The End of Diabetes (19 page)

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Authors: Joel Fuhrman

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Some women are at such a low risk of diabetes during pregnancy that they would not need the glucose challenge. For them, a fasting glucose test would be sufficient. These are typically women who are already eating a healthful diet and have no family history or genetic tendency toward diabetes. They were a normal weight before pregnancy and have had no abnormal weight gain with pregnancy.

 

Medications Are Not the Best Solution

Women who are identified with gestational diabetes are targeted for nutritional counseling, and if that fails, they are placed on oral medications or insulin to lower their glucose levels. Gestational diabetes poses an increased risk to both mother and child. The reason there is such a concern about heightened glucose during pregnancy is that elevated glucose increases the size of the baby and results in delivery complications, often leading to the need for C-section. It also increases the risk of preeclampsia—high blood pressure during pregnancy and excess amniotic fluid around the baby. Babies of diabetic mothers are also at higher risk of underdeveloped lungs and respiratory distress after birth.

However, giving medications to lower the glucose in gestational diabetics is not effective or sufficient to lower the risks. The excess body weight and poor nutritional input that precipitated this problem still remain and are contributors to this risk even if the glucose is lowered with medication. For example, overweight women have children with more birth defects, especially dangerous heart defects. Children born to mothers with gestational diabetes are also more prone to obesity and diabetes themselves. Hypoglycemia after birth and increased risk of neonatal jaundice are also a concern in these babies.

Women who know about excellent nutrition, eat healthfully, and maintain a healthy weight before pregnancy and continue to eat right through pregnancy do not need to worry about gestational diabetes. Its high prevalence in our culture speaks to how poor our American diet is. I do not generally require my slim, healthy patients following my healthful dietary guidelines to even partake in the GCT or GTT. Excellent health and physical fitness are important throughout life—before, during, and after pregnancy.

 

What to Do If You're Diagnosed with Gestational Diabetes

The conventional approach to treating gestational diabetes is inadequate. The dietary advice most typically offered is simply not sufficient to bring the glucose into the normal range without drugs, and this is a time to act quickly and not play around with suboptimal advice. Given the dietary ineptitude, too many treating physicians often prescribe medications during pregnancy. Later on, labor induction and a C-section with a greater risk of neonatal admissions are the typical outcome.

Pregnant women are highly motivated for successful outcomes. It is my experience that they will carefully comply with the prescribed dietary regimen and achieve excellent results. Ideal nutrition is a valuable blessing to give to pregnant women to enhance their health, the safety of their pregnancy, and the health of their children. The problem here is that gestational diabetes is often characterized by very strong insulin resistance, so even when doctors prescribe insulin, large dosages are needed. Therefore, when prescribing a nutritional approach for this condition, an aggressive nutritional protocol is indicated, though not utilized by conventional physicians and dieticians.

This aggressive antidiabetic protocol is important to reverse gestational diabetes quickly and easily without risky drugs, which can induce neonatal hypoglycemia and preterm delivery. Then, if any medication is still necessary, it can be almost always limited to metformin, which is classified as the lowest risk medication to be used in pregnancy.

Avoiding medications whenever possible is wise anyway. Who knows the subtle long-term effects of these medications on your unborn child? Will those medications increase the occurrence of cancer in our children sixty years down the road? We just don't know. Less medication is better medicine, and no medicine is the best medicine. For women at a high risk of diabetes, with diabetes, or significantly overweight during pregnancy, I recommend this aggressive antidiabetic food plan at least until the glucose numbers return to a safe range. This is the same phase one advice for all diabetics attempting to attack their condition with full artillery.

 

A Sample Phase One (Aggressive) Diabetic Reversal Diet for Newly Diagnosed Gestational Diabetes

Do not make choices about what to eat and what not to eat just yet. For now, allow me to make these decisions for you. In order to give this method a chance to see what it can do, you must do it as exactly as prescribed, without modifications.

