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Nutition Question Please

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Bob Newman - 07 May 2004 00:03 GMT
After being a diabetic for 25+ years (currently diet/exercise controlled)
and a recent open-heart surgery patient, I have been following my diet VERY
strictly.  My question is this:  All the recommendations I see are for less
than 30% of calories from fat, a minimum is never mentioned.  I know you do
required some fat though.  I have been running low to mid teens fat
percentage with some days in single digits.  Is this okay?  Where do we draw
the line?  Any input would be greatly appreciated.

Signature

Thanks in advance... Bob

GaryG - 07 May 2004 00:32 GMT
> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.

It depends on who you ask.  Dr. Dean Ornish says we should aim for 10% of
calories from fat, or less.  He claims to have evidence that a diet of
mostly veggies and grains will reverse cardiovascular disease.

However, many people have a hard time sticking with that diet.  Whenever
I've tried to go low fat like that, I seem to end up with more food cravings
and actually eat more total calories. [I suspect this is one reason why the
Atkins diet seems to work, because eating some fat and protein usually makes
us feel more satisfied.]

But, if the low-fat approach is working for you, and your weight, blood
pressure, and glucose levels are OK, I wouldn't see that as a problem.
However, you might want to ask your doctor, and maybe get some lab tests to
make sure.

GG
http://www.WeightWare.com
Your Weight and Health Diary
Brad Sheppard - 07 May 2004 17:39 GMT
The "consenus" is shifting away from low fat.  Here's the latest
study: "A relatively high amount of fat in the diet may be a boon to a
healthy person's cholesterol levels, a small study suggests. On the
other hand, limiting fat intake too much could have the opposite
effect." http://story.news.yahoo.com/news?tmpl=story&cid=571&e=10&u=/nm/20040504/hl_nm/fa
t_heart_dc_1


> > After being a diabetic for 25+ years (currently diet/exercise controlled)
> > and a recent open-heart surgery patient, I have been following my diet
[quoted text clipped - 26 lines]
> http://www.WeightWare.com
> Your Weight and Health Diary
Ignoramus4443 - 07 May 2004 01:23 GMT
Try reading Bernstein's _Diabetes Solution_.

The answer is that I do not believe that your diet is suitable for a
diabetic.

i

> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.

Signature

----------------------------------------------------------------------------
 @ @ @    Please forgive my typos as my right hand is injured.    @ @ @
char*p="char*p=%c%s%c;main(){printf(p,34,p,34);}";main(){printf(p,34,p,34);}
        "It's never too late to have a happy childhood."

Bob Newman - 07 May 2004 02:52 GMT
Nice answer.  Sure didn't say much about desirable percentages though.

Bob

> Try reading Bernstein's _Diabetes Solution_.
>
[quoted text clipped - 10 lines]
> > percentage with some days in single digits.  Is this okay?  Where do we draw
> > the line?  Any input would be greatly appreciated.

char*p="char*p=%c%s%c;main(){printf(p,34,p,34);}";main(){printf(p,34,p,34);}
> "It's never too late to have a happy childhood."
Ignoramus4443 - 07 May 2004 11:57 GMT
> Nice answer.  Sure didn't say much about desirable percentages though.

For diabetics, Bernstein recommends eating a low percentage of
carbohydrates, and explains why, very well. Diabetics have food
metabolism problems that normal people do not have (duh), and
therefore should not eat like normal people (high carb/low fat).

It is an excellent book that is, IMHO, a must read for diabetics. I am
not a diabetic, but I read it and was very impressed.

i

> Bob
>
[quoted text clipped - 24 lines]
> char*p="char*p=%c%s%c;main(){printf(p,34,p,34);}";main(){printf(p,34,p,34);}
>> "It's never too late to have a happy childhood."

Signature

----------------------------------------------------------------------------
 @ @ @    Please forgive my typos as my right hand is injured.    @ @ @
char*p="char*p=%c%s%c;main(){printf(p,34,p,34);}";main(){printf(p,34,p,34);}
        "It's never too late to have a happy childhood."

