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The Diabetes Diet, Chapter 3 – Part 4

The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 4 of Chapter 3
Essential Guidelines for the Diabetes Diet

Keeping It Simple

There are no complicated formulas or calculations in the Diabetes Diet. In the following pages I will show you the foods that you ought to emphasize in your diet and the foods you ought to eliminate.

There are two kinds of carbohydrate, fast-acting (concentrated) and slow-acting (dilute). Eat a limited amount of the slow (for which I provide guidelines in the pages to come) and eliminate the fast/concentrated. That’s about as complicated as it gets. Next time you’re in a restaurant or at a buffet, you can look at the foods that are available and have a very good idea what you should eat and how much — without a calculator and an index.

The guidelines are simple and are provided so that you can use your own common sense to judge what’s acceptable in your diet and what’s not. Before long, you’ll find it all very easy.

So-Called Diet Foods and Sugar-Free Foods

In the recent past, food labeling laws in the United States have permitted products to be called sugar-free if they do not contain common table sugar (sucrose). Such labeling requirements have the effect of allowing manufacturers to perpetuate a myth that sugars that are not sucrose (table sugar) are not sugars, which is nonsense. Still, it fools a lot of people. I’ve been in doctors’ offices that have candy dishes full of “sugar-free” hard candies especially for their diabetic patients. If you read labels, you can often find out what kind of stealth sugar is in the product, but individually wrapped candies may not have labels.

Here is a partial list of stealth sugars. All of these will raise your blood sugar. Keep in mind that sugars (and carbohydrate) tend to end in –ose (as in lactose), while sugar alcohols end in –ol (as in sorbitol).

Some, such as sorbitol and fructose, raise blood sugar more slowly than glucose but still too much to prevent blood sugar rises after eating in people with diabetes.

Other “diet” foods contain stealth sugars or large amounts of rapid-acting carbohydrate, or even both. A sugarfree cookie, for example, is virtually 100 percent rapid acting carbohydrate (flour), so that even if it contains none of the stealth sugars, a small quantity would easily cause rapid blood sugar elevation.

There are exceptions:

• Most diet sodas are fine, although there are glaring exceptions. Sugar-free Slice contains 40 percent “natural fruit juice.” Bottom line: check the nutrition facts label and look for a goose egg — 0 — under carbohydrate. (A great thing about diet drinks: if you spill them, they’re not sticky.)

• Sugar-free Jell-O brand gelatin desserts are also fine, but again you have to check the label. The ready-to eat variety is currently sugar-free, but the powdered mix contains maltodextrin.

• Da Vinci brand sugar-free syrups (see page 88) use Splenda and are good for all sorts of uses, from flavoring and sweetening coffee to making sugar-free soft drinks (mix with sparkling water) or adding to vinegar and oil to customize a salad dressing.

All of these “exceptions” are made without sugar of any kind.

Candy, Including “Sugar-Free” Brands

Even a tiny candy like a SweeTart can raise blood sugars (indeed, I have used them to counteract low blood sugar episodes). A stealth sweetener like sorbitol tastes about a third as sweet as sugar, so candy makers use three times as much. As a consequence, it can eventually bring on about three times the blood sugar rise of table sugar. However, because of the recent low-carb fad, new candies and candy bars have come on the market that are said to be carbohydrate-free. With these, the bottom line is that you must read labels and, when in doubt, use Clinistix and check blood sugars. It’s worth mentioning again, however, that the Clinistix/Diastix method will not detect sorbitol and other stealth sugars.

Honey and Fructose

Honey and fructose (fruit sugar) have been touted as useful to diabetics because they are “natural” and more complex than table sugar. Glucose is the most natural of the sugars, since it is present in all plants and all but one known species of animal. Both honey and fructose will raise blood sugar far more rapidly than medication or phase II insulin response can effectively counter. Both are concentrated carbohydrates, so avoid them.

Desserts and Pastries

With the exception of products marked “carbohydrate — 0” on the nutrition label, virtually every food commonly used for desserts will raise blood sugar too much and too fast. This is not just because of sugar but also because flour, milk, and other components of desserts are very high in rapid-acting carbohydrate. You will find dessert recipes in this book that provide truly slow-acting, low-carbohydrate ways of satisfying your sweet tooth. Avoid the fast-acting carbohydrate you’ll find in most pies, cakes, and frozen desserts. Low-fat products are often the worst offenders.

No-No’s in a Nutshell

Here is a concise list of foods to avoid that are discussed in this chapter. You may want to copy it and keep it with you until you have the concept in hand.


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.

Author’s Note:
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.