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#31
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
wrote:
On May 3, 5:30 pm, brigid nelson wrote: wrote: On May 3, 1:21 pm, brigid nelson wrote: wrote: Now, I'm not always a fan of60Minutes, but I don't see how criticisms leveled by a blog run by a nurse equates to the60Minutes story being untrue or unverified. Clearly that blog has it's own agenda and false statements. Right out of the gate, this blog accuses60Minutesof saying that gastric bypass cures cancer. I saw the story, it's available online and no such thing was ever said. What they did say was obesity raises the risk of several types of cancer and that some studies have found that for people that have the bypass surgery, the risk of cancer is cut in half. The 'nurse' who writes this blog understands research methodology and does an excellent job of de-bunking claims of weight-related morbidity. Poke around her site some more and follow the links to the studies. Here's another interesting article on Gastric Bypass: http://junkfoodscience.blogspot.com/...ally-proof-tha... Also, can you give me a cite for the study that shows the risk of cancer decreasing with bypass surgery? I'm interested to see the sample size, how long subjects were followed, and how these researchers decided they could determine the causation of cancer to be fatness. Sorry if you have a problem with me pointing out that the blog is run by a nurse, but that is apparently her academic credentials related to the discussion at hand. I didn't do the research for60Minutes. I don't know what specific study they based the claim on. But a simple google produced this, which says long term, the risk of dying from cancer was cut by60% and is consistent with what60Minutesreported: I detected a disparaging tone in your original post about the legitimacy of the opinion of a *nurse*. What I objected to was Hakans statement that the opinion of this nurse on a blog means that the 60 Minutes Story is untrue. Knowing a little something about methodology myself, I find this nurse to be an good resource as she carefully explains the methods and statistics used in these studies that the media parade out in order to make us feel bad about ourselves and/or buy expensive drugs and surgical treatments that may do more harm than good. I think she performs a useful service as not everyone has taken a class in research methods or statistical analysis. A nurse with a BSN would have had at least one such class - and she obviously paid attention. I just wish she'd read Taubes as I find her insistance that carbs are harmless to be somewhat uninformed. What I see is someone who has formed a opinion and is using FUD tactics to hurl anything at all to try to paint gastric bypass in an unfavorable light. Take this gem which leads off the blogs criticism of the Swedish study: "We’ll begin with one of the most common misconceptions: years of follow-up. Since this study was examining the long-term effects of bariatric surgery on mortality, it’s understandable you might think that the average 10.9 years of follow-up reported meant the patients were followed for 10.9 years after having surgery. Here is the first example of not reading the study. The follow-up period — which actually ranged from 4 to 18 years — began from the “matching date.” That was the date that the study recruitment campaign ended and the surgical candidates were chosen and matched with controls. This was about 1 1/2 years before the surgeries were actually performed. So, we’re down to just over an average 9 years of post-surgical follow-up. " This is the starting point, the best she can come up with to tear into the Swedish study? Arguing a nit over whether the long term measurement point is 9 years or 10.5 years? What critical difference does that make in the grand scheme of things? If you want to start attacking studies, you can tear any of them apart with such critcisms. But IMO, it does show how biased she is. If one wants to start with a critical analysis, why not start with her own claim that 60 Minutes said gastric bypass cures cancer. That is an outrageous falsehood. They clearly said studies showed it reduced rates of cancer, not cured it. You know what? I didn't see the show so I googled to see if I could find a transcript. I found this: http://www.cbsnews.com/stories/2008/...n4023451.shtml Here's the first paragraph: (CBS) It's pretty well known to doctors that the most successful treatment for obesity is surgery, especially the gastric bypass operation. But here's something the medical world is just realizing: that the gastric bypass operation has other even more dramatic effects. It can force type 2 diabetes into almost instant remission and it appears to reduce the risk of cancer. This is from the third page: In addition to the operation reducing hypertension and coronary artery disease, there appears to be an affect on cancer as well. "Does being fat give you cancer?" Stahl asks Dr. Eugenia Calle, an epidemiologist at the American Cancer Society. "Being overweight or obese increases the likelihood that you'll get several different types of cancer," Calle says. Dr. Calle has been studying the link between cancer and obesity. Asked what kinds of cancer, Calle gives Stahl a long list: "Breast cancer, colon cancer, endometrial cancer, kidney cancer, cancer of the esophagus, pancreatic cancer, liver cancer." "I should have said what cancers don't, aren't affected by