Insulin, the most popular pharmaceutical treatment for type 2 diabetes, was once used only sparingly in diabetes treatment, but today makes lots of money for the manufacturers. Thanks to pharmaceutical marketing and a lack of time, many physicians prescribe insulin rather than nutritional counseling or lifestyle management.
Prior to the 1920s, the mainstay of Diabetes treatment was aimed at controlling glycosuria (glycosuria occurs when the blood glucose level exceeds about 160–180 mg/dL and is easily measured). These dietary recommendations consisted of “meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea” and contained 5% carbohydrates, 20% protein, and 75% fat. This is analogous to the Low Carbohydrate Ketogenic Diet (LCKD) . These recommendations were dramatically different from current low-fat, high-carbohydrate recommendations for patients with diabetes. Also note that the feeding frequency rarely included breakfast, and manufactured snacks were not yet invented, resulting in 2 low-level glucose spikes, as opposed to today’s 5-6 spikes. Also, vegetable oils were not routinely available before the 1940s and 1950s. .
Exogenous insulin for the treatment of Diabetes was introduced in the 1920s, which began the switch to controlling diabetes through pharmaceutical management instead of lifestyle management, to the point that many type 2 Diabetic patients now consume excessive carbohydrates knowing they can chase it with insulin. Unfortunately, these patients already have a high insulin level, and the extra insulin only makes the insulin resistance worse. Additionally, the fat storage action of insulin, makes the metainflammation worse as well as the patient’s obesity. This is like a fat dog chasing its tail. The glucose is the tail, the mouth is the insulin, and the fat dog is the metabolic derangement.
Several recent studies have re-examined the effect of carbohydrate restriction on type 2 Diabetes and revalidated the safety and efficacy of the Low Carbohydrate Ketogenic Diet (LCKD). These studies confirmed that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet. Specifically, the participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. Because LCKD can be very effective at lowering blood glucose, patients on diabetes medication who use this diet should be under close medical supervision or capable of adjusting their medication.
- Allen FM, Stillman E, Fitz R: Total dietary regulation in the treatment of diabetes: monograph No. 11. 1919, New York, The Rockefeller Institute for Medical Research Google Scholar
- Stern L, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams M, Gracely EJ, Samaha FF: The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004, 140: 778-785.View Article Google Scholar
- Samaha FF, Iqbal N, Seshadri P, Chicano K, Daily D, McGrory J, Williams T, Williams M, Gracely EJ, Stern L: A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003, 348: 2074-2081. 10.1056/NEJMoa022637.View Article Google Scholar
- Gannon MC, Nuttall FQ: Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes. 2004, 53: 2375-2382.View Article Google Scholar
- Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP: Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005, 142: 403-411.View Article Google Scholar
- Nielsen JV, Jonsson E, Nilsson AK: Lasting improvement of hyperglycaemia and bodyweight: low-carbohydrate diet in type 2 diabetes. A brief report. Ups J Med Sci. 2005, 110: 179-183. Google Scholar
- Yancy WS, Vernon MC, Westman EC: Brief report: a pilot trial of a low-carbohydrate, ketogenic diet in patients with type II diabetes. Metabolic Syndrome and Related Disorders. 2003, 1: 239-244. 10.1089/154041903322716723.View Article Google Scholar
So, we know that patients with type 2 diabetes have the symptom of too much glucose, but their actual disease process is excessive Insulin, with the cells being insulin resistant; yet, we treat them with more insulin. This begs the question, why and who benefits? (This is in no way to be construed as suggesting insulin is bad; insulin is a lifesaving drug. It’s meant to suggest that patient therapy should be first geared to lifestyle changes, and insulin should be the rescue drug.)
Making lifestyle changes and counseling patients takes time and energy, which most healthcare providers lack. As the one of the key decision makers, physicians remain a primary focus of pharmaceutical company sales success. The pharmaceutical industry employs numerous marketing and promotional efforts to influence prescribing patterns, starting early in medical school, even in the preclinical years of study. These marketing strategies continue throughout a physicians’ career. Drug company marketing strategies include gifts and benefits ranging from low-cost gifts to expensive trips and grants, which leads to suboptimal prescribing practices and promotes more expensive medical treatment. One could postulate that most physicians are simply a marketing tool used by the pharmaceutical companies to get their products sold; they are an indirectly paid sales team.
