This week on the podcast we have guest RD Dikeman. RD is Theoretical Physicist, Research Scientist, and father of a Type 1 Diabetic son.
Download a transcript of this podcast here (PDF)
Show Notes:
00:00 – Pre-Intro/Summary
3:49 – Robb and RD’s experiences with giving T1D information
6:38 – RD’s background and experience with T1D son
10:48 – Using Dr. Bernstein’s book and protocol
17:31 – Double diabetes (type 1 and 2 at the same time)
21:46 – Getting off the standard model of care
22:44 – Diabetes diet for the whole family, parents set the example
25:52 – Physicians and Dietitians telling dangerous myths to T1D parents
29:05 – Managing hypoglycemia
31:17 – How the Bernstein model looks
35:16 – Hypoglycemia and target blood sugar
38:40 – Robb’s blood sugar response and ketone levels
41:20 – High fat meals
43:24 – Chronically high blood sugars and Dr. Bernstein’s history
49:39 – What blood sugars should be in humans
51:31 – Ketogains and Fighting the nonsense in the low carb world
55:02 – Exercise and insulin sensitivity
57:39 – Using solid basics
59:40 – Hyperpalatability and fat bombs
1:00:53 – Reducing weight and fat to improve insulin resistance
1:03:52 – Where to find RD
RD’s video on Diet Doctor: https://www.dietdoctor.com/rd-dikeman-people-type-1-diabetes-avoid-disastrous-high-carb-diet
Diabetes University videos: https://www.youtube.com/channel/UCuJ11OJynsvHMsN48LG18Ag
Dr. Bernstein’s site: http://www.diabetes-book.com/
Book: Dr. Bernstein’s Diabetes Solution
RD’s son
RD’s son’s average glucose.
Don’t forget, Wired to Eat is now available!
Amazon, Barnes & Noble, IndieBound, iBooks
Have been following RD for a while and love what he has done for his son and type 1 diabetes. Always recommend him to people I know with newly diagnosed Type 1. A little disappointed at his blanket statement about fat. Understand in relation to hydrogenated fats, vegetable oils etc but healthy omega 3, 6,9 and saturated fats in balance…not sure where he is coming from? If you take out carbs you need to adjust the micro’s and not saying excessive fats of the wrong kind are ok, but I think you need to up the other macro’s. Am I wrong?
Hi Patrice. Thanks for your kind words about my son. We follow the Bernstein method which he constantly emphasizes is LCHP and not LCHF. The emphasis is on protein foods and fat comes along for the ride and so when he constructs a meal plan with a new patient, he doesn’t replace the carbo with a meal of fat but instead replaces with protein foods. Dr. B is constantly emphasizing the importance of protein foods. Very instructive to look at the ketogains calculator if you are really looking to dial in your fat macro. In general my comment to Robb was about the recent myth fads to equate protein with glucose foods and to reduce protein and carb and replace with meals of fat. That’s not a sound idea and in particular with kids who need a lot of protein. Certainly did not mean to say that fat should be avoided either – just that you don’t go out and buy some fat and make a meal of it.
You say you wish there was a celebrity that could tout the benefit of eating this way to manage Type 1 Diabetes… Halle Berry is a Type 1 and has said she uses this method. Some sources have reported her ‘curing’ her Type 1. Which we know is not possible. I do know I have relieved MANY Type II clients of their need for insulin.
Halle was mistaken and is not t1 but t2. We know of no cure for t1 diabetes. If you catch it very early and normalize blood sugars it is possible to stay in an extended ‘honeymoon’ state for prolonged periods requiring little insulin.
Thanks for this encouraging articles. I’ve got to encourage my friend to learn from you Robb.
