#526 Diabetes Variables: Food Quality

August 17, 2021Scott Benner

Diabetes Variables: Food Quality

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to the next episode of the diabetes variable series with me and Jenny Smith. This is Episode 526 of the Juicebox Podcast. This show is sponsored today by the glucagon that my daughter carries g vo hypo Penn. Find out more at G Volk glucagon.com forward slash juice box.

On today's episode of the podcast, Jenny and I will be talking about the quality of the food you eat, and how that is a variable in your use of insulin. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. Don't forget if you're interested in Jenny, professionally, she works at integrated diabetes.com. And you can hire her last little bit here if you're looking for the diabetes pro tip series, which by the way also includes Jenny Smith. They begin at Episode 210 were are available at Juicebox. Podcast calm and at diabetes pro tip calm. There, you'll also find the defining diabetes series, The how we eat series, the variable series, and all of the other episodes of the Juicebox Podcast, including ones about algorithm pumping, and some of my favorite, the afterdark series.

Before we get started, I just want to briefly remind you that if you're a US resident with Type One Diabetes, or a US resident, who is the caregiver of someone with type one, I would love it if you would check out T one d exchange.org. forward slash juicebox. Consider answering the short survey there. Your answers may help Diabetes Research grow. It's super simple to do completely HIPAA compliant. 100% anonymous, it only took me a few minutes, you can do it from a laptop, phone, anywhere you get on the internet, your answers to those simple questions will support research that may help you or someone you love. He won the exchange.org forward slash juicebox Hey, Jenny, how are you? I'm great. How are you? Oh, I'm so excited to talk about something that I think people are gonna get upset about. So, no, we're gonna do a variable today about Type One Diabetes using insulin. And I'm picking the topic of the quality of the food you eat. So I feel like it's incumbent upon me to start with, I know I am the person who tells you you can eat whatever you want, as long as you understand how to use the insulin. You know, I do want to tell you that I believe that wholeheartedly. And at the same time, it doesn't mean that certain foods don't make things more difficult. It doesn't mean that you know, you're having a meal that you're using 15 units of insulin for when you could have had a different meal that might have used four units of insulin like that's not that's not in dispute. And I'm also not, I'm not judging anyone about how they eat. I think that's fairly obvious if you listen to the entire podcast, but it is a variable of using insulin. It's a diabetes variable. And the truth is that it is easier to Bolus for something natural than it is the Bolus for something that isn't. What do you I think that's a good

Jennifer Smith, CDE 3:55
I think that's a that's a really good statement. I think the word easy. I use it lightly in terms of like diabetes management easier, easier. But in terms of more natural or simple food, versus more processed or like complex nature of something that's been put together in a processing or a process type of way. A food that's simple, like an apple is just an apple, right? It's mostly carbohydrate in terms of like macronutrient content, right? We've got carbs, proteins and fats, and Apple is mostly carbohydrate. And because of that simple nature of one nutrient you have, what we use and the human body makes insulin that works. cleaner isn't the right word, but it works in a more simple way around a simple food. Has this effect, it should go this way your blood sugar should do this. And it should return down here. If your insulin dosing strategy is Right, right. Whereas if you do something like my father in law loves Apple dumplings, like they're in? Is it still a lot of carbohydrate? Absolutely more than the apple. But there's also other stuff in that, that adds a complex nature to your strategy of management after you eat it.

Scott Benner 5:34
Right? So I have zero education on this. But I think if we attack this from a common sense approach, the world's bigger, right, you know, there, there used to be a time where everybody in the village you lived grew the food that everybody in the state, right, so you'd, you'd grow food, you'd pick food, you'd eat food, that's it, people, people started noticing that if you left food laying around, it would rot and be gone. They started finding ways to keep it better. lutzer. Right. Right. Eventually refrigeration happens. salting meats to slow down, etc, etc. Point is, is that we now do it chemically. So if anybody, everybody has to try that thing, where you buy a McDonald's cheeseburger, and then stick it on your, I don't know, countertop, and leave it there for a year, it doesn't mold, notice that it still looks like a McDonald's cheeseburger, right?

