Lifestyle Better Than Medicine For Improving Blood Glucose
The study of 98 adults, just published in JAMA, was titled: “Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes.”1
The effect was, in a word, excellent. “In this ‘lifestyle as medicine’ versus ‘medicine as medicine’ contest, lifestyle won,” writes Dr. Katz in his article.2 Healthy lifestyle changes, very similar to what the physicians, nutritionists, exercise physiologists, and psychologists at the Pritikin Longevity Center have been teaching for more than 40 years, was better than pills at lowering HgbA1c, a long-term measure of blood sugar.
What did medical news outlets do with this study? How did they report it?
Never at the Pritikin Longevity Center would we want to be raisers of blood pressure, but this analysis of the medical news media from Dr. Katz could do it, even if you don’t have hypertension. So take a deep breath before reading it. Then take another deep breath after you’re done.
Most importantly, take pride as a Pritikin alum in knowing how beneficial a healthy, Pritikin life can be. You know a lot more than many physicians in America.
Lifestyle as medicine, as this new study and many others like it over the last four decades have affirmed, really is the best medicine.
Carbs Are Bad? Fat Is Good?
Yet another study, known as the PURE study, garnered a lot of clicks for media outlets this week, thanks to headlines like “Carbs Are Bad, Fat Is Good.”
But what’s really bad is how poorly some of the research in this study was conducted. “The PURE investigators seem to be nothing more than a pure assault on not only science-based but even common sense thinking,” summed up Dr. Tom Rifai, FACP, Medical Director of Metabolic Health and Weight Management at Henry Ford Health System in Michigan and member of the Pritikin Scientific Advisory Board.
PURE was an observational study, which means it merely observed people’s diets and health outcomes. It could not prove cause and effect, as randomized controlled studies, the gold standard of research, do.
PURE followed people from 18 different countries, most from Africa, the Middle East, South Asia, and South America. It reported that the more carbohydrates as a percent of calories that people ate, the higher their rates of disease and death. Also, more fat as a percent of calories was linked with lower rates of disease and death.
You can get a thorough analysis of PURE from another excellent article that Dr. Katz wrote, but if you’re pressed for time, here are two key points:
No Differentiation Between Good and Bad Carbs
In the PURE study, carbohydrates – both good carbs like vegetables and bad carbs like cookies – were lumped into one category. And since bad, unhealthy carbs like added sugars and refined starches comprised most of the carbohydrates in this study, it’s really no surprise that carbs ended up as the bad guy.
Secondly, the findings in PURE indicate that the intake of carbohydrate as a percent of total calories was highest among very poor people. Many ate a lot of white rice, for example, and not much else. There was little in the way of fat or protein, especially from sources like fatty meat. They lived in countries that had the least access to medical care, and the greatest risk of dying prematurely from things like trauma and infectious diseases. Is it any wonder, then, that their high-carb diet would be correlated with increased risk of death?
Higher death rates “that have little to do with the ratio of fat to carbohydrate to protein”
Sums up Dr. Jay Kenney, PhD, RD, FACN, and educator at the Pritikin Longevity Center: “Among poorer countries where access to modern health care and public measures are limited, people will often be eating a diet composed largely of grains and/or potatoes and other starchy vegetables, and with a relatively small percentage of their calories from fat and protein, especially meat. Such people are certainly more likely to die for reasons that likely having little to do with the ratio of fat to carbohydrate to protein in their diets.
“Failure to correct for these confounding variables could easily lead to the positive associations between higher carb, lower fat, and lower protein intake and increased mortality.”
Do not mistake correlation with causation
Bottom line, says Dr. Kenney: “One should not mistake such correlations with causation. However, the PURE researchers certainly are implying that their seriously confounded observational data do in fact imply causation. It’s critical to keep in mind that far better quality data from randomized controlled trials show a clear, causal impact of diets high in saturated fat with higher levels of LDL cholesterol and non-HDL cholesterol.
“Add these trials to the unequivocal increase in atherosclerotic plaque and much higher risk of deaths from heart attacks with higher levels of LDL and non-HDL cholesterol, and it seems apparent that the PURE researchers’ suggestion that a diet higher in saturated fat is healthier than one high in whole grains, fruits, and vegetables is, in a word, naive.”