Diabetes Remission Possible with Diet, Exercise
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By Dr. Mercola
It has taken decades, but medical professionals are finally starting to give diet and exercise for the prevention and reversal of type 2 diabetes some well-deserved attention.
"... the new study can give people with the disease hope that through lifestyle changes, they could end up getting off medication and likely lowering their risk of diabetes-related complications," Reuters Health reports.1
The research,2 also featured by MedPage Today,3 demonstrates that diet and physical activity are the answer diabetics have been searching for, which is exactly what I've been teaching since I started this web site, 16 years ago.
It's worth noting that I do not at all agree with some of the dietary recommendations given to the participants in this study. For example, I believe including healthy saturated fats and avoiding processed liquid meal replacements would be a wise move.
I also believe following the dietary recommendations laid out in my free Nutrition Plan can provide far better results than those achieved in this study.
The researchers randomly assigned diabetic participants, who were also overweight or obese, to an intensive program of diet and exercise, in which they were urged to cut calories down to 1,200-1,800 calories per day and engage in nearly three hours of physical exercise per week.
After one year, 11.5 percent of the program participants no longer needed medication to keep their blood sugar levels below the diabetes threshold. Only two percent of the non-intervention group experienced any significant improvement in their condition.
Those who'd had been diagnosed with diabetes more recently saw greater blood sugar improvements on the program. Ditto for those who lost the most amount of weight and/or made the greatest progress in raising their fitness level. The lifestyle intervention group also managed to sustain their remission better over the following three years.
The Only Way to Avoid and/or Reverse Type 2 Diabetes
Amazingly, one in four Americans has some form of diabetes or pre-diabetes. If this is not a clear sign that conventional health recommendations are flawed, I don't know what is. I too have personal experience with this disease. I developed it myself for a short while, when I tried to implement an Eat Right for Your Type program in the late 90s.
Additionally, most of my paternal relatives (my dad included), have, or have died from, diabetes. My personal experience with diabetes and subsequent review of the literature made it very clear to me that virtually every case of type 2 diabetes is reversible...
And the cure for type 2 diabetes has nothing to do with giving insulin or taking drugs to control your blood sugar. In fact, giving insulin to someone with type 2 diabetes is one of the worst things that can be done.
The truth of the matter is that type 2 diabetes is a fully preventable condition that arises from faulty leptin signaling and insulin resistance, both of which are directly diet- and exercise-related. It is NOT a disease of blood sugar.
Once you understand that, the remedy becomes clear: To reverse the disease, you need to recover your body's insulin and leptin sensitivities. The ONLY way to accomplish this is through proper diet and exercise, as detailed in my free Nutrition Plan. Bariatric surgery, which is being increasingly recommended as a diabetes treatment, will NOT do the trick, and there is NO drug that can correct leptin signaling and insulin resistance... Adhering to the following guidelines can help you do at least three things that are essential for successfully treating diabetes: recover your insulin/leptin sensitivity; normalize your weight; and normalize your blood pressure:
- Severely limit or eliminate sugar and grains in your diet, especially fructose which is far more detrimental than any other type of sugar. Following my Nutrition Plan will help you do this without too much fuss.
- Exercise regularly. Exercise is an absolutely essential factor, and without it, you're unlikely to get this devastating disease under control. It is one of the fastest and most powerful ways to lower your insulin and leptin resistance. If you're unsure of how to get started, I recommend reviewing my Peak Fitness program for tips and guidelines.
- Avoid trans fats.
- Get plenty of omega-3 fats from a high quality, animal-based source, such as krill oil.
- Optimize your vitamin D levels. Recent studies have revealed that getting enough vitamin D can have a powerful effect on normalizing your blood pressure and that low vitamin D levels may increase your risk of heart disease.
- Optimize your gut flora. Your gut is a living ecosystem, full of both good bacteria and bad. Multiple studies have shown that obese people have different intestinal bacteria than lean people. The more good bacteria you have, the stronger your immune system will be and the better your body will function overall. Fortunately, optimizing your gut flora is relatively easy. You can reseed your body with good bacteria by eating fermented foods (such as fermented vegetables, natto, raw organic cheese, or raw milk kefir) or by taking a high-quality probiotic supplement.
- Address any underlying emotional issues and/or stress. Non-invasive tools like the Emotional Freedom Technique can be helpful and effective.
- Get enough high-quality sleep every night.
- Monitor your fasting insulin level. This is every bit as important as your fasting blood sugar. You'll want your fasting insulin level to be between 2 and 4. The higher your level, the worse your insulin sensitivity is.
Diet and Healthy Aging
In related news, an article in the New England Journal of Medicine4 reviewed the conflicting research on calorie restriction and mortality.
"Two long-term studies of the effect of calorie restriction in rhesus monkeys conflict: one concludes that restriction does not affect mortality, and the other concludes that it does. Differences in dietary composition and extent of restriction may explain the discrepant results," Linda Partridge, PhD, writes.
