Dietary Approaches to Diabetes Management

During the week of October 25-31, 2015, the weekly poll asked about members’ approaches to diabetes management. Although we realize there are as many variations on approaches as there are members, for convenience we used the broad categories shown in the chart below.

approaches

For many members, they best they can do is eat whatever they can afford, whatever they have time to fix, or whatever they need to eat due to allergies, compromised immune systems, and other physical ailments. But they are very conscientious about taking diabetes medications and/or insulin as prescribed by their doctor. Often their diet is both high-carb and high-fat and they may be overweight. They may not always achieve the magic 7.0 A1C number. But they are doing the best they can.

Some members have a strong faith in their medical care providers and whatever is published by the American Diabetes Association (ADA), which recommends 150-200 grams of carbohydrates per day, equating to 45-60 grams/meal, and 15-20 grams per serving. This regime, like mainstream Adventism, is the most comfortable to follow as we were brought up to follow the voice of authority, whether it be church, elected officials, or our doctors. For those following ADA recommendations, success means maintaining an A1C of 7.0 or less (or 7.9 or less if over age 65), by whatever means necessary, which is usually oral or injected prescription medication and, eventually, insulin.

Still, there are those for whom the mainstream is not working to their satisfaction and they seek to move “outside of the box.” I have discovered two broad categories of these innovative seekers of better health and control of their diabetes: those who choose to eat low-carb high-fat (LCHF) and range from total carnivore to lacto-ovo vegetarian and even vegan, and those who opt for a high-carb low-fat totally vegan (HCLFV) protocol. In reality, choice of dietary regime is on a seamless spectrum. Although most high-carb low-fat proponents are vegan, some are pescetarian or pollo-pescetarian. Some allow vegan fat sources, such as coconut oil, and others allow no oils of any kind. Some whole-foods advocates allow whole or steel-cut grains but no flours.

And then there are the raw vegans. Some are 100% raw, not cooking anything; so it initially made sense to me that by eliminating potatoes, rice, pasta, grains, and legumes (none of which would be eaten raw), that would substantially reduce carb intake and improve blood sugar readings! From my own research and experience, I have determined that many foods have a lower carbohydrate content when eaten raw than when they are cooked. Examples are onions, tomatoes, and cabbage. I have since learned that the typical raw vegan actually eats only 60%-80% raw and does eat small amounts of cooked grains and legumes. They also eat whole fruits and many have juices and smoothies.

On the other side, there are low-carb high-fat (LCHF) supporters, ranging anywhere from 100 grams of carb per day, to 50 grams, and all the way down to 20-30 grams for a ketogenic protocol. It should be clarified that LCHF does not mean a high-protein diet! It is my personal observation that lacto-ovo vegetarians have the easiest time eating this way, more so than meat eaters who may easily get too much protein, which, like carbohydrates, is converted to glucose, though at about half the rate as carbohydrates.

Both sides are not as much against each other as they are against (a) refined, processed foods, (b) unhealthy fats (by their own definitions of “healthy” and “unhealthy”), and (c) the combination of high carbs and high fats eaten together (such as doughnuts and French fries). Both sides tend to recommend organic whole foods and non-GMO food products. And the goal of both groups is the same: to control/manage diabetes “without pills or needles.” This means achieving a non-diabetic normal HbA1C (blood sugar average over three months) of 4.0-5.6 through diet and exercise alone.

If you are (or were) a Seventh-day Adventist, you also know that Adventists traditionally do not eat pork and shellfish (and other “unclean” meat as described in Leviticus) or drink alcoholic beverages, forbid tobacco use and drug abuse, and discourage consumption of chocolate, tea, coffee and other caffeinated drinks, baking soda and baking powder, vinegar, pickles, black pepper and other “stomach irritants,” and the combination of milk and sugar (in contrast to Jewish protocol of not having meat and dairy at the same meal). And if you were raised “in the church,” you know all the reasons. If you don’t, you don’t need to know; you only need to be aware that some of us were raised and/or educated in this way and many still adhere to these beliefs and practices. And many (both current and former) Adventists do drink coffee, eat chocolate, and even have an occasional glass of wine. Some even eat bacon though they would be aghast at the thought of eating a pork chop, ham, shrimp, or lobster.

Finally, there are those who do not count carbs or calories, such as the member who wrote, “I have never quantified my carbs, so I don’t know how many grams I eat. I try to eat only whole foods, mostly fruits and vegetables, some whole grains a couple times a week. The same with nuts. I have about a teaspoon of maple sugar once a week. Otherwise no sweets. I can’t eat large amounts of sweet fruits, either. This has worked for 35 years. I go from 3 p.m. to 8 a.m. with no food and no low-sugar symptoms. I have a couple of organic eggs per week, and I do use small amounts of olive and coconut oil.”

For more detailed information about each major approach to diabetes management, see this section: https://adventistvegetariandiabetics.wordpress.com/approaches-to-diabetes-management/.

Regardless of your dietary approach to diabetes management, you are welcome in the Adventist Vegetarian Diabetics group!

 

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