Neal D. Barnard, MD
George Washington School of Medicine and Health Sciences
ut calories and keep careful track of the fat, protein and carbohydrates (including sugar) you eat -- those are the usual dietary recommendations for adults with type 2 diabetes (commonly referred to as adult-onset or non-insulin-dependent diabetes).
Trap: In my experience, many people who follow these recommendations still don’t reap the promised benefits -- weight loss, reduced need for medication and fewer complications.
My approach is dramatically different -- and it works. My research team and I conducted a series of studies with hundreds of patients, and we discovered that it is possible to improve blood-sugar levels through diet alone.
Big payoff: People can now control -- and even reverse -- their type 2 diabetes. While the diet won’t reverse type 1 (or juvenile) diabetes, even for type 1 it will reduce risk for diabetic complications and help to minimize use of insulin.
WHERE IT STARTS
If you have type 2 diabetes, your body has become resistant to insulin, the hormone that carries glucose (sugar) into your cells, where it is used for energy.
The cause: Tiny droplets of fat have accumulated inside your muscle cells and are interfering with their ability to use insulin. Glucose can’t get into your cells properly, which means that it builds up in your blood instead.
What if you could remove that accumulated fat from inside your cells? You would improve your body’s ability to use insulin, get your blood sugar under control -- and possibly even reverse your type 2 diabetes.
The best way to do this is by changing the way you eat. With my three-step program, you can eat as much as you want of certain foods, because this approach focuses solely on what you eat, not how much...
THE THREE-STEP PROGRAM
1. Avoid all animal products, including red meat, poultry, fish, dairy and eggs, as well as dishes and baked goods containing these ingredients. Animal protein is harmful to the kidneys. And the principal ingredient of dairy products, even low-fat or nonfat, is sugar in the form of lactose.
2. Minimize fats, and food made with fats, including cooking oils, salad dressings, mayonnaise, margarine and peanut butter, plus fried foods and naturally fatty foods, such as avocados and olives.
3. Consume lots of fruits, vegetables and whole grains. These foods are low on the glycemic index -- meaning that they act slowly on your blood sugar.
Best choices: Whole-grain breads (wheat, pumpernickel, rye), other whole grains (barley, oats, bulgar, brown rice and corn), plus beans, lentils, sweet potatoes (which contain natural sugar but do not raise blood sugar rapidly), green vegetables, most fruits (except watermelon and pineapple, which are naturally sugary) and tofu. Nuts and seeds are also good in small amounts -- unless you need to lose weight. In that case, it’s best to avoid them.
Also: Herbal or regular tea and coffee are fine. Skip the soda and fruit juice, though, as these drinks are high on the glycemic index. I recommend avoiding diet soda as well. Although the reasons are not clear, people who stop drinking diet soda often lower their blood glucose. I also advise that you take a daily multivitamin/mineral supplement and a daily vitamin D supplement of 1,000 international units.
Bonus: If you follow these guidelines, you’ll get plenty of fiber, which has many health benefits including that it helps to control blood sugar. And don’t worry -- you’ll get enough protein from eating beans, leafy green vegetables, seeds and nuts.
MAKING THE CHANGE
If this all sounds like a very low-fat “vegan” diet, that’s because it is. To help yourself ease into this new program...
Throw out all animal products and oils and foods that contain them.
Make a list of foods you like that fit into the plan. Then go to the store and buy a week’s worth so you can test-drive the diet.
Helpful: There are plenty of healthy convenience foods on the market, like frozen cheese-free veggie pizza with a whole-wheat or rice crust, low-fat vegetarian chili and frozen vegan enchiladas.
Follow my plan to the letter for three weeks. Your blood sugar should start to drop within the first week and will continue to improve. Your blood pressure may drop as well. You’ll have more energy, and you may lose some weight (up to a pound a week). By the end of the third week, you won’t be able to imagine going back to your old way of eating.
Our cravings go away because of a simple biological fact -- we crave today what we had yesterday. Once you’ve gotten your diabetes under control, you can treat yourself to small amounts once in a while of, say, chocolate and other favorite foods. You may even find that you’re satisfied with more healthful substitutes, such as strawberries drizzled with chocolate syrup instead of a candy bar.
Best of all, after a few months, you may be able to cut back or eliminate some of your medications. Note: Always discuss medication changes with your doctor first.
GET MOVING
I recommend exercise as something you add to a healthy diet, not as a substitute for eating better. Best: If you can manage a brisk walk for half an hour a day (or longer!), definitely do it.
If you are overweight or have joint or heart problems, you may not be able to do much exercise when you start the diet. Before long, however, you’ll feel so much better, you’ll want to start moving. And once you find a form of exercise that’s appropriate for you -- and that you enjoy -- exercise becomes a lot more fun....and your diabetes becomes even less of a health concern.
Bottom Line/Retirement interviewed Neal D. Barnard, MD, an adjunct associate professor of medicine at the George Washington School of Medicine and Health Sciences and president of the nonprofit Physicians Committee for Responsible Medicine. He is author of numerous books, including Dr. Neal Barnard’s Program for Reversing Diabetes (Rodale). His scientific articles have appeared in many prestigious medical journals, including Diabetes Care and The American Journal of Clinical Nutrition. www.nealbarnard.org.
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