Download Ebook compiled - SweetLife | Diabetes Health Centers

© 2104 SweetLife Diabetes Health Centers, LLC
©2014 by SweetLife Diabetes Health Centers, LLC and Dr. Brian C. Mowll
All rights reserved. No portion of this program manual may be reproduced or transmitted in any
form or by any means, electronic or mechanical including fax, photocopy, recording, or any
information storage and retrieval system without the written permission of the author, except as
granted under the following conditions:
• Each individual user of this guide must download it on their own to ensure that the most
updated information is provided within.
• Pages of this guide may be photo copied or reprinted for personal use by the individual who
downloaded it but not redistributed.
• A reviewer may quote brief passages in connection with a review written for inclusion in a
magazine or newspaper, with written approval from the author prior to publishing.
Disclaimer
This guide is not intended to provide medical advice or to take the place of medical advice and
treatment from your personal physician. Readers are advised to consult their own doctors or other
qualified health professionals regarding the treatment of medical conditions. The author shall not be
held liable or responsible for any misunderstanding or misuse of the information contained in this
program manual or for any loss, damage, or injury caused or alleged to be caused directly or
indirectly by any treatment, action, or application of any food or food source discussed in this
program manual. The statements in this program manual have not been evaluated by the U.S. Food
and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any
disease.
To request permission for reproduction or inquire about private or group diabetes coaching or
workshops, contact:
Dr. Brian Mowll - [email protected]
or online at www.the-diabetes-coach.com or www.sweetlifecenters.com
2
© 2104 SweetLife Diabetes Health Centers, LLC
CORE
NUTRITION
To Prevent and Reverse
Type 2 Diabetes
3
© 2104 SweetLife Diabetes Health Centers, LLC
Table of Contents
Introduction
. . . . . . . . . . . . . . . . . . . . . 5
Is Diabetes really reversible?
. . . . . . . . . . . . . . . . . . . . . 6
What causes type 2 diabetes?
. . . . . . . . . . . . . . . . . . . . . 8
Using the glycemic index
. . . . . . . . . . . . . . . . . . . . . 10
It’s all about carbs
. . . . . . . . . . . . . . . . . . . . . 13
The Diabetes-sugar connection
. . . . . . . . . . . . . . . . . . . . . 15
Don’t be afraid of fat
. . . . . . . . . . . . . . . . . . . . . 16
Be careful with protein
. . . . . . . . . . . . . . . . . . . . . 20
The optimal eating strategy
. . . . . . . . . . . . . . . . . . . . . 21
Supplementing the diet
. . . . . . . . . . . . . . . . . . . . . 25
4
© 2104 SweetLife Diabetes Health Centers, LLC
Introduction
What does it mean to “Reverse Diabetes”?
People often ask what it means to reverse diabetes. Is there a cure?
Diabetes is not a disease, like tuberculosis or the flu. There is no way to expect a magic pill, diet, or
physical activity program to wipe out the enemy and make everything better. It doesn’t exist and it
never will.
Diabetes is a state of dysfunction and this type of condition, much like heart disease, cannot be
cured. That might be bad news for some people. But, there is good news also. Diabetes
(specifically, type 2 diabetes) can be controlled, and the condition can improve to a degree that will
allow you to enjoy life the same as someone without diabetes.
Unfortunately, most people with diabetes will get worse year by year, not better. The blood glucose
levels will gradually creep up, medications will need to be increased, and many times if not properly
controlled, complications will develop. Most people following the standard doctor
recommendations will eventually develop eye problems, neuropathy in the feet and toes, kidney
issues, and accelerated heart and vascular damage. The condition is considered chronic and
degenerative, because that is what typically happens. It doesn’t have to be that way.
Reversing diabetes is about stopping that progression and turing it around. Think about cruising
down the highway going the wrong direction. That’s the way most people are treating diabetes.
You need to gradually slow down the car, stop, and put it in reverse. It doesn’t happen overnight,
but with persistence and direction, you’ll eventually get back to your destination, which is the health
that you deserve.
Complications such as atherosclerosis (blood vessel damage), retinopathy (eye damage), and even
neuropathy (nerve damage) can be improved. Reversing diabetes is about getting healthier over
time, rather than getting worse. Many people are able to work with their doctor to gradually
decrease medications as they improve their diabetes through diet, lifestyle, and functional support.
Most importantly, blood glucose levels can be improved and normalized to protect your body and
your health into the future.
It’s not easy, but diabetes does not have to be a death sentence. It doesn’t have to ruin your life. In
fact, it can be the impetus to make a longterm lifestyle change that can drastically improve your
health and your life forever.
5
© 2104 SweetLife Diabetes Health Centers, LLC
Is Diabetes Really Reversible?
Most people have heard at least one doctor tell them that diabetes in a chronic, degenerative
condition that gets worse over time, not better. The longer you have diabetes, the more problems
you can expect and it’s not a matter of “if ” you’ll develop complications, it’s a matter of “when”.
Why would your doctor tell you that? Because it’s true. If you follow the standard
recommendations prescribed by the ADA and most well-intentioned but misinformed doctors, that
is exactly what will happen. If you ignore the true cause of diabetes, and only treat the symptoms
with medication, without making the necessary changes to your diet and lifestyle, your condition
will get worse over time, not better.
But, that’s not your only choice. You can make the decision to do something different. You can
attack your condition and get control of it, rather than letting your diabetes control and ruin your
life. You can find and address the root cause of your condition and actually get better over time
instead of getting worse. In all likelihood, you can avoid the complications of diabetes.
Last year, a landmark new study was published in the well-respected medical journal, Diabetologia,
which showed that type 2 diabetes, in fact, could be reversed. They put a group of patients on a
special diet for eight weeks and watched as these patients actually got better. Their blood glucose
levels normalized, they lost weight, and their HgA1c scores improved dramatically. Many of them
were able to eliminate medication. The researchers discussed how the pancreatic, insulinproducing beta cells in some of these patients actually regenerated and began working better. In
other words, they reversed diabetes.
Why don’t doctors know about this? They do. At least some of them do. Amber Taylor, MD, an
endocrinologist who cares for diabetic patients said in a recent article, “it’s possible for those in the
early stages of type 2 diabetes to reverse the disease”. She continued, “We have pretty good
evidence, that lifestyle change is really the key. Lifestyle change is better than any drug we have on
the market for reversing and preventing diabetes.”