Yes, as always, the devil is in the details, and this is particularly true when it comes to diet. A calorie is not "just a calorie," for example. There's every reason to believe that the key to improved health and longevity lies not in calorie restriction per se, but in restricting certain kinds of calories—calories from sugars, to be specific. And possibly also those from poor quality proteins.
Dr. Ron Rosedale has been passionate about diabetes and aging for over 30 years and he is constantly reviewing the literature in this area. He is one of my primary mentors on this topic. He is convinced, as most other experts are, that calorie restriction does indeed provide life extension. But it is likely not because there are decreased total calories. He believes the key is to limit the carbs and excessive protein. The fat calories are "essentially free' and do not impair insulin or leptin signaling, or the mTOR pathways, which can contribute to decreased longevity.
Dr. Partridge points out two primary differences between the two studies that may account for the conflicting results:
- The control groups in the two studies were not fed in the identical manner. In the first study, which did find calorie restriction reduced chronic disease and mortality, the control group had no restrictions on their food intake. Rather they were allowed to eat as much as they wanted. In the second study, which did not find a correlation between calorie restriction and reduced mortality, the control group received a fixed amount of food, which was lower than the ad libitum intake. This was done in order to prevent obesity.
"Work with laboratory animals has shown that the benefits of caloric restriction are quantitative, with stronger reductions in food intake producing a greater extension in life span, provided that malnutrition is avoided," Partridge writes. "The controls in the most recent study received a diet that was somewhat calorie restricted, and indeed they were lighter in weight than controls in the earlier study. Thus, they may have had some benefits of caloric restriction, limiting the power to detect any additional benefits from the substantively restricted diet comprising the intervention."
- The nutritional composition of the diets also differed between the two studies. Proportions of carbohydrate, fat, and protein were similar, but in the first study (which did find a correlation between calorie restriction and mortality), sucrose made up nearly 30 percent of the animals' diet. In the second, which did not find such a correlation, the diet contained only four percent sucrose.
This should come as no surprise to any of you who have read any of my articles about the health hazards of sugar. The sugar molecule is one of the most ravaging, and eating a high-sugar diet is the most efficient way to accelerate the aging processes in your body. So clearly, a diet low in sugar will significantly help reduce mortality. When both the study group and the controls are fed a fixed low-sugar diet, their outcomes can be expected to be fairly comparable...
Dr. Partridge also mentions that studies have shown the composition of the protein in your diet can have a substantial effect on your health. According to Partridge:
"Studies of animal models, including rodents, have shown that reduced intake of particular nutrients, especially specific amino acids, rather than reduced calorie intake underlies the health improvements brought about by reduced food intake. This observation underscores the importance of dietary restriction over caloric restriction: the effects on health of reducing overall food intake will often depend on the composition of the diet that is fed to the controls."
I believe this is an important point to remember, as most people simply eat far too much protein of poor quality; thinking it's all the same. This simply isn't true, as the nutritional content of meats and other animal products, such as eggs, are dependent upon how the animal was raised and fed. There are major nutritional differences between protein sources raised in confined animal feeding operations (CAFO's) and those raised according to organic standards, such as grass-fed beef and pastured chickens and their eggs.
Obesity Bigger Health Crisis than Hunger
Understanding what makes for a healthy diet and lifestyle has never been more important. Shockingly, obesity has now become a greater global health crisis than hunger! Obesity is also the leading cause of disabilities around the world, according to the latest Global Burden of Disease study, published in The Lancet.5 As reported by CNN Health:6
"The report revealed that every country, with the exception of those in sub-Saharan Africa, faces alarming obesity rates -- an increase of 82 percent globally in the past two decades. Middle Eastern countries are more obese than ever, seeing a 100% increase since 1990. 'The so-called 'Western lifestyle' is being adapted all around the world, and the impacts are all the same,' [co-author Ali] Mokdad said.
... for the first time, noncommunicable diseases like diabetes, stroke and heart disease top the list of leading causes of years spent sick or injured. 'All these problems are tied to obesity,' Mokdad said. 'We're even seeing a large percentage of people suffering back pain now. If we could lower the obesity rates, we'd see the numbers of noncommunicable diseases and pain decrease as well.'
People are living longer than projected in 1990 -- on average, 10.7 more years for men, and 12.6 more years for women. But for many of them, the quality of life during those years is not good. On average, people are plagued by illness or pain during the last 14 years of life..."
Yes, modern medicine may be able to keep sick people alive longer, but it fails miserably when it comes to providing a high quality of life. Lifestyle-related chronic diseases are also threatening to bankrupt nations across the globe. Dr. Margaret Chan, director-general of the World Health Organization has referred to noncommunicable diseases "a slow-motion disaster" that may eventually become financially unsustainable. According to a 2011 report7 by the World Economic Forum and Harvard School of Public Health, noncommunicable diseases is expected to cost more than $30 trillion over the next two decades alone!
Clearly, something needs to change. Part of the problem is that so many of the recommendations issued by conventional medicine are seriously flawed, having been thoroughly corrupted by conflicts of interest. The notion that you cannot trust your doctor's advice on diet and exercise is disconcerting for most people, but the fact is that many doctors are clueless when it comes to nutrition and fitness. There's no shortage of physicians that will OK aspartame for weight control and diabetics, or tell you to avoid saturated fats and stick to a low-fat diet, for example. The list goes on. The failure of such recommendations to produce good health can clearly be seen among the general population that believes such myths.
