The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 7 of Chapter 3
Essential Guidelines for the Diabetes Diet
FAST FACTS ON WHAT TO EAT AND WHAT TO AVOID
Here is a summary of the kinds of foods you will want to avoid in order to maintain control over your blood sugar. Some of them are no-brainers, but others may surprise you. Many foods recommended by well-known low-carbohydrate diets as “low glycemic index” are too high in carbohydrate to make blood sugar control feasible. These are general categories, so some foods in the categories may be okay, but you will need to read labels carefully. When in doubt, check your blood sugar and use the Clinistix/Diastix method (see page 50) for checking the “sugar integrity” of the labels.
This method will not detect sorbitol and other stealth sugars. If you need a “cheat sheet” to help you remember what’s okay, make a copy of pages 75–94 and keep it with you. You might also want to copy the No-No list on pages 58–61.
Candy, Including “Sugar-Free” Brands
Even so-called sugar-free candies have lots of stealth sugars that will raise blood sugar. Some newer candies — ZCarb candy bars claim 0 carbohydrate — and others that may come on the market as the low-carbohydrate fad heats up might be acceptable. Unfortunately, most no- or low-carb brands misstate carbohydrate content, even though this is illegal.
BOTTOM LINE: Avoid candies.
Honey and Fructose
Touted as “natural” sugars, both are high in fast-acting carbohydrate.
BOTTOM LINE: Avoid honey and fructose and any foods that contain them.
Desserts and Pastries
Most are completely out, especially those that claim “low fat.” On restaurant menus, dessert fruit cups may seem benign in comparison to Death by Chocolate, or crème brûlée, but avoid them (see Fruits and Fruit Juices, below). There are desserts in the recipe section of this book that are in step with the guidelines, plus other ways to satisfy a sweet tooth that won’t significantly affect blood sugar.
BOTTOM LINE: Avoid desserts that contain fruit, flour, sugar, or anything that ends in –ol or –ose.
Bread and Crackers
Among my patients only some of those with delayed stomach emptying can eat a slice of bread without significant, immediate impact on blood sugar. The only brands of crackers I have found acceptable are those that are almost entirely fiber (see “Bran Crackers,” page 83).
BOTTOM LINE: Avoid both, even so-called high-protein bread.
Rice and Pasta
Bestselling low-carb diets claim that al dente pasta is low or close to low in the glycemic index, and tout brown or wild rice. At this writing, nothing in this category will help you lose weight, avoid gaining it, or maintain normal blood sugars.
BOTTOM LINE: Avoid everything in this category, including rice cakes.
Some high-profile low-carb diets recommend particular cooked cereals, such as oatmeal. I know of no commercially available breakfast cereal, hot or cold, that will further your ability to normalize your blood sugars, even those that are “high protein.”
BOTTOM LINE: Avoid all cereals.
This is an extraordinarily broad category, but it comprises mostly foods that are high in fast-acting carbohydrate. Most of my obese patients have problems here because they start out as incessant snackers, which fuels carbohydrate addiction.
BOTTOM LINE: There are really no acceptable snacks for diabetics other than sugar-free Jell-O without maltodextrin.
Protein and Diet Bars
Even a protein bar or diet bar that is manufactured specifically to complement a low-carbohydrate diet is likely to be high in fast-acting carbohydrate. These products are best avoided; most are just candy bars with a high price tag and a fancy wrapper.
BOTTOM LINE: Avoid protein and diet bars even if they claim zero carbohydrate on the label, as virtually all such claims are deceptive.
Milk’s main purpose in the great scheme of things is to deliver healthy nutrients packed with fat and sugar to nursing infants, whether humans or other mammals. Skim milk is highest in lactose, or milk sugar; heavy cream is lowest. A small amount of milk in coffee (2 teaspoons) is acceptable; larger amounts are not.
BOTTOM LINE: Heavy cream or a very low carbohydrate soy alternative is best in your coffee or tea.
Fruits and Fruit Juices
Most of the foods we commonly think of as fruits — oranges, peaches, bananas, grapes — are too high in fast-acting carbohydrate to make blood sugar control feasible. The juices of these are little more than sugar water.
BOTTOM LINE: Avoid all fruits and fruit juices.
Vegetables = Virtue. Actually, this is mostly true, except “vegetable” is a category more than a definition, and there are vegetables, mostly root variety — potatoes, beets, carrots — that are too high in fast-acting carbohydrate to be acceptable. Others that we think of as vegetables, such as tomatoes, are actually fruits.
BOTTOM LINE: Avoid most root or tuber varieties (potatoes, beets, and carrots) and seed varieties (peas, most beans). Enjoy whole-plant or leaf vegetables.
Commercially Prepared Soups
Unless the soup is a broth or consommé, it’s almost impossible to know — even from the label — how high in carbohydrate it is.
BOTTOM LINE: Make your own soups (the Italian Wedding Soup and Cream of Artichoke Soup recipes in this book are wonderful) or use bouillons or consommés labeled as having less than 2 grams of carbohydrate per serving.
Very few so-called health foods are low in fast-acting carbohydrate. That may be changing, but to be sure, you should check labels, check blood sugars, and use the Clinistix/Diastix method.
BOTTOM LINE: As with protein and diet bars, avoid most so called health foods.
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.