type 2 diabetes diet sheet or Fighting-Type-2-Diabetes-HOPE.pdf

1. Index: • Hope • Introduction • A word of warning • Is type 2 diabetes really a progressive disease? • A low carb diet for beginners • First steps and shopping list • Carbs counting • How Many Meals Daily Should Type 2 Diabetics Have • Why Is It Important To Regularly Check BS Levels • Eat to your meter • Blood Glucose Level Ranges Normal And Diabetic • What are carbohydrates • Best vegetables for type 2 diabetics • The question that has always bothered me • Calorie confusion – No relationship between diabetes and calories • Controlling hunger • Type 2 Diabetes: The Exercise Approach • Insulin - The Cause Of Weight Gain And Obesity • The Carbohydrate-Insulin Hypothesis • Hormones • Three rules for reversing type 2 diabetes • Intermittent fasting • Common questions and answers about fasting • After words • How it began? My journey to hope • Examples of Intermittent Fasting • Example of 7 Days Meal Plan • Food Supplements and Magic Pills • Testimonial • Glossary - Acronyms

2. Introduction Most doctors, dietitians and diabetes specialists claim that type 2 diabetes is a chronic and progressive disease. The American Diabetes Association, for example, almost proudly proclaims this on its website. Once you get the diagnosis, it’s a life sentence. But, it’s actually a great big lie. Type 2 diabetes is almost always reversible and this is almost ridiculously easy to prove. This is great news for the more than 50% of American adults who have been diagnosed with pre-diabetes or diabetes. Recognizing this truth is the crucial first step in reversing your diabetes or pre-diabetes. Actually, it’s something that most people already instinctively know to be true. Suppose your friend is diagnosed as diabetic, then works hard to lose 50 pounds. He takes himself off all his medications and his blood sugars are now normal. What would you say to him? Probably something like “Great job. You’re really taking care of yourself. Keep it up!” What you wouldn’t say is something like “You’re such a dirty, filthy liar. My doctor says this is a chronic and progressive disease so you must be lying to me.” It seems perfectly obvious that diabetes reversed because your friend lost all that weight. And that’s the point. The disease is reversible. We’ve known this all along. But only diet and lifestyle changes will reverse it. NOT medications. The most important thing, of course, is to lose weight. But the diabetes medications don’t do this. Quite the contrary. Insulin, for example is notorious for causing weight gain. We intuitively sense that we are heading down the wrong path. They would often say, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” He/She never had a good answer, because none existed. It was not good. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it. Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes. We can pretend the disease is better, but that doesn’t make it true. That’s the reason most doctors think type 2 diabetes is a chronic and progressive disease. They have been using the wrong treatment. They have been prescribing drugs for a dietary disease. No wonder it doesn’t work. So, how can you reverse your diabetes? The sugar bowl The essential feature of type 2 diabetes and pre-diabetes is that our bodies are completely filled with sugar. It’s not just too much sugar in the blood. That’s only part of the problem. There’s too much sugar in our entire body. Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.

3. Insulin is a normal hormone produced when we eat and its job is to allow glucose into the cells. When it is no longer able to do it, glucose piles up outside the cell in the blood, and it is called insulin resistance. But why does this happen? The cells are already over-filled with glucose. Like trying to blow air into an over- inflated balloon, it simply takes more force. The cell resists the glucose because it’s completely full. Insulin resistance is an overflow phenomenon. It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin. When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat. The problem, of course, has not been solved – the sugar bowl is still overflowing. You’ve only moved sugar from the blood (where you could see it) into the body (where you couldn’t see it). So, the very next time you eat, the exact same thing happens. Sugar comes in, spills out into the blood and you take metformin to cram the sugar back into the body. This works for a while, but eventually, the body fills up with sugar, too. Now, that same dose of metformin cannot force any more sugar into the body. So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections. Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar. The medications only hide the blood sugar by cramming it into the engorged body. The diabetes looks better, since you can only see the blood sugars. Doctors can congratulate themselves on a illusion of a job well done, even as the patient gets continually sicker. Patients require ever increasing doses of medications and yet still suffer with heart attacks, congestive heart failure, strokes, kidney failure, amputations and blindness. “Oh well” the doctor tells himself, “It’s a chronic, progressive disease”.

4. Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad. You needed to throw out the garbage, not hide it away. If we understand that too much sugar in the blood is toxic, why can’t we understand that too much sugar in the body is toxic too? The end game What happens over time – 10, 20 years? Every single part of the body just starts to rot. This is precisely why type 2 diabetes, unlike virtually any other disease, affects every part of our body. Every organ suffers the long term effects of the excessive sugar load. Your eyes rot – and you go blind. Your kidneys rot – and you need dialysis. You heart rots – and you get heart attacks and heart failure. Your brain rots – and you get Alzheimer's disease. Your liver rots – and you get fatty liver disease. Your legs rot – and you get diabetic foot ulcers. Your nerves rot – and you get diabetic neuropathy. No part of your body is spared. Medications and insulin do nothing to slow down the progression of this organ damage, because they do not eliminate the toxic sugar load from our body. We’ve known this inconvenient fact since 2008. No less than 7 multinational, multi-centre, randomised controlled trials of tight blood glucose control with medications (ACCORD, ADVANCE, VADT, ORIGIN, TECOS, ELIXA, SAVOR) failed to demonstrate reductions in heart disease, the major killer of diabetic patients. We pretended that using medications to lower blood sugar makes people healthier. But it’s only been a lie. You can’t use drugs to cure a dietary disease. How to reverse diabetes Once we understand type 2 diabetes, then the solution becomes pretty bloody obvious. If we have too much sugar in the body, then get rid of it. Don’t simply hide it away so we can’t see it. There are really only two ways to get rid of the excessive sugar in the body. • Don’t put sugar in • Burn it off That’s it. That’s all we need to do. The best part? It’s all natural and completely free. No drugs. No surgery. No cost. Step 1 – don’t put sugar in The first step is to eliminate all sugar and refined starches from your diet. Sugar has no nutritional value and can therefore be eliminated. Starches are simply long chains of sugars. Highly refined starches such as flour or white rice are quickly broken down by digestion into glucose. This is quickly absorbed into the blood and raises blood sugar. For example, eating white bread increases blood sugars very quickly. Doesn’t it seem self-evident that we should avoid foods that raise blood sugars because they will eventually be absorbed into the body? The optimum strategy is to eat little or no refined carbohydrates. Too much dietary protein is also converted into glucose by the body. Therefore, you should avoid eating too much protein as this, too will only add sugar to the body. Protein shakes, protein bars, and protein powders should all be avoided. Instead focus on eating lots of vegetables and natural healthy fats.

5. Dietary fat, long shunned for its purported effect of causing heart disease, is back. Natural fats, such as found in avocado, nuts and olive oil are well known to have healthy effects on both heart disease and diabetes. Dietary cholesterol has also been shown to have no harmful effect on the human body. Eggs and butter are back. Most importantly, stick to eating whole, natural, unprocessed foods. Step 2 – burn it off Fasting is the simplest and fastest method to force your body to burn sugar for energy. Glucose in the blood is the most easily accessible source of energy for the body. Fasting is merely the flip side of eating – if you are not eating you are fasting. When you eat, your body stores food energy. When you fast, your body burns food energy. If you simply lengthen out your periods of fasting, you can burn off the stored sugar. Since type 2 diabetes is merely excessive glucose in the body, burning it off will reverse the disease. While it may sound severe, fasting has been practised for at least 2000 years. It is the oldest dietary therapy known. Literally millions of people throughout human history have fasted without problems. If you are taking prescription medications, you should seek the advice of a physician. But the bottom line comes to this. If you don’t eat, will your blood sugars come down? Of course. If you don’t eat, will you lose weight? Of course. So, what’s the problem? None that I can see. More about Intermittent fasting later in this e-book/guide. We can reverse type 2 diabetes and pre-diabetes today, right now, immediately. All without cost, without drugs, without surgery, with an all natural, time-tested healing method. We only need to lead our bodies down the healing pathway and have the courage to apply our hard-won knowledge.

6. A word of warning before we start going into details. I am not going to lie and say it will be easy journey for anyone. The opposite is true. It is going to be a hell of ride and many people will want to give up within first two weeks. I have been there and I have done it, so I know what I am talking about. A former serious sugar and carb addict. Yes, I have used the word addict for a simple reason. Sugar is more addictive than crack cocaine. On this journey, each of you, will fight addiction to sugar, same as drug users fight their addiction to drugs. Same as alcoholics fight addiction for alcoholic drink. It’s exactly the same, but with one big difference. You will not be locked out in controlled environment where somebody will watch you 24/7. You will be home with easy access to all that bad stuff. You will fight with your own mind, but with the information’s in this guide, you will be ready to overcome every obstacle that will be thrown in front of you. There is a lot to take in, and most of you will be confused about what is allowed and what is a big NO NO. This might all sound scary at the beginning, but with time it will get easier and the results will keep you going forward. Anyone can get confused, lost, or just don’t understand something time to time. We all do. Thankfully, I am just a simple message or phone call away for those who truly want to change their lives for better(more details at the end of this guide). Let’s get started.

