Carbohydrate/Protein/Fat tradeoff

[MarkMunday]

I am T1 on Lantus before bed and Humalog before meals. And I am on a mission to reduce my A1c. One way to do this would be to reduce post-meal bg spiking by reducing carbs. But I don't want to lose any weight.

So, if I reduce my carb intake, I am going to have to get the calories somewhere else - more protein or fat. As far as I can see, the figures work out something like this.

Carbs and protein contain about 4 calories per gram. And fats contain about 9 calories per gram. So If I reduce my breakfast carbs by 15 grams (15x4=60 calories), I would need to replace it with 15 grams of protein, 6.7 grams of fat (60/9=6.7) or a combination of the two that produces 60 caloiries.

Apparently much of the protein consumed eventually gets converted to glucose. Which would impact on bg levels later on in the morning. So perhaps I should be replacing reduced carbs with fat.

Am I understanding this correctly? And do you have and suggestions?

Mark

[ScottWagner]

Hi Mark,

I don't have an answer for you, but I do have a similar situation. I recently have tried to reduce my carb intake in the morning, due to some apparant insulin resistance. However, by replacing the carbs with protein, I seem to have great 2 hour post readings, but then I tend to rise... May have something to do with the protien turning into glucose??

Scott

[KLD]

The answer, in my opinion (and it works well for me) is to cut back on your carbs, don't increase your protein, but increase your fat as your main source of energy. I know that goes against everything the medical establishment has been preaching for years, but I've been eating this way for two years, and it works. I've just had a thorough course of medical tests, and everything is excellent (A1C, blood pressure, blood lipids, kidney function, etc.) Before you discard the idea outright, please read the book I follow Dr. Bernstein's Diabetes Solutions by Dr. Richard K. Bernstein and, if you're interested, you can pm or e-mail me for further information. Dr. Bernstein is a type 1 himself, but his book is equally valuable for both types.

I'm just reading the newly-published Atkins Diabetes Resolution; it's good, too, but it's definitely geared towards type 2s.

Karen

[Harold]

Mark Scott,

The body only converts so much of the fat and protein into glucose when normal amounts of carbs taken in. The calorie amounts on food labels are calculated with this in mind. However I read somewhere that in the absense of those normal carb intakes the body actually converts more of the fats and protein to glucose. Don't know if it's true or not, but you should keep it in mind and experiment with it. It also takes longer to chemically convert fats and proteins to glucose so testing two hours post may not give a real picture of what's happening. Good luck, and keep us posted as to what you find out.

[KLD]

It is true that the body converts protein to glucose, as needed, and that's why people on low carb diets do not suffer from lack of glucose, as is commonly believed by people opposed to a low carb way of eating. This happens much more slowly than with carbohydrates, hence the milder effect on blood sugars. However, it is my understanding that dietary fat is not converted to glucose. I quote from Dr. Bernstein's book: Dietary fat, by the way, has no effect on blood sugar levels, except that it can slightly slow the digestion of carbohydrate.

Karen

[Shalyndria]

Harold, I've heard the same thing about fat being converted to glucose in the absence of CHO; course I can't find any literature on it at the moment :rolleyes:

High fat meals can also attribute to post-prandial insulin resistance, making insulin less effective. Of course YMMV.

Shy

[KLD]

See also this excerpt from Diabetes Interview, August 1998:

http://www.diabetes-book.com/articles/fat_and_blood_sugar.shtml

Karen

[MarkMunday]

This was my understanding too. The body can produce ATP directly from fatty acids. So converting fats to glucose first would be an uneccessary step in the process of converting fat to energy.

Mark

[Harold]

After reading Karen's post it is my understanding that dietary fat is not converted to glucose. Went to HowStuff works and looked up fats. Sorry don't have time to go get the link now, but it said some of the fats are converted to triglycerides (spelling) and those are transported into the cells which then convert them to energy, effectively calories. Will have to research this more later because my triglycerides are about 11 points out of range. :(

[lilly]

i have to jump in here and say my triglycerides are extremely low,along with the rest of my lipids.The article that Karen posted is one of many thats written by very eminent physicians on the fat issue.
I eat a very high fat diet and i have never ever had a post meal insulin resistance problem as my pp rises are kept within my goal of always staying in the range of under 5.5 due to a low carb/high fat diet,unlike the pp rises i used to get with a higher carb/standard diet.Fat is 70% of my food intake most days and i've never had the problen of worrying about it converting to glucose,unlike a protein increase as 58% of protein can convert to glucose and has to be accounted for.There is nothing to fear from a high fat WOE as long as its accompanied by low carb as a diet high in fat AND carbs is well known to cause weight gain and high cholesterol.

