Diabetes Do Calories Matter

My Notes From the Diabetes Summit

Cassie Bjork RD

I see undeniable results everyday with my clients from the power of real food.

PFC balance is the foundation of everything I teach, protein, fat and carbohydrates. these are the three micronutrients that everything we eat falls into one of these categories, some foods kind of overlap. A lot of diets focus on restricting or completely eliminating a macronutrient but the truth is we need and work best when we have them all. All three of those nutrients support the body, brain and metabolism in their own unique way. I recommend eating all three macronutrients together instead of the standard American diet that’s very high in carbs and low in fat and moderate protein, my approach is more balanced including all three.

I don’t count calories, I love the energy you get from calories but I hate the flawed concept of counting calories and weight is just a matter of doing this. I have many clients that come to me with restrictive ways of eating, they are so brainwashed with these warped approaches of how the body works a lot of people think the body works best when we restrict calories. To me this doesn’t make sense our bodies work better when we actually fuel them properly, one of the obvious flaws to the calories in calories out theory is diet soda is not equivalent to water it’s made with chemicals that the body doesn’t recognize. The first micronutrient that your going to cut is fat because it’s high in calories at nine calories per gram with the other two at four calories per gram, this is how we get the standard American diet being so high in carbohydrates. When you cut fat you have to put something else in there to keep us full but all carbohydrates turn into sugar, essentially the standard American diet is a very high sugar diet. This has led to the increased prevalence of type 2 diabetes, heart disease, cancer and obesity, it’s really not working. I’m not a fan of counting calories I think it’s important to fuel the body with what it needs to work best. I don’t count anything but I think it’s important to be aware of portion sizes when your including protein, fat and carbs. A good rule of thumb is for protein the size should be equal to the thickness and circumference of the size of your hand. At meals it may be four to six ounces of meat or two to three eggs and about half of that at snacks, I do recommend snacks between meals to stabilize blood sugar levels. Protein is really important it has the ability to increase metabolism so it’s important to eat it throughout the day to keep our energy levels up. It’s also an important precursor for creating neurotransmitters, your brain chemicals and for people who have battled sugar, alcohol or carb cravings. It’s even more critical to make protein your best friend because it’s going to help you stay away from these cravings.

We have been told for so long that fat makes us fat I wish we could call it something else like energy or vitality. Fat is really important, it’s essential for every cell in our body, the membrane of every cell in our body is made from fat. It plays a central roll in the function of our nervous system, our brain function, our skin integrity, mineral absorption, it has healing and immunity properties, not to mention it supports metabolism and it helps keep us full. Fat helps slow the assimilation of sugar from carbohydrates into our bloodstream which helps keep blood sugar levels stable. I think this is a big reason why people are having carbohydrate and sugar cravings throughout the day and why the prevalence of type 2 diabetes has increased because we keep riding this blood sugar roller coaster by spiking and dropping our blood sugar levels by eating a lot of carbohydrates without healthy fat, not all fat is created equal. The fats I recommend are things like almonds, avocado, butter, cheese, coconut milk, coconut oil, heavy cream, olive oil, nuts and seeds if you can tolerate them. For fat I generally recommend a minimum of ten to twenty grams of fat at every meal and snack. I don’t count things but what I teach clients is that sixteen almonds or a tablespoon of butter, half an avocado and we just focus on what that looks like so they know how to incorporate that through their day.

Our bodies are pretty amazing and do a good job regulating if we let them.

With carbohydrates for most people I recommend non-starchy carbohydrates first, the non-starch vegetables broccoli, cauliflower, spinach, cucumbers. These don’t effect your blood sugar levels as much as the starchy ones, they provide loads of antioxidants, vitamins, minerals and fiber. You want to fill up on these first with about a cup at each meal as far as the starchy vegetables go potatoes, carrots, squash, fruit limit it to about a half a cup at a time to prevent those massive blood sugar level spikes. Of course it’s different for each person, athletes will need more, men will need more than women and kids will be smaller amounts.

