Top 10 Diabetes Meal Patterns?
The author of the Today’s Dietitian article reviewed the diets that made the Top 10 and included commentary by dietitians with expertise in diabetes management. With the exception of Dr. Andrew Weil’s Anti-Inflammatory Diet and the Mediterranean Diet, all of the plans are low to very low in fat, and none are low in carbohydrates. The dietitians discussing the diets in the article seem to think that calories are more important than carbohydrates because “people with diabetes and prediabetes typically require weight loss.” Perhaps that’s why a Academy of Nutrition and Dietetics spokesperson gave high marks to the No.1 ranked Biggest Loser diet, which limits calories to 1200 per day and encourages vigorous exercise. I have several issues with the Biggest Loser approach to weight loss that will have to wait for another day, but for now I’ll say that almost everyone with diabetes will get hungry eating a low-fat, high-carbohydrate diet that contains 1200 calories (I certainly would), so they’re unlikely to stick to it for any length of time. In addition, not all people with diabetes or prediabetes require weight loss, and many will struggle to achieve adequate glycemic control eating 50+ grams of carbohydrate at every meal. And although it appears that the diets are being discussed in terms of their effectiveness for type 2 diabetes rather than type 1, this should have been clarified.
Several of the plans are plant-based: Engine 2, Flexitarian, Ornish, and Vegetarian. There is some positive research on plant-based diets for diabetes management, so I understand the inclusion of these diets here. If people with diabetes want to follow some form of vegan or vegetarian diet, that’s certainly their right. But others will find it difficult to adhere to the diet. There are many studies supporting carbohydrate-restriction for diabetes as well, and it deserves a mention somewhere in the Today’s Dietitian article. Perhaps after the following quote: “Every year since 2010, US News & World Report has ranked the year’s most popular diets. Using a panel of experts, including RDs and physicians specializing in diabetes, heart health, and weight loss, diets are ranked in eight categories, such as diabetes and heart disease prevention and control, as well as easiness to follow and likelihood of weight loss. According to the 2013 ADA nutrition recommendations, there are several meal patterns that have shown good results in people with diabetes.”
Or even better, after this one:
“The 2013 ADA nutrition recommendations show that the quantity and type of carbohydrate in food impacts blood glucose levels, and the total amount of carbohydrate eaten is the primary predictor of glycemic response.”
I realize that acceptance of low-carbohydrate diets is difficult for many dietitians, but a it is listed in that ADA paper (page 6) as an option. I’ve written a few journal and magazine articles about the benefits of carbohydrate restriction for diabetes (listed on my About Me page), and last August Today’s Dietitian published an excellent article on this subject authored by my friend and fellow dietitian Aglaee Jacob. We’re not advocating anything extreme; we both believe in a whole-foods-based approach with a flexible range of carbohydrate intake based on personal tolerance, preferences, and goals. I’m going to be speaking about carb restriction for diabetes at the Low Carb Down Under conference in Melbourne later this month, and it’s going to be great to meet another low-carb dietitian who’s presenting at the event, Dr. Caryn Zinn from New Zealand, along with the other speakers. I’m also very encouraged by the number of dietitians I’ve been in contact with over the past couple of years who support a low-carbohydrate lifestyle for people with diabetes or are at least open to the idea.
The American Diabetes Association has taken a big step in the right direction by recognizing carb restriction as an option for the millions of people who struggle with this often devastating disease, and I’m hopeful that more dietitians will come around to realizing how effective and sustainable this way of eating can be before it’s time to rank diets for US News & World Report’s 2015 list.
Discouraging. Abandon all hope of good blood sugar control if Hope Warshaw is giving you dietary advice. She doesn’t seem to understand, at all, that we do not process carbohydrates like regular people. Even whole grains can be very problematic for me, and I tried all kinds in varying portions.
It took me six months after my diagnosis of prediabetes to throw in the towel with regards to bread. One slice of Ezekiel bread, which is supposedly low glycemic, and my sugar was out of control.
I also do not need to lose any weight, so any of the low calorie options would not be a good fit for me. My feeling is they should not be giving dietary suggestions to people with diabetes unless they test it out on a large population to see if it works.
Thanks so much for commenting, Judi. All I can say is hang in there! There are many of us working to change the perception of low-carb diets among dietitians and diabetes educators, and little by little, we are making headway.
