Want to lose weight and get healthy? Nutrient-dense foods.

Are you ready to Eat to Live?

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Maybe he’s just another hawker wanting to sell books or sit next to Oprah, or maybe he’s got it right. Joel Furhman is a doctor and up and coming weight loss healthy eating guru. I’m now reading one of his earlier books, Eat to Live, from 2003 and here’s his proposition in a nutshell: Make the overwhelming bulk of your diet nutrient-dense foods and you’ll avoid disease, particularly heart disease and cancer, your diabetes’ symptoms may go away if you’re type 2, your blood pressure and cholesterol will lower and you’ll lose weight and maintain a “normal” body weight. Furhman says most of our weight, ills and diseases come from our (profit-making-big-business) unhealthy American diet which is high in fat, refined carbohydrates and calories and low in nutrient-dense foods, leaving us hungry, unsatisfied, fat and unhealthy.

Further, our most recent mania to control portions is like putting a band-aid on a levy that’s bursting; limiting our portions of non-nutritive food may cut some calories but it still leaves us nutritionally deficient with over stimulated appetites. He says if you have type 2 diabetes you can eradicate insulin resistance using his eating plan, if you have type 1 you can dramatically lower your insulin requirement. And I believe him. It seems common sense to me that the over-processed, packaged, chemically-formulated and steroid-pumped, refined junk we eat causes weight gain and disease.

Furhman just hates the food pyramid the U.S. Department of Agriculture rolls out each year and proposes one of his own. Drum roll please: our personal food pyramid’s bottom, the foundation of our diet, should be built on vegetables and leafy greens, then fruit, beans and legumes, whole grains, with the top of the house giving us a trickle of non-fat diary, animal protein and healthy fats derived from foods like nuts and avocado. If you think you’ve heard this a million times, his USP (unique selling proposition) is he rates foods according to their nutrient density. Something by the way is going to soon make an appearance in supermarkets. But what I found compelling was Furhman’s forceful argument, continue to eat unhealthy foods and your sickening yourself every day, want to truly “fortify” yourself against disease? Do it with food, not drugs. Highlights from his book:

1. Olive oil is not the miracle drug we all thought, 97% of its fat will go straight to your hips so use it limitedly.

2. Leafy greens like salad greens and green vegetables are 1/2 protein, 1/4 carbs and 1/4 fat. Who knew? You don’t need to eat a side of beef to get enough protein if you’re eating lots of veggies.

3. If you’re eating a diet rich in fresh fruits and veggies you’re getting enough water. 8 glasses a day, fugedabout it, 3 is plenty!

4. Furhman agrees, don’t be fooled be foods that say “fortefied.” A spray of folic acid won’t do it.

5. Animal protein whether white, as in chicken or red, as in beef is equally disease causing. Fish is better but even fish should only be eaten 2xweek and mercury-free.

6. Don’t worry about getting the right mix of veggies and beans etc. on your plate to get your protein covered, eat this healthy way and you will.

Mind you, always, any significant change in your eating plan may create a change in your blood sugars, which means a change in your medication–and I guarantee you if you follow this plan you will definitely need less medicine, whether you’re on orals or insulin. So, be alert and discuss this with your health care provider. If you have a condition like kidney disease you may not be able to eat enough veggies, fruits, nuts and legumes for this to work for you, so please don’t undertake this without consulting with a professional. Also if you have vitamin or mineral deficiencies talk with a professional before making any dietary changes.

You might call this a super-charged slightly left of center vegetarian eating plan, but many vegetarians rely on refined carbs and saturated fats like pasta, crackers, pretzels and cheese, which are not nutrient-dense, whereas this plan is mostly vegetables, fruits and beans. Whole grains, healthy fats and animal protein are parceled out according to your weight loss goals.

Of course, restaurants and social outings are harder to maneuver than home cooking, so he proposes using outings as a time when you indulge a little. If you’re living in this century, time is the other nasty. Who has much time to shop and prepare vegetarian meals? Furhman offers recipes, but darn, somebody’s got to make them. I mostly do the simplest thing: steam an assortment of fresh veggies every night for dinner, lunch is a spinach salad with beans, left over veggies from the night before and a little feta cheese. Breakfast is steel cut oats.

