METABOLIC IMBALANCES--no one test fits all

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So far, we know of ten basic ways that body chemistry can go out of balance. These imbalances are divided into five pairs. The first was discovered in the early 1900s, the last in the 1950s and 1960s. These imbalances are very common. Correcting them usually results in major improvements in health. For a more complete understanding of the subject of correcting metabolic imbalances, the book An Analytical System of Clinical Nutrition, third edition by Dr. Schenker is excellent.

Doctors can order the book at 800-736-4320. Patients can call that number to ask for the name of a doctor in their area who can do the test.

An Overview of the Imbalances

Electrolyte Stress
There is an excess certain mineral salts and this places stress on the kidneys and heart. The blood is beginning to "sludge" resulting in poor circulation. The body retains fluid. Blood volume tends to be excessive and the blood pressure is higher than normal. Cells on the other hand tend to be dehydrated. There is inefficient transport of oxygen, nutrients, hormones and other materials to the cells and waste materials away from the cells. There is abnormal pH in the various fluid compartments of the body.

Electrolyte Insufficiency
With electrolyte insufficiency, the person does not have adequate salts (chlorides, phosphates, etc.) in their body. Either the mineral salts intake is too low, or the body cannot retain them. They have low blood pressure, and there is not enough blood volume. There is an inability to take nutrients to cells or to carry waste materials away. They have very low energy, and tend to have other health problems such as decreased sex drive and depression or anxiety. There is abnormal pH in the various fluid compartments of the body.

Anaerobic Imbalance
This imbalance, also called the "anabolic imbalance," is a bit more complicated. First, there is an inability to use adequate oxygen in producing energy. Instead of combining glucose with oxygen to produce energy, glucose is fermented by the cells and lactic acid is produced. This is not an efficient way to make energy, and fatigue results. Also, there is too much of the sterol fats (such as cholesterol) and not enough fatty acids in the cell membranes, with the result that cell walls are not permeable enough. This common imbalance is the chemistry of many cancers, osteoarthritis, and many other health problems. Some common symptoms include low energy, high blood pressure, constipation, irregular heart rate, sleepiness during the day, pain, elevated cholesterol, dizziness, allergies and many other health problems. There can be osteoporosis caused by the use of bone material to neutralize the lactic acid. Not good! Also, the pH of the various fluid compartments of the body is incorrect.

Dysaerobic Imbalance
The dysaerobic (or "catabolic") imbalance is the opposite of the anaerobic imbalance. Oxygen metabolism goes too far, producing free radicals but little energy. Cell membranes contain too much fatty acids and are too permeable. Common symptoms include fatigue, migraines, joint pain (often rheumatoid arthritis) and other pain, colitis, diarrhea, gallbladder problems, blood sugar problems, insomnia, anxiety, depression, dizziness, allergies, rheumatoid arthritis, many cancers, elevated cholesterol, and many other health problems. There is abnormal pH in the various fluid compartments of the body. Tumors often grow very rapidly with this chemistry.

Glucogenic Imbalance
Those with a glucogenic imbalance have also been called "fast oxidizers." They tend to use up carbohydrates (starches and sugars) too fast, and they have difficulty using fat for energy, so they often have a hypoglycemia slump after lunch, or may sometimes wake up between 1 and 3 am because of hypoglycemia. Common symptoms include physical and mental fatigue, high or low blood sugar, depression or anxiety, gallbladder problems, shortness of breath, high cholesterol levels, weight problems (either excess weight or under weight), and many other health problems. Because they burn carbohydrates too fast, they make too much carbon dioxide and they have some degree of acidosis. In fact, this chemistry seems to be the most common reason for acid imbalances.

Ketogenic Imbalance
Unlike the glucogenic "fast oxidizers," the ketogenic or "slow oxidizers" have difficulty using carbohydrates for fuel. What little energy they can make is mostly from fat. Because they make so little carbon dioxide, they tend to run alkaline. This chemistry appears to be the most common reason for alkalosis. Symptoms commonly include physical and mental fatigue, high or low blood sugar, depression or anxiety, over weight or under weight, high blood pressure and other health problems.

