Recipe of the Week: Vietnamese Chicken Salad

Eating for diabetes reversal is all about learning how to make the most of healthy ingredients. I love ethnic recipes, like this one below, because of the exciting flavors and the opportunity to gain familiarity with foreign ingredients.

Find this recipe and hundreds of healthy recipes here.

Vietnamese Chicken Salad

Photo Credit: Michelle Howard

Ingredients:

1 pound boneless chicken breast, or 2 cups cooked, shredded chicken
3 tablespoons freshly squeezed lime juice
2 tablespoons fish sauce
1 tablespoon white vinegar, cider vinegar, or freshly squeezed lime juice
1 tablespoon sugar
1/2 teaspoon black pepper
3/4 cup very thinly sliced onion
2 cups finely shredded green, savoy, or Napa cabbage
3/4 cup shredded carrots
1/2 cup fresh mint leaves, cilantro, or basil leaves
1/2 cup rau ram leaves (available at Asian markets; optional)
3 tablespoons coarsely chopped roasted and salted peanuts (optional)

Preparation:

1. Put chicken in a medium saucepan and add 2 to 3 cups of water, enough to cover chicken by about 1/2 inch. Bring to rolling boil over medium-high heat, then reduce heat to maintain a lively simmer. Cook until done, 10 to 15 minutes.
2. Meanwhile, combine lime juice, fish sauce, vinegar, sugar, and pepper in a medium bowl. Stir to dissolve the sugar and mix everything well. Add sliced onion and toss to coat. Set aside for 20 to 30 minutes, until you are ready to complete the dish.
3. Transfer the meat to a plate to cool, reserving the broth for another use, such as making soup or cooking rice. When the chicken is cool, tear it into long, thin shreds. Coarsely chop the mint and/or herbs. Add the shredded chicken, cabbage, carrots, mint, and herbs to the bowl of onions and seasonings, and toss to coat everything well. Mound the salad on a serving plate, and top with chopped peanuts, if using. Serve at room temperature or chilled.

Yield: 4 to 6 servings

Nutritional Information:
Per serving: (if 4 servings): 206 calories, 29 g protein, 14 g carbohydrate, 3.5 g fat, 1 g saturated fat, 78 mg cholesterol, 2 g fiber, 760 mg sodium. Calories from fat: 15%

Enjoy!

- Michael Dansinger, MD

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• Type 2 Diabetes Message Board with Michael Dansinger, MD
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Research Study of the Week

Doctors and scientists know that obesity and type 2 diabetes are strongly related, and we know that losing excess body fat dramatically improves diabetes, but we don't have a confident understanding about how, exactly, obesity causes or promotes type 2 diabetes. Here's some new research evidence that helps me understand a bit more about how excess body fat promotes type 2 diabetes. The bottom line always comes back to "eat right and exercise", but many will find that understanding why that's true can help them stick to it!

- Michael Dansinger, MD

Critical Link Between Obesity And Diabetes Discovered

ScienceDaily (July 9, 2009) - A Monash University study has proven a critical link between obesity and the onset of Type 2 diabetes, a discovery which could lead to the design of a drug to prevent the disease.

The findings were published July 8 in the journal Cell Metabolism.

The team, led by Associate Professor Matthew Watt, discovered that fat cells release a novel protein called PEDF (pigment epithelium-derived factor), which triggers a chain of events and interactions that lead to development of Type 2 diabetes.

"When PEDF is released into the bloodstream, it causes the muscle and liver to become desensitised to insulin. The pancreas then produces more insulin to counteract these negative effects, " Associate Professor Watt said.

This insulin release causes the pancreas to become overworked, eventually slowing or stopping insulin release from the pancreas, leading to Type 2 diabetes."

"It appears that the more fat tissue a person has the less sensitive they become to insulin. Therefore a greater amount of insulin is required to maintain the body's regulation of blood-glucose," Associate Professor Watt said.

"Our research was able to show that increasing PEDF not only causes Type 2 diabetes like complications but that blocking PEDF reverses these effects. The body again returned to being insulin-sensitive and therefore did not need excess insulin to remain regulated."

Associate Professor Watt said identifying the link is a significant breakthrough in explaining the reasons why obesity triggers the onset of Type 2 Diabetes.

"Until now scientists knew there was a very clear pattern and had strong suspicions that a link existed between the two conditions, but our understanding of the chain of events that are caused by the release of PEDF shows a causal link," Associate Professor Watt said.

"Type 2 diabetes patients will benefit knowing the two conditions are linked. We already know that weight-loss generally improves the management of blood glucose levels in diabetes patients. Researchers can now move forward knowing this link exists and we can begin to design new drugs to improve the treatment of Type 2 diabetes," Associate Professor Watt said.

________________________________________

Adapted from materials provided by Monash University.

Monash University (2009, July 9). "Critical Link Between Obesity And Diabetes Discovered." ScienceDaily.

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Modern Food

Our world today - our civilization,
Progressively shaped by socialization,
Is a cultured modern derivative,
Of hunting tribes more primitive.
We lived in caves or somewhere outdoors,
We ate what we hunted and fished from the shores.

We foraged for berries and other fruits,
Leaves and mushrooms, stems and roots.
We evolved to seek meat, and fruit as a treat,
Thus our cravings for fat and for sweet.
The key to survival and fighting disease,
Had always been eating more calories.

For nearly all of human existence,
We lived this way with no assistance,
From complex tools or modern machines,
Survival depended on simple routines.
There were no farms, no tractors, no crops,
No mills or flour, or bakery shops.

Our natural diet did not contain,
Cereal, bread, pasta, or grain.
No hot dogs, pizza, or pepperoni,
Sausage, salami, cheese or bologna.
No cookies, pies, donuts or cake,
Or any kind of food that is fake.

Modern society has seriously faltered,
We've become addicted to the food we've altered.
The modern foods we love today -
We're just not designed to eat that way.
Once we see it the truth is so clear,
Our bodies can't handle the treats we hold dear.

The reason this problem remains unsolved,
Is due to the fact that we have not evolved,
A new set of genes to eat "modern" food,
Without getting sick, so we must conclude,
The natural way, the way that is best,
Is to eat the food we're designed to digest.

Fish and fowl, or very lean meat,
Are possible foods that we might eat.
Butternut squash, peppers and beans,
Corn, peas and beets, and all kinds of greens.
Carrots, zucchini, melons and berries,
Peaches and oranges, mangoes and cherries.

No human tribe or society,
Has ever had such a variety,
Of healthy food so easy to get,
We take it for granted we tend to forget,
Our good fortune for this cornucopia,
Some might call it a utopia.

