For anyone interested in fine-tuning their nutrition plans a little more, here's a great article from Andrew Berry on the calculations to use for determining how many grams of carbs, protein and fats your body needs!
Your Nutrition Plan - Changing Eating Habits Part II
Ginger
Is this guy HIGH??? Does he know the types of problems associated with consuming that much protein???
Hahah, Andy, I think you'll find you're referring to some very old theories about protein!
The American Diabetes Association and American Dietetics Association have both agreed that a higher protein diet and less carbs is HUGELY beneficial to not only people with diabetes, but most people in general. High carbs are actually much more likely to lead to high triglyceride levels (the LDL count, of course) because of the spike in blood sugar combined with insulins power to store fat on the body.
Unless someone suffers from kidney problems, a diet higher in lean and healthy protein is an incredibly good idea. THere is no concrete data to justify any problem with higher protein diets. Many rumors and theories have gone around, but the research never follows through to support that it's bad. In fact, it supports the opposite.
Ginger
False, false, false. You claim you are doing research but you never cite your sources. Plus, you are trying to translate advice for type 2 diabetics to type 1 diabetics, which is a huge mistake.
If someone is overweight, cutting carbs (or fat for that matter, possibly to a slightly lower degree) is absolutely beneficial. But pushing this advice on lean type 1 diabetics is preposterous. I would LOVE to see any research you find relating specifically to type 1 diabetics and the benefits of a low carb, high protein diet. Either you haven't been involved in academia for quite some time, or you are basing your ideas off of modern cultural ideas about nutrition.
Here is an article I will cite that actually shows an association in the opposite:
BACKGROUND: Persons with type 1 diabetes have received widely varying dietary advice based on putative effects on glycemic control.
OBJECTIVE: The objective was to determine whether diet composition was associated with subsequent glycated hemoglobin (Hb A1c) concentrations during intensive therapy for type 1 diabetes.
DESIGN: We examined associations between quantiles of dietary intake and Hb A1c adjusted for age and sex in 532 intensively treated participants in the Diabetes Control and Complications Trial (DCCT) who had complete dietary data through 5 y of follow-up. Multivariate macronutrient density linear regression models tested the association of Hb A1c at year 5 with macronutrient composition and were adjusted for age, sex, exercise, triglyceride concentration, body mass index (BMI), baseline Hb A1c, and concurrent insulin dose.
RESULTS: Higher insulin dose, lower carbohydrate intake, and higher saturated, monounsaturated, and total fat intakes were associated with higher Hb A1c concentrations at year 5. In age- and sex-adjusted multivariate macronutrient models, substitution of fat for carbohydrate was associated with higher Hb A1c concentrations (P = 0.01); this relation remained significant after adjustment for exercise level, serum triglycerides, and BMI (P = 0.02) but was no longer significant (P = 0.1) after adjustment for baseline Hb A1c and concurrent insulin dose.
CONCLUSION: Among intensively treated patients with type 1 diabetes, diets higher in fat and saturated fat and lower in carbohydrate are associated with worse glycemic control, independent of exercise and BMI.
Source: http://www.ajcn.org/cgi/content/abstract/89/2/518
If you're interested in what is currently recommended by the ADA (diabetes assoc) for type 2 diabetics, I've listed their current POSITION STATEMENT in article #1. There are also a few other studies attached, too (2-8), that explain the respective benefits of low carb diets, ketogenic diets, low fat diets, and low glycemic index diets. Finding one article and claiming it as the only thing that should be recommended for diabetics is not good policy. It's necessary to perform a review of the literature out there and weigh the pros and cons of all articles. The ADA has done this and currently supports a great diet - the personalized diet. Cutting total kilocalories and including regular exercise is essential, but the source of kcal cuts - whether fat or carbohydrate - does not make much difference. And many people fear the long-term benefits of extrememly low carb, ketogenic diets. Ketosis is what first sent us all to the hospital!
1. American Diabetes Association position statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. J Am Diet Assoc. 2002;102(1):109-118.
2. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes. Ann Intern Med. 2005;142(6):403-411.
