The Chinese Restaurant Effect
This is another in my series of articles about diabetes, Chinese food, and eating healthy. The month of July, as I had mentioned, marks the one year anniversary of Mini Mee’s diagnosis with Type 1 Diabetes. Dr. Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S. describes a process whereby low or no carb food can cause big blood sugar spikes if you eat a lot of it. He calls it the Chinese Restaurant Effect.
Many years ago a patient asked me why her blood sugar went from 90 mg/dl up to 300 mg/dl every afternoon after she went swimming. I asked what she ate before the swim. “Nothing, just a freebie,” she replied. As it turned out, the “freebie” was lettuce. When I asked her just how much lettuce she was eating before her swims, she replied, “A head.”
A head of lettuce contains about 10 grams of carbohydrate, which can raise a type 1 adult’s blood sugar about 50 mg/dl at most. So what accounts for the other 160 mg/dl rise in her blood sugar?
The explanation lies in what I call the Chinese restaurant effect. Often Chinese restaurant meals contain large amounts of protein or slow-acting, low-carbohydrate foods, such as bean sprouts, bok choy, mushrooms, bamboo shoots, and water chestnuts, that can make you feel full.
How can these low-carbohydrate foods affect blood sugar so dramatically?
The upper part of the small intestine contains cells that release hormones into the bloodstream when they are stretched, as after a meal. These hormones signal the pancreas to produce some insulin to prevent the blood sugar rise that might otherwise follow the digestion of a meal. Large meals will cause greater stretching of the intestinal cells, which in turn will secrete proportionately larger amounts of these hormones. Since a very small amount of insulin released by the pancreas can cause a large drop in blood sugar, the pancreas simultaneously produces the less potent hormone glucagon to offset the potential excess effect of the insulin. If you’re diabetic and deficient in producing insulin, you might not release insulin, but you will still release glucagon, which will cause gluconeogenesis and glycogenolysis and thereby raise your blood sugar. Thus, if you eat enough to feel stuffed, your blood sugar can go up by a large amount, even if you eat something undigestible, such as sawdust.
The first lesson here is: Don’t stuff yourself. The second lesson is: There’s no such thing as a freebie. Any solid food that you eat can raise your blood sugar.
Some comments I’ve read about his thesis:
Dr. Bernstein used to be about 15 years ahead of the curve in terms of diabetes thinking. He was advocating getting off high-carb diets years before anyone else in the medical profession ‘discovered’ the same thing. A lot of his findings can really be boiled down to a combination of experience with medical training. Once you’ve had diabetes for about 5 years or so you start to realize that you actually know a heck of a lot about how your body reacts to different things, thanks to the trial and error you’ve been through. Bernstein’s also able to explain WHY those reactions happen too. I think he’s a very useful information source and is very helpful for people starting to get a handle on their sugars. On the other hand I do think part of the regime he advocates is too much of a trade-off on quality of life from what I’ve heard from (admittedly militant) supporters, he advocates what can end up being quite a restrictive diet. Yep, I bought it* about 6 months ago and to me it was a Godsend. It was the first book I’ve read that explained the condition in a way that I could understand it without talking down to me. I think you may be surprised how fast you read the book after you receive it as I found it very interesting. Don’t be looking for false hope or miracle cures but I’ll bet you will walk away feeling better about controlling your condition.
So, what does this have to do with The Chinese Quest? Just consider it another public service. And hey, “Chinese Restaurant” was in the title of the article, so of course it caught our attention! If you, or someone you know, has Type 1 Diabetes, and you’d like to read one of his books*, please click on the image below for more information: