The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 2 of Chapter 5
Customizing the Diet
“Fast-acting, concentrated carbohydrate is the ultimate heart-attack food, particularly for those with a sedentary lifestyle.”
My basic approach in helping someone put together a meal plan is that I first set carbohydrate amounts for each meal.
The general parameters work like this. I recommend restricting their carbohydrate to about 6 grams of slow-acting carbohydrate at breakfast, 12 grams at lunch, and 12 grams at supper. Very few people would be willing to eat less. (These guidelines also apply to children.) The limitation of only 6 at breakfast is because of the Dawn Phenomenon (page 33), but it really isn’t hard to stick to.
A recent study of overweight children found that when three groups were fed three different breakfasts — a high carbohydrate breakfast; a so-called complex-carbohydrate breakfast; and a high-fat, low-carb breakfast — those in the last group had the highest sense of satisfaction for the longest period of time after their meal. Those in the first two groups were more prone to feeling the “need” to snack.
When we’ve established parameters for carbohydrate, then we talk about how many ounces of protein, in addition to the carbohydrate, we should add to make you feel satisfied. (If you came into my office, I’d show you plastic samples of protein foods of various sizes, to give you an idea of what various amounts actually look like.)
There is no such thing as an essential carbohydrate for normal development, despite what the popular press might have you believe about the health benefits of “complex” carbohydrate. There most certainly are proteins we must have (essential amino acids) and fats (essential fatty acids). We include carbohydrates in the meal plan not just because you might not enjoy the meals without them, but because in addition to the vitamins and minerals present in vegetables there are many other nonvitamin chemicals phytochemicals that have only recently become understood. These are crucial to good nutrition and cannot be obtained through conventional vitamin supplements. Some phytochemicals, such as beta carotene, are highly beneficial when consumed in plant form but may actually be harmful if taken in supplements.
There are still many things that remain unclear about phytochemicals.
In terms of beneficial phytochemicals, wholeplant and leaf varieties of vegetables are particularly good sources. Folic acid as noted previously, so named because it is derived from foliage is essential to all manner of development, but strictly speaking it is considered neither vitamin nor mineral.
Ideally, your blood sugar should be the same after eating as it was before. If blood sugar increases after a meal, even if it eventually drops to your target value, either the meal content should be changed or blood sugar–lowering medications should be used before you eat.
Con’t: Part 3: Slow Acting Carbohydrate
We would like to thank the publisher Little Brown and Company and Dr. Richard K. Bernstein, for allowing us to provide excerpts from The Diabetes Diet.
Copyright © 2005 by Richard K. Bernstein, M.D. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review.
This book is not intended as a substitute for professional medical care. The reader should regularly consult a physician for all health-related problems and routine care.
For more information on Dr. Bernstein’s and to purchase his books, CD’s or get access to his free monthly webinars, visit his website at DiabetesBook.com.