I'm guessing many people can relate to this concept, if not my own specifics:

I will admit to feeling somewhat surprised when someone talks about how hard it is to find things to eat as a PWD trying to limit carbs. I can't help but think, "well, if that was my only consideration, it would be a piece of cake.....ur, I mean a walk in the park! Yeah, I know this is whining, but still. I don't think I'm alone in having more than just the one food issue to contend with, and some of you have medical issues that limit your food choices, where some of mine are just personal choices.

I don't eat low carb, I eat what I call "moderate/low" - under 100 carbs a day. So as I say, that alone, doesn't feel too restrictive to me. But I'm also a vegetarian which is of course a personal choice, but one I feel strongly about. When I realized I was Type 1 and had to limit carbs, I wondered if I would be able to continue as a vegetarian (I ate lots of rice, pasta, beans and cereal before dx). I knew that my health had to come first and I would change if I had to but am happy I've been able to stay a vegetarian, with some time and creativity. But in the eyes of my friends and family, I've definitely used up my quota of food restrictions. Witness a recent conversation with my nephew: The family was meeting at a gourmet Italian restaurant, and he assured me that "they had really good (vegetarian) pizza for you, Zoe" Pizza? Really? But for my omnivore nephew this was a very considerate statement to his vegetarian aunt.

I don't eat sugar...at all. Well except for those pesky glucose tabs, but I consider those medicine. This isn't due to Diabetes but due to an eating disorder and I stopped eating sugar 13 years before my D diagnosis. This one doesn't cause much difficulty though. I'm well past the cravings. And dessert is not a required food group. If I feel at loose ends when others are having dessert, I order an espresso. I don't use any substitute foods because I don't like them.

Then there is my acid reflux. I have my own version of this. I don't have the typical symptoms many of you are familiar with (it's common in middle age). If it were just my (mild) acid reflux symptoms I would ignore it. But my AR combines almost always with my arrhythmia, and that, while not dangerous, is highly unpleasant - rapid and irregular heartbeat, especially at night...yuck! The foods that stimulate the AR, and thus my arrhythmia are citrus fruits and juice, tomatoes, peppers, onions, and sometimes caffeine. I haven't eaten tomato sauce in years. OJ is, obviously, a double no-no, but one I can live without. But tomatoes, peppers and onions seem to come up in just about every recipe I look at, especially lower carb, vegetarian ones! I can get away with a small amount. I eat habaneros in my eggs every morning, but because they are hot, I only need a small amount. Thank goodness, because I love hot food! And sometimes I eat more than a little of the pepper/tomato/onion triumvirate and suffer for it.

So here's an example of the kinds of discordant symphonies my individual food issues lead to: One night I had a bad bout of the AR/ar. Then the next day I went to make a dish I'd shopped for which is Mediterranean roasted vegies with pine nuts and shaved pecorino. Yum! Good and easy to make I'd bought the tomatoes, onions and red and yellow peppers that were part of the vegies and went, "oh no, I don't want to feel like last night!". So I replaced the terrible triumvirate with potatoes...which of course, are higher carb and meant more insulin and I still ended up high. Sigh.

Then there is the fact that I'm a foodie and both that and my ED require that my food be interesting and satisfying - another mandate, if one that is a choice.

So how many of you deal with these dualing food issues and how do you play out your own symphony?

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I have this, but it is completely all psychological for me. For years, I had a hard time eating anything outside of a very defined group of foods. I consider it sort of a survival mechanism. To keep my BG levels stable, I really restricted what I ate to a few things that I knew I could tolerate. I am definitely a picky eater, although I try to force myself to experiment as much as I can with veggies and any food that is low carb. Forcing myself to do this has made me a much more adventurous eater, but there are definitely days where I feel like I eat the same thing over and over and over and over again....

Good for you MBP, for stepping out of your comfort zone!

