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There's a war going on: The War of the Diabetic Diets. The generals are amassing their loyal troops and building up their ammunition storehouses of research and evidence (both scientific and anecdotal). All the generals are convinced that the better diet-their diet-will prevail and rule the Land of Diabetes forever.
But as the saying goes, "War is too important to be left to the generals." We have to get personally involved since our lives are at stake. But happily, unlike the trials of war, in this conflict everybody wins. Each of us now has the freedom to choose the diet that works best for us.
We've taken the role of reconnaissance scouts, surveying the battlefield for old diets and new diets on the horizon. The following books represent some of the quality literature available for all the soldiers hacking it out in the fat-burning trenches.
ADA's New Nutritional Guidelines
This is the non-controversial, mainstream diet recommended by the American Dietetic Association (800-366-1655) in conjunction with the American Diabetes Association (800-232-3472). It is more flexible than ever since it is now recommended that it be mutually designed by a registered dietitian along with the patient. In fact, the only specific recommendation is that protein should be 10-20 percent of total calories. It suggests following the guidelines of the U.S. Dept. of Agriculture's Food Guide Pyramid with its small peak at the top to the broad base at the bottom: fats, oils, and sweets used sparingly, 2-3 servings of milk, yogurt or cheese, 2-3 servings of meat, poultry, fish, beans, eggs or nuts, 3-5 servings of vegetables, 2-4 servings of fruit and 6-11 servings of bread, cereal, rice or pasta.
With this diet you can use the ADA Food Exchange Lists to help you estimate the carbohydrate, protein, and fat content of the foods you're eating and balance them in a healthy manner. Exchange lists are also helpful for both the high-carb, low-fat and the low-carb, high-protein diets. All of the cookbooks for diabetes include exchanges with their recipes.
High-Carbohydrate, Low-Fat, High-Fiber
Now it gets a little more complicated. Not all diets of this type are created equal. Dr. James Anderson, in his book Diabetes: A New Guide to Healthy Living, recommends 55-60 percent carbohydrate, 12-20 percent protein (some of which comes from grains, beans and milk), 20-25 percent fat, preferably non-animal and non-hydrogenated, and 30-60 grams of fiber per day.
Dr. Julien Whitaker, with his popular book Reversing Diabetes, weighs in with 70-80 percent carbohydrate, 10-15 percent protein, 10-15 percent fat, again preferably non-animal and non-hydrogenated, and 30-40 grams of fiber. Whitaker's diet is vegetarian and therefore low in dietary cholesterol and high in fiber. This is what most of us, supported by studies reported in the media, now consider the healthiest diet.
Here's where the fat hits the fire. The low-carb, high-protein diet is by far the most controversial of the diets. The three proponents of this diet suggest varying amounts of carbohydrates, but all share the belief that it is carbohydrates, not fat, that causes weight gain and raises cholesterol levels. Carbohydrates promote the production of insulin, a potent fat-storing hormone.
We find that Dr. Richard Bernstein on his audio tapes, Bernstein Plan - Type I and Bernstein Plan - Type 2, recommends 30 grams of carbohydrate per day: six for breakfast and 12 each for lunch and dinner. And that's the pattern for the rest of your life. With Dr. Bernstein you never move onto a maintenance diet in which you are allowed more carbohydrates. For protein you are advised to eat enough to make you feel comfortable but not full. He suggests you eat about the same amount of protein at each meal.
Dr. Calvin Ezrin, in his Type 2 Diabetes Book, recommends 40 grams of carbohydrate and 80 grams of protein a day. He does not allow for added fat. Though the diet seems to be short on the calories, taking in less than 1000 a day, Ezrin says that most of the calories come from a person's own fat. In the initial stages of the diet a person burns over 1000 calories of his or her own fat each day.
Drs. Michael and Mary Eades in their Protein Power advise 30-60 grams of carbohydrate a day. You begin with 30 grams and when you reach your goal you can gradually add more carbohydrate until your weight starts to go up or your blood sugars de-stabilize.
At the top of the New York Times best seller list is Dr. Barry Sears. Enter the Zone offers a unique diet that doesn't fit exactly into the classic low-carbohydrate/high-protein category. It is 40 percent carbohydrate, 30 percent protein and 30 percent fat. The unbreakable rule is that you must never eat carbohydrate without protein (seven grams of protein for each nine grams of carbohydrate). You are to determine your personal protein requirement according to Sears' formula, spread it evenly throughout the day, and combine it with "good fats" and "favorable carbohydrates"-mostly fiber-rich fruits and vegetables.
Both Drs. Bernstein and Eades are somewhat lenient in the use of animal fat. Drs. Bernstein, Eades and Sears allow alcohol in moderation; Dr. Ezrin does not. Coffee is OK with Drs. Bernstein and Eades. Dr. Ezrin recommends coffee "in small amounts" while Dr. Sears wants you to "gradually reduce caffeine to zero whenever possible."
To Change or Not to Change
What if you love your diet and it keeps you happy, healthy, at your optimum weight and in good control? Then there is absolutely no reason to gallop off in a different dietary direction. But if your diet isn't doing a good job of keeping you in control, or if no matter how hard you try, you can't lose weight on your current diet, then a change may be in order. If the diet is working pretty well, but you hate it and know in your heart that at any moment you might just chuck the whole thing, then perhaps it's time to rethink how you want to live your life. The diet for diabetes-like life-is more a journey than a destination.
0 comments - Oct 1, 1996
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.