{"id":35516,"date":"2014-03-11T10:00:25","date_gmt":"2014-03-11T14:00:25","guid":{"rendered":"http:\/\/asweetlife.org\/?post_type=feature&p=35516"},"modified":"2016-01-10T05:49:47","modified_gmt":"2016-01-10T10:49:47","slug":"people-with-diabetes-can-eat-everything-really","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=35516","title":{"rendered":"People With Diabetes Can Eat Everything, Really?"},"content":{"rendered":"

\n

There\u2019s a four-letter word lurking behind many conversations about diabetes \u2013 and, at the risk of offending people with my language, it\u2019s spelled c-a-r-b.<\/p>\n

Before I was diagnosed with diabetes in 2001, I rarely thought about carbohydrates \u2013 and when I did, my associations were usually positive. I\u2019d gather with my swim team to binge on pasta before big meets, or bake brownies and cookies for my classmates in my spare time. In my mind, carbohydrates=energy=good (or, at very least, delicious). Then, one cold, Saturday morning 13 years ago \u2013 the moment when I was diagnosed with Type 1 diabetes — that relationship was abruptly and permanently changed.<\/p>\n

Carbohydrates were now mathematical problems to be managed, challenges hiding in every meal. I was surprised by many social occasions I now realized were focused around carbohydrates \u2013 happy hours, ice cream socials, birthday parties, late-night college pizza breaks. Joining friends for dinner became a balancing act: did I make special requests because of my diabetes and potentially inconvenience people, or did I go along with the group\u2019s Chinese\/Indian\/Thai\/Ethiopian\/pizza\/sushi plans, and suffer the blood sugar consequences afterwards?<\/p>\n

For a while \u2013 years, actually \u2013 I tended toward the latter. (Even today, when plenty of people make special requests based on vegetarianism or other dietary preferences, I find it difficult to ask people to go to a different restaurant because of my diabetes.) Like many people with diabetes, I\u2019d internalized the message, meant to be encouraging, that today\u2019s insulin pumps and glucose meters mean that we can eat whatever we want. Granted, I soon found that many foods simply weren\u2019t worth the effort \u2013 I just don\u2019t like bagels that much, and don\u2019t find anything particularly delicious about rice. But deep down, I still adhered to the philosophy that diabetes wasn\u2019t supposed to limit me in any way, including in my choice of food. And I certainly didn\u2019t want to impose a burden on anyone else.<\/p>\n

The idea that today people with diabetes can eat everything is supposed to be a liberating philosophy \u2013 and certainly, compared to the restricted diets of the past, it is. I\u2019m grateful for faster acting insulins, blood glucose meters and continuous glucose monitoring systems. But unfortunately, this supposed liberation can only go so far: even today, every meal requires you to correctly guess how much insulin to take, and to monitor and check yourself multiple times afterwards to make sure that you\u2019ve succeeded. As Dr. Richard Bernstein<\/a> has pointed out, the greater the amount of carbohydrates in your math problem<\/span> dinner, the more likely you are to get it wrong.<\/p>\n

This, I realized, leads to a contradiction in supposed liberation: while part of me was grateful for the flexibility that today\u2019s medications and technology allow, another part of me felt oppressed. \u00a0Here\u2019s why: if diabetes itself is supposedly no longer restricting me, if I supposedly have all the tools at hand to eat whatever I want, then any time I finish a meal with high blood sugar or a scary low, then I must have done something wrong. The problem, in other words, isn\u2019t my diabetes, it\u2019s me<\/em>.<\/p>\n

Eventually, like many other people with diabetes, I learned that the easiest way to \u201csucceed\u201d at diabetes was not <\/em>to eat whatever I wanted; it was to restrict carbs. It\u2019s a philosophy brought up by others on ASweetLife \u2013 check out Leo Brown\u2019s piece A Touch Less Insulin For Diabetes Awareness Month<\/a> or Kerri Sparling\u2019s Sticking It to Diabetes<\/a> or Jess Apple\u2019s (highly controversial!) Diabetes and Ice Cream: Fighting the Wrong Battle<\/a>.<\/p>\n

