A diabetic’s meal on Air France

A few days ago, I was updating a reservation on the Air France website in anticipation of my trip from Madrid to Toronto on my way to the Origin of Stars and their Planetary Systems conference at  McMaster University. Looking through my personal profile, I found a section where to define a preference for the meals served on long flights. Looking through the list, I was intrigued by the “Diabetic” option.

The fact is, I’ve read more than I ever intended about diabetes. That’s because the authors of most, if not all books that relate to natural health and nutrition in some way or another, usually have something to say about diabetes, more specifically, insulin-resistant or adult-onset or type II diabetes. One simple reason for this is that diabetes is so widespread in the populations of industrialised countries that it is almost ubiquitous. Another reason, certainly just as important if not more, is that the most common causes of death in industrialised countries—heart disease, stroke, alzheimer’s and cancer—are all much more common in diabetics than they are in non-diabetics, and in all cases, several-fold more common. Doesn’t this very naturally suggest that there is a fundamental relationship between insulin-resistant diabetes and these other conditions? Maybe even that what causes the development of the diabetic condition also causes the development of the others?

Type II diabetes, also called adult-onset diabetes, should instead always be referred to insulin-resistant diabetes in order to highlight the actual problem—insulin resistance. Unfortunately, it is only rarely referred to as such. Insulin resistance is a description of the state of a cell that does not allow insulin through its membrane to carry glucose to the inside of the cell—it resists insulin’s plea to let the glucose enter. The consequence of this is high levels of blood-glucose and insulin that don’t drop down as they should to acceptable, let alone ideal physiological levels. In fact, as far as I know, the primary, if not the only criteria used by  most MDs to diagnose the onset of diabetes is blood-sugar levels. It is considered normal to have blood-sugar levels anywhere between 65 and 110 mg/dl, but at 120 or above we are considered at risk of developing diabetes.

Interestingly, although fasting insulin concentration is a much better, more robust, indicator of not only the condition of insulin-resistant diabetes, but also of the gradual development of it, which does not appear from one year’s blood test to the next but rather develops over an entire lifetime, slowly and surely, it is almost never performed in standard blood tests ordered by general practitioners. It should.

And why is it better? Because instead of being subject to large fluctuations due to a myriad of different factors as is blood-sugar, such as carbohydrate intake, stress and physical activity, for example, fasting insulin is much more stable, decreasing steadily over the course of several hours, and reflects well the overall state of insulin resistance or sensitivity of our cells.

There is another more direct and accurate way of testing insulin sensitivity that involves measuring blood-sugar and insulin concentrations at regular intervals after ingesting a large amount of glucose. But this method is much more involved and lengthy. Fasting insulin is simple, easy, accurate and cheap. It really should always be done in standard blood tests. Request it on your next blood test. Although, if you follow the dietary advice on this blog, you should never even have to think about getting any blood tests done at all. I just do them because I find it interesting.

I discussed the insulin mechanism in We were never meant to eat simple or starchy carbohydrates, and also in When you eliminatie insulin-stimulating carbohydrates. But for just a second, forget what you remember about it, and consider the following:

Insulin is necessary to clear out excess sugar in the blood: it is the hormone that regulates fat storage. The greater the amount of sugar, the greater the amount of insulin required, and the greater the fat storage. The more often there is sugar, the more often insulin is needed. Insulin resistance in cells develops over time due to over-exposure to insulin, snack after snack, meal after meal, day after day and year after year.

Would we not then immediately conclude that in order to avoid developing insulin resistance we simply and straight-forwardly need to avoid raising blood-sugar levels? Furthermore, would we not immediately hypothesise that in order to reverse insulin resistance and regain insulin sensitivity we need to do just that: avoid raising blood-sugar levels? And how might we do that? You already know this: by not eating simple or starchy carbohydrates. Instead, eating most of our calories from fat to provide all the energy and calories needed for healthy cellular and hormonal activity throughout the body, and never or rarely be hungry.

Now, what was I served as the special order diabetic meal on the flight from Paris to Toronto that I am still sitting on? The salad was of grated carrots sprinkled with super dry, also kind-of-grated white meat, either of chicken, turkey of tuna, (I can’t tell because it didn’t have a smell and I don’t eat meat, so I didn’t taste it). The main course was of a piece of super-dry white fish on a bed of pre-cooked, dry, white rice with boiled frozen ripple-cut carrot slices. This was accompanied by not one of the classic crusty, refined white flour, mini-baguettes they serve on Air France flights, but by two of them. There were also two deserts, a small, dry-baked apple cut in two halves, and a soy-based pudding-like desert. Needless to say that I didn’t eat much of this meal. It was an experiment anyway: I was curious to see what a diabetic would be served, and now I know.

Before reading the next sentence, could you now tell me what is the main characteristic of the meal I just described?

It is a low-calorie, low-protein, super-low fat meal. As a consequence, it is a very high carbohydrate meal: there’s obviously nothing else it could be. Well, that’s not quite true: it is a very low-mineral and enzyme content meal, highly processed and totally dead. But that’s not really important, right? Only calories are important, right? And it is only important that it be low-fat, right?

Therefore, a diabetic that goes to the effort of ordering a special meal instead of the standard menu will end up consuming less protein, a lot less fat, and a lot more carbohydrates. This will cause a much greater rise in blood-sugar levels, that will in turn cause a much greater rise in insulin, and in the case of most diabetics will, in fact, require the injection of additional insulin because their cells are already mostly insulin-resistant. This will inevitably cause increased insulin resistance. But to make matters even worse than this already is, because they are eating very little fat, they will be increasingly hungry after each meal, and thus tend of overeat every time they get the chance. And overeat what? … carbohydrates. This is the definition of a vicious cycle. How sad. How incredibly sad.

I was just offered by second meal: it was pretty much the same thing with a cold dry meat salad instead of the re-heated dry fish with rice dish. What a laugh. This time, I just turned in down.

Oh, and by the way, the first meal was frozen almost solid. Every component, including the carrot salad, baked apple, soy desert and water: everything except for the main course that had been heated. And the second meal was also frozen, but this time, the air flight attendant felt quite sorry about it, and was rather sheepish when offering it to me. How funny! It’s a good thing I am used to fasting.