Jennifer Smith, CDE 6:38
Only really dry. I don't

Scott Benner 6:39
think we usually curse in these episodes. But that's it's kind of scary. So, you know, like, that's fascinating is what it is. It's so there are so many preservatives in some foods. And the idea is to keep it from degrading. But again, if you apply common sense that that would mean that it makes it incredibly difficult for your body to break down as well. Yeah, that's the idea, right? And simply speaking, talking about type one diabetes, that keeps the food in your stomach longer, which allows the leaching into your blood longer, right, the carbs are leaving it, it's coming out of sugar, the sugar is going into your blood, it's more difficult to Bolus process food than it is unprocessed food. I mean, it's just kind of it's, it's, it's my It is my finding over the last 15 years of, of watching our need food, better anything

Jennifer Smith, CDE 7:36
quantity, and what you add up in a day two on one on top of another on top of another on top of another, you know, I see it the most in like vacation days versus eating at home. Right? People go on vacation, and they're like, Yeah, but I had pizza and I know how to Bolus for it at home. Well, what's the difference? Your whole make your pizza, you know what went into it, it's just you know, flour and baking powder and whatever else or baking soda and you make a crust and you put the stuff on top of it now you go out and who knows what they made it with and how they put it together and what they grilled their fries in and

Scott Benner 8:13
what the company they bought it from put in it so that they could ship it across the country etc, etc. Also, Jenny I don't want to be a stickler, but pizza dough is water, salt, flour, and yeast. Nothing

Jennifer Smith, CDE 8:25
and yes, there you go. See I don't I don't usually make real pizza dough. I usually make like a cauliflower crust or like an almond flour. So my ingredients are a little different.

Scott Benner 8:34
definitely understand that. I just don't i don't want people to think I don't know how to make pizza though. I know you've got a pizza oven. It's quite nice. And the truth is, is that the pizza dough I make by hand my body processes better than when I would buy premade at a store or anything I would buy even from a local place. So and then we run into pizza such a great example because the difference between some some guy that owns a shop in New York who's making the dough by hand using salt water, flour, yeast, and you going to any number of Little Caesars Pizza Hut, like those kinds of places that are spread across the country. I mean, that's not really pizza. that's a that's a baker and a chemist getting together and trying to approximate pizza for you. Right and

Jennifer Smith, CDE 9:27
a lot of the reason like you said it's because of a preservative nature that's needed, right? I mean, in general, there may be some corner shop, Mom and Pop pizza place that whole makes everything like you're gonna get it on the street in somewhere in Italy, right? But typically, much of the pizza shop stuff is been pre made, shipped frozen, they might do the rolling out and that kind of still has to have preservative in it. And again, it leaves into the like, how much of that is where are we kind of over and over and over daily putting into our body? There's a lot of processing. If people were looking at labels, there are a lot of ingredients you can't read.

Scott Benner 10:14
Right? Right. And you sound like, Listen, I'm not unaware, you start talking like this. Most people are like, Oh, great, hippie. I'm glad you. I'm glad you have a ton of time to grow cabbage in your backyard. I don't like and and I'm not saying that. I don't understand that. But you can't not understand it. You can't sit there staring at a blood sugar going. I don't, I don't know what happened. This doesn't make any sense. You don't I mean, like this, this, you know, 10 carbs, one unit. That's the ratio always works. But now suddenly, you're like you said, You're, you're out in a restaurant. I mean, there's a reason restaurant food tastes good. It's like so much other stuff in it. You know? Like, it just is really, there's no doubt, I guess I should say that the days I'm most proud of how good I am of using insulin are usually reflective of the days that aren't eating the poorest. Because it really tests my, my skills. Yeah, yeah, like when you when you get up on a summer day, and somebody's like, oh, we're gonna go to the I don't know, we're going to the pool. And which we, which we do four times a year, which is so funny that I picked that as an example. But you know, you stop, and you grab all this food, you have a big lunch, and four or five hours later after baking in the sun and sitting around people like oh, we shorter wings, you know, right, like any and these things start piling on top of each other. Right? So

Jennifer Smith, CDE 11:37
even my husband says the same thing. We actually, we've been in the pool, all but like, five days this summer. So we've been in the pool a lot. But the days that are like a weekend day where we're actually spending like a couple of hours there or whatever. My husband always says the same thing. He's like, now I'm hungry for something that's like, salty, crunchy,

Unknown Speaker 12:00
right?

