What do we know for sure about nutrition?


#1

Not much. The only thing I know reasonably for certain is that for a Type 1, low carb is a necessity. Everything else, all theories, all diets, all studies about nutrition, are basically worthless because you can easily find another that says the exact opposite. Read Gary Taubes and Dr. Bernstein.


#2

I don’t agree with that. Maybe for some T1D’s it is a necessity. Or maybe for you. Certainly not for all, and certainly not for me. I couldn 't survive on low carb.


#3

I have to ditto Eddie ^^^ I also couldn’t survive, don’t want to, don’t need to. I burn off all of the calories I eat whether they are carbs, fats, proteins, whatever.

What I know about nutrition is that I can get all I need from the garden and from unprocessed foods. The more wholesome the foods, the less I need. And I never am hungry. YAY for apple season btw!!


#4

I certainly agree with this providing you insert the word “some.” I’d further say that carb limits provide a useful function to many PWDs in making their metabolic life simpler with less drama.

Some PWDs can eat a large quantity of carbs because they produce a moderate but consequential source of home-grown (endogenous) insulin. This is often seen in the honeymoon phase. In some adult slow-onset T1Ds, this period can be stretched for years.

I have a better quality of life by limiting carbs to under 100 grams/day.

I agree that discussing good nutrition with anyone leads to a wide divergence of ideas. And it’s a very sensitive topic. Especially if you’re trying to tell someone they should change their eating habits. That’s akin to telling someone to change their religion!


#5

I’ve experienced that low-carbohydrate eating certainly can help with controlling my diabetes. But I think it’s wrong, entirely, to state that it’s a necessity.

Nutrition is a complex thing, the fact that there are so many different points of view, many of which actually have legitimate bases, is a strong indication of this.

I would also ask, how do you find that low-carbohydrate eating is the only way of eating with any legitimacy, when there are clearly plenty of nutritionists who suggest otherwise? I’m not saying it’s wrong but it’s somewhat of a fallacy to state on the one hand, one style of eating is the only way to eat, and then state all other ways are worthless when the only reason you give for this could be used against low-carbohydrate eating also.

My personal belief is that nutrition is somewhat personalised. Different people react differently to different ways of eating. I like to think the better approach is some balance, and to limit processed foods as best as possible.


#6

We come from a society that said 400 carbs a day fine. Actually the for profit food entities hid that fact if they could.

So to us as people we are being fed way to many carbs. But 100 + a day should be fine. More even.


#7

And some people can successfully eat more carbs because they respond better, more consistently and more predictably to insulin… and some limit their diets to just a few sources of carbohydrate and finely hone their skills to dose for those… and some people’s digestion speed matches their insulin better than others allowing them to eat and dose for more without getting weird, etc

I generally eat low carb probably 80ish g / day but I certainly fall off the wagon sometimes and do ok when I do…

I do agree with the OP that if one is following Bernstein and their goals are to never ever let their bg creep above 100, low carb is probably the only way that’s going to happen. I can’t help but notice though that he’s pretty much the only doctor on the planet that recommends that, and the rest of them kind of think he’s a bit crazy…


#8

I think that statement is a bit harsh, like anything else carbs in moderation are just fine. IMHO it is very old school to think that diabetics can’t have carbs, if they are treated and handling them well on Insulin then some carbs are fine. Your statement reminded me of what they used to do for Type 1 before insulin, feed them every other day… Perhaps you can qualify what you mean by LOW CARB, is 20 grams too much 100 grams…personally, I strive to put carbs INTO my diet as with some co-conditions I have trouble eating and my body is in starvation…I need the carbs now … in moderation of course, and strive to have at least 15-30 grams with each of the two - three meals I choke down…this helps my body and nutritional status and actually increases my weight loss…whereas before I was just protein no carb and was gaining and my sugars were out of control…


#9

I am not a Bernstein zealot and eat around 100 grams a day. Really enjoyed my popcorn at the movies yesterday. In defense of Bernstein, most doctors and nutritionists are not healthy octogenarian diabetics. Also, the combination of the engineering degree and MD give him a unique perspective. I can’t do it, but you can’t argue with the results.


#10

I think everyone is different. Some people do fine with a high carb diet. But for many of us we do better with lower carb. But some people also make diet choices based on other concerns (like ethics) believing that one should eat vegan. What really irks me is saying that a particular diet is “wrong.” This has been the standard message from the ADA and CDE’s. I have been told my diet is “wrong” so many times over the years I can’t even count them. Sometimes I feel like intervening and suggesting that a raw vegan diet can not possibly cure type 1 diabetes, but diet is a personal choice. If you try to make an informed decision, then your personal choice cannot be wrong.


#11

What did they say was wrong with it? Are you low carb?


#12

You have not told me my diet is wrong, but I have had dozens if not hundreds of so called “health care professionals” criticize my diet. Nobody should be criticized here at TuDiabetes for the diet choices.


#13

Yes, I know I did not do it! I don’t think I have ever criticized anyone’s diet.

But what I am asking is, what is the criticism of your diet? What did health care pros say was wrong? Was it the low carb they did not like?


#14

I think, more or less, anytime anyone tells someone else that they should change anything about their life, in the absence of a direct request for advice and help, that there is going to be friction. We’re all doing the best we can, diabetes is an enormously variable set of diseases and disorders, and it’s a bit silly to get stuck on the idea that what works for me must work for everyone else. I suspect that the two most important qualities for a PWD that wants to live well are:

  1. A willingness to experiment with different diets, treatment regimens, exercise routines, and even doctors until they find something that works in meeting their goals and lifestyle needs.

