By Dr. Mercola
In the US, nearly 30 million Americans have diabetes while 86 million have pre-diabetes, a precursor to the full-blown disease.1 Rates have been on the rise since 2010, a trend that's being echoed worldwide.
The largest analysis of health trends around the world from 1990 to 2013 revealed a striking rise in diabetes.2 The data spanned 188 countries and revealed a 45 percent increase in diabetes prevalence from 1990 to 2013. In the US, the rise was even more striking – 71 percent.
The majority of the rise was due to type 2 diabetes, which is closely related to obesity, another condition that's been on the rise globally. Diabetes, once ranked as the number 10 cause of disability worldwide, is now number seven…
Diabetes is linked to many complications, from heart disease and kidney damage to eye problems and hearing impairments. Most all of its complications are due to underlying insulin resistance, which is a foundational cause in many cases of chronic disease.
Diabetes could easily be called pre-cancer or pre-heart disease, because the insulin resistance is damaging to all of your body's tissues… including that of your brain.
Diabetes Damages Your Brain
Dementia is a well-known risk factor of diabetes, and new study found problems with blood flow in the brain may develop in as little as two years in people with diabetes. That impaired blood flow appears to accelerate cognitive decline, lowering thinking and memory skills.3
The study involved 40 people with an average age of 66. Those with the highest A1C levels, a measure of blood sugar over time, had the greatest impairments in blood flow in the brain, along with the greatest declines on tests of mental functioning.
On average, learning and memory scores declined about 12 percent over two years in people with type 2 diabetes.
This is the equivalent of remembering 10 words on the test at the start of the study and remembering only eight or nine two years later. Blood flow regulation also declined 65 percent among people with diabetes over the course of the study period.4
The results aren't surprising, considering past research has shown diabetes ages your brain about five years faster than normal,5 as well as leads to accelerated losses in brain volume, especially gray matter.6
In yet another study, diabetics were found to suffer a 19 percent greater decline in mental acuity compared to non-diabetics over the course of 20 years.7
Those with pre-diabetes were also at a significantly increased risk for memory decline. The researchers of this study also suggested the decline in memory associated with diabetes is due to damage to small blood vessels in the brain.
Staph Bacteria May Play a Role in Type 2 Diabetes
It's important to realize that type 2 diabetes is not the result of insufficient insulin production. It's actually the result of too much insulin being produced on a chronic basis, primarily from eating a high-carbohydrate, low-fat diet.
This overwhelms and "deafens" your insulin receptors, hence the term "insulin resistance." It's the chronically elevated insulin levels that make your body "resistant" to understanding the signals sent by the insulin. This also occurs with leptin, and most overweight or obese individuals have some degree of insulin and leptin resistance.
One of the best predictors of type 2 diabetes, in turn, is being obese or overweight. Aside from the issues of insulin and leptin resistance, obesity alters the makeup of microbes in and on your body.
Multiple studies have actually shown that obese people have different intestinal bacteria than slim people, and that altering the microbial balance in your gut can influence your weight.
Babies with high numbers of Bifidobacteria and low numbers of Staphylococcus aureus – which may cause low-grade inflammation in your body, contributing to obesity – appeared to be protected from excess weight gain.8 This may be one reason why breast-fed babies have a lower risk of obesity, as Bifidobacteria flourish in the guts of breast-fed babies.
Recent research also revealed that rabbits introduced to a toxin produced by the Staphylococcus aureus bacteria developed symptoms of type 2 diabetes, including systemic inflammation, insulin resistance, and glucose intolerance.9
People who are obese are also known to have increased levels of staph bacteria on their skin, and in turn are exposed to the toxins the bacteria produce.
The toxins were also shown to interact with fat cells, resulting in symptoms of type 2 diabetes. The study's lead researcher, microbiologist Patrick Schlievert, said:10
"What we are finding is that as people gain weight, they are increasingly likely to be colonized by staph bacteria – to have large numbers of these bacteria living on the surface of their skin… People who are colonized by staph bacteria are being chronically exposed to the superantigens the bacteria are producing."