If you want to really get healthier and drop some pounds read the book, try the diet and see what you think. Wouldn’t it be remarkable to shed those 20 pounds forever, really feel full and satisfied, and watch your health transform, including your energy and outlook?

End note: I will be away this week at the American Association of Diabetes Educators annual conference in Washington D.C. I am not an educator or any other type of medical professional, merely a lay person interested in knowing what educators are learning, talking about, being taught, where their struggles are with patients, what they see for the future and will let you know.

Would you change what you eat if you considered food medicine?

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Want to get healthier? Eat better? Feel fitter? Have your “numbers” more in line with where they should be? Try this: look at what you eat as medicine, each morsel providing the nutrients that either increase your health or decrease it, because actually it does.

I’m not advocating that you can’t eat a plate of French fries or a bowl of ice cream, but I am suggesting that if you approached what you eat differently, that everything you eat is either making you healthier or having the opposite effect, would you make healthier food choices?  While vitamin and mineral supplements are useful, particularly for certain conditions, they are not quick fixes or substitutes for a healthy diet. In fact they’ve been shown to be less healthful than eating the real food that contains them because supplements contain only one trace element extracted from a whole host of nutrients that work together in the foods where they naturally exist.

Also, I have to say the notion of “fortifying” foods is somewhat misleading. It leads us to believe those foods become super healthy, but you can’t spray a nutrient on basically white bread (with a little caramel coloring or tablespoon of whole wheat flour and call it whole wheat bread) and then tell people it’s uber healthy. I firmly believe, in case you haven’t gotten it yet, that what we eat, along with physical activity and our genetics forms the building blocks of our health.

I got to wondering whether it would inspire us to eat healthier if we considered food medicine the other day when I got my annual report from my endo: A1C, cholesterol, triglycerides, microalbumin, blood pressure.

I sat across the desk from my doc shrouded in worry, I always find these things worrisome, and then found out that I’m fit as a fiddle. My A1c is in the 5’s, my HDL (good cholesterol) is as high as my LDL (bad cholesterol), my microalbumin which is supposed to be under 30 is 0.3 and on and on, one great result after another. My doctor, in fact, needing to fax my A1c report to the group I do the A1c Champion presentations for wrote on his report patient in “excellent control.”

Seeing “excellent control” I had a flash of insight why I’m in excellent control–my numbers are by and large the direct result of what I put in my body, and what I don’t, and that I walk an hour a day. I translated “excellent control” not merely into blood sugar as he meant it, but something bigger: my overarching diet and exercise routine.

Everyone with diabetes keeps hearing the mantra, “diet and exercise” and I really got it in that moment, yep, it makes all the difference. But diet doesn’t mean low calories, or the debate between low carbs and low fats: it means healthful, nutrition-rich foods, which are basically vegetables, grains, fruits, beans, and a bit of the rest, largely unrefined foods and where fats are concerned the healthy ones.

I’m not discounting the role genetics plays, you may be more prone to one thing or another based on your genes. I’m on synthroid for my underperforming thyroid, my thyroid failed me at exactly the same age it happened to my mother.

And, while my HDL is 105 and my LDL is 106, some would say my LDL should be lower, like 70 often quoted as the target for diabetics. I in fact think it should be lower as a result of my diet, but I know it’s 106 because of genetics, both my parents have high cholesterol. But genes are often triggered by our poor diets.

I’m also not saying in considering your diet as medicine that there’s no room for fried calamari, bread sticks or a piece of incredibly delicious New York cheesecake, but consider that a day you skip your meds and know that the bulk of what you put in your body on a daily basis forms the health of your bones, your blood, your tissue, the foundation that you rest upon, and if you put in whole and wholesome foods, you know the ones that grow out of the ground and on trees, your house is going to stand on a stellar foundation.  Whereas when we stuff ourselves with less healthy foods, lots of sugar and fat, refined carbs and animal protein, rather than plant protein, we cause inflammation of our body’s tissues, the stimulus for disease and premature aging.