This menu includes options—do not attempt to consume all the food or dishes suggested. Choose only one or two options at each meal. You can eat the same dish for more than one meal and even cook extra to use as leftovers for a few days. Please follow this plan until your blood sugar is relatively favorable. Then once your condition is in the safe, nondiabetic range, you can follow the general recommendations in the menu section of this book.

 

Breakfast

Use one of the below suggestions per meal. Please note that carbohydrates (even beans) are not eaten with breakfast because insulin resistance is highest in the morning.

 

•  A green salad with lettuce, thinly sliced red onion, tomatoes, and roasted red peppers with a creamy hemp seed herbal dressing made from hemp milk, seeds, and a fruit-flavored vinegar. Or a roasted tomato-basil dressing made from tomato paste, soaked dried tomatoes, raw and roasted garlic, vinegar, roasted red pepper, chopped scallions, basil, cumin, and cinnamon. Half cup of berries.

•  A roasted eggplant casserole made with sliced zucchini, mushrooms, onions, tomatoes, garlic, and spices such as cinnamon and cumin, sprinkled with lightly toasted and chopped pumpkin seeds. Half cup of berries.

 

Remember, this breakfast seems unusual because with gestational diabetes, insulin resistance is elevated in the morning; so the treatment is a light breakfast of low-glycemic plant foods for breakfast—no grains or fruit, except some berries.

 

Lunch

Select two of the following options per meal.

 

•  A vegetable-bean soup or stew, served over or with a bowl of shredded lettuce and shredded raw spinach. The soup should be made with a low-salt tomato and celery juice base and lots of leafy greens, leeks, zucchini, and onions.

•  Roasted tofu slices or one ounce sliced turkey chopped with avocado, dill, and roasted garlic wrapped in raw collard green leaves.

•  Zucchini-cauliflower casserole baked with chopped onions and mung beans or other sprouts and sprinkled with nutritional yeast.

•  The roasted eggplant and mushroom dish from the breakfast menu can be eaten here instead.

•  Spicy beans or lentils (1 cup) served hot over a bed of finely shredded lettuce and cabbage.

 

Dinner

Include all three options below per meal.

 

•  A steamed green vegetable dish made with steamed or water-sautéed mushrooms and onions. Steamed green vegetables (string beans, artichokes, or asparagus), crushed raw walnuts, and lightly toasted almond slivers.

•  Raw vegetables such as raw broccoli, snow peas, cauliflower, kohlrabi, cucumbers, radishes, peppers, tomatoes, or celery served with a humus or salsa dip. A sunflower-mushroom burger served with lettuce, tomato, raw onion, and tomato sauce with steamed cauliflower or spaghetti squash.

•  One fresh fruit for dessert, or two kiwis or a box of berries.

 

This is also a version of the phase one diet plan to follow for a person who wants the maximum results immediately and for the patient whose glucose is elevated and needs to get in immediate control. In other words, any diabetic beginning this program can start right here with this aggressive phase and then after a few weeks move on to the rest of the menu and recipe options presented in chapter 12. This would especially be the place to start if you are on medications presently, yet still have a fasting glucose level above 150. Once your numbers are more favorable, and you are successfully reducing medication, then you can move on to more menu and recipe options. Be careful because you must reduce or eliminate medications to prevent hypoglycemia, so follow your readings and adjust accordingly.

M
ESSAGE TO
P
HYSICIANS
:

More and more physicians are expressing their support and enthusiasm for the nutritarian approach to treating diabetes and other diseases, and they are supporting this health-promoting mission. I invite other physicians to come to my office and observe the results firsthand. Those who have taken me up on the offer have often commented that the experience was actually more fruitful than anything they did in their residency training. Continuing medical education credits are available to physicians coming to conferences for further training. I am always looking for physicians all over the country that we can refer patients to. America needs physicians who have gained experience with tapering medications and are supportive in managing diabetic patients with superior nutrition excellence and exercise. I encourage interested physicians to contact me and to join the American College of Lifestyle Medicine, a physician organization designed to support such physicians.