[Harold]

Talk about counterintuitive. So your saying that if triglycerides are high eating 70% of your diet in foods the are converted to tri's will lower them? :confused:

[lilly]

Harold,i only know that with a 70% fat diet,arounf 70 grams of protein per day and 30 grams of carbs,these are my results after doing this WOE for over 4 year
Total cholesterol-5.0 (193)
LDL-2.8 (109)
HDL-1.79 (69)
Tri's-.56 (49)

HDL/LDL RATIO-1.6.
HDL/Total-2.7.s now.
A1c 5.4.,BP-110/65....weight-105lbs.

[MarkMunday]

Harold,

Yes, I also thought it sounded somewhat conterintuitive. I figured that eating lots of saturated fat increasing cholesterol and triglycerides sounds very logical. Until I found out that 90% of our cholesterol is produced by our bodies anyway. And it has never been proved that increased dietary intake of fats affects the level of cholesterol.

So could it be that cholesterol increases because something is wrong with the way the body works? And could this have something to do with high levels of carbohydrate in the diet? That also seems counterintuitive, seeing that rice us a staple foofd in Japan and colestorel levels are typically low. So maybe the real problem is high levels of fats and carbs in the diet.

Mark

[lilly]

thats the way i see it Mark,its the combination of the high fat and high carb that causes a problem.
In my mind,its one or the other but the fact that low carb/high fat keeps my blood sugars more even than the higher carb/low fat,including the pp tests,thats the one i chose and have never regretted my decision,even though it went against everything i was taught for the last 20 years.

[KLD]

That's the basis of the low carb way of eating that Lilly and I both follow to control our blood sugars- low carb, moderate protein, and high fat. I'm at work and don't have a record of my blood lipid levels with me, but they are all excellent - better than normal - after eating this way for over two years. I just had another A1C done last week, and it was 5.0; that's down from 5.2 three months ago. I should also add that I lost 25 pounds in the first few months of eating this way, and my blood pressure has improved significantly.

To be perfectly honest, I simply can't understand why more diabetics don't give it a try for a few months and compare their results with their current level of control - what have you got to lose? And before you answer "kidney damage," as rumour suggests, I had a thorough series of lab tests recently, including a 24-hour urine test, and all was well.

Karen

[Harold]

I simply can't understand why more diabetics don't give it a try for a few months and compare their results with their current level of control - what have you got to lose?
At 70%, my cookies. Thirty percent and I have gastric destress. :mad:

My total cholesterol is like 166. Why my tri's went high all of a sudden I don't know. So from what your saying since I can't eat a HIGH FAT diet looks like I need to stick to a HIGH CARB.

[KLD]

Gastric distress, in my case, had been a serious problem long before I was diabetic. I had suffered from irritable bowel syndrome for about 12 years before I started this low carb way of eating, and had been told by a gastroenterologist that I would have it all my life and would have to learn to live with it. Within weeks of starting my low carb eating plan, it had totally disappeared. Of course, everyone's circumstances are different, and this may not apply to you, but is it possible that it's the combination of fats and moderate carbs that causes your gastric problems? (I seem to remember your sayng in the past that you watch your carbs but don't go nearly as low as I do.) Maybe low carbs and high fat wouldn't have the same effect?

Karen

[KLD]

I found my last blood lipid results, Harold.

Total cholesterol: 4.5 (175)
HDL: 1.6 (62)
LDL: 2.5 (97)
Triglycerides: 0.8 (71)

Total cholesterol/HDL ratio: 2.8 (should be < 5)

Karen

[Harold]

Total cholesterol/HDL ratio: 4.74 (should be < 5)

This is the first time I've had high tri's and my lowest HDL's. Working 7 days a week 10 & 12 hours a day has not helped. Yesterday started working second shift and I'm taking this weekend off, YEAH. Like so many others here, keeping to a schedule seems to be impossible because life keeps getting in the way. I need to exercise on a schedule or or I don't exercise. Even being active does not seem to have the same effect as a regular exercise routine. The gastric distress I have is not in the stomach, but when it passes into the intestins. Like when I had a bad gall bladder and an inflamed pancreas. Guessing there is not enough bile to aid in the digestion of the fats without a reserve.