3. Westman EC, Yancy Jr WS, Mavropoulos JC, Marquart M, McDuffie JR. The Effect of a Low-carbohydrate, Ketogenic Diet versus a Low-glycemic Index Diet on Glycemic Control in Type 2 Diabetes Mellitus. Nutr Metab (Lond). 2008;5:36.
4. Atkins RC, Dr. Atkins’ New Diet Revolution (Rev. ed.), New York: Avon Books; 1998.
5. Daly ME, Paisey R, Millward BA et al. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial. Diabet Med. 2005;23(1):15-20.
6. Sargrad KR, Homko C, Mozzoli M, Boden G. Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus. J Amer Diet Assoc. 2005;105(4):573-580.
7. Heilbronn LK, Noakes M, Clifton PM. The Effect of High- and Low-Glycemic Index Energy Restricted Diets on Plasma Lipid and Glucose Profiles in Type 2 Diabetic Subjects with Varying Glycemic Control. J Amer Coll Nutr. 2002;21(2):120-127.
8. Wolever TM, Gibbs AL, Mehling C, et al. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr. 2008;87(1):114-125.
Hi,
A few links below for you. Overall, the implications of simple biochemistry make perfect sense for why a low-carb diet will improve both Type 1 and Type 2 as the carbs require insulin which stores fat which raises HDL. More protein in a diet provides a steady form of sustainable fuel that does not spike blood sugar and requires siginificantly less insulin.
1. From PUB-MED: http://www.ncbi.nlm.nih.gov/pubmed/19167958?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
2. From D-SOLVE: http://www.dsolve.com/news-aamp-info-othermenu-60/23-diabetes-solution/163-lowcarbtrial
3. http://74.125.47.132/search?q=cache:frbyAA5-TTQJ:www.diva-portal.org/diva/getDocument%3Furn_nbn_se_pub_diva-74-2__fulltext.pdf+low-carbohydrate+research+for+type+1+diabetes&cd=10&hl=en&ct=clnk&gl=us&client=firefox-a
ALow Carbohydrate Diet in Type 1 Diabetes:
Clinical Experience
– ABrief Report
Jørgen Vesti Nielsen, Eva Jönsson, Anette Ivarsson
Department of Medicine, Blekingesjukhuset, Karlshamn, Sweden
ABSTRACT
Due to failure to achieve control twenty-two patients with type 1 diabetes with sympto-
matic fluctuating blood glucose started on a diet limited to 70-90 g carbohydrates per
day and were taught to match the insulin doses accordingly. The caloric requirements
were covered by an increased intake of protein and fat. The purpose was to reduce the
blood glucose fluctuations, the rate of hypoglycaemia and to improve HbA1c.
After three and 12 months the rate of hypoglycaemia was significantly lowered from
2.9 + 2.0 to 0.2 + 0.3 and 0.5 + 0.5 episodes per week respectively. The HbA1c level
was significantly lowered from 7.5 + 0.9 % to 6.4 + 0.7 % after three months and was
still after 12 months 6.4 + 0.8 %. The meal insulin requirements were reduced from
21.1 + 6.7 I.U./day to 12.7 + 3.5 I.U./day and 12.4 + 2.6 I.U./day after three and 12
months respectively.
Furthermore the triglyceride level was significantly lowered whereas the levels for
total cholesterol and HDL-cholesterol were unchanged.
Conclusion: the present report shows that a 70-90 g carbohydrate diet is a feasible
long-term alternative in the treatment of type 1 diabetes and leads to improved gly-
caemic control.
ANDY:
I wasnt when I wrote this. JK.
Here's a section pertaining to kidney function from a recent T-Nation.com article.
Kidney Function
It's common dogma among physicians that high protein diets are bad for your kidneys. Dr. Lowery here at TMUSCLE has beaten that idea pretty much to death recently.(6) So I won't get in to too much detail here on that. But the bottom line is that high protein intake may be harmful to your kidneys, and it may not be. We have literally no evidence to go on one way or the other. So your doctor pretty much doesn't have a leg to stand on when he tells you that you're killing your kidneys.
