Low Carb vs Hope Warsaw

[peacelover]

As a 33 year old female, I was diagnosed with Type 2 in June of this year. After my initial freak out (still ongoing at times...) I found this board and it really helped me learn about carbs and control. By following a low carb, low cal diet, I have lost 32 pounds and my a1c is now at 5.5 (down from 5.9). I count all cards (fruits & veggies too) and eat about 50 NET carbs a day. I thought this was the way to go for diabetics. Tonight, I came across this article:

"Why You Don't Want to Go Low Carb or Vegan"

Part 5 of a 5 part feature
Hope Warshaw
24 April 2007

"Hope Warshaw, MMSc, RD, CDE, BC-ADM, is a diabetes educator and freelance writer. She is the co-author of The Complete Guide to Carbohydrate Counting, 2nd ed. and Practical Carbohydrate Counting: A How-to Teach Guide for Health Professionals, 2nd ed (in press); both books are published by American Diabetes Association.

Let’s be realistic and take a long-term perspective in this “which diet is best” debate, rather than wasting time quibbling over extremes—from low-carb to vegan. You’ll have type 2 diabetes for the rest of your life, and you’ll likely struggle with weight management throughout your life as well. The major challenge in weight loss, and even more so in weight maintenance, is long-term adherence.

A Team’s No Good If All the Players Quit

A number of studies that compare low carb diets to conventional diets demonstrate early initial weight loss and improvement in other health parameters, such as blood glucose control (1,2). But studies of low carb diets that last longer than six months do not show significantly more weight loss. They do show that many study subjects drop out of the study and are unable to stick with the diet. (1,2)

Low-carbohydrate diets are not recommended by the American Diabetes Association for two key reasons. First, avoiding carbohydrate, as some low carb diets suggest, does not entirely return blood glucose levels to the normal range after meals. Second, an adequate amount of carbohydrate is an important component of a healthy eating plan, providing essential fuel, vitamins, minerals, and fiber. (3,4)

Simply put, diets that force people to dramatically change their eating style are not maintained over the long haul. These diets require too dramatic change compared to the common, albeit not healthy, eating habits of the 21st century.

Keep Those Players Coming to the Game

Research from numerous studies, including the Diabetes Prevention Program (5) and the National Weight Control Registry (6), show that people can lose weight and keep it off successfully for three years and five years, respectively, by reducing dietary fat and total calories.

In addition, you need knowledge and skills to make lifestyle changes, as well as help in setting behavioral goals, not to mention ongoing and long-term support. The Diabetes Prevention Program (4) and other studies have demonstrated the need for support, yet our health care system does not reimburse for much education, let alone for support. Keep in mind that Medicare beneficiaries diagnosed with diabetes are eligible for both initial and follow-up care, called Diabetes Self-Management Training and Medical Nutrition Therapy (7,8). These benefits, unfortunately, continue to be woefully underutilized. Many other health plans cover these services as well. Ask your health care provider to refer you to a diabetes education program.

Remember, diabetes lasts the rest of your life. You need to find an eating plan that you can follow that long as well. "

Can someone help me understand what she is talking about? If carbs increase blood sugar, why not limit them? What does she mean by "blood sugar does not go back down after eating?" Any help would be appreciated. Thank you for all your help.

[pdxdennisj]

Well, that matches what my Diabetes dietitian told me. She suggested a top of 180 carbs a day for me. I'm actually doing about 120 or so (goal 40 per meal). Things seem to be OK. My Endo is happy. A1c at 6.7 last time. Should be a bit lower this time (Dec).

[rzrbks]

Extremes of all sorts are bad for the system.

[mho357]

Extremes of all sorts are bad for the system.

I agree - your body needs fuel to run - just don't overload it.

M

[Alice]

I agree with her overall summary. I think a lot of people lose weight eating extreme low-carbs due to the fact that junk food (mainly carbs) is eliminated in a dramatic way from the diet. I think the same weight loss can be obtained by eating healthy carbs, balanced with fats & protein.

I really agree that the body needs carbs for nutritional minimums and for energy. The brain needs glucose to function.

