Has anyone read Dr Bernstein's book about his low carb way of living?
I have recently read it and am very interested in what he has to say, but it seems like everyone who follows his way of life are older 55+(no offence of course!). I just want to know if there are any youngins' out there who currently live the way Dr Bernstein recommends?
I myself get a little angry at those who push "the only way" as Dr B's way. It is very hard to identify with such extreme attitudes.
At the same time if I open his books and start flipping through, I do find more openness and things that I can identify with and techniques I can use. It is not a book of absolutes, although the advocates and marketing on the back cover might make you think so.
I no longer qualify as a "youngin" but I've been living with D since I was 30. I wish I had adopted carb restriction sooner. It would have avoided at least some of the BG volatility that plagued my daily control in my younger years.
I bicycled a lot for many years. I didn't have a CGM then and I am grateful that I survived many extreme low BGs during that period. My A1c was consistently in the mid to low 6% range but the average that that implied hid a heap of hypoglycemia, some of it dangerously low.
I remember one four-mile descent at night after a full day of cycling. I had exhausted my glucose tabs and all my food. I knew I was low but all my sugar-starved brain could focus on was that I had to get back to my car where I had extra supplies. I descended at 25-40 miles per hour negotiating occasional car traffic. Looking back, the peril I undertook still frightens me.
Dr. Bernstein's long-established protocol of limiting daily carbs to 30 grams does polarize this community from time to time. The greater lesson that I took from reading his book was that carb limits can be helpful.
It's helped me lose weight and restore my BG control. Together with regular exercise, dosing for fat and protein, and using a CGM, I've been able to reduce BG variability by a lot. This outcome alone has improved the quality of my life tremendously. My BG average is lower, my time in range is much higher and my time less than 70 is low.
These changes were not precipitated by Dr. B, but the diagnosis of a diabetes complication back in 2012. It was then that I picked up his book and gave it renewed consideration. I adopted a reduced carb diet, in the range of 50-70 grams per day. I consider carb limitation on the same level of importance as the BG meter, basal/bolus dosing, the advent of the CGM, and rapid acting insulin analogs.
Why do people get upset when someone here reports that a carb limited diet, perhaps as low as 30 grams/day, does them good? It doesn't mean that everyone should adopt that way of eating. The more important lesson is that carbs drive post meal BGs and PWD will vary regarding the level they can consume before it becomes a problem.
I believe that the reality of carbs and BGs affects people under 55, too. While your metabolisms may still benefit more from increased physical activity and possibly some residual endogenous insulin production, carbs still drive post-meal BGs. I wish that I heeded some of Dr. B's concepts at a younger age. I was lucky to survive my younger years with D. Now I practice a safer lifestyle.
Bernstein is not responsible for any of the things you give him credit for, except the last one (advocating for low carb). It is true that he self-monitored blood glucose with a meter, but there were already visually read blood glucose strips on the market and the industry was moving towards selling home meters regardless of him. He was lucky to get one of the first because his wife was a doctor and he did push for self-monitoring, but he was by no means the first or only (see Joslin Diabetes center). He did not invent basal/bolus - that is simply untrue. He did advocate for lowering blood sugars to reduce complications, but again the biggest voice for that was Joslin, and Joslin and Joslin Diabetes center had been pushing for that for decades before Bernstein was.
I suspect Nyadach's reaction against him has a lot to do with this sort of deification that he is afforded by his followers. Those of us who had diabetes back then know these things aren't true, so to see him being credit for things he doesn't deserve really does grate at me.
I don't consider him a quack, and I have read his book in detail and I learned things from it. But I don't follow his diet (which is actually the whole point of his book), and I consider him a control-freak. Based on his book, the only diet he thinks all diabetics should eat is the one he spells out in his book (30g carb/day or less). He says "what works, works", but ONLY while eating his diet. In fact he would have been a lot more popular and mainstream if he HAD taken the attitude of "what works, works" instead of his very dogmatic attitude of "my 30g way or the highway".
Really, I'm surprised? All editions of his "Diabetes Solution" book mandate 30g carb per day or less (I have the first edition). Do you happen to know which books those were that were more open-minded?