7. IS TYPE 2 DIABETES really a progressive disease? MOST HEALTH PROFESSIONALS consider type 2 diabetes to be a chronic and progressive disease. This promotes the idea that type 2 diabetes is one-way street, a life sentence with no possibility of parole: the disease continually gets worse until you eventually require insulin injections. But this is actually a great big lie, which is excellent news for anyone who has been diagnosed with pre- diabetes or type 2 diabetes. Recognising the fallacy of this belief is the crucial first step in reversing the disease. Actually, most people already instinctively recognise this. It’s ridiculously easy to prove that type 2 diabetes is almost always reversible. We have intuitively sensed this truth all along. But only diet(woe) and lifestyle changes- not medications- will reverse this disease, simply because type 2 diabetes is largely a dietary disease. The most important determinant, of course, is weight loss. Most of the medications used to treat type 2 diabetes do not cause weight loss. Quite the contrary. Insulin, for example, is notorious for causing weight gain. Once we start insulin injections for type 2 diabetes, we often sense that we are heading down the wrong path. Since weight loss is the key to reversing type 2 diabetes, medications don’t help. We only pretend they do, which is the reason most doctors think type 2 diabetes is chronic and progressive. We have avoided facing an inconvenient truth: drugs won’t cure a dietary disease. They are about as useful as bring a snorkel to a bicycle race. The problem is not the disease; the problem is how they treat the disease. Now, we are going to have a closer look at the right diet for reversing type 2 diabetes and who should not be doing it, or more likely be aware of the risks for some people, then we will dig a little bit deeper into details and what’s is good to eat and drink, and what should be avoided.

8. Low carb diet for beginners A low carb diet is low in carbohydrates, primarily found in sugary foods, pasta and bread. Instead, you eat real foods including protein, natural fats and vegetables. Studies show that low carb diets result in weight loss and improved health markers, and just about everyone knows someone who has successfully tried it. There’s not even any need to count calories or use special products. So why is it still controversial? Learn more about low carb and how to use it for your personal goals here. 1. Introduction to low carb A low carb diet means that you eat fewer carbohydrates and a higher proportion of fat. This can also be called a low carb, high-fat diet (LCHF) or a keto diet. For decades we’ve been told that fat is detrimental to our health. Meanwhile low-fat “diet” products, often full of sugar, have flooded supermarket shelves. This has been a major mistake, that coincided with the start of the obesity epidemic. Studies now show that there’s no reason to fear natural fats. Fat is your friend (here’s why). On a low-carb diet, you instead minimise your intake of sugar and starches. You can eat other delicious foods until you are satisfied – and still lose weight. How does it work? When you avoid sugar and starches, your blood sugar stabilises and the levels of the fat- storing hormone insulin drop. This increases fat burning and makes you feel more satiated, reducing food intake and causing weight loss. Studies prove that a low-carb diet makes it easier both to lose weight and to control your blood sugar, among other benefits. The basics Eat: Meat, fish, eggs, vegetables growing above ground and natural fats (like butter). Avoid: Sugar and starchy foods (like bread, pasta, rice, beans and potatoes). Eat when you’re hungry, until you’re satisfied. It’s that simple. You do not need to count calories or weigh your food. And just forget about industrially produced low-fat products. Who should NOT do a strict low-carb diet? Most people can safely start any kind of low-carb diet. But in these three situations you may need some preparation or adaptation: • Are you taking medication for diabetes, e.g. insulin? Consult this with your doctor as your insulin dose may need to be adjusted. Risk of hypos. • Are you taking medication for high blood pressure? Consult this with your doctor. Risk of low blood pressure. • Are you currently breastfeeding? To be safe choose a more moderate low-carb diet, with at least 50 grams of carbs per day. If you’re not in any of these groups, you’re good to go. Great!

9. Getting started fast 2. What to eat on a low-carb diet In this section you can learn exactly what to eat on low carb diet, whether you prefer visual guides, detailed food lists, delicious recipes or a simple get started guide. Let’s start with a quick visual guide to low carb. Here are the basic food groups you can eat all you like of, until you’re satisfied: The numbers above are grams of digestible carbs per 100 grams (3.5 ounces). Fibre is not counted, you can eat all the fibre you want. All foods above are below 5% carbs. Sticking to these foods will make it relatively easy to stay on a strict low-carb diet, with less than 20 grams of carbs per day. Try to avoid Here’s what you should not eat on low carb – foods full of sugar and starch. These foods are much higher in carbs. The numbers are grams of digestible carbs per 100 grams (3.5 ounces), unless otherwise noted.

10. What to drink What drinks are good on a low-carb diet? Water is perfect, and so is coffee or tea. Preferably use no sweeteners. A modest amount of milk or cream is OK in coffee or tea (but beware of coffee latte and other speciality coffees!). The occasional glass of wine is fine too. How low carb is a low carb diet? The fewer carbohydrates you eat, the more powerful the effects on weight and blood sugar will be. We recommend initially following the dietary advice fairly strictly. When you’re happy with your weight and health, you may carefully try eating more carbs (if you want to). Here are three examples of what a low-carb meal can look like, depending on how many carbs you plan to eat per day:

11. Here’s a picture with basic low-carb advice, that you may want to print and have around, or give to friends who are curious: 3. Potential benefits of a low carb diet Why would you consider eating fewer carbs? There are many potential benefits, proven by science and experience, like these four: • Lose weight Most people start eating fewer carbs to lose weight, a well-known and often highly effective method. However, the reason many people keep eating low carb is more often the powerful health effects, like the following ones. • Reverse type 2 diabetes Low-carb diets can normalize blood sugar and thus potentially reverse type 2 diabetes. Low carb can also be very helpful in managing type 1 diabetes. • A grateful gut

12. Low carb can help settle a grumpy gut, reducing symptoms of irritable bowel syndrome such a bloating, gas, diarrhoea, cramps and pain. Indigestion, re-flux and other digestive issues can improve, too. For many, this is the best part of going low carb and happens usually within the first few days, or first week, of starting the diet. • Reduce sugar cravings Are you struggling to stay away from sweet foods, even though you try to eat them in “moderation”? Tons of people do. A low-carb diet usually reduces and sometimes even eliminates cravings for sweets. • Bonus benefits Weight loss, shrinking fat stores, lower blood sugar, improved mental clarity, and a calmer digestive system are the most frequently cited benefits of low-carb eating. But some people experience even more life-changing improvements: lower blood pressure, less acne and better skin, fewer migraines, improved mental health symptoms, better fertility, and even more. 4. Potential side effects on a low carb diet If you stop eating sugar and starch cold turkey (recommended) you may experience some side effects as your body adjusts. For most people these side effects tend to be mild and last a just few days. There are also ways to minimise them. Another option is to decrease the intake of carbohydrates slowly, over a few weeks, to minimise side effects. But the “Nike way” (Just Do It) is probably the best choice for most people. Removing most sugar and starch often results in several pounds lost on the scale within a few days. This may be mostly fluids, but it’s great for motivation. Here are side effects that may occur when you suddenly start a strict low-carb diet. • Induction flu By far the most common side effect is called the induction flu. It’s what makes some induction flu people feel really poorly 2-3 days after starting low carb. Here are the common symptoms: Headache Fatigue Dizziness Light nausea and Irritability These side effects rapidly subside as your body adapts and your fat burning increases. Within a week, they are usually gone. The reason for this is that carbohydrate-rich foods may increase water retention in your body. When you stop eating high-carb foods you’ll lose excess water through your kidneys. This can result in dehydration and a lack of salt during the first week, before the body has adapted, resulting in the symptoms above. You can minimise the induction flu by drinking more fluids and by temporarily increasing your salt intake. A good option is to drink a cup of bouillon/broth one or two times a day. This usually keeps the induction flu minor or even non-existent. Alternatively, drink a few extra glasses of water and put more salt on your food.

13. First steps and shopping list The most difficult step, it is nothing that you need to do any preparations for, yet it is very important for everyone who wants to succeed in low carbing and reversing type 2 diabetes. It all starts with cleaning. For some it may seem as waste of money, but trust me, it will save you some at the end. Cleaning and clearing your cupboards, fridge and other food storage of anything that holds more than 10 grams of carbohydrates per 100 grams of product. You decide what to do with it (bin it, give it away), just get rid of it. I personally have given all of that stuff to the lady next door and she was really grateful for it. As a thank you I have been given two pheasants, can't argue with that. “”NOTE: if this is not possible and you have family members who still eats carbohydrate heavy meals, split the cupboards and set aside all carb heavy products. It will be hard at the beginning not to touch or eat them, but this will get easier with time.”” The food list will help you. This list should also be considered as your shopping list. Do not buy anything what is not on that list, at least for a couple of months or as long as necessary for anyone to get the low carbing right.

14. Carb Counting & Apps that will help you get this right Counting carbohydrates is the most important, and the best way of doing it, is simply write everything down in a notepad. Get yourself a good set of kitchen scales, notepad and pen. Get familiar with nutrition labels as you going to read a lot of them. The most important information for you will be the Carbohydrates value. Here in the UK we are a bit more lucky because all the work has been done for us. I am talking about net carbohydrates. In US unfortunately this must be done by you. But don't worry, it isn't that complicated. What is different and how do I know it is US label? This is very easy. The difference is in the word Fiber. In the UK it is spelled Fibre and it is already deducted from the total carbohydrates value. See the example of US nutrition label. The values that you are looking for are: • Serving Size (per 100 grams preferred) • Total Carbohydrates • Dietary Fiber and • Sugar Alcohol(if there is any) If you are US based, then you will need to deduct Dietary Fiber from the Total Carbohydrates, and if, there is Sugar Alcohol, then deduct half the amount of Sugar Alcohol from the Total Carbohydrates too. Only after that you will get the Net Amount of Carbohydrates. On the example label, if you got it right, it should get you 10.5 grams Net Carbohydrates per serving (26 grams). This is just an example, and whatever the label is from, you would better avoid it. As we prefer to look for values per 100 grams, this example would go to 40.38 grams of Net Carbohydrates per 100 grams of the product. That is simply to much and for somebody like me it would be 1/3 of my daily target in just one serving.

