Dr. Fung’s Quick Start Guide to Diabetes Reversal

Dr. Fung is a nephrologist and huge advocate of intermittent fasting. He has an article over at DietDoctor that you may find interesting (link below). Beware: at the link you will find an accurate photo of a gangrenous foot that you may find nauseating or disturbing.

I see gangrene in the hospital once a month. It’s one of the things that keeps me motivated to help PWDs (people with diabetes) learn to conquer diabetes.

Another caveat. If you take drugs that have the potential to cause hypoglycemia, you may indeed suffer life-threatening hypoglycemia if you drastically cut back on sugar and other refined carbohydrates. You better know what you’re doing.

Dr. Fung writes:

“Once we understand type 2 diabetes, then the solution becomes pretty bloody obvious. If we have too much sugar in the body, then get rid of it. Don’t simply hide it away so we can’t see it. There are really only two ways to get rid of the excessive sugar in the body.

  1. Don’t put sugar in [nor refined starches]
  2. Burn it off

That’s it. That’s all we need to do. The best part? It’s all natural and completely free. No drugs. No surgery. No cost.”

Source: How to Reverse Type 2 Diabetes – The Quick Start Guide – Diet Doctor

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New Evidence Supports Extreme Carbohydrate Restriction in Type 2 Diabetes

Low-Carb Spaghetti Squash With Meat Sauce

Diabetes is a disease of carbohydrate intolerance. Doesn’t that suggest to you that diabetics should reduce or avoid dietary carbohydrates?

The new study at hand was done in Indiana, involving 262 folks with type 2 diabetes. Characteristics of the study subjects:

  • average age 54
  • 66% women
  • BMI 41 (very fat)
  • average Hemoglobin A1c 7.6%

The authors don’t use the term “ketogenic diet,” preferring instead “a diet designed to induce nutritional ketosis” (I’m paraphrasing). For most folks, that’s a diet with under 30 grams of carbohydrate daily, according to the researchers. The study lasted for only 10 weeks.

The drop-out rate was about 10% (25 participants), which is not bad.

Results:

  • Hemoglobin A1c (a test of diabetes control) dropped to 6.5%, a move in the right direction and equivalent or better than that seen with many diabetes drugs.
  • Average weight loss was 7.2% of initial body weight.
  • No severe symptomatic hypoglycemic events.
  • Number and dose of necessary diabetes drugs were reduced “substantially.”

What’s not to love? Why isn’t this the standard of care?

Click the link below to look for details of the Virta Clinic program used in this study.

I put together a Ketogenic Mediterranean Diet for my patients with diabetes. It reduces dietary carbs to 20-30 grams/day. There’s a free version, but consider the low-cost version that includes recipes and extensive initiation and management advice.

Steve Parker, M.D.

McKenzie AL, Hallberg SJ, Creighton BC, Volk BM, Link TM, Abner MK, Glon RM, McCarter JP, Volek JS, Phinney SD
A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
JMIR Diabetes 2017;2(1):e5
DOI: 10.2196/diabetes.6981

low-carb mediterranean diet

Front cover of book

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Filed under Carbohydrate, Drugs for Diabetes, Weight Loss

Upcoming Changes

I need to reach more people. Last fall I tripled my blogging frequency and it did nothing to increase viewership. I plan to cut back on written blogging and Tweeting, but will be doing more videos. It’s an experiment.

I’ll try to keep all videos under six minutes out of respect for your time.

This video mentions the topics I’ll be covering. If they sound interesting, please subscribe to the pxHealth YouTube Channel.

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How Walter White lost weight in “Breaking Bad”

Raw Brussels Sprouts, one of many low-carb vegetables.
Photo Copyright: Steve Parker

In 2014 Howard Stern interviewed Bryan Cranston and asked how he lost weight so quickly for his role as Walter White on Breaking Bad:

“Stern: When you had chemo and was getting sick playing the part of Walter White, in order to go through rapid weight loss you deliberately didn’t eat for 10 days? True or false?

Cranston: False.

Stern: How’d you lose all that weight?