Jennifer Smith, CDE 12:00
He's like, I don't know what it is the haften the whatever. So no, I

Scott Benner 12:05
i've i've looked up on days. And Kelly's like, we're getting Chinese for dinner. And I think to myself, like Didn't they have nachos for lunch? Like, you know, I'm like, Alright, then I feel myself like focusing in on like, I need a I need like a diabetes, Adderall. Like I got to really focus here for a second, like, how am I going to leave nachos and go into Chinese and then get her to bed. Like there's a lot that goes into that. And, and so again, there's no judgement for me. But you have to understand if you're listening, that the quality of the food you're eating is going to impact how it how it works. And, you know, super simple like, you know, your carb ratios that work well for natural foods might not work well for other foods. And that's why in the pro tip series, we talked about being flexible and understanding the different impacts of different foods, etc. But the but this is, I mean, it's a serious thing. It's worldwide mostly, everyone has access to food that's been treated with something or has ingredients in it that's meant to keep it shelf stable longer. And while it makes it harder for your body to deal with. GMO hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about, all you have to do is go to G Volk glucagon.com, forward slash juicebox g vo shouldn't be used in patients with insulin, Noma or phaeochromocytoma visit je Vogue glucagon.com slash risk. Everyone has access to food that's been treated with something or has ingredients in it that's meant to keep it shelf stable longer. And while it makes it harder for your body to deal with,

Jennifer Smith, CDE 13:54
well, I think you know, in terms of like going the distance in this conversation to I even like I try out like different like diets, right? I hate calling them diets just because they come out and I'm like, ah, let's see what that does do something different. And I mean, overall, I consider the food that I eat and I feed to my family and whatnot. pretty clean food. I mean, we don't have a lot of processed kinds of stuff. I mean, we've got like canned beans, because they're a lot more convenient than soaking the beans, right. But overall, I did is a couple years ago I did the whole 30 diet. And you've heard of that it's like a it's like a 30 days of like a reset. It's essentially completely grain free. And it's it's non processed at all. I think one of the most process things is probably like coconut oil or something like that on it right? But doing that for a 30 day time period, even compared To what I typically do, dropped my insulin needs and made it very clearly visible insulin action and insulin need based on literally no processed anything.

Scott Benner 15:17
Really? Yes. So even you who listen, for people wondering, Jenny and I see each other while we're doing this, and there are times I think the camera goes on and she's just like, oh, hideous monster. Like when she's because she's super healthy. That looks so natural. Oh, no, no, but but I still like, Listen, my birthday was this week. And they bought me like a little ice cream cake, which is a holdover from my childhood, right. And so everybody, everybody gets like a piece of ice cream cake. And then there's this like, little voice in my head. That's like, the rest of this is mine. people stay away from it. Birthday. I live this long, not you. And so. And I know in my head, like I'm gonna revert to a small child and have a piece of ice cream cake every day for three days until it's gone. You know, and I don't know what is an ice cream cake. But part of me believes it's not ice cream.

Jennifer Smith, CDE 16:13
But it's darn tasty. In fact, by the funny thing about that is that when my husband and I got married, he for our my first birthday, like married, he really wanted to make me a cake. He's not a baker. He can cook. He's just he's not a baker. So he bought me an ice cream like a mini like it was just us. Right? It was one of those tiny little ice cream cakes. That probably was like four servings. And I think we ate it over like two weeks because it was like, my favorite part of the ice cream cake. Is that crispy? crunchy? Like,

Unknown Speaker 16:52
I don't know what's in the middle. And it's not food. Yeah.

Unknown Speaker 16:57
I don't know where it was made. But it's good.

