5

votes

Help. Pre-diabetic mother told to eat SAD

Answered on August 19, 2014
Created August 12, 2011 at 10:39 PM

My mother is on the heavy side but not morbidly obese. She probably needs to loose 30 or 40 pounds. She recently went to the doctor and they did a bunch of tests. She is pre-diabetic, apparently has a "relatively fast" metabolism (they did a test and told her that her metabolism was good??, and needs to loose some weight. She can't find her blood test results so I'm in the dark on her levels. Her blood sugar levels are apparently all over the place. I'm assuming that she has metabolic syndrome. She had breast cancer about 15 years ago and had a mastectomy with full reconstruction and chemo. About 8 years ago she had success with Atkins but didn't stick with it for more than 4 or 5 months. Also, she doesn't exercise and we can't seem to get her to start.

Here is what she typically eats:
Breakfast: 2 egg whites with 1 yolk, scrambled or fried in butter 1/2 a whole wheat english muffin with a little butter and jelly very small glass of orange juice.

Lunch: leftovers from dinner- usually meat and veggies. She usually steams vegetables and adds butter and spices to make them taste better. She probably has a small square of dove dark chocolate with lunch or dinner. I think sometimes she gets a chicken salad sandwhich on whole wheat from a nearby restaurant.

Dinner- Some sort of meat- usually chicken, shrimp, salmon, steak or pork loin once in a while, never fried always grilled or baked. sometimes meatloaf, with vegetables (broccoli, carrots, rarely corn) and sometimes a small baked potato. also a small glass of red or white wine probably 3 to 4 times a week.

She has low level gastritis so she cut way down on the orange juice in the morning and no longer drinks coffee. She doesn't drink soda, she cooks with butter or olive oil. About once every few weeks she'll bake chocolate chip cookies and probably eat 5 or 6 over the course of a day or two.

Her doctor sent her to this place. What are they telling her? To "eat whole grains, throw away yolks from eggs, focus on reducing fats, and count calories." They told her that her portions are too big. I've seen how much she eats. Her portions are on the small side of normal.

I'm seriously going to SCREAM I'm so furious. She's already eating the way they want her to, with the exception of lowering her caloric intake and dropping the tablespoon of jelly in the morning. How could their suggestions make a difference? Would lowering calories do anything for her insulin resistance?

I need help explaining to her and to my dad the flaws in these suggestions and why VLC would heal the root of the problem. Today my dad asked me "well, if your body has to convert everything to glucose to use it as energy, what does it matter whether you eat fat or carbs?" I understand a little bit about leptin resistance and insulin resistance but its all kinda muddled and I need to be able to explain it in an easy to understand way.

My plan thus far:
I'm headed out to Barnes and Noble to buy Good Calories Bad Calories.
I think the only way to heal her deranged metabolism is to go VLC for a while and slowly introduce carbs back into her diet to find a maintenance level.

UPDATE- I got my hands on her test results:
lipid panel:
cholesterol total: 180 hdl: 56 Trigs: 99
Glucose,serum 113
Hemoglobin: 14.6
Hemoglobin a1c 6.3
Hematocrit: 43
Vitamin d: 26.6

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on August 14, 2011
at 05:21 PM

Bernstein has a GREAT book. Everyone should read it, not just diabetics.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on August 13, 2011
at 09:28 PM

I only wish they had their head buried in 1950. The advice before the low fat/no fat craze was better for diabetics. She should eat high fat/moderate protein/low carb. Test everything that she eats for 2 weeks with a BS monitor. Then you will never have to ask an "expert" if this is good or right for her. If her BS goes over 130...bad for her. If it stays below 120...1 hour after eating...ok. Check her C-Peptide to see how much insulin she produces. Check Leptin...Read Dr. Bernstein, Dr. Ron Rosedale, Jenny @ www.phlaunt.com (diabetes 101)...this is for you too. Good luck and better health.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 13, 2011
at 09:21 PM

WayfinderAli: Here's an article that would make a great quick read for you Mom and start steering her in the right direction. Could also be a nice handout for a SAD dietician trying to convince her to do the standard SAD-diabetes thing... http://www.latimes.com/health/la-he-carbs-20101220,0,5893431,full.story