The International Business Times continued:11
"The researchers further analyzed and compared the level of staph colonies on the skin of four people suffering from diabetes with the dose of superantigen that resulted in diabetes symptoms in rabbits. Both the levels were found to be proportional."
Cut One Soda a Day to Lower Your Diabetes Risk
Added sugars and processed fructose, in particular, is a primary driver of metabolic dysfunction. Refined fructose is actually broken down very much like alcohol, damaging your liver, and causing mitochondrial and metabolic dysfunction in the same way as ethanol and other toxins.
It also causes more severe metabolic dysfunction because it's more readily metabolized into fat than any other sugar. A recent meta-review published in the Mayo Clinic Proceedings found that once you reach 18 percent of your daily calories from added sugar, there's a two-fold increase in metabolic harm that promotes pre-diabetes and diabetes.12
Likewise, recent research revealed that people who consume soft drinks and sweetened-milk beverages have an increased risk of diabetes regardless of body weight.13 Each extra daily serving of sugary beverage increased diabetes risk by 22 percent. Lead researcher Dr. Nita Forouhi, of the University of Cambridge, told WebMD:14
"The metabolic effects of sweetened drinks include rapid spikes in blood glucose [sugar] and insulin levels."
On the contrary, swapping one sugary beverage for an unsweetened one, such as water or unsweetened coffee or tea, lowered diabetes risk by up to 25 percent. Artificially sweetened beverages showed no such benefit and were, in fact, associated with a higher diabetes risk.
133,000 Diabetes Deaths a Year Linked to Sugary Drinks: Industry Says No Connection
Research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions, and published in June 2015, suggested sugary beverages are to blame for about 183,000 deaths worldwide each year, including 133,000 diabetes deaths, 44,000 heart disease deaths, and 6,000 cancer deaths.15
Not surprisingly, the beverage industry, including the International Beverage Association and the Canadian Beverage Association, has slammed the study, claiming it fails to demonstrate cause-and-effect. Yet, research has repeatedly confirmed this linked, such that it is now too strong to ignore.
For instance, for every excess 150 calories of sugar consumed in one study there was an 11-fold increase in type 2 diabetes compared to 150 calories consumed from fat or protein. Meanwhile, lead author Dr. Aseem Malhotra, a cardiologist at Frimley Park Hospital in Surrey, told the Telegraph:16
"'Cutting down on carbs was also found to be the single most effective intervention for reducing all the features of the metabolic syndrome and should be the first approach in diabetes management, with benefits occurring even without weight loss', he said. Instead, fat appears to be the ideal fuel for most exercise."
Decrease Pain from Diabetic Neuropathy by Increasing Your Vitamin D Levels
Peripheral neuropathy is nerve damage in your arms and/or legs, characterized by pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature, or sense of body position.
It's a common complication in diabetics and one that can lead to significant reductions in quality of life. New research presented at the American Diabetes Association 75th Scientific Sessions in Boston, MA, revealed that higher levels of painful neuropathy were associated with lower vitamin D levels. The researchers explained:17
"We have demonstrated a significant reduction of vitamin D levels, measured under careful conditions in subjects with painful-DPN… This suggests a possible role of vitamin D in the pathogenesis of painful-DPN."
If you have diabetes, it's essential to have your vitamin D levels tested and optimize your levels, not only for painful neuropathy but also for your overall health. In a study of more than 100 people, those with low vitamin D levels were more likely to have type 2 diabetes, pre-diabetes, or metabolic syndrome, regardless of their weight.
Among obese people, those without metabolic disorders had higher levels of vitamin D than those with such disorders. And among lean people, those with metabolic disorders were more likely to have low levels of vitamin D. According to one of the study's authors:18
"Our findings indicate that vitamin D is associated more closely with glucose metabolism than obesity… The study suggests that vitamin D deficiency and obesity interact synergistically to heighten the risk of diabetes and other metabolic disorders. The average person may be able to reduce their risk by maintaining a healthy diet and getting enough outdoor activity."
It's not the first time vitamin D has been shown to play a role in diabetes. One Indian study found that vitamin D and calcium supplementation in combination with exercise may prevent pre-diabetes from progressing into full-blown diabetes. For every unit increase in vitamin D levels, the risk of progression to diabetes in people with pre-diabetes went down by 8 percent.19 I believe sensible sun exposure is the ideal way to optimize your vitamin D levels.