In a CNN report, Michelle Magee, MD, director of the Medstar Diabetes Institute in Washington
said, “We have seen numerous people reverse their condition, but it takes a real dedication for the
rest of their lives.” Even the conservative Diabetes Self-Management magazine published an article
in June of 2012 describing how type 2 diabetes may be reversible. They described five different
approaches to reverse diabetes and shared patient stories to illustrate each method.
What did all of these methods have in common? Intensive diet and lifestyle changes. Unfortunately,
in practice however, it seems to be a different story. Instead of doctors taking the time to sit down
with their patients and encourage them to make real dietary and lifestyle changes, patients are
typically hurried in and out of the office. In today’s corporate, insurance-driven medical system,
patient volume often takes priority over quality of care and spending time to educate and
empower patients. The traditional primary care or endocrinology practice is ill-equipped to spend
the hours, weeks, and months coaching, educating, monitoring, and motivating their patients to
6
© 2104 SweetLife Diabetes Health Centers, LLC
make the lifestyle changes necessary to reverse diabetes. When confronted, many doctors feel
that even if they had the time, patients wouldn’t follow through anyway.
This is short-sighted thinking and it’s part of the reason that diabetes has become a global epidemic
in the past decades. Treating diabetes with drug therapy only, with the only goal to reduce blood
glucose and A1c, is like trying to stop a boulder that is already barreling down a hill. It’s difficult,
frustrating, and ineffective.
Diabetes needs to be confronted head-on. To reverse diabetes, it’s essential to evaluate and treat
the root cause, not just the elevated blood sugar. That can take time, effort, and persistence, but
the reward is great.
The evidence is clear. Type 2 diabetes can be reversed. Now, it’s up to you to get on the right
path, find the answers you need, and put in the work to make it happen.
7
© 2104 SweetLife Diabetes Health Centers, LLC
What causes Type 2 Diabetes?
What causes diabetes? First of all, what is diabetes?
Diabetes Mellitus means “sweet urine”. It was first described in an Egyptian manuscript from 1500
BCE. The disease is diagnosed today, not by urinary glucose, but by measuring glucose in the blood
serum. The current diagnostic criteria uses blood glucose of 126 or greater to indicate diabetes. In
addition, the hemoglobin A1c test, which measures the percentage of glycated (sugar-coated)
hemoglobin in the red blood cell, is diagnostic of diabetes at 6.5% or greater.
So, while diabetes is technically just a subcategory of hyperglycemia (too much sugar in the blood),
the condition is much more complex than that.
Diabetes is really blood sugar dysregulation. The body has lost it’s ability to regulate and control
blood glucose levels. This can occur during a resting state, an active state, fasting, or post-prandial
(after eating). It can be effected by sleep quality or disruption, physical activity level and fitness,
stress, hormone balance, immune health, organ function such as liver, thyroid, and kidneys, digestive
system, and the structural integrity of the cell membrane and mitochondria (energy producing
element of each cell).
Ultimately, the cause of type 2 diabetes is a loss in the ability of the body to regulate the complex
blood sugar system. The reasons this may happen vary greatly from one person to the next. That
is why a personalized approach always works best when working to find and correct the cause of
diabetes.
One of the most common patterns in type 2 diabetes involves the hormone insulin. Each
hormone or chemical in the body has a job (usually several jobs). The job of insulin is to assist in
the storage of macronutrients into the cells and tissues. In particular, insulin is released in the
presence of glucose and amino acids in order to open the door to the cells and allow them to
soak up these important nutrients for energy production and storage.
In type 1 diabetes, the pancreas is no longer able to produce insulin, so without this hormone, the
cells are not able to soak up the glucose from the blood. The cells starve, while sugar accumulates
in the blood stream. This is dangerous and can lead to significant damage to the blood vessels and
body tissues if not corrected. The only answer is to provide insulin from the outside. Fortunately,
in the 1920’s, insulin was isolated and we’ve had the benefit of this tool since then.
Type 2 diabetes, however, is completely different. Typically, the pancreas is producing plenty of
insulin. In fact, most type 2 diabetics are hyperinsulinemic, which means they have too much insulin
in the blood. So, what’s the problem?
The problem in type 2 diabetes is called insulin resistance. The cells (liver, muscle, kidney, fat, etc)
have become resistant to the effects of insulin. They have become desensitized, almost like your
hearing does when you are in a loud room. From years of eating too many carbohydrates, too
8
© 2104 SweetLife Diabetes Health Centers, LLC
much sugar, the wrong fats, not enough physical activity, the toxic burden from our environment
and food supply, oxidative stress, and inflammation, the cell receptors for insulin stop working.
Think of insulin like a key that opens a lock. With insulin resistance, the lock is “gummed up” or
damaged, and the key no longer works as well.
The body’s response to insulin resistance is to produce more insulin. If you are at a loud party and
the person you are speaking to can’t hear you, the most logical thing to do is to talk louder. So, the
pancreas continues to produce more and more insulin to overcome the resistant state. This may
work for a while and continue to keep the blood glucose levels down. But, at some point, the body
will reach it’s breaking point where it just can no longer keep up.
Once the blood sugar levels rise above 100 mg/dl, you are said to be in a state of pre-diabetes. In
reality, there is no such thing as pre-diabetes. It’s like being a little bit pregnant. Once your blood
sugar starts to rise, you are losing control of blood sugar regulation, which is diabetes.
At this point, the process has been developing for many years. Diabetes doesn’t develop over
night. It typically takes decades to go from normal blood sugar metabolism to insulin resistance to
blood sugar dysregulation to full-blown diabetes. The body wants to stay healthy and in control, but
it can only take so much abuse.
The diagnosis of diabetes or pre-diabetes can and should be a wake up call for many people. It’s
not too late, but time is wasting. The longer the disorder progresses, the harder it is to correct and
the less correction possible. However, knowing that you are losing, or have lost, the ability to
regulate and control your blood sugar levels is that all important first step.
In some ways, diabetes can be a blessing in disguise. While it would certainly be better to change
your lifestyle habits before you develop diabetes, if you make to necessary changes quickly, it may
prevent you from developing heart disease, cancer, alzheimer’s disease, or having a stroke. It can be
the impetus for change and that may end up saving your life.
