Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

Complications from diabetes result from constant elevations in blood glucose, which damage the blood vessels and other tissues. Excess glucose in the bloodstream results in the formation of Advanced Glycation End Products (AGEs) – products formed when sugars react with and consequently damage proteins or fats in the body’s tissues, especially the blood vessels.  AGEs are produced at an accelerated rate in diabetics and contribute to complications such as impaired wound healing, diabetic nephropathy, and atherosclerosis.^1-4  In addition to the AGE produced in the body due to excess glucose, some can also come from the diet.  Fried foods, meats, and dry cooked starchy foods (roasted/fried potatoes, bread, crackers, cookies, muffins and other baked goods, cold cereals, etc.) are high in AGEs.^5,6

Lessening after-meal blood glucose and exposure to AGEs:

In designing a diet for type 2 diabetics, we aim to limit after-meal increases in blood glucose and to avoid dangerous AGEs by choosing major calorie sources with a low glycemic load  (GL) – foods that provoke relatively small increases in blood glucose.  An important point here is to choose high nutrient, low GL foods, not just any low GL food – this is where some conventional diabetes diets fall short:

• Meat is a low GL food, but higher meat consumption is associated with reduced lifespan and increased risk of developing type 2 diabetes; the diabetes risk is likely due to weight gain and AGE content.^5,7,8  A diabetic diet emphasizing meat sacrifices long-term health for short-term glycemic control.
• Whole grain products and starchy vegetables. Whole grain intake is indeed associated with reduced risk of diabetes, probably due to fiber content.^9,10  A low fat vegan diet emphasizing these foods in place of refined carbohydrates has shown some success with improving glycemic control.¹¹ However, these diets tend to increase triglyceride levels (a risk factor for heart disease)¹², and cooked grains and starches are not ideal calorie sources for diabetics because they still have a significant GL, as you can see in the table below:

Beans, and nuts (and seeds) are high in nutrients and low in GL, and are far more appropriate than grains and meat as major calorie sources for diabetics.  

Beans and legumes are higher in fiber and resistant starch than whole grains, with a lower GL. (To read more about why beans are superior to other carbohydrate sources for diabetics, read my recent Healthy Times Newsletter, Issue #44) 

Regular consumption of nuts and seeds has well documented cardiovascular benefits, including cholesterol lowering, antioxidant activity, improved endothelial function, and reduced risk of sudden cardiac death and coronary heart disease.¹⁴

In addition to reducing the risk of cardiovascular disease, nuts have a number of properties that make them a favorable food for diabetics:¹⁵

• Nuts are a high-nutrient source of plant protein, fiber, antioxidants, phytosterols, and minerals.  

• Nuts provoke a minimal glycemic response, which helps to prevent post-meal hyperglycemia, hyperinsulinemia, and AGE production. They also help to reduce the GL of an entire meal – almonds have been found to decrease glycemic and insulin response of a carbohydrate-rich meal while reducing oxidative stress.¹⁶ 

• Nuts aid in weight maintenance – important since excess weight is the primary risk factor for diabetes. Despite their calorie density, greater nut consumption is associated with lower body weight, potentially due to appetite-suppression from healthy fats.¹⁷

• Nuts have anti-inflammatory effects that may help to prevent insulin resistance¹⁸

In a recent study HbA1C, an indicator of long term glycemic control, was measured in diabetics consuming either 2.5 ounces/day of mostly raw mixed nuts or an equivalent number of calories in a muffin – a cooked starchy food (the muffin had the same amount of fiber and calories as the nuts).  HbA1C levels were lower in the nut group, suggesting long term protection from hyperglycemia when replacing carbohydrate foods with nuts.^19,20

This new data cements the results of previous observational studies that have found inverse relationships between nut consumption and diabetes.  For example, the Nurses’ Health Study found a 27% reduced risk of diabetes in nurses who ate five or more servings of nuts per week.  Among nurses who already had diabetes, this same quantity reduced the risk of heart disease by 47%.^21-23 

Nuts are an important part of a diabetes-reversal diet, along with green vegetables²⁴, beans²⁵, and low sugar fruits. In a recent study on type 2 diabetics following this diet, we found that 62% of the participants reached normal (nondiabetic) HbA1C levels within seven months, and the average number of medications required dropped from four to one.²⁶  Nuts, seeds, beans, and vegetables not only keep glucose levels in check, but promote long term health as well.

References: 

1. Peppa M, Raptis SA: Glycoxidation and Wound Healing in Diabetes: An Interesting Relationshi. Curr Diabetes Rev 2011.

2. Peppa M, Stavroulakis P, Raptis SA: Advanced glycoxidation products and impaired diabetic wound healing. Wound Repair Regen 2009;17:461-472.

3. Goldin A, Beckman JA, Schmidt AM, et al: Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation 2006;114:597-605.

4. Yamagishi S, Matsui T: Advanced glycation end products, oxidative stress and diabetic nephropathy. Oxid Med Cell Longev 2010;3:101-108.

5. Goldberg T, Cai W, Peppa M, et al: Advanced glycoxidation end products in commonly consumed foods. J Am Diet Assoc 2004;104:1287-1291.

6. Pruser KN, Flynn NE: Acrylamide in health and disease. Front Biosci (Schol Ed) 2011;3:41-51.

7. Sinha R, Cross AJ, Graubard BI, et al: Meat intake and mortality: a prospective study of over half a million people. Arch Intern Med 2009;169:562-571.

8. Aune D, Ursin G, Veierod MB: Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia 2009;52:2277-2287.

9. Montonen J, Knekt P, Jarvinen R, et al: Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr 2003;77:622-629.

10. Fung TT, Hu FB, Pereira MA, et al: Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr 2002;76:535-540.

11. Trapp CB, Barnard ND: Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep 2010;10:152-158.

12. Lichtenstein AH, Van Horn L: Very low fat diets. Circulation 1998;98:935-939.

13. Foster-Powell K, Holt SH, Brand-Miller JC: International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 2002;76:5-56.

14. Kris-Etherton PM, Hu FB, Ros E, et al: The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008;138:1746S-1751S.

15. Kendall CW, Josse AR, Esfahani A, et al: Nuts, metabolic syndrome and diabetes. Br J Nutr 2010;104:465-473.

16. Jenkins DJ, Kendall CW, Josse AR, et al: Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136:2987-2992.

17. Martinez-Gonzalez MA, Bes-Rastrollo M: Nut consumption, weight gain and obesity: Epidemiological evidence. Nutrition, metabolism, and cardiovascular diseases : NMCD 2011;21 Suppl 1:S40-45.

18. Casas-Agustench P, Bullo M, Salas-Salvado J: Nuts, inflammation and insulin resistance. Asia Pac J Clin Nutr 2010;19:124-130.

19. Jenkins DJ, Kendall CW, Banach MS, et al: Nuts as a replacement for carbohydrates in the diabetic diet. Diabetes Care 2011;34:1706-1711.

20. Barclay L: Replacing Carbs With Nuts May Be Beneficial in Diabetes. 2011. Medscape Education Clinical Briefs. http://www.medscape.org/viewarticle/746264. Accessed August 30, 2011.

