9) CONTROLLING BLOOD SUGAR WITH DIET
i) Fitting the Diet to the Individual
It is important to individualize the diets for each person's needs and tastes. Anyone with diabetes can modify diets if they wish, for instance taking the diet of Doctor Bernstein and add a lot of fish, added a few ultra low glycemic index carbohydrates with high fiber not recommended by Doctor Bernstein (oatmeal, nuts, beans and bran cereals, a carbohydrate load of 50 to 100 grams per day level, rather than the 30 grams per day of Doctor Bernstein) and take away a lot of red meat. This would end up close to the Zone Diet, about halfway between the Bernstein Diet and Pritikin Diet, when all was said and done. But then some people don't like fish, so white meat chicken and small portions of very lean cuts of beef become an option.
The reaction of each person with diabetes is highly individualized. The lower a person takes their intake of carbohydrates, the lower their blood sugar levels might become. But they might find that high protein intake invariably leads to high fat intake which slows down and ultimately stops weight loss, which is also counterproductive. And, as Pritikin and Ornish note, lots of vegetable oils such as olives, avocados, nuts, and canola or olive oil on salads will also prevent weight loss. So everyone with type 2 diabetes needs to find a balance that they can live with for the rest of their life, with the emphasis being on losing weight and maintaining that weight loss for the rest of their life.
Moderate to high protein diets are attractive for a diabetic. Everyone agrees that persons with diabetes must get down to at least a "normal" weight range for their height and build, something which is difficult on any diet with a lot of fat, even if the fat is the "good" unsaturated type. There are only three food groups, so take away carbohydrates and fat and all you have left is high quality protein such as fish, white meat chicken, nuts, non-fat milk products, beans and shellfish. So a high protein diet using low fat meats and beans is the lesser of three evils for a person with type 2 diabetes. In any case, good research has not found a negative effect from high protein diets on people with normal kidney function, as long as ketosis is avoided.
A very recent study seems to support the concept of avoiding BOTH refined carbohydrates and saturated animal fats in order to avoid heart disease. Once again it was based on the huge Harvard study of nurses. It was reported in the New England Journal of Medicine. It compared low carbohydrate, high fat diets with high carbohydrate low fat diets. It found no difference, even though previous thought had been that only the high fat diets would increase the risk of heart disease. But it has to be remembered that most of the carbohydrates in this study were refined carbohydrates and most of the fats were saturated animal fats. One subset of the nurses did have significantly better heart disease risks and that was the group that both ate largely complex carbohydrates and ate vegetable oils rather than animal fats.
Note that if an individual's doctor indicates there might be kidney damage; a person with diabetes will typically be advised by their doctors to keep their animal protein intake low. This means that, for these individuals with kidney damage: tofu, beans, nuts, olives, colored vegetables with Omega 3 butter substitute, and salads with flaxseed oil, should become the mainstays of the diet. A person with diabetes with kidney disease and on dialysis unfortunately becomes very limited in diet choices, especially if that person is overweight.
Note also that if a person is taking any drug which stimulates the production of insulin, i.e. Chlorpropamide (Diabinese™) Glipizide (Glucotrol™), Glyburide (DiaBeta™, Micronase™, Glynase™), Glimepiride, (Amaryl™), Repaglinide (Prandin™), or Nateglinide (Starlix™) or if they are on insulin, they need to eat at least some carbohydrate with every meal, otherwise that person can become "hypoglycemic", with too low of blood sugar which causes disorientation, the "shakes", dizziness, and sweating. It is rare for some one with non-insulin dependent type 2 diabetes to pass out from low blood sugar but anyone who has low blood sugar is definitely dangerous on the road. Anyone taking insulin is far more likely to experience low blood sugar and needs to exercise more caution than someone who is not taking insulin. In those taking insulin, low blood sugar can result in unconsciousness, coma and even death.
There is a lot of misinformation extent on protein and its effect on the body. Recently a major wire service ran a story which said Americans were eating too much protein and that the excess protein could not be stored by the body and was simply excreted by the kidneys. This is not the complete truth. The nitrogen portion of the unused protein molecule cannot be stored by the body and is excreted as urea. But the approximately 50% of the protein molecule is actually composed of carbohydrate, which is converted to blood sugar by the liver. This excess blood sugar is stored as fat in the body. So the actual truth is that about half of the "excess protein" actually can be stored by the body. In any case, it is better for a food to be excreted as urea rather than having it be deposited in the body as fat.
Current Chapter: 9) CONTROLLING BLOOD SUGAR WITH DIET
a) Blood Sugar Control
b) Individualized Reactions
c) What a Diary Tells a Person with Diabetes
d) Protein Poisoning by Fruit Sugar
e) What are "Acceptable Fruits"
f) Other Sugars
g) Best Mix of Protein, Carbohydrates, and Fats
h) Low Carbohydrate Diets
i) Fitting the Diet to the Individual
j) Politics of Food
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