Parasympathetic Stress
The autonomic nerves, sympathetic and parasympathetic, help regulate body functions over which we do not have conscious control, such as heart rate and digestion. Parasympathetic stress is the opposite to sympathetic stress. Parasympathetic nerves slow things down and stimulate the digestive tract to work. The blood returns to the skin, heart rate slows, respiratory rate slows, pupils and bronchial tubes constrict, and so on. In a parasympathetic stress, the parasympathetic nerves are over-reactive, and the person is "stuck" in this mode. Common symptoms include low energy, high or low blood sugar, digestive problems, arthritis, poor circulation, nervous tension, depression, allergies and asthma. In fact, all asthma patients that benefit from the use of inhalers are stuck in parasympathetic stress - asthma medications speed up sympathetic activity and slow down parasympathetic activity.

Sympathetic Stress
In general, sympathetic nerves speed up the activity of the organs needed for a "fight-or-flight" response. If you are driving along, and someone pulls out in front of you, you slam on the brakes, your skin goes pale, your heart pounds, your pupils and bronchial tubes dilate, your palms may get sweaty, your digestion slows down, and so on. This is the sympathetic half of the autonomic nervous system in action. In sympathetic stress, a person is "stuck" in this sympathetic reaction. There may be high or low blood sugar, low energy, digestive problems, gallbladder problems, nervous tension, insomnia, poor circulation, high blood pressure, food allergies, and other health problems.

Acid Imbalances
There are three kinds of acid imbalance where there is too much acid and not enough alkali in the body. It is interesting that in one kind of acid imbalance, both the urine and saliva are alkaline! This often results in poor digestion and assimilation, joint and muscle pain, shortness of breath, rapid heart beat, allergies, fatigue, fluid retention, and poor function of various glands and organs.

Alkaline Imbalances
There are also three alkaline imbalances, where there is too much alkali and not enough acid in the body. In one of the alkaline imbalances, the urine can be either acid or alkaline. Common symptoms include poor digestion, fluid retention, joint and muscle pain, allergies, fatigue, and poor function of various glands and organs.

Testing for Metabolic Imbalances

Preparation for the Test
The person being tested abstains from eating or chewing gum for thirty minutes before the test. Coffee, tea, chocolate, carbonated beverages, vitamins, minerals, herbs, and non-prescription medications (such as pain killers) are avoided for at least 24 hours before the test. Even one cup of coffee the day of the test will result in altered chemistry. The person will appear more anaerobic, sympathetic, and possibly more glucogenic than they really are. When possible, testing is done just before prescription medications are taken rather than just after. The goal is to find out, as much as practical, what the person's chemistry is like when it is left alone. The person is not, however, asked to stop taking their prescription medications.

An intake form, metabolic screening questionnaire (a symptom survey), and a dysbiosis questionnaire (questions related to the damage that may have been done to the person's normal intestinal flora) may be filled out. A sheet of instructions for measuring the person's morning underarm temperature (an indication of metabolic rate) may be given to them.
Collecting the Information

Urine Chemistry
A fresh urine sample is collected in a new disposable cup. The surface tension is measured using a urotensiometer and recorded. Then an Ames Multistix 10 SG or N-Multistix SG strip is dipped into the sample. The urine pH and the last two digits of the specific gravity (for 1.015 record 15) are recorded along with any other findings.

The oxidation index is calculated using the surface tension and two-digit specific gravity. The formula is specific gravity - ((surface tension -63)X3) so with a surface tension of 68 and a specific gravity of 15, you would get 15-((68-63)X3) or 15-(5X3) or 15-15, or 0. A normal oxidation index is near 0, or about -6 to +7.

Saliva pH
A strip of pH paper is moistened with saliva and the result is recorded.

Hydration Index
The saliva pH and specific gravity are used to calculate the hydration index. The formula is (saliva pHX10)-surface tension. So a saliva pH of 6.5 and a surface tension of 15 would give you (6.5X10)-15, or 65-15, or 50 which is a normal hydration index.

This test is called "dermographic lines." Using a blunt instrument (the 5mm round ball on the top of a four-color Bic pen is just right - if any burrs are polished off first!) an "X" is drawn on the skin each side of the navel using firm pressure, and the time is noted. The lines may turn either red or white. If the lines fade and disappear in less than one minute, a zero is recorded. If, after one minute, the lines are white, "white" is recorded. If the lines are red, "red" is recorded.

The gag reflex is tested by sliding a finger (covered with a new latex glove) along the top and edge of the tongue half way toward the back of the throat to where the oral area narrows. A slight tendency to gag is a zero response. Either discomfort or lack of discomfort with no gag is a negative response. A gag is a positive response.

The person being tested is instructed to look up at the ceiling. The pupil size is recorded on a scale from -4 (very small) to +4 (very large). An average pupil diameter is about the same as the width of the white area (sclera) on either side.

