Pre-diabetic musings

prediabetesI got a rude awakening last week. I had taken just maybe my most comprehensive blood test ever. Disturbingly, my A1C was 5.9, although my fasting glucose was 96.

I’ve known for two years I’m pre-diabetic, but 5.9 is a new threshold for me. Not long ago, through careful eating and nearly daily elliptical machine stints, I had whittled it down to 5.4, though I admit my previous scores have nearly always been from finger sticks rather than lab tests, which my endocrinologist says are more accurate.

Anyway, I’m scratching my head, asking myself, What’s going on? Why should I be even pre-diabetic?

Hey, I’m slender at 175 on a 6’1 frame.

I’ve been a vegetarian for 18 years; in fact, nearly vegan.

I’ve been careful to avoid foods with high sugar content–pastries, cakes, candies, etc.

I don’t eat much fat, at least the bad kind like saturated and trans. I admit, however, to liking nuts. (I eat about 4 ounces daily, mainly to keep my weight up, especially as I’m trying to reduce carbs, the main source for blood sugar and weight gain.)

My nemesis, I think, has been indulging in starchy foods, especially In restaurants, compounded by their normally large portions. I used to have trigs in the 150 range. Giving up potatoes, I find my trigs have stayed below 100. Potatoes, like other starchy foods, are a high GI food, meaning they turn into glucose quickly.

At home, I still indulge in other starches–pasta, rice, and bread–though I always follow the formula for whole wheat sources only and brown rice.

While unrefined grains have lower GI and GL, they can peak your blood sugar several hours later, so you need to check your glucose beyond the usual two hour post meal regimen

My thinking is that if I can eliminate the grains, I can reduce the glucose. But I also know l like these foods so much that I haven’t watched my portions.

It would be easier in all of this if if had the usual excess weight problem. Eighty percent of diabetics do, and when they shed the pounds, the blood results can be impressive.

Skinny diabetics have twice the mortality rate of heavy diabetics. No one really knows why.

The problem with such diets is that confining yourself to greens and beans gets old really fast.

Before closing, I want to mention a recent book on diabetes by endocrinologist Sarfraz Zaidi, called Reverse Your Diabetes. It recommends a five step approach, which includes overcoming stress and using key supplements in addition to the traditional lifestyle changes through diet, exercise, and medication as needed.

His section on supplements is the best I’ve come upon in books dealing with diabetes, with extensive reviews, backed with research findings. Zaidi focuses on reducing insulin resistance foremost in managing diabetes and argues some supplements can help.

I found his take on vitamin D especially good in keeping with his wisdom throughout the book. He points out how the effects of vitamin D are “astounding,” extending to all the organs.

Low vitamin D contributes to insulin resistance.

Nearly all Type 1 and Type 2 diabetics show vitamin D deficiency.

In a landmark Finnish study (2001), later published in the prestigious medical journal, Lancet, children receiving 2000 IU of vitamin D in their first year were then tracked for 31-years for the development of Type 1.

These children showed an 80% reduction in risk for developing Type 1 compared to other children not given vitamin D supplements.

As for Type 2, while being sedentary, obese and over 65 contributes substantially to developing diabetes, all of these factors contribute to vitamin D deficiency as well.

This doesn’t mean that overcoming vitamin D deficiency will right your diabetes, but it can help reduce insulin resistance and thus help you manage it better.

If you’re pre-diabetic like me, there are extensive studies, Zaidi says, that suggest it can help prevent full blown diabetes up to 50%

Though not everyone may agree with Dr. Zaidi, I find his extensive review of the research on vitamin D compelling.









Say it isn’t so: Fast foods in hospitals

Cleveland Clinic
Cleveland Clinic

A McDonald’s in a hospital cafeteria? Say it isn’t so!

According to McDonald’s, it has 27 franchises In hospitals.

One of them is in the world renowned Cleveland Clinic, in the top tier for treating heart disease and former home base of Dr. Caldwell Esselstyn (Prevent and Reverse Heart Disease).

This isn’t to say the Clinic hasn’t tried to rid itself of this glaring contradiction to its public embrace of lower fat and sodium foods. While it succeeded in shedding Pizza Hut, McDonald’s remains out of contractural obligations agreed to more than a decade ago.

The watchdog Physicians Committee for Responsible Medicine (PCRM) did a survey of 110 hospitals across the country and found that some of them feature as many as 5 fast food outlets:

The Five Worst Hospital Food Environments

St. Luke’s Episcopal Hospital/Texas Heart Institute/Texas Children’s Hospital Complex (Houston, Texas) 4 fast-food outlets and fried-chicken bar in the cafeteria

Medical University of South Carolina University Hospital Complex (Charleston, S.C.): 5 fast-food outlets and a cafeteria serving country-fried steak and other high-fat fare.

Naval Medical Center San Diego Hospital Facility Complex (San Diego, Calif.):3 fast-food outlets; patients order from menu featuring pork chops, meatball sandwiches, and other high-cholesterol fare.

Duke University Hospital Complex (Durham, N.C.): 3 fast-food outlets; patients order from cafeteria menu featuring spicy pork loin and other high-fat items.

Children’s Memorial Hospital Complex (Chicago, Ill.): 1 fast-food outlet; patients’ menu has chicken wings, quesadillas with bacon, and grilled hot dogs.

 McDonald’s says it offers a diversified menu that offers many options like salads.

Bull shit!

There are 14,000 McDonald’s in the U. S. Not one of them offers offers a veggie hamburger (unlike in Europe where it’s a government mandate)!   By the way, of all the fast food franchises in the U.S. and Canada, only Burger King offers a vegetarian burger, though it comes with a white flour bun.

Unfortunately, while some hospitals are trying to rid themselves of these outlets, others are adding still more, according to National Public Radio:

 Chick-fil-A recently set up shop in several facilities, including the Texas Medical Center’s St. Luke’s Episcopal Hospital and the Medical University of South Carolina University Hospital in Charleston, S.C. (Elana Gordon, April 2012).

 (We already know about Chick-fil-A’s strident anti-gay bias.)

Let’s face it: Fast foods are a money maker for some hospitals, quite willing to betray their ethics–forfeiting the well-being of their constituents along with it–for the wrong kind of green.

Perhaps we shouldn’t be all that shocked by such blatant hypocrisy, considering medicine’s Faustian trade off with Big Pharma. (See “Doctors And Hospitals Raking In Billions From Big Pharma, Huge Data Trove Reveals”:

But that’s another subject for another day.











Combating the new global killers

The UN’s World Health Organization (WHO) has just announced that heart and lung disease, cancer, and diabetes are responsible for 63% of deaths globally. That surpasses the former number one killer, infectious diseases. WHO attributes the high mortality to largely preventable sources such as smoking, sedentary living, and faulty diet. In the West, Australia ranks first in heart and cancer mortality (35% heart; 20% cancer). 17 % of Australians smoke and a shocking 64% are obese. Unfortunately, Americans top the obesity scale, with some 71% of us overweight.  Global Burden Chart

One noticeable observation is that even third world countries are experiencing rising heart and cancer mortality, as their diets increasingly incorporate meat and daily products. Back in the 80s when noted Cornell nutritionist T. Colin Campbell made his blockbuster study of rural Chinese diets, heart disease and cancer were rare among those consuming an entirely plant based diet. The study’s empirical evidence has been confirmed in analyses differentiating Chinese immigrants and their offspring in the U. S. Americanized Chinese exhibit the same high incident rate for heart disease and cancer as the general population.

The real culprit here is animal protein, not fat per se. To avoid these chronic diseases the world needs to shift to a plant based diet. Studies give convincing evidence that doing so not only lessens the occurrence of heart disease, but often reverses it. Cancer incidence also decreases.

Ironically, our current health system contributes to our declining health with its continuing endorsement of a daily 30 gram fat content, low fat meat, fish, poultry, and dairy foods. Some doctors are downright defiant of plant diet research. Dr. Eduardo Azap, president of the Union For International Cancer Control, debunks the notion that “cancer is a problem of rich countries” as “a misconception” (Chronic Killers).  And yet when you look at WHO’s own listing, Ethiopia, for example, has a 4% cancer mortality rate; India, 6%. Contrast this with the U.S. 23% cancer mortality rate. It isn’t that we eat too much; it’s that we eat the wrong food.

Consider Harvard’s School of Public Health recently released alternative to the USDA’s MY Plate diet. Harvard’s plate seeks to offer more specific nutritional guidelines under the same USDA categories: fruits, vegetables, grains, and proteins. Nonetheless, the Harvard plate still recommends poultry and fish as good food sources, albeit, Harvard does make some helpful suggestions, for example, recommending whole grains in place of refined grains found in foods such as white bread and while rice, which contribute to heart disease and type 2 diabetes. It also makes a bold breakthrough in recommending water over milk.

Concurrently, an independent panel of 22 health experts (nutritionists, dieticians, cardiologists among them) reviewed 20 popular diets, with the Dash and Ornish diets finishing 1 and 3 respectively under Best Heart-Healthy Diets. Dr. Ornish advocates a virtual vegan diet that strongly resembles those proposed by Drs. Campbell, Mcdougall, Esselstyn and Fuhrman, stalwart pioneers with convincing empirical data behind their advocacy of a plant based diet in combating heart disease and cancer.

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