The Hope Warshaw Article that Caused an Uproar

Photo courtesy of Carlos Porto


On every online forum for diabetes there is a low carb debate.  Does it help those with type 2 diabetes?  How many carbs per day constitutes low carb?  Does it help those with type 1 diabetes?  But doesn’t the brain need glucose for energy?  It’s a hot topic to say the least. 

While many debate against the details of what constitutes low carb, few people on these forums combat the notion that reducing carbs helps many people with diabetes.  And this is where I get confused with articles such as this one by renowned dietician and diabetes educator, Hope Warshaw.  In her article, she says low carb diets are not effective for people with diabetes and that weight loss will not lower blood sugar. 

Warshaw says there are “countless” studies to confirm the merits of the diet she recommends which is 45-65% of one’s calories coming from carbohydrates.  Yet, she does not cite a single one of those studies.  As for the weight loss, she points out that  “Large studies have shown that with loss of five to seven percent of body weight (approximately 10 to 20 pounds) and 150 minutes of physical activity (30 minutes five times a week), people can prevent or delay the progression to type 2. Once insulin production is on a dwindling course (particularly after 10 years with type 2), weight loss has less impact on glucose control.”  That’s not a lot of weight loss.  This would be like someone going from 200 to about 190 pounds.  How much blood sugar impact could that have in the long run?  Maybe we should note how well blood sugar is impacted by seeing what happens when an obese person’s weight drops to the healthy weight reange .  For optimal health, the goal is a healthy weight, no? 

Warshaw claims that treating diabetes by reducing carbs is an old dogma because that’s what we did with diabetics back in the days before insulin and medications.  True.  We didn’t have many options back then.  Today, many type 2 diabetics have found it useful to be somewhere along the spectrum of softly limiting carbs to harshly avoiding them.  There are also the type 1 diabetics out there like myself, who have managed to finally lower A1c levels by reducing carbs.  How does someone as influential as Hope Warshaw ignore the online ravings of people with diabetes on the success they have by limiting carbohydrates to some degree?  Does she read this stuff and think that something else must be to blame for our improved health?  Does she read this stuff at all?  Because I tend to think our community’s online sharing is pretty valuable information to medical experts.

I don’t know that every adult with diabetes must limit carbs.  According to my research it seems they should at least be careful about grains.  I just know that I feel and look healthier with my A1c close to a non-diabetic’s and the only way to do that for myself is to limit carbs from grains like bread, pasta, rice, and corn. 

What I find interesting is many dieticians including Hope Warshaw, explain the ineffectiveness of low carb by saying it’s unrealistic eating behavior.  Warshaw recently went head to head with Dr. Bernstein and said that eating low carb is unsustainable.  She said people have the right to eat what they love.  She said we deserve it.  If I want to sell a book about health to the masses, that’s how I would go.  I would tell people what they want to hear.  Many people with diabetes do not feel well and are thus quite vulnerable to an expert’s say so it’s genius, really.  However, when a person smokes too much and are on the brink of emphysema, should a doctor say, “Aw you know what?  You’re addicted to smoking.  Why should I try to take you away from something you love and are addicted to?   Why don’t you just switch to a higher quality tobacco?  Let me prescribe something to help with your symptoms.”  I’ve never heard of that happening.  My thinking is I deserve a long and healthy life with diabetes and so does everyone else.  Does that come with the need for restraint?  Why yes!  But so does being married, being a world class athlete, and doing well in college.

Warshaw says a low carb diet is hard to stick to in the long run.  My thought is, don’t people have a hard time sticking to ANY diet in the long run?  I don’t think low carb is an exception.   Experts stating over and over that low carb is just too hard for people makes me wonder if someone thinks we’re weak little creatures.  Golly, how do we manage to go to work every day?  I mean, the discipline involved!  Round of applause and a cupcake for me please, I got out of bed at 5am this morning to exercise.

Again, I’m not saying low carb is the way to go for everyone.  It just doesn’t make sense to say it’s wrong without any real proof, without consideration for the success others have with it, and without any valid reasons to tell someone not to simply try it.  Telling someone not to try low carb because it’s hard is like telling a child not to go for being a president or a basketball champ or a published author because it’s too challenging.  Puleeez. 

How many times a day do I hear “low carb is a fad diet”?  A lot.  And yet I’ve seen my lab results on the ADA diet and I’ve seen them on the lowish carb diet I follow consisting of around 50-75 grams a day.  The difference is startling and I’m reaping the benefits.  You won’t find my doctor telling me to change my diet.

I have nothing against Hope Warshaw or other medical experts.  I only wish they would recognize what we in the low or “lowish” carb community are desperately saying to them.   We’re saying that A) lowering carbs is helping us be healthy, B) the same diet doesn’t work for everyone (see; the world’s people), and C) what people deserve is to be healthy and to be encouraged towards that and not instant gratification.  Oh and D)  Ignoring the above is dangerous and irresponsible.

We’re not doctors or famous people but we’re capable of great things and we need the medical community to take note of our valuable observations and to believe in us.  We’re smarter and stronger than they seem to think.

11 thoughts on “The Hope Warshaw Article that Caused an Uproar

  1. Amanda S.


    All I can say to your post is I AGREE!!!
    I feel like I need to scream it from the rooftops or something louder for those who need to hear it.

