I love his theoretical approach but he lost me with the Swedish crackers.
What you are describing is interesting and sad (poor ten foods people!) but it is not orthorexia.
Orthorexia would be this: my friend (a T1) who got ensnared in a sick co-dependent relationship with a “guru” who told him that he must only eat foods with “yellow food energy” if he wanted to heal his diabetes – so this guy would eat yellow apples, but not red or green. He’s eat pineapple, but not tomato. Like that. His quest for “health” lead him to make completely irrational and arbitrary food decisions that had nothing to do with his taste-buds, sense of smell or preferences – it was a textbook case of severely limiting diet in an elusive quest to achieve “health”.
Another example would be me religiously following a super low-fat vegan diet (less than 6% of calories from fat and zero animal products) despite the fact that my hair started breaking off and falling out, my nails started splitting and cracking, my muscles in my calves atrophied to nothing, and I was ALWAYS freezing cold and exhausted – I was getting a small fraction of the protein and essential fats that I needed and was so focused on weight loss that I completely ignored the symptoms of severe malnutrition.
I went through one of those with my mother over greenbeans. I sat there for hours – it was probably getting on to midnight when she gave up.
Now I love greenbeans – go figure. Some children do grow up to have a much wider repertoire of food choices than their youthful behavior would predict.
Just slather them with butter. 
But honestly? I have gone back and forth, back and forth, on whether or not Dr. Bernstein is orthorexic – or appeals to too many orthorexics.
I think the bottom line for me on Dr. B is that he is very well-intentioned and brilliant, but he is also quite elderly, has been fighting T1 since the Dark Ages and isn’t a fan of strenuous exercise – these facts make it possible and perhaps even advisable for him to survive on a diet MUCH lower in calories than an active adult in their prime, even a youngish T1 with access to all the newer tools for keeping their BG’s under control.
We’re all different, and what works for Dr. B might be a recipe for disaster for a 21-year-old marathon runner or a young woman nursing twins, etc. I think he’d agree, to a certain extent.
He’s a fan of weight lifting. I don’t think he’d agree we are different though. He comes across very strictly in his book. I found it fascinating but am not that focused. I don’t tink that he was that old when he came up with his schtick either, as it was like late 60s/ early 70s, 40ish years ago?
No, of course, the 10-food people don’t have orthorexia. They are AR’s #1 – adult picky eaters.
Because of my own picky eating, I was very careful not to make an issue of food with my son. He was allowed to eat what he wanted, and we were a team as far as choosing menus. He was a “normal child” picky eater, but as he matured, he ate more and more foods, and now he eats nearly everything. He’s MUCH better than I am. Now, I just hope he doesn’t get diabetes, because he loves his food!
My father did it to us with spinach - we all sat at the table until my mother got rid of it when my father wasn’t looking.
You’re right – he was 48 when he graduated from medical school, but he’d been doing his own thing for a while before that. He’s 77 now, I believe – my mom is of a similar age and she gets by on next to nothing – the metabolism winds right down in people who are not vigorous exercisers (like Jack Lalane) but Dr. B is a fan of weight lifting, not endurance sports.
Like I said, I do go back and forth on Bernstein’s orthorexia – does he or doesn’t he? I have no doubt that he means very well, but then again, so does Dean Ornish and I think he’s just flat out wrong about meat and fat in the human diet. This from a former supporter of super-low-fat vegan diets.
Jag,
Dr. B doesn’t “banish” nuts or cheese. Corn isn’t a vegetable. Corn is a grain. Very few vegetables are off limits because the majority of vegetables are low carb. Tomatoes are fruits. I haven’t read that he’s against powdered artificial sweetener. Where is this?
I’ve followed Dr. B’s recommendations for almost three years with great results-- far less BG swings, an improved lipid profile, more energy. I don’t find low carb in the least Draconian & I was card carrying carb junkie. I eat tomatoes & berries & simply factor this into what else I eat. I’m not hungry & don’t feel deprived
I didn’t say he banished cheese - I said cottage cheese (and I believe also American cheese since it has a higher carb content than cheddar and the rest). He warns against eating nuts in his book because they include carbs with the fat and protein - “So unless you have unusual will power, beware [of nuts]. Also beware of peanut butter—another deceptive addiction”. Powdered artificial sweeteners are listed as a “No-No Food” because of the small amount of sugars they are mixed with.
If you’re speaking as a botanist, then I would agree with you that corn and tomatoes are not vegetables. But both are considered vegetables by everyone else - including Bernstein who lists them as vegetables.
Here’s a link to his list of prohibited foods including the quotes above from the online version of his Diabetes Solution book on his website: LINK HERE.
I used the term Draconian because of the very large number of foods that he prohibits. I don’t doubt that you are having great results and think its great you can stick to his diet. But I hope you’ll agree that it is does indeed sound pretty obsessive.