Scott Benner 17:00
I have one more thing to bring up. But let's finish this thought we had an entire conversation where we sat around and said rate the parts of the ice cream cake. And it's so funny. It's not even it's just so is it the like the decorative icing around the corner, which is is it the vanilla? Is it the cookie I'm making air quotes the cookie in the middle are the chocolate and everyone rated the parts of the ice cream cake differently as ever part was my son throws it up on I Snapchat I think through his friends. And he's like, I've got nine responses. None of them are the same yet, for people's favorite parts of the thing I want to add here. I'm not the healthiest person in the world. But I have made a change in my life that I have found to be impactful. And I think it fits in here. So I saw a woman on a television show once which is the best way to make health decisions next to listening to a podcast. And she said don't eat canola, corn cottonseed, soy sunflower, safflower Grapeseed, or rice bran oils, just don't use those oils. And I thought, well, I use canola oil and corn oil. Like sometimes I use sunflower oil. Okay, so I just cut them out of my diet. I just thought like, like you said, with the 30 days, I was like, let me see what happens. So I cut them completely out of my diet. If I cook with it, I need oil, I only use cold pressed, non fermented olive oil, or butter. Like those are the only two things I'll cook with in a pan. And I can't tell you that my life magically changed, right? Like I didn't like suddenly I wasn't a foot taller or anything like that I but but here's the biggest thing that I noticed. If I got kind of like, ooh, she didn't say peanut oil, I'll have some like, like, I'll pull out a deep fryer and make some chicken nuggets or something like that. Or we'll go to a bar and I'll get wings or something. The minute I add in one of those other processed oils, you might as well just wherever I am to the bathroom decide that I'm on my way to that situation because while I haven't had some great impact by removing them, what I realized has happened is I've stopped taxing my body in a way that it wasn't prepared for. So like I'm giving my body a job with this oil that it's barely keeping up with. And and so I don't know that that's quantifiable for people. But I think of that as when you're thinking of foods to cut out of your life. Like just because your body processes processes that doesn't make it good. Like I could eat a rock and like come out the other end. But right I shouldn't do that. And it's not good for you. Yeah, yeah, at some point, you're gonna attach yourself to the point where your body's gonna be like, Yo, man, listen, that's the last Brock I can get out of here. And and I just think that, you know, that's what I saw with the oil. So you can Yeah, heat oils or don't i don't care. But I'm saying that when I stopped taxing my body with them, I noticed that my body was happier. And my body showed me that it was unhappy when I tried to give it back.

Jennifer Smith, CDE 20:17
Well, and you know, the other thing, too, that you probably would bring into that, given this conversation is that a lot of our processed foods contain those types of fats, because they're processed, they're processed and broken down from these plants that would not naturally like it wouldn't be visible that they would be an oil that we would use, right? In fact, it's only like, these haven't been available. They weren't available until like the 20th century, right? Where we finally had enough technology or different types of machines that we could take these oils out of these products and use them. And we found that they had a very good preservative nature, we could add them to things, they had shelf stability. But are they things that we should be eating? A lot of? No, in fact, most In fact, if you're looking just at canola oil alone, most of the resources kind of show that if you are going to eat it, don't cook with it, use it more in like a salad dressing that remains cold, rather than in actually like cooking with it.

Scott Benner 21:30
Because when you heat it up, you change it again,

Jennifer Smith, CDE 21:32
you can't change the chemical structure of it again. So

Scott Benner 21:35
I oddly enough, I'm gonna equate this to I will not microwave plastic, I don't care if it's plastic, if it's microwave safe or not. microwave safe means it won't melt in there doesn't mean it's good for you.

Jennifer Smith, CDE 21:46
Right, it gives I mean, there again, another like rabbit hole of everything that it gives off chemically at Yeah, I mean, I've always done glass,

Scott Benner 21:55
right. So. So that's my point about that is just that, and Jenny ties it in a nice bow. These oils are processed, where this one oil that I've chosen. Extra Virgin Olive Oil cold fermented. So it's not it's not changed by heat. Right? That that seems to be fine. Like, I don't have any issue processing that whatsoever.

Jennifer Smith, CDE 22:20
Right. Right. And I mean, if you broke it down further, a lot of it has to do with why do we? Why do we need some of these? Well, we're looking at the Omega, the Omega fatty acids kind of coming from some of these products. And there are different types of omega fatty acids, their omega threes and their omega sixes. And you're supposed to have a certain like ratio of these coming in one versus the other. And unfortunately, these oils actually have a very high percentage of omega six. Yeah, which we don't really need a high percentage of omega sixes, I have

Scott Benner 22:51
to tell you again, I have no no education to speak of. But in my mind, at least butter is like it's it's from a cow. I mean, like I at least feel that way about it. You know what I mean? And I don't know, I feel weird talking about this. Because again, I'm like, if you saw me, you'd be like, well, there's a guy who's not out of shape and not in shape. You know, like I don't I don't I'm not a I'm not a bodybuilder. I don't I don't think that way about myself. I don't think I'm interested in it. But I can tell you that I've seen it with Arden. I've seen her eat stuff that's processed, and it makes things more difficult. And I've seen it my own body. I think it's just worth it's just worth thinking about while you're doing this. Like I'm not saying you're going to be able to talk to your four year old into not eating Cheetos, but Cheetos or not food,

