Diet and Diabetes: Carbohydrate Consensus vs. Controversy | Christopher Gardner, Ph.D. | 13.04.2022

This webinar recording is from April 13, 2022, with Christopher Gardner, Ph.D. This webinar is part of the webinar series "A Taste of Healthcare" hosted by the Physicians Association for Nutrition which took place in spring 2022.

About the event
Diabetes cases and their respective health complications have been on the rise globally for decades. Food plays a huge role in the prevention and treatment of diabetes, and dietary interventions should be part of every diabetes therapy. At the same time, the role of carbohydrates in the development and treatment of the disease remains controversial, leading to uncertainty among health professionals and patients.
Professor Gardner from Stanford University shares his insights from landmark trials he conducted on these topics. He will cover relevant human intervention trials with an engaging blend of science and humour. Thereby, the emphasis is on consensus and controversy in the area of dietary carbohydrates.

About the speaker
Christopher Gardner holds a PhD in Nutrition Science from UC Berkeley and is the Rehnborg Farquhar Professor of Medicine at Stanford. He is the incoming chair of the American Heart Association Nutrition Committee. For over 30 years his research has examined what to eat and what to avoid for optimal health. This includes more than 20 nutrition intervention trials conducted with over 2,000 participants. Relevant to this presentation are the two landmark Low-Fat vs. Low Carb weight loss diet trials: A TO Z (JAMA 2007) and DIETFITS (JAMA 2018). A recently completed trial contrasted a Ketogenic Diet to a Mediterranean Diet among adults with type 2 diabetes or prediabetes. The outcomes in these trials are typically cardiometabolic factors (e.g., lipids, insulin, glucose, blood pressure, inflammation/immune function, body composition).

About the series
“A Taste of Healthcare” webinar series covered the links between nutrition and some of our most pressing global health threats. We were extremely happy to welcome a selection of leading international researchers in their fields to share their knowledge. The 5-part series took place in March and April 2022 and provided medical students and healthcare professionals with the knowledge, motivation, and tools to implement optimal nutrition in clinical practice and healthcare systems.

Disclaimer: Any views, thoughts, and opinions expressed by guest speakers in our webinar recordings are solely that of the speaker and do not necessarily reflect the views, opinions, policies, or position of the Physicians Association for Nutrition.

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[sectionalsofa]

I LOVE Dr Gardner's charts. They're SO clear. I wish I could have all of them at my fingertips.

[annam]

thanks for giving us the information for free, very useful!

[k.h.]

Practical summary:
- everybody needs to stop eating added sugar and refined grains (aka anything made of white wheat flour), that is: most of our packaged foods, also don't go to McDonalds.
- most people eat too few fruit and vegetables. Adding plant foods will feed not only you, but also your gut microbiome. This is health promoting in all kinds of ways.
- meat should be a small part of your daily calories: too much protein gets converted into carbs (and potentially fat). If you do eat meat, eat the non-processed stuff (no added salt etc)
- Gardner's food pyramid has beans as a foundational food: something to eat daily.

(from me:) This is, as the title suggests, aimed mostly at diabetes. For heart disease, the saturated fat in meats are a problem. One would also stress the salt in (ultra-) processed foods as an issue.

[chewiewins]

Excellent lecture, thank you. As Borderline diabetic now normal after Keto, finding high non-HDL and LDL means I need switch to more Mediterranean. You study shared confirms it for me.

[gregorygreene]

I like the balanced approach at the end. I'm T2 and definitely have a lower carb diet but I don't go to extremes. The most important thing for me is losing weight and that is dependent on being in a calorie deficit. Doesn't matter what I eat if I'm not in a deficit I'm not losing weight. CICO

[reason]

Lifetime exposure to LDL seems to be the main factor for atherosclerosis (plack) in your arteries. (See mendelian randomization studies) If you include animal products like eggs, chicken and dairy I don’t believe there is evidence you can avoid plack buildup in the later decades of your life. Consuming any animal products will make it very hard to keep LDL levels low enough.

[Appleblade]

This is the least plausible eating imaginable. Our 3 million years ancestors would be puking at the idea... big juicy animals all around and we're supposed to eat fucking beans?

[soundstormdubai]

6:00 : And how long do they live ? to 40yo ?

[chrismartin]

Interesting that @3:00 on your food pyramid, no mention of eggs or fish, two foods that I would think would make up more than 0%.

[kardste]

I wonder about best diet for cancer. Whole food plant based, with low oils, only necessary protein, lots green leafy veggies and fermented foods?

[stevestephens]

you cited populations from very high carb and and very low carb populations demonstrationg similar health outcomes but you land more heavily on plant based high carb as the preferred way to go. just your preference?

[deekap]

So for diabetics is it better to go on Metformin rather than eating high fat low carbs? I am very skinny, vegetarian and ate lot lot of simple carbs as growing up. My dr advised me to go on Metformin but not sure long term side effects. What’s your take on it.

[todd]

I appreciate your videos and enjoy having a reputable source of diet information as there is so much misinformation in the diet world :-/ A small criticism, and that is that your polls are lacking important details. For example, when you ask what percentage of fat and protein in a keto diet, do you mean as commonly practised, as designed by the originator of the diet, or as a well designed keto diet? One can't really answer the question without this additional info. A small point, but I have seen this elsewhere too. For example, you asked what percentage of energy from carbs in the diet. Once again, according to whom? Conventional wisdom, latest research, diet info from the last 60 years like the American Food Pyramid. Not super critical, but if I was taking a test with these questions I would be frustrated and feel that that it wasn't possible to really answer the questions.

[zebonautsmith]

Vegetables ALSO digest to glucose; it's just absorbed more slowly. Why eat exogenous glucose at all; if the body can make it's own through gluconeogenesis? Fermentable carbohydrates lead to tooth decay; insulin spikes; type 2 diabetes, obesity and cancer.

[doddsalfa]

The massai diet isn’t a low carbohydrates diet.Massai woman expect 2 meat meals a week

[realfoodcures]

The ldl goes up in keto in order to move triglycerides out of cells to the muscles. Normal physiology, not pathos.

[rinohunter]

Optimal means avoiding metabolic syndrome 100%

[dorianphilotheates]

I just found The Messiah 😇 — subscribed.

[edsedlak]

The USDA recommendation or recipe for diabetes 300 g is ridiculous.

[jwatkins]

Interesting start. When I dropped HFCs from my diet my wrestless leg syndrome disappeared. In fact, I noticed when I had HFCs shortly thereafter a distinct ants in my pants energy feel occurred. Haven't had any for decades, thankfully.