The foods that can save us are found right beside,
The foods that will kill us and rot our inside.
We all face this challenge, we all face this choice,
We all have free will, we all have a voice.
Our future is bright, our potential is vast,
Once we learn this lesson from our distant past.

~ Michael Dansinger, MD

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating for Diabetes Reversal: Part 7

Sample Meals

Now that I have clarified the types of foods to focus on, you may be wondering how to assemble quick, easy meals from those foods. Below I describe the overall strategy for designing meals, and I provide specific examples of quick, easy meals. You will notice that these are not gourmet meals, because my patients are generally looking to avoid complicated recipes. We'll get into more elaborate dishes at a later time, but for now, use these sample meals as a starting point to create your own personalized approach to the "natural human diet".

Eating Program For Healthy Weight

Overview

Eat 3 meals daily, consisting of healthy protein (about 6 ounces) complemented by vegetables/fruits (1-2 cups) and condiments (up to 2 tablespoons).

The Formula

1. Start each meal by selecting one of 4 protein categories (eggs/dairy, nuts/soy, fish/shellfish, poultry breast)


2. Add vegetables/fruits (fresh, frozen, canned, or dried)


3. Jazz it up and add variety with flavorful condiments

The Rationale

This eating strategy takes advantage of modern conveniences to replicate the nutritional characteristics of the "Natural Human Diet". The human body has been genetically designed to eat low-fat protein and high-fiber vegetables and fruits. Our modern culture has radically changed the diet to consist largely of starch, added sugar, and unhealthy fats from meat and dairy, which together promote obesity, diabetes, and related health problems. Minimizing the starch, added sugar, and animal fat reduces hunger and appetite, increases will-power, and allows individuals to feel full and satisfied with dramatically fewer calories. Therefore, "special occasion foods" containing excess starch and/or animal fat should only be eaten at "special occasions" comprising less than 10% of all meals

Step 1: Chose from the 4 Protein Categories

1. Eggs/Dairy - Egg whites and dairy protein are healthy; fat in egg yolks and dairy is not healthy. By limiting or avoiding the unhealthy fats, eggs and dairy can form an important and versatile base for a wide variety of meals and are a favorite for breakfast.
   
   Recommended items include cartons of egg whites, egg-beaters, whole eggs that have increased omega-3, non-fat cottage cheese, non-fat ricotta cheese, Designer Whey protein powder (dairy protein for smoothies), "light" artificially sweetened yogurt, and non-fat plain yogurt. A serving is: 2 whole eggs/6 egg whites/6 ounces non-fat cottage or ricotta cheese/protein power according to canister directions/8 ounces light or plain yogurt.


2. Nuts/Soy - Soy foods and nuts can be used as the base for a wide variety of meals, with a few caveats. Major advantages include the absence of unhealthy animal fats and excess starch or sugar, their versatility, and the importance of this protein group for vegetarians. However, soy foods can contain excess salt while nuts contain excess calories if eaten in excess, therefore these protein choices are eaten in combination with other healthy ingredients.
   
   Frozen or refrigerated soy-based meat substitutes (Morningstar Farms, Boca, Gardenburger), and Quorn (similar to mushroom protein), can stand in for burgers, sausages, diced chicken, and ground meat, while firm tofu can also be used to provide variety and interest to meals. One serving is approximately 6 ounces.


3. Fish/Shellfish - Fish and shellfish are top choices for healthy protein. I recommend eating from this category once per day. They contain healthy fat or minimal unhealthy fat, taste great, and come in many varieties. Especially convenient are canned and frozen fish and shellfish.Frozen fish can be rapidly thawed in hot water, and like fresh fish, tastes great lightly seasoned or can be marinated quickly for added flavor. Fish is now often frozen right on the boat and does not develop a fishy smell if cooked the same day it is thawed.
   
   Few fish have unacceptable levels of mercury; limit swordfish to twice per month and limit "solid" albacore tuna in cans or fillets to twice per week. Chunk or light tuna, salmon, and other commonly eaten fish and shellfish have low or minimal mercury levels that do not negate the powerful health benefits of fish. One serving is approximately 6 ounces.


4. Poultry Breast - the breast meat from chicken and turkey is high in protein with low levels of unhealthy fat. There is too much unhealthy fat in the dark meat and skin, so only eat the white/breast meat. Ground poultry should also be avoided, unless it contains only white/breast meat.
   
   Chicken and turkey breast are available cooked or uncooked at all supermarkets, and can easily form the base of a wide variety of soups, salads, or main dishes. Turkey breast slices, thin or thick (try half-inch thick slices), are especially convenient and are available at any deli counter. Salt/sodium in prepared poultry breast can be high, but when paired with other low-sodium ingredients, overall salt intake remains low. One serving is approximately 6 ounces.

Step 2: Chose the vegetables/fruits

Much of the variety and interest for the meals come from the vegetables and/or fruits, rather than the relatively limited protein choices. Some meals will call for convenient, rapidly prepared vegetables/fruits while others benefit from preparations that require more time and effort. To maximize convenience, taste, and variety, becoming familiar with all the available varieties and preparations of vegetables and fruits is highly recommended. Fresh, frozen, canned, and dried produce each have advantages and disadvantages. An adventurous spirit and open-mindedness can be great assets when considering potential combinations of various produce and protein options. Do not dismiss combinations of savory and sweet in the same dish. Dried fruits can be used in moderation (1/4 cup per day) straight out of the bag, or rehydrated in water for a few hours or overnight.

Aside from white potatoes, starchy vegetables such as winter squash, sweet potatoes and other root vegetables, and beans/legumes can be used in moderation (3 one-cup servings per week). Avoid fruit juice, discard the juice from canned fruit, and avoid fruit canned in heavy syrup. Vegetables should not be deep fried or cooked with much oil/fat; they can be sautéed in spray oil or skimpy amounts of olive or canola oil. To keep produce fresh, make a weekly trip to the market. Pair a full serving of protein with about 1 cup fruit, 2 cups of cooked vegetables or soup, or up to 4 cups of salad/raw vegetables.

Step 3: Add flavorful condiments

Condiments are typically bottled or jarred sauces, dressings, relishes, jams, chutneys, spices, pickled vegetables, or other similar foods used in small quantities, that add great flavor to meals. They should be used regularly to provide the flavor and variety necessary to make this an exciting and interesting eating strategy. Most condiments are acceptable when no more than 2 tablespoons are added to a meal (up to 100 calories per 2 tablespoons), including salad dressings. Salt, fat, sugar, and starch are often present, but are best used in this context and in these limited amounts. The end result is the transformation of protein/vegetable/fruit combinations into exceptionally flavorful, pleasurable, and unique meals.

