Jan
20
2024

Fasting-Mimicking Diet Is Benefitting Cardiovascular Health

By | diet, fasting mimicking diet, food, Heart Disease, Nutrition, Weight loss

A crossover study showed that a fasting-mimicking diet is benefitting cardiovascular health. This new study was done by Dr. Valter Longo et al. from the University of Southern California. It compared the effect of two diets. They were the fasting-mimicking diet versus an unrestricted diet. In other studies Dr. Longo compared the fasting-mimicking diet (FMD) with a Mediterranean diet. He said: “The significance is that fasting-mimicking diet cycles were able to decrease fat mass without reducing muscle mass and without requiring changes in the subjects’ preferred diet for 25 days a month. In contrast, the everyday Mediterranean diet required a change in everyday dietary habits and was associated with a 5 pounds loss of muscle.”

Findings of the effects of 5 days of the fasting mimicking diet per month

3 cycles of 5-day FMD per month showed the following effect. Fasting-mimicking diet patients experienced a remarkable decrease in trunk fat mass. Dr. Longo also showed in a previous study that the FMD reduces the circulating insulin-like growth factor 1. In addition, blood sugar, triglycerides, LDL and total cholesterol were reduced. In short, cardiovascular markers showed a protective effect in the FMD group.

Comments of a cardiologist to fasting mimicking diet

Dr. Rigved Tadwalkar is a cardiologist at Providence Saint John’s Health Center in Santa Monica, CA. He was not involved in the study by Dr. Valter Longo. He said: “When we look at different sorts of diets, we really want to get down to what sort of health benefit they actually provide. It was nice to see that both the fasting-mimicking diet and Mediterranean diet – which is almost like the mainstay of recommended diets right now – both led to weight loss and improvements in blood pressure, cholesterol, and blood sugar. These are all very important cardiometabolic parameters that lead to cardiovascular disease, so it’s nice to see that both are able to do so.”

Fasting-mimicking diet reduces abdominal fat

He went on to say: “What was interesting about the fasting-mimicking diet is that it had the added benefit of reducing abdominal fat, which was really important because that is a big reason why a lot of people diet. Not to mention it’s still important even from a medical standpoint because abdominal fat is a risk factor for cardiovascular disease.” He continued to point out that it will be important to show the long-term effect of the FMD. He suggested to have observations over several month and years. Also, he stressed the importance of showing the direct effect of the FMD on the reduction of cardiovascular disease. This would be in comparison to controls. All this requires much larger clinical trials with longer follow-ups.

Advantage of fasting-mimicking diet

The FMD is easy to follow. You only have to reduce your daily calorie intake for 5 days out of a month. The remaining 25 days they eat their normal diet. People are often unwilling to change their diet. With the FMD they only have to reduce their calorie intake to 500 to 600 calories per day. And this is only for 5 days in a row once per month. They will lose 0.5 to 0.7 units of body mass index (BMI) once a month. Compare the first day of your 5 day FMD with the day after your last FMD.

My experience with the fasting mimicking diet

I have done this for 6 years. In  December of 2017 I listened to a lecture by Dr. Valter Longo at a conference in Las Vegas. Immediately after I started dong monthly FMD for 5 days. This kept my BMI within 21.0 to 22.0, because I use the FMD to correct any weight gains. Whether you want to adopt a DASH diet or a Mediterranean diet is another issue. This is eventually desirable to solve. But in the meantime stay in a healthy range with your BMI with the help of the FMD.

Fasting-Mimicking Diet Is Benefitting Cardiovascular Health

Fasting-Mimicking Diet Is Benefitting Cardiovascular Health

Conclusion

The fasting-mimicking diet (FMD) is a tool to reduce your abdominal fat.  At the same time you improve your blood pressure, cholesterol, and blood sugar. You can achieve that by reducing your daily calorie intake. With the FMD you aim for between 500 and 600 calories for 5 consecutive days every month. With body composition scales you can see how your weight, fat percentage and body mass index reduce from before. These are all very important cardiometabolic parameters. If you allow them to get out of control they lead to cardiovascular disease.  Start adopting the FMD to keep your weight the same or reduce it slightly. Worry about a possible diet change to a Mediterranean diet at a later point and introduce the beneficial changes. This makes dieting easier.

Jan
14
2023

Cortisol is the Number 1 Longevity Hormone

By | Cardiovascular disease, Hormones, immune system, Stroke

At the 30th American Anti-Aging Academy Medicine Conference in Las Vegas one topic was that cortisol is the number 1 longevity hormone. Dr. Thierry Hertoghe, an endocrinologist from Brussels, Belgium gave a comprehensive lecture on Saturday, Dec.10, 2022. He explained that cortisol from our adrenal glands is vital to our health. Certainly, it is important for our quality of life and for health in general.  Indeed, cortisol keeps us alive when various circumstances challenge our health. Specifically, cortisol is on the bottom of the hormone cascade of corticotropin releasing hormone (CRH) from the hypothalamus/ Adrenocorticotropic hormone (ACTH) from the pituitary gland/and cortisol from the adrenal glands. It is important to realize that this is the hormone axis of the stress reaction that Dr. Selye first described.

