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Dr. Bernstein Shares His Insights
Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S has part 4 of the So What’s Low Carb for you
The Diabetes Diet
Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
Chapter 4
HOW DO PEOPLE REACT TO THE NEW DIET?
Most of my patients initially feel somewhat deprived, but they are also grateful
to feel more alert and healthier —sometimes more so than they have in
years. I fall into this category myself. My mouth waters whenever I pass a bakery
shop and sniff the aroma of fresh bread, but I am also grateful simply to be
alive and sniffing.
Part 3 of Chapter 4
See all parts here
So What’s Low Carb?
Soymilk
There are many soy products
that can be used in our diet plan, and soymilk is no exception. It’s a
satisfactory lightener for coffee and tea, and one of my patients adds a small
amount to diet sodas. Others drink it as a beverage, either straight or with
added flavoring such as those mentioned for yogurt. Personally, I find the taste
too bland to drink without flavoring, and I would probably prefer cream diluted
with water. When used in small amounts (up to 2 tablespoons), soymilk need not
be figured into the meal
plan.
As noted in the No-No foods section, of the many brands of soymilk on the market,
WestSoy offers the only unsweetened one I’ve been able to find, although
other unsweetened brands are available in various parts of the country.
Soybean Flour
If you want to try baking with soybean flour, you’ll find a neat solution
to the pastry restriction in this diet. One ounce of full-fat soybean flour
(about G cup) contains about 7.5 grams of slow-acting carbohydrate and about
1 ounce of protein. You could make chicken pies, tuna pies, and even sugar-free
Jell-O pies or pumpkin pies. Just remember to include the carbohydrate and protein
contents in your meal plan.
Soybean flour usually must be blended with egg to form a batter suitable for
breads, cakes, and the like. Creating a blend that works requires either experience
or experimentation.
Bran Crackers
Of the dozens of different crackers that I have seen in health food stores and
supermarkets, I have found only three brands that are truly low in carbohydrate.
• GG Scandinavian Bran Crispbread, produced by
G. Gundersen Larvik A/S, Larvik, Norway (distributed
in the United States by Cel-Ent, Inc., Box 1173,
Beaufort, SC 29901, fax only, 843-524-9444). Each
9-gram slice contains about 3 grams of digestible
carbohydrate. If this product is not available locally,
you can order it directly from the importer or via the
Web at www.ggbrancrispbread.com.
One case contains
thirty 4-ounce packages. They are also available
from Trotta’s Pharmacy, 877-987-6882.
• Bran-a-Crisp, produced by Saetre A/S, N1411, Kolbotn,
Norway (distributed in the United States by
Interbrands, Inc., 3300 N.E. 164th Street, FF3,
Ridgefield, WA 98642). Each 8.3-gram cracker con-
tains about 4 grams of digestible carbohydrate. Brana-
Crisp may be ordered directly from Interbrands,
Inc., by phone or fax if you cannot find it locally.
Phone 877-679-3552 or fax 360-574-3574. The
Web site www.branacrisp.com will take
you to online
wholesalers and retailers, or you can order from
Trotta’s Pharmacy. This product
is also available in
some food markets as Fiber Rich bran crackers.
• Wasa Fiber Rye. These crackers are available in most
supermarkets in the United States and in some other
countries. One cracker contains about 5 grams of digestible
carbohydrate. Many of my patients feel that
this is the tastiest of these three products. Other
Wasa brand crackers contain more carbohydrate.
Although some people eat these plain, to me they taste like cardboard without
a spread or some other kind of flavoring. My preference is to enjoy them with
chive-flavored cream cheese or butter. Crumbling two GG crispbreads (6 grams
carbohydrate) into a bowl and covering them with water plus a tablespoon or
two of cream can create bran cracker cereal. Add some Equal or Splenda tablets
(dissolved in a bit of hot water) or some liquid stevia or saccharin and perhaps
a baking flavor extract (fruit flavor, butter flavor, etc.), or one of the Da
Vinci brand sugar-free syrups.
If eaten in excessive amounts, bran crackers can cause diarrhea. They should
be eaten with liquid. They are not recommended for people with gastroparesis
(delayed stomachemptying), since the bran fibers can form a plug that blocks
the outlet of the stomach. The small amount of digestible carbohydrate in these
crackers is very slow to raise blood sugar. They are great for people who want
a substitute for toast at breakfast.
Note: In the United States, labeling regulations require that fiber be listed
as carbohydrate. There are different kinds of fiber, and they all behave differently.
My rule of thumb is to deduct half of the stated grams of fiber from the stated
grams of carbohydrate to get a general idea of how the listed carbohydrate will
affect your blood sugars. Remember the Chinese Restaurant Effect. Even a product
that is 100 percent
fiber can raise blood sugar.
Toasted Nori
When my friend and fellow diabetic Kanji Ishikawa sent me a beautifully decorated
canister from Japan, I was most impressed and intrigued. You can imagine my
dismay when I removed the cover and found seaweed. My dismay was only temporary,
however. I reluctantly opened one of the cellophane envelopes and pulled out
a tissue-thin slice. My first nibble was quite a surprise — it was delicious.
When consumed in small amounts, I found, it had virtually no effect upon blood
sugar. Once addicted, I combed the health food stores searching for more. Most
of the seaweed I tried tasted like salty tissue paper. Eventually, a patient
explained to me that Kanji’s seaweed is a special kind called toasted
nori. It contains small amounts of additional ingredients that include soybeans,
rice, barley, and red pepper. It is available at most health food stores, and
is a very tasty snack. Five or six slices at a time have had no effect upon
my blood sugar. The Clinistix/Diastix test showed no glucose after chewing.
A standard slice usually measures 1 x 3 inches and weighs about 0.3 gram. Since
the product contains about 40 percent carbohydrate, each strip will have only
0.12 gram carbohydrate. You can weigh larger sheets of toasted nori in order
to estimate their carbohydrate content.
Too Be Continued in Part 4 (Artifical Sweetners,Flavor Extracts Spices, and
Herbs will be discussed)
Copyright © 2005 by Richard K. Bernstein, M.D.
All rights reserved. No part of this book may be reproduced in any form or by
any electronic or mechanical means, including information storage and retrieval
systems, without permission in writing from the publisher, except by a reviewer
who may quote brief passages in a review.
Author’s Note
This book is not intended as a substitute for professional medical care. The
reader should regularly consult a physician for all health-related problems
and routine care.
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Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
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Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
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Frank Vinicor, M.D., M.P.H. Director, Division of Diabetes Translation,
National Center for Chronic Disease Prevention and Health Promotion Centers
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American Diabetes Association
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New York, is devoted solely to diabetes and prediabetic conditions.
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