Low-Carb Diets and Cycling

[Triskeliongirl]

Anne, I have to take exception with a few of your remarks.

1. "Please, ladies, if you are worried about your ability to process glucose have a glucose tolerance test done by a medical professional who has accurate equipment and the expertise to interpret the results. There are so many variables, meter accuracy, digestion, etc. etc. etc. "

No one is asking anyone to do anything without the help of a medical professional. With that being said, many medical professionals, my endocrinologist included, appreciate when patients bring them data that can often be more informative than that provided for a lab. It was my doctor that asked me to do the eat the pancakes glucose tolerance test and email him the results. He said it was very hard to get a lab to follow you beyond 2 hours, and especially beyond 4 hours, and to take accurate time points. He also said he would rather know how a body responds to a real meal, since that is what we are going to eat, vs glucola syrup. Dr. Bernstein also, suggests that one keep detailed records of food intake and post-prandial blood glucose readings that you bring with you to your doctors visits. Of course all these recommendations assumes that one buys an accurate meter, but accurate meetings are out there, and that a person is trained in how to make and record the measurements, but that information is out there too (very detailed in Dr. Bernstein's book). In fact, my doctor tried to order a test to measure my insulin and glucose response to a high carb meal, but my insurance company refused to pay for it. However, they were happy to pay for single glucose, pepC, and insulin measurements. So, he wrote 2 lab slips and had me take them to the lab with instructions to have the first test done (I was still fasting), then to go to a diner and eat 3 pancakes with syrup, and to return to the lab and ask them to process the second set of tests 2 hours after the first bite of food. I then continued to take more frequent glucose measurements over 6 hours, and he put my data together with the lab's glucose, insulin, and pepC results to determine that my body does not make enough insulin. He could also tell from the ratio of insulin to glucose that my problem is not a lack of sensitivity to insulin, but that there is simply not enough insulin to clear the glucose at the correct rate.

So, all I was suggesting was that while Dianyla was waiting for her doc's appt., she take these measurements and bring them to her visit to have a more productive visit. It sounds like that happened since he ordered a diabetic panel that my have been delayed without the information she provided.

2. "I don't know *anyone* that doesn't have a reaction to a lot of refined carbs and it isn't necessarily an indication of a glucose tolerance problem; The sugar crash will happen to most people as we have evolved to eat a wide variety of foods over a very long time and refined sugars are a very recent addition to that mix. I can feel absolutely exhausted after too much refined sugar and have a BG reading of 90 mg/dl... "

We are not talking about 'a reaction'. We are talking about a very specific reaction, blood sugar rising too high and staying there for two long, with clear definitions of what those numbers are. That is why I suggested a specific test that anyone can do with a $17 meter (the one I recommeded in an early post is both inexpesive and rated as being very accurate).

3. "But low-carb diets are not an ideal solution, especially for an active person."

What is the source of this information? I am a very active person and I am thriving on a low carb/ high protein diet. I cycle 100-150 miles per week., and weight train ~1-2 hours per week. I have now ridden as far as 68 miles on this diet and felt great (and I only stopped because my son was tired, I could easily and comfortably have done a full century that day). The human body is amazingly adaptable, and can run on many different fuel types. Dr. Cordain is an eminent exercise physiologist with many peer reviewed papers cited in his paleo diet for athletes book. I would follow that plan if my body were more glucose tolerant. However, I can eat even lower carb than he recommends by carefully targeting protein (amino acids can be slowly converted to glucose by gluconeogenesis, I am a professor biochemistry at a major research university and I know what I am doing makes biochemical sense), and low carb veggies can also slowly generate some glucose without a glucose spike. You can also train your body to run on a higher percentage of fat to carbs, which has amazing benefits for weight loss (I have painlessly lost 23 pounds with this approach).

So, what is an 'ideal solution.' That may be very individual. I am not advocating that everyone do this diet, but for me, I perform better on this diet because my blood sugars are stabilized. Before, even on the bike, I would go through swings of hyperglycemia and hypoglycemia, all the while not being able to access fat stores that was definitely not performance enhancing. That is because when my blood sugar was high, even though I would have insulin turned on, it would be too little to get the glucose into my cells, yet with insulin on glucagon was off and I couldn't get my fat out of storage, so I would be literally starving on the bike, despite having glucose coarsing through my veins and plentiful fat stores. This bugged me for years, because while I understood this, I didn't know what to do about it.

4. Anne, I just clicked on your homepage and saw you have first hand experience riding with a type I diabetic. Please get her to read Dr. Bernstein's book. This diet is also advocated for type I diabetics, because by eating lower carb, they won't need as much insulin, and won't experience the kinds of blood sugar fluctuations you described your friend going through, which is better for their long term health. The idea is with small inputs there are small changes. If a diabetic eats a high carb meal and their blood sugar skyrockets, they have to get the insulin dosage just right, or it will first go to high, and can then shoot too low. But, by eating lower carb, the blood sugar won't go up as high, so less insulin will be needed to bring it down, and there is less chance of overeating. On this diet I can keep my blood sugars in the 70-120 (OK sometimes it goes up to 130 on the bike........) most of the time. I also ride with a type I diabetic who had to have a pancreas and two liver transplants. My dad was a type I diabetic who died in his 50s. I don't want to end up like them, which is why I follow the diet I do. PLease have Sarah (and her doctor) consider the advice in this book.