Production of cortisol

Sedentary men produce 30 mg of cortisol per day, women 20 mg/day. Under stressful conditions ACTH production increases and causes an increase of cortisol production in the adrenal glands. To clarify, stressed men produce 40 to 60 mg per day and stressed women produce 30 to 40 mg/day. In addition, the older a person is, mononuclear leukocytes have less type 1 and type 2 glucocorticosteroid receptors.

Action of cortisol

Dr. Hertoghe pointed out that cortisol increases energy and stress resistance. It causes blood sugars to increase and also elevates blood pressure. The immune system gets stronger, allergies and inflammation decrease. Cortisol shapes our bodies: when there is cortisol deficiency the body is thin; with normal cortisol production the body has a normal configuration. Your body develops swelling and obesity with cortisol excess, but when cortisol is missing the body gets frail and thin.

Cortisol deficiency

Low cortisol production leads to low blood sugar and low blood pressure. This diminishes glycogen stores in the liver and muscle mass. A lack of circulating cortisol reduces gluconeogenesis in the liver, which is an alternative pathway of glucose production. One of the hallmark symptoms is mental fatigue, particularly in times of stress. With cortisol deficiency the person feels fatigue in the second part of the day.

Chronic fatigue syndrome

The peak age for chronic fatigue syndrome patients is 31 years. The mean duration of the illness lasts 7 years. 58% of patients have free serum cortisol levels at 20:00 hours, which is less than normal. In 40% of patients the total cortisol level is less than normal.

Burnout

With burnout the urinary free cortisol is diminished. Patients with cortisol deficiency have a hyper sensitivity to stress.

A lack of cortisol leads to feeling no energy and having no stress resistance. The person feels tense and has negative thinking. A person who has sufficient cortisol is full of energy, expresses emotions and handles stress well. With enough cortisol a person is relaxed, has positive feelings and finds solutions everywhere.

Adrenal crisis

Dr. Hertoghe explained that an adrenal crisis happens when there is not enough cortisol production in the adrenal glands to support the metabolism and the cardiovascular system. Gastrointestinal diseases, infectious diseases or stressful events like surgery, exposure to heat, strenuous physical activity, major pain or pregnancy can all trigger an adrenal crisis. When glucocorticoid therapy is withdrawn, this can also cause an adrenal crisis.

Addison’s disease

With Addison’s disease there is a lack of energy, muscle weakness, loss of appetite and unintentional weight loss. The reason for the symptoms is that the adrenal glands are not producing enough cortisol and aldosterone. There was a more than 2-fold increased risk of dying from Addison’s disease compared to a normal population in a Swedish study.

In another study the serum cortisol levels were determined in patients with heart attacks. The ones who had extremely low levels of cortisol were at almost a 9-fold risk of dying within 30 days compared to patients with a normal serum cortisol level. One of the famous patients with Addison’s disease was J.F. Kennedy. He collapsed in London, England and was finally diagnosed correctly in a British hospital after having suffered for several years without the correct diagnosis. This disease is not always easily diagnosed.

Cortisol therapy

With an adrenal crisis or Addison’s disease cortisol therapy can be life-saving. The physician uses physiological doses of glucocorticosteroid hormones (cortisol and others) and in emergency situations higher than normal doses. Dr. Hertoghe said that survival data were gathered with various severe disease conditions as follows.

Coronary heart disease survival

Dr. Hertoghe reported about a study that observed 1090 adults over 11 years. There was a 40% reduction of mortality when patients were treated with cortisol following a heart attack compared to controls who did not get cortisol treatments. The researchers also found that there was a 39% lower stroke risk when treatment with cortisol was instituted.

In a clinical trial with 39 patients who had heart attacks those patients treated with pharmacological doses of methylprednisolone (3 grams daily) experienced a significant reduction in infarction size.

In another study with 1118 patients Dr. Hertoghe reported a 28% reduction in mortality over 28 days compared with a placebo group. In this study medical researchers gave 2-3 grams of methylprednisolone early on into the heart attack. In the same study, after 6 months there was a 33% mortality reduction.

Stroke survival

Following a stroke, low cortisol levels (270 nmol/L) and high cortisol levels (550 nmol/L) both had an association with a poor long-term prognosis 1 year after follow-up.  However, the study also showed that patients with normal cortisol levels (between 270 nmol/L and 550 nmol/L) following a stroke had a very good long-term prognosis.

