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Dr. Richard Bernstein Re: Why a Low Carb Diet?

Introduction: From Rejuvenation



I copy this from the March 2004 issue of "Diabetes Interview"

I copy this question from Diane Schafer, LDN (licensed dietetics and nutrition), RD (registered dietician), CDE (certified diabetes educator) who is opposed to a low-carb ("Atkins") diet and the answer by Dr. Richard Bernstein, author of "Diabetes Solution" and my personal mentor, ie, everything I know about diabetes that I think is correct I learned from Dr. Bernstein. (This is the reason why I believe in a low carb diet... to keep my glucose levels between 70 and 105 as much as possible.)

In this question and answer you see a diabetes EXPERT (Diane Schafer) who is also an insulin dependent diabetic, but who is CONVINCED that low-carb diets are BAD for diabetics. On the contrary, she is convinced that HIGH CARBs have been proven to be the CORRECT DIET for a diabetic...

She asks why they should even PRINT information recommending low-carb diets in a serious Diabetes magazine, and she protests that somebody who writes about low carb diets is given a monthly column in the magazine.

Dr. Bernstein's answer reveals the deep differences that exists between his advice for low carbs high protein, and the high carb-low fat advice of the American Diabetes Association.

Dr. Bernstein says that the ADA 7% guideline for Hb A1c, that corresponds to an average blood glucose level of 170 mg/dl, (which I call "HORRIBLE/DEATHLY" in my table of interpretation of glucose) ATTESTS TO THE LACK OF INTEREST OF THE A.D.A. IN BLOOD-SUGAR NORMALIZATION!!!

"TO THIS DAY," he writes, "THE A.D.A. OPPOSES BLOOD GLUCOSE SELF MONITORING FOR THE 90 PERCENT OF PEOPLE WITH DIABETES WHO DON'T TAKE INSULIN. AS A RESULT, MEDICARE WILL NOT PAY FOR BLOOD GLUCOSE SELF MONITORING FOR THIS 90 PERCENT. (!!!-Ellis)

DOESN'T THIS SUGGEST THAT ALL OF US WITH DIABETES HAVE AN 'ORPHAN' DISEASE WITHOUT STRONG ORGANIZED SUPPORT FOR OUR WELL BEING?"

(This is also why I find diabetes doctors IN MEXICO who oppose blood glucose self monitoring on diabetics type 2.... I thought they were ignorant ASSES... Now I realize they are only ignorant SHEEP, because they are only FOLLOWING IN THE FOOTSTEPS and doing whatever the American Diabetes Association recommends!)

I copy Dr. Bernstein's answer, with emphasis in CAPITALS added by me. I am adding this to Dr. Bernstein's My First Fifty Years as a Diabetic which is an unbelievable story which I recommend everybody should read, for the first time if you have never read it, or again, if you have already read it.

- Ellis

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Diane Schafer, LDN, RD, CDE writes:

"I struggle to understand why you are publishing information recommending low-carb or no-carb meals for people with diabetes.

As someone who has taken insulin for 29 years, I would expect you most of all to understand the relationship between carbohydrates and insulin. I have to fight this confusion with my patients on a regular basis.

Do you not agree that people with Type 1 Diabetes who take insulin are at a high risk of hypoglycemia and ketoacidosis when they deplete carbohydrate from their meals? What happened to the knowledge that carbohydrate is our body's primary fuel source as well as B vitamins and fiber?

I truly wish that we would stop confusing our diabetes population by giving them so much conflicting information. Many of the patients are advised to avoid carbohydrates to promote "weight loss" by most of our primary care and family practitioner physicians.

Unfortunately, many of them are also on long acting insulin or sulfonylureas. These patients will be causing hypoglycemia and possible ketosis by following their physician's advice.

Also, many dietitians who read your publication will not agree with Joy Pape's "point of view".

My request to you is to stop publishing articles that contain controversial, unproven, and possible harmful advice. Let's give people clear, concise, proven, and recommended guidelines from health organizations with credibility, shall we?

Diane Schafer, LDN, RD, CDE (certified diabetes educator)




Dr. Richard Bernstein answers:

I was present in the late 1940's when the American Diabetes Association (ADA) first recommended a high-carbohydrate diet. At that time, it was believed that the long-term complications of diabetes were due to the high cholesterol levels so common to people with diabetes. It was assumed that this was a consequence of dietary fat and that by dramatically reducing fat and substituting large amounts of carbohydrate, these complications would be avoided.

There never were, and there still have never been, any studies supporting this hypothesis. So if anything is "unproven," it is the A.D.A. hypothesis. Except for a brief change of mind in 1975-76, it wasn't until the Diabetes Control and Complications Trial terminated that the ADA acknowledged that the real culprit might be high blood sugars.

More recently, studies comparing high and low-carbohydrate diets have finally been performed AND SHOW THAT LOW-CARBOHYDRATE DIETS REDUCE BOTH BLOOD SUGARS (HB A1C) AND CONVENTIONAL CARDIAC RISK FACTORS. A number of these studies were actually PUBLISHED IN A.D.A. research journals such as "Diabetes Care."

IN SPITE OF THIS, probably because a rigid adherence to tradition, THE ADA CONTINUED TO RAISE CARBOHYDRATE GUIDELINES, and EVEN NOW RECOMMENDS THE USE OF RAPID-ACTING CARBOHYDRATES SUCH AS TABLE SUGAR, BREAD, POTATOES, PASTA, ETC. THE NEW BUT UNPROVEN A.D.A. HYPOTHESIS IS THAT PEOPLE WITH DIABETES CAN KEEP BLOOD SUGARS NORMAL BY COVERING LARGE AMOUNTS OF CARBOHYDRATE WITH "INDUSTRIAL" DOSES OF INSULIN.