The notion that protein is harmful comes from studies of people with damaged kidneys—people with either chronic renal insufficiency (CRI) or chronic renal failure (CRF). In these people there's no doubt about it. The higher your protein intake, the faster your kidney disease is going to worsen.
It makes sense when you think about it. These are people whose kidneys can't even keep up with the basic demands their bodies place on them. Increasing the demand on the kidneys above that basal state can't possibly be good. But can we extend that principle to people with normal and healthy kidneys? There's no reason to think we can, and a lot of reasons to think we can't.
The kidneys are remarkably robust organs with a lot of excess capacity. In fact, you have to lose about 75% of the functioning units (nephrons) in your kidneys before we even see changes in your kidney function tests. And that doesn't even take into account the fact that the kidney can dramatically increase its filtration rate from the resting state in a healthy adult.
An analogous situation occurs with the heart. In a healthy adult, HIIT, or any kind of cardio for that matter, is good for your heart. But take someone with heart failure, or severe coronary artery disease. It's probably not a good idea for them to start running stair laps.
Heck, that's why all the ED drugs have disclaimers to ask your doctor if it's safe for you to have sex. If you take an already weakened heart and stress it, bad things can happen. But you don't see doctors recommending healthy people avoid exercise, do you?
Our next concern regarding kidneys is the blood tests doctors use to determine how well they're functioning. There are two numbers in particular we're interested in: Blood Urea Nitrogen (BUN) and blood creatinine (Cr).
BUN is a waste product of protein metabolism. Creatinine is a breakdown product from the creatine phosphate found in your muscles, heart and brain. Doctors normally check these values with a simple blood test, which tells them the concentration of each.
Here's where things get tricky—and where doctors can make wrong assumptions. The concentration of these substances in your blood is affected by multiple factors, only one of which is kidney function. BUN concentration changes with your hydration status (low when you're well-hydrated, high when your dehydrated).
It also changes in response to how much protein you're digesting and turning over. The more protein you take in, the higher your BUN is going to be.
Creatinine on the other hand is a lot more stable. It's produced at a relatively constant rate; higher or lower depending on how much muscle you have, due to the constant process of muscle breakdown and rebuilding.
As such, the concentration in your blood has a lot to do with how much lean body mass you have. That said, there are certain things that can make your creatinine spike. Severe infections or other stressors increase muscle breakdown as a consequence of the cortisol and inflammatory hormones coursing through your body. For the same reason, a particularly intense workout or competition can do the same thing.
There is a 'normal range' for each of these things. And people with blood levels of BUN and Cr that are outside of this range often do have kidney problems.
On the other hand, there are a heck of a lot of weight trainers that end up seeing abnormal values in their bloodwork, which can set them and their doctors to freaking out.
But these 'normal' ranges are based on the assumption that you're 'normal' when it comes to all of those other factors I just discussed. Higher protein intake means a higher BUN. Higher lean body mass means a higher blood Cr. Greater physical stressors (and consequent increase in creatine turnover) means a higher Cr. Do you think any of these factors apply to T-Men? Darn right they do.
So your blood test comes back and your renal function tests indicate a possible problem. The doctor calls you in a panic, telling you that you've murdered your kidneys with all that protein and creatine and you need to stop them now. What do you do?
Well, your doctor's just overextended himself. He actually has no clue how your kidneys are doing and neither do you. But it's okay, because we do have the tools to directly calculate how well your kidneys are working, we just don't use them very often.
But it's going to need a piss test. One heck of a piss test. Twenty-four hours' worth of pee in an opaque jug to be exact. You see, the only way to figure out if your kidneys are filtering waste products well enough is to see how much they're excreting. Seems like common sense, doesn't it?
What I would do is ask to do a direct creatinine clearance measurement. You're going to want to hold off on working out for a couple days—which will drop your creatine down to the basal level from simple muscle turnover—but I wouldn't stop taking protein and creatine.