What I learned many years ago in a college nutrition class was this basic info that has stayed with me for years. The body needs fuel in 3 forms:
1) Protein for building tissue
2) Carbs for energy...immediate energy
3) Fats for stored energy

I fear that the latest "low carb/no carb" fad diets have confused diabetics. I'm type I so I can bolus for carbs of any amount, yet still eat a healthy range.

Type II's have a bit more of a challenge when trying to control solely by eliminating carbs. I'm a firm believer that eventually, medication is needed for metabolizing food. Going low carb is not going to solve the problem, nor does it deal with the fact that your liver is still producing glucose when the body is not receiving necessary fuel via carbs.

I'm not saying all Type II's must be on insulin, obviously there are many on this list who do quite well. But avoiding a large portion of nutritional needs (like milk) seems to miss the mark for me.

[BlueSky]

.... Can someone help me understand what she is talking about? If carbs increase blood sugar, why not limit them? ....
It really is a no-brainer, isn't it. It goes almost without saying that the less carbo you eat, the easier it is to control blood sugar levels. But the ADA and other mainstream diabetes authorities are more heavily influenced by other dietary considerations. The reason nutritionists typically give for recommending a high-carb diet is that "fat is bad for you". And a low-carb diet involves making fat your main source of calories. This is essentially outdated thinking, and there is no evidence that that low-carb eating does any harm. On the contrary, the big potential health benefits can no longer be denied. But most mainstream "experts" are still sticking to their guns on this. It is interesting that the main reason the article provides for eating high-carb is that low-carb is just too hard. What kind of reason is that?

Like you, I have also found that minimising carb makes life a lot easier. If low-carbing is working for you, go for it. Expect to get a lot of dire warnings from the dietary establishment about how it will clog up your arteries. But don't let them worry you. :D

[cheryl]

I guess it depends on the person, if your active like me 50 carbs would and has made me feel like the crappiest human being a live, I felt better, having high sugars...honestly....I felt weak, no energy, completely drained and I get really moody worse then a high sugar mood, I cannot concentrate, I loose my mind...

I don't high carb it either though, I am very comfortable on the days I work or the days I am highly active to eat about 160, on my more laid back days, 120-130 do me just fine....and I think that is actually a healthy amount of carbs....

If I was older maybe, but for me it was the worst experience I had ever felt.....cheese and fat made me constipated.....too much of it....I just have to have my fruit and oat balance....

OH but I do believe you are not missing out on anything if you go vegan....that is screwed up thinking, but I also think if you low carb it you shouldn't go vegan...I don't think the two should mix.....imo...

I think it depends on the person, and let me tell you once you are really thin, like I lost thirty pounds, and am only 105 pounds low carbing does not feel good to me at all...for me that is....

It works for a lot of people...just not me...

Cheryl

[BlueSky]

I guess it depends on the person, if your active like me 50 carbs would and has made me feel like the crappiest human being a live, I felt better, having high sugars...honestly....I felt weak, no energy, completely drained and I get really moody worse then a high sugar mood, I cannot concentrate, I loose my mind.......

How long did you keep it up for? During the first three weeks of low-carbing, the way you felt is not unusual. It takes a while for your body to adapt to using fat as the main source of energy. But once it has done this, most people feel a lot more energised than they felt when eating high-carb. It can take up to 6 months to become fully fat adapted. This is why so many people drop out of low carbing, and why the ones that stick with it often become like religious zealots. ;)

I also found that I lost weight I couldn't afford to lose when on only 30 grams of carb a day. I was able to regain the weight when I re-introduced some carb, which I now get mainly from fruit. But I still only eat 60-70 grams of carbs a day.

I also find Bernsteins carb limit too restrictive and have settled for somewhat higher BG levels. But I will never go back to high-carb eating. Eating like this has improved my BG control to the point where I was able to stop taking anti-convulsant medication, which for me is the biggest benefit. Bernstein made me aware that this was possible, and I guess this is why I feel indebted to him. I find it really strange that he is so despised. I guess this is what happens to people who challenge the entrenched conventional wisdom.

