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I'd like to respond to some of the feedback we've been receiving about the topic of carbohydrates and their place in your diet. I'm not a dietitian, so I've consulted with Jennifer Nelson, M.S., R.D., a Mayo Clinic dietitian, who says, "The American Diabetes Association generally recommends that around 50 percent of the calories in your diet come from carbohydrates — preferably healthy carbohydrates such as vegetables, whole grains and fresh fruit. Lean proteins or fat-free dairy and healthy fats should make up the rest of the calories."
The Dr. Bernstein diet, which has been mentioned in some comments, is low-carbohydrate and calorie restrictive. In some cases, it proposes limiting calories to 800 to 1350 a day. The program also includes behavior modification, education and vitamins and mineral supplements. People with diabetes who follow the Dr. Bernstein diet are required to do intensive management of their diabetes, including blood glucose testing five to eight times a day. The main function of Dr. Bernstein's diet for those who have diabetes is to maintain constant, near-normal blood glucose levels — desirable for anyone with diabetes. Good glucose control can reduce or prevent the chronic complications of diabetes such as nerve damage, kidney damage, eye disease and heart disease risks.
When carbohydrates are reduced, you must make up the difference in fat and proteins. Consuming total daily calories at an amount needed to maintain a healthy weight is key and, over the long run, is probably more important than diet composition.
Can good glucose control be achieved on a traditional diet? It most certainly can. Good glucose control involves paying close attention to the balancing act of healthy eating, insulin use (and diabetes medications, if required), exercise and blood glucose monitoring.
Good diabetes management takes self-direction and work, no matter how it's achieved.
According to Jennifer Nelson, M.S., R.D., "The bottom line is to find a healthy eating plan that works for you lifelong."
Thanks, Jennifer. And, I hope you all have a good week.
Nancy Klobassa Davidson, R.N.
Peggy Moreland, R.N.
Selecting "Submit" signifies that you have read and agree to our posting guidelines.
In response to nancy and Peggy sept 6 2011,
You are giving diabetics advice that will do them physical harm. Any diabetic knows what happens to your blood glucose when grains and starches are eaten vs protein, fat and non starch veggies. It goes up! The ADA trained doctors tell you to just shoot up some insulin to make the number look better. This is absurd. If you are insulin intolerant like most type 2 diabetics then all you are doing is loading your system with too much insulin in addition to the glucose. Insulin is known as the fat storing hormone, so having too much in your system along with excess glucose is going to make you store fat around your organs which further increases insulin resistance. Eating a meal of non starch veggies, protein and healthy fat (not canola oil!) will Not raise your glucose levels much and you will be getting all the nutrients you need.
We have been telling people to eat healthy grains and low fat diets for decades and all that has happened is food addiction had increased, obesity has increased and diabetes has increased. Nice job ADA! You are killing us!
We have a right to normal blood glucose levels just like yours! Please stop saying that a healthy diet for a T2DM person can or should contain grains and starches or should be low in saturated fats. Get yourselves educated!! Read something out of your ADA box. Shame on you and shame on the ADA!
Our response to all the negative feedback is simple:
"The bottom line is to find a healthy eating plan that works for you lifelong" whether it is the Bernstein diet or something else. My sources have been checked and are reliable. Have a good day.
It's shameful that you haven't printed a retraction of your bogus article, even after 21 comments from lay people who know a lot more than you do about treating diabetes have pointed out your errors. I've avoided diabetes by following a low carb way of eating, and I helped my diabetic boyfriend lower his blood sugars with Dr. Bernstein's advice. I'm embarrassed for you, really.
"Can good glucose control be achieved on a traditional diet? It most certainly can. Good glucose control involves paying close attention to the balancing act of healthy eating, insulin use (and diabetes medications, if required), exercise and blood glucose monitoring."
Quoting from the article, the words that stand out here are "Good glucose control involves...insulin use and diabetes medications."
Why must good glucose control include insulin and medication??? In the month since starting Dr. B's plan my morning BG has dropped appx. 70 points into near normal range. I have lost 7 lbs after years of trying, and I am eating more vegetables than ever before. All of this with NO insulin and NO medication. I am certainly not going hungry!
Yes, I have had to give up all white and whole grain carbs and most fruit. I am learning to cook with flax and almond meal. Is it worth my life...absolutely! Even 10gm of multi grain raised my BG 40 - 50 points. I am so grateful to this man for his diligent research and lifelong commitment to this disease.
