How America’s Top Diabetes Doctor Avoids Diabetes

You might think that a diabetes researcher would never develop the disease that he’s dedicated his life to studying. But I can’t count on it

My family’s story: My father was diagnosed with diabetes at age seventy-two and was promptly placed on three medications to control his insulin levels.

What my father did next made all the difference: Even though he began taking diabetes medication, he simultaneously went into action—walking an hour a day and going on the diet described below. A year and a half later, he no longer needed the prescriptions. He still had diabetes, but diet and exercise kept it under control. As a diabetes researcher and physician whose own diabetes risk is increased by his family history, I’ve got a lot at stake in finding the absolute best ways to avoid and fight this disease. Here are the steps I take to prevent diabetes—all of which can benefit you whether you want to avoid this disease or have already been diagnosed with it and are trying to control or even reverse it:

Step 1: Follow a rural Asian diet. This diet includes the most healthful foods of a traditional Asian diet—it consists of 70 percent complex carbohydrates, 15 percent fat, 15 percent protein, and fifteen grams of fiber for every thousand calories. Don’t worry too much about all these numbers—the diet is actually pretty simple to follow once you get the hang of it. You might be surprised by 70 percent complex carbohydrates, since most doctors recommend lower daily intakes of carbohydrates. The difference is, I’m recommending high amounts of complex, unrefined (not processed) carbohydrates. This type of carb is highly desirable because it’s found in foods— such as whole grains, legumes, vegetables, and fruits—that are chock-full of fiber. If your goal is to reduce diabetes risk, fiber is the holy grail.

Why I do it: The rural Asian diet has been proven in research to promote weight loss, improve insulin sensitivity (a key factor in the development and treatment of diabetes) and glucose control, and decrease total cholesterol and LDL “bad” cholesterol levels. To keep it simple, I advise patients to follow a 2-1-1 formula when creating meals—two portions of nonstarchy veggies (such as spinach, carrots, or asparagus); one portion of whole grains (such as brown rice or quinoa), legumes (such as lentils or chickpeas), or starchy veggies (such as sweet potatoes or winter squash); and one portion of protein (such as salmon, lean beef, tofu, or eggs). Have a piece of fruit (such as an apple or a pear) on the side. Portion size is also important. Portions fill a nine-inch-diameter plate, which is smaller than a typical twelve-inch American dinner plate.

Helpful: I take my time when eating—I chew each bite at least ten times before swallowing. Eating too quickly can cause glucose levels to peak higher than usual after a meal.

Step 2: Fill up on dark green vegetables. I include dark, leafy greens in my diet every day. These leafy greens are one of the two portions of nonstarchy veggies in the 2-1-1 formula.

Why I do it: Dark green vegetables contain antioxidants and compounds that help your body fight insulin resistance (a main driver of diabetes). My secret “power veggie”: a Chinese vegetable called bitter melon. It is a good source of fiber and has been shown to lower blood sugar. True to its name, bitter melon tastes a little bitter but is delicious when used in soups and stir-fries. It is available at Asian groceries. Eat bitter melon as one of the two portions of nonstarchy veggies in the 2-1-1 formula.

Step 3: Adopt an every-other-day workout routine. I try to not be sedentary and to walk as much as I can (by using a pedometer, I can tell whether I’ve reached my daily goal of ten thousand steps). While this daily practice helps, it’s not enough to significantly affect my diabetes risk. For that, I have an every-other-day workout routine that consists of thirty minutes of jogging on the treadmill (fast enough so that I’m breathing hard but can still carry on a conversation), followed by thirty minutes of strength training (using handheld weights, resistance bands, or weight machines).

Why I do it: Working out temporarily reduces your insulin resistance and activates enzymes and proteins that help your muscles use glucose instead of allowing the body to accumulate fat—a beneficial effect that lasts for forty-eight hours (the reason for my every-other-day routine). Strength training is crucial— your muscles are what really kick your body’s glucose burning into high gear. A weekly game of tennis helps shake up my routine.

Step 4: eKep the temperature chilly. At the courts where I play tennis, the temperature is naturally cool, but I wear a very thin T-shirt that leaves my neck exposed. This helps activate the “brown fat” in my body. Most people have this special type of body fat—mainly around the neck, collarbone, and shoulders.

Why I do it: Brown fat burns calories at high rates when triggered by the cold. To help burn brown fat, exercise in temperatures of 64°F or lower, set your home’s thermostat in the mid-60s, and dress as lightly as possible in cool weather. Walking for fifty to sixty minutes a day in cool weather also helps.

Step 5: Get the “sleep cure.” I make a point to sleep at least six hours a night during the week and seven hours nightly on weekends.

Why I do it: Lack of sleep has been proven to dramatically harm the body’s ability to properly metabolize glucose—a problem that sets the stage for diabetes. Research shows that seven to eight hours a night are ideal. However, because of my work schedule, I’m not always able to get that much sleep on weekdays. That’s why I sleep a bit longer on weekends. Research now shows that the body has some capacity to catch up on lost sleep and reverse some—but not all—of the damage that occurs to one’s insulin sensitivity when one is sleep deprived.

How to Keep the Toxic Chemical BPA Out of Your Food

BPA (bisphenol A) is used in many plastic food and beverage containers, particularly those made of hard, clear polycarbonate plastic. BPA is also an additive in polyvinyl chloride (PVC) plastic, which is used in some plastic food wraps.

Toxic Chemical BPA Out of Your Food

Surprising news: BPA is in the epoxy resins found in the lining of almost all cans used by the food industry (including baby formula cans!). In fact, canned food is the primary food source of BPA for adults.

The problem: BPA molecules that escape their chemical bonds can migrate into the foods and beverages they contact, especially if the container is heated or the food inside is acidic. We then ingest the BPA, thereby increasing our risk for numerous health problems. There’s even BPA on the coated paper from cash registers—the toxin gets into our bodies when we touch the paper and then handle the food we’re about to eat. BPA can also be absorbed through the skin. Frederick S. vom Saal, PhD, curators’ professor of biological sciences at the University of Missouri and a leading BPA researcher, explains that this chemical has estrogen-like effects on the body. It acts as an endocrine disruptor, interrupting our hormonal patterns and actually reprogramming our genes. Roughly one thousand published, peer-reviewed studies have linked BPA to negative health consequences. These include:

  • Breast cancer, ovarian cysts, and uterine fibroids in females (and prostate cancer, sexual dysfunction, and altered sperm in males)
  • Type 2 diabetes and its precursor, insulin resistance
  • Heart disease and heart rhythm abnormalities
  • Liver disease
  • Thyroid dysfunction
  • Obesity and greater accumulation of fat in cells

Unborn babies, infants, and children are especially susceptible to BPA’s harmful effects because they are still growing. Exposure before birth and/or during childhood has been linked to:

  • Birth defects
  • Cognitive problems, including learning deficits
  • Behavioral problems (e.g., hyperactivity)
  • Early puberty in females
  • Increased risk for cancer in adulthood

How much is too much? The EPA estimates that exposure of up to 50 micrograms (mcg) of BPA per kilogram (kg) of body weight per day is safe. However, recent studies suggest that even a tiny fraction of this amount—as little as 0.025 mcg/kg per day—may be dangerous. Dr. vom Saal says, “No matter what you might hear from the plastics industry, which is trying to convince consumers that BPA is safe, hundreds of published papers show that BPA is a toxin with no safe levels.

Scary: When the CDC studied urine samples of more than twenty-five hundred Americans age six and older, 93 percent of those tested had BPA in their urine.

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