During my last visit to my endocrinologist, I was told by a diabetes educator that the normal trend for most T1’s is an escalation in insulin requirements as the T1 ages. After ten years with T1, I should have seen a doubling of my overall insulin requirements. She was surprised to hear that my insulin levels haven’t moved in all that time. My take away message from this conversation was that a trend toward insulin resistance and metabolic disease is normal even among T1’s. Just because this is normal doesn’t mean it’s healthy. Angelo Coppola does an amazing podcast and blog and his mantra, “Humans are not broken”, is refreshing. A link to his blog (Latest In Paleo) is on my ‘resources’ page.
When 70% of adult Americans are overweight, 30% are diabetic, and hoards of children and adults alike are racing toward a diagnosis of metabolic disease, I think we can conclude that normal is no longer healthy. Likewise, the standard nutritional advice to eat a bunch of healthy whole grains is most likely flawed, especially for the T1.
I have tried the standard nutritional advice from nutrition and diabetes educators for years before finally giving up and throwing “healthy whole grains” in the garbage. My experience tells me that no other food out there requires more insulin than whole grain carbohydrates. I’m not suggesting the T1 avoid these foods altogether, but they certainly should not make up a significant portion of every plate we eat during the day. Insulin is a necessary hormone for life, but we need to stop abusing it. According to Julian Whitaker, MD, “Insulin ALWAYS causes weight gain.” He wasn’t referring to healthy weight gain, but abdominal fat – the kind of fat that leads to insulin resistance, hypertension, heart disease, and possibly dementia.
Another downside to eating whole grains as a portion of every meal is they crowd out more nutritionally dense foods like vegetables. Healthy whole grains are certainly not void of nutrition, but they don’t stand up against real food. What’s worse is the accumulated carbohydrates of a meal containing whole grains. Let’s construct a “healthy” dinner for illustration. The plate consists of fish, broccoli, rice, and whole grain bread. Now imagine you have a beer with that. After dinner, you have a small treat, say a cookie with milk. None of these food items lies outside the nutritional recommendations of diabetes educators. The beer and cookie would not thrill them, but taken altogether as a part of a well balanced meal, these foods are ok. Now, let’s do the math and add up the carbs. The fish and broccoli contain a few carbs, but I wouldn’t count these because I wouldn’t take additional insulin to cover these foods. The rice, beer, bread, brownie, and milk, however, could pack 180 carbs. By following the “rules” dictated by standard nutritional dogma, this meal would send my BG into the stratosphere, requiring a ridiculous insulin load to cover. Doing this consistently over time certainly qualifies as an abuse of insulin not to mention disastrous advice for any T1.
The last thing I want to say about “healthy whole grains” is they disrupt a balanced eating cycle and disrupt productivity. In the early years of my T1 diagnosis, I would often eat old fashioned oat meal for breakfast. Even after mixing in some nuts and chia seeds to add fiber and slow down the absorption of the carbs to reduce the BG spike following the meal, I would often crash (low BG) midmorning requiring additional carbohydrates or juice to pick me back up. By lunch, my BG would be low again and cycle continues.
All said, I think whole grain foods should be mostly eliminated from the diets of T1’s. I say mostly because it’s ridiculously difficult to completely eliminate these foods because wheat, corn, and soy are present in almost every packaged food in the store. Unless a person has celiac disease or is highly sensitive to gluten, eliminating all traces of grain is not necessary. So let’s stop abusing our insulin and eat real food. Allow your body the dense nutrition contained in vegetables, healthy and sustainably grown animal products, fruits, nuts, and seeds. These foods will not only nourish the T1, but will reduce and stabilize insulin requirements and normalize BG levels. When I say normal, I don’t mean our new normal of sickness and disease, but the healthy normal the human body longs for.