I guess it all depends on your definition of a "traditional diet" and a "healthy eating plan" and just how long you want your "lifelong" to be, because I don't believe eating the very foods (carbs, whether simple OR complex) that give me high blood glucose and then injecting myself with a powerful hormone (insulin) to "cover" the damage is healthy at all and certainly won't give me a long, healthy life.
If you do a little research you'll see that a truly "traditional" diet for diabetics IS a low carb diet! I don't have enough room with the 1500-character limitation to post citations but I'm sure you can find the research on your own.
All I can say is thank God I found Dr. Richard K. Bernstein (NOT Dr. Stanley Bernstein!!) before I found the ADA or the Mayo Clinic when I was diagnosed with type 2 less than a year ago. Following Dr. RKB's low carb plan (with modifications to fit my personal needs) has allowed me to bring my A1c down from 13.3 to 5.5, to lose 60 lbs w/o ever being hungry or counting calories, and to need 1/4 of the BP meds I was taking, in just 9 months!
If I was (or ever become) a diabetic who needs to take insulin I would still follow his plan as it would make management easier, more reliable, less dangerous, and less expensive.
I believe you (the Mayo Clinic) and the ADA do diabetics a grave disservice by not recommending Dr. Richard K. Bernstein's books and low carb way of eating.
Some of the foods that one can eat on Dr. Richard K. Bernstein's diet, according to the Lance Armstrong Foundation website."While following Bernstein's diet plan, you should include nonstarchy vegetables at each of your meals, but you will need to control your serving size to get the right amount of carbohydrates at each of your meal. For example, Bernstein explains that 1 cup of raw vegetables, 2/3 cup of cooked vegetables or 1/4 cup of pureed vegetables each provide 6 g of carbs. Meat, fish, seafood, poultry, eggs, cheese, avocado, butter, margarine and cream are suitable foods for Bernstein's diet plan, as long as they do not contain added sugar or carbohydrates. However, you need to count the carbs you get from these foods, although it may be a very small number, especially for yogurt, nuts, vinegar, cottage cheese, cream and nonstarchy vegetables..." http://www.livestrong.com/article/469257-the-doctor-bernstein-diet-plan/#ixzz1X6SxcgLo
Having been on this diet myself for almost a year,I have seen major improvements in ALL my health, including Lipids,A1C(5.2),Kidney Function, everything!My Dr. told me at my last labs I have the bloodwork of a 20 year old. This was not the case before the Bernstein VLC (CARB) diet. I eat better variety and have less restrictions with his diet too. It is a Luxurious eating & wonderful way of eating and seem like a diet.
You owe a great man a written Apology for this Libel,I mean Dr. Richard K. Bernstein.
PS the ADA diet
I have had type 1 diabetes for 52 yrs. I have followed Dr RICHARD Bernstein's advice for the past 7 yrs. Please correct your article, because you have clearly mixed up the doctors. I love eating this way because I don't have to count calories! The information posted here is false. Try reading The Diabetes Solution so that you can understand Dr. Richard Bernstein's advice.
Among the many things this article got wrong is mixing up the Doctors Bernstein.
This poorly-thought our and written piece is not worthy of The Mayo
I find it very disappointing that you did not research this subject better.
Dr. Richard K. Bernstein is a noted Diabetes Doctor of worldwide fame. He does NOT count, nor ask anyone to count calories. The statement about his low calorie diet is totally FALSE! A person with carb intolerance should restrict carbs but that does NOT mean low calorie.
According to the Diet Reviews Guru (http://dietreviewsguru.com/bernstein-diet-review.html)there are 2 DIFFERENT Richard Bernsteins.
"Dr. Richard Bernstein’s Diet
Dr. Richard Bernstein’s diet focuses on a 6-12-12 concept in regards to daily carbohydrate intake in an effort to control blood sugar levels and to lose weight. The guideline is 6 carbs at breakfast, 12 carbs at lunch, and 12 carbs at dinner.
Dr. Bernstein has diabetes. He wanted to show diabetics that it is possible to effectively control your blood sugar while losing weight safely.
Dr. Stanley Bernstein’s Diet
Dr. Stanley Bernstein’s diet is geared for people who want to lose 4-5 pounds per week. His patients are required to visit his clinic 3 times per week for the duration of the program. The entire program is based on VLCD – Very Low Calorie Diet. Daily calories recommended for you could be as low as 800, as high as 1,350 or anywhere in between.
