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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  • Cost of living: if you can’t afford as much fresh produce, are canned veggies or frozen fruit just as good?

    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.

    The cost of living crisis is affecting how we spend our money. For many people, this means tightening the budget on the weekly supermarket shop.

    One victim may be fresh fruit and vegetables. Data from the Australian Bureau of Statistics (ABS) suggests Australians were consuming fewer fruit and vegetables in 2022–23 than the year before.

    The cost of living is likely compounding a problem that exists already – on the whole, Australians don’t eat enough fruit and vegetables. Australian dietary guidelines recommend people aged nine and older should consume two serves of fruit and five serves of vegetables each day for optimal health. But in 2022 the ABS reported only 4% of Australians met the recommendations for both fruit and vegetable consumption.

    Fruit and vegetables are crucial for a healthy, balanced diet, providing a range of vitamins and minerals as well as fibre.

    If you can’t afford as much fresh produce at the moment, there are other ways to ensure you still get the benefits of these food groups. You might even be able to increase your intake of fruit and vegetables.

    New Africa/Shutterstock

    Frozen

    Fresh produce is often touted as being the most nutritious (think of the old adage “fresh is best”). But this is not necessarily true.

    Nutrients can decline in transit from the paddock to your kitchen, and while the produce is stored in your fridge. Frozen vegetables may actually be higher in some nutrients such as vitamin C and E as they are snap frozen very close to the time of harvest. Variations in transport and storage can affect this slightly.

    Minerals such as calcium, iron and magnesium stay at similar levels in frozen produce compared to fresh.

    Another advantage to frozen vegetables and fruit is the potential to reduce food waste, as you can use only what you need at the time.

    A close up of frozen vegetables (peas, carrot and corn).
    Freezing preserves the nutritional quality of vegetables and increases their shelf life. Tohid Hashemkhani/Pexels

    As well as buying frozen fruit and vegetables from the supermarket, you can freeze produce yourself at home if you have an oversupply from the garden, or when produce may be cheaper.

    A quick blanching prior to freezing can improve the safety and quality of the produce. This is when food is briefly submerged in boiling water or steamed for a short time.

    Frozen vegetables won’t be suitable for salads but can be eaten roasted or steamed and used for soups, stews, casseroles, curries, pies and quiches. Frozen fruits can be added to breakfast dishes (with cereal or youghurt) or used in cooking for fruit pies and cakes, for example.

    Canned

    Canned vegetables and fruit similarly often offer a cheaper alternative to fresh produce. They’re also very convenient to have on hand. The canning process is the preservation technique, so there’s no need to add any additional preservatives, including salt.

    Due to the cooking process, levels of heat-sensitive nutrients such as vitamin C will decline a little compared to fresh produce. When you’re using canned vegetables in a hot dish, you can add them later in the cooking process to reduce the amount of nutrient loss.

    To minimise waste, you can freeze the portion you don’t need.

    Fermented

    A jar of red peppers in oil.
    Fermented vegetables are another good option. Angela Khebou/Unsplash

    Fermentation has recently come into fashion, but it’s actually one of the oldest food processing and preservation techniques.

    Fermentation largely retains the vitamins and minerals in fresh vegetables. But fermentation may also enhance the food’s nutritional profile by creating new nutrients and allowing existing ones to be absorbed more easily.

    Further, fermented foods contain probiotics, which are beneficial for our gut microbiome.

    5 other tips to get your fresh fix

    Although alternatives to fresh such as canned or frozen fruit and vegetables are good substitutes, if you’re looking to get more fresh produce into your diet on a tight budget, here are some things you can do.

    1. Buy in season

    Based on supply and demand principles, buying local seasonal vegetables and fruit will always be cheaper than those that are imported out of season from other countries.

    2. Don’t shun the ugly fruit and vegetables

    Most supermarkets now sell “ugly” fruit and vegetables, that are not physically perfect in some way. This does not affect the levels of nutrients in them at all, or their taste.

