Confused about fruit and carbohydrates

[Sniffy]

Having read a lot of different American and UK diabetes care sites and books I have found that the approach to diet seems to be completely at odds with that taken in some countries like Belgium. In Belgium patients are told to abstain from eating pasta and rice and to seriously limit their intake of starchy vegetables. Also bananas and grapes are banned and other fruit severely limited.

How does one deal with such a confusing paradox in what appears a well informed medical world ?

Who should one believe ?

 

[bev]

Hi Sniffy,
It is very confusing isnt it. The only way to tell what is happening to your body after eating carbs is to test your levels. It is very individual - so what may spike one persons levels high may not for another person.

Also if you are getting spikes and you are on medication, it could be that you need to change it or increase the amount. There are a lot of type 2's who limit their carb intake and have a great hba1c - but there are also some on medication who eat lots of carbs and still have a great hba1c.

Who to believe is really up to you and how you prefer to manage your diabetes. If you are eating lots of carbs and still getting good results - then you dont need to change anything. The Medical Profession dont always agree with the management of many conditions and diabetes is on the list, so do some research and then you will be in a better position to make an informed choice.🙂Bev

 

[Copepod]

Yes, it is confusing, and there isn't really a simple answer.

The approach taken by many people is to test themselves to see the effect of various foods, then eating according to their own effects. Some advise limiting all carbohydrates, some advise limiting only sugars.

As well as food content, portion sizes are also important - there's a big difference between 100g and a couple of grapes, for example.

 

[HelenM]

I would agree with the previous posts that testing helps you work out what does and doesn't cause spikes.
I've just looked up the Belgian equivalent of the DUK website. It seems to me to be a lot more detailed than the DUK site and I think a better resource but fundamentally it still starts from the premise that carbs should form 50% of the total calories eaten. There is a whole page about pasta and it's justification in a diabetic diet for example.
They include a lot about using the glycemic index and place an emphasis on how to create a balanced diet.
They also suggest the Idaho plate method (from the US) for apportioning the parts of a meal. This is a method used in many countries( except perhaps the UK which sticks with the rather confusing eatwell plate). I thought the pdf 'les poids des aliments' looked to be a useful leaflet about portion sizes
http://www.diabete-abd.be/alimentation_alimentationsaine.html

Actually it's very similar to what's taught in France where I live.

 

[everydayupsanddowns]

Here are some things I have picked up about this in the last year...

The heart-healthy/eatwell plate/food pyramid advice seems (at least in part) connected to conclusions of the seven country study. This showed a correlation between a reduction in heart disease and consumption of whole grains. Since people with diabetes are at increased risk of heart disease, variations of this advice is then given to many/most type 2 diabetics. Some hear 'eat lots of starchy carbs at every meal' others 'eat some starchy carbs' still others 'eat a moderate amount of starchy carbs, but watch your meter'.

Part of the problerm with this is that people with diabetes have a difficult relationship with carbohydrate. We all need to treat carbs with a good deal of caution if our BG levels are not to remain dangerously high and/or erratic. The possible heart-health benefits indicated by the research may well be being completely overwhelmed by the additional risks involved in unmoderated carb consumption and high BGs.

Additionally the 'seven country' study is itself under question. Initially 20 or 21 countries took part, but results which did not fit the pattern were discarded. I've also read a conspiratorial whisper about the research being funded by a slightly under-performing US grain industry, but I don't know the truth of that.

Part of the problem with the advice is, of course, that all carbs (whether so-called 'starchy' or not) are turned onto glucose in the bloodstream. In fact our bodies are incredibly good at doing this. Eating glucose is obviously the fastest, but some supposedly 'complex' versions can be surprisingly fast. Some people will find (and everyone is different so there's no option but to carry out your own tests unfortunately, despite what your GP might suggest) that mashed potato or grapes will hit the bloodstream in a very similar timeframe while others will be fine with those, but have problems with others. Many T2s seem to find that an between and hour and two after eating is when their BG levels will peak.

For a general guide you can check the GI and GL of foods (glycaemic index and glycaemic load) but these are just average figures based on a sample of 100 or so, so there's no real guarantee that granary bread (or whatever) will behave the same for you.

At the end of the day, as others have said, the best bet is to get hold of a blood glucose monitor and test for yourself. You will soon find which foods you can tolerate and which cauuse you big BG spikes.

Mike

 

[MargB]

There is a thread by Wallycorker somewhere talking about how he has cut down his carbohydrate intake and it has worked for him. I have found I am ok with carbs but watch my portion sizes. I am told bananas and grapes are not the best so I no longer buy them but enjoy them when offered elsewhere or just buy a banana at a time. My main fruits are apples, pears, melons and pineapples which satisfies my need for sweetness.

We are all different so we all react in different ways and you will learn what works for you.