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The orders from your doctor sound fairly simple. If you are a diagnosed diabetic with high blood pressure, high cholesterol, high triglycerides, dehydrated and low on potassium, your doctor will probably tell you to go on a "low carbohydrate", "low fat", "low sodium", "low cholesterol" diet. increase your fluid intake and get sufficient potassium. Our Doctors know exactly what they are telling us. Unfortunately, they seem to forget we have only a vague idea of what they mean. Following doctors orders is primarily educating ourselves to become our own medical advocates. by becoming better educated about our medical conditions and what we need to do we can take control and be better prepared to work with our doctor to control and better manage what ever it is we have been diagnosed with. If we are not diagnosed but we know something like diabetes runs in our family we can possibly delay or completely head off the onset of the disease.

Lets start getting educated. The first thing I highly recommend is getting a good book about what ever it is we are facing. Amazon.com has many excellent books that are convenient to order and usually lower priced than what we will be able to find locally. One book I highly recommend for diabetics, pre-diabetics and insulin resistant (often overweight to obese girls and younger women who have great difficulty in controlling their weight)is "The Insulin-Resistance Diet"

The orders our doctor gave us have specific though often misunderstood definitions. To be able to build an appropriate nutrition plan we need to understand exactly what we are trying to achieve. We will take each term independently. We should note at this point that what is low in gram weight for an active 6 foot 220 pound male will most likely be very high for a 5 foot inactive female. each of us are going to have different metabolism and because of this each of us will need a plan tailored to our specific needs. 

There is an optimal mix when we are trying to balance our nutrient intake. In very simplified terms, there is a Protein, Carbohydrate, Fat Ratio (PCF Ratio) that will work best. The chart to the left shows what is working extremely well for me PCF Ratio: 20-50-30. The standard PCF is more typically defined as 15-55-30. a body builder may want to use something close to 25-50-25. You might notice in all the examples the ratios are pretty close. Some "diets" go to extremes. Some of those extremes can actually be harmful.

In my case, I was told to go on a "low Carb" "low fat" "low Cholesterol" "low sodium" "low sugar" "potassium enriched" diet. I though, "my god, I will never be able to enjoy food again." This turned out to be far from the truth but that is discussed in other parts of the site. I did a lot of research and found each restriction had its own limitations. I also found that most of the "restrictions" are really just good nutrition concepts that everyone should follow. The "low" seems to usually be defined as compared to the normal bad diet most Americans are used to. I also discovered we are fed a lot of misinformation by people and companies with an agenda to push. Be assured my only agenda is good nutrition for good health. I am open to anything that works that is better than what I am doing now. I do not manufacture foods, ,supplements or anything else. Any thing I recommend I recommend because I have found solid research that says it is a good concept and it is something that is working extremely well for me and those I am coaching.

As we go through these steps, each step will build on the previous step. The better your understanding of each step the better you will be able to use the next step.  The food pyramid is something that will come up over and over. learn it. Learn how it applies to you. I thought I was pretty knowledgeable about what was good for me. Most of The information I had was from the popular press. As I started researching I found out just how misinformed I was. Forget all the things you have heard on the news, in the adds, the magazines, and start doing a re-education process. Make sure any new information comes from a reliable source.  You don't know me from Adam. Don't take my word for it either. If nothing else at least read through the back up documentation in the other parts of this site, such as the PDFs in our library section.

We will first deal with each of the "lows."

The term low carbohydrate is really a little misleading. The American Dietetic Association recommends 55% calories from carbohydrates for a "normal" diet and and 50% calories from carbohydrates for a "low carbohydrate diet" such as one that would be recommended for a diabetic. In reality, a "low carbohydrate diet" is mostly just good nutrition advice that applies to everyone. For a diabetic, this advice can be further enhanced or modified by saying to use as much of the lower glycemic index carbohydrates as possible.

Whole foods, like whole grains, fruits, and vegetables, should be the foundation of of good nutrition. If you miss out on these foods, you end up missing out on a whole bunch of nutrients and antioxidants that have a potential benefit on reducing the incidence of chronic, degenerative diseases. 

