It's More Than Carbs

By patch12 Latest Reply 2011-04-14 18:08:27 -0500
Started 2011-03-25 02:15:06 -0500

Every couple of weeks a person newly diagnosed with diabetes walks into my office and says that they’ve changed their diet dramatically, and have cut out the carbs (carbohydrates). Then they tell me what they eat on a typical day:

Breakfast: Three-egg and cheese omelet with 4 slices of bacon
Lunch: Salad with ham, salami, shredded cheese, and ranch dressing
Snack: Couple slices of cheddar cheese
Dinner: 10-ounce steak and broccoli
Snack: 1 Polish sausage (no bun)

Everyone can see that this diet is very low-carb, but that does not mean that it is healthy. Although some people may lose weight with this regimen, it’s high in processed meats and cheese and lacking in in many vitamins, minerals and fiber.

Yes, carbohydrates are the foods that break down into sugar and raise a person’s blood glucose levels. And yes, most Americans eat too many carbs. And yes, people with diabetes should limit their carbs to better control blood sugar, especially if they tend to eat excessive amounts — i.e., bagels, bread, pasta, etc. But let’s not forget that many carbohydrate foods are very healthy.

For example, fruit is a wonderful, natural carb source that is full of vitamins and minerals. Fruit is also a good source of fiber, which may help to lower cholesterol. Milk and yogurt are carb sources too, but they provide calcium, which is important for bone health. Most Americans don’t consume the recommended amount of calcium, and although the mineral can be found in other foods, milk and yogurt are two of the best sources. Skim milk and light yogurt are the lower-saturated-fat options and are therefore recommended over their full-fat counterparts. Also, whole-wheat bread, beans, and brown rice are healthy carb choices, when amounts are customized to a good carb control plan. A registered dietitian can help you determine how many carbs to eat at each meal.

Although meats and cheese do not raise blood sugar, we do not recommended eating large amounts of high-fat, processed meats such as bacon, sausage, hot dogs and salami. Instead you should choose lean, unprocessed meat and poultry such as chicken breast, fish, lean pork (tenderloin), lean beef, and turkey. Your diet should be balanced with lean proteins, fruits, vegetables, whole grains, and dairy products.

Veggies must not be forgotten. Salad, greens, cabbage, zucchini, broccoli, cauliflower, and asparagus are very low in carbs and provide fiber, vitamins, and minerals that are difficult to obtain from other foods. Make half your dinner plate veggies and you’ll be off to a good start.

I haven’t found many people that can follow the very-low-carb diet for the long-term. Remember, diabetes means you should be making a lifestyle change, so it’s best to find a healthy eating plan that you can follow forever. That doesn’t mean you are going eat perfectly every day, but your diet should be balanced — not just low in carbs.

38 replies

Pynetree 2011-04-13 22:35:07 -0500 Report

So, I'm wondering are you a dietician? In the medical field? Why are these newly diognosed diabetics coming to report to you?

squog master
squog master 2011-04-13 21:04:23 -0500 Report

Is what this person ate like the atkins' diet. And didn't atkins die of a heart attack?

Lamort DeLioncourt
Lamort DeLioncourt 2011-04-13 21:20:01 -0500 Report

No, Dr. Atkins did not die from a heart attack.
On April 8, 2003, at age 72, Dr. Atkins slipped on the ice while walking to work, hitting his head and causing bleeding around his brain. He lost consciousness on the way to the hospital, where he spent two weeks in intensive care. His body deteriorated rapidly and he suffered massive organ failure. During this time, his body apparently retained an enormous amount of fluid, and his weight at death was recorded at 258 pounds. His death certificate states that the cause of death was "blunt impact injury of head with epidural hematoma".

squog master
squog master 2011-04-13 21:36:16 -0500 Report

Thanks for the info. I thought he died of a heart attack. Maybe it was some other pesron that wrote a diet book that diet of a heart attack.

jayabee52 2011-04-14 04:00:09 -0500 Report

There was Jim Fix in the '70s or '80s who wrote the "Running Book" in the 1970s. He died of heart attack.

squog master
squog master 2011-04-14 17:44:28 -0500 Report

yeah, that i remember because 2 of my brothers were runners. but this was a guy who wrote a diet book who died of a heart attack following his own diet.

MoeGig 2011-03-30 08:13:45 -0500 Report

I respectfully disagree. After contracting Type 1 diabetes 46 years ago, I did change my diet to the extreme as you mention, and I consider that a good thing. A very low carb intake doesn't mean not eating vegetables as you say. In fact the majority of vegetables are relatively low in carbs. You just have to eliminate starch…potatoes, rice, corn, etc. When I want to lose weight (recently went from 220 to 200), I also eliminate fruit to force my body to burn the fat for energy. After experimenting with just about every different approach, this diet, I believe, is the right one for any diabetic. I thank god that I have no complications with eyes, feet or kidneys yet, and I'll do anything to avoid the onset. The bottom line is, the more carbs you eat, the more insulin you have to take and the more variable your control will be. I take Lantus and Humalog and try to get by with taking minimum Humalog. Blood sugars are easier to control, and everything else works better.