    A mother and daughter preparing food in the kitchen.
    Buying fruit and vegetables during the right season will be cheaper. August de Richelieu/Pexels

    3. Reduce waste

    On average, an Australian household throws out A$2,000–$2,500 worth of food every year. Fruit, vegetables and bagged salad are the three of the top five foods thrown out in our homes. So properly managing fresh produce could help you save money (and benefit the environment).

    To minimise waste, plan your meals and shopping ahead of time. And if you don’t think you’re going to get to eat the fruit and vegetables you have before they go off, freeze them.

    4. Swap and share

    There are many websites and apps which offer the opportunity to swap or even pick up free fresh produce if people have more than they need. Some local councils are also encouraging swaps on their websites, so dig around and see what you can find in your local area.

    5. Gardening

    Regardless of how small your garden is you can always plant produce in pots. Herbs, rocket, cherry tomatoes, chillies and strawberries all grow well. In the long run, these will offset some of your cost on fresh produce.

    Plus, when you have put the effort in to grow your own produce, you are less likely to waste it.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

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

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  • Four Thousand Weeks – by Oliver Burkeman

    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.

    This is not, strictly speaking, a time management book. It’s more a “contemplating mortality and making things count while still doing the necessaries”.

    Burkeman’s premise is that we get around 4,000 weeks of life, on average. If we live to 120, it’s more like 6,200. Unlucky souls may have to do the best they can with 1,000 or so.

    The book is thought-provoking; consider:

    1. how was your last week?
    2. how will your next week be?
    3. what if it were your last?

    Of course, we cannot necessarily liquidate all our assets and spend next week burning out in style, because then the following week comes. So, what’s the solution?

    That’s something Burkeman lays out over the course of the book, with key ideas including passion projects and figuring out what can be safely neglected, but there’s far more there than we could sum up here.

    Bottom line: if you ever find yourself struggling to balance what is expected of you with what is of value to you, this book can help you get the most out of your choices.

    Click here to check out Four Thousand Weeks, and make yours count!

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  • Fat’s Real Barriers To Health

    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.

    Fat Justice In Healthcare

    This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?

    When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…

    There’s a lot of discrimination in healthcare settings

    In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.

    Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”

    Other things may be more systemic, for example:

    When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.

    That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:

    • Surgeons being untrained (and/or unwilling) to operate on fat people
    • Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
    • MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place

    …and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.

    It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.

    Read more on this topic: Shedding Some Obesity Myths

    Does she have practical advice about this?

    If she could have you understand one thing, it would be:

    You deserve better.

    Or if you are not fat: your fat friends deserve better.

    How this becomes useful is: do not accept being treated as the problem!

    Demand better!

    If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.

    See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:

    “You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon

    Are you saying fat people don’t need to lose weight?

    That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.

    Rather: some people might benefit healthwise from losing weight, some might not.

    In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.

    For details of that and more, see: When BMI Doesn’t Measure Up

    But what if I do want/need to lose weight?

    Gordon’s not interested in helping with that, but we at 10almonds are, so…

    Check out: Lose Weight, But Healthily

    Where can I find more from Aubrey Gordon?

    You might enjoy her blog:

    Aubrey Gordon | Your Fat Friend

    Or her other book, which we reviewed previously:

    What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon

    Enjoy!

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  • Is Unnoticed Environmental Mold Harming Your Health?

    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.

    Environmental mold can be a lot more than just the famously toxic black mold that sometimes makes the headlines, and many kinds you might not notice, but it can colonizes your sinuses and gut just the same:

    Breaking the mold

    Around 25% of homes in North America are estimated to have mold, though the actual number is likely to be higher, affecting both older and new homes. For that matter, mold can grow in unexpected areas, like inside air conditioning units, even in dry regions.

    If mold just sat where it is minding its own business, it might not be so bad, but instead they release their spores, which are de facto airborne mycotoxins, which can colonize places like the sinuses or gut, causing significant health issues.