9
© 2104 SweetLife Diabetes Health Centers, LLC
Using the Glycemic Index
The Glycemic Index is a rating system, developed based on the initial research by David Jenkins,
MD, PhD, a nutrition professor at the University of Toronto. Instead of looking at grams of
carbohydrates or sugar in a particular food, it’s based on how that food impacts blood glucose.
The glycemic index has it’s limitations, but it is a good starting point for evaluating which foods to
eat more and which foods to avoid. For example, proteins such as chicken, fish, eggs, and beef have
a score of zero, because they contain no carbohydrate and have little impact on blood glucose.
White bread or potatoes on the other hand, have a score of 50-75, which will quickly raise blood
glucose levels.
Before describing how to use the glycemic index, let’s discuss some problems with the model:
1. It only evaluates one food at a time.
Most people don’t eat this way. The glycemic index does not account for food combinations.
2. It’s based not on serving size, but on a standardized portion (usually 50 grams).
The more modern “Glycemic Load” model re-calculates values based on the amount of
carbohydrates in a 100 gram portion multiplied by the glycemic index. So, the glycemic load of a
food may be more valuable when evaluating it’s effect on glucose control.
3. It does not consider the state of the food (fresh, frozen, ripe, etc) or how the food is
prepared (cooked, raw, steamed, etc).
Cooking food can break down the fiber and activate the starch content, “predigesting” it in a way,
which will raise blood glucose faster. There are some delineations made, such as instant oatmeal vs
traditional oatmeal, but these are only reflected in the newer, up-to-date models.
4. The breakpoint differentiating between low and high are flawed.
With pure glucose setting the standard at 100, low glycemic foods are considered anything with a
score of less than 55. This is way too high for people with diabetes. The numbers should be
adjusted to a more tolerable level, such as 30 and below for low glycemic, 30-50 for moderate
glycemic, and 50 or greater as high glycemic.
5. It does not indicate whether a food is “healthy” or not.
Diet soda and lard both have a glycemic index of zero, but that does not make them healthy. We
have to see the rest of the picture as well when evaluating which foods to include in the diet.
10
© 2104 SweetLife Diabetes Health Centers, LLC
Those limitations not withstanding, the glycemic index can still be an excellent tool to evaluate
various foods and the data can be extrapolated for food combinations as well.
For example, if you are going to eat a moderate glycemic food such as beans, it is best to combine
it with a low glycemic food such as avocado or turkey. Eating beans with a high glycemic food such
as rice would raise the glycemic response and be disastrous for blood sugar control.
Studying and understanding a basic glycemic index chart can be very helpful in guiding basic diet
construction. Focus on foods lowest on the glycemic chart such as proteins, healthy fats, and
fibrous vegetables. Enjoy some nuts, seeds, and moderate glycemic foods such as beans and
legumes combined with low glycemic foods. Fruits should be carefully evaluated and only those
low on the glycemic chart should be used (berries, apple, citrus).
While it is important to evaluate the amount of carbohydrates and protein you are consuming in
the context of your total calories, using the glycemic index as a framework can help make life easier
and prevent you from having to count every carbohydrate gram and calorie you consume.
Try to eat at least 80% of your calories from low glycemic index (under 30) foods, and the
remaining 20% from moderate glycemic foods, combined properly. High glycemic index foods are
essentially toxic to those with diabetes and should be strictly avoided.
11
© 2104 SweetLife Diabetes Health Centers, LLC
The Glycemic Chart
FOOD
GLYCEMIC
INDEX
Animal protein: grass-fed beef, wild-caught fish, free0
roaming turkey, chicken, wild game meats, organic
eggs
Fats and Oils: Olive oil, butter, coconut oil, vegetable
0
oil
Fibrous vegetables: broccoli, asparagus, greens,
15
spinach, salad greens, cucumber, celery, peppers
Nuts/Seeds: Almonds, Walnuts, Macadamias,
15
Pistachio
Barley
25
Low GI Fruit: Apples, berries, cherries, plum,
grapefruit
Beans: Black, chickpeas, Lentils, Kidney
30
Pasta: Whole Wheat
35
Plain, unsweetened Yogurt
35
Chili: vegetarian bean or beef
40
Dry Red or White Wine
45
Quinoa, Buckwheat
50
Moderate GI Fruit: Grapes, Kiwi, Banana, Mango,
Orange juice
Oatmeal, Moderate GI bread: Whole grain,
multigrain, rye, pumperknickel
Moderate GI Vegetables: Yams, Sweet Potato, New
Potato
Corn and corn products (chips, tortillas, etc.)
50
30
GOOD
MODERATE
BAD
50-60
55
65
Soda: Coke, Fanta, Gatorade, Fruit punch
65
TABLE SUGAR (Sucrose)
65
High GI Fruit: Pineapple, Watermelon
70
Pastries: Muffins, cakes, doughnuts, waffles,
crackers
Sweets and Snacks: Jelly beans, pretzels, Candy
bars, pop-tarts
Cereals: Rice crispies, corn flakes, shredded wheat
75
Rice products: rice cakes, rice pasta, white potato
80
Popcorn, white bread, bagels, flour products
85
12
BEST
REALLY BAD
80
80
WORST
© 2104 SweetLife Diabetes Health Centers, LLC
It’s All About Carbs (almost)
Diabetes is a condition of impaired blood sugar and insulin metabolism. It starts when the cells get
overwhelmed with excess sugar and insulin, damaged by inflammation and oxidative stress, and
starved of the important fats and nutrients they need to function optimally.
Once the cells become insulin resistant and blood sugar starts to rise, the situation gets further
exacerbated by the toxic effects of elevated glucose (glycation and glucotoxicity).
To reverse the effects of diabetes, it’s essential to heal the cell membranes, improve hormone
balance, reduce the toxic burden on the body, and reduce inflammation. This starts with reducing
blood glucose and insulin levels. Keeping sugar levels down reduces the need for insulin, which will
allow the body to up-regulate insulin receptors and improve insulin sensitivity.
Combined with good core nutrition, healthy fat consumption, physical activity, stress-reduction,
reduced toxicity, and neutralizing oxidative stress with plant-based phytonutrients and antioxidants,
a low carbohydrate diet is a key component to preventing and reversing diabetes.
Carbohydrates, whether they are simple or complex carbs, all break down into simple sugar
through the digestive process. This starts in the mouth with an enzyme called salivary amylase, and
continues throughout the small intestine with pancreatic enzymes that complete the job. This
process is slowed by fiber, which can reduce the glycemic response, but eventually all carbohydrates
become sugar. To reduce blood glucose, it’s imperative to reduce carbohydrate in the diet.