Sample Meals

Egg/Dairy Meals

PROTEIN	VEGETABLE/FRUIT	CONDIMENTS	INSTRUCTIONS
½ cup Egg Beaters - Southwestern style	½ cup diced peppers & onions	Spray oil ¼ cup salsa	Sauté the vegetables, set aside, cook the egg beaters omelet style, add veggies, then top with salsa.
6 oz cottage cheese - fat free	1 cup fruit such as pineapple, pear, banana, etc.	Any sweet spice or condiment, optional	Place cottage cheese in a bowl, add optional condiment/spice, and fruit.
6 oz ricotta cheese - fat free	1 cup thawed frozen berries	None	Place ricotta cheese in a bowl, add fruit.
2 fresh eggs	½ cup corn salsa (Trader Joes)	½ cup Pinjur (Trader Joes)	Add pinjur and corn salsa to a small pan, cover, cook over medium heat for 4 minutes, add eggs sunny-side up style, cover for 4 minutes and move to plate.
3 hard boiled eggs, minus 2 yolks	1 cup/piece any fresh fruit	2 T. pesto (Trader Joes)	Mash the eggs, add pesto and eat with fruit on the side.
4 hard boiled eggs, minus 2 yolks	1 cup/piece any fresh fruit	2 T. honey mustard	Cut eggs in half, mash 2 yolks with the honey mustard, and scoop into yolk cavity. Eat with fruit on the side.
½ cup Egg Beaters	½ cup spinach ½ clove garlic	2 T. feta - fat free	Sauté the spinach and garlic, then add egg beaters, cover on medium heat until cooked, frittata style.
Protein powder 1 scoop - Designer Whey Chocolate	1 banana	½ tsp. cinnamon 1 cup cold water	Place all ingredients in a blender. Blend until smooth.
Protein powder 1 scoop - Designer Whey Vanilla	½ cup frozen cherries	¼ tsp. almond extract 1 cup cold water	Place all ingredients in a blender. Blend until smooth.

Soy/Nut Meals

PROTEIN	VEGETABLE/FRUIT	CONDIMENTS	INSTRUCTIONS
1 T. spicy peanuts 1 T. plain peanuts	1 T. raisins 1 T. dried cranberries	None	Mix together to make trail mix (makes 1/4 cup).
2 T. peanut butter	1 cup apples, pears, carrots, celery, bell pepper and/or cucumber	None	Spread peanut butter on sliced vegetables/fruits.
Morningstar Farms Grillers - 1 veggie burger	1 cup sliced raw vegetables, pickles Nonfat cheese - Kraft singles	Mustard, ketchup, BBQ sauce	Cook the burger according to package directions. Add cheese, condiments and eat with a fork with side veggies.
2 Boca Italian Veggie Sausages	2 cups raw bell pepper and red or yellow onion	2 T. olive or canola oil 1/2 cup tomato sauce	Slice vegetables into strips and sauté in oil. Thaw sausages in microwave and slice into coins. Add to vegetables. When vegetables are soft, add tomato sauce until cooked through. Transfer to plate.
2 Boca Bratwurst Veggie Sausages	2 cups raw red cabbage and red or yellow onion	2 T. canola oil ¼ cup cider vinegar	Slice vegetables into strips and sauté in oil. Thaw sausages in microwave and slice into coins. Add to vegetables. When vegetables are soft, add cider vinegar until cooked through. Transfer to plate.
1 cup Quorn brand crumbles with ½ cup water	2 cups salad vegetables: lettuce, cilantro, scallions, tomatoes, cucumber, black beans	1/2 packet taco seasoning mix salsa, hot sauce, guacamole, nonfat sour cream	Thaw crumbles in microwave, and heat in skillet with water and taco seasoning. Prepare salad and top with up to 2 T. condiments.
½ block or 1 cup firm tofu 1 fresh egg	1 cup frozen peas	Spray oil 2 T. low sodium soy sauce	Dice tofu into ½ inch cubes. Add all ingredients to hot sprayed skillet and stir fry until hot, about 3-4 minutes. Transfer to plate.
1 cup Quorn brand crumbles with ½ cup water	½ cup black beans mashed 1 diced scallion ½ cup corn salsa (Trader Joes) 1 cup canned diced tomato	½ packet chili or taco seasoning mix	Mix all ingredients together and simmer for ½ hour. Double recipe to make 2 meals if desired.
½ block or 1 cup firm tofu	2 cups frozen Asian vegetables	Spray oil 2 T soy sauce, teriyaki sauce or similar	Thaw vegetables and stir-fry in sprayed skillet. Dice tofu into ½ inch cubes and add with Asian sauce until cooked.
Morningstar Farms breakfast sausage (4 links or 2 patties)	1 cup or 1 piece fresh fruit	None	Cook the sausages according to package directions and eat with fruit on the side.

Fish/Shellfish Meals

PROTEIN	VEGETABLE/FRUIT	CONDIMENTS	INSTRUCTIONS
6 oz. can boneless skinless pink salmon	3/4 cup canned beets ½ cup corn salsa (Trader Joes)	1 T. pesto (Trader Joes)	Drain salmon. Dice beets. Add all ingredients to a bowl, mix and eat.
6 oz can solid white tuna, drained	1 cup frozen green soybeans (edamame) ½ cup canned mushrooms, drained	2 T. teriyaki sauce	Thaw soybeans in microwave. Add all ingredients to a bowl, mix and eat.
Tuna in Thai curry sauce, 1 packet (Trader Joes)	2 cups diced salad vegetables: cherry tomatoes, cucumber, cilantro, mint, red bell pepper, red onion, carrot shavings	None	Add diced salad vegetables to a bowl, add curried tuna, mix and eat.
1 cup shrimp - raw or cooked	2 cups frozen stir-fry vegetables	Spray oil 2 T. teriyaki sauce	Thaw frozen shrimp and vegetables. Cook in sprayed skillet until cooked through. Add sauce and transfer to plate.
6 oz can solid white tuna, drained 1 boiled egg, chopped	½ cup cherry tomatoes, halved, ½ cup frozen green beans	2 T. balsamic vinegar salad dressing	Thaw green beans and add all ingredients to bowl, mix and eat.
6 oz fresh salmon or other fish fillet	1 cup fresh asparagus	2 T. sauce of choice; for example, apricot preserves blended with spicy mustard	Cook fish and asparagus on George Foreman grill, in skillet, or oven. Serve with sauce of choice.
1 cup frozen scallops	1 bag fresh spinach 1 box diced mushrooms	1 T. oil 1 T. diced garlic	Sauté the mushrooms in oil and garlic. Add spinach and transfer to a plate when cooked through. Saute the scallops until cooked through and eat with vegetable mixture on the side.
6 ounces frozen or fresh artificial crab legs, such as Louis Kemps	¼ cup finely diced red onion ¼ cup chopped scallion, 1 cup diced cucumber	2 T. light mayo	Thaw crab legs, then finely chop and mix in a bowl with other ingredients and eat.
Boneless skinless pink salmon - 6 oz. can, drained	2 cups vegetable soup, homemade or canned	2 T. sauce of choice	Heat the soup in a pot and mix in the salmon and any additional seasonings. Transfer to bowl and eat.
6 oz cooked tiny shrimp	2-3 cups diced combination of cucumber, cherry tomato, yellow bell pepper, cilantro, red onion, mango, avocado	2 T. mango chutney or curried mango sauce	Mix all ingredients in a bowl and eat. Tastes best if left to stand in refrigerator several hours or overnight
6 oz can solid white tuna, drained	Diced cucumber 1 cup	2 T. sweet rice vinegar 1 tsp. sesame seeds	Mix all ingredients together in a bowl and eat.

