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:
- Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
- Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
- 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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Never Too Late To Start Over: Finding Purpose At Any Age
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Dana Findwell’s late 50s were not an easy time, but upon now hitting 60 (this week, at time of writing), she’s enthusiastically throwing herself into the things that bring her purpose, and so can you.
Start where you are
Findwell was already no stranger to starting again, having been married and divorced twice, and having moved frequently, requiring constant “life resets”.
Nevertheless, she always had her work to fall back on; she was a graphic designer and art director for 30 years… Until burnout struck.
And when burnout struck, so did COVID, resulting in the loss of her job. Her job wasn’t the only thing she lost though, as her mother died around the same time. All in all, it was a lot, and not the fun kind of “a lot”.
Struggling to find a new career direction, she ended up starting a small business for herself, so that she could direct the pace; pressing forwards as and when she had the energy. This became her new “ikigai“, the main thing that brings a sense of purpose to her life, but getting one part of her life back into order brought her attention to the rest; she realized she’d neglected her health, so she joined a gym. And a weightlifting class. And a hip-hop class. And she took up the practice of Japanese drumming (for the unfamiliar, this can be a rather athletic ability; it’s not a matter of sitting at a drum kit).
And now? Her future is still not clear, but that’s ok, because she’s making it as she goes, and she’s doing it her way, trusting in her ability to handle what may come up, and doing the things now that future-her will be glad of having done (e.g. laying the groundwork of both financial security and good health).
Change can sometimes be triggered by adverse circumstances, but there’s always the opportunity to find something better. For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Take care!
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End the Insomnia Struggle – by Dr. Colleen Ehrnstrom and Dr. Alisha Brosse
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We’ve reviewed sleep books before, and we always try to recommend books that have something a little different than the rest, so what makes this one stand out?
While there is the usual quick overview of the basics that we’re sure you already know (sleep hygiene etc), most of the attention here is given to cold, hard clinical psychology… in a highly personalized way.
How, you may ask, can they personalize a book, that is the same for everyone?
The answer is, by guiding the reader through examining our own situation. With template logbooks, worksheets, and the like—for this reason we recommend getting a paper copy of the book, rather than the Kindle version, in case you’d like to use/photocopy those.
Essentially, reading this book is much like having your own psychologist (or two) to guide you through finding a path to better sleep.
The therapeutic approach, by the way, is a combination of Cognitive Behavioral Therapy (CBT) and Acceptance-Commitment Therapy (ACT), which work very well together here.
Bottom line: if you’ve changed your bedsheets and turned off your electronic devices and need something a little more, this book is the psychological “big guns” for removing the barriers between you and good sleep.
Click here to check out End the Insomnia Struggle, and end yours once and for all!
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Is Cutting Calories The Key To Healthy Long Life?
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Caloric Restriction with Optimal Nutrition
Yesterday, we asked you “What is your opinion of caloric restriction as a health practice?” and got the above-depicted, below-described spread of responses:
- 48% said “It is a robust, scientifically proven way to live longer and healthier”
- 23% said “It may help us to live longer, but at the cost of enjoying it fully”
- 17% said “It’s a dangerous fad that makes people weak, tired, sick, and unhealthy”
- 12% said “Counting calories is irrelevant to good health; the body compensates”
So… What does the science say?
A note on terms, first
“Caloric restriction” (henceforth: CR), as a term, sees scientific use to mean anything from a 25% reduction to a 50% reduction, compared to metabolic base rate.
This can also be expressed the other way around, “dropping to 60% of the metabolic base rate” (i.e., a 40% reduction).
Here we don’t have the space to go into much depth, so our policy will be: if research papers consider it CR, then so will we.
A quick spoiler, first
The above statements about CR are all to at least some degree True in one way or another.
However, there are very important distinctions, so let’s press on…
CR is a robust, scientifically proven way to live longer and healthier: True or False?
True! This has been well-studied and well-documented. There’s more science for this than we could possibly list here, but here’s a good starting point:
❝Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models.
Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity.
In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality❞
Source: Ageing Research Reviews | Calorie restriction in humans: an update
See also: Caloric restriction in humans reveals immunometabolic regulators of health span
We could devote a whole article (or a whole book, really) to this, but the super-short version is that it lowers the metabolic “tax” on the body and allows the body to function better for longer.
CR may help us to live longer, but at the cost of enjoying it fully: True or False?
True or False, contingently, depending on what’s important to you. And that depends on psychology as much as physiology, but it’s worth noting that there is often a selection bias in the research papers; people ill-suited to CR drop out of the studies and are not counted in the final data.
Also, relevant for a lot of our readers, most (human-based) studies recruit people over 18 and under 60. So while it is reasonable to assume the same benefits will be carried over that age, there is not nearly as much data for it.
Studies into CR and Health-Related Quality of Life (HRQoL) have been promising, and/but have caveats:
❝In non-obese adults, CR had some positive effects and no negative effects on HRQoL.❞
❝We do not know what degree of CR is needed to achieve improvements in HRQoL, but we do know it requires an extraordinary amount of support.
