DIABETICS AND DAILY CALORIES

tracyschreier

I'm finding that it is very difficult to reach my calorie goals every single day. I've only been on this site for a week, but I have yet to eat all my calories. I'm wondering if this is because I'm diabetic, and must make sensible food choices when it comes to carbs, and therefore am not able to meet the requirement...especially if I exercise, when more calories are added! Any other diabetics having this problem? What do you do about it? Should I just set a lower caloric range for myself? I haven't seen my dietician since beginning this site, so I set it pretty high (1500), but even still, I'm 200 or more calories under!

nicoleknapp754

I am diabetic on insulin and unless I eat a bunch of animal protein there is no way I can reach the caloric goal and eat back exercise calories burned. So I just adjusted the percentages and lowered my calorie goal. Someone here will probably flame me for saying that I am not eating back any of my calories. But what I am doing is working for me. I've lost 55 lbs since January 1, 2012. I eat very low carb.

albertabeefy

I am a non-insulin dependent diabetic who was initially diagnosed with an HbA1c of 12.2% and fasting glucose of 268mg/dl (14.8mmol/L) and was immediately prescribed insulin... Less than a year later my glucose was completely normalized. My current HbA1c is a completely non-diabetic normal reading of 5.2% and my fasting glucose is always under 100mg/dl (5.5mmol/L) - unless I'm sick.

I control my glucose entirely with diet (low-carb/high-fat ketogenic diet) and have no need to restrict calories except when dieting, which I do twice a year. (I mass-build / diet down 2x each per year.)

You can find more information on treating diabetes with a very low carb ketogenic diet here:

http://www.diabetes-low-carb.org/
http://www.dsolve.com/sucess-stories/150-ronraab

And there are literally dozens of studies which confirm low-carb ketogenic diets are superior to any other (whether low-GI, low-calorie, low-fat, etc.) for not only glycemic control, but also weight loss, overall fat-loss with lean-muscle-retention, improving insulin sensitivity AND all markers of cardiovascular health including triglyceride levels and cholesterol ratio.

http://www.nutritionandmetabolism.com/content/5/1/9
http://www.nutritionandmetabolism.com/content/5/1/36
http://www.nutritionandmetabolism.com/content/5/1/10
http://www.nutritionandmetabolism.com/content/6/1/21

I've included just a few studies/papers above. You can also talk to the literally thousands of diabetics at www.diabetesforum.com that treat their diabetes with low-carb ketogenic diets.

If you have any questions, please let me know. I've been on a low-carb ketogenic diet for over 2 years now with incredible success.

tracyschreier

Wow...thanks for the information. I will definitely ask my dietician about this. Something has to be done.

albertabeefy

Wow...thanks for the information. I will definitely ask my dietician about this. Something has to be done.

Before you see your dietician, repeat after me: "There is NO dietary need for carbohydrate in humans" ... say it a few times, research it ( this article: http://ajcn.nutrition.org/content/75/5/951.2.long and this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/ or this excellent article from Lyle McDonald http://www.bodyrecomposition.com/nutrition/carbohydrate-and-fat-controversies-part-1.html)

Lyle McDonald's article even states "Even the American Dietetic Association bible, the RDA Handbook, states that there is no requirement for dietary carbohydrates. Any decent nutrition or physiology book will state the same. Despite this basic biological fact, many researchers and diet authorities still insist that the majority (50-60% or more) of the human diet should come from carbohydrates."

That being said, a lot of dieticians will state that you NEED carbohydrates in your diet - which is simply untrue, and many are bound by their governing bodies to ONLY promote the dietary guidelines of the American Diabetes Association (or Canadian Diabetes Association ... or association of whatever country you live in ...)

... and there's the rub. The American Diabetes association is primarily funded (to the tune of 10's of millions of dollars each year) by both the pharmaceutical industry and food giants such as Coca Cola, Cadbury-Schweppes and others that simply don't have a vested interest in you controlling your diabetes.

It sounds like a giant conspiracy theory until you actually research it.

Both the American Association of Clinical Endocrinologists and the International Diabetes Federation have guidelines stating that post-prandial glucose should be kept UNDER 7.8mmol/L (140mg/dl) at all times. (It's well-established that the cardiovascular/circulatory damage diabetics experience starts at 7.8mmol/L or 140mg/dl). Yet both the American and Canadian Diabetes associations have clinical targets of glucose under 10.0mmol/L or 180mg/dl. Why would the ADA/CDA want you to be at a level they KNOW causes damage? It makes no sense, yet that's their recommendation.


image from here: http://www.healthy-eating-politics.com/american-diabetes-association.html

One of the best sources of information on diabetes, especially Type II, is Blood Sugar 101: www.bloodsugar101.com ... The site is run by author Jenny Ruhl, herself a diabetic - and includes mountains of clinical research outlined in an easy-to-research format.

