Me and My Carbs
Adventures with the status quo and the nutritionist.
By Ilene Raymond Rush
January 2009 — Visiting the nutritionist makes me giddy.
It's not only her fluorescent green mounds of plastic peas set next to sticky looking globes of play noodles which nudge rubbery chicken slices that bring back early memories of faux kindergarten kitchens. Or her cheery take-aways: carefully calibrated eating plans, color coded menus, and empty pages of daily eating charts waiting to be filled.
It's more than that: it's effervescent hope. The hope that, armed with her pamphlets and portion charts, that this will be the time I will get my diet perfect, my hips slender as Kate Moss', my sugars in great control. It's her buoyant promises. That I will be able to eat carbohydrates – waffles with syrup and bread and mashed potatoes (all recommended on my last food plan) – and still 1) lose those last 24 pesky baby pounds (the baby is also 24, but hey, who's counting?) and 2) keep my sugars in control with the 150-200 or so carbohydrate grams she recommends that I balance in my daily diet.
Which makes me positively giddy.
The nutritionist is not a fool. Or a quack. She depends on United States Government Food Pyramid guide to counsel me to get all the nutrients I need. She insists that for maximum health and well-being, I must partake from all the food groups, particularly high-fiber carbohydrates. And she lectures that while I may have read a great deal about low-carb diets, that they aren't really ‘good for me,' despite a growing mountain of evidence that supports the validity of low-glycemic, low carb eating for people with type 2 diabetes. My nutritionist often goes out of her way to find studies to the contrary, which she often Xeroxes and staples to my personal food plan, as though notarizing her opinion.
The nutritionist has a sense of humor. And it would be funny, hanging onto these color-coded food exchange plans, if it weren't my health we're talking about here.
So why oh why, you ask, do I still go to the nutritionist?
I have my reasons. For one, it keeps me honest about my weight and my determination to count carbohydrates - just many, many fewer than she recommends. Sometimes I pick up a bit of good advice about vitamins (this year vitamin D is her favorite) and sometimes I get free samples of low-sugar, low-carb protein bars.
But mainly, I go because I keep hoping that I can change her mind. That I can convince her that if I exercise an hour a day (which I do) I can live (which I do) on a lower carbohydrate count that will keep my sugars in the normal range. That my improved A1C's are evidence that staying on a lower carbohydrate regimen can have dramatic impact (a drop from the 7's to a more or less permanent 6). And that people can walk around without going into ketosis or impairing their kidneys while eating more protein, and fewer (many fewer) carbohydrates than official diabetic associations recommend.
In 2008, even the American Diabetic Association began to rethink their stance on carbohydrates, recognizing that a somewhat lower carb load may in fact help stabilize sugars.
I don't go to the nutritionist to pick fights. I'm a polite, insistent agitator; we always part with a handshake and a smile. But as I file away the nutritionist's recommendations under "old news" I like to believe that I have the last laugh.
Read more of Ilene's article Busy-Bodies for Health.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Years before I was diagnosed with type 2 diabetes, The Other Half came out of a doctor's appointment with a diagnosis of "borderline diabetes" and an ADA exchange diet sheet. His health insurance agency followed up on the diagnosis with a glucometer and test strips. After a year or so of trying to follow the diet plan and test his glucose levels, things appeared to be back in "normal" range, and stood there until a couple of years after my own diagnosis. Shortly...