obesity," Stahl remarks. "There are very few that aren't affected, yes," Calle says. "Have you been able to calculate how many people die every year of obesity-related cancers?" Stahl asks. "We have. And our estimate is that about 100,000 individuals in the U.S…,every year die of cancer, because of their weight," Calle says. "So if you lose weight, you're fending off cancer?" Stahl asks. "Well, that is and has been, up until now, sort of the piece of evidence that hasn't been in place. People don’t really lose weight in this country," Calle says. "They lose it and they gain it back." ***so sure, they didn't actually come out and say gastric bypass cures cancer, however I'm sure many people who watched this didn't make that distinction. It's very debatable whether cancer is caused by overweight in any case, even though researchers continually claim it regardless of what the study numbers show. http://www.time.com/time/health/arti...655367,00.html "The larger of the two studies — the largest of its kind — led by researchers at the University of Utah School of Medicine, looked specifically at gastric bypass surgery, also known as Roux-en-Y gastric bypass, which accounts for 80% of all bariatric surgeries in the U.S. It's interesting to me that when I asked you for a cite for your data you gave me a link to a press release/story in Time Magazine. Ironically the very story that the link I gave you above does a good job of debunking with the actual statistics from the actual study, not what was presented in a current events magazine. This would be the *actual* cite: http://content.nejm.org/cgi/content/full/357/8/741 To properly evaluate the claims made by the researchers, you will have to read beyond the abstract and look at the methods, especially how the study group was not selected at random and how the 10 years were measured not from the date of the procedures, but the date of the survey mail out. Yeah, here we go again. You asked if 60 Minutes interviewed any long term gastric bypass patients, as if anecdotal evidence proves much of anything. Here you have an actual study, and you want to rail against it over what method is used as the starting point to measure whether long term is 9 years or 10 years, as if that would make a critical difference in the outcome. Unless you have evidence that it does, then it's just attacking the study on any basis because you don't like the results. Interesting though that you have the link to the study, while asking me for it. Nope, I had no idea which study you were talking about. I found the cite after following your link and reading the pr article. From there it was relatively easy to find the actual study. In the Utah study, researchers compiled data on 15,850 severely obese people, half of whom had undergone gastric bypass surgery between 1984 and 2002, and half who were from the general population and had had no surgical intervention for obesity. Overall, researchers found, the surgery patients were 40% less likely to die from any cause during a mean 7 years of follow-up, compared with the obese controls. What's more, the mortality rate attributable to obesity-related disease was 52% lower on the whole in the surgery group: after gastric bypass, patients were 92% less likely to die from diabetes, 59% less likely to die from coronary artery disease, and60% less likely to be killed by cancer." and this: http://www.cbsnews.com/stories/2007/...n3196880.shtml Surprise! it's another press release of the same study. I think some of the criticisms and questions raised are probably valid, and others are likely not. For example, this blog raise the possibility that the remission of diabetes type 2 in gastric bypass could be due to the patients simply eating less food. Geez, I would expect that researchers at a place like Cornell Medical center would have the basic sense to test for this, which would be trivial. This bypass effect results in remission within days. Surely they have data and experience with other obese people with type 2 that have been on severely restricted diets for a week to rule that effect out. As well as the studies with rats. Are we to believe they are so stupid as to not test this hypothesis on the rats, where they found the bypass effect to work, and where they can clearly control the food intake? So, when some blog starts hurling stuff like that around, my BS detector goes off. One aspect this blog focuses heavily on is the supposedly very negative longer range effects. The60Minutesstory had a Dr with 4000 patients and 10-15 years worth of experience. I've also seen other info from actual studies that suggest the long death rate in gastric bypass patients from all causes is substantially less than those that do not have the procedure. You might want to look into that a little deeper. The net is becomming increasingly crowded with blogs and support groups for people who have had the surgery long enough for the serious side-effects to develop. Did 60minutesreally talk to long-term bypass patients? Those who are 7-10 years out to see how those people are living now? 60Minutesdid not show interviews with long term patients. They did, as I pointed out above, interview a doctor with 4000 patients and 10-15 years experience. Would that doctor perhaps, be wanting to sell his services to the viewers of this program? Yes, perhaps. But I could easily dismiss most studies, professional opinions, etc on a similar basis. If gastric bypass is so damaging and bad