Following closely on the heels of last month’s headlines that “Organic Food Is No Better Than Conventional,” we now have been given results of a long-term study which concludes that diet and lifestyle intervention won’t save Type 2 diabetics from the leading and most severe complications of diabetes, namely heart attack, stroke, and cardiovascular disease.
This must be depressing news indeed to any person with Type 2 who is hoping to escape the life sentence of “drugs, drugs, and more drugs” – which according to this headline, seems to be their sole option.
But please don’t believe everything you read in the newspapers!
These days, the mainstream media seems more than happy to report the surface conclusions of researchers (regardless of who is funding the “research.”) No one seems to be without a casting a critical eye or peering deeper.
I’m particularly surprised at the seasoned New York Times health writer Gina Kolata in her pedestrian treatment of the story, “Diabetes Study Ends Early with a Surprising Result”, which reads like a regurgitated press release instead of responsible journalism.
So here’s what the study tried to determine…
The 13-year study, called Look Ahead (Action for Health in Diabetes), was created to see if losing weight could improve cardiovascular risk factors and outcomes for people with Type 2 diabetes.
The researchers, funded by The National Institutes of Health (NIH), were impressed by earlier studies which indicated that obesity correlates with heart disease and Type 2 diabetes – and that weight loss reduced this risk, while improving outcomes.
They selected 5,145 overweight or obese adults with Type 2 diabetes, aged 45-74 years – 30% of who had diagnosed cardiovascular disease – and divided them into two groups.
The treatment group received “intensive diet and lifestyle intervention” (that sounds impressive), while those in the control group got standard counseling on diabetes care and general health. Both groups continued the medications that their individual physicians had prescribed.
The early results looked promising
After one year, there was quite a buzz in the medical community about the Look AHEAD study.
The diet and lifestyle group lost an average of 8.6% of their body weight versus 0.7% in the control group.
Their overall fitness improved by 21% compared to just 5.8%.
Their A1C (90-day blood sugar levels) dropped from 7.32 to 6.6%, while the control group showed no improvement.
Even more impressive: the lifestyle group had better blood pressure, cholesterol and triglyceride levels – which resulted in reductions in their medication doses to control blood sugar, hypertension, and lipids.
Looks like a success, right?
It would have been, but the participants in the lifestyle group couldn’t sustain these improvements.
So after 11 years of seeing the participants regain their weight and poor health, the researchers pulled the plug.
In the end, the lifestyle group had lost about 5% of their weight, which was enough to reduce cardiovascular risk – but because they couldn’t sustain their changes, just as many of them ended up dying from cardiovascular disease as in the control group.
They finished with the same levels of cholesterol, blood pressure, and blood sugar as those in the control group, but they needed fewer medications.
“The outcome is clear.”
That’s the conclusion of Dr. David Nathan, one of the chief investigators.
“We have to have an adult conversation about this,” he said. “This was a negative result.”
But was this expensive study truly a failure?
Does it really prove that diet and lifestyle modifications fail to protect Type 2 diabetics from cardiovascular complications and premature death?
To answer this question, you have to understand what the NIH researchers mean by “intensive lifestyle interventions.” (HINT: It’s the same advice your doctor gives you.)
“Eat less and exercise more.”
This multi-million dollar study might have succeeded, but for the way the researchers tried to get the participants to lose weight.
They restricted their calories by 30% and made them exercise 30 minutes per day (or 175 minutes per week.)
Yep, it’s the same old failed “diet and exercise” advice that doctors have been handing out for decades.
The researchers didn’t change what the participants ate – they just told them to eat less of it. Their “food” options were two meal replacements drinks (think Slim-Fast) and one frozen entrée (think Lean Cuisine).
Now remember, these participants were either overweight or obese. Those who weighed 250 pounds or less only were allowed 1200-1500 calories per day, while those over 250 pounds were limited to 1500-1800 daily calories.
