world, and would require a child to have extreme self-control with their peers, and likely for the entire family to make extreme dietary modifications which didn't necessarily help them. I don't think going paleo works halfheartedly. From what I've read, cutting out carbohydrates reduces the cholesterol-raising effects of fat, which is great, and means that the paleo diet can work for a lot of people without them having incredibly unhealthy cholesterol levels. BUT that is only the case if you go high fat without carbs. I think that means it wouldn't be feasible to do paleo-except-school or paleo-except-parties etc... So I think it's very few children who both needed and were able to do the paleo diet.

    You're wrong. Carbs can and do help children grow, as do fat and protein. All calories create growth - whether that growth is created equal is another question, but it's completely misleading to say that flour doesn't aid growth...

    Diabetes isn't a disease of carbohydrate intolerance, it's a disease where insulin isn't produced. Insulin doesn't enable one to "tolerate" carbohydrates, it just moves the glucose from the bloodstream to the cells. If we could mimic a non-diabetic's pancreatic function with exogenous insulin, we could tolerate carbs just as well as them. And if we had no insulin at all then we would die, regardless of how few carbs we ate. Anyway, given that we can't mimic a non-diabetic's pancreatic function, I'm inclined to agree with you that for some people paleo can result in lower a1cs. However, they are not always below 6. Your child is likely in the initial, 'easier' (in the respect of still having some endogenous insulin) phase of diabetes - a lot of us have found it a lot harder after a few years. Not trying to make you feel bad about your child's future, but please stop being so judgmental of the other members here. You have no idea what any one of us faces on a daily basis and to tell a bunch of parents that their child's a1c is "virtually guaranteed" to lead to complications is complete BS. There have been no studies on the long-term outcomes of people using modern-day diabetes treatment since childhood, because, guess what? Those people are still kids, and haven't grown up yet! You simply cannot tell people that they are doing it wrong when nobody knows what right and wrong are. Your way might work for you right now, but that doesn't mean that it will work for everyone, forever.

    You also might want to take some time to think about your child's psychological health. Food has really high cultural significance (don't think that's necessarily ideal, but it is a fact) and restricting a child is likely to make them want to rebel. You might be setting yourself up for some tough teenage years...

    Just wanted to give this a +1. Anyone who thinks they have a perfect method which will work for everyone is most likely wrong, and needs to reconsider themselves and understand that this site is full of dedicating, caring parents, who wouldn't do anything that they thought was harmful for their kids.

    -------------

    Just wanted to give my own experience, in case anyone is interested. Since I was 11 I had been pesce-lacto-ovo-vegetarian (ate fish, milk products, eggs and veggies). I ate a very high wholegrain diet. After diagnosis at 14, my a1c was 7.5-8 for a year on MDI, then went down to 6.5-7 for two years on the pump. After year 3 it slowly crept through the 7s and 8s until this year it hit 8.9 and I decided to go back to eating meat (independent events, I just really wanted some chicken). My daily carbs have gone from about 200g to around 100g, I've gained weight but gotten a lot more muscular (4 abs now visible, despite gaining around 12lbs, so the gain must have been predominantly muscle) and now find exercise significantly easier. Eating a zero carb breakfast and cutting out carb snacks before bed has done absolute wonders for my BGs. I'm aiming to go back to vegetarianism at some point so will likely never be paleo, but adding protein and fat to my diet, and removing carbs, has made diabetes control easier and improved my fitness. I imagine my a1c will be back below 8 at the next check. I'm not evangelical about it but it has helped me and I imagine could help even some children with D to go to a lower carb diet. Not all, but some.
     
  12. Ellen

    Ellen Senior Member

    Joined:
    Oct 22, 2005
    Messages:
    8,240
    I'll toss in one more re low A1c's

    EURODIAB: High, low HbA1c levels increased risk for all-cause mortality


    ..."Moreover, both low HbA1c (<5.6%; HR=1.31; 95% CI, 0.67-2.42) and high HbA1c (>11.8%; HR=1.86; 95% CI, 1.12-3.05) were associated with an increased risk for all-cause mortality compared with the reference (8.1%), according to data."...

    abstract here:
    Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB Prospective Complications Study



    Danielle A.J.M. Schoenaker, Dominique Simon, Nish Chaturvedi, John H. Fuller, Sabita S. Soedamah-Muthu, and EURODIAB Prospective Complications Study Group
    Received: July 11, 2013
    Accepted: December 13, 2013
    Published Online: January 01, 2014



    Abstract

    Context:


    Glycemic targets and the benefit of intensive glucose control are currently under debate as intensive glycemic control has been suggested to have negative effects on mortality risk in type 2 diabetes patients.

    Objective:


    We examined the association between glycated hemoglobin (HbA[SUB]1c[/SUB]) and all-cause mortality in patients with type 1 diabetes mellitus.

