Dr. Bernstein’s Low-Carb Diabetes Diet Essential features of his advise:

There have been many postings of videos in the forum about Dr Breinstein,s advise on controlling Blood sugar. What exactly was his advise and was it for Diabetes 1 or Diabetes 2 or both.? .Did he advise substituting in diet reducing carb content with high fat?. An attempt is made to understand the authentic version of his advise in this post for information of those who are interested..

Dr. Bernstein’s Low-Carb Diabetes Diet Essential features of his advise:

Dr. Richard K. Bernstein was diagnosed with type 1 diabetes over seven decades ago, created the movement to check blood sugars at home, developed a diabetes management program built on the philosophy that “everyone deserves normal blood sugars” – and then became an endocrinologist so others would take him seriously.

This article, looks at Dr. Bernstein’s diabetes diet. In essence, it is a low-carb, high-protein and moderate fat diet. He recommends this approach because it maximizes the chances for achieving normalized blood sugars..

Dr. Bernstein was diagnosed with type 1 diabetes at the age of 12 in 1946.Dr. Bernstein was diagnosed with diabetes during what is commonly referred to as the diabetes “dark ages”. He had to check his urine for sugar by using a test tube heated over a flame. He had to sterilize his needles and glass syringes by boiling them each day. He explains how his blood sugars were not well managed during this time. In fact, back then fat was deemed the ultimate health culprit and so he was put on a low-fat and high-carbohydrate diet. During the first two decades of his life with diabetes, he says his growth was stunted and nearly all his organs quickly began to suffer the consequences of chronic high blood sugar. Heartbreakingly, he suffered many serious complications of diabetes as a young man. Luckily, blood glucose meters were just becoming available.

In October 1969, Bernstein came across an advertisement in the trade journal Lab World. It was for a new blood glucose meter that would give a reading in 1 minute, using a single drop of blood. The device was intended for emergency staff at hospitals to distinguish unconscious diabetics from unconscious drunks. The instrument weighed three pounds, cost $650, (Adjusted for inflation, that would be $5,000 today)!

and was only available to certified physicians and hospitals.

Determined to take control of his situation, Bernstein asked his wife, a doctor, to order the instrument for him. Dr. Bernstein experimented with this meter, aiming to find out what made his blood sugar levels rise and fall.

After a few years he discovered that the only difference between a diabetic and a non-diabetic were high blood sugar levels. High blood sugar levels were the thing to avoid – the cause of all the complications in people with diabetes. If people with diabetes could get as close as possible to normal blood sugar levels, complications could be prevented and perhaps even reversed. Dr. Bernstein knew this could help people reverse some of their complications because he experienced this himself. Once he managed to fine tune his blood sugar checks, diet and exercise regime, he experienced what he calls “normalized” blood sugars and many of his complications reversed or improved. He felt compelled to get his life-changing news to other people with diabetes so after years of waiting for the medical community to come around to what he found, he decided to quit his job as an engineer and go to medical school at age 45. This way he could publish his findings and gain the attention of his peers. By 1983 he was a physician with his own practice and finally able to help other people with diabetes to self-monitor their blood sugar, eat a low-carb diet and exercise in a way that would create blood sugar levels as close to normal as humanly possible.

The Nutrients in Dr. Bernstein’s Low-Carb Diet

Dr. Bernstein’s low-carb diet can be described as a low-carb, high-protein and moderate fat diet. He recommends this approach because this means requiring very little insulin which he says is best for achieving normalized blood sugar. He credits this diet for his remarkable health turnaround and success managing diabetes over so many years.

Below are his views on carbs, fat and protein.


Dr. Bernstein recommends eating no more than about 30 grams of carbohydrate per day. He advises consuming 6 grams of carbs with breakfast, 12 with lunch and 12 with dinner. The way he sees it, since carbohydrates are converted into glucose once in the body, carbs are basically sugar and sugar strongly impacts blood sugar levels. He advises the avoidance of all grains, fruit, beans, starchy vegetables like potatoes and sweeteners..In his view,there are essential amino acids and essential fatty acids, but there is no such thing as an essential carbohydrate.”


Dr. Bernstein says that fat is not evil and that it is required for survival since much of the brain is made from fatty acids. He says that the widespread problems of heart disease and obesity are all tied to too much carbohydrate and not from too much fat. .


Dr. Bernstein clarifies that, “Non-diabetics who eat a lot of protein don’t get diabetic kidney disease. Diabetics with normal blood sugars don’t get diabetic kidney disease. High levels of dietary protein do not cause kidney disease in diabetics or anyone else.”