The best book on controlling diabetes (whether Type1 or TypeII) I know of is Dr. Richard K. Bernstein's "Diabetes Solution", who is both an MD and a Type I diabetic. Much of his book is free online if you google it.

Here's a blog from a fellow who overcame diabetes with diet, then posted about it ... then got SUED by his states' dietetic/nutritionist governing board for telling people about it on the internet: http://www.diabetes-warrior.net/2013/01/16/listen-to-the-experts-of-diabetes-care/

Sorry for the vast-amounts of information being thrown out here, and for the 'soap-box' speech, but people are dying because of bad advice being given - and they have the ability to turn it around.

fattyfoodie

Albertabeefy- THANK YOU for posting all of this information.

As a person who was diagnosed with gestational diabetes and subsequently with type II, I cannot BELIEVE what "dieticians" are recommending I eat!

After my diagnosis with type II I went back to the endocrinology clinic and was provided a menu entitled "healthy eating for the diabetic new mom." Lunch selections include Kraft dinner, Subway, and many varieties of sandwiches. Snacks include Arrowroot cookies, pudding, and reduced sugar hot chocolate.

I seriously think they want me to be insulin dependent for life....

tracyschreier

You are making me question everything I've been taught, and everything I have taught to patients (I'm an RN). But I am a FIRM believer in conspiracies (don't get me started on how the FDA and AMA *doesn't* want to cure cancer). So, my sway is to believe you. I'm going to have to read the information a few more times and then do my own research. Armed with this, I'm curious as to what my dietician is going to say!

LauraDotts

Wow...thanks for the information. I will definitely ask my dietician about this. Something has to be done.

Before you see your dietician, repeat after me: "There is NO dietary need for carbohydrate in humans" ... say it a few times, research it ( this article: http://ajcn.nutrition.org/content/75/5/951.2.long and this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/ or this excellent article from Lyle McDonald http://www.bodyrecomposition.com/nutrition/carbohydrate-and-fat-controversies-part-1.html)

Lyle McDonald's article even states "Even the American Dietetic Association bible, the RDA Handbook, states that there is no requirement for dietary carbohydrates. Any decent nutrition or physiology book will state the same. Despite this basic biological fact, many researchers and diet authorities still insist that the majority (50-60% or more) of the human diet should come from carbohydrates."

That being said, a lot of dieticians will state that you NEED carbohydrates in your diet - which is simply untrue, and many are bound by their governing bodies to ONLY promote the dietary guidelines of the American Diabetes Association (or Canadian Diabetes Association ... or association of whatever country you live in ...)

... and there's the rub. The American Diabetes association is primarily funded (to the tune of 10's of millions of dollars each year) by both the pharmaceutical industry and food giants such as Coca Cola, Cadbury-Schweppes and others that simply don't have a vested interest in you controlling your diabetes.

It sounds like a giant conspiracy theory until you actually research it.

Both the American Association of Clinical Endocrinologists and the International Diabetes Federation have guidelines stating that post-prandial glucose should be kept UNDER 7.8mmol/L (140mg/dl) at all times. (It's well-established that the cardiovascular/circulatory damage diabetics experience starts at 7.8mmol/L or 140mg/dl). Yet both the American and Canadian Diabetes associations have clinical targets of glucose under 10.0mmol/L or 180mg/dl. Why would the ADA/CDA want you to be at a level they KNOW causes damage? It makes no sense, yet that's their recommendation.


image from here: http://www.healthy-eating-politics.com/american-diabetes-association.html

One of the best sources of information on diabetes, especially Type II, is Blood Sugar 101: www.bloodsugar101.com ... The site is run by author Jenny Ruhl, herself a diabetic - and includes mountains of clinical research outlined in an easy-to-research format.

The best book on controlling diabetes (whether Type1 or TypeII) I know of is Dr. Richard K. Bernstein's "Diabetes Solution", who is both an MD and a Type I diabetic. Much of his book is free online if you google it.