The pulse is counted for 15 seconds, and the result is multiplied by 4 and recorded.

The person being tested is asked to stand. After waiting for 5 seconds the pulse is counted for 15 seconds and again for 15 seconds. Both numbers are multiplied by 4 and recorded.

The standing blood pressure and another pulse are taken and recorded. (There are now two blood pressures and four sets pulses recorded.)

The person being tested is asked to sit down. They are then asked to "Take a deep breath, and hold it as long as you can." The result, in seconds, is recorded. The respiratory rate rate-(breath hold/5) is also recorded. So if the respiratory rate is 16 and the breath hold is 60, we get 16-(60/5), or 16-12, or 4. This is the pH index (not exactly the same as pH, but it is a number that you can easily calculate and it gives you accurate information on the acid-alkaline balance of the blood). The normal pH index is 7 a pH index of 8 or more would be on the acid side. An index of 7 or less is alkaline. A ketogenic person will often have an index below zero. This is opposite to pH which more alkaline as the number goes up. The pH index is the only practical way for most people to find out what their pH balance is. Urine and saliva pH cannot give this information.

Evaluating the Results: General Notes

The imbalances are presented in decreasing order of importance - the most important are covered here first.

There are some general suggestions regardless of what imbalance may be found. For general dietary guidelines see the zone.

Avoid junk food - things made in factories. Chemically altered (hydrogenated) oils, or oils that have been heated to high temperatures, white flour products (like pasta), white rice, refined sugar, caffeine, and so on.

Water. If you have good spring or well water available, that is ideal. Tap water, in most places, is a major problem. Chlorine can easily be removed with a cheap carbon type filter. Fluoride is a bit more difficult. Reverse osmosis, de-ionization, and distillation are the main choices. Those processes take out most everything, so trace minerals such as Concentrace can be added back.

Oxygenic B is a basic multi-vitamin mineral that contains many nutrients in a balance that does not create imbalances or make them worse. (High dose B-complex supplements, for example, make certain imbalances worse, or can even create imbalances.) The adult dose is 1 tablet 3 times a day after meals.

It is important to retest the person after a week or so to make sure they are not being given too little, or even worse, too much of a supplement. It is also important that they understand that they should immediately stop the program if it seems to make them feel worse. Vitamins and minerals have powerful effects on a person's chemistry, and it is not uncommon for these supplements to push a person from one imbalance into the opposite imbalance fairly quickly.

Fine tuning of the supplement programs is too complicated to fully describe here, but but I will give the basics. For more information, see Dr. Schenker's Analytical System of Clinical Nutrition.

Electrolyte Stress
Signs of electrolyte stress will include at least two of the following: 1. At least one of the standing pulses at least 12 points higher than the resting pulse. (This is called "clinostatic pulse increase.") 2. Standing diastolic blood pressure of 88 or more. 3. Systolic blood pressure of 131 or more. If the person is being medicated for high blood pressure you can assume that they have electrolyte stress even if test results to not confirm it (medication is supressing the symptoms).

Supplements to consider for adults would be an Oxygenic B (basic multi-vitamin and mineral designed to supply nutrients without altering basic body chemistry) after each meal. Formula ES before each meal. Other supplements can be used depending on the other test results. (See Dr. Schenker's book.) The diet must be high in vegetables and low in sugars and polyunsaturated oils. No margarine or hardened shorenings of course. Olive and coconut oil are fine. Pure water - 1/2 ounce per day per pound of body weight if the kidneys can tolerate that much. If there is any question, the person is in poor health, or receiving medical care, they should ask their physician how much water they can tolerate. In any case, if increased water intake does not result in increased urine output, water intake should be immediately reduced and a physician consulted.

For more information on this subject, see the book Your Body's Many Cries for Water by F. Batmanghelidj, M.D. The first 2-3 cups of water should be on an empty stomach before breakfast. Aluminum is a major cause of electrolyte stress and must be avoided. It is often found in table salt, antiperspirants, pop cans, cookware, many antacids, and so on. If the person wants to lose wieght, they can consider the zone diet.

Electrolyte Insufficiency
Signs of electrolyte insufficiency will include at least three of the following: 1. At least one of the standing pulses at least 12 points higher than the reclining pulse. 2. Standing diastolic blood pressure of 72 or less. 3. Reclining blood pressure of 112 or less. 4. Reclining pulse of 70 or less.

