6

votes

How do you deal with Paleo paradox?

Answered on September 12, 2014
Created August 26, 2012 at 4:20 PM

Here is another interesting piece about why diabetes is not just a carbohydrate story. When faced with paradox what do you do to explain it? Do you fall upon dogma or do you look at the problem from a new angle?

http://diabetes.diabetesjournals.org/content/52/6/1475.full

863fbe3ea7cacba9a77b19a09bf445cf

on August 28, 2012
at 05:52 PM

I rarely if ever see anyone in the paleosphere advocate a "one size fits all" approach. If anything, people seem preoccupied with constant tweaking/personalizing of their diets. I think The Quilt is setting up a straw man with this argument. He seems to do this a lot. He claims that the paleo leaders (he often calls them "so-called leaders" to be insulting) espouse "dogma" that they most certainly do not, and then he argues against this supposed dogma.

9d43f6873107e17ca4d1a5055aa7a2ad

on August 27, 2012
at 05:36 PM

Well it's not sheep-like denial, since the Quilt was publicly denounced by paleo leaders like Robb Wolf here after his lying witch hunt against Paleo Hacks moderators. Why is he back? Declining hits? Needs to promote epi-paleo, his new program? As for people not liking the message, what exactly is the message here? It's a study posted completely without context to make it look like Quilt knows something more than conventional paleos (he has been denouncing Robb Wolf etc. on his forum lately).

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on August 26, 2012
at 10:54 PM

Yeah it does when you considering what is being offered at in different sites......what this article is presenting a different view of diabetes.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on August 26, 2012
at 10:51 PM

exactly...........

0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on August 26, 2012
at 10:20 PM

Interesting looking study but who are these people who think type 2 diabetes is just about carbohydrates?

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:28 PM

Ketogenic diets cannot reverse diabetes because they exacerbate insulin resistance. Cured would be symptom free upon inclusion, not symptom free upon exclusion. The latter is just stabilized but still diabetic.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:25 PM

But I agree, it's the hyper caloric diet, high in carbs and fat and inadequate exercise that causes the problem to begin with.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:23 PM

Restored beta cell function and improved body composition in just 8 weeks. SO, it would seem that a reduced calorie diet, not a low carbohydrate diet, reverses diabetes.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:21 PM

^ in this study, subjects consumed a liquid diet in which 46% of calories came from carbohydrate, 35% from protein, and 20% from fat.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:19 PM

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/

D5d982a898721d3392c85f951d0bf0aa

(2417)

on August 26, 2012
at 07:16 PM

It's an incorrect use of the word paradox. And it reads like baiting.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:05 PM

you cannot cure diabetes on a VLC, high fat ketogenic diet. T2DM is the result of insulin resistance, and you cannot become insulin sensitive on a ketogenic diet.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:04 PM

Right, from what I've read (and I haven't read it all) it's a hypocaloric diet that cures diabetes, where the primary calories are coming from carbohydrate, then protein, and then fat.

B3173217a49b5b0116078775a17eb21d

(11488)

on August 26, 2012
at 06:23 PM

Can a low-fat diet "cure" diabetes? In an isocalorific diet, "low-fat" almost certainly means "high-carb". I'm not aware of (m)any T2Ds that successfully control their diabetes on a high-carb diet.

A1a7413b99e03bc77f02d95c4170ea43

(2393)

on August 26, 2012
at 05:50 PM

Why the down-vote?

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 05:48 PM

Prime example of the sheep like denial that goes on here at paleohacks. "I don't like the person or the message, so I am going to down vote."

  • Ed71ab1c75c6a9bd217a599db0a3e117

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7 Answers

10
9d43f6873107e17ca4d1a5055aa7a2ad

on August 27, 2012
at 05:33 PM

Wait, what is the paleo paradox? What is the new angle here? This study is from 2003 and has been cited 151 times. How does it connect with your idea that diabetes isn't even a disease at all?

Maybe diabetes is an ancient epigenetic program for survival and not a disease at all? When I found this out I realized immediately why evolution needed to plan for this. In cold environments, if our cell membranes are filled with MUFA???s and saturated fats they become to stiff to work. All cellular functioning in organ systems depend upon proper cellular signaling. Mother Nature knew it, so it designed a system to incorporate PUFA???s normally into all mammals cell membranes to get optimal functioning in cold environments. Any organic chemistist can verify that this is a complete and factual statement.