He advocates plenty of protein in the diet and he says it is an important component of his l0w-carb diet. He does explain that protein is not zero carb. Of any serving of protein consumed, a certain part of that protein will be effectively converted to sugar in the bloodstream, but it is minimal when compared to the impact from carbohydrates.

The Law of Small Numbers

One of the most groundbreaking ideas Dr. Bernstein has putf forward is the “law of small numbers” as he calls it. One aspect of this is the “law of insulin dose absorption”. Every time you give insulin, a small varying percentage is not absorbed by the body (which is unpredictable and unavoidable). This means that blood sugar levels after giving insulin will either be higher or lower than you can predict. Dr. Bernstein explains it like this:

“When you inject insulin, you’re putting beneath your skin a substance that isn’t, according to your immune system’s way of seeing things, supposed to be there. So a portion of it will be destroyed as a foreign substance before it can reach the bloodstream. The amount that the body can destroy depends on several factors. First is how big a dose you inject. The bigger the dose, the more inflammation and irritation you cause, and the more of a “red flag” you send up to your immune system. Other factors include the depth, speed, and location of

your injection.

Your injections will naturally vary from one time to the next. Even the most fastidious person will unconsciously alter minor things in the injection process from day to day. So the amount of insulin that gets into your bloodstream is always going to have some variability. The bigger the dose, the bigger the variation.”

The law of small numbers also includes the “law of carbohydrate estimation”. Dr. Bernstein notes that the FDA allows a plus or minus 20 percent margin of error on their labeling of ingredients like carbohydrates. This throws off carb counting for people with diabetes and does so to a larger degree the more carbohydrates a food contains. Due to all these factors, Dr. Bernstein recommends low-carb eating and never giving more than 7 units of insulin in a single injection.



20 Replies

  • Just compute the mix for 2000 kcal diet with 30 grams carbs and answer wrt how much FAT will be obvious. Watch few of his videos where he also talks about covering proteins with insulin so obviously he can't be talking of substituting the carbs with protein. In one of the videos he himself has said that you can go upto ~1.25gms/Kg protein if active.

    And, BTW, he also says Cholesterol - CVD/CHD theory is all wrong.

  • Wonderful...

  • @gphillips

    Thank you for your positive response to the posted article.

    If what Dr Breinsten has advised is accepted, it would mean limiting carb portion in the diet to 30grams per day (to get ideal bl sugar levels) and looking to his emphasis for high protein and moderate fat diet and further protein portion should be limited to 1.25 grams per kg of body weight , the ratio of C:P;F in terms of percentage to total food intake of kcl works out as below.

    Height weight(kg) carb % protein % fat% total%

    5”4” 58 20 48 32 100

    5”6” 60 20 50 30 100

    5’8” 6 2 20 52 28 100

    6’0’ 66 20 55 25 100

    DR Breinstein being a diabetic 1 patient turned doctor,I believe what he advised is for diabetics1 and in case of diabetics 2 carb content can be varied looking to insulin sensitivity because of partial working of pancreas needing only deficient portion to be supplemented from out side or with oral drug. In case of those diabetics who can regulate their bl sugar level by diet alone they can appropriately vary their carb intake based on masured bl sugar levels. This appears to be more pragmatic and practical way to deal with Blood sugar controlproblem..

  • Let's do some number crunching

    5'4' 58kg 40 yr old male:

    Per BMR theory:


    Light exercise case - daily needs 1,718 Calories/day to maintain your weight

    1.25X58 = 72.5 grams protein = 290 kcal

    (290/1718)X100 = 16.8 ~17% protein

    So not sure from where you got 48% protein and hence all numbers are wrong for protein as a result of which all numbers are wrong for FAT. So for the case 1, if you are trying to limit carbs to 20% the numbers become:

    C: 20%

    P: 17%

    F: 100 - (20+17) = 63%

    Much in line with what we "practice" and "preach". Since your calculations are all wrong, recalculate for each of the height you mentioned and it will be in the same ballpark even if you keep 1.25gm/kg even for most sedentary ones. If we compute 48% as computed by you, proteins needed will be 206 grams or 3.55 grams /kg -- way off from 1.25 upper limit.

    BTW, we can only digest 25-30 grams of protein per sitting. So, to eat 48% protein (even if it can be handled without damaging effects) we have to be eating 7 times a day. Bernstein doesn't eat 7 times a day. Per his own admission, he misses lunch many times due to work.

