Type 2 Diabetes, a Dietary Disease #316: With so much carb restriction, what can I eat?

If you’re newly diagnosed and you’ve investigated your choice of “treatment plans,” and you are willing to consider treating your condition as a “dietary disease,” you next need to know how to choose what to eat! Most folks faced with this challenge ask, “With so much carb restriction, what can I eat?!!”

Most of us have lived our lives eating a surprisingly limited variety of foods. Culture, convenience and habit play a big role, so the answer will be different for everyone. Generally, in recent times that limited variety has consisted largely of carbohydrates. That’s how we got into this mess!! So the foods we have eaten for most of our lives are necessarily going to have to change. And that change will be a process of elimination, which will, for most people, further reduce the variety of foods going forward.

Naturally, most people have come to think of carb restriction as deprivation. And, in the sense that you will need to forego many of the things that got you into trouble, that’s fair. But another way to think of it is to ask yourself if what you ate gave you intestinal distress (cramping and diarrhea), as it does to gluten or lactose intolerant people, wouldn’t you readily and speedily give it up? By this way of thinking, foregoing excessive carbohydrates in the diet is a more moderate (if similarly life-long) change; you are restricting eating excess carbs to avoid future blindness, lower extremity amputations, and end-stage kidney disease! Plus, you are avoiding a much higher risk of heart disease, stroke, sexual dysfunction and certain cancers! This motivates a lot of people.

Under these circumstances, I think you’ll agree that learning what you can safely eat takes on a much more positive aspect. And you have a lot of good choices. Let’s start with the basics: There are three “macronutrients”: protein, fat and carbohydrates. Most animal protein is “complete protein” (contains the essential amino acids), and also contains some fat (mostly saturated). That’s okay. Even dietary cholesterol is okay. In 2014 the Dietary Guidelines Advisory Committee said “cholesterol is no longer a nutrient of concern for overconsumption.”

So, every meal should contain some animal protein and fat. After that, a small amount of carbohydrate is okay, but entirely optional. We need to eat protein and fat, but there is no minimum dietary requirement for carbs. But, if we’re going to consume carbs, let them be 1) unprocessed, whole foods, 2) non-starchy vegetables such as greens, and 3) low in “sugar.” I avoid peas, beets, carrots and corn (except for locally grown ears in summer: LOL).

Good advice I gleaned from Dr. Richard K. Bernstein’s book, “The Diabetes Diet” (Little, Brown, 2005), was to eat the same food every day for one or even two meals each day. For him, an 81yo Type 1 Diabetic, this eliminates the food variable from his insulin regimen, but I find that I am perfectly content to just eat eggs (any style), and coffee with cream, for breakfast. No juice. No bread. This meal is very filling and carries me way past lunch. Five hours after breakfast I usually eat a can of sardines in EVOO. Just one small can. And a small bottle of water.

Five hours later I eat another small meal for supper: a small serving of animal protein with fat, and a moderately sized serving of low carb vegetables prepared with fat. Examples are: asparagus spears or cauliflower florets tossed in olive oil and roasted; steamed broccoli finished with garlic butter; young green beans tossed in melted grass-fed butter; a salad of romaine, endive, mushrooms, and chopped hazelnuts or slivered almonds, tossed in a homemade (not store bought) vinaigrette dressing, with grated Romano or Parmesan.

The meat course is always small and always enough: one roasted chicken thigh (skin on); two small lamb chops (a rack of 8 is enough for two people for two meals!); one 8 ounce filet mignon, cut in half to serve two; ¾ pound of cod (for 2), poached stovetop with celery and fennel; stove-top shrimp with mushrooms and broccoli; veal stew baked with bacon, mushrooms, onions and sour cream. The choices are endless, if you think about it.

If these seem like small meals, they are. But because they have lots of satiating protein and fat, they are filling. Animal protein is expensive, you say. True, but you eat so much less of it when you limit carbohydrates. All the food on this menu plan is unprocessed and nutrient dense. They satisfy the body’s nutritional needs, so you will eat less. These small meals, with very limited carbs, will allow you to go without snacking between meals and without feeling hungry. It will also quickly lead to weight loss, if that is a parallel goal to blood sugar control.

It’s really pretty amazing. Use your meter and the measuring tape (waist - hip ratio) or scale to check your progress. You will soon be convinced that Type 2 Diabetes is a Dietary Disease, and you have all the tools you need to control it and put it in remission.