21. Jiang R, Manson JE, Stampfer MJ, et al: Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 2002;288:2554-2560.

22. Kendall CW, Esfahani A, Truan J, et al: Health benefits of nuts in prevention and management of diabetes. Asia Pac J Clin Nutr 2010;19:110-116.

23. Li TY, Brennan AM, Wedick NM, et al: Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr 2009;139:1333-1338.

24. Carter P, Gray LJ, Troughton J, et al: Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 2010;341:c4229.

25. Villegas R, Gao YT, Yang G, et al: Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women's Health Study. Am J Clin Nutr 2008;87:162-167.

26. Dunaief D, Gui-shuang Y, Fuhrman J, et al: Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density diet. Presented at the 5th IANA (International Academy on Nutrition and Aging) meeting July 26 & 27, 2010 Hyatt Regency Tamaya Resort & Spa 1300 Tuyuna Trail Santa Ana Pueblo, NM, USA J Nutr Health Aging 2010;14:500.

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Mysterious protective effects of coffee against diabetes have been reported in the past.  A 2010 meta-analysis analyzing data from 18 studies reported that each additional cup of coffee consumed per day was associated with a 7% reduction in risk of diabetes.¹  This was surprising, especially because coffee consumption has been shown to raise glucose levels after a meal so you would expect it to worsen diabetes, not help it.  However, this is true of both decaffeinated and regular coffee, although regular coffee raises blood glucose more than decaf.² 

The reason for the decreased diabetes risk remains uncertain, but since coffee comes from a darkly colored bean, it is likely that antioxidants, minerals, or other phytochemicals present in coffee may be responsible for the long term benefits seen in the observational studies.³ With this in mind, we must also remember that almost all of the subjects in the observational studies were eating the standard American diet and therefore starving for antioxidants and phytochemicals. 

Is the standard American diet so nutrient-poor that a significant portion of people’s phytochemical intake comes from their morning coffee? 

It’s likely. Additional studies support this possibility. One observational study of 28,000 postmenopausal women actually found that decaffeinated coffee was more protective than regular coffee – which suggests that the caffeine in coffee might be increasing risk, while the phytochemicals decrease risk.⁴ Chlorogenic acid and trigonelline, two of the major phytochemicals in coffee, have been shown to decrease blood glucose and insulin concentrations in the blood compared to placebo after ingesting sugar, so these phytochemicals likely increase insulin sensitivity.⁵  It is doubtful that coffee would offer any additional protection on top of a nutrient dense diet - the responsible phytochemicals can be obtained from other plant foods and the diet would not be so lacking in antioxidants.  For example, blueberries contain the antioxidant chlorogenic acid, and the phytoestrogen trigonelline is also found in peas, lentils, soybeans, and sunflower seeds. ^6-8  The only reason coffee is beneficial is because of the severe deficiencies in the plant-derived phytochemicals in the diet of most Americans, and coffee at least supplies something.  

New research has found something that makes the insulin desensitizing effects of caffeine even worse - ingesting caffeine with a high-fat meal.

High-fat meals are another factor known to impair glucose tolerance, and saturated fat consumption causes the body to produce inflammatory molecules that contribute to insulin resistance.⁹  This study demonstrated caffeine consumption and a high-fat meal had additive insulin desensitizing effects, and this did  not merely raise the blood glucose - but also when the insulin doesn’t work well the body has to make more of it, and higher insulin causes weight gain and increases cancer risk.^10-12 When subjects ingested a high-fat meal followed by a sugary drink, and blood glucose levels were 32% higher compared to subjects who had water in place of the high-fat meal.  In the second part of the study, subjects were given two cups of caffeinated coffee in addition to the high-fat meal and sugary beverage – this time, blood glucose was even higher – 65% higher than the subjects who had only water before the sugary drink.¹³  Apparently, coffee can have good or bad effects on insulin depending on whether it is consumed with high fat animal products or not.

The message here is that coffee can be both good and bad, but its powerful addictive qualities, with the potential for withdrawal headaches and to increase blood pressure should make people cautious;^14-16 the most likely risks are almost never mentioned in news reports.  I do not think anyone should rely on coffee to protect themselves against diabetes.  If you do choose to drink coffee, stick to water-processed (non-chemical) decaf, and of course skip the doughnuts!

References:

1. Huxley R, Lee CM, Barzi F, et al: Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch Intern Med 2009;169:2053-2063.

2. Greenberg JA, Owen DR, Geliebter A: Decaffeinated coffee and glucose metabolism in young men. Diabetes Care 2010;33:278-280.

3. Tunnicliffe JM, Shearer J: Coffee, glucose homeostasis, and insulin resistance: physiological mechanisms and mediators. Appl Physiol Nutr Metab 2008;33:1290-1300.

4. Pereira MA, Parker ED, Folsom AR: Coffee consumption and risk of type 2 diabetes mellitus: an 11-year prospective study of 28 812 postmenopausal women. Arch Intern Med 2006;166:1311-1316.

5. van Dijk AE, Olthof MR, Meeuse JC, et al: Acute effects of decaffeinated coffee and the major coffee components chlorogenic acid and trigonelline on glucose tolerance. Diabetes Care 2009;32:1023-1025.

6. Zheng W, Wang SY: Oxygen radical absorbing capacity of phenolics in blueberries, cranberries, chokeberries, and lingonberries. Journal of Agricultural and Food Chemis ry 2003;51:502-509.

7. Rozan P, Kuo YH, Lambein F: Nonprotein amino acids in edible lentil and garden pea seedlings. Amino Acids 2001;20:319-324.

8. Sanchez-Hernandez L, Puchalska P, Garcia-Ruiz C, et al: Determination of trigonelline in seeds and vegetable oils by capillary electrophoresis as a novel marker for the detection of adulterations in olive oils. Journal of Agricultural and Food Chemis ry 2010;58:7489-7496.

9. Wen H, Gris D, Lei Y, et al: Fatty acid-induced NLRP3-ASC inflammasome activation interferes with insulin signaling. Nat Immunol 2011.

10. Bowker SL, Majumdar SR, Veugelers P, et al: Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin. Diabetes Care 2006;29:254-258.

11. Davies M, Gupta S, Goldspink G, et al: The insulin-like growth factor system and colorectal cancer: clinical and experimental evidence. Int J Colorectal Dis 2006;21:201-208.

12. Harish K, Dharmalingam M, Himanshu M: Study Protocol: insulin and its role in cancer. BMC endocrine disorders 2007;7:10.

13. Beaudoin MS, Robinson LE, Graham TE: An oral lipid challenge and acute intake of caffeinated coffee additively decrease glucose tolerance in healthy men. J Nutr 2011;141:574-581.

14. Giggey PP, Wendell CR, Zonderman AB, et al: Greater Coffee Intake in Men Is Associated With Steeper Age-Related Increases in Blood Pressure. Am J Hypertens 2010.

15. Noordzij M, Uiterwaal CS, Arends LR, et al: Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials. J Hypertens 2005;23:921-928.

16. James JE: Critical review of dietary caffeine and blood pressure: a relationship that should be taken more seriously. Psychosom Med 2004;66:63-71.