Turkey/Chicken Breast Meals

PROTEIN	VEGETABLE/FRUIT	CONDIMENTS	INSTRUCTIONS
6 oz cooked turkey breast, ½ inch cubes	½ cup diced cucumber, ½ cup diced red bell pepper, ½ cup quartered cherry tomatoes, ½ cup chopped fresh cilantro leaves	¼ cup peach salsa (Trader Joes)	Mix all ingredients together in a bowl and eat. Can use turkey from the deli counter sliced ½ inch thick at time of purchase, then diced when ready to use.
6 oz cooked turkey breast, finely diced in 2 cups soup broth	1 cup frozen peas/corn/carrots, 2 diced scallions, 1 tsp. minced jalapeño pepper, ¼ cup diced avocado	None	Simmer all ingredients in soup pot for 15-30 minutes, transfer to bowl and eat.
6 oz cooked turkey breast, ½ inch cubes	2/3 cup corn salsa (Trader Joes)	2 T. cranberry orange sauce (Trader Joes)	Mix all ingredients in a bowl and eat.
6 oz cooked chicken breast, sliced	1 cup sliced red or yellow onion, 1 cup sliced bell pepper	2 T. canola oil Fajita spices and/or 2 T. fajita sauce	Sauté peppers and onion in a pan until soft and browned. Add chicken slices and fajita seasonings. Transfer to a plate.
6 oz cooked chicken breast, diced	1 cup red cabbage, 3 scallions, ½ cup red bell pepper, ½ cup carrot	1 T. sweet rice vinegar, 1 T. soy sauce, 1 T. olive oil	Finely shred or chop the vegetables and place in a bowl with diced chicken. Mix dressing ingredients and toss all together.
6 oz cooked chicken breast, diced	½ cup diced red pepper, 3/4 cup diced orange, ½ cup diced avocado	¼ cup Mojito sauce (Trader Joes)	Add chicken and Mojito sauce to a skillet to warm, then mix in a bowl with other ingredients.
6 oz ground or diced turkey breast 1/2 cup water	1/2 cup black beans mashed, 1/2 cup corn salsa 9Trader Joes), 1 cup diced tomatoes, 1 scallion diced	Spray oil ½ packet chili or taco seasoning mix	In a soup pot, brown turkey in spray oil, add other ingredients and simmer ½ hour. Transfer to a bowl and eat.
6 oz cooked chicken breast, diced 1 cup chicken broth	½ cup diced yellow onion, 1 cup frozen corn/peas/carrots, ½ cup diced tomatoes in juice	1 T. oil, 2 T. peanut butter	In a soup pot sauté onion in oil, add vegetables until hot, add broth, chicken and peanut butter and simmer 15-30 minutes. Transfer to bowl and eat.
6 oz cooked chicken or turkey breast, diced	2 cups canned low-sodium soup	None	Heat soup and chicken/turkey in a pot until warmed. Transfer to a bowl and eat.

Grocery List

Chicken breast, raw or cooked
Turkey breast, cooked whole, deli slices, or raw
Canned salmon - boneless skinless, 6 oz
Canned tuna - solid white, 6 oz
Packaged tuna in red curry sauce - Trader Joes
Frozen shrimp
Frozen scallops
Frozen fish fillets
Frozen salmon burgers
Boca frozen vegetarian sausages - Italian/Bratwurst/Smoked
Morningstar Farms - frozen vegetarian breakfast sausages links or patties
Morningstar Farms - frozen vegetarian burgers, any flavor
Quorn - frozen vegetarian crumbles and chicken style cubes (tenders) and fillets
Designer Whey - protein powder chocolate or vanilla
Tofu - Extra firm
Eggs - with omega 3
Ricotta cheese - fat free
Cottage cheese - fat free
Feta cheese - fat free
Cream cheese - fat free
Sour cream - fat free
Milk - fat free
Yogurt - artificially sweetened 'light' or plain nonfat
Canned beans - black, pinto, etc
Peanut butter - natural (just peanuts and salt)
Pickles
Condiments - relishes, chutneys, sauces, dressings etc, up to 100 calories per 2 Tbsp.
Corn salsa - Trader Joes
Peach salsa - Trader Joes
Pinjur - Trader Joes
Mojito Sauce - Trader Joes
Canned Soup - low sodium, low fat, low calorie
Canned fruit - preferably 'light' or in light syrup, not heavy syrup
Canned vegetables
Frozen vegetables - peas, corn, mixed, stir-fry Asian, etc.
Frozen fruit - cherries, berries, pineapple, etc.
Dried fruit - raisins, apricots, dates, figs, etc. (eaten in moderation)
Nuts - eaten in moderation
Fresh vegetables - cucumbers, peppers, carrots, cilantro, mint, basil, parsley, red cabbage, red onion, yellow onion, scallions, broccoli, spinach or other greens, cauliflower, zucchini, mushrooms, etc.
Fresh fruit - apples, oranges, grapefruit, pears, bananas, grapes, pineapple, mango, melon, etc.

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating For Diabetes Reversal: Part 6

Dr. Dansinger's Eating Strategy for Diabetes Reversal

So far we've discussed the following principles:

1. The natural human diet has been distorted beyond the nutritional breaking point by modern technology.


2. The modern human diet is too high in caloric density, glycemic load, saturated fat, added sugars, and trans fats, and too low in fiber, omega 3 fats, vitamins, minerals, etc..


3. There are many ways to backpedal away from the modern human diet.


4. Adherence level is the key determinant of weight loss and reduction of diabetes and heart disease risk factors, regardless of the type of eating strategy used.