Therefore, the incentive to offer this intervention to a low-risk, normal or overweight individual is lacking and likely not sustainable in practice.❞
CR a dangerous fad that makes people weak, tired, sick, and unhealthy: True or False?
True if it is undertaken improperly, and/or without sufficient support. Many people will try CR and forget that the idea is to reduce metabolic load while still getting good nutrition, and focus solely on the calorie-counting.
So for example, if a person “saves” their calories for the day to have a night out in a bar where they drink their calories as alcohol, then this is going to be abysmal for their health.
That’s an extreme example, but lesser versions are seen a lot. If you save your calories for a pizza instead of a night of alcoholic drinks, then it’s not quite so woeful, but for example the nutrition-to-calorie ratio of pizza is typically not great. Multiply that by doing it as often as not, and yes, someone’s health is going to be in ruins quite soon.
Counting calories is irrelevant to good health; the body compensates: True or False?
True if by “good health” you mean weight loss—which is rarely, if ever, what we mean by “good health” here at 10almonds (unless we clarify such), but it’s a very common association and indeed, for some people it’s a health goal. You cannot sustainably and healthily lose weight by CR alone, especially if you’re not getting optimal nutrition.
Your body will notice that you are starving, and try to save you by storing as much fat as it can, amongst other measures that will similarly backfire (cortisol running high, energy running low, etc).
For short term weight loss though, yes, it’ll work. At a cost. That we don’t recommend.
❝By itself, decreasing calorie intake will have a limited short-term influence.❞
Source: Reducing Calorie Intake May Not Help You Lose Body Weight
See also…
❝Caloric restriction is a commonly recommended weight-loss method, yet it may result in short-term weight loss and subsequent weight regain, known as “weight cycling”, which has recently been shown to be associated with both poor sleep and worse cardiovascular health❞
Source: Dieting Behavior Characterized by Caloric Restriction
In summary…
Caloric restriction is a well-studied area of health science. We know:
- Practised well, it can extend not only lifespan, but also healthspan
- Practised well, it can improve mood, energy, sexual function, and the other things people fear losing
- Practised badly, it can be ruinous to the health—it is critical to practise caloric restriction with optimal nutrition.
- Practised badly, it can lead to unhealthy weight loss and weight regain
One final note…
If you’ve tried CR and hated it, and you practised it well (e.g., with optimal nutrition), then we recommend just not doing it.
You could also try intermittent fasting instead, for similar potential benefits. If that doesn’t work out either, then don’t do that either!
Sometimes, we’re just weird. It can often be because of a genetic or epigenetic quirk. There are usually workarounds, and/but not everything that’s right for most people will be right for all of us.
Take care!
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PS, We Love You
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PS, we love you. With good reason!
There are nearly 20,000 studies on PS listed on PubMed alone, and its established benefits include:
- significantly improving memory
- potential reversal (!) of neurodegeneration
- reduction of stress activation
- improvement in exercise capacity
- it even helps avoid rejection of medical implants
We’ll explore some of these studies and give an overview of how PS does what it does. Just like the (otherwise unrelated) l-theanine we talked about a couple of weeks ago, it does do a lot of things.
Speaking of unpronounceable wonder-drugs, do you remember paracetamoxyfrusebendroneomycin? If you haven’t heard of it before, you’re in for a treat, and if you have, well, have a dose on us:
Show it to a friend who might need it, and pass on the cheer!
Now, back to more serious things
PS = Cow Brain?!
Let’s first address a concern. You may have heard something along the lines of “hey, isn’t PS made from cow brain, and isn’t that Very Bad™ for humans, mad cow disease and all?”. The short answer is:
Firstly: ingesting cow brain tissue is indeed generally considered Very Bad™ for humans, on account of the potential for transmission of Bovine Spongiform Encephalopathy (BSE) resulting in its human equivalent, Creutzfeldt–Jakob Disease (CJD), whose unpleasantries are beyond the scope of this newsletter.
Secondly (and more pleasantly): whilst PS can be derived from bovine brain tissue, most PS supplements these days derive from soy—or sometimes sunflower lecithin. Check labels if unsure.
Using PS to Improve Other Treatments
In the human body, the question of tolerance brings us a paradox (not the tolerance paradox, important as that may also be): we must build and maintain a strong immune system capable of quickly adapting to new things, and then when we need medicines (or even supplements), we need our body to not build tolerance of them, for them to continue having an effect.
So, we’re going to look at a very hot-off-the-press study (Feb 2023), that found PS to “mediate oral tolerance”, which means that it helps things (medications, supplements etc.) that we take orally and want to keep working, keep working.
