The maverick doctor’s diet for diabetes
Dr. Richard Bernstein, author of Dr. Bernstein’s Diabetes Solution, advocates a low carbohydrate diet that is in direct opposition to the recommendations of the American Diabetic Association. Dr. Bernstein’s rationale for his diet is that carbohydrates must be kept to a minimum because they cause rapid rises in blood sugar. Protein converts much more slowly to glucose and does not cause a rapid rise. Fat is safe, he feels, because it has no effect on blood sugar.
Bernstein has three basic diet rules for normalizing blood sugar:
1. Eliminate all foods that contain simple sugar.
2. Limit total carbohydrate intake to an amount that will avoid a blood sugar increase after meals. This will prevent overworking any remaining insulin-producing beta cells of the pancreas. (Bernstein cites research that beta cell burn-out can be slowed or halted by normalizing blood sugars.)
3. Stop eating when you are no longer hungry , not when you are stuffed. He advocates eating to the point where you are satisfied but not beyond.
What you don’t eat
Specifically, what don’t you eat on Dr. Bernstein’s diet? You eliminate all simple sugars. Simple sugar does not mean just table sugar. All grain products from the flour in “sugar free” cookies to pasta are converted so rapidly into glucose that they are, as far as blood sugar is concerned, no different from table sugar. You eliminate candies, including “sugar free” brands; honey and fructose; desserts and pastries; bread and crackers; pancakes and waffles; rice and pasta; breakfast cereals; snack foods (pretzels, potato chips, crackers, etc.); so called protein bars, which he says are nothing more than candy bars in “healthy” packaging; milk and cottage cheese – they contain a considerable amount of the simple sugar lactose and will rapidly raise blood sugar; fruits and fruit juices; some vegetables – beets, carrots, corn, potatoes, tomato paste and tomato sauce ( the prolonged cooking necessary for the preparation of tomato sauces releases a lot of glucose); beans – chili beans, chickpeas, lima beans, lentils, sweet peas, etc.
This low carbohydrate diet turns the ADA approved Food Pyramid upside down. Grains, beans and starchy vegetables are the foundation of the ADA diet; they are at the base of the ADA’s Food Pyramid, the diet staples to be eaten most often. These same foods are at the top of the low carb pyramid, foods that are to be eaten least often or rarely, if at all.
What you do eat
At the base of the low carb pyramid are meat, fish, fowl, seafood and eggs. (Bernstein considers eggs beneficial to diabetics and nondiabetics alike.) These are the staples of the low carb diet. Most vegetables, other than those prohibited, are acceptable; asparagus, avocado (this is really a fruit), broccoli, Brussels sprouts, cabbage, sauerkraut, cauliflower, eggplant, onion (in small amounts), tomatoes (in small amounts), peppers, mushrooms, spinach, string beans, summer squash, zucchini, greens, escarole, etc. He lists some 40 vegetables in all. You can eat nuts and seeds (raw is best). You can eat cheese, butter and cream. You can eat mustard, pepper, salt, spices and herbs. You can eat low carbohydrate salad dressings. The ideal salad dressing for someone who desires normal blood sugar would be oil and vinegar with added spices, mustard and herbs, if desired.
I disagree with two of the items on the allowed list: soy and artificial sweeteners. Soy can inhibit thyroid function, and artificial sweeteners perpetuate a taste for sweets. They are very controversial. There have been many reports of adverse effects associated with their use. One other respect in which I disagree with Dr. Bernstein’s dietary recommendations is that he does not distinguish between processed foods and unprocessed foods. For example, he considers butter and margarine equally acceptable. Under protein foods, he makes no distinction between fresh meats and processed meats such as frankfurters, bacon and cold cuts. The adverse effects of margarine are well documented. And a study published in the journal Diabetes Care in February of 2002 found that frequent consumption of processed meats may increase the risk of type 2 diabetes.
Otherwise, I think Bernstein is on the right track. He believes that many diabetics can be treated with diet alone. And even if a diabetic requires insulin or other agents, diet will still constitute the most essential part of treatment. He is a true son of the father of medicine, Hippocrates, who said, “Let your food be your medicine. Let your medicine be your food.”
The most important message that I get from Bernstein’s story is that he made his body the final authority in deciding how and what to eat rather than any authority outside himself. By monitoring his blood sugar levels every time he ate, he knew what raised his sugar and what didn’t. I think that is what everyone should do. Follow the basic guidelines, eat unprocessed foods, and then let your body tell you which foods are good for you and which are not by monitoring your body’s response to them.
Mary Lou William, M. Ed., is a lecturer and writer in the field of nutrition. She welcomes inquiries. She can be reaches at 267-6480.