Often, the pharmaceutical companies launder their education endeavors through patient advocacy groups that on the surface appear to be trusted authorities, such as The American Diabetes Association.
It is obvious that Big Pharma will not be likely to support studies that reduce the utilization of their products over non-compensable lifestyle changes. Evidence-based academic research is also unlikely to be performed by academicians who are funded by these same interests. The entire health delivery industry seems to be geared towards medicalization of treatment rather than lifestyle improvement, which would radically disrupt the status quo. Big Pharma is so prevalent in the academic world of policy and thought leaders that it is no longer considered a “conflict of interest” to recommend a pharmaceutical that compensated that policy or thought leader. It is now simply considered a “duality of interest.”
The ultimate way to good health is through changing your eating habits. You can change your eating habits with some conscious decisions, and your body will follow. Start with a clean slate. The easiest way to change is to change your environment first, and your human body will find its way through the new maze.
Your brain is hardwired to solve problems in the quickest and easiest way. Remove the choices you don’t want to make. If you leave tasty bread crumbs, your body will follow them to an anticipated feast.
If you don’t have it in front of you, it’s hard to eat it.
Clean out your kitchen first. Eliminate all boxes of processed foods and all vegetable oils. Go through your refrigerator and freezer and all the hidden places where you might have a stash of hidden candy.
Also, engage all of the people around you.
Undoubtedly, if your dietary pattern is poor, it’s also poor for everybody around you. Humans are social creatures, and we use food to bond and as a shared form of communication and pleasure.
If you change and they don’t, either they will sabotage you or you will outgrow the relationship. Admittedly, some people will not change, so an online community is where you can head to gain additional support.
It’s about creating a new paradigm, a mindset that fits in the new environment.
You are creating a new vision of yourself. Your new vision incorporates what you are and what you do. Your environment reinforces your mindset, not the other way around.
You do not eat processed foods, refined grains, and vegetable oils.
You are concerned about your future self.
Your health determines your financial stability.
You know that movement is what makes the body healthy.
You know that sleep restores the body.
You know that Big Food and Big Pharma have their own agenda — to increase your consumption.
You know that most healthcare providers are educated through industry-sponsored events. There is no industry sponsorship for reducing consumption.
Practical tips through the day
Limit your food choices for the first few weeks to one or two different kind of foods for every meal. Variety will artificially and unnecessarily increase how much you eat, overwhelming your satiety signaling. Limit your seasonings, too, because even if the protein source stays the same, your taste receptors respond to the flavor, texture, temperature, and smell variance.
Your goal is to restrict your feeding window to a shorter part of the day and not feel hungry. When you start the day with a meal, you prime yourself to eat again in 2-4 hours. You are retraining your body to listen to your true hunger symptoms and your satiety signals. This means you need to slow down when eating, and should stretch a meal to 45 minutes, because it takes about 20 minutes for your leptin (satiety hormone) to be produced and recognized.
As a practical tip, have a glass of water before every meal and wait about 10 minutes before starting the meal. Then, have a glass of water at the end of every meal, and take a walk for 10 minutes after every meal.
Tasting a food, smelling a food, visualizing a food, or watching a show about food is only increasing your insulin production. This food porn will only cause you to become more insulin resistant. Don’t watch or participate in food porn.
Snacks beget more snacks. Don’t buy snacks or participate in snacking. If you must have a little something to take medication or feel that you can’t go snack-free yet, save some leftover protein from a previous meal to buffer your stomach.
Don’t eat when distracted by a TV. This is called mindless eating, and you are practicing mindfulness.
Have a consistent bedtime and get at least 7 hours of uninterrupted sleep. Sleep is needed to reset your cells. True sleep, initially, is probably more important than exercise for your metabolism.
Start the day off right and skip breakfast altogether. Unless you are truly hungry, or your metabolism has not yet adjusted, breakfast is a waste of calories and time.
If at first you “need” breakfast, then stick to a protein-rich source like eggs and healthy fats. Some suggestions are eggs, meats, fish, nuts, or salad with olive oil dressing.
You should avoid these foods altogether
(remember you don’t even buy these things, they don’t exist in your new Universe):
Oatmeal, cereal, bagels, bread, granola, breakfast bars
Fruit juice, fruit smoothies
Waffles, pancakes, muffins
You should re-think lunch and dinner. Eat only real food, nothing processed.