You Can Prevent, and Reverse, Type 2 Diabetes
In type 2 diabetes, the pancreas is producing some insulin, in fact usually too much, but is unable to recognize the insulin and use it properly. This is an advanced stage of insulin resistance, which is typically caused by a diet that is too high in sugars and sugar-forming foods.
When you have inadequate insulin signaling, sugar cannot get into your cells and instead builds up in your blood. While anyone can get type 2 diabetes, you are typically considered at highest risk if you are overweight, sedentary, if you are a woman who had gestational diabetes, have family members with type 2 diabetes, or have metabolic syndrome.
However, all of these really have the same underlying root of insulin and leptin resistance. Type 2 diabetes represents the vast majority of all diabetics, and contrary to conventional medical and media teaching, it's nearly 100 percent curable through lifestyle changes alone.
The following nutrition and lifestyle modifications should be the foundation of your diabetes prevention and treatment plan. Also, make sure to monitor your FASTING insulin level. This is every bit as important as monitoring your fasting blood sugar. You'll want your fasting insulin level to be between 2 and 4.
The higher your level, the greater your insulin resistance and the more aggressive you need to be in your treatment plan, especially when it comes to altering your diet.
- Swap out processed foods, all forms of sugar — particularly fructose — as well as all grains, for whole, fresh food. A primary reason for the failure of conventional diabetes treatment over the last 50 years has to do with seriously flawed dietary recommendations. Fructose, grains, and other sugar forming starchy carbohydrates are largely responsible for your body's adverse insulin reactions, and all sugars and grains — even "healthy" grains such as whole, organic ones — need to be drastically reduced.
If you're insulin/leptin resistant, have diabetes, high blood pressure, heart disease, or are overweight, you'd be wise to limit your total fructose intake to 15 grams per day until your insulin/leptin resistance has resolved. This includes about 80 percent of Americans. For all others, I recommend limiting your daily fructose consumption to 25 grams or less, to maintain optimal health. The easiest way to accomplish this is by swapping processed foods for whole, ideally organic foods. This means cooking from scratch with fresh ingredients.
Processed foods are the main source of all the primary culprits, including high fructose corn syrup and other sugars, processed grains, trans fats, artificial sweeteners, and other synthetic additives that may aggravate metabolic dysfunction. Besides fructose, trans fat (NOT saturated fat) increases your risk for diabetes by interfering with your insulin receptors. Healthy saturated fats do not do this. Since you're cutting out a lot of energy (carbs) from your diet when you reduce sugars and grains, you need to replace them with something. The ideal replacement is a combination of:
- Low-to-moderate amount of high-quality protein. Substantial amounts of protein can be found in meat, fish, eggs, dairy products, legumes, and nuts. When selecting animal-based protein, be sure to opt for organically raised, grass-fed or pastured meats, eggs, and dairy, to avoid potential health complications caused by genetically engineered animal feed and pesticides. Most Americans eat far too much protein, so be mindful of the amount. I believe it is the rare person who really needs more than one-half gram of protein per pound of lean body mass.
Those that are aggressively exercising or competing and pregnant women should have about 25 percent more, but most people rarely need more than 40-70 grams of protein a day. To determine your lean body mass, find out your percent body fat and subtract from 100. This means that if you have 20 percent body fat, you have 80 percent lean body mass. Just multiply that by your current weight to get your lean body mass in pounds or kilos. The chart below shows some common foods and their protein content:
|Red meat, pork, poultry, and seafood average 6-9 grams of protein per ounce.
An ideal amount for most people would be a 3-ounce serving of meat or seafood (not 9 or 12-ounce steaks!), which will provide about 18-27 grams of protein
|Eggs contain about 6-8 grams of protein per egg. So an omelet made from two eggs would give you about 12-16 grams of protein.