After you've given your system time to clear out any possible stress-related increase in creatinine production, come back in for another blood test and to grab the jug. The lab will compare your blood concentration of Cr to the amount in your urine. This will tell us exactly how well the kidney is disposing of waste, and allow us to control for all those ways in which you're 'abnormal'.
Like I said, it could turn out that your kidneys really are in rough shape. But more than likely it's just the fact that you get more protein and have more muscle than most.
here's the full article: http://www.t-nation.com/free_online_article/sex_news_sports_funny_grok/what_your_doc_doesnt_know_about_weightlifting
if this doesn't satisfy you, i can find some other articles from the medical journals.
Andrew Berry
MadEvans,
In addition, a diet so low in carbs that it would induce ketosis is obviously harmful. That's not what I'm advocating or suggesting. A diet lower in carbs than the average 200 + diet and higher in healthy protein is NOT going to induce ketosis. And ketones formed during hyperglycemia is when insulin isn't present in order to flush the ketones. If/when ketones are formed and plenty of insulin is present, it is much different situation. Either way, no one, at any point, suggested eliminating carbs entirely. Be careful of leaping to radical assumptions and assuming the others on this website are clueless, lacking any real life experience behind the words they are typing.
Ginger
Plus, you are trying to translate advice for type 2 diabetics to type 1 diabetics, which is a huge mistake.
If someone is overweight, cutting carbs (or fat for that matter, possibly to a slightly lower degree) is absolutely beneficial. But pushing this advice on lean type 1 diabetics is preposterous. I would LOVE to see any research you find relating specifically to type 1 diabetics and the benefits of a low carb, high protein diet. Either you haven't been involved in academia for quite some time, or you are basing your ideas off of modern cultural ideas about nutrition.
MAD EVANS:
First and foremost I'm not going to try and play the citation game because there are studies done and articles written to support both of our views. When I make my recomendations, I take into account many things such as scientific studies, journal articles, my two degrees in the nutrition field, anecdotal evidence from others, my own personal experiences and my common intuition. I also want to say that my recomendations are not the end all/be all of nutrition advice. Other methods work for sure, but I believe that my methods are the quickest and most effective asuming that the person is or is trying to become motivated, trains hard, wants to lose body fat and maintain/gain muscle.
Plus, you are trying to translate advice for type 2 diabetics to type 1 diabetics, which is a huge mistake
sorry got to go to bed. ill hit the rest later
When you look at a healthy person, a type 1 diabetic and a type 2 diabetic and break down their
[quote user="Ginger Vieira"]
Hi,
A few links below for you. Overall, the implications of simple biochemistry make perfect sense for why a low-carb diet will improve both Type 1 and Type 2 as the carbs require insulin which stores fat which raises HDL. More protein in a diet provides a steady form of sustainable fuel that does not spike blood sugar and requires siginificantly less insulin.[/quote]
Ginger, it sounds like you're aware of biochemistry. Excess protein, just like excess carbohydrate will turn into either glucose for quick use or fat for storage. Protein, when metabolized into amino acids, will have its carbon backbone utilized for conversion into fat. Just like carbs are. A reduction in total kcals is the only requirement for weight loss (of course in addition to normal exercise). And, in no way was I questioning that you were not educated; I am completely aware of your educational history. However, I do believe that you developed your ideas based off of the spoken word from your professors and a selected few research articles. The ADA does not support a reduction in carbohydrates (be it moderate or severe) in every single diabetic, not every type 1 and not every type 2, so I would like to get it out there and tell the Juvenation community that this is in no way based on recommendations from the American Diabetes Association. That's all. The low carb thing may work for you, great. But, to push it on to others like it is the best diet for everyone is not only ill-advised, but may exacerbate their disease state.
EDIT: And I assume you meant "lowers HDL" in your post there.
As before, be careful of making such major assumptions. My knowledge and advice on nutrition is not from a text book. I'ave had diaebtes for ten years, and am a personal trainer and powerlifter training at an intensity that a diabetic would only be able to maintain with very thorough nutritional knowledge and adherence. In my workplace, there are also people who train for bodybuilding shows, for example, who do for a short period of time cut carbs drastically - and no, this is not healthy, and this is not what I'm advocating. Despite that, the effect on insulin needs and production that reducing carbs in any person's diet will result in a more maitained blood sugar level throughout the day. I am not saying you should replace your carbs with bacon and butter.
