6) CONTROLLING WEIGHT
d) Food and Diet
The whole subject of food and diet is obviously extremely important to a person with type 2 diabetes. There are three parameters which need to be controlled by the diet. In order of importance they are:
1. weight
2. blood glucose levels (carbohydrate intake and A1c)
3. blood lipids (saturated fats and carbohydrates)Control all three parameters can actually be accomplished with many different diets. There are many people who have lost weight and controlled blood glucose and blood lipid levels in insulin resistant type 2 diabetes with either relatively high carbohydrate diets like the Ornish diet or even with high saturated fat diets such as the Atkins or Bernstein diet. The key is that they weighed themselves frequently, they measured their glucose levels frequently and that they took action accordingly. For instance, in some rare individuals good blood glucose control can be achieved even with high carbohydrate intake (200 grams per day) as long as the carbohydrate intake is spread out in small amounts evenly throughout the day and the carbohydrate has a high fiber content and low glycemic index. The same result occurs if insulin injections are closely timed with carbohydrate intake and exercise. Any individual with type 2 diabetes needs to find the diet mix that best suits their particular needs.
Of course there is always the exception that proves the rule. If an individual's type 2 diabetes has progressed to the point where they need insulin injections, controlling glucose levels with diet becomes paramount and the diet needs to reflect that. If any individual on insulin pays no attention to their carbohydrates, they risk blindness, kidney failure, "insulin shock", ketoacidosis, coma and even death. The carbohydrate intake of such individuals needs to be closely controlled and synchronized with their insulin injections and their blood glucose.
Given that weight loss and exercise are more important for most type 2 "insulin resistant" diabetics, the basic idea for the "ideal diet" is that the individual with type 2 diabetes needs simply to keep his carbohydrates "reasonably" low and then to try and balance protein and fat intake to a level where weight loss occurs. This is the basis of the optimum diet for anyone with type 2 diabetes. We had one patient lose 90 pounds by eating one half can serving of beans, one serving of fish (or grilled chicken breast), two large servings of skim milk, and unlimited green vegetables and lettuce every day. The patient minimized fat intake; even making his own fat free sugar free salad dressing from vinegar, herbs and non-sugar raspberry drink mix.Most importantly, this patient kept a diary where he tracked calories. There is one immutable truth in dieting, in order to lose weight, calories out must exceed calories in, period. One pound of body fat equates to roughly 3,500 calories. That is a lot of calories, considering that the average man takes in 1,800 to 2,000 calories per day. The only way to lose weight is to take in fewer calories than you burn. So if you reduce your food intake by 300 calories per day and work out for an hour, burning another 400 calories, you should lose about a pound every five days.
Current Chapter: 6) CONTROLLING WEIGHT
a) Introduction
b) What is "Overweight"
c) The Endless Cycles of an Overweight Person with Type 2 Diabetes
d) Food and Diet
e) Food "Rules"
f) USDA Food Pyramid
g) Adaptive Human Body
h) Timing of Meals
i) Serving Size
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