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Nutrition and Type 1 Diabetes;
A Plant-Based Approach
Introduction
Michael Fox
Type 1 diabetic
Graduate Student in the Sustainable Food Systems Program at MSU
Completing coursework to become eligible for a dietetic internship so
that I can become a Registered Dietitian
Graduation May 2014
Created diabetic support group
Professional Goal: Specialize in the treatment of diabetes using nutrition as the primary tool to manage blood sugar levels
Today’s Discussion
Managing diabetes with a plant-based diet
My experience with Type 1 diabetes
Food and its relationship with blood sugar levels
Physiological effect of hypoglycemic reactions and its relationship with food
Foods I recommend for treating lows
Situations and challenges that arise in a school setting
My Story
For 24 years, maintained well-balanced and healthy diet
– Salads, lean meats, whole grain carbs
Significant lifestyle changes during the past 4 years
Stress
Exercise
Diet - Removed all processed and refined food products - Decreased intake of animal based food - Increased vegetable intake
Why change?
Lab Values high --- Chol, BP
Raw diet was popular. I was curious.
Health organizations promote
Fruits and Vegetables
Processed Meats
I was studying dietetics. Why not?
My Diet
VEGETABLES
Fermented (sauerkraut)
FRUIT (primarily bananas)
GRAINS (including fermented buckwheat groats, millet)
NUTS & SEEDS (including sprouts)
LEGUMES (primarily lentils and black beans)
http://thepoofairy.files.wordpress.com/2012/01/green-vegetables.jpghttp://upload.wikimedia.org/wikipedia/commons/thumb/5/56/Sauerkraut_Jar.jpg/670px-Sauerkraut_Jar.jpg
My Lab Values
YEAR A1C (%) Chol (mg) LDL (mg) BP (mmHg)
Daily Insulin Dose
2009 6.9 194 122 ↑ 130/80 32 u/Humalog 23 u/Lantus
2010 6.9 171 104 ↑ 130/80 20 u/Humalog 23 u/Lantus
2011 6.7 237 140 ↑↓ 130/80 10 u/Humalog20 u/Lantus
2012 7.3 168 89 ↓ 130/80 5-10 u/Humalog20 u/Lantus
2013 7.1 144 73 122/83 20 u/Lantus
ADA Goal: <7.0 <200 <100 <140/80 120/80
Individualized
What Does Science Say?
Insulin sensitivity can be positively effected by:
Fiber
Bioavailability of nutrients
Microbiomes
Limitation of pesticides
Maintaining pH reserves/Preventing Metabolic Acidosis
Much remains unknown
Challenges to Nutrition Science
The area I find most compelling:
Microbiome capacity to induce systemic change
My Assessment
Back to the Real World
Not everyone wants to, or can, follow my diet
Application to a school environment
Food’s affect on blood sugar and insulin function
Food’s affect on feeling low
Food I recommend for treating lows
The benefits of real, whole foods
Type 1 Diabetes in a School SettingPriorities
Overall safety and prevention of hypo and hyperglycemic reactions
Return child to classroom ready and capable to learn and participate
Maintain balanced blood sugars
Get child back to normal life – and have fun!
http://www.ideachampions.com/weblogs/happy_kid.jpg
Food can effect blood sugar and insulin resistance - can be independent of one another
Real, whole foods
blood sugar
blood sugar
or no impact on blood sugar or insulin resistance
Processed, refined food products
blood sugar immediately or over next 3-6 hrs.
insulin resistance
Food and Blood Sugar Control
Decide What To Eat
How will it affect my blood sugar level?
How will it affect my insulin resistance?
How will I feel after I eat the food?
My Food Recommendations
http://i4.mirror.co.uk/incoming/article1111880.ece/ALTERNATES/s615/Scale%20weighing%20the%20value%20of%20a%20cupcake%20and%20apple-1111880
Physiological Result of Low Blood Sugars
Common descriptions:Hand tremors, cold sweat, confusion, acting drunk, blurred vision
I also experience: Increased speed of thought
In contrast to number one, an “empty head”
Confusion
Varying degree of physical imbalance
Sense of panic
Emotions can be intensified
http://www.sixuntilme.com/blog-mt2/blog_images/2010June/crazy_chicken_diabetes.gif
Foods Often Used to Treat Lows
Refined, Processed Food
Portion Carb (g)
Snickers ½ 18
Granola Bar
(Trail Mix Fruit and Nut)
1 27
Orange Juice 8 oz 26
Coca Cola 8 oz 27
Life savers 1 ring 14
Oreo Cookie 2 cookies 14
Go-gurt 1 tube 13
Standard treatment for a low: eat 15 grams, wait 15 minutes, test
Retrieved from: http://ndb.nal.usda.gov/ndb/search/list
http://usaherald.com/wp-content/uploads/2013/08/Junk-food.jpghttp://www.dienviro.org/s950/images/junk-food.jpg
Processed vs. Real
http://4.bp.blogspot.com/-tnN6FSu-c2s/UcLj8NCRomI/AAAAAAAAAHk/JGXfmPDl8hI/s1600/health+and+G+I+image.jpg
Example of Combining Foods
O’Keefe, Gheewala, O’Keefe. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. Journal of the American College of Cardiology. 2008; 51(3): 249-255.
81 mg/dl
135 mg/dl
Foods for treating low blood sugarsRecommend
FoodPortion Carb (g) Foods with
carb/fat/proPortion Carb (g)
Banana 1 30 Peanut butter 2 T 7
Apple 1 27 Almonds 1 oz 6
Pear 1 27 Yogurt, plain ½ cup 6
Strawberries 15 15 Cheese, cheddar 3 slices 1.2
Carrot 2 12 Hummus 2T 6
Sweet Potato ¼ cup 12-15 Milk 8 oz 12
Coconut Milk 2T 1
Foods that also work (but are more likely to have blood sugar spikes)
Whole grain bread
1 12
Whole wheat crackers
6 20
Raisins 2T 22
Retrieved from: http://ndb.nal.usda.gov/ndb/search/list
My Message
Eat real foods
Identify the type of carbs to eat, as well as the quantity
Combine carbs with a protein or a fat
• Protein and fat slow down panic and brain scatter
• Treats the low and prepares the child to return to the classroom alert
and ready to participate
Provides a better chance to learn and have a normal life
Food can play a major role in the management of blood sugars
Questions?
http://images.feedgrids.com/assets/post_images/e3cef9cf19462cd2b1fa7c67176dd50b.jpg