Eric Westman, MD from Duke University says, “It’s simple. If you cut out the carbohydrates, your
blood sugar goes down, and you lose weight, which lowers your blood sugar even further.” In a
study he completed at Duke, he found that the low carb group was able to lose weight, lower their
blood sugar and A1c, and 95% were able to reduce or eliminate medications.
Why does reducing carbohydrates in the diet work? According to Joseph Mercola, DO, it’s because
the combination of low carbs and exercise “corrects and restores the body’s insulin and leptin
signaling”. He goes on to say, “For the last 50 years or so, Americans have followed the dietary
recommendations of a high complex carbohydrate, low saturated fat diet—the exact opposite of
what actually works”.
For all the logical reasons to avoid sugar and the good research that shows the importance of
following a low carbohydrate diet for diabetes control, there is still much confusion and
contradiction in the media. In one article, for example, the author of an ADA-approved book on
diabetes diet says, "Gone are the days when sugar is strictly off limits. All carbohydrates break
down into glucose in the same way. Your body doesn't recognize whether the carbohydrate is a
cookie, slice of bread or a potato." While the latter statement is true, the conclusion is ridiculous.
Carbohydrates and sugar will raise your blood glucose levels and exacerbate insulin resistance and
diabetes. It’s as simple as that.
13
© 2104 SweetLife Diabetes Health Centers, LLC
So, what exactly is a “low carbohydrate diet”? How many carbs are too many and are some carbs
better than others?
These distinctions are important. No food is 100% carbohydrate, fat, or protein. Foods are a
combination of these three macronutrients, plus fiber, water, and micronutrients like vitamins,
minerals, and other compounds. Determining which foods should be included in a healthy diet for
preventing and reversing diabetes is about balance.
Foods that are high in carbohydrates and low in fiber should mostly be eliminated. Grains,
especially processed grain products like breads and cereals, will spike blood sugar and insulin levels
in most people with diabetes and pre-diabetes. Starchy vegetables, like potatoes and parsnips
should be avoided. Certain fruits should also be avoided due to their low fiber, high sugar content,
such as mango, papaya, grapes, and bananas. Also, dried fruit and fruit juice should be strictly
eliminated.
Carbohydrate-rich foods that are also high in fiber may be more tolerable for some people with
diabetes and pre-diabetes. Beans, legumes, and some root vegetables such as beets and carrots fit
into this category. These foods should be tested using a blood sugar challenge test to check
individual response.
High fiber carbohydrate-oriented foods such as non-starchy vegetables like broccoli, cauliflower,
asparagus, spinach, and high-water content vegetables like bell peppers, cucumber, and celery are
ideal foods. Nuts and seeds are also excellent in moderation due to their high fiber, low
carbohydrate profile.
It’s also important to focus on foods high in healthy fats such as avocado, olive, coconuts, organic
beef, fish, and poultry, butter or ghee from pastured cows, and nuts and seeds in moderation. Fats
stabilize blood sugar and are important for healthy cell membrane, brain function, nerve
protection, and hormone production.
Lastly, protein foods are essential to help preserve and maintain lean body mass, for normal cellular
energy production, and for detoxification. It’s important not to overeat protein, however, because a
percentage of protein consumed can get converted to glucose, especially if physical activity is not
adequate.
There are a wide variety of factors involved with blood sugar regulation and diabetes. While it’s
important to address each one of these, until the diet is corrected and carbohydrates are reduced
to a tolerable level, it will be difficult or impossible to control blood sugar and reverse diabetes.
14
© 2104 SweetLife Diabetes Health Centers, LLC
The Sugar-Diabetes Connection
While it may seem obvious to many that a high sugar and high carbohydrate diet significantly
contributes to the development of insulin resistance and diabetes, there are still opposing views on
whether sugar is to blame for the diabetes epidemic.
The ADA (American Diabetes Association) says it’s not so simple. They claim that it’s bad genes
and weight gain that are the main culprits, and that the cause of weight gain is overeating, not
carbohydrate consumption. In other words, it doesn’t matter what type of food you eat, it’s the
amount of calories that are important.
This point of view is seriously flawed. First of all, there are many people who have a family history
of diabetes that never develop diabetes themselves, and many diabetics have no family history of
diabetes. Second, many type 2 diabetics are normal weight or just overweight, not obese. There
are also may overweight and even obese individuals who never develop diabetes.
Calories are not all the same. In fact, the calculation of a calorie (a measure of heat from the
breakdown of food) is also seriously flawed. Research has made it clear that low carbohydrate, low
sugar diets out perform low calorie diets every time when it comes to blood sugar control and
weight loss.
The truth is that eating too much sugar is not the cause of diabetes. However, it can be a significant
player. At the root of type 2 diabetes in a condition called insulin resistance. This condition is
caused by impaired hormonal signaling pathways at the cellular level. There are many factors that
can influence this including toxic overload from our environment and food supply, chronic systemic
inflammation, oxidative damage to cell membranes, and micronutrient deficiencies. Another
significant factor leading to insulin resistance is the down-regulation of insulin receptors from
repeated insulin surges and hyperinsulinemia (too much insulin in the blood). This results from a
diet high in non-fiber carbohydrates and sugar.
One study, published in early 2013 from Stanford University School of Medicine found that the
more sugar present in a population’s diet, the higher the rates of diabetes. This study examined
175 countries over the past decade. Robert Lustig, MD, pediatric endocrinologist at UCSF
Children's Hospital said this study “places sugar front and center” as an agent that may be a
contributing factor for diabetes.
It’s not just simple sugar, of course, that leads to diabetes. All forms of processed carbohydrates,
starchy vegetables, and grains eventually break down into sugar. To prevent the development of
insulin resistance and type 2 diabetes or to reverse diabetes at it’s source, avoiding sugar and foods
that turn in to sugar is not only important, it’s absolutely essential.
15
© 2104 SweetLife Diabetes Health Centers, LLC
Don’t be afraid of fat
If you talk to any dietitian, doctor, or diabetes educator about diet, they will likely tell you the most
important focus is to avoid fat, especially saturated fat. This advice has been endorsed by the
American Heart Association, the Academy of Nutrition and Dietetics (the new name for the
American Dietetics Association), and of course, the good old American Diabetes Association.
