Carbs and Kids - Clarification....

Since my Blog is titled Three 2 Treat, I should clarify what the other 2 Type 1's eat; those others being my two children.

I know it's obvious what my stance on Carbs is, but I should make it clear that these are my own Food Choices and I certainly don't impose these choices on my five kids. Just in case any readers are inclined to think that I'm a crazy man that only feeds my kids eggs, meat, and veggies. Trust me my children would form a mutiny and lock me out of my own house.

A clue would be to read some past posts like Fire The Easter Bunny , taking note the Pic of my smallest Type 1 chowing down on a large (certainly not low carb) chocolate bunny.

My stance on diet and food choices is also a journey, over my 28 years of dealing with my own type 1 diabetes. Years of  food exchange diets; being told to avoid sugar, being told sugar is okay, to intense carbohydrate counting, using pocket scales, kitchen scales, and nutrient bibles.  Not to mention the thousands of miscalculated carb counts, and the extreme variability in the foods and the effect they have had on my blood glucose readings. So I am what you could call a human  Lab Rat, and I am constantly trying to figure out what works for my diabetes management. If I read compelling enough evidence, not just anecdotal that a certain method of diabetes management may work better then others, I try it.  

I read about carb reduction 10 years ago, but didn't try it, as I didn't think there was enough research regarding it, especially for Type 1 diabetes.  But now the evidence exists and promising and more and more is being done regarding lower carb, moderate protein and fat diets and the effect thay have on health.

I realize that this is my personal choice, and not for everyone, but I also feel strongly that our current lifestyle of 200 gms of CHO plus a day seems to be creating problems that can't be ignored. And, when I continue to try to understand the possible reasons, be it inactivity, genetics, food choices, and metabolic pathways, I really think we need to ask ourselves, are we eating a diet conducive to good blood glucose control and health?

I know for myself, high carb meals, lead to huge errors in carb counting (even measuring on a scale) larger doses of insulin leads to variable absorption, which leads to more extreme fluctuation in blood glucose readings, and more lows and highs. So for me it makes logical sense to reduce the carb a little or a lot depending on your comfort level, to make diabetes management a little more predictable.

As for my kids, they eat a typical kid diet. They have cookies and milk, Kraft Dinner, Mr Noodles, Ice Cream, and pretty much what they want(with in reason) We buy lots of fruit (which isn't low carb) that they have access to when ever they feel the urge. Kids with D or any child for that matter need calories, lots of em, especially active kids, but for the middle aged office worker, hmm me, I am certainly not burning the fuel like the little ones.  

The 2 little Type 1's have good days and bad days with their glucose readings, and unfortunately the bad days are the ones where the meals and snacks are higher in carbs or meals that are difficult to calculate, but this is all part of being a kid with D, I know because I was one once, and I loved my moms home made cookies and milk.  

Trev

The Obvious isn't Always Obvious...

"Relinquishing My Mental Frustrations"

I have this crazy hobby, or maybe obsession.  

I read anything and everything related to nutrition.  I mean everything....Research, Diet Books, Blogs, you name I read it.

I read it with a pair of Diabetic Glasses on, looking for ways to improve my health(and others) I have written posts about food, and controversial topics like What's Up with the Food Guide and Pro Carb vs. Low Carb so one could say I am a little biased in my opinion.

I am now trying to figure out why so many in the medical profession (at least the ones I meet)tend to not agree with reducing the carbs.  So I started looking into what knowledge the General Practitioner gets regarding Nutrition. 

I asked a brand new, wet behind the ears Resident or Family Doc in Training how much education he received in the area of nutrition during his medical degree.  His response was, "Hardly Any" 

Hmmmmm. So I decided to pull a Medical Physiology Textbook written by Guyton from the shelf to have a look at what these doctors review in terms of Insulin Metabolism, and the storage of Macronutriants, like Carbohydrate, Protein, and fat.  Thinking, there must be a profound reason we are offering the general public a guideline to consume a diet that contains 65% carbohydrate. So I flip it to the pertinent section. And read the following:

In time, the insulin plays an important role in storing the excess energy substances.  In the case of excess carbohydrate, it causes these to be stored as glycogen mainly in the liver and muscles.  It causes fat storage in the adipose tissue.  Also, all the excess carbohydrate that cannot be stored as glycogen are converted under the stimulus of insulin into fats also stored in the adipose tissue

Okay, so they are taught in medical physiology that insulin is the main stimulus for fat storage. So I ask myself, what causes increased levels of insulin in the human body?

Excess Carbohydrate causes an increase in blood glucose, which in turn cause an increase in insulin which in turn gets stored as fat.  Apparently most of the world has missed this point.

Okay, I also read from the same text, now this is for those interested in how to up the fat burning engine in your body, which definitely includes me. 