But it\u2019s also a philosophy that\u2019s often shunned by mainstream nutritional advice, from the Institute of Medicine\u2019s<\/a> recommendation that 45-65% of an adult\u2019s calories come from carbs to the American Diabetes Association\u2019s<\/a> meal-planning guidelines, in which most menus include a \u201cmoderate\u201d 45% of carbohydrate, and most meals contain between 45 and 60 grams. (The ADA\u2019s 2013 Nutrition Therapy Recommendations<\/a> finally began to challenge<\/a> the assumption that there\u2019s one ideal blend of macronutrients for people with diabetes, and that a low-carb diet might have benefits, but its meal plans haven\u2019t yet caught up.) Couple these \u201cofficial\u201d recommendations with the idea, drummed into us since the 1960s, that dietary fat (particularly saturated fat) is dangerous, and it can be difficult to balance the everyday recognition that life with diabetes is easier on fewer carbs with the fear that somehow, by restricting carbohydrates, you might be harming your health.<\/p>\n

Thank goodness, then, for the work of people like Gary Taubes<\/a>, David Lutwig<\/a>, and Peter Attia<\/a>, writers and researchers who propose a hypothesis that seems to fly in the face of all that we\u2019ve been taught (but which, when you read into it, seems quite convincing): that carbohydrates aren\u2019t just problematic for diabetics; they are problematic for everyone<\/em>. As such, the fact that I find high-carb meals so difficult to handle doesn\u2019t reflect poorly on me (or my diabetes); it reflects the fact that none<\/em> of our bodies were meant to eat that many carbs.<\/p>\n

According to Gary Taubes\u2019s argument in his excellent book, Why We Get Fat<\/em><\/a> (and his controversial cover story for the New York Times Magazine, \u201cWhat If It\u2019s All Been a Big Fat Lie?\u201d<\/a>), a lot of this has to do with insulin. As a refresher, when we eat carbohydrates \u2013 whether they\u2019re sweet or starchy — they break down into glucose in our blood. (That\u2019s true for anyone, regardless of whether their pancreas works.) Insulin is the hormone that allows our bodies to absorb this glucose. If we don\u2019t take enough insulin to control the spike, our blood sugar will be high, leading to possible complications over time. Too much, and we can go dangerously low.<\/p>\n

But insulin also has another purpose in the body, as Taubes points out. As he explains in Why We Get Fat<\/a>, <\/em>the whole calories-in, calories-out hypothesis of weight management (i.e. if you eat more than you need, you gain weight; if you eat less, you lose it) is incorrect, because it doesn\u2019t take into account how our body regulates when and where to store fat. (If you\u2019re skeptical of this idea, ask yourself why women store fat in different places than men, or why we put on weight differently as we age, or why you will develop a pocket of fat if you continuously inject insulin into the same site). As Taubes points out, our fat storage is regulated by our hormones. And the primary fat storage hormone \u2013 the one that guarantees the food we eat will be turned to fat is, you guessed it, insulin.<\/em> In a nutshell, Taubes\u2019 argument boils down to this: we secrete insulin in response to carbohydrates. Insulin makes us store fat. Therefore, in order to limit the amount of insulin in your body \u2013 and amount of fat your body stores \u2013 you should restrict carbohydrates.<\/p>\n

Taubes goes into much, much more detail \u2013 pointing out, among other things, the fallacy of the idea that fat is dangerous, and the fact that until the 1960s (when the low-fat dogma became popular), the fattening effects of carbohydrates were widely known and accepted. He also makes a convincing case that low-carbohydrate diets (even super-low carbohydrate diets) are actually not <\/em>dangerous to health — in part because fats, even saturated, are not the recipes for heart attacks that they\u2019ve been made out to be. (Trans-fats are an exception: nearly everyone agrees they\u2019re dangerous.) Yes, saturated fat will raise LDL levels, but Taubes argues that the connection between LDL and cardiovascular risk is less robust than we\u2019ve been made to think. Instead, low HDL levels (the \u201cgood\u201d kind of cholesterol) and high triglyceride levels are much more strongly associated with cardiovascular risk. And guess what macronutrient lowers your HDL and raises your triglycerides? Carbohydrate.<\/p>\n