“Abandon all hope of good blood sugar control if Hope Warshaw is giving you dietary advice”
I once wrote Hope Warshaw more dangerous then Osama Bin Laden, some said I was over the top, I don’t think so.
Thank you so much Franziska for your guidance and support, it means so much to me and Jan and our small team.
Highest respect.
Eddie
Thank you so much for your support, Eddie 🙂 I can’t agree with what you said about Hope but understand how you feel. I’m glad you’ve found the key to controlling your blood glucose so well and appreciate you spreading the message to others.
And best of luck to you, Jan, and the entire Low Carb Diabetic crew across the pond 🙂
Best regards,
Franziska
My A1C was out of control when I followed the advise of 4 dietitians in Canada ( they all recommended high carbs for me)
Since I started following LC diet my A1C is improved.
So happy to see there are some LC dietitians around now . However I can not find one in Toronto. Thank you Franziska for your commitment to support this WOE!
Hi Kapka,
I’m so happy you’ve been able to get your BG under control and lower your A1c. Believe it or not, the dietitian I spoke about in this post, Aglaee Jacob, currently lives in Toronto! She’s rather pregnant at the moment and may be trying to cut back on work a bit, but here is her website, which includes contact information for scheduling: http://radicatamedicine.com/services/
Best of luck to you, and keep up the great work!
Franziska
What is the best plan for someone with prediabetes/IR wanting to lose weight foremost? Is it low carb or low fat/low calorie?
Hi Vicki,
Low carb is the way to go for people with prediabetes and insulin resistance who want to lose weight. I’m actually working on a program with another dietitian that will address all of these issues, and it’s low-carb based but quite flexible as well. Stay tuned!
Franziska
Here’s a link to a blog post I wrote that provides more information:
https://www.lowcarbdietitian.com/blog/nutritional-management-of-metabolic-syndrome
My son’s so called “diabetic dietitian” told him,” There is no such thing as a diabetic diet now days, and you can eat whatever you want. If you want to eat McDonalds, you go right ahead” I can still hear those words ringing in my head whilst my son lay in his hospital bed, just diagnosed with type 1 diabetes. I was devastated. Luckily, I have a brain and did my own research and now my whole family eats low carb. And guess what, my son’s blood glucose levels are ALWAYS normal if he eats my cooking. His HbA1c is also normal. It’s very simple in my view. Eat the high carb diet as recommended by mainstream dietitians, and you die a slow and painful death. I am not exaggerating -I work in health care and the majority of our patients have diabetes, so I know what lies ahead if you choose to not eat low carb. Enjoy the Low Carb Down Under conference – Melbourne is my home town!
Thanks so much for sharing your son’s story, Lisa! He’s fortunate to have a mom like you. Bravo! Wish you could attend the conference as well!
I would really like to attend the conference. Maybe next year.
Sort of on topic ……
Don’t know about meal plans for others but mine are all LCHF , and I just love to start the day with a cooked breakfast of eggs, with maybe some ham or bacon, or low carb sausages, and a handful of mushrooms. Delicious, nutritious and it peps me up for the day ahead.
Have a great trip to Australia – can’t wait to hear all about it.
Thanks for your good wishes
All the best Jan
Sounds like a fabulous breakfast to me, Jan! Low carb truly is the most satisfying and sustaining, in addition to being healthy and delectable.
Thanks so much for your continued support and kind words.
Quite discouraging indeed. US News & World Report reaches a huge audience. Once again, the same dangerous propaganda.
Would be helpful if the article designated T1 or T2, but I’ve given up expecting that.
Unfortunately, despite how unsound & unsuccessful, there’s always a new incarnation of a starvation diet for weight loss.
Kudos to anyone who can manage good glycemic control on a vegetarian diet. I couldn’t. After 30+ years vegetarian, I had to radically change when diagnosed T1. The ADA diet is disastrous. All day, every day, I chased highs & corrected lows from the large insulin doses required eating far too many carbs. Only VLC worked for me.
I want to scream repeatedly hearing PWD can eat whatever they like. That’s a life-threatening lie.
Thank you for your continued efforts providing healthy info.
Thanks so much for your comments and sharing your own experience, Gerri. I’m so glad you looked beyond conventional dietary advice and found VLC. It’s unfortunate that the majority of PWDs aren’t being told about the low carb option.
And thank you for your continued support.
