Atkins Diabetes Revolution (48 page)

Medical supervision is even more important for kids taking diabetes medication of any sort.As the blood sugar normalizes, the medication dosage will probably need to be reduced or even eliminated to avoid hypoglycemia. Other medications for blood pressure, blood lipids, and anything else will also probably need to be changed or eliminated as these conditions normalize. Just as for adults, plan this strategy with the child’s physician before dietary changes are instituted.Discuss with your doctor how often to monitor blood sugar levels and blood pressure,when to change medication doses,and when to report back to him or her.

In cases of severe obesity, very high blood sugar, or very high blood lipids in kids, Dr.Atkins usually recommended going to the Induction level of just 20 grams of Net Carbs a day. This must always be done under careful medical supervision with a doctor who understands the Atkins approach.

Goals when treating a child with Type 2 diabetes are similar to those of adults.The first concern is to reduce carbohydrates enough to control insulin and blood sugar levels. As the blood sugar stabilizes, hunger and cravings significantly improve.And as blood sugar and insulin abnormalities improve, so will lipid and blood pressure values. As his or her metabolism approaches normal, the child will probably lose fat and inches around the middle. For children who are very obese, normalization of their metabolism must still be the goal. As a result, weight loss often occurs.

Teens who are nearing puberty need their insulin and blood sugar levels supervised by a practitioner familiar with the ABSCP. As we mentioned earlier, obesity during the early teen years can lead to accelerated puberty and shorter stature than would otherwise have been the case. For this reason, helping a teen control his or her metabolism can play a role in ensuring proper growth to attain proper height.
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Measure progress in kids with Type 2 diabetes not by the scale but by other success markers that are far more revealing: better blood sugar control, improved blood pressure and blood lipids, and good appetite control. Frequent weigh-ins and too much emphasis on quick weight loss can lead to frustration and even eating disorders. Do not weigh your child more often than once every two weeks.

For both kids and adults, the loss of inches is far more rewarding and motivating than the loss of pounds. Remember that growing kids may lose fat even while gaining weight. Rather than recording your child’s weight, record his or her waist and upper-arm measurements. For a more tangible demonstration of how inches are being lost, have the child try on the same piece of clothing once every couple of weeks. Jeans that start out uncomfortably tight may well quickly become too loose, even if the scale is dropping only slowly. Provide encouragement and support for sticking with the program rather than for losing pounds or inches. Helping your child keep a chart of blood sugar values is a great way to illustrate progress, too.

THE OTHER HALF: EXERCISE

The foundation of the ABSCP is the control of carbohydrates to prevent diabetes. However, the dietary plan is only part of the ABSCP. As with adults, aerobic exercise of at least half an hour a day is mandatory. (Check back to Chapter 24 for more on exercise; the recommendations there apply to kids with diabetes as well.) Any activity that gets your child moving and that he or she enjoys is fine.We suggest keeping an activity record.A simple chart that tracks progress can be very motivating for a child, and it assures parents that the exercise is happening on a regular basis.Watch carefully for drops in blood sugar during and after exercise. This problem is most likely to occur in Type 1 diabetes. Eating protein about 30 minutes before exertion can help support the blood sugar levels during exercise.

As every parent knows, younger children and teens can be rebellious and moody.Your efforts to help with dietary changes can be seen by your child as controlling or interfering with his or her life.You can’t expect perfect compliance with the program—especially if you’re not setting a good example by ignoring your own health. Offer congratulations for every effort at improvement.Avoid nagging.Most kids with early-onset diabetes come from families where obesity and diabetes are long-standing problems and where many family members need to make lifestyle changes. Because the kids have seen their parents and other family members struggle with their weight problems without success, they may feel that there’s little point in making the effort themselves. And it’s almost impossible for a youngster to break free of bad eating habits if the rest of the family doesn’t make an effort, too.