Unfortunately, this is bad advice, and it’s dead wrong. Here’s why.
Fat is an absolutely essential nutrient for the body. In fact, without fat, our cell structure would
completely collapse, our brain would shrivel up, our nerves would short-circuit, and we wouldn’t be
able to produce our hormones.
Let’s start with the brain and nerves. In his ground-breaking book “Good Calories, Bad Calories”,
science and medical writer Gary Taubes states, “Our brains are 70 percent fat, mostly in the form of
a substance known as myelin that insulates nerve cells and, for that matter, all nerve endings in the
body.” One of the most common side effects of statin drugs, which deplete cholesterol from the
body is cognitive impairment. This happens because fat and cholesterol is essential for brain
function.
Fats are also important for healthy cell membranes. Taubes went on to say, “Fat is the primary
component of all cell membranes. Changing the proportion of saturated to unsaturated fats in the
diet might well change the composition of the fats in the cell membranes. This could alter the
permeability of cell membranes, which determines how easily they transport, among other things,
blood sugar, proteins, hormones, bacteria, viruses, and tumor-causing agents into and out of the
cell.” Healthy cell membranes are essential for proper insulin signaling, which allows glucose to
enter the cell to be broken down into energy. Damaged, unhealthy cell membranes lead to insulin
resistance, which leads to type 2 diabetes.
Other important functions of fat in the body include hormone production, vitamin D synthesis,
blood sugar control, nutrient absorption, and metabolic health.
In fact, according to Donald Jump, PhD of the Linus Pauling Institute, fat has some wonderful health
benefits. First, it is important in the absorption of fat-soluble vitamins like vitamin A, D, E, and K.
These vitamins have important roles in metabolism, health, and blood sugar regulation. Without
adequate fat intake, it’s difficult to achieve and produce optimal levels of these nutrients. He also
echoes the importance of fats for the health of the cell membranes and hormone signaling. Lastly,
he adds that fat tastes good, adding flavor to food, without raising blood sugar, and creating a sense
of fullness and satiety.
So, fats clearly have benefits. But, doesn’t eating fat cause us to gain weight and store more fat?
Apparently not. Since the low fat push of the 70s, 80s, and 90s has become mainstream and
spread across the globe, we have become heavier, seen increased rates of obesity and diabetes, and
created more nutritional confusion than ever before.
16
© 2104 SweetLife Diabetes Health Centers, LLC
Let’s be clear: eating fat does not make you fat. Low fat diets, loaded with substituted sugar and
chemicals make you fat. In fact, the more healthy fats you consume in the absence of sugar and
carbohydrates, the more fat you burn. It takes a minute to get passed all the low-fat, nutritional
dogma, so let that sink in. Eat fat, burn fat.
The metabolism is wired to burn either sugar as it’s primary fuel or fat as it’s primary fuel. If you
want to encourage your body to burn the stored fat in your adipose tissue instead of storing more
fat, you need to re-train your metabolism to burn fat. What’s the secret? Stop eating sugar and
carbohydrates and eat more healthy fats.
When trying to control blood sugar and insulin levels, it’s even more essential to use fat as a
primary energy source. Fat is the only macronutrient that does not raise blood sugar levels. All
carbohydrates eventually break down into sugar, and a portion of the protein you eat will also get
converted to sugar. Fat stabilizes blood sugar and does not require insulin to metabolize it.
Therefore, increasing fat consumption will improve both insulin and leptin (an important hunger
hormone) sensitivity, and help to control and reverse diabetes.
How much is too much? Fortunately, fat consumption is typically self-limiting. When avoiding
carbohydrates, most people will find it difficult to overeat fat. When evaluating the macronutrient
breakdown of an optimal blood sugar control diet, fat will typically constitute 60-75% of total
calories.
Not all fats, of course, are beneficial for health. Trans fats and partially hydrogenated vegetable oils,
in particular, are not recommended. Trans fats are commercially manipulated vegetable oils
(hydrogenated) that are used as stabilizers for packaged foods and are very difficult to metabolize
in the body. Therefore, they are more likely to be stored and less likely to be burned for fuel and
have long-term risks.
Fried foods are also not recommended as the oils are typically heated at very high temperatures
which oxidizes the oil and turns it toxic. These damaged vegetable oils lead to inflammation and
oxidative stress in the body, which contributes to disease.
Polyunsaturated omega 6 vegetable oils should be limited because they can accumulate in cell
membranes, are easily oxidized, and are considered pro-inflammatory. A moderate level of nut and
seed oils in the diet is important, but it’s easy to overdo it, so be careful.
Polyunsaturated omega 3 oils are found in cold water deep sea fish, and are concentrated in some
nuts and seeds, such as walnuts, chia seed, flax seed, and hemp. Omega 3 oils are important
because of their anti-inflammatory nature and their ability to keep cell membranes fluid and
flexible. These are often lacking in the diet, especially for people who do not consume large
amounts of fish, and should be supplemented. Omega 3 oils are also easily oxidized, however, and
should be kept away from heat, light, and air (refrigerating is a good option).
Monounsaturated fats are probably the most widely accepted form of fat. They are found in large
quantities in the Mediterranean diet and are neutral in their inflammatory profile. These oils are
found in avocados, olives, nuts (especially macadamia nuts), and in animal products like chicken skin
17
© 2104 SweetLife Diabetes Health Centers, LLC
and bacon. Monounsaturated fats are more stable and can be heated at low temperatures, but are
best used in their raw, natural state.
Saturated fats are perhaps the most controversial and misunderstood of all the fats and oils. Since
the 70s, 80s, and 90s, saturated fats have been vilified as unhealthy, artery-clogging, obesity-causing
foods. This is simply not true. In fact, saturated fats may be one of the healthiest types of foods
that you can consume, especially for blood sugar control. In addition, saturated fats are much more
stable, resisting oxidation, and are, therefore, excellent for cooking.
Even the New York Times is starting to publish articles rescuing the damaged reputation of this
essential nutrient. In 2011, Melissa Clark wrote an article called “Once a Villain, Coconut Oil
Charms The Health Food World”. She quotes Thomas Brenna, a professor of nutritional sciences
at Cornell University as saying, “I think we in the nutrition field are beginning to say that saturated
fats are not so bad, and the evidence that said they were is not so strong”.
