Nutrition questions

I have a couple questions about eating low carb that I'm sure people here will be able to answer.

1. When you add up the number of carbs you eat in a day, is that WITH fibre included or without fibre included?

2. When you eat less carbs, should you eat more fat or more protein, or both, or does it matter?

3. What is the maximum amount of fat you should eat in a day? I looked at my numbers for today and the fat grams were like 98g which seems high to me, but I've never really paid attention to the amount of fat I eat so I have no idea what to aim for, if anything.

4. Any idea for low-carb breakfasts that do NOT involve cooking or eggs?

My answers Jen.

1. When you add up the number of carbs you eat in a day, is that WITH fibre included or without fibre included?

Don't know, but told to eat at least 15 gm fiber by the colon doc.

2. When you eat less carbs, should you eat more fat or more protein, or both, or does it matter?

Not sure if it matters. Pretty sure not to eat saturated fat though.

3. What is the maximum amount of fat you should eat in a day?

This I do know. Don't eat more than 30% of your food in saturated fats. Omega 3's OK, but don't overdo that either. Just because a product has omega 3's, doesn't make it any more healthy.

4. Any idea for low-carb breakfasts that do NOT involve cooking or eggs?

This one is tough. Forget the eggs,bacon,sausage,and pancakes,corn flakes. I usually have lowfat milk, and any fresh fruit. Maybe once in a while a bagle, no cream cheese.

Anyway, me pipes are clean. I read that two out of three die from heart disease. So far so good. I'm in my 50's.

I log everything in Diabetes Pilot which automatically logs all the nutritional information (as long as I've pre-entered food and/or it's already in their database), so it's easy for me to look at the daily totals without any extra effort.

I am getting comments from family about eating "too much fat" now because I am not eating as many carbs. My last cholesterol test a few days ago was too high for my endo's liking (total cholesterol was 198, HDL was 58, LDL was 122, triglycerides 90). So I would like my cholesterol to go down a bit ...

I do like eggs but I usually eat them for lunch, so would like something different for breakfast. Breakfast is my one meal where I REALLY like cold cereal so trying to find an alternative that's crunchy, maybe yogurt with granola or something ... If there was such thing as low-carb cereal that would be awesome. I drink almond milk which has way fewer carbs than regular milk.

Today my fat came from eggs, peanut butter, nuts ... I didn't have anything unhealthy.

Hi, Jen.

1. When you add up the number of carbs you eat in a day, is that WITH fibre included or without fibre included?

Subtract the fibre from the carbs. Fibre isn't digestible at all and it contains no glucose or protein, so it won't affect your BG numbers or insulin requirements.

2. When you eat less carbs, should you eat more fat or more protein, or both, or does it matter?

You should be eating a lot more fat and probably more protein, too. Your diet should be about 70-75% fat, 20-25% protein and 10-15% carbohydrate each day. Saturated fat is perfectly okay, so use butter and cream (though cream does have some carbohydrate in it) and eat the fat in meat--on the edge of a steak, under the skin of a broiled piece of chicken, in bacon, and so on. Oils and nuts are good sources of fat, too, and nuts are also good sources of protein without a lot of carbohydrate.

High levels of fat along with high levels of carbohydrate will raise your BG and increase weight, too. But when carbohydrate rates are low, the body has to burn fat, instead of sugar. If you don't take in enough fat, your hair and nails will become brittle, hair may fall out, you may have menstrual irregularities, dry skin, gallstones and be more prone to colds, other viruses and infections.

3. What is the maximum amount of fat you should eat in a day? I looked at my numbers for today and the fat grams were like 98g which seems high to me, but I've never really paid attention to the amount of fat I eat so I have no idea what to aim for, if anything.

Nearly everyone sets their own level of fat intake naturally. Fat is very satisfying. It makes us feel full. No one sits down to eat a pound of butter or drink a cup of olive oil, even if they like these things a lot. We quickly reach a point where we simply don't want more of it. And without carbohydrate for the fat to cling to, the fat isn't very appealing in large quantities. Who would have the oil that french fries are cooked in, without the potatoes?

If you follow a low-carbohydrate way of eating, you don't need to be concerned about the amount of fat you eat.

4. Any idea for low-carb breakfasts that do NOT involve cooking or eggs?

Try sliced meat and cheese. Many, many people find that carbohydrate in the morning raises BG rapidly and keeps it up there, and so we don't eat things like fruit, bread or cereal in the morning, if at all. Later in the day, most of us don't have a problem with carbohydrate to the same degree.