Forget about foods that never fill you up.
Always avoid food variety inside a meal. Limit yourself on one food type per meal.
For now, avoid food variety between meals until you can retrain your brain for real hunger and satiety signals.
Focus on protein and healthy fats
Focus on getting meals that are rich in protein and healthy fats. Eat all types of meat like beef, fish, chicken, lamb and seafood. Yogurt & cheeses are also nutritious and filling, but increasing variety will make your brain overeat. Fill up on olives, peppers, cucumbers, and avocado, and eat as many green leafy vegetables as you please.
About drinks: Sweet drinks will only drive up your hunger. Whether they have sugar in them or just artificial sweeteners, both will spike your insulin and make you overeat later.
- Juice
- Soda
- Smoothies
- Shakes
- Protein supplements
- Energy drinks
- Sweetened coffee/tea
Instead drink:
- Water
- Seltzer
- Unsweetened iced tea
- Unsweetened coffee
Snacks are unnecessary when your body habituates to real food.
If you must snack, pick from a variety of nuts, macadamia, brazil, pecans, almonds, and walnuts. Leftover protein from the previous meal is also good.
Desserts:
If you are going to eat dessert, what are your best options? Stay away from the ice cream, cookies, cakes that are all full of sugar. They only increase your appetite and your blood glucose levels.
Instead, eat delicious & convenient low carb desserts.
Consider Halo Top or another low-sugar ice-cream. The perfect keto almond butter brownie bar can be an amazing rescue for a desperate sweet tooth. Remember dessert is a special occasion, not a routine.
Many people think that sugar is sugar, but there are different types and sugar comes in many forms. Compared with glucose, fructose plays a primary role in development of metainflammation, obesity, prediabetes, and type 2 diabetes
Fructose directly increases de novo lipogenesis, promotes dyslipidemia, decreases insulin sensitivity, increases visceral adiposity, and stimulates the reward center, similar to cocaine.
What is sugar?
Because glucose is the sugar that we most often talk about and measure in diabetics, most people assume that their regular table sugar is made of glucose. However, common table sugar is actually a disaccharide, made of two monosaccharides, fructose and glucose, bonded together in a 1:1 ratio.
High fructose corn syrup (HFCS) contains about 5% more fructose than glucose. HFCS is manufactured by hydrolyzing corn starch into glucose, which then is isomerized into fructose. Fructose is preferred by food and soft drink manufacturers because fructose exerts a significantly increased perception of sweetness and likely because its production is subsidized. Glucose has a sweetness index of 74 compared to sucrose of 100 or fructose of 173.
According to the CDC, over 30 million Americans have diabetes, with 1 in every 4 not knowing their diagnosis. Fructose is more strongly linked to obesity and diabetes than glucose. There is no biochemical reaction in any eukaryotic organism that requires fructose.
Metabolism of glucose and fructose
Glucose can be utilized as an energy source by almost every cell in the body. Only the liver can metabolize fructose, and it will preferentially convert fructose into fat storage. The body has the ability to handle a small amount of fructose at a time, without adverse health consequences. Fructose does come naturally from fruits, but the absorption is slow due to the large amount of fiber. Unfortunately, removing the fiber by juicing or destroying the fiber, as done in a smoothie, dramatically increases the speed of absorption, overwhelming the liver and sending a fructose rush to the brain.
Glucose consumption normally causes insulin release from the pancreas. Insulin acts on surface cell receptors, which allow glucose absorption into the cell for energy use or converting it to fat inside the cell. High levels of insulin, in the presence of high levels of glucose, cause a liver enzyme [phosphofructokinase PFK] to convert glucose to fructose, which is then quickly turned into fat storage and not used for energy production. However, if you directly ingest fructose, it bypasses the enzyme gateway and insulin is not released, and it goes straight to fat storage.
The metabolism of fructose differs from that of glucose, with liver metabolism of fructose favoring de novo lipogenesis [fat production directly from fructose]. Additionally, fructose does not stimulate insulin secretion or leptin production. Insulin normally regulates the absorption of sugar into the cells, and leptin normally notifies brain receptors that you are full. Because insulin and leptin act as key signals in the regulation of food intake and body weight, fructose consumption causes yet further hunger and additional weight gain. The body is rapidly storing fat, and doesn’t know it’s full.
