Read Online The World Turned Upside Down: The Second Low-Carbohydrate Revolution by Richard David Feinman - Free Book Online

carbohydrates).
    That there is no dietary requirement
for
carbohydrate means, in a
practical sense, that if do want to reduce carbohydrate, there is no biological limit on how
much you can restrict intake. The extent to which you actually do so
will
depend on your personal reaction and taste but you do not need to consume any at
all. It is always emphasized that the brain needs glucose but your body
is
capable of making glucose from protein from the process known as gluconeogenesi s
and supplying glucose from storage as glycogen .
There are also alternative
fuels in the form of ketone
bodies . You more or less knew this. If you
did need dietary
carbohydrate, you would die if you went without food for a week; you
store a
lot of fat but not much carbohydrate. More on glycogen and
gluconeogenesis in Chapter 7 .
    6.        The
amount of carbohydrate recommended by the American Diabetes Association
(ADA)
and other health agencies:
    _____ approximately 130 g/day
    __X_ approximately 50 % of calories
    _____ as much as possible
    _____ as little as possible

    Student
Performance on Question 6
    It is hard to believe that a diabetes
agency would recommend any amount of
carbohydrate but this is it. Their 2008 dietary guidelines contain the
rather
remarkable advice:
    Sucrose-containing foods can
be substituted for
other carbohydrates in the meal plan or, if added to the meal plan,
covered
with insulin or other glucose-lowering medications. Care should be
taken to
avoid excess energy intake. (A)
    To many people this seems to be
saying
that it is okay to make
things worse so that you can take more drugs. The (A) mark indicates
that they
consider this advice to be based on their highest level of evidence.
They don't
cite that evidence but it is surely not experimental. While this book
was being
written, the ADA quietly dropped this passage from their 2013
guidelines [10]
but have not explicitly indicated that it was wrong. It is unknown
whether the
rank and file of ADA membership ever read those statements or and, if
so,
thought that they were of high quality or simply political statements
with
which no one has time to fight.
    Although brain fuel needs can be
met on lower-carbohydrate
diets, long-term metabolic effects of very low-carbohydrate diets are
unclear.
    In fact, the long term effects are clear. Very clear – there are trials going out to one or two years, and
internet sites and forums make apparent that it is a way of life for
many
people with diabetes. Although personal stories are hard to document,
we would
know if there were any indication of long term problems. More
important,
there is no reason to suggest that there would be any long term effects. In science, you don't start from scratch. You
don't
assume that there is harm unless there is a reason to. Nothing in
reducing
carbohydrate suggests harm. And "unclear" implies conflicting
data.  There
is no conflicting data and no reason to expect any. I suggested to a
spokesperson for the ADA that they were stronger on what they were
opposed to
than on anything positive that they had to offer. She admitted that
that was a
fair criticism. So, why are they opposed to carbohydrate restriction?
    ...such diets eliminate many foods
that are important
sources of energy, fiber, vitamins, and minerals and are important in
dietary
palatability.
    If "care should be taken to avoid
excess
energy intake," what
would it mean for carbohydrate to be "an important source of energy?"
And, does
anybody think that taking a vitamin pill is the equivalent of injecting
insulin? There is also a subtle switch from "carbohydrate" meaning
macronutrient, to using the term to mean carbohydrate-containing food.
Finally,
I would suggest, as in the future history (see Appendix),
that dietary palatability is
not their area of expertise.
    The guidelines from the ADA, as from
other
health agencies are
supposed to be serious but, in fact, have the character of an
infomercial and
the standards are those