I'll also chime in and say that it's discussions like this that got me to try low-carb. Even though I didn't like really low carb (like <50g/day), I at least tried it and I never would have done that if I hadn't been exposed to discussions like this one. I've settled on 80-100g/day as a number that helps my blood sugar but is flexible enough that I can still eat what I want. For that reason, I don't think it's a bad thing that they pop up every now and then.
Nyadach: Bernstein, when interviewed by James Hirsch for Cheating Destiny, said that he has a medical condition unrelated to diabetes that causes frequent hypos. Bernstein doesn't specify what medical condition. And sadly, many Type 1s who brag about their low A1c's, if you dig a little deeper, have lots of hypos including severe hypos. Finally, as a Type 1 who loves exercise, when I do extreme cardio I lower my basal rate on my pump 1.5 to 2 hours prior AND fuel with carbs, often fruit. Otherwise I go low. Bernstein fuels his workouts with glucose tabs--yuck. As I said in a separate post, there is some good info in Diabetes Solution, but much is just too extreme for me and doesn't work for me.
Thanks for your detailed response Nyadach, I apologize for my post being hard to read, it was supposed to contain some blockquote tags but they got lost somewhere along the way. When you mentioned mental damage I assumed you were referring to the common criticism of Bernstein that our brains need a minimum of 130 g/day of carbs to function. You are of course right that hypo's are dangerous and can cause damage.
The endurance athletes that use keto adaption to fuel their activity rely on the body's store of fat as fuel, not an external source such as walnuts. Because fat is such a dense store of energy as compared to carbs and the body's store of carbs is limited, even a thin person has a orders of magnitude more energy stored as body fat as compared to carbs. Of course having to use external insulin may well make this approach untenable.
Here's a video that explains the energy equation as it relates to endurance athletes by Dr. Steve Phinney who is also a cyclist.
Yeah Jen, I agree that there is a lot more to controlling BG than controlling carbs. On the extreme end, it was the demonization of carbs that initially turned me off about how Dr. Bernstein's diet is often portrayed, not necessarily by Dr. Bernstein himself.
As a T1 college track and field sprinter, I lived and trained on unimagineable amounts of carbs a day. Of course, there is wisdom to limiting carbs. 25 years down the road now, doing what I did when I was 22 would be suicide. But, still, I remain pretty carb tolerant just because of my underlying physiology I suspect. It would take a lot, maybe just a lot more years, to make me consider limiting carbs to the point of going ketogenic. It's not a miracle diet without drawbacks. I suspect I would be fighting a lot of issues that would just replace any issues I have with carbs now..
Excellent answer, I agree completely (except that it is Bernstein himself and not just his ardent supporters who are adamant about strictly limiting carb with his diet).
I low carb, about 50 - 60 grams per day. However, honestly, I'm not sure why because I end up having to bolus for protein and have made myself so carb intolerant it's become counter-productive. Analog insulins aren't meant to work on or for protein - fats. Before 'carb' counting, one bolused by counting calories/meal. If one is low carbing so drastically, eventually everything is going to turn into glucose anyway and one ends up bolusing for the protein...so, what's the difference? If I have a meal high in protein, veggies, etc...I have to bolus for that protein. If I mix in carbs (true carbs), the bolus works with those carbs and control is better. The comments on here mostly praising Dr. B's diet are from Type 2's who needed or wanted to address weight issues, high cholesterol, etc...which for many type 1's isn't an issue.
Me too for agreement! One thing that goes unmentioned is that many folks increase protein and fat in the limiting carbs diet. Some folks have issues with one or both of those and need to limit them. A person cannot live on walnuts and avacados - however delicious that would be.
Well, strictly limiting carbs is one thing. Suggesting that carbs should be treated like poison, or that subsisting on a 0 carb diet is a practical approach to living is even more extreme than anything I've heard or read from Dr Bernstein.
Who in the beep ever suggested a 0 carb diet? Not me, I promise!
Let's just say that a definite positive to these ongoing discussions regarding diet is that more moderate viewpoints are far more common these days. I include myself as a convert to a much more moderate viewpoint.
I think that one of the first steps in controlling whatever form of diabetes a person my get is to do some sort of analysis regarding the amount of carbs you consume daily and how that amount affects your BG profile. I would say that most newly diagnosed PWDs could stand to limit carb intake right out of the gate. That is a viewpoint that is a direct result of influence from Bernstein followers.
However, like Jen says, there is just so much more to at least consider though.
One thing about the low carb thing is that it's important to make up the calories from some other food source. I'm still not 100% sure about how many calories to eat. I was at 1800 for a while and that seems to work ok but if I "splurge" and go up to 1900, it almost seems I lose weight (this aiming for 50% protein/ 30% carb/ 20% fat...I don't always hit it but the 50Pro days seem to coincide pretty eerily with finding myself down a couple of lbs). There's a bunch of videos at http://www.biolayne.com/videos/ talking about how many folks trying to lose weight/ get healthy or, I guess in his context, get, uh, ripped, cut calories too low causing what he refers to as "metabolic damage", slowing your metabolism to the point where you don't lose weight/ fat because your body retains it, particularly fat I guess.
I have, of course, no idea if it's true but there are quite a few reports of folks who don't sound like they eat that much around here who might benefit from perhaps going after protein more aggressively?