    Not everyone in the same household is affected the same way by mold due to genetic differences and varying pre-existing health conditions. But as a general rule of thumb, mold inflames the brain, nerves, gut, and skin, and can negatively impact the vagal nerve, which is linked to the gut-brain connection. Mycotoxins also damage mitochondria, leading to symptoms like fatigue, brain fog, and cognitive issues. To complicate matters further, mold illness can mimic other conditions like anxiety, chronic fatigue, fibromyalgia, IBS, and more, making it difficult to diagnose.

    Testing is possible, though they all have limitations, e.g:

    • Home testing: testing the home for mold spores and mycotoxins is crucial for effective treatment; professional mold remediation companies are a good idea (to do a thorough job of cleaning, without also breathing in half the mold while cleaning it).
    • Mold allergy testing: mold allergy testing (IgE testing or skin tests) is often used, but it doesn’t diagnose mold-related illnesses linked to severe symptoms like fatigue or neurodegeneration.
    • Serum antibody testing: tests for immune reactions (IgG) to mycotoxins may not always show positive results if the immune system is weakened by long-term exposure.
    • Urine mycotoxin testing: urine tests can detect mycotoxins in the body, though are likely to be more expensive, being probably not covered by public health in Canada or insurance in the US.
    • Organic acid testing: this urine test can indicate mold colonization in areas like the sinuses or gut. Again, cost/availability may vary, though.

    For more information on all of this, enjoy:

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    Want to learn more?

    You might also like to read:

    Mythbusting Moldy Food

    Take care!

    Don’t Forget…

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  • Keeping Your Kidneys Healthy (Especially After 60)

    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.

    Keeping your kidneys happy: it’s more than just hydration!

    Your kidneys are very busy organs. They filter waste products, balance hydration, pH, salt, and potassium. They also make some of our hormones, and are responsible for regulating red blood cell production too. They also handle vitamin D in a way our bodies would not work without, making them essential for calcium absorption and the health of our bones, and even muscular function.

    So, how to keep them in good working order?

    Yes, hydrate

    This is obvious and may go without saying, but we try to not leave important things without saying. So yes, get plenty of water, spread out over the day (you can only usefully absorb so much at once!). If you feel thirsty, you’re probably already dehydrated, so have a little (hydrating!) drink.

    Don’t smoke

    It’s bad for everything, including your kidneys.

    Look after your blood

    Not just “try to keep it inside your body”, but also:

    Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.

    Watch your over-the-counter pill intake

    A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.

    Many people take ibuprofen (for example) constantly for chronic pain, especially the kind cause by chronic inflammation, including many autoimmune diseases.

    It is recommended to not take them for more than 10 days, nor more than 8 per day. Taking more than that, or taking them for longer, could damage your kidneys temporarily or permanently.

    Read more: National Kidney Foundation: Advice About Pain Medicines

    See also: Which Drugs Are Harmful To Your Kidneys?

    Get a regular kidney function checkup if you’re in a high risk group

    Who’s in a high risk group?

    • If you’re over 60
    • If you have diabetes
    • If you have cardiovascular disease
    • If you have high blood pressure
    • If you believe, or know, you have existing kidney damage

    The tests are very noninvasive, and will be a urine and/or blood test.

    For more information, see:

    Kidney Testing: Everything You Need to Know

    Take care!

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  • Statins and Brain Fog?

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I was wondering if you had done any info about statins. I’ve tried 3, and keep quitting them because they give me brain fog. Am I imagining this as the research suggests?❞

    If you are female, the chances of adverse side-effects are a lot higher:

    Statins: His & Hers?

    As an extra kicker, not only are the adverse side-effects more likely for women, but also, the benefits are often less beneficial, too (see the above main feature for some details).

    That’s not to say that statins can’t have their place for women; sometimes it will still be the right choice. Just, not as readily so as for men.

    Enjoy!

    Don’t Forget…

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