15. The amount of Net Carbohydrates you should be aiming for? The amount of Net Carbohydrates per day is each persons individual decision. As you remember, we are aiming for a low carbohydrate way of eating. This means that everything below 100 grams of Net Carbohydrates per day is considered low carbohydrate. Keep in mind that this target might not be suitable for everyone and many people will need to go lower than that. In my experience, 50 grams of Net Carbohydrates per day should really be target to aim for, but some may have to go as low as 20 grams per day. Apps to make it easier for you: MyFitnessPal – App Store | Google Play Carb Manager – App Store | Google Play This leads directly to next step, and you might have already guessed which one. Yes, you are right. How on earth one can keep eating just 50 grams of Net Carbohydrates per day? This is achievable only by changing your eating habits and the amount of meals per day. Current ADA (American Diabetes Association) and NHS (National Healthcare System- UK) recommendations are, at least 3 meals and 2 snacks per day. These recommendations are simply too old and we know that this will not work, at all. Not just because one cannot simply do low carb diet by eating so many times per day, but also it will keep your insulin levels high all the time. About insulin and why we need to keep it low for longer periods of time, later in this guide. Let’s get back to how many meals per day is acceptable and why.

16. How many meals per day should a type 2 diabetic have? How Many Meals Daily Should Type 2 Diabetic Have? will always be question asked by many newly diagnosed, and for many who is in it for some time now this will always be a subject to discuss and give advice to newly diagnosed. In most cases their advice can lead to other complications and will never help anybody to better manage their BS levels. I have seen many times over and over, people newly diagnosed with Type 2 Diabetes ask the question, How Many Meals Daily Should Type 2 Diabetic Have? There are many websites and Facebook groups that “allegedly” offer help and support with type 2 diabetes related questions. While the question is always same, there are many different answers and opinions. People get scared and confused. I bet you, that most of them have been told by their GP’s and DN’s to eat at least 3 main meals and two snacks in between. I have even seen some advice to eat 6 small meals daily. It’s like WHAT? Six times, how on the earth I am going to do this? This is the most stupid advice I have ever heard. Why would someone stuffed themselves five or six times a day and feel like shit? Excuse the language. So, How Many Meals Daily Should Type 2 Diabetic Have? As many as one needs to feel satiated, not hungry. Meaning, if one needs to have three meals, have three meals, but if you are not as hungry as others and you follow a good woe(way of eating), then you might need just two meals per day(don’t worry if you skip breakfast). Some people prefer to eat OMAD(one meal a day, not recommended long term and for weight loss) and it’s totally fine as long as you get enough calories, carbs(100 grams or less) and healthy fats for your body to function properly. To put some light on the eating patterns. Every Type 2 Diabetic must think about their BS levels. The aim is to get them as low as you can within the safe range. Every time you have a meal your BS levels changes. Depends on the type of the meal, they go up, stay same or they might go slightly down. Insulin levels also spikes to deal with the food. I will talk about insulin a bit later.

17. If a person is new to all of this type 2 diabetes stuff, they have been in most cases advised to eat up to 45g of carbs per meal and up to 20g of carbs per snack. This is far too many carbs per day, if you are lucky they will bring your levels down a little, but will keep you dependent on medications, which will happily regulate BS levels exactly where the big pharma companies want them to be. WHY? Because, if they keep us sick they make money. They do treat us as customers and not humans. Conclusion: Eat as much as your body needs. When you feel satiated stop eating. If you are not hungry don’t eat. Skipping meals is fine as long as you are not on insulin(consult skipping meals with your GP or DN). STOP EATING FAKE AND HIGHLY PROCESSED FOOD. And finally, ENJOY YOUR LIFE, have fun. By following low carb way of eating this will not be hard to achieve and I promise, you will feel more happy, energised and say good bye to many health problems along the way.

18. Checking blood glucose (sugar) levels Why Is It Important To Regularly Check BS Levels? There are many opinions on checking BS levels regularly. Many of us have been told that checking is not necessary for type 2 diabetics. In my opinion, checking BS levels is absolutely necessary if you want to manage type 2 diabetes and send it to remission. WHY? If you don’t check BS levels then it is impossible to find out if your diet/woe works. This way you can just be in illusion that everything is fine and nothing needs to be changed. Then you are back for your check up and the amount of medications will just be increased every time. HOW OFTEN SHOULD I CHECK? If anyone is serious about managing type 2 diabetes then it is necessary to check before each meal and then 2 hours after first bite to see if you are having spikes. The amount of tests will decrease in time and you will not need to test if you know that the meal has been OK before. UNFORTUNATELY I know that many people did not get their meters from their DN and test strips,lancets on prescription as it seems to be like a postcode lottery. But don’t worry too much. Meters can be bought online and they don’t even cost that much. If you are one of the unlucky people, check the link bellow. This whole set can be purchased for £15.59 or if you are diabetic then for £12.99. Codefree Blood Glucose Monitor Set

19. So, if anyone wants to manage type 2 diabetes and lower their medications instead of increasing them, TEST!!! “” REMEMBER THIS: Bread, Pasta, Potatoes, Rice, Veg that grows below ground, Legumes, Sugar(any type), Fruit(except berries occasionally), Milk, Wheat products, Flour, Grains, and low fat products are forbidden. Also, NO canned or processed food is allowed. Carbohydrates, Low Fat products, Sugar and Artificial Sweeteners are your enemy. Some sweeteners doesn’t seem to rise blood sugars(not always the truth) yet they still rise your insulin levels which is the cause of insulin resistance and leads to type 2 diabetes.”

20. Eat To Your Meter: Phrase Explained Eat to your meter is a phrase used to describe the use of systematic blood glucose testing to inform the dietary choice of appropriate foods and quantities of foods for good diabetes control. Using the ‘eat to your meter’ system is of particular use to people with type 2 diabetes. If you are on insulin, the principles of eating to your meter can be applied but you must take care not to increase your risk of hypos. How to eat to your meter To get started, you will need: A blood glucose meter ( discount for diabetics) Blood glucose test strips Blood glucose level targets to aim towards A notebook, desktop app or phone app to record results Take the following steps: • Test your blood glucose before a meal and record the result • Have your meal and record what you ate • Test your blood glucose levels 2 hours after having started your meal and record the result • Test your blood glucose levels 4 hours after having started your meal and record the result (optional) Also note down any other factor that may affect your blood glucose levels, this could include any activity carried out earlier in the day or after eating or any periods of stress or illness. Making sense of the results: The aims of eating to your meter is in identifying the foods or meals that lead to a larger rise in your blood sugar levels after eating and the foods and meals that lead to a smaller rise after eating. This helps you to tailor your diet towards the foods that help you to meet the guideline blood glucose targets.

21. If a meal causes a large rise in blood glucose levels at the 2 hour mark, you may wish or need to either remove this meal from your regular diet or look to reduce the size of the portion you had of it. Note that it is the rise in your sugar levels you are looking for. To find the rise, take your result 2 hours after eating and subtract from this your before meal reading. Similarly, it is also worth looking at the difference between the result 4 hours after eating and your before meal reading when deciding whether a meal is suitable for you. An example of eating to your meter It helps to run through an example to see how eating to your meter can be applied. In the example below, we look at two meals in which we take readings before the meal (A), 2 hour after eating (B) and 4 hours after eating (C). To assess the best meal for blood glucose levels, we need to look at the columns marked ‘2 hour rise’ and ‘4 hour rise’. In this example, the pork chops and swede mash show the best results as it produces a smaller rise at both the 2 hour and 4 hour mark. So, in this example, we may want to consider either having egg sandwiches less regularly in our diet or to test again to see if having egg sandwiches with whole grain bread produces better blood sugar readings. Note: this is just an example and you may find that you have different results to those above. The best way to see how your own body responds is to try it out for yourself. The simple way to understand blood glucose spikes is this: check your levels before meal and then 2 hours after first bite. If the blood glucose levels are same or close to the pre-meal levels then the food is good to eat. But if there is rise and your blood glucose levels are 3 points (US – 30 points) or more higher than the pre- meal levels, then that is considered as spike in blood glucose. That food should be avoided or at least looked at. Find out what could caused the spike and avoided next time. Prepare for surprises Be prepared to get some surprising results. It’s not uncommon for people with diabetes to get results that don’t match their expectations. Take porridge as an example, some people find their sugar levels respond very well to porridge, but other members find, it can lead to a big rise in blood glucose levels. Whilst porridge is widely regarded as being a healthy breakfast, it’s well worth testing to see whether your body copes well with it.(do not always believe to what others say is healthy)

22. Note #2: when testing foods or meals, it’s often worth re-testing foods at least to build up a fair picture of how it affects your sugar levels as irregular results can sometimes occur for different reasons. Benefits of eat to your meter There are a number of benefits to support eating to your meter: Allows you to tailor your diet, to your own needs. We’re all individuals and how different foods affect different people can vary substantially. Eating to your meter helps you to test how much different foods and meals affect your own sugar levels. Effective at reducing high blood glucose levels after meals As after meal periods can account for around a third of the day, improving your after meal blood glucose results can have a significant effect on lowering your HbA1c. Reduce unpleasant symptoms of high sugar levels It stands to reason that by reducing your sugar levels after meals, this will help to reduce the effect of symptoms linked to high sugar levels such as tiredness, hunger, brain fog and increased need to urinate. Build confidence in your control As you begin to build a greater understanding of how different foods affect your blood glucose levels and your sugar levels start to improve as a result, this will not only help you feel better but build your confidence in your diabetes control. Disadvantages of eat to your meter Testing blood glucose levels is an essential part of eating to your meter so you will need to get used to taking blood tests. Blood glucose testing is not always pain free but it has become easier as technology has improved and most people get used to and comfortable with testing once the first few tests have been done. In addition, cost can be an issue. If you get blood glucose test strips supplied this may not be an issue. If your doctor is not happy to prescribe test strips or only happy to prescribe limited amounts, you may need to personally buy some of your test strips. How to deal with blood glucose spikes The best way to deal with blood glucose spikes is to drink a plenty of water and light exercise. Walking would be one of the best light exercises or if you have, by any chance exercise bike at home, that would be good too.