Dr. Stanley’s diet focuses on losing fat tissue and supposedly keeping lean muscle intact. There are three phases – weight loss, maintenance, and tune up. He claims patients can safely lose up to 20 pounds per mo
The Bernstein diet has help me reduce my A1c and my daily blood glucose levels. I no longer have symptoms since starting the 6-6-12 program.
How is it that two nurses, neither of them who are diabetic, are allowed to comment on what diabetics may eat and not eat?
On the other hand, Dr. Richard K. Bernstein, who is himself a diabetic, has written numerous books on diabetes, runs a very successful diabetes patient clinic, and is a strong proponent of a low carb diet that controls blood sugars, is besmirched in this column?
I am a type 2 diabetic and personally lost two of my toes on one foot following the high-carb ADA diet. Then I discovered Richard K. Bernstein and after he read me the riot act, I changed my diet to low-carb which prevented me from having my foot amputated.
Dr. Richard K. Bernstein has completely reversed my neuropathy and now I have feeling in my legs and feet again.
Don't pay your researchers this week: I think they confused their Bernsteins. Dr. RICHARD K. Bernstein is NOT "calorie restrictive", and I've been following his way of eating since 2004, with a1C's in the low 5's and high 4's. On the other hand, Dr. STANLEY Bernstein champions a near-starvation way of life that most knowledgable diabetics want no part of. Please, please, please issue a correction. There are desperate people out there who will read this and do still more damage to themselves.
It would have been helpful if you had specified WHICH Dr. Bernstein you were speaking of. Dr. Richard Bernstein (author of The Diabetes Solution and other books) is not the same as Dr. Stanley Bernstein who is recommending the reduction in calories you mention. You really didn't do your homework on this article!
Dr. Richard Bernstein recommends carbohydrate reduction to 6-12-12 to reach normal blood glucose. If it isn't possible to reach normal b.g. with diet and exercise alone, he recommends oral meds and/or insulin.
Please GET your FACTS straight.
I think it is disgusting for the Mayo Clinic to get a couple of nurses to attack a well-respected physician in public, especially since their characterization is inaccurate and they did not pay him the courtesy of advance notice or opportunity to respond. "Find a healthy eating plans that works for you lifelong" as long as it isn't low-carbohydrate.
Carbohydrate restriction is nothing new.
Before talking about Dr. Bernstein' book and mine, Carbohydrates Can Kill, you can read this free eBook, published in 1916 by Lewis Webb Hill, M.D. of Children's Hospital in Boston, Mass. and Ms. Rena S. Eckman, a dietitian of Mass. General Hospital, Boston, Mass., at http://www.gutenberg.org/files/26058/26058-h/26058-h.htm. You should find carbohydrate restriction is the best treatment for DM.
I simply do not understand where the rumor comes from that Dr. Bernstein's diet limits diabetics to between 800 and 1350 calories per day. That is absolutely untrue. I have read his book from cover to cover several times over the eight years I've been following his program, and I have never seen him recommend any specific amount of calories. In fact, I can't see how one could keep their calories that low since the diet is high in fat. What he does recommend is keeping carbohydrates down to 6 grams for breakfast and 12 grams for lunch and dinner which makes perfect sense when you consider that diabetes is characterized by an intolerance to carbohydrates. I have never felt better in my life than these years I've been following his advice, and my blood sugar levels are absolutely normal - not "good for a diabetic" but as normal as a non-diabetic's. My family doctor, my endocrinologist, and my eye specialist fully approve of my diet; my endo says that any doctor who doesn't recommend this way of eating for his diabetic patients has his/her head buried in the sand.
There is a Dr. Bernstein here in Canada who has a chain of diet clinics for weight loss, and I understand that he advocates a very low calorie diet. I sometimes wonder whether some of your "experts" confuse him with Dr. Richard Bernstein, the diabetes doctor.
I too can bear testament to the effacacy of Dr Bernsteins program for managing my diabetes. I have an HbA1C of 5.2% down from the 7.9% - in a period of 6 months and have dropped 50lb in weight. I too am extremely grateful for the wise words of Dr Bernstein and a workable program that helped me to achieve these results.
Every recommendation he makes is based on sound science which clearly is more than we diabetics get from the ADA.
