By Marika Sboros
UK GP Dr David Unwin is receiving high praise globally from medical colleagues and other experts for his new low-carb study. It shows efficacy of low-carb diets as first-line treatment for type-2 diabetes. It builds on research showing benefits of these diets as possible prevention against the ongoing COVID19 pandemic.
Published in the BMJ (British Medical Journal) Nutrition, Prevention & Health, the study is open-access. Among plaudits, US professor of medicine Mark Cucuzella calls it “an amazing work of faith, perseverance, and the desire to heal”.
On Twitter, Czech medical lawyer attorney and global health management consultant Jan Vyjidak declares its results “astonishing”. No other real-world, primary-care evidence has comparable results, he says – as far as he knows. Scottish GP Malcolm Kendrick goes further in a provocative blog (scroll down for a full version). It proves that “Dr David Unwin can stop people dying of COVID-19 – by helping them lose weight”, Kendrick says.
Others call the study ground-breaking. It’s poised to break barriers to widespread medical use of low-carb diets for treatment and prevention of type 2 diabetes, they say. In many cases, patients have also been able to significantly reduce or come off diabetes drugs altogether.
Among the study’s conclusions:
- Doctors can “effectively incorporate advising a lower-carbohydrate diet approach for patients with T2 (diabetes) and prediabetes into routine primary care over a prolonged period (six years)”;
- Cost implications are significant. There was a £50,885 annual saving on the study’s Norwood GP practice NHS (National Health Service) type-2 diabetes drug budget. That’s compared to the average for 17 GP practices in the Southport and Formby region;
- If every GP practice in England were to make the same savings on medications for type-2 diabetes as the Norwood practice, the NHS could save up to £277,000,000 annually.
Given the “massive financial interests” involved, many will attack the study, Kendrick writes in his blog. “Scaled up to the US, with much higher drugs costs, one could be looking at around $2Bn/year. Around the world, who knows, but vast sums of money,” he says
Click here to read: COVID-19: is diet best weapon for protection, survival?
Drug-company boardrooms globally are also unlikely to welcome the study. The words “lead” and “balloon” spring to mind, writes Kendrick. “Equally, the massive low-fat, high-carb food manufacturers will be throwing their hands up in horror – ‘My bonus, my bonus…nooooo,’.”
The authors acknowledge study limitations. Because patients self-selected, they may have been more motivated to achieve positive results. As well, there was no group for comparison in regular practice. However, the authors point to low remission rates in these control groups of other studies.
Despite this, their results support major benefits for a low-carb approach in primary care. With adequate support and supervision, they say that a low-carb approach can extremely effectively improve blood glucose control. Wider health markers can improve and achieve drug-free remission of type-2 diabetes “in those who choose to pursue it”.
Dr David Unwin – the pioneer!
Maintaining diabetes control without drugs is likely “an important motivating factor for patients”.
Experts have widely acknowledged Dr David Unwin for pioneering the low-carb approach in the UK. In 2015, they made him a UK Royal College of General Practitioners expert clinical advisor. In 2016, he won the prestigious NHS Innovator of the Year award.
From 2017 to 2018, his practice saved £57,000 annually on drugs for type-2 diabetes, hypertension, and other conditions. All simply by offering patients a dietary alternative to drugs.
That made Kendrick’s blog on the study’s implications in the time of the COVID19 pandemic that much more relevant. (Scroll down for a link to the full version). If you are among those who “want to avoid dying of COVID19”, Kendrick says that one of the most important things you can do, if you are overweight, is to shed the pounds
The link between metabolic health and positive outcome of COVID19 infection remains extraordinarily controversial. Many MDs and dietitians still dismiss it out of hand despite mounting evidence.
Click here to read: COVID-19: Biggest risk is ‘not the virus’
Kendrick, as usual, backs it all up with the strongest of weapons – the evidence. He delivers in his pointedly whimsical didactic style. He refers to the first meta-analysis of its kind published in Obesity Review in August 2020. In it, an international team of researchers pooled data from scores of peer-reviewed papers capturing 399,000 patients. They found that people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital. Seventy-four percent more likely to be admitted to an ICU and 48% more likely to die”.
Why that is so centres around the damaging effect of raised blood glucose on endothelial cells and… “it gets complicated”, Kendrick writes. The most important thing is not to understand the complex metabolic and physiological pathways involved, he says. “It is simply to help people to lose weight “. That’s where Unwin comes in.
A shortened version of Kendrick’s blog follows:
By Malcolm Kendrick:
For years now (Dr David Unwin) has believed, as I do, that the main driver of weight gain, leading on to type 2 (T2) diabetes, is a high-carbohydrate diet.
This, of course, is the exact opposite of what we have been told for decades by “experts” who demonise fat and promote carbohydrates. We have the (UK Public Health England) “Eat-well” Plate and the “food pyramid. And hundreds of thousands of dieticians around the world all promoting carbohydrates as the ‘healthy’ option.
Dutifully following this advice, the entire population of the western world has become fatter, and fatter… and fatter. This is not coincidence; it is cause and effect.
Getting back to Dr David Unwin, years ago he despaired of ever getting any of his patients to lose weight. It was so disheartening that he furtively studied his pension plan and dreamed of retirement. So fed up was he becoming.
Then one day a patient came in who had lost a lot of weight and kept it off. At first, this woman was reluctant to say how she had done it as she feared the inevitable criticism. In the end, she told Dr Unwin that she had (been) eating a low-carbohydrate diet.
In Dr David Unwin’s own words:
” She confessed she had ignored my advice and learnt a much better way to look after herself, from the internet. I suppressed my wounded pride and looked at the Low Carb Forum on Diabetes.co.uk. There were thousands of type-two diabetics on there, ignoring their doctors and getting great results (Now that is just not allowed).”
Yes, Dr David Unwin did not criticize and instead, he was intrigued. Could this possibly be true? It went against everything he had been told about healthy eating and weight loss and type-2 diabetes. Fat has twice the calories, per gram, as carbohydrates and suchlike. Eating fat, he believed, makes you fat and then you develop diabetes and heart disease.
He did more research and made the decision to work with patients, mainly those with diabetes. He wanted to see if a low-carbohydrate diet could be beneficial. Lo and behold, it was very beneficial, like a miracle cure.
In 2014, he published a paper on his results on a small number of patients.
“Based on our work so far, we can understand the reasons for the internet enthusiasm for a low-carbohydrate diet; the majority of patients lose weight rapidly and fairly easily; predictably, the HbA1c levels are not far behind. Cholesterol levels, liver enzymes and BP levels all improved. This approach is simple to implement and much appreciated by people with diabetes.”
Now, he has published results of the much larger study on nearly 200 patients over a six-year period.
As for the rest of us, I can assure you that Dr David Unwin has only ever been interested in one thing. Working out how to help people lose weight and control their diabetes. He has achieved this.
Will authorities around the world take up his research? Will we move away from promoting a high-carbohydrate diet? You have to be joking. Companies who exert tight control over the world of medical research have far too much money to lose. Their lobbyists swarm around the politicians in rich countries.
Which is a damn shame because more than ever in this endless COVID19 pandemic, obesity represents a health crisis. This paper and Dr David Unwin’s tireless work clearly tells us what we need to do, now, urgently.
His approach won’t work instantly and it won’t work for everyone. Nothing ever does. However, it represents hope. It could save hundreds and thousands of lives. Better than any vaccine?
- Click here for a full version of Dr Kendrick’s blog
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