    Design, Setting, and Patients:


    A clinic-based prospective cohort study was performed in 2,764 European patients with type 1 diabetes aged 15–60 years enrolled in the EURODIAB Prospective Complications Study.

    Outcome measure:


    Possible non-linearity of the association between HbA[SUB]1c[/SUB] and all-cause mortality was examined using multivariable restricted cubic spline regression using three (at HbA[SUB]1c[/SUB] 5.6, 7.1, 8.1, 9.5 and 11.8%) and five knots (additionally at HbA[SUB]1c[/SUB] 7.1 and 9.5%). Mortality data were collected ~7 years after baseline examination.

    Results:


    HbA[SUB]1c[/SUB] was related to all-cause mortality in a non-linear manner after adjustment for age and sex. All-cause mortality risk was increased at both low (5.6%) and high (11.8%) HbA[SUB]1c[/SUB] compared to the reference (median HbA[SUB]1c[/SUB]: 8.1%) following a U-shaped association (P overall effect=0.008 and 0.04, P non-linearity=0.03 and 0.11 (three and five knots, respectively)).

    Conclusions:


    Results from our study in type 1 diabetes patients suggest that target HbA[SUB]1c[/SUB] below a certain threshold may not be appropriate in this population. We recognize that these low HbA[SUB]1c[/SUB] levels may be related to anemia, renal insufficiency, infection, or other factors not available in our database. If our data are confirmed, the potential mechanisms underlying this increased mortality risk among those with low HbA[SUB]1c[/SUB] will need further study


    Affiliations

    • 1School of Population Health, University of Queensland, Brisbane, Queensland, Australia
    • 2Diabetes Department, la Pitié Hospital and University Pierre et Marie Curie, Paris, and INSERM CESP, U-1018, Villejuif, France
    • 3National Heart and Lung Institute, Imperial College London, London, UK
    • 4Department of Epidemiology and Public Health, University College London, London, UK
    • 5Division of Human Nutrition, Wageningen University, Wageningen, Netherlands




     
  13. KatieSue

    KatieSue Approved members

    Joined:
    Oct 5, 2010
    Messages:
    921
    A few honest questions for Dave.

    If you're seeking such tight control I'm going to assume you have lows as well as highs. How do you treat the lows without carbs?

    Has your child had an illness yet? We've had a few, strep was the worst, that meant we had highs for days even with corrections and basal increases. As a result that quarters A1C had a higher result. Just Monday she was in the low 200's almost all night, that's after corrections and basal increases. Woke up and threw up then stayed in the low 200's all day. Will these kinds of things in your opinion result in my child say loosing a leg because her bg is higher than wanted for a few days?

    How do you handle parties at school for your child.? Or things like birthday parties? Do you not allow your child to participate?
     
  14. RomeoEcho

    RomeoEcho Approved members

    Joined:
    Dec 22, 2008
    Messages:
    483
    Mostly unrelated to the rest of the thread, however, the cultural significance of food in most populations increases overall health. One of the problems with the modern western diet is how detatched we've gotten from the act of eating. Eating cultural foods in a ritualistic manner, with community is generally associated with a higher overall health and lower incidence of modern first world diseases. This isn't to say that eating fruit loops because your peers are is the right answer, just that cultural significance of food doesn't have to be bad, if it's of a traditional significance.
     
  15. emm142

    emm142 Approved members

    Joined:
    Sep 7, 2008
    Messages:
    6,883
    That's really interesting to know, thanks for pointing it out. I mostly eat pizza in mass-pizza-eating sessions with a whole bunch of my friends, hopefully that makes it an overall more healthy activity! (Slightly tongue in cheek, but it does make sense. I think savouring your food makes you more aware of how much you've eaten, and how much you need.)
     
  16. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    I, too, would LOVE a cite for your assertion that a1cs in the 6s are virtually guaranteed to lead to complications. Since that is so "well-known" and all. And I would also love to hear your thoughts on the studies that show that our kids are more prone to cardiovascular disease than the general population. Also, what about the study that Ellen linked that shows higher mortality rates with both very high and very low a1cs? Because I think you have a honeymooning child with a very restricted diet and are making up stuff as you go along to feed your ego at being so "good" at this, while simply ignoring every bit of information that contradicts what you've decided is the One True Way to treat diabetes.

    All of our kids have "problem" foods that are ridiculously hard to dose for. But really, through trial and error and using the tools at our disposal, it's possible to dose reasonably well for most foods. I'm baffled as to why you would choose to feed your kid bacon on a daily basis, as opposed to taking a bit of time and effort to figure out how to dose for some healthy alternatives. And by the way, chastizing the members of this board for feeding our kids unhealthy diets, while advocating for a bacon and eggs regimen is just laughable.

