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August 27, 2000

Meal Planning, Food and Diet

Question from Clifton, New Jersey, USA:

My daughter was diagnosed with eype 1 diabetes about a month ago. Since then, I have been reading everything I can get my hands on. One book in particular intrigued me, "Diabetes Solution" by Dr. Richard Bernstein. I would like your opinion on his theory of maintaining near normal blood sugars by eating a higher protein and lower carb diet than the ADA currently recommends. What is the thinking on this at this time?

Answer:

How old is your daughter? Children are not to be tinkered with. They need to eat normal, healthy, tried and true kid food! If you haven’t done so already, setup an appointment with a pediatric diabetes dietitian to discuss your concerns.

LD
Additional comments from Dr. Stuart Brink:

Richard Bernstein’s theories are controversial but seem to work for him and his patients. Most of us believe that excess protein is a burden on kidney function and that, since high sugars also cause such burdens on kidney function, the excess protein should be decreased rather than increased. Having said that, there is no had evidence provided by any scientifically valid clinical trials either way.

The best bet to minimize, delay or prevent kidney problems in people with diabetes, including kids, is to keep the blood glucose levels as close to normal as possible — without excessive or severe episodes of hypoglycemia. If Dr Bernstein’s methods accomplish this goal, this may be more important than how much protein is provided to the body to utilize. Most Americans and people in Japan, Australia and Western Europe receive more than double the amount of protein needed by the body for growth and development as well as normal body functions so there is plenty of room for maneuvering.

In summary, we don’t know the answer but only a small minority of diabetes experts agree with Dr Bernstein’s dietary recommendations at present.

SB

[Editor’s comment: Stick with what your diabetes team has told you. While Dr. Bernstein’s methods have some merit, they are difficult to follow, especially for a child. Kids need to be kids first and they happen to have diabetes. If your daughter is doing well, don’t fix things if they are not “broken.” If her treatment is not working, discuss any changes with your health care team first before making any changes.

SS]