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There are a few different classifications of fiber, and their common characteristic is resistance to digestion in the human small intestine.   Eating fiber-rich foods is associated with a number of health benefits:

• Fiber promotes weight maintenance by slowing gastric emptying; and adding volume to food, promoting satiety
• Fiber helps to prevent diabetes by slowing entrance of glucose into the bloodstream, curbing glucose (and insulin) spikes after meals
• Soluble fiber (a type of fiber abundant in oats and beans) has cholesterol-lowering effects.
• Cardiovascular health – a pooled analysis of 10 prospective studies found that an increase of 10 grams of dietary fiber per day was associated with a 24% decrease in deaths from coronary heart disease.¹
• Digestive health – fiber adds bulk and acts as a stool softener, making bowel movements faster and easier, and preventing constipation and diverticular disease.
• Fermentation of fiber and resistant starch by bacteria in the large intestine helps to prevent colorectal cancers ²

Fiber vs. fiber-rich foods: Fiber can be isolated and taken as a supplement or added to a processed food, but these are not the recommended ways to get your fiber.  Although fiber itself has beneficial properties, fiber-rich whole foods come packaged with disease-fighting phytochemicals.  There have been inconsistencies in the results of studies on fiber and colorectal cancer, probably because it appears to be high-fiber foods, not fiber alone that reduces risk. ^3-8

The American Heart Association recommends consuming 25 grams of fiber each day –a nutritarian diet far exceeds that recommendation, providing about 60-80 grams of fiber each day, since the vast majority of my recommended food pyramid is made up of fiber-rich foods like vegetables, fruits, seeds and beans.  

A study relating dietary fiber intake to lifetime risk of cardiovascular disease was presented at the American Heart Association’s Nutrition, Physical Activity, and Metabolism conference last week. Data from the 2003-2008 U.S. National Health and Nutrition Examination Surveys were analyzed. The researchers used a mathematical algorithm to predict lifetime risk for cardiovascular disease, based on diet, blood pressure, cholesterol, smoking, and history of diabetes.  All of the participants were free of cardiovascular disease at the start.  

The algorithm placed participants in groups of either high or low lifetime risk of cardiovascular disease.  Then they were arranged into four groups according to the ratio of their intake of dietary fiber to calories - dietary fiber only, no fiber supplements were included.  The lowest fiber intake was 0.1g/1000 calories, and the highest was on par with a nutritarian diet, 49.1g/1000 calories.

Individuals aged 20-39 in the highest quartile of fiber intake were almost twice as likely to be in the low risk category than those in the lowest quartile. Middle aged individuals in the highest quartile were about 50% more likely to be in the low risk category. Interestingly though, a similar association was not seen in 60-79 year olds.  The researchers theorized that many older adults with high fiber intake may have already developed significant risk for heart disease before they added more high-fiber foods to their diet.   They concluded that starting to increase fiber intake at a younger age helps to decrease the risk of cardiovascular disease later in life.^9,10

It is important to eat healthfully your entire life to get maximum benefits, however once you have not eaten properly for the first 60 years, then to get the disease-protective benefits to dramatically reduce heart attack, stroke and cancer risk from a plant-based diet (vegan or flexitarian) later in life, it is not good enough to just be good, you have to be great.  In other words, a nutritarian diet with attention to the most nutritionally powerful and protective plant foods is necessary, not just the dietary mediocrity practiced by most vegans and vegetarians.

Eating to Live is a lifetime commitment – just like it takes years for heart disease to develop, it takes years to build up protection against heart disease.  No matter what your age, you can benefit from improving your diet – but the point is, the time to start is right now and the place to start is with a nutritarian diet that pays attention to the disease-fighting nutrients in foods. Once you are past middle age, the way to start is not with some wishy-washy low fat, high fiber diet.  That is not good enough, you have to do better than that and pay attention to the micronutrient-richness of your meals and achieve comprehensive nutritional adequacy, which is the core of my message.  

References:

1. Pereira MA, O'Reilly E, Augustsson K, et al: Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med 2004, 164:370-376.

2. O'Keefe SJ, Ou J, Aufreiter S, et al: Products of the colonic microbiota mediate the effects of diet on colon cancer risk. J Nutr 2009, 139:2044-2048.

3. Singh PN, Fraser GE: Dietary risk factors for colon cancer in a low-risk population. Am J Epidemiol 1998, 148:761-774.

4. Uchida K, Kono S, Yin G, et al: Dietary fiber, source foods and colorectal cancer risk: the Fukuoka Colorectal Cancer Study. Scand J Gastroenterol 2010, 45:1223-1231.

5. Park Y, Hunter DJ, Spiegelman D, et al: Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies. JAMA : the journal of the American Medical Association 2005, 294:2849-2857.

6. Michels KB, Fuchs CS, Giovannucci E, et al: Fiber intake and incidence of colorectal cancer among 76,947 women and 47,279 men. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2005, 14:842-849.

7. Terry P, Giovannucci E, Michels KB, et al: Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst 2001, 93:525-533.

8. Wakai K, Date C, Fukui M, et al: Dietary fiber and risk of colorectal cancer in the Japan collaborative cohort study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2007, 16:668-675.

9. Northwestern University (2011, March 23). Load up on fiber now, avoid heart disease later. . In ScienceDaily; 2011.

10. Ning H, Van Horn L, Shay CM, et al: Dietary Fiber Intake and Long Term Cardiovascular Risk: Findings from the National Health and Nutrition Examination Surveys (NHANES) 2003-2008. In American Heart Association: Nutrition, Physical Activity, and Metabolism 2011.

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In 2009, over 220,000 people had bariatric surgery (weight loss surgery) in the U.S. – these procedures are growing in popularity as obesity rates climb.¹

On Monday, the International Diabetes Federation announced that they now recommend bariatric surgery as a treatment for diabetics with a body mass index (BMI) of 35 or more; and also as an alternative treatment for diabetics with a BMI of 30-35, either when diabetes is not being adequately controlled with medication or in the presence of major cardiovascular risk factors. As its rationale, the IDF cites effective reversal of diabetes, reduced health costs, reduced risk of all-cause mortality, and reductions in cardiovascular risk factors that occur as a result of the surgery.²

Of course, bariatric surgery is effective for reversing diabetes (note however that diabetes remission rates do decrease over time³). Obesity is the primary risk factor for diabetes, and bariatric surgery forces weight loss by physically limiting either intake or absorption of food. But should bariatric surgery be recommended before radical lifestyle changes? The IDF and the American public seem to think so. Yesterday, on Good Morning America, gastric bypass was called a “breakthrough” treatment for reversing diabetes.

According to the physician that discussed bariatric surgery on Good Morning America, “For people who are truly obese and have diabetes, diet and exercise just aren’t really effective.”

Really? Diet and exercise aren’t effective?

Hundreds of formerly obese, formerly diabetic individuals have followed my dietary recommendations and would disagree with that statement.

For example:

• Charlotte, who lost half her body weight (133 lbs.) and reversed her diabetes
• Calogero, who lost 100 lbs. in only seven months and reversed his diabetes
• Richard, who was on insulin for 25 years, and was able to stop taking it after just a few days of a high nutrient diet.

Do you disagree too? Have you reversed your diabetes by changing your lifestyle? If so, let Good Morning America know about it. Comment on the article, or send them your story.