Yogirajj 2011-03-30 08:36:32 -0500 Report

"eliminate fruit to force my body to burn the fat for energy"… that sounds like an extreme low carb diet, did you not have ketones?

MoeGig 2011-03-30 09:22:46 -0500 Report

Keytones are a byproduct of burning fat. (which is what you want to do if you want to lose weight). You just have to make sure you're blood sugar is reasonable…say under 200 (in my case). And drink a lot of water so the fat byproduct (keytones) can flow out of your body easily. It's the only diet that let's a diabetic actually lose weight and keep it off (IMHO). The reason it works is that you're not hungry; whereas, with every other diet, you have to focus on eating less than you really want. Eventually you lose your will-power, and you're back where you were before the diet, and in the process, you screw up your blood sugars catching up. As they say, "been there, done that, got the t-shirt".

Yogirajj 2011-03-30 09:42:14 -0500 Report

I'd have to check with my dr. 'cause i'm not sure if that's entirely true. Yes, keytones are a byproduct of burning fat, we all have at least a little keytones in our bodies; however, thats not the same thing as depriving yourself of carbs and forcing your body to break down muscle, in order to substitute energy. You need some kind of carbs & calories in order to safely burn fat. Then again, everyone is different. If I did this, I would be in the hospital throwing-up for sure.

Yogirajj 2011-03-30 07:22:06 -0500 Report

My biggest problem is, I can't have a lot of many vegetables, otherwise, I'll spending most of my day in the commode.. LOL. The vegetables that I DO feel safe eating, unfortunately has many carbs, such as potatoes. Unfortunately, I also have IBS, and hi carb foods seem to be the only thing that settle my stomach, should I get an attack.

I absolutely hate diabetes sometimes. I wish non-diabetics can live our lives for 1 week; i'll bet all the ignorant diabetic comments would stop almost immediately.

GabbyPA 2011-03-30 09:26:47 -0500 Report

Walking a mile in anyone's shoes always opens eyes. I can't imagine how horrible it is to deal with both IBS and diabetes. What a crummy combination. Have you tried to use things like Quinoia for your "starch". It is low carb and full of omegas. I am not sure how it would react, but you can give it a try.

Yogirajj 2011-03-30 10:00:37 -0500 Report

Sounds interesting. I have not heard of it before.. I am googling it right now.. So is this a rice substitute like couscous?

GabbyPA 2011-03-30 10:02:55 -0500 Report

In a way, but it is actually a seed not a grain and so the starch in it is far less and it digests differently because of all the fiber. I found it from a member here and I order mine from I get it in bulk from them much cheaper than in the grocery store.

jayabee52 2011-03-30 10:45:39 -0500 Report

I use Quinoa ("Keen WAH") and I really like it. I use it with mixed vegetables, I plan on using it with a pasta sauce instead of the pasta. At least for me it doesn't present any IBS issues.

There are also pastas made from blends of Quinoa and other gluten free grains, like corn. I haven't tried any of them yet, so no experience with them.

hoosierphilly 2011-03-30 08:04:10 -0500 Report

Have you had a reliable test for celiac disease? If you must have a carb, will a healthy carb work…like brown rice, cooked oats, sweet potato…but not too much, or beans maybe humus with carrot or red pepper…if too much a little real whole wheat bread. Try to avoid those potatoes. Some think allergies to a food aggrivate IBS? I am not much help with that.

Yogirajj 2011-03-30 08:44:28 -0500 Report

No, I didn't have the test yet, but I strongly suspect that I do have a touch of gluten intolerance. First I thought it was milk, then I discovered that gluten is in a lot of cereals. Also I have trouble with 7 whole grain breads, etc. Beens give me too much gas (except for Lentil for some reason). Rice is fine, but I try to avoid it most of the time, because even with an insulin pump, my sugars are slightly more elevated, for longer periods of time then i'd like it. Potatoes, are good for me, because although they are hi in carbs, so long as they are baked, and not fried or anything, my body processes the sugar a lot better. Unfortunately, there are a LOT of things that can set of IBS, even stress.

Yogirajj 2011-03-30 09:46:49 -0500 Report

Yes, I am aware of it. I guess I got so connected to this community that, talking about bowl issues just did not seem as appealing to me as talking about diabetes here.. LOL.. Maybe i'll give it a try though..

jayabee52 2011-03-30 09:57:47 -0500 Report

There's not a lot of gross-out stuff there, just some of the same people on DC, and a few others talking about what triggers them, what type of IBS they have and foods to avoid.

Not as much activity there as here, but IMO well worth a look-see. You sign in using your DC sign in information. Very easy!

shorty31 2011-03-29 16:26:30 -0500 Report

my doc. told me not much red meat and to use my fist to mesure my food yes eat more veggies and by the time i get to my starch i will be full and it works haven't lost what i should but will get back on track.