The most important thing is listening to your body and we have gotten so far away from that with counting and restricting our bodies so I teach my clients to listen to your body to figure out what is the right amount for you. You want to find the perfect balance it’s all about balance, you don’t want to be stuffed but you also don’t want to be so hungry that you start to notice signs of hypoglycemia those low blood sugar levels. The key is you want to have balanced blood sugar levels all throughout the day you want to feel stable, your hunger levels should be stable, moods should be stable, you should be able to focus, you shouldn’t feel cravings throughout the day, that’s really how you can tell if your eating the right amounts.

A lot of clients come to me with goals of weight loss and they are shocked at how many other health issues are resolved and their journey to wellness with a real food approach. There are so many benefits to keeping your blood sugar levels stable other than just weight loss. Once you get into the habit of getting your blood levels stable by embracing the PFC approach and eating it throughout the day people notice that their cravings go away and if their trying to loose weight it comes off almost effortlessly. It’s amazing how your body works so well when you give it what it needs instead of restricting and working against it.

Good and bad foods – bacon is good, it depends on the quality if your buying commercially raised meat it’s not the best quality so I would choose a lean cut because toxins are stored in the fat. but. If your buying high quality organic grass fed pasture raised without nitrates I would recommend buying full fat it’s good healthy fat, it could be a good source of protein and fat if it’s high quality. Popcorn is a carbohydrate and normally I like you to get your carbs from fruits and vegetables. I do think popcorn can be part of a balanced diet, one of the things I’m big on is including a bedtime snack. It’s a big myth about eating after a certain time because you can store fat, I believe a bedtime snack helps to stabilize your blood sugars before you go to sleep so the right bedtime snack helps to do that. Popcorn is not the best for this because it’s all carbohydrate and this turns to sugar in your bloodstream which spikes your sugars and then an hour or one and a half hours later you feel that crash, the same thing happens if you eat a banana. But if you balance it out with some healthy fat it’s much better and you can work it into your eating regime so I tell my clients it’s not the best but it’s ok if you add real butter and not more than one to two cups because it does turn to sugar. The butter does buffer the effect of that carbohydrate and slow that assimilation of that sugar into your bloodstream, if you can’t do butter you can melt a little coconut oil and drizzle that on it. With a half banana if you combine it with a couple tablespoons of nut butter and a hard boiled egg it’s a great balanced snack, it’s not about calories it’s about balance.

I do not believe milk is necessary or healthy it’s one of those myths that we have been told for so long that we need it for calcium and growth. I think breast milk provides babies what they need to grow and develop, no one needs cows milk, I don’t think it’s a good source of nutrition. We don’t have any nutritional requirement for cows milk and we actually can obtain any and all the nutrients we find in milk with meat, seafood, veggies, fruits and nuts. I read studies that say that milk is highly insulinogenic which means it stimulates the production of insulin their fat storing hormone much more than most carbohydrate sources and can be really inflammatory. Because of it’s inflammatory properties I see with clients all the time with milk is a common offender of acne, sinus congestion, sneezing and digestive distress. A lot of people don’t realize they have a sensitivity or intolerance to milk but if you struggle with any of those I really recommend cutting it out and seeing how you feel and see if some of those things resolve. Even if you don’t have a documented sensitivity and you feel fine milk can block calcium absorption and it’s very counterintuitive.

If were eating real food eggs instead of cereal, real butter or coconut oil in our coffee I don’t think we need milk for anything. If people want an alternative I think almond milk and coconut milk can be healthier options. Milk is designed to make the body grow and most diabetics don’t want that in fact it’s just the opposite. If people do choose to drink milk because of the amount of hormones and antibiotics fed to dairy cows I think it’s really important to get grass fed or organic milk. It’s perfect coming out of the cow but refining it to make it low fat removes so many vitamins and minerals which they actually end up adding back in.