Supplements to consider for adults are Oxygenic B (3 per day after meals) and Formula EI (3 per day after meals). The person may have to increase their salt intake (using Real Salt or similar unrefined product with no aluminum added). Salt, by the way, is not the "bad guy" that you may have heard that it is. The sodium level on blood tests gives an accurate picture of body levels. If the sodium is below the middle of the normal range, sodium is actually depleted from the body - a common but dangerous situation. There are a dozen other supplements that can be used depending on the oxidation index and other test results. Protein must be adequate and starches and sugars must not be excessive. Polyunsaturated oils must be avoided along with other junk fats such as margarine. Olive oil is fine.

Anaerobic (anabolic) Imbalance
The signs of an anaerobic imbalance are: Urine urface tension of 69 or more, oxidation index of -7 or lower, adjusted urine pH of 6.3 or more, adjusted saliva pH of 6.6 or less, and red dermographics. If there is an anaerobic imbalance, there will be either a high surface tension or low oxidation index and at least two other items.

Supplements to consider for adults include 3 Oxygenic B per day after meals, 1-3 Oxygenic A tablets per day after meals, Oxygenic A Plus in water before breakfast. Extra A Plus can be taken for pain. Taurine, methionine and tyrosine can also be added depending on symptoms. The person should avoid sugars, coffee, tea, chocolate, cola beverages and milk fat (butter, high-fat cheese and cream) and junk fats such as polyunsaturated oils and margarine. Olive oil and coconut oil are fine.

Dysaerobic (catabolic) Imbalance
Signs of a dysaerobic imbalnce are: Urine surface tension of 67 or less, oxidation index of 8 or more, adjusted urine pH of 6.1 or less, adjusted saliva pH of 6.8 or more, and white dermographics. If there is a dysaerobic imbalance, there will be either a low surface tension or a high oxidation index and at at least two other items.

Supplements to consider for adults include 3 Oxygenic B per day after meals, 1-3 Oxygenic D per day after meals and Oxygenic D Plus in water before the evening meal. Extra D Plus can be taken for pain. Glutamine, histidine, or glucosamine sulfate can be added depending on symptoms. The person should avoid junk fats such as polyunsaturated vegetable oils and margarine, deep fried and even pan fried foods, and canned meat and fish (because of oils heated to high temperatures in canning).

Glucogenic and Ketogenic Imbalances
Determining whether or not there is a glucogenic (fast oxidizer) or ketogenic (slow oxidizer) imbalance has in the past been a challenge for doctors. One method previously developed required that the pH of a venous blood sample be accurately measured to 2 places beyond the decimal without the sample coming into contact with air. This test is beyond the capability of most clinics, or even most hospitals. Many doctors gave up even trying to test for these imbalances.

The method developed by Dr. Guy Schenker is to compare the adjusted saliva pH (A-SpH) with the respiratory rate (RR), breath hold (BH), and fourth pulse (P4). This method works very well. You will need to see the book for details, but in general, a glucogenic person will have most of the following: High urine surface tension, a pH index (respiratory rate-(breath hold/5) of 8 or more (acid), a respiratory rate of 17 or more, and a breath hold of less than 50 seconds. A ketogenic person will have most of the following: High surface tension, pH index of 6 or less (alkaline), a respiratory rate of 15 or less, and a breath hold of 50 or more.

Supplements and Diet for Glucogenic and Ketogenic Imbalances

Supplements to consider for a glucogenic imbalance include one Oxygenic B 3 times a day after meals, and one Oxygenic G 1 to 3 times a day after meals. Other supplements can be added depending on symptoms and other test results. (See the book.) The glucogenic person needs to keep their protein intake up, keep the sugar intake down, and not eat meals that are mostly starch or sugars. Caffeine, alcohol, fruit juices and even large amounts of fruit should be avoided. Junk fats such as polyunsaturated oils and margarine should be avoided. Onions, peppers, tomatoes and yams also make the imbalance worse. Proteins (especially red meat, poultry, organ meats and eggs) along with non-starchy vegetables should make up much of the diet. For this person to eat a big plate of pasta could be compared to fueling a wood stove with gasoline. Not a wise choice! Additional B-complex vitamins will make this chemistry much worse. As the chemistry corrects, the person will become more alkaline. This means that their respiratory rate will slow down toward normal and their breath hold time will increase toward normal.