Have a look at Dr. Bernstein's Diabetes Solution. He has excellent explanations about how our diabetic metabolism works. He also gives very clear reasoning for his low-carb meal plans (6g for breakfast, 12g each for lunch and dinner). And he's a great resource for working all of this out with insulin, too. He's a Type 1 diabetic and has been following this plan for over 40 years.

Thanks for all the information. I was curious about the fibre because I subtract it from carbs when I bolus, but I wasn't sure if people count it or not when they say they eat, say, 30 grams of carbs in a day. I've eaten 51 grams today if I don't count the fibre, but 79 grams if I do count it.

I would try not subtracting the fiber? That could account for some the issues you've documented, off 5G of carbs here and 10G of carbs there? I don't bother subtracting it. I have no "evidence" but I suspect that if you are eating less, you are likely to process fiber more? I dunno for sure but the numbers you've posted haven't been off that much but might be off by a degree sort of consistent with the fiber adjustments? Just a thought.

I only subtract fiber from carbs if it's around 50% or more of the total count. When it's a negligible amount, I've found it doesn't make a difference. I don't trust the fiber content on nutritional labels as accurate. High fiber is a buzz word & one of things that food companies enjoy cashing in on.

Yep, it matters. If you want to do true low carb, it's moderate protein & high fat. Some people believe they can just eat loads of protein & that's not helpful for either weight loss or BG control since around 58% of protein converts to glucose. A great protein calculator http://www.phlaunt.com/lowcarb/DietMakeupCalc.php. Sufficient fat, good fats, will prevent hunger & crankiness.

I sometimes make extra for dinner & eat that for breakfast on hurried mornings, but not something you might like to do. Sliced meat rolled up with cheese is a good no cook breakfast. When I have time on weekends & am in the mood, I make a bunch of low carb muffins & freeze or refigerate for during the week. A couple with cream cheese or butter are filling. Some mornings I eat cheese & nuts for breakfast. Can't tell you if it's any good, but people break up super high fiber crackers in a bowl with unsweetened almomd milk (or cream diluted with water), with cinnamon & sweetener for a kind of cereal. I prefer protein for breakfast because it stays with me longer because some days I don't have time for lunch.

Hmm, I have always been told to subtract the fibre for the purposes of dosing insulin. I am not really eating less, just less carbs, but I'm eating the same number of calories as I was before.

Today I've actually had fantastic blood sugars, still some highs in there but I need to work on a lower-carb breakfast and also not sure what happened there tonight, maybe didn't need that snack before exercising ... Maybe I will try not subtracting the fibre and seeing what happens tomorrow ...

10:00 - 4.2 (76) - Breakfast (25g)
12:00 - 8.5 (153) - Correction
2:00 - 4.9 (88) - Lunch (16g)
3:30 - 7.0 (126)
4:45 - 6.0 (108) - Snack (3g)
5:15 - 5.7 (103) - Dinner (12g) - Bolus reduced by 25%
7:15 - 7.2 (130) - Snack (4g), no bolus, 30 minutes on stationary bike
7:45 - 6.2 (112) - 0.5u bolus
9:40 - 8.6 (155) - Correction

I think my endo is counting me in the ultra high-risk category as far as cholesterol goes ... I do need to learn more about cholesterol, though. Don't know much about how that all works.

Realize it's not many carbs, but why the snack after lunch 30 minutes before dinner? Do you snack after dinner if you're not going to exercise?

I actually didn't realize I was going to have dinner so soon. I was eating at my parents' place and they had it ready way sooner than I thought! I would have just waited till dinner to eat if I'd known.

I usually don't snack after dinner if I'm not exercising, unless I'm hungry before bed or something. But I exercise after dinner almost every day. And actually, usually I don't eat beforehand but then I usually end up low ... I usually drop a LOT more than I did today during exercise (usually I would start at say 7 and end up at 3 ...). I find it really hard to figure out how to not either go high before exercise (from reducing bolus too much) and also avoid going low after. Today was one of the rare times it actually worked out (well, till the 9:40 test).

I have the same problem with exercise. High than crashing low several hours later. Royal pain in the tush! Eating some protein before exercise helped me with the lows, but there are still the highs after. I've read that exercising in the evening may be responsible for overnight lows. Well, that's only time most of us have for exercise.

I seem to mostly have problems with dropping too much during the exercise itself ... I've found doing a -10% basal rate on my pump for eight hours following works really well (took me forever to figure that out!). So I'm able to to go bed and wake up at a perfect level, but if I forget to set that basal rate then I end up low overnight or in the morning.

