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Wednesday 24 February 2016

Good News from Melbourne University's NZO Mouse LCHF "Paleo" Study

The egregious behaviour of Prof Sol Andrikopoulos in his press release to global media has obscured the finding that was the primary purpose of the "Three Mouseketeers" study.The study was supposed to answer a question that is actually of great importance in diabetes research:

- the blood sugars of people with diabetes usually improve and can become completely normal on the LCHF diet - this is actually something that has been known for a century or more.
- if you challenge someone who is doing well on the LCHF diet with an oral glucose tolerance test (a sudden large carbohydrate load) their response is often poor.
- is this a physiological adaptation to the diet, or does it indicate a risk of beta cell deterioration (as is usually seen long-term when high carb diets are fed to people with type 2 diabetes)?

The problem with the study, with regard to this question, is:
1) that the NZO mice chosen had a genetic defect, one that has never occurred in humans, which makes them fat-intolerant.

2) the NZO LCHFD mice gained weight significantly, whereas most overweight humans lose weight on the LCHFD and it is very rare to gain a significant amount of fat mass.

Weight is an important determinant of insulin resistance and glycemic control.

3) there was no deterioration in all 4 parameters of beta-cell morphology in the LCHFD NZO mice despite their weight gain and insulin resistance.

4) the diets were in no way designed to test the Paleo premise, which is that specific Neolithic and refined and processed modern foods have deleterious effects on the human organism, including with regard to weight and glycemic control.

Thus the study was inconclusive on its own terms, and could shed little light on the effect of a LCHFD in humans, and press releases equating its results to the probable effect of a LCHF or a Paleo diet (2 different things) were wholly unjustified.

These remarks and the wide publicity they received amount to unjustified interference in diabetes treatment methods that are working well.

If we take the results at face value, and assume they do apply to humans, it's an interesting exercise.

Most humans with type-2 diabetes told to eat high-starch diets will suffer beta-cell damage in a few years time and require ongoing increases in dose and number of anti-hyperglycaemic medication. These mice gained weight and became insulin resistant on the LCHFD yet didn't suffer beta-cell damage (at least according to the tests chosen by the Three Mouseketeers).
If pre-diabetic mice that become fat and IR on a LCHF diet don't suffer beta-cell damage, maybe humans that lower fat and insulin won't either. Unlike most type 2 diabetic humans on high-carb diets.  I don't see how one could be any worse off, anyway, and at least you'd always be eating the way that exposed you to least excess blood glucose and lowest risk of medication side effects.

As the authors say, "Indeed, there is mounting evidence that initial hypersecretion of insulin in prediabetes contributes to β-cell stress and failure."

If mice were men.

More here