Following Dr. Bernstein on Holiday

A type 2’s challenge during nine weeks in New Zealand and Australia: Stay away from bad carbs and keep blood sugar scores down

Intrepid adventurers, Al Krause and Ruth Higgins

| Aug 14, 2008

At the beginning of 2007, we began studying guidebooks and making reservations for a long-anticipated trip to New Zealand and Australia. With limited funds and so much we wanted to do, we decided our budget would go farther if we stayed at hostels. At the same time, we were concerned about Al’s rising blood sugar scores. After visiting relatives during Christmas and celebrating the New Year, Al’s morning scores were as high as 154 mg/dl.

When Al was diagnosed in 2002, we lived in San Francisco. An endocrinologist encouraged him to regulate his blood sugar with diet and exercise rather than pharmaceuticals. Over the next six months, at the age of 72, Al closed out his business career to coincide with Ruth’s retirement. This allowed him more time for exercise.

In March of 2003, we moved to northwest Washington, near the city of Bellingham. In September of 2004, Ruth, whose career was in hospital quality management, interviewed a Bellingham endocrinologist for a column she was drafting. The endocrinologist told Ruth about an acupuncturist, Scott Paglia, L.Ac, who was helping control her diabetes. Shortly thereafter, Al began regular treatment with Scott, who had studied in South Korea and the Oregon College of Oriental Medicine. He incorporates several disciplines within his practice, including acupuncture, herbal medicine, diet, and qigong.

Discovering Dr. Richard Bernstein

Although Al continued under the care of a hospital-sponsored group physician, he also looked to this specialist for regular diabetes treatments, which consisted of acupuncture and an array of supplements. These included Equilibrium (a collection of herbs) and chromium picolinate to control blood sugars and Choleast (red yeast rice) to control cholesterol. (Later we tried the juice of bitter melon, but that was messy to prepare. Diamaxol, with a long list of ingredients including bitter melon extract and cinnamon bark, soon replaced the melon juice. Paglia’s special herbal formulation has since replaced Equilibrium.) In response to those early 2007 scores, Paglia told us about Dr. Richard Bernstein, MD. We read Diabetes Type II: Living a Long, Healthy Life Through Blood Sugar Normalization, and The Diabetes Diet: Dr. Bernstein’s Low Carbohydrate Solution, and we immediately adopted his dietary recommendations. (Ruth got on board because she believes the diet is healthy. With the help of Choleast, her cholesterol measures have been excellent in spite of the high protein component.) In the eight weeks prior to the start of our trip, Al’s daily scores were down to an average of 106.
(See below for a list of Dr. Bernstein’s good and bad carbs)

On our trip, the choice of hostels for lodging turned out to be a good one, and not just for the budget. For anyone who envisions hostels as overrun with grungy backpackers, those in New Zealand and Australia will be a surprise. Yes, there are backpackers, but they are not grungy, nor are the premises. The facilities under the Hostelling International umbrella must meet high standards to ensure safety, cleanliness, and comfort. A subset of HI in Australia and New Zealand is the Youth Hostel Association, which, in addition to complying with the HI standards, operates hostels in an environmentally sympathetic way (see sidebar). We were very comfortable in these quarters, easily making friends with people from Europe and Asia. We usually did not significantly increase the median age. In nine weeks, we stayed in hostels 38 nights.

(See below for some tips on traveling on a budget)

Typical hostel communal kitchen, this one at the Central YHA Backpackers in Cairns, gateway to the Great Barrier Reef.

Taking control by fixing our own meals

The ability to prepare our own meals went a long way toward good control. Most hostels have stainless steel kitchens, adequate utensils, and clean dishes with food stores nearby. Generally, we cooked our own breakfasts and evening suppers, eating the midday meal out in conjunction with our explorations. Our typical breakfast was eggs in a stir-fry with shallots, courgettes (zucchini), capsicum (green peppers), and sausage or bacon. When short of time for an early tour or flight, we put lox and cream cheese on low-carb rye crackers. Our best suppers were chicken, beef, or fish with broccoli, Brussels sprouts, or green beans.

Experience underscored the need to combine exercise with diet and to maintain discipline in keeping to our Bernstein diet. When Al was careful with food and had abundant exercise kayaking in Milford Sound and Able Tasman National Park and hiking on Stewart Island, his scores stayed low. Two train trips across the New Zealand Alps and a stunning bus trip from Greymouth to Nelson were sedentary, and his scores shot up. In Tasmania, trekking for three days brought correction.

Eating at restaurants created more of a challenge than we expected – a challenge to our discipline. We like fish and chips and found them on almost every menu in both countries. Most kitchens would substitute salad for the French fries when we asked. We would say, “Just let us have a few chips,” but a full plate would come. Al would say, “I’ll just have four.” Then another four, and soon it was 24. Of course, most fish batters are heavy on carbs. We did eat a lot of salads – Caesar salads and Greek salads were ubiquitous. But what did we know about the carbs in prepared dressings?

Sometimes there aren’t a lot of choices

A few times, tours trapped us into meals with little or no choice. From Melbourne we had a very long bus tour on the Great Ocean Highway. It was worth the time because the scenery exceeds that along Big Sur in California. Lunch at a café offered fish and salad, which was fine. However, the road back was barren except for one small town where the driver/guide was enamored with a noodle house. We went across the road to a McDonald’s and bought cheeseburgers without buns, which were dry and barely adequate to stave off starvation.