I wasn't reacting to your comments. We all need to find our own way and if you can attain your goals without restricting carbs, that is great. I just think we do a disservice by not recognizing that carb restriction can be an effective option.
Could it have something to do with the fact that most type II's are older?
I for one do not understand why any diabetic would not follow his advice to normalize blood glucose and to do so with a very low carb diet. I have been following his guidelines and have gotten my blood glucose normalized to around 83 mg/dl with highs below 100 mg/dl. I eat from 20 to 30 grams of carbs per day.
But you are T2, and T1 is very different in this regard. You don't take any insulin, and apparently his approach works for you as a T2 to keep you off medication. So you should definitely keep doing it as long as you can.
Be aware, though, that T1's need to inject or dose insulin multiple times a day regardless of what they eat. I think EVERY diabetic would like to normalize their blood glucose - but the issue is HOW to do it. Some are happy with Bernstein, others aren't.
Most of the time I do a pretty good giving someone the benefit of the doubt as I pick and choose among the advice I'm given.
I think there's lots of tips and truisms in Dr B's books that are useful even if I don't go militant-low-carb.
I do have to ignore the blurbs on the back cover of many of the editions.
I completely agree with your comment here, Kathy. I'm interested in this polarizing topic and see positives in discussing how low carb can work or not work for different folks.
I had a similar approach that I took a lot from reading Dr Bernstein and it helped confirm an approach I was taking naturally, which was to drastically reduce the number of carbs I ate. I do eat a low carb diet (generally) and find it keeps me off the blood sugar roller coaster. I also left behind a lot of the strictness of his regime - although I often eat at 30 g per day, I really appreciate being able to be flexible with what I eat and being aware and confident about how my body reacts to more carbs/less exercise and how to adjust my insulin accordingly. (I'm 30 and pretty active.)
I am a pragmatist through and through. I am interested in empirical results, not theory or opinion, no matter how well expressed. And I'm not going to get into the who-invented-what debate because frankly, I don't give a rodential fundament who takes the credit (or doesn't). I care about the results.
Before I started following Bernstein, my A1cs were in the 7s and my lipids were bad enough to require a statin. Since I began using his methods, my A1c's have remained consistently in the 5s and my lipids have dropped like a rock. I dropped the statin cold turkey, and my trigs now stay consistently in the 40s. LDL:HDL is about 1:2 and total cholesterol is in the low 100s. Those numbers have held steady for a long time now. Oh yeah, I also dropped 35 lbs and it's stayed off.
I like those results. Slice and dice the who's-to-credit/who's-to-blame any way you like and I will readily agree with you. Because I just don't care. It's the result that matters to me. Everything else is angels on the head of a pin.
That being said, the whole like him/hate him debate misses the point. YDMV. Every case is individual and personal and requires an individual and personal approach. The way to deal with Bernstein -- or Scheiner, or Ruhl, or any other expert you care to name -- is to take what you can use and leave the rest. What matters is not what anyone says, but what works for you. Full stop.
$0.02
Thoughts on the book....
There is a ton of information, and frankly I haven't seen any other books that even approach the scope/depth that his book does. I don't take it all as gospel, but he is philosophically taking a different approach than the mainstream medical community and frankly it is good to get a different perspective before deciding how I want to proceed. Additionally, this is my go to book when I want to look something up.
Think Like a Pancreas, Pumping Insulin, and Your Diabetes Science Experiment are great books that get recommended a lot. But I have to add that Dr B's book is the only complete system for diabetes management I have really seen. There is a clearcut goal of 'normalized blood glucose levels' and he talks about dealing with all the other issues (feet) that we deal with. A lot of individuals here have figured out ways that they can get below 6 A1Cs safely without many lows, but there aren't other books showing us how. The mainstream medical community assumes that most patients are pretty lazy and gears their information and treatment with that mindset, and it isn't good advice for those of us willing to work hard, so that we can live a long healthy life.
I don't take what Dr B says as gospel, but I listen/read his opinion and form my own views. I'm not in the extreme low carb camp, but reading his book certainly gave me a better understanding of BG management (as did the other books).
Okay then, who was the first to take a basal/bolus approach with insulin? Who put out the first paper?