Or is this no longer valid in your Epi-Paleo??? program?

The real paleo paradox is why do Kalahari Bushman and Pygmies exhibit insulinopenia in response to oral glucose tolerance tests?

The newest paleo review paper has a hypothesis on this

Another example of the healthy lifestyle of present-day hunter???gatherers comes from the observed ???insulinopenia??? or ???impaired insulin secretion??? following an oral glucose tolerance test (Fig. 6) in Central African Pygmies and Kalahri Bushmen(340,341), respectively. As opposed to the ???impairments??? noted by these authors, it may also be argued that these researchers were actually witnessing an insulin sensitivity that has become sporadic in Western countries as a consequence of the decrease in physical activity and fitness, increase in fat mass and as a result of the quantity and quality of the foods consumed(36,133,342).

8
5f3e1f803d7a9b8704bb11cda26bcf9a

on August 26, 2012
at 07:04 PM

I think the question Jack is posing is just addressing conventional and paleo dogma--that is, the one size fits all approach. This study (if I am reading it correctly) shows that T2D is different in different people with differing genetics. The statement "progression in these measures toward diabetic thresholds may represent distinct phenotypes in the pathogenesis of type 2 diabetes." It also shows that these tests (fasting glucose and glucose tolerance) can indicate a movement towards the development of T2D (although not always).

This challenges the dogma of both the conventional American Diabetes Association measurements of abnormal and the approach doctors take toward working early on with the patient to negate the damage that high blood sugars can cause AND the dogma of the paleo one size fits all approach with its "safe starches" stance. (not that I think everyone here believes that paleo must include starch for everyone) I think (hope) we all realize that what diet will work for a young, fit 20 something male might not be the answer for a 50 something metabolically damaged post menopausal woman....(or a 30 something recovering vegan. or....or...) I think we all DO believe that eating REAL food is the healthiest approach for everyone.

Chris Kresser, Jenny Rule and Dr. Bernstein have stated that the post meal blood glucose measurements are the better measurements in determining your bodies reaction to food and if your glucose levels are safe (avoids diabetic complications)-- this measurement wasn't even considered in this study. The glucose tolerance tests are so unnatural (drinking pure glucose?? WHO DOES THAT?) And some people have higher than normal fasting glucose due to the "dawn phenomena" which isn't about how their bodies handle glucose but is more about manufacturing it in the liver before awakening as a fuel source. So I basically ignore studies that don't include post meal studies.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on August 26, 2012
at 10:51 PM

exactly...........

863fbe3ea7cacba9a77b19a09bf445cf

on August 28, 2012
at 05:52 PM

I rarely if ever see anyone in the paleosphere advocate a "one size fits all" approach. If anything, people seem preoccupied with constant tweaking/personalizing of their diets. I think The Quilt is setting up a straw man with this argument. He seems to do this a lot. He claims that the paleo leaders (he often calls them "so-called leaders" to be insulting) espouse "dogma" that they most certainly do not, and then he argues against this supposed dogma.

7
141171c0810650168d82601d85cfa5a3

(415)

on August 26, 2012
at 05:42 PM

What paradox? We've known for a long time that both low fat and low carb diets can cure diabetes. It's a hypercaloric diet high in both carbs and fat that is likely the culprit.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:05 PM

you cannot cure diabetes on a VLC, high fat ketogenic diet. T2DM is the result of insulin resistance, and you cannot become insulin sensitive on a ketogenic diet.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:21 PM

^ in this study, subjects consumed a liquid diet in which 46% of calories came from carbohydrate, 35% from protein, and 20% from fat.

B3173217a49b5b0116078775a17eb21d

(11488)

on August 26, 2012
at 06:23 PM

Can a low-fat diet "cure" diabetes? In an isocalorific diet, "low-fat" almost certainly means "high-carb". I'm not aware of (m)any T2Ds that successfully control their diabetes on a high-carb diet.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:19 PM

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:23 PM

Restored beta cell function and improved body composition in just 8 weeks. SO, it would seem that a reduced calorie diet, not a low carbohydrate diet, reverses diabetes.