Jennifer Smith, CDE 23:42
like you have and if they're everyday versus Yeah, right. Gosh, I want Cheetos because we're on vacation and we're gonna have like sandwiches on the side of the road, you know, when a wayside snacking on okay. But yeah, I mean, kids don't nobody needs Cheetos, or Doritos, or, I mean, like calling out big brands here. But truly, if you read any of the books that are really about, like mindless eating, and they all prove points of research that companies make, quote, unquote, food, which isn't real food taste better than it would actually taste without salt and sugar, and flavorings added to it. And that what, it's what hooks you

Scott Benner 24:23
Yeah, it makes you want more? Yeah, I mean, what more we could talk about if you cut sugar out of your diet, you'd go crazy in the first couple of days until it was out of your system. You have crap, you'd have incredible cravings and, you know, all all that stuff. So I mean, to try to keep it in the into the diabetes realm, I guess and keep it around that. It just you just need to be aware of it. Like again, if you want to eat Cheetos all day long. I'm sure there's a way to Bolus for now I'm pretty sure that way exists in this podcast. It'll explain it to you. Right, right. But you can't. I guess we're this episode comes from for me or where my perspective comes from is that I hear from so Many people I'm sure Jenny does too. And at some point, it's frustrating to hear somebody say, I need you to help me My stomach hurts. So what did you eat? I ate a rock. And you're like, well, well don't eat rock, don't eat rocks. You know, what, can't you They told me you could get the rock out like, Okay, well, I guess we can but like, let's not do it again. You know, I'm not gonna tell you that I was at a picnic the other weekend. And I brought my own food cuz I like there's problems like, I'll do it so that I knew there's something there I could eat, right?

Jennifer Smith, CDE 25:33
That's my trick. Like, I know what I could do. Because I know what I added to,

Scott Benner 25:39
I'd be happy to make something which means I want to eat while I'm there. And I don't want to be sick, like five hours after I leave. So. But I rode past the ball once and I looked because you brought it up. I was like, God, Doritos, when's the last time I had to read those? Say, I don't think it's been in forever. I took about four or five Doritos, and I ate them. And I was like, Huh, okay. And then that was it. But I saw a person living next to those Doritos. And their arm, like just kept going back and forth. You know, and because that stuff is like, like you said, some of these foods you have to understand I'm going to go off course for a second. I once tried to explain to my younger brother, that I wouldn't smoke a cigarette, if for no other reason. Because I could imagine 12 really rich people sitting in a conference room laughing at me for buying their cigarettes. And and so there's sort of that process food thing makes me feel the same way. Like I know for sure they make that food so that your body is just exploding at every pleasure center when you have it. Right. And they don't care if you can't get your blood sugar down later or, and you know, I've want to CGM and everything we talked about on the show everything around insulin I saw impact me with a working pancreas. I saw what happens if I ate late at night. And I chose poor food. My blood sugar would sit at 110 all night long. Right? You know, I saw what happens is where it would naturally

Jennifer Smith, CDE 27:06
sit. I mean, some people be like, Oh my god, 110 how horrible right

Scott Benner 27:09
and my works. So here's right, yeah, I 110 for nine hours, because at 10 o'clock. I mean, I did it as a test. But at 10 o'clock, I said to myself, well, I'm gonna eat this thing and see what it does to me. And just like we talked about, I went to sleep, my body slowed down digestion, slowed down, the food stayed in my stomach forever. And it kept driving up my blood sugar. So yeah, that's it. Alright, just got out of hand? I don't think so. Actually, but yeah, for anybody who wants to read about the doctor that I saw, called the oils, The Hateful Eight. And so I think if you google Hateful Eight oils, you'll find it. It's not made that

Jennifer Smith, CDE 27:50
whatever the doctor was referring to also included things that are very relevant to diabetes, including things like chronic inflammation.

Scott Benner 27:57
She was talking a lot about the metabolic impact of Yeah, well,

Jennifer Smith, CDE 28:03
yeah. Yeah. And that has a huge component to diabetes management and insulin and what you see happen and everything. So yeah, absolutely.

Scott Benner 28:17
A huge thank you to one of today's sponsors, je Vogue glucagon, find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juice box, you spell that GVOKEGL Uc AG, o n.com. forward slash juicebox. And don't forget to head over to the T one D exchange and fill out that brief survey your us resident who has type one or a US resident, who is the caregiver of someone with type one, they need your help T one d exchange.org. forward slash juice box only takes a few moments.

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