Saturated fats are not all the same, however. They come in different lengths based on how many
carbons are bonded together in a chain. The longer chains, like the ones found in commerciallyraised animal products, are more difficult to metabolize and therefore, more likely to get stored.
The shorter chain saturated fats, like the ones found in coconut, palm, and to a lesser extent,
butter, are quickly transported to the liver and burned as fuel. These are the fats that can be the
most helpful in stimulating the metabolism and helping the body to burn fat for fuel.
Somewhere along the way, fats got a bad reputation. This has been reinforced by a misinformed
and misguided segment of the nutrition community and led to disastrous results for our health. It’s
time to free the fats and enjoy them as part of a healthy diet. Eating less carbohydrate and more
fat will lead to better blood sugar control, better insulin sensitivity, and an improved likelihood of
preventing and reversing diabetes.
18
© 2104 SweetLife Diabetes Health Centers, LLC
The Fat Spectrum
Monounsaturated Fats:
•Avocado
•Nuts (especially macadamia)
•Seeds
•Olives
•Animal products (chicken skin, bacon)
Medium-Chain Saturated Fats
•Coconut
•Palm
•Breast Milk
•Butter
•MCT Oil
Omega 3 Polyunsaturated Fats
•Cold-water, deep sea fish
•Grass-fed pastured beef and dairy
•Walnuts
•Flax, Chia, Hemp seeds
•Certain types of seaweed or algae
The gems of the Mediterranean diet, these
fats are more stable, have a neutral
inflammatory profile, and can be burned
easily for energy.
These fats are easily metabolized and are
therefore not stored. They are
transported directly to the liver to be
burned for fuel.
Omega 3 fats are long chain fats that are
anti-inflammatory and important for cell
membrane and brain health. They are
unstable and prone to oxidation.
Longer chain Saturated Fats
These fats are harder to break down and
may get stored in adipose tissue if not fully
metabolized. They are stable and good for
cooking or heating.
Omega 6 Polyunsaturated Fats
Omega 6 fats are long chain fats that are
important for cell membrane and immune
response. They are pro-inflammatory and
prone to oxidation.
Trans Fats
These fats are chemically altered,
hydrogenated vegetable oils, which are
very difficult for the body to metabolize.
These fats are toxins.
•Most animal products
•Dairy
•Eggs
•Cocoa
•Nuts
•Seeds
•Commercial oils (safflower, canola, corn)
•Vegetable oils
•Borage and Evening Primrose oil
•Many packaged snack food
•Margarine and Crisco
•Many commercial pastries and desserts
•Fried foods
© 2104 SweetLife™ Diabetes Health Centers, LLC
19
© 2104 SweetLife Diabetes Health Centers, LLC
Be Careful With Protein
It’s important to realize that low carbohydrate does not mean high protein. There are many low
carb diets available, but one of the most common mistakes someone can make for proper blood
sugar control is overeating protein.
Protein is made up of amino acids, which are the building blocks of muscle, are important for
detoxification, and make up the structure of many hormones and neurotransmitters in the body.
Just like glucose, but to a lesser extent, amino acids require insulin to enter the cell. If the amino
acid content of a food is high or the amino acids are quickly absorbed, it can lead to an insulin
surge, even in the absence of carbohydrates that can aggravate insulin resistance.
Amino acids are the only macronutrient that cannot be stored by the body. Glucose gets stored as
glycogen in the liver and muscles, and fat can be stored in the adipose tissue if necessary. Because
they cannot be stored, extra amino acids from overeating protein get converted in the liver to
sugar. This process is called gluconeogenesis and it can lead to blood sugar elevations in people
with diabetes and blood sugar regulation problems.
Requirements for protein vary greatly from person to person, largely related to physical activity
level, lean muscle mass, size and weight, and sex. Men may require slightly more protein and those
with more lean mass and who are bigger obviously need more protein to maintain their mass.
Athletes or people who engage in resistance training may also require more protein to prevent the
breakdown of their own muscle, especially during recovery.
A general rule is to consume one gram of protein per kilogram [lb/2.2] of body weight. This should
be based on your ideal weight. If a man has an ideal weight of 175 pounds, he would require about
80 grams of protein. For a sedentary person, subtract 5-10 grams, and add 5-10 grams for
someone who is athletic or engages in resistance training.
It’s also important to not overeat protein at each sitting. The body can only utilize a certain
amount of protein at any given time and overdoing it will cause the body to convert the amino
acids to glucose and raise insulin and blood sugar levels. The ideal amount of protein at each meal
is between 15-25 grams depending on daily allowance.
While limiting carbohydrates is by far the most important factor in controlling blood sugar,
improving insulin resistance, and reversing diabetes, it’s essential to be aware of protein
consumption as well. Keeping protein to a moderate level will protect lean muscle mass, allow for
rebuilding and repair, enhance detoxification, and limit conversion of amino acids to sugar.
20
© 2104 SweetLife Diabetes Health Centers, LLC
The Optimal Eating Strategy
What is the perfect diet to prevent and reverse diabetes? Unfortunately, there is no such thing. At
it’s best, nutritional therapy is customized to the individual and is dynamic and evolving, rather than
a static set of rules.
There are, however, some guidelines which are important for anyone to follow, especially those
with diabetes, pre-diabetes, metabolic syndrome, and insulin resistance. From here, the optimal diet
can be adjusted to the individual based on blood sugar response, inflammation, energy, immune
health, sleep quality, physical activity level, organ function or dysfunction, and overall health.
An optimal diet begins with whole foods. As my colleague Sean Croxton says, “JERF: Just Eat Real
Food”. That’s a good start. But for blood sugar control, unfortunately, it’s not quite that simple.
Whole, real foods are things like plants and animals. It’s the only food that we would have access
to if it were not for technology and agriculture.
There are some foods that should not be eaten by anyone. Let’s start with the easy ones.
✦
✦
✦
✦
✦
Candy like starburst, skittles, snickers, m&ms, chocolates, and licorice.
Anything that comes in a snack package, like potato chips, pretzels, crackers, cheese curls,
cookies, pastries, and granola bars.
Dessert-like foods such as donuts, pancakes, waffles, pastries, cakes, cookies, pie, ice cream,
sorbet, and mousse.
Refined flour-based foods like bagels, bread, pasta, and muffins.
Sweetened (or naturally sweet) beverages like sweet tea, sweetened coffee, soda, sugary
drinks (vitamin water, gatorade), and fruit and vegetable juice.