We also had some pleasant surprises. Very hungry after a morning of snorkeling at the Great Barrier Reef, we were welcomed back on the catamaran by an abundant buffet including plentiful cold cuts and salad.

Another challenge was food at friends’ homes. We are members of the Affordable Travel Club, which enables us to stay with friends we have yet to meet. In return for $20 U.S. per night for a couple, members get a bed, breakfast, and an hour of orientation (see sidebar). A wonderful couple in New Zealand entertained us in their home. In addition to the expected, they took us on two tours of their community and treated us to dinner at their table, lasagna and beets. What does Al do when confronted with no choices from his preferred list (see sidebar)? He enjoyed the lasagna and limited the beets to two. Happily, the next morning his score was only 119.

Temptation beckons to us all

As our trip progressed, we continued to have good and bad food experiences. In Melbourne, our plan was to experience city life for a week. Hostel arrangements were perfect and, with a larger Greek population than any other city in the world except Athens, salads were abundant. However, at a comedy club where dinner was included in the admission, the first course was toasted bread. At an Ethiopian restaurant, Al could not resist the puffy flat bread. That evening at the hostel, a woman wasn’t able to eat all her pizza; Al helped her by consuming two slices. The next morning his score was 140.

One of the best meals we cooked was on the barby at the Outback Pioneer Hotel at the Ayers Rock Resort – steak, shrimp and mushrooms with a large salad.

At Cairns, with snorkeling, kayaking and food discipline, the scores came down—but not enough. A week later, at Ayers Rock (Uluru), Al got back on track with continued exercise and better food discipline. In addition to a communal kitchen, there was an outdoor “barby,” where every evening we cooked steak, chicken, prawns, or fish, adding some mushrooms and zucchini with lots of salad. We walked the circumference of the Rock, around the rim of Kings Canyon and into the Olgas. His last four morning scores were 110, 97, 109, and 103.

While we were satisfied that we had met the challenges on the road, we returned home recognizing the need to be more creative with food choices and more aggressive with exercise while traveling.

Now we are studying Costa Rica guidebooks that tell us beans and rice are the basis of most meals—even breakfast.

Another challenge!

Bad Carbs

Beets, carrots, corn, onions, potatoes, winter squash, yellow bell peppers, all fruits and juices, milk, yogurts, cottage cheese, grains (including rice), pasta, breakfast cereals, pancakes, bread, crackers, powdered sweeteners, candies, (especially “sugar free”), cookies, cakes, and pies.

Good Carbs

Artichokes, asparagus, bok choy, broccoli, Brussels sprouts, cabbage, celery, daikon radish, endive, mushrooms, mustard greens, pumpkin, spaghetti squash, turnips, zucchini.

Lists abridged from The Diabetes Diet, Richard K. Bernstein, M.D. Little, Brown and Company 2005

About Reservations

We made all of our own reservations except for airlines. Because hostels have a limited number of private rooms, we reserved ahead. Our itinerary was complete when we left home and we experienced no significant deviations. With few exceptions, we made arrangements via the Internet. For hostel reservations:

We made our Affordable Travel Club (ATC), reservations by email prior to departure – – and confirmed by telephone a few days prior to our visit.

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Categories: Blood Sugar, Complementary Therapies, Diabetes, Diabetes, Doctors & Nurses, Food, Living with Diabetes, Low Carb, Personal Stories, Type 2 Issues, Type 2 Medications

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Posted by Pauline Barrett on 14 August 2008

I'm 66 and recommend hostels as an affordable way to travel for several reasons, too. One can usually cook his own meals, meet friendly people from all over the world, and those hostel under the auspices of the IYH have to meet strict guidelines for cleanliness, quietness, and drugfree environments. I've stayed in hostels in the US, England, Scotland, Paris, Germany (watch the upper age limits), Canada, the US, and Australia. Even some of the Non-IYH one, such as Backpackers are OK. I've been diabetic for nearly 10 years, and when traveling, staying in hostels, carrying a backpack, and doing lots of other activities, I always lose weight and have optimum glucose readings even if my diet goes a little wacky now and then.

Posted by Anonymous on 16 August 2008

I applaud the efforts of the travelers to stay within their dietitaty guidelines and to travel as they did. I personally find that the Dr. Bernstein diet is rather hard overall to follow long term for most folks. I note that Mr. Krause had some pizza. My point is, I find it more realistic to follow a low carb diet, and if you are going to have the pizza, have one piece and a big salad. I also have found with myself, with the exercise that I do, ( gym, hiking, tennis)that if I don't have enough carbs, my workout will suffer. I will loose steam. I take metformin 500 2x a day. I will be at 65 after 30 minutes of cardio and 1/2 hour of free weights without enough carbs. Dr. Bernstein would not be for me. But, your mileage will vary!

Posted by seashore on 20 August 2008

The most difficult meal for a diabetic is breakfast. Since I started my low-carb diabetic diet nearly five years ago, I have eaten 2 eggs for practically every breakfast. Since eggs do not contain carbs, they are ideal nutritionally for a diabetic. They are also inexpensive and readily available.

What about the high cholesterol and fat in the eggs? There is overwhelming evidence that dietary cholesterol does not affect blood cholesterol, and that dietary fat and blood choolesterol does not affect coronary heart disease.

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