The chinese restaurant syndrome effect is real?

dr bernstein says stuffing yourself with anything, even something low carb like lettuce, will raise blood sugar. has anyone here ever found that to be true thru testing?

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Once a year, when I overstuff myself on my homemade, low carb turkey stuffing made with Wasa flatbreads. A reasonable portion is quite doable even for a very lo-carber like me. But I can’t resist it and eat a big, disgusting pile of it—LOL. So I would say yes–there can be too much of a good thing!..'Tis the season, after all!

I find that larger than usual volumes of fired definitely affect my blood sugars and this effect may be delayed. Ie. Eat a bigger than usual Neal with appropriate insulin doses. Go to bed at normal blood sugar a few hours or more later. Wake up with high sugars the next day. I now increase my overnight basal dude in this situation. More art than science to this type of dosing. It usually helps damp the effect…

This probably says more about Bernstein’s often cavalier attitude to presentation of the facts. Depending on which source you use, 100g of lettuce contains around 2-3 g carbohydrate. On that basis if you were to eat a kilogram (2.2 lbs) of lettuce, you would end up with the same amount of carbohydrate as a largeish slice of bread.

So Bernstein’s statement is factually correct, but absurd in the real world as not many people would eat 2 large heads of iceberg lettuce. Even a generous portion of salad leaves would provide under 5 grams of carbohydrate. This is only going to worry the most extreme low carbers like Bernstein.


i am always trying to dampen my appetite as i have some weight to lose, so i eat enormous salads (with protein). but i am wondering if a smaller salad with the same amount of protein would be better for my bg, and thus my appetite (as my appetite increases the longer my bg has to drop to baseline).

i can easily check this for myself, though. i am just wanting to hear others’ experiences first.

But even if you ate 2 whole heads of lettuce, that would only provide about 80 calories - that’s not a lot considering it is going to be quite filling.

What Bernstein called the “Chinese Restaurant Effect” is now recognized as the incretin effect. I’m not sure it is really well understood but the mere passing of food through the digestive tract causes changes in the signals we now know of as DPP and GLP. These changes would normally cause a secretion of both insulin and glucose. Unfortunately for those of us who a pancreatically challenged only the glucose secretion operates and of course it causes our livers to dump blood sugar a rise in blood sugar even if all we ate was lettuce or water. The incretin effect is used by the DPP-4 and GLP-1 drugs to improve mealtime responses (in both T1s and T2s) and what they do is change this signalling to be less dysfunctional.

In my opinion, this effect is real and we should think of it as one way the incretin effect manifests itself.

ps. And I have personally observed larger than expected blood sugar rises with large quantities of low carb food.


Thanks Brian. I stand corrected.