I have also heard that the brain needs 130 grams of carbs a day; aware that protein can be converted to carb by the body. A ten year old child has different needs than a fully grown adult. Your endo or CDE should be able to tell you what they are. My niece, dx’d at eight, was put on a 1,800 calorie a day and about 180 grams carbs per day diet at dx. Yes, she did have higher postprandial spikes than we would like, but there are ways to get around that, i.e., overbolusing (and giving a rescue snack to cover some of the IOB two hours postprandial) or prebolusing (does not work as well for us as overbolusing). Have not tried superbolusing (giving meal insulin and basal insulin at once for the next two hours, then reducing the basals, as you have given it in one superbolus). Sounds like superbolus would work really well. In other words, you need to give him the calories and carbs he needs to grow and figure out a way to compensate for the higher postprandials. You can effect postprandials also by the content of the food, low glycemic index carbs combined with protein and fat. There are other ways than relying on Bernstein, with his 6, 6 and 12 carb allotment per day. An adult can basically try any diet and, obviously, such low carb amounts are going to lead to very low A1cs… not disputing that. I could never stick to such a diet; it would be too extreme. Now I am not sure if 100 grams a day is enough carbs a day for a growing child; I think it would be fine for adults. My niece is now 13 and eats 35 grams for breakfast, 40 for lunch, just omitted her afternoon snack and will have about 70 grams for dinner. This is her appetite these days; her choice. A few months ago, she was eating 225 grams a day some days. Because she has little appetite for breakfast and lunch and I am able to keep the carb count relatively low, she does not spike. I simply overbolus when she is home for dinner (because it is a higher glycemic load). A1cs always have been, and still are in the very low 6s, with mid 6s sometimes. You do not have to go on a low carb diet to have good control.
You goof! If you’re putting up diagrams of whatever the heck it is, I’m not convinced you turned out ok… But wait, I remember how much you loved you mother on Mother’s Day. You’re right Danny, you turned out A-ok.
Absolutely Judith. Like you said, those of us who are metabolically challenged have different tolerances for carbs. Test, test, test! If you discover that your own needs happen to be higher than somebody elses, so be it.
Yup, the brain can only use glucose as energy. That probably also explains why it’s difficult to determine exactly how much dietary carbohydrate is necessary for survival. Gluconeogenesis from protein is necessary and always available to keep your brain functioning normally. But, you require energy and building blocks to make glucose so you have excess waste product from protein and fat metabolism. If you simply eat enough carbohydrates, you don’t have to worry about where your glucose is coming from or any metabolic consequences of trying to provide enough of it.
Throw in a wide range of metabolic demands and it really does come down to what works best for each individual.
I am really surprised at the turn this thread has taken. The original question was whether it was safe and appropriate to follow a very low carb diet for a young child. And the answer is basically “yes” is is safe, but it is not necessarily as appropriate as it might be in an adult. You can argue about whether the child will have enough energy or not, but you can see how she is doing. She is not an Olympic athlete. If she has enough energy and is happy with her diet, then fine. All of this will of course be irrelavant once Clara becomes a teenager. In which case she will rebel, eat what she wants and her blood sugar will go crazy anyway.
As to all the comments here on the science behind very low carb diets, I almost don’t know where to start. There is clearly a great deal of misconception and differences in opinion. If you want to understand more, I would suggest reading Gary Taubes “Good Calories, Bad Calories” as a start.
" he advocates regular intake of glucose tablets over the duration of the workout etc " …added by
" nourishments " in the form of tablets, vitamins and the like ??
No wonder it is confusing …
Carb101 hang in there !.
Geez. Why didn’t you just say that in the first place?
Tery
Um, actually, that is not my undersanding. Red blood cells are the only parts of our body stuck on a glucose only diet. Recent work seems to have shown that even our brains can run on ketones. Our bodies can generate sufficient glucose through Gluconeogenesis for those needs and there is no metabolic need for dietary carbs.
Thanks Danny!! I finally get it!!! LOL
bsc,
If the answer to the OPs question would have been as simple, reasonable, and well stated as you said here, there definitely would not have been an argument from me anyway. I, however, was surprised at the turn the thread took. The thread started out pretty much in support of Dr Bernstein over the incompetant practitioner, which is fine. Along the way there were suggestions that a 10 year old should follow Bernstein and some generalized disagreement, which is fine.
Somehow along the way, however, carbs became pretty much demonized and Bernstein is the only way to go. In the clip you provided, that’s the point I got, carbs = bad.
I’ve never read Taubes book, but I have heard of it. It’d be ironic to me if somewhere in the book or in his teachings Taube had the same issues with carbohydrates, in general, given how much he talks about how fats were erroneously demonized.
As far as being an Olympic athlete is concerned, wouldn’t it be awesome if 10 years from now carb 101 posts how Clara will be doing exactly that!!!???
My point is as simple as yours, regardless of whether or not she will be one, pay attention to her nutrional needs as she develops. Be flexible. If it turns out she needs more carbs than Bernstein says, don’t sweat it. Carbs, in and of themselves, aren’t evil, especially for a growing kid.
Being as inflexible regarding carbs and Bernstein, imho, is as bad as the CDE in the OP being inflexible regarding the traditional diet, especially for a 10 year old child.
Nel,
Dr. Bernstein’s suggestion for glucose needed during exercise is using glucose tablets as a controlled way of getting exactly what’s needed. Not confusing:)
You can see why Danny won a TuD award!