A diet of lean proteins, lots of low-GI vegetables and healthy fats from nuts, fish and olive oil is going to help many average americans. Carbs such as oatmeal, brown rice, sweet potato, etc., are suggested for breakfast when your glycogen stores are low, and after a workout, again, when your glycogen stores have been depleted. You are not going to induce ketoacidosis.
Have 2 degrees in nutrition is an excellent start, having to ever applied them to your own body or experimented with different approaches while training at intensity where your body clearly relies on your nutrition source and blood sugar maintance for its full recovery is a very clear way of learning about your body and your diabetes. I've had type 1 diabtes for ten years, and I didn't gain 20 pounds of muscle in less than two years and work my way to a competitive level in powerlifting by following any advice professors gave me. The last nutrition professor I had, in fact, was severely overweight.
Looks like we'll agree to disagree. Hit me up in ten years, when you've been diabetic for longer than 3, and let me know what you've learned about your diabetes as your body's needs change. It's a fascinating process that you can't learn from a text book.
Cheers.
-Ginger
[quote user="Ginger Vieira"]
As before, be careful of making such major assumptions. My knowledge and advice on nutrition is not from a text book. I'ave had diaebtes for ten years, and am a personal trainer and powerlifter training at an intensity that a diabetic would only be able to maintain with very thorough nutritional knowledge and adherence.
I've had type 1 diabtes for ten years, and I didn't gain 20 pounds of muscle in less than two years and work my way to a competitive level in powerlifting by following any advice professors gave me.
Looks like we'll agree to disagree. Hit me up in ten years, when you've been diabetic for longer than 3, and let me know what you've learned about your diabetes as your body's needs change. It's a fascinating process that you can't learn from a text book.
[/quote]This is exactly what I was hoping you'd say. I just wanted to ensure that the rest of the Juvenation community was aware that this diet plan is not, by any means, recommended by ADA - which is an organization that reviews scientific literature to make its recommendations.
So, to all those out there who are hoping to gain lots and lots of muscle and be able to lift tons of weight, this article may have something for you. For those of you that simply intend on eating a balanced diet and maintaining tight glucose control, there is less for you to gain from this article. It works for Ginger, but that in no way means it is an appropriate recommendation for every diabetic.
Low carb diets can work wonders to decrease body weight and improve blood lipids. Low fat diets also improve these parameters. If you are a fairly lean type 1 diabetic, which many of us are, then low carb diets are neither required nor recommended. Low glycemic index, complex carbohydrate foods are some of the best sources of fuel and nutrients out there. Excess protein will convert into triglycerides just like excess carbs and fats do.
Keep those A1C values low, continue maintaining normal blood lipid values, and exercise regularly.
All the best,
MadEvans
"When you've been diabetic for longer than 3 [years], let me know what you've learned about your diabetes as your body's needs change."
Thanks for the ad hominem attack on me there.
You still seem to entirely miss my point and have skewed everything together, making statements I did not actually say. I did not EVER say "eat this way to gain muscle"...etc. These recommendations are for the average diabetic looking for stable blood sugars.
Let it go, Mad Evans, before you completely confuse everyone.
Thanks for the conversation. Good luck in your medical pursuits. Your tenacity and passion for research and health are absolutely qualities of a successful doctor.
-Ginger
Hey Guys!
Check it out: I won my first powerlifting meet!
http://gingervieira.blogspot.com/
"BEST OVERALL FEMALE
LIFTER" and best in my weight class for Junior and Open.
Actually
found out I set 7 records for the WPA Federation in all three lifts for
"Raw" lifting between the Junior and Open division for 148lbs.
265 squat.
300 dead. 170 bench, 185 DQ cuz I racked too soon.
Total 735 score baby! Nobody else even came close :)