That’s not a lot of food for big people
Worse, the composition of these meals followed the “official” low-fat diet of the American Diabetes Association (ADA) and the American Heart Association (AHA).
This diet calls for 30% fat, 15% protein, and 65% carbohydrates. This means the participants were eating the same high-carb diet that probably gave them diabetes and heart disease in the first place – or at least contributed to these health conditions. Only they got one-third less of it!
You can believe these people were hungry. And, since they were told to walk or exercise for 30 minutes per day, this only made them hungrier.
Is it any wonder that this study failed?
The real wonder is how the diet-and-exercise group stayed with it for the first year.
I’m betting that the novelty of participating in an “important national study” kept their willpower fired up. But ultimately, their constant gnawing hunger got the best of them – as it always does.
I’m stunned that the NIH researchers were oblivious to earlier findings which show that calorie restriction (or “dieting”) fails 95% of the time.
Or that exercise is widely-recognized as a lousy way to lose weight. (TIME magazine announced this on the cover of its August 17, 2009 issue.)
In case you’re curious, I explain why both of these methods are doomed to failure in a previous post entitled, “Is This The World’s Worst Way To Lose Weight?”.
“Modern” dietary advice is trapped in the last century
A lot of the official dietary advice we still receive from doctors, the ADA, and the AHA (“a calorie is a calorie” … “low-fat diets are heart-healthy” … “eat less, exercise more” … etc) is outdated, misinformed, and outright dangerous. (This is why I asked the question, “Should Doctors Give You Nutritional Advice”.
For one example, how can the ADA and AHA continue to recommend a high-carb diet to diabetics?
It’s no secret that carbs spike blood sugar and perpetuate the need for medication, while advancing inflammation and artery damage, boosting blood pressure, and encouraging cardiovascular disease.
Shouldn’t doctors be advising their patients to cut back on carbs, while increasing their intake of healthy fats and clean protein?
The 30-Day Diabetes Cure eating plan
This is the very diet that has helped thousands of Type 2s reverse their diabetes, toss away their meds, and quit worrying about cardiovascular complications.
And – surprise! – eating this way has allowed these “ex-diabetics” to shed weight without dieting, exercising, or feeling hungry.
I’m not talking about a paltry 5-10% of their body weight, either. People on this eating plan usually shed a lot of weight.
As she reported on our Facebook page, Alison Chastain’s brother-in-law lost 40 pounds and is now off all his diabetes drugs.
Her sister is on Day 17 of the plan and already has lost 15 pounds and cut her medication dose in half.
Her husband is so impressed that he just started the plan 5 days ago and has already dropped 3 pounds.
And Doug N, who is featured in our soon-to-be-published book, Diabetes Heroes, has lost 120 pounds (from 306 to 186) in the past two years – while getting off all his diabetes drugs.
Wouldn’t you rather: “Eat more and exercise less?”
This is all possible by cutting out the foods and beverages that trigger insulin, the body’s fat storage hormone. This way, you can eat your fill and never feel hungry.
If you want to exercise, please feel free. It’s just not required. (I explain the scientific explanation for this in “Is This Really Why We’re Overweight?”).
So, if you have Type 2 diabetes and want to be free of it – or if you’d just like a no-stress, no-hunger way to lose (a lot of) weight – I encourage you to order a copy of The 30-Day Diabetes Cure and give it a try.
Maybe one day the NIH will run a clinical trial on the health effects of restricting sugar and refined carbs, while consuming more healthy fats and protein. Now that would be a great study!
Meanwhile, I’ve got good news for Dr. Nathan
His study wasn’t a failure. It actually was a big success.
It showed us (hopefully, once and for all) that “eat less and exercise more” doesn’t work for weight loss. Period.
Please remember this the next time your doctor tries to pass off that tired old advice onto you.
So what has worked for you?
Have you been successful at losing a bunch of weight?
How did you do it? And how do you keep the weight off?
Please share your most successful tips and secrets [here] so the rest of us can benefit from your wisdom and experience.
Till next time…