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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  • I’ve recovered from a cold but I still have a hoarse voice. What should I do?

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    Cold, flu, COVID and RSV have been circulating across Australia this winter. Many of us have caught and recovered from one of these common upper respiratory tract infections.

    But for some people their impact is ongoing. Even if your throat isn’t sore anymore, your voice may still be hoarse or croaky.

    So what happens to the voice when we get a virus? And what happens after?

    Here’s what you should know if your voice is still hoarse for days – or even weeks – after your other symptoms have resolved.

    Why does my voice get croaky during a cold?

    A healthy voice is normally clear and strong. It’s powered by the lungs, which push air past the vocal cords to make them vibrate. These vibrations are amplified in the throat and mouth, creating the voice we hear.

    The vocal cords are two elastic muscles situated in your throat, around the level of your laryngeal prominence, or Adam’s apple. (Although everyone has one, it tends to be more pronounced in males.) The vocal cords are small and delicate – around the size of your fingernail. Any small change in their structure will affect how the voice sounds.

    When the vocal cords become inflamed – known as laryngitis – your voice will sound different. Laryngitis is a common part of upper respiratory tract infections, but can also be caused through misuse.

    Two drawn circles comparing normal vocal cords with inflamed, red vocal cords.
    Viruses such as the common cold can inflame the vocal cords. Pepermpron/Shutterstock

    Catching a virus triggers the body’s defence mechanisms. White blood cells are recruited to kill the virus and heal the tissues in the vocal cords. They become inflamed, but also stiffer. It’s harder for them to vibrate, so the voice comes out hoarse and croaky.

    In some instances, you may find it hard to speak in a loud voice or have a reduced pitch range, meaning you can’t go as high or loud as normal. You may even “lose” your voice altogether.

    Coughing can also make things worse. It is the body’s way of trying to clear the airways of irritation, including your own mucus dripping onto your throat (post-nasal drip). But coughing slams the vocal cords together with force.

    Chronic coughing can lead to persistent inflammation and even thicken the vocal cords. This thickening is the body trying to protect itself, similar to developing a callus when a pair of new shoes rubs.

    Thickening on your vocal cords can lead to physical changes in the vocal cords – such as developing a growth or “nodule” – and further deterioration of your voice quality.

    Diagram compares healthy vocal cords with cords that have nodules, two small bumps.
    Coughing and exertion can cause inflamed vocal cords to thicken and develop nodules. Pepermpron/Shutterstock

    How can you care for your voice during infection?

    People who use their voices a lot professionally – such as teachers, call centre workers and singers – are often desperate to resume their vocal activities. They are more at risk of forcing their voice before it’s ready.

    The good news is most viral infections resolve themselves. Your voice is usually restored within five to ten days of recovering from a cold.

    Occasionally, your pharmacist or doctor may prescribe cough suppressants to limit additional damage to the vocal cords (among other reasons) or mucolytics, which break down mucus. But the most effective treatments for viral upper respiratory tract infections are hydration and rest.

    Drink plenty of water, avoid alcohol and exposure to cigarette smoke. Inhaling steam by making yourself a cup of hot water will also help clear blocked noses and hydrate your vocal cords.

    Rest your voice by talking as little as possible. If you do need to talk, don’t whisper – this strains the muscles.

    Instead, consider using “confidential voice”. This is a soft voice – not a whisper – that gently vibrates your vocal cords but puts less strain on your voice than normal speech. Think of the voice you use when communicating with someone close by.

    During the first five to ten days of your infection, it is important not to push through. Exerting the voice by talking a lot or loudly will only exacerbate the situation. Once you’ve recovered from your cold, you can speak as you would normally.

    What should you do if your voice is still hoarse after recovery?

    If your voice hasn’t returned to normal after two to three weeks, you should seek medical attention from your doctor, who may refer you to an ear nose and throat specialist.

    If you’ve developed a nodule, the specialist would likely refer you to a speech pathologist who will show you how to take care of your voice. Many nodules can be treated with voice therapy and don’t require surgery.

    You may have also developed a habit of straining your vocal cords, if you forced yourself to speak or sing while they were inflamed. This can be a reason why some people continue to have a hoarse voice even when they’ve recovered from the cold.