CHAPTER ELEVEN

Frequently Asked Questions

I
understand that for a lot of readers, this plan is a radical shift from your current approach to food. I am sure you have a lot of questions. Based on my years of leading patients through this diet, I have compiled the most asked questions I hear from patients following this diet protocol. I urge you to be patient and diligent, and I promise that the results will be life-changing.

 

What if I do not like eating this way?

To eat healthfully takes practice and perseverance. What makes change possible is a strong desire and motivation, a willingness to sometimes be uncomfortable, and perseverance to keep working on it. The more you make healthy meals, and the more days you eat these foods, the more your brain will naturally prefer to eat that way. Your taste for healthy, nutrient-rich foods will develop. A new food has to be eaten about fifteen times to make it become a preferred food. The more days you eat healthfully, the more you will lose your addiction to unhealthy stimulating substances. With time, you will look forward to—and prefer—eating a diet that is more natural and wholesome.

People can always come up with excuses why something is too difficult to do, and your subconscious mind may promote this. But a strong desire and commitment to achieve your health and weight goals can silence these objections. With planning and support, you can overcome every obstacle. I promise that eventually you will prefer your new diet and newfound health.

There are over fifty great-tasting recipes in this book. Try them. There are hundreds more available on my website and in my other works. I promise that you will find many recipes you love.

 

Why is it so difficult for me to give up foods that I know are destructive to my health?

To be successful in achieving optimal health and permanent weight loss, we have to consider the complexity of human nature. We have discussed how a disease-promoting diet can be physically addicting, resulting in some mild discomfort during the first few weeks of the change. Of course, food is addicting physically and emotionally, so much so that some people would prefer death to diet change. The subconscious mind does not always care about logic and science. We are physical, emotional, and social beings. These factors must be considered. If not, many people will reject learning more about a health-giving lifestyle despite having an interest in gaining more information. Some will come up with rationalizations or excuses why they can't change.

It is not uncommon for people to give reasons and excuses to continue down the road of dietary suicide. This is a manifestation of a subconscious process. Our brains are designed to dim awareness to information that causes us distress and anxiety. For many people, the thought of changing the way they think about food and the way they eat is a source of anxiety in itself. Unhealthy foods are a slow-working poison, but our mind fears change even more than it fears this poison.

The addictive mind can always create a reason to justify the continuation of their addiction. For example, food addicts may think,
If you had a life like mine, you would binge too.
They get into a self-defeating cycle of self-pity and gloom. Once addictions take hold, they lose total control of their decision making, and continuing the addiction returns to the top of the subconscious agenda. Overeating, eating poorly, and remaining overweight in spite of health consequences are examples of the power food addiction has to control the subconscious mind.

Overeating is often the direct result of low self-esteem, which makes people vulnerable to negative peer pressure, addictions, and emotional binging. Some people may fear appearing different from others and believe that changing the way they eat will result in a loss of social status. Also, people sometimes overeat to raise dopamine and serotonin activity in the brain so that they can dull the frustration, disappointment, and pain of life.

Nevertheless, all the negativity can be turned around. Changing your diet can go hand in hand with a new attitude about yourself, life, and the possibilities in front of you. A healthy diet goes hand in hand with a healthy attitude about life and a love of life.

Acknowledge the conflict, acknowledge the difficulty, and just do it. You must face facts, accept your discomfort, and work through it. The subconscious mind might not like the changes you are making, but you have to hang in there until the change feels natural. You can't cure an addiction unless you are willing to fight through your internal debate and move on. Addiction thrives in isolation. The keys to getting over it are to make the commitment to stick with your new program and to acknowledge that commitment to people you know. It gets easier and more pleasurable every day that you move toward better health.

 

Will I feel unwell from withdrawal when I first start out? How long will any negative sensations last?

As your body's detoxification activities increase in the first week or two of this program, the symptoms of toxic hunger could increase. These feelings could include lightheadedness, fatigue, headaches, increased urination, sore throat, flatulence, and, very rarely, fever, body itching, or rashes. These uncomfortable sensations rarely last longer than one week, and even if they do, they will lessen with time.