For more detail on these ideas, I recommend looking into the work and lectures of these three men. But getting back to my own relationship with carbohydrate, here\u2019s what they\u2019ve helped me to realize: the fact that my body reacts poorly to high carbohydrate meals, it isn\u2019t just because I have diabetes; it\u2019s because high carbohydrate meals might be bad for everyone<\/em>. A high carbohydrate meal will cause a spike in blood glucose in all <\/em>people; it\u2019s just that if you\u2019re not diabetic, you\u2019ll never see it, because your body will spurt out insulin to cover it. Being diabetic, therefore, turns us into the nutritional equivalent of a fish tank: our lack of insulin makes it possible to see, via the rise in our blood sugars, what happens to our bodies when we eat carbohydrates. And if carbohydrates and insulin spikes are as fattening and dangerous as these writers and researchers so convincingly suggest \u2013 and if I know firsthand how goddamn hard it is to manage my blood sugar when I eat lots of them \u2013 then you know what? I\u2019m just going to restrict carbs.<\/p>\n

This doesn\u2019t, of course, get past the fact that many carbohydrates are delicious, and that resisting the smell of a fresh-baked cookie requires nearly inhuman levels of self-control.\u00a0 But it\u2019s turned the burden of avoiding carbohydrates into a source of empowerment for me (whenever I have the willpower and food choices to achieve it). And it\u2019s changed my attitude from \u201c I want to eat carbohydrates so I can be like other people,\u201d to \u201cother people can learn a lot from the way that I have to eat.\u201d For me, that<\/em> is a liberating thought.<\/p>\n","protected":false},"excerpt":{"rendered":"

The idea that today people with diabetes can eat everything is supposed to be a liberating philosophy \u2013 and certainly, compared to the restricted diets of the past, it is. I\u2019m grateful for faster acting insulins, blood glucose meters and continuous glucose monitoring systems. <\/p>\n","protected":false},"author":9,"featured_media":41946,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1453],"tags":[],"yoast_head":"\nPeople With Diabetes Can Eat Everything, Really?<\/title>\n<meta name=\"description\" content=\"The idea that today people with diabetes can eat everything is supposed to be a liberating philosophy \u2013 and certainly, compared to the restricted diets of the past, it is.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/asweetlife.org\/?p=35516\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Catherine Price\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/asweetlife.org\/?p=35516\",\"url\":\"https:\/\/asweetlife.org\/?p=35516\",\"name\":\"People With Diabetes Can Eat Everything, Really?\",\"isPartOf\":{\"@id\":\"https:\/\/asweetlife.org\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/asweetlife.org\/?p=35516#primaryimage\"},\"image\":{\"@id\":\"https:\/\/asweetlife.org\/?p=35516#primaryimage\"},\"thumbnailUrl\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/03\/shutterstock_Pasta.jpg\",\"datePublished\":\"2014-03-11T14:00:25+00:00\",\"dateModified\":\"2016-01-10T10:49:47+00:00\",\"author\":{\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/f16ebb52b0d6b1882336149c48618b74\"},\"description\":\"The idea that today people with diabetes can eat everything is supposed to be a liberating philosophy \u2013 and certainly, compared to the restricted diets of the past, it is.\",\"breadcrumb\":{\"@id\":\"https:\/\/asweetlife.org\/?p=35516#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/asweetlife.org\/?p=35516\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/asweetlife.org\/?p=35516#primaryimage\",\"url\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/03\/shutterstock_Pasta.jpg\",\"contentUrl\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2014\/03\/shutterstock_Pasta.jpg\",\"width\":1000,\"height\":667,\"caption\":\"Carbohydrates - Pasta\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/asweetlife.org\/?p=35516#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/asweetlife.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"People With Diabetes Can Eat Everything, Really?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/asweetlife.org\/#website\",\"url\":\"https:\/\/asweetlife.org\/\",\"name\":\"ASweetLife\",\"description\":\"The Diabetes Magazine\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/asweetlife.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/f16ebb52b0d6b1882336149c48618b74\",\"name\":\"Catherine Price\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/991f86d105bb54022be9be587aa788fa?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/991f86d105bb54022be9be587aa788fa?s=96&d=mm&r=g\",\"caption\":\"Catherine Price\"},\"description\":\"Catherine Price was diagnosed with Type 1 diabetes when she was 22 years old. 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