Medium avatar

(2169)

on August 13, 2011
at 07:37 PM

Its insane to me that they tell her to lower her fat intake, when that is the one fuel she can use that won't spike her insulin levels. I just feel like so many "doctors" and "specialists" have their heads buried in 1950. I think low carb paleo will make her feel better, help her deranged metabolism and help her loose weight. Thanks for the great response. Its nice to know I was thinking in the right direction

149af6e19a06675614dfbb6838a7d7c0

(3202)

on August 13, 2011
at 07:30 PM

This is no cure either. Restrict your cals for a time then what? When they go back to "normal" eating ...still the insulin resistance. Just as the majority of bariatrics who are "cured" relapse, so to with this. Of course Paleo is sustainable, that is why we are here.This is no cure. Low Carb Paleo is control. That is great. Low carb/high fat Paleo not only controls Diabetes but it mimics the calorie restricted diet.

4bf5827bfb7df85c5b4b485db0945e64

(1386)

on August 13, 2011
at 04:36 PM

Cool. Yeah, basically trying the diet for 30 days is a good idea with no/low risk, especially since you have some baseline numbers with these blood tests. Then check them again after the 30 days. But keep in mind what I said about LC. If she is eating more CHO, then the GTT is more relevant but if she really was on the LC-side, then the GTT could have been inaccurate based on what I had said.

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on August 13, 2011
at 08:21 AM

The study was 8 weeks long and MRI scans confirmed that the pancreas & liver returned to normal functioning. The diet is 800kcal when the veggie meal is added. No, it's not sustainable, but following a paleo diet after the 8 weeks is sustainable. It's all very well controlling diabetes with LC paleo, but it's no cure. I think this study worked because it helped heal a leaky gut/gut issues/micronutrient deficiencies. Not just because it was low calorie.

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on August 13, 2011
at 08:14 AM

Oh yep, Bernstein! Not read his book, but diabetics seem to like it.

Medium avatar

(2169)

on August 13, 2011
at 02:12 AM

Thanks Stabby! That link rocks. I'll be picking up a copy of the Paleo Solution too. Maybe I should start with that one and read GCBC afterward.

Medium avatar

(2169)

on August 13, 2011
at 02:06 AM

Thanks for the tips, I'll check all of those out!

Medium avatar

(2169)

on August 13, 2011
at 02:06 AM

I bought GCBC today and recognize it is a pretty intense read. I'm planning to read it and the other books suggested here over the course of the next couple of weeks with the idea that I can be the filter. I'll be out on a 2+ week long cross country road trip with my boyfriend and will have lots of time to read in the car. Thanks for the Bernstein tip, that sounds more like what I want to steer her towards. Thanks for the support!

Cbb1134f8e93067d1271c97bb2e15ef6

on August 13, 2011
at 01:54 AM

+1 for obviously important question and great detail with diet etc in an attempt to help you Mom.

Medium avatar

(2169)

on August 13, 2011
at 01:01 AM

@Chapa- this is totally a possibility.

Medium avatar

(2169)

on August 13, 2011
at 12:51 AM

NVM googled CHO

Medium avatar

(2169)

on August 13, 2011
at 12:27 AM

When she gets home from this party they went to I'll get more info and update. She lost the print out of her bloodwork, otherwise I would post it here. What does CHO stand for? I've also got her started on fitday and put fitday mobile on her phone so we can get a more accurate idea of what she is actually eating.

C0fcb48d7da4f76fac17318efd2cd6b8

(4069)

on August 12, 2011
at 11:49 PM

My Mom is a full blown SAD diabetic twice a day diabetic. She has the same sort of diet that your Mom says she eats. What I find in her fridge is however: a half eaten muffin, an old pie, five boxes of brown sugar in the cupboard, ice cream in the freezer- uneaten but ready, for tat special alone time, just in case. So My Mom eats really small portions of OK seeming food, but kinda hidden in the crevices of her life is all the stuff- and the thinking and emotions behind it- that keeps her a twice a day insulin dependent diabetic. Just sayin'.