23. Blood Glucose Level Ranges Normal And Diabetic Understanding blood glucose level ranges can be a key part of diabetes self-management. This page states ‘normal’ blood sugar level ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes. Because, if a person with diabetes has a glucose meter, test strips, lancets and is testing, it’s important to know what the blood glucose level means. Recommended blood glucose level ranges have a degree of interpretation for every individual and you should discuss this with your healthcare team. In addition, women may be set target blood sugar levels during pregnancy. As a result, the following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE). Therefore, each individual’s target range should be agreed by their doctor or diabetic consultant. Recommended target blood glucose level ranges The NICE recommended target blood glucose level ranges are stated below. For adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes. The table provides general guidance. An individual target set by your healthcare team is the one you should aim for. *The non-diabetic figures are provided for information but are not part of NICE guidelines. Normal and diabetic blood sugar level ranges For the majority of healthy individuals, normal blood sugar levels are as follows: • Between 4.0 to 5.4 mmol/L (72 to 99 mg/dL) when fasting • Up to 7.8 mmol/L (140 mg/dL) 2 hours after eating For people with diabetes, blood sugar level targets are as follows: • Before meals: 4 to 7 mmol/L for people with type 1 or type 2 diabetes • After meals: under 9 mmol/L for people with type 1 diabetes and under 8.5mmol/L for people with type 2 diabetes

24. Blood sugar levels in diagnosing diabetes. The following table lays out criteria for diagnoses of diabetes and pre-diabetes. • Random plasma glucose test A blood sample for a random plasma glucose test is taken at any time. This doesn’t require as much planning and is therefore used in the diagnosis of type 1 diabetes when time is of the essence. • Fasting plasma glucose test A fasting plasma glucose test is taken after at least eight hours of fasting and is therefore usually taken in the morning. The NICE guidelines regard a fasting plasma glucose result of 5.5 to 6.9 mmol/l as putting someone at higher risk of developing type 2 diabetes, particularly when accompanied by other risk factors for type 2 diabetes. • Oral Glucose Tolerance Test (OGTT) An oral glucose tolerance test involves taking a first taking a fasting sample of blood and then taking a very sweet drink containing 75g of glucose. While you having this drink you need to stay at rest, until a further blood sample is taken after 2 hours. • HbA1c test for diabetes diagnosis An HbA1c test does not directly measure the level of blood glucose. Because, each result of the test is encouraged with the aid of how excessive or low your blood glucose ranges have tended to be over a duration of 2 to 3 months. Consequently, symptoms of diabetes or pre-diabetes are given beneath the following conditions: Normal: Below 42 mmol/mol (6.0%) Pre-diabetes: 42 to 47 mmol/mol (6.0 to 6.4%) Diabetes: 48 mmol/mol (6.5% or over) • Why are good blood sugar levels important? It is important that people control their blood glucose levels as well as they can. Because, too high sugar levels for long periods of time increases the risk of diabetes complications developing. Diabetes complications are health problems which include: Kidney disease Nerve damage Retinal disease Heart disease Stroke This list of problems may look scary. People can make a note that the risk of these problems can be minimised via properly blood glucose level ranges control. Small improvements in the way of eating can make a big difference if you stay dedicated and maintain those improvements over most days.

25. I have already mentioned that there are many opinions on checking BS levels regularly. Many of us been told that checking is not necessary for type 2 diabetics . In my opinion, checking BS levels is absolutely necessary if you want to manage type 2 diabetes and send it to remission. For example. I have been testing 7 times every day for the first two or three months. Before each meal and then two hours after, that was a total of 6 test plus one test in the morning for a fasting blood glucose levels. Bare in mind that morning fasting blood glucose levels are usually higher and will settle after few months. The reason for them being higher is your liver. Every morning, just before you wake up, your liver will dump stored glucose into your system to get you ready to go. This is also called Dawn Phenomenon.

26. Carbohydrates And Their Impact On Your Health What are carbohydrates? Carbohydrates are the sugars, starches and fibres found in fruits, grains, vegetables and milk products. Though often maligned in trendy diets, carbs — one of the basic food groups — are important to a healthy life. Carbohydrates are macro-nutrients, meaning they are one of the three main ways the body obtains energy, or calories. Carbs provide your body with energy that is required to carry bodily functions and physical activity. However, not all carbohydrates sources are equally nutritious. Unlike unprocessed carbohydrates, refined carbs have been processed and lack health-promoting components such as dietary fibre, vitamins and minerals. According to the 2010 Dietary Guidelines for Americans, Americans consume more than the recommended amount of refined carbohydrates, which is no more than 3 ounces per day for a 2,000-calorie diet. Learning about the risks of eating processed carbohydrates may motivate you to make wise dietary decisions. Carbohydrates And Their Impact On Your Health (in excessive amount) Strokes and Obesity A study published in The American Journal of Clinical Nutrition in 2016 analysed the eating habits and instances of stroke in over 64,000 middle-aged Chinese women with no history of diabetes, cancer or heart disease. The researchers found a significant link between diets rich in refined grains and stroke risk. Another study, published in Genetics Research in 2015 linked a high-carbohydrate diet with abdominal obesity. Fat that accumulates in this area is associated with heart disease, certain types of cancer and stroke.

27. Increased Triglycerides Triglycerides are a type of fat found in your fat tissue and bloodstream. Eating a sugar-rich diet can increase your triglyceride levels, which may elevate your risk of heart disease. Many processed carbohydrate sources contain high amounts of added sugars such as high-fructose corn syrup, cane syrup and honey. Unfortunately, according to MayoClinic.com, most Americans eat about 22 teaspoons of added sugar per day, which vastly exceeds the daily recommended maximum of 6 to 9 teaspoons. Risk of Chronic Diseases Processed carbohydrates, such as white pasta, white bread and white rice, are rich in rapidly digested carbohydrates. That means they have a high glycemic index and glycemic load. Such foods cause rapid fluctuations in insulin and blood sugar, causing hunger to spike and leading to overeating. Over time, this increases the risk of diabetes and heart disease. In contrast, unprocessed carbohydrates are digested at a slower pace in your body than their refined counterparts. As a consequence, they have a gentler effect on your insulin and blood sugar, which may help you feel satiated. Healthy Alternatives The Harvard School of Public Health states that when it comes to preventing chronic diseases and maintaining a stable weight, carbohydrate quality takes precedence over carbohydrate quantity. Therefore, for optimal health, choose whole grains such as barley, brown rice, rye, quinoa and whole-wheat bread(in moderation) over French fries or refined white bread. These foods can also help improve blood sugar control and appetite control. Furthermore, swapping unhealthier sources of carbohydrates for unprocessed or minimally processed vegetables, fruits (berries) and beans (in moderation) will deliver fibre, vitamins, minerals and a number of phytonutrients, thereby promoting good health. Note: For people diagnosed with Type 2 diabetes(like myself) the best practice is to give up all white carbohydrates(rice, pasta, bread, potatoes, wheat products, grains etc.) All these may spike your blood sugar levels(my personal experience) Note #2: Whole grains such as barley, brown rice, rye, quinoa and whole-wheat bread are for sure healthy alternatives, but I would advise to avoid them for at least 6 months. Let your body heal before you start feeding it with high carb foods. Even then, limit these products to once in two weeks. Maybe you can get away having them once a week, but it is advised to check your blood glucose levels when you eat them. Just to be sure that you can tolerate them.

28. Best Vegetables For Type 2 Diabetics The best vegetables for type 2 diabetics are low on the glycemic index (GI) scale, rich in fibre, or high in blood pressure-lowering nitrates. Why choose vegetables? When considering foods to avoid, many people with diabetes might think about sugary or high-carbohydrate foods, such as cinnamon rolls or bread. Certain vegetables, however, can also cause blood glucose issues. The GI refers to how rapidly foods cause blood sugar levels to rise. Foods high on the GI, for example, most potatoes, quickly release glucose, potentially activating blood glucose spikes. They can likewise cause weight gain when eaten in excess. Low to moderate GI vegetables, for example, carrots, offer better blood glucose control, and a lower danger of weight gain. Nitrates are synthetic compounds (chemicals) that naturally occur in some vegetables. They are also used as preservatives in some foods. Eating nitrate-rich foods, not foods processed with added nitrates, can lower blood pressure, and enhance general circulatory well-being. This means that nitrate-rich foods, such as beets, are among the best vegetables for people with type 2 diabetes who have a higher risk of cardiovascular disease. This is still true despite their high level of carbohydrates. The key to good food management, in this instance, is to reduce carbohydrate consumption elsewhere, such as by eliminating bread or sugary snacks. Fibre and protein are both very important in a healthful diabetes diet. Protein is vital for good health, and can help people feel fuller for longer, reducing the urge to snack and supporting weight loss. Many dark, leafy greens are rich in many vital nutrients, fibre, and contain protein. Fibre can help control blood glucose levels. It also supports healthy cholesterol levels, can lower blood pressure, and relieve constipation. Like protein, fibre can help people feel fuller for longer.