[kgm0612]

When I was first dx'd almost 5 years ago and met with the dietition, her meal plan for me included a total of 245 grams of carbs a day. Not knowing any better, I followed her meal plan and my blood sugars were running over 200 every day! I went searching the web and found a diabetes message board where the members set me straight about lowering my carb intake.

After a couple of weeks, my blood sugars were below 130. I continued to follow a low carb diet (under 65g a day) until I started pumping almost 2 years ago. I now take in 75-100g a day. Just because this works for me, doesn't mean it will work for someone else.

Karen

[peacelover]

Since I went lo-carb, my energy has increased dramatically. My cravings have also gone away. Sure bread smells wonderful in the store...but I used to eat my high carb meal and then immediately crave something sweet so I would bake some brownies...It became a really bad cycle. Now that I'm low carb and get those carbs from fruits, veggies and whole grains, I don't have those sweet cravings.

When I met with a dietician, they also told me to eat at least 180 carbs a day! I was too afraid to try it, but am sure my numbers would go high. As for the fat in a low carb diet, I do not go over 54 grams of fat each day. This fat comes from nuts mainly. Since I also have high cholesterol, all meat is lean and cheese is fat free. Therefore, I do not agree with the article stating that low carb equals high fat.

Diabetes is such a frustrating disease. It takes a lot of hard work, dedication and motivation. It would be nice if the experts could agree, but apparently the only experts with the disease are those who deal with it on an hourly basis.

[cheryl]

How long did you keep it up for? During the first three weeks of low-carbing, the way you felt is not unusual. It takes a while for your body to adapt to using fat as the main source of energy. But once it has done this, most people feel a lot more energised than they felt when eating high-carb. It can take up to 6 months to become fully fat adapted. This is why so many people drop out of low carbing, and why the ones that stick with it often become like religious zealots. ;)

I also find Bernsteins carb limit too restrictive and have settled for somewhat higher BG levels. But I will never go back to high-carb eating. Eating like this has improved my BG control to the point where I was able to stop taking anti-convulsant medication, which for me is the biggest benefit. Bernstein made me aware that this was possible, and I guess this is why I feel indebted to him. I find it really strange that he is so despised. I guess this is what happens to people who challenge the entrenched conventional wisdom.



But I don't think 120-160 carbs a day is even high in my opinion....at all, for instance today...ok if fruit is soooooooo awful, then why did I plumit.....I mean I was 56 an hour after my bolus....and then I was in the 90's or 80's all day long....seriously I am highly active.....and I test more then 15x's a day....so I know me....

I love to eat oatmeal it is healthy, and I love potato's and I love fruit, and I love my low carb bread stone ground whole wheat.....and I love my soy, and I love my lentils.........and I love my low carb wrap with flaxseed.....I love my nature's own granola bars.....I mean everything I have metioned is not unhealthy at all....you just got to learn how to work around it, I think bernstein is more lazy if he can't learn it.....oh yea and I love my cinnamon sunchips too....

I am not even metioning anything bad it is not like I am crying over a cinnamon bun, or a bowl of fruity pebbles....LOL...

Cheryl

[cheryl]

OH well that 56 was because I bolused and was only supposed to wait 15 minutes to eat, ummm I got so busy at work, it was almost 30 minutes when I ate after the bolus, and then right before it was an hour after my bolus I was 56 a juice box later an hour later i was 92, then I was 89 by lunch then I was 96 after lunch, then I was 85 just a few minutes a go.....not bad...and I ate already let's see how many carbs......more then most low carbers eat a day...so I ate 35 for breakfast 40 for lunch, 16 for the low, and 20 for snacks inbetween....so I injested 111 so far and I still got two more meals to go LOL.....

Oh I forgot the 3 creamers i had in coffee total 15 carbs, and the carrots I don't count about 9 more so Ok that is a total of.....135 carbs so far I eat more carbs when I work...like i said i did...

[CliveL]

If you are still on a weight loss diet then this is obviously different to a stable diet once you reach your target weight since some of your daily needs are being met by burning fat.

[BlueSky]

.... As for the fat in a low carb diet, I do not go over 54 grams of fat each day. This fat comes from nuts mainly. Since I also have high cholesterol, all meat is lean and cheese is fat free. Therefore, I do not agree with the article stating that low carb equals high fat....