I've spent the better part of the last two decades researching and trying to pin down the necessary ingredients of a healthy diet and lifestyle. The end result can be found in my comprehensive Nutrition Plan, which is available free of charge.
There's still cause for hope however. According to a national study8 featured in The New York Times,9 there's been a modest decline in obesity rates among 2- to 4-year-olds from poor families, which is a good sign, however small it might be. As reported by the NYT:
"The study was based on data from 30 states and the District of Columbia and covered the years from 1998 to 2010. The share of children who were obese declined to 14.9 percent in 2010, down from 15.2 percent in 2003, after rising between 1998 and 2003. Extreme obesity also declined, dropping to 2.07 percent in 2010 from 2.22 percent in 2003... It is unclear what drove the decline, but Dr. Blanck offered hypotheses.
Breastfeeding, which often leads to healthier weight gain for young children, has increased since 2000. The percentage of 6-month-olds still being breast-fed increased to 47.7 percent among children born in 2009, up from 34.2 percent among children born in 2000. Breastfeeding of infants from low-income families has risen over the years. In 1980, only 28 percent of infants from those families had ever been breast-fed, compared with 66 percent in 2011. ... the amount of money spent on food marketing to children declined by nearly 20 percent from 2006 to 2009, with the biggest drop in television advertising."
How to Stop Wasting Food
Fresh whole food is an essential part of a healthy diet, but buying and storing fresh foods does require a bit more planning and know-how, compared to stocking up on processed foods with extended expiration dates. A recent article in CNN Health10 explored the many ways you can reduce your food waste, which can cost the average American household anywhere from $500 to $2,000 a year. Below are two of my favorite tips. For the rest, which includes what to do with bread, fresh fruits (and especially bananas), please see the original article.11
- Seasonal vegetables
Use it now: As with fruit, the flavors of most vegetables marry well. Cut whatever you have into bite-size pieces, sauté a diced onion in a soup pot, and add the veggies (starting with the firmest, since they take longest to cook). Cover with vegetable broth and simmer until tender. Purée or eat chunky.
Save it for later: Make your own frozen veggies. Prepare them as you'd cook them, except stop when they're halfway done. You can steam or boil green beans, corn, broccoli, and chard, then quickly rinse in cold water to stop the cooking, and drain and pack in freezer-safe bags. Or pickle your veggies.
Use it now: Fresh herbs are flavor powerhouses, so it can be tricky to improvise without a recipe. A few combos that work deliciously: Try thyme, rosemary, and bay leaf with chicken; add rosemary, parsley, and sage to pork. Toss mint, dill, and cilantro in your salads or green veggie dishes.
Save it for later: To preserve tender herbs (dill, cilantro, parsley), make a sauce or paste (think pesto) with olive or vegetable oil. Purée the cleaned leaves in a food processor with the oil and a little salt. Cilantro oil, for example, can later be mixed with coconut milk, chilies, lime, and soy sauce to make a Thai sauce for fish or chicken. Herb pastes keep up to one week in the refrigerator (drizzle oil over the top to prevent browning) and up to six months in the freezer.
Hardy herbs, like rosemary and sage, meanwhile, are easy to dry. Clean a bunch, grasp the stems, tie with string, then suspend, leaves down, in a dry room. When herbs crumble, transfer to a jar and store in a cool, dry place. Or submerge herbs in a bottle of white-wine vinegar. The flavor will spruce up your salads for months.
To this I would add the following recommendations:
- FoodSaver Vacuuming System: One of my all-time favorite tricks, which works for most produce, is to create a "vacuum pack" to help protect it from oxygen and airborne microbes that will accelerate its decay. Leave the produce in the bag it came in from the grocery store, place it against your chest and use your arm to squeeze the excess air out of the bag. Once the air is removed you can seal it with a twist tie and thus minimize exposure to oxygen.
This simple technique can easily double or triple the normal shelf life of your vegetables by keeping air away from them. I typically store my food in quart or pint glass Ball jars. The FoodSaver brand also has a wide-mouth jar sealer attachment, which is ideal for sealing your leftovers, fermented veggies, sauces and other liquids stored in a wide-mouth jar, and can keep your food fresh up to five times longer. I regularly use it for extending the life of my vegetable juice and making my juicing more efficient so I don't have to juice every day.
- Ferment your own vegetables using all the left-overs, before they go bad. Fermenting your own veggies is a really inexpensive way to make sure you're getting beneficial bacteria (probiotics) in your diet, and it's much easier than you might think!
To learn more, please refer to this previous article, How to Easily and Inexpensively Ferment Your Own Vegetables, which includes an informative interview with Caroline Barringer, a Nutritional Therapy Practitioner (NTP), and an expert in the preparation of the foods prescribed in Dr. Natasha Campbell-McBride's Gut and Psychology Syndrome (GAPS) Nutritional Program.