29. Examples of GI values of foods: Frozen green peas score 39 on the GI index, Carrots score 41 when boiled and 16 when raw, Broccoli scores 10, Tomatoes score 15. Eating a wide variety of foods, including a mix of the best vegetables for type 2 diabetes, can help people stay healthy while enjoying a range of meals. Low GI: Vegetables, with GI scores less than 30, include: artichoke asparagus broccoli cauliflower green beans lettuce eggplant peppers snow peas spinach celery It is worth remembering that the GI gives a relative value to each food item, and it does not refer to an amount of sugar. The glycemic load (GL) refers to how much a person will eat in a serving. Healthy Nitrates Food-nitrates: Vegetables rich in nitrates include: arugula beets and beet juice lettuce celery rhubarb Protein: Daily protein recommendations depend on a person’s size, sex, activity level, and other factors. People should speak to a doctor for the best insight on what their ideal daily protein intake is. Pregnant or lactating women, highly active people, and those with large bodies need more protein than others. Vegetables higher in protein include: spinach pak choy asparagus mustard greens

30. broccoli Brussels sprouts cauliflower Fibre: Most people need 25-38 grams (g) of fibre each day. The American Academy of Nutrition and Dietetics recommend 25 g per day for women, and 38 g per day for men. This recommendation varies depending on body size and similar factors. Fibre should come from real food, not supplements. Vegetables and fruits with high fibre content include: carrots beets broccoli artichoke Brussels sprouts split peas avocados Vegan or vegetarian food: Eating vegan or vegetarian with diabetes Eating a vegan or vegetarian diet can prove challenging for people with diabetes. Animal products are generally the most protein-rich options, but vegans avoid dairy and other animal products. Some of the best vegan protein-rich options include: lentils beans and chickpeas peas almonds pumpkin seeds amaranth and quinoa sprouted grain bread soy milk (these are examples and some may have more carbs than others) A vegan or vegetarian person who has diabetes can eat a balanced diet. Nuts, seeds, and lentils offer high protein, often with few calories.

31. Healthful diabetes meals: Any meal that blends several of the ingredients listed above offers excellent nutrition. To keep meals healthy and flavourful, people should avoid using lots of added salt, or relying on pre-packaged ingredients that are high in sodium. People with diabetes should watch the number of calories in their food, too. Excess calories can turn an otherwise healthful meal into something that leads to excessive weight gain. Not enough calories (long term) can/will lower your BMR (Basal Metabolic Rate) and can be irreversible. Balancing less healthful foods with more nutritious ones is a way to remain healthy. People with diabetes who want to eat well, should focus on a balanced overall approach to nutrition. There is a risk that forbidding certain foods can make them feel even more appealing (this usually does not apply to (LCHF) Low Carb High Fat (WOE) Way Of Eating), and this can lead to less control of diet choices and blood sugar over time. People should eat a wide variety of foods from all food groups, and consider eating five to seven small meals instead of three large meals. NOTE: This is an old research and three, even two meals per day are just fine with introduction of (IF) Intermittent Fasting. About that a little bit later. Click Here

32. What happened to fruit? Maybe you are wondering what happened to fruit. Why is it missing from here? We have always been told that fruit is a must to have every day. Fruit is very healthy, we have been told all the time. But is it, really? As type 2 diabetics, your whole body is full of sugar. This is nothing new. Fruit is sugar, fruit makes us fat, so why would you eat more of it. Sounds crazy, doesn’t it. “Let me give an example from an animal world. In the animal world, fruit is eaten only before the long migrations or before winter, to store energy(fat) for survival. Animals don’t eat fruit just because its tasty as humans do. They eat it because the sugar from fruit is stored as fat and used for energy later.” We need to burn off the sugar that is already stored in our bodies. We don’t need any more. Ahh, now you’re thinking about all the vitamins that fruit provide. Good thinking, but all the vitamins can also be found in vegetables, minus the sugar. But, occasionally, a handful of berries should not cause any problems. Limit them, have them as a treat once a week with full fat Greek yogurt. Just a little bit about fructose, the type of sugar in fruit. It’s also found in various sugary sweeteners like high- fructose corn syrup and agave syrup. If a product lists added sugar as one of its main ingredients, you can be pretty sure it’s high in fructose. Why Is Fructose Bad for You? Glucose and fructose are metabolized very differently by the body. While every cell in the body can use glucose, the liver is the only organ that can metabolize fructose in significant amounts. When people eat a diet that is high in calories and high in fructose, the liver gets overloaded and starts turning the fructose into fat. Many scientists believe that excess fructose consumption may be a key driver of many of the most serious diseases of today. These include obesity, type II diabetes, heart disease and even cancer. Now, we have covered carbohydrates and we have had a look at best vegetables. Fruit section is really short one and unfortunately, there isn’t much to add to it. But we still need to cover a very important group of macro-nutrients. Without them it would be near impossible to sustain a low carb diet without complications. The last group of macro-nutrients are Fats. Ever since fat was demonized, people started eating more sugar, refined carbs and processed foods instead. As a result, the entire world has become fatter and sicker. However, times are changing. So, let’s have a look at the 10 High Fat Foods that are incredibly healthy.

33. High Fat Foods That Are Actually Super Healthy Studies now show that fat, including saturated fat, isn’t the devil it was made out to be . All sorts of healthy foods that happen to contain fat have now returned to the “superfood” scene. Here are 10 high-fat foods that are actually incredibly healthy and nutritious. 1. Avocados The avocado is different from most other fruits. Whereas most fruits primarily contain carbs, avocados are loaded with fats. In fact, avocados are about 77% fat, making them even higher in fat than most animal foods. The main fatty acid is a mono-unsaturated fat called oleic acid. This is also the predominant fatty acid in olive oil, associated with various health benefits. Avocados are among the best sources of potassium in the diet, even containing 40% more potassium than bananas, a typical high potassium food. They’re also a great source of fibre, and studies have shown that they can lower LDL cholesterol and triglycerides, while raising HDL (the “good”) cholesterol. Even though they are high in fat and calories, one study shows that people who eat avocados tend to weigh less and have less belly fat than those who don’t. NOTE: Avocados are a fruit, with fat at 77% of calories. They are an excellent source of potassium and fibre, and have been shown to have major benefits for cardiovascular health. 2. Cheese Cheese is incredibly nutritious. This makes sense, given that an entire cup of milk is used to produce a single thick slice of cheese. It is a great source of calcium, vitamin B12, phosphorus and selenium, and contains all sorts of other nutrients . It is also very rich in protein, with a single thick slice of cheese containing 6.7 grams of protein, same as a glass of milk. Cheese, like other high-fat dairy products, also contains powerful fatty acids that have been linked to all sorts of benefits, including reduced risk of type 2 diabetes. NOTE: Cheese is incredibly nutritious, and a single slice contains a similar amount of nutrients as a glass of milk. It is a great source of vitamins, minerals, quality proteins and healthy fats.

34. 3. Dark Chocolate Dark chocolate is one of those rare health foods that actually taste incredible. It is very high in fat, with fat at around 65% of calories. Dark chocolate is 11% fibre and contains over 50% of the RDA for iron, magnesium, copper and manganese. It is also loaded with antioxidants, so much, so that it is one of the highest scoring foods tested, even outranking blueberries. Some of the antioxidants in it have potent biological activity, and can lower blood pressure and protect LDL cholesterol in the blood from becoming oxidized. Studies also show that people who eat dark chocolate 5 or more times per week are less than half as likely to die from heart disease, compared to people who don’t eat dark chocolate. There are also some studies showing that dark chocolate can improve brain function, and protect your skin from damage when exposed to the sun. Just make sure to choose quality dark chocolate, with at least 70% cocoa. NOTE: Dark chocolate is high in fat, but loaded with nutrients and antioxidants. It is very effective at improving cardiovascular health. 4. Whole Eggs Whole eggs used to be considered unhealthy because the yolks are high in cholesterol and fat. In fact, a single egg contains 212 mg of cholesterol, which is 71% of the recommended daily intake. Plus, 62% of the calories in whole eggs are from fat. However, new studies have shown that cholesterol in eggs doesn’t affect the cholesterol in the blood, at least not in the majority of people. What we’re left with is one of the most nutrient dense foods on the planet. Whole eggs are actually loaded with vitamins and minerals. They contain a little bit of almost every single nutrient we need. They even contain powerful antioxidants that protect the eyes, and lots of choline, a brain nutrient that 90% of people don’t get enough of. Eggs are also a weight loss friendly food. They are very fulfilling and high in protein, the most important nutrient for weight loss. Despite being high in fat, people who replace a grain-based breakfast with eggs end up eating fewer calories and losing weight. The best eggs are omega-3 enriched or pastured. Just don’t throw away the yolk, that’s where almost all the nutrients are found.

35. NOTE: Whole eggs are among the most nutrient dense foods on the planet. Despite being high in fat and cholesterol, they are incredibly nutritious and healthy. 5. Fatty Fish One of the few animal products that most people agree is healthy, is fatty fish. This includes fish like salmon, trout, mackerel, sardines and herring. These fish are loaded with heart-healthy omega-3 fatty acids, high quality proteins and all sorts of important nutrients. Studies show that people who eat fish tend to be much healthier, with a lower risk of heart disease, depression, dementia and all sorts of common diseases. If you can’t (or won’t) eat fish, then taking a fish oil supplement can be useful. Cod fish liver oil is best, it contains all the omega-3s that you need, as well as plenty of vitamin D. NOTE: Fatty fish like salmon is loaded with important nutrients, especially omega-3 fatty acids. Eating fatty fish is linked to improved health, and reduced risk of all sorts of diseases. 6. Nuts Nuts are incredibly healthy. They are high in healthy fats and fibre, and are a good plant-based source of protein. Nuts are also high in vitamin E and loaded with magnesium, a mineral that most people don’t get enough of. Studies show that people who eat nuts tend to be healthier, and have a lower risk of various diseases. This includes obesity, heart disease and type 2 diabetes. Healthy nuts include almonds, walnuts, macadamia nuts and numerous others. NOTE: Nuts are loaded with healthy fats, protein, vitamin E and magnesium, and are among the best sources of plant-based protein. Studies show that nuts have many health benefits.