A lowcarb, low-fat diet is a contradiction in terms. If a low-carb diet isn't high in fat, you will starve. You have to get your calories from somewhere. Your 50 grams of carbo contains 200 calories. 54 gram of fat contains another 486 calories. I don't know how heavy or active you are, but you probably wouldn't require more than 60 grams of protein a day (240 calories). That adds up to only 926 calories. Where do you get the rest from?

On the cholesterol issue, the notion that consuming fat clogs up your arteries is a misleading oversimplification. It doesn't work that way. Most people on low-carb/high-fat diet find that their lipid profile improves. The people who don't believe this will happen are generally the ones who have not tried it themselves. :D

[cheryl]

A lowcarb, low-fat diet is a contradiction in terms. If a low-carb diet isn't high in fat, you will starve. You have to get your calories from somewhere. Your 50 grams of carbo contains 200 calories. 54 gram of fat contains another 486 calories. I don't know how heavy or active you are, but you probably wouldn't require more than 60 grams of protein a day (240 calories). That adds up to only 926 calories. Where do you get the rest from?

On the cholesterol issue, the notion that consuming fat clogs up your arteries is a misleading oversimplification. It doesn't work that way. Most people on low-carb/high-fat diet find that their lipid profile improves. The people who don't believe this will happen are generally the ones who have not tried it themselves. :D



I just realized that I am insulin sensitive this is another reason why this is too too hard for me to do.....my ISF most time is 100 so there for, even if I bolus for let's just say 10 or 12 carbs and eat a load of fat....I am gonna plummit still, not balanced I can't balance that.....I guess it would work if your not, but I am completely too sensitive to eat to maintain that kind of diet and to answer the other question low carbed it for 6 or so weeks, so I want well over the period of supposedly feeling better.....

But I just want to say I am not really knocking what other's choose to do, but I do feel there are many different ways of handling your diabetes, you just got to find what works for you and your health and for me. This really works fine..

Cheryl

[Alice]

I think (not counting what I had for lunch today! that I eat "moderate carbs"...for some extreme low-carbers, this would be high carb. I don't eat typically more than 45 carbs a meal. A big meal for me would be above 45.

Remember that many undiagnosed people are eating 3,000 calories and more a day. Not realizing what they are eating, fat or carb. So, eating a balanced diet may seem "low", but is not for the average person.

On the other hand, if you are a high school football player, you will need those extra carbs for energy. If you are a house painter, a landscaper, etc., your needs will be different than someone with an office job.

Saying that "low-carb" is a no-brainer (not really quoting here, but it came up somewhere in this topic)...is too general for the different types of diabetics we have in the world.

An extreme low carb can be very dangerous for anyone on insulin...no matter how "perfect" your basal is controlled. Frankly, I haven't met that many people who have perfected the perfect basal...as it always is changing.

Eating around 45 grams of carbs a meal is only 3 servings. Not "momma's servings"...but true measured servings of carbs. A few ounces of juice, one serving. Half a banana, another serving. Less than a slice of bread, often, another serving. It's really not "high carbs" eating.

For those who are eating with no control, it may seem extremely low. But it depends on the person, how active and your medications.

[Dawn]

Everyone is different and you will find what works best for you. Like its been said generally anything extreme is to be avoided...however examine what extreme means for you. Some people may think I am too extreme because I choose not to eat fruit. That however works for me. I consider myself on a restricted carb diet rather than low carb because low carb tends to cause a bit of a ruckus and may be misunderstood (I don't mean here...I mean my doc, family, etc). I feel good, I've lost 100 pounds, I've maintained that weight loss, my numbers are good and I'm not on medication. I am very focused on my carb intake. A lot is confusing in the diabetes world - do what makes sense and what is working for you. I felt so overwhelmed when I was first diagnosed and I was eating only for my meter...I was terrified!!! Since much of that terror has dissapated I have relaxed, eat what works for me and test often to see how it is all going.

