In January 2001, I started myself on a diet based loosely on the Barry Sears Zone Diet and the Fresh Start Metabolism Program by Cathi Graham. My main food targets are 1800 calories/day with each main meal spaced 4-5 hours apart and made up using 15g fat/ 30g protein/ 45g carbohydrates (note the 1/2/3 ratio and that this equates to 30/30/40% calorie contribution ratios; using 1g fat=9 calories and 1g protein or carbohydrate=4 calories). I eat a variety of foods and try to eat carbohydrates with a low glycemic index. I also started myself on a vitamin/herb supplement regime based largely on the recommendations made by Kathi Mead, ND, in Natural Treatments for Diabetes. I started recording everything I eat and my blood glucose levels before and after every meal; for example, see a typical breakfast and an excerpt from my Food Diary. In January 2002, I started recording, but didn't keep it up, what I eat using Diabetes Diary and producing weekly nutrition reports. Once my diet has become a normal routine, I intend to start an exercise program (I've been saying this for two years now, I guess I'd better get going soon!)

I would say that over 80% of bringing your diabetes under control is directly related to what you eat. The other 20% is due to exercise, medications, and supplements. There are no magic cures, no magic pills, natural or synthetic, just a simple remedy; control what you eat before you experience the complications associated with diabetes!

Diet Guidelines...

The following guidelines assume that you don't have special physical needs which may be unrelated to Diabetes. For example, if you have kidney problems, you may have to limit the amount of protein in your diet. In any case, always seek the advice of your doctor, registered nutritionist or dietician before initiating any major change in your eating habits.