    In those cases, a speech pathologist may play a valuable role. They may teach you to exercises that make voicing more efficient. For example, lip trills (blowing raspberries) are a fun and easy way you can learn to relax the voice. This can help break the habit of straining your voice you may have developed during infection.

    Yeptain Leung, Postdoctoral Research and Lecturer of Speech Pathology, School of Health Sciences, The University of Melbourne

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

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  • Walden Farms Caesar Dressing vs. Primal Kitchen Caesar Dressing – Which is Healthier?

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    Our Verdict

    When comparing Walden Farms Caesar Dressing to Primal Kitchen Caesar Dressing, we picked the Primal Kitchen.

    Why?

    As you can see from the front label, the Walden Farms product has 0 net carbs, 0 calories, and 0 fat. In fact, its ingredients list begins:

    Water, white distilled vinegar, erythritol, corn fiber, salt, microcrystalline cellulose, xanthan gum, titanium dioxide (color)

    …before it gets to something interesting (garlic purée), by which point the amount must be miniscule.

    The Primal Kitchen product, meanwhile, has 140 calories per serving and 15g fat (of which, 1.5g is saturated). However! The ingredients list this time begins:

    Avocado oil, water, organic coconut aminos (organic coconut sap, sea salt), organic apple cider vinegar, organic distilled vinegar, mushroom extract, organic gum acacia, organic guar gum

    …before it too gets to garlic, which this time, by the way, is organic roasted garlic.

    In case you’re wondering about the salt content in both, they add up to 190mg for the Walden Farms product, and 240mg for the Primal Kitchen product. We don’t think that the extra 50mg (out of a daily allowance of 2300–5000mg, depending on whom you ask) is worthy of note.

    In short, the Walden Farms product is made of mostly additives of various kinds, whereas the Primal Kitchen product is made of mostly healthful ingredients.

    So, the calories and fat are nothing to fear.

    For this reason, we chose the product with more healthful ingredients—but we acknowledge that if you are specifically trying to keep your calories down, then the Walden Farms product may be a valid choice.

    Read more:
    •⁠ ⁠Can Saturated Fats Be Healthy?
    •⁠ ⁠Caloric Restriction with Optimal Nutrition

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  • Gravitas – by Caroline Goyder

    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.

    A no-nonsense guide to (more than!) public speaking that isn’t just “tell jokes in your speech and imagine the audience naked”.

    Because this isn’t just about speech-writing or speech delivery, so much as giving you important life skills. The kind that weren’t taught in school, but that nevertheless make a huge impact on success… whether you’re giving a presentation or hosting a party or negotiating a deal or just attending a social event. Or making a phonecall, even.

    Whereas a lot of books of this kind treat “the audience” as a nebulous and purely responsive passive crowd of extras, Goyder does better. People are individuals, even if they’re all facing the same way for a moment. She works with that! She also teaches how to deal with not just hecklers, but also simply those people who sap your confidence and find fault with you and anything you do or say.b

    Bottom line is: if you for whatever reason communicate with people, and would like them to think better of you, this is the book for you.

    Order your copy of Gravitas from Amazon today!

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  • The Truth About Handwashing

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    Washing Our Hands Of It

    In Tuesdays’s newsletter, we asked you how often you wash your hands, and got the above-depicted, below-described, set of self-reported answers:

    • About 54% said “More times per day than [the other options]”
    • About 38% said “Whenever using the bathroom or kitchen
    • About 5% said “Once or twice per day”
    • Two (2) said “Only when visibly dirty”
    • Two (2) said “I prefer to just use sanitizer gel”

    What does the science have to say about this?

    People lie about their handwashing habits: True or False?

    True and False (since some people lie and some don’t), but there’s science to this too. Here’s a great study from 2021 that used various levels of confidentiality in questioning (i.e., there were ways of asking that made it either obvious or impossible to know who answered how), and found…

    ❝We analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.❞

    ~ Dr. Laura Mieth et al.

