9
The Basic Food Groups
OR MUCH OF WHAT YOU’VE BEEN TAUGHT ABOUT DIET
IS PROBABLY WRONG
In Chapter 1 we discussed how diabetics and nondiabetics might react
to a particular meal. Here we’ll talk about how specific kinds of foods
can affect your blood sugar.
A curious fact about diet, nutrition, and medication is that while
we can make accurate generalizations about how most of us will react
to a particular diet or medical regimen, we cannot predict exactly how
each individual will react to a given food or medication.
The foods we consume, once you take away the water and undigestible
contents, can be grouped into three major categories that provide calories
or energy: protein, carbohydrate, and fat. (Alcohol also provides calories,
and will be discussed later in this chapter.) Seldom will food from
one of these groups contain solely one type of nutrient. Protein foods
often contain fat; carbohydrate foods frequently contain some protein
and some fat. The common foods that are virtually 100 percent fat are
oils, butter, some types of margarine, and lard. Since our principal
concern here is blood sugar control, we’ll concentrate on how these
three major sources of calories affect blood sugar. If you’re a long-standing
diabetic and have followed standard
ADA teachings for years, you’ll find that much of what you’re about
to read is radically at odds with the ADA’s dietary guidelines—and with
good reason, as you’ll soon learn.
When we eat, the digestive process breaks down the three major food
groups into their building blocks. These building blocks are then absorbed
into the bloodstream and reassembled into the various products our bodies
need in order to function.
PROTEIN
Proteins are constructed of building blocks called amino acids. Through
digestion, dietary proteins are broken down by enzymes in the digestive
tract into their amino acid components. These amino acids can then be
reassembled not only into muscle, nerves, and vital organs, but also
into hormones, enzymes, and neurochemicals. They can also be converted
to glucose, but very slowly and inefficiently.
We acquire dietary protein from a number of sources, but the foods
that are richest in it—egg whites, cheese, and meats (including fish
and fowl)—contain virtually no carbohydrate. Protein is available in
smaller amounts from vegetable sources such as legumes (beans), seeds,
and nuts, which also contain fat and carbohydrate.*
Protein and carbohydrate are our two dietary sources of blood sugar.
Protein foods from animal sources are only about 20 percent protein
by weight (about 6 grams per ounce), the rest being fat, water, and/or
undigestible “gristle.” The liver (and to a lesser degree, the kidneys
and intestines), instructed by the hormone glucagon,† can very slowly
transform as much as 36 percent of these 6 grams per ounce into glucose‡—if
blood sugar descends too low, if serum insulin levels are inadequate,
or if the body’s other amino acid needs have been met. Neither carbohydrate
nor fat can be transformed into protein. In many respects—and going
against the grain of a number of the medical establishment’s accepted
notions about diabetics and protein—
protein will become the most important part of your diet if you are
going to control blood sugars.
If you are a long-standing diabetic and are frustrated with the care
you’ve received over the years, you have probably been conditioned to
think that protein is more of a poison than sugar and is the cause of
kidney disease. I was conditioned the same way—many years ago, as
I mentioned, I had laboratory evidence of advanced proteinuria, signifying
potentially fatal kidney disease—but in this case, the conventional
wisdom is just a myth.
Nondiabetics who eat a lot of protein don’t get diabetic kidney disease.
Diabetics with normal blood sugars don’t get diabetic kidney disease.
High levels of dietary protein do not cause kidney disease in diabetics
or anyone else. There is no higher incidence of kidney disease
in the cattle-growing states of the United States, where many people
eat steak virtually every day, than there is in the states where beef
is more expensive and consumed to a much lesser degree. Similarly, the
incidence of kidney disease in vegetarians is the same as the incidence
of kidney disease in nonvegetarians. It is the high blood sugar levels
that are unique to diabetes, and to a much lesser degree the high levels
of insulin required to cover high carbohydrate consumption (causing
hypertension), that cause the complications associated with diabetes.
* Phosphate, a by-product of protein digestion, requires calcium in
order to be eliminated from the body—about 1 gram of calcium for every
10 ounces of protein foods. If you don’t eat much cheese, cream, milk
(too high in carbohydrate),
yogurt, or bones, all good sources of calcium, it would be wise to take
a calcium supplement. This will prevent slow loss of calcium from your
bones. I recommend calcium in formulations supplemented with magnesium
and vitamin D.
† And other so-called counterregulatory hormones, such as cortisol
and growth hormone.
‡ This amounts to about 7.5 percent of the total weight of a protein
food. Say you eat a 3-ounce (85 grams) hamburger, no bun, for lunch—the
protein in it can slowly be transformed by the liver into about 6 grams
of glucose.
FAT
The Big Fat Lie
Call it the Big Fat Lie. Fat has, through no real fault of its own,
become the great demon of the American dietary scene. It is no myth
that more than half of Americans are overweight, and the number of obese
Americans is growing.
Current dietary recommendations from the government, and nearly every
“reputable” organization with an opinion, are to eat no more than 30
percent of calories as fat—which very few people can
maintain—and there are some recommendations for even lower percentages
than that. The current low-fat mania in our culture has spawned an increase
in sugar intake. All a candy or cookie has needed is the label “fat
free” to send its sales through the roof. The fallacy that
eating fat will make you fat is about as scientifically logical as saying
that eating tomatoes will turn you red.
This is the kind of fallacious thinking behind the prevailing “wisdom,”
which maintains that there is an unavoidable link between dietary protein
and fat and high serum cholesterol. And that if you want to lose weight
and reduce cholesterol, all you need to do is eat lots of carbohydrate,
limit consumption of meat, and cut out fat as much as possible. But
many contemporary researchers exploring this phenomenon have begun to
arrive at the conclusion that a high-carbohydrate
diet, especially rich in fruit and grain products, is not so benign.
In fact, it has been shown—and it is my own observation in myself and
in my patients—that such a diet can increase body weight, increase blood
insulin levels, and raise most cardiac risk factors.
In an unbiased, clearheaded, and award-winning article in the respected
journal Science of March 30, 2001, the science writer Gary Taubes explores
what he calls “The Soft Science of Dietary Fat.” (The full text of this
article is available at www.diabetes-book.com.) Taubes cites the failure
of the antifat crusade to improve the health of Americans: Since the
early 1970s, for instance, Americans’ average fat intake has dropped
from over 40% of total calories to 34%; average
serum cholesterol levels have dropped as well. . . .
Meanwhile, obesity in America, which remained constant from the early
1960s through 1980, has surged upward since then—from 14% of the population
to over 22%. Diabetes has increased apace. Both obesity and diabetes
increase heart disease risk, which could explain why heart disease incidence
is not decreasing. That this obesity epidemic occurred just as the government
began bombarding Americans with the low-fat message suggests the possibility
. . . that low-fat diets might have unintended consequences—among them,
weight gain. “Most of us would have predicted that if we can get the
population to change its fat intake, with its dense calories,* we would
see a reduction in weight,” admits [Bill] Harlan [of the NIH]. “Instead,
we see the exact opposite.”
I urge you to have a look at the article, which will give you a notion
of the kinds of competing personal, economic, and political interests
that go into the formulation of “scientific” guidelines.
The U.S. Centers for Disease Control and Prevention (CDC) released
data in the year 2000 indicating that 64.5 percent of U.S. adults were
overweight and 30.5 percent were obese. Furthermore, 25 percent of obese
teenagers now have type 2 diabetes. These statistics are occurring even
though people are eating less fat.
* Contrary to traditional thinking, a study recently published in the
Journal of the American College of Nutrition demonstrated that “fat
calories” are about the same as “carbohydrate calories.”
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