as you seem to believe it is, 60 Minutes could have done a story on the irresponsible greed of doctors and medical professionals. That would have been an even more sensational story. Perhaps you haven't noticed, but it's really not fashionable these days to question the rationale that fat will kill you. Why on earth would the sponsors pay for a program that bashes a surgery that 'cures' fat people. I looked at the60Minutesstory as a view into a curious side effect of gastric bypass that no one expected, which is leading to more research and COULD lead to treatment or cure for type 2 diabetes. That could come from gastric bypass itself.. It could also come from a better understanding of what goes on in the duodenum that causes bypass to work, which in turn leads to a drug, etc. I guess you could argue that the story was overly positive on gastric bypass, but there certainly are studies that support it as a valid procedure for some patients. And60Minutesclearly stated that patients typically don't lose all their excess weight, but typically lose about 1/3 and instead go from morbidly obese to just obese or overweight, etc. Once again, I'd like a cite, with long-term data. Try googling. I'm not claiming to be an expert on gastric bypass or to have all the answers, long term data, etc. If you're so familiar with the various aspects, pro and con, why do I have to be the one to find the studies? Because you're the one who said that you knew of studie(s) showing the amazing benefits of gastric bypass surgeries. Look, over the years, I've seen endless posts from many people here talking about some new study, whether it be about LC, weight loss, cholesterol, diabetes, etc. And in the majority of cases, all that is provided is a link to the news story or perhaps an abstract of the study, at best. I've never seen such hostility or demand for the whole study, proof etc directed at them. And for good reason. Many times these studies have been printed in medical journals and unless you pay for access, you can't get the whole study. I provided links that give the same sort of summary info for the 2 studies that directly support much of what 60 Minutes reported You actually have one of the studies and the opening attack against it is the silly 9 years vs 10.5 years argument. So, what's the point? In short, you can draw your own conclusions. But I would look at actual data from many sources before jumping to the conclusion that the60Minutesstory is untrue because one blog says so. Good idea. Let us know when you start. Excuse me? Why the sarcasm? Because while telling me to look at the actual data to form my own conclusions, you are linking to ****ing press releases. And now you interject profanity, which is never a good way to convince people of your position. Why exactly are you so emotional over this? I provided links to the news reports, exactly as many others have done here over the years without being attacked. I've looked at the nurses blog you provided and IMO it's clear that she has a very biased approach to looking at this whole issue. Nothing there is even close to being balanced and objective. I understand that you think that she's not objective. What if the studies are flawed? These studies have legitimate flaws that delegitimize their reported claims. If gastric bypass (or bariatric surgery, or lap banding) is safe and helpful in the long term than you wouldn't have to play games with the methods and the reporting to sell the procedure. How can you report good news if there isn't any. On the other hand, despite all the time this thread has been going on, it's quite obvious that you haven't even bothered to find out what 60 Minutes actually reported. If you had, you wouldn't be asking me about what 60 Minutes did or did not say. If you're interested in being fair and objective, that would seem to be a good place to start, rather than demanding I provide full research studies. As I said in this thread many times, I saw the 60 Minutes Story mostly as opening a whole new avenue of potential treatments for type 2 diabetes and perhaps more. Researchers have found that bypassing the duodenum reversed type 2 diabetes ina few days in humans. They confirmed it with studies in rats. More studies are under way to find out more about how this works and how it might be used. Exactly the same process over the years has resulted in major medical breakthroughs, which is a good thing and has saved lives. Bottom line, are you against this research? Should this medical curiosity just be ignored? What exactly do you want? I want people to have access to information that will help them to make good health care decisions. I don't think that's a bad thing. I doubt that you will find unbiased health information from newsshows whose advertising often comes from the heathcare conglomerates. As to whether I want research, of course I do, but research is only as good as the methodology. The criticisms in the pieces I linked to were valid. You should know from hanging out in this group how often studies are mis-reported or methodologically unsound. Just because it's been published in a peer reviewed journal does not mean that all is right with the paper. Especially currently in the medical journals. Want to see just how bad it can be? Google 'Enhance Trial'. The internets are increasingly home to blogs and support groups by and for people who are past the honeymoon period and are starting to get very sick, mostly from starvation-related diseases. So great, bariatric surgery will cure my diabetes, I'll get nesidioblastosis and rotting teeth instead. Sounds great, sign me up. If you refuse to look critically at study data with an eye to the methodology than no-one can help you. good luck, brigid |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