The best way to help your child with diabetes is to get the whole family to eat better, lose weight where necessary, and exercise more. That might mean major changes for everyone,but the reward of better health for each individual—and saving just one child from the ravages of diabetes—is worth the effort.

The only way to stop the epidemics of obesity and diabetes is to change the way we eat and live today—so that our children have healthy examples on which to model their own lives. It’s never too early and never too late to recognize and renounce the American standard of unhealthy, high-carb eating combined with physical inactivity. The solution is in your hands. Why waste another minute?

At age 16 Amanda S. weighed 208 pounds and her waist measured 44 inches. Before she came to see me, she was well on her way to developing Type 2 diabetes, with a c-peptide level of 9.2 (almost twice the norm), signifying severe hyperinsulinism. Within six months of starting the ABSCP, Amanda’s c-peptide level was normal at 4.5. After one year of controlling her carbohydrates, she weighed 142 pounds with a waist measurement of 35 inches. She reveled in the compliments she received from family and friends and had no difficulty maintaining the nutritional approach that made such a wonderful difference in her health. It was gratifying to see this young woman pull herself back from the brink of such a devastating illness and experience an enhanced quality of life.

—
Mary Vernon

DOES YOUR CHILD HAVE DIABETES?

Just as many adults have Type 2 diabetes and don’t know it, so too do many kids. Agree or disagree with the following statements to see if your child is at risk of diabetes.

1. My child is overweight.
   Yes
   No
   
2. Other close blood relatives have diabetes.
   Yes
   No
   
3. My child’s genetic heritage is African
   American,Hispanic,Asian American,
   Native American,or Pacific Islander.
   Yes
   No
   
4. My child doesn’t get much exercise.
   Yes
   No
   
5. My child is hungry all the time.
   Yes
   No
   
6. My child is always eating junk food.
   Yes
   No
   
7. My child drinks a lot of sugary drinks.
   Yes
   No
   
8. The doctor says my child has high blood pressure.
   Yes
   No
   
9. The doctor says my child has high blood lipids.
   Yes
   No
   
10. The doctor says my child has high blood sugar.
    Yes
    No
    

Scoring: If you answered yes to just three or more statements, your child may be at risk for Type 2 diabetes or may already have it.Discuss these issues with your child’s doctor.

Part Three

Living the Program

Chapter 26

MEAL PLANS

In this chapter,we provide you with meal plans at three different levels of Net Carb intake, starting with 20 grams and building to 40 and 60 grams; the next chapter presents recipes specially developed for this book. Your individual tolerance for carbohydrates may be lower, higher, or somewhere in the middle, but these meal plans are designed to give you an idea of the range of foods you can include at various levels. Carb counts for individual foods are those that appear in
Dr. Atkins’ New Carb Gram Counter
(2002). The Net Carb level is indicated at the top of each meal plan and there is a subtotaled carb count for each meal.At the bottom of the plan, the total number of grams of Net Carbs for the day appears. There is a 10 percent spread in either direction for a given day, but they average out to the appropriate level. To a certain extent the numbers are approximations.

INDIVIDUALIZING MEAL PLANS

You can be assured that even at 20 grams of Net Carbs, each meal plan contains a minimum of five servings a day of vegetables and fruits.Re- member, avocados, tomatoes, and olives are technically fruits. Understand that these meal plans are suggestions. They are not written in stone. We encourage you to make your own substitutions based on personal tastes, budget, and seasonality of produce. If you find that an ingredient listed on a meal plan is not one of your favorites, you can swap it for an equal portion of a similar vegetable—greens beans for asparagus, for example. (For an extensive list of acceptable vegetables in Induction,turn to pages 456–457.) Likewise,if you do not care for a recipe, substitute one with a comparable carb count.