Our discussion of carbohydrates must include the new sub category of net Carbs. In an effort to cash in on the low-carb craze, food manufacturers have invented a new category of carbohydrates known as "net carbs," which promises to let dieters eat the sweet and creamy foods they crave without suffering the carb consequences. The problem is that there is no legal definition of the "net," "active," or "impact" carbs popping up on food labels and advertisements. The only carbohydrate information regulated by the FDA is provided in the Nutrition Facts label, which lists total carbohydrates and breaks them down into dietary fiber and sugars. Any information or claims about carbohydrate content that appear outside that box have not been evaluated by the FDA. Although the number of products touting "net carbs" continues to grow, nutrition experts say the science behind these claims is fuzzy, and it's unclear whether counting net carbs will help or hurt weight loss efforts.

What's in a Net Carb?

The concept of net carbs is based on the principle that not all carbohydrates affect the body in the same manner. Some carbohydrates, like simple or refined starches and sugars, are absorbed rapidly and have a high glycemic index, meaning they cause blood sugar levels to quickly rise after eating. Excess simple carbohydrates are stored in the body as fat. Examples of these include potatoes, white bread, white rice, and sweets.

Other carbohydrates, such as the fiber found in whole grains, fruits, and vegetables, move slowly through the digestive system, and much of it isn't digested at all (insoluble fiber).

Also in this category of largely indigestible carbohydrates are sugar alcohol's, such as mannitol, sorbitol, xylitol, and other polyols, which are modified alcohol molecules that resemble sugar. These substances are commonly used as artificial sweeteners.

In calculating net carbs, most manufacturers take the total number of carbohydrates a product contains and subtract fiber and sugar alcohols because these types of carbohydrates are thought to have a minimal impact on blood sugar levels.

Sugar Alcohols

Researchers say the impact of sugar alcohols on blood sugar levels and the body is not fully understood, and they may also cause problems in some people. There are some sugar alcohols that can raise your blood sugar. Certain sugar alcohols have a higher glycemic index, and they still are not counted as carbohydrates by the food companies.

When you tell a person 'net carbs' or 'impact carbs,' it's very confusing. A person with diabetes may think, 'It's fine for me to have as much as I want. People with diabetes are advised to closely monitor their intake of carbohydrates because their bodies can't produce enough insulin to keep blood sugar levels within a safe range.

Sugar alcohols also contribute calories, too much of them can actually have a bad effect, and some of them can also have a laxative effect." The larger issue with products that tout a low "net carb" count is that they also often contain a lot of calories. People interested in weight loss should focus on the "big C"-- calories.

Terms like net carbs shouldn't trick you into thinking, "This is a free lunch, and I can have as much as I want, just because a food company says the impact or net carbs are only so much. You lose track of the fact that foods have calories, and what has impact on weight management is the number of calories you consume and the amount of exercise you do.

In 2004, the FDA's Obesity Working Group advocated a simple "calories count" approach to battling obesity and helping people make healthy food choices.

"Our report concludes that there is no substitute for the simple formula that 'calories in must equal calories out' in order to control weight," said FDA Acting Commissioner Lester Crawford in a news release announcing the report. Additionally, the report recommended that the FDA respond to requests to define terms such as "low," "reduced," and "free" carbohydrates as well as provide guidance on use of the term "net carbs." Several industry and consumer groups as well as food manufacturers have petitioned the FDA to set official "low carb" levels as well as take action on "net carb" claims.

Until the agency takes action on the carbohydrate claim issue, experts say carb counters are probably better off eating foods that are naturally low in refined carbohydrates, such as fruits and vegetables, rather than highly processed foods like snack bars, pastas, and sweets that have had their natural carbohydrates stripped away.

2. Low Fat

Low fat is an other misunderstood term that almost has a cult following. Low fat, no fat is something that is heavily promoted by food manufactures and others with agendas that have nothing to do with good health. The good fats are absolutely essential in a good nutrition plan. Registered Dietitians I have spoken with recommend about 30% calories from fat. This recommendation is tempered by the advice to make the fat mix as much good fat and as little bad fat as possible. Good fats are polyunsaturated fats, monounsaturated fats and specialized fatty acids such as ,omega 3 omega 6 and omega 9.

Bad fats are saturated fats, transfats and cholesterol. The body does not need these and the less you have of each the better of you are.