" wrote:
For example, this blog raise the possibility that the remission of diabetes type 2 in gastric bypass could be due to the patients simply eating less food. That's the very first thing I noticed about it. Get the surgery and you're instantly on a program far more strict than Atkins Induction, yet plenty of type 2 diabetics who go on Atkins Induction find they go asymptomatic without meds. Geez, I would expect that researchers at a place like Cornell Medical center would have the basic sense to test for this, which would be trivial. If so I'd sure like to see the data that compares folks put on a diet more restrictive than Atkins Induction without the surgery compared to folks forced into it because of the surgery. It's quite possible they've never done such a study, or that their data is poor because the non-surgery folks are self reporting and the surgery folks have forced total adherence. This bypass effect results in remission within days. As opposed to Atkins Induction which appears to do the same with probably lower result percentages. *Surely they have data and experience with other obese people with type 2 that have been on severely restricted diets for a week to rule that effect out. I'm far from convinced of this. There are still studies coming out that compared whole grains (oatmeal) against refined grains (frosted flakes) that give the obvious data that frosted flakes are worse, but the conclusion is that after comparing grain to grain it turns out that grain is good. With studies having such poor logic getting published, I want to see the data that compares folks in resident programs fed the same thing as the surgery folks. As well as the studies with rats. *Are we to believe they are so stupid as to not test this hypothesis on the rats, where they found the bypass effect to work, and where they can clearly control the food intake? * So, when some blog starts hurling stuff like that around, my BS detector goes off. Is the data there for rats? I want the data for humans. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
On May 4, 6:23*pm, brigid nelson wrote:
wrote: On May 3, 5:30 pm, brigid nelson wrote: wrote: On May 3, 1:21 pm, brigid nelson wrote: wrote: Now, I'm not always a fan of60Minutes, but I don't see how criticisms leveled by a blog run by a nurse equates to the60Minutes story being untrue or unverified. * *Clearly that blog has it's own agenda and false statements. * Right out of the gate, this blog accuses60Minutesof saying that gastric bypass cures cancer. * I saw the story, it's available online and no such thing was ever said. What they did say was obesity raises the risk of several types of cancer and that some studies have found that for people that have the bypass surgery, the risk of cancer is cut in half. The 'nurse' who writes this blog understands research methodology and does an excellent job of de-bunking claims of weight-related morbidity. Poke around her site some more and follow the links to the studies. Here's another interesting article on Gastric Bypass: http://junkfoodscience.blogspot.com/...ally-proof-tha.... Also, can you give me a cite for the study that shows the risk of cancer decreasing with bypass surgery? I'm interested to see the sample size, how long subjects were followed, and how these researchers decided they could determine the causation of cancer to be fatness. Sorry if you have a problem with me pointing out that the blog is run by a nurse, but that is apparently her academic credentials related to the discussion at hand. * *I didn't do the research for60Minutes. *I don't know what specific study they based the claim on. *But a simple google produced this, which says long term, the risk of dying from cancer was cut by60% and is consistent with what60Minutesreported: I detected a disparaging tone in your original post about the legitimacy of the opinion of a *nurse*. What I objected to was Hakans statement that the opinion of this nurse on a blog means that the 60 Minutes Story is untrue. *Knowing a little something about methodology myself, I find this nurse to be an good resource as she carefully explains the methods and statistics used in these studies that the media parade out in order to make us feel bad about ourselves and/or buy expensive drugs and surgical treatments that may do more harm than good. I think she performs a useful service as not everyone has taken a class in research methods or statistical analysis. A nurse with a BSN would have had at least one such class - and she obviously paid attention. I just wish she'd read Taubes as I find her insistance that carbs are harmless to be somewhat uninformed. What I see is someone who has formed a opinion and is using FUD tactics to hurl anything at all to try to paint gastric bypass in an unfavorable light. * Take this gem which leads off the blogs criticism of the Swedish study: "We’ll begin with one of the most common misconceptions: years of follow-up. Since this study was examining the long-term effects of bariatric surgery on mortality, it’s understandable you might think that the average 10.9 years of follow-up reported meant the patients were