Mind you, my bike is pretty short and light exercise. I have more problems with delayed lows if I do exercise that lasts for an hour or more.

I don't have a pump, so I'm stuck with whatever happens.
Great you've figured out a reduced basal rate that works.
My BG keeps climbing with a real work-out, so I do more moderate for longer.

Thanks for all the great posts. I was DXed in late October 2011 with T1 (LADA) and started low carbing within a couple days. With no medications my BG average has gone from an a1c of 5.7 to 5.0. I eat eggs, fatty meats of all sort, butter, tree nuts (especially almonds and macadamia), sunflower seeds, low carb veggies, high fat dressing, small amount of cheese, and sugar free jello.
I have lost 30 lbs and am never desperate to eat, my appitite is naturally supressed, and I am living on a very even keel. I am feeling much better than prior to DX other than the stress of knowing I am only honeymooning and the heavy lifting awaits.

What are you having for the 4G snack before exercise? I have noticed that a lot of the "complex carb" type of snacks, powerbars, that Gu stuff a lot of runners use, etc. take longer to "deploy" and might not be worth it for a 30 minute workout? If it was something more like food and less like candy, it might have taken until the 155 to deploy and sort of explain it?

If it's a 30 minute workout and my BG is a shade lower than I want it, I have some skim milk to be on the safe side although a lot of times, I just sort of arrange things and hope it doesn't run too low. To me the best workout/bg results are when I don't have too much insulin on board as that seems to hit harder and faster when I do some type of workout?

That being said, it looks like the "curves" are sort of dancing, in that you had the 130 w/ a small snack (again, for working out, I think the speed of the snack is sort of critical?) then saw the 112 and did a small bolus. It might have "caught" the snack, perhaps preventing the low a bit more if you had had the bolus with the snack but cut it, like .3 or .4 instead of .5U?

I do subtract the fiber. I aim for 10 grams of fiber per meal and 5 per snack. So unless a meal has a lot of fiber I don't eat it. Supposedly fiber doesn't enter your bloodstream, so it doesn't raise bgs. The only way to know is to test though. I keep my meals 5-15 carbs depending on the time of day. Breakfast is usually the lowest. As far as breakfast ideas, on the weekends make LC muffins, waffles and pancakes. That way you can just reheat in microwave. Also you can make a hot high fiber cereal with 1/4 cup of flaxseed, chia seeds, coconut milk, cinnamon and favorite sweetner or SF maple syrup. Some mornings I will eat LC chocolate chip cookies made with almond flour for breakfast. They do give me a 10-15 point spike, though.

1. Yes, I subtract fiber for anything over 1g of fiber.
2. Yes, my understanding is that you need to eat more fat and protein if you take out the carbs.
3. I have no idea. I am sure this varies from person to person. To be honest, I don't count fat, protein, or calories. I've tried and it's just too overwhelming. If I know that I'm eating a meal that is relatively high in fat and protein, I will tend to use the dual-wave bolus feature. But I do this based on "gut knowledge" and not actual protein and fat amounts.
4. Yogurt is my favorite alternative. There are also some good veggie options such as vegetarian sausage, but those require some cooking. I do eat a lot of eggs...yet my cholesterol is surprisingly normal.

I should have clarified about the fibre question. When I bolus for carbs I do take away fibre. I was just wondering when people say they eat "50 grams of carbs a day" or whatever, on this or other websites, if they are including the fibre in that total or not, especially if they are non-diabetics ...

I've been tracking everything (blood sugar, insulin, carbs, exercise, food) in Diabetes Pilot which I have on my desktop and iPhone. Once you enter the foods you eat into the food database it's really easy to track, you can even group foods by meals so that it literally just takes one click to add the whole meal if you eat the same thing often. So this software tracks all the nutritional data and makes it easy to look at fat/protein/calorie totals, even though I don't usually track those ... I am trying to lose weight as well as get my A1c down, which is why I'm doing the manual logging. I find when I just rely on my pump data downloads I'm not as mindful of what I'm eating and I also don't spot patterns as quickly.

This morning I just took what I was eating (high-fibre cereal and almond milk) and cut it in half (I was already using half the serving size suggested) and added a few strawberries and some cheese. In the next few days I'll go shopping for something better.

I like the sound of low-carb muffins, didn't think you could make stuff like that!

To me a 10-15 point spike is nothing, that could just be meter variation ... Heck, my BG went down 18 points this morning from just sleeping (I woke up, tested, went back to bed for two hours, then woke up for real).