Medium avatar

(39831)

on August 12, 2011
at 11:18 PM

Ascorbate intake leads to urate excretion, so the vitamin C from a glass of orange juice is negated by the huge fructose load. Strawberries have fructose, but it's very little, especially compared to their vitamin c content. A better choice if she can stomach it would be red bell peppers, but that may aggravate things. Perhaps optimally would be a period of as close to 0g of fructose intake for 2 weeks and then the aforementioned recommendations.

Medium avatar

(2169)

on August 12, 2011
at 11:13 PM

I was hoping you would comment! Thanks for the great advice. I'll talk to her about how much fruit she's eating. Could you explain: "her vit C intake is soaked up by fructose intake" further? I don't understand this relationship. Also, don't strawberries have lots of fructose? So it would be better to get her to take sodium ascorbate instead of eating strawberries?

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10 Answers

6
Cbb1134f8e93067d1271c97bb2e15ef6

on August 13, 2011
at 01:43 AM

If you haven't yet bought GCBC, consider holding up on that. Although in my opinion, it is an excellent read, I don't believe it is what will be most helpful to your Mom right now. It's a pretty heavy read with alot of info that for your Mom right now is superfluous, may be overwhelming, and won't give her the blueprint she needs now to begin most successfully managing her diabetes.

Check out Dr. Bernstein's site and his book. This book is written by a physician who himself suffered from type 1 diabetes from the age of 12 and prior to researching and finding the solution (low carb) for his disease, was suffering from advanced medical complications.

Your Mom would come out with the info + the exact tools she needs to begin to manage her diabetes successfully.

Note also the podcasts on the site available for listening, as well as a 60 min free teleseminar/webcast scheduled for August 31, that you could register for and listen to together.

http://www.diabetes-book.com/index.shtml

Best to you all!

Medium avatar

(2169)

on August 13, 2011
at 02:06 AM

I bought GCBC today and recognize it is a pretty intense read. I'm planning to read it and the other books suggested here over the course of the next couple of weeks with the idea that I can be the filter. I'll be out on a 2+ week long cross country road trip with my boyfriend and will have lots of time to read in the car. Thanks for the Bernstein tip, that sounds more like what I want to steer her towards. Thanks for the support!

3
Medium avatar

on August 12, 2011
at 11:09 PM

Is it at all possible that there is more fructose in her diet than she told you? If so, that's the first thing that I would focus on. Is she sedentary? Adding activity should do wonders for insulin resistance in her muscles. It seems like her vitamin C intake is totally soaked up by her fructose intake. The hyperuricemia from the fructose metabolism is a likely factor in her insulin resistance. Cutting out anything sweet and adding a vitamin C supplement like sodium ascorbate should help out without aggravating her stomach. At the very least, she could replace orange juice and jam with whole strawberries.

Medium avatar

(39831)

on August 12, 2011
at 11:18 PM

Ascorbate intake leads to urate excretion, so the vitamin C from a glass of orange juice is negated by the huge fructose load. Strawberries have fructose, but it's very little, especially compared to their vitamin c content. A better choice if she can stomach it would be red bell peppers, but that may aggravate things. Perhaps optimally would be a period of as close to 0g of fructose intake for 2 weeks and then the aforementioned recommendations.

Medium avatar

(2169)

on August 12, 2011
at 11:13 PM

I was hoping you would comment! Thanks for the great advice. I'll talk to her about how much fruit she's eating. Could you explain: "her vit C intake is soaked up by fructose intake" further? I don't understand this relationship. Also, don't strawberries have lots of fructose? So it would be better to get her to take sodium ascorbate instead of eating strawberries?

2
5113df7e1c5a7e9c7555b6b59144de24

(920)

on August 13, 2011
at 04:51 AM

If her blood sugars are all over the place, you may want to read "Blood Sugar 101" by Jenny Ruhl. She has a website by the same name. http://www.phlaunt.com/diabetes/

2
64433a05384cd9717c1aa6bf7e98b661

(15236)

on August 13, 2011
at 02:26 AM

Today my dad asked me "well, if your body has to convert everything to glucose to use it as energy, what does it matter whether you eat fat or carbs?"

