July 9, 2013

How Do You Find Acceptable Diabetes Food Plans?

This is the topic for this blog. How do you find acceptable food plans (diets)?

I always have fun with this topic. I receive about two questions per month on this and a few are honest questions that are difficult to answer. Others are people just wanting permission to continue consuming the same junk foods they have been. This I will not do and I ask them why they even asked since nothing I say will change their mind. I am not happy with the way I answered one of these questions, but apparently, it was the only way that I was going to get this person's attention. The discussion after I broke through was very gratifying.

Let me be very clear about this – there is not a specific diabetes diet, food plan, or even a clear guideline. Many people eat different meal plans. The success of their meal plan is determined by what their blood glucose meter tells them. This is the key and using your meter is a must, especially at the start and for approximately the first six months. Some are able to get their doctor to work with them to obtain extra test strips and others are not. Some are able to afford extra test strips and make use of them. Still others use what insurance will allow and carefully guard their usage, watch for trends, and other variances. Is this easy when this happens? No, and I have people tell me that they were fortunate to find the extra money for one or two containers of test strips and this was a great help once they got past many of the changes necessary in their food plan.

Admittedly, the American Diabetes Association (ADA) has relaxed their position on carbohydrates, but the Academy for Nutrition and Dietetics (AND) has not. They are promoting calories in the form of whole grains and promoting them very heavily. They are proud to proclaim who their corporate sponsors include. It is not surprising that there is such a conflict of interest.

This section from the 2013 ADA guidelines (two paragraphs) is important enough to quote, “Although numerous studies have attempted to identify the optimal mix of macronutrients for meal plans of people with diabetes, a recent systematic review confirms that there is no most effective mix that applies broadly, and that macronutrient proportions should be individualized. It must be clearly recognized that regardless of the macronutrient mix, total caloric intake must be appropriate to weight management goal. Further, individualization of the macronutrient composition will depend on the metabolic status of the patient (e.g., lipid profile, renal function) and/or food preferences. A variety of dietary meal patterns are likely effective in managing diabetes including Mediterranean-style, plant-based (vegan or vegetarian), low-fat and lower-carbohydrate eating patterns.

It should be noted that the RDA for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat. Although brain fuel needs can be met on lower carbohydrate diets, long-term metabolic effects of very low-carbohydrate diets are unclear and such diets eliminate many foods that are important sources of energy, fiber, vitamins, and minerals and are important in dietary palatability.” The bold in the two paragraphs above is my emphasis.

Now if the AND people would follow instead of mandating 180 to 230 grams per day of carbohydrates or more, we might actually put a dent in the obesity epidemic.

Most of the time I do suggest that people reduce their whole grains intake and if they are interested, they should consider this book by Dr. William Davis after reading my review and several others.

Of course, I always suggest avoiding white rice and most potatoes, but I always suggest they use their meter when possible to find out what they must reduce, limit, or exclude in their food plan. Those that have been successful have been surprised that some types of potatoes and a few types of rice in small quantities do work for them. We all get surprised occasionally when someone finds certain vegetables can be juiced and are very low carb. Most avoid carrots and everyone avoids most fruits except for a small apple (certain varieties only) that can add flavor to the mixture. Some are happy with the leafy greens they use and I will use some of them in what my wife likes.

Eating well balanced meals really makes a difference and I do use supplements when my tests show that I am at the low side or below the recommended ranges. Most of the time I am well within the recommended ranges for vitamins and minerals.

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