I think that the hundreds of people who have reclaimed their lives by losing over 100 pounds following my high nutrient dietary recommendations would also disagree. Ronnie, Scott, Bill, Sue, Theresa, Anthony, and Julia, to name a few.

It’s not that diet and exercise aren’t enough – it’s just that small changes aren’t enough. A slightly modified version of the standard American diet is not enough. Artificially sweetened sodas and processed foods, excess meat, and a modest increase in vegetable intake cannot do the job of reversing diabetes. With their position statement, the IDF is perpetuating a misguided view, that lifestyle changes are not powerful enough to reverse disease.

Only dramatic changes will produce radical results. Surgery is radical. But there is a safer radical change – a radical lifestyle change, to a natural, high-nutrient plant-based diet-style, plus exercise.
In a recently published study, we investigated the efficacy of a high nutrient density diet for treating diabetes – 62% of the participants reached normal (nondiabetic) HbA1C levels within seven months, and the average number of medications dropped from four to one.⁴ All participants were able to eliminate or reduce medication, except one, who was already on the lowest dosage of Metformin. A high nutrient density diet has tremendous therapeutic potential for diabetes, and for dramatically reducing health care costs.

To those who are considering bariatric surgery, I ask you to please consider my nutritarian (high-micronutrient) diet-style changes first. We live in an obesity and diabetes-promoting food environment, but we can find freedom from these influences. My discovery that high nutrient eating derails toxic hunger and food addictions enables my overweight clients to achieve dramatic weight loss results that parallels or exceeds the long-term results of gastric bypass, and likewise, when diabetic, it most often resolves or dramatically improves.

Diabetics should be aware that superior nutrition works and it works better than drugs or surgery. Surgery will physically limit your portion sizes, but it will not remove addictive foods from your diet, and it will not give your body the nutrients it needs to protect you against heart disease, cancer, and other chronic diseases. Most often the initial results recede over the years as most of the surgery-treated individuals gain back much of the lost weight.

Once you become a nutritarian nutritional expert, consider the sense of satisfaction, accomplishment, and improved self-esteem that can come from losing the weight and watching diabetes disappear. Consider that you may be stronger than you think you are, and that you capable of reclaiming your health.

Also, surgery does not come without risk.

Potential complications of bariatric surgery:
Gastric bypass is the most common bariatric surgery, and carries the following risks⁵:

• Infection
• Hardening of the connection of the stomach to the small intestine
• Bleeding
• Obstruction of the small intestine
• Gastrogastric fistulae (leaks between the “pouch” and the rest of the stomach), requiring additional surgery
• Internal hernia, a potentially life-threatening complication that requires additional surgery⁶
• Venous thromboembolism (blood clots)
• Nutrient deficiencies⁷
• Neurologic complications are said to be often disabling and irreversible, and many do not produce symptoms until over ten years after the surgery⁸
• Bone loss

Diabetes and severe obesity both put the patient at greater risk of complications.⁵ Diabetes is associated with poor weight loss following gastric bypass.⁹

Laparoscopic gastric banding (lap-band) surgery is also not without complications – a recent study reported a long-term complication rate of over 40% (including leakages and band infections, and esophageal dilatation), a re-operation rate of 20.4%. The failure rate of the procedure after 10 years was 31.6%.¹⁰

Addiction and emotional attachment to food is so prevalent and so powerful in our culture that these surgical procedures seem more reasonable than diet change. But it is not – weight loss surgery is extreme and risky; my dietary approach is safe and in most cases, the results are even more effective compared to gastric-bypass surgery. It could save your life.

References:
1. American Society for Metabolic & Bariatric Surgery [http://www.asmbs.org]
2. Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes: A position statement from the International Diabetes Federation Taskforce on Epidemiology and Prevention.
3. Sjostrom L, Lindroos AK, Peltonen M, et al: Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. The New England journal of medicine 2004, 351:2683-2693.
4. Dunaief D, Gui-shuang Y, Fuhrman J, et al. Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density diet. Presented at the 5th IANA (International Academy on Nutrition and Aging) meeting July 26 & 27, 2010 Hyatt Regency Tamaya Resort & Spa 1300 Tuyuna Trail Santa Ana Pueblo, NM, USA J Nutr Health Aging 2010;14:500.
5. Campos GM, Ciovica R, Rogers SJ, et al: Spectrum and risk factors of complications after gastric bypass. Arch Surg 2007, 142:969-975; discussion 976.
6. Schneider C, Cobb W, Scott J, et al: Rapid excess weight loss following laparoscopic gastric bypass leads to increased risk of internal hernia. Surg Endosc 2010.
7. Bell BJ, Bour ES, Scott JD, et al: Management of complications after laparoscopic Roux-en-Y gastric bypass. Minerva Chir 2009, 64:265-276.
8. Juhasz-Pocsine K, Rudnicki SA, Archer RL, et al: Neurologic complications of gastric bypass surgery for morbid obesity. Neurology 2007, 68:1843-1850.
9. Campos GM, Rabl C, Mulligan K, et al: Factors associated with weight loss after gastric bypass. Arch Surg 2008, 143:877-883; discussion 884.
10. Naef M, Mouton WG, Naef U, et al: Graft survival and complications after laparoscopic gastric banding for morbid obesity--lessons learned from a 12-year experience. Obes Surg 2010, 20:1206-1214.

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Depression is a growing problem in our society, and diabetes has reached epidemic proportions.
Major depressive disorder affects nearly 15 million American adults – that’s almost 7% of the adult population, and it is the leading cause of disability in the U.S. for individuals aged 15-44. [1] Type 2 diabetes affects almost 10% of Americans, about 24 million people, and is the 7th leading cause of death in the U.S. [2]

In women, it has been shown that those with depression are more likely to develop diabetes, and those with diabetes are more likely to develop clinical depression.[3] Diabetes doubles the risk of heart attack and stroke, and depression is also an independent risk factor for heart disease, increasing risk by 64%. [2, 4] A new study has found that the coexistence of depression and diabetes imposes additive detrimental effects, especially with regard to death from cardiovascular disease. As a part of the Nurses’ Health Study, 78,000 women were followed for 6 years, and diagnoses of depression and type 2 diabetes were recorded.

Compared to subjects with neither diabetes nor depression:

• Depression alone increased risk of all-cause mortality by 53%, and cardiovascular mortality by 56%
• Diabetes alone increased risk of all-cause mortality by 52%, and cardiovascular mortality by 146%
• The risk of death from all causes climbed in those with both conditions to more than double, and risk of cardiovascular mortality almost quadruple that of individuals with neither condition.
• Those who had lived with diabetes for more than ten years combined with depression more than tripled their risk of death from cardiovascular disease.
• Depressed individuals who were also on insulin therapy had almost 5 times the risk of death from cardiovascular disease.[5, 6]

This is a reminder not only of the substantial health hazards associated with diabetes, but also the significance of the mind-body connection – in this study, depression increased the risk of death from all causes by 53%. Psychological conditions profoundly affect physical health. The potential physiological effects of depression on the cardiovascular system include increased platelet aggregation and inflammation, sympathetic nervous system hyperactivity, and impaired endothelial function. [7] Living healthfully, with the right lifestyle and diet-style in conjunction with judicious use of supplements to assure comprehensive nutritional adequacy can go a long way to making sure you and your loved ones avoid both diabetes and depression.

