The Hope Warshaw Article that Caused an Uproar

Originally published July 2011

On every online forum for diabetes there is a low carb debate.  Does it help those with type 2 diabetes?  How many carbs per day constitutes low carb?  Does it help those with type 1 diabetes?  But doesn’t the brain need glucose for energy?  It’s a hot topic to say the least. 

While many debate against the details of what constitutes low carb, few people on these forums combat the notion that reducing carbs helps many people with diabetes.  And this is where I get confused with articles such as this one by renowned dietician and diabetes educator, Hope Warshaw.  In her article, she says low carb diets are not effective for people with diabetes and that weight loss will not lower blood sugar. 

Warshaw says there are “countless” studies to confirm the merits of the diet she recommends which is 45-65% of one’s calories coming from carbohydrates.  Yet, she does not cite a single one of those studies.  As for the weight loss, she points out that  “Large studies have shown that with loss of five to seven percent of body weight (approximately 10 to 20 pounds) and 150 minutes of physical activity (30 minutes five times a week), people can prevent or delay the progression to type 2. Once insulin production is on a dwindling course (particularly after 10 years with type 2), weight loss has less impact on glucose control.”  That’s not a lot of weight loss.  This would be like someone going from 200 to about 190 pounds.  How much blood sugar impact could that have in the long run?  Maybe we should note how well blood sugar is impacted by seeing what happens when an obese person’s weight drops to the healthy weight reange .  For optimal health, the goal is a healthy weight, no? 

Warshaw claims that treating diabetes by reducing carbs is an old dogma because that’s what we did with diabetics back in the days before insulin and medications.  True.  We didn’t have many options back then.  Today, many type 2 diabetics have found it useful to be somewhere along the spectrum of softly limiting carbs to harshly avoiding them.  There are also the type 1 diabetics out there like myself, who have managed to finally lower A1c levels by reducing carbs.  How does someone as influential as Hope Warshaw ignore the online ravings of people with diabetes on the success they have by limiting carbohydrates to some degree?  Does she read this stuff and think that something else must be to blame for our improved health?  Does she read this stuff at all?  Because I tend to think our community’s online sharing is pretty valuable information to medical experts.

I don’t know that every adult with diabetes must limit carbs.  According to my research it seems they should at least be careful about grains.  I just know that I feel and look healthier with my A1c close to a non-diabetic’s and the only way to do that for myself is to limit carbs from grains like bread, pasta, rice, and corn. 

What I find interesting is many dieticians including Hope Warshaw, explain the ineffectiveness of low carb by saying it’s unrealistic eating behavior.  Warshaw recently went head to head with Dr. Bernstein and said that eating low carb is unsustainable.  She said people have the right to eat what they love.  She said we deserve it.  If I want to sell a book about health to the masses, that’s how I would go.  I would tell people what they want to hear.  Many people with diabetes do not feel well and are thus quite vulnerable to an expert’s say so it’s genius, really.  However, when a person smokes too much and are on the brink of emphysema, should a doctor say, “Aw you know what?  You’re addicted to smoking.  Why should I try to take you away from something you love and are addicted to?   Why don’t you just switch to a higher quality tobacco?  Let me prescribe something to help with your symptoms.”  I’ve never heard of that happening.  My thinking is I deserve a long and healthy life with diabetes and so does everyone else.  Does that come with the need for restraint?  Why yes!  But so does being married, being a world class athlete, and doing well in college.

Warshaw says a low carb diet is hard to stick to in the long run.  My thought is, don’t people have a hard time sticking to ANY diet in the long run?  I don’t think low carb is an exception.   Experts stating over and over that low carb is just too hard for people makes me wonder if someone thinks we’re weak little creatures.  Golly, how do we manage to go to work every day?  I mean, the discipline involved!  Round of applause and a cupcake for me please, I got out of bed at 5am this morning to exercise.

Again, I’m not saying low carb is the way to go for everyone.  It just doesn’t make sense to say it’s wrong without any real proof, without consideration for the success others have with it, and without any valid reasons to tell someone not to simply try it.  Telling someone not to try low carb because it’s hard is like telling a child not to go for being a president or a basketball champ or a published author because it’s too challenging.  Puleeez. 

How many times a day do I hear “low carb is a fad diet”?  A lot.  And yet I’ve seen my lab results on the ADA diet and I’ve seen them on the lowish carb diet I follow consisting of around 50-75 grams a day.  The difference is startling and I’m reaping the benefits.  You won’t find my doctor telling me to change my diet.

I have nothing against Hope Warshaw or other medical experts.  I only wish they would recognize what we in the low or “lowish” carb community are desperately saying to them.   We’re saying that A) lowering carbs is helping us be healthy, B) the same diet doesn’t work for everyone (see; the world’s people), and C) what people deserve is to be healthy and to be encouraged towards that and not instant gratification.  Oh and D)  Ignoring the above is dangerous and irresponsible.

We’re not doctors or famous people but we’re capable of great things and we need the medical community to take note of our valuable observations and to believe in us.  We’re smarter and stronger than they seem to think.