Supplements to consider for a ketogenic imbalance are 1 Oxygenic B 3 times a day after meals, and 1 Oxygenic K 1 to 3 times a day after meals. Other supplements can be added depending on symptoms and other test results. The ketogenic person should avoid foods which make their imbalance worse - junk fats such as polyunsaturated oils and margarine, sugars, fruit juices, meals which are mostly starch or sugars, organ meats, shrimp, lobster, clams and peanuts. Protein intake (meat, poultry, eggs, cheese) must be adequate. Olive oil is fine. Their supplement speeds up carbohydrate metabolism. As the chemistry corrects, the person's pH will move toward normal. (In this case, more acidic!) This means that their respiratory rate will increase toward normal and their breath hold time will decrease toward normal.

Parasympathetic Stress
Parasympathetic test results include small pupil size, standing systolic blood pressure increase of 3-, standing diastolic blood pressure increase of 4-, fourth pulse increase of 8- compared to the reclining pulse, red dermographics, fourth pulse of 75-, first pulse 63-, when the standing systolic blood pressure is divided by 10 and subtracted from the respiratory rate, the answer is 5+, and increased gag reflex. If a person appears to be both ketogenic and parasympathetic, you should not try to correct both. Usually, ketogenic is treated.

Supplements to consider include 1 Oxygenic B 3 times a day after meals and 1 Complex P 1-3 times a day after meals. We try to use Complex P the first half of the day. Other supplements can be added depending on symptoms and other test results. The person also needs to keep their protein intake adequate. They need to avoid sugars, fruit juices, large amounts of fresh fruit, and meals that are mostly starches or sugars. Polyunsaturated oils and margarine must be avoided. If they have asthma, they almost certainly have parasympathetic stress even though they may test sympathetic due to their medications or stress caused by the illness. In this case, use Complex P regardless of test results. They may also appear to have respiratory acidosis. This must never be treated as this would make their plight worse.

Sympathetic Stress
Sympathetic test results include large pupil size, standing systolic blood pressure of 5 or more than reclining, standing diastolic blood pressure 6 or more than reclining, fourth pulse 12 or more than the reclining pulse, white dermographics, fourth pulse of 80+, first pulse 73+, when the standing systolic blood pressure is divided by 10 and subtracted from the respiratory rate, the answer is 3-, and reduced gag reflex. If a person tests both glucogenic and sympathetic, you should not try to correct both. Usually, glucogenic is treated.

Supplements to consider include 1 Oxygenic B 3 times a day after meals and 1 Complex S 1-3 times a day after meals. We try to use Complex S after noon. Other supplements can be added depending on symptoms and other test results. It is important to eat lots of vegetables at 2 meals a day, and avoid sugars, caffiene (coffee, tea, chocolate, cola beverages, etc.) and soft drinks that contain phosphoric acid (such as colas). Junk fats such as polyunsaturated oils and margarine must be avoided. If they have asthma, they actually have parasympathetic stress - the sympathetic stress is almost certainly caused by their medications and must not be treated.
Acid Imbalances

Acid imbalances are usually a result of imbalances discussed above. In acid imbalances, the respiratory rate is generally 19 or more. The one exception is with resperatory acidosis with high blood pressure where the respiratory rate may be reduced. The breath hold tends to be 40 or less. When the breath hold is divided by 5 and the result is subtracted from the respiratory rate, (wht I am calling the pH index) the result is usually 10 or more.

With metabolic acidosis, the adjusted urine pH is usually 5.9-, adjusted saliva pH is usually 6.8+. The first pulse is usually 75+, and the pulse increase from pulse 1 to pulse 4 is usually 10 or more.

With potassium excess acidosis, the adjusted urine pH is usually 6.3+, adjusted saliva pH is usually 6.8+. The pulse increase from pulse 1 to pulse 4 is usually 10 or more. It is interesting that we can have an acidosis with an alkaline urine - the kidneys are dumping excess potassium and thus save hydrogen (acid). So we have an acid condition with alkaline (high pH) urine!

With respiratory acidosis, the adjusted urine pH is usually 5.9-, adjusted saliva pH is usually 6.6-. The first pulse is usually 75+, and the pulse increase from pulse 1 to pulse 4 is usually 10 or more.
Alkaline Imbalances

Alkaline imbalances are usually a result of imbalances discussed above. In alkaline imbalances, the respiratory rate is generally 13 or less. The one exception is with respiratory alkalosis where the respiratory rate may be increased. The breath hold tends to be 65 or more. When the breath hold is divided by 5 and the result is subtracted from the respiratory rate, the result is usually 5 or less.