AIDS survival

AIDS patients belong into the group of chronic diseases that are associated with low cortisol levels in the blood. There are also clinical signs of low cortisol, namely dark circles around the eyes, hollow cheeks, brownish pale skin with pigment spots, hand creases that are pigmented and weight loss. Severely ill AIDS patients often have severe lung infections (Pneumocystis carinii pneumonia) due to their immune deficiency. A study involving 23 AIDS patients used methylprednisolone in the treatment group and no methylprednisolone in the placebo group. The clinicians administered 40 mg of methylprednisolone every 6 hours for 7 days in addition to antibiotic treatment for 3 weeks. They compared this to the placebo group without methylprednisolone. 75% of the treatment group survived until the hospital discharge compared to only 18% of the placebo group.

Sepsis and septic shock

Treatment of patients with septic shock with ACTH (the stress hormone) infusions showed that 88% had a cortisol response among survivors. The ultimate non-survivors only had a 27% cortisol response of their adrenal glands when stimulated by intravenous ACTH. Dr. Hertoghe pointed out that this suggests that some patients with septic shock may have relative adrenocortical insufficiency. This would explain why the adrenal glands of septic shock patients can be non-responsive to ACTH. In these cases, it is important that the physician treat with either intravenous cortisol or with synthetic glucocorticoids.

Treating septic shock with intravenous hydro-cortisol

One study showed that treating septic shock with intravenous hydro-cortisol gave the following results compared to placebo:

  • 7- fold higher septic shock resolution when compared to the placebo group
  • 8 – fold survival in the intensive care unit
  • 2 – fold higher hospital survival
  • 2 – fold better septic shock reversal in 7 days
  • 8 – fold better survival in the next 28 days.

Overall, this study clearly revealed that septic shock recovery is much better with intravenous hydro-cortisol treatment.

Cancer survival

A study found that breast cancer patients with metastases had flat saliva cortisol curves when compared to patients without breast cancer. If left alone breast cancer patients with a flat cortisol curve die earlier than those who used cortisol supplementation.  The researchers found out that the natural killer cells (NK cells) in these patients were missing. These are special lymphocytes that can kill cancer cells with their enzyme vesicles.

Glucocorticoid treatment

Dr. Hertoghe talked about short-term high-dosed glucocorticoid therapy and the difference between synthetic cortisol equivalents (Dexamethasone etc.) and the natural cortisol. He also talked about adding small amounts of these hormones: DHEA, fludrocortisone (0.1 mg daily orally), and bioidentical vasopressin to optimize cortisol replacement.

Cortisol is the Number 1 Longevity Hormone

Cortisol is the Number 1 Longevity Hormone

Conclusion

One of the vital hormones in our bodies is cortisol, the stress hormone. There is a hormone cascade starting with CRH in the hypothalamus, which stimulates ACTH release from the pituitary gland. This in turn releases cortisol from the adrenal glands. The end product, cortisol is the number 1 longevity hormone. It helps us to survive any stressful event. It gives us energy, stimulates the immune system and helps us to overcome dangerous illnesses. Dr. Hertoghe, an endocrinologist from Belgium gave a detailed lecture at the 30th American Anti-Aging Academy Medicine Conference in Las Vegas on Dec. 10, 2022. Dr. Hertoghe discussed how to survive a heart attack or stroke, sepsis, AIDS or Addison’s disease (=adrenal gland insufficiency) by adding appropriate cortisol doses or equivalent synthetic glucocorticosteroids. One thing is clear: we all need cortisol until the end of our lives.

Jan
14
2017

How To Avoid Being Hungry

By | Cardiovascular disease, diet, heart attack, Heart Disease, Nutrition, Obesity, Stroke, Weight loss

Dr. Ludwig gave a lecture about how to avoid being hungry at a conference in Las Vegas. The actual topic was “Always Hungry?” I attended the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas where this lecture was given. Dr. Ludwig is a Harvard-based endocrinologist who has been researching weight loss methods and obesity for over 20 years. Here is a list of his major publications.

Dr. Ludwig stated that the low fat/high carb diet popular in the1980’s until the early 2000’s was misguided and probably even harmful. The theory at that time was that obesity was caused by too much saturated fat. This has since been proven to be wrong. Instead it has been proven that increased sugar intake is responsible for the obesity wave.

General information about weight gain

The carbohydrate-insulin model states that without insulin you cannot gain weight, because in order to store fat in fatty tissue you need insulin to transport fatty acids across the cell membrane of fat cells.

In this context it is important to note that high glycemic index food increases the blood sugar. This leads to stimulated insulin production, and the liver converts the extra sugar into fatty acids that get deposited as fat in fatty tissue.

The glycemic load from a person’s diet is the single best predictor for a rising blood sugar level. After food intake the blood sugar goes up, glucagon goes up, epinephrine goes up within 4 hours. It is the epinephrine, which after 4 hours makes you hungry again.

The nucleus accumbens is the addiction center. At 4 hours after a high glycemic index milk shake the nucleus accumbens was stimulated in 12 subjects of a double blind trial.

The nucleus accumbens does not work in isolation. It is not only involved in food satisfaction, but also in sexual satisfaction and even plays a role in satisfaction that some people get from playing video games.

Low-carbohydrate, Mediterranean or low-fat diet

In an Israeli study from the New England Journal of Medicine in 2008 investigators were interested to find out which diet was helping people to lose most weight.

322 moderately obese subjects that were aged 52 years on average were randomized to one of the following diet groups.

They compared

  1. a low fat diet (Atkins type, restricted calorie) with a
  2. Mediterranean diet (low carb, restricted-calorie) and a
  3. Low fat/high carb diet (low fat, non-restricted-calorie)

What was the result? The mean weight losses were: 2.9 kg (low fat group), 4.4 kg (Mediterranean diet group), and 4.7 kg (low fat/high carb group). Of the 272 participants who had completed the intervention after two years of the study the weight loss was 3.3 kg, 4.6 kg, and 5.5 kg in the same sequence as above.

Next the researchers examined the ratio of total cholesterol to high-density lipoprotein cholesterol, which is a measure for the heart attack risk. It was 20% lower from the baseline in group 2 (Mediterranean diet group). The low fat groups (group 1 and 3) were 12% lower from the baseline.

36 subjects had diabetes. There was a clear winner with respect to lower fasting blood sugar and insulin levels, namely the Mediterranean diet (group 2).

The authors concluded that the Mediterranean diet is preferable to low fat diets as they have shown an improvement in lipid profiles and in control of diabetes.

The “POUNDS LOST” study

This was a 2-year study that investigated 4 different lower calorie diets to help people lose weight. Despite the significant difference in diet composition, these 811 free-living overweight or obese adults ages 30-70 from Boston, MA and Baton Rouge, LA lost 16 pounds at 6 months and 9 pounds at the end of two years. The diets were 1) low fat (20%) or 2) high fat (40%) 3) average protein (15%) or 4) high protein (25% of total calories).

The authors concluded that any reduced, calorie-controlled diet would help obese or overweight people to achieve weight loss that lasts. It is interesting that it did not matter whether the diet was low or high in fat, or had low or high protein content. What did matter was that all diets were low in sugar.

Sugar is the driving force

Dr. Ludwig pointed out that without insulin you couldn’t gain weight. High glycemic index food increases blood sugar. The glycemic load is the single best predictor to indicate whether a person will gain weight or lose weight when you consume food. It is an irony that in the 1980’s and 1990’s the wrong assumption that a low fat/high carb diet would be heart healthy created the obesity wave. We have abundant data available that show otherwise: high sugar content of food brings the calorie count up as everybody can read on the food labels.

Sugar stimulates the food addiction center

This will lead to weight increase, which has been abundantly proven. Sugar also stimulates your nucleus accumbens, the food addiction center. As you probably know it is extremely difficult to get out of this food addiction cycle unless you cut out sugar. You even need to go one step further and include many starchy foods that will within 30 minutes of digesting them turn into sugar. Your system makes no difference whether you eat a few teaspoons of sugar or two slices of white bread. The response of your pancreas is insulin, which gladly stores the fatty substances your liver made as fat.

How to get out of the vicious food cycle

As the quoted publications and many other ones have shown, it only matters that you limit your refined carb intake. You can vary the fat content and you can vary the protein content and still lose weight provided you watch the low carb intake. You also need portion control, which is a given! Study glycemic index and glycemic load sites on the Internet. The links I provided are just some examples. The more you educate yourself about carbs, the better for you. Note that many fruit and vegetables belong to the low-glycemic load/index foods. Avoid the high glycemic index foods like dates and cornflakes. Stick to low-glycemic index foods, which are less than 55. With regard to low-glycemic load food the values should be below 10.

The Mediterranean diet is a very desirable diet, which has been proven to be anti-inflammatory.

The zone diet of Barry Sears is also an anti-inflammatory diet and he summarizes this in this link.

How To Avoid Being Hungry

How To Avoid Being Hungry

Conclusion

I have summarized the content of a talk given by Dr. Ludwig. We learnt from this that sugar and refined carbs are the driving force that leads to “feeling hungry”. This stimulates your nucleus accumbens, the food addiction center. Let’s assume that a person is obese or overweight and wants to lose some weight. You need to start by being strict with yourself. Cut out sugar and high-glycemic foods. This will remove the food addiction factor that keeps you going back to the wrong, high calorie foods. You will also consume more low calorie vegetables and fruit, which have more fiber that fills you up.

Monitor your body mass index

Once you are used to the new way of eating, there is no need to count calories. I recommend that you weigh yourself daily on body composition scales and record the results. This allows you to monitor your body mass index (BMI), your weight, your fat percentage, and your muscle percentage. Typically you will lose 2 to 3 pounds per week on such a low-calorie diet. Later the weight loss will slow down to 1 to 2 weeks per week until you reach your goal. Don’t go lower than a BMI of 21.0 to 22.0 and discuss your goal with your doctor.

Apr
05
2014

Yes, There Are Healthy Sugar Substitutes

By | Cancer, Diabetes, Heart Disease, Nutrition, Obesity, Prevention, Weight loss

It is true that sweets are not good for you because they lead to fat accumulation and to diabetes. I explain how this works later in this blog. But who says you cannot sweeten your life with healthy ingredients? Not all sugar substitutes are the same; some are awful, some are in between and one is good (see below).

General information why sweets and starches are bad for you:

There is a triple whammy from sweets that you don’t really want:

a) First, sugar gets absorbed really fast through the gut wall and arrives in your blood stream within 15 to 20 minutes. Starches can be just as powerful in terms of blood sugar surges, but it takes perhaps 30 to 40 minutes for the peak of blood sugar to occur. The end result is the same: whether you load up with a pizza, a doughnut or drink a large, sugar-loaded soda drink, your pancreas reacts the same way. It produces a lot of extra insulin to bring the blood sugar level down. When you do this day after day your pancreas gets used to overproducing insulin and you develop insulin resistance meaning that your insulin receptors that are on every cell surface get tired and become less sensitive to insulin. Due to insulin resistance the muscle cells and the liver cells do not take up sugar (in the form of glucose) as easily as before.

b) Second, because excess sugar cannot be stored as glycogen (the storage form of glucose in the liver and the muscles), the liver converts excess glucose into triglycerides and oxidized fatty acids get taken up by white blood cells called macrophages. These attach to the inner lining of the arteries and lead to atheromatous plaques, the first stage of hardening of the arteries.

c) Third, glucose is an oxidizing agent that will oxidize LDL cholesterol. This makes the LDL particles much denser and forms the so-called very dense LDL lipoprotein fraction (VDLDL) that can be detected in special blood tests (Ref.1).

Not surprisingly people who consume sugar, sweets, soft drinks and starches on a regular basis will have very dense LDL particles (=VDLDL, also called “pattern B-LDL”). The treatment for this is to quit sugar and starchy foods.

I have explained in more detail what sugar does in this blog.

Yes, There Are Healthy Sugar Substitutes

Yes, There Are Healthy Sugar Substitutes

The food industry’s answer to low carb diet drinks and low sugar foods:

Many years back the food industry decided to offer alternative diet drinks that would not contain sugar, but instead have aspartame in it.

Dr. Blaylock has researched excitotoxins like MSG and aspartame (NutraSweet) and urges you in this link to abandon both. I agree with him. But while we are at it, don’t take other artificial sweeteners like sodium cyclamate in Canada (Sweet’N Low). Are you thinking of taking sucralose (Splenda) instead? Think again. What the industry seems to have forgotten is that it was originally developed as an insecticide. This website states that sucralose was actually discovered while trying to create a new insecticide. A researcher tasted it and found it exceedingly sweet. I have done the experiment myself in Hawaii where small ants are ubiquitous. I thought I take a package of Splenda from a coffee shop and do the experiment: In the beginning the ants were reluctant to eat it, but after a few hours they came and took it in. One day later there were only shrivelled up dead ants left in the area where Splenda had been sprinkled. Proof enough for me that Splenda was developed as an insecticide!

In the Splenda marketing scheme they decided to first introduce Splenda gradually into diabetic foods as a sweetener, then later sell it to the public at large. Don’t fall for it. It was a side product of insecticide research, and insecticides have the undesirable quality of being xenoestrogens, which block estrogen receptors in women. As a result of that estrogen can no longer access the body cells, including the heart. The final consequence for a woman is a higher risk for cardio-vascular disease. This can cause heart attacks, strokes and cancer. In men estrogen-blocking xenoestrogens can cause breast growth and cause erectile dysfunction.

The natural sweeteners:

One wonders why the food industry did not choose healthy sweeteners like stevia that has been used for decades in Japan and South America.

Other sweeteners like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol are sugar alcohols. Contrary to what many believe they have calories, but much less than sugar, so they are perceived as “safe” as a dietary supplement for weight loss. These alcoholic sugar compounds still produce partial LDL oxidization; interfere with weight loss and still lead to a certain insulin response.  Stevia, a natural sweetener from a leaf of South America is safer and without any calories.

The key is that stevia will not oxidize your LDL cholesterol and will not cause a hyperinsulinism response following a meal. It is metabolically neutral. It is the ideal sweetener for people who desire to lose some weight. It is also safe as it is no excitotoxin. The FDA has recognized stevia as “generally recognized as safe” (GRAS).

What about fructose, agave syrup, honey, brown rice malt syrup, fruit juice concentrates, refined fructose, maple syrup?

The problem is that they are all sugars, which cause a full insulin response leading to obesity, diabetes and hardening of the arteries. This causes heart attacks and strokes. These natural sugar products also oxidize LDL cholesterol, which initiates plaque formation as discussed above; this is the first step leading to hardening of the arteries. It took the medical profession 30 years of observing that a low fat/high carb diet makes us fat and causes heart attacks, leads to strokes and causes diabetes. Let’s not make the mistake of trusting the food industry and mindlessly swallow so-called natural other sugars and sugar substitutes like xylitol, sorbitol, maltitol, mannitol, glycerol, and lactitol. You may want to chew the odd gum with xylitol, as this will prevent cavities in your teeth. But otherwise it is much safer to just stick to Stevia to sweeten your tea, coffee or food. There are brands that are less bitter than regular stevia products, like stevia from New Roots in Canada and stevia from KAL in the US (no, this is not a commercial, it is based on my own observations).

Conclusion:

Sugar is an emotional topic that can get people caught up in heated discussions. The sugar industry and the sugar substitute industry have also powerful lobby groups that provide the Internet and the popular press with conflicting stories to convince you to buy their product. This blog was meant as a no-nonsense guide to get you removed from the high-risk group of candidates for heart attacks, strokes or diabetes. Let’s not forget the metabolism behind the various sugars and starchy foods described above, which I have explained in more detail in my recently published book (Ref.2). Forget the emotions of severing yourself from your favorite fix and stick to a tiny amount of stevia that can replace the familiar sweet taste that you have become accustomed to from childhood onward. At least this is what I do. The only alternative would be to take the plunge and cut out any sweet substance altogether, which I am not prepared to do. If you can do it, by all means go ahead.

More information on carbohydrates: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/carbohydrates/

 

Reference:

1. Life Extension: Disease Prevention and Treatment, Fifth edition. 130 Evidence-Based Protocols to Combat the Diseases of Aging. © 2013

2. Dr. Ray Schilling: “A Survivor’s Guide to Successful Aging“, Amazon.com, 2014

Last edited Nov. 7, 2014

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Nov
09
2013

Successful Diabetes Treatment Requires Patient’s Discipline

By | Diabetes, Fitness, heart attack, Heart Disease, Hormones, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements, Weight loss

90% of all diabetes cases are due to type 2 diabetes, which is associated with being overweight or obese. The other 10% are due to type 1 diabetes, which is caused by an autoimmune disease within the pancreas destroying the insulin producing beta cells. Diabetes, type 1 often occurs in childhood (hence the name “juvenile diabetes”), while type 2 diabetes is a condition of the middle aged and older population. There is however an alarming trend: overweight or obese youngsters are also being diagnosed with type 2 diabetes. Here I am discussing type 2 diabetes.

Causes that trigger diabetes

There is not just one way to get diabetes; it usually is a multifactorial disease. Sure, genetics play a minor role. But you need to have epigenetic factors to trigger the genes to develop diabetes: eating too much sugar, eating wheat and wheat products, drinking soda drinks that contain sugar or high fructose corn syrup. Alcohol binges can also cause diabetes as can accumulation of excessive weight (a body mass index above 25.0). Even when there is no genetic risk in your family (your family tree has nobody that came down with diabetes and all your ancestors lived into their 90’s), you can still develop diabetes, if you are exposed to one or more of the risk factors mentioned.

What is the reason why diabetes occurs?

At a Keystone Symposium from Jan. 27 to Feb.1, 2013 in Keystone, Colorado (Ref.1) leading scientific researchers gathered to discuss exactly this question. There seem to be several mechanisms, all of which lead to diabetes. It has been known for some time that in type 2 diabetes insulin resistance develops that renders the cells incapable of absorbing blood sugar (glucose) from the blood into the cells. It is because of this insulin resistance that doctors can diagnose diabetes when blood sugar levels are high.

Successful Diabetes Treatment Requires Patient’s Discipline

Successful Diabetes Treatment Requires Patient’s Discipline

There are at least 5 mechanisms that are presently known that can cause insulin resistance (and thus diabetes) by itself or in combination. For a deeper understanding of diabetes it is crucial to be aware of these. Without knowing the enemy, you cannot fight it.

1. When a person eats too much sugar or fructose the liver converts this into excessive fat that is accumulated in the body’s cells. As a result insulin receptors are becoming inefficient in absorbing sugar from the blood, and blood sugar levels stay high. The pancreas reacts to this by making even more insulin, which after a few years will cause the pancreas to fail in producing insulin. At this point the patient requires insulin or else gets into a diabetic coma.

2. Chronic inflammation is another mechanism that has been shown to cause insulin resistance. Obesity, the metabolic syndrome and diabetes have a common inflammatory denominator that results in insulin resistance. With the aging process there is also deterioration of mitochondrial function (mitochondria are the mini batteries inside of every cell that are responsible for you having energy). This causes fat accumulation and also insulin resistance. Exercise and weight loss are effective in combatting insulin resistance. Fasting has also been shown to improve insulin sensitivity.

3. The metabolism of visceral fat (the type of fat causing the apple appearance in obesity) is highly active and is associated with an increased risk for heart attacks and developing diabetes. The pear shaped woman runs less of a risk, as the fat around the hips is not metabolically active. On the other hand when these women enter into menopause, they also develop abdominal fat (apple-like fat distribution) with a high secretion of inflammatory substances causing insulin resistance, heart attacks and strokes.

4. Another mechanism of causing inflammation comes from invasion of organs with fat cells. The development of fat toxicity from these displaced fat cells can also cause insulin resistance. Heart cells have been shown to die from fat toxicity and in the pancreas the insulin-producing cells can be killed by fat toxicity as well causing diabetes or making existing diabetes worse.

5. Interestingly another line of research, namely researching binge drinking, has revealed that there is a short-term insulin resistance that lasts for several days until the alcohol has been properly metabolized. It is of concern that adolescents who are experimenting with binge drinking are very vulnerable to develop brain damage from this habit.

Consequences of insulin resistance

We know that insulin resistance is the cause for adult onset, type 2 diabetes. It is entirely preventable. But there are powerful influences on people’s lives that will allow one or more of these factors mentioned to cause diabetes. The most common cause is putting on excessive weight. The reason for this is that people like to eat fast foods, drink sugar-containing sodas, and feast on processed foods, bagels and cookies. The end result is a change of the metabolism with an increase in triglycerides from the liver, an increase in LDL cholesterol, particularly the very low-density lipoprotein sub fractions of cholesterol. It has been known for some time that this is the connection to the high, premature death rates from heart attacks in diabetics, in people with obesity and in people with the metabolic syndrome. Hardening of the arteries is accelerated by the deposition of foam cells in the walls of arteries. These are scavenger cells (macrophages) that have engulfed noxious fats. This leads to narrowed coronary arteries and also a general narrowing of arteries all over the body including the brain vessels. In diabetics hardening of the arteries is accelerated and leads to premature strokes, heart attacks and heart failure, kidney failure, blindness and amputations of limbs.

Important tests for borderline diabetics

I you have a fasting blood sugar that is above 100 mg/dL (5.5 mmol), but less than 126 mg/dL (7 mmol) you are considered to be prediabetic or “borderline diabetic”. In this case rather than waiting for disasters in terms of cardiovascular disease, take action and ask your doctor to do the following three tests.

a) Arrange for a glucose tolerance test where you are given 75 grams of glucose; then blood tests are taken at one, two and three hours after this challenge dose. These blood tests are checked for blood glucose levels and insulin levels and tell the doctor exactly what is going on in terms of your sugar metabolism. It shows the glucose clearance and also the insulin response from your pancreas.

b) Have a hemoglobin A1c test done: it shows how your blood sugars have been controlled over the last 2 to 3 months.

c) You also need a VAP (vertical auto profile) test, which tests your lipid profile. Both prediabetics and overtly diabetics have been shown to have lipid profile disorders. Apart from low values in sub fractions of HDL cholesterol this test will also measure the very-low density lipoproteins (VLDL), which has been shown to be responsible for heart attacks and strokes.

With these three tests your doctor can  tell you more accurately what treatment protocol you require to succeed in controlling or curing your pre diabetes or diabetes.

Conventional treatment of diabetes

The conventional treatment of diabetes is to send the patient to a dietician, to ask the patient to do regular exercises and to either start them on hypoglycemic drugs or on insulin injections. Unfortunately the dietician often will encourage the patient to eat “healthy multigrain bread”, which will stimulate your taste buds to eat more sugar, high fructose corn syrup and starchy foods making weight loss impossible. Often the treating physician is satisfied that a hemoglobin A1c of 7% or less is good enough for the diabetic. But non-diabetic people have a hemoglobin A1c of 4% and 5.6%. This should be your goal or you will suffer the consequences of uncontrolled diabetes.

This is what I would call the conventional, symptomatic treatment approach. This may be the approach for patients who are not willing to seriously change their lifestyles, but it is more powerful on the long-term to treat diabetes by treating the underlying causes.

Alternative treatment approach for diabetes

Based on the above discussion regarding the various causes of insulin resistance, it is important to analyze what would be the main contributory factors in your particular case of diabetes.

Here are some suggestions:

1. If you are on the typical North American diet, also known as Western diet, it would be important to face the fact that wheat, wheat products in processed foods and sugar including high fructose corn syrup are the main culprits in stimulating your appetite and making you a sugar and wheat addict. Ref. 2 describes this in detail and offers 150 recipes to overcome this addiction. For more information just follow this reference text. Essentially it is a wheat-free Mediterranean type diet without rice, pasta and bread. You will shed significant amounts of pounds within a short period of time and feel a lot more energetic (due to revitalization of your mitochondria). At the same time insulin resistance is disappearing, because the insulin receptors are fully functional again. The insulin production of the pancreas will go down to normal levels and fat from the visceral fat storage gets melted away resulting in less inflammatory substances circulating in your blood.