5. Glycemic load reduction helps reduce hunger resulting in decreased caloric intake and weight loss.


6. Caloric density reduction helps reduce caloric intake resulting in weight loss.


7. Saturated fat reduction helps reduce insulin resistance and the duration of glucose spikes.


8. Loss of excess body fat is a potent tool for combating type 2 diabetes.


9. I define type 2 diabetes remission as hemoglobin A1c of 6.0 or less without diabetes medication for at least 2 months.


10. Many people can achieve type 2 diabetes remission with sufficient adherence to the right eating and exercise strategy.

For my Diabetes Reversal Program patients I have devised a specific eating strategy based on my cumulative knowledge and experience, aiming to find the right balance between effectiveness and feasibility. Too strict or extreme and the strategy will not be feasible, too liberal or compromising and the strategy will not be effective. There are many eating strategies that work well, but this is the one I have come to favor because it fits best with my personal preferences and philosophy. I use other strategies sometimes, but this is my main one.

My aim is to use modern food to approximate the nutritional characteristics of the Natural Human Diet. I'm aiming to substantially reduce caloric density, glycemic load, and saturated fat, in the most reasonably balanced manner possible. The eating strategy must have rules that are clear and simple. Most importantly, the strategy must work to reliably achieve caloric reductions, weight loss, and A1c reductions, in all who follow it, plus it must improve (or not worsen) any heart disease risk factor that needs correction.

People cannot be expected to follow the eating strategy at 100% adherence level. Nobody is perfect and everybody wants to eat unhealthy treats occasionally. Following the eating strategy at 90% adherence level, such that no more than 10% of the food eaten is outside the healthy food list, is the goal. Following the eating strategy at 70% level will not bring 70% of the health benefits, unfortunately. Furthermore, there is a major difference between 80% adherence and 90% adherence, when it comes to weight loss and health improvement. Ninety percent adherence is an ambitious goal, but that's what it takes to get it right. All the guesswork and complexity has been eliminated for the individual user--just learn to stick to the food list at the 90% level and everything else will fall into place.

A prominent feature of my favored eating strategy is that it is very critical of starchy foods. When I say starchy foods I'm referring to breads, rice, pasta, cereal, grains, white potatoes, foods made from flour, etc. The body turns starch to sugar, and this stimulates hunger and appetite, and spikes the blood sugar in people with diabetes or insulin resistance. Starchy foods usually have a high caloric density, and they often serve as a vehicle for fat (for example, a roll with butter, French fries, mashed potatoes with gravy, etc.).

Another prominent feature is that it aims to reduce saturated fat, which worsens insulin resistance. For this reason I encourage poultry breast instead of the dark meat, and discourage red meat unless it is 95% lean or leaner. Even 95% lean means about a third of the calories are coming from fat. Dairy products should be fat-free or 1% fat, and small amounts of low-fat cheese are allowed. Egg yolks can be eaten in moderation, aiming for more whites than yolks. Fish and shellfish are encouraged, since they contain healthy fat, and generally help with weight loss.

I am liberal with fruit, despite the fact that it has natural sugars. I have found that in the case of this particular eating strategy, fruit helps with weight loss and dietary adherence, and I rarely have to limit fruit to get excellent control of the blood sugar levels. If we're desperate to push the A1c lower after getting as much weight loss as possible, we sometimes limit the amounts or types of fruit, but even then it can be counterproductive or produce little marginal benefit. Fruit turns out to be crucially important.

"Borderline foods" have both starch and fiber, so they have mixed effects. Foods like sweet potatoes, corn, popcorn, oatmeal, whole grains, high-fiber cereals, bananas, and legumes (lentils, kidney beans, etc.) are moderate to high in glycemic load, but have other nutritional properties that are favorable, including fiber, therefore those of us aiming for a "moderate-carb" eating strategy usually have mixed feelings about these foods and there is lack of consensus about how to handle these foods. If we allow all the borderline foods it seems to be too liberal, but if we exclude all the borderline foods it seems to strict, therefore we draw some kind of arbitrary line that allows some but not others. My rule of thumb is if it is a vegetable or fruit, then I allow it, and if it is a grain then I do not. Bananas, sweet potatoes, corn (as a vegetable), and legumes are "in", while oatmeal, whole grains, corn (when ground for flour), popcorn, and high-fiber cereals are "out". Chemically and nutritionally these foods have fairly similar properties, but philosophically they differ because fruits and vegetables have always been mainstays of the natural human diet, while grains are relative newcomers. The line is fairly arbitrary, but that is how and why I draw the line as I do. Sticking to a clear rule is even more important than the specifics of the rule in this case.

I allow low-fat dairy products even though they are not part of the natural human diet for adults. The nutritional profile of fat-free or very low fat dairy products is favorable enough, given the low caloric density, glycemic load, low saturated fat, and high protein and calcium content.

The eating strategy is low in sodium. Most sodium is used to flavor starchy foods, and does not necessarily correspond to how "salty" a particular food tastes. Following this eating strategy automatically reduces sodium without having to pay special attention to sodium and salt.

I encourage people to use their appetites as a guide. I do not limit food portions (with a few exceptions) or meal timing. Foods that are on the approved list can generally be eaten in any reasonable amount at any time of day. Because the eating strategy minimizes appetite-stimulating foods, hunger goes way down, and because the food is low in caloric density the daily caloric intake goes way down as well. People eat much fewer calories without hunger, and that is the key to achieving substantial weight loss. Learning how to stick to it for the long-term is the key to maintaining substantial weight loss "forever".

Below is a list of food types that I usually encourage, and a list of food types that I consider unfavorable, and to be minimized (considered to be "treats").

