Sunday, December 4, 2016

Type 2 Diabetes, a Dietary Disease #357: Ten years ago…I had a relapse (Part 2).

As I started to tell you in #356 here, ten years ago this past summer, I had a relapse. I regained 12 of the 60 pounds I had lost over a nine month period 4 years earlier. I had lost focus. So, I decided that it was time to get serious again and rededicate myself to the principles and practice of the Very Low Carb Way of Eating.
That summer of 2006, 10 years ago, I also read Dr. Richard K. Bernstein’s book, “The Diabetes Diet.” So, with my renewed resolve, I decided to switch to Bernstein’s Diet Plan for Diabetics. Dr. Bernstein has been a Type 1 Diabetic for most of his 70-odd years and was an engineer before he became an MD, like his wife. She had a big blood sugar testing machine in her office, so he used it to develop a strict regimen for “eating to the meter.” After all, he reasoned (as an engineer), if carbs make your blood sugar rise, the best treatment for regulating your blood sugar would be to restrict carbs. That makes sense doesn’t it? It’s just common sense!
Bernstein’s credo is that “everyone deserves a normal A1c.” His is in the 4s. Being a Type 1, he achieves this by injecting insulin, both 24-hour and at mealtimes, on a 30g-of-carbs-a-day plan. He calls it 6-12-12: 6 grams at breakfast (lower due to what he calls the “Dawn Phenomenon”), 12g at lunch and 12g at supper. No snacks. These principles are all well documented in the latest edition of his book, “The Diabetes Solution.”
Another difference from Atkins Induction is that Bernstein limits protein. When digested, protein breaks down into amino acids, from which some are made into glucose by the liver and thus raise your blood sugar. So, to limit this unwanted glucose production (called gluconeogenesis), protein needs to be limited. But how much protein should a person eat? In 2006 I studied the question carefully and discovered that opinions vary widely, but the “correct” way is to use a number based on an estimate of ideal, or lean body weight.
Lean Body Weight is the optimal weight for a person, and it is your lean body that needs protein. In 1998 the HHS/NIH adopted the Body Mass Index (BMI) Chart used by WHO, the World Health Organization. Your doctor is required to use this chart to “evaluate” your weight. It is a really gross metric that takes no account of gender, body type, or your cultural environment. It is also a pie-in-the-sky number for almost everyone who will read this post, i.e. people living in a part of the world where food is abundant and where processed food has replaced real food in our lives. Thus, according to the BMI, most of us are now overweight or obese. Nevertheless, your BMI “normal” weight is what you should use to calculate the amount of protein to eat.
The middle of the “normal” range in the BMI chart for a 5’-11” person (me) is 150 pounds. I still weighed 300 pounds in 2006, so that sounded totally ridiculous to me, so, by “mistake,” I chose instead a “goal” weight of 180 pounds for my calculation. And since I was pretty sedentary and did no exercises, I used 0.5 grams of protein per pound (1.1g/kg) of my goal body weight. So, 180 x 0.5 = 90 grams of protein a day. Honestly, though, the grams per pound is also a variable where opinions vary widely, so the number you settle on is up to you. That’s how I started. Note: I was soon to reduce my protein budget further, but not the carbs…yet.
For fat, I followed Bernstein’s dictum: Eat enough to be satisfied. I didn’t avoid saturated fat or cholesterol. I was convinced by Taubes, and others by this point, that the 1977 “Dietary Goals for the United States” and The Dietary Guidelines from 1980 on, every five years thereafter, were a failed Public Health experiment and were in fact the cause of our obesity and diabetes epidemic. And they certainly weren’t the right diet for anyone who was diabetic, pre-diabetic, or had even a touch of Insulin Resistance. It just didn’t make sense.
So, for breakfast, I usually ate 2 fried eggs and 2 strips of bacon, with coffee and whole cream. That’s all. No juice. No bread. No jelly. No fruit and No cereal. Period! No exceptions. I found this small meal very satiating. I wasn’t hungry later in the morning or even at lunch time. I ate something though – out of habit – but it was usually a couple of hard boiled eggs, or later a can of sardines in olive oil or kippered herring in brine. Yum.

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