Go to any bookstore and look at the diet and cookbook section. You’ll find book after book of lowfat diet plans and cookbooks. Go to any market and you’ll see shelf after shelf of lowfat products. You’d think the lowfat lifestyle was the only way to go. The Fickle Finger of food facts can’t abide by this. It just has to swivel in the opposite direction. And strangely enough, that swivel is starting right here in Diabetesland.
Just the beginning
In our original 1969 book, The Peripatetic Diabetic, we explained what a struggle it was for June to eat the interesting and varied foods she loved and still stay on the diabetes diet of the time. In restaurants, she’d sit with Food Values of Portions Commonly Used in her lap and count the calories, carbohydrates, fat, and protein of the dishes on the menus.
Witnessing this agonizing process, Barbara evolved a scheme to overcome it. She reasoned that counting all those proteins and fats and calories was unnecessary if it’s only eating too many carbohydrates that does the blood sugar damage. This made sense to June and since she had no weight problems, consuming a non-calorie-counted diet wouldn’t hurt. So she spent her evenings memorizing the grams of carbohydrate in the foods she might want to eat and gave up her laborious calculations. But we really could not evaluate the success of carbohydrate counting because blood sugar monitoring had not yet arrived on the scene.
Utilizing the program in other countries
We later found that at that time the British, French, and Australian diabetes associations all used this kind of carbohydrate counting for underweight and normal weight people with diabetes. But in this country everybody used the Exchange Lists. After all, that’s the way to get a balanced diet-and it’s easy. So after the Exchanges were expanded to include more and more foods, June finally joined the Exchange List party line.
But now some 35 years later the Fickle Finger has swiveled again and look what it’s pointing to now: carbohydrate counting! This is probably in great part because of the increase in the number of people on insulin pumps who estimate the amount of carbohydrates they’re going to eat before giving themselves their pre-meal bonus of insulin. Many of those on the “poor man’s pump” (a combination of long-acting insulin and pre-meal injections of regular) count their carbs as well.
Carbohydrate counting makes a comeback
But the Fickle Finger has another swivel up its sleeve. If carbohydrate counting is here, can low carbohydrate diets be far behind? The carbohydrate diet had its heyday about 30 years ago with The Drinking Man’s Diet and The Air Force Diet (the Air Force denied any association with this) but the Fickle Finger swiveled away from it big-time, turning toward the low fat, high complex carbohydrate way of eating of the Pritikin Plan and Dr. Anderson’s HCF (high carbohydrate and fiber, low fat diet). Dr. Anderson’s still popular diet is explained in his book Diabetes: A Practical New Guide to Healthy Living.
To Richard K. Bernstein, MD, the low carbohydrate diet has always been the way to go. He advocated it back when nobody else did and because of that he endured a lot of questions and disagreement from other health professionals and a lot of amiable ribbing from us. We’d mail him every article we ran across in praise of high complex carbohydrate, low fat diets. He’d fire right back with articles that were against them. He continued to espouse this “bizarre” diet in his books (both now out of print) Diabetes: The Glucograf Method and Diabetes, Type 2. When Dr. Bernstein says low, he means low: six grams of carbohydrate at breakfast, and 12 grams at lunch and dinner.
Others preaching the same thing
And now as the Fickle Finger turns, Dr. Bernstein is not the only voice crying in the low carb wilderness. Pregnant women are often put on a low carbohydrate diet and even high fat diet. In the diabetes sector there is Dr. Calvin Ezrin, research endocrinologist and Clinical Professor of Medicine at UCLA, author of The Endocrine Control Diet: How to Beat the Metabolic Trap and Lose Weight Permanently (first published in 1990). With health writer Robert Kowalski, Dr. Ezrin thoroughly updated his book in 1995 and renamed it The Type 2 Diabetes Diet Book; The Insulin Control Diet: Your Fat Could Make You Thin.
Still the low carb chorus grows. Drs. Michael and Mary Eades, bariatricians (weight-loss experts), have written a convincing, fact-filled book called Protein Power based on their eight-year experience with the low carbohydrate diet. In the book they state, “The program we outline in this book triumphs where the high-complex carbohydrate, low fat diet fails. It reduces cholesterol rapidly without increasing other risk factors; it reverses, or at the very least significantly improves, adult-onset (type 2) diabetes; it drops elevated blood pressure like a rock; it offers a long-term solution for the problem of excess weight-all without asking you to count fat grams or worry about fat percentages. It does all this simply by selecting foods that work with your body’s metabolic biochemistry instead of against it.”
And guess what the two of us are doing? We’re trying a noble experiment with the low carbohydrate diet. Barbara is doing it to lose 12 pounds she gained during and after a trip to Italy. All that pasta and pizza! June is doing it to stabilize her blood sugars that started going off the wall-and on the floor and ceiling-after her dearly beloved beef ultralente insulin was taken off the market.
How is it working? So far, so good; in fact, very good. Barbara lost six pounds in six weeks; June’s blood sugars are again hovering around the 100 mark at last.
And how about you? If you’ve ever tried the low carbohydrate diet, why don’t you join our anecdotal evidence-a-thon? How did it work for you? If you wanted to lose weight, did you? If you wanted to achieve better control, did you? Did you love being on the diet or did you hate it? Tell all.
We’d particularly like to hear from healthcare professionals-physicians, nurses, and dietitians. Have you had any patients on a low carbohydrate diet? How did they do? Or do you think the low carbohydrate diet with the accompanying protein and fat is a sure ticket to cardiovascular disaster and you wouldn’t put a laboratory rat on one let alone a diabetic human being?
The Fickle Finger impatiently awaits the results, so that whatever they may be, it can start another swivel in the opposite direction. Send your experiences to DIABETES HEALTH.
According to our board member, Susan Thom, RN, LD, CDE, “Different diets work for different individuals depending on their blood glucose, lipids, weight,and the presence or absence of complications (as well as medications and activity levels). The same diet should not be advocated for all people. I’m sure low-CHO diets have a place for many, but it’s not for all people with diabetes. May the ‘Fickle Finger’ be gone and not point in any one direction.”
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Barbara Toohey and June Biermann have written 17 books and hundreds of magazine in the 30 years of their collaboration. They own Prana Publications & Paraphernalia, and publish The Diabetic Reader, a spirit-raising publication covering the latest in diabetes news and guidance on living with diabetes. For information about Prana, or a free copy of The Diabetic Reader, call (800) 735-7726.