Book Review: The Diabetes Diet

Richard K. Bernstein, M.D. The Diabetes Diet: Dr. Bernstein's Low-Carbohydrate Solution. Little, Brown & Company, 2005.

Unlike the American Diabetes Association, Richard Bernstein, a medical doctor with Type 1 diabetes, believes the path to health for diabetics--and overweight nondiabetics like me--is an extremely low (low) carbohydrate food plan. He lays it out in The Diabetes Diet.
One of the book's strengths is his clear description of why high carbohydrates are fat magnets (they 1. boost insulin; 2. efficiently store carbs as fat and 3. turn off an enzyme that helps the body burn fat) and harmful for diabetics and non-diabetics alike.

Low-carbing, Bernstein says, saved his life. He was diagnosed with Type 1 diabetes at 12, way back in 1967. Diabetics died quite young, and high-carbohydrate food plans were the norm. In addition, blood glucose meters were very expensive and sold only to hospitals.
As an adult, Bernstein didn't like the diabetes-related health problems he experienced, nor his doctor's inability to do much about them. Bernstein did so research, and got his own glucometer, then saw that blood sugar levels--and need for insulin--were significantly lower when he consumed fewer carbs. (He notes, here, that the ADA long opposed access to glucometers for people with diabetes, and still opposes their use by diabetics who don't use insulin.) Bernstein kicked his doctor to the curb, went to medical school himself, and started a practice serving those with diabetes and/or excessive fat. He has thrived for 64 years with Type 1 diabetes
A reader would be wrong to think Bernstein's is just like other better-known low  carbohydrate food plans and diets. Unlike Atkins, South Beach, and the Sonoma diets, for example, there are no phases in Bernstein's food plan: you get low and stay low. That makes sense to me. I mean, what's the point of getting off of sugar and other carbohydrates only to reintroduce them?(In contrast, however, see the results of this study.) He also scoffs at the value of the glycemic index, and rejects it.
Bernstein's plan is pretty simple:

1. Eat 30 grams of carbs daily, mostly from leafy greens and other vegetables
2. Track your carbs closely (including those in eggs)
3. Split your carbs up among meals, and keep to that breakdown every day
4. Stop snacking
5. Don't worry about fat
6. Exercise

He laid much of this out (and in greater detail) in Dr. Bernstein's Diabetes Solution. The Diabetes Diet summarizes this info and also contains scores of recipes.

Fat-Friendly

Bernstein is probably one of the least fat-phobic writers of plans to help people achieve health by losing weight. He states, "When I see a very overweight person, I don't think, 'He ought to control his eating.' I think, 'He has the thrifty genotype.'" No blame, no shame.

In fact, don't pick this book up if you are afraid of fat: this book (particularly the recipes) is larded with fat. In fact, you could argue that the American Dairy Association is his BFF, because the majority of recipes contain lots of cheese and cream. In this way, his plan is similar to many paleo food plans and, of course, Atkins. Unlike many paleo plans, however, Bernstein cautions against consuming more than the standard amount of protein, as the body can convert it to sugar. And, unlike paleo followers, his plan doesn't include organ meats, bone broths, or extra fat (e.g., bacon grease at every meal and coconut oil in your coffee).

Shortcomings 
Bernstein's biggest flaw in this book is that he doesn't warn the reader--many of whom will come to the book while eating the Standard American Diet, which contains more than 600 grams of carbs daily--of how the body can react when first deprived of it's glycogen supply: the malaise known as "carb crash"  (see my post on this). In effect, he'll be taking them from 600 to 20 grams of carbs overnight. I wouldn't wish that on my worst enemy. It would be much more helpful to offer a plan that steps readers down from high carb levels over time. 
The doctor also mentions the importance of cellulose, a dietary fiber, but doesn't use net carb counts in his daily carb totals, so the reader is actually getting fewer carbs on Bernstein's plan than he or she would on say, the Eades' Protein Power Diet or other plans that count only available carbs, not dietary fiber. 
Finally, this book will not be for you if you have an aversion to artificial sweeteners (many of the recipes, and Bernstein, rely on them) and dairy products. They fill the pages of this book
But I would encourage you to at least read it. First, the author's clear and effective explanations about the way carbs and insulin work (and other nutritional and digestive issues) make doing so worthwhile. Also, many of the recipes are yummy.