Saturday, January 23, 2010

What Do the Experts Say pt.5 (Final)

This will be the last post concerning the Men's Health article entitled, "A Cure for Diabetes". I hope the information has been helpful. I'll get back to my own ramblings again tomorrow. I know you're looking forward to that. Before I get on, though, you may have noticed a different look to the blog. Lisa has been working very hard on the site to make it more user friendly fo me and more pleasing to the eye for you. We may be adding the ability for you to comment sometime soon so look for that. Let's talk about nutrition and the ADA's take on it. Okay, here we go.

"You need a certain level of dietary carbohydrate to provide enough fiber, minerals, and vitamins," says the ADA's Dr. Buse, when asked why a person with diabetes would want carbohydrates, given their effect on blood sugar.

And he's right. Why risk a nutritional deficiency in someone with a chronic health condition? Except this is exactly the gamble you'd take if you ate according to the ADA's own Diabetes Food & Nutrition Bible. An analysis of the high-carbohydrate, low-fat plan, presented last January at a conference of the Nutrition & Metabolism Society, showed that it didn't provide the recommended dietary allowances (RDA) of four essential nutrients: potassium, iron, vitamin D, and vitamin E. The ADA diet, in fact, was deficient.

The culprit? The plan's 2,000-calorie limit, says Judith Wylie-Rosett, Ed.D., R.D., a coauthor of the ADA's 2006 nutrition recommendations. "The more you restrict calories on any diet, the harder it is to get the nutrients you need from food."

It might be hard to imagine how a high-fat, low-carbohydrate diet would be any more nutritious, even if the calories were in the right range. But that's only because most of us have a skewed view of what we'd be eating. Specifically, we think low-carb means low-produce. In truth, many vegetables contain very few carbohydrates per serving, and most of those are the fibrous kind, which hardly budge blood sugar. So vegetables are not only acceptable but encouraged on a low-carb diet.

Dr. Vernon, for example, recommends that most of her diabetic patients eat vegetables at every meal. Dr. Joslin, back in 1893, proposed that patients simply limit their vegetable intake to those containing "less than 5 percent carbohydrate content," which he identified as spinach, tomatoes, asparagus, broccoli, and 23 other choices. And in a survey of more than 2,000 low-carb dieters, Feinman discovered that 80 percent actually consume greater amounts of vegetables than they did before they adopted the approach.

More bizarre than the ADA's general recommendation of carbohydrate consumption, though, is the organization's stance on sucrose, commonly known as table sugar. According to the ADA, there's no need for people with diabetes to restrict their intake of the sweet stuff. The organization's published rationale: When it comes to raising blood sugar, sucrose is no worse than starch.

"That's an almost devious justification," says Feinman. "Starch may be the worst food you can eat in terms of controlling blood sugar."

A bit of chemistry: Sucrose is composed of equal parts of two simple sugars, glucose and fructose. The former is the same glucose that circulates in your bloodstream. As such, it's already in the form your body needs, so it's easily digested and quickly raises blood sugar. Fructose, however, has to be converted to glucose in your liver. This slows down the rate at which it's digested, and reduces its impact on your blood sugar.

Starch, on the other hand, consists almost entirely of glucose. In fact, think of starch -- the primary carbohydrate in bread, rice, pasta, and other flour-based foods -- as a bundle of glucose molecules, held together by chemical bonds. These bonds start to dissolve the moment they make contact with saliva, immediately freeing the glucose to enter your bloodstream. As a result, starch has an even greater impact on blood sugar than sucrose; essentially, it's like injecting glucose before your shot of insulin. "The [ADA's] implication is that likening sugar to starch is a favorable comparison," says Feinman, "when it's actually the opposite."

The ADA's sanctioning of sucrose -- as well as that of starch -- does come with one caveat: "Intake must be adequately covered with insulin or other glucose-lowering medication." That sounds like you can eat all the sugar you want, as long as you take enough drugs.

"We're not saying it's okay for people with diabetes to eat lots of sweets," says Franz. "But they deserve the right to eat all types of carbohydrates, just like any other person." Never mind that the need for more medication usually indicates that a disease is worsening. "This is like saying it's all right to eat contaminated spinach just because you have an antibiotic," says Feinman.

Me, again. Did you get that last paragraph? You should read it again. It's statements like those that really got me thinking. It's like saying that alchoholics deserve the right to drink, just like any other person. My mantra is, "if your body can't handle sugar, then don't eat sugar". If you're allergic to bananas or nuts, don't you stay away from them? In my mind, it's just that simple, but some might say I have a simple mind. Anyway, I hope this little series has helped. It changed my life.

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