Patricia Heil - 07 May 2004 02:30 GMT
Well, since I assume you're not trying to get pregnant
and carry a child to term, I wouldn't think it matters.
A fetus needs some fats for proper development.
I don't know any diabetic women that I can think of
so I don't have anybody that I can ask what their
doctor said when they were trying to get pregnant.

> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.
determined - 07 May 2004 15:18 GMT
> Well, since I assume you're not trying to get pregnant
> and carry a child to term, I wouldn't think it matters.
> A fetus needs some fats for proper development.
> I don't know any diabetic women that I can think of
> so I don't have anybody that I can ask what their
> doctor said when they were trying to get pregnant.

???  where does his post say ANYTHING about being pregnant?  Did I miss
something?  Fat content in the diet DOES matter.  And it matters what KIND
of fat you eat.
Lictor - 07 May 2004 07:58 GMT
> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.

First, it depends on how your are doing with your diabete and blood lipids.
Do you have high cholesterol? How is your HDL/LDL? Do you have high
triglycerides? How good is your control? Is your weight normal?
The idea behind cutting fats is to keep your cholesterol levels low. Some
diabetics have good blood lipids, it's pretty meaningless for them to cut
lipids. Actually, it can do more damage than good, since cutting the wrong
lipids will also lower HDL cholesterol. Another idea between this is to get
you to lose weight through the "traditionnal" low fat diet. But I'm really
not convinced you need to cut fat to control your blood lipids. You just
need to control what fat you eat and to get good control for your blood
sugar. I went from slightly high cholesterol and high triglycerids to normal
values (though HDL is still at 0.37, got to get this one to move up, but LDL
dropped to 1.2 and triglycerids to 1.13) in just a couple of months. I did
eat less and lost weight, so total amount of fats was reduced, but in
proportion it actually went up a bit. The only thing I cut dramatically was
trans fats. I tried to educate my mother the other day, and I was unable to
find any product with hydrogenated fats at home. ;) I did add some omega-3
(fish, walnut oil). And that's all. I still eat butter, red meat...
Moreover, cutting fat has a disadvantage for diabete control. The only way
to slow down a given carb and lower its glycemic index is to eat it in a
meal, along with other food. Some nutriments will slow down carbs :
proteins, fibers, fats, acids (lemon juice, vinegar)... Among these, fats do
a *very* good job at slowing things down. For instance, I didn't manage to
find the glycemic index for traditionnal paella, but I'm willing to bet it's
much lower than plain water cooked rice because of the various factors
lowering the GI (rice coating in fat before water is added, proteins, lemon
juice and olive oil added before serving...).
So, it's a problem of balance between how well you control your BG and how
bad your blood lipids are. And also of what kind of fat you eat, and your
exact lipid profile. Adding the right fats can actually improve both the BG
and the lipids.

Most "reasonnable" nutritionnists don't think it's healthy to go under 20%.
Many actually think 30% is the lower limit - it's already low fat. If you
really go too low, you run the risk of lacking some essential fatty acids
(which *will* worsen the heart condition and can mess the balance between
HDL and LDL), some fat soluble vitamins (A, D, E mainly). You also have the
risk of over-eating, because fats provide good long term satiety.
If you try to reintroduce some fats, I don't think adding some olive oil and
walnut oil (ideal omega 3/omega 6 ratio) would hurt anything. If you prefer
canola oil, you should only buy the organic ones (cold extracted, not
deodorized) - the others get some trans fats and the omega-3 are partly
destroyed by the industrial process.
Maybe that's something you could try to consult a good nutritionist (if such
a thing exists) for advice.
Bob Newman - 07 May 2004 13:18 GMT
The rest of my "specs" on the diet & test results have been very good at
this point, so far I am leaning towards that 20% fat that you mentioned.