This is not true, our body can very easily burn fat and ketone bodies, and many cells actually prefer them.

Our body converts everything to ATP, which is the energy currency of the body. Fat is a much better source of generating ATP than glucose and does not get converted to glucose first.

I'd also suggest Dr. Eades' book over GCBC.

2
8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on August 13, 2011
at 12:21 AM

Sounds like they trust doctors, so why don't you suggest plans by doctors, like Protein Power, Rosedale or Bernstein?

Medium avatar

(2169)

on August 13, 2011
at 02:06 AM

Thanks for the tips, I'll check all of those out!

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on August 13, 2011
at 08:14 AM

Oh yep, Bernstein! Not read his book, but diabetics seem to like it.

8949bf87b0e0aefcad10f29975e4fa2b

(8989)

on August 14, 2011
at 05:21 PM

Bernstein has a GREAT book. Everyone should read it, not just diabetics.

2
C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on August 12, 2011
at 11:23 PM

I have diabetes, it seems "mild" in comparison to others - I must've been diagnosed early, that's all.

I've personally found that cutting dairy has helped immensely. Even going LC with dairy didn't bring my levels into line (resting around 90 ish, but now around 70-90).

I believe Walmart does a very cheap glucometer called the Relion.

Have a look at :http://www.diabetes-warrior.net/ & http://lowcarbdiabetic.co.uk/

Prof Taylor et al have reversed diabetes recently, so this could be something to think about: http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

There are some people in the UK who are undertaking this diet now of their own accord. I am going to see my GP this week to discuss this too... eek!

1
149af6e19a06675614dfbb6838a7d7c0

on August 13, 2011
at 05:41 AM

Prof Taylor et al have reversed diabetes recently, so this could be something to think about: http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

Reverse it till when? This is a 600 cal diet. After you are off of it...what now? Be realistic...600 can't be sustained...it is not enough. Didn't you see the movie "300"...

After she is ready to change, get the CDs of Dr. Bernstein with a Type 2. She can listen at her leisure and learn. http://www.diabetes911.net/secrets.php

Fat is the one macro that won't raise her blood sugar. Educate yourself and her. Normal BS www.phlaunt.com...and read Dr. Rosedale to understand why high insulin is as dangerous as high blood sugar.

Breakfast: 2 egg whites with 1 yolk, scrambled or fried in butter 1/2 a whole wheat english muffin with a little butter and jelly very small glass of orange juice.

The yolk and butter are all that is good about breakfast. Lunch... chicken salad sandwhich on whole wheat...ditch the bread.

Dinner...carrots, rarely corn) and sometimes a small baked potato...again, not for her. go to green leaves...in a day this combo for food has too many sugary carbs. She is carb intolerant. More veggies and fat. Save yourself then save her.

149af6e19a06675614dfbb6838a7d7c0

(3202)

on August 13, 2011
at 09:28 PM

I only wish they had their head buried in 1950. The advice before the low fat/no fat craze was better for diabetics. She should eat high fat/moderate protein/low carb. Test everything that she eats for 2 weeks with a BS monitor. Then you will never have to ask an "expert" if this is good or right for her. If her BS goes over 130...bad for her. If it stays below 120...1 hour after eating...ok. Check her C-Peptide to see how much insulin she produces. Check Leptin...Read Dr. Bernstein, Dr. Ron Rosedale, Jenny @ www.phlaunt.com (diabetes 101)...this is for you too. Good luck and better health.

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on August 13, 2011
at 08:21 AM

The study was 8 weeks long and MRI scans confirmed that the pancreas & liver returned to normal functioning. The diet is 800kcal when the veggie meal is added. No, it's not sustainable, but following a paleo diet after the 8 weeks is sustainable. It's all very well controlling diabetes with LC paleo, but it's no cure. I think this study worked because it helped heal a leaky gut/gut issues/micronutrient deficiencies. Not just because it was low calorie.