THIS HAS NEVER WORKED FOR ME (I've had diabetes for 58 years) OR FOR MY THOUSANDS OF PATIENTS!

The reasons for this include the following:

1) We can never know the exact carbohydrate content of a meal. In the United States, labeling laws permit an error of plus or minus 20 percent of the carbohydrate content of a serving. For a typical A.D.A. meal containing 150 grams of carbohydrate, the uncertainty is plus or minus 30 grams (ie, it can vary between 120 and 180 grams of carbohydrate.) ONE GRAM OF CARBOHYDRATE WILL TYPICALLY RAISE THE BLOOD SUGAR OF A TYPE 1 PERSON BY 5 MG/DL for a NET UNCERTAINTY of plus or minus 150 mg/dl. Carbohydrate estimates in books are even more uncertain.

2) For a given individual from day to day, the uncertainty of insulin absorption from typical A.D.A. megadoses varies from plus or minus 29 percent to plus or minus 39 percent. The timing action of these large doses is likewise highly variable.

Thus, IT IS THE HIGH-CARBOHYDRATE DIETS COVERED BY MEGADOSES OF INSULIN THAT INCREASE THE LIKELIHOOD OF HYPOGLYCEMIA.

THE AMERICAN DIABETES ASSOCIATION's DESIGNATION OF HIGH BLOOD SUGAR - AN A1C OF 7 PERCENT (corresponding to an average blood glucose of 170 mg/dl) WHEN NON-DIABETICS WHOM I HAVE TESTED SHOW ABOUT 4.2% TO 4.8%--- ATTESTS TO ITS LACK OF INTEREST IN BLOOD SUGAR NORMALIZATION.

This may further explain the A.D.A. failure to give up on its high-carbohydrate diet. This likelihood is also supported by ADA OPPOSITION TO BLOOD GLUCOSE SELF MONITORING FOR 14 YEARS, from 1969 when I first demonstrated it to their president until 1983 when pressure from patients became overwhelming. TO THIS DAY, THE A.D.A. OPPOSES BLOOD GLUCOSE SELF MONITORING FOR THE 90 PERCENT OF PEOPLE WITH DIABETES WHO DON'T TAKE INSULIN. AS A RESULT, MEDICARE WILL NOT PAY FOR BLOOD GLUCOSE SELF MONITORING FOR THIS 90 PERCENT.

DOESN'T THIS SUGGEST THAT ALL OF US WITH DIABETES HAVE AN "ORPHAN" DISEASE WITHOUT STRONG ORGANIZED SUPPORT FOR OUR WELL BEING?

If some readers still consider this subject "controversial," they should log on to the internet and search for my book "Diabetes Solution" to read what hundreds of readers over the years have been saying about the lifesaving effects of their new low-carb diets.

Remember, however, that lowering dietary carbohydrate without drastically lowering insulin doses and doses of other blood-sugar lowering medications can cause severe hypoglycemia.

"Diabetes Interview" asked Joy Pape to write a low-carbohydrate column for an obvious reason... it is essential to the best thing that can be offered to us short of a cure... normal blood sugars.

- Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.


I am a distributor of Serono de Mexico, and Humatrope by Eli Lilly, and other excellent brands of growth growth hormone in Mexico. If you come to Mexico I will help you to get a legal prescription and you can buy Humatrope, Saizen, or Norditropin at excellent prices. If you are not coming to Mexico, I can help you to buy growth hormone legally in the United States. See my page, and write to me:

You Too can Buy Growth Hormone in Mexico

Buying Growth Hormone in Mexico



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Note: I am not a doctor, and I do not give medical advice or treatment of any kind. My advice is limited to a discussion of nutrition and a general discussion of anti-aging hormones and available blood tests and therapies, etc. Please consult with an anti-aging doctor of your choice after you have consulted with me.


I invite you to subscribe to Rejuvenation, a discussion list (moderated by me) for persons taking rHGH by sub-cutaneous injection, also open to anybody who wishes to monitor the discussion, or read the archives. Discussion centers on any issue related to the rHGH experience, or rejuvenation techniques in general, except amino acids and merits or demerits of multi-level marketing. Read a full description here:


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I became interested in growth hormone and antiaging three years ago and have been taking growth hormone at bedtime for over two years. Like you, my results have been impressive. I'm 57 years old. I am 6 ft 1 in and weight 202 pounds with 9% body fat. I exercise regularly ( 5 times a week) and do moderate weight training.

My diet is good, high protein, moderate complex carbs and low fat. After reading your page I certainly need to improve it some.

Due to my personal results, I started offering anti-aging and growth hormone replacement to my patients 8 months ago. I've read much of the literature and have attended two meetings of the American Academy of AntiAging Medicine. Although it only been a few months my patients are THRILLED about the therapy and almost all are reporting specific areas of improvement.

Thanks so much for your work in this area. I want to return to Puebla for more Spanish education. Possibly I could include some time in Mexice City also. I would love to meet you. Gracias, Dr. Jim McDonald


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Read my personal program below, then read all my pages in my Table of Contents. Then e-mail me and I will send you a long examination. If you pass my test with a 95% or better, I will send you a Diploma in Anti-Aging Therapies, signed by me, at cost, plus whatever you wish to add.

No Bull. Just learning, and good ideas. - Ellis

If you liked this page, and if you have a website related to health, anti-aging, diabetes, or diet, and if you would like other people to learn some of the good ideas which are on my pages and pretty unique on the internet, I would appreciate if you would add a link to any of my pages. Let me know, and I will be glad to reciprocate with an appropriate link somewhere on my site (usually, my links pages). Thanks.

For comments about this page:

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