The good fats can be found in fish, nuts, certain legumes such as soybeans, avocados, olive oil and the newly developed oils such as canola oil and the newest and maybe the best, Enova oil. Their is one fat in this discussion that needs special attention. Omega 3 is getting more and more attention. As public awareness of omega 3 grows, there are companies competing for your attention and trying to cash in on the growing awareness of omega 3. There are many grades of supplements. Some are pretty bad and pretty useless. Plain fish oil is a waste of your time and money. Many of the capsulated omega 3 three products are very low in strength. A good guide is to look for at least 500 mg of EPA and DHA per 1000 MG capsule. I have noticed some of the inferior products cost a lot more. This is a case where you may not be getting what you are paying for. If you want a recommendation, there is a good source for what I believe to be a good product on our omega 3 page .

3. Low Cholesterol

This one is easy! Your body doesn't need it. You make all you need naturally. As much as possible, eliminate it.

The American heart Association suggests limiting cholesterol to 200-300 mg per day. It has been my experience, that if I show a little attention to how much cholesterol is in a food item, I am able to reduce my cholesterol intake to less the 60 mg per day. Consuming less than 100 mg per day is fairly easy with a little bit of practice. The opposite is also true. If you are not aware and not making an attempt to control your cholesterol, you are probably going way over.

Take an example: You eat 3 eggs and 4 slices of bacon as part of your breakfast. Each large egg yolk has 211 mg of cholesterol. (633 mg in the eggs) Your bacon has 15 mg per slice. (Isn't that a surprise? The bacon has less cholesterol than the eggs.) Add an other 60 mg.

For lunch you have a 1/4 pounder with cheese. (95 mg)

Dinner, add meat loaf made with regular hamburger and macaroni and cheese and we can add at least an other 200 mg.

633 + 60 + 95 + 200 = 988mg, or nearly 3 times the higher limit of the recommended limits. 6-8 times as much as I consume daily.

4. Low Sodium

Low sodium is fairly easy to achieve with a little practice. Fist, stop eating canned and prepared frozen foods. Just about all of them are really loaded with sodium. (Even the ones that claim to be healthy) (There are usually other reasons as well why the "healthy" prepared foods aren't. That is discussed in other places)

We have all been indoctrinated about how good soup is for us. Start reading the labels. Canned soups are typically from 800-2400mg of sodium per serving. A serving is not a bowl! A serving is 1/2 cup 2.5 servings per can. My daily limit is 1500 mg. One bowl of canned soup would put me over my limit. The average American consumes in excess of 4000 mg of sodium per day. The recommended daily allowance for a healthy normal person is 2500 mg or less per day. I restricted sodium diet is from 1500-2000 mg per day. Our bodies only need from 250-300 mg per day. We don't need it, we just like the taste of it.

One level U.S. teaspoonful of granulated evaporated salt contains approximately 6,200 mg sodium chloride, or approximately 2,400 mg sodium. Sodium, however isn't just in what we think of as table salt. There is a lot of sea food that has a lot of naturally occurring salt. (such as shrimp) sodium is also found in celery, onions and vegetables, and most meats. There are also other things beside salt that contain sodium, such as baking powder, baking soda, MSG (monosodium glutamate) and probably a lot of other things I am not thinking about.

< Either too much or too little potassium can cause serious health risks.

Too little. An abnormally low plasma potassium concentration is referred to as hypokalemia. Hypokalemia is most commonly a result of excessive loss of potassium, e.g., from prolonged vomiting, the use of some diuretics, some forms of kidney disease, or disturbances of metabolism. The symptoms of hypokalemia are related to alterations in membrane potential and cellular metabolism. They include fatigue, muscle weakness and cramps, and intestinal paralysis, which may lead to bloating, constipation, and abdominal pain. Severe hypokalemia may result in muscular paralysis or abnormal heart rhythms (cardiac arrhythmias) that can be fatal.

Too much Abnormally elevated serum potassium concentrations are referred to as hyperkalemia. Hyperkalemia occurs when potassium intake exceeds the capacity of the kidneys to eliminate it. Oral doses greater than 18 grams taken at one time in individuals not accustomed to high intakes may lead to severe hyperkalemia, even in those with normal kidney function. Hyperkalemia may also result from a shift of intracellular potassium into the circulation, which may occur with the rupture of red blood cells (hemolysis) or tissue damage (e.g., trauma or severe burns). Symptoms of hyperkalemia may include tingling of the hands and feet, muscular weakness, and temporary paralysis. The most serious complication of hyperkalemia is the development of an abnormal heart rhythm (cardiac arrhythmia), which can lead to cardiac arrest.

The recommended amount of daily water intake is 8- 9 8 oz glasses of water per day. (anything that has caffeine in it does not count)