2. A regular exercise program in a gym with an aerobic component (30 minutes of treadmill for instance and 20 to 30 minutes of isometric machine exercises) will help you to lower the triglycerides, and increase the healthy HDL cholesterol. It will also improve insulin sensitivity and control inflammation in your body. The best is to exercise 7 days per week. Remember your body works for you 7/7 every week, but for those of you who need a little rest in between 5 days per week is still very good. You may have to adjust your medication and insulin dose downwards, ask your physician about that.

3. Cut out alcohol. This may sound radical to you, but studies show this to be true. I have not mentioned cutting out smoking (it is causing inflammation and insulin resistance), because this is an absolute must that is given. When it comes to alcohol, the famous 1 drink per day for cardio protective purposes may not show up statistically as a bad effect, but your body will nevertheless get the message and let you age somewhat faster than a person who stays sober all the time. Staying sober will allow your brain to think clearly and adhere to your overall lifestyle approach in treating diabetes. Cutting out alcohol protects your brain (including the hypothalamus), liver and pancreas and prevents the prolonged periods of insulin resistance mentioned above that last for days. By keeping your hypothalamus in good working order, your hormone balance will stay stable for as long as possible until you reach menopause (for women) or andropause (for men). When you reached this milestone, I suggest you engage in bioidentical hormone replacement, which I have reviewed here. Hormones are essential to keep you younger for longer.

4. It is useful to monitor your blood sugar with a home glucometer, as this will show you when your blood sugar normalizes. Stay in touch with your doctor at all times, as this will help you in your overall management of your diabetes. Also, you will want to discuss with your doctor that you should have a blood tests called “hemoglobin A1c” measured every three months to see how well your diabetes is controlled. It should be below 7% for sure, but better below 6%. Non-diabetic people have levels of 4% and 5.6%. You may not know that hemoglobin A1c is actually measuring the amount of advanced glycation end products (“AGE”) of red blood cells. These AGE substances essentially are firmly bound sugar/protein compounds that shut down the cell metabolism wherever they are formed. In my opinion it is best to aim at a hemoglobin A1c level of non-diabetic people (4% and 5.6%) to avoid the consequences of tissue damage of all vital organs, which is the reason why long-term diabetics have a life expectancy of 15 to 20 years shorter than non-diabetic persons. Some diabetic patients may benefit from the oral hypoglycemic drug, metformin (brand name: Glucophage), which has anti-inflammatory properties and is used in patients with type 2 diabetes and a high fasting insulin level, but this is a decision requiring your physician’s input.

5. Supplements: There are some supplements that are useful to take as an adjunct, like chromium, which helps insulin to transport glucose into the cell; alpha-lipoic acid, an antioxidant, which is useful to prevent glycation (formation of a complex between sugar and protein, which prevents normal cell functioning); and coenzyme-Q10, which supports your heart (A4M recommends 400 mg per day, higher than Dr. Weil’s link). Other supplements of merit are curcumin, cinnamon, genistein and silymarin (standardized extract of milk thistle), which suppresses a pro inflammatory molecule, which in turn helps to fight insulin resistance (Ref. 1). Omega-3 fatty acid supplements are anti-inflammatory and will improve insulin resistance as well (dosage 1000mg or more per day). According to Ref. 3 vitamin D3 is useful as a supplement for diabetics, because it activates DNA, is involved in cellular repair and deficiency of it is known to lead to higher mortality rates in diabetics. Ref. 3 recommends between 1000 and 4000 IU of vitamin D3 daily and suggests doing blood tests to measure effective vitamin D3 levels (keep 25-OHD in the blood between 30 and 80 ng/mL).

6.Patients whose pancreas no longer produces insulin will need insulin injections, but instead of using long-acting insulin once per day the best results in getting blood sugar control is by injecting insulin three or more times per day using short acting insulin. It is important to always monitor the blood sugar lowering effect by glucometer readings; the injections are best given just before meals (recombinant human insulin is the preferred insulin to be used). Ask your physician or diabetic coach for more details.

Conclusion

Diabetes used to be a dreadful disease that caused premature heart attacks, strokes, blindness, kidney failure, and limb amputations. With aggressive management of diabetes as well as strict lifestyle intervention this has changed. A diabetic who treats the causes of the illness can have a normal life expectancy. In many cases the initial diagnosis of type 2 diabetes can disappear, when treatment was started early enough and insulin resistance could be stopped in its tracks. Without the patient’s full co-operation disciplining him/herself to follow through on all of these recommendations the caregiver will fail in controlling the patient’s diabetes. It is the patient who owns the problem; it is the patient who needs to make every possible effort and follow through on all of the details of dieting, exercising, blood sugar monitoring using a glucometer and taking the required supplements.

More information on diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference

1. http://www.lef.org/magazine/mag2013/oct2013_2013-Keystone-Diabetes-Symposium_01.htm

2. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

3. Rakel: Integrative Medicine, 3rd ed. © 2012 Saunders. Integrative Therapy; Supplements.

Last edited Dec. 17, 2014