D5d982a898721d3392c85f951d0bf0aa

(2417)

on August 26, 2012
at 07:16 PM

It's an incorrect use of the word paradox. And it reads like baiting.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:04 PM

Right, from what I've read (and I haven't read it all) it's a hypocaloric diet that cures diabetes, where the primary calories are coming from carbohydrate, then protein, and then fat.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:28 PM

Ketogenic diets cannot reverse diabetes because they exacerbate insulin resistance. Cured would be symptom free upon inclusion, not symptom free upon exclusion. The latter is just stabilized but still diabetic.

1edb06ded9ccf098a4517ca4a7a34ebc

(14952)

on August 26, 2012
at 07:25 PM

But I agree, it's the hyper caloric diet, high in carbs and fat and inadequate exercise that causes the problem to begin with.

6
3d58b5fb4f9780e2f47d4dcc53338a5a

(2771)

on August 26, 2012
at 11:15 PM

Yeah, I'm not getting anything paleo or even diet related in the study. Please correct me if I'm wrong, but its talking about people progressing to full type 2 diabetes after years of showing glucose intolerence. If that's really what the article is about, then that's like saying "if you keep kicking a brick wall, it could lead to toe damage." Its a no brainer thesis to get published.

I'm curious at why you think this might be a paleo paradox? Genetically speaking, some of us are probably more likely to develop diabetes if they have constant elevated insulin levels. Some, maybe less so. Some will get fatter than others. Some will age more rapidly or develop cancers.

All I know is, I got close to some, if not all, of these ailments, and controlling my insulin levels by eating more naturally has reversed every issue I had. I don't see the paradox.

By the way, there was a recent study where overweight diabetics lived longer than skinny ones and they called it the Obesity paradox. I'm going to add that to the "French Paradox," "American Paradox," and all the others and say "If your conclusions have so many paradoxes, maybe your theory is wrong."

2
43e9d0f324c2fc8b5f283786a1e3bf4f

(419)

on August 26, 2012
at 06:43 PM

Wait, what? The article doesn't say anything about paleo. It says:

"In conclusion, data from more than two decades of serial glucose tolerance testing in Caucasian subjects of the BLSA suggest that fasting and postchallenge hyperglycemia may represent distinct phenotypic pathways to the development of type 2 diabetes."

Big news: observational data shows some fat white people develop diabetes and others don't. Clearly this disproves all thine enemies.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on August 26, 2012
at 10:54 PM

Yeah it does when you considering what is being offered at in different sites......what this article is presenting a different view of diabetes.

1
77877f762c40637911396daa19b53094

(78467)

on August 28, 2012
at 10:40 AM

"Current data leave unanswered whether people with initially normal glucose tolerance progress directly to diabetes or develop diabetes only after a period of impaired fasting glucose or impaired glucose tolerance, or whether people with impaired fasting glucose also eventually develop impaired glucose tolerance, or vice versa, before developing diabetes."

i.e. the road to diabetes:

a) normal glucose tolerance > diabetes (direct)

b) normal glucose tolerance > impaired fasting glucose > diabetes

c) normal glucose tolerance > impaired glucose tolerance > diabetes

d) normal glucose tolerance > impaired fasting glucose > impaired glucose tolerance > diabetes

e) normal glucose tolerance > impaired glucose tolerance > impaired fasting glucose > diabetes

This is an interesting question to research in terms of the various underlying mechanisms that result in abnormal blood glucose homeostasis particularly with a view towards determining causality and designing targeted interventions. However, the basis for a paradox is not apparent.

paradox = a seemingly absurd or contradictory statement or proposition which when investigated may prove to be well founded or true, or, a statement or proposition which, despite sound (or apparently sound) reasoning from acceptable premises, leads to a conclusion that seems logically unacceptable or self-contradictory.

0
B3173217a49b5b0116078775a17eb21d

(11488)

on August 26, 2012
at 06:22 PM

Can a low-fat diet "cure" diabetes? In an isocalorific diet, "low-fat" almost certainly means "high-carb". I'm not aware of (m)any T2Ds that successfully control their diabetes on a high-carb diet.

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