Atkins Diabetes Revolution (35 page)

Dr. Atkins would often encounter patients who told him they were willing to try his approach, but just couldn’t live without chocolate, or ice cream, or some other sugary treat. He would remind them that there are plenty of good low-carb versions of these favorites, but would also ask them to give up these foods, at least during the first few weeks. When the patients returned, they almost always told him how they no longer missed sweet foods.And in the next breath, they would tell him how much more energy they now had. It always gave him great pleasure to point out the connection between the two. By eliminating sugar and controlling their carbs,these fortunate folks had gotten off the blood sugar roller coaster.Instead of struggling with energy ups and downs, they now had stable blood sugar, which gave them a steady supply of energy. They did it—so can you.

WHAT’S YOUR SWEETENER IQ?

1. How many carb grams are in 1 teaspoon of table sugar?

1. 9
   
2. 4
   
3. 6
   
4. 1
   

2. Which of the following ingredients are disguises for sugar?

1. corn sweetener
   
2. dextrose
   
3. fruit juice concentrate
   
4. malt syrup
   
5. molasses
   

3. Which of the following are acceptable substitute sweeteners?

1. maple syrup
   
2. sucralose
   
3. saccharin
   
4. sweetened carob powder
   

Answers

them.3.b,c.
1.b.2.all of

Chapter 19

DRINK TO YOUR HEALTH

When you first begin controlling your carbs, your focus is understandably going to be on what you can and can’t eat. Don’t forget, however, that you’ll likely need to make some changes in what you drink. If you’re not a big water drinker, it’s time to develop a relationship with the office water cooler. It’s all too easy to forget that the liquid carbs count just as much as the solids. On the Atkins Blood Sugar Control Program (ABSCP), you also need to give careful thought to the pros and cons of drinking alcohol.

STAY LIQUID

Most medical authorities agree: For good health, you should drink at least 64 ounces of water each day. That’s eight 8-ounce glasses, or 2 quarts, or about 2 liters. (However, individuals diagnosed with renal function decline need to follow the advice of their physician with regard to water intake.) That might sound like a lot, but it really isn’t, especially when you spread it out over the day. Bear in mind that a typical can of soda pop or other beverage contains 12 ounces, and that today’s supersized beverages often contain 20 ounces or more. These beverages do not count toward your 2 liters a day; water is still the best drink of all and diet sodas should be only a small part of your daily fluid intake.

Getting plenty of fluids keeps your system hydrated and flushes waste products from your body efficiently. Regardless of your dietary approach, if you drink less than you should, you may experience constipation and an increased risk of kidney stones.

There’s another problem with not drinking enough: It may increase your food intake. That’s because it’s common to confuse thirst with hunger,especially if both sensations happen at the same time.In- stead of drinking, you eat. That fools you into thinking your thirst has been quenched, even though you haven’t taken in any fluids. Next time you feel hungry between meals, try drinking something instead, or having a drink along with a small protein/fat snack such as some nuts or a piece of cheese.You may be surprised to see how quickly your hunger goes away. Likewise, having something to drink before you eat a main meal may help you avoid overeating. The liquid fills you up a bit so that your meal satisfies you faster. For some reason, hot drinks seem to work better than cold ones—try a cup of hot tea or herbal tea or some hot broth about half an hour before suppertime.

By the time your body signals that it’s time for some fluid,you’re already a little dried out. Also, as you get older, your sense of thirst generally gets less acute, and it’s easier to become dehydrated. You also need to drink more in both hot
and
cold weather. Hot weather makes you lose fluid by sweating; in cold weather, the air is usually dry, which pulls moisture from your body.

THIRST IS A DANGER SIGNAL

Increased thirst, increased hunger, and increased urination are all classic symptoms of diabetes. If you notice these symptoms, even if you’ve already been diagnosed with diabetes, check with your doctor immediately.(See Chapter 6,Diagnosis: Diabetes.)