    So, once you fix your wrong calculations, yes what we do is the most prudent way to manage diabetes. Thank you for accepting it ;)

    BTW, Dr Bernstein treats Type 2 also by the same theory as Type 1.

    Also, protein computation is on lean weight, but to give you advantage I skipped that part too.

  • If 30grams corresponds to 20 % of total calories (2000kcl)then for wight of 58 kg protein requirement is 72.5 grams i.e.,2.42 times carb=20x 2.42=48%

    Fat%is 100-68=32%

  • 30gms cannot correspond to 20% of 2000 kcal intake. Sorry no "mathemagic" can make it happen. Bernstein is not 20% carbs theory. His is 6:12:12 rule for carbs in grams. I think you mixed up two cases (gms versus %) just to make sure fat is in Low Fat range.

    30 gms carb = 120 kcal = 6% of 2000 kcal, and not 20%

    100 gms carb = 400 kcal = 20% of 2000 kcal

  • There is no mix up, I have understood the advice of Dr Breinstein correctly as stated in the post as well as his recommendation of protein in th video and made a projection to estimate the fat % in the diet keeping in mind what LCHF protocol of C:P:F.ratio should be in the light of Dr Breinstein’s legendary advice on dietary protocol to keep blood sugar level to ideal level to reverse complications which he says he could achieve. Any other C:P:F percentage cannot be as per his advice.

  • Then let me clarify for you more based on your first number and 72.5 grams proteins

    30 grams = 120 kcal

    72.5 grams protein = 290 kcal

    Where does the balance 2000 - (120+290) = 1590 kcal come from? It has to be 1590/9 = 176 gm fat. Which is 79.5% fat energy.

    There surely is a MIX UP.

  • Check this video on how much protein:

    So, might as well correct the numbers calculated.

    And BTW, thanks for agreeing that his advice is "Legendary". One of your friends keep ridiculing him many times over. We always considered him legendary.

    Also, in one of his videos, he has mentioned that he is pretty close to Atkins minus the phases in Atkins diet and he doesn't believe in phases. Here's more on Atkins with the phases:


    And, on many things he agrees with Atkins.

    One of the Type diabetic and a "Doctor" on Atkins style diet is Dr Jay Wortman --12+ years on no drugs and still counting:


    And, here's a beautiful lecture from Dr Wortman:

  • There is need to change the ratio from 20:20:60 to 20::48:32 to confirm to the professional advice of Dr Breinstein (if the goal of keeping bl sugar levels to ideal leavel is to be achieved) and re distribute 2000 kcl in the revised ratio.In that case 20% carb will give 400kcl,=100grams 960kcl protein=240grams and 640 kcl fat.=71 grams .Alternatively you reduce the figure of food intake from 2000kcl to 600kcl which will give 120kcl carb=30 grams.288 kcl protein=72 grams and 192 kcl fat=21 grams.

    If you wish to adhere to 20:20:60 as at present ,it is your own dietary advice and not Dr Breinsteins advice. There cannot be both ideas mixed up to make cocktail.

  • Check the video on proteins from Bernstein once again. In another video somewhere, he has also said that this has to be brought down to as low as 0.5 for those with ckd.

    Well, cocktail was prepared by you, not me when you first started with 20% for 30 gms carbs quoted 2000 kcal.

    600 kcal? How long does 5' 4" 58 kg by weight survive on that?

    240 grams protein?

    An ounce of chicken is 6 gm protein. So eat 40 ounce chicken a day? One Egg is 7 to 8 gms protein. So eat 30 to 35 eggs a day? Or 600 grams Soya meal per day?

    Does Bernstein eat 8 times a day? To digest and assimilate that amount of protein one will have to eat 8 times a day and watch for urea and nitrogen levels at such a high protein consumption.

  • As i do not follow these diets i do not need to satisfy who is correct.It is for you to satify yourself.

    Thanks and goodbye

  • Debate is about numbers and mathematics and not personal ego caressing. Since you do not follow it, it's easy to make all the mistakes made.

    Bye and take care.

  • So what is conclusion?

  • Two conclusions:

    (1) After close to 3.5 years of discussions on this forum, it was agreed that Dr Bernstein's advise is "Legendary"

    (2) The attempt to stick in low fat territory while working with 30 gms carbs did not work out as intended.

  • Thanks a lot for your reply!

