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?

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