Here's a blog from a fellow who overcame diabetes with diet, then posted about it ... then got SUED by his states' dietetic/nutritionist governing board for telling people about it on the internet: http://www.diabetes-warrior.net/2013/01/16/listen-to-the-experts-of-diabetes-care/

Sorry for the vast-amounts of information being thrown out here, and for the 'soap-box' speech, but people are dying because of bad advice being given - and they have the ability to turn it around.

Amen! Amen! and...
Amen!

LauraDotts

You are making me question everything I've been taught, and everything I have taught to patients (I'm an RN). But I am a FIRM believer in conspiracies (don't get me started on how the FDA and AMA *doesn't* want to cure cancer). So, my sway is to believe you. I'm going to have to read the information a few more times and then do my own research. Armed with this, I'm curious as to what my dietician is going to say!

Believe Al. He's telling the truth. The ADA diet is killing diabetics slowly... limb by limb.

albertabeefy

You are making me question everything I've been taught, and everything I have taught to patients (I'm an RN). But I am a FIRM believer in conspiracies (don't get me started on how the FDA and AMA *doesn't* want to cure cancer). So, my sway is to believe you. I'm going to have to read the information a few more times and then do my own research. Armed with this, I'm curious as to what my dietician is going to say!

It's very frustrating to those of us with medical training to find out everything we were taught about certain subjects is wrong.

Honestly, my medical school taught (and still teaches) about 20 hours of nutrition, which is why doctors almost universally refer diabetic patients to dieticians.

However regardless of your field of study - whether it be the nursing or medical model, or dietetics / nutrition, certain things are still being taught as "fact" that science doesn't support, such as the lipid hypothesis and the closely related diet-heart hypothesis. (It's quite disconcerting to those that specialize in cardiology - for whom the diet-heart hypothesis is sacrosanct.)

Cardiologists such as Dr. William Davis (author of 'Wheat Belly'), Dr. Eric C. Westman (President Elect of the American Society of Bariatric Physicians and now a consultant to Atkins) and many others are stunned when they do independent research and discover that what we were taught in medical school is, simply put - completely wrong.

Even Dr. Mehmet Oz, who's been an almost rabid supporter of both the lipid and diet-heart hypotheses is slowly turning around.

Author/Researcher Gary Taubes has really done a lot to bring this information into the mainstream - his excellent books on the subject, though controversial, have helped spark the debate that's causing people to revisit and research the truth for themselves. I don't agree with Taubes in every respect - he suggests that exercise doesn't assist in weight-loss, but that's another topic for another post.

... and I'm GLAD you're questioning everything - that's how we all learn. BTW it's very possible your dietician already knows everything we've talked about - but is unable to make other recommendations. That is the case where I live. After talking with her in great detail about it - she confessed she DID know everything I was saying was correct (or at least open to debate) but she was required to follow a medical protocol she knows is inconsistent with proper treatment of the condition. That's likely as frustrating for her as for the patient.

AbsoluteNG

The food pyramid isn't used anymore. Can you link me to where they say you should be ingesting carbs on the ADA website?

albertabeefy

Just to add - regarding medical professionals coming around... There are a few nutritionists coming around and blogging about it.

Zoe Harcombe is my favorite: http://www.zoeharcombe.com/blog/ she not only specializes in nutrition, but has a background in mathematics/statistics and does excellent study analysis.

AbsoluteNG

Just did a quick look through on the website. What I found interesting is that there is not one mention of any protein product. Seems like they are pushing for more fiber. What's so great about fiber anyway? All it does is make you poop easier right?

kennie2

something that I've heard, but it only works for type 2, not sure which type you are
http://www.guardian.co.uk/society/2011/jun/24/low-calorie-diet-hope-cure-diabetes
my grandma tried it and her diabetes was gone. maybe speak to your doctor about it? i do not advise just jumping into something like that.

kennie2

Just did a quick look through on the website. What I found interesting is that there is not one mention of any protein product. Seems like they are pushing for more fiber. What's so great about fiber anyway? All it does is make you poop easier right?

Keeps your digestive system healthy and prevent constipation by making stools bulky and soft.
Lower blood cholesterol and triglyceride levels.
Lower your risk of colon cancer, heart disease, and digestive problems like diverticulosis.
Improve blood sugar in people with diabetes.
Control weight gain by making you feel full so that you eat less.

dab52776

Bump for reading the links later. Thanks for posting!

albertabeefy

The food pyramid isn't used anymore. Can you link me to where they say you should be ingesting carbs on the ADA website?