Insulin resistance from fructose and the beginning of metabolic inflammation
Fructose can also directly trigger insulin resistance. When mice are fed with excessive amounts of fructose, they produce carbohydrate responsive element-binding protein, or ChREBP, which blocks the liver from responding to the insulin.
Fructose is 20 times more likely to cause fatty liver (the key problem of insulin resistance) compared to glucose alone. Fructose feeding studies, replacing glucose with a calorically equal amount of fructose, document a 5x increase in de novo lipogenesis and an increased liver fat by 38% within eight days.
[The metabolism of ethanol (alcohol) is similar to that of fructose. Nearly 80% of the ingested ethanol is delivered to the liver, and metabolized to acetaldehyde, which also stimulates de novo lipogenesis.]
Fructose overfeeding can provoke insulin resistance. Healthy subjects overfed 1000 calories per day of fructose demonstrated a 25 percent worsening of their insulin sensitivity in seven days.
Fructose induces insulin resistance even at typical consumption doses, in less than eight weeks. Subjects were fed 25 percent of their daily calories as Kool-Aid sweetened with either glucose or fructose. The fructose group increased their insulin resistance, and could be clinically classified as pre-diabetic. The glucose group did not.
Fructose engages in the Maillard reaction, or glycation seven times faster than glucose, and a metabolite of fructose does it 250 times faster. We commonly measure this as HgBA1C for glucose. The measure for fructose is fructosamine. This glycation effect makes the cell walls sticky, and the receptors not work. This may explain why patients with high glycation levels require more pain medication, because their receptors simply don’t work. It also is part of the explanation how insulin resistance occurs.
Fructose and addiction
Fructose stimulates the reward center of the brain while glucose does not. Data suggests that the fructose molecule in sugar is what it makes it addictive.
- Glucose activates the cortex, the basal ganglia, and certain other parts, but not the limbic system. Glucose results in a sensation of serotonin-induced happiness. By contrast, fructose stimulates the limbic system and is associated with increased dopamine release in the nucleus acumbens, similar to other addictive drugs (glucose does not stimulate the nucleus acumbens). Fructose results in a sensation of dopamine-induced pleasure.
Agricultural subsidies
Governmental subsidies were initially a method to subsidize farmers during the Depression and the Dust Bowl in 1933. We had a destitute population in the American southwest, dying of famine. Most of the the food and food manufacturers were in the Northeast. By the time it took to transport food by rail to the Southwest, it would go rancid. They had to process it: remove the fiber from the wheat, package it in 5 pound bags, ship it to the Southwest, and then bake it locally. The subsidy was designed to make it worthwhile for the American food industry to invest in a processing and distribution system for a famine-stricken population, which made sense through World War 2.
Unfortunately, President Nixon, concerned about re-election, knew that fluctuating food prices caused political unrest. Nixon instituted a policy of maintaining low consumer prices for food by agricultural subsidy. Until that point, our subsidies were actually designed to pay farmers to not grow certain crops and maintain inflated prices. This policy also allowed the soil to regain nutrient after crop harvest. His agriculture secretary, Rusty Butz, changed farming operations so soil was no longer left fallow; there was no time to restore nutrient after a crop was harvested. It also encouraged monocropping and megafarms. Subsidies have created an agricultural farmer dependency on governmental support. The massive overproduction of just a few grain items resulted in a huge surplus and difficulty in long-term storage. Distributing this slowly rotting surplus was solved through the food stamp system, creating a consumer dependency on governmental support. Unfortunately, these processed staple items are carbohydrate-rich, but have had most of their fiber stripped and fat removed to prevent rancidity, and lack much of the soil-derived micronutrients.
Governmental subsidies and import tariffs have resulted in corn being a much more economical sweetener than sugar–a trend that is not seen in other parts of the world. The consumption of HFCS increased by more than 1000% between 1970 and 1990, far exceeding the changes in intake of any other food or food group. HFCS now represents more than 40% of caloric sweeteners added to foods and beverages, a daily average of 132 calories per person. The effect of governmental subsidy is most evident when you compare the same soft drink in the United States to one in Mexico; for example, Coke contains corn syrup as the sweetener in the United States while it contains cane sugar in Mexico.
The per capita consumption of high fructose corn syrup — the primary sweetener in soft drinks and other sweetened beverages — has increased from 38.2 pounds in 1980 to 868 pounds in 1998 (Chou et al., 2004). In 1942, annual U.S. production of soft drinks was 90 8 oz. servings per person; in 2000, it was 600 servings (Jacobson, 2005).