All aspects of fat breakdown and use are greatly enhanced in the absence of insulin

Short quote. Now in the complete absence we'd be dead, so I guess what this Medical text is suggesting is that in cases of reduced insulin levels, we set our metabolism up to burn more fat then if we have higher levels.

So as I read this from a Medical Text Book on Physiology, that Doctors use to reference, I question how the hell we can in good conscious tell people to increase their insulin levels beyond capacity, when basic Insulin Metabolic Theory indicate the outcome of doing so?

What's my point?

Well, I guess I don't understand why the obvious isn't noted, and practiced. Perhaps it's the "Hardly Any" training some groups of health professionals receive in the area of nutrition. However, even the Professionals that are trained in the area of nutrition still encourage this high carbohydrate approach.

Who knows.

Trev 

Source:

Textbook of Medical Physiology, Guyton, Arthur C.8th Edition, WB Saunders Company, 1991. pp. 858-859. 

Top 10 List: Cursed Food

My list of food items that make it next to impossible to control blood sugars.


1.  Cold cereal --- No matter what we do it never works.

2.  Popcorn --- I love it, but my fasting doesn't

3.  Pizza --- Yup, still digesting three days later, kidding, but not far from the truth

4.  Chinese Food --- Hungry an hour later, and impossible to guess the carbs not to mention the rebound

5.  Alcohol --- Okay,  but who can stop at two? When I'm over the limit --- it 's low then high later

6.  Casseroles --- Unless I measure and count all the ingredients; which I humbly admit I do not, so my sugars suck later on. 

7.  Buffets --- nothing more to say, other then, bolus, upon, bolus, upon, bolus......3-4 peaks later, it's a       major gamble on predicting blood glucose, and I always lose my bet

8.  Late night Binging --- any item, your choice, nothing like an insulin peak when your body doesn't need it!

9.  Fast Food --- Just refer to 3 and 4, same deal different meal

10.  All items that are difficult to measure or "eye ball" --- You all know the ones....

Have a great day! 

PS:  Feel free to add to the list

Diet-Betes? What is the Best Choice?

"So many choices"

All right,  I must revisit this topic, as I find myself "Flip-Flopping" in my mind as to what is the best diet for Diabetes.

I have talked about the "The Food Guide" I have discussed eating more natural in my post "The Diabetic Caveman" and really stirred up some serious discussion on Tudiabetes Discussion Forums by posing my question and post titled "Pro Carb or Low Carb?" the big debate.

I am sure most of you have heard from others with minimal knowledge related to diabetes the following statement:  "So your on the diabetic diet, eh?"  and, I am sure your response is as variable as Charlie Sheen's erratic behavior.

 I respond by saying "There is no such thing as a "Diabetic Diet" and because I am mouthy(opinionated) I usually add my two or three cents worth of information. 

But this "Flip flopping" got me thinking; since there are so many diets on the market, and it is a bit of a "past time" for me to read up on them, what is the best diet for diabetes?

One of my older posts, actually the most popular thus far, titled  "Pro Carb or Low Carb?"  touched on the Low Carb Diets on the Market and how research makes a point for them being an effective method to control weight, blood fat levels, blood glucose levels etc.

However,  there is also research indicating the opposite, that eating vegan, and or a "The Food Guide" type diet also creates weight loss over time.

I personally don't adhere to a low carb diet. I do go on low carb kicks, but can't seem to adhere to the diet long term. When I say low Carb I am talking 30-50 grams per day.

Recently I tied a Natural "Caveman Type Diet"  Basically if you can shoot it, pick it, pluck it, and it is unprocessed you can eat it.  With a few exceptions of course.  This was also hard to adhere to.......I'll blame my kids this time. 

The hardest part of any extreme diet is adhering to it. Consistency is key. But in my house full of little people, I find it extremely difficult (hence blaming them above) to be consistent.

I enjoy, popcorn, ice cream, and other high carb choices. I do agree that it is difficult to control Blood Glucose readings when I consume copious amounts of Carb(greater then 30).  If you have read Dr Bernstein's "Diabetes Solution" where he talks about the law of small numbers it does make sense. Actually makes a lot of sense but it's very rigid and extreme.  I'm talking 30 grams of carb a day extreme.  Man I just can't do that!

I just read today that the American College of Sports Medicine doesn't endorse any diet that is less then 1800 Cal for men and 1200 for woman.  More data to chew on. 

As stated above I also look at the government food guides.  Are they onto something?  Is it really as simple as eating a balanced meal, 25-30% calories from fat, 50-60 % from CHO, and the rest protein. The old calories in equals calories out formula for weight maintenance.

It got me thinking; man this sure is confusing, even to someone who understands basic human nutrition.  No wonder people are confused about what to fill their plates with.

I didn't even touch on the GI(Glycemic Index)of foods, which is also a commercial diet and numerous others, hormone, alkaline, blood type, lots of fad diets. I remember one diet my mom went on and all she ate was cabbage.  That was a stinky time in my life, but goes to show you how people do silly things.