If you add cheese, you need to calculate that protein in as well (check the label of your cheese)
|Seeds and nuts contain on average 4-8 grams of protein per quarter cup
||Cooked beans average about 7-8 grams per half cup
|Cooked grains average 5-7 grams per cup
||Most vegetables contain about 1-2 grams of protein per ounce
- As much high-quality healthy fat as you want (saturated and monounsaturated). For optimal health, most people need upwards of 50-85 percent of their daily calories in the form of healthy fats. Good sources include coconut and coconut oil, avocados, butter, nuts, and animal fats. (Remember, fat is high in calories while being small in terms of volume. So when you look at your plate, the largest portion would be vegetables.)
- As many non-starchy vegetables as you want
- Exercise regularly and intensely. Studies have shown that exercise, even without weight loss, increases insulin sensitivity.20 High-intensity interval training (HIIT), which is a central component of my Peak Fitness program, has been shown to improve insulin sensitivity by as much as 24 percent in just four weeks.
- Improve your omega-3 to omega-6 ratio. Today's Western diet has far too many processed and damaged omega-6 fats, and has far too little omega-3 fats. The main sources of omega-6 fats are corn, soy, canola, safflower, peanut, and sunflower oil (the first two of which are typically genetically engineered as well, which further complicates matters). The optimal ratio of omega-6 to omega-3 is 1:1. However, our ratio has deteriorated to between 20:1 and 50:1 in favor of omega-6. This lopsided ratio has seriously adverse health consequences.
To remedy this, reduce your consumption of vegetable oils (this means not cooking with them and avoiding processed foods), and increase your intake of animal-based omega-3. Vegetable-based omega-3 is also found in flaxseed oil and walnut oil, and it's good to include these in your diet as well. Just know they cannot take the place of animal-based omega-3s.
- Maintain optimal vitamin D levels year-round. Evidence strongly supports the notion that vitamin D is highly beneficial for diabetes. The ideal way to optimize your vitamin D level is by getting regular sun exposure or by using a high-quality tanning bed. As a last resort, consider oral supplementation with regular vitamin D monitoring to confirm that you are taking enough vitamin D to get your blood levels into the therapeutic range of 50-70 ng/ml. Also please note that if you take supplemental vitamin D, you create an increased demand for vitamin K2.
- Get adequate high-quality sleep every night. Insufficient sleep appears to raise stress and blood sugar, encouraging insulin and leptin resistance and weight gain. In one 10-year long study of 70,000 diabetes-free women, researchers found that women who slept less than five hours or more than nine hours each night were 34 percent more likely to develop diabetes symptoms than women who slept seven to eight hours each night.21 If you are having problems with your sleep, try the suggestions in my article "33 Secrets to a Good Night's Sleep."
- Maintain a healthy body weight. If you incorporate the diet and lifestyle changes suggested above you will greatly improve your insulin and leptin sensitivity, and a healthy body weight will follow in time. Determining your ideal body weight depends on a variety of factors, including frame size, age, general activity level, and genetics. As a general guideline, you might find a hip-to-waist size index chart helpful. This is far better than BMI for evaluating whether or not you may have a weight problem, as BMI fails to factor in both how muscular you are, and your intra-abdominal fat mass (the dangerous visceral fat that accumulates around your inner organs), which is a potent indicator of leptin sensitivity and associated health problems.
- Incorporate intermittent fasting. If you have carefully followed the diet and exercise guidelines and still aren't making sufficient progress with your weight or overall health, I strongly recommend incorporating intermittent fasting. This effectively mimics the eating habits of our ancestors, who did not have access to grocery stores or food around the clock. They would cycle through periods of feast and famine, and modern research shows this cycling produces a number of biochemical benefits, including improved insulin/leptin sensitivity, lowered triglycerides and other biomarkers for health, and weight loss.
Intermittent fasting is by far the most effective way I know of to shed unwanted fat and eliminate your sugar cravings. Keep up your intermittent fasting schedule until your insulin/leptin resistance improves (or your weight, blood pressure, cholesterol ratios, or diabetes normalizes). After that, you only need to do it "as needed" to maintain your healthy state.
- Optimize your gut health. 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 beneficial bacteria by regularly eating fermented foods (like natto, raw organic cheese, miso, and cultured vegetables).