As a 56 yo physician with pre-diabetes I am grateful to have partaken in the low carbohydrate lifestyle augmented with the liberal use of a glucometer. I now know which foods drive my blood sugars up, and which are stabilizing. I take no medications for my condition. Currently my HDL is 105, Triglycerides 57, and LDL is pattern A. I eat great food, eat all I wish, and never go hungry while maintaining a BMI of 18.2. My patients enjoy similar success when they follow this approach. I have not been able to accomplish such results with carbohydrate rich dietary approaches and find the use of a glucometer throughout the day provides invaluable feedback, particularly when I add new foods. I enjoy good health overall. Considering the damage that can occur during pre-diabetes I owe a debt of gratitude to Dr. Bernstein for his valuable instruction.
Physicians, nurses, dietitians, medical researchers should go back to our basic science, biochemistry in particular, for refreshing their knowledge about where glucose comes from, other than glycogenolysis and gluconeogenesis. The only answer is dietary carbohydrates. Diabetes mellitus is a disease as a result of overwhelming and damaging the beta cells of the pancreas with uncontrollable hyperglycemia as its major problem, which is responsible for the development of many, if not all, diseases. The best way to normalize the blood glucose level is first and ultimately to restrict the supply of blood glucose from dietary carbohydrates. To allow the diabetic victim to continue consuming a measurable amount of carbohydrates, which fluctuates the blood glucose level, is simply prolong the course of the disease. Such approach is unacceptable!
OK, if we're diabetic, a disease of carbohydrate intolerance, you think we should eat more carbs. I'm curious - does the Mayo Clinic advise lung cancer patients to smoke more cigarettes?
I have had type 1 Diabetes since I was 2 yrs. old. At age 19, I felt like I was in my 60s or 70s. I was *dying* following the ADAs carbohydrate, carb-toxic diet plan. I'd been to Diabetes camps, and all my doctors had previously followed the standard ADA recommendations you're referring to in this article. Unfortunately, it doesn't work. And, until you've been a type 1 diabetic for years, you do not truly understand how rampantly you EXPERIENCE it destroying every cell in your body that is affected by your blood traveling through the body (basically, everything but your hair).
Thank God - I was introduced to Bernstein's diet at around 20. Since about 2006, my A1Cs and overall health readings have been better than anytime ever in my LIFE. I run 5 - 5.2 A1Cs all year. Secondly, I am able to maintain a normal job making a great salary and all kinds of other incredible blessings. I maintain with exactitude Bernstein's 6-12-12 carbo diet. It is NOT calorie restrictive in any way whatsoever & no vitamins required. It's "FULL" restrictive. When you're FULL, you stop eating. I eat LOTS of fat - which, by the way, has zero impact on my weight or blood sugars no matter how much I eat - and the more I lift and workout, the more protein I eat. I can eat as much as I need to stay full. And, BTW, I can actually build and INCREASE my muscle mass now instead of being fat from over-insulin dosing or SUPER thin from the chaotic highs. With Type 1 for 30 yrs, I'm thankful to be
With a surprise diagnosis of diabetes I lucked into a doc with firm anti-ADA, pro-Bernstein position. I limit my intake to 20 carbs per meal, pay no attention to fat, calories, etc. All blood work is better than its been for decades, my A1c has been 5.2 for the last 14 months, diabetes in complete control. It's painless, takes discipline, has been completely successful. And I am down 75 pounds, below what I was in high school. Bernstein rocks!
If you want to make your insulin resistance, pre-diabetes or diabetes worse over the longterm just keep buying into the conventional dogma (ADA, AHA etc.) that a high "complex" carbohydrate, high fructose diet loaded with grains and fruit will maintain healthy blood sugars. Totally bogus! Dr. Bernstein and others that advocate reduced carbohydrate intake get it. Your glucose meter and A1C test will give you the data you need. Ignore advocacy groups, physicians, or organizations that may in fact have a conflict of interest because of funding from big pharma or the food industry!
I really think this mis-characterizez Dr. Bernstein's advice. His recommendations are definitely low-carbohydrate, but they are not "calorie restrictive." I don't know what is meant by "behavior modification," so I can't comment one way or the other. Dr. Bernstein does recommend testing 5 to 8 times a day, but I think the ADA does as well. If you test when you get up, before each meal, and before going to bed, that's 5 times per day right there. Throw in a test for before exercise, and an extra in the case of an unusual high or low, and you've gotten to 8.
From personal experience, managing BG levels is much easier if I minimize the amount of carbohydrate I eat. Many, many Type 1 diabetics have shared this experience. I don't know why the ADA is so resistant to the idea.
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