No one needs to resign to becoming a victim of these common American conditions.

Even if you have or have had depression, there are effective natural methods for getting well. Dr. Fuhrman uses a treatment regimen that includes morning light therapy and exercise combined with a high nutrient diet and supplementation with vitamin D and omega-3 fatty acids for patients with depression. Type 2 diabetes is a disease of poor lifestyle choices. As such, health-promoting lifestyle habits – a plant-based diet and exercise – are established in the medical literature as effective treatments for diabetes. [8-13] Furthermore, Dr. Fuhrman’s high-nutrient, vegetable-based diet offers dramatic results as it unlocks the body’s enormous healing potential, enabling many people to completely reverse their diabetes. Living a healthy lifestyle allows you to take control of your own health – both physical and mental health.

References:

1. The Numbers Count: Mental Disorders in America.
2. American Diabetes Association: Diabetes statistics. Available from: http://www.diabetes.org/diabetes-basics/diabetes-statistics/.
3. Pan, A., et al., Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med, 2010. 170(21): p. 1884-91.
4. Wulsin, L.R. and B.M. Singal, Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med, 2003. 65(2): p. 201-10.
5. Pan, A., et al., Increased mortality risk in women with depression and diabetes mellitus. Arch Gen Psychiatry, 2011. 68(1): p. 42-50.
6. Walsh, N. Depression Plus Diabetes Raises CV Death Risk. Medpage Today, 2011.
7. Huffman, J.C., C.M. Celano, and J.L. Januzzi, The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatr Dis Treat, 2010. 6: p. 123-36.
8. Barnard, N.D., et al., A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr, 2009. 89(5): p. 1588S-1596S.
9. Barnard, N.D., et al., A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care, 2006. 29(8): p. 1777-83.
10. Barnard, N.D., et al., Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev, 2009. 67(5): p. 255-63.
11. Trapp, C.B. and N.D. Barnard, Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Curr Diab Rep, 2010. 10(2): p. 152-8.
12. Thomas, D.E., E.J. Elliott, and G.A. Naughton, Exercise for type 2 diabetes mellitus. Cochrane Database Syst Rev, 2006. 3: p. CD002968.
13. Conn, V.S., et al., Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia, 2007. 50(5): p. 913-21.

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According to the U.S. Centers for Disease Control and Prevention (CDC), the prevalence of type 2 diabetes has more than tripled in the past 30 years.[1] As of now, about one in ten Americans (about 24 million people) have type 2 diabetes. The CDC released a statement last week predicting that one-fifth to one-third of all Americans will have diabetes by the year 2050, if current trends continue. [2] Excess weight promotes insulin resistance and is the chief risk factor for type 2 diabetes[3], so this prediction is not surprising given the prevalence of overweight and obesity, which are 68% and 33.8% of adults, respectively.[4]

Diabetes is taking a huge toll on the health of our nation:

• Diabetes is the 7th leading cause of death in the U.S.
• Diabetes doubles the risk of heart attack and stroke.[5]
• Diabetes is the leading cause of kidney failure and blindness in older adults.
• Diabetes increases the risk of cancer, especially colorectal cancer.[6-8]

Diabetes is also taking a huge financial toll. Our unhealthy eating habits may eventually bankrupt our nation:

• Healthcare costs related to diabetes are estimated to be $174 billion per year.
• About 1 out of every 10 health care dollars is spent on diabetes.[2]
• The average type 2 diabetic incurs $6649 in health care costs per year directly attributable to their diabetes. [9]

In order to prevent this prediction from proving true, our country has to change the way it approaches diabetes – we must emphasize prevention. Earlier this year, the editors of the medical journal The Lancet called it a “public health humiliation” that diabetes, a largely preventable disease, has reached such epidemic proportions. In reference to this year’s American Diabetes Association national meeting, they said, “…there is a glaring absence: no research on lifestyle interventions to prevent or reverse diabetes. In this respect, medicine might be winning the battle of glucose control, but is losing the war against diabetes.” [10]

These authors are correct – this is a public health humiliation, because type 2 diabetes is both preventable and reversible. The American diet of refined grains, oils, sugars, and animal products is at the root of the crisis, and keeping glucose under control with drugs in individuals who continue to consume this diet will not prevent diabetes complications.

The cure for type 2 diabetes is already known – removing the cause can reverse the disease.

Many whole, plant foods are high in antioxidants and fiber and have low glycemic load, characteristics that make them effective at preventing and reversing diabetes. [11] As such, there have been a few randomized trials using a plant-based diet to treat diabetes, and they have had impressive results. In a 22-week study published in 2006, a low-fat plant-based diet allowed for an average decrease of 1.23 points in A1C, weight loss of 13 lbs., and 21.2% decrease in LDL cholesterol. Most importantly, 43% of the participants were able to reduce their diabetes medications. An earlier study reported a 28% decrease in fasting blood glucose, as well as reduction or discontinuation of diabetes medications.[12]

Based on my experience with diabetic patients, I believe that a high-nutrient plant-based (nutritarian) diet, focused on green vegetables and beans, along with exercise, is much more effective at reversing diabetes. My eating plan for diabetics, as outlined in my book Eat to Live, has helped hundreds of people get rid of their diabetes. Take Charlotte, for example: At age 56, 5’4” and 263 pounds, upon suffering a stroke, she was diagnosed with diabetes, high blood pressure, high cholesterol, and with significant arterial blockages. She was confined to a wheelchair and was on several medications for all these ills. Charlotte and her husband then embarked on a nutritarian diet style to try to improve her health. A year and half later, Charlotte had lost half her body weight! Most importantly, she is no longer diabetic, and no longer has high cholesterol. Charlotte is now healthy.

Hundreds of others have exciting disease-reversal stories to tell and have also completely reversed their diabetes and that means that even those severe type II diabetics with failure to adequately control their glucose reading on multiple diabetic drugs, including insulin have made complete recoveries and no longer require any diabetic medications. With a nutritarian diet and exercise; food is more powerful than drugs.

Foods that provide substantial protection against diabetes:

• Green, leafy vegetables. Pooled data from four studies determined that eating 1.35 servings (about 3.5 cups of raw greens) of green leafy vegetables vs. 0.2 servings or less per day provided a 14% decrease in diabetes risk [13]
• Beans. Beans are high-nutrient, high-fiber, and low-calorie. They are digested slowly which induces satiety and stabilizes blood glucose. Therefore, beans are the most appropriate source of carbohydrate for diabetics. A study on 64,000 women followed for 4 years found that high intake of legumes were associated with a 38% decreased risk of diabetes.[14]
• Nuts and seeds. An inverse relationship between nut consumption and diabetes was reported in the Nurses’ Health Study – 5 servings of nuts per week was associated with a 27% decrease in risk.[15]
• Fresh fruit. Adding three servings of fresh fruit per day to one’s diet can decrease diabetes risk by up to 18%. (Note that those who already have diabetes should limit fresh fruit and focus on low sugar fruits) [16]

With Americans now consuming over 85 percent of calories as animal products and processed foods we could expect this tragic epidemic to continue. The only way to stop this worldwide trend toward dietary suicide is the type of broad public educational effort that has been organized against smoking. Obesity is responsible for more chronic disease than smoking [17]; we must collectively we all must fight against the proliferation and consumption of junk food, fast food, processed foods and commercial and processed meats, which are at the root of the obesity epidemic.