In the scientists’ own words (we love scientists’ own words because they haven’t been distorted by the popular press)…
❝This immunotherapy has been shown to prevent/reduce immune response against life-saving protein-based therapies, food allergens, autoantigens, and the antigenic viral capsid peptide commonly used in gene therapy, suggesting a broad spectrum of potential clinical applications. Given the good safety profile of PS together with the ease of administration, oral tolerance achieved with PS-based nanoparticles has a very promising therapeutic impact.❞
Nguyen et al, Feb 2023
In other words, to parse those two very long sentences into two shorter bullet points:
- It allows a lot of important treatments to continue working—treatments that the body would otherwise counteract
- It is very safe—and won’t harm the normal function of your immune system at large
This is also very consistent with one of the benefits we mentioned up top—PS helps avoid rejection of implants, something that can be a huge difference to health-related quality of life (HRQoL), never mind sometimes life itself!
What is PS Anyways, and How Does It Work?
Phosphatidylserine is a phospholipid, a kind of lipid, found in cell membranes. More importantly:
It’s a signalling agent, mainly for apoptosis, which in lay terms means: it tells cells when it’s time to die.
Cellular death sounds like a bad thing, but prompt and efficient cellular apoptosis (death) and resultant prompt and efficient autophagy (recycling) reduce the risk of your body making mistakes when creating new cells from old cells.
Think about photocopying:
- Situation A: You have a document, and you want to copy it. If you copy it before it gets messed up, your copy will look almost, if not exactly, like the original. It’ll be super easy to read.
- Situation B: You have a document, and you want to copy it, but you delay doing so for so long that the original is all scuffed and creased and has a coffee stain on it. These unwanted changes will get copied onto the new document, and any copy made of that copy will keep the problems too. It gets worse and worse each time.
So, using this over-simplifier analogy, the speed of ‘copying’ is a major factor in cellular aging. The sooner cells are copied, before something gets damaged, the better the copy will be.
So you really, really want to have enough PS (our bodies make it too, by the way) to signal promptly to a cell when its time is up.
You do not want cells soldiering on until they’re the biological equivalent of that crumpled up, coffee-stained sheet of paper.
Little wonder, then, that PS’ most commonly-sought benefit when it comes to supplementation is to help avoid age-related neurodegeneration (most notably, memory loss)!
Keeping the cells young means keeping the brain young!
PS’s role as a signalling agent doesn’t end there—it also has a lot to say to a wide variety of the body’s immunological cells, helping them know what needs to happen to what. Some things should be immediately eaten and recycled; other things need more extreme measures applied to them first, and yet other things need to be ignored, and so forth.
You can read more about that in Elsevier’s publication if you’re curious 🙂
Wow, what a ride today’s newsletter has been! We started at paracetamoxyfrusebendroneomycin, and got down to the nitty gritty with a bunch of hopefully digestible science!
We love feedback, so please let us know if we’re striking the balance right, and/or if you’d like to see more or less of something—there’s a feedback widget at the bottom of this email!
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Your Simplest Life – by Lisa Turner
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We probably know how to declutter, and perhaps even do a “unnecessary financial expenditures” audit. So, what does this offer beyond that?
A large portion of this book focuses on keeping our general life in a state of “flow”, and strategies include:
- How to make sure you’re doing the right part of the 80:20 split on a daily basis
- Knowing when to switch tasks, and when not to
- Knowing how to plan time for tasks
- No more reckless optimism, but also without falling foul of Parkinson’s Law (i.e. work expands to fill the time allotted to it)
- Decluttering your head, too!
When it comes to managing life responsibilities in general, Turner is very attuned to generational differences… Including the different challenges faced by each generation, what’s more often expected of us, what we’re used to, and how we probably initially learned to do it (or not).
To this end, a lot of strategies are tailored with variations for each age group. Not often does an author take the time to address each part of their readership like that, and it’s really helpful that she does!
All in all, a great book for simplifying your daily life.
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Surviving with Beans And Rice – by Eliza Whool
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If you’d like to be well-set the next time a crisis shuts down supply lines, this is one of those books you’ll want to have read.
Superficially, “have in a large quantity of dried beans and rice” is good advice, but obvious. Why a book?
Whool gives a lot of advice on keeping your nutrition balanced while subsisting on the same quite few ingredients, which is handy.
More than that, she offers 100 recipes using the ingredients that will be in your long-term pantry. That’s over three months without repeating a meal! And if you don’t think rice and beans can be tasty and exciting and varied, then most of the chefs of the Global South might want to have a word about that.
Anyway, we’re not here to sell you rice and beans (we’re just enthusiastic and correct). What we are here to do is to give you a fair overview of this book.
The recipes are just-the-recipes, very simple clear instructions, one two-page spread per recipe. Most of the book is devoted to these. As a quick note, it does cover making things gluten-free if necessary, and other similar adjustments for medical reasons.
The planning-and-storage section of the book is helpful too though, especially as it covers common mistakes to avoid.
Bottom line: this is a great book, and remember what we said about doing the things now that future you will thank you for!
Get yourself a copy of Surviving with Beans And Rice from Amazon today!
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