Articles -
Dr. Bernstein Shares His Insights
Do vitamins and minerals make a difference in carb counting, Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S explains this in part 9 of the So What’s a Carb.
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 9 of Chapter 4
So What’s Low Carb?
(Con’t)
See all parts here
VITAMIN
AND MINERAL SUPPLEMENTS
It is common practice to prescribe supplementary vitamins and minerals for
diabetics. This is primarily because most diabetics have chronically high blood
sugars and therefore urinate a lot. Excessive urination causes a loss of water-soluble
vitamins and minerals. If you can keep your blood sugars low enough to avoid
spilling glucose into the urine (you can test it with Clinistix or Diastix),
and if you eat a variety of vegetables, and red meat at least once or twice
a week, you should not require supplements. Note, however, that major dietary
sources of B-complex vitamins (folic acid is one of these) include “fortified”
or supplemented breads and grains in the United States. If you’re following
a low carbohydrate diet and therefore exclude these from your meal plan, you
should eat some bean sprouts, spinach, broccoli, brussels sprouts, or cauliflower
each day. If you do not like vegetables, you might take a B-complex capsule
or a multivitamin/mineral capsule each day.
Supplemental vitamins and minerals should not ordinarily be used in excess
of the FDA’s recommended daily requirements. Large doses can inhibit the
body’s synthesis of some vitamins and intestinal absorption of certain
minerals. Large doses are also potentially toxic. Doses of vitamin C in excess
of 500 mg daily may interfere with blood sugar readings (causing them to appear
erroneously low). Large doses of vitamin C can actually raise blood sugar, cause
kidney stones, and even impair nerve function (as can doses of vitamin B-6 in
excess of 200 mg daily, so beware of B-complex capsules). Vitamin E has been
shown to reduce one of the destructive effects of high blood sugars (glycosylation
of the body’s proteins),* with increased amounts providing increased benefit
up to 1,200 IU (international units) per day.
*Glycosylation of protein — the bonding of glucose to protein —
is essentially what you see in bread crust. Inside the bread loaf the proteins
are supple, but the proteins in the crust have bonded with sugars and lost any
resilience. Bad news when it happens inside your body.
It has recently been shown to lower insulin resistance. I therefore recommend
400–1,200 IU per day to a number of my patients. Be sure to use the forms
of vitamin E known as gamma tocopherol or mixed tocopherols, not the common
alpha tocopherol, which can inhibit the absorption of essential gamma tocopherol
from foods. Vitamin E can reduce the ability of blood to clot and must therefore
be restricted in some people. Consult your physician before using it.
The insulin-sensitizing agent metformin can cause systemic reduction of vitamin
B-12. This can be corrected with calcium supplements or more calcium in your
diet (cream or cheese, for example).
CHANGES IN BOWEL MOVEMENTS
A new diet often brings about changes in frequency and consistency of bowel
movements. This is perfectly natural and should not cause concern unless you
experience discomfort. Increasing the fiber content of meals, as with salads,
bran crackers, and soybean products, can cause softer and more frequent stools.
More dietary protein can cause less frequent and harder stools. Calcium supplements
can cause hard stools and constipation, but this is usually offset if they contain
magnesium. Normal frequency of bowel movements can range from 3 times per day
to 3 times per week. If you notice any changes in your bowel habits more or
less than these frequencies, discuss them with your physician.
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.
We would like to thank the publisher Little Brown and Company and Dr. Richard
K. Bernstein, for allowing us to provide excerpts from The Diabetes Diet.
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.
For information on how you can purchase Diabetes
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Dr. Bernstein's Low-Carbohydrate Solution
Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
In
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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., is recognized as one of the foremost experts
on diabetes and its complications. His private practice in Mamaroneck,
New York, is devoted solely to diabetes and prediabetic conditions.
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