Occasionally people find it takes time for their digestive tract to adjust to all the additional raw fiber. They experience an increase in gas or bloating or have looser stools. This is usually caused by the increased volume of raw vegetables and because you swallow more air when you eat salad than you would eating other foods. It is remedied by chewing better so the air is out of the food before swallowing it. Better chewing also breaks down the cells, making them easier to digest. If you encounter this problem, increase the amount of raw salad you eat only in gradual amounts. You can also eat fewer raw foods and more cooked vegetables, such as steamed zucchini, squash, artichokes, peas, and intact whole grains such as steel-cut oats and wild rice. When the symptoms subside, gradually increase the amount of raw greens and cruciferous vegetables in your diet.

Beans, nuts, and seeds can also contribute to digestive problems at the beginning of transitioning to this way of eating. To combat these issues, use beans at almost every meal but in very small amounts until you adjust. Make sure the nuts and seeds are spread out at various meals and you are not eating too much at one time.

If you are troubled by digestive problems, try the following:

 

•  Chew your food better, especially salads.

•  Eat beans in smaller amounts.

•  Soak beans and legumes overnight before cooking.

•  Avoid carbonated beverages.

•  Do not overeat.

•  Eat fewer raw vegetables and more cooked green vegetables, and then increase your raw vegetables gradually.

 

Be patient and give your body a little time to adjust to a different eating style. Remember, your digestive tract can make the adjustments if it's allowed to do it gradually.

 

Isn't diabetes mostly genetic? It isn't my fault—my whole family is overweight.

The role that genetics plays in obesity and diabetes is undeniable. People of certain descent have a smaller beta cell reserve in the pancreas. If these individuals eat an American-style diet and become overweight, they have a dramatically higher risk of becoming diabetic.

That said, the doubled rate of diabetes in this country in the last twenty-five years obviously did not occur because of genetics. Even though some people may be at a high genetic risk of developing diabetes, this does not mean that their health fates are predetermined. In fact, the reason for the increased genetic risk is likely because their ancestors were all thin and highly active. They did not require a large reserve of beta cells in the pancreas. This inheritance pattern is only a risk factor for people who eat a disease-promoting diet. Although people whose parents are obese have a tenfold increased risk of becoming obese themselves, the explosion of obesity is a recent phenomenon in human history brought on by fast food and the processed food industry. Clearly, obesity is not primarily genetic.

So it is the combination of food choices, inactivity, and genetics that determines obesity and diabetes. Those who genetically store fat more efficiently may have had a survival advantage thousands of years ago when food was scarce. But in today's modern food pantry, where high-calorie, toxic foods abound, those people are at a survival disadvantage. Focusing on the element of genetics in the formula doesn't solve the problem. You can't change your genes. Rather than taking an honest look at what causes diabetes, Americans are still looking for a magical, effortless cure for it—a gimmick, drug, or surgery. The only answer is living a healthy lifestyle focused on excellent nutrition along with adequate activity and exercise. When you live this way, the benefits will overwhelm genetics and allow even those people with a genetic predisposition to weight gain and diabetes to achieve a healthy weight and a long, disease-free life.

One of the most exciting studies in the field of weight control and obesity in recent years was published in the
New England Journal of Medicine.
1
This study documented that if you have a friend who is obese, your risk of developing obesity increases by close to 60 percent, a higher rate than if a sibling or even a spouse becomes obese. This high percentage held up even after controlling for the fact that people tend to form bonds with others similar to themselves. If both people listed each other as friends, and one became obese first, the second was approximately three times as likely to follow suit.

This finding illustrates that obesity is spread by similar eating styles in social networks. Peer influence is not to be underestimated. However, understanding how powerful bad influences can be, especially with society's approval and promotion of addictive eating, leads to the inescapable conclusion that healthful behaviors can be just as contagious if you are surrounded by health-conscious people. One powerful secret to a slim body and good health is to cultivate friends who are supportive and can share a healthy eating style with you. Genetics are not the major factor. The social norms of the modern world have made obesity and diabetes pervasive.