Medium avatar

(2169)

on August 13, 2011
at 07:37 PM

Its insane to me that they tell her to lower her fat intake, when that is the one fuel she can use that won't spike her insulin levels. I just feel like so many "doctors" and "specialists" have their heads buried in 1950. I think low carb paleo will make her feel better, help her deranged metabolism and help her loose weight. Thanks for the great response. Its nice to know I was thinking in the right direction

149af6e19a06675614dfbb6838a7d7c0

(3202)

on August 13, 2011
at 07:30 PM

This is no cure either. Restrict your cals for a time then what? When they go back to "normal" eating ...still the insulin resistance. Just as the majority of bariatrics who are "cured" relapse, so to with this. Of course Paleo is sustainable, that is why we are here.This is no cure. Low Carb Paleo is control. That is great. Low carb/high fat Paleo not only controls Diabetes but it mimics the calorie restricted diet.

1
Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on August 13, 2011
at 02:06 AM

Well, paleo has been demonstrated to be superior to the SAD diet in a clinical study http://www.ncbi.nlm.nih.gov/pubmed/19604407 So there!

I would go for The Paleo Solution by Robb Wolf over GCBC. There is just a lot more useful information for someone getting into natural health in Robb's book, and it isn't so hard to read except for one part, but he lets you skip it if you want. The study I linked to above is all the evidence she needs. Better than the standard diet, for real. And that isn't even educated paleo, it's just a general paleo diet. I really don't know how to improve upon the SAD diet except making it as nutritious and paleo as possible. But Robb's book also shows how much better a paleo diet is for nutrition. Plus there are definitely ways to make a paleo diet better and it's a good springboard into advanced nutrition.

The caveat is that if she just eats from the paleo list of foods she will improve, but not as much as if she gets into holistic health and advanced nutrition. Effort=success.

edit: and here's the abstract of another http://www.ncbi.nlm.nih.gov/pubmed/19209185

Medium avatar

(2169)

on August 13, 2011
at 02:12 AM

Thanks Stabby! That link rocks. I'll be picking up a copy of the Paleo Solution too. Maybe I should start with that one and read GCBC afterward.

0
8c2d9e2db306fbe72d857fcea4ee8778

on August 13, 2011
at 03:24 AM

In addition to the good advice re: paleo/lc books dealing diabetes, such as those of Dr. Richard Bernstein, perhaps you could persuade her to simply TRUST you enough to follow one of these plans, to the letter, for a month, and get blood work immediately before and after...

0
4bf5827bfb7df85c5b4b485db0945e64

(1386)

on August 12, 2011
at 11:35 PM

Maybe them saying her metabolism was good was referring to some thyroid function tests? Like TSH, T4, and T3?

You say she's obese. You also say you have no idea what her blood results are and her blood sugar was all over the place. Maybe some more information is needed here. Anyway, if someone is obese, I think it's safe to say they are leptin resistant and, probably more likely than not, insulin resistant.

Is it possible your mom is already on a LC diet? Half a whole-wheat English muffin is only 26 grams of CHO and also contains almost 4 grams of fiber. The orange juice might add around 20 grams of CHO if it's around 6 oz. and a little bit of jelly seems pretty small. So we're talking 50 grams of carbohydrate a day plus the small amounts of CHO in the garden variety kinds of veggies. Furthermore, if someone is LC and then they are administered a GTT (glucose tolerance test), they're going to fail it because of the down regulation of pancreatic glucokinase.

So my question is whether or not she tapered her CHO intake up a week prior to being tested?

Medium avatar

(2169)

on August 13, 2011
at 12:27 AM

When she gets home from this party they went to I'll get more info and update. She lost the print out of her bloodwork, otherwise I would post it here. What does CHO stand for? I've also got her started on fitday and put fitday mobile on her phone so we can get a more accurate idea of what she is actually eating.

Medium avatar

(2169)

on August 13, 2011
at 12:51 AM

NVM googled CHO

4bf5827bfb7df85c5b4b485db0945e64

(1386)

on August 13, 2011
at 04:36 PM

Cool. Yeah, basically trying the diet for 30 days is a good idea with no/low risk, especially since you have some baseline numbers with these blood tests. Then check them again after the 30 days. But keep in mind what I said about LC. If she is eating more CHO, then the GTT is more relevant but if she really was on the LC-side, then the GTT could have been inaccurate based on what I had said.

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