36. 7. Chia Seeds Chia seeds are generally not perceived as a “fatty” food. However, an ounce (28 grams) of chia seeds actually contains 9 grams of fat. Considering that almost all the carbs in chia seeds are fibre, the majority of calories in them actually comes from fat. In fact, by calories, chia seeds are around 80% fat. This makes them an excellent high-fat plant food. These aren’t just any fats either, the majority of the fats in chia seeds consists of the heart-healthy omega-3 fatty acid called ALA. Chia seeds may also have numerous health benefits, such as lowering blood pressure and having anti- inflammatory effects. They are also incredibly nutritious. In addition to being loaded with fibre and omega-3s, chia seeds are also packed with minerals. NOTE: Chia seeds are very high in healthy fats, especially an omega-3 fatty acid called ALA. They are also loaded with fibre and minerals, and have numerous health benefits. 8. Extra Virgin Olive Oil Another fatty food that almost everyone agrees is healthy, is extra virgin olive oil. This fat is an essential component of the Mediterranean diet, which has been shown to have numerous health benefits. Extra virgin olive oil contains vitamins E and K, and is loaded with powerful antioxidants. Some of these antioxidants can fight inflammation and help protect the LDL particles in the blood from becoming oxidized. It has also been shown to lower blood pressure, improve cholesterol markers and have all sorts of benefits related to heart disease risk. Out of all the healthy fats and oils in the diet, extra virgin olive oil is the king. NOTE: Extra virgin olive oil has many powerful health benefits, and is incredibly effective at improving cardiovascular health. 9. Coconuts and Coconut Oil Coconuts, and coconut oil, are the richest sources of saturated fat on the planet. In fact, about 90% of the fatty acids in them are saturated. Even so, populations that consume large amounts of coconut do not have high levels of heart disease, and are in excellent health.

37. Coconut fats are actually different than most other fats, and consist largely of medium-chain fatty acids. These fatty acids are metabolised differently, going straight to the liver where they may be turned into ketone bodies. Studies show that medium-chain fats suppress appetite, helping people eat fewer calories, and can boost metabolism by up to 120 calories per day. Many studies show that these types of fats can have benefits for people with Alzheimer’s, and they have also been shown to help you lose belly fat. NOTE: Coconuts are very high in medium-chain fatty acids, which are metabolised differently than other fats. They can reduce appetite, increase fat burning and provide numerous health benefits. 10. Full-Fat Yogurt Real, full-fat yogurt is incredibly healthy. It has all the same important nutrients as other high-fat dairy products. But it’s also loaded with healthy, probiotic bacteria, that can have powerful effects on your health. Studies show that yogurt can lead to major improvements in digestive health, and may even help fight heart disease and obesity. Just make sure to choose real, full-fat yogurt and read the label. Unfortunately, many of the yogurts found on store shelves are low in fat, but loaded with added sugar instead. It is best to avoid those like the plague. Healthy fats will become your number#1 friend. They will keep you satiated for longer, they are good source of calories and they will help to kill cravings for sugary treats.

38. HERE IS A QUESTION that has always bothered me: Why are there doctors who are fat? Accepted as authorities in human physiology, doctors should be true experts on the causes and treatments of obesity. Most doctors are also very hard-working and self-disciplined. Since nobody wants to be fat, doctors in particular should have both the knowledge and the dedication to stay thin and healthy.(In my case, the dietitian I was seeing and who was telling me how and what to eat) So why are there fat doctors? The standard prescription for weight loss is “Eat Less, Move More.” It sounds perfectly reasonable. But why doesn’t it work? Perhaps people wanting to lose weight are not following this advice. The mind is willing, but the flesh is weak. Yet consider the self-discipline and dedication needed to complete an undergraduate degree, medical school, internship, residency and fellowship. It is hardly conceivable that overweight doctors simply lack the willpower to follow their own advice. This leaves the possibility that the conventional advice is simply wrong. And if it is, then our entire understanding of obesity is fundamentally flawed. Given the current epidemic of obesity, I suspect that such is the most likely scenario. So we need to start at the very beginning, with a thorough understanding of the disease that is human obesity. We must start with the single most important question regarding obesity or any disease: “What causes it?” We spend no time considering this crucial question because we think we already know the answer. It seems so obvious: it’s a matter of Calories In versus Calories Out. A calorie is a unit of food energy used by the body for various functions such as breathing, building new muscle and bone, pumping blood and other metabolic tasks. Some food energy is stored as fat. Calories In is the food energy that we eat. Calories Out is the energy expended for all of these various metabolic functions. When the number of calories we take in exceeds the number of calories we burn, weight gain results, we say. Eating too much and exercising too little causes weight gain, we say. Eating too many calories causes weight gain, we say. These “truths” seem so self-evident that we do not question whether they are actually true. But are they?

39. CALORIE CONFUSION – No relationship between diabetes and calories EAT LESS. CUT YOUR CALORIES. Watch your portion size. These mantras have formed the foundation of conventional weight-loss advice over the past fifty years. And the widespread obesity epidemic proves that this advice has been an utter disaster, perhaps only topped by the nuclear meltdown of Chernobyl. This caloric reduction advice is based on a false understanding of what causes weight gain. WHAT CAUSES OBESITY? We don’t stop to consider this basic question because we believe that we already know the full answer. It seems so obvious, doesn’t it? Excessive intake of calories in compared to too few calories out leads to weight gain. This energy balance model of obesity has been drilled into us since childhood. “Fat Gained = Calories In – Calories Out” For the past fifty years, our best weight-loss advice was primarily to restrict our caloric intake. Specifically, we were told to restrict the amount of dietary fat, which is calorically dense. This means reducing foods high in fat, such as meat, butter, cheese and nuts, in order to lower our calorie intake and therefore lose weight. They made food guides, food pyramids and food plates to indoctrinate children into this brand-new, low calorie religion. “Cut Your Calories“, they declared. “Eat Less, Move More”, they chanted. Nutrition labels were mandated to include calorie counts. Programs and apps were created to more precisely count calories. They invented small devices such as Fitbits to measure exactly how many calories we were burning. Using all our ingenuity, focused like a laser beam and dogged as a turtle crossing a road, we cut calories.

40. WHAT WAS THE RESULT? Did the problem of obesity simply fade away like the morning mist on a hot summer day? In a word, NO. The underlying, unspoken premise of this model is that energy creation(calories in), energy expenditure(calories out), and fat gain are independent variables fully under our conscious control. It assumes that the number of calories used to keep our bodies running more or less normally remains stable and unchanging. But this is untrue. The truth is that the body can adjust its basal metabolic rate(BMR) – the energy required to keep the heart pumping, lungs breathing, kidneys and liver detoxifying, brain thinking, body generating heat and so on – up or down by 40 percent. When you eat fewer calories, your body slows down so it uses fewer calories, which means you don’t lose weight. This model also completely ignores the multiple overlapping hormonal systems that signal hunger and satiety. That is, we may decide what to eat and when to eat it, but we cannot decide to feel less hungry. We cannot decide when to burn calories as body heat and when to store them as body fat. Hormones make these decisions. The results of the so-called “caloric reduction as primary” advice could hardly have been worse if we had tried. The storm of obesity and type 2 diabetes that began in the late 1970’s has today, some forty years later, become a global category 5 hurricane threatening to engulf the entire world in sickness and disability. Only two possibilities can explain how obesity could spread so rapidly in the face of their shiny new advice to reduce fat and calories: first, perhaps this advice is good but people are simply not following it; second, perhaps the advice is simply wrong. “The idea that the spirit is willing but the flesh is weak – that people have the dream but not the drive – is as absurd as expecting a drowning man to laugh.” Was the entire obesity epidemic simply a sudden, simultaneous, coordinated, worldwide lack of willpower? The world can’t agree which side of the road we should drive on, yet without discussion, we all decided to eat more and move less so that we could become undesirably fat? This explanation is only the latest iteration of the game called “blame the victim”. It shifts the responsibility from the advice giver( the advice is bad) to the advice taker (the advice is good, but you are not following it). By declaring that their scientifically unproven caloric reduction advice was flawless, doctors and nutritionists could conveniently shift the blame from themselves to you. It wasn’t their fault. It was yours. Their advice was good. You didn’t follow it. No wonder they love this game so much. To admit that all their precious theories of obesity were simply incorrect was too psychologically difficult. Yet evidence continued to accumulate that this new caloric restriction strategy was about as useful as a comb to a bald man. The women’s Health Initiative was the most ambitious, important nutrition study ever done. This randomised trial involving almost 50,000 women evaluated the low-fat, low-calorie approach to weight loss. Although it was not specifically a weight-loss trial,one group of women was encouraged through intensive counselling to reduce their caloric intake by 342 calories and to increase their level of exercise by 10 percent. These calorie counters expected a weight loss of 32 pounds every single year. When the final results were tallied in 1997, there was only crushing disappointment. Despite good compliance, more than seven years of calorie counting had led to virtually no weight loss. Not even a single pound. This study was a stunning and severe rebuke to the caloric theory of obesity. Reducing calories did not lead to weight loss. More about the studies here… Real world studies have only confirmed this stunning fiasco. The conventional weight-loss advice to eat fewer calories carries an estimated failure rate of 99.4 percent. For morbid obesity, the failure rate is 99.9 percent.

41. These statistics would not surprise anybody in the diet industry or, for that matter, anybody who has ever tried to lose weight. “The Calories-In, Calories-Out theory gained widespread acceptance based on its seemingly intuitive truth.” The most important error is believing that basal metabolic rate, or Calories Out, always remains stable. But a 40-percent reduction in calorie intake is quickly met with a 40-percent decrease in basal metabolic rate. The net result is no weight loss. The other major false assumption is that weight is consciously regulated. But no system in our body functions like that. The thyroid, parathyroid, sympathetic, parasympathetic, respiratory, circulatory, hepatic, renal, gastrointestinal and adrenal systems are all closely controlled by hormones. Body weight and body fat are also strictly regulated by hormones. In fact, our bodies contain multiple overlapping systems of body weight control. Body fat, one of the most important determinants of survival in the wild, is simply not left to the vagaries of what we decide to put in our mouths.