WATER, PURE AND SIMPLE

What’s the best thing to drink when you’re following the ABSCP? Water. Convenient and carb-free, water is the way to go. Bottled water, mineral water, and filtered water are good choices. If you prefer something with a bit of flavor, look for no-carb flavored water and flavored seltzers; you can also add a squirt of lemon or lime juice or some sugar-free flavored syrup to your water or club soda.

Fruit juice, despite its reputation for being “healthy,” is actually high in carbohydrates and low in fiber. Whether they’re made only with pure fruit juice or contain some juice and additional high- fructose corn syrup, fruit juices are higher on the glycemic index than whole fruit.
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Whole fruit is a better choice if your carb threshold allows you to include fruit, because the fiber content slows down the absorption of fructose.
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Once your palate adjusts to your new eating style, you will be amazed by how sweet fruit juice tastes.

NOT MILK?

When you choose your beverages, remember that an 8-ounce glass of whole milk has more than 11 grams of carbohydrates, mostly in the form of lactose, or milk sugar. It’s not acceptable on Induction. For active kids and teenagers who can add more carbs to their diet, however, using up some carbs each day on a glass or two of full-fat milk is fine— the protein and calcium in the milk are important nutrients.If you want the taste of milk without all the carbs, try one of the new reduced-carb dairy beverages, which have about 3 grams of Net Carbs per cup. Those few grams of carbs are in the form of lactose,however.If you’re very lactose intolerant,you still might not be able to drink these beverages.

You’ll still be getting dietary calcium when you follow the ABSCP, because you’ll be eating a lot of green vegetables, along with cheese and nuts.(One ounce of almonds has 80 mg of calcium and about 4 grams of Net Carbs.) Leafy green vegetables, such as kale, Swiss chard, collard
greens, and broccoli, are excellent sources of calcium. Unlike milk, they also contain the other vitamins,minerals,and flavonoids that are essential for helping your body absorb calcium and use it to build your bones.

You may have heard something about calcium in greens not being absorbed as easily. The calcium in some greens is bound up to some extent by other natural substances such as phytates and oxalates. Some dark leafy greens,such as beet greens,spinach,and Swiss chard,are high in oxalate. Individuals with a predisposition to form calcium oxalate kidney stones should consult with their physicians. The calcium in broccoli, however, is easily absorbed. Cheese is a great source of calcium—and it’s definitely an indulgence you can enjoy during all phases of Atkins. One ounce of Cheddar cheese has 204 mg of calcium. Some emerging research also suggests that the calcium and protein in dairy products may have a potential benefit for weight loss.
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CAFFEINE AND YOUR BLOOD SUGAR

Coffee and tea are the world’s most popular beverages,and that means caffeine is perhaps the world’s most widely used drug. Caffeine is perfectly legal, of course—in fact, caffeine is the only drug that can legally be added to foods in the United States. You may find that caffeine can cause a slight, temporary rise in your blood pressure; it may also interfere with your sleep. Excessive caffeine also seems to have an effect on blood sugar and insulin—so,especially at the beginning of the ABSCP, you may want to switch entirely to decaffeinated beverages. (See Caffeine and Insulin on page 238.)

Tea is a better source of caffeine than coffee because it also contains a lot of valuable antioxidants and other substances, such as vitamin K, which can benefit your health. We discourage excessive caffeine in- take, but 1 or 2 cups of green tea or black tea a day may well be bene- ficial. However, if you have blood sugar abnormalities or diabetes, you may find that you are more sensitive to caffeine and may need to limit it.