Once again, David, you are a T2, not a T1. That certainly doesn't invalidate your experience, it just makes it different from mine. I've never had any lipid issues or even a suggestion that I take statins; I don't have any weight I need to lose.
My issue as a T1 is to get the best control I can while living life the way I want and eating foods that I like and that I think are good for me. I learned the most in this regard from Walsh (Pumping Insulin), Hanas (Type 1 Diabetes), and Scheiner (Think Like a Pancreas). Bernstein is not the top of my list, though I did find useful information there too; just not diet advice as his diet is too extreme for me. But I certainly agree that what works for you and you alone is all that really matters.
Nyadach, as a T2 not on insulin I don't have anything to contribute to the OP's question, I have however been on a 30 to 50 g/day diet for 4.5 + years. I am curious what type of mental damage I may be facing?
I work in IT and make my living with my brain, believe me I would notice a decline in mental function. So far I seem to be holding my own. Here are a couple of articles, article 1 and article2 which together say that our brains are quite happy switching fuel from glucose to ketones and that this ability is probably a vital evolutionary adaptation. Both imply that ketones are a more efficient source of energy and also burn cleaner producing fewer harmful byproducts. They also make the point that the long term effects of a ketogenic diet have not been studied.
I would also dispute the claim that
Bernstein's system seems fine if you sit on a sun lounger all day
Here is an article about an experiment of N=1 conducted by Peter Attia MD and endurance athlete. His conclusion after examining the results is
The one drawback, it seems, to completely eliminating carbohydrates from my diet was a loss of all-out top end power. For someone like me, this doesn’t seem to hinder performance too much, but if I was trying to win an Olympic gold medal in the 400 meter run or the 100 meter freestyle, it seems I’d be better off with some carbohydrate in my diet.
So what did I learn? Keto-adaptation made me far more metabolically flexible and efficient in the aerobic environment. This seems particularly important for folks who compete in events longer than a few minutes (e.g., 10K, marathon, triathlon), but less so for folks doing short-burst activity
To be fair Attia switched to a ketogenic diet when he saw unmistakable signs of metabolic syndrome in his own body. Cutting carbs drastically successfully addressed this problem. Since he is neither a T1 nor an insulin user, his experience may not be relevant to either you or the OP.
Characterizing Bernstein as a quack implies that all the folks around here who have derived benefit from reading his book, even if they don't strictly adhere to the 30 g/day, are either lying, delusional or brainwashed in some way. I think this is completely unfair. We each have to find our own way but attacking those who are following a different path is not useful. If you have found something that enables you to meet your blood sugar goals great, tell us about it, but always remember others may have found a different equally valid path.
As a T2 on insulin, I have plenty to say but I've already said it, time after time. Not gonna do it again.
There are certain topics -- and this is one of them -- that apparently must be debated and redebated endlessly. Every few months this discussion (and others) start up again. Everyone restates their positions, nobody changes their mind, and everyone jockeys to have the last word. Broken records. Make me tired.
Bernstein is not responsible for any of the things you give him credit for, except the last one (advocating for low carb).
I think Dr. Frederick Allen gets credit for that. Typically in his advocated diet, 8% or less of total calories come from carbs (that may be slightly more carbs than Bernstein allows).
"Total Dietary Regulation in the Treatment of Diabetes", 1919.
NPH + Regular was 1950. http://www.ncbi.nlm.nih.gov/pubmed/14846799
I did pretty well for a couple decades with 4x a day NPH for basal.
Hi Kiwikrystie, I am not a "youngin" as far as age but certainly in activity and in heart and mind. LOL
I have read the book and did find it interesting as well. I usually don't drop in on the Dr B debacles that come around the forums...it's a big yawn. But I thought your question was deserving of an answer from one who is at least young at heart!
The one thing I follow is to keep my blood glucose in the normal range. It can be done and I don't follow a low carb eating plan. I am a fan of fresh produce and fruit is my favorite food because not only are they delicious they are incredibly healthy and nutritious and worth every bite!
You could try living the Dr B way (keep in mind that he does not practice weight lifting and competitive exercise activities), and if it works for you and improves your manangement and you can continue to participate in your active lifestyle...then go for it!
Actually Dr. B. does exercise vigorously, both aerobically and anaerobically. But your points are still 100% true and valid.