  2. A willingness to change the results of those experiments when the disease inevitably changes.

The people I’ve heard from in real life and online who have serious problems with managing their diabetes are those who get stuck in a rut about “the right way to do things.” I’ve heard of people committed to the “50% of calories from carbs per day” orthodoxy really struggle with managing, and I’ve likewise heard some people suffer from repeated lows who just couldn’t get the “carbs are the enemy” idea out of their heads…


#15

can’t help but notice though that he’s pretty much the only doctor on the planet that recommends that, and the rest of them kind of think he’s a bit crazy…

I also think he’s a bit crazy (in the sense of suggesting that it’s the best way to manage one’s diabetes), but I actually have a doctor (a metabolic specialist) who agrees entirely with him. It appears to me that there is a growing body of medical practitioners that advocate for a low-carb diet in some circumstances (for those with diabetes, those that are obese, etc.). This isn’t reflected, so far, in the nutritional guidelines of most major associations: high-carb is definitely still the orthodoxy. My issue with those guidelines are the same as I have with any orthodoxy :slight_smile: They don’t acknowledge that different things work for different people.


#16

I think perhaps I used the term “low carb” in a technical way that I did not intend to, or that some here misinterpreted what I meant. What I DO know, for sure, is that sugar, any cereals, milk, bread, snacks, potatoes, and the like spike my BG immediately and dramatically. I DO know that if I do not eat those things, I do not get that result. So I try to limit my intake of “carbs”, especially any processed carbs. “Low carb” is a relative term. I do eat vegetables and some fruit, which I know are “carbs” but not a lot of them.

It’s not rocket science. Sugar and carbs produce glucose in the body. Insulin is required to clear the glucose in the body. Type 1s do not produce insulin. Fewer carbs equals less glucose and less insulin needed, and probably weight loss or maintenance as well.


#17

I think most of us get what you are talking about. Low-carb is both pretty common in this community (both T1 and T2) and a frequent topic of conversation. However, the overall point is that many people do quite well on a moderate- (and occasionally even a high-) carb diet. There are a number of athletes in this community who have to balance both blood glucose and athletic performance, and that can be challenging on a low-carb diet. Of course it’s challenging on a high-carb diet too :slight_smile:

The point being, there are plenty of people here that practice low-carb and do very well in terms of tight control, but there are also people in this forum that eat moderate- or high-carb and also have tight BG control! It’s really a matter of what works best for an individual. As for me, your description is pretty much exactly right. As a Type 1 not currently on exogenous insulin (early in LADA presentation), low-carb eating is critical to maintaining a BG in my preferred range (70-126 mg/dL). When I start insulin therapy, I may very well re-evaluate the amount of carbs in my diet. I’ll make a decision about that when it becomes necessary, not now!


#18

David49, I think your response should be stickied and read by every diabetic starting this journey. We are blessed by a diabetic team that encourages experimentation, and finding what works for us, without encumbering us with what others are doing, unless we ask. I am also encouraged by our physicians having enough skepticism to ask questions to find out if what we are doing is within their bounds of “healthy”.

While we have only been at this for a little over one year, I feel like we have been through 3 distinct stages of diabetes, and each stage has required a different approach. Sometimes this approach is limited by our knowledge and tools, but mostly it is just the variable way the body reacts. My son is looking forward to a more predictable response by his body, but whenever things get out of whack, we test and find a strategy that works the best.

As a parent, I hold myself back from the very strong urge to micro-manage, and am consistently encouraged by seeing my teen taking many parts of this on, and working out a plan that works for him. It is also unspoken, that whenever he wants help, we are there to take on whatever part of this disease he wants to give to us for as long as he wants.

Without the awesome tools of today and the ability to experiment a little, I feel like this would be more difficult to deal with.


#19

My great-grandmother was Type 1 (presumably…she was insulin-dependent and slim in the bad old days), and lived before the days of at home blood glucose meters and rapid acting insulin. She took two shots a day and ate on a schedule or suffered terrible lows. She had hard candy around that we were forbidden to touch (we just knew she needed it for “her sugar”), and she ended up losing her feet and eyesight, but not until she was in her late 80s. She was a wonderful woman, and I can’t imagine doing what she did to stay alive and being as cheerful as she was. I’m eternally grateful to be a diabetic in a time with good tools and knowledge to help manage my condition.

And I’m glad there are parents out there like you! That reluctance to micro-manage will serve your boy well when he has to make his own decisions on a day-to-day (and often minute-to-minute) basis.


#20

I always kinds laugh about diets and what’s right or wrong. And over the many years being on this planet, the diet we should be eating has changed and will continue to change. Remember the starvation diets before insulin. Or the exchange diets way back when. Or how bout eggs being bad for you, or diet sodas helped you lose weight. And those things have all changed. I am not on a diet. I don’t really think about it a whole lot. I eat what I want when I want and just take the amount of insulin needed to handle it. I am little old school on this one. A little veggies, a little protein, a little fat, a little carbs (ok maybe a little more sometimes), but for me it’s a well rounded plate. A little bit of everything and in moderation, except for the holidays and than I’m all in. Love baking Christmas cookies. So while the statement that all people with diabetes should do (insert whatever), we all know that what works for one of us won’t work for the next. So now I eat eggs a lot more than ever because they are not the cholesterol nightmare they were said to be.
And while I don’t see a RD very often, I have never been told what to eat, never or that what I was doing was wrong. It has always been a team effort to make what I want work. We are all one big experiment everyday. So get out there and experiment and find what works for you today.