    Your arrogance on this topic is so off-putting that even if you have something reasonable to add to the conversation, no one is going to listen to you. You joined this board and immediately started treating the other posters (who are honestly the 5 star, gold medal, cream of the crop of D parents) as if we were all total morons who didn't have a clue when it came to this disease. I'll tell you what, Dave, you don't even know what you don't know yet, and I'm not even really ashamed to admit that I will enjoy it a bit too much when D kicks you in the junk, as it will.
     
    Last edited: Jan 8, 2014
  17. Christopher

    Christopher Approved members

    Joined:
    Nov 20, 2007
    Messages:
    6,771
    Unfortunately, I have some bad news for you Dave. You aren’t helping anyone. And the members here have tried to tell you that over and over. Your perspective is way off, your posts are full of misinformation, and (worst of all) you refuse to listen to the growing choir of voices telling you to stop. Your misdirected focus about carbohydrates being the root of all evil has put blinders on you so that you can’t see anything else but that one, incorrect point.

    So not only are you not helping anyone, you might actually be harming people here. Most likely newly dx parents who read the ridiculous nonsense that you spout and may just believe it. And I am afraid the one person you are hurting the most is your son, and that is very sad indeed.
     
  18. GChick

    GChick Approved members

    Joined:
    Nov 9, 2013
    Messages:
    213
    I think you are spot on with this. While I do not think Dave's ideas are 100% off the mark (I do believe they are indeed "off the mark" .. but not horribly so) and there are some things in his suggestions that might work for those having very specific troubles. I think what may be problematic is for him to think that low/no carb to be the standard for good diabetes care in all. Also if his son doesnt get down how to deal with "bad" high carb food, he will be in some problems when life gets a little more "real" and a little more out of daddy's hands.

    If restricting has worked well for your son and he doesn't feel as though he is severely missing out, then good for you and good for him. That is honestly great! But while your advice may work and low/no carb may be a good way to go for SOME... I just think your tact may be what needs some work, not the advice itself.

    Note: While you may think you have read enough to understand everything, fact is you are just starting and will realize how much things will change for your son over time... this is all coming from a diabetic that has had diabetes for over 31 years and did not have her first A1c until she was about 4 years into having diabetes and the next A1c was about 9 years after that and the next 4 years after that and has no measurable complications and while "watching" carbs has always been a part of life, eliminating/severe restricting has never been a part of life and shouldn't be the only goal to good control (note: I started getting regular A1cs after I turned 20 or so... half of that was due to lack of access in my country and the other half due to ignorance/lack of education)... this is also just to say that A1cs while an extremely useful tool are not to be the end all predictor of complications... no matter the level (well... the level does matter up to a certain point... but certainly not the strict "in the 6s" that you think it does).
     
    Last edited: Jan 8, 2014
  19. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Back before the discovery of insulin, when diabetes was a fatal disease, people with diabetes were put on lettuce "starvation" diets as a last ditch effort to keep them alive. These were diets highly restricted in calories and virtually no carbohydrates. Lettuce.

    You know what happened to these people? They died anyway.

    If diabetes was nothing more than a "disease of carbohydrate intolerance", then the lettuce diets would have kept people alive. Further, if diabetes was nothing more than "disease of carbohydrate intolerance" then eating your beloved bacon and eggs would have no effect on blood sugar, and any fool (or expert) will tell you that protein and fat play a big role , which is why your suggestions make zero sense.

    Just one example:
    http://care.diabetesjournals.org/content/early/2013/10/22/dc13-1195
     
  20. Lakeman

    Lakeman Approved members

    Joined:
    Nov 10, 2010
    Messages:
    956
    I didnt get a chance to see the database but the site looks like it may have an interesting perspective and I might check it out in the future.

    It was great to see Ryan's CGM and to read his comment and to see what I would describe as a flat line referred to as typical. I would even go so far as to describe it as normal. I have no doubt that having flat lines would be good for one and think that each and every day that one has a flat line would be incrementally and cumulatively better than each and every day that it is not flat. From what I have learned about A1C's each reduction toward normal should result in less complications. Of course, excessive lows are probably not good and it is no easy feat to achieve normal BG without also having lows. I personally fear lows less than highs but each person must strike their own balance or find their own way.

    I would not say that the consequences of elevated BG means that kids don't need carbs. It simply means that kids should not be high. That being said it is probably true that the standard american diet does have way too many carbs and reducing the number of carbs and especially poor sources of those carbs would be good for kids. Should carbs be reduced to near zero? Well, we were given a pancreas for a reason. I doubt one could go wrong consuming all ones carbs from vegetables and occasional fruits. Most of us in this culture just can't do that and it must remain a goal.

    Thank you for sharing enthusiastically and I hope you find what works for you.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice