How To Prevent And Reverse Type 2 Diabetes

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Turn back the clock on insulin resistance

This is Dr. Jason Fung. He’s a world-leading expert on intermittent fasting and low carbohydrate approaches to diet. He also co-founded the Intensive Dietary Management Program, later rebranded to the snappier title: The Fasting Method, a program to help people lose weight and reverse type 2 diabetes. Dr. Fung is certified with the Institute for Functional Medicine, for providing functional medicine certification along with educational programs directly accredited by the Accreditation Council for Continuing Medical Education (ACCME).

Why Intermittent Fasting?

Intermittent fasting is a well-established, well-evidenced, healthful practice for most people. In the case of diabetes, it becomes complicated, because if one’s blood sugars are too low during a fasting period, it will need correcting, thus breaking the fast.

Note: this is about preventing and reversing type 2 diabetes. Type 1 is very different, and sadly cannot be prevented or reversed in this fashion.

However, these ideas may still be useful if you have T1D, as you have an even greater need to avoid developing insulin resistance; you obviously don’t want your exogenous insulin to stop working.

Nevertheless, please do confer with your endocrinologist before changing your dietary habits, as they will know your personal physiology and circumstances in ways that we (and Dr. Fung) don’t.

In the case of having type 2 diabetes, again, please still check with your doctor, but the stakes are a lot lower for you, and you will probably be able to fast without incident, depending on your diet itself (more on this later).

Intermittent Fasting can be extra helpful for the body in the case of type 2 diabetes, as it helps give the body a rest from high insulin levels, thus allowing the body to become gradually re-sensitised to insulin.

Why low carbohydrate?

Carbohydrates, especially sugars, especially fructose*, cause excess sugar to be quickly processed by the liver and stored there. When the body’s ability to store glycogen is exceeded, the liver stores energy as fat instead. The resultant fatty liver is a major contributor to insulin resistance, when the liver can’t keep up with the demand; the blood becomes spiked full of unprocessed sugars, and the pancreas must work overtime to produce more and more insulin to deal with that—until the body starts becoming desensitized to insulin. In other words, type 2 diabetes.

There are other factors that affect whether we get type 2 diabetes, for example a genetic predisposition. But, our carb intake is something we can control, so it’s something that Dr. Fung focuses on.

*A word on fructose: actual fruits are usually diabetes-neutral or a net positive due to their fiber and polyphenols.

Fructose as an added ingredient, however, not so much. That stuff zips straight into your veins with nothing to slow it down and nothing to mitigate it.

The advice from Dr. Fung is simple here: cut the carbs. If you are already diabetic and do this with no preparation, you will probably simply suffer hypoglycemia, so instead:

  1. Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
  2. Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
  3. Eat carbs last (preferably whole, unprocessed carbohydrates), and stop eating when 80% full.

Adapting Intermittent Fasting to diabetes

Dr. Fung advocates for starting small, and gradually increasing your fasting period, until, ideally, fasting 16 hours per day. You probably won’t be able to do this immediately, and that’s fine.

You also probably won’t be able to do this, if you don’t also make the dietary adjustments that help to give your liver a break, and thus by knock-on-effect, give your pancreas a break too.

With the dietary adjustments too, however, your insulin production-and-response will start to return to its pre-diabetic state, and finally its healthy state, after which, it’s just a matter of maintenance.

Want to hear more from Dr. Fung?

You may enjoy his blog, and for those who like videos, here is his YouTube channel:

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  • Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

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    As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.

    This is especially true if it has been a while between workouts.

    A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.

    Research, however, shows lactic acid has nothing to do with it. The truth is far more interesting, but also a bit more complex.

    It’s not lactic acid

    We’ve known for decades that lactic acid has nothing to do with muscle soreness after exercise.

    In fact, as one of us (Robert Andrew Robergs) has long argued, cells produce lactate, not lactic acid. This process actually opposes not causes the build-up of acid in the muscles and bloodstream.

    Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.

    Lactate doesn’t cause major problems for the muscles you use when you exercise. You’d probably be worse off without it due to other benefits to your working muscles.

    Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.

    So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?

    Muscle pain during and after exercise

    When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.

    That causes the pressure inside and between muscle cells to increase.

    This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause discomfort during exercise.

    The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.

    If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.

    Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.

    This is sometimes known as “delayed onset muscle soreness” or DOMS.

    While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.

    The upshot

    Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with lactate or lactic acid.

    The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.

    So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.

    If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.

    Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.

    Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.The Conversation

    Robert Andrew Robergs, Associate Professor – Exercise Physiology, Queensland University of Technology and Samuel L. Torrens, PhD Candidate, Queensland University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Age Later – by Dr. Nir Barzilai

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Barzilai discusses why we age, why supercentenarians age more slowly, and even, why it is so often the case that supercentenarians outside of Blue Zones have poor lifestyles (their longevity is because of protective genes that mitigate the harmful effects of those poor lifestyles—the ultimate in “survivorship bias”).