References:

1. U.S. Centers for Disease Control and Prevention: Diabetes Data & Trends. 2008; Available from: http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm.
2. Boyle, J.P., et al., Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr, 2010. 8(1): p. 29.
3. Khaodhiar, L., S. Cummings, and C.M. Apovian, Treating diabetes and prediabetes by focusing on obesity management. Curr Diab Rep, 2009. 9(5): p. 348-54.
4. National Insitutes of Health: Overweight and Obesity Prevalence Estimates. Available from: http://win.niddk.nih.gov/statistics/#overweight.
5. American Diabetes Association: Diabetes statistics. Available from: http://www.diabetes.org/diabetes-basics/diabetes-statistics/.
6. Campbell, P.T., et al., Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men. Gastroenterology, 2010. 139(4): p. 1138-46.
7. Flood, A., et al., Diabetes and risk of incident colorectal cancer in a prospective cohort of women. Cancer Causes Control, 2010. 21(8): p. 1277-84.
8. He, J., et al., The association of diabetes with colorectal cancer risk: the Multiethnic Cohort. Br J Cancer, 2010. 103(1): p. 120-6.
9. Economic costs of diabetes in the U.S. In 2007. Diabetes Care, 2008. 31(3): p. 596-615.
10. Type 2 diabetes--time to change our approach. Lancet, 2010. 375(9733): p. 2193.
11. Jenkins, D.J., et al., Type 2 diabetes and the vegetarian diet. Am J Clin Nutr, 2003. 78(3 Suppl): p. 610S-616S.
12. Nicholson, A.S., et al., Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet. Prev Med, 1999. 29(2): p. 87-91.
13. Carter, P., et al., Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. Bmj, 2010. 341: p. c4229.
14. Villegas, R., et al., Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women's Health Study. Am J Clin Nutr, 2008. 87(1): p. 162-7.
15. Jiang, R., et al., Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA, 2002. 288(20): p. 2554-60.
16. Bazzano, L.A., et al., Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women. Diabetes Care, 2008. 31(7): p. 1311-1317.
17. Rand Corporation. Research Highlights: The Health Risks of Obesity. Worse than Smoking, Drinking, or Poverty. 2002; Available from: http://www.rand.org/pubs/research_briefs/RB4549/index1.html.

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Vitamin D is continuing to make news.  Although previously well-known for its effects on calcium absorption and therefore bone health, vitamin D has now emerged as a contributor to many nonskeletal physiological processes, and functions have been attributed to vitamin D in the prevention of cancer, cardiovascular disease, infections, autoimmune diseases, and more. There are vitamin D receptors in almost every cell in the human body, and vitamin D regulates the expression of over 200 different genes. It is not surprising that sufficient vitamin D is crucial to the proper function of so many of our body’s tissues.¹

Scientists estimate that 50% of the population of North America and Western Europe has insufficient blood vitamin D levels (as measured by 25(OH)D; sufficient is defined as greater than 30 ng/ml). Although recommended vitamin D intakes remain at only 200-400 IU per day, there is consensus among the scientific community that 2000 IU or more may be necessary for most  people to maintain sufficient blood levels.²

The newest research has found that vitamin D sufficiency is important for preventing type 2 diabetes, cognitive decline, asthma, and cardiovascular disease.

Type 2 diabetes

There is some evidence that vitamin D is involved in insulin secretion by pancreatic beta cells, since insulin secretion is a calcium-dependent process. Vitamin D may also prevent the development of insulin resistance by stimulating expression of the insulin receptor on the surface of cells that use glucose as fuel.³ A recent study performed at Johns Hopkins University School of Medicine on type 2 diabetics found that 91% of the patients were either deficient (less than 15 ng/ml) or insufficient (between 15 and 30 ng/ml) in vitamin D. Furthermore, there was inverse association between vitamin D levels and HbA1c, an indicator of blood glucose levels over the preceding 2-3 months, implying that vitamin D sufficiency contributes to glycemic control in diabetics.⁴ Vitamin D’s effects are not specific to type 2 diabetes; there is also convincing evidence that vitamin D supplementation during pregnancy and early childhood can reduce the risk of type 1 diabetes, and prospective studies on this topic are ongoing.^1,5

Cognitive decline

Vitamin D receptors are present throughout the entire human brain, and genes that are regulated by vitamin D are involved in processes such as memory formation and neurotransmission.^6,7 Although previous studies have been inconclusive⁸, this new data supports a role for vitamin D in maintaining brain health in older adults. 

Asthma

Two recent studies on asthma, one in adults and one in children, has linked vitamin D insufficiency with increased asthma severity.⁹ Those with 25(OH)D levels above 30 ng/ml had greater lung function, and used less medication.¹⁰ A similar study in children also found that lower vitamin D levels were associated with increased asthma severity, and that higher vitamin D levels were associated with reduced odds of hospitalization for asthma.¹¹ Vitamin D’s anti-inflammatory actions or regulation of smooth muscle cell contraction via calcium handling may be the responsible factors. The researchers are currently conducting a trial investigating vitamin D supplementation as a therapeutic option for asthma. Vitamin D is also important for lung development in utero, so maternal supplementation with vitamin D during pregnancy is recommended.¹²

Cardiovascular disease

There is continually building evidence in the literature that sufficient vitamin D levels protect against cardiovascular disease. Vitamin D deficiency is extremely prevalent among heart attack sufferers – 96% of heart attack sufferers in a recent study were either insufficient (21%) or deficient (75%) in vitamin D. Those with sufficient vitamin D levels are less likely to die from heart attack or stroke.  Vitamin D insufficiency may allow for increased cholesterol uptake by inflammatory cells, which contributes to atherosclerosis.¹³ A newly published study recorded vitamin D levels at baseline and throughout 6 years of follow-up. At the start of the study, the average 25(OH)D level was 19.3 ng/ml (insufficient). During the trial, about half of the subjects increased their levels to the sufficient range (above 30 ng/ml), and these subjects had significantly reduced incidence of heart attack, heart failure, and coronary artery disease. Some subjects raised their 25(OH)D levels above 44 ng/ml, and they received even stronger protection against cardiovascular disease. Compared to those who reached levels above 44 ng/ml, those whose levels stayed between 10 and 19 ng/ml had a 27% increase in coronary artery disease, a 32% increase in heart failure, and a 59% increase in heart attack incidence.¹⁴

Maintaining sufficient vitamin D levels is essential to our health. 

Very few foods naturally contain vitamin D and we cannot rely on sun exposure alone because of indoor jobs, cool climates, and the risk of skin cancer that may arise from adequate amounts of sun exposure to maintain vitamin D levels.   Plus, requirements vary with genetics and skin type greatly effecting Vitamin D production in the skin.  Taking a multivitamin is not the answer because almost all  multivitamins still provide an inadequate amount of vitamin D (400 IU). Favorable levels can be confirmed with a blood test, and supplementation can be adjusted accordingly.   I recommend supplementing with an adequate amount of vitamin D in order to maintain 25(OH)D levels of 35-55 ng/ml. For some people 2000 IU will be sufficient, but others may require more.

