I've had bariatric surgery and I've now got several bariatric cookbooks. One of them in particular really stresses that diabetics should have some carbs (+15 grams) with every meal. When this author gives a recipe that includes less than 15 grams of carbs in a serving, she has a special note "If you are diabetic, add some bread, crackers, pasta, or potato to this meal."
My question is, why? Is it because some people still don't dose their insulin based on the carb load of their meal, but take regular doses a couple times a day? Or is there some non-medication-related reason? I've seen this recommendation before that diabetics need to eat carbs, but I've never seen the "why." If you don't eat carbs, what will happen?
I seem to recall that Dr. Bernstein recommends only something like 24 grams of carbs in a whole day, and my understanding is that that's only to allow some variety in the diet. What am I missing?
Might be referring to the generic 'diabetic' with emphasis on type 2s. The concern might be that many type 2 diabetics are taking a multiple drugs on the assumption that they will eat X number of carbs per meal. I know a couple who are on like 2-3 oral meds plus insulin. Then doctors wonder why their BG control is crap.
i have never heard that i should eat some carbs in each meal, however i can understand that maybe its not a bad idea. if you only eat fat and protein, some of the fat and protein will be converted into carbs, and then you have to bolus for them too. as long as you are aware of that, i think you can even eat carbless for some meals, but i would not recommend it for every meal, as carbs are a very important part of our daily diet.
take care sc
The recommendation to eat carbs comes from a long history of bad science and corruption of the public guidance by big agricultural interests. The key problem is the "Diet Heart Myth" first started back in the 50s. It claimed that high fat diets raised cholesterol and caused CVD. Unfortunately, none of this has proven to be true in any general sense, but the train left the station and nobody can stop the crazy driver. In fact the evidence seems to actually point to carbs as much bigger factor in raising cholesterol and CVD.
And then we get to the second problem, corruption. The nutrition guidelines in the US are put forward by the USDA (the US department of Agriculture). Their job isn't to just worry about health, they worry about the "business." And they have done an admirable job of taking care of big agriculture companies by making sure that "heart healthy grains" are a central part of the world's diet. Shame on them.
In my view, you don't need any dietary carbs, you can make all the glucose you need from protein. And even the Institute of Medicine in the US agrees.
Thanks all. I sort of expected this was the case. I just find it very strange that the recommendations are still happening in a fairly modern book by a fairly progressive (in other respects) dietitian. I may reach out to her for clarification. I found it especially surprising because bariatric patients, who have limited capacity for food, are also generally encouraged to eat a high-protein diet. These recommendations were specifically for diabetics to forego some protein in favor of carbs, which would drive up calories and drive down satiety. It seems strange to me.
Full disclosure, I am Type 2 in full remission after bariatric surgery and significant weight loss. I have not had to "manage" my diabetes in quite a long time now. Even before my surgery almost 9 months ago, my diabetes was very mild and boring, and now it is not physiologically evident at all (since directly after surgery). I eat less than 100 grams of carbs a day, most day less than 50. Daily protein is 70+ grams and I aim for 90. I've lost 35 kg, reduced body fat % from 50 to 28, and increased cardiovascular fitness to the tune of 20km/week running, Zumba each week, and just starting Body Pump this week. I think I'm doing fine without those carbs.
misty, that is awesome. you must feel great. if you get a chance and like reading a bit of science, "good calories, bad calories" was written about what brian is talking about. the same auther wrote "what makes us fat", which was also a slimmed down(haha)version of the first book. i think the author is gary (?) taubes. really surprising and scandalous info! congratulations again on the amazing lifestyle changes-and scaring away your beetus!
I've read both books! Yes, I found them quite shocking and frustrating. I wish that the science could be funded to back Taubes' assertions. The food/nutrition science up to now has been quite shoddy. I am actually considering a career transition into bariatric dietetics because I don't think there are enough people in the field that stay current on science, and I think that patients are being led gravely astray.
Some people use the N and/or R insulin to manage, and so they have peaks and need to deal with those. I happen to like carbs in the and don't mind bolusing for them. Not everyone wants to follow the Dr. B plan.
I would guess it is for pwd on insulin and meds etc. who don't stay stable, have many lows and who don't have predictable results a lot of the time? I include myself in that category even though I low carb. I have increased my carbs lately but not 15 for every meal necessarily.