To individualize these meal plans, use the following tools, where you will find other comparable food selections:

• The Atkins Glycemic Ranking (Appendix 4, page 467)
  
• The Carbohydrate Ladder (Appendix 2, page 462)
  
• The Power of Five, which lists 5-gram carb servings of many foods (Appendix 3, page 464)
  

Although the plans include the dishes from recipes in Chapter 27, you can also find numerous recipes at www.atkins.com and in books authored by Dr. Atkins.

BEYOND THE ATKINS NUTRITIONAL APPROACH

The Atkins Blood Sugar Control Program (ABSCP) differs from the Atkins Nutritional Approach (ANA) in important aspects that must be considered when moving from one phase to another or designing your lifetime way of eating. Depending upon the degree of imbalance in your blood sugar/insulin mechanism, the ability of your body to respond to a lowering of carbohydrates and other factors as detailed in this book, these meal plans can be added to, mixed, and matched. (If your tolerance for carbs changes as a result of aging,hormonal changes, or a decrease in your activity level, you may need to modify your meal plans in the future to maintain your health and well-being.) You are succeeding as long as the quantity and quality of carbs allow you to address your weight, control hunger, and maintain optimum lab values.

HELPFUL HINTS

Keep these guidelines in mind to be sure you are following the program correctly:

• Don’t skip meals, especially breakfast.
  
• Each meal should include a sufficient amount of protein to satisfy your appetite.
  
• Eat until you are satisfied—but not stuffed.
  
• Be aware of the number of grams of Net Carbs you eat each day (use a carb gram counter).
  
• In addition to counting your daily carbs,it is important to spread them throughout the day.
  
• If you are hungry between meals, have a snack comprised of protein and fat, especially with fruit or vegetables. (Never eat pure carbohydrate foods alone as a snack.)
  
• We have provided for an evening snack, but if you are hungry between meals, you can have the snack earlier in the day.
  
• You can even add another snack, so long as it is composed primarily of protein and fat. Be sure to count the carbs.
  
• Pay attention to serving sizes on labels to avoid mistakenly over- consuming carbs.
  
• Read nutrition labels and avoid food with added sugars,bleached white flour, and manufactured trans fats (hydrogenated or partially hydrogenated oils).
  
• The longer you are on the program, the more likely it is that your hunger will be under control and you may no longer need snacks.
  

PROTEIN POINTERS

Except for recipes in Chapter 27, we leave protein sizes to your discretion:You can eat them until you are satisfied but not stuffed.When the meal plan calls for a pork chop or a breast of chicken, for example, we do not give a weight; you may choose to have two chops or two pieces of chicken. Keep in mind, however, that following the Atkins Blood Sugar Control Program is not a license to gorge. Unless otherwise indicated, tuna and other protein salads contain just mayonnaise and are listed as containing 0 gram of Net Carbs.Add extra grams of carbs for celery, onions, and other vegetable additions. As you increase your intake of carbs, you will naturally find you need slightly less protein and fat.

Meats such as sausages and beef jerky should be nitrate-free and without added sugars or fillers. Try to purchase brands with no carbohydrate content. Ham refers to boiled or baked, not honey-baked, which is made with sugar.

When we list an item such as a beef burger, you can grill it, broil it, or pan-fry it, whichever you prefer. Be sure not to char meat, which can form carcinogens.

DAIRY DO’S AND DON’TS

Cheeses vary in carb content.We often list a certain cheese. Feel free to make substitutions so long as the replacement contains a similar number of grams of Net Carbs. In any case, do not exceed more than 4 ounces of cheese each day. All dairy products and products such as mayonnaise should be full-fat products, which means they are the lowest in carbs. Do not use any low-fat products, such as cheese, cottage cheese, mayonnaise, and yogurt, which are almost inevitably higher in carbohydrates. Instead of commercially prepared whipped cream, which usually contains sugar and sometimes added trans fats, use heavy cream and whip it yourself.

Dairy beverages are a new food category made from milk but with significantly reduced-carb content. One brand is Hood Carb Count- down (which is Atkins-approved) and contains only 3 grams of Net Carbs per cup.