Dev 2011-03-25 09:02:48 -0500 Report

I have a question about the 'half plate of veggies'. I have seen it in various places, a meal defined as portions of a plate. My question is, when it says veggies, is it cooked or raw? There is a huge difference between eating half plate of salad greens and half plate of cooked spinach for example.

LabRat90 2011-03-25 11:23:17 -0500 Report

The answer lies in the size of the plate. Recently, dinner plates have grown. If you eat off a salad plate (or even better a saucer), your portions will be better controlled because you will "think" that your plate is full with less food. A serving of cooked veggies is 1/2 cup whereas a serving of raw veggies is 1 cup.

See this for a reference:

GabbyPA 2011-03-29 07:20:16 -0500 Report

Raw is generally better for you anyway as well. I try to eat as many of my veggeis as I can raw. Not just to fill me up, but to keep the nutrients in them. Plus, if they are raw, I don't tend to add salt or other things to them.

hoosierphilly 2011-03-30 08:07:49 -0500 Report

I love raw vegetables, but actually some of them offer better nutrient absorbion if cooked …try aldente. I love to dip veges in a spinach yogurt dip.

pixsidust 2011-03-25 08:53:52 -0500 Report

I have to ask the new person questions. In what you describe as a menu does have salad and broccoli. Is that not fiber? I have moved to fat free cheese as I need to have something for that craving while lowering my fat. AlsoI have heard in another discussion that the carb game was being played. My understanding is that fiber grams are being subtracted from the carbs giving a net carb but never got an answer. How are we to look at that. Do we always have to combine a protein while eating a veggie? I adore eating a box of frozen spinach zapped in the microwave for 12 minutes. I usually do not care about eating anything else after that.

Thank You for posting this!

GabbyPA 2011-03-29 07:23:09 -0500 Report

The Net carb thing is kind of a game. The way my diabetes educator told us to calculate it is like this.

You can deduct 50% of the fiber grams from your carb grams ONLY if it is over 3grams of fiber per serving.
Example: 10 g carb and 4 g of fiber
10 - 2 = 8 net grams of carbs.

I don't usually do the game and just use the whole carb number. However, I am not on insulin either, so that could make a difference in your calculations in that.

Type1Lou 2011-03-29 11:03:35 -0500 Report

I'm a type 1 on Lantus and Novolog. I, too, don't bother with the NET CARB thing, preferring to use the total carbs in my calculations for my carb to insulin ratio. I try to keep my meal carbs below 50g each and haven't been watching my fats at all but that may need changing because of higher cholesterol readings!…Aging does present us with challenges!

Type1Lou 2011-03-29 17:08:16 -0500 Report

I agree, it is much preferable to be LIVING with diabetes! As chronic diseases go, diabetes is far from the worst. (I have a dear friend coping with a spouse's deteriorating Parkinson's and would not trade places with them!) There is much within our power that we can do to help our bodies better cope with Diabetes and improve our quality of life. By taking care of ourselves, we also make the lives of our loved ones easier. I'm grateful for this site as it is a wealth of info, knowledge, and support.

jayabee52 2011-03-29 17:27:36 -0500 Report

To be sure! I love it here among the folks who walk the walk!

Point well taken about the Parkinsons. I have an uncle and a HS classmate (married to my uncle's daughter) both have Parkinsons.

My bride had Diabetes, Lupis, CHF, COPD, RA. Diabetes was the least troublesome of all those conditions.

Graylin Bee
Graylin Bee 2011-03-25 11:51:48 -0500 Report

Some of the questions are best answered by what your BG meter tells you. If the frozen zapped spinach doesn't spike your BG then it is great for you. If it spikes it then you might need to eat smaller amount or add some protein, nuts, cheese, meat, whatever your medical diet and personal needs allow. For me it seems best to follow a 2 carb to 1 protein ration when eating most carbs. Other people may need to use a different ratio based on what their bodies are doing.
I usually assume all carbs are equal, until my BG meter tells me different. Then I make personal choices based on that. Corn carbs as in dried corn products are ok for me. Corn carbs as in an ear of fresh corn are not ok. Rice carbs are not as good for me as the dried corn carbs. Some fiber carbs do not spike BG as soon as the usual 1 -2 hour rule. Since they take longer to digest and enter the system from further down the digestive tract their effect may take much longer than the 1-2 hrs to show a spike. As you can see it gets complicated to explain whether you can ignore certain carbs as a general rule. When I asked my Dr in the hospital about the carb and protein issue he just shrugged and walked away since he didn't know what would work for me. My FP lets me tell him how things seem to be going for me and as long as the numbers are good he hasn't offered much advice just says I seem to be doing ok. We were all concentrating on fixing a few much more critical problems at the time.

GabbyPA 2011-03-25 06:07:41 -0500 Report

The other thing I would add to this that is my issue is portion size. Even healthy foods can be too much. I can cut carbs, but if I am eating too much other stuff, I find that my numbers though better, stay higher. Days when my portions are well controlled are my best days.

Balance is the key. Your half plate of greens/veggies is such a good rule to go by. I also have had other people share that they eat their veggies and protein first. Then save the carb for last because if they are getting full, they may tend to eat less of it.