Since I was a youngin (way before diabetes found me) low carbing was what worked for me as far as losing weight -- those pounds would just drop off! -- and making me feel better in every way. Now I low-carb for diabetes control (and also because I'm missing some carb-digesting enzymes, so the carbs really don't agree with me).
But actually, I'm happy that I'm forced to low-carb -- I believe its a healthy lifestyle. Do some reading on the internet - not just diabetes-related. Sugar, white (and other) flour, and carbs in general, are being implicated for many of the diseases that abound in the Western world. Read Taubes book - "good calories, bad calories" -- and so many others. To all you PWD who find it so important to be able to prove that you can 'live a normal life, eating chocolate bars, etc', who says that's normal?! I think that following Dr. Bernstein, to whatever degree you can, helps make you a healthier person all around.
If you aren't able to digest carbs because you don't make the proper digestive enzymes, then of course it makes sense that you wouldn't eat them. I'm sorry you are in that position, but please remember that most of us aren't.
Do you seriously think Bernstein's diet is "normal"? He doesn't just restrict sugar, white flour and chocolate bars - I understand those restrictions and have lived with those since I got diabetes. But Bernstein goes way out on a limb when he says you must never again eat any food made from grain such as whole wheat breads, cereals, pasta and rice; you must never again eat vegetables such as potatoes, corn, carrots, peas, tomatoes and beans; you must never again eat any fresh fruit; you must never again eat any dairy products except for butter, cream and fermented cheeses. Instead you are to replace all these foods with sawdust-tasting swedish crackers. Is that "normal"? And I sincerely question whether eating massive servings of meat and butter every day is "healthy".
Sounds like you've found a diet that really works for you Negg. Personally, Ican agree that being a PWD means you should definitely be conscious of the acrbs you eat and probably need to limit them to some extent. I think most of us would agree that limiting sugar and processed foods is probably a good thing regardless.
However, it's all relative. Eating more than Bernstein levels of carbs doesn't mean you're eating chocolate bars, or donuts, or washing it all down with a 32 oz Coke. OTOH, I don't think that being a PWD suddenly means that eating a Hershey Kiss with less than 3 gr of carbs or maybe even an Oreo cookie with less than 9 gr of carbs means you've put yourself on the path to bad BG control and complications. If you're on berstein, those are both big percentages of your daily carb allowance and probably not worth it. Beyond ketogenic diets and extreme lifestyle choices, I don't know that simply depriving yourself is always necessary. It's a personal thing and depends on your own tolerance.
From what I can gather from the direction of research, the big issue has been replacing the calories you would get in fat and protein with carbs, not necessarily the presence of carbs themselves. I've found that I have BG issues if I try to replace a big portion of the calories I eat in a day from carbs with fat and protein. So, i've found a more moderate approach as far as Bernstien goes works for me. It's acyually a low-carb solution if you consider what literature generally considers low-carb.
I had two breadsticks at Olive Garden last night.
I will not feel guilty.
No I won't.
Nope!
Not gonna do it.
Uh uh.
:-)
Yeah, but the big question is were the two breadsticks lying next to a big bowl of pasta? I wouldn't say I ever feel "guilty" per se; it's just not an emotion I have any use for. And I never feel any kind of bad until and unless I see some hideous number. Then what I feel is amazed at the human mind which can forget/deny so well the previous 1,000 times it saw that number after eating that food!!
I could tell you, but then I'd have to kill you. Secret spy stuff and all that.
Suffice it to say it was my son's 18th birthday. Unique occasion. Some caution tossed to the wind.
It's has been so far, and will continue to be, a tough BG day today :-)
Yeah, I don't do guilt over food choices. 75% of the time I can walk past a bowl of Hershey Kisses or a plate of cookies. If 1 out of 4 times, I feel like eating a snack, I think I can handle that. If my BG goes out of control because of it, there is a tinge of regret, but I have a much higher incidence of bad BG numbers as a result of bad TAGing a high protein meal than I've had from eating the occasional high carb snack.
Having an 18 year old child who wants to spend his birthday with his dad is worth celebrating!
Your trip to Olive Garden reminds me of when I was due to meet my family for dinner and my nephew picked the restaurant and said, "they have some excellent vegetarian pizza for you, Zoe". That's when I realized people only allow you one food quirk and I used mine up with vegetarianism. I was also reminded that before my diagnosis I wouldn't have had a clue that pizza (or carbs in general) were hard on diabetics. When I was diagnosed I had a five minute conversation with a diabetic educator. I said: "I'm a vegetarian and I eat very healthy and I haven't eaten sugar in 13 years". She said: "Then you really won't have to change anything." She never asked if, as a vegetarian I ate a lot of pasta, beans, rice, cereal. (I did).
I agree with you, I had to do a lot more research and ask questions about proteins and fat, fiber etc. They do require different sets of ratios, actually much more insulin than carbs. And they do have impact on my BG. So not everything is in his book and not that simple as 6-12-12, unfortunately.
Another thing are my struggles with hunger, which he controls either with symlin or hoodia, Both are not available here, in Europe :)
But the golden rule of small numbers is good, that's why I hardly get lows (even I do not personally 100% comfortable with low carb and high fat, but it is another story)