    He also talks not just genetics, but also epigenetics, and thus gene expression. Bearing in mind, there’s a scale of modifiability there: with current tech, we can’t easily change a bad gene… But we often can just switch it off (or at least downregulate its expression). This is where studies in supercentenarians are helpful even for those who don’t have such fortunate genes—the supercentenarian studies show us which genes we want on or off, what gene expressions to aim for, etc. Further clinical studies can then show us what lifestyle interventions (exercise, diet, nutraceuticals, etc) can do that for us.

    With regard to those lifestyle interventions, he does cover many, and that’s where a lot of the practical value of the book comes from. But it’s not just “do this, do that”; understanding the reasons behind why things work the way they do is important, so as to be more likely to do it right, and also to enjoy greater adherence (we tend to do things we understand more readily than things we have just been told to do).

    There are areas definitely within the author’s blind spots—for example, when talking about menopausal HRT, he discusses at great length the results of the discredited WHI study, and considers it the only study of relevance. So, this is a reminder to not believe everything said by someone who sounds confident (Dr. Barzilai’s professional background is mostly in treating diabetes).

    In terms of style, it is very much narrative; somewhat pop-science, but more “this doctor wants to tell stories”. So many stories. Now, the stories all have informational value, so this isn’t padding, but it is the style, so we mention it as such. As for citations, there aren’t any, so if you want to look up the science he mentions, you’re going to need a bit of digital sleuthery to find the papers from the clues in the stories.

    Bottom line: if you’re interested in the science of aging and how that has been progressing for the past decades and where we’re at, this book will give you so many jumping-off points, and is an engaging read.

    Click here to check out Age Later, and indeed age later!

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  • The Kindness Method – by Shahroo Izadi

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Shahroo Izadi here covers everything from alcohol addiction to procrastination to weight loss. It’s a catch-all handbook for changing your habits—in general, and/or in whatever area of your life you most feel you want or need to.

    She herself went from yo-yo dieting to a stable healthy lifestyle, and wants to share with us how she did it. So she took what worked for her, organized and dilstilled it, and named it “the kindness method”, which…

    • promotes positivity not in a “head in the sand” sense but rather: you have strengths, let’s find them and use them
    • offers many exploratory exercises to help you figure out what’s actually going to be best for you
    • plans support in advance—you’re going to be your own greatest ally here

    Basically it’s about:

    • being kind to yourself rather than setting yourself up to fail, and “judging a fish by how well it can climb a tree”
    • being kind to yourself by being compassionate towards your past self and moving on with lessons learned
    • being kind to yourself by getting things in order for your future self, because you need to treat your future self like a loved one

    In fact, why not buy a copy of this book as a gift for your future self?

    Click Here To Order Your Copy of “The Kindness Method” on Amazon Today!

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  • Your Brain On (And Off) Estrogen
  • ‘It’s okay to poo at work’: new health campaign highlights a common source of anxiety

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    For most people, the daily or near-daily ritual of having a bowel motion is not something we give a great deal of thought to. But for some people, the need to do a “number two” in a public toilet or at work can be beset with significant stress and anxiety.

    In recognition of the discomfort people may feel around passing a bowel motion at work, the Queensland Department of Health recently launched a social media campaign with the message “It’s okay to poo at work”.

    The campaign has gained significant traction on Instagram and Facebook. It has been praised by health and marketing experts for its humorous handling of a taboo topic.

    A colourful Instagram post is accompanied by a caption warning of the health risks of “holding it in”, including haemorrhoids and other gastrointestinal problems. The caption also notes:

    If you find it extremely difficult to poo around other people, you might have parcopresis.

    Queensland Health/Instagram

    What is parcopresis?

    Parcopresis, sometimes called “shy bowel”, occurs when people experience a difficulty or inability to poo in public toilets due to fear of perceived scrutiny by others.

    People with parcopresis may find it difficult to go to the toilet in public places such as shopping centres, restaurants, at work or at school, or even at home when friends or family are around.

    They may fear being judged by others about unpleasant smells or sounds when they have a bowel motion, or how long they take to go, for example.

    Living with a gastrointestinal condition (at least four in ten Australians do) may contribute to parcopresis due to anxiety about the need to use a toilet frequently, and perceived judgment from others when doing so. Other factors, such as past negative experiences or accessibility challenges, may also play a role.

    A man in office attire holding a roll of toilet paper.
    Some people may feel uncomfortable about using the toilet at work. Motortion Films/Shutterstock

    For sufferers, anxiety can present in the form of a faster heart rate, rapid breathing, sweating, muscle tension, blushing, nausea, trembling, or a combination of these symptoms. They may experience ongoing worry about situations where they may need to use a public toilet.

    Living with parcopresis can affect multiple domains of life and quality of life overall. For example, sufferers may have difficulties relating to employment, relationships and social life. They might avoid travelling or attending certain events because of their symptoms.

    How common is parcopresis?