Too many people are eating weak, not nutrient dense, foods and believing that “fortified” on a product label is the seal of approval. The real reason portion control has become so big is we’re eating the wrong things and rather than pushing the right foods, some self invested organizations are trying to solve the problem by limiting the amount of bad things you eat. In the end, this is not the solution.

If there’s room for you to do better with your “numbers” those target ranges for all your vitals, instead of thinking about another medication to add to your regimen, think about what you eat.

I’m not giving any medical advice, or telling you not to take your medication, I’m just saying in addition try viewing the foods and beverages you put in your body, your engine, as either premium, super, leaded or leaded and to for the ones that will give you the most mileage so you’re running like a fine tuned lamborghini. Leafy greens, broccoli, kale, salmon, walnuts, spinach, blueberries, ginger, tumeric, these are not “fortified” foods, these are whole, real foods, and among the most healthful, and I like to think medicinal foods you can feed yourself.

Ask yourself: Would I make healthier food choices if I viewed everything I put in my mouth—well almost everything—as having a high or low rating of medicinal effect? I would, I do, and I can’t go back, not when I’ve seen the results of an ironically fabulously tasty and satisfying “medicinal” diet.

The continued carb debate

It’s really amazing what a muddle we are in over food these days. It’s on our morning new programs every day, nutritionists telling us, “How to eat, what to eat, what not to eat, what children should eat, how to make pancakes that look and taste like brownies…” Weekly doctors, gurus and alternative healers discourse on Larry King Live about diets, non-diets, trans-fats and why Americans are increasingly obese.

In my last entry I wrote about how my low carb diet has helped control my blood sugars and reduce my insulin requirement. I wondered aloud why everyone doesn’t see the logic in less carbs in = less meds in. But, I must admit, having recently picked up a book that takes this to the extreme — The PH Miracle for Diabetes, The revolutionary diet plan for type 1 and type 2 diabeticsby Robert O. Young — that everything is relative. 

Young says diabetes, largely type 2 but I believe he’s including us type 1s, is caused by our body’s overly acidic PH level (the acidity or alkalinity of our internal fluids). Our over acidity, if I understand him correctly, comes from eating carbs. Carb intake causes the body to flood itself with the ‘fight or flight’ hormones: cortisol, adrenaline and insulin, which cause inflammation. Inflammation, which causes corrosion of our body tissues, prompts a too acidic PH level. Sorry, as you might have guessed, chemistry and physics were not my strong suits. Young says we need to make our PH level less acidic and more alkaline, and the way to do this is through a diet largely of vegetables.

Dr. Andrew Weil, alternative medical guru, says many of today’s diseases and health ailments are caused by inflammation and he advocates ananti-inflammatory diet. Even Gary Taubes author of, Good Calories, Bad Calories, says our over consumption of carbs, trans fats and high fructose corn syrup type additives, trigger a genetic predisposition to haywire our hormonal system and cause unsuspecting citizens to put on weight. Taubes says, it is not our over consumption of calories that is making us fat, but this haywire handling of refined carbs and these other ills in our diet. Seems no one can agree on what makes us fat but these three pundits are speaking a similar language about illness.

So, what to do? Several years ago I vacuumed the refined carbs out of my diet. Admittedly, I felt pretty virtuous doing this. But now Young says I should get rid of: coffee, tea, chocolate, alcohol, grains, dairy and exist almost exclusively on vegetables, fish and what he calls his “green drink” — juiced vegetables with some magic powder in it. Hmmm…I suppose if I was forced to do this, I could, but it really doesn’t sound like a happy life. And, given that he says a positive attitude is an important aspect of his eating plan, I’d fail miserably. Tears shedding all over my clothes and furnishings.