  • Conclusion

    1 Dr breinstein speaks from his own experience as diabetic 1 and asadoctor and endocrinologist. His advice can be followed by diabetcs 2 with modification in so far as carb content in the meal plan.is concerned.

    His advice to keep protein portion high and fat portion moderate has to be appreciated in context that high fat content is still a medical controversy and the medical feternity still feels fat affects’ the heart health although observations and recent research implicate carbohydrates rather than dietary fat in the heart disease and abnormalblood lipid profiles of diabetics and even of nondiabetics.

    2.The C:P:F ratio has to change from 20:20:60 to 20:48:32 to keep the integrity of Dr brainsteins advice intact.The potein content in the meal has to be related to body weight of the person looking to his height.@ 1.25 grams per kg of weight of the person.

    3. If the protein content in the meal cant be achieved with chicken, eggs etc., then look for any other diet with protein high density to satisfy the protein requirement. Dr Breinstein recommends soya milk,flour as protein rich,

    4.As per his advice all most all foods have carb to some extent and this fact has to be figured in the meal plan while deciding carb portion of the diet

    5.keeping blood sugar to the desired level should be the only goal in deciding the meal plan .

  • 1.25 gm/kg is the key. Not 48% proteins. For ckd patients he says this goes down to 0.5/0.6 So, how does he treat CKD patients?

    There's no controversy about fat. He says in one of his videos that cholesterol and cvd is all a FAILED Theory. So, he is not against FAT. He talks about how he recommended 60 ml Olive Oil to one patient for gaining weight and it failed to give any weight gain.

    Soy milk is for vegetarians, as they don't have meat, chicken, egg in their diet.

    His recommendation for more proteins is for anyone who wants to gain weight. But, that has shown some downside also as many people start having no hunger to eat. This also he has talked about in one of his videos.

  • Dear ragivrao ji,

    I haven't gone for a study of Dr bernstein.

    But I had few years ago gone through an encyclopedic description of him. Wikipedia.

    Two things I have noticed

    One is misrepresentation as I read in the encyclopedia...

    That he never prescribes a fixed diet :In practice he gives different diet to each patient says the Wikipedia.


    He is not to be considered competent to contradict world scientific opinion as he is just a practicing doctor in new York. I mean he is not a great scientist or anything like that.

    But he was the man who propagated self monitoring of glucose at home. And also a bernstein test for acid reflux. So far so good. No discrediting him.

    Some people quoting him as having a grudge for ADA is to be brushed aside as those people are invention level scientists near Nobel prize.

    He was t1 Dm when animal insulin only was available. In the 1960s.

    Obviously erratic BS levels and side effects those days.

    After the recombinant insulins in 80s those reasonings are of only

    Significance outdated.

    Diabetologists came to recommend balanced diet in the 1990s only.

    Low carb diet was the most prevalent diet in late 19th and early 20 th centuary.....

    Allen... Joslin.. History.

    It is all wastage of time to talk bernstein bernstein now. Low carb is meant for a few obese and Diabetic.

    Thanks for the post..

    Good luck

  • Is Wikipedia considered an authentic source to cite by Harvard? Just asking as you only believe in Harvard and Mayo.

    Bernstein knows a lot more about who Low Carb is for and he has been doing what he is doing for last 40 years under the nose of ADA. And, he doesn't believe in ADA diet at all. He also says that ADA pushes high carb to get million dollar for advertisements in magazine and donations. I am sure he knows more and talks honestly about it. ADA hasn't sued him for what he talks and what he does.

    No point talking ADA ADA as world is far bigger than ADA and diabetics are rejecting their advise in HUGE numbers across the globe. Insulin is not some wonder drug that one can keep injecting industrial doses. So study something about damaging effects of insulin too. Injecting insulin is not some fashion statement. People have gone off insulin just by changing diet. Doesn't matter what ADA says. ADA doesn't live in our body. WE do. ADA doesn't foot our bills. WE do.

    Number of successes prove who LC is for. Forget what ADA says. Look at MEDICAL reports of those who live by that diet, and here's a latest one:


    And BTW, whatever Bernstein does, his target for eABG is 83 and A1C between 4.2 to 4.8 so whatever diet he decides, even if it varies from one person to another, is based on that target. Surely that's not possible on ADA diet + Drugs regimen.

    And, he surely knows more than you about diabetes management. Scientists have failed where he has succeeded. So, let's not gloat over the word "Scientists". First understand the science behind what he does before commenting.

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