Who ya gonna trust?

If you have just found out you have diabetes, you will almost certainly be told that part of the treatment for diabetes is "diet." The problem arises when you ask which diet.

It will take about 5 minutes of web research to learn that there is no agreement on what is the right diet for a person with diabetes. People with impressive medical credentials argue, often convincingly, for every possible diet a human could eat and some that very few humans would ever want to eat.

It is not my intention to debate diets in this blog entry. Instead, I'd just like to share a couple thoughts with you that might help you sort through the torrent of conflicting advice you're about to receive.

Most Dietary Research So Poorly Conducted the Results are Not to be Trusted.

Almost all research conducted by dietitians relies on having participants fill in a standard questionnaire about what they ate in the recent past.

I participated in one such study during a period when I was carefully weighing and logging every single bite I ate using LifeForm software because I wanted to really understand the impact of my food input on my weight and blood sugar.

After submitting my survey, the people conducting the study kindly sent me a print out they said showed what I'd been eating during the time period covered by the questionnaire.

Since I also had LifeForm's report that broke out exactly what I'd been eating over the identical period, I was surprised to see that the dietitians report was about 500 calories higher per day than what I had actually eaten, and that the percentages of Carb/Fat/Protein the dietitian's survey claimed I'd eaten bore no relationship to what analysis of my actual food logs showed I'd actually eaten.

I emailed the dietitian about this and offered to send a copy of my own computerized log and records to the dietitian but was told there was no need for it. They had confidence in their survey which used a standard form that was universal in dietetic studies.

So much for the accuracy of dietetic studies!

Beyond that, most dietary studies fail to control for many other factors than the one they are studying. Reading the actual study you see cited in the news often shows that strong conclusions are being drawn from the thinnest bits of data.

Even worse, most dietary research is funded by someone who profits from the food the research investigates. I've already discussed the deceptive studies that have touted the healing properties of chocolate and soy yogurt in this blog. But there are thousands of other such studies, all highly promoted in the press because the companies who sell these foods have active PR departments.

Bottom line: Treat all dietary studies with caution. Over the 9 years I've been following diabetes-related research I've seen just about every dietary research conclusion published contradicted by another equally poorly designed study. It's jungle out there!

Dietitians Do Not Keep Up With Research

No matter how much research comes out in mainstream journals showing that low fat diets have none of the positive health effects they were expected to have, a large proportion of dietitians continue to chant the religious mantra "fat is bad."

Even worse, many give out highly erroneous information such as the idea that the brain can't function on less than 130 grams of carb a day--which is more carb than I've eaten daily for the past 9 years, a period during which, apparently, brain-free, I've published several successful nonfiction books and designed some very complex software!

Dietitians continue to suggest people eat soy--though it is known to be poisonous to iffy thyroids. They suggest "low glycemic" diets to people with Type 1 diabetes who have no second phase insulin response which is what makes slow carbs useful to people with normal second phase insulin response--i.e. normal people and people with very early Type 2.

Don't Take Advice about Diabetes Diets from anyone who is NOT a Person who has Your Kind of Diabetes with Great Control

It was interesting to read the blog postings a couple years ago describing the diabetes journey of Dr. Bill, founder of the diabetes blog, who was an endocrinologist for years before he himself developed Type 1 diabetes. It was only when he started testing his own blood sugar after meals that he discovered that following the dietary advice he'd been giving patients for years raised his own blood sugar unacceptably.

This does not surprise me. Anyone who has tried to make insulin work with a nutritionist-recommended 300 grams of carbs a day or even a diet that is 1/3 carbs--and hence 55-70 grams of carbs per meal knows that this level of carb intake combined with unpredictable insulins makes it very tough to avoid hypos unless you let your blood sugar run high enough to cause complications.

This is one reason that so many of us people with diabetes have so much respect for Dr. Richard Bernstein, who was the very first diabetes patient in the world to use a blood sugar meter, with dramatic results. You may not agree with everything he writes (I don't) but Bernstein has forgotten more about diabetes than most of us will ever know, and everything he writes is worth checking out, if only because he's lived it.

It's that simple: The people whose advice is worth checking out are those who have the kind of diabetes you have, who have been able to maintain excellent control over a period of at least five years and who have not developed serious complications after adopting the diet they are advising you to try.

You'll get different and even conflicting advice from these people, too, because our bodies are different. If you are diagnosed with Type 2, there may be a huge difference in how much your diabetes is caused by insulin resistance and how much by insulin deficiency. People who are mostly diabetic from insulin resistance will get very good results from diets that won't work if your problem is insulin deficiency.

But the advice of someone who has your kind of diabetes and has made their diet work for them, is a good place to start. And the emphasis here is on the word "start".

No advice is good advice if your meter shows you getting blood sugars consistently over the level known to cause complications.

The AACE (American College of Clinical Endocrinology) says this level is 140 mg/dl (7.7 mmol/L) at 2 hours after eating. The ADA says it is 180 mg/dl at the same interval (though there is no current research that supports this level and a lot that supports the lower level.) But whatever your target is, if your diet is raising your blood sugar over that target, it's a bad diet.

Try out the ideas people share with you, but check them against what your meter tells you.

The best diabetes diet for you is the one that keeps your blood sugars in the safe zone!