Favorable Foods

• Vegetables (any vegetable except white potatoes). Fresh, frozen, canned are all fine.
• Legumes (lentils, kidney beans, etc.) Dried and canned are fine. Limit hummus to ¼ cup per day.
• Soups made from vegetables, legumes, and/or other foods on the favorable food list.
• Fruits (fresh, frozen, canned are all fine. Drain juice from canned fruit, limit dried fruit to ¼ cup/day).
• Fish and shellfish (not deep-fried)
• Poultry breast (avoid dark meat, ground poultry must be breast meat only)
• Eggs (eat more whites than yolks, omega 3 enriched yolks are best)
• Lean meats (95% lean or leaner)
• Soy foods (such as veggie burgers, tofu, etc., limit low-fat soy milk to 1 cup per day)
• Milk (skim or 1% only, limit up to 2 cups per day)
• Cottage cheese, fat free or 1%
• Yogurt, plain or "light" only (Greek style plain non-fat yogurt is preferable)
• Non-fat cheese, or low-fat cheese (limit to 1 ounce low-fat cheese per day)
• Non-caloric beverages (up to 10 calories per 8-ounces)
• "Diet desserts" with no added sugar, up to 100 calories per day (diet jello, diet pudding, etc.)
• Protein powder (example: Designer Whey)
• Condiments and salad dressings (up to 50 calories per tablespoon, limit 2 tablespoons)
• Vegetable oil, nuts, peanut butter, and seeds limit 2 tablespoons per day

Foods to minimize or avoid

• Starchy foods and grains (flour, bread, cereals, all rice, all pasta, all grains, pizza crust, popcorn, etc.)
• Full-fat cheese, cream, butter, and other dairy products
• Fatty meats (less than 95% lean)
• Foods with added sugar (canned fruit ok if juice is drained, condiments ok if less than 50 cal/tbsp.)
• Margarine, unless no trans fats or partially hydrogenated oil (limit 1 tablespoon per day)
• Juice
• Alcohol

Next time I will discuss general approaches to breakfast, lunch, dinner, and snacks.

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating for Diabetes Reversal: Part 5

Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal

Ready to take your diabetes reversal nutrition knowledge to new heights of sophistication? Hold on to your hats, we're about to take off!!

Different eating strategies work for diabetes reversal by reducing "Caloric Density", "Glycemic Load" and/or "Saturated Fat". Let's see why these three concepts are so important to understanding diabetes reversal.

Caloric density, as many already know, refers to how many calories are packed into a given amount of food, and allows us to compare different foods. What has more calories--an ounce of carrots or an ounce of hot fudge? Obviously the hot fudge! The caloric density of hot fudge is greater than the caloric density of carrots. It doesn't matter whether we're comparing a tablespoon of each, or a pound of each, as long as the amount of food we're comparing is the same, the hot fudge will always have more calories because it has a high caloric density.

When considering whether a particular eating strategy will be good for achieving and maintaining a healthy body weight, it stands to reason that foods with a low caloric density, with few calories per ounce of food, should be favorable. Indeed, the average caloric density of any particular eating strategy is a very important consideration. There are charts and books that indicate and rank the caloric density of common foods. For example, Volumetrics by Dr. Barbara Rolls, provides such information and uses it as the basis for an entire eating strategy designed to minimize caloric density as a means to weight loss. The idea is to fill up on foods that are low in calories - vegetables, most fruits, low-fat proteins, low-fat dairy, soups, etc. Foods that are high in fat, high in sugar, and low in water content, tend to be higher in caloric density - fatty meats, oils, fried foods, nuts, olives, avocados, crackers, regular cheese, etc.

In fact, a major criticism against the modern human diet is that it is much too high in caloric density, and this has fueled the obesity and diabetes epidemics.

Almost all eating strategies aim to keep caloric density low, however that is not the only major consideration when it comes to effective eating strategies.

This is where glycemic load comes in. Glycemic load reflects the blood sugar raising effects of a given amount of food. Which food raises blood sugar levels more--an ounce of carrots or an ounce of hot fudge? Again, the hot fudge is the culprit! An ounce20of hot fudge raises blood sugar much more than an ounce of carrots does. The glycemic load mainly reflects the total amount of carbohydrate in a defined amount of food. It stands to reason that a good strategy for keeping the blood sugar low should be to keep the glycemic load of the eating strategy low. This generally means keeping the total number of carbohydrate grams low, but it also means choosing foods that are less processed, are higher in fiber, and do not have added sugar. For example, an ounce of white rice raises the blood sugar a bit more than an ounce of brown rice. When the fiber coating of grains, or the fibrous membranes of fruits and vegetables are disrupted or removed, the glycemic load of the food increases because the sugar and/or starch in the food is more rapidly digested and absorbed into the blood, causing a greater blood sugar elevation than when the food is digested more slowly.

Foods with high glycemic load not only raise blood sugar--they are appetite stimulants! The greater the glycemic load, the greater the appetite stimulation. This is not readily apparent to most people. After all, high carb foods like bagels, pasta, and rice seem filling when you eat them, but what many fail to realize is they can make you hungry later in the day or the next day.

Interestingly, some foods are high in caloric density, but low in glycemic load, while other foods are low in caloric density and high in glycemic load, and that's where things start to get complicated. For example, bacon and other fatty meats are typically high in caloric density, but low in glycemic load. Same story for cheese, vegetable oils, avocados, olives, and nuts. On the other hand, lentils, beans (kidney, garbanzo, etc.) bananas, pineapple, oatmeal, brown rice, etc. are low to moderate in caloric density, but high in glycemic load. Experts often have mixed opinions on the role for these foods in eating strategy design.

To make matters more complicated, the blood-sugar raising effects of a certain food is affected by the presence of saturated fat and trans fat. Saturated fat is found primarily in red meat, poultry, dairy, and tropical oils (coconut oil, palm oil, cocoa butter). These fats, especially from meat and dairy, worsen insulin resistance on the day they're eaten. Ice cream, cheese, whole milk, cream, hamburger, bacon, salami, etc. have enough saturated fat to significantly prolong the amount of time a high-glycemic food will raise the blood sugar.

When someone with type 2 diabetes or insulin resistance eats ice cream, the sugar in the ice cream causes the blood sugar (glucose) levels to soar, and the saturate fat in the ice cream exacerbates the pre-existing insulin resistance, thereby hindering the insulin from getting glucose into muscles and organs where it belongs. The glucose levels stay up even longer than usual! The combination of high glycemic load and saturated fat is especially unfavorable for diabetes and blood sugar control. A double whammy!

In principle, an eating strategy that is low in caloric density can work well for weight loss and diabetes reversal, but the effectiveness might be limited if the food is high in glycemic load. Appetite might be stimulated, but the food is so low in calories, and so high in fiber, that appetite stimulation does not result in a significant problem. Similarly, high glycemic load can increase blood sugar levels in the short-term, but the weight loss offsets any short-term worsening in glucose levels. The Ornish diet works this way.

On the other hand, in theory an eating strategy that is very low in glycemic load can work well for weight loss and diabetes reversal, but the effectiveness might be limited if the food is high in caloric density and saturated fat. The foods might be high in calories, but there is little appetite stimulation or excess hunger, and the total daily caloric intake can go down, leading to weight loss. Saturated fat intake might be high, but there is little opportunity for prolonged glucose spikes, with such low glycemic load. In theory, the weight loss can offset any ill effects that saturated fat would cause under more typical situations with a higher carbohydrate intake.