✦
Processed meat and meat products such as hot dogs, bologna, salami, and deli meats
✦
Fried foods and foods containing partially-hydrogenated vegetable oils
For optimal blood sugar regulation, there are a few additional types of food that should be avoided.
These foods typically raise blood glucose because they rapidly break down to sugar in the body.
The blood sugar rush, and resulting insulin surge will interfere with proper blood sugar control.
✦
✦
21
Grains, such as oatmeal, wheat, rice, quinoa, and barley as well as any products made from
these foods.
Starchy vegetables, such as potatoes, corn, and parsnips.
© 2104 SweetLife Diabetes Health Centers, LLC
✦
✦
Moderate-High glycemic fruits such as bananas, grapes, mango, papaya, melons, and pineapple,
as well as dried fruits including raisins.
Lactose-containing or sweetened dairy products such as milk, yogurt, and ice cream.
Now, let’s focus on what to eat. The optimal diet for blood sugar control includes a wide variety of
whole, real foods. The two main rules are simplicity and diversity. Keep things simple. Elaborate
meal plans can be fun and interesting down the line, but in the beginning, can invite temptation and
lead you astray. Apply diversity within the scope of foods you’ll be eating. There are dozens of
acceptable vegetables, fruits, nuts, seeds, beans, legumes, animal proteins, and beverages. Mix it up,
focusing on a variety of colors so that you are getting a wide range of vitamins, mineral,
antioxidants, and phytonutrients.
✦
✦
✦
✦
✦
✦
Fibrous Vegetables such as broccoli, cauliflower, asparagus, spinach, greens, bell pepper,
tomato, cucumber, and celery.
Low glycemic fruits such as avocado, coconut, olives, berries, cherries, and apples.
Animal protein such as grass-fed beef, free-range poultry, wild-caught fish, and organic eggs, as
well as shellfish and organic pork in moderation.
Nuts and seeds, such as macadamia nuts, almonds, walnuts, pistachio, sunflower seed, flax,
chia, and hemp.
Bean and legumes such as black bean, pinto beans, white and red kidney beans, as well as
green peas and chickpeas in moderation.
Healthy fat sources such as olive, coconut, avocado, nuts, organic meat and eggs, and butter
from pastured cows.
In addition, there are certain foods that may be acceptable in limited quantities for some people,
but may create problems in others. This largely depends on blood sugar response, food
sensitivities, and inflammatory factors.
✦
✦
✦
Organic (preferably raw) dairy products with little to no lactose, such as cheese, whey
protein, milk protein, cream, and butter from pastured cows.
Alcohol is typically acceptable in limited quantities, particularly one serving of dry red or white
wine or hard alcohol such as gin, vodka, or whiskey.
Artificial sweeteners are generally not recommended, however, consuming small amounts in
chewing gum, mouthwash, and sugar-free breath mints is probably safe.
There are a few other guidelines that are helpful to follow as well to ensure optimal success in
controlling blood sugar and preventing and reversing type 2 diabetes.
22
© 2104 SweetLife Diabetes Health Centers, LLC
It’s best to eat two to three moderately sized meals per day rather than eating five to six meals,
which is sometimes recommended by dietitians. Continually eating throughout the day by
“grazing” or eating frequent meals keeps the blood sugar, insulin, and leptin levels elevated and
interferes with the healing and correction process. Instead, spread the time between feedings out
at least 4-5 hours to allow insulin and leptin levels to reset.
While it may be difficult at first, it’s best to avoid snacking between meals and before bed. For the
same reason just discussed, snacking keeps the blood sugar and insulin elevated and interferes with
the correction process. Snacking also reinforces food cravings and emotional eating, which can be
an issue for many people with blood sugar regulation problems.
Experiment with intermittent fasting (I.F.). I.F. involves going an extended period of time without
food to allow blood sugar, insulin, and leptin levels to reset. During this fasting period, the primary
nutrient the body uses for fuel is fat which improves metabolic efficiency and causes an upregulation of insulin receptors on the cell membranes. One simple way of accomplishing this is to
skip breakfast 1-2 days per week.
As covered throughout this book, it’s extremely important to limit carbohydrate consumption. A
good starting point for most people who want to prevent or reverse diabetes in 50-100 grams of
carbohydrate per day. While this is a broad range, there are many differences based on size,
condition, and physical activity level. Eventually, you may want to consider reducing your non-fiber
carbohydrate consumption to less than 50 grams per day for optimal blood sugar control.
Low carb does not mean high protein, and it’s also important to limit protein to a moderate level.
Again, this is largely based on size, lean mass, and physical activity level. Generally, it’s recommended
to limit protein to 50-75 grams per day and no more than 25 grams per meal. As stated, this can
be adjusted based on lean body mass, size, sex, and physical activity.
Drinks lots of water and eat high-water content foods. Water is essential for life and many people
are chronically dehydrated. If you feel hungry, try drinking 12-16 ounces of water and waiting 20
minutes. Don’t wait until you are thirsty. Start the day with a glass of water and sip water, herbal
tea, and green tea throughout the day. Squeezing a lemon or lime wedge in the water is
acceptable, and using carbonated water in moderation in fine as well.
Another important, but often overlooked strategy is to eat with intention and focus on
nourishment, rather than entertainment. Sure food can be delicious and a great source of
enjoyment, but if you are depending on food to fill some need other than nourishment, it’s going to
be nearly impossible to eat for health. When you eat, close your eyes, and savor the texture, taste,
and flavor of the food. Eat with a sense of gratitude and be fully present while dining. Do not eat
while watching television, sitting at your desk, talking on the phone, or playing cards.
Use food for nourishment. Find other ways to entertain yourself through hobbies, books, friends,
and community groups. Think like an animal in nature and just eat to fuel your body. If you do this,
you will be less likely to be “hungry” an hour after you eat or to feel deprived because you can no
longer eat your “favorite foods”. It’s time to break the bad habits that got you where you are and it
starts by changing your relationship with food.