CAFFEINE AND INSULIN

A study in 1993 confirmed what Dr.Atkins had long observed in many of his patients with unstable blood sugar: Caffeine in large quantities can make you feel hungry, even if your blood sugar is normal. The amount of caffeine used in the study was 400 mg,or about the amount found in 4 cups of strong brewed coffee.
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Two studies in 2002 suggested that caffeine can decrease insulin sensitivity. In the first study, 12 healthy volunteers were given either a caffeine-loading dose or a placebo and their insulin response was measured. When they got the caffeine, their insulin sensitivity decreased by about 15 percent. The amount given was equal to a “moderate” caffeine intake. The authors noted that the decrease in insulin sensitivity was roughly the same as the improvement in insulin sensitivity that is obtained from drugs used to control blood sugar, such as metformin.
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The second study looked at the effects of caffeine on how well skeletal muscles took up glucose—another way of looking at the effect of caffeine on insulin resistance. Seven healthy volunteers were given doses of caffeine and then they exercised for an hour; their blood was tested for insulin levels before and after. The researchers concluded that caffeine decreased the ability of the muscles to take up glucose, although exercise can reduce the effect of caffeine.
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Do the studies indicating that caffeine increases insulin resistance mean you should give up your morning coffee? Not necessarily—unless you are unusually sensitive to caffeine, but it does mean you should have no more than 1 or 2 cups of caffeinated coffee a day, taken with meals.

When you get up in the morning, your blood sugar may well be on the low side, because you haven’t eaten anything during all the hours you were asleep. But if you have a breakfast of only java, or coffee with a sweet roll, you’ll probably spike your blood sugar too high. A few hours later, your blood sugar could crash and send you on a seek-and-devour mission for carbs and more coffee. Following the ABSCP, however, you start the day with a good breakfast containing protein, fat, and a small amount of allowable carbohydrates along with your morning cup of coffee. That keeps your blood sugar steady and maintains it on an even keel for several hours. You’ll then find it much easier to resist the doughnuts in the break room later in the morning.

If you can bite the bullet and substitute decaf for regular coffee,you may find that your carbohydrate cravings decrease. If you’re a con- firmed caffeine addict, taper off slowly by combining caffeinated and decaffeinated coffee and then gradually increasing the amount of decaf over a week or so. (Watch out for flavored coffee drinks, even if they are decaf. They often contain added carbs and trans fats. Choose sugar-free, milk-free versions.) Although tea has far less caffeine than coffee (only about 50 mg in 8 ounces of brewed tea), you may also experience mild withdrawal symptoms if you go cold turkey—follow the same combination approach, using decaffeinated tea.

Most colas and some other soft drinks contain caffeine—in fact, some have added caffeine for an extra jolt.If you want to consume soft drinks,choose the sugar-free,caffeine-free versions.And be aware that those caffeine-laden energy drinks in the little cans are full of carbs.

Some herbal teas, such as maté and guarana, and tea mixtures also contain caffeine. Most herbal teas are caffeine-free, however, and make a good alternative to caffeinated coffee and tea. Caffeine also occurs naturally in chocolate, although the amounts are minimal— about 20 mg in an ounce of dark chocolate.

TEA AND YOUR HEALTH

Tea—either black tea, the kind most commonly consumed in the United States, or green tea—can have a very positive effect on your health. Numerous studies of large groups of people have consistently shown that those who drink the most tea also have the lowest risk of heart disease. In a study of men and women in the Boston area, for example, the participants who drank at least 1 cup of tea a day had a 44 percent lower risk of a heart attack than those who drank no tea.
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When it comes to controlling blood sugar, it’s also possible that tea can be helpful. In a study in Taiwan in 2003, twenty people with diabetes who were taking an antihyperglycemic drug were randomly assigned also to drink either 1,500 ml (about 6 cups) of oolong tea (a type of tea that is halfway between black and green) or an equal amount of plain water every day for 30 days. They then switched off and repeated the process. The researchers found that after 30 days of tea drinking, the participants had markedly lower blood sugar levels. There was no change after 30 days of drinking plain water.
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It’s probably the catechins and other chemicals called polyphenols in tea—not the caffeine—that have the beneficial effect.

RESEARCH REPORT: THE HEALTH BENEFITS OF TEA

A daily cup or two of brewed black or green tea could be beneficial to your overall health—and might even help speed up weight loss. One health benefit is that tea can help keep your bones strong as you age. A study of over 1,200 older British women found that those who drank tea had higher bone mineral density levels in their spines and hips than those who drank no tea at all.Because higher bone mineral density generally means a lower risk of fracture (from falling, for example), it appears that tea had a definite protective effect for these women.
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