With metabolic alkalosis, the adjusted urine pH is usually 6.3+, and the adjusted saliva pH is usually 6.6-. The first pulse is usually 67-.

With potassium depletion alkalosis, the adjusted saliva pH is usually 6.8+. The first pulse is usually 67-. The urine can be acid (low pH) in this alkalosis, by the way, because there is a potassium shortage, and the kidneys save potassium and dump hydrogen ions (acid) instead. So we have an alkalosis with an acid urine!

Treating Acid and Alkaline Imbalances.

To correct acid imbalances drink plenty of pure water, eat lots of vegetables, avoid junk fats such as polyunsaturated oils and margarine, sugars, carbonated beverages, fruit juices, large quantities of fruit, and meals that are mostly starch or sugars. Many combinations of supplements are used for acid imbalances. See the book for details.

To correct alkaline imbalances, drink plenty of pure water. Protein intake must be adaquate at every meal. Avoid junk fats such as polyunsaturated oils and margarine. Avoid excess sugars, starches, and fruit (especilly juice). Antacids make this imbalance worse. Various supplements combinations are used. See the book for details.
The Zone

Introduction: There is considerable evidence that obesity is a glandular problem. We all know people who can eat very large amounts of high calorie foods and stay slim. Others gain weight on 700 calories. But obesity does not appear to be just a thyroid problem. The real culprit is high levels of insulin. A diet that includes refined carbohydrates (white flour and sugar) is known to raise blood sugar levels in many people. Insulin levels must then go up to try to deal with the excess blood sugar. Eventually, the person may become insulin resistant, and normal levels of insulin are no longer able to control blood sugar levels. Now the pancreas produces excess insulin when any carbohydrate foods are eaten, and insulin levels are higher than normal. And we know that most overweight people do produce too much insulin.

Insulin is a storage hormone. Above normal insulin levels get you at least four ways. First, excess insulin forces blood sugar into storage as fat. Second, excess insulin prevents the utilization of stored fat for energy. Third, excess insulin can increase hunger. Fourth, high levels of insulin are also associated with coronary artery disease. You have probably figured out by now that an abnormally high level of insulin is not in your best interests!

Dr. Barry Sears has researched the insulin problem, and has come up with a program that lowers insulin levels by using a specific ratio of protein to carbohydrate. For a fuller account of his research, see his book Enter the Zone. (Note: If you are a diabetic, are pregnant, or are being treated for any serious illness, you should consult your physician before making dietary changes.)

Find out your lean body weight. Enter the Zone tells how to do this. If you do not have the book, use your approximate ideal weight.

Figure out how much protein you need per day. Take your lean body weight (or your approximate ideal weight if you don't know your lean weight) and multiply it by 0.0714 if you are sedentary, by 0.0857 if you walk some, by 0.1 if you exercise for 30 minutes 3 times a week, and by 0.114 if you exercise an hour a day, 5 times a week. Round this number off to the nearest whole number to give you the number of protein units you need per day. One protein unit is one ounce of lean meat or cheese, one large egg, one and one-half ounces of fish, one cup of milk, one-half cup of yogurt or one-half cup of cooked dried beans, split peas or lentils. (Each protein unit actually has about 7 grams of protein.)

Add one unit (actually 9 grams) of carbohydrate to your daily requirement for each protein unit. Best carbohydrate units are: One cup of cooked non-starchy vegetables, one-fourth cup of cooked dried beans, split peas or lentils, one-half cup cooked onions, two cups of raw non-starchy vegetables, one cup of tomatoes, one-half cup of unsweetened fruit, or one-third cup of cooked oatmeal. Some carbohydrate units that can be used less often are one-fourth cup of winter squash or corn, one-third cup peas or potatoes, one-half cup cooked carrots, one-third of a banana, one-fourth cup of fruit juice, one-half slice of whole- grain bread, one-fourth cup of whole-grain pasta, one-fourth pita pocket, two cups of popcorn, one-fifth cup of rice, one rice cake, or one-half tablespoon of honey. For a lot more ideas, buy the book or a carbohydrate gram counter.

Add one unit of fat (1.5 grams) for each protein unit. There are many possibilities, but a few are one-third teaspoon of oil or butter, one-half teaspoon of nut butter, two tablespoons of avocado, or three olives. This fat, by the way, is in addition to the fat that is in your other units.

Do not eat large servings of protein or very large meals. Large servings of protein or any very large meal will raise insulin levels.

DISCLAIMER: The material on this site is for informational and educational purposes only. Please consult with your health care provider for treatment advice.

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