followed for 10.9 years after having surgery. Here is the first example of not reading the study. The follow-up period — which actually ranged from 4 to 18 years — began from the “matching date.” That was the date that the study recruitment campaign ended and the surgical candidates were chosen and matched with controls. This was about 1 1/2 years before the surgeries were actually performed. So, we’re down to just over an average 9 years of post-surgical follow-up. " This is the starting point, the best she can come up with to tear into the Swedish study? * Arguing a nit over whether the long term measurement point is 9 years or 10.5 years? * What critical difference does that make in the grand scheme of things? * If you want to start attacking studies, you can tear any of them apart with such critcisms. * But IMO, it does show how biased she is. If one wants to start with a critical analysis, why not start with her own claim that 60 Minutes said gastric bypass cures cancer. * That is an outrageous falsehood. *They clearly said studies showed it reduced rates of cancer, not cured it. You know what? I didn't see the show so I googled to see if I could find a transcript. I found this: http://www.cbsnews.com/stories/2008/...n4023451.shtml Here's the first paragraph: (CBS) It's pretty well known to doctors that the most successful treatment for obesity is surgery, especially the gastric bypass operation. But here's something the medical world is just realizing: that the gastric bypass operation has other even more dramatic effects. It can force type 2 diabetes into almost instant remission and it appears to reduce the risk of cancer. This is from the third page: In addition to the operation reducing hypertension and coronary artery disease, there appears to be an affect on cancer as well. "Does being fat give you cancer?" Stahl asks Dr. Eugenia Calle, an epidemiologist at the American Cancer Society. "Being overweight or obese increases the likelihood that you'll get several different types of cancer," Calle says. Dr. Calle has been studying the link between cancer and obesity. Asked what kinds of cancer, Calle gives Stahl a long list: "Breast cancer, colon cancer, endometrial cancer, kidney cancer, cancer of the esophagus, pancreatic cancer, liver cancer." "I should have said what cancers don't, aren't affected by obesity," Stahl remarks. "There are very few that aren't affected, yes," Calle says. "Have you been able to calculate how many people die every year of obesity-related cancers?" Stahl asks. "We have. And our estimate is that about 100,000 individuals in the U.S…,every year die of cancer, because of their weight," Calle says. "So if you lose weight, you're fending off cancer?" Stahl asks. "Well, that is and has been, up until now, sort of the piece of evidence that hasn't been in place. People don’t really lose weight in this country," Calle says. "They lose it and they gain it back." ***so sure, they didn't actually come out and say gastric bypass cures cancer, however I'm sure many people who watched this didn't make that distinction. It's very debatable whether cancer is caused by overweight in any case, even though researchers continually claim it regardless of what the study numbers show. It's rather bizarre that you think the above supports the outrageous claim made on your blog reference that said 60 Minutes said GASTRIC BYPASS CURES CANCER. Everything you've excerpted above is very clear. 60 Minutes actually stated that gastric bypass and the resulting weight loss reduces cancer rates, not cures it. And what they reported is supported by studies. Still funny how you focus on 60 Minutes, and give free passes to others who can't get even one of the most basic facts right while hurling criticism. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
On May 5, 10:53*am, Doug Freyburger wrote:
" wrote: For example, this blog raise the possibility that the remission of diabetes type 2 in gastric bypass could be due to the patients simply eating less food. That's the very first thing I noticed about it. *Get the surgery and you're instantly on a program far more strict than Atkins Induction, yet plenty of type 2 diabetics who go on Atkins Induction find they go asymptomatic without meds. Geez, I would expect that researchers at a place like Cornell Medical center would have the basic sense to test for this, which would be trivial. If so I'd sure like to see the data that compares folks put on a diet more restrictive than Atkins Induction without the surgery compared to folks forced into it because of the surgery. How is the diet of a gastric bypass patient more restrictive than Atkins induction? AFAIK, they are free to eat reasonable amounts of carbs and aren't even close to induction. They must be eating plenty of something, because in most cases patients lose about 1/3 of their weight and while not morbidly obese, remain overweight or obese, yet apparently the type 2 disappears. *It's quite possible they've never done such a study, or that their data is poor because the non-surgery folks are self reporting and the surgery folks have forced total adherence. This bypass effect results in remission within days. As opposed to Atkins Induction which appears to do the same with probably lower result percentages. It would be interesting to hear from the type 2's here as to whether Atkins induction made their type 2 disappear within days. *Surely they have data and experience with other obese people