Dr Sarah Hallberg Part 2
January 20, 2016 2:38 am | By TSP
So, how do we recommend to these people to eat, because it seems like that would be really important, and it is. Let’s focus just on type 2 diabetes, because the general recommendations are to tell patients with type 2 diabetes to consume 40 grams to 65 grams of carbohydrates per meal, plus more at snacks. Trust me on this, that’s a lot of carbs.
And remember what’s going to happen to glucose and insulin, blood sugar and insulin, when we eat them? Yes, we are essentially recommending that they eat exactly what’s causing their problem. Sound crazy? It really, really is. Because, at its root, diabetes is a state of carbohydrate toxicity. We can’t get the blood sugar into the cells, and that causes a problem in the short term. But the long-term consequences are even greater. And insulin resistance is essentially a state of carbohydrate intolerance.
So why, oh why, do we want to continue to recommend to people to eat them? The American Diabetes Association guidelines specifically state that there is inconclusive evidence to recommend a specific carbohydrate limit. But those guidelines go right on to say what we all know: Our carbohydrate intake is the single, biggest factor in blood sugar levels, and therefore need for medication. These guidelines then go on to say: Hey look, if you are taking certain diabetic medications, you actually have to eat carbs, otherwise your blood sugar can go too low.
Okay, so let’s take a look at the vicious cycle that that advice just set up. So it’s: Eat carbs so you have to take medicine, then you have to eat more carbs so you avoid the side-effect of those medications, and around and around we go. Even worse is that nowhere in the ADA guidelines is the goal of reversing type 2 diabetes. This needs to be changed, because type 2 diabetes can be reversed, in many, if not most, situations, especially if we start early.
Not only do we need to let people know this, but we have to start giving them the practical advice so they can do this.
Consider carbs. First, here’s a shocker for you: We don’t need them. Seriously! Our minimum daily requirement for carbohydrates is zero. We have essential amino acids, those are proteins, essential fatty acids, but, nope, no essential carb.
A nutrient is essential if: We have to have it to function, and we can’t make it from something else. We make glucose, plenty of it, all the time, it’s called gluconeogenesis.
So, we don’t need them, the overconsumption of them is making us very sick, yet we are continuing to recommend to patients to consume close to, if not more than, half of their total energy intake every day from them. It doesn’t make sense.
Let’s talk about what does. Cutting carbs, a lot. Yes, in my clinic we teach patients to eat with carbs as the minority of their intake, not the majority.
So, how does that work? Well, when our patients decrease their carbs their glucose goes down, and they don’t need as much insulin. So those insulin levels drop, and fast. And this is very important, because a study looking at our National Health and Nutrition Examination Survey data, better known as NHANES, showed that the single, biggest risk factor for coronary artery disease is insulin resistance. It is responsible for a whopping 42% of heart attacks. Low-carb intervention works so fast that we can literally pull people off of hundreds of units of insulin in days to weeks.
One of my favorite stories is a very recent one. A young gal, but who had an almost 20-year history of type 2 diabetes, came in when a physician from another clinic told her she was just sick, and she’d probably get used to it. Her diabetes was way out of control. This despite the fact that she was on multiple medications, including almost 300 units of insulin, that was being injected into her continuously every day via a pump. All of this, remember, blood sugar still out of control.
So we put her on a low-carb diet, and now let’s fast-forward four months. She lost weight, yes, but, better than that, sick no more. Her blood sugar levels were now normal all of the time. This on, get this, no diabetes medication. Gone was the 300 units of insulin, no more insulin pump, no more pricking her finger multiple times each day, gone, all of it, no more diabetes.
One of the greatest joys of my job is to be able to tell a patient like this that they no longer have diabetes, and we ceremoniously take it off their problem list together.
So, are they cured, is this a miracle? We’ll leave that grandstanding to Doctor Oz. 8Cured would imply that it can’t come back. And if they start eating excessive carbs again, it will. So no not cured, but they don’t have diabetes any longer. It’s resolved, and it can stay that way as long as we keep away the cause.
So, what does this look like then? How does somebody eat this way? Well, first, let me tell you what it’s not.
Low-carb is not zero carb, and it is not high protein. These are common criticisms that are so frustrating because they are not true.
Next, if we take the carbs out, what are we going to put in? Because, remember, there’s only three macronutrients: if one goes down, one has to go up. My patients eat fat, and a lot of it. “What!?” you say. What’s going to happen when you eat fat? Well, let me tell you, you’re going to be happy, because fat tastes great, and it is incredibly satisfying.
But, remember, fat is the only macronutrient that’s going to keep our glucose – blood sugar – and insulin levels low, and that is so important.
So, I want you to now hear my simple rules for eating. These rules, you have to remember, are even going to be more important if you are one of the tens of millions of Americans who have trouble with insulin levels.
Rule number one: If it says light, low fat or fat-free, stays in the grocery store. Because if they took the fat out, they put carbs and chemicals in.
Rule number two: Eat food. The most important rule in low-carb nutrition: Real food does not come in a box, and no one should have to tell you real food is natural. You should know that when you look at it. Rule three :Don’t eat anything you don’t like. Rule four: Eat when you’re hungry; don’t eat when you’re not, no matter what the clock says.
And rule number five is a simple way to remember what we want to avoid. No GPS: no grains, no potatoes and no sugar.
That last one is a biggie, right, no grains? Na, no grains. But we have to have them. Nope, they’re a carb.
But whole grains are so good for us. Well, first of all, there are actually very few foods out there that are truly whole grain even when they say they are. Most foods that purport themselves to be wholegrain are highly processed and the fiber benefit ruined. Or they’re coming with highly refined flour, usually both of these things.
So if you are one of the truly insulin-sensitive people, you can eat real, whole grain. But if you’re in the enormous slice of our population with insulin issues, it’s making things worse.
So what if you are one of the real insulin-sensitive people? Can you still eat this way? Yes! I am a great example.
Watch out for Part 3 of the transcript …to be posted tomorrow, InshaAllah.