Sometimes, I think that if you want to control diabetes, especially if you got it while young, it’s necessary to be obsessive. There is too much at stake NOT to be obsessive.
On the other hand, when I get to be 80 or 85 (I should live so long, LOL!) I fully plan on throwing all caution to the wind and eating any damn thing I want to, because at that point, I’m NOT going to be worried about complications, and if I die of a heart attack, it’s a quick, clean death. And if I develop dementia, I fully intend to commit suicide by glucose, because I’m NOT going into a nursing home!
Dr. Bernstein’s Diabetic Diet book (which doesn’t have particularly interesting recipes) has recipes with almonds, pecans, walnuts, pine nuts & macadamias. The caveat is not to go overboard. I use almond flour & coconut flour for baking to stay within carb limits Many more vegetables that can be eaten than avoided. I eat ricotta & Greek yogurt since it has less carbs. Can’t stand milk or cottage cheese, so that was no problem for me. I use cream with water & unsweetened almond milk as a milk substitute in recipes.
I think a lot of people dismiss Dr. B low carb as undoable without realizing how many incredible low carb recipes have been created by resourceful people. I had one woman ask me how I could live on lettuce & meat:) My meals are varied & delicious. We entertain frequently & no one knows they’re eating a low carb dinner. For breakfast I have eggs with cheese, almond flour pancakes or waffles, muffins (made the night before) or faux cornbread made with almond flour, scallions, eggs & sour cream. Last night for dinner we had salmon with mustard sauce, sauteed string beans with shallots & almonds & chocolate mousse.Tonight we’re having chicken pot pie. I make puddings & custards, crepes, tortillas, crackers, cheesecake, cookies, truffles, cakes & pies. Came up with a great crispy pizza crust that I posted. So, it’s not as limiting as people imagine. Does take a lot more cooking. The results I’ve had giving up grains, beans & starchy vegetables are worth it. Honestly, I have no cravings for these foods any more. They hold no appeal. I don’t feel obsessed with what I eat or don’t eat. It’s just the way I eat now. I feel great & I felt horrible following the food pyramid.
Dr. B is very precise & it’s his engineering background. Quite exacting & I can see how people who haven’t given this a try would see it as obsessive.
I think there are at least three ways in which his program sort of slips over the orthorexia threshold:
- It’s almost impossible to just go somewhere and eat what’s served there (e.g. a company function, a wedding supper, a great-aunt’s birthday dinner) without having to greatly limit your food choices or perhaps eat nothing but meat, or perhaps nothing at all. I am thinking of dinners at my aunt’s house, which might consist of lasagna, some kind of starchy vegetable dish made with cracker meal and canned mushroom soup (more starch) and grated carrot Jello (she’s in her late 70’s and that’s how they roll at her house.) Also, I’d be eating nothing at all when my crew goes to the pizza parlor if I tried to strictly adhere to Dr. B.
- Chewing something and spitting it onto a Clinistix strip? At a restaurant? C’mon! Aren’t poking ourselves and injecting ourselves enough? We have to spit and smear at the table, too? (Harumph.)
- It would be next to impossible to participate in any kind of endurance sport while following him to the letter: long distance running, cycling, hiking all day in the mountains, etc. His solution? "Just don’t do that."
I’m also pretty ambivalent about the cooking. While your menu choices sound yummy, Geri, if my father were to try to follow Dr. B on his own, he’d be living on hamburger patties, steaks, fried eggs, celery sticks and boiled broccoli or green beans (not even steamed.) There are millions of diabetics who simply are all thumbs in the kitchen. This begs the question of what they’d be eating instead. Fair enough. At least they could put some sliced turkey and a variety of “normal American” sandwich veggies between two slices of whole wheat bread – or open a can of minestrone soup – and have a meal, without needing The Julia Child Gene or a personal chef to do all their cooking for them. With so many divorced and never-married people in the world, authors of best-selling health-related books need to consider that not everyone has June Cleaver bustling around the kitchen all day, whipping up crustless quiches.
I’m a great admirer of Dr. B – but…whew.
You make some very good points, Jean. I’m a lot like your father, so I don’t follow Bernstein exactly. For one thing, I eat more carbs (60g) than he recommends, but it works for me. In my case, I refuse to give up dairy; I use half and half in my tea, and eat cottage cheese and Greek yogurt. I also eat salad and peanut butter. And when there are festivities, I eat what is there, albeit in small portions. When I go out, I can usually find things to eat, and have not experienced undue hardship. And I’m a picky eater, too!
So, for me, it’s more about Bernstein’s philosophy than his actual directions. Limiting carbs has allowed me to lose a significant amount of weight (BMI down to 24.1), and my last lipid panel was the best I’ve ever had in my whole life. I don’t think I’m orthorexic, because I can relax my standards when I want to or have to, and not feel ashamed of what I do. But whether Bernstein himself is orthorexic is, as you say, open to question.