So, in theory, the ideal eating strategy for good health would be low in caloric density, low in glycemic load, high in fiber, and low in saturated fat. These differences characterize the differences between the "Natural Human Diet" and "Modern Human Diet" I discussed in Part 1 of "Eating for Diabetes Reversal"

Unfortunately, the theoretically ideal eating strategy does not usually work in actual practice because it is too strict for most people. They just can't stick to it and figure out how to make it work under real world conditions. Again, the problem comes down to adherence. The more ambitious the eating strategy, the lower the adherence level, and the less effective it becomes!

My job is to help motivated people to master an eating and exercise strategy that will help them achieve and maintain diabetes remission, or get as close to it as possible. Not just in theory, but in actual practice!

How do I do it? I'm excited to share the specifics of my basic eating strategy next time!

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating for Diabetes Reversal: Part 3

The Tufts Popular Diet Trial

About 10 years ago, during the summer of 1999, the Atkins diet was starting to catch on like wild fire. I first learned about it from another doctor. We were out to dinner with friends, and he ordered a bacon cheeseburger without the bun and a side dish of buttered vegetables. I was flabbergasted by such an odd choice, and dumbfounded when he explained he was eating this way to lose weight! "You can't lose weight on a high fat diet" I insisted, but his wife backed up his ludicrous claim that the pounds were melting off week by week on this crazy diet. This doctor friend encouraged me to read Dr. Atkins' New Diet Revolution so I could understand the scientific rationale, and I came to understand Dr. Atkins' hypothesis: in the absence of carbohydrates, the body is forced to use its own fat for fuel, resulting in weight loss and reduction in heart disease and diabetes risk factors. The Atkins diet is the prototype for an entire category of popular diets I refer to as "Low-Carb" diets.

At the same time, the Zone diet, by Barry Sears PhD., was also becoming increasingly popular. He too hypothesized that the modern diet was too high in refined carbohydrates, and should be more like the natural human diet. He proposed using food like a powerful drug to keep insulin levels in the optimal range – or zone – by eating 40% of calories as carbohydrate, 30% as fat, and 30% as protein. Like Atkins, he too cited many scientific studies supporting his hypothesis. There were many spin-offs of the Zone diet that became bestsellers, including Sugarbusters! and the Suzanne Somers diet book series. The Zone diet is the prototype for an entire category of popular diets I refer to as "Moderate Carb" diets.

Low carb and moderate carb diets flew in the face of conventional wisdom. The nutrition experts had reached a consensus that fat, especially animal fat, was a major problem in the Western diet. Discouraging excess fat and meat consumption has been (and remains) an important public health goal, and likewise for encouraging whole grain consumption, and these new and unproven "fad diets" were running counter to the public health message. Such diets were mainly viewed as pseudoscientific and largely dismissed and criticized by the authorities. A few scientific papers projected such diets would be harmful, and such diets became easy targets for nutritionists who were eager to bash them in the popular press. Moderation, balance, and variety are the keys to healthy eating and weight control, according to popular wisdom, and the Weight Watchers diet is a prototype for this type of "Moderate Fat" diet.

In addition to the classical moderate fat dietary approach embraced by the mainstream, there has also been a school of thought dedicated to pushing dietary fat very low. In theory it makes a lot of sense to follow a very low fat diet – the food is low in calories, and minimizes artery-clogging saturated fat. Most non-Westernized cultures follow a very low fat diet high in complex carbohydrates and fiber, and their rates of heart disease, obesity, and diabetes have been much lower than in Western cultures. Dean Ornish MD has been the most outspoken expert to advocate for this dietary approach, and his popular diet books on this topic are the prototype for the "Low Fat" cate gory of diets.

So, in late 1999, while I was starting a fellowship training program in medical research at Tufts University and Medical Center in Boston, I sought out the opportunity to work with USDA nutrition scientists to compare the health effects of various eating strategies. I was intrigued and bothered by the large gap between the enormous growing public interest in popular diets, and the absent body of scientific research directly comparing them to one another. As popular press articles about the "Diet Wars" drew the nation deeper into the debate, the importance of conducting a comprehensive research study seemed to grow exponentially, and it was a thrilling opportunity for me to actually design and conduct a research study that some might call a popular diet "smack down".

With the help of my research mentors Ernst Schaefer MD, and Harry Selker MD of Tufts University/Tufts Medical Center, and USDA research dietitian Joi Gleason RD, I was able to recruit 160 overweight or obese men and women to follow either the Atkins, Zone, Weight Watchers, or Ornish diets for a year. We needed to randomly a ssign participants to their study diet, in order to ensure that each diet group was evenly matched at the start. Participants agreed to attend diet training classes during the first 2 months, and to follow their assigned diet to the best of their ability during that time. Participants were then encouraged to follow their diets to whatever extent they wanted during the following 10 months, because we wanted to determine how well these diets would work under "real-world" conditions where people only follow the diets voluntarily, rather than being pushed to do so for "study purposes". We measured their dietary intake according to diet records, as well as their weight, blood pressure, cholesterol levels, glucose, insulin, hemoglobin A1c, and C-reactive protein (a measure of artery inflammation) at 0, 2, 6, and 12 months, thus enabling a scientifically valid comparison between the 4 diets at various time points. The study was paid for by the National Institutes of Health, Tufts Medical Center, and the USDA Human Nutrition Research Center at Tufts. No diet book authors were involved in the funding, design, or conduct of the study.

The study took 5 years from conception to publication, and was the lead article in the highly respected Journal of the American Medical As sociation (JAMA) on January 5th, 2005. It received a large amount of media coverage, and was one of the most highly read scientific research articles of the year. See these links for WebMD coverage of the study:

4 Popular Diets Heart Healthy Whether it's Atkins, Ornish, Weight Watchers or Zone, it's the pounds that matter

4 Diets Face Off: Which Is the Winner? The Best Diet: The One You Stick With

In my view, the study results provided the scientific data to support a new way of thinking about "which diet is best?"

In short, it was a 4-way tie between the diets. There was no winner! All 4 diets produced weight loss by reducing daily caloric intake, but most people found it difficult to stick closely to their diets as time went on. Those people who consistently stuck to their assigned diet ate less calories than they did prior to starting the study. They lost weight, and the weight loss produced improvements in their risk factors for heart disease and diabetes. Adherence level, rather than diet type, was the key determinant of weight loss and risk factor reduction. The best diet turns out to be the one you can stick to! This is a whole different mindset and viewpoint than the previous view, that the classical approach should be best for everyone. In the 5 years since I published the Tufts Popular Diet Trial, many other studies have been published that confirm and strengthen the validity of our findings and this new viewpoint.