Is it as simple as calories in equals calories out?  Or is it more complicated then that?  I just know what I observe and read.  For instance; since the agricultural revolution and mass food production there has been a direct correlation with obesity and a heavier over all population.  However, this is can be explained by lack of exercise, more sedentary jobs and lifestyle, TV remotes, etc.  Likely a combination of both. Who knows?

As a Type 1 Diabetic I'm left to ponder; what is the best diet? 

Well I am still really trying to figure this out.  I think it depends on personal tastes and preferences.  I also find one common theme.

That is; eat less, eat balanced, eat natural and don't forget about protein.

But I say it is what you do 80% of the time that counts.  So bloody hell have a piece of cake would ya!

I will have to write another top ten list, so I think the next will be top ten tips  tricks to diabetic eating.


Trev

Singing the Post Breakfast Blues

"Couldn't find any with five kids"

I must say that for us;  the hardest blood sugar reading to contend with in our house full of diabetics is the Post Breakfast one.

It is bloody relentless.

I for example take 50% more Novorapid to cover any carb with my breakfast dose of insulin. That's right, 50%. 

Rowan, is no different, and the most frequent calls from the school are when they do her mid morning glucose check and I get the text that reads; "Hi Trev, her readings say 25 Mmol,(Divide by 18 for US) should I ask the wizard what to do?"

This happened a lot in the beginning but we are starting to conquer the post meal spike.

Dr Berntein, in his book, The Diabetes Solution discusses this issue at length, and thus recommends eating only 6 gms of Carb for breakfast. I can do that, but tell that to a group or more accurately a pack of hungry wolf cubs ripping into a box of cereal.  He further explains in detail the increased hormones(Cortisol) that cause an increase in blood glucose readings in the first two hours after waking.  It is a good book, however, very rigid.

It is also recommended that taking your meal time insulin 20 min (for rapid) prior to that first bite as this lessons the 2 hours spike in glucose.  This I found scary when Rowan was 18 months, and throughout her toddler years. You all know how predictable small children are with eating(sarcasm).

Okay for the most part we try to adhere to the above recommendations, the key word here is try. Now if you have children of school age(or even know these little creatures), and you somehow forget to pre-make lunches, pre-put out the clothes, and end up doing what we do 50% of the time and wing the "Launch Sequence" out the door in the morning;  then you can hopefully understand how following Dr B's recommendations are tricky, and next to impossible most mornings.(I know that sentence structure sucked, never liked writing, lots to say, so little time)

However, I will say this:  When we do give the insulin 20 min before a meal, and we make the eggs or some other  good source of protein, I don't get any text messages from the school during the week, and we don't have any post meal blues on the week-end.

Trev

Ketones - are they bad?

Well another hot topic in the diabetes and weight loss world.

Ketone:  A waste product in the body when it is burning fat for fuel, instead of carbohydrate.

Are they Dangerous?  Good question.  In the wrong quantity yes. In small quantities I would have to say no.

Let's look at some definitions, then go from there:




http://www.worlddiabetesday.org/

 Diabetic Ketoacidosis:  Is a medical emergency, it is when the quantity of ketones in the body become high enough to make the bodies inner environment too acidic on the Ph scale, and results from not having enough insulin on board.  The body essentially goes into shock. So if you have Type 1 diabetes, and you are unable to get your blood glucose down, start to vomit, feel confused, can't quench your thirst, this is a medical emergency, seek medical attention immediately.

Ketogenic diet:  This is where I feel the controversy starts, people automatically link Ketoacidosis with Ketogenic, and therefore they conclude that having a small quantity of ketones in the blood is a life threatening thing.  Which it is not, in my opinion. Actually it is very common when fasting for over 12-15 hours to have a small amount of ketones in the blood or urine. 

The question arises, as usual with science is; what are the long term consequences of being in a semi-ketogenic state while dieting?  Good question; and there are studies, many of them, and I have yet to find a negative one.  I am not a scientist, however, but I like to believe I have common sense.

It has been noted in many popular weight loss books using the ketogenic diet principals, that the heart and brain prefer the energy derived from ketones as opposed to Carbohydrate.  Interesting.  In the book titled Advanced Nutrition and Human Metabolism, Sareen and colleagues provide evidence of what the body prefers during a 40 day period of starvation.  Basically the brain and the muscles convert to using ketones as an energy source, not out pf preference but necessity.

There is once again, a lot of controversy, or perhaps confusion, about ketones, or more specifically Ketogenic diets.

So are ketones bad? My opinion, not in the right quantity with the appropriate amount of insulin.

What do you think?


Trev


Sareen S, et al,  Advanced Nutrition and Human Metabolism  (2009)Page 263, table 7.2.