Bob

> > After being a diabetic for 25+ years (currently diet/exercise controlled)
> > and a recent open-heart surgery patient, I have been following my diet
[quoted text clipped - 53 lines]
> Maybe that's something you could try to consult a good nutritionist (if such
> a thing exists) for advice.
Lictor - 07 May 2004 13:27 GMT
> The rest of my "specs" on the diet & test results have been very good at
> this point, so far I am leaning towards that 20% fat that you mentioned.

Blood cholesterol is only loosely related to dietary cholesterol. If your
metabolism is in good shape and you have no genetic tendency, you can eat
high amounts of cholesterol without upping your blood cholesterol. Diabete
is sometimes related to cholesterol problems, though it seems it's more a
consequence of high BG (ie., cholesterol goes lower when you lower BG) than
of diabete itself (the genetic/metabolic condition). If you never had
cholesterol problems, it's unlikely to be affected much by your dietary
intake.
Did you have HDL cholesterol tested as well? It's possible to have normal
total cholesterol and an unbalance. That's where what kind of fat you eat is
as important as the total amount you eat. It's pretty weird of your doctor
to ask you to go low fat if your lipids are good to start with. Unless it's
something very specific related to your heart surgery, and I'm afraid noone
is an expert on this one here. Maybe that's something to check out on the
cardiology newsgroups.
Brad Sheppard - 07 May 2004 16:24 GMT
Bob,

Higher fat diets are gaining medical approval - but the fats must be
"good" fats - olive oil, fish oil, peanut oil, etc - low saturated,
low "trans-fats." I generally run at 40% fat and have excellent lipid
profiles. To prevent heart disease 1) take fish oil capsules or eat
fatty fish daily 2) check with your doc about moderate drinking 3) get
BP under excellent control 4) Ask your doc about chol control
(Lipitor, etc) - you should aim for an aggressive (low chol) target.
5) make sure you're eating enough tomato paste/sauce or taking
Lycopene 6) of course, keep your BG under tight control. For the best
nutrition advice, see
http://www.hsph.harvard.edu/nutritionsource/fats.html

> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.
jmk - 10 May 2004 15:01 GMT
> After being a diabetic for 25+ years (currently diet/exercise controlled)
> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 3 lines]
> percentage with some days in single digits.  Is this okay?  Where do we draw
> the line?  Any input would be greatly appreciated.

I'm not sure that tons of research has been done on this, although I
believe the Ornish diet is quite low in fat (please feel free to correct
me if I am off base on that).

Here's a link that you may find to be helpful:

How Low Fat Can You Go?
http://my.webmd.com/content/article/24/1728_57712.htm?lastselectedguid={5FE84E90
-BC77-4056-A91C-9531713CA348
}

Signature

jmk in NC

Ignoramus15189 - 10 May 2004 15:19 GMT
>> After being a diabetic for 25+ years (currently diet/exercise controlled)
>> and a recent open-heart surgery patient, I have been following my diet VERY
[quoted text clipped - 12 lines]
> How Low Fat Can You Go?
> http://my.webmd.com/content/article/24/1728_57712.htm?lastselectedguid={5FE84E90
-BC77-4056-A91C-9531713CA348
}

This study only addresses vitamin absorption, and not other effects  of
fat, such as getting essential fatty acids or effect on satiety.

Besides, as far as I understand, fat soluble vitamins are absorbed
better if they are eaten with some amount of fat. Fat consumption
during parts of the day when fat soluble vitamins are not eaten, is
not particularly relevant. So the study answers a question that is not
very interesting, namely, whether you can eat extremely low fat on
parts of the day when absorption of fat soluble vitamins is not an
issue.

----------------------------------------------------------------------------
 @ @ @    Please forgive my typos as my right hand is injured.    @ @ @
char*p="char*p=%c%s%c;main(){printf(p,34,p,34);}";main(){printf(p,34,p,34);}
        "It's never too late to have a happy childhood."
 
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