Cranston: No carbohydrates. I just took out all the carbohydrates.

Stern: How much weight did you drop?

Cranston: 16 pounds, in ten days.

Stern: Painful?

Cranston: No. The first three days are really hard, ’cause your body’s changing and craving sugar and wants, you know, and then you deprive it of the sugar and it starts burning fat.”

Source: How Walter White lost weight in Breaking Bad, it wasn’t chemo – High Steaks

h/t Tom Naughton

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Karl Denninger Says He Can Cut Medicare’s Budget by 25% With One Simple Measure

Karl’s no physician, I don’t even think he has diabetes, but he’s a smart guy:

“You simply have to allow me to make the following policy change with regards to one disease — Diabetes:

  • For those with Type II diabetes we will provide unlimited metformin (cheap, off-patent generic medicine that costs pennies a day) to anyone with the disease.
  • We will provide no other care of any sort for Type II. You want or “need” it, pay cash or die. Period.
  • We will also make changes to how we deal with Type I diabetics’ insulin requirements, as detailed below, that will cut said requirements dramatically.

Now before you scream in horror that I’m a monster, listen up.

Instead of medicine and, inexorably, amputations, dialysis, hospitalization and death we’re going to prescribe a lifestyle of eating no more than 50g of carbs a day, all in green vegetables high in vitamin C (e.g. broccoli, brussels sprouts, etc.)

Caloric intake is to otherwise be 70% saturated (animal) fat and 20% protein. Sugars, grains and starches, including but not limited to “white” foods (pasta, potatoes, breads, etc) are all prohibited. Zero-calorie / zero-carb spices and condiments are unrestricted, of course.

In short you eat (and don’t eat) what’s described in this post, less the fruits (since they are all fairly high-glycemic and the vitamin C requirement is taken care of.)

For most Type II diabetics eating this way will reduce their need for other drugs, including insulin, to a literal zero and since their blood sugar will normalize their need for many-times-a-day testing will also disappear, getting rid of both the pain of sticking one’s finger repeatedly and the cost.

For those who it doesn’t the metformin is there to help.

We will also accommodate all actual, documented exceptions — that is, those people for whom this lifestyle change legitimately doesn’t work.

Those who claim “it doesn’t work” will be locked in an isolation ward where they will be fed that diet for two weeks (with no access of any sort to any other source of sustenance) and be able to prove that for them, individually, it doesn’t work. If they’re right then they will get whatever medication or other intervention is necessary provided they keep to the lifestyle change. But if that empirical test shows that it does work (and it will for virtually everyone) then their ass will be discharged, the fact that they refuse to change what they eat will be noted in their chart and further complaints of “impossibility” will be ignored.”

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Mediterranean Diet With Extra Olive Oil May Prevent Breast Cancer

From my pantry...

From my larder…

A Mediterranean-style diet with supplemental extra-virgin olive oil seemed to reduce the incidence of breast cancer in a Spanish population. This is consistent with prior observational studies that link the Mediterranean diet with lower rates of breast and other cancers (colon, prostate, uterus, and melanoma).

The study population involved 4,000 women who were followed for five years. Thirty-five new cases of breast cancer occurred in this PREDIMED study sub-analysis.

The comparison diets were a reduced-fat diet and Mediterranean diet supplemented with mixed nuts.

This is a relatively small study, so results may not be entirely reliable.

Action Plan

If you’re a woman hoping to avoid breast cancer, consider the Mediterranean diet and be sure to eat plenty of extra-virgin olive oil. A good way to do this is to use home-made vinaigrettes.

Steve Parker, M.D.

PS: Even if you think Spaniards are jovial, you won’t find any in my books.

Reference: Mediterranean diet and invasive breast cancer risk among women at high cardiovascular risk in the PREDIMED trial. JAMA Internal Medicine, 2015. doi: 10.1001/jamainternmed.2015.4838

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DPP-4 Inhibitors Increase Risk of Pancreatitis

…although the risk of getting pancreatitis is pretty small in any case.

DPP-4 inhibitors are sometimes called gliptins. They’re used to treat type 2 diabetes.