with type 2 that have been on severely restricted diets for a week to rule that effect out. I'm far from convinced of this. * This curious fact about bypassing the duodenum and the disappearance of type 2 came apparently came about through clinical observation. You don't think with all the millions of obese people that doctors have seen for decades that they would not have noticed his effect due simply to reducing food intake? I mean you have type 2 patients that have had all kinds of surgeries, accidents, etc that have been in hospitals, where they are eating drastically reduced amounts, or not at all and need to adjust their medication, monitor them, etc. If the same dramatic complete reversal of type 2 occured due to simply eating less, it would seem to me that it would have been noticed long ago. Now, I'm not saying that isn't possible. I'm just saying I find it dubious that this is one of the opening lines of attack leveled by that blog. It doesn't seem likely to me. But even more important, it would seem to me that it's up to the person trying to refute 60 Minutes to actually find out what the researchers did, what they ruled in and out, rather than throwing out baseless what if speculation. There are still studies coming out that compared whole grains (oatmeal) against refined grains (frosted flakes) that give the obvious data that frosted flakes are worse, but the conclusion is that after comparing grain to grain it turns out that grain is good. *With studies having such poor logic getting published, I want to see the data that compares folks in resident programs fed the same thing as the surgery folks. As well as the studies with rats. *Are we to believe they are so stupid as to not test this hypothesis on the rats, where they found the bypass effect to work, and where they can clearly control the food intake? * So, when some blog starts hurling stuff like that around, my BS detector goes off. Is the data there for rats? *I want the data for humans. Don't you think that would be a good thing for someone to find out, before they start hurling speculative objections trying to refute 60 Minutes, the doctors, researchers, etc? I would be very surprised if the study with rats did not have a control group that was fed the same diet as the rats that had the duodenum bypass. To not do so, this research would be laughed out of any peer review. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
" wrote:
Doug Freyburger wrote: " wrote: Geez, I would expect that researchers at a place like Cornell Medical center would have the basic sense to test for this, which would be trivial. If so I'd sure like to see the data that compares folks put on a diet more restrictive than Atkins Induction without the surgery compared to folks forced into it because of the surgery. How is the diet of a gastric bypass patient more restrictive than Atkins induction? Based on this I can't tell if you have no idea what foods are eaten by folks fresh out of by pass surgery or by folks fresh on Induction. Given your history of willfully ignoring parts of Atkins both. AFAIK, they are free to eat reasonable amounts of carbs and aren't even close to induction. No. At-kids are allowed whatever it takes to get through cravings then use the appetite suppression of ketonuria to taper down portions - rule 5 of Induction. Bypass folks start out well under 1000 calories and taper back up on a time scale of multiple months. They eat both low carb and low fat. They must be eating plenty of something, because in most cases patients lose about 1/3 of their weight and while not morbidly obese, remain overweight or obese, yet apparently the type 2 disappears. To me the mystery of lap band or by pass is how they avoid starvation mode symptoms like T3 reduction. This bypass effect results in remission within days. As opposed to Atkins Induction which appears to do the same with probably lower result percentages. It would be interesting to hear from the type 2's here as to whether Atkins induction made their type 2 disappear within days. Absolutely. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
Doug Freyburger wrote:
To me the mystery of lap band or by pass is how they avoid starvation mode symptoms like T3 reduction. I know I said I was done playing in this particular sandbox, but: Amongst all that stuff I linked to in previous posts are descriptions of some of the nutritionally-related disorders that affect bariatric patients. These include beriberi, calcium deficiencies, anemia, and various pancreatic disorders. If you're really curious, look at some of the blogs written by bariatric patients - especially the ones written by patients who are more than five years out. Warning, it gets depressing really fast. Couple of links: http://meltingmama.typepad.com/wls/2...xiest-pos.html http://gastricbypass.netfirms.com/jib.htm http://gastricbypass.netfirms.com/ And a Yahoo group that you can subscribe to and read but not post, unless you are a post-surgical patient: http://groups.yahoo.com/group/OSSG-gone_wrong/ Really, not going to post about this anymore brigid |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
On May 5, 12:57*pm, Doug Freyburger wrote:
" wrote: Doug Freyburger wrote: " wrote: Geez, I would expect that researchers at a place like Cornell Medical center would have the basic sense to test for this, which would be trivial. If so I'd sure like to see the data that compares folks put on a diet more restrictive than Atkins Induction without the surgery compared to folks forced into it because of the surgery. How is the diet of a gastric bypass patient more restrictive than Atkins induction? Based on this I can't tell if you have no idea what foods are eaten by folks fresh out of by pass surgery or by folks fresh on Induction. *Given your history of willfully ignoring parts of Atkins both. Instead of simply answering the question, you open instead with an attack on my credibility? A very curious attack, because regular readers here should know that over the years, I've provided many excerpts directly from Atkins books and similar references to backup what I've stated. You, on the other hand, never do, despite being asked to do so. AFAIK, they are free to eat reasonable amounts of carbs and aren't even close to induction. No. *At-kids are allowed whatever it takes to get through cravings then use the appetite suppression of ketonuria to taper down portions - rule 5 of Induction. *Bypass folks start out well under 1000 calories and taper back up on a time scale of multiple months. *They eat both low carb and low fat. With Atkins you are allowed whatever it takes to get through cravings? During induction? That's a new take on induction. There is no question that gastric bypass patients are eating limited amounts of food. They reduce both sugar and fat. But whether that translates into it being more restrictive than Atkins induction is certainly arguable. I took it to mean that it is more restrictive in the sense that it similar to induction, but even more limited. The fact that the post-operative diet for 4-6 weeks includes refined cereal, mashed potato, applesauce, and unsweetened fruit juice means it isn't anything at all like Atkins induction. Here's a reference as to what the diet is: http://www.hopkinsbayview.org/health...stricdiet.html And please note who provided a reference. Also take a look at the next stage from that reference, after the 6 weeks, when they expand the list of allowed foods to include rice, pasta, toast, crackers, etc. The obvious point being, that this is nothing at all like the Atkins diet. Yet, these patients have a very high rate of diabetes remission that starts within days of surgery and continues long term, when their diet includes more sugar, starch etc. Curiously, these patients also report a lack of cravings, which if you were following Atkins and started eating all that, one would think would return. They must be eating plenty of something, because in most cases patients lose about 1/3 of their weight and while not morbidly obese, remain overweight or obese, yet apparently the type 2 disappears. To me the mystery of lap band or by pass is how they avoid starvation mode symptoms like T3 reduction. You completely avoided the obvious point. Most of these patients go from morbidly obese to obese or overweight. Therefore, they are obviously eating a reasonably high amount of food. Which makes sense, because the stomach slowly expands again, so it eventually holds more food. It's not the diet of the first week after surgery. And the list of allowed foods contains rice, bread, crackers, pasta, fruit juice, etc. Yet, the reversal of diabetes that occurs within days of the surgery persists. How do you explain that in terms of a restricted diet or comparing it to Atkins induction? You can't. And while we're on references, here's another one that answers your question about rats. Remember how I said it would be extremely unlikely for the researchers to not have had a control group of rats that were fed the same diets, as the group of rate that received the bypass, so the bypass would be the only variable? That's because unlike some people here, I think most researchers at well known institutions who publish peer reviewed studies have sufficient intelligence to do a study that at least covers the obvious basics. Since you apparently would rather pontificate instead of google, here once again is the reference to the study: http://lib.bioinfo.pl/auth:Rubino,F "Ann Surg. 2006 Nov ;244 (5):741-749 17060767 (P,S,E,B,D) Favorite:1 The Mechanism of Diabetes Control After Gastrointestinal Bypass Surgery Reveals a Role of the Proximal Small Intestine in the Pathophysiology of Type 2 Diabetes. METHODS:: Goto-Kakizaki (GK) type 2 diabetic rats underwent duodenal- jejunal bypass (DJB), a stomach-preserving RYGB that excludes the proximal intestine, or a gastrojejunostomy (GJ), which creates a shortcut for ingested nutrients without bypassing any intestine. Controls were pair-fed (PF) sham-operated and untreated GK rats. Rats that had undergone GJ were then reoperated to exclude the proximal intestine; and conversely, duodenal passage was restored in rats that had undergone DJB CONCLUSIONS:: This study shows that bypassing a short segment of proximal intestine directly ameliorates type 2 diabetes, independently of effects on food intake, body weight, malabsorption, or nutrient delivery to the hindgut. These findings suggest that a proximal intestinal bypass could be considered for diabetes treatment and that potentially undiscovered factors from the proximal bowel might contribute to the pathophysiology of type 2 diabetes. " So, clearly in rats, the effect is independent of food intake, providing strong evidence that something besides diet or the size of the stomach is responsible for what is going on. And note that in this study, only the duodenum was bypassed, not the stomach itself. Surely there is something