References:

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Usually, when we think about foods that increase diabetes risk, we think of white flour-based processed foods, sugary sodas, and desserts, since these foods are known to produce dangerous increases in blood glucose. Also, many diabetics are under the impression that that they should avoid carbohydrate-containing foods, and eat higher levels of protein to keep their blood glucose levels in check. However, dietary factors associated with diabetes are not a simple question of carbohydrate vs. protein. Whole food sources of carbohydrate, like fruit and whole grains, are protective.¹ On the other hand, several studies have now confirmed that high intake of meat, which contains no carbohydrate, increases the risk of diabetes.

A meta-analysis of 12 prospective cohort studies has revealed that high total meat intake increased type 2 diabetes risk 17% above low intake, high red meat intake increased risk 21%, and high processed meat intake increased risk 41%.²

All the reasons behind these associations are not yet clear. One possibility is the pro-oxidant properties of heme iron (found only in animal products), the primary source of which is red meat. High dietary intake of heme iron and also high body stores of iron have been previously associated with increased diabetes risk in multiple studies^3,4, whereas dietary nonheme iron (found only in plant foods) was protective. Heme iron from fish and poultry was also associated with diabetes risk.⁴ Oxidative stress, which may be brought on by excessive iron, plays an important role in the production of advanced glycation end products (AGEs), which contribute to both insulin resistance and diabetes complications.⁵ Also meat is a concentrated source of calories, it has a high caloric density and people can get a good blast of fat and protein, easily exceeding the body’s requirements for macronutrients.  Meat eating is also associated with weight gain and of course, excess body weight is the most important risk factor for diabetes. Like most other chronic diseases that plague Americans, diabetes is a consequence of a high-calorie, low-nutrient diet-style that is deficient in protective unrefined plant foods. 

References:

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Surgeon General Warning: Quitting smoking now greatly reduces serious risks to your health.

A year ago I bought my first pack of cigarettes.  Yes, you read correctly. This mother of five made the big purchase.  The entire episode at my neighborhood gas station lasted no longer than four minutes, and it was the most pathetic thing that I've ever done in my life. Obviously, I had no clue of what to even ask for; my ignorance was obvious to all. I felt like I was robbing the place. I was paranoid that someone would recognize me, and kept looking over my shoulders to see if anyone I knew was lurking behind the candy counters.   

The cost was $4.71; and that was for the cheapest brand. I spent almost five dollars for something that ruins health. I immediately thought, “What a waste of money.” I quickly threw the cigarettes into my purse and scrambled out. 


Since childhood I'd been influenced by teachers, coaches, 4-H leaders, clergy, and various other leaders that smoking was wrong. It was totally out of the question if one wanted to be successful; not so much a health issue as a moral issue.  

However, this same conservative community saw absolutely nothing wrong with eating fried tenderloins, apple dumplings, and cotton candy at school carnivals; serving donuts and hosting all-you-can-eat potlucks at religious gatherings; or devouring BBQ sandwiches, taffy, and sno cones at the 4-H County Fair. They taught their values well. I didn’t become a nicotine addict.        

A Dairy Queen treat averages $3.50. Add carbonated fountain drinks, and the evening indulgence can easily cost a family of five more than $30. According to statistics, two of those family members may end up developing diabetes on down-the-road. In today’s economy, that would cost one person ten or fifteen dollars a day just to manage insulin dependent diabetes. That number doesn’t reflect the cost of doctor visits, lab tests or hospitalizations due to complications from the disease.  In the next 24 hours 4,384 cases of diabetes will be diagnosed in America.¹ Is eating for disease a negligent waste of money? 

Exploding Epidemic Set to Potentially Cripple our Healthcare System; Diabetes and Pre-Diabetes Tops 40 percent of US Adults  by Joel Fuhrman, M.D. 

         

morals - ideal codes of conduct which are held to be authoritative in manner of right and wrong (Wikipedia)

By the way, I hid the cigarettes.  I sure didn’t want my kids to discover them in my purse!  That would certainly set a bad moral example for them, wouldn't it?

Don’t worry.  I’m never going to smoke the pack of cigarettes.  I only bought them to prove how psychologically brainwashed we’ve become that suicidal and self-destructive eating is the acceptable norm in our culture.   

1  stopdiabetes.diabetes.org
 image credits: tabaccofreeaz.wordpress.com; heitmannsnuts.netfirms.com; pizza slice by ruthboller.com      

 

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Today, March 23, 2010 is the 22^nd annual American Diabetes Association Alert Day, and the American Diabetes Association reports sobering statistics:

Over 20 million people in the United States have type 2 diabetes. That doesn’t count the 6 million who have diabetes and don’t know it yet.¹ Type 2 diabetes has been called the most challenging health problem of the 21st century. The dangerously high prevalence of overweight and obesity is at the heart of this problem.

In the last five months, over 600,000 people have been diagnosed with diabetes. That's one person every 20 seconds.²  The ADA is correct – it is time to stop diabetes. The problem is they have no idea how to do this. They have no idea that in over 90% of patients, type 2 diabetes can be effectively and relatively quickly reversed through my nutritarian diet-style and exercise. 

Diabetes is the 7^th leading cause of death in the United States. Diabetes is the leading cause of blindness in adults and the leading cause of kidney failure. Sixty to 70 percent of diabetics have nervous system damage. Diabetes doubles risk of heart attack and stroke.¹ This suffering is tragic because excellent nutrition and exercise can reverse diabetes, and are much safer than conventional care. Taking glucose-lowering medications does not prevent diabetes complications. In fact, they often cause weight gain, exacerbating insulin resistance. Some of these medications even increase the risk of heart failure. Diabetics who take medications and continue to remain overweight and consume their disease-causing diet continue to damage their organs, develop complications, and die prematurely.

Did you know that type 2 diabetes also increases the risk of cancer?  Scientists believe that this is at least in part due to insulin therapy. A new review that analyzed data from several studies found that diabetic patients are 30% more likely to develop colorectal cancer, 20% more likely to develop breast cancer, and 82% more likely to develop pancreatic cancer.³  It is time to stop diabetes. So how do we stop it?

Simple. The ADA may encourage you to make small changes, afraid that you will give up if it looks difficult. But the truth is, a radical improvement in your health will require a radical improvement in your lifestyle. Some physicians may assume that patients will not be willing to adopt a diet that is based on unrefined plant foods, but they are wrong – a study comparing the American Diabetes Association guidelines to a whole-food, plant-based diet found exactly the opposite. Subjects assigned to the ADA diet reported that they felt more restricted in their dietary choices, and the rate of adherence was greater in the plant-based diet.⁴ Once people start to see positive changes in their health, they are enthusiastic about sticking to their plan.  The nutritarian diet-style I teach to my diabetic patients is even more effective. In fact, we just completed a study, soon to be published,which demonstrated that 9 out of 10 diabetics were able to come off all medications and have normal glucose readings. That essentially means they became non-diabetic. 

My Eat For Health dietary protocol is simply the most effective remedy for those with all types of diabetes. The type II can get completely well and the type I diabetics reduce their insulin by about half and stop the huge swings in glucose and prevent the devastating complications of diabetes.

