9
The Basic Food Groups
OR MUCH OF WHAT YOU’VE BEEN TAUGHT ABOUT DIET
IS PROBABLY WRONG
In light of the above, you might guess that I advocate a nocarbohydrate
diet. In fact, in the next chapter you’ll discover that I include small
amounts of carbohydrate in my meal plan. Back in 1970, as I was still
experimenting with blood sugar normalization, I remembered that during
the twentieth century a new vitamin had been discovered every fifteen
years or so. While there may be no such thing as an essential carbohydrate,
it seemed reasonable to conclude that, since our prehistoric ancestors
consumed some plants, plant foods might well contain essential nutrients
that were not yet present in vitamin supplements and had not even been
discovered. I therefore added small amounts of low-carbohydrate vegetables
(not starchy or sweet) to my personal meal plan. All of a sudden I was
eating salads and cooked vegetables instead of the bread, fruit, cereal,
skim milk, and pasta that I had been eating on my prior ADA diet. It
took a while to get used to salads, but now I relish them. Only recently,
in my lifetime, have phytochemicals (essential nutrients found in plant
foods) been discovered. Phytochemicals are now incorporated into some
vitamin pills, but research on the use of isolated phytochemicals is
still in its early stages. You may have heard of such phytochemical
supplements as lutein, lycopene, and so on. It would appear that many
chemicals— large numbers of which are likely not even known about yet—work
together to provide beneficial effects. So at this point, it certainly
makes sense to eat low-carbohydrate salads and vegetables. (Although
fruits contain the same phytochemicals as vegetables, they are too high
in fast-acting carbohydrate to be part of a restricted-carbohydrate
diet, as the next chapter will explain.)
SOME WORDS ABOUT ALCOHOL
Alcohol can provide calories, or energy, without directly raising blood
sugar, but if you’re an insulin-dependent diabetic, you need to be cautious
about drinking. Ethyl alcohol, which is the active ingredient in hard
liquor, beer, and wine, has no direct effect on blood sugar because
the body does not convert it into glucose. In the case of distilled
spirits and very dry wine, the alcohol generally isn’t accompanied by
enough carbohydrate to affect your blood sugar very much. For example,
100 proof gin has 83 calories per ounce. These extra calories can increase
your weight slightly, but not your blood sugar. Different beers—ales,
stouts, and lagers—can have varying amounts of carbohydrate, which is
slow enough in its action that if you figure it into your meal plan,
it may not raise your blood sugar. Mixed drinks and dessert wines can
be loaded with sugar, so they’re best avoided. Exceptions would be a
dry martini or mixed drinks that can be made with a sugar-free mixer,
such as sugar-free tonic water.
Ethyl alcohol, however, can indirectly lower the blood sugars of some
diabetics if consumed at the time of a meal. It does this by partially
paralyzing the liver and thereby inhibiting gluconeogenesis so that
it can’t convert all the protein of the meal into glucose. For the average
adult, this appears to be a significant effect with doses greater than
1.5 ounces of distilled spirits, or one standard shot glass. If you
have two 1.5-ounce servings of gin with a meal, your liver’s ability
to convert protein into glucose may be impaired. If you’re insulin-
dependent and your calculation of how much insulin you’ll require to
cover your meal is based on, say, two hot dogs, and those hot dogs don’t
get 7.5 percent converted to glucose, the insulin you’ve injected will
take your blood sugar too low. You’ll have hypoglycemia, or low blood
sugar.
The problem of hypoglycemia itself is a relatively simple matter to
correct—you just eat some glucose and your blood sugar will rise. But
this gets you into the kind of messy jerking up and down of your blood
sugar that can cause problems. It’s best if you can avoid hypo and hyperglycemia
(high blood sugar) entirely.
Another problem with alcohol and hypoglycemia is that if you consume
much alcohol, you’ll have symptoms typical of both alcohol intoxication
and hypoglycemia—light-headedness, confusion, and slurring of speech.
The only way you’ll know the cause of your symptoms is if you’ve been
monitoring your blood sugar throughout your meal. This is unlikely.
So you could find yourself thinking you’ve consumed too much alcohol
when in fact your problem is dangerously low blood sugar. In such a
situation, it wouldn’t even occur to you to check your blood sugar.
Remember, that early blood sugar–measuring device I got was developed
in order to help emergency room staffs tell the difference between unconscious
alcoholics and unconscious diabetics. Don’t make yourself an unconscious
diabetic. A simple oversight could turn fatal.
Many of the symptoms of alcohol intoxication mimic those of ketoacidosis,
or the extreme high blood sugar and ketone buildup in the body that
can result in diabetic coma. The buildup of ketones causes a diabetic’s
breath to have an aroma rather like that of someone who’s been drinking.
If you don’t die of severe hypoglycemia, then you might easily die of
embarrassment when you come to and your friends are aghast and terrified
that the emergency squad had to be called to bring you around.
In small amounts, alcohol is relatively harmless—one glass of dry wine
or beer with dinner—but if you’re the type who can’t limit drinking,
it’s best to avoid it entirely. For the reasons already discussed, alcohol
can be more benign between meals than it is at meals. One benevolent
effect of alcohol is that it can enable some diabetics to consume one
beer or one bloody Mary (tomato juice mixed with an ounce and a half
of vodka) without raising blood sugar.
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