Letter to My HR Department

It’s weird how things happen – I start a blog about migraines, and several months later I am tilting at the windmill that is the American Diabetes Association.

Here’s the letter I sent to my HR department regarding its support for the ADA.  I have omitted the name of my company and our HR SVP for privacy reasons.  Next I plan to find out the name of the chief fundraising officer at the ADA and explain why s/he’s getting no money from me.

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Dear [names of HR SVPs],

As the grandchild, child, niece, sister, and sister-in-law of diabetics, and as someone at risk of developing diabetes myself, I applaud [name of company]’s effort to fight this devastating disease.  However, after careful consideration, I have decided that I simply cannot support the American Diabetes Association, and I hope that, when this event rolls around again next year, [name of company] will consider withdrawing its support as well.  If [name of company] is really serious about reducing diabetes-related medical claims costs and supporting employees and their families, it is counterproductive to fund an organization that promotes a lifestyle that leads to increased use of medication rather than one that reduces the health care costs of diabetes sufferers.

In spite of its stated mission to provide “diabetes research, information, and advocacy,” the ADA is no friend of the diabetic.  After many years of independent reading on the causes and treatments of insulin resistance, pre-diabetes, and diabetes, as well as general nutrition, I have concluded that, if you wanted to deliberately devise a diet that would cause a diabetic to die a slow, painful death, you couldn’t do better than the diet currently recommended by the ADA.  The organization’s insistence on a high-carbohydrate diet, in the face of mounting evidence that diabetes is better managed by limiting carbohydrate consumption, would be laughable if it was not endangering the health and the very lives of the people it claims to advocate for.  In the nutrition section of the ADA website at http://diabetes.org/nutrition-and-recipes/nutrition/starches.jsp, the ADA says, “Yes, foods with carbohydrate — starches, vegetables, fruits, and dairy products — will raise your blood glucose more quickly than meats and fats, but they are the healthiest foods for you.“

If it sounds unconvincing that a food that raises blood glucose quickly is the “healthiest” food for a diabetic, perhaps this is because the ADA itself does not believe it.  At http://diabetes.webmd.com/news/20060616/do-low-carb-diets-help-diabetes, WebMD reports that ADA spokesman Nathaniel Clark admits that, while a low carbohydrate diet results in reduced reliance on medication, the organization does not promote a low-carb lifestyle for diabetics, because the ADA believes carbohydrate restriction is too hard to stick to.

There are so many things wrong with this reasoning, it is hard to list them all.  First, there is no evidence that the current low-fat diet recommended by the ADA is any easier to stick to than a carbohydrate-reduced diet; in fact, several of the low-fat participants in the study defected to the low-carb camp before the study’s end, but none of the low-carb participants switched to the low-fat diet.  This suggests that the low-carb diet was preferable and easier to stick to than the low-fat diet.  Secondly, in spite of what the ADA spokesman says, the study in question showed that blood lipids remained stable on the low-carbohydrate diet. In fact, 3 out of 5 participants in the low-fat group actually developed cardiovascular disease, while none of the participants on the low-carb diet showed any evidence of cardiovascular disease.  You can see the study, published in the journal Nutrition and Metabolism, by clicking on the following link: http://www.nutritionandmetabolism.com/content/3/1/22)

But the most important problem with the ADA’s reasoning is that it flies in the face of its role as an advocate of the diabetic.  As a counter example, it is very hard to quit smoking, but both the American Heart Association and the American Lung Association continue to encourage smokers to quit, and both have advocated for stronger restrictions against smoking in public, stronger bans on advertising cigarettes, and stronger enforcement of laws forbidding the sale of cigarettes to minors.  The ADA’s responsibility is similar:  educating diabetics on the benefits of a low-carbohydrate diet, organizing and providing low-carbohydrate support groups, and advocating with food producers, restaurants, school and office cafeterias, vending machine companies, and other providers of prepared food and snacks to provide more healthy, natural, lower-carbohydrate food choices.  For the ADA to fail to recommend the right course because it is too difficult is not only defeatist, it creates a situation in which research-savvy diabetics who would like to try a health-promoting low-carbohydrate regimen have nowhere to turn for expert advice and support, exactly the kind of service that the ADA should be providing.

I have focused on this single study because the ADA has commented publicly on it, but please be assured that there are myriad additional studies that show that a low-carbohydrate diet is beneficial to patients.  The following study is a meta-analysis of many, many studies into the effects of a low-carbohydrate diet on weight, blood sugar control, cholesterol, insulin resistance, blood pressure, and inflammation in diabetics.  The study authors conclude, “Based on our examination of current evidence, we find concerns about LoCHO diets to be unsubstantiated and we see no problem in recommending them, at least as a means of caloric reduction. …. We believe from the evidence presented here that replacing fat with carbohydrate is deleterious and caloric restriction should be carried out by removing carbohydrate in preference to removing fat. “  (Study at:  http://www.nutritionandmetabolism.com/content/2/1/16)

In short, rather than encouraging diabetics to make simple, inexpensive lifestyle choices that result in reduced need for medication and reduced numbers of doctor visits, the ADA is promoting a diet that increases reliance on medication, increases the number of doctor visits, and increases costs for [name of company].  I hope you will reconsider your decision to support this organization until it reconsiders its position on what constitutes a healthy lifestyle for diabetics.