Great article. When I was in high carbs low fat my bs was swinging severely between 400 and 50 all the time and my A1C was between 9 to 11 …now my A1C is 5.6 under 50 gms of carbs and my overall health is much better…
Thank you so much for your kind words, Ahmed! Fantastic improvement in your A1c and health. The success stories shared by you and other PWDs strengthen my resolve to continue pushing for low-carb acceptance. Keep up the great work!
We need more dieticians like you. Thanks for fighting the good fight. And I don’t think it really matters whether someone is T1 or T2–low carb is the way to go. Regardless of type, diabetics can’t process carbs as well as “normal” people, so they should all be restricting carbs. T2s can reduce or eliminate meds and T1s (like my son) can reduce the amount of insulin required as well as stabilize blood sugar and avoid the roller coaster BG swings. Personally, I think it’s criminal to recommend anything else to ANYONE who is diabetic! As to being vegetarian and diabetic, I’d say bad idea. My brother’s wife is T2 and lifelong vegetarian (she’s Indian) and not doing well at all. But how do you not eat meat and eggs (she does eat dairy) and not eat too high carb? I really don’t think it’s possible. But what do I know?
Thank you so much for the nice feedback and words of support, Margaret! I agree completely that people with Type 1 diabetes do best on a carb-restricted diet and am so happy that this way of eating works so well for your son. It’s definitely tough being both low carb and vegetarian, although some people are able to do it if they include eggs. Still, it’s quite a limited diet. Thanks again, and best of luck to you and your son.
Once I discovered for myself how wrong my doctors were about a fairly simple thing like a good diabetic diet, it made me question their wisdom about other matters. Except for things like a broken leg or conditions that require surgery, I have found them alarmingly deficient. Mine was wrong about blood pressure, cholesterol, basically anything that involved ingestion of food or medication. The dietitians whose classes I attended were even further out of synch with reality. I am so thankful for people like you and like the nurse who took me aside when I was first diagnosed as a T2 diabetic and said, “Whatever you do, do NOT follow the diet they give you. Read these books and investigate low carb.” That was 8 years ago. My A1C has never been over 5.6 since then, mostly it stays around 5.2. My doctor? Last time I saw her she said, “I don’t think you’re really diabetic.” I thought, “I don’t think you’re really a doctor.”
Thanks so much for your comments and words of support, Janice! I really appreciate you sharing your own experience. I’m very glad to hear that you got great advice from that nurse shortly after being diagnosed. And your last line gave me a good laugh 🙂
LOL. Too bad that this is a serious matter that physicians will not come to grips with. My four-month low-carb living has virtually eliminated pain from osteoarthritis, my morning headache AND nightly indigestion. Not to mention that I have lost 50 pounds since May 14 WITHOUT exercise. I am a low-carb proponent.
Fantastic results, Brenda! Congratulations!
Thank you for your courage to bring change and understanding to the community of dieticians, and ultimately, diabetics. I was diagnosed with T2 about 2 years ago and almost immediately went low carb. Since then I have felt so much better, and my A1C hovers between 5.2 and 5.7. Besides raising blood sugar, sweets now give me an instant headache, almost like a poison to my system. While my diet may be considered non-traditional to most Americans, I’ll continue down this path and root for you and others to pave the way!
Thank you so much for your very kind words of support, Belinda! I’m so glad to hear that you’ve been able to improve your blood glucose control with carb restriction. Keep up the great work!
What do you think about the new results that low carb diets ARE good for cardiovascular issues. . . . Who’d have thought (scarcasm) http://www.nytimes.com/2014/09/02/health/low-carb-vs-low-fat-diet.html
You, Ms. Spritzler, have been on the vanguard and your research puts you WAY ahead of the pack.
Thanks so much for the link to the NY Times article, Brenda! I shared it on my Facebook page and Twitter yesterday, but it’s great that you shared it here as well. 2014 is shaping up to be quite a good year for carb restriction!
Thank you also for your kind words of support. Very much appreciated.
You have to wonder the basis for these sorts of rankings that get it so wrong.
I would have thought a good diet involves plenty of nutrients, good protein and, in the middle of a diabesity epidemic only a moderate proportion of insulinogenic calories.
Here’s my attempt at a food ranking which supports everything you say!
https://optimisingnutrition.wordpress.com/2015/03/22/best_diet/
Thanks for your comments, Marty — they’re spot on! And I absolutely love your diet ranking with full analysis! Bravo! I’m going to share this on my Facebook page.