I've noticed something interesting. When someone is diagnosed with type 2 diabetes, the doctor thinks about controlling risk factors. Control the blood sugar. Control the blood pressure. Control the cholesterol. All of this to reduce the risk of developing problems related to diabetes.
Most people when diagnosed, however, think about reversing diabetes. Make it go away. Get off medications. Punch diabetes in the face so it never comes back.
Unfortunately studies and experience have not suggested that people are likely to make and sustain the changes needed to reverse type 2 diabetes.
But could diabetes reversal be possible?
The "Twin Cycle" Hypothesis
Dr. Roy Taylor from Newcastle, UK, developed an interesting hypothesis about the cause for diabetes which gives hope that it can be reversed commonly, especially within the first 4-6 years after diagnosis. He published about the twin cycle hypothesis in 2012 after performing preliminary studies showing support for the idea.
Meet your river guide
Just before I got married, several of my friends took me on a guys' adventure day, which included a day whitewater rafting on the Arkansas River. As we signed in, we received instruction about river safety, got our life vests, and hopped on a bus that took us to our starting point.
On this day we would be hitting class 3 and class 4 rapids, which are not as big as they come, but plenty big for a novice like me.
And then we met our guide. He would be in charge of steering the raft, helping us to make our way down the river safely, showing us where to go, what to avoid, and how to get past obstacles. He was skilled and knowledgeable, a good teacher, and he delivered us to our destination safely. Along the way we had an amazing time together.
The healthcare system - a contrasting approach
In some ways, I believe that the healthcare system uses a very different approach. As you try to make healthy choices, overcome obstacles, and make progress, how often do you...
"Eat breakfast like a king, lunch like a prince, and dinner like a pauper."
It's likely you've heard this statement before. Results from a new study add additional support for the idea that this might be the way the human body was designed to eat.
Bigger dinners may increase risk of metabolic disease
Researchers analyzed data from the NHANES nutrition survey, specifically from almost 4700 people with diabetes. Based on food recall questionnaires performed on 2 separate occasions, they broke people into 5 groups based on the amount of food eaten at dinner compared with breakfast.
What they found was that compared with the group the ate the least at dinner, the group that ate the most had an increased risk of diabetes-related mortality (1.9 times greater risk) and heart disease-related mortality (1.7 times).
The authors of the study also created risk models based on their data, and concluded that:
The Value of Exercise
You know that exercise is important. The body just doesn't work right if you are not moving. In particular, it becomes harder for you to efficiently burn fat when you are sedentary. But even though we know exercise is important, it can be really hard to get it done, right?
Let me tell you about two of my clients, each of whom has diabetes or prediabetes. I was struck by their stories, and I'd like to share a bit with you.
Matthew* uses insulin to control his blood sugar, and he tests his glucose regularly. Over the past year he has gone back and forth from being well-controlled, to not well-controlled, and back to controlled again. Now Mr. L will admit he doesn't like to exercise. It is hard for him to get out for a walk on a regular basis. But interestingly, the key factor we identified for when he is well-controlled is that during both of these periods he was remodeling his house - first his kitchen and then his garage. And he really...
Everyone loves a hero
When I was a kid, every week I could not wait for Saturday morning cartoons. I would get up, race downstairs with my sister, and spend the next 2-3 hours watching the week's new shows.
My favorite cartoon was Super Friends, which brought together all the superheroes from the Justice League - Superman, Batman & Robin, Aquaman, and Wonder Woman - who would use their superpowers to battle the forces of evil.
While watching Saturday morning cartoons is no longer a childhood ritual, I believe most children still dream of using their special gifts to save others, fight for justice, and bring goodness into the world.
What is a hero?
Where does your mind go when you eat?
I heard this question recently when listening to the Ten Percent Happier podcast interview with Evelyn Tribole, one of the developers of the intuitive eating. I have to admit, when I heard the question my first thought was, "huh, I'm not sure."
How about you? Where does your mind go when you eat?
Let's start with a story...
My low point in my relationship with food occurred just before my 15th birthday. I so badly wanted to fit in, to be popular. Somehow in my mind I began to believe that if I were only a bit skinnier I would get what I wanted.
From 125 pounds, I dropped roughly 20% of my body weight while trying to keep my food-restricting and purging behaviors hidden from my parents. Although I was never diagnosed, I clearly had an eating disorder. I bottomed out just under 100 pounds.
Fortunately I somehow "snapped out" of this phase after about 6 months. While my weight returned to normal, I've maintained a complex relationship with...
James' system was breaking
It was too much for James*. His father was ill, and he was travelling back east frequently to help with his father's healthcare. Combined with his business travel, lots of stress, and the difficulty he faced finding the right foods on the road, it was just way to hard for James to eat well and keep his blood sugar down. He was feeling tired, frustrated, and ashamed.
About 3 years ago James found great success controlling both his blood sugar and his weight by following a ketogenic diet. He'd lost over 50 pounds, and when everything was ticking just right, all of his blood sugar numbers were excellent. He'd even been able to stop one of his diabetes medicines. And he felt really good.
The problem was that he needed to devote a fair amount of effort to keeping on track. Shopping for groceries ahead of time, packing lunches, and keeping his stress down helped him stay on track. When life was "normal," this was all very manageable.
However, with all the...
Headlines won't always tell you the whole truth
I'd like to come back to the question of "what's the best diet?" This week let's look at a study that compared a low carbohydrate ketogenic diet vs. a low glycemic index diet. Take a look at the authors' conclusion from this study (bold text mine):
"Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes."
You might read this and conclude you need to follow a ketogenic diet, and that a low glycemic index diet is not good. But let's dig a little bit.
It is true that participants in the ketogenic group lost more weight, had a bigger blood sugar drop, and were able to...
"Overfed and Undernourished"
One hundred years ago, if you ate a food that had calories, it also contained nutrients - vitamins, minerals, and other small molecules that help your body produce energy, heal itself, and fight infection and cancer. Over the last 70 years food production has changed substantially, leading to the introduction of many calorie dense foods that are depleted of their natural nutrient value.
Many foods are produced using inexpensive fats and grains that have been stripped of their natural nutrients, and these fats and grains are mixed with salt and sugar to become "highly palatable" (think hard to stop eating, more below) and with chemicals that help preserve stability and shelf life. Unfortunately, these have adversely affected our health by contributing to weight gain and insulin resistance, weakening our immune systems, and increasing the risk of certain cancers.
These weight gain caused by such poor quality foods in our food supply led one nutrition...
Time for an Added Sugar Audit
Today we'll focus on reducing or eliminating added sugar from your diet. But before we get to that, let me give you some background information.
What's the best diet?
Time and again I get asked, "what's the best diet?" There is so much confusion and hype in the nutrition and weight loss industries that it's hard to know what's best. This can leave you feeling confused, frustrated, and even overwhelmed when you try to improve your nutrition.
This past week I was reviewing studies published by Dr. Dean Ornish, including this powerful study which showed that heart disease could be effectively treated with a healthy diet, exercise, and stress reduction. With these measures, the amount of plaque buildup in people's arteries actually decreased over 5 years, compared with an increase in the "usual care" control group.
While the Ornish diet focuses on a whole-food, plant-based, low fat approach, it is just one example of a healthy eating...
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