very amazing going on in the first few inches of the small intestine. Now, what should we do? Join the chorus railing against all gastric bypasses? Heap more baseless criticism on the research methods, without even understanding what they did? Or welcome more research that could benefit diabetics and the obese? And note, I'm not saying that means surgery is the answer. For example, it could very well be that it results in discovering the true underlying mechanism here, which in turn leads to a drugs that could combat diabetes and obesity. Finally, here's a fairly balanced article about the whole subject of type 2 diabetes and gastric bypass from the Washington Post: Surgery Shows Promise For Treatment of Diabetes http://www.washingtonpost.com/wp-dyn...r=emailarticle This bypass effect results in remission within days. As opposed to Atkins Induction which appears to do the same with probably lower result percentages. It would be interesting to hear from the type 2's here as to whether Atkins induction made their type 2 disappear within days. Absolutely. I found a small study that addresses that as well. The study put type 2's on a LC diet and monitored them for 2 weeks. The conclusion was that they had much improved BG profiles and insulin sensitivity. But no where does it come close to saying that diabetes went into remission. I could post the reference, but maybe you should do some googling yourself. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
" wrote:
A very curious attack, because regular readers here should know that over the years, I've provided many excerpts directly from Atkins books and similar references to backup what I've stated. You, on the other hand, never do, despite being asked to do so. Incorrect. I've given you numerous citations and quotes. You responded with disagreement and blindly stuck to your own simple minded interpretations. As a result I long ago wrote you off. You get all the citation responses your prior history justifies. It isn't requests for citations I ignore - It's your requests I ignore. And until you start paying attention to folks who disagree with your points and show that you are able to learn based on evidence that status will continue. |
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60 Minutes Story on Gastric Bypass and elimination on Type 2Diabetes
On May 6, 3:55*pm, Doug Freyburger wrote:
" wrote: A very curious attack, because regular readers here should know that over the years, I've provided many excerpts directly from Atkins books and similar references to backup what I've stated. * You, on the other hand, never do, despite being asked to do so. Incorrect. *I've given you numerous citations and quotes. LOL, I'll leave it for others to judge who has frequently cited Atkins, complete with page, and who just posts and insists that it is so, without any reference. Your most cherished reference is your own "internet observations", which you claim to log and spew forth as fact. Remember when you made up the story that Dr. Agatston, the creator of the South Beach diet, worked at the Atkins Center and got the basis for his South Beach diet via that route? Hmmm? Did you provide a citation for that falsehood? In the course of that thread, other people had problems with how you frequently state personal opinion as if it were established fact and can't distinguish between the two. You responded with disagreement and blindly stuck to your own simple minded interpretations. No, I gave you the Atkins page and excerpts on many occasions. Like when someone asks if they can stay on induction for longer than 2 weeks and you tell people that induction should only last 2 weeks and Atkins had a hard check list of conditions that must be met for it to go longer. That was BS. Or when you claimed Atkins said that moving past induction to higher carb levels results in faster weight loss. That was BS as well. On both those, I provided you citations from Atkins book, complete with pages. You provided zippo, while continuing to spout those two assertions as if they were Atkins truths. *As a result I long ago wrote you off. *You get all the citation responses your prior history justifies. *It isn't requests for citations I ignore - It's your requests I ignore. *And until you start paying attention to folks who disagree with your points and show that you are able to learn based on evidence that status will continue. In other words, as usual, you have zippo to support your position. I even gave you the citation for the rat study that you questioned the existence of, and were obviously too lazy to go find yourself. It goes a long way to smashing your conjecture that food intake is responsible for the remission in diabetes. Just as I stated, when we first got into this, the researchers were not so stupid as to not have done a valid study, with diet held constant, so as to eliminate it as a factor. And guess what? The diabetes disappears with the duodenum bypass and returns when it's restored, with the same diet. In an attempt to bring some balance to the discussion, I included a reference to the Washington Post story, that discusses the whole diabetes gastric bypass issue in what I think is a pretty fair way. As far as being written off, I take that as good news. I've written you off as a big blow hard long ago. But I still won't let you own the newsgroup and spout your nonsense, without it going challenged. |
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