Just look at any of their meal plans or recipes:

http://www.diabetes.org/mfa-recipes/about-our-meal-plans.html ... quite clearly states, regarding their recommended diet:

Moderate-carbohydrate (45-50% of calories come from carbohydrate)

* Carbohydrate intake is spread throughout the day.
* Most meals have 45-60 grams of carbohydrate.
* Most snacks have 10-25 grams of carbohydrate.

I don't eat 10% of my calories from carbohydrate, and am often under 45-60g for an entire day on over 2,000 calories.

You can also look at their most-recent position statement on nutrition: http://care.diabetesjournals.org/content/31/Supplement_1/S61.full.pdf html ... which is interesting because they clearly show the research indicates low-carb is better for weight-loss and glycemic control, and very-low-carb (Atkins style, ie:ketogenic) are better still.

Yet they also state in the same position paper that diabetics should eat a "dietary pattern that includes carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk" ... which is contrary to their earlier statements.

They also state in the position paper that the RDA intake of carbohydrate for 'healthy' individuals is 130g a day ... yet they recommend 45-60g per meal AND an additional 10-25g per snack, which as diabetics is quite unhealthy and exceeds that recommended for 'healthy' individuals.

They make no sense. They are the most contradictory organization I know of.

albertabeefy

something that I've heard, but it only works for type 2, not sure which type you are
http://www.guardian.co.uk/society/2011/jun/24/low-calorie-diet-hope-cure-diabetes
my grandma tried it and her diabetes was gone. maybe speak to your doctor about it? i do not advise just jumping into something like that.

Actually, the fact that it was an extreme-low-calorie diet is secondary to the fact that at 600 calories a day and using 'optifast' weight-loss product for 400 calories and non-starchy veggies for the other 200 calories, they were consuming on-average around 30-40 net grams of carbohydrate per day.

As such it was a very-low-carb ketogenic diet. It just happened to also be low-calorie, which combined can be dangerous without ongoing medical supervision, and will result in considerable loss of lean mass over time compared to a ketogenic diet above BMR but below TDEE.

AbsoluteNG

I noticed that you are a medical researcher. Would you know what factors it would take for a diabetic to rebuild insulin receptors?

albertabeefy

...What's so great about fiber anyway? All it does is make you poop easier right?

Keeps your digestive system healthy and prevent constipation by making stools bulky and soft.
Lower blood cholesterol and triglyceride levels.
Lower your risk of colon cancer, heart disease, and digestive problems like diverticulosis.
Improve blood sugar in people with diabetes.
Control weight gain by making you feel full so that you eat less.

A couple of points:

Studies showing increases in fiber reduce cholesterol and triglycerides actually reduced the overall amount of net-grams of carbohydrate being eaten AND reduced the amount of ingested refined carbohydrate. As such the confounding variable here is the simultaneous reduction in both total-net and refined carbohydrate. Which really lowered triglycerides and overall blood cholesterol?

There are studies that also show that reducing refined carbohydrate while increasing dietary fat both improve the cholesterol profile and greatly reduce triglycerides. (Even though conventional wisdom likes to suggest dietary fat worsens both). As such scientific evidence is that reducing one's intake of refined and total-net carbohydrate is what actually improves ones trigs and cholestrol profile.

With glycemic control - fiber (like dietary fat) slows the digestion/absorption of carbohydrate in the digestive system. As such ingestion of both will reduce spikes in glucose, but the same amount of glucose is still assimilated just over a longer period of time (regardless of how slowly you digest 45g of carbohydrate, it's still 45g of carbohydrate). As such it improves post-prandial glucose levels but does nothing to actually effect one's overall HbA1c.

I will completely agree fiber helps in satiety.

Jennieam

In response to your initial query, I'm a diabetic on insulin.

In the last 18 months, I've lost 25 kg (about 55 lb) through using MFP. Not surprisingly, my blood sugar levels are under much better control, and I've managed to drop the other medication I was on. My insulin is less than half.

Until now (trying to focus on toning-up, and not on weight loss), I've tried to keep to my daily calorie intake. Unless I was doing a large amount of exercise, I managed this fairly well. I do however have two "breakfasts". One at 5.15 am when I get up, and another at 8.45 when I get to work (having walked the dog, changed and travelled to work).

Have you considered including fruit/nuts, low-GI muesli etc in your diet? Also some types of low-GI bread?

