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Home > Ask Dana Carpender – Breast Cancer, Diabetes and Carbs
Ask Dana Carpender – Breast Cancer, Diabetes and Carbs
by Dana Carpender, CarbSmart Contributor

Posted May 30, 2009

Dear Dana,

I am a one year breast cancer survivor and at the same time became diabetic. I am struggling with my weight as I have to eat carbs they say for both cancer preventive and for my diabetes. I need your help desperately as I look like I still have my spare tire around my middle. It is huge and I cannot lose weight. I am 57 and 5 ft 6 in. Help....Help.....THANK YOU for all your interesting read.....

Blondee
Dear Blondee,

That's a lot to be dealing with. I'm sorry you're going through so much.

Before I go on, I have to be clear: I am not a doctor, nor do I play one on television. I'm just an educated layperson who has been fascinated with nutrition for over 30 years. I cannot give medical advice, I can just tell you what the sources I have been reading have told me. Okay?

Quite frankly, I think your doctors are wrong. It sounds like they're still caught in the now-disproven carbs-are-good-fat-is-bad paradigm. Many people, doctors and lay people alike, accept that low carb diets cause weight loss, but are convinced that they are otherwise unhealthy. The research coming in demonstrates that to be untrue – indeed, that the opposite is true, that carbohydrate restriction improves health across many body systems. It's not surprising, when you think about it: We all have hunter-gatherer ancestors. Animal protein and fat, nuts and seeds, vegetables, and low sugar fruit in season, is the "factory specified diet."

Women have been told for years and years that we have to eat a low fat diet to prevent breast cancer, but the evidence is exactly to the contrary. A February 1998 article in the New England Journal of Medicine reviewed the results of seven different studies of the effect of fat on breast cancer etiology. They found no evidence that fat causes breast cancer. In fact, they found that the group with the lowest intake of fat – less than 15% of calories from fat – had an increased risk of breast cancer. The Harvard Nurses Study turned up the same result.

In the meanwhile, there is growing evidence that a high carb diet may increase the risk of breast cancer. A 2008 study in the International Journal of Cancer looked at the diets of 2,569 breast cancer patients and 1,031 ovarian cancer patients. They found that a "starch rich pattern" – a diet full of grains, potatoes, and the like – was directly associated with an increased risk of both cancers, while a diet high in animal products, vitamins, and fiber – which sounds a lot like steak-fish-chicken and salad to me - appeared associated with a reduced risk.

Similarly, in May 2008 the American Journal of Clinical Nutrition published a study looking at diet and breast cancer rates in 62,739 post menopausal French women. They found that a diet high in concentrated, rapidly absorbed carbohydrates – in other words, starches and high-sugar foods – increased breast cancer risk among overweight women and those with a larger waist circumference. It should be noted that a large waist circumference – ie, an "apple" shape – is a marker of poor carbohydrate tolerance.

There is also research indicating that cancer cells have damaged mitochondria – the powerhouses in the cells where much of energy production takes place. These damaged mitochondria mean that cancer cells cannot produce the energy for their growth using oxygen – ie, aerobically – and therefore cannot use fat for fuel. That means that they must use glucose – blood sugar – for their growth. In other words, cancer cells are glucose hogs. This appears to be at least part of the reason for the severe weight loss that so often accompanies cancer: In people eating the common carbohydrate-rich diet, the cancer cells eat most of their calories, leaving little for healthy tissue to feed on.

Your doctor may well be concerned about your intake of antioxidants from plant foods. According to the report Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, from the World Cancer Research Fund and American Institute for Cancer Research, fruits and vegetables do appear to lower the risk of some kinds of cancer – but interestingly, not of breast cancer. Still, you can reassure your doctor that you can eat plenty of green leafy vegetables, cruciferous vegetables (the low carbers best friend, cauliflower, is a crucifer,) low sugar fruits, and other great sources of antioxidants.

As for your diabetes, Dr. Eric Westman's work at Duke University demonstrates that a very low carbohydrate diet is superior to a calorie restricted diet or a low glycemic index diet for controlling blood sugar. Dr. Mary Vernon and Dr. Richard Bernstein have also done important work showing carbohydrate restriction to be the most effective treatment for diabetes.

What I suspect is happening is that your doctor has you on hypoglycemic medication, insulin, or both. Since these medications lower blood sugar, sometimes pretty drastically, it is indeed important to consume enough carbohydrate to keep from going into hypoglycemic shock. The question is would those drugs be necessary given a very low carbohydrate diet? Dr. Westman says that in his clinic at Duke University they take diabetics off of all oral hypoglycemic medications and cut insulin doses in half from the first day of a very low carbohydrate diet. (Dr. Westman uses a 20 gram-per-day diet, like the Atkins induction phase.) Here’s a link to Dr. Westman's study: http://tinyurl.com/aouz3v.

Too, it is important to remember that healthy weight loss reduces risk of both cancer and diabetes.

Again, I am not a doctor, I cannot prescribe, I cannot give medical advice. I can, however, give this advice: Be an active health care consumer. Do not passively accept what your doctor tells you if it sounds wrong to you. Doctors can be wrong, and most accept unquestioningly the low fat/high carb diet propaganda of the past few decades. Read Dr. Bernstein’s Diabetes Solution. Google Dr. Vernon and Dr. Westman. Get your ducks in a row. Then talk to your doctor. And be willing to change doctors if you feel your doctor is unwilling to listen to you.

© Copyright 2009 by Dana Carpender. Used by kind permission of the author.

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