Before diabetes was bestowed, I was a vegetarian for over 30 years. Lunch meetings, holiday dinners, picnics & celebrations were a challenge. People are just as insensitive about vegetarians as they are about diabetics. Have some turkey, it’s Thanksgiving. There’s only a little meat in the meat sauce. The soup has vegetables (in chicken broth). I’d take what was offered, push it around the plate & hope for vegetables with no added animal products. Was good practice for being diabetic & it’s actually easier now:)
Some people don’t like to cook. I used to be the take-out queen. What did I make for dinner–reservations. I never ate breakfast. I like to eat, so now I cook. I make what doesn’t entail special techniques or involved preparation. Most everything I cook is easy & fast. I don’t bother with recipes with a dozen steps & fancy equipment because I don’t have the time. I never baked a thing before & come from a long line of non-baking women. My mother & grandmother’s view was that what bakeries were for.
I think people with various cooking styles can successfully adopt to a low carb WOE. My late wife liked to cook and was constantly trying new recipes, but it was never elaborate or fancy. I believe if she were still alive she would be cooking much like Gerri does to accommodate my condition.
I’m much more in the thumbs in the kitchen crowd, but I have successfully adapted my cooking style to my new reality. Chili now has few or no beans. I used to make lots of one pot meals that included potatoes, pasta or noodles, now I just leave them out. I eat a lot of salads that include meat and cheese.
Eating out can certainly be more of a challenge. My employers bought Chinese takeout for us at lunch yesterday. I skipped the rice and noodles and picked through everything else choosing various meats, shrimp and broccoli. Everything had a thick sauce probably thickened with corn starch and some of the meat had a sweet looking sauce so I only had a little bit of that. I even had 1 egg roll. My sugar hit 168 at 2 hrs, high for me, but was back to 100 before dinner.
If I ate this way every day my A1C would suffer, but every once in a while is no big deal IMHO. I don’t use insulin but I suspect that a modest increase in insulin before this meal would have gotten most insulin users through this situation successfully.
One size can’t fit all, but I think low carb can be adapted to work for diverse types of people with a little creativity and pragmatism, and without becoming orthorexic.
Hi Natalie. About putting dairy in your tea… You may have heard that some German researchers found that milk blocks the use of the polyphenols in tea. This was in my memory, so I just took a look at Dr. Andrew Weil’s Q & A section, where he referred to this finding. I like fresh mint in my tea, but when I make chai, I add rice milk. Other types of milk might be richer, almond or coconut for instance. Anyway, I didn’t know whether you had considered this. I do know that it’s hard to give up favorite drinks (like my morning mocha latte).
I agree about the cornstarch or whatever else they put on Chinese meat/ veg/ etc. . I can count the rice fine but the other stuff is fraught with peril!
I think your approach and attitude are better than 100% strict adherence to the regimen Dr. B puts forward in his book. I’m not a big social eater, but I want to be able to join friends or work associates once in a while (say twice per month, perhaps three or four times per month in December due to the holidays) without feeling like a failure as a diabetic. I do bolus with short-acting insulin now, but I can completely understand why Dr. B wants to keep the bolusing down to a dull roar – I’m certainly not an advocate of bingeing and bolusing for it every day of the week.
I have to wonder if, for Dr. B, it’s almost a kind of game – where he’s trying his best to “beat” diabetes and each and every “perfect” day isn’t a way for him to show diabetes who’s boss? I get a hint of the same competitive spirit that I see in my friends who are marathon runners: Take THAT, inertia and laziness!
In recent weeks, I’m finding that I am having success with a relaxation of the Bernstein program, although I am trying to keep the need for insulin down (his concept of “small numbers”.) For example, I’ll have one whole grain English Muffin (23 gm) but not the hash browns AND toast AND several sugars AND several half-n-half servings in several cups of decaf AND orange juice that I would have had pre-diagnosis (150+ gm). I’ll get the plain greek yogurt (8 gm) rather than the sugar-laced flavored yogurt (32 gm) I used to have. I’ll eat spaghetti squash or some other low-starch veggie (5 gm) rather than the heap of pasta (40-60 gm) I’d have had before, and I won’t sweat a little marinara sauce on it (14 gm) even though he discourages tomatoes.
But if once in a blue moon I was at a friend’s house and the only thing to eat was mac-n-cheese and salad, I’d have a serving of the starch bomb and bolus for it without making a scene. Perhaps all those years as a vegetarian, macrobiotic, vegan, etc. have taught me to dread being the one who is always, always, always “different” at the table – plus the irony of my being the morbidly obese “healthy” eater at a table of normal weight “unhealthy” eaters has not escaped my attention.