I am very against all artificial sweeteners when it comes to real food chemicals like splenda don’t fit into that category, it’s one of the greatest health misconceptions. Companies are telling us low fat and sugar is good they take them out and replace them with artificial sweeteners, even though they don’t contribute calories research is finding they might interfere with our metabolism causing it to slow down and alter the way our metabolism works and the way our bodies store fat. I had one client who drank a twelve pack of regular soda everyday and when he switched to diet soda he started gaining weight. Research is agreeing with this there isn’t a single study that shows artificial sugar helps us loose weight, that’s why people use this in the first place because it’s calorie free. I am strongly against using these chemicals and just putting real food into the body skipping all the junk. There is some data showing that artificial sweeteners can actually increase insulin resistance giving it the potential of making type 2 diabetes worse. Our bodies can begin secreting insulin just by tasting something sweet so the sugar doesn’t come into the body these chemicals do and you have this insulin with no sugar to work on it’s not good for anything.

I’m a little torn on stevia I don’t think there is enough research out there to use it like crazy but it is a decent alternative. I’m actually torn between stevia and sugar, sugar is not good for us but the body knows how to process it. Stevia is plant based so I’m ok with it but I’m not ok with truvia it’s a false advertising job, it’s not even close to being like stevia and full of chemicals that are notoriously known for their unpleasant side effects we do a terrible job at digesting sugar alcohols. Because their not fully digested they hang out in our intestines and then are fermented by bacteria and the byproducts of fermentation includes digestive distress, diarrhea, cramping, gas and bloating. Use pure stevia where the ingredients say stevia only.

I am also torn on edamame, I’m not a fan of soy but edamame is relatively unprocessed and I think it has lower amounts of these enzyme inhibitors and phytates than most soy products do if your talking about it as a snack food it’s way better than chips or cookies it has a decent amount of vitamins and minerals calcium, magnesium, potassium and folate. Out of all the soy out there it’s probably the best one it’s not as processed.

I love coconut oil it’s antibacterial, antifungal, antimicrobial, it’s the most versatile fat out there. It’s the only thing in my kitchen that when I’m done with it I can wipe it all over my face because it’s really good for your skin too. You can cook with it at higher temperatures, the oils I cook with are coconut oil, olive oil and butter. I love that I can have it in my kitchen and in my bathroom it’s so heart protective it’s a good healthy saturated fat.

I say no to whole wheat bread, bread is not good for us it really spikes our blood sugar levels a lot it’s another one of those health misconceptions that we have been told for a long time. These whole grains are refined and refined will never be better for us than whole real food. They turn into sugars the minute they hit our bloodstream, they contain anti-nutrients, phytates which combine to nutrients in the food magnesium, copper, calcium, zinc and iron so they prevent us from absorbing other nutrients. It’s always better to get our carbohydrates from vegetables and fruit.

Out of all the alcoholic choices red wine is great or white wine it doesn’t contain as much sugar as the other drinks out there.

Oatmeal is another one of those foods that is all carbohydrate, diabetics are told oatmeal with skim milk is good but that’s not the case it’s also said to be heart healthy which it doesn’t deserve. It’s another highly processed grain that can spike blood sugars and increase inflammation and most people eat far more than the recommended half cup serving size. Then they may top it off with more sugar or the packets that contain as much sugar as a candy bar so it’s not good. If you do eat oatmeal make it PFC balanced by adding a scoop of protein powder or have an egg on the side and maybe a couple tablespoons of heavy cream, butter or coconut oil and try to stick to the half cup serving size to make it more balanced but it’s not what I consider a healthy breakfast food.

With eggs pastured are best or omega 3 enriched, eggs contain six grams of the highest quality protein along with those omega 3 fatty acids for brain health, healing internal inflammation and protecting our heart. Eggs are one of the best foods for us they contain all of the essential amino acids that our body requires. They have been shown over and over to help with weight loss, increase our focus and keep our mood and energy levels stable. You can have as many eggs as you want they are full of healthy fat and quality protein.