I agree with Patricia Savage – RD is confusing with his stance on Fat. But that is not unusual in this community. Most guru’s seem to actually run away from claiming to add extra fat or eating Saturated Fat. I believe we get a mixed message. When the Macros are discussed in abstract there is really no way for the listener to know what is the ideal of Fat, Protein, Carbs. My husband is a Type I Diabetic for appoximately 35 years and is 66 years old. I found Dr. Bernstein (and by extension the rest of the LC community) circa 2011-2012 and immediately bought and read his book and instituted his recommendations for my husband and as RD says accurately…for myself. My Husband, Bob, discontinued his pump use (after 20 years on it) and immediately gained better control. Bob’s last two HbA1c’s were 4.9 and 5.0. He just had a Dexa Body Comp Scan (per Mike Julian’s recommendation) to determine his protein needs because there is so much discord in the LC community regarding protein. He is 6′ tall, 160 lbs (an ectomorph) with a BF of 19% – and a lean body mass of 128 lbs. Using the Ketogains calculator his daily caloric needs to add muscle are 2121 with macros of PROTEIN – 130 (He eats 145 gms of Protein) FATS – 167 the equivalent of 12 tablespoons and 25 allowed CARBS. If he does not ADD fat to his meals he will not reach his Macro requirements. If he eats a lean piece of meat…he will need to add fat. If we can afford Rib Eye…it has a better ratio of Protein to Fat and does not require the addition of fat or butter the way a Sirloin would. Don’t know how RD can quote Bernstein (who is obsessive – as am I – about numbers) and not recognize the need to differentiate between the different cuts of meat. Sirloin has 6 gms of protein and 1.6 grams of fat per ounce. An 8 ounce Sirloin Steak has 48 gms of Protein and 13 gms of Fat. Rib Eye has 4.9 gms of Protein and 6.2 gms of fat per ounce. An 8 oz. rib eye steak has 39 gms of Protein and 50 gms of Fat. Sounds like RD thinks Rib Eye is a bad choice??? Anyway…our DEXA and Ketocalculator came up identical to my original calculations (only insignificant variation) of 75-20-5% ratio that was very popular and floating around the “interwebs.” Dr. Bickman says, “Limit Carbs, Prioritize Protein, and Fill with Fat.” Wish everyone would be 100% honest…stop being ambiguous…and using vague recommendations. I think those advocating cream cheese for dinner are far and few between. BTW…RD kicked me off Type I Grit (FB page) because I asked the admins (collectively) to address the abundance of posts that shared FAT BOMB recipes and low carb BROWNIES that parents were feeding their kids. I doubt there is a single word that has been uttered by Dr. Bernstein that I have not read or listened to multiple times and I stated that I did not think he would approve of replacing real food with “hyperpalatable junk food.” I was told it is very difficult for Type I children and their parent’s and they just wanted to make their kids feel normal and I could not possibly understand and was making their lives harder so Bye Bye. One last thought to this already too long post. For years people asked Dr. Bernstein on his Monthly radio Q&A exactly what he ate. At first he wouldn’t because he said he is not a “foodie” and didn’t mind eating the exact same thing everyday…but after repeated request he gave in. I wrote down his diet and still have it to this day. He literaly ate the exact same thing every day and perhaps after 6 months to a year might switch it up but then it was the same for another year or so. He ate a lot of fish especially canned sardines with the fat, pistachios, Coffee with HWC, and cheese…all three meals every day. He gave actual amounts and I calculated the ratios…it was pretty much a 75-20-5% fat, protein, carb ratio. Please talk specifics…fat is fat whether it comes from the food or from added butter, tallow or lard. I LOVE you, Rob…and consider you one of my Sons as your life story is so similar including your digestive issues (also your politics 😉 ) I really appreciate your generous sharing.
You couldn’t have said it any better.
👏👏👏👏
I hate when people make it seem like their way is the only way, and everyone is wrong. I feed my 3 YO T1 a variety of food and yes I do give his junk food here and there. But mainly low carbs. His A1c is 5.4. I not looking for a record 4 A1c but I’m looking for a happy child that it’s not deprived and yet enjoy his food.
Thanks Robb and RD. I share Dr B with all my diabetic patients and it changes their lives . Needs to be required reading in med school but sadly no one in the mainstream has even heard of him. Keep spreading the word and like Dr B leading by example
Great show, guys. The Bernstein book has been sitting on my bookshelf for about 6 months but I have yet to crack it open. I think it’ll be next on my list. I didn’t realize he was an advocate of higher protein — that’s really interesting, especially in the context of type 1. Really interesting! I had to chuckle when you said his recommendations are basically the same as you’d get from KetoGains…nice! Everyone is so damn terrified of protein because of the insulin “spike” — a word that is problematic in itself! Insulin has gotten a bad reputation in the keto world, to the point where people are afraid of even the *normal,* *necessary,* and healthy/physiological rises (not “spikes”).
I’d say about 8 out of 10 of the emails I get are from people having a hard time with fat loss, and…you know it…they’re all skimping on protein while downing fat bombs and pouring oil & butter into their coffee. I don’t know how keto came to be this laughingstock type thing where people think they *need* to be upwards of 70-80% fat, and that they’re “supposed to” add fat to everything to make it “more ketogenic.” I honestly fear that we have jumped the shark and people are going to start rebelling because things have become that ridiculous. But hey, when these folks get “macros” from some random calculator that tells them to eat 80% fat and that they shouldn’t “overdo” protein, I guess it’s just more job security for me. :-/
Where should we start ? Our son was 12 almost 13 in puberty when he was diagnosed 🙁 it was shocking! He was athletic competitive soccer player . He is now 21 . Engineer student at Purdue. He has always fought ! He eats good but he has the bad stuff too that sets the rollercoaster ride in place! He is smart ! Stubborn! But we need to show him he needs to try a different way ! College and diabetes don’t work!! When he went to college the stress and food in dorms set him back so so far now he is home mending!! We are gluten free grain free ! He is eating better !! But he is still struggling with weird stuff! Need a direction and a trust ! Can you recommend a start for him? Thanks for listening!
From a mom who cares and has been his diabetic partner from age 12 .
Oh and also !! It stunted my sons growth! His growth plates closed before age 15!! The stress of diabetes during puberty hurt him! I think others need to know this !!! He topped out at 5’7!! Which is fine but again he got jipped because of diabetes !