The best diet for longevity, heart disease and cancer prevention, and a high level of overall health is also the best diet to prevent or reverse diabetes. It is a diet with a high nutrient per calorie ratio:

• lots of non-starchy vegetables like greens, eggplant, tomatoes, mushrooms, onions, and garlic

• beans

• raw nuts and seeds

• limited fresh fruit

• limited animal products

• no sweeteners

• no white flour

When those with diabetes follow my recommendations, it becomes relatively easy for them to eat liberally – not feeling deprived or restricted – and still lose their excess weight easily. Their diabetes will melt away astonishingly quickly, reducing or eliminating their need for medications.

Tony is no longer diabetic. He succeeded in restoring his health despite the failures of conventional diabetes care. Read his incredible story below.

“I am 57 years old. I have always had a weight problem like everyone in my family. In December of last year, after feeling strange for several months, my sister (who has been diabetic for 25 years) tested me with her meter & my blood sugar was 491. 

She dragged me to the ER where I got 2 shots of insulin & a meal that included turkey, gravy, a box of sweetened cranberry juice & chocolate pudding which my sister advised me not to eat. After paying the $2,400.00 tab, I was instructed to make an appointment with an endocrinologist & sent home with a prescription for Metformin, daily aspirin & NO dietary advice. My sister suggested buying a meter on the way home. None of the two doctors or RN’s suggested getting a meter & testing. I started taking the Metformin as instructed.

My appointment with an endocrinologist a few days later was another eye opener. As soon as he walked into the room, without even looking at me or my meter which I brought with me with 80 stored blood sugar readings, he said “You need insulin.” Then he started to do a physical & said “You need to be hospitalized with an IV because you’re dehydrated; do you have medical insurance?” When I said “no,” he said “Get some Pedialyte and Gatorade & drink 6 glasses of each per day.” I asked “Don’t those drinks have sugar in them?” He said “Not really.” He gave me a prescription for “Januvia” ($400.00 for 100 tablets) & directed me to take two/day. He then handed me an 1800 calorie/day diet & disappeared. 

After paying the $1,200.00 for the visit & labs, I started taking the medication as directed. After two weeks, the medication made me too ill to drive or exercise & somehow caused my intestines to become obstructed (gas or something) & I spent all night trying to go to the bathroom. Only being low on cash kept me from going to the E.R. again. I also had to get up 3 or 4 times each night to eat. I phoned the doctor several times over the next week to get a different medication but he never returned one single call so I stopped taking the medication. 

Naturally, I was afraid to eat anything because I was afraid my blood sugar would climb. At my next visit, when I told him the medication was making me sick, he said “Just keep taking it, the symptoms will subside when your body gets used to it.” He said my A1C was 8.9%. One week later, I found a different doctor but my new doctor wasn’t interested in seeing me unless I paid him another $1,200.00 to repeat the physical & labs from two weeks ago even though I had a copy of my labs & he could consult with the other doctor. 

I was running out of money after spending $4,000.00 in two weeks. I’m not insurable due to “preexisting conditions” – diabetes and carpal tunnel. Here in CA, an HMO has the right to deny coverage to anyone with an illness. You can imagine how stressed I was, having to choose between constant expensive medication & the illness it caused or high blood sugar with its consequences. 

While doing research on the web, I came across Dr. Fuhrman’s website and ordered Eat to Live and Eat For Health and started the program. With all the weight loss/nutrition books out there from Atkins & a bunch of others, I was skeptical. 

I started following the recommendations in the section “Advice for the Diabetic Patient” weighing 220 lbs on 1-8-09 – the same day I stopped taking all diabetes medication. Within 3 months, I weighed 195. I had new blood work completed on 4-8-09 with a new doctor. She downloaded my blood sugar numbers from my meter & said “Whatever you’re doing, keep doing it because it’s working." I explained Eat to Live, my typical meals & snacks & told her I stopped taking medication on my own three months ago. She later phoned me with my lab results: A1C: 6.0% which she said was in a non-diabetic range (4 - 6%) The improvement from 8.9% to 6.0% in 3 months on “Eat to Live” was far better than I expected. I would have been happy with 7.0%.

I have even found it easy to maintain these guidelines while eating out – even though my diabetes class educators said “If you’re diabetic, it is impossible to eat right at restaurants so try to avoid eating out altogether.” Yesterday, my family took me out to our favorite Mexican restaurant for my birthday. I had grilled vegetarian fajitas with tofu and black beans. Remembering the information in Eat to Live about fiber, I left the pasty processed rice alone, I had ONE tortilla chip, ate the whole cup of Salsa & left the flour tortillas alone. Just as you stated in Eat to Live, by doing that, I had room for the grilled vegetables, mushrooms & tofu. I tested my blood sugar two hours later, expecting it to be around 180 because I overate. It was 124. 

The next morning, after your suggested breakfast without processed cereal, substituting raw nuts & a diced, unpeeled apple, I was shocked to test at 78 two hours after breakfast & 30 minutes of exercise (NordicTrack cross-country skier). I was so astounded that I re-tested with another meter & it indicated 90. The biggest revelation was the fact that I HAD NEVER ACHIEVED THESE RESULTS WITH MEDICATION - Metformin and Januvia (which made me ill). 

I have attended five diabetes “education” classes & I am appalled that the “Certified Diabetes Educators” constantly hand out suggested meals with eggs & toast or processed cereal & milk for breakfast, daily roast beef or turkey sandwiches for lunch & more chicken or other meat at dinner & limiting fruit to 1-2/day. They also teach that protein stabilizes blood sugar so it’s important to eat meat & dairy at each meal. After those dietary recommendations, she then spoke at great length about the evils of high cholesterol, high blood pressure & high blood sugar, then she spent two hours talking about the various drugs available to treat them. I have always wondered about the notion that if you are eating the right foods, why would you need drugs to protect yourself from the damage they cause? I now weigh 188 pounds. 

When I chat on WebMD’s diabetes message boards, some people with Type 2 Diabetes want to know how I’m managing my blood sugar without medication & I always tell them about www.drfuhrman.com !”

The human body has an amazing capacity to heal, even from diabetes. All we have to do is establish the optimal nutritional environment for healing with nutrient-rich foods and let the body do its work. A long, healthy life, free of diabetes and its tragic complications is possible, and it can be yours. 

You are the one who chooses whether you are going to live with your diabetes or get rid of it.

References:

1. American Diabetes Association: Diabetes statistics http://www.diabetes.org/diabetes-basics/diabetes-statistics/

2. American Diabetes Association: Stop Diabetes http://stopdiabetes.diabetes.org/site/PageServer?pagename=SD_homepage

3. Eurekalert: Experts call for further research into the relationship between insulin therapy and cancer

http://www.eurekalert.org/pub_releases/2010-03/w-ecf030210.php

Pollak M, Russell-Jones D. Insulin analogues and cancer risk: cause for concern or cause célèbre? Int J Clin Pract. 2010 Feb 26. [Epub ahead of print]

4. Barnard ND, Gloede L, Cohen J, et al. A low-fat vegan diet elicits greater macronutrient changes, but is comparable in adherence and acceptability, compared with a more conventional diabetes diet among individuals with type 2 diabetes. J Am Diet Assoc. 2009 Feb;109(2):263-72.

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