The Personal Choice of Food and Diets



Want to see a bunch of people with diabetes freak out? Make a comment about what they should eat. Food is very personal. It represents comfort, entertainment, art, and culture for many of us in addition to basic sustenance—it’s no surprise that the attachment of a very immediate health value on our food choices can provoke strong reactions. I don’t write this with the intent of creating reaction, but I do so knowing that could be an outcome of this—and if there is one single thing that inspired me about the mission and research of T1D Exchange, it’s that understanding that comforting people is not necessarily tantamount to helping them.  Diabetes is a hard, punishing journey—and the road to innovation through research is not one without significant challenges.

Diabetes is a hard teacher but if there is one thing I have learned—to my benefit—it’s how food works. Now, I know, we all learned that in health class in middle school—remember the experiment where we’d chew the saltine cracker and not swallow—to feel the saliva begin the digestion process? I’d argue that seeing blood sugar values measured pre- and post-meal (to say nothing of CGMs) gives an eye-opening new perspective on things.

That’s my perspective. We have to have this data in our lives, so why not use it to fine-tune our bodies’ performance, if we can? I genuinely wonder what is stopping us as a community from being more excited about trying new dietary modifications to see what works and what doesn’t—because diet matters. A lot. I read a lot on social media that insulin is not a cure—and it’s not. Being healthy is more than just numbers and blood sugar which in some cases insulin can give you—but actually being healthy (not trading one set of risk factors for another) relies on some attention to where our food comes from. If it’s from a factory, it’s probably suspect.

Diet is one thing we can control in a world that seems to rotate on an axis that we can’t ever seem to get a handle on. Good nutrition is not just for people with diabetes—it’s for everyone. We just have the distinction of not being able to delay the impacts of our choices as we are aware of our blood sugar fluctuations since our body doesn’t cut us any slack. The point of this article is not to sell you on the dietary approach that works for me; in fact, I have just completely overhauled my diet because I want to see how a different approach could work! My goal is to create a positive conversation around diet from a philosophical standpoint.  As a friend recently told me when we discussed this topic, “A cure won’t mean much tomorrow if you don’t take care of yourself today.”

Rather than take a position about the diet that will fix everything—I personally only advocate for the quality of the foods we eat. High carb, low carb, and everything in between—if we are prioritizing whole, unprocessed foods, I think that everything else can be adapted from person to person based on what works with blood sugar and how we feel. Some people need more carbs, others more protein. Still others may fluctuate between the two based on other variables like season and exercise. If our vision of our diet is positive, we will be empowered to be proactive and less defensive.  That’s how we could discover that someone else knows something that might help us.

Right? Or am I missing something here?

I am going to troubleshoot my argument here and I’d honestly like some help, because this vexing question of “why is diet so polarizing” has perplexed me since I first stuck my head out from under a rock and greeted my fellow type 1s in 2011. So here are some probable nerves that get struck when these discussions arise.

  • There is a feeling of guilt from parents at the idea that they have to deprive their child who has lost some of their childhood to managing an unfair disease through limiting their intake of sweets/junk food.
  • We are quick to dismiss dietary experiments out of hand because of the Facebook marketing of okra water cures or cinnamon pills—perhaps we simply object to discussing diet in glib terms?
  • We are burnt out emotionally and it’s easier to check out and refuse to take the risk of getting hopes up by trying new methods.
  • It’s too expensive to eat well—good food out of the price range of many people, as we know technology to manage diabetes often is.
  • Lifestyle interferes to the point that we don’t have time to prepare our own food?
  • It’s just something we don’t think about because we are focused on “putting out fires” of everyday management.
  • It’s too confusing with all the junk science out there—where diet is the scientific “Wild West,” where anyone can just ride into town and blow people away without having to really base their statements on anything but anecdote.

I’d love to say that I wrote this because I have answers. I have ideas, suggestions and questions but that’s one person whose expertise is limited to, well, my own diabetes and me. I’d love for everyone to have their own answers and the opportunity to examine the way we think about this fundamental aspect of living with type 1 diabetes.

Steve Richert–GluSteve


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