I'm eager to hear your comments about the findings I describe above. Stay tuned for the implications and applications of these findings to the field of diabetes reversal.

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating for Diabetes Reversal: Part 2

A Spectrum Of Options

I have proposed that the "Modern Human Diet" has reached the nutritional breaking point, as a result of excess deviation from the "Natural Human Diet", an unintended consequence of modern technology.

The diabetes, obesity, and heart disease caused by modern food is a result of the way it has been altered by modern technology. Problems include high caloric density, excess unhealthy saturated fat in meat and dairy, low fiber, high glycemic load, high added sugar, trans fats, and the list goes on.

There is general agreement that we are NOT going back to eating mostly wild food like hunter-gatherers, but there has been considerable debate about how to eat in order to avoid the nutritional breaking point caused by the modern diet.

Put another way, the modern diet differs from the natural diet in many ways, and therefore there are many potential directions in which to backpedal away from the nutritional breaking point.

Anyone who has spent any time looking at the "Diet Books" section of the bookstore or library has noticed there are hundreds of different perspectives on how to eat for good health. Most, if not all, argue that the modern diet is problematic, and that their strategy will work well for disease prevention or recovery if followed. Sometimes the authors claim their strategy is best, and that other strategies are flawed. Some focus on diabetes, others focus on weight loss in general, and others focus on other conditions.

I refer to this phenomenon as the "Popular Diet Spectrum", because, with few exceptions, the eating strategies proposed by these popular diet books fall neatly along a nutritional spectrum ranging from very low in carbohydrate to very high in carbohydrate (or very low in fat to very high in fat). Also with few exceptions, authors provide "science-based" rationales for why their eating strategy will work well to reverse or prevent disease, and these rationales are reasonable and plausible. In a few cases, the rationales are clearly pseudoscientific meaning just plain incorrect (or incompatible with current knowledge), but even in these cases the eating strategy may work well, for reasons other than what the authors propose.

Although the diets fall along a continuous spectrum, I believe it is useful to categorize the popular diet strategies into 4 types. I call them low-carb, moderate carb, moderate fat, and low fat. Each has strengths and weaknesses, and each can work for diabetes reversal, in large part because they all reduce daily caloric intake and produce weight loss.

I'm happy to report that the past 5 years of scientific research has dramatically improved our medical knowledge of popular diets and various eating strategies.

In January 2005, my research group published a research study comparing the effects of four popular diets (Atkins, Zone, Weight Watchers, and Ornish vegetarian) on weight loss and heart disease risk factor reduction, and it is a privilege for me to share the results of this study with you.

Which eating strategies work best for diabetes reversal? Stay tuned for Part 3 of "Eating for Diabetes Reversal"

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox

Eating for Diabetes Reversal: Part 1

"Natural Food" versus "Modern Food"

What will be the top global threats during the next century? I nominate climate change, terrorism, and the diabetes/obesity epidemic caused largely by modern food.

Yes, modern food, the majority of the foods in our grocery stores, and most meals in our restaurants, are the top cause of skyrocketing diabetes and obesity rates, in my view. Reductions in exercise over the past century are also to blame, but the doubling, tripling, and quadrupling of type 2 diabetes rates we're seeing and anticipating around the world is mostly due to the radical change in what the human population eats. Human food has morphed so severely, due to food processing technology that caters to our love for sweet, starch, and fat, that our species is chronically ill everywhere modern food is found. We're eating ourselves to death!

Most of what we eat is so far removed from the natural wild food our prehistoric ancestors ate – so much lower in fiber content, so much higher in caloric density, so much higher in sugar and starch content, so much higher in saturated fat content, so much lower in omega 3 fats, and so different in so many other ways – that our bodies become chronically ill after decades of such nutritional abuse.

To put our species' current nutritional situation into context, consider the following perspective. For the first 99% of human existence, for 2 million years, humans have been eating a combination of lean protein and high-fiber fruits and vegetables derived from wild natural plants and animals. I'll refer to this as the "Natural Human Diet". We are genetically designed, through millions of years of evolution, to thrive on these foods. But when our eating became too different from the "natural human diet" KABOOM! Heart disease epidemic! Obesity epidemic! Diabetes epidemic!

For most of human existence, our beloved tastes (or cravings) for fat and sweet were crucial for survival. We've been genetically designed to conserve calories, store excess calories as body fat, and rest whenever possible, because we are genetically designed to survive in the wild, natural world. Our genes are the same as they were when we all lived outdoors and ate wild food. Ironically, these genetic traits that once favored our survival are the same traits that favor poor health in today's modern environment!

Our initial departure away from the "natural human diet" started about 10,000 years (500 generations) ago, with the advent of primitive farming. This period of time may seem long to some folks, but in terms of human genetic evolution, this is a very short time. Not long enough to produce major genetic changes in the human population, meaning we are the same, genetically speaking, as people who lived hundreds of thousands of years before farming was invented.

Interestingly, our gradually increasing departure away from the natural human diet (and toward a grain-based society afforded by the agricultural revolution) did not lead us to the nutritional breaking point until recent decades. This raises the question: "If we're genetically designed to eat like hunter-gatherers, why have hundreds of generations of humans been able to get away with eating a grain-based diet without the diabetes, obesity, and heart disease epidemics we've seen in the most recent generations?".

Until recent times, the absence of modernization has made a grain-based diet viable. The relative scarcity of food and calories, the less sophisticated grain processing methods, the hard physical work of daily life, and the relatively short human lifespan, all served to mask the cumulative effect of eating starch-based foods throughout life. In my view, modern technology is the culprit that has turned our grain-based diet into the fuel that propels the diabetes, obesity, and heart-disease epidemics. For example, I suspect the sharp rise in type 2 diabetes in China, affecting all age groups, is due to the difference between a rice-based diet in modern versus pre-modern times.

In contrast, human groups who eat primarily wild, natural food t o this day, members of hunter-gatherer societies, do not develop the high rates of heart disease, diabetes, and obesity seen in modern societies. When these people switch to a modern, grain-based diet, modern diseases come fast and furious, and these same diseases reverse in individuals who go back to their traditional hunter-gather routine.

So how should we eat in today's modern world? Stay tuned for Part 2 of "Eating for Diabetes Reversal".

- Michael Dansinger, MD

Read the entire series:

1. "Natural Food" versus "Modern Food"
2. A Spectrum Of Options
3. The Tufts Popular Diet Trial
4. Dating the Diets
5. Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
6. Dr. Dansinger's Eating Strategy for Diabetes Reversal
7. Sample Meals

Related Topics:

• Type 2 Diabetes Message Board with Michael Dansinger, MD
• Get the Diabetes Newsletter in your inbox