[peacelover]

Bluesky: You are exactly correct that I take in 926 calories a day. I am 5'3 and weighed 160 at diagnosis in June. Since then, I have lost over 32 pounds. I currently weigh about 127. I know I'm not eating enough calories each day, but I don't know what else to eat.

Tonight is a very bad night. I began testing this week as my Dr. did not have me testing my first 3 months after diagnosis. I have no idea why. I did ask, believe me. I tested a few times when I got ahold of a free kit and my numbers after eating were always below 120 or 130. Tonight, I only consumed 800 calories total for the day as when I came home tonight at 7pm, I had 3 very small whole wheat pancakes with peanut butter and sugar free syrup. After 1 hour, I was at 128, after 2 hours I was at 171. At this point, I broke down. This was the highest reading I had ever seen. I thought whole wheat was acceptable. According to the nutritional information I only consumed about 30 carbs. I have been crying all night. I feel completely out of control and don't know who to listen to. I am very hungry, but am terrified to put anything into my mouth.

As for the fat clogging arteries, my dr. told me no cheese, milk, fat anything, only lean meat, and only nuts as sources of fat. My cholesterol consumption only averages about 50 mg a day and it is still so high that she put my on cholesterol meds. I am only 32 years old and I'm on cholesterol meds. With the way I eat and exercise (4xs a week cardio & weights) I don't understand.

[BlueSky]

... I had 3 very small whole wheat pancakes with peanut butter and sugar free syrup. After 1 hour, I was at 128, after 2 hours I was at 171......
That is unusual. After a meal like that, blood glucose normally peaks within an hour and is on its way down after 2 hours. A pattern like your is typical of T1s before they start taking insulin. Watch the numbers, and if they get any worse, you may want to have your diagnosis confirmed.
... I know I'm not eating enough calories each day, but I don't know what else to eat ...... my dr. told me no cheese, milk, fat anything, only lean meat, and only nuts as sources of fat. .....
If you want to stick with the low-carb way of eating, you will have to get those calories from fat .... and you will have to take what your doctor says about it with a pinch of salt :D . Modern thinking is that food high in cholesterol (like eggs) doesn't actually increase your cholesterol levels. My experience certainly bears that out. I eat 700mg+ of cholesterol every day (3 eggs for breakfast), and my serum cholesterol levels are rock steady. There is really no good reason for you be taking choesterol meds. Studies show that there is no net benefit for women of taking statins, regardless of their age and whether or not they have had a heart attack.

Don't get too stressed about it. The most important thing for you to be doing at this stage is testing often. It will provide you with the information to fix the problem.

[labob]

All carbs are not created equal, and repeated testing will help you figure out what works for you. I've pretty much sworn off bread unless I know I'm going to be very active immediately afterwards -- and I can't imagine eating pancakes and syrup (even sugar-free syrup has lots of carbs). But I can pretty much eat my weight in non-starchy vegetables (which also have carbs) and not have a problem. As for the starches, a baked potato, for me, is just fine, but the few times I've tried to eat french fries since being diagnosed, no matter how few, my glucose level skyrocketed and stayed there. Be patient, keep testing, keep an open mind when you go to the grocery store, and you'll figure out what works for you.

[volleyball]

Peacelover,
The ADA diet plan is to give a moderate diet that will give you a steady amount of carbs, fat and protein. Then you can medicate for that amount. They are thinking that people are eating worse so this is healthier. They have no plan for people who realize that if they just avoid the bad carbs and test, they don't need the amount of meds.
There are low carb, high carb and good carb proponents. I was low carb, then switch to low glycemic with good carbs.
Don't cry over a bad reading, it means nothing. A bunch of bad readings does. This will make your life a lot easier.
As far as your pancakes, not all whole wheat brands are really whole wheat. I like Aunt Jemima's. I think you need some fat in that meal. Eat a sausage first and have butter instead of peanut butter. It works for me.
As far as your cholesterol, You have to break down the components. Most likely, its you triglycerides that is high. Your new diet should fix it. Cholesterol drugs have not proven to be beneficial to women your age. I would personally avoid it but you have to decide for yourself. My doc tried to put me on them years ago, I didn't buy it and now my numbers are miraculously fine.