Bread for Diabetics?

Registered dieticians, certified nutritionists, even doctors specializing in diabetes are all schooled in the same traditions: those promulgated by the ADA, the FDA, the USDA, and the medical establishment as a whole. In fact, medical schools' curricula focus on anatomy, physiology and chemistry, and train their doctors in surgery, but do not include coursework in nutrition. Dieticians and nutritionists do study nutrition, and delve deeply into the chemistry of macro- and micronutrients and how they affect the body, as well as the biology of the human body, but their curricula are supported mostly under the auspices of the various governmental institutions that are charged with monitoring the public's health and make various nutritional recommendations. It is based on those recommendations that dieticians and nutritionists earn their certifications.

Enter diabetes, the current epidemic lifestyle disease rampant in the United States, and indeed, throughout the entire world. Diabetes and obesity have seen a skyrocketing rise over the past 50 years or so, ever since the war on fat was waged through the courtesies of one Ancel Benjamin Keys' "Seven Countries Study" who attempted to show that the healthiest people abstained from fat. The fallacy in his Seven Countries Study was that it was in fact a 22-country study, but he simply, and unscientifically, ignored the evidence obtained from the countries that did not support his own skewed ideas.

But the dye was cast, and the government jumped on the bandwagon, launching a campaign to reduce dietary fat. This was in the early 1970s. Since fat-reduced food was tasteless, manufacturers devised more and more clever ways to enhance the flavor, especially by adding chemicals and SUGAR in all its many (56) forms, especially high-fructose corn syrup, which incidentally came on the market at much the same time, the early 1970s. What a boon to manufacturing!

The supermarket shelves were now brimming with all manner of fat-free this, reduced-fat that, non-fat creams and sauces, and people clamored to buy more, eat more - and get FATTER and SICKER ever since.

Oh, and by the way, on the heels of Dr. Keys' "findings," the government recommended reducing dietary fat from 40% of daily calories to 30% of daily calories - hardly such a dramatic reduction. But as we see so often in any sort of government interference, things get skewed, distorted, misinterpreted, and the results are often disastrous.

Back to diabetes.

In spite of the horrendous and catastrophic rise in diabetes and obesity since the advent of these FDA recommendations, the American Diabetics Association has been endeavoring to make its own recommendations to diabetic patients, no doubt with plenty of participation from doctors, certified nutritionists and dieticians, all of whom get their education from the same place. The current ADA diabetic diet - and recommendations from the doctors, nutritionists and dieticians - is for diabetics to consume from 45g to 75g of carbohydrates PER MEAL. They do not bother to distinguish between refined carbohydrates and complex carbohydrates. Given the overwhelming lack of nutritional understanding among the public, the problem is massive:

1. How are people going to interpret 45g-75g of carbohydrates per meal if they do not understand what carbohydrates are in the first place?

2. The vast majority of people interpret carbohydrates to mean bread, pasta, or potatoes (or similar). A rare few will understand carbohydrates to include Brussel sprouts or cabbage or squash. So, given the recommendation to have 45g-75g of "carbohydrates" per meal, they will naturally gravitate to bread/pasta/pizza or the like.

3. Tragically, I have seen some sample diets where whole-grain bread is specifically recommended, and unless the patient is extremely interested in reading further, he/she will gobble it up - and expand from there.

Diabetes is an insulin-resistance disease. It is a complex mechanism where the tissue cells are no longer able to efficiently absorb blood glucose, and the pancreas is no longer producing sufficient insulin to mop up the sugar from the food.

This is where things get interesting. Everything we eat is digested and converts to blood glucose (blood sugar), from green pepper to a slice of bread. But the amount of blood sugar that is produced, and the amount of insulin required by these two sample foods vary enormously. The diabetic is already having trouble with his/her insulin, therefore, it is critical that he/she not stimulate insulin production too dramatically. That's why complex carbohydrates, those that metabolize slowly and release blood glucose slowly and steadily are much preferable to those that spike blood glucose, such as bread or doughnuts or pizzas.

Diabetic patients should be instructed in what constitute complex carbohydrates, and how satisfying and deliciously filling they can be, rather than be left with the impression that they are doomed to eating rabbit food for the rest of their lives. More to the point, diabetic patients must be educated on the deleterious risks of continuing to feed their disease with the very foods that got them sick in the first place!

Doctors make money from ongoing visits by sick patients; nutritionists and dieticians prolong the misunderstanding that diabetes is an incurable, lifetime "management" disease. Nothing could be further from the truth.