Eating healthy on a budget I tell my clients it’s not anymore expensive to eat real food, I have a few clients that did a test to see what the difference would be and some said their bill went down eating real food. I do emphasize the importance of the quality of the food but when you first start changing to real food don’t worry if it’s not all organic if you can’t afford that, eating real whole food is most important. Don’t stress out about food quality right away just start where your at doing the best you can. Just choosing real foods over the processed ones and loading up on veggies, fruits, meats and healthy fats instead of grabbing frozen diners and convenience foods. Also shop around if you have a Trader Joes you could get the Kerry Gold grass fed butter and good coconut oil. Costco has good deals on organic produce and great prices on nuts. I buy a lot of things online coffee, dried beef sticks and the fermented cod liver oil butter blend.

A plate of food would have lot’s of the non starchy vegetables, at least one to two cups and add a healthy fat of butter or coconut oil and the protein. It’s important to have all three micronutrients on your plate, the best detox is one that heals your body and provides you with lasting changes. I am not a fan of detox programs I believe the best approach is saturating your body with the things it needs to heal your metabolism and cellular function. When doing a detox it’s important to start with the gut the most critical and overlooked starting point is the gut where you have digestion, elimination and absorption all take place it’s important to get this under control right off the bat. The gut plays such a vital roll in our metabolism there has been tons of research about how their connected. Following the high sugar high carbohydrate standard American diet can really wreak havoc on our gut and contribute to inflammation. When we heal our body from this inflammation we can feel a lot better and see results that we want quicker. It’s tough to reach our weight loss goals when our body is continually working on inflammation and healing. For gut health I recommend loading up on probiotics and fermented foods things like kombucha, kefir, sauerkraut or taking a high quality probiotic supplement for supporting getting those good healthy critters into our gut. L-glutamine is also a good supplement it focuses on the structural integrity of our intestinal tract and fish oil can be beneficial to heal the gut and reduce inflammation. So our body can really focus on using the nutrients we are feeding it to run efficiently and heal itself supporting our metabolism with healthy fats they are so healing. Give your body a break from the sugar and get those antioxidants in they are so important and especially when we want to hit that reset button antioxidants act as a shield for free radicals and oxidative stress.

I also have everyone eat every three to four hours maximum to keep blood sugar levels balanced and those blood sugar levels are what contribute to consistent energy levels, focus, stable moods, no cravings and their really essential for weight loss and protecting against type 2 diabetes. That’s what I would focus on a detox with real foods, a break from the sugar, getting antioxidants and really focusing on helping your body to heal that gut.

If you fall off the wagon it’s ok were not perfect, not getting frustrated and not falling into that vicious cycle it’s really easy to fall into that pithole. When a client eats a bunch of sugar and doesn’t know what to do after that I always recommend having a balanced snack with protein, fat and carbohydrate an hour or two after and that’s the last thing their going to want to do. When they indulge in a bunch of food that’s not good for them their not going to feel good, they don’t want to eat anything and what happens is it spikes their blood sugar so much and a couple hours later their levels are super low again. The biochemical response is to create more sugar so they want more of that junk that got them there in the first place. This is how we get into this vicious cycle of riding this blood sugar roller coaster when we get these massive spikes and drops in our blood sugar levels that just leaves us craving sugar. We have been told it’s all about will power and when we crave sugar just say no, it’s actually a biochemical response when blood sugar levels are really low your brain is really smart and knows the quickest thing to raise them is sugar that’s why we crave it. We don’t have to feel guilty about it it’s kind of empowering that we can balance our blood sugar through real food. When you fall off track just have the PFC an hour later and it could be small to help stabilize that blood sugar.

One more thing is drinking plenty of water it’s not only going to make you feel better but it also naturally supports your liver and kidney’s and organs responsible for detoxing. If your binge was at night when you get up the next morning have your breakfast right away, research shows that breakfast eaters are more focused at work and they weigh less because they don’t over indulge later in the day.

Cassie Bjork RD web page dietitioncassie

and here at healthysimplelife



Disclaimer: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.

M. Scherker medical researcher


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