Other names for sugars:
Processed foods will most likely have sugars added. Unfortunately, they can go by any number of names. While this is an extensive list, it is not complete. The more naturally you can eat your foods, the better success you will have with creating a permanent weight loss solution.
Agave Syrup
Amasake
Any name ending in “ose” or “ol” or “syrup”
Barbados Sugar
Barley Malt
Blackstrap Molasses
Black Sugar
Brown Sugar
Cane Juice or Cane Juice Crystals
Cane Sugar
Caramel or Caramel Coloring
Castor Sugar
Confectioner’s Sugar
Corn Sweetener
Corn Syrup – a manufactured syrup of corn
starch, containing varying proportions of glucose
maltose, and dextrose
Corn Syrup Solids
Crystallized Cane Juice
D-mannose
Date Sugar
Demerara
Demerara Sugar
Dehydrated Cane Juice or Dehydrated Cane
Juice Crystals
Dextran
Dextrin
Dextrine
Dextrose (glucose) – a simple sugar made of
only one molecule
Erythritol
Evaporated Cane Juice
Evaporated Cane Juice Sugar
Florida crystals (a trademarked name)
White or Brown Sugars
Fructose – a simple sugar refined from fruit
Fruit Juice Concentrate
Galactose or Galatactose
Glucose or Glucose Syrup
Golden Syrup
Grape Sugar
Grape Juice or Grape Sweetener
High Fructose Corn Syrup (HFCS)
Honey
Hydrolysed or Hydrolyzed Starch
Hydrogenated Glucose Syrup
Hydrogenated Starch Hydrolysates (HSH)
Invert Sugar
Isomalt
Levulose
Lactitol or Lactital
Lactose – a simple sugar from milk
Malt
Malt Extract
Malt Syrup
Maltodextrin
Maltose
Malitol
Maple Syrup
Molasses
Monosaccharide
Muscovado
Organic Dehydrated Cane Juice
Organic Brown Sugar
Panocha
Polysaccharide
Powdered Sugar
Raw Cane Crystals
Raw Honey
Raw Sugar
What does weight have to do with minority population and voter suppression?
We are hopeful that the title of this article gets your attention, and that this might convince you to read our comments. We are not conspiracy nuts. We don’t at all belief in conspiracy theories; we leave the interpretation of facts to you.
We are presenting the facts as we see them daily, as owners of medical practices treating severely injured and disabled patients. Our viewpoint is definitely skewed because we don’t see patients that are healthy and happy; we only see patients who are suffering from significant disease and most often have been pushed aside medically, economically, and socially. In short, they are “marginalized.”
If we told you that a completely man-made and preventable plague was spreading across the United States and would affect 75% of the population within twenty years, causing countless deaths and costing over $215 billion dollars per year, you might pay attention. Like most epidemics, obesity is accelerating, and now affects 17% of all children and adolescents in the United States — triple the rate from just one generation ago. Obese children are more likely to become obese adults and carry a significantly higher negative lifetime economic and medical burden. If you are overweight or obese, there is a 90% chance you will develop type 2 diabetes; yet, if you smoke for 30-40 years, you have a 10-17% chance of developing lung cancer. Ask yourself which you are more afraid of, being overweight or smoking, and most people think smoking is more deadly. (This is not intended to suggest smoking is beneficial; it’s intended to frame the issue in context.)
Low-income families already face high levels of stress and poor mental health (e.g., anxiety, depression) due to the financial and emotional pressures of food insecurity, low-wage work, lack of access to health care, inadequate transportation, poor housing, and violence.
The federal government spends more than $20 billion a year on subsidies for farm businesses, with the majority going to the largest producers of corn, soybeans, wheat, cotton, and rice. This federally subsidized production reduces manufacturing costs for processed foods containing high fructose corn syrup. Simultaneously, consumer demand for processed foods containing high fructose corn syrup is stimulated by the U.S. Department of Agriculture (USDA), which operates multiple food assistance programs. Supplemental Nutrition Assistance Program (SNAP) currently allows the purchase of almost any food, except alcohol, hot foods, and foods that will be eaten in the store. SNAP participants on average eat about the same number of calories per day as nonparticipants but typically consume more hyperpalatable (tasty) foods containing fructose and industrial seed oils. In fact, low-income individuals who were eligible for SNAP, but did not participate in SNAP, consumed fewer processed foods. Consumers on food stamps get about 12 percent of their daily calories from sugary drinks, compared to 6 percent for higher-income people, even as overall soda sales are declining in the U.S. SNAP households spend approximately 5% of their food assistance budget on soft drinks, and 9.3% on ‘sweetened beverages,’ which includes soft drinks, fruit juices, energy drinks, and sweetened teas. The sweetened beverage industry has lobbied aggressively to prevent SNAP from limiting soda purchases.
Some of this could be caused by lack of access to foods other than these. Low-income neighborhoods frequently lack full-service grocery stores and farmers’ markets, and many of the stores do preferentially stock heavily processed foods that are shelf-stable and less likely to spoil. Even when healthy food is available — especially fresh produce and meat — it is often of poorer quality in lower-income neighborhoods, which diminishes the appeal of these items to buyers
Low-income communities also have a greater availability of fast-food restaurants, especially near schools. These restaurants serve high-calorie, nutrient-poor foods at low prices. Low-income youth are also exposed to disproportionately more marketing and advertising for obesity-promoting products that encourage the consumption of unhealthful foods and discourage physical activity (e.g., fast food, sugary beverages, television shows, video games).
Due to safety concerns and the potential for violence, children and adults are more likely to stay indoors and engage in sedentary activities, such as watching television or playing video games, further increasing the risk for obesity and type 2 diabetes.
By 2035, less than 16 years from now, data suggests that nearly 100% of the African American female population will be overweight or obese. The real issue with this is not directly in the female population, but in their children, who are then predisposed to obesity due to a change in their genetics caused by environmental epigenetic factors. This change will cause a genetic shift for 3-5 generations. This change will shorten lives, worsen disability, reduce lifetime economic earning, reduce academic performance, and increase rates of incarceration.
Placating the masses with hyperpalatable non-nutritious subsidized food maintains generational poverty and generational obesity through changes in genetics. Poverty reduces a population’s economic participation through both disability and a shortened life span. The end result of specifically targeting low-income minority communities with processed food messaging is reduced political participation. Reduced political participation then reinforces the cycle of economic poverty. This is what weight has to do with political participation and voter suppression.
Some people ask the questions: What happens if I stop eating carbohydrates and sugars? What is the minimum daily carbohydrate intake requirement for health? These answers might not be what you think, and your body can be healthy without these.
The lower limit of carbohydrate consumption is likely zero, and there are no essential carbohydrates required for living. According to the Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (2005), the Recommended Dietary Allowance (RDA) for carbohydrate, considered to be the average minimum amount of glucose needed by the brain or central nervous system (CNS), is 130 g/day for adults and children.
The CNS comprises less than 2% of total body weight, but consumes roughly 20% of the total daily calories. Historically the brain has been considered the only organ that required glucose as a fuel source, utilizing approximately 100-140 g glucose per day. However, with ketoadaptation, the CNS reduces the obligatory glucose requirement by approximately 80%, resulting in a true utilization of 20-28 g glucose/d.
However, traditional civilizations (Masai, the Greenland and Alaskan Inuit and Pampas indigenous people) survive on a “minimal amount of carbohydrate for extended periods of time with no apparent effect on health or longevity.”
Research goes on to state that “In the absence of dietary carbohydrate, de novo synthesis of glucose requires amino acids derived from the hydrolysis of endogenous or dietary protein or glycerol derived from fat. Therefore, the marginal amount of carbohydrate required in the diet in an energy-balanced state is conditional and dependent upon the remaining composition of the diet.”
Endogenous glucose production through gluconeogenesis is approximately 2.8-3.6 g/kg/d, or approximately 210-270 g/d in a 70kg human, far greater than the obligatory requirement of 20-28g glucose/d of the ketoadapted human.
According to the Food and Nutrition Board of the Institute of Medicine, “The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate amounts of protein and fat are consumed” (pg. 275). There is no essential need for dietary carbohydrate, provided that “adequate amounts of protein and fat are consumed.”
Carbohydrates are necessary for metabolism, but it’s not necessary to eat them. Your body will manufacture the carbohydrates it needs.