From Diabetes Care:

“CONCLUSIONS Treatment with gliptins significantly increased the risk for acute pancreatitis in a combined analysis of three large controlled randomized trials.”

Source: Diabetes Care

Speaking of risk reduction, lower your risk of being prescribed a gliptin by reducing your carbohydrate consumption.

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Mediterranean Diet Limits Weight Gain in Adolescents

"I may not make wine with all of my grapes, but when I do, it's red wine."

“I may not make wine with all of my grapes, but when I do, it’s red wine. Don’t give it to children.”

Overweight and obesity are increasing in U.S. adolescents, which may hamper their health as adults. In fact, some experts predict that we will see a decrease in average life expectancy because of lifelong excess weight.

Youths who follow a Mediterranean diet pattern don’t see as much increase in body mass index as others.

From the International Journal of Obesity:

“Among adults, the Mediterranean dietary pattern (MDP) is inversely related to body mass index (BMI) [i.e., as the Mediterranean diet is followed more closely, we see less increase in body weight.]. Data are lacking on adherence to the MDP among youth in the United States and whether the MDP is related to weight change in that group.”

Now we have some data, and it looks good for the Mediterranean diet.

In other words, if you want to keep your kid from getting fat, the Mediterranean diet will help. Fo you adults, the Low-Carb Mediterranean Diet also helps control diabetes.

Source: International Journal of Obesity – Abstract of article: Adherence to the Mediterranean dietary pattern and BMI change among US adolescents

Steve Parker, M.D.

low-carb mediterranean diet

Front cover of book

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I Told You So: Low-Carb Diets Help Control Diabetes

Reviewers at London Metropolitan University wondered if carbohydrate restriction was a legitimate approach to controlling diabetes. No surprise to me, they conclude that it is:

“A carbohydrate restricted diet can provide a safe and effective solution for improving diabetes management and should have a place within the diabetic guidelines. The diet was effective in reducing postprandial hyperglycemia and glycaemic variability resulting in low levels of glycaemia without the risk of hypoglycaemia. The ability of the diet to reduce the symptoms of dyslipidemia is of particular importance and when compared to the traditional low fat diet for weight loss, the low carbohydrate diet was comparable and in some instances better. There were significant reductions or cessation of diabetic medication reported throughout the literature alongside a reduction in the psychological aspects of living with a long-term disease. It is possible that the current dietary advice may actually accelerate beta cell exhaustion with elevated blood glucose diminishing the islet cells ability to produce insulin.”

Action Plan. But it’s expensive: $16.95.

low-carb mediterranean diet

Front cover of book

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Which Cancers Does Exercise Prevent?

Needs a bit more hormetic stress

“Would you spot me, bro?”

I’ve always assumed that exercise reduces the risk of cancer, contributing to the well-established fact that folks who exercise live longer than others.

But a recent study found a positive association between exercise and two cancers: melanoma and prostate. “Positive association” means the more you exercise, the higher your risk of melanoma and prostate cancer (if you have a prostate).

The good news is that exercise was linked to lower risk of 13 other cancers.

Here’s a quote for the New York Times Well blog:

The researchers found a reduced risk of breast, lung and colon cancers, which had been reported in earlier research. But they also found a lower risk of tumors in the liver, esophagus, kidney, stomach, endometrium, blood, bone marrow, head and neck, rectum and bladder.

And the reductions in risk for any of these 13 cancers rose steeply as people exercised more. When the researchers compared the top 10 percent of exercisers, meaning those who spent the most time each week engaging in moderate or vigorous workouts, to the 10 percent who were the least active, the exercisers were as much as 20 percent less likely to develop most of the cancers in the study.

I’m surprised the protective effect of exercise against cancer wasn’t stronger.

Action Plan

So how much physical activity does it take to prevent cancer? And what type of exercise? We await further studies for specific answers.

I’m hedging my bets with a combination of aerobic and strength training two or three times a week.

Steve Parker, M.D.

PS: If you think cancer’s bad, read one of my books. Wait, that didn’t come out right.

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