23
© 2104 SweetLife Diabetes Health Centers, LLC
General Food Guidelines
Enjoy
Limit
Carbohydrates:
Fibrous vegetables, nuts
and seeds
Carbohydrates:
Beans, legumes, carrots,
sweet potatoes
Carbohydrates:
Whole grains such as
oats, barley, rice,
quinoa, whole grain
pasta and breads
Carbohydrates:
Processed grain
products and sugars,
such as bread, pasta,
pastries, sweets,
desserts, candy, sugar
Fruits:
Coconut, Avocado,
Olives, Berries
(blueberries,
raspberries,
strawberries,
blackberries), Cherries
Fruits:
Apples, citrus, pears,
plums, peaches
Fruits:
Watermelon, banana,
melon, mango, papaya,
grapes, pineapple, kiwi
Fruits:
Dried fruit, raisins, fruit
juice
Vegetables:
Broccoli, cauliflower,
asparagus, spinach,
greens, bell peppers,
cucumber, celery,
sprouts
Vegetables:
Tomatoes, carrots,
sweet potatoes, beets
Vegetables:
White potatoes,
parsnips, corn (grain)
Vegetables:
Potato starch, corn
starch, instant potatoes,
fried vegetables (french
fries)
Proteins:
Grass-fed beef, freerange poultry, wildcaught fish, organic
eggs, wild game
Proteins:
Commercial poultry,
farm-raised fish,
shellfish, organic pork
and pork products,
commercial eggs
Proteins:
Commercial beef,
commercial pork and
pork products,
minimally processed
deli meats
Proteins:
Processed meat and
meat products (hot
dogs, deli meat), fried
meat (fried chicken)
Fats:
Monounsaturated oils
(avocado, olive,
macadamia), medium
chain saturated fats
(coconut, palm, MCT
oil), omega 3 oils (fish
oil, flax, chia, walnuts,
hemp)
Fats:
Long-chain saturated
fats from animal
products, nuts and
seeds
Fats:
Omega 6 fats from
vegetable oils like
safflower oil, soybean
oil, canola oil, and corn
oil
Fats:
Partially hydrogenated
oils, fried foods
24
Avoid
Eliminate
© 2104 SweetLife Diabetes Health Centers, LLC
Supplementing the Diet
Reversing diabetes is a process that requires patience and persistence. The primary factor is a
healthy diet designed to improve blood sugar and insulin metabolism with reduced carbohydrates,
moderate protein, and high in healthy fats. Other factors include physical activity, stress
management, sleep quality, reducing toxicity, inflammation, and oxidative stress, and improving
hormone balance.
Another key factor to preventing and reversing diabetes and blood sugar dysregulation is
eliminating nutrient insufficiencies and supplementing the diet with key botanical agents to improve
insulin and blood sugar metabolism.
Plant-based medicinal supplements can be very effective at helping to regulate, control, and
improve blood sugar levels long term, by addressing the root cause, insulin resistance. There are
dozens of vitamins, minerals, and plant extracts which have been studied using controlled clinical
trials, and have shown positive benefits for diabetes.
Here are some of the most effective and promising nutrients:
Chromium Polynicotinate - Chromium improves insulin sensitivity, reduces insulin resistance, and
improves glucose uptake. Dozens of studies have shown the benefits of chromium on blood sugar
and diabetes.
✦
Recommended dose: up to 1,000 mcg per day
Biotin - Combined with chromium, biotin has been shown to improve carbohydrate metabolism,
reduce blood sugar levels and create more insulin sensitivity. It addition, it has been shown to
lower cholesterol and reduce the risk of heart disease.
✦
Recommended dose: 2-9 mg per day
Vanadyl Sulfate - Improves glucose metabolism, insulin sensitivity, and mimics the activity of insulin
directly stimulating insulin receptors.
✦
Recommended dose: 50-100 mg per day
Omega 3 fatty acids (DHA, EPA) - Reduces inflammation, protects the lining of the blood vessels,
prevents blood clots, enhances circulation, improves hormone sensitivity, lifts mood, improves
attention, and nourishes the brain.
✦
25
Recommended dose: 2-4 grams per day of combined EPA and DHA
© 2104 SweetLife Diabetes Health Centers, LLC
Gymnema Sylvestre - Ayurvedic herb used for blood sugar regulation since 600 BCE. Decreases
absorption of glucose in the blood, blocks the taste of sugar and may help with appetite control
and sugar cravings. Studies have shown a possible effect of regenerating beta cells in the pancreas.
✦
Recommended dose: 400 mg per day
Alpha Lipoic Acid - Powerful antioxidant for both fat and water soluble toxins. Enhanced energy
production and carbohydrate metabolism. Improves insulin sensitivity, prevents against glycation
from elevated sugar. Effectively improves the symptoms of peripheral neuropathy.
✦
Recommended dose: 1200 - 1800 mg per day
Bitter Melon (gourd) - Contains compounds that improve blood sugar metabolism, and transport
glucose into the cells. Inhibits enzyme that breaks down carbohydrates into smaller pieces for
absorption. Improves insulin resistance and prevents diabetic complications.
✦
Recommended dose: 2-5 g per day
Cinnamon extract - Slows the gastric emptying time, delaying the glycemic response. Improves
insulin sensitivity, reduces insulin resistance, and acts as an antioxidant protecting the cell
membranes. Contains a bioactive component with “insulin-like” properties.
✦
Recommended dose: 2-4 g per day
Berberine - Plant alkaloid that is used in chinese and Ayurvedic medicine to reduce blood sugar
levels. Helps prevent and treat type 2 diabetes, by activating AMPK, which stimulates uptake of
sugar and improves insulin sensitivity. Also reduces glucose production in the liver.
✦
Recommended dose: 500-2,000 mg per day
Banaba Leaf - Medicinal plant that lowers blood sugar by producing an insulin-like effect.
✦
Recommended dose: 32-48 mg per day
Green Tea extract - Rich in polyphenols, antioxidants that reduce inflammation, increase insulin
activity, and prevent type 2 diabetes. Also helps to reduce blood pressure, improve metabolism,
reduces glucose absorption in the gut, and limits the liver’s production of glucose.
✦
Recommended dose: 250-500 mg per day
Using these agents individually or in combination has been shown through various trials to have
documented benefits. It’s important to work with a doctor trained in functional medicine or a
diabetes educator with a working knowledge of diet and effective supplement support and how
these may interact with medications. It’s important to discuss any changes to your health regime,
including dietary changes or supplements with your personal physician so he’s aware of the
changes and can treat you accordingly
26
© 2104 SweetLife Diabetes Health Centers, LLC
Nutritional Food Log
27
© 2104 SweetLife Diabetes Health Centers, LLC