Why do we care so much about food and diet and its impact on your health? We own and operate chronic care health-related companies, but also own and operate restaurants. We have been fascinated with the intersection of health, dietary intake, and lifestyle. We view nutrition as a program, or a subroutine, that informs and instructs the body to specific action. A corrupted program leads to a corrupted outcome.
Our clinics evaluate and treat several thousand patients per year for chronic and acute pain, in an urban setting where access to high-intensity healthcare is readily available through several large academic centers as well as government-sponsored outreach clinics. Unfortunately, despite the availability of cutting-edge medical treatment, the health of individuals and populations continues to decline year over year. Over 90% of our patients have untreated metabolic syndrome, and over 80% have undiagnosed prediabetes or diabetes type 2. The symptom of pain is the final common pathway for the human body to signal impending tissue damage, and most patients avoid contact with the health delivery system until they develop a symptom that they can no longer ignore. Unfortunately, our clinical practice is not unique. Pain is the leading reason for patients seeking medical care and is one of the most disabling, burdensome, and costly conditions in the US. Overall, pain care/treatment and lost productivity costs $635 billion per year. The commonality in metabolic syndrome and chronic pain is the hyperinflammatory state or metainflammation.
As we have treated this patient population over the last 20-plus years, we have discovered some common threads that trouble us. About 80% of the patients have either obesity, prediabetes or diabetes, with the vast majority remaining undiagnosed. More than half of these patients go on to have significant expensive complications and about 20% eventually require dialysis. By 2026, the Medicare system will be so overwhelmed with the diseases of metainflammation that it will literally run out of money. We must engage individual patients in improved health outcomes in order to change the community. We have fewer than seven years.
We are passionate about returning this patient population to health, and avoiding bariatric surgical procedures, which are costly and carry significant risks of organ injury, death, and long-term disability. We have found that academic institutions avoid this population until extraordinary and expensive complications set in, requiring hospitalization. It is our opinion that there is a fundamental cultural disconnect between the ivory tower of the institutions and the actual communities where these patients reside. This cultural disconnect prevents patient engagement in lifestyle changes. Additionally, the Medicaid system does not reimburse for lifestyle and dietary modification for obesity but does reimburse for bariatric surgery. The overwhelming marketing from processed food manufacturers targets the urban minority communities with disingenuous messaging, suggesting health benefits for obesogenic foods. This combined with supplemental nutrition benefits and game theory promotes the hyper-consumption of farmer-subsidized high fructose corn starch as well as industrial seed oils. It is our opinion that the overconsumption of hyperpalatable, nutritionally deficient food is a major contributor to reduced academic success, reduced employment opportunities, increased incarceration rates, and progression of metabolic dysfunction. It is a root cause of the social and economic disparity.
Vegetable oils have been studied for their potential medicinal properties, including their use in pain management. Some research suggests that certain vegetable oils, such as peppermint and lavender oil, may have analgesic effects and could be used as alternative therapies for pain relief. However, more research is needed to fully understand the efficacy and safety of vegetable oils in medicine and pain management.
Understanding the risk factors that could lead to prediabetes and diabetes type 2… • Weight: Being overweight (have a body mass index—a BMI—of higher than 25), increases your risk for developing prediabetes. This is especially true if you carry a lot of extra weight in your abdomen. The extra fat cells can cause your body to become more insulin resistant.
• Being inactive: This often goes hand-in-hand with being overweight. If you aren’t physically active, you’re more likely to develop prediabetes.
• Having a close family member with type 2 diabetes: Prediabetes has a hereditary factor. If someone in your close family has (or had) it, you are more likely to develop it.
• Race/ethnicity: Certain ethnic groups are more likely to develop prediabetes, including African-Americans, Hispanic Americans, Native Americans, and Asian Americans.
• Age: The older you are, the more at risk you are for developing prediabetes. At age 45, your risk starts to rise, and after age 65, your risk increases exponentially.
• Gestational diabetes: If you developed diabetes while you were pregnant, that increases your risk for developing prediabetes later on.
• Other health problems: High blood pressure (hypertension) and high cholesterol (the “bad” LDL cholesterol) increase your risk of getting type 2 diabetes. • Polycystic ovary syndrome (PCOS) also raises the risk of prediabetes because it’s related to insulin resistance. •
Hypothyroidism (low thyroid function; not enough circulating thyroid hormone), and you have prediabetes, then your risk of developing T2D more than doubles in comparison to individuals with normal thyroid function.