 

I don't have time to cook. Do you have any tips for quick and easy meals?

You do not have to use fancy and complicated recipes all the time. Simple foods are quick and easy and can work in this program too. Consider some of these options to make your diet easier and more convenient.

 

Breakfast

Combine fresh fruit in season, or even frozen fruit, with raw nuts and seeds. You can soak some oatmeal in water overnight—no cooking is needed. Then add some berries and walnuts and a splash of unsweetened soy, almond, or hemp milk and you have a meal. You can make a quick smoothie with one fruit, a handful of greens, a half cup of unsweetened hemp milk, and flax seeds. It is okay to eat even lighter for breakfast and have just one or two fruits.

 

Lunch and Dinner

Your basic lunch or dinner should be a salad with a healthy dressing and a bowl of vegetable or bean soup. Make a quick salad from premixed and prewashed greens. Add chopped nuts and cut fresh fruit or no-salt canned beans, and top it with a low-fat and low-salt dressing, dip, fresh lemon, or balsamic or flavored vinegar. You can also eat raw vegetables and avocado with a low-salt salsa or hummus dip. I often heat up a little soup and pour it over some shredded lettuce as my lunch meal. I have also developed bottled dressings for this program, and they can be purchased and shipped anywhere.

Including some defrosted frozen vegetables or fresh or frozen fruit is a good way to round out a meal, salad, or leftover dish. Try steaming some fresh broccoli, spinach, or another green vegetable and adding a no-salt seasoning. Before cooking, apply a little olive oil to your hands and rub the raw vegetables, and then add chopped garlic and onion. A quick and tasty dish can be made from whatever fresh vegetables you have on hand. Use a no-salt canned soup and add your own steamed or frozen vegetables to increase the nutrient density.

Another easy meal option is to make a meal with a low-salt tomato sauce as the base. I often mix tomato sauce with some almond butter and a little gourmet vinegar, usually fig vinegar, and then use it as a dressing or dip for the vegetable dish, either cooked or raw.

When you do have the time, cook in large batches and save leftovers for other meals.

 

How can I stay on this diet style if I have to eat out in a restaurant?

Choose restaurants that have healthful options, and get to know the places that will cater to your needs. When possible, speak to the management or chef in advance. Eat early, before the restaurant gets very crowded, so the staff will have time to modify a dish or make something special for you. If you eat out for breakfast, avoid bread, bagels, and breakfast sweets. Go for oatmeal and fruit instead. For lunch and dinner, ask for a side of steamed vegetables instead of pasta or white rice to accompany your main dish.

In Asian restaurants, order vegetable dishes that are steamed with the dressing or sauce on the side. Because soups are made in advance in restaurants and are always very high in salt, it is best to stay away from them. Go with salads, simple vegetarian entrées, or on occasion plain broiled fish, shrimp, or chicken prepared without empty-calorie sauces. I often order a double-size salad and pay double for it. Tell the food server not to bring bread to the table to avoid the temptation to fill up before the meal. Always ask for the salad dressing (which is usually high in salt) on the side and use sparingly. Or better yet, use balsamic vinegar or lemon juice.

You can follow this diet on the road if you are committed to success. It just takes some diligence to plan where to go and to make sure in advance that you will have the foods you now eat. If you're staying at hotel, it is not difficult to eat healthy. When traveling, I go to a supermarket and purchase lettuce, frozen vegetables, fresh fruits, and canned beans to bring to my hotel room. I request a small refrigerator in my room, and I travel with a bowl, a can opener, silverware, and raw seeds and nuts in my suitcase. Then I can eat healthy canned beans, canned veggie-bean soup, frozen veggies, and frozen fruit tossed on a salad. I often use the electric coffee maker that is usually in the hotel room to heat up soups and oatmeal.

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