Many times people tell me they’d like better blood sugar control. Yet when I mention reducing their carbs they say, “Hey, I’m human, I want to enjoy what I eat.” Well, for me cutting way back on carbs was not a major hardship and I like the return benefit. I’d already cultivated years of cozying up to veggies and cutting back on butter, muffins, fries and white bread. Then, when I restricted my carbs a little more, like not eating grains too often and eating one piece of whole grain toast with my omelet instead of two, it gave me the kind of control that makes it worth it to me.

But, truly, Dr. Young, I must be weak — I just couldn’t go the distance as you propose. Giving up yogurt, cottage cheese, dark chocolate, wine, manchego and gruyere cheese, the occasional fried dish and friend’s birthday cake would be downright unsocial, not to mention aggravating. So it really is up to each of us where we feel the trade-off is worth the return.

There are plenty of case studies in Young’s book where people proclaim following his diet changed their lives, even to the degree that they don’t need any diabetes medication anymore, including insulin. I imagine that’s type 2s talking. While I understand if I didn’t eat anything that raised my blood sugar, I could probably cut out my bolus insulin entirely, my basal insulin is not optional. We still need insulin for various bodily functions. So if this regimen and its possible benefits appeal to you, check it out. I’m not playing advocate here, just reporting the news.

The debate goes on: carbs in or carbs out?

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A friend, and fellow A1c Champion, saw author, Gary Taubes, talk about his new book Good Calories, Bad Calories, a month ago on Good Morning America and sent this email around, “Taubes says that exercise makes us hungry for carbohydrates, not lean, and that carbohydrates cause insulin secretion which creates fat.”  One of her email recipients, who is a Ph.D and medical specialist, wrote back: ‘There is still a lot that we don’t know but for me eating less and moving more has led to my weight reduction. I could have dieted on birthday cake as long as I did not eat more cake calories than I spent.’

It’s a constant debate in this country: What’s the magic formula for losing weight, fast – and easy. The second battle ground, and especially for us d-people, is are carbs good or bad? To me, the answer to both is simple: eat less, move more and since carbs raise your blood sugar, if you want to lower it eat less carbs. Why is that such a difficult notion? Seems crystal clear to me and trust me I’m no rocket scientist.

Around the same time my friend’s email went around, a wicked debate was playing out on DiabetesHealth’s web site. Hope Warshaw, MMSc, RD, CDE, BC-ADM, and diabetes educator, wrote five articles on carbs, Don’t Want to Go Low Carb or Vegan, that garnered more comments than I’ve ever seen in response to an article, and a rebuttal article by Richard D. Feinman, PhD, Professor of Biochemistry and Director of the Nutrition and Metabolism at State University of New York Downstate Medical Center.

In a big nutshell Feinman said, “I’m astonished that experts encourage people with diabetes to eat carbohydrates and then “cover” them with insulin. Why would anyone, (let alone doctors who advocate it every day), recommend a diet that requires more medication?” Are they all in bed with pharma companies? Sorry, that last question is my own.

“It strikes me as odd that what most experts know about metabolism – diabetes is, after all, a metabolic disease,” said Feinman, “they learned in medical school from somebody like me. The first thing we teach medical students is that there is no biological requirement for carbohydrate. It is true that your brain needs glucose, but glucose can be supplied by the process of gluconeogenesis; that is, glucose can be made from other things, notably protein. This is a normal process: when you wake up in the morning, between thirty and seventy percent of your blood glucose comes from gluconeogenesis. There is no requirement for dietary glucose. And, all of the metabolic syndrome ills – high triglycerides, low HDL, hypertension and obesity – are improved by low carbohydrate diets. If we had been describing a drug,” Feinman goes on to say, “everybody would have rushed out to buy stock in our pharmaceutical company.”

I can’t comment on the metabolic workings, but being like most diabetics I can share with you what I experienced when I changed my diet several years ago to low carb. I read Dr. Richard Bernstein’s book, Diabetes Solution, and for the first time read someone advocating getting rid of carbs to control blood sugar. Dr. Bernstein advocates next to no carbs in a diabetic diet.

