Quick update: My article, "A Low-Carbohydrate, Whole-Foods Approach to Managing Diabetes and Prediabetes" has been published in the Fall/Winter edition of the ADA journal, Diabetes Spectrum! Unfortunately, you won't be able to view it online for several months unless you're a professional ADA member (or you want to shell out $30 for the privilege), although you can read the first few paragraphs. They do offer open access to all archived articles originally posted at least six months prior. I'll try to post a PDF on this site as well if I'm able to.
Essentially, I recommended a moderately low-carb diet (100-110 grams total carbs, 80 grams net), as a starting point. While I definitely believe many people would benefit from going lower (in fact, I generally consume slightly less than half this amount of carbs myself), the notion of taking in less than 130 grams a day is still considered dangerous by many diabetes health professionals, and one of my primary aims was to dispel this myth while recommending a more gradual easing into carbohydrate restriction. Also, for anyone who does read the article, please be aware that it was heavily edited: I was asked to remove some of what I considered important statements and add in content in the form of qualifiers (lots of "however's.") Some of the verbiage is also not my own. Apparently this is what happens to all authors of professional papers, so I can't complain too much. Overall, I think the paper adequately addresses the benefits of, concerns about, and how-to's of low carbohydrate eating.
One other exciting bit of news is that, based on writing this article, I was been asked to speak on a panel at the annual meeting of the American Association of Diabetes Educators (AADE) in August! The name of the panel is "Diabetes Meal Planning," and I believe the other people on the panel will be the dietitians who wrote the Diabetes Spectrum articles "Rationale for the Use of a Mediterranean Diet in Diabetes Management" and "Preparing to Prescribe Plant-Based Diets for Diabetes Prevention and Treatment." While I'm looking forward to this opportunity to promote a way of eating I feel passionately about, I can't deny feeling a little nervous speaking to what will surely be a tough room : doctors, nurses, and dietitians who largely disapprove of low carb (although I'm hoping to find some like-minded practitioners as well). Fortunately, they're giving me plenty of time to prepare.
I just wanted to thank all my regular and new readers for your kind words of support in the comments section of my blog and in your e-mails. It's very gratifying to know how many of you enjoy and in some cases learn from my posts :)
A common belief held by many health professionals, including dietitians, is that weight loss occurs when a person burns more calories than they take in. While I know from my own personal experience and that of hundreds of others that calories do count in terms of weight balance, there are many other factors in play as well. Several hormones (including insulin, leptin, cortisol, estrogen, and T3) have a substantial influence on caloric intake and/or weight, although the exact mechanisms are not universally agreed upon. And in recent years, the effect of various chemicals on weight has also been investigated. Most notable among these is bisphenol A (BPA), an organic compound extremely common in the modern world.
Recent animal studies have found that BPA disrupts hormonal activity, resulting in insulin resistance and fat accumulation. Research also suggests that BPA may cause neurological and thyroid problems and increase the risk for breast cancer, prostate cancer, and many other health conditions, particularly in pregnant women and infants. To say that BPA has the potential for harm is likely an understatement.
All the more concerning, then, that BPA is virtually ominpresent in our society. From plastic water bottles to canned foods to grocery store receipts, we are exposed to this chemical multiple times a day. While the Bisphenol A website
contains links to studies meant to assure us that its use is absolutely safe, at this point I'd prefer to limit my exposure as much as possible based on several animal studies that suggest otherwise, as well the Environmental Working Group's assertion that the compound is toxic even at low levels.
There are several ways to do this, including carrying a thermos instead of bottled water, never heating foods in plastic, reducing consumption of canned foods, and purchasing BPA-free containers and bakeware. While I don't use a lot of canned items, I do eat a fair amount of canned fish. As of now, Trader Joe's states that while most of its salmon is packaged in BPA-free cans, sardines (my favorite), are not, although the chain hopes to remedy this by the end of the year. Treehugger.com has a nice list of companies that use BPA-free cans., and the Inspiration Green site has additional useful information.
Does BPA exposure cause weight gain, insulin resistance, and other health problems in humans? While further research needs to be done to determine the extent of risk posed by BPA, it's disturbing that the manufacturer's site states the product causes no harmful effects despite significant evidence to the contrary. Because it's impossible to completely avoid this chemical, I recommend we do our best to limit exposure as much as we can for the time being.
1. Soriano S, et al. Rapid Insulinotropic Action of Low Doses of Bisphenol-A on Mouse and Human Islets of Langerhans: Role of Estrogen Receptor β. PLoS One 2012; 7(2): e31109
2. Masuno H, et al. Bisphenol A in combination with insulin can accelerate the conversion of 3T3-L1 fibroblasts to adipocytes. J Lipid Res. May 2002. 43:676-684
3. Masuno H, et al. Bisphenol A accelerates terminal differentiation of 3T3-L1 cells into adipocytes through the phosphatidylinositol 3-kinase pathway.Toxicol Sci. Apr 2005; 84(2):319-27
4. Brisken C. Endocrine disruptors and breast cancer. CHIMIA Int National J Chem 2008 62(5) 406-409
5.Ho S-M, et al.Developmental exposure to estradiol or bisphenol A increases susceptibility to prostate carcinogenesis and epigenetically regulates phosphodiesterase Type 4 variant 4. Cancer Res. June 2006;66:5624–5632
Franziska Spritzler, RD, CDE