    Source: Do they really wash their hands? Prevalence estimates for personal hygiene behaviour during the COVID-19 pandemic based on indirect questions

    Note: the abstract alone doesn’t make it clear how the anonymization worked (it is explained later in the paper), and it was noted as a limitation of the study that the participants may not have understood how it works well enough to have confidence in it, meaning that the 78.1% is probably also inflated, just not as much as the 94.5% in the direct questioning group.

    Here’s a pop-science article that cites a collection of studies, finding such things as for example…

    ❝With the use of wireless devices to record how many people entered the restroom and used the pumps of the soap dispensers, researchers were able to collect data on almost 200,000 restroom trips over a three-month period.

    The found that only 31% of men and 65% of women washed their hands with soap.❞

    Source: Study: Men Wash Their Hands Much Less Often Than Women (And People Lie About Washing Their Hands)

    Sanitizer gel does the job of washing one’s hands with soap: True or False?

    False, though it’s still not a bad option for when soap and water aren’t available or practical. Here’s an educational article about the science of why this is so:

    UCI Health | Soap vs. Hand Sanitizer

    There’s also some consideration of lab results vs real-world results, because while in principle the alcohol gel is very good at killing most bacteria / inactivating most viruses, it can take up to 4 minutes of alcohol gel contact to do so, as in this study with flu viruses:

    Situations Leading to Reduced Effectiveness of Current Hand Hygiene against Infectious Mucus from Influenza Virus-Infected Patients

    In contrast, 20 seconds of handwashing with soap will generally do the job.

    Antibacterial soap is better than other soap: True or False?

    False, because the main way that soap protects us is not in its antibacterial properties (although it does also destroy the surface membrane of many bacteria and for that matter viruses too, killing/inactivating them, respectively), but rather in how it causes pathogens to simply slide off during washing.

    Here’s a study that found that handwashing with soap reduced disease incidence by 50–53%, and…

    ❝Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap.❞

    ~ Dr. Stephen Luby et al.

    Read more: Effect of handwashing on child health: a randomised controlled trial

    Want to wash your hands more than you do?

    There have been many studies into motivating people to wash their hands more (often with education and/or disgust-based shaming), but an effective method you can use for yourself at home is to simply buy more luxurious hand soap, and generally do what you can to make handwashing a more pleasant experience (taking a moment to let the water run warm is another good thing to do if that’s more comfortable for you).

    Take care!

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  • Families including someone with mental illness can experience deep despair. They need support

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    In the aftermath of the tragic Bondi knife attack, Joel Cauchi’s parents have spoken about their son’s long history of mental illness, having been diagnosed with schizophrenia at age 17. They said they were “devastated and horrified” by their son’s actions. “To you he’s a monster,” said his father. “But to me he was a very sick boy.”

    Globally, one out of every eight people report a mental illness. In Australia, one in five people experience a mental illness in their lifetime.

    Mental illness and distress affects not only the person living with the condition, but family members and communities. As the prevalence of mental health problems grows, the flow-on effect to family members, including caregivers, and the impact on families as a unit, is also rising.

    While every family is different, the words of the Cauchis draw attention to how families can experience distress, stress, fear, powerlessness, and still love, despite the challenges and trauma. How can they help a loved one? And who can they turn to for support?

    The role of caregivers

    Informal caregivers help others within the context of an existing relationship, such as a family member. The care they provide goes beyond the usual expectations or demands of such relationships.

    Around 2.7 million Australians provide informal care. For almost a third of these the person’s primary medical diagnosis is psychological or psychiatric.

    It has long been acknowledged that those supporting a family member with ongoing mental illness need support themselves.

    In the 1980s, interest grew in caregiving dynamics within families of people grappling with mental health issues. Subsequent research recognised chronic health conditions not only affect the quality of life and wellbeing of the people experiencing them, but also impose burdens that reverberate within relationships, caregiving roles, and family dynamics over time.

    Past studies have shown families of those diagnosed with chronic mental illness are increasingly forced to manage their own depression, experience elevated levels of emotional stress, negative states of mind and decreased overall mental health.

    Conditions such as depression, anxiety disorders, bipolar disorder, and schizophrenia can severely impact daily functioning, relationships, and overall quality of life. Living with mental illness is often accompanied by a myriad of challenges. From stigma and discrimination to difficulty accessing adequate health care and support services. Patients and their families navigate a complex and often isolating journey.

