Wednesday, November 16, 2005

It's Not Magic - It's Metabolism

Today, in the journal Nutrition & Metabolism, researchers published findings that can only be considered one of those rare moments in scientific discovery - Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction.

In a review of the medical literature about low-carb diets, researchers found something that's been there, in the published data, all along - the list of things carbohydrate restriction improves happens to be the same list of features a patient presents with in the diagnosis of Metabolic Syndrome, a cluster of metabolic markers that increase the risk of diabetes, stroke and heart disease: obesity, high triglycerides, low HDL ("good" cholesterol), high blood sugar, high blood pressure and insulin resistance.

"It's been staring us in the face for years," said Dr. Richard Feinman, PhD, of SUNY Downstate. "Now we've connected the dots."

Now that may not seem like much, but when you consider that in recent months there has been dissent and question about the definition, diagnosis and treatment of Metabolic Syndrome, from some of the leading medical organizations, this is a big deal.

As Jeff Volek, PhD, RD, lead researcher from the University of Connecticut, Storrs said, "Make a list of the features of metabolic syndrome, then, make a list of the things that carbohydrate restriction is good at fixing. They're the same list. Somehow, we never really noticed that. We know the cause of metabolic syndrome is often linked to disruption of insulin. Thus, the key to treating metabolic syndrome is to control insulin, and carbohydrates are the major stimulus for insulin."

The findings of this study should help in establishing a firm diagnosis criteria with observation of the impact carbohydrate restriction has on the markers of Metabolic Syndrome in an individual already diagnoised or suspected of having the disorder. This is a ground-breaking, evidence-based approach that could radically change how the estimated 25% of Americans with Metabolic Syndrome have their symptoms managed and treated!

Often those with the features of Metabolic Syndrome are told to follow a low-fat diet in the course of managing the different markers of the disorder. But, as this study points out, data from published studies shows that low-fat diets often worsen the features of Metabolic Syndrome. The key in these new findings is that fat intake is less of an issue than reducing carbohydrate intake and that how a person responds to carbohydrate restriction may actually be a critical key to diagnose Metabolic Syndrome.

Basically, if a dietary intervention is tried and it restricts carbohydrate wihtout restricting fat and that leads to improvements of the features of Metabolic Syndrome, than that may be the right dietary approach for that person. Too often these days when one is trying to reduce their carbohydrate intake, they also try to limit their fat intake, which makes following a reduced carbohydrate diet difficult.

These findings show that fat intake is less important when a person has Metabolic Syndrome - that the carbohydrate is the key, not the fat in their diet. As Dr. Feinman pointed out, "The most obvious factor in the obesity epidemic is the drastic increase in carbohydrate consumption in recent years and the decrease in fat consumption, so the story is consistent. I think people have learned the value of reducing carbohydrates during the media popularization of low-carb diets, but they are still making it hard for themselves by also trying to reduce fat, when fat seems to be much less important a factor than carbohydrates.”

This article highlights how even those of us who have been deeply involved with controlled carbohydrate nutrition have missed the forest for the trees about just how appropriate a low-carb diet may be for some - when I first read through the paper, my first reaction was "oh yeah - well, duh!" - because it is so obvious, yet until now was not out there, in full view, as it is today.

Dr. Feinman and Dr. Volek, in addition to being co-authors of this paper, are also organizers of the upcoming conference, Nutritional & Metabolic Aspects of Carbohydrate Restriction 2006, in Brooklyn, New York - January 20-22, 2006. For anyone who is interested in nutrition, metabolism, diet and health, this is a must attend conference - there will be three dozen speakers, presenting data from studies across the spectrum of controlled-carb nutrition, many coming from around the world to speak.

Of particular interest to those with Metabolic Syndrome, or phyisicans and other healthcare professionals working with those who have Metabolic Syndrome, will be presentations from Dr. Gerald Shulman from Yale University, Dr. Marc Hellerstein from University of California, Berkeley, Dr. Marcus Stoffel from Rockefeller University, and Dr. Jeff Volek from UConn, Storrs.

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