42. Controlling Hunger Controlling hunger is crucial to weight loss. How do you rein in hunger? We all think that eating more or eating more often will prevent hunger, but is this really true? Standard dietary advice is to eat 6 or 7 small meals per day with the hope that this will stave off hunger and prevent overeating. If you can prevent hunger, then you may also be able to make better food choices. On the surface, it seems pretty reasonable. However, on the surface, the disastrous Eat Less, Move More or Calories in Calories out paradigms also seemed pretty reasonable, too. Like fool’s gold, appearances can be deceiving, and we must dig deeper to appreciate the truth, otherwise we are the fools. So, let’s think about this a little more. The most important determinant of how much you eat is how hungry you are. Yes, you can deliberately eat less, but you can’t decide to be less hungry. So if you are constantly eating less, but are still hungry, it takes a toll on you, day after day, month after month, year after year. And the moment you let your guard down, you are going to eat more. You are constantly fighting with your own body. If you are less hungry, then you’ll eat less. But you’ll be working with your body, not against it. Obesity, as I’ve explained in my book, is not a disorder of too many calories. It’s a hormonal imbalance of hyperinsulinemia. The main reason we eat more calories is not lack of willpower, it’s hunger. And hunger and satiety are functions of our hormones. You can decide what to eat, but you can’t decide to be less hungry. In the long term, it is the amount of hunger that determines how much you eat. On the other side, ‘Calories Out’ is not primarily a function of exercise. It’s determined mainly by the basal metabolic rate, which is the amount of energy (calories) required to keep our body in good working order. Energy is needed to generate body heat and to keep the heart, lung, kidneys and other vital organs working properly. You can exercise more, but you can’t decide to have a higher metabolic rate. It doesn’t work like that. And neither is the metabolic rate stable over time. It can fluctuate up or down 40% depending upon our hormones. Fat accumulation, even from a Calories In, Calories Out standpoint is almost entirely a hormonal problem. It is not something that people ‘decided’ to do. Nobody decided they wanted to eat more so that they could get fat. They ate more because their hunger wasn’t satisfied. And there are many different reasons for that – mental and physiological. But the bottom line is that obesity is not merely the lack of willpower or a bad choice that somebody made. It’s a disease that deserves compassion. Cutting calories when the problem is hormonal is not going to work. And guess what? It doesn’t.

43. Is there any evidence to suggest that eating constantly will prevent hunger? That would be a big NO. Somebody made it up, and it’s been repeated so many times that people assume it’s true. Mostly, it’s been promoted heavily by the snack food industry to make sure that people continue to buy their products. Up until the 1970s or so, people ate 3 meals per day – breakfast, lunch and dinner. It was unusual to snack and certainly not considered a healthy habit. It was an indulgence to be done very occasionally. Eating constantly is sort of a nuisance. If you are trying to eat 6 or 7 times per day, then when are you supposed to get your work done? You are constantly thinking about what you need to eat and when to eat it. Anyway, it is clearly not necessary to snack because our body stores food energy (calories) as body fat for the exact reason of providing calories when needed. Body fat exists precisely so that we do NOT need to constantly eat. But is it useful to prevent hunger? Let’s take some analogous situations. Suppose you need to urinate. Which is easier? Hold it until you find a wash-room. Pee just a tiny little amount and then stop yourself voluntarily. Do this repeatedly throughout the day, each time stopping before your bladder is empty. Once that first bit of urine come out, there’s no stopping until it’s done. It’s incredibly hard to stop once you start. That’s inertia. An object in motion tends to stay in motion until something else acts to stop it. Let’s think about another situation. Suppose you are thirsty Which is easier? When you find water, you drink until you are no longer thirsty. Drink a thimbleful of water and then voluntarily stop drinking while looking at the full glass of ice- cold water. Do this repeatedly throughout the day. Again, you and I both know that once you get that first sip, there’s no stopping until the glass is empty. Once you start, it is easier to continue until satisfied, whether it’s emptying your bladder or slaking your thirst. It’s like my daughter. You can’t ever get her into the bath. Once she’s in, you can’t ever get her out of the bath. But this is normal behaviour. So why do we assume this does not apply to eating? You might believe that eating a small amount constantly or ‘grazing’ will prevent overeating. If this were true, what is the point of an appetizer? The hors d’oeuvre is literally served ‘outside the main

44. meal’. For what purpose do we serve an appetizer? Is the point to spoil our dinner so that we cannot eat what the host has slaved over all day because we are full? Really? No. The whole point of an appetizer is that this is a small tasty morsel to make us eat more. Eating a small, appetizing amount makes us hungrier, not less. The reason it works is because it overcomes that initial inertia. The appetizer starts us salivating and thinking about food and therefore our appetite increases. In French, this may also be called an amuse bouche – meaning literally ‘something that amuses the mouth’. Why? So that we will eat more. It might be oysters, stuffed eggs or nuts. It’s not served to fill you up so that you can’t eat that expensive intricate meal prepared by the chef. Virtually all cultures in the world have a culinary tradition of whetting the appetite. The ancient Greeks and Romans stimulated their guest’s appetite with little bits of fish, seasoned vegetables, cheese and olives. The Italian Renaissance writer Platina recommended thin rolls of grilled veal. Giving too large a portion would stimulate the satiety hormones, and dull the appetite. But a tiny portion almost paradoxically stimulates the appetite. This appetizing effect is no secret – being known to any person who has ever thrown a dinner party over the last 200 years. Now think about a time where you weren’t really all that hungry, but it was breakfast time anyway. So, you eat because people have always said it’s the most important meal of the day. To your surprise, as you start eating, you finished an entire meal relatively normally. Before you started eating, you could have easily skipped the meal and have been full. But once you started eating, you ate everything. Has this happened to you? It’s happened to me many, many times, mostly because I’m always aware of this fact. Eating when you are not hungry is not a good strategy for weight loss. Yet people are continually scolded for having the temerity to skip a single meal or snack. They are admonished to be sure to never miss a snack. If we eat small meals 6 or 7 times per day, as most dietary authorities recommend, then what we are doing is giving ourselves appetizers but then deliberately stopping before we are actually satiated. And then repeating that multiple times per day. This is not going to decrease our appetites, it will increase it, a lot. Now because we are hungry but have not eaten our fill, we must exert a significant amount of willpower to stop ourselves from eating. We count our calories, but we don’t count the willpower we’ve spent to stop ourselves from eating. Day after day it goes on. Eating WHETS the appetite. Got it? We’ve known this for at least 150 years! Eating all the time so that you’ll eat less sounds really stupid, because it is really stupid. Don’t fall for it. If you hear a doctor or dietician giving you this advice, run far, far away, very, very quickly. They will literally kill you with this idiotic advice. So if eating more frequently gives you a bigger appetite, then the converse must be that eating less frequently gives you a smaller appetite. Luckily, this turns out to be true.

45. Fasting and Hunger Ghrelin, originally purified in 1999 from rat stomachs, is the so-called hunger hormone. It strongly stimulates growth hormone, and increases appetite. So, if you want to lose weight on a long-term basis, you need to tune down ghrelin. So, how to do that? In one study Patients undertook a 33 hour fast, and ghrelin was measured every 20 minutes. Here’s what ghrelin levels look like over time. Ghrelin levels are lowest at approximately 9:00 in the morning, the same time that studies of circadian rhythm indicate hunger is lowest. This is also generally the longest period of the day where you have not eaten. This reinforces the fact that hunger is not simply a function of ‘not having eaten in a while’. At 9:00, you have not eaten for about 14 hours, yet you are the least hungry. Eating, remember, does not necessarily make you less hungry. There are 3 distinct ghrelin peaks corresponding to lunch, dinner and the next day’s breakfast. This is not a coincidence, but indicates that hunger can be a learned response. We are used to eating 3 meals per day, so we begin to get hungry just because it is ‘time to eat’. But if you don’t eat at those times, ghrelin DOES NOT CONTINUALLY INCREASE. After the initial wave of hunger, it recedes, even if you don’t eat. Hunger comes as a wave. After it passes, it loses much of its power. Ghrelin spontaneously decreases after approximately 2 hours without food consumption. If you simply ignore hunger and don’t eat, it will disappear. The average ghrelin levels over 24 hours of fasting decreases! In other words, eating nothing made you less hungry.

46. We’ve all experienced this before. Think of a time that you were too busy and worked right through lunch. At about 1:00 you were hungry, but if you just drank some tea, by 3:00 pm, you were no longer hungry. Ride the waves – it passes. Same goes for dinner. Further it has been shown that ghrelin spontaneously decreases independently of serum insulin or glucose levels. Eating more sometimes makes you hungrier, not less. In the same vein, eating less can actually make you physically less hungry. That’s terrific, because if you are less hungry, you will eat less, and are more likely to lose weight. This same effect happens over multiple days of fasting. Over 3 days of fasting, ghrelin and hunger gradually decreased. Yes, you read that right. Patients were far LESS hungry when they didn’t eat for three days. This jives perfectly with our clinical experience with patients undergoing extended fasting. They all expect to be ravenously hungry, but actually find that their hunger completely disappears. They always come in saying ‘I can’t eat much anymore. I get full so fast. I think my stomach shrank’. That’s PERFECT, because if you are eating less but getting more full, you are going to be more likely to keep the weight off. There’s also the substantial difference between men and women. There’s only a mild effect for men, but women show a huge decrease in ghrelin. Women would be expected to have much more benefit from fasting because their hunger drops more. Many women have remarked how a longer fast seemed to completely turn off cravings. This may be the physiologic reason why. Intermittent and extended fasting, unlike caloric restriction diets, help to fix the main problem of weight gain – hunger. Ghrelin, the main hormonal mediator of hunger decreases with fasting, making hunger a manageable problem. We want to eat less, but be more full.

47. Type 2 Diabetes: The Exercise Approach LIFESTYLE INTERVENTIONS, TYPICALLY a combination of diet and exercise, are a universally acknowledged mainstay of type 2 diabetes treatments. These two stalwarts are often portrayed as equally beneficial, and why not? Exercise improves weight loss efforts, although its effects are much more modest than most assume. Nevertheless, physical inactivity is an independent risk factor for more than twenty five chronic diseases, including type 2 diabetes and cardiovascular disease. Low levels of physical activity in obese subjects are a better predictor of death than cholesterol levels, smoking status, or blood pressure. And the benefits of exercise extend far beyond simple weight loss. Exercise programs improve strength and balance, blood pressure, cholesterol, blood glucose, and insulin sensitivity, without involving medications and their potential side effects. Trained athletes have consistently lower insulin levels, and these benefits can be maintained for life, as demonstrated by many studies on older athletes. These seem like good returns for a low cost investment. Yet results of both aerobic and resistance exercise studies in type 2 diabetes are varied. Meta-analyses show that exercise may significantly reduce A1C, without a change in body mass. This finding suggest that exercise does not need to reduce body weight to have benefits, which echoes clinical experience with patients. However, the corollary is that exercise programs have minimal effect for weight loss. With all the proven benefits of exercise, it may surprise you to learn that I think this is not useful information. Why not? Because everybody already knows this. The benefits of exercise have been extolled relentlessly for the past 40 years. I have yet to meet a single person who has not already understood that exercise might help type 2 diabetes and heart disease. If people already know its importance, what is the point of telling them again? The main problem has always been non-compliance. Many real issues may deter someone from embarking on an exercise program: obesity itself, joint pain, neuropathy, peripheral vascular disease, back pain, and heart disease may all combine to make exercise difficult or even unsafe. Overall, however, I suspect the biggest issue is lack of visible results. The benefits are greatly over-hyped and exercise doesn’t work nearly as well as advertised. Weight loss is often minimal. This is what happened to me recently. I have met one of my friends and we had a chat about hers 7 pounds weight loss in two months. She was so happy about it. I told her well done, what have you been doing? Are you go to gym? She told me that she has this aerobic classes three times a week and that she is always so exhausted after them but feels good, because she thinks that she has done so well. Then she said, tell me about you. You look different. Did you lose some weight. I said yes, actually I did lose 12 KG within the same time as you. Well done she said. Let me guess, gym? I said NO, I just walk wherever I can and some weight lifting at home. Nothing that exhaustive like yours. Just to keep me fit. But I do something else too. All the weight loss is from low carbing and intermittent fasting. She didn’t want to hear more about it. Just the thought about it got her scared. She carry on doing her aerobic classes three times a week, with minimal weight loss and, “ ME “? Steadily losing more weight with low carb and intermittent fasting. The lesson here is: exercise has minimal effect on weight loss, but has other health benefits.

48. Insulin: The Cause Of Weight Gain And Obesity INSULIN WILL MAKE YOU FAT ACTUALLY, INSULIN CAN make anybody fat. How? By prescribing insulin. It won’t matter that you have willpower, or that you exercise. It won’t matter what you choose to eat. You will get fat. It’s simply a matter of enough insulin and enough time. High insulin secretion has long been associated with obesity: obese people secrete much higher levels of insulin than do those of normal weight. Also, in lean subjects, insulin levels quickly return to baseline after a meal, but in the obese, these levels remain elevated. Insulin levels are almost 20 percent higher in obese subjects, and these elevated levels are strongly correlated to important indices such as waist circumference and waist/hip ratio. The close association between insulin levels and obesity certainly suggests—but does not prove—the causal nature of this relationship. Insulin levels can be difficult to measure since levels fluctuate widely throughout the day in response to food. It is possible to measure an “average” level, but doing so requires multiple measurements throughout the day. Fasting insulin levels (measured after an overnight fast) are a simpler, one-step measurement. Sure enough, research reveals a close association between high fasting insulin levels and obesity, and this relationship becomes even stronger when we consider only a person’s fat mass rather than his or her total weight. In the San Antonio Heart Study, high fasting insulin was tightly correlated to weight gain over eight years of follow up. Insulin-resistant state leads also to high fasting insulin. This relationship is not coincidental, as insulin resistance itself plays a key role in causing obesity. INSULIN IS PRESCRIBED to lower blood glucose in both type 1 and type 2 diabetes. Virtually every patient taking insulin and every prescribing physician knows full well that weight gain is the main side effect. This is strong evidence that hyperinsulinemia, high levels of insulin in the blood, directly causes weight gain. But there is other corroborating evidence as well. Insulinomas are rare tumors that continually secrete very high levels of insulin. These cause low blood glucose and persistent weight gain, underscoring insulin’s influence once again. Surgical removal of these tumors results in weight loss. Similarly, sulfonylureas are diabetic medications that stimulate the body to produce more of its own insulin. With insulin stimulation, weight gain is the main side effect. Although the thiazolidinedione (TZD) drug class, used to treat type 2 diabetes, does not increase insulin levels, it does increase insulin’s effect. The result? Lower blood glucose, but also weight gain. Weight gain, however, is not inevitable consequence of treating diabetes. Currently, metformin is the most widely prescribed medication worldwide for type 2 diabetes. Rather than increasing insulin, it blocks the liver’s production of glucose (gluconeogenesis) and therefore reduces blood glucose. It successfully treats type 2 diabetes without increasing insulin and, therefore , does not lead to weight gain. Where excessively high insulin levels lead to weight gain, excessively low insulin levels lead to weight loss. Remember, patients with untreated type 1 diabetes have pathologically low insulin levels and no matter how many calories they ingest, they cannot gain any weight. Without normal levels of insulin, these patients cannot properly use or store food energy and, untreated, they waste away and die. With the replacement of insulin, these patients gain weight once again. Increasing insulin causes weight gain. Decreasing insulin causes weight loss. These are not merely correlations but direct causal factors. Our hormones, mostly insulin, ultimately set our body weight and level of body fat. “Remember, obesity is a hormonal imbalance, not a caloric one.”

49. The Carbohydrate-Insulin Hypothesis AS WE’VE NOW established that insulin causes obesity, our next question is: What foods causes our insulin levels to rise or to spike? The most obvious candidate is the refined carbohydrate— highly refined grains and sugars. This brings us not to a new idea, but back to a very old idea that predates even William Banting: the idea that “fattening carbohydrates” caused obesity. Highly refined carbohydrates are the most notorious foods for raising blood sugars. High blood sugars lead to high insulin levels. High insulin levels lead to weight gain and obesity. This chain of causes and effects has become known as the carbohydrate-insulin hypothesis. The man who found himself at the center of the controversy was the infamous Dr. Robert Atkins. In 1963, Dr. Robert Atkins was a fat man. Like William Banting 100 years before, he needed to do something. Weighing in at 224 pounds (100 kilograms), he had recently begun his cardiology practice in New York City. He had tried the conventional ways to lose weight, but had met with no success. Recalling the medical literature published by Drs. Pennington and Gordon on low- carbohydrate diets, he decided to try the low-carbohydrate approach himself. To his amazement, it worked as advertised. Without counting calories, he shed his bothersome extra weight. He started prescribing the low-carbohydrate diet to patients and had some notable success. In 1965, he appeared on the Tonight Show, and in 1970, was featured in Vogue. In 1972, he published his original book, Dr. Atkins’ Diet Revolution. It was an immediate bestseller and one of the fastest-selling diet books in history.

50. HORMONES – Food Body Weight And Diabetes HORMONES CONTROL HUNGER, telling our body when to eat and when to stop. Ghrelin is a powerful hormone that causes hunger and cholecystokinin and peptide YY are hormones that tell us when we are full and should stop eating. Imagine you’re at all-you-can-eat buffet. You’ve already eaten many heaping platefuls of food and you are completely, 110 percent full. Now, could you eat a few more pork chops? Merely the thought might make you nauseous. Yet these are the same pork chops you ate happily just a few minutes ago. The difference is that satiety hormones are exerting a powerful effect to stop you from eating. Contrary to many popular beliefs, we do not continue eating simply because food is available. Calorie consumption is under tight hormonal regulation. Fat accumulation is truly not a problem of energy excess. It’s a problem of energy distribution. Too much energy is diverted to producing fat as opposed to, say, increasing body heat or forming new bone tissue. This energy expenditure is controlled hormonally. As long as we believed, wrongly, that excessive caloric intake led to obesity, we were doomed to failure as we uselessly tried to reduce calories. We cannot “decide” to feel less hungry. We cannot “decide” to increase basal metabolic rate. If we eat fewer calories, our body simply compensates by decreasing its metabolic rate. If calories are not the underlying cause of weight gain, then reducing calories cannot reliably reduce weight. The most important factor in controlling fat accumulation and weight gain is to control the hormonal signals we receive from food, not the total number of calories we eat. Obesity is a hormonal imbalance, not a caloric one. The hormonal problem in undesired weight gain is mainly excessive insulin. Thus, type 2 diabetes, too, is a disease about insulin imbalance rather than caloric imbalance. The crucial point to understand, however, is not how insulin causes obesity, but that insulin does, in fact, cause obesity. Once we understand that obesity is a hormonal imbalance, we can begin to treat it. If we believe that excess calories cause obesity, then the treatment is to reduce calories. But this method has been a complete failure. However, if too much insulin causes obesity, then it

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