    The family is a system

    The concept of family health acknowledges the physical and psychological wellbeing of a person is significantly affected by the family.

    Amid these challenges, family support emerges as a beacon of hope. Research consistently demonstrates strong familial relationships and support systems play a pivotal role in mitigating the adverse effects of mental illness. Families provide emotional support, practical assistance, and a sense of belonging that are vital for people struggling with mental illness.

    My recent research highlights the profound impact of mental illness on family dynamics, emphasising the resilience and endurance shown by participants. Families struggling with mental illness often experience heightened emotional fluctuations, with extreme highs and lows. The enduring nature of family caregiving entails both stress and adaptation over an extended period. Stress associated with caregiving and the demands on personal resources and coping mechanisms builds and builds.

    Yet families I’ve interviewed find ways to live “a good life”. They prepare for the peaks and troughs, and show endurance and persistence. They make space for mental illness in their daily lives, describing how it spurs adaptation, acceptance and inner strength within the family unit.

    When treating a person with mental illness, health practitioners need to consider the entire family’s needs and engage with family members. By fostering open and early dialogue and providing comprehensive support, health-care professionals can empower families to navigate the complexities of mental illness while fostering resilience and hope for the future. Family members express stories of an inner struggle, isolation and exhaustion.

    two people embrace in a hallway in supportive gesture
    Family bonds can be a cornerstone of wellbeing. Gorodenkoff/Shutterstock

    Shifting the focus

    There is a pressing need for a shift in research priorities, from illness-centered perspectives to a strengths-based focus when considering families “managing” mental illness.

    There is transformative potential in harnessing strengths to respond to challenges posed by mental illnesses, while also supporting family members.

    For people facing mental health challenges, having loved ones who listen without judgement and offer empathy can alleviate feelings of despair. Beyond emotional support, families often serve as crucial caregivers, assisting with daily tasks, medication management and navigating the health-care system.

    As the Cauchi family so painfully articulated, providing support for a family member with mental illness is intensely challenging. Research shows caregiver burnout, financial strain and strained relationships are common.

    Health-care professionals should prioritise support for family members at an early stage. In Australia, there are various support options available for families living with mental illness. Carer Gateway provides information, support and access to services. Headspace offers mental health services and supports to young people and their families.

    Beyond these national services, GPs, nurses, nurse practitioners and local community health centres are key to early conversations. Mental health clinics and hospitals often target family involvement in treatment plans.

    While Australia has made strides in recognising the importance of family support, challenges persist. Access to services can vary based on geographic location and demand, leaving some families under-served or facing long wait times. And the level of funding and resources allocated to family-oriented mental health support often does not align with the demand or complexity of need.

    In the realm of mental illness, family support serves as a lifeline for people navigating the complexities of their conditions.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Amanda Cole, Lead, Mental Health, Edith Cowan University

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

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  • Zucchini & Oatmeal Koftas

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    These vegetarian (and with one tweak, vegan) koftas are delicious as a snack, light lunch, or side to a larger meal. Healthwise, they contain the healthiest kind of fiber, as well as omega-3 fatty acids, and beneficial herbs and spices.

    You will need

    • ¼ cup oatmeal
    • 1 large zucchini, grated
    • 1 small carrot, grated
    • ¼ cup cheese (your preference; vegan is also fine)
    • 2 tbsp ground flaxseed
    • 2 tbsp nutritional yeast
    • ¼ bulb garlic, minced
    • 2 tsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Small handful fresh parsley, chopped
    • Extra virgin olive oil, for frying

    Method

    (we suggest you read everything at least once before doing anything)

    1) Soak the flaxseed in 2 oz hot water for at least 5 minutes

    2) Combine all of the ingredients except the olive oil (and including the water that the flax has been soaking in) in a big bowl, mixing thoroughly

    3) Shape into small balls, patties, or sausage shapes, and fry until the color is golden and the structural integrity is good. If doing patties, you’ll need to gently flip them to cook both sides; otherwise, rolling them to get all sides is fine.

    4) Serve! Traditional is with some kind of yogurt dip, but we’re not the boss of you, so enjoy them how you like:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

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