diet plan recommendation questions

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Tanya posted on Thu, Jul 23 2009 7:02 PM

I am trying to get back on track again after some lapses in managing my diabetes and I have questions about diet plan and Joslin recommendations.  In particular, I would like to know how to put together/calculate/balance a diet plan with the 40% carb and slightly higher protein that I saw as currently recommended on the Joslin website. That seems different from what I see elsewhere.

I'm a 47 year old obese woman. I was diagnosed with Type II diabetes approximately 4 years ago. My PCP sent me to diabetes education (in Portland, Maine) which I completed. 

I was surprised at the time how many carbs were prescribed on the diet the dietition gave me, probably 55% and maybe 3 ounces of protein a day. Even during times that I am overeating, eating junk etc., though I clearly eat too many calories, too many bad fats and too many simple carbs,  I have never had a bowl of cereal and two pieces of toast for breakfast.  Maybe this is just subjective, but whenever I have been on that kind of ratio of carbs to protein with low fat I have felt  weak and hungry on and off throughout the day. I remember this particularly long before I was diagnosed with diabetes, back in the early 90's when my husband insisted that we go on the super low fat diet where dinner might be spaghetti with tomato sauce.

Of course I need to lose weight, and my other concern is that on the previous calorie restricted diet my dietition gave me, there was a relatively low proportion of the fruits, vegetable and milk that I read are important to health, as well as so little protein that it was hard to work enough oily fish in.

I am going to my new doctor in Austin next week and I am sure he will once again refer me to a diabetes educator (though I am not insured and cost will be an issue.) I am wondering if diabetes educators in general are now prescribing the formula recommended on the Joslin website, and if not, how to find one that does (as long as it is safe for me.) And, again, how to calculate for myself the proportions for a 40/30/30 diet of, say, 1,700 calories. 

Thanks for any info.

 

 

 

 

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Ron AKA replied on Thu, Nov 5 2009 6:47 PM

Nelle:
They die of heart disease, strokes and kidney failure caused by high BG.  Read Gary Taubes What If It's All Been a Big Fat Lie and his book Good Calories, Bad Calories for some interesting stuff on what is good for the heart.

I'm afraid I'm more traditional in my approach to medical advice. I will stick to the mainstream and avoid saturated fats, trans fats, excess sodium. I also like to eat foods that are high in soluble fiber and of a low glycemic index. For heart and stroke advice I go to the heart and stroke foundation for information.

I agree that you need to avoid high BG, but you also need to avoid the bad foods noted above.

Ron

Not a med prof. Just diabetic type 2 on Prandin, Levemir, ramipril, bisoprolol, & Crestor. Diag. Feb/01.

"I have not failed. I have just found 10,000 ways that don't work." - Thomas Edison

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Nelle replied on Fri, Nov 6 2009 9:10 AM

Well, still, you might want to read a little of the research that is being done and the new thinking about fat and even sodium.  Gary Taubes article that I mentioned before is a good place to start.

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Tor replied on Fri, Nov 6 2009 10:45 AM

I was diagnosed with type 2 in March of 1998, I was under a bit of stress in the last year due a death in the family and a few other circumstances, And I had become a bit lazy and had reduced the time I spend exercising to about half an hour per day. So my thoughts about BG expectations were Oh Oh,.

Yesterday I had my annual endo appointment (Dr. Richard Bebb here in Vancouver) and we were both surprised when reviewing my test results. HBa1c was up a bit - 5,6 - not too bad, fasting was ok at 108, given my age he though blood pressure 124/72 was ok as well. Cholestral was perfect - I am taking meds for that.

I attribute these results to my diet. The ONLY carbs I consume are GG bread and low carb pasta I order online and just like Ron I avoid saturated fats and trans fats like the plague. If you do a google search for GG bread you will find sources.  I also go for a walk after each meal. Used to be 40 minutes now maybe 10 minutes,

My absolutely favorite breakfast though I can't afford it every day is two slices of GG bread, a few capers, a slice or two of smoked salmon, a scrambled egg and freshly ground pepper.

Wow!

 

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lebrecht replied on Fri, Nov 6 2009 12:00 PM

Hi Tor:

I am  so relieved to see you posting again.

Keep up the good work.

I missed you, even if I no longer post as much. I find this new board a bit confusing and hard to adjust to.

Best wishes for your continued success.

Anne

Type 2  for 25 years. On insulin, Humalog, Lantus. 

Published author:     http://www.annelebrecht.com 

Novels, Poetry, Short Stories, Articles.

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kat replied on Fri, Nov 6 2009 1:42 PM

 

Wow, Tor -- Those results would be great in more usual times.  Considering what you've been through recently, they're downright fabulous!  Keep up the good work.

T2, diagnosed 12/98.  Diet and exercise 2/03 - 11/08.  Now back on metformin 500 ER.