You do have your challenges in front of you for sure. Mine? I have gastroparesis that was diagnosed (April 2010) before my LADA (Nov 2011). Oh, and I have high cholesterol. Gastro doc told me low fat, low fiber, limit fresh veggies and fresh fruits. If I ate red meat, cheeses, and fiber and fruit, it was like my digestion would come to a stand still. So I learned high carb, low fat, low fiber. Introducing a high carb diet. 1.5 yrs later, in comes LADA and now what am I going to eat? Doc tells me low carb, fresh veggies, fresh fruit (in moderation) and legumes. Endo said, try vegan foods. All of which go against my gastroparesis diet. I'm still trying to sift through different foods to see which ones I can tolerate in both worlds. If one upsets my stomach, I try to avoid it or eat less of it. If it makes my BG high, I either opt for more insulin or I don't eat it. Most of the time, I don't eat it. I'm not going to eat to my insulin as that will more than likely result in weight gain. I'm still a newbie at all this and don't know how I'm going to handle it for the rest of my life. I don't like how I feel when my BG is high and I don't like how I feel when it is low and I surely don't like how I feel when my food sits in my stomach for hours on end. I know there's no "perfect" method nor is there a perfect formula to make things easier and it is all trial and error. Oh and my pancreas is still spitting out insulin so add that in the mix of trying to figure out insulin. I am still hoping for that day that I wake up and all this is just a bad dream.

One day at a time....

--Loretta

This is an even better example than mine of the juggling act some of us do. From what I understand of gastroparesis, it is probably the most difficult "food issue" to have because it directly impacts blood sugar control.

I have different dueling issues to you, Zoe.

My extra restriction is gluten free as I have celiac disease, in addition I find I feel better if I avoid most dairy products. The last one isn't too difficult as I drink my tea with lemon & coffee black. But I do miss cheese.

Gluten free is a lot easier nowadays, but gluten free products contain more carbs than their normal equivalents, e.g. breads or pasta. Like you I think I probably eat moderately low carb about 40 grams per meal. I do like fruit, & I do fine with brown or wild rice. Unlike you I am not vegetarian but I do try to eat fish at least twice a week.

I've always enjoyed cooking so eating at home is easy as I prepare all the meals, & now I am retired I seldom eat out. But when I was working it was much harder, my colleagues favorite restaurant was Italian, nothing but pasta! I used to travel a lot for work & living in hotels for weeks was not easy.

So, yes I can appreciate your dilemmas. I was asked once which would I rather have cured, diabetes or celiac, well duh diabetes I could manage celiac much more easily if I wasn't trying to figure out carbs in GF products.

Both you and Loretta have that same "lesser of two evils" thing going. I think we make those kind of decisions on almost a daily basis. And it's harder when like with celiac, the results are so difficult. My understanding is it's not only immediate symptoms you get if you eat gluten, but re-starting a cycle that had been ended by being gluten free?

I've been thinking of my choice in the potatoes vs peppers, onions and tomatoes scenario. Really the best choice would be to skip that recipe but I'd already shopped for it. It's funny but even when I make a conscious choice like that to eat more carbs I feel bad. I think for a woman diagnosed in middle age there is less realistic likelihood of developing complications (unless you go totally nuts!) But then there is the whole post-menopausal weight gain thing that's for me more of a motivator to keep carbs (and insulin) limited.

Thanks for the input, Shawnmarie. I had 13 years recovery from my eating disorder when I got diagnosed with D. For me, like you, my recovery was not all about restriction. I did totally eliminate sugar (which stopped feeling like a hardship years ago) and I eat three meals a day with nothing in between. Other than that I found I do best cooking and eating foods I truly enjoy. When I realized I was a Type 1 I had to do things completely the reverse, like measure food and count carbs. So it was hard at first. But now that "enjoy your food" is still very important to me, and that (and being a foodie..lol) was the last factor I didn't bother listing because it's not a hardship, but it is very important to me.

Yes, being a Type 1 vegetarian is a challenge but it helps to have lots of time to plan, cook and eat. I like the thanks to the animals. And I didn't know that about the Dalai Lama!

Zoe, I am not menopausal yet but it's not too far away. I'm 46. I am also concerned about the weight gain associated with that and am trying to maintain my weight. I hear insulin makes that a bit harder.

for those that have celiac...... I do have a great deal of respect for you. It has got to be very difficult with D too. If they told me I had celiac's today, you'd find me in a mental ward because I really wouldn't know what I could eat............