    We don’t really know how common parcopresis is, partly due to the difficulty of evaluating this behaviour. It’s not necessarily easy or appropriate to follow people around to track whether they use or avoid public toilets (and their reasons if they do). Also, observing individual bathroom activities may alter the person’s behaviour.

    I conducted a study to try to better understand how common parcopresis is. The study involved 714 university students. I asked participants to respond to a series of vignettes, or scenarios.

    In each vignette participants were advised they were at a local shopping centre and they needed to have a bowel motion. In the vignettes, the bathrooms (which had been recently cleaned) had configurations of either two or three toilet stalls. Each vignette differed by the configuration of stalls available.

    The rate of avoidance was just over 14% overall. But participants were more likely to avoid using the toilet when the other stalls were occupied.

    Around 10% avoided going when all toilets were available. This rose to around 25% when only the middle of three toilets was available. Men were significantly less likely to avoid going than women across all vignettes.

    For those who avoided the toilet, many either said they would go home to poo, use an available disabled toilet, or come back when the bathroom was empty.

    Parcopresis at work

    In occupational settings, the rates of anxiety about using shared bathrooms may well be higher for a few reasons.

    For example, people may feel more self-conscious about their bodily functions being heard or noticed by colleagues, compared to strangers in a public toilet.

    People may also experience guilt, shame and fear about being judged by colleagues or supervisors if they need to make extended or frequent visits to the bathroom. This may particularly apply to people with a gastrointestinal condition.

    Reducing restroom anxiety

    Using a public toilet can understandably cause some anxiety or be unpleasant. But for a small minority of people it can be a real problem, causing severe distress and affecting their ability to engage in activities of daily living.

    If doing a poo in a toilet at work or another public setting causes you anxiety, be kind to yourself. A number of strategies might help:

    • identify and challenge negative thoughts about using public toilets and remind yourself that using the bathroom is normal, and that most people are not paying attention to others in the toilets
    • try to manage stress through relaxation techniques such as deep breathing and progressive muscle relaxation, which involves tensing and relaxing different muscles around the body
    • engaging in gradual exposure can be helpful, which means visiting public toilets at different times and locations, so you can develop greater confidence in using them
    • use grounding or distraction techniques while going to the toilet. These might include listening to music, watching something on your phone, or focusing on your breathing.

    If you feel parcopresis is having a significant impact on your life, talk to your GP or a psychologist who can help identify appropriate approaches to treatment. This might include cognitive behavioural therapy.

    Simon Robert Knowles, Associate Professor and Clinical Psychologist, Swinburne University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Almonds vs Walnuts – Which is Healthier?

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    Our Verdict

    When comparing almonds to walnuts, we picked the almonds.

    Why?

    It wasn’t just our almond bias, but it was close!

    In terms of macros, the main important differences are:

    • Almonds are higher in protein
    • Walnuts are higher in fats (they are healthy fats)

    So far, so even.

    In terms of vitamins, both are rich in many vitamins; mostly the same ones. However, walnuts have more of most of the B vitamins (except for B2 and B3, where almonds win easily), and almonds have more vitamin E by several orders of magnitude.

    So far, so balanced.

    Almonds have slightly more choline.

    Almonds have a better mineral profile, with more of most minerals that they both contain, and especially, a lot more calcium.

    Both nuts have [sometimes slightly different, but] comparable benefits against diabetes, cancer, neurodegeneration, and other diseases.

    In summary

    This one’s close. After balancing out the various “almonds have this but walnuts have that” equal-but-different benefits, we’re going to say almonds take first place by virtue of the better mineral profile, and more choline.

    But: enjoy both!

    Learn more

    You might like this previous article of ours:

    Why You Should Diversify Your Nuts

    Take care!

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  • Change Your Brain, Change Your Life – by Dr. Daniel G. Amen

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    To what extent can we change our brains, and to what extent are we stuck with what we have?

    Dr. Amen tells us that being mindful of both ends of this is critical:

    • Neuroplasticity means we can, indeed, change our brains
    • We do, however, have fundamental “brain types” based on our neurochemistry and physical brain structure

    He argues for the use of brain imaging technology to learn more about the latter… In order to better go about doing what we can with the former.

    The book looks at how these different brain types can lead to situations where what works as a treatment for one person can often not work for another. It’s also prescriptive, about what sorts of treatments (and lifestyle adjustments) are more likely to do better for each.

    Where the book excels is in giving ideas and pointers for exploration… Things to take to one’s doctor, and—for example—request certain tests, and then what to do with those.

    Where the book is a little light is on including hard science in the explanations. The hard science is referred to, but is considered beyond the scope of the book, or perhaps beyond the interest of the reader. That’s unfortunate, as we’d have liked to have seen more of it, rather than taking claims at face value without evidence.

    Bottom line: this is distinctly “pop science” in presentation, but can give a lot of great ideas for learning more about our own brains and brain health… And then optimizing such.

    Click here to check out “Change Your Brain; Change Your Life” on Amazon today!

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