1. Start a Food Diary. Record when and what you eat and drink throughout the day. I use a small spiral-bound notepad to record what I eat and then input the information into my Sony SJ-20 using RMRdiet and then transfer my results to my PC for analysis and report creation using Microsoft Excel. Eat small meals at least every 4 to 5 hours (and preferably more frequently). Record how you feel during the day. Record you blood glucose level immediately before and two hours after each meal. Set premeal and postmeal blood glucose target levels (see Using your meter).
2. Estimate your daily protein requirement based on your weight, percentage body fat, and physical activity level. Record your height, weight, waist, hip, and wrist measurements and then use the Zone Body Fat Calculator.
3. Reset your metabolism using the method suggested in the Protein Diet. Eat your protein requirement plus 50g/day of low-glycemic carboydrates, spread throughout the day (the Protein Diet recommends 30g/day but this is insufficient to prevent ketoacidosis); continue this until you have reached your desired weight and fat percentages, and your blood glucose levels have been normalized and stable for at least 4 weeks.
4. Increase your carbohydrate intake in 10g increments/week until every meal and snack calories are balanced in the ratio 30% fat/ 30% protein/ 40% carbohydrate (1g/2g/3g ratio). If you are taking insulin, you may find it easier to control and predict blood glucose swings due to carbohydrates, so you might want to consider increasing your carbohydrate percentage.
5. Consider using vitamin and food supplements (probably needed to minimize future diabetic complications); as a minimum add B6, B12, folic acid to lower your homocysteine level and your risk of heart disease (see ref#36 to ref#52); a multivitamin (see ref#54); at least 30g/day of Whey Protein Isolate to improve your immune system (see ref#55 to ref#68); and 1 tbsp/day of EFA (see ref#69).
6. Limit carbohydrates to foods with a low glycemic index (see ref#70 to ref#78). I'm using a Palm-based Glycemic List SmartList database to help determine which carbs to eat. For example: chana dal (GI 8), available in Canada from Loblaws and the Real Canadian Superstore (owned by Loblaws); pearled barley (GI 25); beans (GI 34); lentils (GI 30); cheese; milk (GI 32); low fat, artificial or unsweetened, yogurt (GI 14); rice: long-grain parboiled (GI 48) or brown (GI 55); potatoes: boiled, steamed or roasted, low-starch new potatoes (GI 60); apples (GI 38); blueberries; grapes (GI 46); pears (GI 37); bread: whole-grain pumpernickel (GI 51), whole-wheat pita (GI 57), sourdough (GI 52), whole-grain breads (in Canada, I find Loblaws President's Choice Bran Loaf [2 slices: 103cal, 1.5g fat, 5.5g protein, 17g carb-4g fibre] and Multigrain Loaf [2 slices: 110cal, 1.7g fat, 4.6g protein, 19g carb-3g fibre] very good); if you can find them in your area, try the Natural Ovens and Healthy Choice breads; soups: tomatoe (GI 38), lentil (GI 44), split pea (GI 60); cereals: Kellogg's All-Bran Buds (GI 45), Raisin Bran (GI 61), Special K (GI 66), and Frosted Flakes (GI 55, this surprised me; but I tried it and my blood glucose level didn't rise any more than it did with oatmeal); Quaker Oat Bran (GI 50); McCanns Irish Oatmeal (GI 49). Combining high and low glycemic foods gives you a glycemic index somewhere in the middle; for example, combine 1 cup of brown rice with 1/4 cup of pearled barley and boil in 2 cups of water for about 45 minutes (makes 3 servings), to get an excellent side dish that affects my postmeal blood glucose levels significantly less than rice alone; in addition, you don't get sticky rice!
7. Limit your food intake to between 1500 to 2000 calories per day, if you aren't expending large amounts of energy!
8. Minimize your intake of processed grains and refined foods. Eat organically grown whole foods and as much raw food as you can (I mean fruit and vegetables; not raw meat!)
9. Minimize your intake of all sugar and high-sugar foods; this means candy, cookies, cakes, pastries, ice cream, frozen yogurt, fruit juices, and soda. Minimize your use of artificial sweeteners (Aspartame: NutraSweet, Equal, Canderel, Neotame; Sucralose: Splenda; Acesulfame-K: Sunette, Sweet & Safe, Sweet One; Saccharin; Cyclamates). Avoid Stevia because of possible DNA mutation evidence reported by the European Commission on Food Safety (also see the CSPI report on Stevia). Also see the CSPI report Foods Additives to Avoid. The safest artificial sweetener seems to be Spenda/Sucralose (see European opinion). If you must use a sweetener, try a natural product that has undergone minimal processing. The best natural sugar appears to be Sucanet (but it may be unsuitable for bread making); also try using a small amount of honey (GI=58), I use one teaspoon in a pot of peppermint tea.
10. Avoid alcohol, tobacco, and caffeine.
11. Maximize your intake of fish, chicken and turkey (without skin); mimimize your intake of low-fat red meats.
12. Always eat your minimum daily protein requirement (about 0.4g/lb of body weight, to a maximum of 100g/day). If you have kidney disease you may be asked to limit your protein intake, based on weight (0.25g/lb), to about 20-60g/day; this recommendation only seems to make sense, if you are already on dialysis, to reduce the frequency of dialysis treatments. There are indications that if you keep your blood glucose levels between 4-7mmol/L (72-126mg/dL) that you needn't be too concerned about how protein affects your kidneys. However, there are also indications that you should keep your protein intake below 100g/day because of its possible effect on calcium loss. Determine your daily protein requirement with the help of your doctor, nutritionist, or dietician (also see item 2). Because of its effect on improving your immune system, by boosting glutathione production, try to incorporate at least 30g/day of Whey Protein Isolate into your daily diet.
13. Use fats rich in Omega 3-6-9 EFA (Essential Fatty Acids) found in nuts, meats, fish, and dairy products. Use cold-pressed unrefined vegetable oils; try Grapeseed and Flaxseed oils. Use a balanced EFA supplement (at least 5g/day, about 1 teaspoon/day; I use 1 tablespoon/day of Udo's Choice Ultimate Oil Blend).
14. Choose a high-fiber diet (whole-grain cereals, brown rice, bran, nuts, seeds, beans, lentils, fresh fruit, and vegetables). You need to consume about 25 to 35g of fiber/day (5-15g soluble). You can get about 50% of your daily fiber at breakfast time by eating 1/3-cup of Kellogg's All-Bran Buds.
15. For snacks, consider selecting foods from Rick Mendosa's Free Food List.
16. Eat as many fresh raw vegetables as you want.
17. Drink water all day. Sip at least 8 glasses (64oz/2 litres) every day.

What to do next...

Review your proposed diet with your doctor, nutritionist, and dietician; but remember, you are the one in charge and you have to live with the consequences of your choices and control your diet and blood glucose levels on a daily basis.