I’m aware, and there’s even evidence to suggest that a diet low enough in carbs to produce ketones might even be beneficial for your brain. However, I’m not aware of a Human study involving the complete absence of carbohydrates and the long term effects of complete reliance on ketones by the brain. If you are suggesting that as a long term survival strategy, I’d love to see the data. Everybody here, of course, should be aware of the reletively short term effects of a complete reliance on those substrates when dietary carbs are effectively removed from the equation by diabetes mellitus. There are plenty of data on that.
As I said, yes, you can produce glucose from protein and fat catabolism, proteins providing the building blocks and fat providing the energy, but it is costly. Gluconeogenesis is an anobolic process that requires the use of ATP, much more compared to straightforward Glucose catabolism through Glycolysis/Krebs/ETC which requires, what, 2 ATP to breakdown a single molecule of glucose with a net gain of 36? Not only does gluconeogenesis require ATP to produce glucose, it also requires ATP to break down the resulting nitrogen waste products to urea in addition to costing valuable precursors for protein and enzyme anabolism. Again, long term survival strategy?
I don’t know where the idea that you don’t need dietary carbohydrates for survival comes from. If those studies or data exist, I’d love to see them. Nevertheless, another assertion that it is possible.
Perhaps it arises from the idea that you can break down the essential nutrients needed for humans to survive into a laundry list that does not overtly include carbohydrates. What the removal of carbohydrates does, though, is screw with metabolic homeostasis and forces the reliance on gluconeogenesis. Again, if there are data to support that as a long term survival strategy for Humans, I’d love to see them.
I mean, we produce lot’s of metabolic water but nobody would suggest that you can survive without drinking it.
I am not suggesting that everybody is free to go load up on a diet of 70% carbs because of my assertion that carbs are a healthy and necessary part of the Human diet. You are, however, suggesting that just because a low carb diet is healthy for you, it’s possible to exist on a no carb diet.
Jan,
Dr, Bernstein’s recommendation is 6, 12, 12. Not 6, 6, 12:)
This article explains it well. The brain needs glucose, not carbs. Glucose comes from sources other than just carbs. Being alive contributes to glucose to the bloodstream as cells breakdown & as part of other metabolic processes.
Before I get jumped, I’m not suggesting that anyone should relie on cell breakdown for fuel.
The Carbohydrate Brain Fuel Myth
http://www.mendosa.com/blog/?p=282">http://www.mendosa.com/blog/?p=282
Gerri , I don’t know if my comment is helpful here …but here goes : I use glucose tablets or any other form of fast acting carbs , if the need arises for " medication " , when I have a low blood glucose …
What I ment by " confusing " …so many for me complex stories , Danny calls them " scientific gobbledigook " , from the Dr. Bernstein’s , Dr. Mendosa’s etc. etc.etc. remember , I am a simple almost 70 year young gal .Yet I love reading about it here .
Yes, & that’s what Dr. B suggests for additional glucose needed during exercise (as well as to correct lows, of course). He stresses using glucose tablets because they’re a set quantity. He recommends testing very frequently during exercise to know how exercise of different intensity effects individual BG & learning how much 1 gram of glucose effects BG.
Glucose by definition is a carbohydrate.
http://www.biology-online.org/dictionary/Carbohydrate
Glucose is a simple sugar, and like all simple sugars is the building block of complex carbohydrates and itself a carbohydrate. One way to get glucose in the diet is to eat a carb like a starch and let your body break it down to glucose very quickly like Dr. Bernstein showed in the video clip, or, you can just eat sugar. Either way, you are eating a carb.
I just don’t understand the need to categorize glucose as something needed by the body, but not a carbohydrate itself, unless the purpose really is to demonize carbohydrates as being bad and unnecessary to make a low carb diet seem more necessary.
Not my intent to demonize anything, or make a low carb diet more necessary. What I & others have experienced is that a low carb diet provides better BG control. Our numbers provide the evidence.
Believe we all know what a carb is & that is breaks down into glucose. The point is that there are other means of the body receiving glucose other than from eating carbohydrates. Eating carbs is just one way. This has already been explained by several posters here.
No one is denying that our bodies need carbs. The question is how many.
Fair enough. I’m still trying to wrap my brain around the concept and I’m learning from the people who have boots on the ground.
Sorry, it has been a long while since I have read Bernstein. I did buy his book shortly after she was dx’d. Six, twelve and twelve then. 30 grams of carbs a day for a growing 10 year old child in no way could be construed as “safe.” And I sincerely doubt there is a child who would be content to exist on a diet of 30 grams of carbs a day. What about the psychological health of the child? It is not safe; it is unhealthy; it is similar to the diets they put children on before insulin was discovered. I have no objection to fully grown adults going on such a diet; it is their choice. Since I know you can have good control and eat a moderate amount of carbs, why would I choose to make a kid’s life a living hell by imposing such a diet on them? As to only 100 grams a day for a growing child of ten, I also think that is a bit too low, but not sure if 100 grams a day every day is safe for a child that age. Ask your endo, CDE and nutritionist. P.S. Just for curiosity’s sake, I, too, would like to know how many carbs per day are optimum for an adult with Type 1 to maintain good control. I, personally, can’t see going below 40, 40 and 50. I would be very unhappy if I had to cut carbs lower than that. I like carbs. I mean, a small apple has 19 grams. No fruit?