All the best,

Jennie

LauraDotts

On a 1470 calorie diet, 5-10% of my calories come from carbohydrates. That is about 20 net carbs a day. I have been on that diet since the beginning of May 2012. I lowered my A1c from 8.3 to 5.1 without medication. I firmly believe that had I followed the ADA's recommendation of 45-60 grams of carbs per meal I would be on insulin right now.

DonnaLeeCattes

bump

albertabeefy

I noticed that you are a medical researcher. Would you know what factors it would take for a diabetic to rebuild insulin receptors?

If we're talking actual "damage" to the insulin receptors - there is no research to suggest this is currently reversible. If we're talking insulin-resistance, there are many factors that influence it.

1) Excess adipose tissue (ie: body fat), but especially visceral (in/around the organs) adipose tissue, has a very large role to play here. Studies universally show that reducing visceral adiposity (even for subjects that have little reduction in subcutaneous adipose tissue) improves insulin sensitivity. Unfortunately we cannot target where we lose bodyfat first (with the exception of liposuction, but that's not done for subcutaneous adipose tissue, not visceral adipose tissue) when we lose weight - as such some subjects lose visceral adipose tissue first, others lose subcutaneous tissue first. Some lose all-over at a very similar rate.

2) Exercise, but especially HIIT (high intensity interval training) improves insulin sensitivity. The exact mechanism is unknown, but recent medical research is clear that HIIT is superior to steady-state cardio (IE: walking/jogging at a moderate pace continuously) for insulin-sensitivity.

3) Metformin, even the $4 a month generic version, improves insulin-sensitivity. I still consider Metformin the #1 diabetes medication ever. (Insulin technically isn't a medication - it's a naturally occurring hormone.)

Some that believe they are (and have even been diagnosed as being) insulin-resistant are actually hypoinsulinemic. It's not so much that they're resistant but that they have reduced amounts of serum insulin levels. When this occurs it's usually a result of damaged/impaired β cell function, and is not currently reversible. This most commonly happens either through autoimmune disease (IE: Type I diabetes and LADA - Latent Autoimmune Diabetes in Adult) or through long-term elevated blood glucose in a state of insulin-resistance/hyperinsulinemia that apparently burns out pancreatic β cells.

DrBorkBork

I'm diabetic too. Make sure you're replacing those reduced carbs with healthy fats. Not only will they help you meet your daily cal requirements, but fat can help slow insulin spikes as well.

doctorwhome

bump...for later.

CJ_Holmes

In response to your original post, I would recommend upping your fat intake. I'm a Type I diabetic, and try to keep my fat at 50%, protein at 30%, and carbs at 20% of my calories. A couple of tablespoons of coconut oil in your coffee would boost you up 250 calories! Yum!

I used to eat very low carb, but love more variety in my diet. I do think that the ketogenic diet would probably be the best for sugar control, and I just haven't been able to bring myself to give up fruit. I have a feeling as I get older, if something else doesn't change, I will eventually give in to what I already know!

JaceyMarieS

image from here: http://www.healthy-eating-politics.com/american-diabetes-association.html

One of the best sources of information on diabetes, especially Type II, is Blood Sugar 101: www.bloodsugar101.com ... The site is run by author Jenny Ruhl, herself a diabetic - and includes mountains of clinical research outlined in an easy-to-research format.

The best book on controlling diabetes (whether Type1 or TypeII) I know of is Dr. Richard K. Bernstein's "Diabetes Solution", who is both an MD and a Type I diabetic. Much of his book is free online if you google it.


Sorry for the vast-amounts of information being thrown out here, and for the 'soap-box' speech, but people are dying because of bad advice being given - and they have the ability to turn it around.

I can 2nd, 3rd and 4th (and on and on) both of these reading recommendations. And the suggestion of a much lower carb, much higher fat diet than is recommended by most nutritionists/dieticians. It has made a huge difference in my overall health

mikejholmes

Bump to read later -- this seems very interesting!!!

retiree2006

Interesting read. Thanks.

PolacaFL

This is so contrary to what I’ve always believed. I grew up thinking that we are built to be vegetarians and that that is the spiritual way of eating (Buddhism/Hinduism). Plus I was concerned about what they fed the animals and what hormones was given to them.

I’ve been on a low-carb diet and even though it’s odd to me I’m trying to keep an open mind about it and I have kept at it because I’m losing the weight and I don’t crave foods.

What if we ate a high veggie diet with legumes and no refined carbs?