  2. Kelly Booth

    Great article Sysy. I agree with you that low carb is not for everyone but it does work for a lot of people. I also think that there is a huge difference between a person not sticking to it long term when they are just trying to lose weight than someone doing it for health reasons. I wish I had discovered low carb years ago pre-internet days and I might not have neuropathy today. I can’t change my past but I can change my future and I intend to fight with every ounce of energy I have to stay healthy – that includes attempting keep my BS as normal as possible.

  3. Scully

    Wow. SO SMART! I love your writing. You touched on SO many good topics I can’t even reply to them all!
    and yes, same here, I was never officially diagnosed with Celiac but I am living a gluten-free life because it’s the only thing in 6 years that’s made me feel GOOD.
    it doesn’t work for everybody.
    BUT… “golly, how do we manage to get to work everyday?” made me laugh out loud!
    I agree with that point you made the MOST. We are humans and we are incredibly able to adapt. It’s not that hard.

  4. Natalie Sera

    I think the reason they say “lose 5 – 10% of your body weight, and the Type 2 may go into remission” is that it DOES work for very early stage Type 2’s for a while. Whereas getting down to “normal” weight may not even be possible for the severely obese, because they have multiple metabolic problems. Part of the reason bariatric surgery works for many of them is that it circumvents a number of gut hormones, and forces them to eat an extremely limited amount of calories without the hunger that simply eating a starvation diet would cause (and it has been PROVEN that a starvation diet prevents Type 2). And some of them manage to circumvent the surgery, and stretch their pouches, and go back to being extremely obese again. There are NO easy answers to obesity, but I agree that low-carb could at least help.

  5. Sysy Post author

    I totally agree, Natalie. That is subject matter for another long post and definitely deserves the same attention. Thanks for the comment :)

  6. Jane

    Like you said, so many people on diabetes forums and blogs are writing about this article…people are not happy with it at all. People are tired of being treated like idiots by others who are supposed to be in a position of authority (not just doctors and dieticians, but politicians, investment bankers, ect…). I think we are in for radical change throughout the world, as “The People” take the power that is theirs. We will not give our power away, but find our way to the right path for us (regardless of what we are being told by these “authorities”). They will have to start listening and putting “The People”‘s needs and desires ahead of their own agenda, because without “us”, they do not have any power.

  7. Reyna

    LOVED this post (btw, your blog isn’t showing up on my blog roll!!! sorry for my absence over here ~ I will fix it).

    I struggle with this for Joe. I myself dont eat a ton of carbs…under a 100/d. Joe usually eats about 150/d…1/2 of them fruit and dairy and 1/2 in grains. He does well (for the most part) with a routine (I usually feed him the same amount of carbs at the same time daily).

    I am also not sure about how much to limit a primary fuel source for a growing/very active boy. Admittedly, I need to research this more. Thank you, as always, for a wonderfully thought provoking post. xo

  8. Forest Ray

    I am a low carb loser to the tonnage of 135 pounds in less than one year. I am a type 2 diabetic currently on Metformin only and I want to keep it that way. Every high carb diabetic i know has complications eyes,circulation and heart. No thanks keep the Hope and I will keep the results.

  9. Jennifer G

    I personally find that I have a harder time controlling (predicting) my numbers when I eat high carb and high protein together. I actually did surprisingly well on a high carb vegan diet last summer. However, it was expensive to maintain, especially since my hubby and son were on a regular diet. This summer, I am pregnant and I am doing much better on a Dr supervised, high protein moderate carb (approx 170 g carbs per day divided evenly between 3 meals and 3 snacks.) My cholesterol is high right now, though, I am not sure if that is the pregnancy or the high protein/high fat diet. If it does not go back to the normal range after the baby is born, I might not be able to continue a high protein diet.

  10. Janet Love

    Jennifer, how much (real) fat are you eating ?
    – I’d guess “low”. If you feel you need to regulate fats, then cut out the so-called “vegetable” oils, – such as canola. Replace with coconut oil and/or butter for cooking, olive for salads, – but get rid of poisonous artificial fake margarine. There is nothing evil about saturated fats, our body stores it on our hips & thighs and tummy… as Saturated Fat – which it then consumes while sleeping.
    Our current eating balance can be traced back to the (USA) McGovern Senate Enquiry into what the Standard American Diet should be.
    They got it woefully wrong, with emphasis on grains & carbs, with minimal meat and fats, enshrined in the Food Pyramid, and its descendants.

    The beauty of the LCHF approach is that it’s just that. A direction, a philosophy, a Guide. NO weighing or calorie counting – don’t start me on THAT one ! – just a judgement on ‘balance’. Keep going with high(er) fat and protein and it morphs into Ketogenic territory, again useful for many diabetics, especially for weight control.
    We have been fed lots of lies, from the US McGovern Enquiry through to current (HCLF) Diabetic Institutes guidelines, to the need to consume a set number of veggie and fruit servings per day. The use of “5 & 2” in both the veggie/fruit ratio AND in ‘eating/fasting’ popularised by a British TV Doctor….tells us “5 & 2” is a marketing jingle, not Science! Funny thing is, the ratio 5&2 varies in other countries…

    Then there is the Mediterranean Diet we are always being referred to as “Heart Healthy” – Big difference between the DIET, – and what people around the Mediterranean ACTUALLY eat.

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