Himself a diabetic for more than 50 years, Bernstein claims he has reversed many of his early complications and gotten his blood sugar under tight control by virtually eliminating carbs. Less carbs means you’ll be taking less insulin and by taking less insulin, Bernstein claims, your insulin will be better absorbed, there’ll be less variability in its time and efficacy and greater predictability with your blood sugars. Let’s just say after I read his book, I was encouraged and inspired to try his “solution,” so I pretty much vacuumed the carbs out of my diet. “Vacuumed” in the sense that I cut way, way back. I essentially eliminated refined carbs: white bread, white potatoes, rice, pasta, sweets, muffins, starchy veggies. The result? My sugars indeed dropped, were consistently lower, my insulin doses dropped, and maybe best of all I was no longer chasing high blood sugars. You know the ones that come from refined carbs where you just can’t seem to knock them down all day. My Lantus dose went from 20 to 12.5 units and my mealtime Humalog was all but cut in half before each meal. The results were so dramatic and made life so much easier, I have not in five years gone back to my old ways. I do have to add the caveat that we’re all different and your body may not respond the same as mine.

It’s common sense, though, that the less carbs you eat the less your blood sugar will rise and the less medication you’ll need. I don’t understand how anyone can argue the logic in that. If we’re still being given diets with substantial carbs in them it’s probably because the American Diabetes Association (ADA) and powers that be think the average diabetic will never stand for, and won’t be able to, cut the carbs. Not unlike why the ADA’s A1c recommendation is as high as 7 – which correlates with 170 on your meter – even though we’re advised to stay in a target range of 80 – 120. Something sound fishy?

For those interested, here’s my routine that keeps my sugars low. My one carb meal is breakfast. I figure it’s healthy, high fiber, it’s satisfying, and since I walk in the morning, the blood sugar rise gets leveled out. Every morning I make a bowl of slow-cooked, steel cut oatmeal. I know many people who make a batch a week and freeze portions, but I like the morning ritual. I actually eat less than a whole serving and make up the difference with a dollop of low fat plain yogurt or cottage cheese and a tablespoon of peanut or almond butter. Also I add flax seed and cinnamon. For this treat, and like Jerry on Seinfeld I could eat breakfast for any meal, I need 3.5 units of Humalog or 3 if I’m taking my hour walk around my local park. Lunch is generally a spinach salad with feta cheese, tomatoes, beans, left over veggies, or a spinach/feta omelet. For that I need .5 – 1 unit, and dinner is typically fish or chicken, vegetables and beans. If I’m having a glass or two of wine with this dinner I don’t need any insulin – alcohol for most people lowers their blood sugar, unless you’re drinking Strawberry Margaritas and Singapore Slings.

A few months ago I interviewed a fellow type 1 who had had an islet cell transplant, two actually. For 18 months afterward she was insulin-free. Unfortunately, as for most islet cell transplant recipients, if not all, her new cells began to fail and she had to add some insulin back to keep her blood sugars in range. She told me, though, she’s on a very small dose — 14 units total daily. My daily dose is about 18 units and none of my beta cells work. Seems argument enough for me that you can keep your insulin, or meds, at a minimum by sweeping most of the carbs out of your diet.

I should tell you in full disclosure my diet is not carb-free – and alas, I am not perfect. When out to dinner I often nibble on the bread and love it dripping with olive oil. Thank God someone decided that’s healthy. I indulge in an order of fried calamari or crab cakes from time to time, and if dessert comes to the table I’ll stick my fork in like everyone else for a taste. But without question, the less carbs I eat the less insulin I need, and for me the control I get and the way I feel is worth it.

If you’re curious about a lower carb diet, give it a try. First hook up a hoover to your pantry and suck out all the chips, pretzels, rice and muffin mixes. Second, while experimenting, test, test, test. Third, see if your blood sugars and meds don’t drop. Fourth, reward yourself with some high cocoa dark chocolate — Lindt’s 85% Excellence chocolate bar has only 8 carbs per serving! Good luck.