Patricia Thompson - NUTRITION TALK THE OLD advice given to persons with diabetes is that they should avoid eating carbohydrate. This is like a death sentence to some persons. I remember my grandmother, who had diabetes saying, "let me die before I give up my rice and peas". Yet, unbeknown to her, she did not have to and she did not die from eating carbohydrate.
This advice implies that it is carbohydrate that causes diabetes in the first place and that eating foods rich in carbohydrate would only worsen the condition. This is not so. Carbohydrate is a nutrient found primarily in plant foods but not in meats or other foods of animal origin except for milk. This means that persons who eat only plant foods that is, strict vegetarians have an extra high intake of carbohydrate. Yet studies show that these persons are less likely to develop diabetes than others who eat products of animal origin such as meat.
What really causes diabetes?
The real cause of diabetes is that there is an abnormality in the secretion and/or action of insulin, the hormone that regulates how the body uses carbohydrate. The problem is not with carbohydrate but rather, with how carbohydrate and the other energy nutrients (protein and fat) in food on a whole are utilised. Eating too much food, which may or may not be high in carbohydrate, will result in obesity and this is the root cause of most cases of diabetes.
All three energy nutrients will result in obesity if taken in excess that is, if too much food is eaten. The excess fat deposited in the body cells during obesity, then puts up resistance to the action of insulin so that carbohydrate has difficulty in entering the body cells to be used for energy. Instead, the carbohydrate remains in the blood as glucose sugar and accumulates to cause high blood sugar.
If you do not eat any carbohydrate, this will not help insulin work any better. It only means that there is less carbohydrate for the body to handle, so blood sugar levels will not rise as sharply. In fact, insulin needs the presence of carbohydrate to stimulate its action. Instead of improving, the diabetes may even get worse since you may now eat more fat and protein than you would normally do.
Meat, although called a high protein food, oftentimes has more fat than protein. Fat has twice the energy value of carbohydrate or protein and weight gain would be more rapid. As obesity worsens, so does diabetes. The real culprit is obesity and not carbohydrate.
How then should these persons eat?
Rather than trying to avoid carbohydrate, you should strive to eat only such amounts of food that will help you reach and maintain a healthy weight. Weight loss will allow the insulin that is secreted to better regulate the carbohydrate eaten. In an effort to lose weight, you should not however deprive yourself of food. The common practice of alternating missing meals (fasting) with overeating (feasting) strains the secreting processes and eventually causes the body to totally break down. You should instead eat at regular intervals and in reasonable quantities that your body can handle.
Another important aspect of a diabetic diet is that you need to develop a regular pattern of eating so that the body knows what to expect from day to day. These two characteristics: regularity and consistency are very important aspects of a diabetic diet. There are no special foods to be eaten or avoided. There is also no set diet that will suit all persons.
The quantity of food to be eaten and the distribution of carbohydrate intake between various meals and snacks are based on individual needs and preferences. A registered dietician or nutritionist can assist in evaluating these needs and in planning a diet most suited to those needs.
Patricia Thompson M.Sc., Registered Nutritionist, The Nutrition Centre, Eden Gardens.