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I found a reasonable source for GG Scandinavian Crisp bread.  The one Tor suggested.

http://www.netrition.com/gg_bran_crispbread_page.html

 

 

Anne

Type 2  for 25 years. On insulin, Humalog, Lantus. 

Published author:     http://www.annelebrecht.com 

Novels, Poetry, Short Stories, Articles.

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Tor replied on Tue, Nov 10 2009 1:19 AM

They do have a good price at tne source you found Anne. I pay $100 Canadian (about $95 US) for a case of 30. However there are stores that sell them for up to $6 a package.

Also a slight correction to what I said earlier about the low carb (Dreamfield) pasta and GG bread being my only carb sources. What I meant to say was that they are my main carb sources.

I do enjoy the occasional breakfast with fresh multigrain rolls and once a week I'll have oatmeal from Irish steel cut oats, fresh or frozen berries depending on the season. And I eat squash and vegetables that contain some carbs. It's the old 80 percent rule I guess, if you follow that you can get away with some exceptions in the 20 percent slot.

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Joe replied on Sat, Nov 28 2009 3:45 PM

Nelle:

Well, still, you might want to read a little of the research that is being done and the new thinking about fat and even sodium.  Gary Taubes article that I mentioned before is a good place to start.

 

If you plan to follow some of the "new" stuff you should also read Michael Pollan's "The Omnivore's Dilemma" and "In Defense of Food" as well as David Kessler's "The End of Overeating".  The things to avoid are Trans & Saturated Fats as well as processed foods which tend to be high in Salt, Fat, and Sugars.

Wishing everyone the very best.

 

Joe Buffalo

Type 2 Dx'd 4/98;

"Even if you're on the right track, You'll get run over if you just sit there." -- Will Rogers

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Tor replied on Sat, Nov 28 2009 5:29 PM

Based on my 12 years of managing diabetes without medications and living a healthy life i fully agree with Joe and Ron on avoiding trans or saturated fats, However living healthy is about many things.

For me, good time management (avoiding stress) is another big factor. In fact I believe that the training I had taken in stress management saved my life during the rather difficult year I've been through. On a related issue, mental and psysical health are, in my opinion, very closely related. My daily walks along the seawall or beach, regular trips out on the ocean, sitting on my veranda and listening to the birds while reading a John Steinbeck or Ernest Hemmingway novel for the umptiest time, are as important to my physical health as watching what I eat.

Tor

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Spirit replied on Sat, Nov 28 2009 5:58 PM

Tor:  The Roman poet Juvenal first expressed your thoughts when he said," Mens sana in corpore sano" (meaning "A healthy mind in a healthy body").  I agree that emotional/mental health is a big part of good diabetic management.  I also think that ties in closely with exercise if you work it right.  My walks through the Maine woods are peaceful and restful.  I look for wildlife signs and often encounter nature up close and personal, like when I stood so still that a doe felt comfortable enough to cross her tiny twin fawns in front of me from one side of the woods to the other.  I also enjoy walking through lively towns to enjoy the bustling energy of a different milieu.  Reading and gardening give me pleasure. These are part of my healthy life. 

Spirit

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jen1229 replied on Sun, Nov 29 2009 10:29 AM

I agree with Spirit.  When I'm swimming laps I just let my mind wander, and no one can bother you.  I think that is why I enjoy swimming so much.  I'm up to a half-mile now and it takes me about an hour.  It is very peaceful (except when trying remember how many laps I've done.  It is more relaxing than the water fitness class where we tend to talk about food for the whole hour.

Jen  - LevemirConfused and Novalog Wink A1c 5.8

 

 

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As a life-long swimmer..I agree..swimming clears your mind and lets you think....and in AZ..learn a bit about different cloud formations...as we swim out doors year round..yes..heated pool...around 84 in Winter...not a time for classes..swimming is for me.

However.....to add a bit of healthy stress....I took up golf..!!!!!!!!!!!!....and..I have a mostly vegetarian diet...some seafood.

Fruit, berries, veggies, oilive oil, tea, water...nuts, grains, Greek yogurt and tofu...for the most part, and just a bit of cheese...

Pre-Diabetic for 4-5 years..no meds...just diet and exercise.

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Madman replied on Tue, Dec 1 2009 2:23 PM

golf is great exercise, especially if you walk the course.

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I was diagnosed with Diabetes a few years ago and have learned that not everyone can use the same diet plan. It has been a hard thing to work with. I came acorss this really awesome site that allows you to create meal plans that work for you and they have also wonderful recipes for Diabetics. It really has helped a lot to plan ahead with my meals.

I really hope this site helps you. http://www.fitclick.com/recipe_finder_search

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Are there any Doctors at Joslyn who do not subscribe to the "whole grains, low fat dairy"  and believe the studies and work by Richard K. Bernstein, MD,  author of   

Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars?

 

I am looking for a new doctor for my son,  18 who has Type 1.   He have better mood and energy and A1C when he keeps Carbs to < 100gm/day.  Even when doing significant excercise.   (2 hrs of high school soccer practice).

 

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