I am taking Domperidone for my gastroparesis and it does a great job in making things tolerable. I have to order it out of Canada though because it is not approved here in the U.S. One thing that concerns me is that the pharmacy sent a note stating that the US is trying to stop oversees pharmacies from shipping/selling to the US. If this happens, then I cannot get my meds anymore. sigh......... but hopefully, it'll never happen and I cannot think about that right now with everything else that's going on.

Interesting post because I'm in the process of writing a blog post about this very issue! Specifically about how growing up with food allergies and Type 1 diabetes (at a time when it was match-food-to-insulin and not the other way around) have affected my perceptions of food. Some of the effects are that I am a very picky eater and really do not enjoy eating unfamiliar foods very much. I am trying to remedy this, however, because I would like to enjoy foods and experimenting with foods more!

I'm allergic to potatoes, so that doesn't cause a problem as far as diabetes is concerned, really. I don't crave things like French fries or potato chips or mashed potatoes, so I'm glad of that. Where I DO run into problems is trying to eat out at restaurants or other people's homes, because most low-carb dishes aside from salads are likely to either come with potatoes or have been cooked around potatoes. I won't touch soup or stew unless I have made it myself because I've had three instances where people insisted there were no potatoes anywhere in it only to start having a reaction within a few bites of eating. So, maybe there were no potatoes in it, but clearly they'd encountered potatoes somewhere along the line! (And seriously, there is no quicker way to ruin a meal than to have an allergic reaction!) I also have to read all ingredients on everything, as potato and potato starch are in a ton of stuff. I think the hardest part about a food allergy is not so much being unable to eat the food but the fact that even the TINIEST amount can cause a reaction and you have to be so ultra-careful.

I truly hope I never develop celiac disease. A high percentage of gluten-free foods are made with potato starch, and I think I would have to basically stop eating anything I myself hadn't prepared!

That must have been rough, Jen, dealing with those two things growing up. It's hard for children to hear "you can't have that" especially if all their peers can! But I'd think all it takes is once with a food allergy to become disciplined about avoiding it. You are right, that is harder than any of the things I mentioned where one little bit wouldn't hurt. (Although with my sugar addiction I learned that " a little bit" made it much harder to not have another little bit and so on!).

I didn't know that potato is in a lot of foods you wouldn't expect it to be in. I learned when I stopped sugar how many places they hid that little ingredient! Those of us who have to read labels are way ahead of those who don't in how kind we are to our bodies.

Hi Zoe. I have slow digestion, Celiac and Type 1. I don't eat a lot of red meat, but some, so to my disgust my recent test said that my red blood cells are anemic. That makes my Pernicious Anemia more difficult. I hate iron pills, even the low dose time release type I'm taking, because they are giving me a belly ache. Some days you can't win for losing.

When I say everything in moderation works for me, I mean it and I don't know how I'd be able to exist on low carbs or high protein; an absolute prohibition on gluten is about the only absolute I want. I'm concerned with the taste of food also, and as I've said before, my husband is a great cook/chef. As for "cheating" with respect to gluten, I have not done so in the almost 20 years I've had Celiac (and an intolerance for corn and soy), but accidents happen. When I accidentally eat some gluten, my digestion is destroyed for 2 weeks, not nice added to slow digestion (not to mention becoming very, very spacy). Well, but thanks to my husband, we still eat well and enjoy our food -- meat, seafood, veggies, wonderfully prepared; also fruit, dark chocolate, occasional gluten-free bread, and beer or wine -- all in moderation! Thanks for letting me rant and rage!

Yes, I too am grateful that I love cooking, so I very much do eat well and enjoy my food. If I had some kind of food restriction that didn't allow me to do that I would have a serious gap in my life. Yeah, I know we're supposed to "eat to live" not "live to eat" but good food (that is also healthy) is definitely one of life's little joys.

Speaking of which it's pouring rain out and in the 40s and I just made myself a cappuchino into which I poured some Bushmill's Irish Whisky. Ahhhhh. I almost never drink hard liquor anymore (not a restriction, just no desire to), but that is a very decadent pleasure in winter!

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