I started listening to some of Bernstein’s monthly speaking sessions and he did clarity his position on one - I tend to agree he is striving for a perfection that most non diabetics don’t have and I tried it to start but found it impossible to accomplish
On the one I heard he said he believes that as the majority of non diabetics follow a bad diet - ie majority of people indulge in large quantities of carbs and sugar that we don’t really need to eat - that if they followed the paleo extreme diet he follows - that your average would be 83 and you wouldn’t stray out of the range he prescribes - and that they would br healthier and live longer also / he also thinks non diabetic toddlers are lower than this as they have not had the high carb diet impacts yet once they come off breast milk and were fed paleo diets that exclude fruit
His theory seems to be that once you stray past a1c of 4.5 to 5.5 even if medical profession says your ok you are not and damage is happening - something not proven except I guess that artherioscolosis is going to be the worlds largest killer by 2020 and many non diabetics die of that as well
I guess if you really believe that caveman didn’t eat this type of diet rich in foods that absorb ultra quickly then removing these carbs completely from your diet you will be better off and you a1c will be 4.5
In general, extremes are not healthy. I think Dr. B is on the extreme side.
For many people, his recommendations can be used, and they can manage their BG well and have good A1C numbers.
But for others…well, there are a lot of things you can’t do well on a Bernie diet.
The trouble wit his belief that “paleo” people ate so few carbs is that it’s just not supported by archaeological or anthropological evidence or even by paleobotany.
Basically, the level of low-carbing he advocates isn’t eaten by any living hunter-gatherer groups or even Inuits, and the range of wildlife presumed to exist in Africa at the time when humans truly became Homo sapiens would not have supported the low-carb, high-fat diet he advocates (Game and plants in Africa at the time were too stringy and low in fat to support the high fat requirements that would prevent protein toxicity). Other groups with low levels of cardiovascular disease do not uniformly eat carb-restricted diets (the Hadza, for instance, get some huge percentage of their calories from honey, while indigenous people in South America with low levels of heart disease actually eat lots of chocolate and coffee beans with relatively high carb percentages). i think the evidence that huge amounts of processed carbs devoid of fiber are harmful is on solid footing, but Bernstein seems to even count fiber in his carb counts, so he’s way more extreme than that.
What’s more, archaeological evidence shows signs of atherosclerosis even in archaic hunter-gatherers who ate a relatively low-carb diet. Other primates who live in the wild also do eventually develop atherosclerosis. So the idea that atherosclerosis is simply a byproduct of modern living is not supported by the evidence.
Bernstein works for many T1DS, but I consider it a kind of body hacking. A major body system is broken; without that functioning you can rely on what is essentially a survival backup system (fat metabolism) and get good results, but that doesn’t mean it’s the physiological norm for healthy humans with a functioning pancreas.
yes 30 grams a day from vegetables only is on the extreme side but it’s far better than what the current ADA and USDA recommends daily - diabetic kids in the Uk are still told to eat 240 grams a day and ‘limit’ starch and sugar - a recipe that’s impossible unless you spend all day eating vast amounts of vegetables
So I think he’s on the better side still - Bernstein is getting old now - his methods predate cgm and analog insulin and would make a lot of sense then but now it’s possjble to get to an a1c of 5 comfortably without having to go so restrictive and sugar surfing but it’s still a challenge for most of us to safely consume something starchy or sugary without a massive spike
He also admits for the first 20 yrs when he set on his path - his target was 100 and not 83 and that is what reversed all his awful complications he had by 42
The world has woke up to the fact that sugar is bad for you (including fructose) - but biochemically maltose is hardly that different - so not sure why it gets a pass
A biochemist friend of mine recently told me that it’s now an open secret in the food biochemistry field that starch is as bad as sugar and the warnings about sugar there are should equally apply to our daily slice - but the amount of political money that opposes this is enormous - think Monsanto
Whatever paleo man ate - I would bet it wasn’t a bowl of cereal for breakfast, a sandwich for lunch and a bowl of pasta for dinner - which is what you need to eat to consume 300g of carbs a day !!
The balance in my opinion is somewhere in the 50-70 grams range and some small quantities of starch as long as it’s with a hefty amount of protein and fat