THEENDOFDIABETES

TheEattoLivePlantoPreventandReverseDiabetes

JoelFuhrman,M.D.

Dedication

InmemoryofDanielBoller,awonderfulyoungman,takenbytheviciousconsequencesofdiabetes

Contents

DedicationIntroduction:ALetterofHopeOne:TheFirstStep—UnderstandingDiabetesTwo:Don’tMedicate,EradicateThree:StandardAmericanDietVersusaNutritarianDietFour:ReversingDiabetesIsAllAboutUnderstandingHungerFive:High-Protein,Low-CarbCounterattackSix:ThePhenomenalFiberinBeansSeven:TheTruthAboutFatEight:TheNutritarianDietinActionNine:TheSixStepstoAchievingOurHealthGoalsTen:ForDoctorsandPatientsEleven:FrequentlyAskedQuestionsTwelve:MenusandRecipesTake:ItFromHereIndexRecipeIndexAcknowledgmentsNotesAbouttheAuthorAlsobyJoelFuhrman,M.D.

PraiseCreditsCopyrightAboutthePublisher

ACAUTIONTOTHEREADER

If you are taking any medication, do not make dietary changes without theassistanceofaphysician,asmedicationadjustmentwillbenecessarytopreventexcessive lowering of the blood sugar level (hypoglycemia). Hypoglycemiafromusingtoomuchmedicationcanbedangerous.Because this diabetic reversal program is so effective, it is even more

importanttoconsultwithaknowledgeablephysicianwhoisfamiliarwiththemedication reduction needed as a result of aggressive dietarymodifications.Do not underestimate how effective this program is because withoutmedication reductions, a serious hypoglycemic reaction could occur fromtakingtoomuchmedication.Many physicians, not realizing how effective this diet style is, may be

hesitanttotapermedicationssufficiently.Makesureyouwarnyourphysicianaboutthisandfollowyourbloodsugarmorecarefullythefirstfewweeksafterbeginning thisplan. If you are alsoonmedications forhighbloodpressure,this nutritional advicemay also lower your blood pressure toomuch, so besuretowatchthatanddiscussanychangeswithyourphysicianaswell.Iwilldiscussmedicationsindetailandofferguidancefortheirreductionin

this book. You must realize, however, that a book cannot take the place ofindividualizedcouncilfromthephysicianwhoknowsyourmedicalcondition.It is your responsibility toworkwith the physician of your choice to assureyourbloodsugarandbloodpressurereadingsarenottoohighortoolow.Note:Thecasesinthisbookareallreal,butthenameshavebeenmodified

forprivacypurposes.

INTRODUCTION

ALetterofHope

DEARFRIEND,Congratulations.Youhave taken the first step in freeingyourself from the

life-threateningdiseaseknownasdiabetes.Asyoumayhavereadorheard,nearly26millionAmericans(11.3percent

ofadults)nowhavediabetes,accordingtotheCentersforDiseaseControlandPrevention new estimates of diagnosed and undiagnosed diabetes.Nearly 80million (35 percent of adults) qualify as having prediabetes. If the trendcontinues,oneinthreeAmericanadultscouldhavediabetesby2050.Diabetes is widespread, and we can no longer take a passive approach to

getting our health back. This book is designed for peoplewhowant to takeaggressive action in their battle to lose a dramatic amount of weight andreversediabetes,highbloodpressure,andheartdisease.Youcanseizecontrolofyourhealth.Itisinyourhands.Together,wecanstartrightnow.This program has been tested by thousands of individuals, and the

extraordinaryresultshavebeendocumentedinmedicalstudies.Itispossibletopreventandrecovercompletelyfromtype2(adult-onset)diabetes.Asadiabeticyouprobablyhaveaplantokeepontopofyourconditionwith

glucose monitoring, HbA1C measurements, regular physician visits, andmedication adjustments. These standard and accepted practices to maintaincontrol of your blood glucose are seen as essential to your health.Unfortunately,thisisallwrong.Yourlifeandthesetreatmentsarefocusedoncontrolling your blood sugar instead of learning how to rid yourself ofdiabetes.Evenwithadequateglucosecontrol,ifyouremaindiabetic,theillnesswillageyouprematurelyandshortenyourlife.What’smore,whenyoufocusonly on the numbers instead of removing the causes of diabetes, it couldactuallyworsenyourdiabetesinthelongrun.

Themajorityofmedicationsusedtolowerbloodsugarplacestressonyouralreadyfailingpancreas.Theprobabilityofyourdiabetesgettingworseunderconventional medical care is especially likely since medications used tocontrolbloodsugar,suchassulfonylureasandinsulin,alsocauseweightgain.The dangerous combination of pushing the pancreas to produce insulin andgainingmoreweightwithmedicationactuallyresultsintheneedforadditionalmedicationasyoubecomeincreasinglydiabetic.Thiscommonandyetfailedapproachshortenslifespanandincreasestheriskofheartattacks.The number of people with type 2 diabetes is rapidly increasing, having

tripledinAmericaoverthelastthirtyyears.Themainreasonforthisisopenlyrecognized: America’s expanding waistline. Yet physicians, dieticians, andeven the American Diabetes Association (ADA) have all but given up onpromotingweightlossastheprimarytreatmentfordiabetes.Medicationistheacceptedtreatment—eventhoughitisoftenthemedicationitselfcausingmoreweightgain,worseningsymptoms,andmakingindividualsmorediabetic.Thiscreatesaviciouscycle:asapersonbecomesmorediabetic,moremedicationsare needed, the doses keep going up and up, and the person become morediabetic. It is a misguided approach to our health. Most diabetics would bebetter off if thesemedicationswere never invented becausemaybe then theywouldhavebeenforced tochange their lifestyleandeatinghabits.Reversingandpreventingdiabetesonanindividualandnationalleveldoesnotrequireaprescription.Itrequiresachangeinthewayweeat.Themedical communityhasgivenuponweight loss as an avenue tohelp

diabetics mostly because traditional diets don’t work. But even if you havefailedononedietafteranotherinthepast,pleasedon’tgiveup.Thedietplanin thesepagesdoeswork.Youwill see radical improvements inyourhealth.You are the owner and operator of your body. You can reverse and eveneliminate your diabetes with the life-saving nutritional information in thisbook.ThenutritionalplanIhaveusedforovertwentyyearsonmorethantenthousandpatientsisbasedonacentralidea:

YourHealthFuture(H)=Nutrients(N)/Calories(C)

My approach is radically different from other methods and is proven towork. I will show you how your body can heal itself when you give it thenecessary tools. The fact is, your body is designed forwellness.Give it therightbiochemicalenvironmentforhealinganditbecomesamiraculousself-

healingmachine.Myapproachisbasedonascientificformulathatdetermineslife span and health. This formula, known as H=N/C, means your health isdeterminedbythenutrient-per-caloriedensityofyourdiet.Whenyoueatmorefoods that have a high-nutrient density and fewer foods with a low-nutrientdensity, your health will dramatically improve and your diabetes will meltaway.Whenyoueatmostlyhigh-nutrientfoods,thebodyagesslowerandisarmed

toprevent and reversemany common illnesses.Thenatural self-healing andself-repairingabilitythatishibernatinginyourbodywakesupandtakesover,and diseases disappear. A nutrient-rich menu of green vegetables, berries,beans, mushrooms, onions, seeds, and other natural foods is the key toachievingoptimalweightandhealth.Contrarytopopularspeculation,themanydiseasesthatplagueallpeopleand

threatenour livesarenotan inevitableconsequenceofaging.Wearenot thevictimsofpoorgenetics.Wedonotneedasteadysupplyofpillsfortherestofourlives.Wehavecometobelievethatourexcess,disease-causingbodyfatisnormal,acceptable,andtoodifficulttotakeoff.Drugsarenotthesolutiontotheweight,diabetes,orotherproblemsthatseemtocomewithaging.Knowledge leads to power. Learning how the foods you eat affect your

healthandwell-beinggivesyouthepowertobecomehealthy,livelonger,andfeelbetter every singleday.Peoplewhousemyprogramare amazedby theresults.Whenyoueat sufficientmicronutrientsand fiberwithahigh-nutrientdiet, it suppresses food cravings. Amazingly, you begin to naturally cravefewer calories. This puts an end to overeating. If you are overweight, thisapproach will rapidly create weight loss until your body finds its natural,healthy weight. For most people, the weight loss obtained through this dietrivalsthatofgastricbypasssurgerybutwithouttherisk.Iknowyou’rethinking,WillIbehungryall thetime?Andwill thefoodbe

good?Here’sthegreatnews:healthyfoodshouldbeandcanbeeasytoprepareanddelicious.Ihavetraveledtheworldandhaveworkedwithcelebratedchefsto come up with recipes and meal plans that are filling, mind-blowinglydelicious,andgoodforyou.Nokitchenexpertiseisrequired,astheserecipesareforeveryone.Asyoufollowthisdiet, Ipromise that itwillsoonbecomethewayyouprefertoeat.SomanyofmypatientswhostartedEattoLivehavechanged theway they eat forever.The food tastes good, and they feel good.Thetruthisthatoncepeopleunderstandthefundamentalsandamazingrewardsof healthy eating, we never go back to our old habits. This approach is

pricelessbecauseitislifesaving.Yourhealthisdependentontheamountofnutrientsinyourdiet.

Icalladietthatisrichinmicronutrientsanutritariandiet. Inotherwords,the more nutrient dense your diet, the healthier you become. It sounds sosimple, and it is.Whenyoueat adiet rich inhealthy,natural foods from theearth, you give your body the nutrients it needs to heal and protect itself.Diabetesisafood-createddisorder,andtherightfoodchoicescanridyouofthislife-shorteningdiseaseanditsassociatedmedicalcomplications.OfthemorethantenthousandpatientsIhavecounseled,manywhocameto

mesick,overweight,andsufferingfromahealthcrisis,mosthavefound thesolution they sought for so long. They recovered and returned to healthwithoutdrugs.ThenumberonerecommendationImakeforallofmypatients,regardlessoftheircondition,istooverhaultheirdiet.Ihavehelpedthousandsof people with type 2 diabetes to reduce and eliminate their disease withnutrient-dense food.A largemajorityof themhavebecomenondiabetic.Theresults fromapplying this approachhavebeendocumented. In fact, I believethatmynutritariandiet,oftencalledEattoLive,isthemosteffectiveprogramfor diabetes ever studied and will continue to prove to be so as it is morewidelyimplementedandlargerresearchstudiesareperformedinthefuture.In a case series published in theOpen Journal of PreventiveMedicine, 90

percentofparticipantswereabletoeliminateorreducetheirmedicationby75percent, and the average hemoglobin A1C dropped from 8.2 to 5.8.1HemoglobinA1C is ameasurement of average glucose levels over a three-monthperiod.Alevellowerthan6isconsiderednondiabetic,ornormal,andabove 8 is considered poorly controlled. The participants also saw theirsystolicbloodpressuredropfromanaverageof148to121whilemedicationswerewithdrawn. These dramatically positive results are enabling larger andmorelong-termstudiestobegin.Ofcourse,nodietaryapproachtodiabeteswillsucceedwithoutattentionto

other risk factors—the main ones being a sedentary lifestyle, smoking, andlackofsleep.Theroadtowellnessinvolvesmakingacommitmenttoahealthylifestyle.Exerciseisalsocritical.Thegoodnewsis,thehealthieryoueatandthebetteryoufeel,themoreyouwillwanttoexerciseandkeepyourbodyinthebestpossibleshape.Yes,diabetesisaveryseriousdisease.Itcancauseahostofproblemssuch

as heart disease, kidney damage, and vision loss, problems that can shortenyourlifeandlessenthequalityofyouryearsonearth.Butitdoesn’thaveto.The answer is simple: eat a nutritarian diet and exercise daily. It may notalwaysbeeasy,buttheeffortdeliverslife-savingresults.I urge you to take the plunge and carefully follow this program. I know

firsthandthatitcanchangethecourseofyourhealthandlifeforever.Joinusand turn the page of your health history. Let’s create a new story to tell ofhealth,vitality,andlonglife.It’stimeforafirmcommitmenttogettinginthebest shape of your life. Thousands of people have already embraced thismessageandarecreatingahealthrevolution.We’rethrilledtohaveyoualongforthisexcitingandtransformativejourney.

—JoelFuhrman,M.D.

CHAPTERONE

TheFirstStep—UnderstandingDiabetes

JaneGillianwasanobesefifty-six-year-oldwhenshebecameseriouslyillandwashospitalized.Sheexperiencedanembolicstroke,paralyzingherleftside,and,whileatthehospital,theyalsofoundthatshehadseverediabetes.Janehadafamilyhistoryofdiabetes;bothparentswereoverweightanddiabetic.Hermedicalhistoryincludedhighbloodpressure,highcholesterol,andplacementoftwomedicatedstentsinhercoronaryarteries.WhenshewasadmittedtothehospitalwithanHbA1Cof9.6andabloodpressureof200/100,Janewasontwobloodpressuremedicationsaswellasotherprescriptionpills.Shewasplacedoninsulinandremainedinthehospitalforalmostamonth.Finally,shewasdischargedwheelchairboundandontwoinsulininjectionsadayforatotalof60unitsdailypluseightothermedicationsincludingthreebloodpressure–loweringmedications.AfriendrecommendedJanereadEattoLive,andonemonthlater,shestartedthenutritariandiet.Herinsulinneedssoontaperedandthenstopped.Herresultsonthehigh-nutrientdietwereexciting.Threeyearslater,Janehaslostatotalof117pounds—herweightwentfrom248to131pounds.HerHbA1Candglucoselevelsareinthenondiabeticrange.Sheisnolongerdiabetic.Hercholesteroldroppedfrom219to152,triglyceridesfrom174to66.Herbloodpressure,whichusedtorunaround160/80onthetwobloodpressuremedications,nowrunsaround125/75withoutanybloodpressuremedications.ThebestnewsofallisthatJaneisnolongerinawheelchairandcanwalkonatreadmillsetatafifteen-degreeinclineformorethanfifteenminutes.

Diabetesmellitusisachronicdiseasethatcausesserioushealthcomplications

including renal (kidney) failure, heart disease, stroke, and blindness. Asmentioned, this serious disease has seen a drastic increase in the number ofAmericanswhoareaffected.TheCentersforDiseaseControlandPreventionreleased a 2011 report stating that over 25millionAmericans are currentlyplaguedbydiabetes.That’sanincreaseof15percent,or3millionpeople,inonly two years and over 700 percent in the last fifty years. More than 40percent of Americans aged twenty years and older have either diabetes orprediabetesaccordingtoareviewofdatafromthe2005–2006NationalHealthandNutritionExaminationSurvey.Approximately30percentofadultsolderthansixtyhavebeendiagnosedwithdiabetes,anditsprevalenceisthesameinmenandwomen.Manypeopleareeitherunawarethattheyarediabeticorareinaprediabetic

statethatwill leadtodiabeteswithinafewyears.ThestandardAmericandiet(SAD)causessusceptibleindividualstodevelopdiabetes.Unfortunately,mostpeople in America are eating themselves into a premature grave. TheAmericandietisatthecoreofourhealthcarecrisis,anddiabeticssufferevenmoretragicmedicalcomplications,suchas:

•Heartdisease—Deathfromheartdiseaseandriskforstrokeisthreetimeshigherfordiabetics.•Highbloodpressure—75percentofdiabeticshavehighbloodpressure(130/180orhigher).•Blindness—Diabetesistheleadingcauseofnewcasesofblindnessamongadults.•Kidneydisease—Diabetesistheleadingcauseofkidneyfailure.•Nervoussystemdisease—Themajorityofdiabeticsdevelopnervoussystemimpairmentsuchasreducedfeelinginthefeet,impaireddigestion,anderectiledysfunction.•Amputations—Diabetesistheleadingreasonforlimbamputations.•Cancer—Diabetesincreasestheriskofcancer,includinga30percentincreaseincolorectalcancer.1Diabetes is also taking a huge financial toll on America. Our unhealthy

eatinghabitsmayeventuallybankruptournation.Theaveragetype2diabeticincurs $6,649 in health care costs directly attributable to diabetes per year.2MorethanhalfofAmericanswillhavediabetesorbeprediabeticby2020atacost of $3.35 trillion to the U.S. health care system if current trends go on

unabated, according to analysis of a report released byUnitedHealthGroup.Diabetes and prediabetes will account for the largest percent of health carespendingbytheendofthedecadeatanannualcostofalmost$500billion—upfrom an estimated $194 billion in 2010 according to the report titled TheUnitedStatesofDiabetes:ChallengesandOpportunitiesintheDecadeAhead.3Inordertopreventthis,wehavetochangethewayweapproachdiabetes—

andwemustemphasizeprevention.Earlierthisyear,theeditorsoftheLancetmedical journalcalledita“publichealthhumiliation”thatdiabetes,a largelypreventable disease, has reached such epidemic proportions. In reference tothisyear ’sADAnationalmeeting,thejournalreported,“...thereisaglaringabsence:noresearchon lifestyle interventions topreventorreversediabetes.Inthisrespect,medicinemightbewinningthebattleofglucosecontrol,butislosingthewaragainstdiabetes.”4Theseauthorsarecorrect—thisisapublichealthhumiliationbecausetype2

diabetes is bothpreventable and reversible.TheSADof refinedgrains, oils,sugars, and animal products is at the root of the crisis.Using drugs to keepglucoseundercontrolinindividualswhocontinuetoconsumethisdietwillnotpreventdiabetescomplications.Thecurefortype2diabetesisalreadyknown—removingthecausecanreversethedisease.

UnderstandingtheCauseEverycell in thehumanbodyneedsenergy inorder to function.Thebody’sprimaryenergysourceisglucose,asimplesugarresultingfromthedigestionof foods containing carbohydrates (sugars and starches). Glucose from thedigestedfoodcirculatesinthebloodasaneededenergysourceforourcells.Insulin is a hormone produced by the beta cells in the pancreas, an organ

locatedbehind thestomach. Insulinbonds toa receptorsiteon theoutsideofcellsandactslikeakeytoopenadoorwayintothecellthroughwhichglucosecanenter.Whenthereisnotenoughinsulinproducedorwhenthedoorwaynolonger

recognizestheinsulinkey,glucosestaysinthebloodratherthanenteringthecells.Sodiabetesistheriseofglucoseinthebloodstreamduetoarelativelackoftheinsulinthatisresponsibleforthetransferofglucosefromthebloodintothe tissues or cells. Normally as we eat and the glucose rises in thebloodstream,insulin-producingcellsinthepancreassensetheglucoseriseinthebloodstream.Theythensecretetheappropriateamountofinsulintodrive

theglucoseintothebody’stissues,loweringthelevelinthebloodstreambacktoanappropriaterange.

Bloodsugar greaterthan125 =diabeticBloodsugar 110–125 =prediabeticBloodsugar 95–110 =notideal

When a person has type 2 diabetes, the amount of insulin produced is

insufficient to lower the glucose level to normal; the level of glucose in theblood remains too high. In type 1, or juvenile, diabetes, the beta cells in thepancreashavebeendestroyed,so thebodydoesnotproduce insulinatall. Intype2,oradult-onsetdiabetes,usuallythebodyisnotadequatelyrespondingtothe insulin being produced. Fat on the body coats the cell membranes andimpedes insulin function. The pancreas produces more and more insulin inresponse, but over timeas thepancreas struggleswith the extraworkload, iteventually loses the fight and becomes unable to meet the unnaturally highdemands.As insulin production starts to falter under the increased demands,theglucoseinthebloodstreamstartstorise.Inbothcases,withtype1ortype2,insulinlackorinsulininsensitivity,theglucoserisesinthebloodstream.Ifitgetshighenough,italsospillsoverintotheurine.Initialsymptomsofdiabetesincludefrequenturination,lethargy,excessivethirst,andhunger.Thebodywillattempttodilutethedangerouslyhighlevelofglucoseinthe

blood,aconditioncalledhyperglycemia,bydrawingwateroutofthecellsandintothebloodstreaminanefforttodilutethesugarandexcreteitintheurine.Itis not unusual for peoplewith undiagnosed diabetes to be constantly thirsty,drinklargequantitiesofwater,andurinatefrequentlyas thebodytries togetridoftheextraglucose.Thiscreateshighlevelsofglucoseintheurine.

SavingtheLifeofType1DiabeticsOnlyabout10percentofdiabeticsaretype1,alsocalledchildhoodonset(orjuvenile) diabetes because it typically begins in childhood. Type 1 diabetesreferstoadiseaseinwhichthebetacellsinthepancreasthatproduceinsulinare destroyed by the immune system, usually early in life.When the body’simmune system mistakenly targets our own cells instead of a foreignsubstance, it is called an autoimmune reaction. The causation is complicatedand comes about partially as a result of an antibody reaction against a viral

proteinthatmistakenlyattacksthebetacellsinthepancreas.In this form, the body produces almost no insulin. It is characterized by a

sudden onset and occurs more frequently in populations descended fromnorthern European countries compared to those from southern Europeancountries, theMiddle East, or Asia. Type 1 is also called insulin-dependentdiabetesbecausepeoplewhodevelopthistypeneedtohavedailyinjectionsofinsulin.Approximately80percentofourat-restenergyisusedbythebrain.Under

normalsituations,thebodycanonlyfunctiononglucose;however,whenthereis insufficient insulin, the brain and other tissues are unable to utilize theglucoseinthebloodstream.Whenthebodyisunabletoutilizeglucosestoresnormally, free fatty acids will rise in the bloodstream. The body can makeketonesfromthesefats,andthenthebrainandheartcanusetheketonesasanemergency fuel, when unable to get sufficient glucose.Glucose and ketonesbuild up in the blood and can have devastating consequences. For example,type1diabeticsaremorepronetodevelopingketoacidosis,whichcanbelifethreateningifleftuntreated,leadingtocomaanddeath.Ketonesaremoderatelyelevated in blood and urine during fasting or significant carbohydraterestriction, but they can get to dangerously high levels in decompensated oruntreatedtype1diabetes.Ketosis(highketonesintheblood)andketoacidosiscan occur in type 2 diabetics in some circumstances as well. It is thecombinationofthehighglucoselevelinthebloodalongwiththehighlevelofketonesthatcanleadtodangerousacidosisanddehydration.Type1diabetesisnotcausedbyweightgainorobesity,andpeoplewithtype

1diabeteswillalwaysrequireinsulintopreventseriousissueswithhighbloodsugar (hyperglycemia) and other life-threatening conditions. Even so, asuperior nutritional diet is essential for health and longevity of a type 1diabetic,andeventhoughexcessbodyfatisdangerousforeveryone,itismoredangerousforthetype1diabetic.I amoften asked, “Is your programappropriate for type 1 diabetics?Will

insulinberequiredforever,nomatterwhat?”Theanswertobothquestionsisyes.Unlikea type2diabetic, ifyouarea type1diabetic,youcanneverstoptaking insulin entirely. However, after adopting this high-nutrient dietaryapproach,youwillneedmuchlessinsulin,inmostcasesabouthalfasmuchasbefore, following the typicalADAapproach.Theneed for less insulin isnottheonlymajor reason for type1diabetics to follow thisdiet style.Thevitalreason is that it can save a type1 fromserioushealth complications later in

life.Ihavehelpedseveralpatientswithtype1diabetescompletelyrecoverfrom

their condition by flooding their body with micronutrients, fortifying theirimmune system,and resting thepancreas.Thisopportunity,however, isonlyavailablewhen thedisease is just starting, usually in an adolescentoryoungadult.This is theexception,not the rule.Unfortunately,most type1diabeticshavetolivewiththediseasefortherestoftheirlives.But here’s the important news: With conventional care, the long-term

outlook for a type 1 diabetic is dismal. More than one-third of all type 1diabeticsdiebeforetheageoffifty.Thisdoesnothavetobethecase.Type1diabeticsneednotfeeldoomedtoalifeofmedicaldisastersandanearlydeathsentence.Type1diabeticscanleadanormallifeandhaveabetter-than-averagelife expectancy. It is true that type 1 diabetics are more sensitive to thedamaging effects of theSADdiet, but if they eat a vegetable-baseddietwithplentyofbeans,nuts,andseeds,theyarenolongeratriskforheartdisease.Scientificstudiesrevealthatdeathduetoearly-onsetheartdiseaseintype1

diabeticsis linkedtoinsulinresistance.Thatmeansweightgain,poordietarychoices,andthereforetheneedforexcessiveamountsofinsulinisdangerousfor type 1 diabetics.Butwhen type 1 diabetics followmynutritional advice,theyrequiresubstantially less insulinand take it inphysiologicdosages—theamountofinsulinwillnotbeexcessiveandwillnothurtthem.Type1diabeticscanhavehealthy,normal,andlonglives.Thetypicalhealth

tragedies that befall type 1 diabetics are the result of the combustiblecombination of American food and excessive insulin use, a fire fueled byphysiciansanddieticianswhosenutritionaladviceunfortunatelyremainsinthedarkages.Byadoptingthishigh-nutrientapproach,type1diabeticslowertheirinsulin

needsandnolongerhaveswingsofhighsandlows.Glucoselevelsandlipidsstay under control with minimal insulin. Requiring less insulin while stillhaving excellent glucose readings is the goal. The simple truth is that thereason why type 1 diabetes leads to heart attacks and other life-shorteningailments is theexcess insulinrequiredbya low-nutrientdiet,not thediabetesitself.Itisnottype1diabetesthatcausessuchnegativehealthconsequences.Rather,

itisthecombinationofthediabetesandthetypicalnutritional“advice”giventopatients—advicethatrequiresthemtotakelargenonphysiologicalamountsofinsulin to maintain favorable glucose readings. Insulin itself promotes the

development of atherosclerotic plaque, the foundation of heart disease andheart attacks. Insulin increases appetite and promotes fat storage andweightgain,thusfurtheringinsulinresistance.Thisisparticularlyexacerbatedbythehighglycemicandexcessivecaloricloadinconventionaldiets.I have been on your plan for two years and am really happy with theresults.Iamatmyidealweightwithabout10percentbodyfat.AcoupleofyearsagoIwas190poundswithhighcholesterol.Myinsulinwasat30uLantus and Humalog on a sliding scale but often like 6u per meal.Following your advice I dropped the weight to 170, my cholesterol isawesome now, and blood pressure and lipid profiles are great! Now myLantusis10uandIamonNovolog,twoorthreeunitspermeal.WhenIwasdiagnosedinmyteens,mydoctorsaidthereweretwoways

tolookatthediagnosis:1.astheendofmyhealthforeveror2.anopportunity togainanunderstandingofmybodyandhow itworksandbecomehealthierthaneverI tried to take the latter road,andnow,atage thirty-four, I think Iam

finally realizing that potential. Your writings were the suit of armor Ineededinthefightalltheseyears.Thanksagainforeverything.

—TonyGerardo

Severalstudiesillustratethedangersofgivinginsulintotheadultdiabetic.Inonesuchstudy,whendiabeticpatientsweregiven insulin,compared to thosegivenmetformin (Glucophage), the risk of death fromheart attacks tripled.5The negative effects of insulin are related to both the systemic metabolicabnormalitiesfromexcessiveinsulinandthedirectpro-atherogeniceffectsofinsulin on the endothelial lining of blood vessels that promotesatherosclerosis.6Themoreinsulinthat isneeded, themoredangerousplaqueispromoted,especiallywhen theamountofcirculating insulin ishigh.Extrainsulin and high blood sugar levels also raise cholesterol, promote fatdeposition, and damage the body.With this in mind, it should be clear thatwhiletheSAD,whichhasspreadtoallindustrializednations,isdangerousforeveryone, it is particularly deadly for diabetics. Diabetes is not a deathsentence, but we can’t keep following conventionalmedicine and dieticians’adviceortheexcessiveinsulinandoveruseofothermedicationstheycallfor.Thenegativesofoverprescribinginsulinarenotlimitedtoweightgainand

heartdisease.Theconnectionbetweendiabetesandcanceristhoughttobedueatleastinparttoinsulintherapy.Anewreviewthatanalyzeddatafromseveralstudies found that diabetic patients are 30 percent more likely to developcolorectal cancer, 20 percent more likely to develop breast cancer, and 82percentmore likely todeveloppancreatic cancer.7 I amcertain thatbyusinginsulininsmallphysiologicalamountsintype1diabetics,whoseinsulinneedswouldbelowonmynutritariandiet,themetabolicnegativesandtheincreasedriskofcancerfrominsulinwouldnotbenoted.Thesenegativesaretheresultof the excessive use of insulin necessitated by the SAD and the standarddiabeticdiet.When type 1 diabetics follow the Eat to Live approach, it is possible to

prevent many of the complications that can accompany the disease. Asdiscussed,anormal lifeand lifespanarewellwithin reach.Type1diabeticswill still require insulin, but for almost all patients, the insulin dosagesrequired will be greatly reduced, and they will require only the amount ofinsulin that a person’s pancreas would secrete if eating healthfully andnondiabetic, so no damage will ensue because they are not requiringabnormallyhighamountsofinsulin.Specifically,iftype1diabetesiswellmanaged,therewillbemanybenefits:

•Nohighsorlowsinbloodsugar•Lessinsulinuse—mosttypically,doseiscutbyhalf•Normal,stablebodyweight•Normallifespan,withoutdiabeticcomplicationsThe key formula to remember here is that favorable glucose levels +

excellentnutrition=ahealthyand longlife. Ifyouorsomeoneyoulovehastype1diabetes,please read thisbook. Ipromise that itcansave lives; Ihaveseenithappen.

TheDramaticIncreaseinType2Diabetes:ATragicPhenomenon

Type2 diabetes occurs in approximately 3 to 5 percent ofAmericans underfiftyyearsofageandincreasesto10to15percentinpeopleoverfifty.Morethan90percentofdiabeticsintheUnitedStatesaretype2diabetics.Sometimescalledadult-onsetdiabetes, this formofdiabetesoccursmostoften inpeople

whoareoverweightandwhodonotexercisesufficiently.Theexplosionintheoccurrence of diabetes in the last twenty-five years inAmerica parallels theskyrocketingnumberofoverweightpeople.Type 2 diabetes almost never occurs in people who eat healthy, exercise

regularly,andhavealowbodyfatpercent.Thediseasehardlyexistedinpriorcenturieswhen foodwasnot so abundant orwhenhigh-calorie, low-nutrientfoodwasnotavailable.ItisalsomorecommoninpeopleofNativeAmerican,Hispanic, Indian, and African-American descent, though no background isimmune to the effects of a diabetes-inducing diet. Worldwide, diabetes isexploding as populations in all corners of the globe are being exposed toprocessed foods for the first time in human history. The development andabundanceofprocessedfoodsintheworld’sfoodsupplycombinedwithmoresedentaryjobshascreatedanexplosionofobesity,diabetes,andheartdisease.Most countries have attempted to solve this problem with medications fordiabetes, high blood pressure, and high cholesterol. Invasive medicalprocedures and surgeries are used at a substantial expense but withoutsignificantlifespanenhancementsorbenefitstosociety.In the United States, being overweight is the norm, and almost all adults

eventuallytakeprescribedmedicationsfortheirheart,diabetes,cholesterol,orblood pressure. In fact, 51 percent of those over the age of 65 take five ormoreprescriptiondrugsaday!ThenumberofobeseAmericansishigherthanthe number of those who smoke, use illegal drugs, or suffer from otherphysical ailments. Obesity is a major risk factor associated with highlyprevalentseriousdiseasessuchasheartdisease,cancer,anddiabetes.Itiswhatweeatthatcreatesthesediseasesandfuelsout-of-controlmedicalcosts.Evenfiveextrapoundsonanormalbodyframecanleadtodiabetes.Researchshowsthatexcessbodyfat is themostsignificantcauseof type2

diabetes. Throughworkingwith thousands of patients, I have observedwithconsistencythatlosingbodyfatinconjunctionwithmaintaininghighlevelsofmicronutrientsinthebody’stissueswillreducetheneedformedicationsand,in most cases, reverse type 2 diabetes for good. As we’ll explore in detailthroughout thisbook,scientificstudiesshowit isnot just theweight lossbutalso thecell’sexposure toa favorablemicronutrientenvironment thatenablerecovery.Manyofmypatientsrecoverfromtheirdiabetesbeforemostoftheirweight has been lost.The cells becomemore responsive to insulinwhen thebodyisnotburdenedwithexcessfat,andthehighlevelofmicronutrientsinthetissuesenablesthebetacellsthathavepoopedoutfromstrugglingtoproduce

extrahighlevelsofinsulinforyearstoreclaimlostfunction.

Becauseof itsslowonsetand thefact that itcanusuallybecontrolledwithdiet, type 2 is considered a milder form of diabetes, sometimes developingover the course of several years. The consequences of uncontrolled anduntreatedtype2diabetes,however,arejustasseriousasthosefortype1.Heartattacks,infections,amputations,blindness,andstrokesarepossible,butunliketype1,type2diabeticscanalmostallcomeoffinsulinandothermedicationsiftheytakeofftheexcessweight.

PrevalenceofDiabetesWorldwide

Diabetesisn’tjustaboutelevatedbloodsugarlevels—whichposeimmediatethreats including blurred vision, drowsiness, confusion, and vomiting—it’sabout every other long-termcondition and complication it creates aswell. Itcantakeaseveretollonthehealthofadiabetic—increasingnotonlytheriskofheartattacksandstrokesbutalsoofdepressionandcancer.8

WhataType2DiabeticCanExpectSpecifically, if type 2 diabetes is well managed with exercise and superiornutrition,therewillbemanybenefits:

•Nohighsorlowsinbloodsugar•Reductionofmedicationsbyanaverageof50percentinthefirstweek,moreinthefirstmonth,andmosttypically100percentwithinsixmonths•Needforinsuliniseliminated,usuallywithinthefirstweek•Normal,lean,andstablebodyweight•Normallifespan,withoutcomplications•Reversalofdiabetesandpreventionofdiabetes-relatedcomplicationsThegoalistoreversediabetestothepointofbecomingnondiabeticagain,

meaningideally thatyourglucose levelsrunbelow100withoutmedications.Be aware, though, that once you’ve been diabetic, the tendency to becomediabetic again remains if you regainweight or go back to unhealthy eating.Thisisanewdietstyleandlifestyleforever.

Youcananticipateyourbloodsugarfallingwiththisdietandlifestyleplan.Asdiscussedearlier,youwillbeable toreduceyourmedications.Errontheside of too little medication, not too much. Prevent the occurrence ofhypoglycemic episodes with good communication with your physician andcarefuluseofminimalmedications.If your blood glucose has been elevated for a while, even as your blood

sugarapproaches thenormal range,youcould feel somewhat illas thebodygets accustomed to experiencing normal blood glucose levels.Nevertheless,when on diabetic (glucose-lowering) medications, especially insulin andsulfonylureas—Amaryl(glimipiride),Diabenese(chlorpropamide),Glucotrol(glipizide), Diabeta, Glynase (glyburide), Actos (pioglitazone), Avandia(rosiglitazone)—it’s important to check your blood sugar frequently duringthe first week to make sure you are not being overmedicated. Glucophage(metformin)isacommonlyusedoraldiabetesmedicationthatdoesnotcausethebloodglucosetodroptoolowanddoesnotcauseweightgain,sothisisthepreferredmedicationtoremainon,ifoneisneeded.Snacking to prevent a hypoglycemic reaction from the overuse of

medication ispoormedicalmanagementandshouldnothappen.Medicationsshould be reduced in time so this never occurs. I tell patients starting thisprogram that if a blood sugar reading is below 120, it is time for the nextround of medication reduction. It is better to be undermedicated slightly, topreventtheneedtotreathypoglycemicevents,thanitistobeovermedicated.Ifthediabeticpatient experienceshypoglycemicepisodes andextra snacking isrequiredtobringtheglucoseup,thenthephysicianovermedicatedthepatientanddidnotdohisjobcorrectly.TheADAdiet uses the diabetic exchange list to help diabetics createwhat

they call balanced meals. This exchange diet divides foods up into groupsbased on similarities in nutrient content and includes starches, fruits, milk,vegetables,meats,fats,sweets,andothercarbohydrates.Itlookstomakemealsthatarebasedonapreconceivednotionthatbalancinganequalamountoffat,carbohydrates,andproteinateachmealisfavorable.Itthenallowsexchangesbasedontheamountofcaloriesfromthatmacronutrient.Forexample,inthestarch group, one slice of toast can be exchanged for a half cup serving ofcookedoatmeal.Because the foods the diet is designed with are inherently poor in fiber,

micronutrients,andresistantstarch, theyfuelanobsessionwithfoodbecausethedieterisneversatisfied.Thiscontinualstrugglewithdietingandtryingto

maintainsmallportionsizesoffoodsthatdonotbiologicallyfillyouuprarelyworks. Even in controlled dietary studies in which calories are carefullymonitored,theresultsarerelativelypoorsimplybecausetheAmericandietarystandardissopoorandtheADAdietmimicsthisfaileddietarypatternutilizingtoo much unhealthy, low-micronutrient foods. Researchers have alsofrequently noted the difficulties involved in the ADA plan, particularly therequirementstodramaticallyrestrictportionsizesthatmostindividualssimplycannotcomplywithlongterm.9An ADA sample breakfast meal may include two slices of toast with one

teaspoon of margarine, a scrambled egg, three-quarters of a cup ofunsweetened ready-to-eat cereal with one cup of nonfat milk, and a smallbanana.Anotherbreakfastchoiceonthe1,800-calorieADAdietmayincludetwo four-inch whole wheat pancakes with two tablespoons of light pancakesyrup,oneteaspoonofmargarine,onecupofslicedstrawberries,one-quartercupoflow-fatcottagecheese,andonecupofnonfatmilk.Thesesamplemealsareaformulafordisasterfordiabetics.Inordertogettheglucosecontrolledafter consuming all those low-fiber carbohydrates, an excessive amount ofdiabetes medication will have to be prescribed, which will lead not only tohighs and lows but also potentially to hypoglycemic episodes.Then diabeticpatients are instructed to snack to prevent the lowblood sugar results of themedication,furtherimpedingtheirpossibilityofdroppingtheexcessbodyfat.Theadditionalsideeffectsandweightgainfromthemedicationsjustleadtoaworseningofthediabetes.Thefocuswithstandardcareisontheglucoseleveland maintaining the right amount of medication to optimally stabilize theglucose.Itmissestheboat, though,becauseitfails tofocusonthehealthandweightof thepersonfirst,andthemiraculoushealthandweight lossbenefitsof the right dietary pattern based on greens, beans, mushrooms, onions,tomatoes, peppers, berries, intact grains (not just whole grains), seeds, andnuts.In contrast, type 2 diabetics can become nondiabetic, achieving complete

wellness and even excellent health.They can be diabetes-free for life. Inmytwentyyearsofclinicalexperiencewiththisprogram,Ihaveexperiencedthatmore than 90 percent of type 2 diabetics who follow this diet and exerciselifestyleareabletodiscontinueinsulinwithinthefirstmonth.

CHAPTERTWO

Don’tMedicate,Eradicate

JimKenney,afifty-eight-year-oldmale,wasreferredtomyofficefromhisnephrologist(kidneyspecialist)atSt.BarnabasHospitalinLivingston,NewJersey.Hewasoriginallyreferredtothenephrologistbyhisendocrinologist(diabeticspecialist)attheJoslinDiabetesCenterinBostonbecauseofkidneydamagethatresultedfromveryhighglucosereadingsinspiteofmaximummedicalmanagement.Atthisfirstvisit,Jimweighed268poundsandwason175unitsofinsulinperday(averyhighdosage).Hehadalreadysufferedfromseverecomplicationsoftype2diabetes,includingtwoheartattacksandCharcot(destructiveinflammation)jointdamageinhisrightankle.Inspiteofthishugedoseofinsulinandsixothermedications,Jim’sglucosereadingsaveragedbetween350and400.Jimsaidthiswasthecasenomatterwhatheate,addingthathewasalreadyonadiabetesdietandwasalreadyfollowingtheprecisediabetesnutritionanddietaryrecommendationsofthedieticianattheJoslinclinic.Duringhisfirstvisitwithme,afterwediscussedhisnewdietprogram,Ireducedhisinsulindoseto130unitsperday.Thefollowingfewdays,JimandIspokeoverthephone,andIcontinuedtodecreasehisinsulingradually.Withinfivedays,Jim’sglucosewasrunningbetween80and120andhelosttenpounds.AtthisjunctureIreducedhisLantuslong-actinginsulindoseto45unitsatbedtimeandhisHumalogregularpre-mealinsulinto6unitspermeal,foratotalof63unitsperday.Athistwo-weekvisit,Jimhadlostsixteenpounds.Iwasalreadystoppingsomeofhisbloodpressuremedicationsandhewasdowntoatotalof58unitsofinsulinperday.Afterthefirstmonth,IwasabletostopallofJim’sinsulinandstarthimonGlucophage(metformin).He

losttwenty-fivepoundsinthefirstfiveweeks,andhisbloodglucosereadingswerewellcontrolledwithoutinsulin.Inaddition,hisbloodpressurecamedowntonormal,henolongerrequiredanybloodpressuremedications,andhisabnormalkidneyfunctionwasimproving.Fivemonthslater,Jimhadlostsixtypoundsandwasoffallmedicationsfordiabetes.Henolongerhadhighcholesterolorhighbloodpressure.Hiskidneyinsufficiencyhadcompletelynormalizedaswell.Jim’sstoryillustratesnotmerelyhowpowerfulthisdietaryprotocolisbutalsohowthestandardnutritionaladvicegiventodiabeticsfromconventionalphysiciansanddieticianscanbediseasepromoting.Thestandardnutritionaladvicegiventodiabeticsisnotonlyinsufficient—itisdangerous.JimKenneywouldlikelybedeadbynowhadhisnephrologistnotreferredhimtomyoffice.

Tobegin examininghow type2diabetes canbehealed,weneed to look athow it developed in the first place. As mentioned, the heavier you are, thegreateryourriskofdevelopingtype2diabetes.Forsomepeopleevenasmallamountof excess faton thebodycan triggerdiabetes.Yourbody’s cells arefueledprimarilybyglucose. Insulin is thehormonalmessengerproducedbythe beta cells in the pancreas, which induces glucose uptake into the body’scells.Glucosecannotpassintothecellsunlessinsulinopensthegate.However,aslittleasfivepoundsofexcessfatonyourframecaninterferewithinsulin’sability to carry glucose into your cells.When you have excess fat on yourbody, insulin does not work as well, and then the glucose has difficultyenteringthecells.Fatonthebodyinterfereswiththeactionofinsulinthroughmultiplemechanisms.Free fatty acids released from the fat cells is one of the mechanisms

promoting insulin resistance in liver andmuscle inaphenomenonknownaslipotoxicity. The excess of circulating fats in the bloodstream also blocksinsulin binding on the outer membrane of cells and interferes with normalmusclecellfunctionandenergyproduction.Whencellularenergyproductionis slowed,more insulin is required. This lipotoxicity can affect the heart aswell, promoting an irregularheart beat and increasing susceptibility toheartfailure.Fat cells also produce binding proteins that attach to the insulin hormone

blocking its activity. Some of these fat cell–produced molecules also causemusclecells tobedesensitizedtoinsulin.If that isnotbadenough,whenour

cellmembranesare impregnatedwithdietarytransfatsandsaturatedfats, theinsulin-binding sites are distorted, impairing insulin from binding to thedocking station on the cell membranes, making insulin less effective atenabling glucose uptake. To overcome all these issues, your pancreas mustproduceadditionalinsulin.Withsignificantweightgain,theinsulin-producingbeta cells in the pancreas become dramatically overworked. In short, type 2diabetes is a disease of heightened insulin resistance, not one of absoluteinsulindeficiency.Insulinworkslesseffectivelywhenpeopleeatfattyfoods,overeat,eatlow-

nutrient foods, or gainweight. Sowhenpeople are overweight, they requiremore insulin,whether they’rediabeticornot.Butgivingoverweightdiabeticpeople even more insulin makes them sicker by promoting further weightgain, causing them to become even more diabetic. How does this processwork? Our pancreas secretes the amount of insulin demanded by the body.Peopleofnormalweightwithaboutone-thirdofan inchofperiumbilical fatwill secrete a certain amount of insulin. But what happens when they gaintwentypoundsoffat?Theirbodieswillnowrequiremoreinsulin,almosttwiceasmuch,because the fat on their bodies interfereswith theuptakeof insulinintothecellsbythevariousmechanismsmentioned.

BodyFatDeactivatesInsulinandRaisesBloodGlucose

•Freefattyacidscirculatinginthebloodhaveatoxiceffect,inhibitingenergyproductionfrommuscletissues,whichthendemandmoreinsulin.•Fatcellsproducepigmentepithelium-derivedfactor,causingcellstobedesensitizedtoinsulin.1•Fatcellsproduceretinol-bindingprotein,whichpreventsinsulinfrom

activatingglucose-carryingproteins.2•Transfatsandsaturatedfatscanstiffenanddistortmembrane-locatedinsulinreceptors,interferingwithefficientbinding.3When people are significantly overweight or obese, with more than fifty

poundsofexcessfatweight, theirbodiesdemandhuge loadsof insulinfromthepancreas, even asmuch as ten timesmore thanpeople of normalweightrequire.Whatdoyouthinkoccursaftertenormoreyearsofoverworkingthepancreassohard?Ofcourse,itbecomesexhaustedandlosestheabilitytokeepupwiththehugeinsulindemands,andlessinsulinisproduced.Eventually,withlessinsulinavailabletomoveglucosefromthebloodstreamintothecells,theglucose level in thebloodstarts to rise,and thosepeoplearediagnosedwithdiabetes.Inmostcases,thesepeoplearestillsecretinganexcessiveamountofinsulin,comparedtoanormal-weightpeople,butjustnotenoughforthem.Astimegoeson,eventhoughtheoverworkedpancreasmaystillpumpoutmuchmoreinsulinthanathinnerpersonmightneed,itwon’tbeenoughtoovercometheeffectsofthedisease-causingbodyfat.Icallitpancreaticpoopout.Some severely overweight individuals have a large pancreas beta cell

capacity,sotheycanproducehighlevelsofinsulinwithoutbecomingdiabetic.Thesehighinsulinlevelsinthebloodareastrongpredictorofheartattackriskand life span.Sowhether these people are diabetic or not, their high insulinlevelsarestilldangerous.Infact,insulinlevelisabetterindicatorofafutureheartattackthancholesterollevel.Oftenpeoplewillbeinanemergencyroomwith their first heart attack and be told for the first time that their sugar iselevated. These heart attack victims never knew they had diabetes. The firstsignofitwastheheartattackfromyearsofhavingaheightenedinsulinlevel.Damagewasbuildingupbeforetheelevatedglucosebecameapparent.Inmostcases,thepancreas’sabilitytoproduceinsulincontinuestolessenas

thediabetesandtheoverweightconditioncontinueyearafteryear.Unliketype1diabetes,totaldestructionofinsulin-secretingabilityalmostneveroccursintype 2 diabetes. But the sooner type 2 diabetics lose the extra weight that iscausingthediabetes,thegreaterthelikelihoodtheywillbeabletomaintainafunctionalreserveofinsulin-secretingcellsintheirpancreas.Whatthismeansisthattypicaltype2diabetesiscausedbyexcessweightin

individuals who have a smaller reserve of insulin-secreting cells in thepancreas.Asthestatisticsareshowing,type2diabetesisagrowingepidemic.Butwhat is surprising is that people suffering can range anywhere from ten

pounds overweight to significantly obese. It is important to say here that inindividualswhoaresusceptible,tentotwentyextrapoundscanleadtodiabeticsymptoms. No matter what the number is, losing the excess weight enablesthese individuals to live within the capabilities of their body. Most type 2diabetics still produce enough insulin tomaintain normalcy as long as theymaintainafavorablebody-fatpercentage.Simplyput, since the levelof insulin inyourblood is agood indicatorof

yourriskforheartattack,andsinceatapemeasurearoundyourwaistisnearlyas good an indicator of insulin levels as a blood test, it makes sense toremember the ancient saying, “The longer your waistline, the shorter yourlifeline.”Following a nutrient-rich, lower-calorie diet—a nutritarian diet—coupled

withagoodexerciseprogramisthemostimportantchangeyoucanadopttoextendyourlifespan.Ithasbeenknownforyearsthatintentionalweightlossimprovesbloodsugar, lipids,andbloodpressure indiabetics.Gastricbypasssurgeryandlapbandproceduresarerisky,leadtomalnutrition,andmostoftenproduceonlytemporaryresults.Nevertheless,overweightindividualswhogothrough gastric bypass surgery and become too uncomfortable to eat muchoftenalsoresolvetheirdiabetes.Overtheyears,asthestomachstretchesandtheweightreturns,theseindividualscanbecomediabeticagain.Unfortunately,they did not learn enough about nutritional excellence. A recent studydocumentedasignificant increase in lifespan,withanaverageof25percentreducedmortality,whendiabeticindividualsdroppedtheirbodyweightbyjusttwenty to twenty-five pounds.4 Imagine the results when a program ofnutritionalexcellenceachievestheweightlossandthebody’scellsarefloodedwithmicronutrientsthatfuelcellularrepair.Scientificliteratureshowsitisnotjust theweight reduction that enablesdiabetic reversal and recoverybut alsothehighlevelofplant-derivedmicronutrientsandphytochemicalsthatcanfuelthebody’sownremarkableself-healingproperties.5The results you can achieve with a nutritarian diet are predictable and

remarkable,butittakessomeeffortandtime.Therearelotsofdietbooksandexercise plans written for diabetics, but this nutritarian diet is designed andproveninclinicalpracticetobethemosteffectiveforlosingweight,loweringcholesterol,andreversingdiabetes.Itisthegoldstandard,writtenspecificallyforpeoplewhowanttodowhatisverybestfortheirhealthandgiveittheiralltobecomenondiabetic.A nutritarian approach is all about superior nutrition, not just moderate

improvementindiet.Moderationdoesn’twork.Butnot toworry—asalreadymentioned,nutritionalexcellencewillmakeyourtastebudshappyandyouwillbemorethansatisfiedwiththeamountoffoodyoucaneat.Butwewillgetintothatlaterinthebook.

DecreasingInsulinandOtherMedicationsType2diabeticsareoverweighttobeginwithand,asyouhavelearned,beingoverweight is the significant causative factor in diabetes. Because insulintherapyresultsinfurtherweightgain,howcouldgivingmoreinsulinororalmedicationtoforcethealreadyoverworkedpancreastoproducemoreinsulinbeagoodthing?Aviciouscyclebeginsthatusuallycausesdiabeticstorequiremore andmore insulin or othermedications as they put on the pounds. Ontheir initial visit to me, patients often report their sugars are impossible tocontrolinspiteofmassivedosesofinsulin,whicharetypicallycombinedwithoral medication. These patients are significantly overmedicated but are stilloverweightandeatingunhealthfully. It is like theyarewalkingaroundwithalivehandgrenade,readytoexplodeatanyminute.Excess insulin in thesameenvironmentasexcessweight,highcholesterol,

hypertension, and inflammation from inferior micronutrient exposurepromoteshardeningofthearteries,whichwilleventuallyleadtoheartattacksand strokes. Studies have shown that high levels of insulin in the bloodpromotehardeningofthearterieseveninnondiabetics.Indiabetics,theeffectsof excess insulin are evenworse. In a study of 154 treated diabetics, bloodvesseldiseasewasgreatestinthosewiththehighestlevelsofinsulin.6Itmadeno differencewhether the insulinwas self-produced in the body or taken byinjection.Quiteafewstudiesillustratethedangersofgivinginsulintotype2diabetics.Whenthesepatientsaregiveninsulin—comparedwiththosegivenanoralantidiabetesmedication,theriskofdeathfromheartattackstripled.7Thebottomlineisthatinsulinusecreatesaviciouscyclethatcutsyearsoffa

person’slife.Insulinbothblockscholesterolremovalanddeliverscholesterolto cells in the blood vessel walls, increasing the risk for heart attacks andstrokes.Almost80percentofalldeathsamongdiabeticsareduetohardeningof the arteries, particularly coronary artery disease. Many diabetics turn totheir physician for guidance, but oftentimes the well-meaning doctor onlyworsens theproblembyprescribingmore insulin.Theextra insulindoesnotjust cause heart disease, weight gain, and the eventual worsening of the

diabetes;aswithtype1diabetes,insulincanincreasetheriskofcanceraswell.Type 2 diabetic patients exposed to insulin or sulfonylureas,which push thepancreas to producemore insulin, have significantly increased incidence ofcanceratmultiplesites.8Manyotherunfavorablesideeffectsoccurfromusingdiabetesmedications.

Forexample,medicationssuchasinsulinandthiazolidinedioneslikeActosandAvandianotonlycauseweightgainand legswellingbutalso,as reported inthe April 2009 issue of theAmerican Journal of Ophthalmology, have beenshowntodramaticallyincreaseadiabetic’sriskofdevelopingmacularedema,a serious eye disease. Recently, a study published in the British MedicalJournalexaminingoverninetythousanddiabeticsdemonstratedasignificantlyhigherriskofheartfailureandall-causemortality(death)indiabeticpatientsprescribed sulfonylureas.9 Sulfonylureas are one of the most commonlyprescribed drugs for diabetes. A recent retrospective study, reported at the2012 annual meeting of the Endocrine Society, reviewed these widelyprescribed diabetic drugs in 23,915 patients with type 2 diabetes onmonotherapy (one medication only). It reported the death rates on patientstaking glipizide, glyburide, or glimepirmide (all sulfonylurea drugs) andfoundtheyhada58to68percentincreaseinall-causemortalitycomparedtopatients taking only metformin. This study may have under-represented thedangerssinceitonlyfollowedthepatientsfor2.2years.10Clearly our present dependency on drugs to control diabetes without an

emphasis on dietary and exercise interventions is promoting diabeticcomplicationsandprematuredeathinmillionsofpeopleallovertheworld.Thetendencytothrowdrugsateverymedicalconditionistheproblemwith

medicinetoday.Physiciansprescribedrugsinanattempttolowerdangerouslyhighblood sugar, riskyhighcholesterol, anddamaginghighbloodpressurelevels typically seen in diabetics, since these high levels can lead to furtherdamage or premature death.Unfortunately, treating diabeteswithmedicationgives patients a false sense of security because they mistakenly think theirsomewhat controlled glucose levelsmean they are healthy.Whether patientshavehighcholesterol,highbloodpressure,oranyotherriskfactor,theuseofmedication takes the emphasis away from the complete overhaul of thelifestyle and diet style that is absolutely essential to save their life.Going todoctors and getting a pill for every issue has a subconscious effect to avertpersonalresponsibility,andthemotivationforpatientstoearnbacktheirhealthislessened.Thisprovidesdiabetics(andheartpatients)withthejustificationto

continue with the same disease-causing diet and lifestyle that led to thedevelopmentof theircondition in the firstplace,while falselybelieving theyarereceivingsignificantprotection.Whatpatients(andmanyphysicians)donotunderstandistheir“controlled”

diabetes continues to damage their organs and heart. Inevitably, the diabetesworsens, tragic complications develop, and patients die much too soon.Seventy percent of adults with diabetes die of heart attacks and strokes.Tragically, much of this suffering is unnecessary because diabetes and itscomplicationscanbeavoided.What’sworse is that physiciansoften advise diabetics to learn to livewith

andmanagetheirdiabetesbecausetheysayitcannotbehealedorcured.Type2diabetics who adopt a healthy nutritional approach can defeat diabetes andachieveexcellenthealth.That’sdiabetes-freeforlife.Almostallofmytype2diabeticpatientsareweanedoffinsulinwithinthefirstfewweeks,andthankstoexcellentnutritionalhabits,theyhavemuchlowerbloodsugarthanwhentheywereoninsulin.Stoppinginsulinalsomakesiteasiertoloseweight.

What’saDoctortoDo?Conventionalphysiciansspecializingindiabetesareinabind.Theyknowthathigh blood sugar levels create problems—not just by stressing the heart butalsobyagingtheeyesandkidneys,leadingtodevastatingcomplicationssuchas kidney failure and blindness. They want to prescribe aggressive insulintherapytodecreasepatients’bloodsugar.Theproblemis,theyalsoareawarethattheextrainsulinaccelerateshardeningofthearteries(whichleadstoheartattacks) and weight gain (which eventually makes patients more diabetic).Tighteningbloodsugarcontrolwith insulin is riskybusiness. In fact, studiesthatfollowpatientswhocarefullymonitor theirglucoselevel,adjustingtheirmedications precisely tomaintain themost favorable levels, show that thesepeoplehave increasedmortality.Theydonotdobetter.Theonlywaytobeatdiabetesistogetthin,eatright,anduselessmedication.Theincreaseduseofmedications is to blame when diabetics attempt to maintain lower glucosereadingsandthendieyounger.OnFebruary6,2008,theNationalHeart,Lung,andBloodInstitutestopped

the Action to Control Cardiovascular Risk in Diabetes study when resultsshowed that intensive treatment of diabetics increases the risk of dyingcompared to patients who are treated less aggressively. When you read thecommentsofphysiciansandresearchersdiscussingtheseresults,itisapparent

thattheystilldonotunderstandwhythisoccurred.Physiciansarestilllookingfor the magic combination of drugs to treat diabetes. They still do notunderstand that drugs cannot effectively treat this disease,which ismerely aside effect of an unhealthy lifestyle and diet. Giving stronger and strongerdrugs—which drive up appetite, causemoreweight gain, and rack up otherdetrimentalsideeffects—willneverbetherightapproachfortype2diabetes.Nomedicationscandowhatadietaryandlifestyleoverhaulcan.Mostphysicianswould likelyagree thatweight reductionandhigh-nutrient

eatingisthemostsuccessfulroutetohealth,buttheydonotknowmuchaboutit or how to motivate their patients to change, and they doubt their patientswould do it. Certainly, in rare instances when physician interventions aresuccessful at achieving significant weight reductions, the outcomes areinvariablypositive.Wehavealreadydiscussedthatpatientswithdiabeteswhoundergo gastric bypass surgery typically see their diabetes resolve.11 Plusnutrition interventions that control and limit calories have been effective forreversingdiabetestoo,enablingmanypatientstodiscontinuemedications.12Preventing and reversing diabetes is not all about weight loss. The

nutritionalfeaturesofthisdiethaveprofoundeffectsonimprovingpancreaticfunction and lowering insulin resistance over and above what could beaccomplishedwithweightlossalone.Theincreasedfiber,micronutrients,andstoolbulk,plusthecholesterol-loweringandanti-inflammatoryeffectsofthishigh-micronutrienteatingstyle,haveradicaleffectsontype2diabetes.Scoresof my patients have been able to restore their glucose levels to the normalrange without any further need for medications. They have becomenondiabetic. Plus, one’s blood pressure, cholesterol, and overall health andvitality are radically improvedor normalized.Evenmy thin, type1, insulin-dependent diabetic patients are able to reduce their insulin requirements byabout half. They experience greatly improved glucose control and stabilizedhighsandlows,whichprotects themfromthetypicaldangers thatarealmostinevitabletolong-termdiabeticswhoeatmoreconventionally.Sadly, theADA aswell asmost dieticians and physicians offer dangerous

advice todiabetics.Theyprovideminimalguidanceonweight reductionandcholesterol lowering, and worse yet, the diets they recommend are notsuccessful for helpingdiabetics loseweight andkeep it off.Typical diabetescare is focused on the wrong thing—monitoring blood sugar to determinewhenitisnecessarytochangeinsulindosagesoradjustothermedications.Instead of motivating excellent nutrition to prevent disease, the ADA

reinforces our disease-causing food habits. For example, here are somestatementsfromtheADAwebsite:Fact: If eatenaspartofahealthymealplan,orcombinedwithexercise,sweetsanddessertscanbeeatenbypeoplewithdiabetes.Theyarenomore“off limits” to people with diabetes than they are to people withoutdiabetes.Fact:Formostpeople,type2diabetesisaprogressivedisease.Whenfirstdiagnosed,manypeoplewithtype2diabetescankeeptheirbloodglucoseatahealthylevelwithoralmedications.Butovertime,thebodygraduallyproduceslessandlessofitsowninsulin,andeventuallyoralmedicationsmaynotbeenough tokeepbloodglucose levelsnormal.Using insulin togetbloodglucoselevelstoahealthylevelisagoodthing,notabadone.Thisadviceisflat-outwrong.Caseinpointwiththelatterfact:asdiabetics

aregiven inadequatedietary advice, placedonmedications that causeweightgain and push the failing pancreas to work harder, and generally guided tomismanagetheirdiabetes,theresultwillofcoursebemoremedicationandtheeventual need for insulin. This is simply drug-promoting double-talk thatmakes medications the answer over effective and proven lifestyleinterventions. The ADA medical advisory committee states: “It is nearlyimpossible to takeveryobesepeopleandget themtolosesignificantweight.Soratherthanspecifyinganamountofweightloss,wearetargetingmetaboliccontrol.”Thisisdoublespeakfor“Ourrecommendeddietsdon’twork,sowejustgivemedicationsandwatchpatientsdeteriorate.”Physiciansengaginginsuchconventionalmedicalpracticeareendangering

their patients’ lives. Instead, they should always offer the option of treatingdiabetes with effective nutritional and dietary changes. The problem is thatmost physicians don’t really understand the proper nutritionalrecommendationstomake.Howcandiabeticssafely lower thehighbloodsugar levels thatareslowly

destroying their bodies? How can they lower their cholesterol and bloodpressure, loseweight,andavoid takingdangerousdrugs?Themosteffectiveglucose-loweringdrugsarealsothemostdangerousinthelongterm.The best medicine for diabetics is a high-nutrient, lower-calorie diet and

exercise,notdrugs.Thisistheonlyapproachthatlowerscholesterol, lowers

triglycerides,andlowersbloodpressureasitdropsweightandbloodglucose.High-nutrient plant foods also have an anti-inflammatory effect on bloodvessels and organs. This enables self-repair mechanisms that are essentiallydisabledonalow-nutrientdiet.Thisdietaryapproachhashelpedthousandsofdiabeticsreduceoreliminatetheneedforinsulinandothermedications.Ithaschangedtheentirecourseoftheirhealthandlongevitythroughthefoodstheyeat.Thebottomlineisthis:youcangetridofyourdiabetes,not

just“manageit.”Donotrelyonstandarddrugmethodstotreatdiabetes.Withnomedication

tocoverup theirdietaryfailings,diabeticswillbecompelled toeatproperlyandexercisemoretocontroltheirelevatedglucose.Thisaggressiveapproachbased on nutrient-rich foods is the most effective way to reverse thisdangerouscondition.Learningaboutthenutrientsinsidethesehealingfoodsisanimportantstepindefeatingdiabetes.

YourHealthFuture(H)=Nutrients(N)/Calories(C)Acareerinmedicineissomuchmorerewardingwhenpatientsactuallyget

well.Howoftendoesthephysiciansaytohispatient,“Congratulations,youdonotneeddrugsforyourhighbloodpressureandcholesterolanymore.Youdidit! You removed your risk factors because you are healthier!” Or,“Congratulations, your stress test has normalized.” Or, “Your carotidultrasound showsno visible plaque anymore.”These are typical statements Imakeeverydayinmyoffice.Itisexcitingtoseepeoplerecovertheirhealth.Unfortunately,toomanypeopleinthisprofessiondonotgivetheirpatients

theopportunitytogethealthy.Imagineifalldoctorstoldtheirpatientsthatdietand exercise are more powerful than drugs and they were adamant aboutcompliance.Instead,mostphysicianshavetheassumptionthattheeffortistoogreat; that patients are not willing eat right, exercise, and get slim; and thatdrugs are the only answer. They prescribe drugs and tout them as the onlyviableoptionandthenwatchpatients’healthdeteriorate.Oftentheydon’tknowthereisanother,moreeffectiveoption.Inallofthis,thepublicloses.Somuchof our conventional medical system is based on ignorance. Nutritionalmedicine, when practiced properly, is much safer and more effective thanconventionalmedicine.

A medical diagnosis such as diabetes is an opportunity for physicians toteach patientswhat they are doing to hurt themselves and how theAmericandiet is disease causing. It is an opportunity to motivate them to earn backsuperiorhealth.Oneveryvisit,thenutritionallyastutephysicianshouldreviewthe patient’s list ofmedications and gradually be able to reduce dosages ordiscontinuemedications.Medicationsare an insufficient and ineffective intervention for the chronic

diseases that have been created by bad lifestyle and dietary choices. Aconsiderablepartoftheproblemisbadinformation.Inappropriatedietsofalldescriptions flood the marketplace, and traditional dietary teachings areriddled with myths and inaccuracies. The failure of conventional dietaryprogramstoachievelong-termweightreductionmerelyreflectstheweaknessof the advice given and the poor educational and motivational techniquesoffered.Thislackofawareness—evenamonghealthprofessionals—doesnotweaken thescience, logic,oreffectivenessofutilizingsuperiornutritionandlifestyleinterventionsastheprimarytherapeuticmodality,however.Followingacorrectdietandexerciseplanasaremedyshouldnotbelabeled

alternative or complementary medicine. It is simply the way all properlyeducated doctors should be practicing. Everything else should be calledmalpractice medicine. Offering patients drugs and surgical interventionswithout informing them that, for most diseases, nutritional excellence andexercisearesaferandmoreeffectiveinthelongrunisnotadequateinformedconsenttotheuseofmedications.Therisksofmedicinesaredownplayedandtheirsupposedbenefitsgreatlyexaggeratedbyamedicalprofessionanddrugindustrywhoofferdrugsasthepanaceatoallthatailsus.Most often alternative, or complementary, medicine offers the same

treatmentmentalityasthephysiciansfocusedondispensingdrugs.Ratherthandealing with the dietary and lifestyle factors that caused the condition,alternativephysiciansarealsoofferingsomemagic in theformofanherbalpillorIVvitamindrip.Naturalherbsorothermodalitiescansometimesoffersimilar effects as drugs. There are plenty of natural substances that havetherapeuticeffects,buttheydonotdealwiththecauseoftheproblem,sotheirbenefitsarelimited.Adiet-induceddiseaseneedsadietarysolution,notmoretreatment options. It is typical to find an alternative physician offeringchelation,IVnutrients,hormones,andanexpensiveassortmentofsupplementsand remedies while the patient remains fifty pounds overweight. Effectiveweightreductionwillnotbeachieved.Remediescanchangetheexpressionof

symptoms,buttheynevermakepatientswell.Theyjustcausepeopletobecomemoredependentondoctorsandtheirremedies.Physiciansandconsumersarequick to embrace doctor-recommended medical interventions while theyignore simple, inexpensive, and dramatically effective lifestyle interventions.Optimallifestylemedicinewouldfreethesepeoplefromneedingmedicalcare.Theyneedlessandlesstherapyandmedicalintervention.Thispathofadviceisnotamoneymakerfortheprofessional.Thereisnohugeeconomicincentivetopromotethebasicsofgoodhealth.The problem with lifestyle medicine today is the varying opinions and

dietaryprograms thatarepopularbutnot ideal.These in turn result ina fewstudies showing limited effectiveness—all ofwhich help the currentmedicalapproachmakeitscaseforprescriptions.Wouldn’t itbesimpler ifweallcouldagreeononeprogram?If therewas

oneprogramthatwasmostlogical,mosteffectivetherapeutically,andbeatoutalltheotherswhensubjectedtoscientificscrutinyandlong-termevaluation,itwould change the health conversation radically, and all doctors and healerswould naturally begin embracing such a protocol. I have been developing,teaching, and fine-tuning this program over the last twenty years. Studiescontinue to show it can meet any scrutiny and testing. It is ready forimplementation and documentation. It works effectively for a surprisinglywidearrayofchronicdiseasesanddoesnothavetobeoverlycomplicated.Aswe’ve explored, significant research already supports its use, and furtherresearchispresentlyinprocess.Testitforyourself,andyouwillbeshockedwithitseffectiveness.

CHAPTERTHREE

StandardAmericanDietVersusaNutritarianDiet

WhenIstartedDr.Fuhrman’sprogram,Iweighed206poundsandhadhaddiabetesforsevenyears.Hisnutritionalprogramenabledmetolosesixty-threepoundsandgetridofmydiabetes,highbloodpressure,andhighcholesterolwithoutmedication.MyLDLwentfrom168to73infivemonths(withoutdrugs),andIamnowmaintainingmyhealthyweightof143pounds.ThemostamazingthingisthatmyophthalmologisthadtoldmeIrequiredlasersurgerytotreatdiabeticretinopathy.WhenIwentbacktoseehimagainthreemonthslater,aftereatingthehigh-nutrientdiet,hecanceledthesurgerybecausehefoundthatdamagetomyeyeswasnolongerthere.IamextremelygratefulbecauseIknowthislife-savinginformationhasaddedmanyqualityyearstomylife.

—MartinMilford

Morethan85percentoftheSADconsistsoffoodsfromlow-nutrient,high-calorieprocessedfoods,animalproducts,dairyproducts,andsweets.Theseallcontribute toexcessiveweight,highcholesterol,andhighbloodpressure, soit’s no wonder we have an epidemic of diabetes. Natural plants such asvegetables andbeans contain thousands of protectivemicronutrients, such asantioxidants and phytochemicals. When we eat a diet rich in colorful plantfoods,wegleana full symphonyofnutritional factors that enablebetter cellfunctionandresistancetoagingandstress.What happens when we combine high-calorie foods without sufficient

amounts of protective micronutrients? Cells become congested with wasteproducts such as free radicals and advanced glycation end products (AGEs).ThebuildupoffreeradicalsandAGEsincells issometimescalledoxidativestress. It can lead to inflammation, cell damage, and premature cell death.AGEs are the critical toxins that cause nerve damage, blindness, and othercomplicationsofdiabetes.Theybuildupfasterinpeoplewhoeatlow-nutrientjunkfoodandalsoindiabeticswithelevatedglucoselevels.1Whenwegainweight,wenotonlyproducemoredamaging toxicwaste in

our cells, but we also dilute our body stores of nutrients, lowering themicronutrientconcentrationinourcells.Thesimplekeytoalong,disease-freelife is toweigh lessandkeepahigh levelofmicronutrients inourcells.Weneedtoberelativelythinbutwell-nourishedwithmicronutrients.The American diet contains very little nutrient-rich food. Overall,

Americansconsume62percentof theircalories inprocessedfoodsand25.5percentfromanimalproducts.Thisisthecruxoftheproblem.Bothprocessedfoodsandanimalproductsaredeficientinantioxidantsandphytochemicals.We could not design a better plan to prematurely kill off our population.

Only 10 percent of American food intake is from vegetables, beans, seeds,nuts, and fruits—the natural high-micronutrient foods that help prevent andreversediabetes.Thesecret:eatingmorenutrientbangforeachcaloricbuck.

USDAEconomicsResearchService,2005;www.ers.usda.gov/publications/EIB33;www.ers.usda.gov/Data/FoodConsumption/FoodGuideIndex.htm#calories

Much is known about nutrition and its power to create disease or protectagainst disease. But the unanswered questions for the majority of ourpopulationare:Whatconstitutesahealthydiet?Howdoweknowifourchosendiet is disease producing or disease protecting? What degree of dietaryexcellencemakesadietreverseadisease?Anutritariandiet isnot just aboutweight loss. It answers these issueswith

logic, math, and science. It gives individuals the ability to measure andintuitivelyjudgethenutritionalqualityof theirdietsanddiscernwhether it isadequate.Whatconstitutesahealthydietforahealthypersonwithgoodfamilyhistoryandnohealthproblems?Howdowedesigntherightdietforthosewithmultiple risk factors or a poor family history?What about people who arefacedwithserioushealthchallenges?Howshouldtheirdietsbestructuredformaximumtherapeuticeffects?

ANutrientBreakdownTherearetwokindsofnutrients:macronutrientsandmicronutrients.Here’sa

simpledefinitionofeach:

•Macronutrientsarenutrientsthatsupplythecaloriesourbodiesneedforenergyandgrowth.•Micronutrientsarenutrientsthatappearintraceamountsinfoodsbutareessentialforhealthandgrowthandthatdonotcontaincalories.There are four macronutrients in the foods we eat: water, carbohydrates,

proteins,andfat.Becausewateriscalorie-free,wewillnotconsideritnow.Allthe foods we eat contain some combination of the three calorie-containingmacronutrients. If you eat too many macronutrients, you are overeatingcalories,whichcausesweightgain,chronicconditions,andprematuredeath.Yes, to loseweight and improveyour health, youneed to eat less fat, less

carbohydrate,and lessprotein, reducing totalcaloric intake.But the secret isnot to count calories to reduce calories. That never works. The secret is tofocusonmicronutrients.Iknowitdefieslogic,atfirst,buttruehealthliesinahigh-qualitydiet—eatingfoodspackedwithmicronutrients.Micronutrientsarewherethemagichappens.Thesenutritionalsubstancesin

thefoodsweeatdon’tcontaincalories,buttheydocontain theverynutrientsthat heal the body.Micronutrients are needed for your body to rid itself ofwaste,repairdamage,andsupportnormalday-to-dayfunctions.Micronutrients include fourteen vitamins and sixteen essential minerals

knowntobevital tohumanhealth,andtheimportanceofincorporatingthemintoyourdietforoverallhealthcannotbeunderstated.Theirimpactonhealthis broad and vast.However, these vitamins and essentialminerals, identifiedoverseventy-fiveyearsago,arejusttwotypesofmicronutrients.Phytochemicalsarethethirdtypeofmicronutrientandwereidentifiedmore

recently.Thevariouskindsofphytochemicalsarestillbeingdiscovered,andacomprehensivelistoftheirmanyfunctionshasyettobecompleted.Inthelastdecade,wefoundthatfoodscontainthousandsofbeneficialmicronutrientsinaddition to theoriginal vitamins andminerals discoveredback in the1940s.Now we know the major micronutrient load in food is not vitamins, notminerals,butphytochemicals.Thesesubstancespackapowerfulpunch.Theyfunction to improve human health and longevity. We found the fountain ofyouth, and it was right in front of our noses all along. There are tens ofthousandsofphytochemicals innatural,whole, vegetable-based foods.Theseplant nutrients are essential in helping protect you from disease. If you are

alreadysick,theycanhelpyourecover.All of these life-protecting and life-saving nutrients are found in whole

foods. Vegetables, beans, berries, and seeds are particularly high in thesenutrients. They are the key to optimal health aswell as disease reversal andprotection.Remembermyhealthequation:

H=N/CThismeans your health is dependent on the nutrient-per-calorie density of

yourdiet.Thequalityofadietcanbejudgedbasedonthreesimplecriteria:

1.Itslevelofmicronutrients(vitamins,minerals,andphytochemicals)percalorie

2.Adequatemacronutrients(fat,carbohydrates,andprotein)tomeetindividualneedsbutwithoutexcesscaloriesthatmayleadtooverweightorhealthcompromise

3.Avoidanceofpotentiallytoxicsubstances(suchastransfats)orsubstancesharmfulinexcess(suchassodium)My health equation H = N/C expresses this simple concept of eating for

micronutrient per calorie density. The foods with the highest micronutrientdensityhavethemostpowerfultherapeuticeffectandarethemosteffectiveinpromotingweightlossandreversingdiabetes.

ANDIThe concept of micronutrient density is put into action by looking at anassortment of foods and analyzing the micronutrients they contain. I haveranked the nutrient density ofmany common foods in the table on page 49using my Aggregate Nutrient Density Index (ANDI).* This index assignsscorestoavarietyoffoodsbasedonhowmanynutrientstheydelivertoyourbody ineachcalorie consumed.Eachof the food scores isoutof apossible1,000 based on the nutrients-per-calorie equation. Because nutritional labelsdon’tgiveyou the informationnecessary tounderstandexactlywhatyouareeating, these rankingsdo the equation for you andgiveyou a senseofwhatfoodsscorethehighest.Youcanusethisindextoestimatethequalityofyour

currentdietortoplanforanimproveddiet.UsingANDIissimple—itismeanttoencourageyoutoeatmorefoodsthathavehighnumbersandtoeatlargeramountsofthesefoods.Thehigherthenumberandthegreaterpercentageofthosefoodsinyourdiet,thebetteryourhealth.Because phytochemicals are largely unnamed and unmeasured, these

rankingsunderestimatethehealthfulpropertiesofcolorfulnaturalplantfoodscompared toprocessedfoodsandanimalproducts.One thingwedoknowisthatthefoodsthatcontainthehighestamountofknownnutrientsarethesamefoods that contain the most unknown nutrients too. So even though theserankingsmaynotconsiderthephytochemicalnumbersufficiently,theyarestillareasonablemeasurementoftheircontent.Vegetables clearlywalk awaywith the goldmedal—noother food is even

close. So, of course, green vegetables have the best association with lowerratesofcancerandheartdisease.Whilethemajorityofmostpeople’scaloricintakeisfromthelowerendofthistable,peoplewhomovetheirconsumptionhigherwillsubstantiallyprotecttheirhealth.Andtherecipesandmealplansinthisbookwillhelpyoureachthisgoal.When you seek to consume a broad array of both discovered and

undiscoveredmicronutrientsviayourfoodchoices,youareanutritarian.Itisnotsufficienttomerelyavoidtransfatsorsaturatedfats.Itisnotsufficientforthediettohavealowglycemicindex.Itisnotsufficientforthediettobelowin animal products. It is not sufficient for the diet to bemostly raw food.Atruly healthy dietmust bemicronutrient rich, and themicronutrient richnessmustbeadjustedtomeetindividualneeds.Becausethefoodswiththehighestmicronutrient- per-calorie scores are green vegetables, beans, colorfulvegetables,berries,andotherfruit,theconsumptionofenoughofthesefoodsis required to meet our micronutrient needs and to promote reversal ofdiabetes. Not only is it necessary to ingest a high enough absolute value ofmicronutrients, but the full breadth ofmicronutrient diversity is also neededforsuperiorhealth.IcallthiscomprehensivemicronutrientadequacyCMA.Indiabetesresearch,theglycemicindex(GI)ofcarbohydrateshaslongbeen

recognizedasafavorableaidfordiabeticstocontrolbloodsugar.Thesameisnow often the case in lipid research, as it has been demonstrated that highglycemic diets, rich in white flour, refined sweets, and processed foods areunfavorabletobothglucoselevelsandlipidparameters.2TheGIisarankingof carbohydrates on a scale from0 to 100 according to the extent towhichtheyraisebloodsugarlevelsaftereating.FoodswithahighGIarethosewhich

are rapidlydigestedandabsorbedand result inmarked fluctuations inbloodsugarlevels.Low-GIfoods,byvirtueoftheirslowdigestionandabsorption,producegradualrisesinbloodsugarandinsulinlevels,andtheyhaveprovenbenefits for health. Refined foodsmade from sugar andwhite flour are notonlyhigh-glycemicfoods,buttheyarealsonutritionallydeficientandinducemicronutrient loss.Theglycemic load (GL) is thenumber that considers theglycemic index within a given serving of food and the actual calories ofglucoseproduced,therebymakingitmorepracticalforcalculatingtheoverallbloodsugar–raisingeffectofaserving,meal,ordailymenu.Thosewhoadvocateahigh-protein(meat-based)diet,hangtheirhatonthe

lowGIofanimalproducts toexplain theadvantagesofadiet rich inanimalproductsand lower invegetation.Thisviewoversimplifies themultifactorialnuances of nutrition and results in a distorted understanding of nutritionalscience.Ranking food onGI alone ignoresmany other factors thatmaymake that

foodfavorableorunfavorable.BecauseacarrothasahigherGIthanasliceofbacon does notmake the bacon a better food for a diabetic or heart patient.ThereareotherimportantnutritionalconsiderationsbesidesGI,includingthetoxicity,micronutrient density, and fiber.Good examples of such nutritionalnonsense include Dr. Barry Sears of the Zone Diet, who warns against theconsumptionoflimabeans,papayas,andcarrotsbecauseoftheirGI;andDr.Robert Atkins, who excludes fruits and vegetables with powerful anticancerbenefitsfromhisdiet.

GlycemicIndexandGlycemicLoadofCommonCarbohydrate-

ContainingFoods3

Carrotsareagoodexampleofthelackofprecisioninherentinusingonlytheglycemic index. They are high in fiber and nutrient rich, but theirGI is 35.Carrots are relatively low in calories, and when they are eaten raw theirglycemic effect is lessened further, as the body does not absorb all of thecalories in raw foods.TheGL is the accuratemeasurement here, not theGI.Carrotsarenotanegativefood,evenforthediabetic,astheGLisonly3.Thisis why raw carrots are a favorable weight loss–promoting food. Instead offocusingnarrowlyontheconceptofGI,wehavetoconsidertheothervaluesofthefoodaswellasthehealthfulqualitiesandGLoftheentiremealwhenputtogether. By the way, weight loss and micronutrient adequacy are moreimportantthanminorandtemporaryfluctuationsinbloodsugar,becausetheyleadtolong-termwellnessandresolutionofthediabeticcondition.Studiesevaluatingthenegativeeffectsofahigherglycemicdietrevealedthat

foodscomposedoflow-nutrient,low-fiber,processedgrainsandsweetshavedeficiencies, and they harm far beyond their glycemic response. Processedfoods are also low in fiber, phytonutrients, and antioxidants and are rich intoxicacrylamides.InadditiontohavingahighGL,theyaredisease-promotingfoods.Whenadietisrichinnutrients,thedisease-protectivequalitiesofthesefoods and their weight-loss benefits overwhelm any insignificant drawbackfromtheirmoderateGL.

UNDERSTANDINGTHEGLYCEMICINDEXFood GlycemicIndex GlycemicLoadWhitePotato(1mediumbaked) 90 29WhiteRice(1cupcooked) 68 29BrownRice(1cupcooked) 58 24WhitePasta(1cupcooked) 53 21ChocolateCake(1⁄10boxcakemix+2Tfrosting) 38 20Raisins(1⁄4cup) 64 19Corn(1cupcooked) 52 18SweetPotato(1mediumbaked) 69 14BlackRice(1cupcooked) 65 14

Grapes(1cup) 59 14RolledOats(1cupcooked) 55 13WholeWheat(1cupcooked) 30 11Mango(1cup) 51 11Lentils(1cupcooked) 40 9Apple(1medium) 39 9Kiwi(2medium) 58 8GreenPeas(1cupcooked) 53 8ButternutSquash(1cupcooked) 51 8KidneyBeans(1cupcooked) 22 7Blueberries(1cup) 53 7BlackBeans(1cupcooked) 20 6Watermelon(1cup) 76 6Orange(1medium) 37 4Carrots(1cupcooked) 39 3Carrots(1cupraw) 35 2Cashews(1ounce) 25 2Strawberries(1cup) 10 1Cauliflower negligible negligibleEggplant negligible negligibleTomatoes negligible negligibleMushrooms negligible negligibleOnions negligible negligible

Recently a systematic review was performed of published humanintervention studies comparing high- and low-GI foods or diets and theireffectsonappetite,foodintake,energyexpenditure,andbodyweight.Inatotalof thirty-one short-termstudies, the conclusionwas that there isnoevidencethatlow-GIfoodsaresuperiortohigh-GIfoodsinregardtolong-termbodyweightcontrol.4Morerecentresearchcomparedtheexactsamecaloricdiets,onewithalowerandonewithahigherGL,anddemonstratedthatloweringtheGL and GI of weight-reduction diets does not provide any added benefit tocalorierestrictioninpromotingweightlossinobesesubjects.5SotheGIandGLareimportant,buttheycannotbetheprimaryfocusofahealthydiet.Theyarejustoneofmanyaspectstobeconsideredwhenunderstandingwhatmakesthis proposed diet style ideal. This will come into play in the design of the

optimaldietandbestcarbohydratechoicesinchapter6.The important point to remember is that a diet with a high micronutrient

densityalreadyhasafavorableGL.Itisalsolowinsaturatedfat,highinfiber,rich in phytochemicals, and naturally alkaline. In other words, instead offocusingononepositiveaspectalone,considerallthepositivefeaturesofwhatmakesadietstylediseaseprotective.Faddietstoooftenrelyononeaspectoffoodanddigestionregardlessofthepotentialpositiveandnegativefactorsthatexistsimultaneously.SotheGLplaysaroleindesigningtheoptimalreversaldietforadiabetic,butlet’snotallowtheGIortheGLbethesoledeterminantofourdiet.

Also keep inmind that nutrient-density scoring is not the only factor thatdeterminesgoodhealth.Forexample,ifweateonlyfoodswithahighnutrient-densityscore,ourdietswouldbetoolowinfat.Sowehavetopicksomefoodswith lowernutrient-densityscores (butpreferably theoneswith thehealthier,highernutrient-containingfatssuchasseedsandnuts)toincludeinourhigh-nutrient diet.Additionally, if thin or highly physically active people ate onlythehighest-nutrientfoods,theywouldbecomesofullfromallofthefiberandnutrients that they would be unable to meet their caloric needs and wouldeventuallybecome too thin.This, of course,givesyouahint at the secret toestablishing a permanent low body-fat percentage if you have a metabolichindrancetoweightloss.But,shhh,don’ttellanybodyaboutthis.Optimal health cannot be expectedwithout attention to the consumption of

high-micronutrientfoods.Forexample,avegandiet,centeredonhigh-starchfoods such as white rice, white potatoes, refined cereal grains, and breadproducts, does not contain sufficient micronutrient richness for maximizing

longevity. In some susceptible individuals, the lack of attention tomicronutrientdensitymayevenbediseasecausing.Hundredsofindividualshavelostoverahundredpounds,someevenmore

than two hundred pounds, and several more than three hundred pounds byfollowing this nutritarian diet. Countless others have just lost the amount ofweighttheyneededtoearnbacktheirhealth.Butitisnotjustaboutweightloss.Utilizing large volumes of nutrient-rich vegetation in the diet has beendemonstratedtolowercholesterolmoreeffectivelythancholesterol-loweringdrugs.6Mypatientsroutinelyandpredictablyseetheirbloodpressurereturntonormal and their atherosclerotic heart disease or peripheral vascular diseasemeltawayaswell.Another revolutionary finding besides the importance of consuming a

sufficient quantity and variety of nutrients is that high-nutrient eatingsuppressesyourappetite.Younaturallydesirefewercalories.Soalthoughthisbookisabouteatingless,youdon’trealizeyouareeatingfewercaloriesandyoudon’tdesiremorecalories.Thenutritariandietstylebluntsyourdesiretoovereat.Inthefollowingpages,wewilldiscussthisaddedbenefitandtheinsandoutsofhungerandcravings.

CHAPTERFOUR

ReversingDiabetesIsAllAboutUnderstandingHunger

Dr.GlenPaulsonwasaforty-year-oldchiropractorandfatheroffour.Hesufferedfromuncontrolledtype2diabetes,diabeticneuropathy,kidneystones,highcholesterol,andobstructivesleepapnea.Heweighed330pounds,hisfastingbloodglucoselevelwas240,hisHbA1Clevelwas10.4,andhisbloodpressurewas145/90onmetformin1,000milligramstwicedailyandGlyberide5milligramstwicedaily.Hisphysicianwantedhimtogooninsulinbecausehisbloodsugarcouldnotbecontrolledonoralmedicationandalsowantedhimtoaddmoremedicationtofurtherlowerhishightriglyceridesandhighbloodpressure.Dr.Paulsonrecalls,“Mykidneyswereshuttingdown,Ihadstones,andIwasconstantlyinpain.MydoctortoldmeifIdidn’tchangemydiet,Iwouldneeddialysisinafewyears.WhenIturneddownthemedicationrequestthenursegavemeoverthephone,thedoctorcalledmebackandexplainedtheriskstomyhealthandhowseriousamatteritwas.Igotoffthephone,andIjustcried.“IreadEattoLiveanddecidedtochange.Ihadbeenignorantandrecklesswithmyhealth.”Eightweekslater,whenDr.Paulsonwentbackforacheckup,hisphysicianhuggedhimandsaidheneversawanyonereversesomanyhealthproblemsjustfromdietandexercise.Aftersixmonthsoffollowingmyadvice,Dr.Paulsonlosteightypounds,hisfastingbloodglucoselevelloweredto90,hisHbA1Clevelwentto6.5,andhisbloodpressurereducedto120/70.Hisonlymedicationatthesix-monthmarkerwasmetformin1,000milligramstwicedaily.*Dr.Paulson’swife,Jillian,alsolostthirtypounds.ShetoldusGlen“is

doingsomuchbetter.Hehasbeenagoodexampleforhispatients,andtheyarechangingtheirdietsaswell.WhentheyseewhathappenedtoGlen,theyallwanttoloseweightandgetofftheirmedicationstoobecauseofhisgoodexample.Thisisthebestlifestylechangewehaveevermade,andwe100percentpromotethisplan.Wenowteachahealthclassonthisonceamonth,andithasbeenphenomenal.Thanksforeverything.”

Ahigh-micronutrientdietdoesnotjustimprovehealthforyourbody,butitalso decreases food cravings and sensations leading to overeating behavior.Individualsadoptingadietstylerichinmicronutrientsreportachangein theperception of hunger signals. The sensations commonly considered hunger,and even reported in medical textbooks as such, appear to dissipate for themajorityofpeople,andanewsensationthatIlabeltrueorthroathungerarisesinstead.A diet too low in micronutrients leads to heightened oxidative stress.

Oxidativestressmeansinflammationinthecellsduetoexcessivefreeradicalactivity. It is accompanied by a buildup of toxic metabolites that can createphysical symptoms of withdrawal when digestion ceases in between meals.Besidesthetoxinsweconsumefromfood,cellsproducetheirownmetabolicwastesthatneedtoberemovedfromcellsandtissues.When our diets are low in phytochemicals and other micronutrients, we

buildupintracellularwasteproducts.Itiswellacceptedinscientificliteraturethat toxinssuchasfreeradicals,AGEs, lipofusion,andlipidA2Ebuildupintissueswhenpeople’sdietsarelowinmicronutrientsandphytochemicals,andthatthesesubstancescontributetodisease.1It has already been noted that overweight individuals build up more

inflammatory markers and oxidative stress when fed a low-nutrient mealcompared to normal-weight individuals.2 Because of this, people prone toobesity experience more withdrawal symptoms that direct them to theoverconsumption of calories. These are the sources of the toxic hungercravings that often lead to binging and other gut-busting behavior. It is aviciouscyclepromotingtheproblemandpreventingitsresolution.Thosewithhealthierdietsdonotbuildupsuchhighlevelsofinflammatorymarkersandasaresultdonotexperienceintensewithdrawalhungersymptoms.3Phytonutrients are required for the body to properly detoxify metabolic

waste products—they enable cellular detoxification. When we don’t eat

sufficient phytochemical-rich-vegetation and instead consume low-nutrientfoodandexcessanimalproteins(creatingexcessnitrogenouswastes)weoftenexacerbate the buildup of metabolic waste products in our bodies.4 Thesewastesarejustlikedrugtoxins.The withdrawal symptoms, conventionally called hunger, develop from

inadequateorpoornutrition.Icallthesewithdrawalsymptomstoxichunger.Itis important for us to understand and differentiate toxic hunger from truehunger.Toxichunger appears at the lowerplateauof theblood sugar curve,drivesovereatingbehavior,andstronglyincreasesthedesiretoconsumemorecalories than the body requires, leading to weight gain and diabetes. Truehunger,however,appearswhenthebodyhasusedupmostofthecaloriesfromthe previousmeal aswell as the stored glucose (stored as glycogen) and isreadytoberefueled.Withachangeofdiet,toxichungergraduallylessensandresolves,allowingindividualstobesatisfiedeatingless.Whenyouadoptthisnutritariandiet,becominghealthyisthefirststep.You

soon find that the symptoms of toxic hunger are gone. Instead, you willeventuallyexperiencethefeelingoftruehunger,whichencouragesthepreciseamount of calories required for good health and the maintenance of idealweight. True hunger serves as an important guide to promote enjoyment offood. Itgivesusprecise signals fromourbodies soweknow theamountofcalories needed to sustain our lean body mass. When we eat when we arehungry,foodtastesmuchbetterandwearephysiologicallyprimedforproperdigestion.Hunger,inthetruesenseoftheword,indicatesthatitistimetoeatagain.

TYPICALSYMPTOMSOFTOXICHUNGERFeelingofemptinessinstomachGurgling,rumblinginstomachDizzinessorlightheadednessHeadacheIrritabilityoragitationLackofconcentrationNauseaShakinessWeaknessorfatigueImpairmentinpsychomotor,vigilance,andcognitiveperformances

TYPICALSYMPTOMSOFTRUEHUNGERThroatandupperchestsensationEnhancedtastesensationIncreasedsalivation

The critical message is that the wrong food choices lead to withdrawalsymptomsthataremistakenforhunger.Youcanalwaystellthatthesearetoxichungersymptomsbecauseyouexperienceshakiness,headaches,weakness,andabdominal cramps or spasms. Initially, these symptoms are relieved aftereating,butthecyclesimplystartsoveragainwiththesymptomsreturninginamatterofhours.Eatingwhenyouexperience toxichunger is not the answer.Changingwhatyoueattostoptoxichungeris.Whenourbodiesbecomeacclimatedtonoxiousortoxicagents,itiscalled

addiction.Ifwetrytostoptakingnicotineorcaffeine,wefeelill.Thisiscalledwithdrawal.Whenwestopdoingsomethingharmful toourselves,we feel illbecausethebodyattemptstomobilizecellularwastesandattemptstorepairthedamage caused by the exposure. If we drink three cups of coffee a day, wewould get a withdrawal headache when our caffeine level dipped too low.Whenweconsumemorecaffeineagain,wefeelalittlebetterbecauseitretardsdetoxification, or withdrawal. In other words, the caffeine withdrawalsymptomscancontributetoourdrinkingmorecaffeineproducts.Similarly, toxic hunger is heightened by the consumption of caffeinated

beverages,softdrinks,andprocessedfoods.Toxichungerappearsafteramealis digested and the digestive track is empty, and it can feel extremelyuncomfortable,whichcanmakeusthinkweneedtoeatordrinkacaloricloadforrelief.Theconfusionaboutfood-addictivebehavioriscompoundedbecausewhen

we eat the same heavy or unhealthful foods that are causing the problem tobegin with, we initially feel better. This makes becoming overweightinevitable,becauseifwestopdigestingfood,evenforashorttime,ourbodieswillbegin toexperiencesymptomsofdetoxificationorwithdrawal fromourunhealthfuldiet.Tocounter this,weeatheavymeals, eat toooften, andkeepour digestive track overfed to lessen the discomfort from our stressful dietstyle. Inotherwords,wekeepeating toooftenand toomuch topostponeormitigatethephysicaldiscomfortcausedbyourbaddiet.

Theglucoseabsorbedrightafteramealiscalledpostprandialglucose.Afterthe carbohydrates from the meal are broken down to simple sugars andeventually utilized or stored in the body,most of the glucose not burned isstored as glycogen in the liver and muscle tissues. Glucose is continuallyutilizedtofuelourcellsandespeciallyourbrain.Ourbrainusemakesup80percentofourcaloricneedsintherestingstate.Afterthemeal’scontributionisutilized anddigestion ceases,we start to gradually burn downour candle ofstored glycogen in the liver as our glucose source. This catabolic orbreakdown phase, when stored glycogen is our main source of glucose, iscalledglycolysis.Whenglycogenstoresarebeingburnedforglucose,toxinsarebettermobilizedforremovalandrepairactivitiesareheightened.Spendingtime in glycolysis, while resting the digestive apparatus in this non-feedingstage,isimportantforhealthandalonglife.But Americans, and especially diabetics, become uncomfortable when

beginningglycolysis.Theydon’tfeelrightiftheydelayeatingtoolong.Thisis an important reason why they became diabetic to begin with. They mustovereat to feel okay. Just like a person addicted to tobacco must smokecigarettesjusttofeelokay,theyhavebecomeaddictedtotheirdangerousandtoxicdiethabitsand theycan’t tolerate the symptomaticdetoxificationeventsthatoccurduringglycolysis.Mostoftentheseuncomfortablesymptomsoccursimultaneoustoourblood

sugar decreasing and glycolysis beginning, but they are not caused byhypoglycemia.Whilewefeedoffglycogenstores, rather thanactivelydigestandassimilateglucose,ourbodiescycleintoheighteneddetoxificationactivity—so these sick feelings that accompany glycolysis are a result of tissuesensitivity tomobilizationofwasteproducts,whichoccurswhenmostactivedigestionisfinished.Theyoccurwhenthebloodsugarisatitslowerplateau.Thesesymptomsareobviouslynotmerelycausedbylowbloodsugar,thoughthesymptomsoccurinparallelwithlowerbloodsugar.Gluconeogenesis is the breakdown of muscle tissue to fabricate glucose

after glycogen stores have been depleted.As the liver ’s glycogen stores are

utilizedanddiminish,truehungersignalstheneedforcaloriesbeforemusclebreakdown begins, thus preventing the onset of gluconeogenesis.Gluconeogenesis becomes activated after the glycogen stores have beendepleted, so if fasting is continued too long, the body would utilize muscletissueasaglucosesource.Doesthebodywanttowastemuscletomaintainourglucoselevels?Ofcoursenot.Wegetaclearsignaltoeatbeforethatbegins.Icallthisclearsignaltruehunger.Truehungerisprotectiveofourmusclemassandgivesaclearsignaltoeatbeforethebeginningofgluconeogenesis,astheglycogenstoresarerunninglowandglycolysisiswindingdown.Phytonutrients are required for the body to properly detoxify metabolic

wasteproductsastheyenablecellulardetoxification.Oxidativestressiscausedbyan imbalancebetween theproductionof reactiveoxygenandabiologicalsystem’sability to readilydetoxify thereactive intermediatesoreasily repairtheresultingdamage.Thisoxidativestressfromthebuildupoftoxinsleadstodiseases, including most of the conditions commonly considered thecomplicationsofdiabetes.All forms of lifemaintain a reducing environmentwithin their cells. That

means they are continually removing wastes and removing free radicals.Disturbancesinthisnormalredoxstateoccurfrommicronutrientdeficienciesand can cause toxic effects through the production of peroxides and freeradicals, which damage all components of the cell. When oxidative stressoccurs, certain by-products are left behind and are excreted by the body,mostly in the urine. These by-products are oxidized DNA bases, lipidperoxides,andmalondialdehydefromdamagedlipidsandproteins.Thehigherthelevelsof thesevariousmarkers(whichcanbemeasuredintheurine), thegreater the damage to the cells—marking the advancement of an oxidativestress-induceddisease.Themammaliancircadiansystemisorganizedinthebrain’shypothalamus.

Thissectionof thebrainsynchronizescellularoscillators inmostperipheralbodycells.Theliverglucosesensoractivatesthesepartsofthebraininvolvedin cellular cycles.Fasting-feeding cycles accompanying rest-activity rhythmsare themajor timing cues in the synchronization ofmost peripheral clocks,especiallymetabolicactivityandcellulardetoxification.Detoxificationeffortsof the body vary cyclically and correspond with the rhythm and repetitivetimingof sleepingandeating.Thedeactivationofnoxious foodcomponentsbyhepatic,intestinal,andrenaldetoxificationsystemsisamongthemetabolicprocesses regulated in a cyclic manner. The detoxification output of by-

products is enhanced during cyclic periods corresponding with glycolysis.5Thismeans thatwhenwearenot digesting food, thebody is in an enhancedrepairanddetoxificationcycle.Not only does eating low-nutrient food build up more toxins, creating

inflammation and disease in our cells and organs, but the buildup of thesetoxins also leads to us to feel ill theminute our digestive tract is no longerbusy digesting. So we are almost forced to overeat to prevent withdrawalsymptoms.Assoonasthedigestionoffoodiscomplete,changesinallbodysystems begin to occur. Some patients report symptoms even within a fewhours of not eating a food.Coffee drinkers, for example, are usually on anobligatory ingestion cycle and may get withdrawal headaches and cravingswithinhoursofmissingregularcoffeedoses.It has already been noted that overweight individuals build upmore toxic

waste products and express heightened inflammatory markers and oxidativestress when on a low-nutrient meal compared to normal-weight people.6Becauseofthis,menandwomenpronetoobesityexperiencemorewithdrawalsymptoms, causing overconsumption of calories. It is a vicious cyclepromotingtheproblemandpreventingitsresolution.Peoplewhoeathealthierdietsdonotbuildupinflammatorymarkersnearly

as much as people who don’t.7 The point here is that many people areoverweightbecausetheirbodyisforcingthemtorequiremorecaloriesjusttofeel normal. They don’t feel well when they attempt to eat the amount ofcaloriesbetteralignedwiththeirmetabolicneeds.Acriticalfeaturethatmakesapersonoverweightordiabeticistheenvironmentofexcessiveandtoxicfoodin the modern world. This in turn leads to the chronic oxidative andinflammatorystresscreatedbymodernfoodchoices.Thiscellular“dis-ease”thencreatessymptoms thatsupport itscontinuation, just likeacocaineaddictseekscocaine.Thisiswhydietsalwaysfail.Thesecrettobeatingthisviciouscycle is to focus on micronutrient quality. Only then will the desire forexcessivecaloriescease.Every cell is like a little factory—itmakes products; produces waste; and

thenmustcompact,detoxify,andremovethewaste.Ifweletwastemetabolitesbuild up through the consumption of processed grains, oils, and animalproductsand insufficientconsumptionofvegetation, thebodywillattempt tomobilizethesewastes(creatingdiscomfort)whenitcan.Butitonlycandothateffectively if it’snotactivelydigesting food.Eatingalleviates thediscomfortbecauseithaltsordelaysthedetoxificationprocess.

What I have observed and quantified with not merely hundreds but withthousandsofindividualsisthatthedrivetooverconsumecaloriesisbluntedbyhigh-micronutrient, high-antioxidant food consumption. The symptoms thatpeople thought were hypoglycemia or even hunger simply disappear aftereatinghealthfullyforafewmonths.Afteratwo-tofour-monthwindow,whenmicronutrients in the body’s tissues are enhanced, people not only losesymptoms of fatigue, headaches, irritability, and stomach cramping, but theyalsogetbackin touchwith truehungerfelt in the throat.Thissensation, theyreport, makes eating more pleasurable and better directs them to anappropriateamountofcaloriesfortheirbody’sbiologicalneeds.Mydiscoverydocumentingthechangingperceptionofhunger,resultingina

lowercaloricdriveinmorethansevenhundredpeopleeatingahigh-nutrientdiet,waspublished inNutritionJournal inNovember2010.8Of interestwasthathungerbecameasensationintheupperchestandthroatfor90percentofthosecompliantwiththedietaryrecommendationsandalsothatittookthreetosixmonthsformostoftheparticipantstoexperiencethischangeinhungerandthelesseningofhungersymptoms.Threetosixmonthscorrespondswiththetime frame it takes to achieve adequate tissue levels of phytochemicals afterdietaryexcellenceisbegun.Thestudy’sconclusionwas:Our findings suggest that it is not simply the caloric content, but moreimportantly, the micronutrient density of a diet that influences theexperienceofhunger.Itappearsthatahighnutrient-densitydiet,afteraninitial phase of adjustment during which a person experiences “toxichunger” due towithdrawal from pro-inflammatory foods, can result in asustainableeatingpatternthatleadstoweightlossandimprovedhealth.Ahighnutrient-densitydietprovidesbenefitsforlong-termhealthaswellasweightloss.True hunger signals when our bodies need calories to maintain our lean

bodymass.Whenweeatfooddemandedbytruehungerandtruehungeronly,we do not become overweight to beginwith. However, in our present toxicfoodenvironment,wehavelosttheabilitytoconnectwiththebodysignalsthattellushowmuchfoodweactuallyneed.Wehavebecomeslavestowithdrawalsymptoms and eat all day long, even when there is no biological need forcalories.Thebodyhasacompoundedsensationofhungerandcravings that,formost,issimplyoverwhelming.Asaresult,peopleareeitherunabletolose

weightorareunabletokeepitoff.Inanenvironmentofhealthyfoodchoices,wewouldnotfeelanysymptoms

after amealuntil ourbodies actually requiremorenourishment.Ourbodieshavethebeautifullyorchestratedabilitytogiveustheprecisesignalsthat tellus exactlyhowmuch to eat tomaintain an idealweight for long-termhealthandwell-being.Thousandsofpeoplehavelearnedthisandhavedemonstratedthat this phenomenon is real. After learning and applying this information,manyhavelostoverahundredpounds,somemorethanthreehundredpounds,withoutsurgicalinterventionandhavekepttheweightoff.Inaportion-controlled(calorie-counting)diet,itislikelythatthebodywill

not consume adequate fiber or nutrients. The bodywill have a compoundedsensation of hunger and craving that, for most, is impossible to control.Invariably,itresultsinfailuretoloseweightorthecycleoflosingweightandeventuallygaining itback.Caloriecountingsimplydoesn’twork in the longrun.Dietsbasedonportioncontrolandcaloriecountinggenerallypermittheeating of highly toxic, low-nutrient foods and then require us to fight ouraddictivedrivesandattempt toeat less.Thiscombinationundernourishes thebody, resulting in uncontrollable and frequent food cravings. Without anadequateeducationinnutritionandsolidprinciplestostickto,peopleonthesedietsareforcedtoflounderandfail,bouncingfromonediettoanother,alwayslosingalittleandregainingit.Theyfrequentlyregainmorethantheylost.Life is prolongedby eating lesswhilemaintaining a high-nutrient cellular

environment.However, trying to eat fewer calories is ineffective and almostfutile. The secret is to desire fewer calories. The high consumption of low-calorie,high-nutrientfoodssuchasrawvegetables,cookedgreens,beans,andseedspreparedindeliciouscombinationsmakesyoufeelphysicallyfullfromallthefiberandsatisfiedfromallthechewing.Youlosetheaddictivecravings,andthenyousimplyandnaturallydesirelessfood.Itmakesitquitesimpletoloselotsofweight.Thecoreelementstothisrevolutionarydietare:

•Micronutrient-per-caloriedensityisimportantindevisingandrecommendingmenuplansanddietarysuggestionsforthemosteffectiveapproachforbothweightlossandforpreventingandreversingdiabetesandheartdisease.•Low-nutrienteating(andtoxiceating)leadstoincreasingcellulartoxicitywithundesirablelevelsoffreeradicalsandAGEs.Thistoxicitycausesaddictivewithdrawalsymptoms(toxichunger),whichresultinmorefrequent

eatingandovereating.•Dietarymicronutrientquality(H=N/C)mustbeincreasedaccordinglytoutilizedietaryrecommendationstherapeuticallyfordiseasereversalortoprotecthigh-riskindividuals.Thisisnotadietinthesenseofsomethingyoudotoloseweight.Thisisa

newdietstyleforlife—adietstylethateveryAmericanhastherighttoknowabout,soweallhave thechoice toprotectourprecioushealth. It ishealthfuleating. It is effective for long-term weight control because it modifies anddiminishesthesensationsofso-calledhunger,enablingoverweightindividualstobemorecomfortableeatingfewercalories.Makethechangeforlife.

CHAPTERFIVE

High-Protein,Low-CarbCounterattack

Jessicawasaforty-eight-year-oldmotheroftwoteenagers,whooriginallyweighed193pounds.ShewaswhatIcallavegejunkarian,eatinghighlyprocessedvegetarianfoodsandfewfreshfruitsorvegetables.Lookingbackonherhealthatthattime,Jessicasaid,“Myhealthwasinthetoilet!Ihadachesandpainsallover,includingchestpains,severediabetic[frozen]shoulderthatcausedmyarmtobenearlyimmobile,andhorriblegastroesophagealrefluxdisease.Inappedthreetimesaday.Ialsohadahostofskinconditions,rosacea,andtendonitisinmylefthand.Ihadchronicinsomniaandhadtogetuptwoorthreetimesanighttogotothebathroom.Myvisionwasreallyblurryfromtheout-of-controlsugars.Ihadneuropathyintwotoesinmyrightfoot,andIwaslosingalotofhair.Iwasawalkingtimebomb!”Jessica’sfastingbloodglucoselevelwas282,herHbA1Cwas12.2,andherbloodpressurewas150/110.Shewasonnomedicationsbecauseshewasincompletedenialandwouldn’tgotothedoctor.Aftersearchingforananswerandfindingmyprogramonline,Jessicabecameamemberofmyonlinesupportcenterandbeganfollowingahealthy,nutritariandiet.Sixmonthslater,shereportedherweightdroppedto151pounds.Herfastingbloodglucoselevelisnow96,herHbA1Cis5.4,andherbloodpressureis110/70.Theonlymedicationshetakesis100microgramsoflevothyroxineperdayforherlowthyroidfunction.Shenowdescribesherhealthas“somuchbetter!Nomoreachesorpains.Nomoregastroesophagealreflux.Myfrozenshoulderis98percenthealed.Myvisionismuchbetter,andmypainfulneuropathyiscompletelygone(thattookthreemonths).Irarelyhaveinterruptedsleepanymore,andIneverhavetogetupatnighttopee.Mytendonitis

seemstobegone,myhairisfuller,myeyesarebrighter,andmyskinisclear.Iamanewwomen,andithasonlybeensixmonths.”Jessicawasdelightedtoobservethereactionsofpeoplesheworkswith.“IwenttomyofficelastFriday—Ihadn’tbeenthereinsixmonths,asIworkfromhome.Severalpeopleabsolutelydidnotrecognizeme.Ispentthewholedayexplainingthisprogram,andI’msureIsoldafewbooks...thatday.”

Diabetics mostly die of heart attacks. A meat-based diet promotesatherosclerosis, increases the risk of blood clots, and accelerates kidneyfailure indiabetics.Adiethighinanimalproductsandlowinvegetablesandbeansistheformulaforamedicaldisaster.Diabeticsneedtheopposite:adiethighinvegetablesandbeansandlowinanimalproducts.Some people have bought into the faulty logic that if sugar and refined

grainsandotherhigh-glycemicfoodsraisebloodsugarandtriglycerides,thenwe should eat more animal products instead of these refined carbohydrates.Unquestionably,sugar,whiteflour,andotherprocessedgrainsareunfavorableandmustberemovedtoachievegoodhealth,buttoincreaseanimalproductsatthe expense of vegetables, beans, nuts and seeds, and other low-glycemic,nutrient-rich plant foods (which are protein adequate) is not only dangerousbut also reduces the potential for the diabetic to recover and get off allmedications.Carbohydrate-restrictive diets that are rich in animal products can offer

some short-term improvement in glucose control and can potentially aidweight loss in some people, but because those diets are too rich in animalproducts (which do not contain phytochemicals or antioxidants), they incurother significant risks such as cancer, heart disease, and kidney disease.Themainproblemswithrecommendingadietwithasignificantamountofanimalproducts for diabetics are that the increased protein intake promotes theprogression of diabetic kidney disease, and the animal-source protein andsaturatedfatintakeraisecholesterolandpromoteheartdisease.Eventhoughaprotein-densedietmightoffer somemarginalweight lossbenefits comparedto a diet with lots of processed carbohydrates, it still does not allow thesubstantiveweightreductionthatdiabeticsreallyneedtoridthemselvesofthedisease.Emerging evidence also suggests that carbohydrate-restrictive, also called

ketogenic, diets “create metabolic derangement conducive to cardiac

conductionabnormalitiesand/ormyocardialdysfunction.”1 Inotherwords, itmay cause other potentially life-threatening heart problems. Ketogenic dietsare the most dangerous; medical literature has shown them to causecardiomyopathy,apathologicalenlargementoftheheartthatisreversiblebutonlyifthedietisstoppedintime.2Evenfollowingaketogenicdietshortterm,suchaswiththeinductionphaseoftheAtkinsorDukandiets,isdangerous,anddeaths have occurred from cardiac arrhythmias induced from the electrolytederangement.3Notonlyaredietsveryhighinanimalproductsdangerousintheshort-term,

theyaremoredangerouswhenfollowed long term.Animalproductsneed tobe restricted for disease reversal to occur predictably. Diabetics havesignificantlybetterchancesat reversing theirdiseasewhen theyavoidexcessanimal protein. Scientific studies have demonstrated that a high intake ofanimal products creates an excess of branched-chain amino acids, whichfurtherinhibitinsulinfunctionandworsendiabetescontrol.4Thisworseningofdiabetesfromincreasedanimalproductconsumptionwas

borneoutinarecentstudyinwhichresearchersanalyzedthedietsof38,094participants from the European Prospective Investigation into Cancer andNutrition study. Researchers found that for every 5 percent of caloriesconsumed from animal protein, the risk of diabetes increased 30 percent.5Increased animal protein intake also coincided with increased body massindex, waist circumference, and blood pressure. Vegetable protein was notassociatedwith increaseddiabetesrisk.Quiteafewotherstudiescorroboratethat diets that contain meat enable or worsen diabetes. Of note is the mostrecentAdventistHealthStudy-2, involvingmorethansixtythousandmenandwomen,whichisrevealingbecausewhenthoseeatingonlyasmallamountofanimal productswere comparedwith those eating none, those following thevegan dietwere found to have a diabetes prevalence thatwas approximatelyone-thirdthatofthenonvegetarians(2.9percentversus7.7percent).Thelacto-ovo vegetarians, pesco-vegetarians, and semi-vegetarians had intermediatediabetes prevalence rates of 3.2 percent, 4.8 percent, and 6.1 percent,respectively.6 Obviously, the best way to reverse diabetes is to avoid dietscenteredonprocessedandhigh-glycemiccarbohydratesandanimalprotein.Tip:Eatmorefoodsrichinvegetableproteinandlessorno

foodswithanimalprotein.

Ihaveseenmanydiabeticpatientsonphysician-recommendedhigh-proteindietsdevelopkidneyorheart problems.Numerouspeoplehave suffered anddiedneedlesslybecauseofmisinformation.Iconsiderthisadvicemalpractice.This issue still exists. Many doctors are still advocating this diet style fordiabetics. Advocates for high-animal-protein diets flood bookstores and theInternetbecausepeoplewanttoheartheycaneatalltheserichfoodsthattheydesire.Peoplebuyintothehypeandoftendon’tunderstandthedangersuntilitis too late. Some enthusiastically jump on a bandwagon of pseudoscientificclaims that support the continuation of their preferred food habits and foodaddictions.These enthusiastswouldhaveyoubrainwashedwith saturated fat.Toundo

thedamage, let’s review somemoreof the evidence.AMay2004Annals ofInternal Medicine study showed that a third of Atkins dieters suffered asignificantincreaseinLDLcholesterolandvirtuallynoneofthemachievedafavorable LDL below 100. My nutritarian diet invariably drops cholesterolradicallyandistheonlydietstyletestedinthemedicalliteraturetodropLDLcholesterolasmuchormore thancholesterol-loweringdrugs,as reported inthe medical journal Metabolism.7 The goal is to have nonmedicated LDLcholesterolbelow100,andthatwillalmostneveroccurwithameat-baseddiet.Alandmarkstudypublishedin2000actuallymeasuredwhatwashappening

to the arteries of people on low-carb, high-protein diets. Utilizing SPECTscans to directly measure blood flow within coronary arteries, thedevelopmentofheartdiseasewasexaminedinsixteenpeopleonavegetariandiet that was high in fruits and vegetables and in ten people on a low-carb,high-animal-protein diet. The results were shocking. Those sticking to thewholefoodsvegetariandietshowedareversalinexpectedheartdisease.Theirpartially clogged arteries literally got cleaned out, and blood flow to theirheart through their coronary arteries increased by 40 percent. Those on thehigh-proteindietexhibitedrapidadvancementoftheirheartdiseasewitha40percent decrease in blood flow in the heart’s blood vessels.8 Thus, the onlystudyonthehigh-proteindiettoactuallymeasurearterialbloodflowshowedthatthisstyleofeatingisexceedinglydangerous.The main problem with low-carbohydrate, high-protein diets is that the

intake of the high-nutrient plant foods that contain protective fiber,antioxidants, and phytochemicals, is lowered while calorie-dense andnutritionallypooranimalproductsisraised.Bothofthesefactorsareknowntodiminishcardiovascularhealthandincreasetheriskofstrokeandheartattack.

ThiswasfurtherdocumentedinalargestudypublishedintheBritishMedicalJournal. To conduct the study, researchers examined nearly forty-fourthousandSwedishwomenaged thirty to forty-nineyears and followedupanaverage of fifteen years later. During the fifteen-year study period, 1,270cardiovascular events took place in the 43,396women (55 percent ischemicheart disease, 23 percent ischemic stroke, 6 percent hemorrhagic stroke, 10percent subarachnoidhemorrhage, and6percent peripheral arterial disease).Researchersfoundthatcardiovasculardiseaseincidencemorethandoubledinthelow-carb,high-proteinfollowers.9Fortunately,theAtkinsdiethaslostitslusterasaresultofstudieslikethese,

andmoredoctorsareinformingtheirpatientsaboutitsdangers.Unfortunately,other diets with similar strategies but different names, such as the paleo orDukandiets,keeppoppingupand luring individuals into thesamedisprovenand dangerous eating patterns. Many people are lured into these dangerousdietsbecausetheyclingtoanyargumentthatcondonestheirfoodpreferences.Diabetics can’t afford to make such mistakes, because these mistakes ofjudgmentcouldresult indramatically increasedsufferingandacurtailed lifespan.Thepaleodietusesadistortedviewofancienthistorytoarguethatadietof 50 to 80 percent animal products is the most life span enhancing. (ThisrecommendationisdoubletotripletheaverageanimalproductconsumptioninAmericatoday.)Earlyhumansatemanydifferenttypesofdietsinvariouspartsoftheworld,butwhattheyatehereorthereisnoteventherelevantquestion.Itishowlongtheylived,andhowlongpresenthumanswilllive(ingoodhealth)with various diet styles that ismore relevant. The answer to this question isclearasthepreponderanceofevidenceisoverwhelmingtoday.If the increased risks of heart attack and cancer aren’t enough of an

argument, a large study tracking kidney damage showed that a high-proteindietaccelerateskidneydamageinpeoplewithevenverymildcompromisetotheirkidneys.10Almost25percentofpeopleoverforty-five,especiallythosewithdiabetesorhighbloodpressure,havesomedegreeofkidneyimpairment.Although the study did not proceed long enough to detect kidneydamage inthosewithperfectlyhealthykidneys,it’simportanttonotethatkidneydamageis often not detectable at lower levels of damage. Higher levels of damagemakeiteasytodiagnose,butbythenitcouldbetoolatetoreverse,especiallyin diabetics. In fact, Dr. Knight, the lead researcher in this study concluded,“Thepotentialimpactofproteinconsumptiononrenalfunctionhasimportantpublichealthimplicationsgiventheprevalenceofhigh-proteindietsanduseof

proteinsupplements.”Itisalsowellestablishedthatlotsofmeatequalslotsofgoutandkidneystones.11In a press release titled “American Kidney Fund Warns About Impact of

High-ProteinDietsonKidneyHealth,”AKFChairofMedicalAffairsPaulW.Crawford,M.D., said, “Wehave long suspected thathigh-proteinweight lossdietscouldhaveanegativeimpactonthekidneys,andnowwehaveresearchtosupport our suspicions.” Dr. Crawford is worried that the strain put on thekidneys could result in irreversible “scarring in the kidneys.” Dr. Crawfordalsodiscussedtheriskthatbodybuilderstakeineatinghigh-proteindietswhilebuildingmuscle.Henoted,“Bodybuilderscouldbepredisposingthemselvestochronickidneydiseasebecausehyperfiltration(thestrainonthekidneys)canproducescarringinthekidneys,reducingkidneyfunction.”Dr.Crawfordconcluded,“Chronickidneydiseaseisnottobetakenlightly,

andthereisnocureforkidneyfailure.Theonlytreatmentsarekidneydialysisandkidney transplantation.This research shows that even in healthy athletes,kidneyfunctionwasimpactedandthatoughttosendamessagetoanyonewhoisonahigh-proteinweightlossdiet.”12There is a vast amount of scientific literature supporting what constitutes

excellentnutrition. Ihavereviewedover twenty thousandstudies that indicatethatwhatweputinourmouthdoesmatterandthatwecanpreventdiseasewithahigh-nutrientdiet.Itisimportantthatweallknowthatwecannolongerdenythedangersfromadietstylerichinmeatandotheranimalproducts.Humans are primates, and all primates eat a diet of predominantly natural

vegetation. If they eat animal products, it is a very small percentageof theirtotal caloric intake. Luckily, we have modern science that shows that mostcommonailmentsintoday’sworldaretheresultofwrongnutritionalchoicesarisingfrommisguidednutritionalinformation.Nowourknowledgebasehastakenagiantleapforwardandwecaneatadietrichinphytochemicalsfromavariety of natural plant foods that can afford us the ability to live a long,healthylife,whichwasnoteasilyobtainedbyourancestors.With millions of high-protein, low-carb enthusiasts around the world

graspingatstraws to justifyeatingadiet rich inanimalproducts, Ihope thisinformationservestocounterhealthclaimsbythesepeopleandperhapssavesa few livesor reduces suffering.Keep inmind that there isa similarityherebetween my recommendations and those of the high-protein, low-carbadvocates:thelow-nutrient,high-glycemicjunkthatmostAmericansconsumeisdangerous.However,withthenutritariandiet,thelow-GIbenefitthatahigh-

protein diet offers is still achieved butwith an emphasis on very high-fibervegetables, beans, and nuts, which avoid the disadvantages that come fromeatingtoomanyanimalproducts.Becausethenutritionalqualityof theentiredietissohigh,withsomuchfiberandsomanymicronutrientspercalorie,theGIofthewholedietisfavorableoverall,andtriglyceridesandbloodsugarfalldramatically.ThemainpointherethatIcannotoveremphasizeisthebenefitofnutritional

excellence. In describing the bad science utilized to promote low-carb diets,let’salwaysframeitwithwhatahealthydietshouldlooklike.Whenyoueatatrulyhealth-supportingdiet,youcanexpectnotonlyadropinbloodpressure,adecreaseincholesterol,andareversalofheartdisease,butalsoaresolutionof headaches, constipation, indigestion, and bad breath. Dietary excellenceenables people to reverse diabetes and gradually lose dependence on drugs.You should not only achieve a normalweightwithout counting calories anddieting,butyoucanalsogainrobusthealthandlivealonglifefreeofthefearofheartattacksandstrokes.Understanding the differences in various dietary choices is critical for the

health seeker. Longevity and disease prevention are the ultimate goals ofdietary changes. Obviously, weight loss is not the only goal. You can loseweightbysmokingcigarettesorsnortingcocaine.Whenyousettleforsecond-classnutritionaladvice,youdoomyourselfnotonlytoashorterlifebutalsotoapoorqualityoflife,sufferingfrommedicalproblemsthatcouldhavebeenavoided.Not amonth goes by that I do not see at least one diabetic patient whose

healthhasbeendamagedby followingahigh-protein faddiet. It’s sad to tellpeoplelikethisthatthediettheychosehascausedpermanentdamage,suchasaheartattackorkidneydisease.But I am able to offer them good news too. Because I am a specialist in

nutritional medicine and see many overweight diabetic patients every day, Ihavetheexperiencetoassurepatientsthattheycanquicklygetofftheirinsulinandotherdrugsand, inmostcases,becomecompletelynondiabeticwith thisprogramofdietaryexcellence.Theydothiswithoutincurringtheriskofadietburdened with a dangerously high amount of animal products. Not only isdietaryexcellencesafeandoverallhealthpromoting,buttheamountofweightlossachievedandthereversalofdiabetesaredramatic—resultsthatcouldnotbeenachievedwithahigh-proteindiet.

HowMuchandWhatTypeofAnimalProductsArePermitted?Nutritionalexcellencedoesnothavetoexcludeallanimalproducts.Butithastobeveryrichinhigh-nutrientplantfoodscomposingwellover85percentofcaloric intake.Theminimalamountofanimalproducts inyourdiet thatmaystill permit optimal health is not a fixed or determined number, so it can beadjustedforindividualdifferencesorneedswithintheguidelinesofferedhere.However, ifyouhavehaddiabetesa long timeorhaveheartdiseaseorhighbloodpressureandaresignificantlyoverweight,you’llachievebetter resultswithfeweranimalproducts,notmore.Mostpeopledofinewithtwoorthreesmall servings of animal products a week, but for some, even this smallamountofanimalproteincancausetheircholesteroltogointotheunfavorablerange. In this book, because I am designing the optimal diet for reversingdiabetes, I recommendamaximumofonlyoneor two(two- to three-ounce)servings of animal products a week. Of course, I emphasize that if you useanimalproductsonaregularbasis,theservingsizeshouldbesmall,suchasacondiment to flavor a vegetable dish, stew, soup, or salad, not as a caloriccontributortothemeal.Irecommendoneortwoservingsoffishperweek—such as salmon, sardines, squid, flounder, scrod, or trout—or one or twoservingsoffishplusonesmallservingofwhitemeatfowl, totalinglessthansixouncesperweek.Nootheranimalproductsarerecommended.More than two servings of fish perweek are associatedwith significantly

higherincidenceoftype2diabetes.13Followingalmosttwohundredthousandindividuals for fourteen to eighteen years, researchers found that the risk ofdeveloping diabetes rose as fish consumption increased, resulting in a 22percent increased incidence of diabeteswhen participants ate fishmore thanfive times a week compared to those who ate fish less than once a month.Researchersareunsureexactlywhymorefishinthedietworsenstheriskfordiabetes,butwhether it’saneffectof thefishfat, theconcentratedprotein,orthetoxinslikedioxinormercuryfoundinfish,itisclearthatafish-heavydietisnotappropriatefordiabeticsorpeopleatriskofdevelopingdiabetes.Iwanttomakeitclearthatthereisnosignificantbenefitfromusingfishinyourdietat all. The healthful omega-3 fats can be ingested via a supplement (even aveganDHA/EPAsupplement).Theallowanceforthissmallamountofanimalproductisdiscussedhereassomepeopleareinsistentonnotgoingallthewaytoavegandiet.Redmeatsaretobeavoidedcompletely.Studiesondiabeticsandmeateating

indicatea50percenthigherincidenceofheartdiseaseinpeoplewithhighredmeatintake.14Researchersbelieve this isnotassociatedwith thehigher levelof saturated fat in red meat but instead with the heme iron it contains. It isincreased consumption of both processed foods and animal products that islinked to increased mortality, diabetes, and heart problems.15 Large-scalestudiesofthemetabolicsyndromehavelinkedtheincidenceofhighglucose,abdominalfat,hightriglycerides,andhighbloodpressureinWesternsocietieswith red meat, processed meat, fried food, refined grains, and diet soda.16When multiple dangerous foods are consumed, it creates a deadlycombination. Themetabolic syndrome is a cluster of cardiovascular diseaserisk factors associatedwith increased risk of diabetes andmortality. Studiesinvariably show that the most protection, prevention, and reversal of, andlower risk of, heart disease occurswhen the diet style is high in vegetables,beans,fruits,andnutsandisverylowinanimalproducts.17Wehavetodramaticallyreducebothprocessedfoodsandanimalproductsif

wehaveasignificantmedicalissueandexpectthebodytorecover.Toooftendietproponentswanttomakejustoneortheotherthevillain.Oneofthemostinteresting studies emerging this year was the negative effect of eggs ondiabetes.Researchersfoundthatpeopleconsumingseveneggsaweekhada58percenthigherriskofdevelopingdiabetes thanthosewhodidnoteateggs.18Furthermore,egganddairyintakearealsolinkedtoheightenedriskofheartfailure, up to a significant 23 percent higher risk.19 Neither eggs nor thefrequent intake of dairy are appropriate for diabetics. They worsen glucosecontrolandincreaseheartdiseaserisk,whichisdangerousfordiabetics,whoalreadyhaveheightenedheartdiseaserisk.Again, thepreferredanimalproductsaresmallamountsoffishjustoncea

week,orfishonceaweekandwhitemeatfowlonceaweek,keepingthetotalunder six ounces per week. That’s it, because this is too important to letanythingslowyourprogressandincreaseanydiseaserisks.

ReviewingtheFactsAboutEggsandDiabetes1.TheNurses’HealthStudy,HealthProfessionalsFollow-upStudy,andPhysicians’HealthStudyreportedthatdiabeticswhoeatmorethanoneeggadaydoubletheircardiovasculardiseaseordeathriskcomparedtodiabeticswhoatelessthanoneeggperweek.20

2.AGreekstudyofdiabeticsreportedafive-foldincreaseincardiovascular

deathriskinthoseeatingoneeggadayormore.213.Arecentstudyevaluatingatheroscleroticplaqueinthecarotidarteriesfoundthatsubjectseatingmorethanthreeeggsaweek(comparedtolessthantwoeggsaweek)hadsignificantlymorecarotidplaquearea—evenafterstatisticalcontrolsformultiplepotentiallyconfoundingfactors,includingserumcholesterol.Thedatarelatedthatsomeonewhohadeatenfiveeggsaweekforfortyyearswouldhavetwo-thirdstheamountofplaqueassomeonewhosmokedonepackofcigarettesadayforfortyyears,otherfactorsbeingequal.Thisindicatesthateggsmayincreaseatheroscleroticplaquedevelopmentinwaysunrelatedtoelevatingbloodcholesterol.22

4.Eatingfiveeggsaweekormoreisalsoassociatedwithanincreasedriskofdevelopingtype2diabetes,nottomentionprostatecancer.23The inevitable conclusion of all the data is that eggs aremore harmful to

cardiovascular health than earlier studies suggested. They are particularlyunsafeforpopulationsatriskofdiabetesandcardiovasculardisease.

GetProteinfromYourVegetablesMost ofmy patients tellme that the typical question their friends or familymembershaveaboutthisplant-baseddietishowyougetenoughproteinwithsofewanimalproducts.Manypeoplearestilltiedtothemyththatadietneedsanimalproductstobenutritionallysound.Toaddtotheconfusion,dietbooksandmagazinearticlespromulgatethemyththatmoreproteinisfavorableforweightlossandcarbohydratesareunfavorable.If you are overweight, you have consumed more calories than you have

utilized.Micromanaging thepercentof fat,protein,orcarbohydratesyoueatisn’tgoingtochangetheamountofcaloriesmuch.Youneedtoconsumelesscalories. Therefore, almost all overweight individuals need to consume lessprotein, less fat, and fewer carbohydrates—the sources of calories. Don’tworryaboutnotconsumingenough.Withtheexceptionofanorexics,itisveryraretofindanAmericandeficientinfat,protein,orcarbohydrates.Inhabitants of modern Western societies generally consume more

macronutrients, especially protein, than needed. Protein is ubiquitous; it iscontained in all foods, not only animal products. It is almost impossible toconsume too little protein, no matter what you eat, unless the diet issignificantlydeficientincaloriesandothernutrientsaswell.Proteindeficiency

isnotaconcernforanyoneinthedevelopedworld.Americansalreadygettoomuchprotein,andithurtsus.Whenyoueatadietrichingreenvegetablesandbeans,youareactuallyonadietfairlyhighinproteinbecausetheyareprotein-richfoods.Andofcoursewhenyourdietismostlyplantprotein,yougetyourprotein packagedwith protective fibers, antioxidants, and phytochemicals—ahorseofadifferentcolor.Butshouldwecarryaroundlittlepocketcalculatorsandtrackeverythingwe

eat tomake surewe don’t accumulatemore than 10 percent of our caloriesfrom fat? Do we have to watch what we eat to make sure we get enoughprotein?The reality is that theprecise ratio of thesenutrients doesn’tmattermuch.Whatmattersisthatyouarenotdeficientinanyneededmacronutrient,thatyouarenotconsumingexcesscaloriesorexcessofanythingelsethatmaybeharmful,andmostimportantly,thatyoumeetallyourmicronutrientneedswithoutoverconsumingcalories.Simplyput,thegoalofahealthydietistogetthe most micronutrients, both in amount and diversity, from the fewestcalories.Andfewercaloriesmeanslessproteintoo.Therealconcernshouldbegettingtoomuchprotein,nottoolittle.The focus on the importance of protein in the diet is one of the major

reasonstheAmericanpublichasbeenleddownthepathtodietarysuicide.Wehave equated protein with good nutrition and tend to believe that animalproducts,notvegetablesandbeans,are themost favorablesourceofprotein.We bought a false bill of goods, and the dairy- and meat-heavy diet hasbroughtforthanepidemicofheartattacksandcancers.When we hear something over and over, starting when we’re young

children, we accept it as true. For example, themyth that plant proteins are“incomplete”andneedtobe“complemented”foradequateproteinisrepeatedover and over.24 All vegetables and grains contain all eight of the essentialamino acids (as well as the twelve other nonessential ones), although somevegetables have higher or lower proportions of certain amino acids thanothers. When eaten in an amount to satisfy our caloric needs, however, asufficientamountofallessentialaminoacidsareprovided.Becausedigestivesecretions and sloughed-off mucosal cells are constantly recycled andreabsorbed, theaminoacidcompositioninpostprandial(after-meal)bloodisremarkablycompleteinspiteofshort-termirregularitiesinthedietarysupplyofaminoacids.InNorthAmerica about 70 percent of dietary protein comes from animal

foods.Worldwide, plants provide 84 percent of calories. It wasn’t until the

1950s that human protein requirement studies were even conducted. Thesestudiesdemonstrated thatadults require20 to35gramsofproteinperday.25Today,theaverageAmericanconsumes100to120gramsofproteinperday,mostly in the form of animal products—much more than necessary. Peoplewhoeatavegetable-baseddiethavebeenfoundtoconsume60to80gramsofproteinaday,stillwellabovetheminimumrequirement.26

AdvantagesofGoingVeganorVeryClosetoVeganEventhougheatinganoccasionalsmallamountofanimalproductasflavoringoracondimentwon’tlikelyhaveamajoreffectonyourdiabetescontrol,thereareotherbeneficialreasonstogoingall,oralmostall,thewaytoavegandiet.Themainreasonisthat,formanypeoplewithdiabetes,evenarelativelylowamountofanimalproteininthedietcouldraiseahormonecalledinsulin-likegrowthfactor1(IGF-1).ThisisthemainreasonIamrestrictingintaketoonlysixouncesperweek.IGF-1 is one of the body’s important growth promoters in thewomb and

during childhood growth, but it also has anabolic (body-building) effects inadulthood.It isahormonewithasimilarstructure to insulin.TheproductionofIGF-1primarilytakesplaceintheliver,anditsproductionisstimulatedbypituitary-derivedgrowthhormone.IGF-1signalingiscrucialforgrowthanddevelopmentinchildhood,butitpromotestheagingprocesslaterinlife.ReducedIGF-1signalingisassociatedwithenhancedlife

span.27

There is a tremendous amount of evidence regarding the life-span-enhancing effect of lower levels of IGF-1, especially in adulthood.Centenarians are known to be exceptionally insulin sensitive, which mayprotectagainsttheinsulin-resistance-associated,age-relatedincreaseinbloodglucose levels. Lower levels of IGF-1 are associated with enhanced insulinsensitivityandenhancedlifespan.28Thisiscriticallyimportantforpeoplewithdiabetesoratendencytodevelopdiabetes,ashigherlevelsofIGF-1promoteboth diabetes and cardiovascular death from diabetes. The higher thebiological value of the protein consumed, and themore of it consumed, themore IGF-1produced.So the regular consumptionofanimalproducts is themost significant factor promoting IGF-1.Muscle tissue can produce its own

IGF-1inresponsetoresistanceexercise,butthisdoesnotraisesystemicIGF-1unlessadietrichinanimalproteinisconsumed.29

IGF-1andCancerThelargestconcernaboutelevatedIGF-1fromourmoderndiet is its linktocancer. Elevated hormone levels caused by the Western diet are thought tocontribute to the high rates of cancer in the modern world—not just sexhormones, such as estrogen and testosterone, but insulin and IGF-1 as well.TheconnectionbetweenincreasedIGF-1signalingandcancerhasbeenknownformanyyears—infact,cancerdrugstargetingtheIGF-1pathwaybegantobedevelopedinthelate1990s,andoverseventyclinicaltrialshavebegunsincethen,manywith encouraging results.30 Because IGF-1 signaling plays a keyrole in tumor growth, reducing IGF-1 levels by dietary methods is nowconsidered bymost scientists studying this subject to be an effective cancer-prevention measure. IGF-1 signaling is involved in a number of processesrelevant to tumor growth: proliferation, adhesion, migration, invasion,angiogenesis, and metastatic growth. A diet rich in antioxidants andphytochemicals results in reduced inflammation, oxidative stress, and IGF-1,whicharecriticaltoprotectingagainstcancerandmaximizinglongevity.31

ProteinIntakePromotesIGF-1The composition of protein and the amount consumed also modify IGF-1levels. Protein that is rich in the full array of essential amino acids causeslargerincreasesinIGF-1comparedtoproteinnotasbiologicallycomplete.38Plant sourcesofproteinare less concentrated.They supplyadequateprotein,but not excessive amounts like animal products do, and the body needs tocombinetheaminoacidsforbiologicalcompleteness,sotheydonotpromoteasurgeinIGF-1likeanimalproteinsdo.Forexample,milkanddairyproductscontribute to this excessive IGF-1 in circulation. In ameta-analysis of eightrandomized controlled trials, circulating IGF-1 was found to be higher inmilk-consuminggroupscomparedtocontrolgroups.39

HIGH-CIRCULATINGIGF-1LEVELSHAVEBEENLINKEDTOSEVERALCANCERS

BreastCancerThe European Prospective Investigation into Cancer and Nutrition studyfoundthatelevatedIGF-1levelswereassociatedwitha40percentincreasedrisk for women over the age of fifty.32 In the Nurses’ Health Study, highIGF-1 levels were associated with a doubled risk of breast cancer inpremenopausalwomen.33 Additional human studies, reviews of literature,and meta-analyses have also associated elevated IGF-1 levels with breastcancer.34

ColorectalCancerElevated IGF-1 levels are associated with colorectal cancer, and IGF-1promotesthespreadofcolorectalcancercells.35

ProstatecancerA2009meta-analysisof42studiesconcludedthatelevatedcirculatingIGF-1isassociatedwithincreasedriskofprostatecancer.36

OtherCancers37

GynecologicalcancersMultiplemyelomaSarcomasRenalcarcinoma

TheCalorieRestriction Society is a collection of individualswho believethat consuming fewer calorieswill lead to a longer life.A six-year studyofmembers of this group found that their IGF-1 levels were not significantlydifferentfromcontrolgroupsonastandardWesterndiet(ofcourse,bodyfat,fastinginsulin,andinflammationmarkersweremarkedlylowerinthecalorie-restricted group). The Calorie Restriction Society group members wereconsuminganaverageof108gramsofproteinperday,farmoreproteinthannecessary.This ledtheresearchers to thencompareIGF-1levels inmembersof the Calorie Restriction Society to vegans who had been consuming a

moderatelyprotein-restricteddiet,averaging50gramsofproteinperdayforatleastfiveyears.(One3.5-to4-ounceservingofchickensupplies100gramsof protein.) The calorie intake was greater in the vegan group, but proteinintake was lower and IGF-1 levels were indeed much lower.40 This studycautions thatoverconsumptionofprotein,evenwhenrestrictingcalories,cankeep IGF-1 levels elevated—to a point similar to those of typical Westerneaters, who overconsume calories overall, blunting the potential of alongevity-inducing diet style. For example, many people eat egg whitesbelievingthatbecausetheyarealmostpureproteinandhavenofat,theymustbehealthy. In truth, thehighconcentrationofabiologicalproteinmakeseggwhitesdiseasepromoting.Plant-basedproteinismuchhealthier.

RefinedCarbohydratesPromoteIGF-1Although protein is the most important determinant of IGF-1 levels, excessintake of refined carbohydrates can also have an effect. Insulin regulatesenergymetabolism and affects IGF-1 signaling by increasing production ofIGF-1anddecreasingIGF-1-bindingproteins.ItislikelythattheWesterndietincreasesIGF-1viabothexcessproteinandexcessrefinedcarbohydrate.Type2diabetesisassociatedwithbreast,colon,andpancreaticcancers,andthereisevidence that insulin-mediated stimulation of IGF-1 production is partiallyresponsible.41 The take-home message here is to recognize that refinedcarbohydrates from processed foods and our nation’s preoccupation witheatinganimalproteinarebothatthecoreofourcanceranddiabetesepidemic.Untilnow,wehavemistakenlyfocusedonfatasthebadapple,endorsingeggwhites and white meat, when actually these foods are not favorable forlongevity.Note thatswitching tograss-fedbeeforwildmeatsdoesnotsolvethe problemwith consumptionof toomany animal products, as the negativeeffects are not limited to fattened and sickly farm-raised animals. Theheterocyclic amines, theheme iron, and theconcentrationofhighbiologicalproteinareallnegatives,especiallyforpeoplepronetodiabetes.For many people, even a moderate amount of animal protein in the diet

maintains unfavorably elevated IGF-1 levels and impedes the cholesterol-loweringandblood-sugar-loweringeffectsofaplant-baseddiet.Butwhenwestrive toconsumemostofourprotein fromplants,wesolve the IGF-1 issueandhelppreventbothcanceranddiabetes.Theaminoacidsinplantsarenotascomplete as those in animalproducts, so theydonot raise IGF-1 toharmful

levels,and theycomplementeachothersowecanachieveadequate levelsofproteinwithoutgoingintoexcess.EatingMorePlantProteinIstheKeytoIncreasingOur

MicronutrientIntakeIt is interesting to note that foods such as peas, green vegetables, and beanshave more protein per calorie than meat does. But what is not generallyconsideredisthatthefoodsthatarerichinplantproteinareusuallythefoodsthatarerichestinnutrientsandphytochemicals.Byeatingmoreofthesehigh-nutrient, low-calorie foods, we get adequate protein and our bodies aresimultaneouslyfloodedwithprotectivemicronutrients.Thisfuelsthereversalofdiabetesandheartdisease,helpshealthekidneys,andrestoresthebodytoamore youthful state.Animal protein is low-nutrient food. It does not containantioxidantsorphytochemicals,butplantproteindoes.

PROTEINCONTENTFROMSELECTEDPLANTFOODSFOOD GRAMSOFPROTEINAlmonds(3ounces) 10Banana 1.2Broccoli(2cups) 10BrownRice(1cup) 5ChickPeas(1cup) 15Corn(1cup) 4.2Lentils(1cup) 18Peas,frozen(1cup) 9Spinach,frozen(1cup) 7Tofu(4ounces) 11WholeWheatBread(2slices) 5

Whenyoudropbodyfat,yourcholesterollowerssomewhat,butwhenyoureduce or eliminate animal protein intake and increase vegetable proteinintake,youlowercholesterolradically.Thisclearlyisavegetable-baseddiet,notonebasedingrainsoranimalproducts.Vegetablesarerichinproteinbutalso have almost no saturated fat or cholesterol, and they are higher innutrientsthananyotherfoodis.Thecholesterol-loweringeffectofvegetables

andbeansiswithoutquestion.Inaddition,theycontainanassortmentofheart-disease-fighting nutrients independent of their ability to lower cholesterol.Amazingly, they also fight cancer. This food plan is designed to use largequantitiesofthemostpowerfulanticancer,disease-fightingfoodsontheplanet.Thepointtokeepinmindisthatevenifyoucompletelyditchanimalprotein,orsignificantlyminimizeyourconsumption,youwillstillreceivetheproteinyourbodyneedsthroughyourvegetable-baseddiet.Thelow-nutrientstandarddietthatisenjoyedbymostAmericansresultsin

fattydepositsinthewallsofthebloodvessels.Theseeventuallyleadtobloodvessel narrowing and blood clots that cause strokes and heart attacks. Thisoccursbecauseoftoomanyanimalproducts, toomanyprocessedfoods,andnotenoughnatural,high-nutrientplantfoods.Thedisease-buildingprocessisnottheby-productofaging;itistheby-productofadietpoorlydesignedforhumans.Thisdietgraduallycausesmoreandmoredamageas timegoeson.Eventually,certaindiseasesandconditionscropup,mainly:Heartattacksandangina—diseasedbloodvesselsintheheart(coronaryarteries)

Highbloodpressureandstrokes—diseasedbloodvesselsleadingtoandinthebrain

Dementia—diseasedbloodvesselsinthebrainImpotence—diseasedbloodvesselsleadingtoandinthepenisClaudication—diseasedbloodvesselsinthelegs

Unfortunately,thedrug-favoringdietaryadvicetypicallyofferedtodiabeticsandheartpatients isnotsciencebased,and itcaters toAmericans’socialandfood preferences and food addictions. In contrast, the nutritarian dietmaximizes benefits for weight reduction, cardio protection, and diabetesreversal,effectivelypreventingandreducingtheeffectsofalltheseconditions.And the food is delicious.With time, youwill be shocked not onlywith theresultsbutwiththetasteaswell.

CHAPTERSIX

ThePhenomenalFiberinBeans

SusanCarno,aneighty-year-oldfemale,wasdiagnosedwithtype2diabetesin1987.Shewasoninsulintherapyfortwentyyears,duringwhichtimesheexperiencedahypoglycemicepisode(abnormallylowglucose)atleastonceamonth.Herbloodsugarwouldbeexceptionallyhighattimes,andtheninafewdays,toolow.Shegainedasignificantamountofextraweightwhileshewasoninsulin.Shealsohadahistoryofhighcholesterolandhighbloodpressureandafamilyhistoryofheartdisease,diabetes,andhypertension.Duringthelastyearbeforebecomingmypatient,shewasexperiencingincreasedfrequencyofhypoglycemicreactions.Agrandmalseizureattributedtothehypoglycemiafinallyconvincedherthatsheneededtodosomethingdifferentandmotivatedhertofindme.Susan’sphysicianhadinitiallyprescribedstatindrugsforhighcholesterol,butwhenSusandevelopedmuscleaches,themedicationwasdiscontinued.Besidestakinginsulin(30unitsofLantusonceadayand5unitsofHumalogwitheachmeal),shewasalsotakingmetforminandByettainjectionsfordiabetes.ItalkedtoSusanonthephonebrieflyalmosteverydaytocheckhermorningglucosenumber,andshewasabletocutbackontheinsulinmorequicklythanIexpected.OriginallyIthoughtthatshewouldstillneedsomeinsulinevenonthisdietbecauseshewaseightyyearsoldandherpancreaticbetacellreservewaslikelycompromised.Iwaswrong.Onceshestartedmynutritarianapproachfordiabetes,Iwasabletodiscontinueallofherinsulinwithinthefirsttendays.Thedietwasmorepowerfulthan45unitsofinsulin,evenwithnochangeinheractivitylevel.

Susanwasabletodiscontinueallofherdiabetesmedicationsbytheendofthefirstmonth.HerHbA1Cwentfrom7.3to6.6withnodrugs.IttakesthreemonthsforHbA1Ctoreflectnewlowglucosereadings,andatthethree-monthcheckup,onnomedications,herglucosewasrunningaround100.Shealsohadnofurtherhypoglycemicreactions.Shelostthirty-eightpounds,goingfrom148poundsto110pounds.Herbloodpressuredeclinedfrom172/82to130/75.Hertotalcholesteroldidnotchangemuch,buthercholesterol/HDLratioimprovedfrom4.0to3.3,andhertriglyceridesimprovedconsiderably.Susanwasthrilled.Whiletakinginsulin,she’dfeltlikeaprisonerinsideherownbody,agingrapidly.Itmadeherfeelhungryandoverallleftherfeelingconstantlysick.Fortwentyyears,sheinjectedherselfbecauseshesawnootheroption.Whentheinsulinstopped,Susansuddenlydiscoveredshehadagreatdealmoreenergy.Overtheyearafterwestartedworkingtogether,Susan’sexerciseenduranceincreasedconsiderablyandshewasabletocomfortablywalkforafullhourormore.Shehasbeenenjoyingsixty-minutewalkseveryday.Afterbeingonthedietforayear,shecelebratedwithherfavoriteicecream.Surprisingly,shedidnotlikeitasmuchasthefreshfruitsorbetItaughtherhowtomake.Itwasjusttoosugaryforher,soafterthefirstfewspoonfulsshestopped!

Beans, green vegetables, seeds, and some fruits are high in soluble fiber.Solublefibersuppliesagelatinous-likematerialinthebowel.Itisnotabsorbedanddoesnotgiveuscalories.Solublefiber isveryimportant,as itslowstheabsorptionofglucoseandhelps lowercholesterol.Beansareespeciallyhighinsolublefiber.Insoluble fiber—roughage—is important too. It providesbulk toour stool

andkeepsusregular.Andguesswhat:seeds,nuts,vegetables,and,yes,beanshaveplentyofinsolublefibertoo.Foryears,nutritionists and scientists thought therewereonly twokindsof

fiber—soluble and insoluble.Nowweknow there is a carbohydrate that actslikeafibertoo.Itiscalledresistantstarch.Itsuppliesfewcalories,andmostofthecaloriesdonotraiseglucoselevels.Itiscalledresistantstarchbecauseitisresistanttostomachacidanddigestiveenzymes.Itisnotdigestedinthesmallintestine but passes to the large intestine, where it undergoes fermentation.Fermentationmeans that thebacteriadecomposeanddegrade this starch intosimpler compounds. When the bacteria in the bowel degrade the resistant

starch, it forms new compounds that have health benefits. Resistant starch isimportantforgoodhealthandhasbeneficialeffectsfordiabetics.Legumessuchasbeans,lentils,peas,andchickpeasfallfarbelowgrainson

the list of foods Americans eat. However, legumes are richer in nutrients,protein, and fiber, and they contain much higher levels of resistant starch.Considering their favorableeffectsonblood sugarandweight loss, theyarethepreferredcarbohydratesourceforpeoplewhohavediabetesorareatriskfordiabetes.Most starchy foodshavea small amountof resistant starch in them.At the

beginning of human history, fruits containedmore resistant starch and fiberand less sugar than fruits that are commonly available now.Wild foods, thesameasthoseearlyhumanfoods,aremorefibrouscomparedtowhatisbred,cultivated, and processed today. If you were to taste a wild pineapple, wildlychee,orwildplantaininthetropicaljungle,youwouldfindthatanyofthemarehardlysweet,muchchewier,andfibrous—andfillingfromallthefiber—but they are certainly not calorically dense. It is certain that in a primitivetropical habitat that provided a diet of justwild food and greens andmaybesomefish,therewouldbenooverweightordiabeticpeople.Ifyouwereevershipwreckedonadesertedisland,itwouldbealmostimpossibletobecomeorremainoverweight.Proponents of high-protein, low-carbohydrate diets argue that intake of

carbohydrates—especially starch—should be restricted or eliminated andsubstituted with animal products instead. This might seem logical on asuperficial level, but when you look deeper into the science, you find thatfiber-less animal products contribute to diabetes-related health risks, whilebeans—even though they are largely carbohydrates— directly lessen theserisksandpromotethereversalofdiabetes.Dietary starch is most often converted to glucose. When not burned as

energyfor immediateuse, it isstoredasglycogen,ahighmolecular-weightpolymerofglucose.Thebodyiscapableofstoringapproximately300to500gramsofglycogenatonetime.Anyexcessglucosethatisnotrapidlyburnedasfuelorstoredasglycogenisconvertedtofatandstoredasbodyfat.Meat-based-dietproponentsarguethattoloseweight,weshouldeatlessstarch.Theyarerighttoadegree.Certainlyweshouldeatlesshigh-glycemic,low-nutrientstarch, and certainlywe should not overeat.Whenwe eatmostly high-starchfoods,especiallyrefinedcarbohydrates,itpromotesswingsinbloodglucose,puttingexcessworkonthepancreastoproduceahugeinsulinload.Plusifwe

overeat, our glycogen stores could be already full, meaning the extracarbohydratecalorieswedon’tneedwillbestoredasfatonthebody.Butnotallcarbohydratesfallintothishigh-glycemic,low-nutrientstarchcategory.

TheWhitertheBread,theSoonerYou’reDeadSome people think that sugar-free cookies, cakes, and pastries can actuallyhelptheirdiabetesorhelpthemloseweight.Thisisnotthecase—thesesugar-free products are essentially low-nutrient junk foods. White flour actuallymakes your blood sugar rise almost as much as plain sugar does.Carbohydratesarechainsofsugarmoleculeslinedinarow.Theyarefoundinallplantsandfoodsmadefromplants.Carbohydratescanbeasinglesugar,orthreeorfourboundtogether,butwhenthousandsofsugarsareboundtogether,theyarecalledstarch.Whenthesesimplecarbonmoleculesareboundtogetherso tightly that your body cannot break themdown and digest them, they arecalledfiber.Only simple sugars can pass from your intestines into your bloodstream.

When your digestive enzymes break down the carbohydrates into simpleglucosemolecules,theyareabsorbedimmediatelyandenterthebodyjustasifyouhadsuckedonasugarcube.Indeed,eatingsugarandwhiteflourdoesnotcause just diabetes; these foods are also linked to heightened risk of cancer.Quite a few studies have linked the consumption of high-glycemic, low-nutrientfoodtocancer.Onestudyshowedovera200percentincreaseinriskof breast cancer in women eating more than half their diets as refinedcarbohydrates.1ToomanyAmericansstilleatthistypeofdiet,withmorethanhalftheircaloriescomingfromprocessedfoods.Theseindividualsareslowlydestroying their health. Eating processed foods is like snorting cocaine.Eventually you will pay a big price—your health. And the more a personconsumesthisdeadlywhitestuff,thestrongerthecravingsformore.Bagels,whitebread, pasta, pizza, and rolls are all staplesof theAmerican

diet,andtheyarealargecontributortoourepidemicofobesity,diabetes,heartdisease, and cancer. Commercial wheat products are also treated withfungicide, sprayedwith insecticides, andbleachedwithchlorinegasorotherchemicals. They return little nutrient bang for all their calories. To put itbluntly, these staples of our diets are disease-promoting junk food. All thewhite starches—basically,white bread,white rice, and evenwhite potatoes—arevery rapidly converted toglucose,which is sugar, and absorbed into the

bloodstream,shootingbloodsugarlevelsup.Whenbloodsugarskyrockets, itoverworks thepancreas tomatch the load

ofsugarwithalargeamountofinsulin.Thisisnotonlystressfultothebodyand the pancreas, but metabolizing that large energy load without aconcomitant intake of micronutrients creates metabolic havoc in the cells.Toxic metabolites build up in cells when we consume calories withoutantioxidant and phytochemicalmicronutrients needed to remove and controlthe toxic by-products. So as we eat more low-nutrient and low-fibercarbohydrates, we build up more cell toxicity, leading to disease and foodaddiction.Mostofthecommoncarbohydratesweeatareturnedintoglucose,butitis

importanttorealizethattheconversionefficiencyandratevarygreatlyfromone type of carbohydrate to another. For example, the starch in potatoes,cereals,andbakedgoodsdigestsveryrapidly;alltheircaloriesareconvertedquickly, supplying the body with a huge glucose load. The starch in beans,barley,andblackwildriceisdigestedmoreslowlyandcausesamuchslowerandlowerbloodsugarrise.Beansareatthetopofthepreferredcarbohydratetotem pole because they contain more of both slowly digestible starch andresistantstarch.Uniquepropertiesofthecarbohydratesinbeansandlegumesinclude:

•Higheramountofslowlydigestiblestarch•Higheramountofresistantstarch•Higheramountofinsolublefiber•HigheramountofsolublefiberResistantstarchactuallygoesallthewaythroughthesmallintestinewithout

being digested at all. In thisway, it ismore like fiber, and in some cases isclassifiedasatypeofinsolublefiber.

ResistantStarchIstheSecretTherearedifferenttypesofresistantstarchinfoods.Amyloseandamylopectinare examples. It is starch that is tightly packed in a stable crystalline formwithin foods, making it difficult to digest. The more resistant starch thatreachesthecolonundigested,thelesscaloriesweabsorbfromthatfood.Whenresistantstarchreachesthecolon,thebacteriathereuseitforfuel.Theresistantstarch is also, therefore, aprebiotic,meaning it serves to fuel thegrowthof

beneficialbacteriainthecolon.This process of degrading these starches by bacterial action is called

fermentation, and it produces a type of fat called short-chain fatty acids(SCFAs).Inotherwords,theresistantstarchdoesnotevengetconvertedtoasimplesugar;itgetsconvertedintoasimplefat.Onlyasmallpercentofthesecaloriesareabsorbedbythebody,buttheyarehighlybeneficial.2Socaloriesfrom resistant starch are listed on the food labels but almost 90 percent ofthose calories do not get absorbed and they do not raise blood sugar at all.ResistantstarchisespeciallyassociatedwithonetypeofSCFAcalledbutyrate.Now here’s the fascinating part: even though only a small amount gets

absorbed, butyrate offers a wide array of health benefits, including strongprotectionagainstcoloncancer.Itprotectsourbodiesinlotsofotherwaystoo,namely by enhancing the absorption of beneficialminerals like calcium andmagnesium and so, importantly, improving insulin sensitivity. It has theopposite effect of eating sugary or high-glycemic starches. It actuallyimprovesdiabeticglucosenumbersthedayafterit’seaten.3Most importantly, these SCFAs slow down glycolysis in the liver, thus

delayinghunger,and they increase thebreakdownofbodyfatasasourceofenergy,facilitatingweightloss.Asyourecall,glycolysisisthebreakdownofthestoredglycogenbackintoglucoseforusebythebody.ThesmallamountofSCFAsthatareabsorbedincreasesfatoxidation,meaningyourbodyburnsfatforenergymoreefficiently,encouragingweightloss.4When you eat a meal of mostly green vegetables, eggplant, onions,

mushrooms, and a cup of beans, biochemical events occur that workmedicinally;theyrepairthebiochemicaldefectsthatwouldleadtodiabetes.Infact, in direct contrast to meat and potatoes, just one additional serving ofgreen vegetables in a diet has been demonstrated in meta-analysis to offersignificantdiabetesprotectionindependentoftheeffectsonweightreduction.5Theauthorsofthestudyspeculatetheseprofoundbenefitswereduetothehighlevelsofbeneficialmicronutrients ingreens.Thenyouaddbeans, andmoremagichappens.Beansstorewellandareinexpensive,highlynutritious,and

entertaining.Let’s review some of the benefits of eating greens and beans, instead of

bread,rice,andpotatoes:

•Increasednutrients,SCFAs,bacterialactivity,andfiber,whichlowercholesterolandtriglycerides6•Asensationoffullnessorsatiety,leadingtomealsatisfactioneventhoughfewercaloriesareconsumed•Lowerglucoselevelandimprovedinsulinsensitivity,aidinginthereversalofdiabetes•Promotionofgoodbacteria,whichaidnutrientabsorption;suppressionofbadbacteriaandtheirtoxicproducts•Bowelregularity,preventingconstipation•Efficientremovalofcholesterolandotherunhealthfulfats•Lessfatstoredaftermeals•Increasedfatbreakdown•Slowedglycogenutilizationintheliver,whichdelayshungerandpromotesalowercalorieintake•ProtectionagainstcoloncancerdevelopmentBeansaretheverybestsourceofresistantfiber.Althoughthetypesofbeans

and preparation methods cause varying amounts of resistant starch (cannedbeans are more glycemic), in general, the starch in beans is about evenlydividedbetweenslowlydigestedstarchandresistantstarch.Note,though,thattaking products such as Beano to increase digestibility of beans will alsoincreasethedigestibilityofresistantstarchandenhanceitscaloricabsorption.Instead, it isbetter to allow thebody to adjust to theuseofbeans in thedietover time, then, gradually, favorable bacteriawill increase in number in thedigestive tract,whichwill facilitate thedigestionof theresistantstarch in thebeans.Blackbeans,forinstance,containthehighestamountoftotaldietaryfiberat

43 percent, and 63 percent of their total starch content is resistant starch.Cerealgrains,especiallybarleyandcorn,followlegumesintheirpercentagesofresistantstarchthatreachthecolon,buttheydropoffsignificantlyinfibercontent.Heavily processed flours and grain-based products have a very lowresistantstarchcontentwitharangeof5percentinbrownriceto10percentinrolled oats. The point here is that themajor source of carbohydrates in thediabetic diet should be beans, not grains or root vegetables like potatoes. Isometimescallmydiabeticdietrecommendationsthegreensandbeansdiet.The resistant starch found in beans powerfully reduces hunger and, thus,

food consumption over many hours, coinciding with the fermentation thattakesplaceinthelargeintestinehoursaftereatingthebeans.Soeatingbeanswithlunchwill reduceyourhungerandappetitefordinnermanyhours later,overallloweringtheamountofcaloriesyoudesirefortheday.Fordiabetics,beans are critical for lowering the insulin requirement for starch digestion.Theyalsosupplyaminoacidsthatcomplementtheothervegetables,nuts,andseeds toenhance thebiologicvalueof theprotein in thediet,without raisingIGF-1.Refertothefooddatachart.Ifyouaddupthepercentofresistantstarch(RS)

(90percentofwhichisunabsorbed)andfiber(whichalsoisnotabsorbed)andmake comparisons with other starches, you will see why beans are thepreferred starch for diabetics. The RS + fiber is a handy measurement toillustratethefavorableeffectsofbeansfordiabeticscomparedtootherhigh-carbohydratefoods,andcertainlyitisamuchmorecriticalmeasurementthantheglycemicindexfordiabetesmanagementandweightloss.Let’snot forget that theANDIscoresofbeansarehighaswell.Theyhave

beenfoundtocontainsignificantlevelsofpolyphenols,whichhaveanticancereffects.Redandblackbeanshavebeenfoundtoproduceapoptosis(celldeath)ofcoloncancercells.Thismeansthecompoundsinbeansandthoseproducedinthedigestionofbeanshavebeneficialeffectstofortifycellsagainstcancer.Theyalsocausecells thathavebecomeprecancerousorcanceroustodieoffbefore theycanactuallymultiply intocancerous tumors.Theyprotectpeopleagainst colon cancer—the exact opposite of what redmeat does. The PolypPrevention Trial demonstrated that beans provide more protection againstadvancedadenomasof thecolon thananyotherfooddoes,witha65percentreduction of adenomas in participants in the highest quartile of dried beanintake.7And peoplewho eat beansmerely twice aweekwere found to haveabout a 50 percent reduction of colon cancer.8 Imagine the protection wewouldachieveifweatebeansalmosteverydayinconjunctionwithotherwell-investigatedcancer-fightingfoods.Othersources toutbeans’ life-lengtheningbenefits too.Theconclusionsof

an important longitudinalstudyshowthatahigher legume intake is themostprotectivedietarypredictorofsurvivalamongsttheelderly,regardlessoftheirethnicity,inmultiplepopulationsstudied.9Thestudyfoundthatlegumeswereassociatedwithlong-livedpeopleinvariousfoodculturesincludingJapanese(who eat beans in the form of soy, tofu, natto, and miso), Swedish (brownbeansandpeas),andMediterranean(lentils,chickpeas,andwhitebeans)diets.

Beansandgreensare the foodsclosely linked in thescientific literaturewithprotectionagainstcancer,diabetes,heartdisease,stroke,anddementia.

We are not done with beans yet. Because beans contain somuch resistantstarch,asmuchas20gramsineachcupofnavybeans(4caloriespergram),and because they contain amylase inhibitors that resist the digestion of theirstarch,adecentpercentageofthecaloriesthatarelistedonthefoodlabeldonotactuallycomeintothebloodstreamasglucoseorevenascalories.Thisiscomplicated, but remember thatwhen the resistant starch hits the colon, it isactedonbybacteriaandtransformedintoSCFAs.Thattransformationresultsinonlyabout2caloriespergram.Thefermentationoccurssolowdowninthedigestivetrackthatverylittleofitgetsabsorbed.Thisresistantstarch,aswellasmostoftheotherfibersthatarenotassimilated,arecountedas200to300caloriespercupinthenutritionalinfo.Butthebottomlineisthateventhoughacupofcookedbeansmaybelistedas225calories,theyactuallygiveyoumuchfewercaloriespercup,ahigherpercentofprotein,and fewercarbohydratesthan show up in their analysis. All those listed 225 calories are setting offcaloricandnutrientreceptors in thestomachandsmall intestines, registeringsatiationand tellingyou thatyouhaveeatenenough.Andhere’s theamazing

thing,becauseofthepresenceoftheamylaseinhibitorsandtheresistantstarch,maybeaquarterofthosecarbohydratecaloriesdon’tevengetabsorbed.11

EDAMAME,ASUPERBEANEdamame beans are young green soybeans that are boiled in the pod andserved hot or cold. They are usually served in the pods, but you squeezethem out of the inedible pods to eat them. They are available insupermarkets,mostlyinthefrozenvegetablesection,bothshelledandinthepods.Younggreensoybeansareanunprocessed,naturalfoodthatisrichinminerals,calcium,andomega-3fatsandextremelyhighinprotein.Frozenpodscanbeboiledforfiveminutesorjustdefrostedovernightintherefrigerator. They are a unique bean because they are so low incarbohydrates.Theyareagreatfoodfordiabeticsandadeliciousadditionto a salad or vegetable dish.Multiple scientific studies have demonstratedthatunprocessedsoybeanshavedramatichealthbenefits.Besidesloweringcholesterolandbloodglucose,theyalsopreventbreastcancer.10

Sowhenyoumakebeansyourfavoredcarbohydratesource,you:Gethigh-qualityproteinGetapowerfulanticancerfoodGetmoresatiationthatturnsoffyourdesiretoeatmorefoodBurnmorefat,helpingyougetridofyourdiabetesHavebetterdigestion

Ahealthypantryneedstocontainastockofdriedbeansandcannedbeans.Ifyour localmarket doesn’t have unsalted canned beans, you can usually findthem in a health food store. If you have no other option but salted cannedbeans, rinse them before using to remove about half the excess salt. Driedbeans thatarefirstsoakedovernightand thencookedare thebestwaytousebeans.Theydon’thavetobesoakedinadvance,but itspeedsupthecookingtime.Driedbeansarethemosteconomicalhigh-nutrientfood.Yousavemoneyon

foodwhenyouuselotsofdriedbeansinyourcooking.Also,sproutedwholebeansandgrainsoffergreatnutritionandsavemoneyonyourfoodbills.Soakbeansovernightinajar,andthenrinseanddrainthewaterouteverydayfor

thenextfourtosixdays,andyouwillhavebeansproutstouseinyoursaladorinavegetabledish.Splitpeas,squash(butternut,acorn,orwinter),corn,wildrice,quinoa,and

wheatberriesarehealthyhigh-carbohydrate foods thatcontainamoderate tointermediateamountof resistantstarchbutarestill fairlynutrient-richfoods.Dark or black wild rice is more fibrous and higher in resistant starchcomparedtoordinarybrownrice.Notethatwheatberriesandcoarselygroundsproutedwheat aremore favorable thanwholewheat flour, especiallywholewheatpastryflour.Themorefinelygroundthegrain,thehigheritsglycemicload,andthemoreitiscooked,themorediabeticunfavorableitbecomes.

Avoidanythingthatiswhite—whiteflour,whitepasta,whitepotatoes,andwhiterice.Othercarbohydrate-richfoodscanbeusedinmoderatequantitiesdependingon

bodyweightanddiabeticparameters.When looking at a choice of various high-carbohydrate plant foods, as a

diabetic,consider:

1.Thefibercontent2.Thepercentofslowlydigestiblestarch3.Thepercentofresistantstarch4.Themicronutrientcontent5.Thecaloricdensity6.ThebeneficialqualitiesofotherfoodsinthemenuthatmayhavetobeeliminatedorreducedtoallowroomforthisfoodThere is a nutritional hierarchy of carbohydrate-rich plant foods. Beans,

cauliflower, and other more nutritious high-carbohydrate foods are mostheavily emphasized because of their micronutrient density, fiber, low GL,slowly digestible starch, and resistant starch content. Interestingly andconveniently, the micronutrient density of high carbohydrate plant foodsparallelstheirfiberandresistantstarchcontent.TheGLisalsoanimportantcomponenttoconsiderincreatingthebestdiet

forthosewithdiabetesorpronetoit.Aswediscussed,dietscontaininglargequantities of high GI foods are associated with the risk of diabetes, heartdisease,multiple cancers, and overall chronic disease.12 GLmay not be the

mainthing,butitshouldnotbecompletelyignored.Itislikelythemainreasonwhywhite potatoes have been linked to aworsening of glycemic control indiabetics.13 In fact, when 84,555 women aged thirty-four to fifty-nine weretracked for twenty years in theNurses’Health Study, researchers found thatregular potato andFrench fry consumptionwas significantly associatedwithincreased riskofdiabetes; substitutingawholegrain for a servingofpotatoperdayloweredriskofdiabetesbyalmost30percent.14Examiningtheglycemiceffectsofvariouscarbohydratechoicesenablesus

tomodify foodchoices for improvedglycemiccontrolandenhancedweightloss.15

GLYCEMICLOADOFCOMMONHIGH-CARBOHYDRATEFOODS16(1CUP)Cauliflower negligibleSplitPeas 4BlackBeans 6RedKidneyBeans 7ButternutSquash 8GreenPeas 8Beets 9Lentils 9WholeWheat 11Barley 13NavyBeans 13Rolled/Steel-cutOats 13BlackEyedPeas 14Quinoa 16Corn 18WhiteBread(2slices) 20WhitePasta 21BrownRice 24Millet 26WhitePotato 29WhiteRice 29Cola(16ounces) 32

Itisreasonabletolimitwhiteflour,whitepotato,andriceintakeconsidering

thelargevarietyofcarbohydrate-richplantfoods(beans,intactwholegrains,cauliflower,peas,squash,andotherstarchyvegetables)tochoosefromthataremore nutrient dense and without such a high GL. In general, I recommenddiabeticsavoidregularandliberalconsumptionoffoodswithaGLabove15,at least until their diabetes is in better control and their weight has droppedsignificantly.Remember,intactwholegrainsreferstomostgrainsthatarenotgroundintoflour.Ifyouwanttoeatafoodmadefromflour,likepasta,useanalternativelikeblackbeanpastaorlentilpasta.Youwillbeamazedbyitstaste.My results with thousands of clients and patients indicate that excessive

consumptionofwhitepotatoes(evenpreparedhealthfully)andwhitericemaybeproblematicduetotheirhighGL,especiallyinoverweightindividualsandthose with diabetes and prediabetes.With some consideration of the factorsdiscussedhere,diabeticscanremedytheirchallengessuchasresidualbodyfat,high triglycerides, suboptimal lipid profiles and nonoptimal fasting glucoselevels.Theyalsogleanotherbenefits,especiallyheightenedprotectionagainstcancer due to the inclusion of more cancer-protective micronutrients in thenutritariandiet.So formaximizing weight loss and reversing diabetes, the trick is to use

beansasyourprimarystarchsource.Eatsomebeans inasaladorsoupwithlunchandagainwithagreenvegetablefordinner.Eatothernon-bean,starchyfoods such as squash, green or split peas,water-cooked steel-cut oats, black(wild) rice, orwheatberries in small amountswithbreakfast or aspart of adinner vegetable casserole, but do not eat them as themain volume of foodwith the meal. Remember, incorporate these whole grains only in a limitedamountinthedietuntilweightlossandglucosereadingsareundercontrol.

THEBESTFOODSTOEATTOREVERSEDIABETESRawgreens TomatoesCookedgreens CauliflowerMushrooms BeansEggplant Nuts,SeedsOnions Lower-sugarfruitssuchasberriesandkiwi

WhatAbouttheGas?

Thebodycanlearntoadjustthebacteriainthedigestivetracttobetterdigestbeansandavoidgassiness.Itjusttakessometime.Startoutwithatablespoonofbeans,chewedwell,ateachmeal.Inotherwords,havebeansallthetime,butbeginwithanonthreateningamountsoyoudonotbecomeagasfactory.Inafew weeks, you will be able to gradually increase the amount withoutexperiencing digestive difficulty. Lentils, split peas, and garbanzo beans arelessgassybecausetheyhavelessresistantstarch.Sostartwiththosefirstandgraduallymove up to red and black beans that are evenmore favorable fordiabetics. Do not take digestive enzymes or Beano; instead take a probioticsuchaslactobacillusacidophilus.Don’tforgettochewthebeansverywell,asmostgasproductioncomesfrompoorlychewedfood.Mostpeopleonmyantidiabeticdietenjoyasaladandabean-basedvegetable

soupforlunch.Thebeansusedarethedrybeansthathavebeencookedinthesoupbase.Fordinneryoucan toss somebeanson topofyour saladormixthemintoacookedgreenvegetabledish.Beansofferawidevarietyofflavorsandtexturesandalsomakegreatdips,sauces,andchewybeanburgers.

CHAPTERSEVEN

TheTruthAboutFat

MybloodsugarwasalwaysoutofcontroluntilIstartedeatingthewayDr.Fuhrmanshowedme.MyendocrinologistsaidtherehadtobeamistakewhenhesawmyHbAlCbelow6.0.Ifeelmuchbettereatingthisway,becausewhenbloodsugarisupanddown,itmakesyoufeelbad.

—Robert,age11

WhenIgotdiabetes,mymomtookmetoDr.Fuhrman,andnowmywholefamilyishealthier.IthoughtIcouldn’tlivewithoutbagelsandpizza,butIlearnedtolikethefoodsthataregoodforme.WhenmymomtookawaythefoodIwasusedto,IthoughtIwasgoingtostarvetodeath,butnowI’mhappyshedidit.

—Janice,age13

Themajordeterminantofourlong-termhealthisthenutritionalqualityofthecalorieswe eat. It is the quality of the fat, the quality of the protein, and thequalityofthecarbohydratesweeatthatmostinfluenceourhealth.Askyourself:IsthefoodIamabouttoeatawhole,naturalplantsourceof

calories? Is it packed with fiber, antioxidants, and phytochemicals? Does itcontainnotonlyknownnutrientsbutplentyofundiscoverednutrientstoo?Orweremostofthosefragile,butbeneficial,nutrientslostinthewaythefoodwasprocessedorprepared?Theseareevenmoreimportantquestionsthanwhetheritisalow-fatorhigh-fatfood.Youmayhaveheardthatnutsandseedsarefattyandfatteningandarefoods

to be shunned. However this myth is finally buried.1 Recent evidence fromseveralstudiesshowsawidevarietyofhealthbenefitsfromeatingthesefoods.

Therehasneverbeenastudythatshowedanynegativehealthoutcomesfromconsumingthesenatural,high-fat,wholeplantfoods.Infact,thestudiesshowonly positive health benefits and conclude that these foods should be animportantpartofawell-rounded,healthydiet.Itmustbeemphasizedthathealthproblems associated with high-fat diets are from consuming animal fats,processedoils,andtransfats,notfromavocados,rawnuts,orseeds.Asdiscussed,macronutrients—fat,carbohydrates,andprotein—arethethree

sourcesofcalories.Americanseattoomuchofallthree.Iintentionallydonotgive a preferred percentage of each macronutrient in the diet, and I do notrecommend that fat be (exclusively) limited. Trying to micromanage thepreciseamountofeachcaloricsourcemissesthemostcriticalissueinhumannutrition. The real critical issue in human nutrition is meeting yourmacronutrient needs without excess, while getting sufficient micronutrients(vitamins,minerals,andphytochemicals—thepartsoffoodthatdonotcontaincalories)intheprocess.Thereisabroadacceptablerangeinthemacronutrientratioaslongaswearenotovereatingcalories.Certainlyifwe’reoverweight,wewant tobemorecarefuland limitconsumptionof thesehigher-fat foods.Aswehaveseen,itiseasytoovereathigh-fatfoods,astheyareaconcentratedsourceofcalories.Thegoalistofindtherightbalance.Adheringtoadietthatis less than 10 percent of calories from fat is not an appropriaterecommendation for ideal health. This too-low percentage of fat results inless-than-ideal health outcomes such as low energy andminimized hormoneproduction. The simple truth is that a healthy diet could be 15 percent ofcaloriesfromfatoreven30percentofcaloriesfromfat.Aslongasthedietisrich in micronutrients and does not exceed our daily need for calories, alower-fatdiethasnoadvantageinthepreventionandtreatmentofdisease.Thereisnoevidencetosuggestthatadietofequalcaloriesthatisextremelylowinfatisanadvantageforpreventionortreatmentofheartdiseaseoranyotherdisease.Studiesthatcomparedietaryfatpercentagessuggestthatitisnotthefatlevel,butothermorecriticalqualities,thatmakethe

dietmoreorlessbeneficial.Iwanttobeclearthatthebenefitsofavegetarianorvegetable-baseddietare

not the result of low-fat intake.Most vegan or vegetarian diets are not idealbecausetheylackgreenvegetables.ItmayseemoddthatIamclaimingmost

vegetarian diets are lacking in high-nutrient vegetation, seeds, and nuts—allhealthful vegetarian foods—but all too often, that is the case. Achieving anideal level of phytonutrients and other micronutrients necessitates eating alarge amount of green vegetables each day. Any diet that does not containsufficient vegetables is lacking.When you eat lots of vegetables, especiallygreenvegetables,youmeetyourbody’sneedforfiberandmicronutrientswithveryfewcalories.Thentobalancethedietandfillyourcaloricneeds,youcanchooseanassortmentofotherfoods,preferablyonesthatareofhighnutrientquality.Unlikeotherpeopleadvocatingplant-baseddiets, I recommendmorevegetables, fruits,beans,nuts,andseedsand lessbread,potato,andrice.Thedaily addition of one or two ounces of nuts and seeds,which average about175 calories an ounce, can bring the diet up to 15 to 30 percent of caloriesfrom fat.This is important, and I repeat:my recommendeddiet is eating 15percentormorecaloriesfromfatintheformofhealthy,wholefoods,notoil.It might seem logical to restrict higher-fat foods like nuts, seeds, and

avocadoesbecausehigh-fatfoodsarehigherincalories(fatis9caloriespergram compared to 4 calories per gram in carbohydrates and protein).Althoughyoushould takecarenot toeat toomanycaloriesand toadjust thelevelofthesefoodstomaintainaslimbody,therearelotsofgoodreasonstoinclude at least some of these higher-fat foods in your diet. Accumulatingresearchshowsthatadietaslowas10percentofcaloriesfromfatmaybetoolow,evenfortheoverweight,diabetic,orheartdiseasepatient.Judicioususeofthese higher-fat foods is beneficial for not just heart disease, but forweightlossanddiabetestoo.The scientific literature corroborates my clinical experience over the last

twenty years as I have cared for thousands of patientswith obesity, diabetes,and heart disease. It provides evidence to show that for every calorie fromwhite rice, potato,white bread, or animal products that is removed from thediet and substitutedwith raw seeds and nuts, there aremany health benefits,including:

•Lowerbloodsugar•Lowercholesterol•Lowertriglycerides•BetterLDL/HDLratio•Betterantioxidantstatus•Betterabsorptionofphytochemicalsfromvegetables

•Betterdiabeticcontrol•Lowerweight•Moreeffectivereversalofheartdisease•Preventionofcardiacarrhythmiasinheartpatients•Moreweightloss,notweightgain•Betternutritionaldiversityandsatisfactionwithfewercalories•Increasedprotectionagainstcancer•Bettermuscleandbonemasswithaging

NutsandSeedsProtectAgainstCardiovascularDeathRaw nuts and seeds are packed with nutrients. They contain lignans,bioflavonoids, minerals, and other antioxidants that protect the fragilefreshnessofthefatswithinandcontainplantsterolsandproteinsthatnaturallylowercholesterol.Because thesefoodssupplycertainfibers,phytochemicals,phytosterols,andbioactivenutrientslikepolyphenolsandargininethatarenotfoundinotherfoods,theyalsopreventbloodvesselinflammation.Perhapsoneofthemostunexpectedfindingsinnutritionalepidemiologyin

the past five years has been that nut consumption offers strong protectionagainstheartdisease.Severalclinicalstudieshaveobservedbeneficialeffectson blood lipids as a result of diets high in nuts (includingwalnuts, peanuts,almonds, and other nuts).2A reviewof twenty-three intervention trials usingnutsandseedsconvincinglydemonstratedthateatingnutsdailydecreasestotalcholesterolandLDLcholesterol.3NotonlydonutsandseedslowerLDL(bad)cholesterol,buttheyalsoraiseHDL(good)cholesterol.Interestingly,theycanhelp normalize a dangerous type of LDL molecule—the small, dense LDLparticles that are particularly damaging to blood vessels, especially theendothelialcellsliningthebloodvessels.4Ellagitannins are dietary polyphenols with potent antioxidants and other

cancerchemopreventiveactivities.Theyare found inberries,nuts, andseedsand are best absorbed fromwalnuts.5Walnuts can reduceC-reactive proteinand harmful plaque adhesion molecules, two significant markers ofinflammation in arteries. The result is improved, and even restored,endothelial function (which includes the elastic property of arteries to dilatewhenmeetinganincreaseddemandforblood).Accordingtotheresearchers,walnutsarethefirstfoodtoshowsuchcardiovascularbenefits.6Studies on nuts reveal much more than just their power to change risk

factorslikebloodglucoseorcholesterol;theyactuallyshowthatnutsdecreasecardiovascular death and overall increase life span.7 Five large prospectivecohort studies (Adventist Health Study, Iowa Women Health Study, Nurses’Health Study, Physicians’ Health Study, and CARE Study) have studied therelationship between nut consumption and the risk of atherosclerotic heartdisease.8 All found a strong inverse association. That means nuts arelifesaving.The protective effect of nut consumption on heart disease is not offset by

increasedmortalityfromothercauses.Infact,nutconsumptionhasbeenfoundtobeinverselyrelatedtoall-causemortalityinalltestedpopulationsincludingwhites,blacks,andtheelderly.Eatingnutsandseedsoffersawell-documentedintervention for increasing longevity. The beneficial effects of nutconsumption observed in clinical and epidemiologic studies underscores theimportanceofdistinguishingdifferenttypesoffat.Nutscontainmostlymono-and polyunsaturated fats that lower LDL cholesterol levels. However, thefavorable fat issuedoesnotaloneaccount for thehealthbenefitsofnutsandseeds.Thesepowerfulhealthbenefitsarenotachievedwhenoils, rather thanwholenutsandseeds,aresubstitutedasacaloricsource.Based on data from the Nurses’ Health Study, it was estimated that

substituting fat from one ounce of nuts for equivalent energy fromcarbohydratesinanaveragedietwasassociatedwitha30percentreductioninheart disease risk.The substitutionofnut fat for saturated fatwas associatedwitha45percentreductioninrisk.FrankHu,M.D.,aleadingresearcherattheHarvardSchool of PublicHealth, on the value of nuts in theAmerican diet,says,“Ourepidemiologicalstudieshaveshowneatingaboutoneounceofnutsa day will reduce the risk of heart disease by over 30 percent.”9 ThePhysicians’HealthStudyaddedmuchmoretothestory.Themostfascinatingand perhapsmost important finding is that nuts and seeds do not just lowercholesterol and protect against heart attacks. Components of nuts apparentlyalsohaveantiarrhythmicandantiseizureeffects,whichdramaticallyreducetheoccurrence of sudden death.10 These rhythm-stabilizing effects of nuts andseedsareduenotonlytotheamountofomega-3fattyacidsbutalsotootherbeneficialqualitiesofthesenaturalfoods.The Physicians’ Health Study followed 21,454 male participants for an

averageofseventeenyears.Researchersfoundalowerriskofsuddencardiacdeathandothercoronaryheartdiseaseendpointsaftercontrollingforknowncardiac risk factors and other dietary habits.When comparedwithmenwho

rarely or never consumed seeds or nuts, thosewho consumed two ormoreservings per week reduced their risk of sudden cardiac death by over 50percent. This means that the consumption of nuts powerfully reduces thechance of having a life-threatening cardiac arrhythmia called ventricularfibrillation or ventricular tachycardia. Peoplewho have heart disease do notalwaysdieofheartattacks;theyoftendieofanirregularheartbeatthatpreventstheheartfrompumpingproperly.Theabsenceofnutsandseedsinadietmayactuallyincreasetheriskofone

of these fatalheart rhythmdisturbances. Inmyyearsofmedicalpractice, themostcommonreasonspatientshavecometoseemearehighbloodpressure,high cholesterol, atherosclerosis, angina, diabetes, and being overweight.People followingmynutritional advicehave seendramatic improvements intheir conditions.Theyhave lostweight,normalized theirbloodpressureandcholesterol, and reversed their heart disease and atherosclerosis in animpressive and often dramatic fashion. All my patients were advised to eatsomerawnutsandseedsintheirdiets.

FortheReversalofDiabetesandObesityEpidemiologicstudiesindicateaninverseassociationbetweenfrequencyofnutconsumption and body mass index. Interestingly, their consumption mayactuallysuppressappetiteandhelppeoplegetridofdiabetesandloseweight.11Inotherwords,peoplewhoconsumemorenutsandseedsarelikelytobeslim,while people consuming fewer seeds andnuts aremore likely to beheavier.Well-controlled nut-feeding trials, designed to see if eating nuts and seedsresultedinweightgain,showedthateatingrawnutsandseedspromotedweightloss, not weight gain. Several studies have also shown that eating a smallamount of nuts or seeds actually helps dieters feel satiated, stay with theprogram,andhavemoresuccessatlong-termweightloss.12Oilisfattening,containing120caloriespertablespoon,andcansabotageyouropportunitytoloseweightorreverseyourdiabetes.Plus,itdoesnothavetheprotectiveeffectsonyourheartordiabetes.Thisprogramusesseedsand

nuts,notoil,asthemainfatsource,andtoflavordressingsanddips.

BecausenutsandseedsarerichinmineralsandfiberandhavealowGI,theyarefavorablefoodsto includeinadietdesignedfordiabeticsandthosewithprediabeticsymptoms.ResearchersfromHarvardnotedthatpeopleeatingoneounceofnutsfivetimesaweekreducedtheirriskofdevelopingdiabetesby27percent.13 The features of a diet that make it favorable to diabetics are notadequately described by the terms vegan or low fat. There are many veganfoodsandvegandietsthatwouldbeunfavorablefordiabetics,especiallythosethatincludelotsofoil,finelygroundgrains,andfoodsmadefromwhiteflourandwhitepotatoes.Thequalitiesofadietthatmakeitmaximallyfavorabletodiabeticsare:OverallcaloriesandweightlossresultsAmountoffiberconsumedpermealMicronutrientdiversityandcompletenessGlycemicloadofthemealsAntioxidantandphytochemicalindexSatietyandremovaloffoodcravingsandaddictions

Avegandiabeticstudy“ALow-FatVeganDietImprovesGlycemicControlandCardiovascularRiskFactorsinaRandomizedClinicalTrialinIndividualswithType2Diabetes”waspublishedinDiabetesCare.14Thewordvegandidnot adequately describe the features of the diet that made it more favorablecompared to the ADA diet. The researchers were careful to remove allvegetableoils andwhite flourproducts. If they’dcalled thediet ahigh-fiber,no-processed food, vegan diet, it would have been a more descriptive titleindicating why it was somewhat more effective compared to the ADA diet.However,theresultsstilldidnotcompareineffectivenesswiththeprogramIamteachinghere.Typical vegan diets do not show the dramatic improvements in lipids,

triglycerides,glucose,andevenweightloss.Oneimportantdesignfeatureforbetterhealthanddiseasereversalisthereductionofhigh-starchvegetablesandgrains and the substitution of beans, nuts, and seeds instead. For example,another representative study showed that women on a low-fat vegan dietlowered LDL cholesterol by 16.9 percent.15 In a similarly conducted studyincludingnuts and seeds, participants droppedLDLcholesterol 33percent.16Forprotectionfromalltypesofheartdisease,avegandietwiththeinclusionof raw nuts and seeds is simply a healthier diet. However, the limitation of

grains(especiallyflour)andtheinclusionofgreenvegetablesandlow-starchvegetables in place of grains and starchy vegetables both play a role in thedramaticlipid-loweringbenefitsandweightloss.When the diabetic diet is carefully designed around green vegetables and

beans,withtheadditionofasmallamountoffruitandasmallamountofrawnutsandseeds,patientsareabletostopinsulinandsulfonylureas—theprimaryoffendersthatrestrictweightloss—assoonaspossible.It is even more important for children, people who are thin, people who

exercisealot,andwomenwhoarepregnantandnursingtoconsumesufficientfat.Thehealthiestdietforallagesisonethatincludessomehealthyfattyfoods.This same diet will also prevent and reverse disease. There is no need forpeoplewithheart diseaseor diabetes tomove to a special typeof extremelylow-fat vegan diet void of raw seeds and nuts, thinking this restriction isnecessaryorvaluablefortheircardiachealth.Foranoverweightdiabetic,Irecommendoneouncedailyof

raw,unsaltedseedsornuts,suchassesameseeds,sunflowerseeds,flaxseeds,chiaseeds,hempseeds,

pumpkinseeds,walnuts,pistachionuts,oralmonds.Addthemtoasaladorblendthemintodressingsasanoil

replacement.Wearebeginningtogetaclearpictureofhowwecanpreventandreverse

diabetes.As theweight comesoff, it is important to remember that themainrisk of weight loss is weight regain. Dietary improvements that are notmaintained are of no long-termbenefit, and rapidweight gain is, of course,unfavorable. When you really “Eat to Live” you enjoy the combination ofdramaticresultsforyourbodyweightandyourhealth,andyourtastebudsgethealthier too. We marry great flavor with the emotional satisfaction ofknowingyouaredoingthebestthingforyourhealthanditbecomesthewayyouprefertoeatforyourlife.The other risk from weight loss is the formation of gallstones, or

cholelithiasis.Myexperience,however,isthatpeoplelosingweightfollowingmy dietary recommendations have an extremely low rate of gallstoneformation. Certainly, the formation of gallstones and the possibility oflaparoscopicgallbladderremovalmaybeareasonablepricetopayforlosing40to140poundsoflife-threateningbodyfat.Nevertheless,itisimportantto

notethattheinclusionofrawnutsandseedsinthediet,especiallywhilelosingweight, is crucial protection against gallstone formation. Nuts are rich inseveralcompoundsthatprotectagainstgallstonedisease.The American Journal of Clinical Nutrition reported that when 80,718

women from theNurses’HealthStudy,age thirty to fifty-fiveyears in1980,werefollowedfortwentyyears,researchersfoundthattheconsumptionofnutsand seeds offered dramatic protection against gallstone formation. Womenwhoconsumedfiveouncesofnutsperweekhadadramaticallylowerriskthandidwomenwhorarelyconsumedthem.Furtheradjustmentforfatconsumption(saturated, trans,polyunsaturated, andmonounsaturated fats)didnot alter therelation.17Thesefindingswerealsoduplicatedinacohortofmen.18Perhaps, then, the reason I have not observed a high rate of gallstone

formation in spite of having thousands of clients and patients all over thecountrywho’velostlargeamountsofweightistheinclusionofnutsandseedsin theprogram.Because it isdifficult todeterminewhomightbeatahigherriskforgallstoneformation,itiswiseforeverydietertoincludeatleastoneounceofrawnutsandseedsperdayinanyweight-lossprogramtooffsetthisrealrisktohealthyweightloss.

FatDeficiencyCanCauseaFailuretoThriveFormanypeople, theundueemphasisonextremelylow-fatdietshasresultedinhealthdifficulties.Ihaveencounteredmanyindividualswhohavenotthrivedonveganorflexitariandiets.Theymayhavedevelopeddryskin,thinninghair,muscle cramps, poor sleep, and poor exercise tolerance. Often they do notrealize their real problem. They go back to eating large amounts of animalproducts,notknowingthattheywerefatdeficientontheirlow-fatvegandiet.Formost of these individuals, eatingmorehealthy fats fromnuts and seeds,takingaDHAsupplement,andeatingfewerstarchycarbohydratesclearsuptheproblem. This is not so uncommon. Some people simply require moreessential fatty acids, both omega-6 and omega-3. DHA and EPA are thosehealthful, long-chain omega-3 fatty acids found in fatty fish and commonlyknownasfishoil.Theyareavailablefromvegansourcestoday,mostlyfromalgaeoryeast.Ahigh-starch,low-fatdiet—regardlessofwhetherornotthedieteriseating

meat—can derail weight loss and lead to high triglycerides, preventinglowered cholesterol levels. I have cared for some patients who came tome

after they developed irregular heartbeats or cardiac arrhythmias. TheseconditionsresolvedwhenIaddednutsandseedsbacktotheirdiet.Insufficientfatinthedietcanalsocompromisetheabsorptionoffat-solublevitaminsandhealthful phytochemicals.When you eat a nut- or seed-based dressing on asalad,youabsorbmoreofthecarotenoidsintherawvegetables.Morethantentimesasmuchofcertainnutrientsareabsorbed.Astudydetectingbloodlevelsof alpha-carotene, beta-carotene, and lycopene found negligible levels afteringestionofsaladswithfat-freesaladdressingbuthigh levelsafter thesamefoodswereeatenwithfattydressings.19Ultimately, the nut icing on the carrot cakewas displayed in theAdventist

Health Study-1, a twelve-year study of thirty-four thousand Adventists inCalifornia. This group is the longest-lived population that has ever beenformallystudied indepth.Weknewthat theveganandnear-veganAdventistslived longer than other Californians, but what were the precise factorsaccountingfortheyearsoflifegained?Interestingly,thisstudyfoundthatthestrongesteffectofanyfoodonpromoting longevitywas theconsumptionofnuts or seeds five ormore times perweek. The consumption of nuts addedyearsoflife,likelyduetotheantiarrythmiceffectofnutsandseeds,comparedtonon–nuteaters,whosuffereddoubletherateoffatalcoronaryevents.20Foranypopulationatriskofheartdisease,especiallydiabetics,eatingsomeseedsandnutsdailyisimperativeandmaybeevenlifesaving.Let’stakealookataday’smenuofequalcaloriesbothwithandwithoutnuts

andseeds,toseesomesubtlebutimportantnutritionaldifferences.

WITHOUTNUTS/SEEDS WITHNUTS/SEEDSBreakfast Oatmeal OatmealBlueberriesandDates Blueberries,Walnuts,FlaxSeedsLunch SaladwithFat-freeItalianDressing SaladwithCaesarSaladDressing/Dip*BakedPotatowithBroccoli BroccoliwithRedLentilSauce*WholeGrainBread AppleDinner RawVeggieswithFat-freeRanchDressing RawVeggieswithGarbanzoGuacamole*EasyBeanandVegetableChili* EasyBeanandVegetableChili*

BrownRice FruitBowlWholeWheatRoll

Note:*indicatesrecipeincludedinthisbook.

WITHOUTNUTS/SEEDS WITHNUTS/SEEDS

TotalCalories 1,882 878Fat 21gm9.2% 66gm28%Carbohydrate 381gm76.8% 277gm54%Protein 69.5gm14% 85.5gm18%Arginine(aminoacid) 3,627mg 5,806mgVitaminE .29mg .66mgSodium 1,570mg 644mgCalcium 978mg 1,356mgIron 24mg 29mgPhosphorus 1,387mg 1,694mgMagnesium 540mg 750mgZinc 9.6mg 13.6mgCopper 2.2mg 4.6mg

Youcansee that thedietwithnutsandseeds ishigher inproteinandmuch

higherintheaminoacidarginine.Argininehasspecialpropertiesthatbenefitthe heart, promoting vasodilatation (relaxation of the vessel wall) andpreventing blood clotting. It also includes higher amounts of vitamin E andminerals, but that does not adequately reflect the major difference betweenthesediets.Theverylow-fatdietgreatlyreducestheabsorptionofmostofthecarotenoidsandotherphytochemicalscontainedinameal.Theysimplyarenotwellabsorbedinsuchalow-fatenvironment.Thebenefitsofnutsandseedsareenhancedwhentheyareeatenwithameal;theyarenotforsnacking.Thereisonemorefascinatinggemaboutnutsandseeds,andIdonotwant

youtoforgetit:thecaloriesarenotallbiologicallyavailable.Theyaresimilarto the resistant starch calories in beans. About 30 percent of the recordedcalories fromnuts and seeds arepassed into the stool, not absorbed into thebloodstream.21Eatingnutsandseeds increasesstool fat,whichmeansnotall

the fat is absorbed. Plus, the sterols, stanols, and other sponge-like fibers innutsandseedscarryothercaloriesfromthedietintothestoolaswell.Sointhecalculateddietarymenusabove—onewithnutsandseeds,onewithout—eventhough the calories recorded and eaten are about the same, the amount ofabsorbed calories from the diet planwith the nuts and seedswouldbe about100calories lower. Interestingly,however, the increase in fecal fat and fiberdoesnotoccurwhenthedietcontainstheoilsinsteadofwholenutsandseeds.In other words, calories from oil are absorbed almost 100 percent. Forexample, eating whole peanuts versus peanut oil would have completelydifferentbiologicaleffects.Remember,itisbesttoeatnutsandseedsraworonlylightlytoasted.When

you roast nuts and seeds, you form carcinogenic acrylamides as the food isbrowned. You decrease the protein and create more ash from the roastingprocess.Themorethenutsandseedsarecooked,themoretheiraminoacidsare destroyed. You also lower levels of calcium, iron, selenium, and othermineralsintheroastingprocess.With your growing awareness of the health properties of nuts and seeds,

pleasetakeintoconsiderationthattheyshouldbeeateninmoderation.ShouldwesitinfrontofourTVs,eatanentirebagofnutsinanhour,andcomplainwhenwegainweight?Ofcoursenot.Healthyeatersavoidexcessivecaloriesanddonoteatforrecreation.Eatonlyoneounceadayifyouareoverweight.Ifyouarethin,physicallyactive,pregnant,ornursing,eattwotofourouncesdailyaccordingtoyourcaloricneeds.Aswearebeginning toseeclearly, idealhealthhasvery little todowitha

preciseratioofcarbs, fats,andproteins.Topreventandreversediabetes,wemust make certain that we are paying attention to our nutrient-per-caloriemodel. We need to eat foods with micronutrients and other proven healthbenefitstoachieveourhealthgoals.It’s time foraction. It’s time toeat the right foods that lead to long-lasting

health.

CHAPTEREIGHT

TheNutritarianDietinAction

Iamonehundredpoundsoverweight.Threeweeksago,Ihadaphysicalandmybloodsugarwas289.ThedoctortoldmeIwasdiabeticandwouldbeonmedicationfortherestofmylife.Insteadoftakingthemedicationthedoctorprescribed,IstartedyourprogramonSaturday,May19.Threedayslater,myglucosewas90pointslower!Everydayitisgettinglower.Myfastingglucoseisnow117,andwhenIcheckatnightbeforegoingtosleepitis120to122.Adrasticchangefrom289—inlessthanthreeweeks’time!Iwillcontinuethisplanandmyexerciseregimensothatmynumbersgetevenlower.Iamlosingaboutfivepoundsaweek.Youradvicehassavedmylife.Thankyou,Dr.Fuhrman.

—LaverneStone,agefifty

For diabetics, optimal health is not achieved by eating less to lose weight.Rather, diabeticshave tomake abig commitmentnotonly to formingbettereating habits but also to eating the right foods to help the body heal. Thischangeincludesmakingadjustmentsintheirthinkingaswellastheirdiet.Butitcanbechallengingtochangeyourthinkingwhenthedoctorsandthemediaarespewingmisguidedinformation.ArecentarticlepublishedbytheAssociatedPressquotesaformerpresident

oftheADA:“Thereisnospecialdiet[fordiabeticstoloseweight].Youhaveto eat fewer calories than your body burns,” saidDr. Robert Rizza, aMayoClinic endocrinologist and former president of the American DiabetesAssociation.1Nothingcanbemoreuntrue.Adiabetic’slifeordeathcanmostcertainlydependon thequality andnot just thequantity ofwhat is eaten. It’sessential to understand what to eat, not just how many calories are in the

doughnutor largeFrenchfryorder.Adiabetic’s lifedependson it.Allofuswant a healthy life expectancy.Whowouldwant to suffer needlessly in theirlateryears?Eatinghigh-qualityfoodsthatarerichinmicronutrientsareyourbody’sbest

friend. They fuel your body’s self-repair mechanisms; they curtail yourappetite; and they are the ticket to a slim, healthy body free of diabetes andheartdisease.Therightdietstylecanremoveyouraddictivedrivetoovereatandenableyoutocontrolyourchronicovereatingforthefirsttime.Itcansaveyourlife.Whenyoueatanutrient-richdiet,youareeatingmorefoodvolume,more

food by weight, and more high-water-content food, meaning you may feelmorefullafteramealeventhoughyouareeatingfewercaloriesoverallandlessfoodthathasahighcaloricconcentration.

High-Nutrient,High-VolumeFoodstoFillUpOnI call high-nutrient, high-volume foods that fill you up the unlimited foods.Theyinclude:

1.Allrawvegetables2.Allcookedgreenvegetables3.Tomatoes,peppers,eggplant,mushrooms,onions,cauliflowerThegoalistoeatlargeamountsofthesethreefoodcategoriestofloodthe

bodywithmicronutrientsandfiber.Memorizethem!So these foods richest in nutrients per calorie are also naturally low in

calories.Yougetmorenutrientsandfewercaloriessimultaneously.Thatistherealfountainofyouth.Fruit is not unlimited, but you can eat a few with breakfast and one with

lunch and dinner if desired. Beans are not totally unlimited, but they are arecommendedfoodthatyoushouldeatliberallyeachday.Youcaneatlotsofthem,up to a cupof beanswith each lunch anddinner, two cups total a day.Nutsandseedsarean importantandhealthyfoodto include inyourdiet,butthey should be limited to one ounce a day for overweight females or 1.5ouncesadayforoverweightmales.Obviously,theselimitscanbeliberalizedforpeoplewhoarenotoverweightordiabeticandrequiremorecalories.Remember,rawvegetablesandallcookedgreenandnon-starchyvegetables

such as string beans, artichokes, zucchini, snow peas, eggplant, tomatoes,

peppers, mushrooms, cauliflower, onions, and leeks do not have to bemeasured. Eat asmuch as you like of these dishesmadewith gentle spices,tomatoes,onion,andgarlic.

TheSaladIstheMainDishRaw vegetables should be eaten in large quantities at the beginning of eachmainmeal.Asensiblegoalistoshootforonepoundofrawvegetablesdaily.Ioften say, “The salad is the main dish.” The word salad here means anyuncooked vegetable. Think big when it comes to salad. The more rawvegetablesyoueat,thelessyouwilldesireofeverythingelse.Rawvegetablesarethehealthiest,mostweight-loss-promotingfoodsyoucaneat.Useavarietyof raw vegetables in your salads. In addition to plenty of lettuce, includetomatoes, shreddedbeets, carrots, cucumbers, andpeppers.Youcanalsoaddany leftover steamedgreenson topofa lettucesalad, somedefrosted frozenpeas, stewed mushrooms, or a handful of beans. Add a little fruit-flavoredvinegaroroneofmydipsordressings,andthesaladcanbethewholemeal.

RECOMMENDEDSALADVEGETABLESLettuces—allvarieties

Tomatoes Celery ZucchiniCarrots Broccoli OnionsandScallionsRadishes Cauliflower SproutsFennel BabyBokChoy CucumberStringBeans SnapPeas SnowPeasEnglishPeas Endive PeppersHeartsofPalm WaterChestnuts Stewed Mushrooms

(chilled)*

The increasedproductionof thebiologically activephytochemicals in rawvegetables is consistent with the studies that show a radically lower risk ofcancerinpeoplewhoconsumemorerawgreensintheirdiet.2Forthoseintheknow,eatinglotsofrawgreensisthemostimportantnutritionalinterventiontopreventcommonhumancancers.3Eatnotonlylotsofrawgreenseverydaybutalsobigportionsofcookedgreenvegetables.Remember,ifit’savegetablewith the color green, it is rich in micronutrients and low in calories. It’s agreenlighttoeatmoreofit.Themoregreensyoueat,theincreasedlikelihood

youwilleatlessofsomethingelsethatishigherincalories.Whenyoufillupwithhigh-volume,high-nutrientfoodsthathaveahighmicronutrientcontent,you will not feel the need to overeat foods that sabotage your health andweight.Theaddedbenefitsincludeprotectionagainstheartattacksandcancer.Ofcourse,greenvegetablesarethefoodthatshowsthemostprotectionfromdiabetestoo.4Howgreatisthat?With the growing popularity of nutritional supplements, more and more

Americansarelookingforaccurateinformationaboutnutrientsthatcanmakearealdifferenceintheirhealthandtheirlives.However,therealityisthatthemostpowerful thingpeoplecandotoimprovetheirhealthiseatmoregreenvegetables. Americans eat a piddly amount of greens, but if they ate muchmore,diseaseratesofalltypeswouldplummet.Notonlyarevegetablesrichindiscoveredvitaminsandminerals,butasdiscussed,theyalsocontainthousandsofphytochemicalsthatarecriticallyimportanttoourhealth.Themorewegetabetterunderstandingofnutritionalscience,themorewe

learn that individual nutrients taken as supplements do not have the samehealing andprotectivepowers of high-nutrient, superfoods.Supplements canbe used to supplement an area of potential suboptimal intake, such as B12,iodine, zinc, vitaminD, orDHA, but theynever can take the place of eatinghealthfully. Not all vegetables are created equal, and one of the mostfascinatingareasofresearchinthelasttenyearshasbeenthetherapeuticvalueofcruciferousgreenvegetables.

TheWorld’sHealthiestFoodsAlmostthreehundredcase-controlledstudiesshowthatvegetableconsumptionprovidesaprotectiveeffectagainstcancerandthatcruciferousvegetablesarethe foodswith themostpowerfulanticancereffectsofall foods.Cruciferousvegetablesarethoseinthebroccoliandcabbagefamilyandincludesuchfoodsas bok choy, radishes, and watercress. While eating fresh fruits, beans,vegetables, seeds, and nuts have been all been shown in scientific studies toreduce theoccurrenceofcancer,cruciferousvegetablesaredifferent. Insteadofaone-to-onerelationshipagainstcancer,theyhaveaone-to-tworelationshipwithawidevarietyofhumancancers.Inotherwords,asplantfoodintakegoesup20percent in a population, cancer rates typically drop20percent.But ascruciferousvegetableintakegoesup20percent,cancerratestypicallydrop40percent.5

Cruciferousvegetablescontainphytochemicalsthathaveauniqueabilitytomodifyhumanhormones,detoxifycompounds,andpreventtoxiccompoundsfrombindingtohumanDNA,thuslimitingtoxinsfromcausingDNAdamagethatcouldleadtocancer.Sulforaphane,anextensivelystudiedcompound,isanisothiocyanate thathasauniquemechanismofaction.Thiscompoundblockschemical-initiated tumor formationand inducescellcyclearrest inabnormalcells, meaning it inhibits growth and induces cell death in cells with earlycancerous changes in a dose-dependentmanner.Recent studies show that theamountofsulforaphanethatcanbeobtainedfromeatingareasonableamountofbroccolicanhavedramaticeffectstoprotectagainstcoloncancer.6

CRUCIFEROUSVEGETABLESKale, collards, broccoli, broccoli rabe, brocollina, brussels sprouts,watercress, bok choy, cabbage,Chinese cabbage,mustardgreens, arugula,kohlrabi,redcabbage,mache,turnipgreens,horseradish,rutabaga,turnips,radishes

Mostmicronutrientsthatwereadabout(vitaminC,vitaminE,beta-carotene,lutein, lycopene) function as antioxidants in the body, meaning thesecompounds neutralize free radicals, rendering them harmless. But thephytochemicals in cruciferous vegetables do more. They enable the body’sown antioxidant control system.Whenwe take in direct antioxidants such asvitamin C and E, they fight a one-on-one war against free radicals but notmuch more. Their effects are gone in a few hours. Synthetic or isolatedfractionsofvitaminE,beta-carotene,orvitaminCcanalsocausepro-oxidantbehavior, creating more free radicals. So instead of having a short-livedbenefit that gets used up quickly, the unique compounds in cruciferousvegetablescycleoverandover,protectingthebodyforthreetofivedaysafterconsumption. They fuel body systems already in place so that they functionmoreeffectively,buttheyalsoinducemanydifferentsystemstodefendagainstmanydifferenttypesofdamage.

CRUCIFEROUSVEGETABLES•Repairandprotect•Detoxifytoxinsandcarcinogens,renderingthemharmless•Regulatetheliver ’sabilitytoremovetoxins

•RemovefreeradicalstopreventoxidativeandDNAdamageincells•Transformhormonesintobeneficialcompoundsthatinhibithormone-sensitivecancers•Enhanceandprotectagainstage-relatedlossofcellularglutathione•EnablecelldeathincellsthathaveabnormalmutationsandDNAdamage7

A study on prostate cancer shows that it takes twenty-eight servings ofvegetablesaweektodecreasetheriskofprostatecancerby33percent,butjustthreeservingsofcruciferousvegetablesaweekdecreasestheriskofprostatecancerby41percent.8TheNationalCancerInstituteof theNationalInstitutesfor Health recommends nine servings of fruit and vegetables per day. Irecommendeightservingsofvegetablesaday,withatleasttwoofthosebeingcruciferousvegetables,onerawandonecooked.Doyoueatgreencruciferousvegetablesdaily?Doyoueatbothrawandcookedgreenvegetables?Let’sallmakesurewedo.

GreensandHeartDiseaseHeartdiseaseiscausedbythebuildupoffattyplaquesinthearteries,knownasatherosclerosis.However,arteriesdonotgetcloggedupwiththeseplaquesina uniformway. Bends and branches of blood vessels—where blood flow isdisruptedandcanbesluggish—aremuchmorepronetothebuildup.ArecentstudyshowsthatNrf2,aproteinthatusuallyprotectsagainstplaquebuildup,isinactive in areas of arteries that are prone to disease.9 However, aphytochemicalfoundingreenvegetablesactivatesNrf2inthesedisease-proneregions.ActivationofNrf2 is importantformaximizingbothpreventionandremovalofplaque.IngestionofthesebeneficialcompoundsfromcruciferousgreenvegetableshadthestrongesteffecttoactivatetheNrf2proteins,blockingatherosclerosis.Vegetables have other powerful disease-fighting nutrients as well.

Carotenoids are just one compound that is important for excellent health.Greens have high levels of carotenoids and other nutrients that prevent age-relateddiseasesthatdiabeticsareproneto.Forexample,theleadingcauseofage-related blindness in America is macular degeneration. If you eat thesegreensatleastfivetimesperweek,yourriskdropsbymorethan86percent.10Luteinandzeaxanthinarecarotenoidsfoundingreenvegetableswithpowerfuldisease-prevention properties. Researchers have found that people with the

highestbloodlevelsofluteinhadthehealthiestbloodvessels,withlittleornoatherosclerosis.11Of course, losing body fat, lowering glucose levels, and lowering blood

pressure all play an important role in the prevention and reversal of heartdisease. But the message here is that a diet rich in greens protects againstdiabetes, aids inweight loss, and fights cancer, in addition to enablingmoretargetedandeffectivereversalofhighbloodpressureandheartdisease.Andgreenvegetablesaresoincrediblylowincaloriesandrichinnutrients

andfiber that themoreyoueatof them, themoreweightyouwill lose. Iamgoingtostophereandhighlightthispoint.Themoregreenvegetablesyoueat,themoreweightyou

willlose.This is an incredible gift of nature. One of my secrets to nutritional

excellenceandsuperiorhealthistheonepoundrule.Thatis,trytoeatatleastonepoundofgreenvegetablesaday,combiningyourrawandcookedgreens.Thismayappeartobeanambitiousgoalatfirst,butIassureyou,youwill

achievethedietarybalanceandresultsyouenvisionwhenyouworktowardit.Let’ssayitagain:themoregreensyoueat,themoreweightyouwilllose.Thehighvolumeofgreenswillnotonlybeyoursecret toa thinwaistline,but itwill also simultaneously earn you future protection against life-threateningillnesses.And lastly,while everyone jumps on the cruciferous-vegetables-are-good-

for-you bandwagon and more science continues to build on their powerfulhealth benefits, let’s not forget H = N/C. In other words, besides all theseuniquefeatures,greencruciferousvegetablesstillcontainmorevitaminsandmineralspercaloriethananyotherfoodontheplanet.Notethatgreenvegetablesarerelativelyhighinproteinper

calorie.For many years, most Americans incorrectly believed that only animal

products contained all the essential amino acids and that plant proteinswereincomplete. False. They were taught that animal protein is superior to plantprotein.False.Theyaccepttheoutdatednotionthatplantproteinmustbemixedand matched in some complicated way that takes the planning of a nuclearphysicistforavegetariandiettobeadequate.False.

Iguesstheyneverthoughttoohardabouthowarhinoceros,hippopotamus,gorilla,giraffe,orelephantcouldbecomesobigwhileeatingonlyvegetables.Animalsdonotmakeaminoacids fromair; all the aminoacidsoriginate inplants.Even thenonessential amino acids that are fabricatedby thebody arejust basic amino acids that are modified slightly by the body. So the lion’smusclescanonlybecomposedoftheproteinprecursorsandaminoacidsthatthezebraandthegazelleate.Greengrasses(orleafygreens)madethelionandarethemotherofalltheproteinthatbuiltallthecreaturesonplanetEarth.I’ve askedhundredsofpeople thisquestion:whichhasmoreprotein—one

hundred calories of sirloin steak or one hundred calories of broccoli? Thetypicalanswer is,“Steak,ofcourse.”WhenI tell themit’sbroccoli, themostfrequentresponseIgetis,“Ididn’tknowbroccolihadproteininit.”Ithenask,“Sowheredidyouthinkthecaloriesinbroccolicomefrom?Didyouthinkitwasmostlyfat,likeanavocado,ormostlycarbohydrates,likeapotato?”People seem to know less about nutrition than any other subject. Even the

physiciansanddietitianswhoattendmylecturesquicklyvolunteertheanswer,“Steak!”Theyaresurprisedtolearnthatbroccolihasmoreproteinpercaloriethanmanycutsofmeatandthatifyoueatlargequantitiesofgreenvegetables,you receive a considerable amount of protein.One ten-ounce bag or boxoffrozenbroccolicontainsover10gramsofprotein.Whenyougetmostofyourproteinfromgreensandbeans,yougetabonanzaofprotectivehealthbenefitsin the process—not to mention that fountain of youth people have beensearchingfor.

PROTEINCONTENTOFSELECTEDPLANTFOODS(INGRAMS)Spinach(frozen,1cup) 7Collards(2cups) 8Peas(frozen,1cup) 9Almonds(3ounces) 10Broccoli(2cups) 10Tofu(4ounces) 11SesameSeeds(1⁄2cup) 12KidneyBeans(1cup) 13SunflowerSeeds(1⁄2cup) 13ChickPeas(1cup) 15

Lentils(1cup) 18Soybeans(1cup) 29

TheEatingPlan

Thinkaboutsettingupyourmenuplanintwophases.Thefirstisamorestrictphaseinthefirstfewweekstogetyourweightdowntoasafernumberandtoreduceasmuchofyourmedicationaspossibleearlyon. In thisphase,otherthan a limited amount of beans, avoid high-carb foods and eat no animalproducts.Ofcourse,youcanremaininphaseoneaslongasyouneedorwanttomaximize results.What followshere are general guidelines to understandphasetwoofthisprogram.Themaindifferencebetweentheseguidelinesandphase one (when you are looking to control your out-of-control glucosenumbers and reduce medications) is more restriction on fruit, grains, andstarchyvegetables.Theexactspecificsofthephaseoneplanwillbelaidoutinchapter10.Thenmoveontophasetwo,amorelivablephase,onceyouhavereacheda

stableplace.Thenyoucouldaddoneservingadayofpeas,butternutoracornsquash, and intact whole grains such as black wild rice or steel-cut oats. Ifyou’reeatinganimalproducts,trytodosoonlyinverysmallamounts,suchasa condiment to flavor a vegetable dish or soup, so it is not amajor caloriesource.Useonlyaboutoneounceforthispurpose,anddonotusemorethantwoouncesinoneday.

BreakfastBreakfast should consist of a few low-sugar fruits, such as berries, papaya,kiwis,pomegranates,oranges,andgreenapples.Youcaneatawholeorangeorapple,butdonotdrinkorangeorapplejuice.Limitfruitstoatotaloffiveservingsdaily,usuallytwotothreefreshfruitswithbreakfast,oneafterlunch,andone after dinner.Blueberries, raspberries, blackberries, and strawberriesare especially recommended because of their concentration of importantphytochemicals andoverall highANDI score.Consider using frozenberrieswhenfresharenotavailable.Becauseberriesareexpensive,manypeoplegotoa berry-picking farm in the summer andbuy large amounts at a great price.Youcansavemoneyandgethigh-quality foodwhenyoupickyourownandthenfreezetheminserving-sizedbagsforuseallwinter.Eatthesefruitswith

somerawvegetablessuchascucumbers,celery,fennel,orlettuce.Ahalfcupofcookedoats—orevenawholecupformen—isalsoacceptable

toeatwithbreakfast.Userolledoatsorsteel-cutoats(preferred)butnotquickoats. Raw oats have more resistant starch than cooked oats, so try soakingsteel-cut oats and regular rolled oats overnight in the fridge and then eatingthem soft, but not cooked, the next morning. You can put fruit on top too.Another great option is a squash-based breakfast soup, made with cookedbutternut squash, chopped greens, almond milk (almonds and hemp seedsblendedwith water), cinnamon, nutmeg, and chopped apple. Baked eggplantchopped with onion, shredded green apple, chia seeds, crushed walnuts,cinnamon,andnutmegalsomakesadeliciousbreakfastdish.Try to eat one tablespoon of ground chia seeds or flaxseeds daily with

breakfast. Sprinkle them over a bowl of cut fruit ormix them into the oats.Groundchiaandflaxseedsarerichinomega-3fattyacids,lignans,andotherbeneficial fibers, so they are strongly recommended. These seeds haveprotectiveeffectsfortheheartandagainstcancer.Also,eatfourwalnuthalvesevery day with breakfast. They also have highly protective properties. Amixtureofslicedapples,flaxorchiaseeds,crushedwalnuts,justasprinkleofrawoats,andcinnamonmakesagreatbreakfasttreat.

LunchLunchisthemostimportantmealofthedaybecausepeopleareusuallyawayfromtheirhome,inpublic,atworkorschool,andaroundothers.Whenyou’reaway fromyourownkitchen,make sure tobringplentyofgood-tastingandfilling food to keepyou satisfied.Whenyouhave a lunchwithyou that youenjoy,itmakesthedaypleasantandyou’llfinditeasiertosticktoyourhealthyeatingplan.Make salad your main lunch dish. Always include lots of raw vegetables.

Dressingsordipscanbemadeusingrawgroundnutsandseedsoranavocadoasthebase.Topyoursaladwithsomebeansandagreat-tastingdressing,andfinishwithapieceoffruitfordessert.Deliciousdressinganddiprecipesareavailable in the menu section of this book with many more options on mymemberwebsiteatwww.drfuhrman.com.One serving of any type of fruit, not just the low-calorie ones, is okay

because the sugar loadwill be dilutedwith the rest of the vegetablemeal.Amango,peach,pear,orange,orbananaaregoodideas.Oryoucanhaveasaladandabowlofvegetable-beansoupandapieceoffruitfordessert.

Prepare a huge pot of vegetable soup on the weekends. Portion it intoseparate small containers so you can just grab a container out of therefrigeratoranddropitinyourlunchbagwithsomerawgreens,tomato,andotherrawveggiesduringyourbusyweek.Besuretoincludeasmallcontainerofyour favoritehealthy saladdressing.Eat the soupat room temperatureorwarmitupatworkforaheartyandfillingmeal.Remember,thisisthebeans-and-greensdiet,orthesalad-and-soupdiet,becauseoftheabundanceofgreensinyoursaladandgreenvegetableswithbeansinyoursoups.SometimesIliketopourthehotsoupovermyshreddedrawsaladvegetablesandusethesoupasaheavydressingfor thelettuce,spinach,andcabbagethatIhaveshreddedverythin.IliketomakesaladdressingsonSundayandWednesdaysotheystayfresh.

TheSundaydressinglastsmeforthreedays,andtheWednesdaydressinglastsforfourdays.Measureout theouncesofnutsandseeds(oravocado)you’reusing in the recipe so you can then divide the full recipe according to theappropriate servingsofnutsperday.So, if youaremaking thedressing forone person and you include four ounces of seeds and nuts, separate thatdressing into four separate containers for use over the next four days.Yourflaxseedsandfourwalnuthalveswithbreakfastdonotcountintheoneounceofpermittedseedsandnutsperday.

DinnerDinnerbeginswithanothersalad,orrawvegetableswithdip.Atomato-basedsalsa-typediporhummusare themost favoredchoices.Try the low-calorie,high-nutrientdipsanddressingsfeaturedinthisbook.Ifyouusedthesoupasyour salad dressing at lunch, use the nut- or seed-based salad dressingwithdinner.Always have a large plateful of steamed green vegetables with dinner.

Choosefromawidevarietyofvegetablessuchasstringbeans,cabbage,bokchoy, artichokes, brussels sprouts, kale, broccoli, and zucchini. Frozenvegetablescanbeusedinsteadoffresh.Theprototypedietisalargesaladwithabowlofvegetablebeansoupatlunchandalargesaladwithsteamedgreensatdinner, but you can switch themeals around.And if you’re not having soupwithyourmeal,besuretoincludesomebeans,eitherabeandishorunsaltedcannedbeanstossedontopofyoursalad.Avegetablestewsuchasaratatouillemadewithpeppers,onions,tomatoes,

andzucchini,andherbsorsomegrilledvegetablesareoptionstoeatafteryour

dinner salad. A bean burger with sliced raw onion and tomato is anotheroption,orifit isyourfishnight,havethesalad,steamedgreens,andasmallpieceoffishcookedwithgarlic,onions,andtomato.Or eat a light dinner of salad and greens cooked with onions and

mushrooms, with some beans scooped on top, and finish it off with adelectablesorbetfordessert.Frozenfruitwhippedinahigh-poweredblenderwithsomefreshfruitmakesadelicioussorbetdesserttreat.Orhaveasliceofmelonorabowlorberries.Youhavenowcometotheendofyourfoodallowancefortheday.Agood

habittoadoptistoflossandcleanyourteethatthispointasaremindertostayoutofthekitchenandawayfromfoodtherestofthenight.

STEAMEDARTICHOKESARELUSCIOUSSlice one inch off the top of an artichoke.Cut off the very bottom of thestem,butkeeptherestofthestemattached—it’sedibleanddelicious.Slicethe artichoke in half lengthwise. Use a sharp knife to slice out the fuzzysectioninthecenterof thechoke.Removethetriangleofsmall leavesthatcoverthefuzzycentertoo.Nowtheartichokewillcookmuchfasterthanitwouldifitwerewhole.Steamitforeighteenminutes,untiltheouterleavespulloffeasily.Drainandserve.You can eat the heart stem andmost of the smaller leaves as well as thetenderinsidesofthelargerleaves.Artichokeshavesuchadelicious,subtleflavor,theyrequirenoseasoning.

OtherGeneralGuidelines

Starchyvegetablesshouldbelimitedinthefirstphaseofthisdiabetes-reversalprogram. For maximizing weight loss, the trick is to use beans as yourprimarystarchsourceandonlyoneotherservingadayofanon-beanstarchyfoodlikebeets,carrots,peas,andsquashes.Ifyou’reeatingaone-cupservingof a starchy whole grain, such as oatmeal, steel-cut oats, or wild rice withbreakfast,donoteatthestarchyvegetableoptionwithdinner.The amount of starchy vegetables varies with body weight and exercise

habits.Slimpeoplewhodonothavediabetesandexercisealotcanhavemorestarches, and more seeds and nuts, to meet their higher caloric needs. Foroverweight diabetics, these aremore limited foods.Colorful cooked starchy

vegetablessuchasbeets,carrots,corn,andbutternutandwintersquashescanbe eaten in small amounts with dinner. High-starch foodsmade from flour,rice, or white potatoes are even more limited in the recommended diabeticmenu.It’spreferabletoeliminatethemfromyourdietuntilyou’recompletelyoffinsulinandsulfonylureas.Phase one of this program is for people coming off insulin and other

diabetesmedications, so that occurs as quickly as possible, because inmostcases,themoremedicationsyourequire,themoreweightlossishindered.Ifyou follow your blood sugar closely, with physician monitoring, themedicationscanbereducedandinmanycaseseliminated.Duringphaseone,Irecommendnohigh-starchvegetablesorgrains.Insteaditisbettertogetyourcarbohydrateandcalorierequirementsfromcauliflowerandbeans.Thatwayyouwill be utilizing only the starchy foods that have a lowGL and that arehigh in resistant starch.Make use of the non-starchy cooked vegetables andtofu toprepare filling, low-caloriestews.Eggplant, tomatoes,onions,garlic,mushrooms,peppers,beans,andzucchiniformthebaseofthesedishes.Nosweeteneddrinksofany typearepermitted,evenartificiallysweetened.

Evenno-caloriesweetenerscanstimulatethepancreastowork.Nofruitjuice.Vegetable juice can be used as part of the soup base—dilute it with water.Drinking only water and eating whole foods are strongly recommended. Ingeneral,drinkingourcaloriesisunfavorablefordiabetics.Driedfruit,suchasraisins,arelimitedtoaminimalamount,usuallyonlyas

a flavor enhancer as a small part of the recipe in a breakfast dish, soup, orvegetabledish.Seedsandnutsarelimitedtoonetotwoouncesdaily,dependingonweight

andactivitylevel—usuallyaone-ouncelimitforoverweightwomenanda1.5ouncelimitforoverweightmales.Seedslikerawsunflower,chia,hemp,rawunhulled sesame, and pumpkin seeds are great choices, and even preferredover raw nuts, as they are higher in nutrients and have beneficial fatty acidprofiles.Ahalfofanavocado ispermittedoccasionallyonasaladorwithadip, butmake sure the seeds andnuts donot exceedoneouncewhenyou’realsousingthehalfavocado.Refinedflourproducts,bread,whiterice,processedcoldcereals,andwhite

potatoesarenotallowedinthesemenus,asthesefoodsarenotrecommendedonaregularbasis.Nordothesemenusandrecipescontainaddedsalt,oil,orsweetenersofanykind.Wholemilk,cheese,butter,andredmeatarenotrecommended.Thesefoods

should only be considered on special occasions or holidays. Nonfat dairyproductscouldbeusedasaflavoringinsmallamountsonceor,occasionally,twice a week. However, they are not missed and can easily be replaced inrecipeswithalmondorhempmilkandothernondairyalternatives.Blendingahalfcupofrawalmondsandhulledhempseedswiththreecupsofwaterinahigh-poweredblendermakesasimplemilkwhenarecipecallsforthat.Animalproductsingeneralshouldbelimitedtoasmallamountoffishonce

aweekandthenonlyoneothersmallservingofnon-fishwhitemeatperweek.Noeggs,meat,orcheese.Usually, you can still achieve good resultswith a small amount of animal

productssuchasoneounceofturkey,scallops,shrimp,orchickentoflavorasoup,stew,orstir-fry.Manypeoplefeelmoresatisfiedwhentheyareallowedtohaveeventhissmallamountoftheiranimalproductallotmentdividedupasacondimenttoflavordishes.Insteadofeatingonefour-ounceservingaweek,theysplititupoverseveralmeals.Some recipes in my menu plans are used twice in the same day or as

leftovers thenextday.This isdone intentionallybecausewhenyouprepareadish,itmakessensetoreduceyourworkloadandmakeenoughforatleasttwomeals.Manypeoplechoosetouseaprepareddishfortwotothreedaystosavetime and cooking efforts. My family cooks huge amounts of food and eatsleftovers fora fewdays.Thatwayweonlyhave toprepare food twodaysaweek.Experimenttofindoutwhatworksbestforyou.With theremovalofpotato, rice,andflourproducts,andtherestrictionon

nutsandseeds tooneouncedaily,youmayneed toaddmorebeans toreachyourcaloricneeds.Greens,beans,fruit,nuts,seeds,tofu,andthelow-calorievegetables listedabovesupply themajorvolumeofcalories in thediet.Nutsand fruits somewhat less, of course. Spaghetti squash and cauliflower arepermissiblesubstitutionsforhigher-starch,higher-caloriegrainsandpotatoes.Turnips, parsnips, and other squashes are alternatives to rice, bread, andpotatoesandareabetter,morenutrient-andfiber-richchoice.Grainsshouldbewhole and intactwhen cooked inwater.Whole grains such as brown andblackrice,barley,quinoa,andsteel-cutoatsorold-fashionedoatmealareidealexamples; nevertheless, they are best avoided in phase one and limited to aone-cupservingorlessperdayinphasetwo.Mostofmypreferreddiabetic-reversalmenushavesuchgrainsonlyafewtimesperweek.Alwayswashfreshfruitandvegetablesthoroughly.Buyorganicifpossible.

Alwaysbuyorganicstrawberries,spinach,andcelery,asthesethreeitemsare

themostpesticide-contaminatedfoodsintheproducesection.

CookingTechniquesandTipsoftheTradeAbasiccookingtechniqueutilizedinsomeoftheserecipesiswater-sautéing.Thisisusedinsteadofcookingwithoil.Water-sautéingissimpleandgoodforstir-fries,sauces,andmanyotherdishes.Towater-sauté,heataskilletonhighheatuntilwatersputterswhendroppedinthepan.Usesmallamountsofwater,startingwithtwotothreetablespoonsinahotskillet,wok,orpan,thenaddingthe finely sliced vegetables, stirring and then covering to maintain themoisture. Continue to stir and add more water only if necessary. In manydishes, the moisture from tomatoes, mushrooms, zucchini, and other high-water-contentvegetablesissufficient.Soupsandstewsarecriticalcomponentsofthisnutritariandietstyle.When

vegetables are simmered in soup, all the nutrients are retained in the liquid.Manyofthesouprecipesusefreshvegetablejuices,especiallytomato,celery,andcarrotjuice.Thesejuicesprovideaverytastyantioxidant-richbase.Ifyoudon’thaveajuicer,considerpurchasingone.Ifyouareshortontime,bottledtomatoandothervegetablejuicescanbepurchasedatmosthealthfoodstores,but nothing beats the flavor of freshly juiced vegetables. I also use a simpleproceduretocreate“cream”soups.Rawcashewsorcashewbutterareblendedintothesouptoprovideacreamytextureandrichflavor.Abigadvantageofhomemadesoupsisthattheymakewonderfulleftovers.Soupsgenerallykeepwell for up to four days in the refrigerator but should be frozen if longerstorageisdesired.Shouldyouoccasionallychoose touseaprepared soup,keep inmind that

your overall daily sodium intake should remain under 1,200milligrams formenandunder1,000milligramsforwomen.Naturalwholefoodscontain400to 700 milligrams of sodium, which allows for a leeway of about 500milligrams.Besuretoreadlabels.Youwillbeamazedbyhowmuchsodiumcannedsoupcontains.Trytoselectano-saltaddedvariety.My recipes includemany delicious salad dressings and dips.Conventional

dressings usually startwith oil and vinegar; the oil provides the fat, and thevinegarprovidestheacidity.Thefatsourcesinmysaladdressingsarewholefoods suchas rawalmondsandcashews,other rawnuts and seeds, avocado,andtahini.Thisisnotafat-freeeatingstylebecauseourbodiesrequirehealthyfatsfromwholefoods;thewaynaturedesignedustoconsumethem.Byeatingthisway,wereceivethelignans,flavonoids,antioxidants,minerals,andother

protective phytochemicals that come along in the package. So the oil isremoved, and seeds andnuts supply thehealthy fats insteadbecause they aresuch a healthy disease-fighting food. Removing the oil and using nuts andseedsastheprimaryfatsourceinthedietiscriticaltoreversingdiabetes.A powerful blender such as a Vitamix is very helpful for making salad

dressings, creamysoups, smoothies, and fruit sorbets.Nutsand seedsdonotget soft andcreamy fordressings ina regularblenderunlessmore liquid isadded.Onlythemoreexpensive,high-poweredblenderscanmakefruitsorbetsfrom frozen fruits and blend vegetables effortlessly for fruit and greensmoothies.

FrequentMini-MealsAllDayorThreeMealsaDay?Hereisaquiztoseeifyouunderstandpartofthiscomplicatedmessage.Isithealthiertoeatfrequentsmallmealsorjusttwoorthreemealsaday?I’ll give you a hint. Remember, deep cellular repair and detoxification

occursmostreadilyinthenon-digestivestage(duringglycolysis)andduringsleep.Iamsureyounowhavetheanswer.Contrarytopopularadvice,itisbesttoeatonlywhenyou’rehungry,andnot

eat after dinner. Your next meal should be when you feel true hunger thefollowing morning. Giving the pancreas the prolonged time to rest and tolower insulin levels iskey.Snackingafter finishingdinner is theworst thingyou can do.When you consider the advice to eat frequent small meals andsnackalldaylong,rememberthis:

1.Peoplewhoeatmorefrequentlyusuallytakeinmorecaloriesperday.2.Obesepeopleareinvariablysnackers;snackingcorrelateswithobesity.3.Animalsfedthesamecalorieamountsmonthly,butonaless-frequentschedule,livelonger.

4.Diabeticrecoveryisenhancedbyresting,notutilizing,thepancreas.5.Youdon’twantorneedtoeatfrequentlywhenyoueatproperly.Foodtastesbetterwhenyouwaituntiltruehungeroccurs.

6.Eatingwhentrulyhungrydirectsyoutoyourprecisecalorieneedstomaintainaleanbody.Eatingoutsideoftruehungerisusuallyaddictiveeatingorrecreationaleatingandpromotesdiabetes.

7.Morefrequenteatingorsnackinghasbeenshowntoincreasetheriskofcoloncancerinmen.12

TheDiabetesSolution:High-Nutrient,High-Fiber,High-Water-

ContentFoods,withNoSnackingMostpeoplefollowingthisprogramfordiabetesreversaleattwomainmealsofmostlyvegetablesandbeansplusalightbreakfast.Thatmeanstheyusuallyeatabreakfastconsistingofabout300caloriesandthenabout400to500atlunchandagainatdinner.Becausetype1diabeticsareoninsulin,theyshouldeatapproximatelythesameamountofcaloriesateachmealandstaywiththreemealsaday.Somepeopleclaim thatmore frequenteatingspeedsup themetabolic rate,

andafastermetabolicratefacilitatesweightloss.Thisisamyth.Eatingmorefrequentlyoreatingmorecalorieswillnotchangemetabolismsufficientlytomakeupfortheincreaseincalories.Ifeatinglessmadeyoufat,thenanorexicpeople would be the heaviest. Of course, overweight people naturally haveslow metabolic rates. That was a favorable genetic inheritance to enhancesurvival for most of human history when food was not as plentiful as it istoday.Aslowmetabolismmeansapersoncancomfortablyeatlessandnotgettoo thin. Actually, a slower metabolic rate means one is aging slower too.Therefore,ifyouareanaturallyheavyperson,youhavebeengivenasurvivalgift. A slower metabolic rate is only a bad thing in today’s toxic foodenvironment, not the food environment that has existed for most of humanhistory.Youcanstillhavealong,healthylifefreeofdiabetesandheartdisease.It is just that you are designed efficiently and can handle lots of physicalactivitywithoutneedingtoomanycalories.People on this diet style are actually amazed how satisfied they are with

fewercalories.Sincetheyaregettingsomanymicronutrients,theyfeelgreat,havemoreenergy,anddefinitelyarenotsuffering thesamehungercravingsoftenfeltonmostrestrictivediets.Youcaneatabundantlyfromhealthyfoodsandstillnotovereatcalories.The only safeway to enhancemetabolism is exercise. Supplements, green

tea,caffeine,metabolicboostingherbsandsupplements,drinkinghotorcolddrinks,orpackingyourselfinicedonotplayasignificantroleinweightloss.

SupplementsandMultivitaminstoConsiderorAvoidMultivitamins and supplements have pros and cons. Themain problemwithtakingatypicalmultivitaministhatitmayexposeyoutoextranutrientsthatnot

only are unnecessary for your body but could actually be harmful too.Excessivequantitiesofsomevitaminsandmineralscanbetoxicorhavelong-term negative health effects. We know it is important to avoid vitamin andmineraldeficiencies,but it is justas important toavoidconsumingtoomuchofcertainnutrients.

FolateFolateandfolicacidaremembersoftheBvitaminfamily.Folateistheformfound naturally in foods, especially green vegetables and beans. Too muchfolate obtained naturally from food is not a concern. It comes naturallypackaged in balance with other micronutrients, and the body regulates itsabsorption.Folicacidisthesyntheticformthatisaddedtofoodorusedasaningredient invitaminsupplements.Folicacid isalsoadded tomostenriched,refined grain products like bread, rice, and pasta in the United States andCanadainanattempttoreplacethenutrientslostduringtheprocessingofthewholegrain.Recently,therehavebeentroublingstudiesconnectingfolicacidsupplementationwithincreasesinbreast,prostate,andcolorectalcancers.13Adietrichingreenvegetablesishighinfolate,sosupplementalfolicacidisnotnecessaryonthiskindofdiet.Itisimportantforourhealthtoeatvegetablestoobtain thefolate (andothernutrients)weneedandavoid thesignificant risksassociatedwithsupplementalfolicacid.

VitaminAVitaminA isalso risky to take in supplemental form. IngestingvitaminAorbeta-carotenefromsupplementsinsteadoffoodhasbeenshowntoincreasetherisk of certain cancers.14 In Finnish trials, using beta- carotene supplementsfailed toprevent lungcancer,and therewasactuallyan increase incancer inthose who took the supplement. This study was halted when the physicianresearchersdiscoveredthedeathratefromlungcancerwas28percenthigheramong participants who had taken the high amounts of beta-carotene andvitaminA.15Thedeathrate fromheartdiseasewasalso17percenthigher inthosewhohadtakenthesupplementscomparedto thosejustgivenaplacebo.Another recent study showed similar results correlating beta-carotenesupplementation with an increased occurrence of prostate cancer.16Furthermore, a meta-analysis of antioxidant vitamin supplementation foundthatbeta-carotenesupplementationwasassociatedwithan increasedall-cause

mortality rate.17 As a result of these European studies, as well as similarstudiesconductedhereintheUnitedStates,articlesintheNewEnglandJournalofMedicine, theJournal of theNationalCancer Institute, and theLancet alladvisepeopletostoptakingbeta-carotenesupplements.18Taking extra vitaminA (retinyl palmitate and retinyl acetate)may be even

more risky than using supplemental beta-carotene. Because beta-carotene isconverted to vitamin A by the body, there is no reason a person eating areasonably healthy diet should require any extra vitamin A. There is solidresearch revealing that supplemental vitaminA increases calcium loss in theurine, contributing to osteoporosis. One study found that subjects with avitaminAintakeintherangeof1.5milligramshaddoublethehipfracturerateover those with an intake in the range of 0.5 milligrams.19 For every 1milligramincreaseinvitaminAconsumption,hipfracturerateincreasedby68percent.VitaminAsupplementationhasalsobeenassociatedwitha16percentincreaseinall-causemortality.20In spite of the huge volume of solid information documenting the

deleteriouseffectsofbeta-carotene,vitaminA,andfolicacid,itisstillalmostimpossibletofindamultiplevitaminthatdoesnotcontainthesesubstances.

Iron,Copper,andSeleniumAlthough iron is crucial for oxygen transport and other physiologicalprocesses, in excess iron is anoxidant thatmay contribute to cardiovasculardisease and cognitive decline in older adults.21 Iron should be taken as asupplement onlywhen a deficiency or increased need exists, such as duringheavymenstrualbleedingorpregnancy.Recentstudieshavealsoshownthatexcesscoppercouldbeassociatedwith

reduced immune function, lower antioxidant status, atherosclerosis, andacceleratedmentaldecline.22Forthesereasons,IalsoexcludecopperfrommysupplementsandthoseIrecommend.Ahealthydietgivesusenoughcopper.Selenium,ofcourse,isessential,butahealthfuldietgivesusenough.There

is some evidence that high selenium levels may contribute to diabetes,hyperlipidemia,prostatecancer,cardiovasculardisease,andimpairedimmuneand thyroid function. Therefore, supplementation beyond what is present innaturalfoodsislikelynotbeneficialandmayresultinoverexposure.23Somepeople,evenwhenconsuminganidealdiet,mayneedmoreofcertain

nutrients.Individualabsorptionandutilizationofnutrientsvariesfromperson

toperson,andsomepeoplesimplyrequiremoretomaximizetheirhealth.Forexample, B12 is always low on a near vegan or vegan diet, and someindividualsrequireiodineormorevitaminDduetodifferencesinabsorptionandutilization.Likewise,somepeoplemayalsorequiremoremineralssuchaszinc for maximizing their health and longevity.24 I have designed a fewsupplements thatconvenientlysupply themicronutrientsofvalue, leavingoutany potentially risky or controversial elements. These are available atwww.drfuhrman.com.Idorecommendtakingahigh-qualitymultiplevitamin/mineralsupplement

tosupplyextravitaminsDandB12,zinc,andiodinebecauseidealamountsofthesearehardtoacquireeveninanexcellentdiet.Asdiscussedabove,themainissuehereismakingsureyoudonotingestsupplementalingredientsthatarepotentially harmful in your quest to optimize your levels of these valuablemicronutrients.Mostvitaminsandmineralshaveawindowofoptimalintake,sothegoalistotaketherightamount,nottoomuchortoolittle.

VitaminDandCalciumEven thoughmost people are deficient in VitaminD, toomuch can also besuboptimal,sobloodtestsareoftenrecommendedtoassuretheproperlevelofsupplementation. The multivitamin/mineral I make available atwww.drfuhrman.comcontains2,000IUofvitaminD3,anappropriateamountforthemajorityofindividuals,eventhoughsomepeoplecouldrequiremore.VitaminD is a critical nutrient, not just for your bones but also for generalprotectionagainstheartdisease,cancer,autoimmunedisease,andmanyotherhealthproblems.TakingthishigherlevelofVitaminDhasbeenshowntoofferbenefitstodiabetics.25TheidealamountofvitaminDsupplementationisbestdeterminedbybloodwork.The25-hydroxyvitaminDlevelideallyshouldbebetween 30 and 50 ng/ml. I do not recommend high-dose calciumsupplementationunderthefalsepretensethat it isgoodforthebones.Infact,toomuchcalciumcanweakenbonesandcanevencontributetocalcificationsin thevascular system.26 Extra calcium is not required for people followingmynutritionalguidancebecausethediethasadequatecalciumalready.

Long-ChainOmega-3(EPAandDHA)Ialsorecommendasupplementsupplyingthelong-chainomega-3fattyacidsEPAandDHA.DHAisessentialforoptimalbrainandeyefunction,andEPAis

particularly protective and therapeutic for depression.27 Deficiency posesincreased risks to diabetics.28 Conversely, adequate intake of long-chainomega-3 has been shown to benefit diabetics.29 This can pose a challenge,however,becausemostDHAandEPAarederivedfromfishoil,andfishhasbeendemonstratedtoactuallyworsendiabetes.30 Infact, fishintakeshoweda22percenthigherriskfordiabeteswhencomparingfiveormoreservingsperweekwithlessthanoneservingperweek.31Therefore,Irecommendfishonlyin limited quantities, which are sufficient to assure adequacy in these fats.ThoughthebodycanmakesomeEPAandDHAfromwalnuts,flaxseeds,andgreens,theconversionisvariablefrompersontopersonandthelevelsinmostvegans are suboptimal. Besides, few people consume enough walnuts andflaxseeds every day to assure adequateDHA production. SupplementalDHAandEPAisagoodideafornutritionalassurance,especiallyfordiabetics.However, I do not recommend fish oil capsules regularly because each

capsulecontainsabout1,000milligramsofoil,andthishighdoseoffishfatmayhaveanegativeeffectondiabetes.Thegoalistopreventdeficiency,notsupplyexcess.Instead,150to300milligramsadayissufficient.Considerthealgae-sourcedDHAsupplementsavailableorDHA/EPAPurity,whichprovidesa clean and effective source of these omega-3s without harvesting fish andwithoutoverdosingonfattyacids.Idonotrecommendthepharmacologicuseof high-dose fish oil to lower cholesterol and triglycerides, because thosedosagesarenotwithoutrisks.

Thiamine(VitaminB1)Another supplement to consider taking if you have diabetes is thiamine(Vitamin B1). Studies indicate thiamine deficiency often accompaniesdiabetes.32 The higher the glucose levels, the more likely you are thiaminedeficient,asthiamineislostasglucoseisexcreted.Furthermore,evenamilddeficiencyofthiaminecanpromotecomplicationsofdiabetes.33Supplementalthiaminecanhelpprotectthekidneyinthediabetic.Thiamine

deficiency in diabetics is linked to increased oxidative stress and damage tokidney and nerves.34 Studies have demonstrated that diabetics benefit fromtaking extra thiamine.35 Diabetic nephropathy, neuropathy, and possiblyretinopathyhavebeenshowntoimprovewiththiaminesupplementation.36I typically recommend that people with active diabetes in the process of

reversalingestabout10to20milligramsadayofextrathiamine,thatisabout

ten times the normal recommended daily intake. However, once the diabeticissues are resolved, this need not continue.Many health professionals use amuchhigherdose,whichwouldonlymakesenseiftheglucosewasveryhighand uncontrolled evenwithmedications, but this is not the casewith peoplefollowingmynutritionalguidelines.

AlphaLipoicAcidEventhoughalphalipoicacidiscommonlytoutedasanimportantsupplementfor diabetics, its use is questionable.When given intravenously, it has beenshowntohavesomebenefittodiabeticneuropathy,butitsusefulnessorallyisnot proven. Alpha lipoic acid is already available among the hundreds ofbeneficial compounds ingreenvegetables.Thebottom line is that ifyouarefollowingthisprogramtoreversediabetes,itisunlikelythataddinganalphalipoicacidsupplementwillofferadditionalprotection.However,peoplewithneurological problems from their diabetes, especially if they are eating adiabetes-promoting diet, would be reasonable candidates for this type oftherapy.

Glucose-LoweringPlantsandHerbsSupplementingyourdietwithherbsandplantstolowerglucoseisreasonable,both in capsule form and added into dishes.A fewgrams of cinnamonhavedemonstrated benefits at lowering blood glucose and improving lipidparameterswithoutapparentsideeffects.37Gymnemasylvestre isalsomildlyeffective.38Powderedfenugreekseedsrequiretoolargeadosetobeeffectivesoaremoredifficulttoutilize.39Thereareotherplantsandplantextractsthathavelittlesideeffectsandhavebeenshowntomildlylowerbloodsugar.Theyincludegreentea,acaciaextract,hops,bittermelon,andnopalescactus.40Though these plant extracts are not as strong as blood-glucose- lowering

medicationsare, theadvantageofusingnaturalagents is that,by themselves,they do not cause hypoglycemia.On the other hand, they do not address themaincauseofdiabetes.Ifindthatmostofmypatientsdonotneedtheseaidstoadequatelycontroltheirbloodsugarbecausethedietandexerciseprogramissoeffective.However, incaseswhereextrahelp isneeded,acombinationofnaturalplantextractscanbeaddedtotheprotocol,whichcanfurtherreduceoreliminatetheneedformedicationsandtheirsignificantside-effectprofile.

PlantSterolsandPomegranateExtractsPlantsterolsandpomegranateextractsmayalsobeconsideredfortheirlipid-lowering and cardio-protective properties in diabetics. Plant sterols arenaturallypresentinplantfoods(especiallynutsandsoybeans),arestructurallysimilartocholesterol,andarecomponentsofplantcellmembranes,similartocholesterolinanimalcellmembranes.Plantsterolshavelongbeenrecognized,andareFDAapproved, for theircapacity to reduceLDLcholesterol.41MorethanfortyhumanstudieshavebeenpublishedconfirmingtheirLDL-loweringproperties.Plantsterolsupplementscanproduceadecreaseofapproximately15percentinLDLlevels.42ThisLDLloweringoccursinthedigestivesystem,where plant sterols inhibit cholesterol absorption. This blocks not onlyabsorption of dietary cholesterol but also reabsorption of the cholesterolproducedbythebody.43Aninterestingrecentfindingisthatplantsterolshaveadditionallybeenshowntoofferprotectionagainstseveralcancers.44Pomegranates are a delicious and unique fruit that contain a wealth of

beneficial phytochemicals. Their potent antioxidative compounds have beenshowninmedicalstudiestoreverseatherosclerosisandlowercholesterolandblood pressure.45 Among the antioxidant substances in pomegranates areanthocyanins, catechins, quercetins, and distinctive ellagitannins calledpunicalagins—punicalaginsmakeupthebulkofthepomegranate’santioxidantload.46These potent antioxidative compounds are believed to be responsibleforthepomegranate’snumeroushealthbenefits.Indiabeticsandnondiabeticsalike,pomegranatereducescholesterol,oxidativestress,andinflammation.Inaddition, pomegranate acts similarly to ACE-inhibiting drugs, naturallyloweringbloodpressure.47Inonestudyofpatientswithseverecarotidarteryblockages,aftertakingoneounceofpomegranatejuicedailyforoneyear,onaverage these patients experienced a 12 percent reduction in blood pressureanda30percent reduction in atheroscleroticplaque. In strikingcontrast, theparticipantswho did not take the pomegranate juice experienced a 9 percentincrease in atherosclerotic plaque.48 Also look for pomegranates in season,andifyoucan,freezesomeoftheseedsforuselaterintheyear.

ChromiumChromium is another nutrient commonly recommended to diabetics becausethose with diabetes are typically overweight and have been eating diabetic-promoting diets low in chromium. In other words, eating refined grains,

sweets, and processed foods leads to chromium deficiency and worsensdiabetes.Ameta-analysisidentifiedforty-onetrialsthatevaluatedtheeffectsofvarious chromium formulations and dosages and found mild benefits,especiallyamongpatientswhosediabeteswaspoorlycontrolled.49Ofcourse,whenyoueatanutritariandietwithtomatoes,onions,andgreens

—foods that are very high in chromium—you protect yourself fromchromium deficiency and diabetes. So even though clinical trials show amodest improvement in markers of insulin resistance and glucose levels inpatientswhosupplementwithchromium,Iamnotcertainthissupplementwillbeofvalueforpeoplefollowingmyhigh-micronutrientapproach,astheyarenowreceivingadequatechromiumandhavealreadycurtailedfoodsthatcausechromiumdeficiency.Remember, this isnotacalorie-countingplan.Youcaneatasmuchasyou

desire of the recommendedunlimited foods.You can eat limited amounts ofseveralotherfoodstoo.Lethungerbeyourguide.Donoteatuntilyou’refull.Justeatsoyourhungerissatisfied.Youdonothavetoeatallthefoodsinthesuggestedguidelinesandmenus,andyoucanswitcharoundthemealsifthat’swhat works best for you. The most favorable way to eat is to learn fromexperience so you know the right amount of food thatwill allow you to behungryintimeforthenextmeal.Ifyouarenothungrybeforethenextmeal,then you have eaten too much at the prior meal. Remember, hunger is feltmostly in the throat and increases your ability to enjoy food. If you are nothungry,donoteat.Youwillnotdieifyouskipamealortwoorthree.Erronthesideofundereatingsoyoucanmakesureyouareeatingonlywhenyou’rehungry.Youwillenjoyeatingmorewhenyoufeelyouhaveemptiedyourtankbeforerefueling.Astheysay,hungeristhebestsauce.

CHAPTERNINE

TheSixStepstoAchievingOurHealthGoals

IwasdiagnosedlateNovember2006withdiabetesattheageoffifty-two.Myfastingbloodsugarlevelatthetimewas160.Myweightwas218pounds.Ihadbeenprediabeticforsometime,alongwithastrongfamilyhistoryofthedisease.Itookthisnewsasapersonaldeathwish.Beingapharmacist,Iknowthelong-termcomplicationsandrisksthatdiabetescarries.Ibecamedeterminednottoletthisdiagnosisdoommetoalifeofmedicationandroutineinsulinshots.MywifefoundDr.Fuhrman’sbookwhenshewasbrowsingthroughthehealthsectionatourlocalbookstore.Itwasagodsend.WhileIhaveneverbeenabigredmeateater,thethoughtofevolvingmydietfromachickenandfishdiettotheultimategoalofaprimarilyplant-baseddietseemedlikeahugechallenge.However,Iwasdeterminedtobeatdiabetesatanycost.IamproudtosaythatDr.Fuhrmansavedmylifewithhiseatingprogram.AndIenjoyit.Mylatesttestresultsspeakforthemselves:Cholesterol(total)139,LDL79,HDL49;bloodpressure110/75;weight172;A1C5.3.Theonlydownside(ifyoucallitthat)tothisexperiencewasmyneedtobuyanewwardrobe.Mywaistsizedroppedfromthirty-eightinchestothirty-threeinches.Mylargeshirtsnowhangonmelikeatrashbag!Ihavelostthefatfacethatyouseeinmybeforephoto.Thankyousomuchforgivingmethemeanstochangemylifeandbecomehealthy.Iamanewman!

—SteveD.

Youhavenowreadlotsofscienceandlogic.Hopefully,Ihavemotivatedyouto make a change. The problem for some of us is that our behavior is notcontrolledbylogicorscience;itiscontrolledbyfeelingsandemotions.Change can be very difficult for some people and easier for others.

Knowledgeisclearlythekeythatcansetusfreefromtheviciouscycleoffoodaddictionandself-destructiveeatingpractices. Ifyouareoneof thosepeoplewho finds change difficult, then let’s work together to lose the emotionalbaggagethatcouldbeinterferingwithachievingexcellenthealth.Youhavetolose the fearofchangeand the fearofgivingup thecomfort foods that fuelyourfoodaddictions.Replacethemwithexcitementaboutamorepleasurableand comfortable life driven by the results you will see as your body istransformed.Wemust look to thebigpictureand focuson long-termresults,not short-

term recreational eating. Together,we can get rid of the on-a-dietmentalityandmovetobecominganexpertinnutritionalexcellence.Partofgainingthisexpertise is learning some great-tasting recipes that youwill love.You alsohave toaccept that it takes time toallowyour tastebuds toadapt to thisnewwayofeating.Bepatientwithyourself.Itcouldtakeafewmonthstopreferthiswayofeatingandforyourtastebudstosensitizethemselvestolowerlevelsofsalt,sugar,andoilinnaturalfoods.Overtime,though,youwillfindthatyouenjoy this styleof eatingeverybit asmuch, andevenmore, thanyourpriordiet.Thisbecomesespeciallytruewhenyouseethephysicalresultsofeatingfoodthatissogoodforyou.It is a good idea to have a meeting with your family members or other

people you livewith to explain your new diet direction and to ask for theirsupport.Donottrytochangetheireatinghabits,butaskthemiftheycanhelpyoubyunderstandingwhatyouaredoingandwhy.Perhapstheycanreadthisbooktohelpyoustayfocusedonyournewdietstyleandnewhealthgoals.Ifyourlovedonesfeelthatyouaren’ttryingtochangethembutarejustaskingthemtorespect,understand,andsupportyouinyournewdietplan, theymaychoosetomakeimportantchangestowardbetterhealthforthemselves.Support is important. If you don’t have supportive family or friends, or a

supportivelocalnetwork,joinmywebsitemembershipatwww.drfuhrman.comto help you interactwith otherswho eat the sameway. The connectionwithothersisvaluable.Youwillfindyouarenotalone.Thousandsofothersareonthe same path to good health andwant to support you and share your life’s

challenges.Lastly, please don’t forget the personal rewards and sense of achievement

youwillreceivefromearningbackyourexcellenthealth.Thisisarewardthatcontinuesyearafteryear, a reward thatmultipliesoverandoveragainwhenotherpeoplearepositivelyinfluencedtoearnbacktheirhealthbecauseofyourexample.Youdonotlivealoneonanisland.Yourhealthandwell-being,andthe positive message you radiate to those around you, affect your family,friends,fellowworkers,andcommunity,evenyournation.Destructiveeatingmay give you amomentary high, but themost pleasure in life comes frommoremeaningfulachievements.Make thecommitment toearnbackexcellenthealth, and soon youwill find that healthy eating can be just as pleasurable.Everydayonthisprogramplacesyoucloser to improvedhealthandamorerewardingandpleasurablelife.SixEssentialStepstoHelpYouReachYourHealthGoals

Step#1:MaketheCommitmentandWriteItDownKeeptrackofyourprogressinanotebook.Startbywritingdownatleastfivereasonswhyyoueatthefoodsyounowdo.Thinkofreasonswhyyoushouldcontinueonyourcurrentcoursethathasmadeyoudiabeticandiskeepingyoudiabetic.Thismaysoundlikeasillyexercise,butitishelpfulforclosureandclarityasyouexaminehowyougot to thispointandhowyouplan tomovetowardhealth.Then on the next page, write down the advantages ofmaking a complete,

firm, and irrevocable commitment to eating theway I amsuggesting for thenext twelveweeks.Thismeans if you have diabetes, staywith the phase onedietary guidelines for the full twelve weeks. Allow time for your tastepreferencestochange,foryourweighttodrop,andforyoutoreduceserioushealthrisks.Then,afterthefirsttwelveweeks,youcanchooseifitistherighttimetomakesomesmallmodificationstotheprogram(movingtophasetwo)or to staywithphaseone tomaximizemoregains. If the advantages arenotimmediatelyclear, takeamomentand reflectonhowyourdietaryhabitsareaffectingyouandeveryonearoundyou.Whatare the long-termdangersandconsequences?Thissectionwillincludewhywhatyouwereeatingwasslowlykilling you and what you hope to gain from this great change in foodpreferencesandeatingstyle.

Somepeopleprefertorationalizeandprotecttheiraddictions.Thedesiretomaintaintheseaddictionshastakenovertheirlifedespitethelong-termhealthconsequences.Myguessisthattheseindividualsdidnotgetveryfarintothisbook.Butthefactthatyouarestillreadingtellsmeyouareready.ThisstepisveryimportantbecausetherestofsocietyeatingtheSADwillsurelyattempttoconvince you otherwise. This notebook will prepare you for any internalconversationswithyourselforanyexternalconversationsthatmayariseaboutyour choices. It is the ultimate shield that protects you and enables you toconfidently move toward health and a life that is not ruled by disease,medications,doctorvisits,andfear.The reason I chose twelve weeks for this firm commitment is because it

takesusthatlongtochangeourtastepreferences,learnnewfavoriterecipes,andgetinarhythmofeatingandenjoyingthisplan.Twelveweeksgetsuspastthestageofexperimentationandintotherealmofrealeverydayliving.Aftertwelve weeks, the health turnaround will be in full swing, and you will beseeing powerful results daily. Then it will be easy for you to feel andunderstand that this is a lifetime commitment to excellent healthbecause thisbecomesthewayweallprefertoeatandenjoymost.Afteryouhavelistedtheadvantagesanddisadvantagesofyournewdietstyle

inyournotebook,writedownyourcommitment:

I, (your name), commit to a new effort of health excellence over the nexttwelve weeks of my life. This includes eating only the healthiest foods,learningmoreabouthowtopreparethemproperly,andcontinuingwithoutexcusesordistractions consistently for the twelve-weekperiod. Iwill alsoexerciseeveryday.

A commitment means that an excuse is not an excuse. There can be noexcusestobreakthiscommitment.Addictsalwayshaveexcuses.Theyalwayshavea reasonor rationalization toexplainwhy their lifestylechangedidnotworkorwastoodifficult.“It is too difficult a time right now”; “I had to travel on my job”; “I am

invited toawedding”;“Mysonsmashedup thecar”;“Iamhaving troubleatwork” are all common excuses. The reality, however, is that life is stressfulandchangeisdifficult,butacommitmentmeansyoudoitnomatterwhat.Donottrytodothisbecausetryingmeansyouwillacceptanexcusenottodoit.Instead,commitnomatterwhatlifethrowsyourwayandnomatterhowmuch

effortittakes.Thingsthathavehugevaluerequireeffort.Givingitatryistheformula for failure. Moderation means failure. Great success means asignificant effort isusually required.Doing itnomatterwhat is the formulaforsuccess.Itistheformulathatallsuccessfulindividualsusetoachievegreatresults.

Step#2:DrawUpa“BusinessPlan”Regardlessofthescaleofanyventure,abusinessplanisaninvaluableasset.Itisamapofhowyouplantoachieveyourgoals.Ibelieveaplanisessentialforsuccess.Let’s start by creating aweekly schedule. Firstwork on the plan onscrap paper, and thenwrite it in your notebook. The plan should consist ofdeterminingyour foodshoppingdays,what tobuyandwhere,whichdays todoyourcooking,whatyoucook,andwhatyouplantosaveasleftoversforthedaysyouarenot cooking. It shouldalso includewhatdaysyouexerciseandwhatexercisesyoudoonthosedays.Allofthesedetailsneedbepartofyourweeklyplanner.Themorepreciseyouarewiththeplan,theeasierthefollow-throughasyourdaysunfold.Thisstep isessential forcreating the importantbalancebetweenyour job,yourdiet,yourexercise,andotherdetails inyourlife.Thisplanwillmakesure thisprogramisaccessiblenomatterhowbusyyouare.Most people useweekends to do a big food shopping trip aswell as their

majorweeklycooking.It’sagoodideatomakeabigpotofveggie-beansoup,a salad dressing, and a cooked vegetable. Then you have food to use asleftoversforthemainpartoftheweek.Youmayalsoconsiderdoinganothersmallshoppingtripandafoodpreparationsessiononasmallerscale,perhapson an evening you take off from going to the gym. Sometimes frozenvegetablesorcannedbeanscanbeusedsoyoucanexerciseinsteadofcookingone night.When writing your business plan, choose which recipes you aregoingtomakeandthefoodsyouhavetobuytopreparethem.Nowyouhaveyourdietplanfortheweek.Writeyourbusinessplan in the formofaweeklycalendar soyoucan see

when you shop, cook, exercise, and do other errands and recreationalactivities.Planningisessentialforsuccess.Youhavetoplantomakesurethisprogram fits into your life.You don’t always have to cook, but you alwayshavetoplan.

Step#3:TrackYourProgress

Next,makeasectioninyournotebooktotrackyourmedications,yourweight,yourbloodpressure,yourbloodsugar,andyourlabtests.Addanentryatleasttwiceweeklydocumentingyourprogress,andincludehowmanypoundsawayyouarefromyourgoalweight.Alsowritedowntheexercisesyoudoandthelengthandvigoroftheexercisesoyoucanrecordyourincreasesinexercisetolerance. This all will make it easy to reduce your medications at theappropriaterateandtime.It has been shown in medical studies that keeping a diet diary to record

everything you eat helps with staying on a diet. This is not necessary foreveryone, but I believe it is valuable to have the stats and details at yourfingertips.Trackingprogresscanbeapowerfulmotivator.Notonlyareyoufeelingbetter,moreenergetic,andlosingweight,butalsoyouhaveallthedatatoproveit.

Step#4:MakeItPublicNow make your commitment public. Tell at least six people that you aremaking a radical change in your diet and your health. Tell them about thisbook,why you aremaking this commitment, andwhat you hope to achieve.Puttingyourcommitmentout inpublicmakes itharder to turnback.Voicingyourcommitmenttoothersmakesitmoreestablishedinyourmindandmakesiteasier to resist the temptationof justeatingyouroldway. It iscommon toreceiveaskepticalanddiscouragingresponseinreturn,sometimesevenfromyourphysician.Thatshouldonlyhardenyourdesireandabilitytoprovethemwrong.Youarenowincontrolofyourlifeandyourhealth.Itisnotuptoyourphysician,friends,orfamily.Doingwhateveryoneelsedoesgotyouintothismess to beginwith.Now it is up to you.You now knowmore than they doaboutgettinghealthy.Youcandowhatever it takes to earnbackyourhealth.Thousandsofpeoplehavesucceeded,andsocanyou.Thereisnoturningback.

Step#5:MakeYourKitchenHealthyStartbyriddingyourhomeofallunhealthyfoodsthatyounolongerintendtoeat. Stocking your refrigerator and cupboardswith the right ingredients foryourdietanddiscardingthediabetesunfavorablefoodsisamajorstep.Ifyouare livingwithpeoplewhocannotgoalongwithexcellentnutrition,separatethestorageareasforyourfood.Useadifferentrefrigeratorfortheunhealthyfood or use a separate area of themain refrigerator.Get rid of or separate

otherfooditemsaswell.PutabiglabelonthatsectionthatsaysyournameandDon’tTouch.Giveyourspouseorothersyoulivewithpermissiontoofferyouhelpifyouneedit.Theyhavetobeinstructed,“Don’tletmeeatthefoodthatyou are saving for yourself.” Don’t forget that if you are having problemscommittingtothisprogram,ithelpstotalkwithotherswhohavedoneitandare doing it. You can find a support group on my website, www.drfuhrman.com.Stock up on plenty of fresh and frozen fruits and vegetables. Buy many

varietiesofdriedbeans.Alsobuysomecannedbeans.Lookforbrandswithoutsalt,usuallyavailableinhealthfoodstores.Thekitchenshouldbecomehealthcentral.Itisvitaltohaveitstockedandreadytohelpyouhelpyourself.Rollupyoursleeves,andlet’sgettowork.

Step#6:TheExercisePrescriptionIt cannot be overemphasized that if you have diabetes, exercise is yourprescription of choice. In place of dependency-inducing drugs, the propermedical interventionforthisdiseaseis tofocusontheaggressiveuseofdietandexercise.I alwaysasknew type2diabeticpatients, “Howmanydaysaweekdoyou

forget to take yourmedication?” Theymost often say, “Never.” Then I ask,“Whydon’tyoujusttakeitsometimes?”TheylookatmelikeIamcrazy.ThenIsay,“Whichdoyouthinkismoreimportanttoyourlong-termhealth,takingyourmedicationdailyorexercisingdaily?Theanswerisexercise—itismuchmoreeffectiveandmoreprotectiveofyourfuturehealthandsurvivalthanthemedication.Ifyouwanttoneglectyourselforforgettocareforyourself,thenforgettheprescriptiondrugs,butneverforgettoexercise.”Toomanypeoplesufferingfromdiabeticconditionsbelievethatdrugsaretheirsavior.Inreality,drugscandiscourageus from taking the right steps towardgoodhealth,andthedependencyonmedicationcanbeadownfall,notasavior.Diabetes isadiseasewhoseinherentcausationis toolittleexerciseandtoo

muchfatteningfood.Thetwokeygoalsforanyonewithtype2diabetesaretogetslimandfit.Sowhyaremoreandmoreofusgettingsickeachyear?Aswediscussedearlier,toomanypeopleareaddictedtounhealthyfoodsandvicioustoxic eating cycles. And toomany are told by well-meaning physicians thatdiabetes is safely and effectivelymanagedwith drugs, not diet and exercise.Diabetics typically think (falsely) that their medication is life saving. Theywouldn’t daremiss it. The truth is that doing daily exercise is the real life-

saving prescription. I make this clear to my patients and emphasize, “Fromnow on, never miss your exercise. That is so much more important. It iscritical toyour recovery.Youmustbephysically fit ifyouaregoing tobeatdiabetes.”Infact,accordingtolargestudies,diabeticswhobecomefitcanlowertheir

riskofprematuredeathby40 to60percentdependingon theirbodyweight.One study, reported at the 2008 European Society of Cardiology Congress,showedthatthosediabeticswhowerehighlyfithada65percentreducedriskofdeathinthesevenyearsfollowingthestudycomparedtothosewithalowleveloffitness.1Performingdailyexerciseandbuildingupexercisetolerancearethemosteffectivewaystoenhancesurvival—theirresultsarenotmatchedbyanymedicationstoanydegree.There is no excuse for not exercising.Time is not an excuse. If you have

timetotakeashower,brushyourteeth,andgotothebathroomdaily,youcanput aside tenminutes twice a day to exercise. Poor fitness is not an excuse.Evenbodilyinjuryrarelyinvolvestheentirebody,soyoucanusuallydosomekindofphysicalactivity.Evenpeopleinwheelchairscanexercise.Andifyouhavepoorexercisetolerance,thatisevenmorereasontostart.Ifyourbloodsugarisrunninghigh,getitdownquickly;addressthisright

awaywithwhatgoesinyourmouthandhowoftenyouexercise.Youmustde-emphasizetheroleofmedicationsandaddressyourconditionhead-on.Ifyoudidnothavemedications,iftheyhadneverbeendeveloped,whatwouldyoudotobringyourglucosedown?Youwouldexercisemoreandeat less, amuchsaferandmoreeffectiveoptionthanmedication.

HowtoExerciseWhenYouHaveDiabetesOkay,youarecommittedtogettinghealthyandfittogetridofyourdiabetes.Youaregoingtoeattherightfoodsandexerciseeverydaybecauseyouhavefinallydecidedtobeatthisdiseaseonceandforall.Nowyouknowyoushouldeatonlywhenyou’rehungryandnoteatsomuchthatyouarenothungryagainforthenextmeal.Mybasicexerciserulesformydiabeticpatientsworkhandinhandwiththeunderstandingoftruehunger.Generallyifyoueatthreetimesaday,youshouldexercisethreetimesaday.Ifyoueattwiceaday,youshouldexercisetwiceaday.Eatonlywhenyouarehungry,andthatusuallymeanseatonlyafteryouhaveexercisedtoworkupanappetite.Ideally, calories should be expended via exercise or physical activity in

betweenmealssothatbeforefoodiseaten,youhaveearnedit.Exercisingtwotothreetimesadayisusuallynecessarytoachievetruehungerbeforeameal.Thepointisthatyoushouldnotbeeatingfoodunlesshungerdemandsyoudo.Andthenwhenyouseehowmuchbetterfoodtasteswhenyouaretrulyhungry,youcanappreciatethateatinglessandexercisingmoreincreasesthepleasureofthefoodyoudoeat.Agoodplace to start your exercise regimen iswithwalking.Theultimate

goalisworkinguptothirtyminutesthreetimesaday.Ofcourseifyouhavenot been walking regularly, we don’t start out at that level. I recommendbeginningwith tenminutes three timesaday.These short intervalsmake theexerciseveryeasytofitintoourbusylives,andtheyallowustoquicklybuildupstaminaoverafewshortweeks.Iftenminutesistooeasy,extendtofifteenminutesthreetimesaday.

TENEASYEXERCISESYOUCANDOANYWHERE1.Walkbriskly.2.Putonsomemusicanddancewithabouncingmotion,transferringyourweightfromlegtoleg.

3.Make-believejumprope—jumpinplaceasifholdingajumprope.4.Getupanddownfromyourchair50to100times.5.Walkupanddownaflightofstairs(ormuchmorethanoneflight).6.Dojumpingjacks.7.Hoparoundtheroominacircleorbackandforthinalinefirstononefoot,thenontheother.Startoutwith30secondsperfoot.

8.Riseupanddownonyourtoes.9.Standononelegandholdontoachairorawallforbalance.Extendyourfreeleginfrontofyousotheheelstretchesoutabout12inchesinfrontofyourstandingleg.Now,bendyourstandinglegkneesoyouloweryourbodyabout6inches,andthencomebackup.Dothis25timesandthenswitchlegs.RepeatXtimesoneachleg,dependingonyourfitnesslevelandexercisetolerance.

10.Joginplace.Pickyourkneesuphigherasyougetinbetterphysicalcondition.Modifyyourexerciseprescription toyour individualcapacityabilitiesand

needs. Jumping is more vigorous than walking, so start out with only oneminuteofjumpingorhoppingifthisisnewforyou.Alsouseavarietyofthe

aboveexercise techniques (andmanyothers) at eachexercise session so thatyouinvolveavarietyofskillsandmuscles.Startslowly,butdoasmuchasyoucanhandlecomfortably.Theworseyourphysicalconditionandexercisetolerance,

themorefrequentlyyouneedtoexercise.If you are overweight and poorly conditioned, fatigue and soreness from

exercise can be a limiting factor. The objective is towork up your exercisetolerancegradually.Walk,doafewflightsofstairs,and then ifyoucan’tdoanymore,waitafewhoursandtryagain.Themoreoutofshapeyouare,themoretroubleyou’llhavedoingmuchexercise,sothemorefrequentlyyou’llhavetoexercise.Ifyoucan’texercisemuchatonetime,youhavetoengageinshorter periods of regular butmore frequent exercise. If you can only do alittle exercise, such as fiveminutesor less, thenplanondoing something atleastfourtimesaday.Exerciseinspurtsthroughouttheday.Astimegoesby,youwillbeable to increasethe intensityanddurationof theexercises.Whenyou can spend an hour ormore in the gym exercising vigorously, you canexerciselessfrequently.You can burn calories, lower your blood sugar, andmelt away fat with a

variety of calorie-burning activities and exercises.However, calorie-burningactivities such as walking, stair-climbing, biking, swimming, and using theelliptical machine are not sufficient. Weight training to increase muscularstrengthisalsoimportant.Sooften,diabeticscomplainitisdifficultforthemtoloseweighteveniftheycutbacksignificantlyontheirfoodintake.Thewaytoaddressthisisbycombiningtherightdietwithanassortmentofexercises,especiallymuscle- strengthening exercises. Invariably, peoplewho complainthattheirmetabolicrateislowandtheyhavetroublelosingweightnomatterwhattheyeathaveweakmusclesandarepoorlyconditioned.Increasingtheirstrengthbyweight traininganddoingotherweight-bearingexercises createsan increase inmuscledensity,whichhelps tometabolizemorecalories.Thiscritical increase inmuscle densitywill help normalizemetabolism, and as aresultwilladdresstheproblemthat’scausingdiabetes.Walkingupflightsofstairsistheverybestexercise.Walkupasmanyflights

ofstairsasyoucaneachday,andkeeptrackofthetotalnumberofflightsyoudo.Walking twenty to thirty flights a day is an effective way to meet yourfitnessgoal.Mostofmypatientshaveahealthclub in theirhome—that is, astairway.Manyevenhaveasecondstairwaygoingdowntothebasement.Iask

them towalk up and down the two flights ten times in themorning and tentimesatnight.Ittakesonlytenminutes,butitreallyworks.I also encourage patients to join a real health club and use a variety of

equipmentthatusesmanybodypartsformaximumresults.Themoremusclegroups thatareexercised, themoremetabolicallyactiveplayersyouhaveonyourteamtohelpyoumeetyourgoals.Itisdefinitelyhelpfultohaveaccesstoan assortment of exercise equipment, such as ellipticalmachines, treadmills,stair steppers, recumbent bicycles, and numerous resistancemachines.Whenyoutireofonemachine,youcanmoveontoanewone.Strength-building exercise should be done daily too.However, themuscle

groupsexercisedshouldberotatedsothesamemusclesarenotexercisedtwodaysinarow.Forexample,onMonday,doexercisestostrengthenyourchest,shoulders, and middle back (latissimus dorsi). On Tuesday, do abdominals,lower back, and thighs.Wednesday, do biceps, triceps, forearms, upper back(trapezius),andcalves.Thursday,startwithchest,shoulders,andmiddlebackagain.Of course, this is done in coordination with the other walking, running,

jumping, climbing, stairs, swimming, tennis, racket ball, incline treadmill,biking,orothercalorie-burningactivitiessoasnot toworkthesamemusclegroupsheavilytwodaysinarow.Forexample,avoidstairclimbing,elliptical,orbikingthedayafterdoingthigh-strengtheningexercises.However,walking,treadmill walking, jogging, swimming, continuous dancing, and rowingmachine exercises can be done every day in addition to strength trainingbecause these exercises will not make your thighs too sore. Ideally, Irecommendmydiabeticpatientswalkatleastamileeverymorning,exercisefortenminutesorsobeforelunch,andthenexercisevigorouslywithjumpingandstrengthtraininginthelateafternoonorearlyeveningbeforedinner.Itisalsohelpfultominimizingsittingduringtheday.Ifyouworkatadesk,

consider purchasing a draft table which has a work surface at a heightconvenientforstanding.Orworkpartofthedaywithyourlaptoporpapersonanelevatedcountersoyoucanstand.Nowadays,youcanpurchasecomputerstands that riseupsoyoucanworkstanding. Ifyou’re talkingon thephone,standupandwalkasyou talk. Ifyousitallday,youwillmake thisprogrammore difficult. Sitting all day is unhealthy, even if you exercise regularly. Ifyouworkstandingandthensitforabit,thenworkstandingagain,youwillbemorealertandefficientonthejobwhileyou’realsotrainingyourbodytobemorefit.

IsExerciseEssentialforSuccess?

Exerciseisextremelyimportant,butifyourabilitytobeactiveandtoexerciseislimited,donotdespair.Mymenuplanswillstillenableyoutoloseweight.Peoplewhoareunabletoexercisejustrequireastricterdiet.Somepeoplehavehealth conditions that preclude them from much exercising. However, anexerciseprescriptioncanbedevisedtofityourcapabilities.Almosteveryonecan do something; even thosewho cannotwalk can do arm, abdominal, andbackexerciseswithlightweightsoruseanarmcycle.Youcanlistentoupbeatmusicandrhythmicallybounceupanddownforafullsong.Evenifyourfullbody weight does not lift off the ground, see if you can do some mildbouncingandhoppingasyouaredancing.Trytokeepdancingforafullfiveminutesormore.Exercisewill facilitateyourweight loss andmakeyouhealthier.Vigorous

exercisehasapowerfuleffectonpromotinglongevity.Ifyouhavethewilltoadopt this plan and take good care of yourself, you will find the will toexercise.Startslowandgraduallyworkup,soyoudonotinjureyourself.Butimmediatelybegintodomorethanyouaredoingnow.Younowknowthenutritionalsciencebehinddiabetesandwhydrugsarenot

thesolution.Youunderstandtheinsandoutsofwhatyoushouldeat,andyouhavethesixcriticalstepsforpreparationandachievingyourhealthgoals.Itisnowtimetogetslimandfittopreventorreversediabetesforgood.

CHAPTERTEN

ForDoctorsandPatients

WhenRicardoPachecostartedthisprogramsixteenyearsago,hehadafastingbloodsugarof175andweighed256pounds.Hisbloodpressurewas155/85,andhewastaking20milligramsofAccuprildailyforbloodpressureaswellas15unitsofinsulinand500milligramsofmetformintwicedaily.Atthefirstvisit,Icuthisinsulintojust10unitsthatfirstnightandthenjustonemoredosethefollowingnightwith5units.Theinsulinwasstoppedafterthetwo-daytaper.Twoweekslater,heweighed237,adropofnineteenpounds.Hisfastingbloodsugarwas115,andhisbloodpressurewas125/80.Aboutamonthafterthat,heweighed221,alossofthirty-fivepoundsinfifty-twodays.Hehadafastingbloodsugarof80,whichallowedustostopthemetforminatthattime.Hisbloodpressurewas88/70,soIdiscontinuedhisAccupril,whichactuallycouldhavebeencutoutsooner.Luckily,hewasnotfatiguedorlightheaded.Hecouldhavefaintedorinjuredhiskidneyfromtheunnecessarymedication.Tenmonthsafterthefirstvisit,Ricardoweighed190,alossofsixty-sixpoundssincestartingtheprogram,andhisHbA1Cwas5.3withatotalcholesterolof134andabloodpressureof112/76.Hewasonnomedication.Hehasbeendoingwell,medication-freeforoverfifteenyears.*

Aswehavediscussed,diabetesmellitusisatremendousfinancialandhealthburden on an already overstressed health care system. Diabetes and itscomplicationscontributetoanestimatedtotal(directandindirect)costof$174billion in the United States on an annual basis, including $116 billion inmedicalexpendituresand$58billioninlostproductivity.1In2011,accordingto the National Institutes of Health, the prevalence was 25.8 million, or 8.3percent of the population.2 It complicates the issue that approximately two-

thirds of the U.S. population is overweight and/or obese, increasing thepossibility of exponential growth in diabetes due to the higher likelihood ofinsulinresistanceamongthispopulation.3It is generally assumed that a combination of failure to loseweight, poor

glucose control, and poor management of other risk factors increase thecomplicationsandriskofdiabetes.Currently,medicalcarefortype2diabetesconsists of attempts to lower risk and achieve better metabolic control.Successful treatment outcome, however, is not consistently achieved withcurrentdrug-basedrecommendations.In the2009consensusstatementof theADAand theEuropeanAssociation

for the Study of Diabetes, the organizations recommend starting a nascentdiabeticpatientonlifestylechangesplusmetformin.Accordingtotheauthors,formostindividualswithtype2diabetes,lifestyleinterventionsfailtoachieveormaintainthemetabolicgoalseitherbecauseoffailuretoloseweight,weightregain, progressive disease, or a combination of factors.4 Only about 36percentof type2diabeticshaveachieved theADA’s recommendedgoalofaHbA1C <7.0, which means about 64 percent are still not reaching even thebasic (suboptimal) therapeutic goal.5 These percentages are worse than in1988through1994,when44percentreachedtheADAgoal.Alsodisappointingisthefindingoftwolargeclinicaltrials,eachwithover

ten thousand patients, that intensive medication therapy to tightly controlglucosetonearnormoglycemiclevelsmaynotbethemosteffectivetreatmentapproach.6 One trial was halted when data showed an increase in all-causemortality(257vs.203)andnobenefitincardiovascularcomplications.Theproblemisthatthemoderndietissodiabetogenicthatmostpatientswith

type2diabetesdonotachievetargetglycemiclevelswithtraditionaltherapies,and these agents are also associatedwithweight gain and poor tolerability.7Insulin therapy or intensification of insulin therapy commonly results inweight gain. Weight gain associated with insulin therapy is believed to beprimarilyduetotheanaboliceffectsofinsulin,anincreaseinappetite,andthereductionofglucoseexcretionintheurine.Thisweightgaincanbeexcessive,adversely affecting cardiovascular risk profile.8 These less-than-satisfactoryresults create a quagmire for the medical community. Diabetic care withoutsubstantiallymotivatingpatientstoeatmorecarefullyanddomoreexerciseissuboptimal.

HeartDiseaseandDiabetesHaveanUnbreakableBondDiabeticsdevelopatherosclerosisearlyinlife.Theydevelopitevenbeforethediagnosis of diabetes is entertained. Atherosclerosis, or the buildup ofcholesterol and plaque inside of the blood vessels, is a disease created byexcess caloric consumption.We can’t separate the discussion about diabetesandheartdiseasecompletelyfromweightloss.Heartdiseaseandheartattackswere exceptionally rare occurrences in human history until the explosion ofcommercial foodmanufacturing and processed food exposure in the 1900s.The low-micronutrient diet people eat today contributes to atheroscleroticplaque deposition in two basic ways. First, low micronutrient consumptionpromotesexcesscalorieintake,andsecond,lowmicronutrientintakeincreasesoxidative stress and inflammation in the body, which further promotesatherosclerosis.Itiswell-establishedthatatheroscleroticplaquedevelopmentandthefactors

that contribute to the instability of plaque that promotes clot formation arelinked to inflammation-prone tissue. From the initial phases of fatty streakformation to the evolution toward plaque instability and rupture, the SAD,which gets itsmajority of calories from low-micronutrient processed foodsandanimalproductsinsteadofvegetables,beans,fruits,seeds,andnutsisthecauseofthisdiseaseprocess.Circulatorydisease,theleadingcauseofdeathinthemodernworld,isadietary-causeddiseasethatismosteffectivelydealtwithfromadietarystandpoint.The impact of low-micronutrient eating takes its toll, promoting an

inflammatorycascadeunderlyingmostdiseasesthatplaguethemodernworld.It is this combination of excess calories, fat deposition, and inadequatephytonutrientsthatcreatesanationofcardiovascular-diseasedindividuals.Itispossible,butmuchlesslikely,forthinpeopletodevelopatheroscleroticheartdiseasewhen eating a disease-promotingdiet, but evenmost of these peoplestillhavesignificantamountsofabdominaladiposityandvisceralfat.In addition to my twenty-plus years of experience in treating advanced

cardiac patients and diabetics with aggressive nutrition, my main scientificcontribution to this body of knowledge is the explanation that the sameunderlyingbuildupof free radicals,AGEs, andother toxic agents causedbyinadequate micronutrient intake not only create disease and promote tissuedamageandaging,buttheyalsopromoteovereatingbehavior,foodaddiction,and foodcravings.Theunderlyingdrive tooverconsumecalories is just toodifficulttoaddresswhileaddictivesymptomsdriveovereatingbehavior.This

physical need formore frequent and concentrated calories creates emotionaland thought rationalizations that seek to justify bizarre and illogical eatingbehaviors, leading almost everyone to overconsume calories. When amicronutrient-deficient diet is consumed, we desire an excessive amount ofcalories just to feel normal. There is no longer the connection betweensatisfyinghungerandanormalbodyweight.Sobecomingoverweightisduenotjusttoeasilyobtainablecaloriesandsedentaryjobsbutalsotounhealthfuleating that leads to addictive food-consuming behavior, resulting in overlyfrequent eating and overeating. The result is that the vast majority ofAmericansbecomeoverweight,atherosclerotic,and—nowmoreandmore—diabetic.Usingmedical and surgical interventionswhile the underlying nutritional,

biochemical, and lifestyle factors that caused the problems continue topercolateisdoomedtofailure.Medicalcareisexpensiveandfutilecomparedtonutritionalinterventionswhichareremarkablyeffectivefor:

•Loweringcholesterolandlipidriskmarkers•Improvingvascularremodelingtofacilitateoxygenationandtorelieveandresolveangina•Losingweightandglucoseintolerance,reversingthediabeticprocess•Reducinginflammatoryandclot-promotingtendencieswithoutincurringariskofbleeding•Reducingthetendencytowardarrhythmia,suddencardiacdeath,heartattack,andstroke•Reducingall-causemortalityinallpatientswithallmedicalconditionsItcan’tbereinforcedenoughthatthegoalisalowbody-fatpercentage,nota

low dietary-fat percentage. The low body-fat percentage is best achieved byprescribed regularexerciseandnutritionalexcellence,andbringingback theconnectionwith true hunger so recreational eating and eating outside of thedemandsoftruehungercanbereduced.Keepinmindthatloweringcholesterolandlosingweightdonotadequately

explain this high-nutrient diet’s protective effects against cardiovasculardisease. This prescribed diet effectively lowers high-sensitive C-reactiveprotein.Thisproteinfoundinthebloodhasbeenproventoincreasetheriskofheart disease. In addition, this powerful diet offers vital anti-inflammatoryprotection and other beneficial biochemical effects. Even though drugsmay

lower cholesterol, they cannot be expected to offer the protection againstcardiovascular events that superior nutrition can. The aggressive use ofcholesterol-loweringdrugsdoesnotpreventmostheartattacksorstrokesanddoes not decrease the risk of fatal strokes.9 In clinical trials, a significantpercentage of patients who are taking the best possible statin therapy stillexperiencecardiovascularevents,suchasheartattacks,suddencardiacdeath,andstrokes.Loweringcholesterolwithnutritionalexcellence,however,canbeexpected to offer radically more protection and disease reversal than drugtherapycan,withouttheriskorexpenseofprescriptionmedication.Ihaveseenthe results in patients for more than twenty years, and now finally we arebeginningtoseetheresearchresultscatchupandsupportmyexperience.Therewardfortreatingpatientsinthismanneris toseeimprovementsand

disappearance not only of diabetes but somany othermedical conditions aswell. Headaches resolve, asthma episodes often go away, fatigue and bodyachesimprove,digestiveissuesresolve,andmostimportantly,atherosclerosisandchestpainsresolvewithoutinvasiveproceduresorsurgeries.

HeartDiseaseCaseStudiesThe interesting part of the results achieved with excellent nutrition on thisnutritarian diet style is that many of these participants were already on so-calledhealthydiets andwereworseningbefore they followedmynutritionalprotocols to reverseheartdisease.Somewereevenworseningonvegetariandiets.Theothernotableachievementisthatpeopleonthisregimendonotseejust a small reversal of atherosclerosis with excellent nutrition; they get adramaticamountofreversal.

Case#1:DavidDavidwasasixty-year-oldmanwhohadreadthe1980srunawaybestsellerFitfor Life over ten years ago and was following its recommendations for astarch-basedMediterranean-typediet.Davidatemostlyvegetarian foodswithbrown rice, potatoes, andwholewheat, fruits andvegetables, chickenonly afewtimesamonth,fishonceortwiceaweek,andsomeoliveoilonsalads.HebegananexerciseprograminJuneof2006andwassurprisedtofindthathehadchestpainwithexertion.Hisweight had been stable at 158 pounds for years.A thallium stress test

indicatedasignificantcoronaryarterydiseasewithanLDLcholesterolof126.

His CT angiogram done on June 30, 2006, showed near total obstructivedisease in the proximal left anterior descending artery due to low-densityplaque.David beganmy careful dietary protocol for the reversal of heart disease

and did not have an angioplasty or bypass as was suggested by thecardiologists.After followingmynutritionaladviceforonemonth, thechestpains resolved.Hisweightdropped to140 in the first eightweeks.Oneyearlater,arepeatoftheCTangiogramshowedtheleftanteriordescendingarterywithanon-obstructivemixed-densityplaquewithastenosisestimatedat50to70percent.David’sweighthas remainedaround138 to140 since followingmydietarysuggestions.InAugustof2008,thelastevaluationofhiscoronaryarterieswasperformed,showingnormalcardiacbloodflowandnoevidenceofheartdisease.

Case#2:StanStanwasamiddle-agedmalewhohadbeenonthestrictversionofapopularlow-fatdietprogramthat includedmeatbutwas largelybasedonvegetables,grains, and fruits for over three years while his carotid artery diseasecontinued to worsen. After the first year on this seemingly healthy diet, theresults showed no or very slight improvement. Stan continued on this verystrict program for two more years to improve his disease. But it gotsignificantlyworse!Theradiologistsaid,“Thelesionontheleftsideisstable.There is someearlybuildupon the right side thathasworsened, and Igot anicepictureofalipid[fat]inclusioninthearterywall.”Stanwas then referred tome by the dietician at the health center thatwas

monitoringhis progress.After twentymonthsonmyprogram,he sawgreatresults.The radiologist’scomments this timewere:“Borderlineevidence foratherosclerotic burden.” He was no longer talking about a lesion or earlybuildup.Therewasbarelyanysignofatherosclerosis.In twentymonthsonmydietaryprotocol,Stan lost tenpounds and is now

157 pounds.He is now running twomiles per day,whereas hewas runningfourmilesadayduringthelasttwounsuccessfulyearsonhisformerlow-fatflexitariandiet. “I just changed the emphasis off of lots ofwholegrains andontohigh-nutrient foods. I felt lotsbetter, Idroppedmyabdominal fatgirdlewithouteffort,andIenjoyedit,”hesaid.

Case#3:Susan

Sixty-six-year-oldSusanhadahistoryofoccasionalirregularheartbeatsnotedtoworsenwith the ingestionofcaffeine, alcohol, and sometimesevenheavyexercise. She changed her diet first to vegetarian and then to low-fat vegan.After a little more than one year on the very low-fat vegan diet, herarrhythmiasworsened,andshethendevelopedatrialfibrillation.Unsatisfiedwith the results of following the extremely low-fat vegan diet,

she changedher diet tomynutritional recommendation.Susan improved thenutritionalqualityofherdietandaddedbacknutsandespeciallyseeds.Withinthreemonths,hercardiacarrhythmiascompletelydisappeared.

Case#4:DebraDebraarrivedinmyofficeasaseventy-two-year-oldfemaletype2diabeticatfive-foot-one andweighing 160 pounds. She had been on insulin for twentyyears.Shewasusing30unitsofLantusinsulinatbedtimeand5unitsofLisproinsulin before each meal, with blood sugar running between 125 and 175.Because Debra was taking under 50 units of insulin a day and the dietaryinterventioncanaccountforat least30unitsof insulin,Idiscontinuedall theinsulin at that first visit and started her on 250 milligrams of Glucophage(metformin)threetimesaday.Asitturnedout,shedidnotfeelwellusingeventhe low dose of Glucophage, and since her glucose levels were runningbetween 110 and 130 in the few days after her initial visit, we decided tomanage thediabeteswithoutmedications. In this case,we essentially stopped50unitsofinsulinperday,andherbloodsugarwasbettercontrolledwithoutit.Debrareportedathertwo-weekfollow-upvisitthatshefeltmuchbetteroff

of theinsulin.Herappetitewasnolongerravenous,andshefelt immediatelylighterandmorecomfortablewithwalkingandexercise.Shelostninepoundsinthosefirst twoweeks.Debraisnowsafelyoffallmedicationandshowingnosignsofdiabetes.My high-nutrient-density diet is designed to be diabetic favorable, to reducebody fat, and to promote the regression of atherosclerosis. It accomplishesthesegoalsformultiplereasons:

•Norefinedcarbohydrates,neithersugarsnorstarches•Minimalgrains(intactgrainsonly),1servingdaily•Veryhighfiber(over50gramsperday)•Highviscousfiber(flax,oats,beans)

•Highpercentageofresistantstarch•Moderatefatfromseedsandnuts•Verylowsaturatedfat•Zerotrans-fattyacids•Sufficientomega-3fattyacids•Highphytochemicalsandantioxidants•Lowglycemicload•Verylowsodium(lessthan1,200mg/day)•Lowcaloricdensityperfoodvolume•Minimalanimalproducts,3servingsaweek(fewouncesmaximum)orlessIt isdesignedasa therapeutic interventionfordiabeticswhowant themost

effectivedietaryregimenformaximizinghealthprotection.Becausetheresultshavebeensoimpressive,patientcompliancehasbeenfavorable.Resultsareaidedwhendiabeticpatientsmakeafirmdecisiontoattacktheir

medicalissuewithcompletededicationandefforttoahigh-nutrientdiet.

ManagingInsulinUseforType1DiabetesNutritional excellence is critically important for type 1 diabetics. ThecombinationbetweenthediseaseandtheSADoreventheADArecommendeddiet results in needless medical tragedy in all type 1 diabetics. My type 1diabetic patients wind up using approximately half the insulin dosages theyrequiredbeforeworkingwithme.TheyobtainfavorableglucoseandHbA1Clevels, and get rid of the swings in glucose that require varying dosages ofinsulin. They are able to stick to an insulin dose without monitoringnightmaresandconstantadjustments.Theyhavefewerfluctuationsinnumbersandavoidhypoglycemia,astheirinsulinrequirementsarenowphysiological,notpathological.

FORDOCTORSONLY(BUTNONPHYSICIANSCANREADITTOO)Afteradequatediscussion,letpatientsknowhowmuchmorerewardingandexcitingitisforyouasaphysiciantowatchpeoplegettingwellandbeatingdiabetesandtheirothermedicalissues.Afterall,didwegetintomedicinetowatchpeopledeteriorate,ordidwedoittohelppeoplegetbetter?Makeagoalwiththepatienttoshootforatthenextvisit.Makeitabsolutely

cleartothepatientthatdietandexercisearenowthemainmeansofglucosecontrol,notdrugs.Withoutanexplanationandunderstandingofthefutilityof the drug-only approach and the absolute necessity of using diet andexercisetoprotectagainstfurtherdamage,patientsarenotgiventheproperopportunitytoprotectthemselves.Highglucosereadingscanbetreatedwithenhancementsinexerciseanddietaryadjustmentsmuchinthesamemannerdoctors use medications. Medication used in the interim period untilsufficient weight is lost should be limited to those drugs that are notcounterproductive to losing weight or to saving and restoring pancreaticfunction,oratleastmovinginthisdirection.This protocol essentially rules out the use of sulfonylureas and insulin,except considering insulin invery small amountswhen thepancreaticbetareserveisunusuallydepleted.Whenthepropereatingstyleiscombinedwiththeproperexerciseprogram,medicationsarerarelyneeded,andeventhenonly in small amounts. We also want to discontinue or at least reducemedications that can cause hypoglycemia since caloric reduction andincreased exercise can reduce glucose so dramatically. Glucophage(metformin) and Januvia (sitagliptin) do not cause hypoglycemia and aresafemedicaloptionswhenmedicationsareneeded.Byetta(exenatide)isanoptionwhen theglucose is running toohighonmetforminandsomethingstrongerisneeded,asitdoesnotcauseweightgain.Atthefirstvisit,whenpatientsbeginthisprotocol,insulinandsulfonylureasshould be reduced by at least one-half and discontinued in the weeks thatfollow,ifpossible.Averylowdoseof250milligramsofGlucophagethreetimes daily can help people who experienced indigestion from higherdosages in the past. If the dose is increased slowly, the side effects areminimized.Byetta—injectionsof5milligramstwiceaday—canbeusedinplaceofinsulinintheinitialphaseiftheglucoselevelsareunfavorable.Inmostcases,theoralmedicationssuchasGlucophage,Prandin(repaglinide),andJanuviacanbeusedbecausetheydonotinducehypoglycemiaorweightgain.

MOSTFAVORABLEMEDICATIONSFORUSEINCONJUNCTIONWITHDIETARYTREATMENTOFDIABETES

LessLikelytoCauseHypoglycemiaorWeightGainGlucophage(metformin) Januvia(sitaglitin)Byetta(exenatide) Prandin(repaglinide)Starlix(nateglinide) Precose(acarbose)Glyset(miglitol)

LEASTFAVORABLEMEDICATIONSFORUSEINCONJUNCTIONWITHDIETARYTREATMENTOFDIABETES

MoreLikelytoCauseHypoglycemiaandWeightGainInsulin(varioustypes);ultra-long-actingLantusandLevemircauselessweightgainAmaryl(glimpiride) Diabenese(chlorpropamide)Glucotrol(glipizide) Diabeta,Glynase(glyburide)Actos(pioglitazone) Avandia(rosiglitazone)

The goal is to avoid having a hypoglycemic event in the first week ofdietary change. The glucose readings in the first few days of dietaryadjustmentshouldrun125to175;doattempttightglucosecontrol.Itissafertoallowthepatienttorunalittlehighthantoriskahypoglycemicevent when they start a diet this aggressive. I always give the first-timediabeticpatientsmycellphonenumberandask them tocallmeeverydayforthefirstthreedaysaftertheirvisit.Onthethirdcall,Ideterminewhenthenextcallwillbeoriftheycanwaituntiltheirfollow-upappointmentintwoweeks.I also instruct the patientswho are reducing their insulin dose to cut backtheir dose considerably each time they get even one reading below 120. Iemphasizestrongly that if theydon’t, thenext readingmayhave theminadangerous hypoglycemic episode. I write out exactly which insulin to cutback on and by how much, reducing both the long-acting (Lantus orLevemir)andtheshort-actingmeal-timeinsulin(usuallyLispro).Icarefullywatch theirmorning fasting readings forguidanceon the reductionof thelong-actinginsulindose.

Themostphysiologicalinsulinregimenistousefourshotsaday:oneofthe

long-acting, twenty-four-hour insulins (such as Levemir or Lantus) beforedinner or at bedtime, and one short-acting insulin immediately before eachmeal.Thismostaccuratelymimicswhatanormal,nondiabeticpancreaswouldsupply.Long-actingandshort-actinginsulinscannotbecombinedinthesameshot,thusfourshotsarerequiredperday,notthree.Thenighttimelong-actinginsulindoseisusuallycutbackby40percentat

thefirstvisit,andthepre-meal(quick-acting)insulinisreducedby30percent.Becauseregularinsulinextendsitsactionbeyondmealtimeneedsandcanleadtohypoglycemia,itisnolongerrecommendedasthemedicationofchoice—especially for my patients, whose mealtime insulin requirements are evenshorterlived.Reviewing themorning fastingandpreprandial insulin levelswillhelp the

physicianadjust thebedtime long-actingdose, and the two-hourpostprandialinsulinreadingswillhelpfurtheradjustthemealtimequick-actinginsulindose.For type 1 diabetics, adjust the long-acting dose so the morning and

preprandialglucosereadingsrangefrom80to120,andadjustthepreprandialinsulin dose so the two-hour postprandial glucose readings hit in the 130 to175range.Theonlywaytosafelyachievetheseresultswithouthypoglycemicreactions

is not by conventional carbohydrate counting but by stability in the diet andstability in the insulin dosage. For example, a sample dietary skeleton for atype1diabeticwomanwithadailyintakeof1,500calorieswouldbe:

Breakfast 400calories Two fruits, oats and oat bran,almonds,groundflax,walnuts

Lunch 500calories Salad with nut/seed-baseddressing, veggie/bean soup, onefruit

Dinner 500calories Salad with hummus/bean/salsadip, steamed greens, veggie stew,tofuorflavoredbeansorfish,onefruit

The consistency is in the food choices, as the carbohydrates used and the

overall GI of the meal is low and the fiber is very high. The secret to the

excellentcontrolistheuseofgreens,beans,seeds,andnutsalltogetherinthemealatbothlunchanddinner.Thishypotheticaltype1patientwillnowrequireonly3to5unitsofinsulin

beforeeachmealand15 to25unitsof long-acting insulinatnight.Whereasunder the standard carbohydrate-counting ADA regimen, the average type 1diabeticwouldtake6to9unitsbeforeeachmealand40to50unitsatnight.With consistency in diet and medication, precise management of type 1

diabetesispossiblewithouthighsorlows.Patientsarenolongerathighriskforheartdisease,stroke,orothertragiccomplicationsofthecondition.Theyarenolongeroverusinginsulin.Theyarenolongerdestinedtobeoverweight.Their lipids come under control, and they get better glucose management,without the risk of being hypoglycemic. Their condition is managed morephysiologically,andtheyfeelbetter.

DiabetesDuringPregnancyGestationaldiabetesisapregnancy-relatedconditionaffectingover5percentof pregnancies in which women without previously diagnosed diabetesdevelophighbloodglucoseinthediabeticrange.Becausetheearlystagesofdiabeteshavenosymptoms,gestationaldiabetes

is most commonly diagnosed by screening with a glucose challenge test(GCT) or a three-hour glucose tolerance test (GTT). American women aresubject to intensive screening to identify gestational diabetes. Their blood ischeckedforanelevatedglucoseearlyinpregnancy;andthen,attwenty-fourtotwenty-eightweeks, they aregiven a50gramGCT to test their blood sugarunderthehighglucosestress.Ifthattestissuggestive,theglucoseiselevatedabove 130 one hour later, amore definitiveGTT is offered. TheGTT is alonger test conducted over three hours, with blood drawn for glucose eachhour.OnlyaboutathirdofwomenwhohaveanabnormalGCTarefoundtohavegestationaldiabeteswiththeGTT.HoweverthehigherthenumberisontheGCT,themorelikelytheGTTwillbepositive.Of course if a woman was already diagnosed with diabetes before

pregnancy, shewould not need to be screened, but it ismore important thaneverforhertoadoptadiabeticreversaldietandbegintoreverseherdiabeticconditionimmediately.IntheUnitedStates,wherewehavethemostobeseanddiabetic-pronepopulationintheworld,thisextensiveandelaboratescreeningregimen is set up by obstetricians because gestational diabetes is moreprevalent compared to other areas of the world where the diet is not so

excessiveandunhealthypeopledonotcarrysomuchdiabetes-promotingbodyfat.Womenaremorepronetogestationaldiabetesiftheyareoverweightbefore

becoming pregnant. Then the placenta-produced pregnancy hormones, inconjunction with the increasing body fat, make the body more and moreinsulin resistant. People prone to diabetes in general are those with a morelimited beta cell reserve in the pancreas. Gestational diabetes develops forreasonssimilartotype2diabetesdevelopmentinlateradultlife.Astheinsulinneeds of the body increase during pregnancy, the beta cells can’t producesufficient insulin to keep up anymore. In this case, the heightened needs ofpregnancy emulate the insulin needs in an overweight person. So diabetesdiagnosedduringpregnancy ispredictiveofan increased riskofdevelopingdiabetes in subsequent pregnancies and later in life, if the standard (disease-causing)diet is continued.One long-termstudy followedagroupofwomendiagnosed with gestational diabetes for thirty years and found that halfdevelopedtype2diabetesaftersixyearsandmorethan70percenthaddiabetesaftertwenty-eightyears.10Somewomenareatsuchalowriskofdiabetesduringpregnancythat they

wouldnotneedtheglucosechallenge.For them,afastingglucosetestwouldbesufficient.Thesearetypicallywomenwhoarealreadyeatingahealthfuldietandhavenofamilyhistoryorgenetic tendencytowarddiabetes.Theywereanormalweightbeforepregnancyandhavehadnoabnormalweightgainwithpregnancy.

MedicationsAreNottheBestSolutionWomenwhoareidentifiedwithgestationaldiabetesaretargetedfornutritionalcounseling,andifthatfails,theyareplacedonoralmedicationsorinsulintolowertheirglucoselevels.Gestationaldiabetesposesanincreasedrisktobothmotherandchild.Thereasonthereissuchaconcernaboutheightenedglucoseduring pregnancy is that elevated glucose increases the size of the baby andresults in delivery complications, often leading to the need for C-section. Italso increases the risk of preeclampsia—high blood pressure duringpregnancy and excess amniotic fluid around the baby. Babies of diabeticmothers are also at higher risk of underdeveloped lungs and respiratorydistressafterbirth.However,givingmedicationstolowertheglucoseingestationaldiabeticsis

noteffectiveorsufficienttolowertherisks.Theexcessbodyweightandpoor

nutritionalinputthatprecipitatedthisproblemstillremainandarecontributorsto this risk even if the glucose is lowered with medication. For example,overweight women have children with more birth defects, especiallydangerousheartdefects.Childrenborntomotherswithgestationaldiabetesarealsomorepronetoobesityanddiabetesthemselves.Hypoglycemiaafterbirthandincreasedriskofneonataljaundicearealsoaconcerninthesebabies.Womenwhoknowaboutexcellentnutrition,eathealthfully,andmaintaina

healthyweightbeforepregnancyandcontinuetoeatrightthroughpregnancydo not need to worry about gestational diabetes. Its high prevalence in ourculturespeakstohowpoorourAmericandietis.Idonotgenerallyrequiremyslim,healthypatientsfollowingmyhealthfuldietaryguidelinestoevenpartakein the GCT or GTT. Excellent health and physical fitness are importantthroughoutlife—before,during,andafterpregnancy.

WhattoDoIfYou’reDiagnosedwithGestationalDiabetesTheconventionalapproach to treatinggestationaldiabetes is inadequate.Thedietary advice most typically offered is simply not sufficient to bring theglucoseintothenormalrangewithoutdrugs,andthisisatimetoactquicklyandnotplayaroundwithsuboptimaladvice.Giventhedietary ineptitude, toomanytreatingphysiciansoftenprescribemedicationsduringpregnancy.Lateron,laborinductionandaC-sectionwithagreaterriskofneonataladmissionsarethetypicaloutcome.Pregnant women are highly motivated for successful outcomes. It is my

experiencethattheywillcarefullycomplywiththeprescribeddietaryregimenandachieve excellent results. Ideal nutrition is avaluableblessing togive topregnantwomentoenhancetheirhealth,thesafetyoftheirpregnancy,andthehealthoftheirchildren.Theproblemhereis thatgestationaldiabetesisoftencharacterized by very strong insulin resistance, so even when doctorsprescribe insulin, large dosages are needed. Therefore, when prescribing anutritional approach for this condition, an aggressive nutritional protocol isindicated,thoughnotutilizedbyconventionalphysiciansanddieticians.This aggressive antidiabetic protocol is important to reverse gestational

diabetes quickly and easily without risky drugs, which can induce neonatalhypoglycemiaandpretermdelivery.Then,ifanymedicationisstillnecessary,itcanbealmostalwayslimitedtometformin,whichisclassifiedasthelowestriskmedicationtobeusedinpregnancy.Avoiding medications whenever possible is wise anyway.Who knows the

subtlelong-termeffectsofthesemedicationsonyourunbornchild?Willthosemedications increase the occurrence of cancer in our children sixty yearsdowntheroad?Wejustdon’tknow.Lessmedicationisbettermedicine,andnomedicine is the best medicine. For women at a high risk of diabetes, withdiabetes, or significantly overweight during pregnancy, I recommend thisaggressiveantidiabeticfoodplanatleastuntiltheglucosenumbersreturntoasafe range.This is the samephase one advice for all diabetics attempting toattacktheirconditionwithfullartillery.ASamplePhaseOne(Aggressive)DiabeticReversalDietfor

NewlyDiagnosedGestationalDiabetesDonotmakechoicesaboutwhat toeatandwhatnot toeat justyet.Fornow,allow me to make these decisions for you. In order to give this method achancetoseewhat itcando,youmustdoitasexactlyasprescribed,withoutmodifications.This menu includes options—do not attempt to consume all the food or

dishessuggested.Chooseonlyoneortwooptionsateachmeal.Youcaneatthesamedishformorethanonemealandevencookextratouseasleftoversforafewdays.Pleasefollowthisplanuntilyourbloodsugarisrelativelyfavorable.Thenonceyourconditionisinthesafe,nondiabeticrange,youcanfollowthegeneralrecommendationsinthemenusectionofthisbook.

BreakfastUse one of the below suggestions per meal. Please note that carbohydrates(evenbeans)arenoteatenwithbreakfastbecauseinsulinresistanceishighestinthemorning.

•Agreensaladwithlettuce,thinlyslicedredonion,tomatoes,androastedredpepperswithacreamyhempseedherbaldressingmadefromhempmilk,seeds,andafruit-flavoredvinegar.Oraroastedtomato-basildressingmadefromtomatopaste,soakeddriedtomatoes,rawandroastedgarlic,vinegar,roastedredpepper,choppedscallions,basil,cumin,andcinnamon.Halfcupofberries.•Aroastedeggplantcasserolemadewithslicedzucchini,mushrooms,onions,tomatoes,garlic,andspicessuchascinnamonandcumin,sprinkledwithlightlytoastedandchoppedpumpkinseeds.Halfcupofberries.

Remember, this breakfast seems unusual becausewith gestational diabetes,

insulin resistance is elevated in the morning; so the treatment is a lightbreakfastoflow-glycemicplantfoodsforbreakfast—nograinsorfruit,exceptsomeberries.

LunchSelecttwoofthefollowingoptionspermeal.

•Avegetable-beansouporstew,servedoverorwithabowlofshreddedlettuceandshreddedrawspinach.Thesoupshouldbemadewithalow-salttomatoandceleryjuicebaseandlotsofleafygreens,leeks,zucchini,andonions.•Roastedtofuslicesoroneounceslicedturkeychoppedwithavocado,dill,androastedgarlicwrappedinrawcollardgreenleaves.•Zucchini-cauliflowercasserolebakedwithchoppedonionsandmungbeansorothersproutsandsprinkledwithnutritionalyeast.•Theroastedeggplantandmushroomdishfromthebreakfastmenucanbeeatenhereinstead.•Spicybeansorlentils(1cup)servedhotoverabedoffinelyshreddedlettuceandcabbage.

DinnerIncludeallthreeoptionsbelowpermeal.

•Asteamedgreenvegetabledishmadewithsteamedorwater-sautéedmushroomsandonions.Steamedgreenvegetables(stringbeans,artichokes,orasparagus),crushedrawwalnuts,andlightlytoastedalmondslivers.•Rawvegetablessuchasrawbroccoli,snowpeas,cauliflower,kohlrabi,cucumbers,radishes,peppers,tomatoes,orceleryservedwithahumusorsalsadip.Asunflower-mushroomburgerservedwithlettuce,tomato,rawonion,andtomatosaucewithsteamedcauliflowerorspaghettisquash.•Onefreshfruitfordessert,ortwokiwisoraboxofberries.Thisisalsoaversionofthephaseonedietplantofollowforapersonwho

wants themaximumresults immediatelyandfor thepatientwhoseglucose is

elevated and needs to get in immediate control. In otherwords, any diabeticbeginningthisprogramcanstartrightherewiththisaggressivephaseandthenafterafewweeksmoveontotherestofthemenuandrecipeoptionspresentedin chapter 12. This would especially be the place to start if you are onmedicationspresently, yet still have a fastingglucose level above150.Onceyour numbers are more favorable, and you are successfully reducingmedication, then you can move on to more menu and recipe options. Becareful because you must reduce or eliminate medications to preventhypoglycemia,sofollowyourreadingsandadjustaccordingly.

MESSAGETOPHYSICIANS:Moreandmorephysiciansareexpressingtheirsupportandenthusiasmforthenutritarianapproachtotreatingdiabetesandotherdiseases,andtheyaresupportingthishealth-promotingmission.Iinviteotherphysicianstocometomyofficeandobservetheresultsfirsthand.Thosewhohavetakenmeupon the offer have often commented that the experiencewas actuallymorefruitful than anything they did in their residency training. Continuingmedicaleducationcreditsareavailabletophysicianscomingtoconferencesforfurthertraining.Iamalwayslookingforphysiciansalloverthecountrythat we can refer patients to. America needs physicians who have gainedexperience with tapering medications and are supportive in managingdiabeticpatientswithsuperiornutritionexcellenceandexercise.Iencourageinterested physicians to contact me and to join the American College ofLifestyle Medicine, a physician organization designed to support suchphysicians.

CHAPTERELEVEN

FrequentlyAskedQuestions

I understand that for a lot of readers, this plan is a radical shift from yourcurrentapproachtofood.Iamsureyouhavealotofquestions.Basedonmyyears of leading patients through this diet, I have compiled the most askedquestions I hear frompatients following this diet protocol. I urge you to bepatientanddiligent,andIpromisethattheresultswillbelife-changing.

WhatifIdonotlikeeatingthisway?To eat healthfully takes practice and perseverance. What makes changepossible is a strong desire and motivation, a willingness to sometimes beuncomfortable,andperseverance tokeepworkingon it.Themoreyoumakehealthymeals,andthemoredaysyoueatthesefoods,themoreyourbrainwillnaturallyprefertoeatthatway.Yourtasteforhealthy,nutrient-richfoodswilldevelop.Anewfoodhas tobeeatenabout fifteen times tomake itbecomeapreferredfood.Themoredaysyoueathealthfully,themoreyouwillloseyouraddiction to unhealthy stimulating substances. With time, you will lookforwardto—andprefer—eatingadietthatismorenaturalandwholesome.Peoplecanalwayscomeupwithexcuseswhysomething is toodifficult to

do, and your subconsciousmindmay promote this. But a strong desire andcommitment to achieve your health and weight goals can silence theseobjections. With planning and support, you can overcome every obstacle. Ipromisethateventuallyyouwillpreferyournewdietandnewfoundhealth.Thereareoverfiftygreat-tastingrecipes in thisbook.Trythem.Thereare

hundredsmoreavailableonmywebsiteandinmyotherworks.Ipromisethatyouwillfindmanyrecipesyoulove.

WhyisitsodifficultformetogiveupfoodsthatIknowaredestructivetomyhealth?

To be successful in achieving optimal health and permanentweight loss,wehave to consider the complexity of human nature.We have discussed how adisease-promoting diet can be physically addicting, resulting in some milddiscomfort during the first few weeks of the change. Of course, food isaddicting physically and emotionally, so much so that some people wouldpreferdeathtodietchange.Thesubconsciousminddoesnotalwayscareaboutlogicandscience.Wearephysical,emotional,andsocialbeings.Thesefactorsmust be considered. If not, many people will reject learning more about ahealth-givinglifestyledespitehavinganinterestingainingmoreinformation.Somewillcomeupwithrationalizationsorexcuseswhytheycan’tchange.Itisnotuncommonforpeopletogivereasonsandexcusestocontinuedown

theroadofdietarysuicide.Thisisamanifestationofasubconsciousprocess.Our brains are designed to dim awareness to information that causes usdistress and anxiety. Formanypeople, the thought of changing theway theythinkaboutfoodandthewaytheyeatisasourceofanxietyinitself.Unhealthyfoodsareaslow-workingpoison,butourmindfearschangeevenmorethanitfearsthispoison.Theaddictivemindcanalwayscreateareasontojustifythecontinuationof

their addiction. For example, food addicts may think, If you had a life likemine,youwouldbingetoo.Theygetintoaself-defeatingcycleofself-pityandgloom. Once addictions take hold, they lose total control of their decisionmaking, and continuing the addiction returns to the top of the subconsciousagenda.Overeating,eatingpoorly,andremainingoverweightinspiteofhealthconsequences are examples of the power food addiction has to control thesubconsciousmind.Overeatingisoftenthedirectresultoflowself-esteem,whichmakespeople

vulnerabletonegativepeerpressure,addictions,andemotionalbinging.Somepeoplemayfearappearingdifferentfromothersandbelievethatchangingtheway they eat will result in a loss of social status. Also, people sometimesovereat to raisedopamineandserotoninactivity in thebrainso that theycandullthefrustration,disappointment,andpainoflife.Nevertheless,allthenegativitycanbeturnedaround.Changingyourdietcan

gohandinhandwithanewattitudeaboutyourself,life,andthepossibilitiesinfrontofyou.Ahealthydietgoeshandinhandwithahealthyattitudeaboutlife

andaloveoflife.Acknowledge the conflict, acknowledge the difficulty, and just do it. You

must face facts, accept your discomfort, and work through it. Thesubconsciousmindmightnotlikethechangesyouaremaking,butyouhavetohanginthereuntilthechangefeelsnatural.Youcan’tcureanaddictionunlessyouarewillingtofightthroughyourinternaldebateandmoveon.Addictionthrivesinisolation.Thekeystogettingoveritaretomakethecommitmenttostickwithyournewprogramandtoacknowledgethatcommitment topeopleyouknow.Itgetseasierandmorepleasurableeverydaythatyoumovetowardbetterhealth.WillIfeelunwellfromwithdrawalwhenIfirststartout?Howlong

willanynegativesensationslast?Asyourbody’sdetoxificationactivitiesincreaseinthefirstweekortwoofthisprogram,thesymptomsof toxichungercouldincrease.Thesefeelingscouldinclude lightheadedness, fatigue, headaches, increased urination, sore throat,flatulence, and, very rarely, fever, body itching, or rashes. Theseuncomfortablesensationsrarelylastlongerthanoneweek,andeveniftheydo,theywilllessenwithtime.Occasionallypeoplefindittakestimefortheirdigestivetracttoadjusttoall

the additional raw fiber. They experience an increase in gas or bloating orhave looser stools. This is usually caused by the increased volume of rawvegetables and because you swallowmore air when you eat salad than youwouldeatingotherfoods.Itisremediedbychewingbettersotheairisoutofthe food before swallowing it. Better chewing also breaks down the cells,making them easier to digest. If you encounter this problem, increase theamountofrawsaladyoueatonlyingradualamounts.Youcanalsoeatfewerraw foods and more cooked vegetables, such as steamed zucchini, squash,artichokes,peas, and intactwholegrains suchas steel-cutoats andwild rice.Whenthesymptomssubside,graduallyincreasetheamountofrawgreensandcruciferousvegetablesinyourdiet.Beans, nuts, and seeds can also contribute to digestive problems at the

beginningof transitioning to thiswayof eating.Tocombat these issues, usebeansatalmosteverymealbut inverysmallamountsuntilyouadjust.Makesurethenutsandseedsarespreadoutatvariousmealsandyouarenoteatingtoomuchatonetime.

Ifyouaretroubledbydigestiveproblems,trythefollowing:

•Chewyourfoodbetter,especiallysalads.•Eatbeansinsmalleramounts.•Soakbeansandlegumesovernightbeforecooking.•Avoidcarbonatedbeverages.•Donotovereat.•Eatfewerrawvegetablesandmorecookedgreenvegetables,andthenincreaseyourrawvegetablesgradually.Bepatientandgiveyourbodyalittletimetoadjusttoadifferenteatingstyle.

Remember,yourdigestivetractcanmaketheadjustmentsifit’sallowedtodoitgradually.Isn’tdiabetesmostlygenetic?Itisn’tmyfault—mywholefamilyis

overweight.The role that genetics plays in obesity and diabetes is undeniable. People ofcertain descent have a smaller beta cell reserve in the pancreas. If theseindividuals eat an American-style diet and become overweight, they have adramaticallyhigherriskofbecomingdiabetic.Thatsaid,thedoubledrateofdiabetesinthiscountryinthelasttwenty-five

yearsobviouslydidnotoccurbecauseofgenetics.Eventhoughsomepeoplemaybeatahighgenetic riskofdevelopingdiabetes, thisdoesnotmean thattheir health fates are predetermined. In fact, the reason for the increasedgenetic risk is likely because their ancestorswere all thin and highly active.They did not require a large reserve of beta cells in the pancreas. Thisinheritancepatternisonlyariskfactorforpeoplewhoeatadisease-promotingdiet.Althoughpeoplewhoseparentsareobesehaveatenfoldincreasedriskofbecomingobesethemselves,theexplosionofobesityisarecentphenomenonin human history brought on by fast food and the processed food industry.Clearly,obesityisnotprimarilygenetic.So it is the combination of food choices, inactivity, and genetics that

determines obesity and diabetes. Those who genetically store fat moreefficientlymay have had a survival advantage thousands of years agowhenfoodwasscarce.Butintoday’smodernfoodpantry,wherehigh-calorie,toxicfoods abound, those people are at a survival disadvantage. Focusing on the

elementofgeneticsintheformuladoesn’tsolvetheproblem.Youcan’tchangeyour genes. Rather than taking an honest look at what causes diabetes,Americansarestill lookingforamagical,effortlesscureforit—agimmick,drug, or surgery. The only answer is living a healthy lifestyle focused onexcellent nutrition alongwith adequate activity and exercise.When you livethis way, the benefits will overwhelm genetics and allow even those peoplewithageneticpredispositiontoweightgainanddiabetestoachieveahealthyweightandalong,disease-freelife.Oneofthemostexcitingstudiesinthefieldofweightcontrolandobesityin

recent years was published in theNew England Journal of Medicine.1 Thisstudy documented that if you have a friend who is obese, your risk ofdeveloping obesity increases by close to 60 percent, a higher rate than if asibling or even a spouse becomes obese.This high percentage held up evenaftercontrollingforthefactthatpeopletendtoformbondswithotherssimilarto themselves. If both people listed each other as friends, and one becameobesefirst,thesecondwasapproximatelythreetimesaslikelytofollowsuit.This finding illustrates that obesity is spread by similar eating styles in

social networks. Peer influence is not to be underestimated. However,understanding how powerful bad influences can be, especiallywith society’sapproval and promotion of addictive eating, leads to the inescapableconclusion that healthful behaviors can be just as contagious if you aresurrounded by health-conscious people.One powerful secret to a slim bodyand good health is to cultivate friends who are supportive and can share ahealthy eating style with you. Genetics are not the major factor. The socialnormsofthemodernworldhavemadeobesityanddiabetespervasive.Idon’thavetimetocook.Doyouhaveanytipsforquickandeasy

meals?You do not have to use fancy and complicated recipes all the time. Simplefoodsarequickandeasyandcanworkinthisprogramtoo.Considersomeoftheseoptionstomakeyourdieteasierandmoreconvenient.

BreakfastCombine fresh fruit in season,oreven frozen fruit,with rawnutsandseeds.Youcansoaksomeoatmeal inwaterovernight—nocookingisneeded.Thenadd some berries and walnuts and a splash of unsweetened soy, almond, or

hempmilkandyouhaveameal.Youcanmakeaquicksmoothiewithonefruit,ahandfulofgreens,ahalfcupofunsweetenedhempmilk,andflaxseeds.Itisokaytoeatevenlighterforbreakfastandhavejustoneortwofruits.

LunchandDinnerYour basic lunch or dinner should be a saladwith a healthy dressing and abowl of vegetable or bean soup. Make a quick salad from premixed andprewashed greens. Add chopped nuts and cut fresh fruit or no-salt cannedbeans, and top it with a low-fat and low-salt dressing, dip, fresh lemon, orbalsamic or flavored vinegar. You can also eat raw vegetables and avocadowitha low-salt salsaorhummusdip. Ioftenheatupa little soupandpour itover some shredded lettuce asmy lunchmeal. I have also developed bottleddressingsforthisprogram,andtheycanbepurchasedandshippedanywhere.Including some defrosted frozen vegetables or fresh or frozen fruit is a

goodwaytoroundoutameal,salad,orleftoverdish.Trysteamingsomefreshbroccoli,spinach,oranothergreenvegetableandaddingano-saltseasoning.Before cooking, apply a little olive oil to your hands and rub the rawvegetables,andthenaddchoppedgarlicandonion.Aquickandtastydishcanbe made from whatever fresh vegetables you have on hand. Use a no-saltcanned soupand addyourown steamedor frozenvegetables to increase thenutrientdensity.Anothereasymealoptionistomakeamealwithalow-salttomatosauceas

thebase.Ioftenmixtomatosaucewithsomealmondbutterandalittlegourmetvinegar, usually fig vinegar, and then use it as a dressing or dip for thevegetabledish,eithercookedorraw.When you do have the time, cook in large batches and save leftovers for

othermeals.

HowcanIstayonthisdietstyleifIhavetoeatoutinarestaurant?Chooserestaurantsthathavehealthfuloptions,andgettoknowtheplacesthatwillcater toyourneeds.Whenpossible, speak to themanagementorchef inadvance.Eat early, before the restaurant gets very crowded, so the staffwillhavetimetomodifyadishormakesomethingspecialforyou.Ifyoueatoutfor breakfast, avoidbread, bagels, andbreakfast sweets.Go for oatmeal andfruitinstead.Forlunchanddinner,askforasideofsteamedvegetablesinsteadofpastaorwhitericetoaccompanyyourmaindish.

In Asian restaurants, order vegetable dishes that are steamed with thedressing or sauce on the side. Because soups are made in advance inrestaurantsandarealwaysveryhighinsalt,itisbesttostayawayfromthem.Gowith salads, simplevegetarianentrées,oronoccasionplainbroiled fish,shrimp, or chicken prepared without empty-calorie sauces. I often order adouble-sizesaladandpaydoubleforit.Tellthefoodservernottobringbreadtothetabletoavoidthetemptationtofillupbeforethemeal.Alwaysaskforthesaladdressing(whichisusuallyhighinsalt)onthesideandusesparingly.Orbetteryet,usebalsamicvinegarorlemonjuice.Youcanfollowthisdietontheroadifyouarecommittedtosuccess.Itjust

takessomediligencetoplanwheretogoandtomakesureinadvancethatyouwillhavethefoodsyounoweat.Ifyou’restayingathotel,itisnotdifficulttoeathealthy.Whentraveling,Igotoasupermarketandpurchaselettuce,frozenvegetables,freshfruits,andcannedbeanstobringtomyhotelroom.Irequesta small refrigerator in my room, and I travel with a bowl, a can opener,silverware, and raw seeds and nuts in my suitcase. Then I can eat healthycanned beans, canned veggie-bean soup, frozen veggies, and frozen fruittossed on a salad. I often use the electric coffeemaker that is usually in thehotelroomtoheatupsoupsandoatmeal.

HowmuchsaltcanIusesafely?Whataboutseasalt?This book is designed for people who want to reverse their diabetes, loseweight, regain theirhealth ingeneral, andprevent furtherdisease. Ifyouarelookingtogetridofdiabetesandhighbloodpressure,anyaddedsalt—outsideofwhatiscontainedinnaturalfoods—islikelytohinderyourrecovery.Seasaltis99percentchemicallythesameastablesaltandisjustasharmful.

The very small amount of minerals found in special salts, touted for theirhealthbenefits,isinsignificantanddoesnotmakeconsumingahighamountofsodiumany lessharmful.Saltconsumption is linked tostomachcancer,highbloodpressure,andheartattacks.Foroptimalhealth,Irecommendthatnosaltbeadded toany food.The famousDietaryApproaches toStopHypertension(DASH) study clearly indicates thatAmericans consume five to ten times asmuchsodiumas theyneedand thathighsodiumlevelsover theyearshaveapredictableeffectonraisingbloodpressure.2Saltalsopullsoutcalciumandothertraceminerals,whichisacontributory

causeofosteoporosis.3Ifthatisnotenough,highsodiumintakeispredictive

ofincreaseddeathfromheartattacks.InalargeprospectivetrialpublishedintheLancet, therewasa frighteninglyhighcorrelationbetweensodium intakeandall-causemortalityinoverweightmen.4 Theresearchersconcluded,“Highsodium intake predicted mortality and risk of coronary heart disease,independent of other cardiovascular risk factors, including high bloodpressure.Theseresultsprovidedirectevidenceoftheharmfuleffectsofhighsaltintakeintheadultpopulation.”There is controversy regarding the use of salt, as well as other points in

human nutrition. Some studies indicate salt is not bad for health. However,thosefindingsarealwaysdistortedbylookingatasicklypopulationwithhighbloodpressureandatherosclerosisthatthenattemptstolowersaltintakelaterinlife,whenmuchofthedamageisalreadydone.It isalwayswisetoerronthesideofcautionandnottoincurneedlessrisk.Theearlierinlifeyoubeginthe right choices, the greater the benefits. You would not want an error injudgment tocostyouyourgoodhealthoryour life.Forahundred thousandyears, our human ancestors and pre-human primates never salted their food.This is a recent phenomenon in the history of the human race, but naturalplantssupplyallthesodiumweneed,astheyhaveforthosethousandsofyears.Iheardgorillasgolightonthesaltshakertoo.My thousands of patients and website members have achieved dramatic

reversalsofheartdisease,diabetes,andhighbloodpressure,andIamcertainthatremovingsaltfromtheirdietswasanimportantfactorcontributingtotheirhealth accomplishments. That said, a small amount is permissible; thoseparametersarediscussedfurtherbelow.It’s best not to add salt to foods, and I recommend looking for salt-free

canned goods and soups. Because most salt comes from processed foods,bread, and canned goods, it shouldn’t be hard to avoid added sodium. Useherbs, spices, lemon, vinegar, or other no-salt seasonings to flavor food.Condimentssuchasketchup,mustard,soysauce,teriyakisauce,andrelisharevery high in sodium. If you can’t resist them, use the low-sodium varietiessparingly.Ideally, allyour foods shouldhave less thanonemilligramof sodiumper

calorie. Natural foods contain only about half a milligram of sodium percalorie.Ifafoodhas100caloriesperserving,yetcontains400milligramsofsodium,itisaveryhigh-saltfood.Ifa100-calorieservinghaslessthan100milligramsofsodium,itisafoodwithlittleaddedsaltandcanbeusedinyourdiet. Overall, the guideline is for women to consume not more than 1,000

milligramsofsodiumadayandmennotmorethan1,200.Sinceanaturalfooddietgivesyou500to800milligramsaday,thatleavesyouonlyafewhundredextratobeflexiblewith.Ifyoudon’tusesalt,yourtastebudswilladjustwithtimeandyoursensitivity

totastesaltimproves.Whenyouareusinglotsofsaltinyourdiet,itweakensyourtasteforsaltandmakesyoufeelthatfoodtastesblandunlessitisheavilyseasoned or spiced. The DASH study observed the same phenomenon that Ihavenotedforyears:ittakessometimeforaperson’ssalt-saturatedtastebudsto get used to a low sodium level. If you follow my nutritionalrecommendationsstrictly,withoutcompromise,avoidingallprocessedfoodsor highly salted foods, your ability to detect and enjoy the subtle flavors infruitsandvegetableswillimproveaswell.Overtime,youwon’tmissthesaltandwon’tevenwantit.Whataboutalcohol—shouldIbedrinkingredwineformyheart?Alcohol is not actually heart-healthy; it simply has anticlotting effects,muchlike aspirin. Researchers have found that even moderate consumption ofalcohol, including wine, interferes with blood clotting and thereby reducesheart attacks in high-risk populations, such as people who eat the typical,disease-promoting,Americandiet.Thinningthebloodwithalcoholoraspirinisnothealth-enhancingunlessyouareeatingthetypicalheart-attack-inducingdiet. Once you are protected from heart attacks and strokes with superiornutrition, the blood thinning only adds risk in the form of gastrointestinalbleeding or a hemorrhagic stroke. Red wine contains some beneficialcompoundssuchasflavonoidsandresveratrol,apotentantioxidantintheskinof grapes associated with a number of health benefits. Of course, grapes,raisins,berries,andotherplantfoodsalsocontainthesebeneficialcompounds.Youdonothavetodrinkwinetogainthesebenefits.Moderatedrinkingisdefinedasamaximumofonedrinkperdayforwomen

andtwodrinksformen.Consumingmorethanthisisassociatedwithincreasedfat around the waist and other significant health problems.5 But moreconcerningis the linkbetweendrinkingandcancer.Evenamoderateamountof alcohol may also increase the risk of breast cancer.6 A review of meta-analyses reported in2009 concluded that onedrinkper day increasedbreastcancer riskbetween7 and10percent.7More recently, a careful twenty-eightyearsoffollow-upoftheNurses’HealthStudyfoundasignificantincreasein

riskatevenlowerlevelsofconsumption:therangeof5to9.9gramsperday(three to six drinks per week) was associated with a 15 percent increase inbreastcancerrisk.8Another problem with alcohol consumption, especially at more than one

drink a day, is it can create mild withdrawal sensations the next day. Thesesensationsarecommonlymistakenforhunger,whichleadspeopletoovereat.Because of this, moderate drinkers are usually overweight. Furthermore,recent studies have also shown that even moderate alcohol consumption islinked toa significantly increased incidenceofatrial fibrillation,aconditionthatcanleadtostroke.9Overall,itissafertoeatadietthatwillnotpermitheartdisease.Don’trely

on alcohol to decrease the potential of blood to clot. Strive to avoid thedetrimentaleffectsofalcoholandtoprotectyourselffromheartdiseasewithnutritional excellence. Having one or two alcoholic drinks aweek or a fewglass of wine per week is not a major risk, nor is it a major health asset.However,ifconsumedinexcess,itcandevelopintoasignificanthealthissue.Isitimportanttoeatorganicallygrownfoodsforgoodhealth?

Theconcern implicit in thisquestion isaboutpesticides, and it is a realone.The Environmental Protection Agency has reported that the majority ofpesticides now in use are probable or possible causes of cancer. Studies offarmworkerswhoworkwith pesticides suggest a link between pesticide useand brain cancer, Parkinson’s disease, multiple myeloma, leukemia,lymphoma,andcancersofthestomachandprostate.10However,doesthelowlevel of pesticides remaining on our food present much of a risk? Somescientistsarguethattheextremelylowlevelofpesticideresidueonproduceisinsignificantandthat therearenaturallyoccurring toxins inallnatural foodsthataremoresignificant.Thelargeamountofstudiesperformedonthetypicalpesticide-treated produce have demonstrated that consumption of produce,whether organic or not, is related to lower rates of cancer and increaseddiseaseprotection.Inshort, it isbetter toeatfruitsandvegetablesgrownandharvested using pesticides than not to eat them at all. The health benefits ofeating phytochemical-rich produce greatly outweigh any risks that pesticideresiduesmightpose.It shouldbe recognized that fruits andvegetables arenot all subject to the

samepesticideexposure.The followingchart shows thepesticidebreakdown

by food inorderofpesticide content.Spinach, strawberries, andceleryhavethe highest pesticide residue and are the most important foods to consumeorganicallygrown.Ifavailable,organicfoodiscertainlyyourbestbettolimitexposuretotoxic

chemicals.Even if youcaneatorganicversionsofonly the top twelvemostcontaminatedfruitsandvegetables,youcanreduceyourpesticideexposurebyabout90percent.Inaddition,organicfoodsusuallyhavemorenutrientsthantheir conventional counterparts.11 They also taste better and are generallybetterforfarmersandtheenvironment.Remember thatcuttingoutprocessedfoods, canned foods, and animal products already reduces your exposure tochemicals,toxiccompounds,pesticides,antibiotics,andhormones,sothatisahugestepintherightdirection,evenifyourentiredietisnotorganic.

TWELVEFOODSWITHTHELOWESTPESTICIDES1.Onions2.SweetCorn3.Pineapple4.Avocado5.Cabbage6.SweetPeas(frozen)7.Asparagus8.Mangos9.Eggplant10.Kiwi11.Cantaloupe(domestic)12.SweetPotatoes

TWELVEFOODSWITHTHEMOSTPESTICIDES1.Apples2.Celery3.BellPeppers4.Peaches5.Strawberries6.Nectarines(imported)7.Grapes8.Spinach

9.Lettuce10.Cucumbers11.Blueberries(domestic)12.Potatoes

Whynotoliveoil?Ithoughtitwasgoodforme.

Nooilshouldbeconsideredahealthfood.Alloil,includingoliveoil,is100percent fat and contains 120 calories per tablespoon.Oil is high in calories,lowinnutrients,andcontainsnofiber.Itistheperfectfoodtohelpyouputonunwanted and unhealthful pounds and sabotage your plan to rid yourself ofdiabetesandextrabodyfat.Oilisaprocessedfood.Whenyouchemicallyextractoilfromawholefood

(such as olives and various nuts and seeds) you lose the vast majority ofnutrients and end up with a fragmented food that contains little more thanempty calories. You do need some fat in your diet, but when you consumewhole foods, such as walnuts, pistachio nuts, sesame seeds, chia seeds, andflaxseeds insteadof theirextractedoils,yougetallof the fibers, flavonoids,severalphenoliccompounds,sterols,stanols,andothernutrients theycontainaswellasalloftheirpositivehealthbenefits.Foodsrichinmonounsaturatedfatslikeoliveoilarelessharmfulthanfoods

fullofsaturatedfatsandtransfats,butbeinglessharmfuldoesnotmakethemhealthful. The beneficial effects of theMediterranean diet are not due to theconsumption of olive oil; they are due to antioxidant-rich foods includingvegetables,fruits,andbeans.Pouringalotofoliveoilontofoodmeansyou’reconsumingalotoffat.Eatingalotofanykindofoilmeansyou’reeatingalotofemptycalories,whichleadstoexcessweight,whichleadstodiabetes,highbloodpressure,stroke,heartdisease,andmanyformsofcancer.When you eat oil instead of seeds and nuts as a source of fat, the fat is

absorbed and enters the bloodstream rapidly. Because you cannot utilize thesurgeofcalories, thebodyefficientlystoresthemasfatonyourbodywithinminutes.Whenyouconsumeoil, thecaloriesgofromyour lips toyourhipswithin minutes, and as you know by now, fat stored on the body promotesdiseaseandcausesdiabetes.Whenyouinsteadconsumesomeseedsandnutsasasourceoffat,thefatisboundtosterols,stanols,andotherfibersthatslowtheabsorptionof the fat overmanyhours and limit all the absorptionof the fatcontained,enablingthebodytoburnthefatforenergy.

While nuts and seeds have anti-inflammatory effects, oil has pro-inflammatoryeffects,soitisahorseofadifferentcolor.Forexample,astudycompared an olive oil–containing Mediterranean diet with one whichsubstituted pistachio nuts as a source of fat. The researchers documentedimprovementinendothelialfunction(healthoftheliningofthebloodvessels).They noted reduced inflammation, increased youthful elasticity of the bloodvessels,loweringofthecholesterolandtriglycerides,aswellasaloweringofbloodglucoseasaresultofeatingthenutsinplaceofoil.12Plus,asdiscussedearlier,whereasoilpromotesweightgain,whennutsorseedsaresubstitutedforoilsorcarbswithoutincreasingtheoverallcaloricload,theresultislowerglucose,lowercholesterol,andlowerbodyweight.13Youcanaddalittlebitofoliveoiltoyourdietifyouarethinandexercisea

lot.However, themoreoilyouadd, themoreyouare lowering thenutrient-per-caloriedensityofyourdiet—andthatisnotyourobjective,asitdoesnotpromotehealth.Hopefullytheanswersinthischapterhaveprovedusefulasyoubeginyour

journey toward health. This approach may sound complicated at first, but Iassureyouthat itwillstart tomakesenseveryquickly.Ihavedevisedaverysimple formula of nutrients per calorie. In the next section, Imap out somemealplansthatwillallowyoutoseehowtostartbuildingyourownpersonalmenu.Yourhealthbeginsnow.

CHAPTERTWELVE

MenusandRecipes

Thesesamplemealplansprovide1,400caloriesperdayandaredesignedformoderateweightloss.Youcanfollowthesemenuscloselyorjustusethemasguidelines.Feelfreetosubstituteotherhealthyrecipesfrommyrecipelistinthisbook.Ifyouarea slim type1diabeticmaleanddonotneed to loseweight,you

mayadd1to2additionalouncesofrawnutsorseeds,someavocado,orevensome additional starchy vegetable or grain such as wild rice, whole grainbarley, quinoa, peas, corn, sweet potato, or squash. In otherwords, you caneasily adjust these menus to your caloric needs by increasing some of thefoods that generally would be more limited for overweight individualslookingtomaintainalowercaloriclevel.On the other hand, somepeoplemay require even fewer calories than are

present in thesemenus.Remember,youcanalwayseat lessfood.Youshouldnoteatifyou’renothungry.Whenyoueatsohealthfully,youdonotneedasmuch food as you used to think you needed, and youwill feel better and besatisfiedwith less. Try to eat lightly so you can feel the pleasure of gettinghungry again in time for your next meal. If you consume too much withbreakfast,youwillnotbehungryforlunch.Ifyouconsumetoomuchfoodforlunch, you will not be hungry for dinner. Try to eat only enough to holdyourselfovertothenextmeal,soyoucangetthatfullsatisfactionfromeatingonlywhenyou’re reallyhungry.Youdonot have to eat threemeals a day. Iconsiderasnack(breakfast)andtwomeals(lunchanddinner)enoughformostpeople.Thefoodsinthesemenusarenotweighedandmeasured.Thatispurposeful.

It is necessary foryou to livewith andadjust thisdiet styleunderyourowncontrol.Thesizeoftheportionsandhowmuchyoueatmustbecontrolledby

your body and mind, applying the knowledge you’ve learned here andachievingastableplanthatyoucanlivewithforyears.Whenyoueatadietwiththisdegreeofnutritionalexcellence,itenablesyou

to be comfortable eating fewer calories. Hopefully you will have lost yourdesire toovereat andyouhave theknowledgeyouarehealingyourbodyasyou do so. It is still possible for some people to overeat, due to emotionalhabits and other self-destructive thought processes. The most effectivetreatmentbreakinganybadhabitoraddictionisabstinence.Inotherwords,thisgetseasierthelongeryoudoit.Iencourageyoutoerronthesideofcaution,don’t overthink this, just do it, and give this newway of eating a chance tobecomeyournewhabitandpreferredwayofeating.Remember, a slower metabolic rate is not a bad thing. The slower your

metabolism, the slower you are naturally aging. One of the mechanismsthroughwhicheatinglessprolongslifespanisbyslowingthemetabolicrate.Thesloweryourmetabolismandtheloweryourbodytemperature,thesloweryouareaging.Soridyourmindofthemyththatyouhavetoeatmoreormorefrequentlytoraiseyourmetabolism.Thatisnotdesirable.Ifyouareoverweightandnotlosingweightadequatelywiththisprogram,it

may be because ofmedications such as insulin or sulfonylureas,whichmayneedtobetaperedordiscontinuedunderphysiciansupervision.Talkwithyourdoctor.

VeganorFlexitarianThemenusherearelargelyveganwiththeoptionofincludingasmallamountofanimalproductsafewtimesaweek.Ifyoudesiretoincludeanimalproductsinyourdiet, I strongly recommend that theyonlybeusedas a condiment toflavor a dish, not as amain part of themeal. In otherwords, do not have awholepieceofchickeninonemeal,butinsteaduseapieceofchickentoflavora soup thatmay then be consumed over three to five days. If you’re addingsome shrimp or salmon to a salad or vegetable dish, use only a very smallamount,suchasonetotwoounces.Thisnutritariandietcanbeeitherveganorflexitarian(minimalanimalproducts),butdon’tsabotage theresultswith toomanyanimalproducts.Lastly, remember that eating this healthfully is the most delicious and

pleasurablewaytoeat.Asyougainexperiencewithusingwhole,naturalfoodstorevampyourhealth,youwillrealizethatyoucaneatslower,chewwell,andsavor each bite.Nature is the best doctor and the best chef. Think about the

goodyou are doing for yourselfwhenyou eat naturally nutrient-rich foods.Whenyoupurchasehigh-quality, fresh food,yougethigh-quality tasteandahigh-qualitybody.

TheMenus

Week1

DAY1BreakfastSoakedOatsandBlueberries*

LunchSalad with romaine lettuce, mixed greens, and assorted vegetables toppedwithwhitebeans

CaesarSaladDressing/Dip*Freshfruit(apple)

DinnerSteamedasparaguswithSesameGingerSauce*GoldenAustrianCauliflowerCreamSoup*Freshfruit(melon)

DAY2BreakfastFruitandnutbowl(assortedfreshand/or frozenfruit toppedwithnutsandseeds)

LunchRomaine,spinach,andwatercresssaladtoppedwithchickpeasRussianFigDressing/Dip*GoldenAustrianCauliflowerCreamSoup*Freshfruit(orange)

DinnerRawvegetablesFreshTomatoSalsa*

SimpleBeanBurgers*GreatGreens*PeachSorbet*

DAY3BreakfastBlendedMangoSalad*Walnuts

LunchRawvegetablesRussianFigDressing/Dip*BlackBeanLettuceBundles*Freshfruit(twokiwis)

DinnerSeasonededamameRoastedVegetableSaladwithBakedTofuorSalmon*Mixedberries

DAY4BreakfastQuickBananaOatBreakfasttoGo*

LunchMixedgreenssaladwithassortedvegetablesandflavoredvinegarSavoryPortobelloMushroomswithChickpeas*Freshfruit(grapes)

DinnerRawvegetablesIslandBlackBeanDip*Dr.Fuhrman’sFamousAnticancerSoup*FreshfruitorBananaWalnutIceCream*

DAY5BreakfastFruit and nut bowl (assorted fresh and/or frozen fruit toppedwith nuts or

seeds)LunchRawvegetablesIslandBlackBeanDip*Dr.Fuhrman’sFamousAnticancerSoup*Freshfruit(appleslicesandcinnamon)

DinnerRomaine,spinach,andwatercresssaladTofuRanchDressing/Dip*EggplantRollUps*Freshfruit(berries)

DAY6BreakfastBlueAppleNutOatmeal*

LunchSaladwithmixedgreensandveggiesTofuRanchDressing/Dip*YumGoodBeans*Freshfruit(strawberries)

DinnerRawveggiesHerbedWhiteBeanHummus*FrenchLentilSoup*MangoCoconutSorbet*

DAY7BreakfastSoakedOatsandBlueberries*

LunchMixedgreenssaladwithassortedvegetablesandflavoredvinegarFrenchLentilSoup*Freshfruit(Grapes)

Dinner

TheBigVeggieStir-Fry*HerbedBarleyandLentils*Freshfruit(applesliceswithcinnamon)

Week2

DAY1BreakfastFruitandnutbowl

LunchRomaineandarugulasaladwithassortedvegetablesCreamyBlueberryDressing*VegetableBurrito*Freshfruit(pear)

DinnerRawvegetablesChoiceofhealthydipsEasyBeanandVegetableChili*Strawberriesdustedwithcocoapowder

DAY2BreakfastBlueAppleNutOatmeal*

LunchRomaineandmixedgreenssaladandflavoredvinegarEasyBeanandVegetableChili*Freshfruit(blueberries)

DinnerMushroomSoupProvencal*ChoiceofcookedvegetablewithAlmondTomatoSauce*Freshfruit(cherries)

DAY3Breakfast

GreenGorillaBlendedSalad*LunchRawvegetablesChoiceofhealthydipsMushroomSoupProvencal*Freshfruit(watermelonslices)

DinnerSteamedartichokeGreenVelvetDressing/Dip*MediterraneanBeanandKaleSauté*

DAY4BreakfastBlueAppleNutOatmeal*

LunchRomaine,spinach,andwatercresssaladThousandIslandDressing*SpeedyVegetableWrap*

DinnerRawvegetablesFreshTomatoSalsa*Pistachio-Crusted Tempeh with Balsamic Marinade and ShiitakeMushrooms*

BraisedBabyBokChoy*BlueberryCobbler*

DAY5BreakfastTropicalFruitSalad*Nutorseedtopping

LunchSouthern-StyleMixedGreens*Freshfruit(apple)

Dinner

FastMexicanBlackBeanSoup*SwissChardwithGarlicandLemon*Freshfruit(melon)

DAY6BreakfastFruitandnutbowl

LunchFastMexicanBlackBeanSoup*AsparagusPolonaise*Freshfruit(orange)

DinnerRomainesaladwithassortedvegetablesCaesarSaladDressing/Dip*No-MeatBalls*Low-sodiummarinarasauceGarlickyZucchini*Freshfruit(pear)

DAY7BreakfastQuickBananaOatBreakfasttoGo*

LunchMixedgreenssaladFlavoredvinegarorchoiceofhealthydressingsSteamedvegetableofchoicewithRedLentilSauce*Freshfruit(papaya)

DinnerRawvegetablesChoiceofhealthydipsThaiVegetableCurry*StrawberryPineappleSorbet*

Note:Anasteriskindicatestherecipeisincludedinthisbook.

TheRecipes

BREAKFAST

BlueAppleNutOatmealServes:21⅔cupswater¼teaspooncinnamon⅓cupold-fashionedrolledoats1cupfrozenblueberries1apple,choppedorgrated2tablespoonschoppedwalnuts

Inasaucepan,combinewaterwithcinnamonandoats.Simmerabout5minutes,untiloatmealiscreamy.Stirinblueberries,apples,andnuts.

QuickBananaOatBreakfasttoGoServes:22cupsfrozenblueberries½cupold-fashionedrolledoats⅓cuppomegranatejuice2tablespoonschoppedwalnuts1tablespoonrawsunflowerseeds1banana,sliced

Inacerealbowl,combineallingredients.Heatinthemicrowavefor3minutes.Note:Onthego,combineallingredientsinasealedcontainertoeatlater,eitherhotorcold.

SoakedOatsandBlueberriesServes:2

¼cupunsweetenedsoy,hemp,oralmondmilk1cupold-fashionedrolledoats½cupwater1cupblueberries(freshorfrozen)1greenapple,chopped1tablespoongroundflaxseeds

Pourmilkoverrawoats,addenoughwatertocovertheoats,andsoakforatleast30minutes,preferablyovernight.Addberries,apples,andflaxseeds.Mixandserve.

TropicalFruitSaladServes:42cupscubedpineapple1cupcubedmango1cupcubedpapaya2oranges,peeledandsliced1banana,sliced2tablespoonsunsweetenedshreddedcoconut2cupscurlyleaflettuceleaves

Tossfruittogether.Addcoconutandserveontopoflettuce.

GREENSMOOTHIES

BlendedMangoSaladServes:21large,ripe(preferablychilled)mango1cupchoppedspinach4cupschoppedromainelettuce¼cupunsweetenedsoy,hemp,oralmondmilk

Peelandchopmangoandplaceinfoodprocessororhigh-poweredblender.Addspinachandhalfoflettuce.Blend.Addmilkandtheremaininglettuce.Blenduntilcreamy.

GreenGorillaBlendedSalad

Serves:2½avocado1banana5ouncesbabyromainelettuce5ouncesorganicbabyspinach

Inafoodprocessororhigh-poweredblender,blendavocadowiththebanana.Thenaddlettuceandspinach.Processuntilsmooth.

DIPS,DRESSINGS,ANDSAUCESDipsandDressings

CaesarSaladDressing/DipServes:33clovesgarlic,roasted3tablespoonsraw,un-hulledsesameseeds½cupunsweetenedsoy,hemp,oralmondmilk⅓cuprawcashews1tablespoonfreshlemonjuice1½tablespoonsnutritionalyeast1½teaspoonsDijonmustardBlackpepper

Breakthegarlicclovesapartandleavethepaperyskinson.Roastthemonabakingpanat350˚Funtilsoft(about20minutes).Inaflatpan,toastthesesameseeds,shakingfor3minutes,andputaside.Skintheroastedgarlicandplaceitinafoodprocessororhigh-poweredblenderalongwiththemilk,cashews,lemonjuice,nutritionalyeast,andmustard.Sprinkleonadashofblackpepper.Blenduntilcreamyandsmooth.Drizzlethedressingoveratossedsaladandtopwiththetoastedsesameseeds.Ifusingasadip,mixthesesameseedsintothedip.

CreamyBlueberryDressingServes:42cupsfresh,orfrozenandthawed,blueberries½cuppomegranatejuice⅓cuprawcashews

6walnuthalves3tablespoonsWildBlueberryVinegarorwhitewinevinegar

Blendallingredientsinafoodprocessororhigh-poweredblenderuntilsmoothandcreamy.

FreshTomatoSalsaServes:42freshtomatoes,chopped1smallredonion,finelychopped2scallions,finelychopped2clovesgarlic,finelychopped½jalapenochilipepper,seededandminced3tablespoonschoppedcilantro3tablespoonsfreshlimejuice

Stirtogetherallingredients.Serveimmediately,orrefrigerateinanairtight,coveredcontainerforupto3days.

GarbanzoGuacamoleServes:31½cupscookedgarbanzobeansor1(15-ounce)can,nosaltadded,drained2clovesgarlic1tablespoonlemonjuice1avocado,peeledandcubed1½freshgreenchilipeppers,minced1cupchoppedtomato¾cupchoppedgreenonions1teaspoonBraggLiquidAminosorlow-sodiumsoysauce2tablespoonschoppedcilantro

Inafoodprocessor,pureebeansandgarlicwithlemonjuice.Addavocadoandchilipeppers,pulsinguntilmixtureisfairlysmoothwithsomesmallchunks.Removetobowlandstirintomato,greenonions,liquidaminos,andcilantro.Servewithrawvegetables,orrefrigerateinanairtightcontainerforupto4days.

GreenVelvetDressing/Dip

Serves:4¾cupwater½cupfreshlemonjuice½cupun-hulled,rawsesameseedsorrawtahini⅓cuprawcashews¼cupchoppedfreshparsley¼cupchoppedfreshdill2tablespoonsVegiZestorotherno-saltseasoningblend½tablespoonchoppedfreshtarragonor½teaspoondried1teaspoonBraggLiquidAminosorlow-sodiumsoysauce2clovesgarlic

Blendallingredientsinafoodprocessororhigh-poweredblenderuntilsmooth.Serve,orrefrigerateinanairtightcontainerforupto4days.

HerbedWhiteBeanHummusServes:21⅔cupscookedwhitebeansor1(15-ounce)can,nosaltadded,drained1tablespoonlemonjuice2tablespoonsun-hulled,rawsesameseeds2tablespoonsredwinevinegar½teaspoonDijonmustard2tablespoonswater¼cupchoppedfreshbasil2tablespoonsfreshthyme

Placebeans,lemonjuice,seeds,vinegar,mustard,andwaterinahigh-poweredblenderorfoodprocessor.Blenduntilsmooth.Addbasilandthymeandpulseverybriefly.Donotoverprocessherbs;theyshouldbevisibleinsmallpieces.Serve,orrefrigerateinanairtightcontainerforupto4days.

IslandBlackBeanDipServes:41⅔cupscookedblackbeansor1(15-ounce)can,nosaltadded,drained2teaspoonsno-saltsalsa¼cupmincedscallions1½tablespoonsRieslingReserveVinegarorotherfruityflavoredvinegar

2tablespoonsMatoZestorotherno-saltseasoningblend2tablespoonsmincedredonion½cupfinelydicedmango¼cupdicedredbellpepper1tablespoonfreshmincedcilantroorparsley,forgarnish

Remove¼cupoftheblackbeansandsetaside.Placeremainingbeansinablenderorfoodprocessor.Addsalsa,scallions,vinegar,andseasoningmix.Pureeuntilrelativelysmooth.Adjustseasoningstotaste.Transfertoabowlandaddthereservedblackbeans,redonion,mango,andredbellpepper.Mixwellandchillfor1hour.Garnishwithcilantroorparsley.Servewithunsalted,oil-freebakedpitaorrawveggies,orrefrigerateinanairtightcontainerforupto4days.

RussianFigDressing/DipServes:25tablespoonsno-orlow-saltpastasauce3tablespoonsrawalmondbutteror1.5ouncesrawalmonds2tablespoonsrawsunflowerseeds3tablespoonsBlackFigVinegarorbalsamicvinegar

Blendallingredientsinafoodprocessororhigh-poweredblenderuntilsmooth.Serve,orrefrigerateinanairtightcontainerforupto4days.

ThousandIslandDressingServes:4½cuprawalmonds½cuprawcashews½cupunsweetenedsoy,hemp,oralmondmilk2tablespoonsbalsamicvinegar2tablespoonslemonjuice1tablespoonfreshdillor1teaspoondried1teaspoononionpowderorgranules1bulbor8clovesroastedgarlic3tablespoonstomatopaste½cucumber,peeledandcutintotwoequalportions¼cupfinelychoppedonion

Inafoodprocessororhigh-poweredblender,blendtogetherthenuts,milk,vinegar,lemonjuice,dill,onionpowder,garlic,tomatopaste,andhalfofthecucumberuntilsmooth.Removefromblender.Finelychopremainderofcucumber,combinewithonions,andfoldintothedip.Serve,orrefrigerateinanairtightcontainerforupto4days.

TofuRanchDressing/DipServes:46ouncessilkentofu3dates,pitted1clovegarlic¼cupfinelychoppedgreenonion3tablespoonswater2tablespoonslemonjuice1½tablespoonsItalianseasoning1tablespoonchoppedfreshparsleyor1teaspoondried1tablespoonchoppedfreshdillor1teaspoondried1teaspoonBraggLiquidAminosorlow-sodiumsoysauceCayennepepper

Inahigh-poweredblenderorfoodprocessor,combineallingredientsandprocessuntilsmooth.Serve,orrefrigerateinanairtightcontainerforupto5days.Note:Useasadressing,dip,spread,ormayonnaisesubstituteinyourfavoriterecipes.

SaucesforCookedVegetables

AlmondTomatoSauceServes:4½cuprawalmonds1largeclovegarlic2mediumtomatoes¼teaspoonsweetpaprika1tablespoonredwinevinegar

¼cupunsweetenedsoy,hemp,oralmondmilk2tablespoonsfreshbasil

Processalmondsinafoodprocessoruntilfinelyground.Addgarlic,tomatoes,paprika,vinegar,andmilkandcontinuetoprocessuntilsmooth.Addbasilandpulseuntilmixedin.Serveoversteamedorwater-sautéedvegetables.Oruseasatoppingforamixtureofroastedredpeppersandsteamedsnowpeas.

RedLentilSauceServes:4½cupredlentils1mediumonion,chopped1clovegarlic,chopped1cupcarrotjuice1tablespoonVegiZestorotherno-saltseasoningblend1teaspooncumin½teaspoonbalsamicvinegar½cupwater¼cupchoppedpecans

Addlentils,onions,garlic,andcarrotjuicetoasaucepanoverhighheat.Bringtoaboil,cover,andsimmeruntilthelentilsaresoftandpale(20–30minutes).Addmorecarrotjuiceifneeded.PutthecookedlentilmixtureintoafoodprocessororblenderwithVegiZest,cumin,andbalsamicvinegarandblendtoasmoothpuree.Addadditionalwaterifitistoothick.Servewithsteamedbroccoli,cauliflower,orothervegetables.Topwithchoppedpecans.

SesameGingerSauceServes:4½cuptahini2tablespoonsfreshlemonjuice1teaspoonwhitemiso1tablespoonfinelygratedginger2pitteddates1clovegarlic,crushed

Freshlygroundpepper⅔cupwater

Blendallingredientsinahigh-poweredblenderorfoodprocessor.Additionalwatercanbeaddedtoachievedesiredconsistency.Servewithsteamedorwater-sautéedvegetables.Thissaucegoeswellwithbokchoy,asparagus,orkale.

SOUPS

Dr.Fuhrman’sFamousAnticancerSoupServes:106–8mediumzucchini1½cupsmixeddrysplitpeas,lentils,andbeans6cupswater5poundscarrotsor5–6cupscarrotjuice2bunchesorganicceleryor2cupsceleryjuice4mediumonions3leekstalks,slicedlengthwisetounravelandrinse2buncheskale,collards,orothergreens,chopped,toughstemsandcenterribscutoffanddiscarded½cuprawcashews8ouncesmushrooms(shiitake,cremini,and/oroyster),chopped2tablespoonsVegiZestorotherno-saltseasoningblend1teaspoonMrs.Dashorotherno-saltspiceblend

Placethezucchini,beans,andwaterinaverylargepotoverlowheatandcover.Juicecarrotsandceleryandaddtopot.Blendonions,leeks,andkaleinahigh-poweredblenderwithsomeofthesoupliquid.Removethepartiallycookedzucchinifromthepot.Additandthecashewstotheblendedonions,leeks,andkale.Blendmixinbatchesuntilthickandcreamyandreturntothepot.Addtheseasoningsandmixthoroughly.Addthechoppedmushroomsandsimmeruntilbeansaresoft(aboutonehour).Note:Juicecarrotsandceleryinajuiceextractor.Freshlyjuicedorganiccarrotsmaximizetheflavorofthissoup.

FastMexicanBlackBeanSoup

Serves:52(15-ounce)cansblackbeans,nosaltadded2cupsfrozenmixedvegetables2cupsfrozencorn2cupsfrozenchoppedbroccoliflorets2cupscarrotjuice,freshorbottled1cupwater1cuppreparedblackbeansoup,noorlowsalt¼cupchoppedcilantro1teaspoonchilipowder,ortotaste1cupchoppedfreshtomatoes½cupchoppedscallions¼cuprawpumpkinseeds

Combineblackbeans,mixedvegetables,corn,broccoli,tomatoes,carrotjuice,water,soup,cilantro,andchilipowderinasouppot.Bringtoaboilandsimmeronlowfor20minutes.Servetoppedwithextratomatoes,scallions,andpumpkinseeds.

FrenchLentilSoupServes:88cupswater2cupscarrotjuice,freshorbottled2(15-ounce)cansno-saltaddeddicedtomatoes,or3cupsdicedfreshtomatoes4tablespoonsVegiZestorotherno-saltseasoning2onions,chopped3ribscelery,chopped2carrots,sliced6clovesgarlic,minced1tablespoondriedoregano1½teaspoonsdriedbasilor2tablespoonschoppedfresh1teaspoongroundcoriander1teaspoongroundcumin1teaspoondriedthymeor1tablespoonchoppedfresh1pounddryFrench(green)lentils,rinsed1redbellpepper,chopped

½greenbellpepper,chopped2smallzucchini,chopped1(10-ounce)boxfrozenlimabeans1bunchkale,toughstemsremoved,finelychopped3tablespoonsRieslingReserveVinegar½cuprawcashews½cuprawfilberts

Putalltheingredientsexceptforthenutsinalargesouppot.Bringtoasimmerandcookuntillentilsaretender(about1hour).Put2cupsormoreofthesoupintoafoodprocessororhigh-poweredblender,addnuts,blenduntilsmooth,andstirbackintosoup.Serve.

GoldenAustrianCauliflowerCreamSoupServes:41headcauliflower,cutintoflorets3carrots,coarselychopped1cupcoarselychoppedorganiccelery2leeks,coarselychopped2tablespoonsVegiZestorotherno-saltseasoningblend1teaspoonMrs.Dashorotherno-saltspiceblend2cupscarrotjuice,freshorbottled4cupswater2clovesgarlic,minced½teaspoonnutmeg1cuprawcashews5cupschoppedorganicbabyspinach

Placecauliflower,carrots,celery,leeks,VegiZest,Mrs.Dash,carrotjuice,water,garlic,andnutmeginalargesouppot,cover,andsimmeruntilcauliflowerissoft(about15minutes).Transfer⅔ofthesoup(vegetablesandstock)toablenderorfoodprocessor,addcashews,andblenduntilsmoothandcreamy.Returnblendedmixturetothesouppot,stirinspinach,andsimmeruntilspinachiswilted.Serve.

MushroomSoupProvencalServes:8

1⅓cupsdriedwhite,Northern,navy,orcannellinibeans,rinsed,or2(15-ounce)cans,nosaltadded,drained4cupswater(ifusingcannedbeans,decreasewaterto1cup)3cupsunsweetenedsoy,hemp,oralmondmilk5cupscarrotjuice,freshorbottled2carrots,coarselychopped1(10-ounce)packagefrozencorn1cupchoppedorganiccelery3leeks,slicedlengthwisetounravelandrinse,thencutin½-inchslices2poundsmixedfreshmushrooms(button,shiitake,orcremini),sliced¼-inchthick2clovesgarlic,mincedorpressed2mediumonions,chopped2teaspoonsherbesdeProvence4tablespoonsVegiZestorotherno-saltseasoningblend¼cuprawcashews1tablespoonlemonjuice1tablespoonchoppedfreshthymeor1teaspoondried2teaspoonschoppedfreshrosemaryor½teaspoondried1(6-ounce)bagbabyspinach,chopped¼cupchoppedfreshparsley

Inalargebowl,submergebeans1inchbelowwaterandsoakthemovernight.Orinasouppot,bringthemtoarapidboil,cover,andsetasidefor1hour.*Drainthebeans.Inalargesouppot,add4cupswaterandbeansandheatonlow.Add2½cupsofthemilkandallofthecarrotjuice,carrots,corn,celery,leeks,mushrooms,garlic,onions,herbesdeProvence,andVegiZesttothepot.Simmeruntilbeansaretender(about1hour).Inablenderorfoodprocessor,blendcashewsandreserved½cupmilk.Addhalfofthesoupandthelemonjuice,thyme,androsemary.Blenduntilsmoothandcreamy.Returnpureedsoupbacktothepotandaddchoppedspinach.Cookonlowflameuntilheatedthroughandspinachiswilted.Serve,garnishedwithparsley.*Ifthebeansarenotpresoaked,increasecookingtimeanduse8–10cupswater.

QuickandCreamyVegetableBeanSoupServes:84cupslow-sodiumorno-salt-addedvegetablebroth2cupsfrozenbroccoliflorets2cupsfrozenchoppedorganicspinach2cupscarrotjuice1cupfrozenchoppedonions4(15-ounce)canscannellinibeansorotherwhitebeans,nosalt,drained3freshtomatoes,chopped1bunchfreshbasil,chopped4tablespoonsVegiZestorotherno-saltseasoningblend1teaspoongarlicpowder1teaspoonItalianseasoning½cuprawcashews¼cuppinenuts

Inasouppot,combineallingredientsexceptcashewsandpinenuts.Coverandsimmerfor30–40minutes.Transfer¼ofthesoupmixturetoahigh-poweredblender,addcashewsandpinenuts,andblend.Returnblendedmixturebacktothesouppot,andserve.

TomatoBisqueServes:83cupscarrotjuice1½poundsfreshtomatoes,chopped,or1(28-ounce)canSanMarzanotomatoes¼cupchoppedsun-driedtomatoes2organicceleryribs,chopped1smallonion,chopped1leek,chopped1largeshallot,chopped3clovesgarlic,chopped2tablespoonsVegiZestorotherno-saltseasoningblend1teaspooncrumbleddriedthyme1smallbayleaf½cuprawcashews¼cupchoppedfreshbasil

1(5-ounce)bagorganicbabyspinachInalargesaucepan,addcarrotjuice,freshandsun-driedtomatoes,celery,onion,leek,shallot,garlic,VegiZest,thyme,andbayleaf.Simmerfor30minutes.Discardbayleaf.Withaslottedspoon,remove2cupsofvegetablesandsetaside.Transferremainingsouptoafoodprocessor,addcashews,andpureeuntilsmooth.Returnpureetopotandaddsoupvegetablestomakeacreamybisquewithchunksofvegetables.Stirinbasilandspinachandletthemwilt.Serve.

MAINDISHES

AsparagusPolonaiseServes:42bunchesasparagus7ounces(orhalf15.5ouncepackage)softtofu1tablespoonlemonjuice2pitteddates1clovegarlic,chopped½cupfreshchoppedparsley½cupunsweetenedsoy,hemp,oralmondmilk

Cuttoughendsoffasparagusandsteamuntiltender(about8minutes).Inafoodprocessororhigh-poweredblender,blendtofu,lemonjuice,dates,garlic,parsley,andmilkuntilsmooth.Pouroverasparagus,andserve.

TheBigVeggieStir-FryServes:41tablespoonmincedfreshginger2clovesgarlic,minced2tablespoonstahini¼teaspoonhotpepperflakes¼cuppineapplejuice2tablespoonsricevinegar2teaspoonsreduced-sodiumsoysauce1½cupswater1(8-ounce)tofu,cutinto1-inchcubes

5cupsbroccoliflorets2cupschoppedbokchoy1zucchini,chopped1redbellpepper,chopped4cupsshreddedcabbage2stemslemongrass,thinlysliced2teaspoonscornstarch4scallions,chopped2tablespoonssesameseeds

Inasmallbowl,combineginger,garlic,tahini,hotpepperflakes,pineapplejuice,ricevinegar,soysauce,and¼cupwater.Setaside.Rubalargewokwithoilandstir-frytofuoverhighheatfor5minutesoruntilslightlybrowned.Transfertoabowlandtenttokeepwarm.Tothewok,addbroccoli,bokchoy,zucchini,redpepper,cabbage,andlemongrassalongwith¾–1cupofwater.Coverandcookovermedium-highheat,stirringoccasionally,untilcrispbuttender(about10minutes).Stirtofuintoveggiemixtureinwokandaddsaucemixture.Stir-fryuntilheatedthrough(about2minutes).Inasmallbowl,combinecornstarchand3tablespoonswaterandstirintowok.Cookuntilthickened(2–3minutes).Additionalwatermaybeaddedtoadjustconsistency.Topwithscallionsandsesameseeds.ServeoverHerbedBarleyandLentils.Note:Substitute1chickenbreast,cutintostrips,shrimp,orscallopsfortofuifyouwish.

BlackBeanLettuceBundlesServes:41½cupscookedblackbeansor1(15-ounce)can,nosaltadded½largeavocado½greenbellpepper,chopped3scallions,chopped⅓cupchoppedfreshcilantro2tablespoonslimejuice1teaspooncumin2clovesgarlic,minced

⅓cupmildsalsa,lowsodium8largeromainelettuceleaves

Withafork,mashbeansandavocadotogether.Inamediumbowl,combinethemashwithremainingingredients,exceptlettuce,andmix.Placeapproximately¼cupoffillingincenteroflettuceleaf,rolllikeatortilla,andeat.

BraisedBabyBokChoyServes:48babybokchoyor3regularbokchoy1tablespoonBraggLiquidAminosorlow-sodiumsoysauce1tablespoonun-hulledsesameseeds,lightlytoasted

Coverbottomoflargeskilletwith½inchwater.Cutbabybokchoyinhalflengthwise,orcutregularbokchoyintochunks,andaddtothewater.Drizzlewithliquidaminos.Coverandcookonhighheatuntilbokchoyistender(about6minutes).Lightlytoastsesameseedsinapanovermediumheatfor3minutes,shakingpanfrequently.Platethebokchoyandtopwithtoastedsesameseeds.

CaliforniaCreamedKaleServes:42buncheskale,toughstemsremoved,chopped1cuprawcashews1cupunsweetenedsoy,almond,orhempmilk4tablespoonsonionflakes1tablespoonVegiZestorno-saltseasoningblend(optional)

Placekaleinalargesteamerpot.Steamuntilsoft(10–20minutes).Meanwhile,placeremainingingredientsinahigh-poweredblenderandblenduntilsmooth.Placesteamedkaleincolanderandpresswithacleandishtoweltoremovesomeoftheexcesswater.Coarselychopthekale,transferittoabowl,andmixitwiththecreamsauce.Note:Saucemaybeusedwithbroccoli,spinach,orothersteamedvegetables.

Cauliflower,SpinachMashed“Potatoes”Serves:46cupscauliflowerflorets,freshorfrozen6clovesgarlic,sliced1(10-ounce)bagfreshorganicspinach½cuprawcashewbuttersoymilk,asneededtothin2tablespoonsVegiZestorotherno-saltseasoningblend¼teaspoonnutmeg

Inavegetablesteamer,steamcauliflowerandgarlicuntiltender(about8to10minutes).Drain,pressingoutasmuchwateraspossible.Setaside.Placespinachinsteamer,steamuntiljustwilted,andsetaside.Withthe“S”bladeofafoodprocessor,processcauliflower,garlic,andcashewbutteruntilcreamyandsmooth.Ifitistoothick,addasmallamountofsoymilk,process,andcheckagain.AddVegiZestandnutmeg,adjustingtotaste.Mixpureedcauliflowerwithwiltedspinach.Servehotorwarm.

EasyBeanandVegetableChiliServes:61poundfirmtofu,frozen,defrosted5teaspoonschilipowder,ortotaste1teaspooncumin10ouncesfrozenchoppedonions3cupsfrozenbroccoli,finelychopped3cupsfrozencauliflower,finelychopped3clovesgarlic1canpintobeans,nosaltadded,drained1canblackbeans,nosaltadded,drained1canredbeans,nosaltadded,drained1(28-ounce)candicedtomatoes,nosaltadded,or2½cupsdicedfreshtomatoes1(4.5-ounce)canchoppedgreenchilies,mild2½cupscorn,freshorfrozen2largezucchini,finelychopped

Squeezeexcesswateroutoftofuandcrumble.Placeinalargepanonhigh

heat,addchilipowderandcumin,andquicklybrown.Addonions,broccoli,cauliflower,garlic,beans,tomatoes,chilies,corn,andzucchini,cover,andsimmerfor2hours.Servehot.

EggplantRollUpsServes:42tablespoonsbalsamicvinegar2tablespoonsplus¼cupwater1largeeggplant,peeledandslicedintothin,flat,longstripsNonstickcookingspray1redorgreenbellpepper,or½ofeach,diced1onion,chopped2clovesgarlic,chopped1cuptomatosauce,nosaltadded1cupdicedtomatoes1teaspoonItalianherbseasoning1teaspoondatesugar

Combinebalsamicvinegarand2tablespoonswater,addeggplantslices,andmarinatefor1hour.Draineggplantandplaceinabakingpanthathasbeenlightlycoatedwithcookingspray.Bakeat350˚Fdegreesuntilflexible(about20minutes).Meanwhile,sautépepper,onion,andgarlicin¼cupwaterovermediumheatfor5minutesoruntilwateriscookeddown.Addtomatosauce,dicedtomatoes,seasoning,anddatesugarandsimmerfor10minutes.Takeastripofpartiallycookedeggplant,spreadalayerofthetomatosaucemixtureinthemiddle,androllup.Repeatforalleggplantslices.Placeinabakingdish,coverwiththeremainingtomatosaucemixture,andbakeat350˚Ffor30minutes.Servehot.

GarlickyZucchiniServes:46cupsslicedzucchini4clovesgarlic,minced¼teaspoonblackpepper2tablespoonschoppedlightlytoastedpinenuts

Sautézucchiniandgarlicinasmallamountofwaterovermedium-highheatuntiltender(about3minutes).Addmorewaterifnecessarytopreventscorching.Addblackpepperandsprinklewithchoppedpinenuts.Servewarm.

GreatGreensServes:52largebuncheskale,toughstemsandcenterribsremoved,chopped1bunchSwisschard,mustardgreens,ororganicspinach,stemsremoved,chopped1tablespoonSpicyPecanVinegarorbalsamicvinegar2clovesgarlic,minced½tablespoonVegiZestorotherno-saltseasoningblend1tablespoonchoppedfreshdillor1teaspoondried2tablespoonschoppedfreshbasilor1teaspoondriedFreshlygroundblackpepper

Steamkalefor10minutes,addSwisschard,mustardgreens,orspinach,andsteamanother5minutes.Transfertoamediumbowl.Inasmallbowl,combinevinegar,garlic,VegiZest,dill,basil,andpepper;addtogreens,andserve.

HerbedBarleyandLentilsServes:4½cupchoppedonions2clovesgarlic,chopped3cupscoconutwaterorwaterblendedwithadate1cuphulledbarley*¼cuplentils½teaspoonItalianseasoning1tablespoonchoppedfreshdillor¼teaspoondried1tablespoonfinelychoppedfreshchivesor1teaspoondried2tablespoonsfinelychoppedfreshbasilor½teaspoondried

Inalargesaucepan,sautéonionsandgarlicinasmallamountofcoconutwater,about5minutesoruntilsoft.Addremainingingredientsandbringtoaboil.Reduceheat,cover,andsimmeruntilbarleyandlentilsaretenderandwaterisabsorbed(about1hour).*Hulledbarleyisbarleythathasbeenminimallyprocessedtoremoveonlythe

toughinedibleouterhull.Donotusepearledbarley;itreceivesadditionalprocessingandhasalowernutritionalvalue.

MediterraneanBeanandKaleSautéServes:32buncheskale,toughstemsandcenterribsremoved,chopped½cupchoppeddriedtomatoes(unsulfured,unsalted)1mediumonion,finelychopped1cupcoarselychoppedshiitakeoroystermushrooms3clovesgarlic,pressed1tablespoonVegiZestorotherno-saltseasoningblend1cupdriedandcookedbeans,anytype,orcanned,nosaltadded1½tablespoonsRieslingReserveVinegarorothersweetvinegar1tablespoonDijonmustardRedpepperflakesTomato-basedpastasauce

Inasmallbowl,coverdriedtomatoeswithwaterandsoakatleast1hour.Inalargeskillet,sautékale,tomatoes,onion,mushrooms,andgarlicinalittlewaterovermediumheatfor5minutes,addingwaterasneeded.AddVegiZestandenoughwatertokeepfromscorching.Coverandsteamfor10minutes.Addbeans,vinegar,mustard,andredpepperflakesandcookuntilmushroomsaretenderandliquidhascookedout(about3minutes).Stirinpastasauceasdesired,andserve.Note:Topwithchickenstripsorbakedfishfiletifyouwish.

No-MeatBallsServes:5½cupdicedonion4clovesgarlic,roasted*andcrushed¼cupdicedcelery2tablespoonsmincedparsley¼teaspoondriedsage2tablespoonschoppedfreshbasilor1teaspoondried1teaspoondriedoregano1⅔cupscookeddriedlentilsor1(15-ounce)can,nosaltadded,drained

¼cupcookedwildrice2–3tablespoonstomatopaste1tablespoonarrowrootpowderorwholewheatflour2tablespoonsMatoZestorotherno-saltseasoningblend2tablespoonsnutritionalyeastFreshlygroundblackpepper2tablespoonsvitalwheatglutenflour

Inafryingpan,heat1tablespoonofwater.Addonionandgarlicandsautéfor5minutes.Addcelery,parsley,sage,basil,andoreganoandsautéanother5minutes,addingalittlemorewaterifneededtopreventsticking.Inalargebowl,combinethesautéedvegetableswiththeremainingingredientsandmixwell.Mashlightlywithapotatomasher.Withwethands,form2tablespoonsofthelentilmixtureintoasmoothballandplaceonaverylightlyoiledbakingsheet.Repeatwiththeremaininglentilmixtureandbakeno-meatballsat350˚Ffor30minutes.Servewithlow-saltmarinarasauce.*Toroastgarlic,breaktheclovesapart.Leavethepaperyskinson.Roastat350˚Funtilsoft(about20minutes).

Pistachio-CrustedTempehwithBalsamicMarinadeandShiitakeMushroomsServes:48ouncestempeh,thinlysliceddiagonally

Marinade2clovesgarlic,minced1tablespoonchoppedfreshcilantro1tablespoonchoppedfreshbasilHotpepperflakes1cupvegetablebroth,noorlowsalt2tablespoonsbalsamicvinegar1teaspoonBraggLiquidAminosorlow-sodiumsoysauce

Crust1cuppistachios,shelled4tablespoonscornmeal2tablespoonsnutritionalyeast

1teaspoononionpowder1teaspoongarlicpowder½poundshiitakemushrooms,stemmed,thinlysliced

Placetempehinasaucepanwithwatertocover,bringtoasimmer,andsimmerfor10minutes.Inabowl,combinealltheingredientsforthemarinade.Transfertempehtothebowlandmarinateforatleast1hour.Placepistachiosinafoodprocessorandprocessuntilfinelychopped.Addremainingcrustingredientsandpulseuntilthoroughlymixed.Placeinlarge,shallowbowl.Draintempehfrommarinade—reservingthemarinade—anddipincrustmixturetocoat.Placecrustedtempehandslicedmushroomssidebysideonarimmedbakingsheet.Spoonsomemarinadeovermushrooms.Bakeat400˚Funtilmushroomsaresoft(13minutes),turningmushroomsoccasionally.Transferremainingmarinadetoapanandsimmerfor2minutes.Drizzletempehandmushroomswithwarmmarinadebeforeserving.

RatatouilleServes:41mediumonion,thinlysliced2clovesgarlic,chopped2largetomatoes,chopped,or1(15-ounce)candicedtomatoes,nosaltadded1mediumeggplant,cutinto1-inchcubes1mediumzucchini,sliced½inchthick1mediumredbellpepper,cutinto1-inchpieces1teaspoondriedoregano1tablespoonfreshbasil,chopped,or1teaspoondriedBlackpepper

Inalargedeepskillet,sautétheonionin2tablespoonswateruntilsoftened(about3minutes).Addgarlicandcookfor1minute,addingmorewaterasnecessarytokeepfromscorching.Reduceheattomoderatelylowandaddtomatoes,eggplant,zucchini,redbellpepper,oregano,andbasil.Addblackpeppertotaste.Coverandcook,stirringoccasionally,untilvegetablesareverytender(about1hour).Servewarmoratroomtemperature.

RoastedVegetableSaladwithBakedTofuorSalmonServes:42redbellpeppers,cutinto½-inchpieces1mediumeggplant,cutinto½-inchpieces1largeyellowsquash,cutinto½-inchpieces1½cupsbutternutsquash,peeledandcutinto½-inchpieces1teaspoonoliveoil*2tablespoonsbalsamicvinegar3clovesgarlic,minced1teaspoonBraggLiquidAminosorlow-sodiumsoysauce1⁄8teaspoonblackpepper12cupsmixedgreensBakedTofuStripsorBakedSalmon(seebelow)

Lightlycoatalargebakingpanusingapapertowelmoistenedwitholiveoil.Placepeppers,eggplant,andsquashinpan.Inasmallbowl,mixtogetheroliveoil,vinegar,garlic,aminos,andblackpepper.Pourovervegetablesandtoss.Roastat400˚Funtiltender(18–20minutes),stirringonce.Arrangemixedgreensonplates.Removeroastedvegetablesfromovenandspoonovermixedgreens.CanbeservedasisortoppedwithBakedTofuStripsorBakedSalmon.BakedTofuStripsCut1poundofextra-firmtofuinto1-inchstrips.Placeonalightlyoiledbakingdishandsprinklewith1teaspooneachgarlicpowderandonionpowder.Bakeat350˚F,turningonce,untilyellowandfirmontheoutsideandstilltenderinside(about30minutes).BakedSalmonCut12ouncesofsalmoninto4pieces.Seasonwithgarlicpowderandblackpepper,totaste.Placesalmonskin-sidedownonanonstickbakingsheet.Bakeat450˚Funtilsalmoniscookedthrough(about12minutes).*Only1teaspoonofoil(only10caloriesofoilperserving)usedherefor4servings,sothisisacceptableperiodically

SaucyLentilLoaf

Serves:42largeartichokes,rinsed1tablespoonwaterorvegetablebroth½cupdicedonion2clovesgarlic,minced3cupsbuttonmushrooms,finelychopped¼cupdicedcelery2tablespoonsmincedparsley½teaspoonpoultryseasoning1⅔cupscookeddriedlentilsor1(15-ounce)can,nosaltadded,rinsedanddrained⅓cuprawpecans,finelychopped¼cuprolledoats¼cuptomatopaste,plusextrafortopofloaf2tablespoonsarrowrootpowderorwholewheatflour2tablespoonsMatoZestorotherno-salt,tomato-basedseasoningmixFreshlygroundblackpepper

Sliceoneinchoffthetopofeachartichoke.Cutofftheverybottomofthestems,butkeepthestemsattached,andsliceartichokesinhalflengthwise.Placetheminasteamerbasketoverseveralinchesofwater.Bringwatertoaboil,cover,andsteamfor40minutes.Setartichokesasideuntilcoolenoughtohandle.Scoopoutanddiscardthefibrouschokefromthecenterofeachartichoke.Removetheheartsandtransfertoabowl.Mashlightly.Scrapeoffthebottomthirdofeachleafandaddtomashedhearts.Carefullyscrapeoutthetenderinsideofthestemstouseaswell.Inafryingpan,heatwater,addonionandgarlic,andsautéfor5minutes.Addmushrooms,cover,andsautéanother4minutesuntilmushroomsaretender.Addcelery,parsley,andpoultryseasoning.Sautéanother5minutes,addingwaterifneededtopreventsticking.Transferthesautéedvegetablestoabowlandadd1cupmashedartichokes,lentils,pecans,oats,tomatopaste,arrowrootpowder,andMatoZest.Sprinklewithblackpepper,totaste.Stirwelltocombine.Lightlyrubaloafpanwithaminimalamountofoil.Fillwiththelentilmixtureandpressdownevenly.Spreada1⁄8-inchlayeroftomatopasteoverthetop.Bakefor1hourat350˚F.Removefromtheovenandletstandatroomtemperaturefor30minutesbeforeslicingandserving.

SavoryPortobelloMushroomswithChickpeasServes:21largeonion,chopped2clovesgarlic,chopped3largePortobellomushroomcaps,thinlysliced⅓cupredwineorlow-sodiumvegetablebroth1largetomato,diced,or8halvedcherrytomatoes1⅔cupscookedgarbanzobeans,or1(15-ounce)can,nosaltadded2tablespoonswater1tablespoonchoppedfreshmintor1teaspoondried

Water-sautéonionandgarlicforafewminutes.Addmushroomsandredwineandcookfor5moreminutes.Addtomatoes,garbanzobeansandwater.Cookforanother5–10minutes.Stirinmint,andserve.

SimpleBeanBurgersServes:6¼cuprawsunflowerseeds1½cupscookeddriedredorpinkbeansor1(15.5-ounce)can,nosaltadded,drained½cupmincedonion2tablespoonsketchup,lowsodium1tablespoonwheatgermoroats½teaspoonchilipowder

Chopthesunflowerseedsinafoodprocessororhandchopper.Mashthebeanswithapotatomasherorinafoodprocessor,transfertoabowl,andmixwithsunflowerseedmeal.Mixintheremainingingredientsandformintosixpatties.Lightlycoatabakingsheetwitholiveoil.Placepattiesonthesheetandbakeat350˚Ffor25minutes.Removefromtheovenandletcool(about10minutes)untilyoucanpickupeachpattyandcompressitfirmlyinyourhandstore-formtheburger.Turnpattiesoverandbakeanother10minutes.

Southern-StyleMixedGreensServes:2

1cupwater1clovegarlic,mincedBlackpepper1⅔cupscookeddriedblack-eyedpeas*or1(15-ounce)can,nosaltadded,rinsedanddrained1cupchoppedyellowpepper1cupchoppedtomato⅓cupchoppedfreshparsley¼cupchoppedredonion2tablespoonsbalsamicvinegarorlow-fatdressing1(10-ounce)packagemixedsaladgreens

Combinewater,garlic,andadashofblackpepperinalargesaucepan;bringtoaboil.Addblack-eyedpeas,cover,andsimmeroverlowheatfor10minutes.Drain.Inabowl,combineblack-eyedpeaswithyellowpeppers,tomato,parsley,onion,andvinegar.Coverandchillfor3hoursorovernight.Serveoversaladgreens.*Smallwhitebeanscanbesubstituted.

SpeedyVegetableWrapServes:21tablespoonlow-fat,low-sodiumdressing2wholewheattortillasorwholewheatpitas2cupsbroccolislawmix1largetomato,diced¼cupredonion,chopped

Oneachtortilla,spreadhalfofthedressing,thebroccolislawmix,thetomatoes,andtherawonion.Heatinatoasterovenormicrowavejustlongenoughtosoften.Rolluptortillas,enclosingfilling.Ifusingpitas,stuffwithdressing,vegetables,andservewithoutheating.Note:Prepackagedbroccolislawcanbepurchasedintheproducesectionofmanymarkets.Coleslawmix,shreddedcabbage,orshreddedbroccolimayalsobeused.

SwissChardwithGarlicandLemon

Serves:42poundsSwisschard,toughstemsandcenterribsremoved,chopped2tablespoonswater3clovesgarlic,minced1tablespoonfreshlemonjuice¼teaspoonfreshlygroundpepper

Inalargepan,sautéSwisschardinwaterovermediumheatuntilslightlywilted(about1minute),addingmorewaterasnecessarytokeepfromscorching.Stiringarlic.Coverandcookuntiltender(4minutes),stirringoccasionally.Uncoverandcookuntiltheliquidevaporates(1–2minutes).Stirinlemonjuiceandpepper.Serve.Note:Ifyouwish,topwithchoiceofhealthydressing.

ThaiVegetableCurryServes:44clovesgarlic,finelychopped2tablespoonspeeledandfinelychoppedfreshginger2tablespoonschoppedfreshmint2tablespoonschoppedfreshbasil2tablespoonschoppedfreshcilantro2cupscarrotjuice1redbellpepper,thinlysliced1largeeggplant,peeled,ifdesired,andcutinto1-inchcubes2cupsgreenbeans,cutin2-inchlengths3cupsslicedshiitakemushrooms,stemsremoved1smallcanbambooshoots2tablespoonsVegiZestorotherno-saltseasoning½teaspooncurrypowder2cupswatercressleaves3tablespoonschunkypeanutbutter,natural,unsalted2poundstofu,cutinto¼-inchthickslices,or1poundscallopsorshrimp½cuplightcoconutmilkMint,basil,cilantro,unchopped,forgarnish

Addgarlic,ginger,mint,basil,cilantro,carrotjuice,pepper,eggplant,greenbeans,mushrooms,bambooshoots,VegiZest,currypowder,and1cupofthe

watercresstoawokorlargeskillet.Bringtoaboil,cover,andsimmer,stirringoccasionally,about10minutes,untilallvegetablesaretender.Mixinpeanutbutter.Addtofu,simmerandtossuntilhot.Orifyou’resubstitutingshrimporscallops,simmeranother5minutesuntilcookedthrough.Addcoconutmilkandcookuntilheated.Topwiththeremaining1cupofwatercressandthegarnish.

VegetableBurritoServes:51mediumonion,thinlysliced1carrot,thinlysliced1mediumredorgreenbellpepper,thinlysliced1mediumzucchini,chopped¼teaspoonchilipowder¼teaspooncumin1mediumtomato,chopped1avocado,sliced¼cupchoppedcilantro5wholegraintortillawraps1lime

Water-sautéonions,carrot,peppers,andzucchiniovermedium-highheatuntiltender(about6minutes).Stirinchilipowderandcumin.Spoonsautéedvegetables,tomatoes,2slicesofavocado,andchoppedcilantroontoeachtortilla.Addsqueezeoflimejuiceandrollup.

YumGoodBeansServes:43cupscookeddriedkidneybeansor2(15-ounce)cans,nosaltadded,drained4–6clovesgarlic,minced⅔cuptomatosauce,nosaltadded2teaspoonscumin½teaspooncayennepepper2tablespoonswater

Placeallingredientsinamediumpot.Simmerovermedium-lowheat,stirring

often,for6minutes.Turnoffheatandmashthebeanswithamasherorfork.Usethesebeansto:rollupinseverallayersofromainelettuceleaves,stuffintosteamedorrawredorgreenbellpeppers,oruseasatoppingforasalad.Oraddasmallamountofno-salt,no-oilcornchipswithplentyoftomatoesforatacosaladtreat.

DESSERTS

BananaWalnutIceCreamServes:22ripebananas,frozen*⅓cupvanillasoymilk(hemporalmondmilkmayalsobeused)½ouncewalnuts

Blendallingredientstogetherinahigh-poweredblenderorafoodprocessoruntilsmoothandcreamy.*Freezeripebananasatleast12hoursinadvance.Tofreezebananas,peel,cutinthirdsandwraptightlyinplasticwrap.

BlueberryCobblerServes:21banana,sliced1cupfrozenblueberries2tablespoonsold-fashionedoats1tablespooncurrents1⁄4teaspoonvanilla2tablespoonschoppedrawalmonds2tablespoonsunsweetenedshreddedcoconut¼teaspooncinnamon

Combinebanana,berries,oats,currents,andvanillainamicrowave-safedish.Microwavefor2minutes.Topwithalmonds,coconut,andcinnamonandmicrowavefor1minute.Servewarm.

CantaloupeSlushServes:4

1cantaloupe,seeded,rindremoved2cupsice2Medjooldatesor4regulardates,pitted

Blendtheingredientstogetherinahigh-poweredblenderuntilsmooth.Note:Thesamedrinkcanbemadewithpeachesornectarines.

MangoCoconutSorbetServes:4½cupunsweetenedshreddedcoconut2tablespoonswater¼teaspoonlemonorlimejuice1(10-ounce)bagfrozenmangos2slicesdriedmango,unsweetenedandunsulfured

Blendingredientsinahigh-poweredblenderorafoodprocessoruntilsmooth.

PeachSorbetServes:41poundfrozenpeaches¼cupsoy,almond,orhempmilk4dates,pitted

Blendallingredientsinahigh-poweredblenderorfoodprocessoruntilsilkysmooth.

PoachedPearswithRaspberrySauceServes:22pears1teaspoonlemonjuice⅔cupfrozenredraspberries,thawed1Medjooldate,or2regulardates,pitted

Peelthepearsandleavethestemsattached.Drizzlewithlemonjuiceandplaceinamicrowave-safebowl.Microwavefor4minutes.Removepearstoindividualbowls,reservingcookingliquid.Blendraspberriesanddatesinahigh-poweredblenderuntilsmooth.Mixwithcookingliquid.Toppearswithraspberrysauce,andserve.

StrawberryPineappleSorbetServes:41(10-ounce)bagfrozenstrawberries1peelednavelorange,orotherorange,peeledandseeded(pre-soakedinwatertocover)4slicesdriedpineapple,unsweetenedandunsulfured

Blendfrozenstrawberries,orange,andpineapplewithsoakingwaterinahigh-poweredblenderorfoodprocessor.Pourintosorbetglassesandtopwithslicedfreshstrawberries,ifdesired.

TakeItfromHere

Ihopethisbookisthebeginningofyourjourneytolastinghealthandvibrantliving.Many of the suggestionsmay be different than anything you’ve triedbefore, and I acknowledge that this may also require a significant lifestylechangeforyouandthosearoundyou.Changeisn’talwayseasy,butitcanbeimmensely rewarding. Watching your diabetes reverse and potentiallydisappear will be a wonderful experience, especially when you know youcreatedtheopportunitybyprovidingyourbodywiththenourishmentitneedstodoitsjob.Asyoubeginyourjourneytohealth,remembertoplanforyoursuccessand

addresseveryobstacleasarewardingchallengetoovercome.YoucanclimbMountEverest and raiseyour arms in triumph.This is your chance to shineand to glowwithpride as you allowyour body to glowwithhealth.Recruityourpersonalsupportteam,andencouragethemnotjusttocheeryouonbutalso to join you. After all, the diet recommendations in this book are alsolargelythesamesuggestionsIwouldmaketoanyoneforweightloss,superiorhealth, and longevity.Good luckwith your journey. I am privileged to haveshared this informationwithyou,and Iencourageyou to shareyour successstorywithme.Visitmeatwww.drfuhrman.com.Iwillbeexcitedtohearfromyou.

Index

Thepaginationofthiselectroniceditiondoesnotmatchtheeditionfromwhichitwas created. To locate a specific passage, please use your ebook reader ’ssearchtools.A1Clevels.SeeHbA1Clevelsacaciaextract,150acarbose(Precose),180acrylamides(toxic),50ActiontoControlCardiovascularRiskinDiabetesstudy,35Actos(pioglitazone),21,32,37,180adult-onsetdiabetes.Seediabetestype2AdventistHealthStudy,112,118AGEs(advancedglycationendproducts),42alcoholintake,201–2almonds:AlmondTomatoSauce,225;ANDIscoreof,49;BlueberryCobbler,255;proteincontentof,86,132;RussianFigDressing/Dip,223;ThousandIslandDressing,224

alphalipoicacid,149Amaryl(glimpiride),21,37,180AmericanCollegeofLifestyleMedicine,189AmericanDiabetesAssociation(ADA):consensusstatement(2009)issuedonrecommendationsfortype2diabetics,170–71;dietapprovedbythe,21–23,124;disease-causingfoodhabitsreinforcedby,36–37;onthelostwaragainstdiabetes,9;medicationspromotedasacceptedtreatmentby,2,36–37AmericanJournalofClinicalNutrition,117AmericanJournalofOphthalmology,32“AmericanKidneyFundWarnsAboutImpactofHigh-ProteinDietsonKidneyHealth”(Crawford),73amputations,9ANDI(AggregateNutrientDensityIndex):descriptionofthe,46–47;Fuhrman’sANDIScoresforspecificfoods,49;understandinghowtousethe,47–48,50

animalproducts:chickenbreast,49;comparingproteinofplantsand,131–32;eggs,77,78;fish,76,77–78,139,246,252;limitingconsumptionof,77–78,139;low-carbohydratehigh-proteindiet,69–75,92;milk,49,139;recommendednutritionalamountsof,75–76;redmeats,49,77,139;scallopsandshrimp,139,252;U.S.dailyconsumptionof,80–81.SeealsoproteinAnnalsofInternalMedicine,71antioxidants:ellagitannins,111–12;inpomegranates,151;processedfoodslowin,50apples:ANDIscoreof,49;GIandGLof,51;highpesticidecontentof,204;SoakedOatsandBlueberries,

218artichokes:preparingsteamed,137;SaucyLentilLoaf,247–48artificiallysweeteneddrinks:cola,49,103;nutritariandieton,138arugula,49asparagus:ANDIscoreof,9;AsparagusPolonaise,234;lowpesticidecontentof,204atheroscleroticplaque:diabetesanddevelopmentof,171–72;eggconsumptionandbuild-upof,78;howthehigh-nutrient-densitydietpromotesregressionof,177–78;studiesonhowtheNrf2proteincanprotectagainst,129–30

Atkinsdiet,50,69,71,72autoimmunereaction,11Avandia(rosiglitazone),2,21,32,37,180avocados:ANDIscoreof,49;BlackBeanLettuceBundles,236;GarbanzoGuacamole,221;GreenGorillaBlendedSalad,219;lowpesticidecontentof,204;VegetableBurrito,253

bananas:ANDIscoreof,49;BananaWalnutIceCream,255;GreenGorillaBlendedSalad,219;proteincontentof,86;QuickBananaOatBreakfasttoGo,217;TropicalFruitSalad,218

barley:GLof,103;HerbedBarleyandLentils,241;resistantstarchof,99Beano,105beans:ANDIscoreofallvarietiesof,49;cannellini,231–32;Dr.Fuhrman’sFamousAnticancerSoup,227;dried,101;EasyBeanandVegetableChili,238;FastMexicanBlackBeanSoup,228;FrenchLentilSoup,229;garbanzo,221,248;GarbanzoGuacamole,221;gasproducedby,105;HerbedWhiteBeanHummus,222;IslandBlackBeanDip,223;kidney,51,99,132,238,254;MediterraneanBeanandKaleSauté,242;MushroomSoupProvencal,231–32;navy,99,103,231–32;Northern,99,231–32;nutritariandietandallowedconsumptionof,125;pinto,238;QuickandCreamyVegetableBeanSoup,232;asresistantstarchsource,91,95–105;SavoryPortobelloMushroomswithChickpeas,248;SimpleBeanBurgers,249;solublefiberprovidedby,91;string,126;uniquepropertiesofcarbohydratesin,94;YumGoodBeans,254.Seealsoblackbeans

beets,103beta-carotene,128,146betacells:insulinproducedbythe,10,26;largecapacityinseverelyoverweightindividuals,29beverages:alcohol–redwine,201–2;cola,49,103;permittedbynutritariandiet,138;pomegranatejuice,49,220;recommendedwaterdrinking,138

bittermelon,150blackbeans:ANDIscoreof,49;BlackBeanLettuceBundles,236;dietaryfiberof,97;EasyBeanandVegetableChili,238;FastMexicanBlackBeanSoup,228;GIandGLof,51;GLof,103;IslandBlackBeanDip,223;resistantstarchof,99.Seealsobeans

blackberries,ANDIscoreof,49black-eyedpeas:GLof,103;resistantstarchof,99;Southern-StyleMixedGreens,250blackrice,GIandGLof,51blindness:diabeticcomplicationof,9;greenvegetableconsumptiontolowerriskofmasculardegeneration,130

bloodglucoselevels:build-upof,12;howbodyfatdeactivatesinsulinandraises,28–31;prediabeticanddiabetic,10;standardpracticestocontrol,2.Seealsoglucose

bloodpressure:diabetescomplicationofhigh,8;howthenutritariandietreducessystolic,5blueberries:ANDIscoreof,49;BlueberryCobbler,255;CreamyBlueberryDressing,220;GIandGLof,51;highpesticidecontentof,204;QuickBananaOatBreakfasttoGo,217;SoakedOatsandBlueberries,218

bodyfat:howbloodglucoseisraisedby,27,28–31;howinsulinisdeactivatesandbloodglucoselevelsraisedby,28–31;lowbody-fatpercentagegoalofweightlossand,173;lowercholesterolwithlower,86;producingbindingproteinsthatblockactivityofinsulin,27,28.Seealsofats;obesity

bokchoy:ANDIscoreof,49;baby,126;TheBigVeggieStir-Fry,235;BraisedBabyBokChoy,236;asrecommendedsaladvegetable,126

breakfastmenus:comparingwithoutnuts/seedsandwithnuts/seeds,119–20;generalguidelinesfor,133–34;fornewlydiagnosedgestationaldiabetes,187;recipesfor,217–18;tipsforquickandeasy,197;Week1,210–13;Week2,213–16

breastcancer,15,83,85BritishMedicalJournal,33,72broccoli:ANDIscoreof,49;TheBigVeggieStir-Fry,235;EasyBeanandVegetableChili,238;FastMexicanBlackBeanSoup,228;proteincontentof,86,132;QuickandCreamyVegetableBeanSoup,232;asrecommendedsaladvegetable,126;SpeedyVegetableWrap,251

brownrice:GIof,51;GLof,51,103;proteincontentof,86;resistantstarchof,99brusselssprouts,49butter:cashew,141;nutritariandietdisallowanceof,139butternutsquash:GIandGLof,51;GLof,103;RoastedVegetableSaladwithBakedTofuorSalmon,246butyrate,95Byetta(exenatide),179,180

cabbage:ANDIscoreof,49;TheBigVeggieStir-Fry,235;lowpesticidecontentof,204caffeinewithdrawal,59calcium,147calorie-counting(portion-controlled)diet,65CalorieRestrictionSociety,84calories:comparingwithoutnuts/seedsandwithnuts/seedsmenuswithsame,119–20;examiningthemythsabouthigh-fatandlow-fat,108–10;exercisetoburn,164;goodhealthdependentonnutritionalqualityofconsumed,107–8;greenvegetablesandlow,130–32;micronutrient-per-caloriedensity,66;asnotallbiologicallyavailable,120;ofresistantstarchfoods,100;U.S.foodconsumptionby,43

cancers:breast,15,83,85;colon,85,98;colorectal,9,15,83;diabetesandincreasedriskof,9;Dr.Fuhrman’sFamousAnticancerSoup,227;IGF-1(insulin-likegrowthfactor1)linkto,82,83;linkbetweenalcoholconsumptionand,202;pancreatic,85;prostate,83,129.Seealsohealthcomplications

cannellinibeans:MushroomSoupProvencal,231–32;QuickandCreamyVegetableBeanSoup,232cantaloupe:ANDIscoreof,49;CantaloupeSlush,256;lowpesticidecontentof,204carbohydrate-restrictive(ketogenic)diet,69–75,92carbohydrates:dietofhigh-proteinandlow,69–75,92;goodhealthdependentonnutritionalqualityofconsumed,107–8;IGF-1promotedbyrefined,84–85;resistantstarch,91;turnedintoglucose,94;uniquepropertiesinbeansandlegumes,94

carcinogenicacrylamides,120cardiovasculardeath.Seeheartdisease/cardiovasculardeathCAREstudy,112carotenoids,130carrotjuice:ANDIscoreof,49;FastMexicanBlackBeanSoup,228;FrenchLentilSoup,229;GoldenAustrianCauliflowerCreamSoup,230;MushroomSoupProvencal,231–32;QuickandCreamyVegetableBeanSoup,232;RedLentilSauce,226;TomatoBisque,233

carrots:ANDIscoreof,49;Dr.Fuhrman’sFamousAnticancerSoup,227;FrenchLentilSoup,229;GIandGLof,51;GoldenAustrianCauliflowerCreamSoup,230;MushroomSoupProvencal,231–32;asrecommendedsaladvegetable,126;VegetableBurrito,253

cashewbutter:Cauliflower,SpinachMashed“Potatoes,”237;mixedintosoups,141cashews:ANDIscoreof,49;CaliforniaCreamedKale,237;CreamyBlueberryDressing,220;Dr.Fuhrman’sFamousAnticancerSoup,227;FrenchLentilSoup,229;GIandGLof,51;GoldenAustrianCauliflowerCreamSoup,230;GreenVelvetDressing/Dip,222;MushroomSoupProvencal,231–32;QuickandCreamyVegetableBeanSoup,232;usedinsoups,141;ThousandIslandDressing,224;

TomatoBisque,233.Seealsonutscauliflower:ANDIscoreof,49;Cauliflower,SpinachMashed“Potatoes,”237;EasyBeanandVegetableChili,238;GIandGLof,51;GLof,103;GoldenAustrianCauliflowerCreamSoup,230;asrecommendedsaladvegetable,126;“unlimitedfood”statusof,125

celery:Dr.Fuhrman’sFamousAnticancerSoup,227;GoldenAustrianCauliflowerCreamSoup,230;highpesticidecontentof,204;MushroomSoupProvencal,231–32;No-MeatBalls,243;organic,140;asrecommendedsaladvegetable,126;SaucyLentilLoaf,247–48;TomatoBisque,233

celeryjuice,227CentersforDiseaseControlandPrevention,1,8cerealgrains:nutritariandietdisallowanceofprocessedcold,138–39;resistantstarchof,97cheese:ANDIscoreoflowfatcheddarcheese,49;nutritariandietdisallowanceof,139cherries,49chickenbreast,49chickpeas,86,132childhoodonset(orjuvenile)diabetes.Seediabetestype2chocolatecake,51cholesterol:HDL(good),111;LDL(bad),111,112,150;medicationstolower,173,174cholesterol-loweringdrugs,173,174chromium,151–52cinnamon,150circadiansystem,62CMA(comprehensivemicronutrientadequacy),48cola:ANDIscoreof,49;GLof,103collards:ANDIscoreof,49;Dr.Fuhrman’sFamousAnticancerSoup,227;proteincontentof,132coloncancer,85,98colorectalcancer,9,15,83copper,146–47corn:ANDIscoreof,49;EasyBeanandVegetableChili,238;FastMexicanBlackBeanSoup,228;GIandGLof,51;GLof,103;lowpesticidecontentofsweet,204;MushroomSoupProvencal,231–32;proteincontentof,86;resistantstarchof,99

cornchips,49Crawford,PaulW.,73C-reactiveprotein,112cruciferousvegetables:descriptionandgeneralhealthbenefitsof,127–29;heartdiseaseandgreen,129–31

cucumbers:ANDIscoreof,49;highpesticidecontentof,204;asrecommendedsaladvegetable,126

dairyproducts:ANDIscoreof1%milk,49;nutritariandietlimitson,139DASH(DietaryApproachestoStopHypertension)study,199,201dates:AsparagusPolonaise,234;CantaloupeSlush,256;PeachSorbet,256;PoachedPearswithRaspberrySauce,257;SesameGingerSauce,226;TofuRanchDressing/Dip,225

deathrates:ActiontoControlCardiovascularRiskinDiabetesstudyfindingson,35;diabeticcomplicationsleadingto,6,8–9;EndocrineSocietystudylinkingdiabeticdrugsand,33;studyonphysicallyfitdiabeticsandreduced,161.Seealsoheartdisease/cardiovasculardeath

dessertrecipes,255–57DHA(omega-3),76,118,148Diabenese(chlorpropamide),21,37,180Diabeta,21,37,180DiabetesCare,115diabetesmellitus:atheroscleroticplaquedevelopmentassociatedwith,78,129–30,171–72;common

healthcomplicationslisted,8–9;financialandeconomiccostsof,9,170;gestational,183–88;managementduringpregnancy,183–84;needtoemphasizepreventionof,9–10;overdependenceonmedicationstocontrol,34–40;overviewofthechronicdiseaseof,8;understandingthecauseof,10–11;worldwideprevalence(1985–2025)of,19.Seealsoheartdisease/cardiovasculardeath;type1diabetes;type2diabetes

diabetespopulation:demographicsof,1;standardpracticestocontrolbloodglucoseby,2DietaryApproachestoStopHypertension(DASH)study,199,201dietarytreatment:ADA’sapproved,21–23,124;diabeticreversaldietfornewlydiagnosedgestationaldiabetes,186–88;lessfavorablemedicationsforuseinconjunctionwith,180;mostfavorablemedicationsforuseinconjunctionwith,180.Seealsonutritariandiet

dietplans:ADA(AmericanDiabeticAssociation),21–23,124;Atkins,50,69,71,72;carbohydrate-restrictive(ketogenic),69–75,92;criteriaofahigh-quality,45–46;Dukan,69,72;healthriskoflow-fat,117–21;paleo,72;poorstateoftypicalAmerican,42;portion-controlled(calorie-counting),65;type1diabeteshealthproblemsexacerbatedbypoor,14;understandingGIandGLin,50–54;U.S.foodconsumptionbycalories,43;vegan,81–82,115,209;ZoneDiet,50.Seealsonutritariandiet;SAD(standardAmericandiet)

dinnermenus:comparingwithoutnuts/seedsandwithnuts/seeds,119–20;generalguidelinesfor,136;maindishrecipesfor,234–54;fornewlydiagnosedgestationaldiabetes,188;tipsforquickandeasy,197–98;Week1,210–13;Week2,213–16

dips/saladdressingrecipes,220–25Dr.Fuhrman’sFamousAnticancerSoup,227driedbeans,101driedfruit,138Dukandiet,69,72

EattoLivediet,5eggplant:EggplantRollUps,239;GIandGLof,51;lowpesticidecontentof,204;Ratatouille,245;RoastedVegetableSaladwithBakedTofuorSalmon,246;ThaiVegetableCurry,252;“unlimitedfood”statusof,125

eggs:ANDIscoreof,49;diabetesandconsumptionof,77,78ellagitannins,111–12endive,126EndocrineSociety,33Englishpeas,126EPA(omega-3),76,118,148EuropeanAssociationfortheStudyofDiabetes,170EuropeanProspectiveInvestigationintoCancerandNutritionstudy,70,83EuropeanSocietyofCardiologyCongressstudy(2008),161exenatide(Byetta),179,180exerciseprescription,160–62exerciseprogram:burningcaloriesthroughexercise,164;enhancingmetabolismthrough,144,165;extendingyourlifespanthrough,30;hownecessityofweightlossfor,166–67;managingphysicallimitations,166–67;recommendationswhenyouhavediabetes,162–66;teneasyexercisestoincorporateintoyourlife,163–66;weight-bearingexercises,165

fats:examiningthemythsabouthigh-fatandlow-fatfoods,108–10;failuretothriveduetodeficiencyin,117–21;healthbenefitsofhigh-fatnutsandseedsconsumption,111–17;healthbenefitsofjudicioususeofhigher-fatfoods,110–11;oliveoil,49,204–6;omega-3(EPAandDHA),76,118,148.Seealsobodyfat

fennel,126

fenugreekseeds,150fermentationprocess,95fish:cautionregardingconsumptionof,76,77–78;RoastedVegetableSaladwithBakedTofuorSalmon,246FitforLife,175flexitarianmeal/eatingplan,209flour:potato,99;whitewheatproducts,93–94;wholewheat,99,103,247–48folate/folicacid,144–45,146food-addictivebehavior:chronicoxidativeandinflammatorystresscreatedby,62–64;understandingtoxichungerconsequenceof,57–59

foods:besttoeattoreversediabetes,104;Fuhrman’sANDIScoresonspecific,49;(GI)glycemicindexandglycemicloadof,50–54;GLofcommonhigh-carbohydrate,103;highnutrientdensity,3,124–25;learningaboutthehealthconsequencesof,4;withthelowestpesticides,204;lownutrientdensity,3;withthemostpesticides,204;NutritarianFoodPyramidforDiabetics,52;proteincontentfromselectedplant,86;resistantstarch,91,95–105;starchy,91–95,209;U.S.foodconsumptionbycalories,43.Seealsospecificfood;vegetables

freefattyacids,27,28frequentlyaskedquestions(FAQs):Anytipsforquickandeasymeals?,197–98;HowmuchsaltcanIusesafely?Whataboutseasalt?,199–201;Isn’tdiabetesmostlygenetic?,195–96;Itisimportanttoeatorganicfoods?,203–4;Whataboutalcohol–shouldIbedrinkingredwineformyheart?,201–2;Whatabouteatingoutinarestaurant?,198–99;WhatifIdonotlikeeatingthisway?,191–92;Whyisitsodifficulttogiveupfoodsthataredestructivetomyhealth?,192–93;Whynotoliveoil?,204–6;WillIfeelunwellfromwithdrawal?Howlongwillanynegativesensationslast?,194–95

fruit:buyingorganicandwashingfresh,140;dried,138;generalguidelinesforbreakfast,133–34;generalguidelinesforlunch,135;nutritariandietandallowedconsumptionof,125;organic,140,203–4.Seealsospecificfruits

gallbladderremovalsurgery,116–17gallstoneformationrisk,116–17garbanzobeans:GarbanzoGuacamole,221;SavoryPortobelloMushroomswithChickpeas,248gastricbypasssurgery,30gastroesophagealrefluxdisease,67,68gestationaldiabetes:adviceforpatientsdiagnosedwith,185–86;diabeticreversaldietfornewlydiagnosed,186–88;riskfactorsfor,183–84;riskofmedicationstotreat,184–85;screeningtestsfordiagnosing,183.Seealsopregnancy

Glimpirmide(Amaryl),21,37,180gluconeogenesis,61Glucophage(metformin),15,26,179,180glucose:carbohydratesturnedinto,94;howthebody’scellsarefueledby,26–27;normalvs.restrictedglucoseuptakeintocells,28;postprandial,60.Seealsobloodglucoselevels

glucosechallengetest(GCT),183,185glucose-loweringplants,149–50glucosetolerancetest(GTT),183,185Glucotrol(glipizide),21,33,37,180glycemicindex(GI):ofcommoncarbohydrate-containingfoods,50,52–54;descriptionof,48;practicalapplicationtoyourdiet,48,50;forspecificfoodslisted,51

glycemicload(GL):ofcommonhigh-carbohydratefoods,103;asconsiderationincreatingbestdiet,102;descriptionof,48

glycolysis,60,96,142Glynase(glyburide),21,33,37,180

Glyset(miglitol),180grapes:ANDIscoreof,49;GIandGLof,51;highpesticidecontentof,204greenbeans,252greenbellpeppers:BlackBeanLettuceBundles,236;EggplantRollUps,239;highpesticidecontentof,204.Seealsoredbellpeppers

greensmoothiesrecipes,219greentea,150greenvegetablehealthbenefits,129–32groundbeef(85%lean),49gymnemasylvestre,150

H=N/Chealthequation:adjustedforhigh-riskindividuals,66;greencruciferousvegetablesrolein,131;introductionto,3;nutrient-per-caloriedensityof,45–46

HarvardSchoolofPublicHealth,112HbA1Clevels:howthenutritariandietreduces,5;asmeasureofdiabetes,2;normalaveragerangeof,5;reachingfavorable,181.Seealsospecificpersonalstories

HDL(good)cholesterol,111health:asdependentontheamountofnutrientsinyourdiet,4 ,107–8;howobesityimpactsyour,3–4;nutritariandietbenefitstoyour,4–5,53–54,110–11,123–24;sixessentialstepstohelpreachyourgoalsfor,156–67.Seealsolifespan

healthbenefits:ofgreenvegetablesforheartdisease,129–32;ofjudicioususeofhigh-fatfoods,110–11;ofnutritariandiet,4–5,53–54,110–11,174–78

healthclubs,165healthcomplications:amputations,9;blindness,9,130;highbloodpressure,8;kidneydisease,9,72–73;nervoussystemdisease,9.Seealsocancers;heartdisease/cardiovasculardeath

healthgoalsachievement:step1:makethecommitmentandwriteitdown,156–58;step2:drawupa“businessplan,”158–59;step3:trackyourprogress,159;step4:makeitpublic,159–60;step5:makeyourkitchenhealthy,160;step6:theexerciseprescription,160–62

HealthProfessionalsFollow-upStudy,78heartdisease/cardiovasculardeath:ActiontoControlCardiovascularRiskinDiabetesstudyfindingson,35;atheroscleroticplaqueand,78,129–30,171–72,177–78;comparingmedicalcaretonutritionalinterventionsfor,173;ascomplicationofdiabetes,8;diabeteslinkto,171–74;healthbenefitsofgreenvegetablesfor,129–32;high-proteinlow-carbohydratedietassociatedwith,69–75,92;hownutsandseedsprotectagainst,111–13;insulinresistancelinktoearly-onset,13;levelofinsulinasindicatorofriskfor,30;lowbody-fatpercentagegoaltoreduceriskof,173;Nrf2proteinblockingatherosclerosis,130;SADdietleadingto,87.Seealsodeathrates;diabetesmellitus;healthcomplications

heartdiseasecasestudies:1:David,175;2:Stan,175–76;3:Susan,176;4:Debra,177heartsofpalm,126hemp,49herbalsupplements:glucose-loweringplantsandherbs,149–50;plantsterolsandpomegranateextracts,150–51

highbloodpressure,5,8.Seealsospecificpersonalstorieshigh-fatfoods:examiningthemythsaboutlow-fatand,108–10;healthbenefitsofjudicioususeof,110–11;healthbenefitsofnutsandseedconsumption,111–17

highnutrientdensityfoodsH=N/Cformula,3high-proteinlow-carbohydratediet,69–75,92hops,150Hu,Frank,112–13hunger:exerciseand,162–63;toxic,57,58–59;true,57–58,60,142–43,162–63hyperglycemia,11,12

hypoglycemicreactions:advicetophysiciansonhowtoavoid,180–81;mistakinghungerassymptomsof,60,63;snackingaspoormanagementof,21;stabilityindietandinsulindosagetoavoid,182

hypothalamus,62

iceberglettuce:ANDIscoreof,49;highpesticidecontentof,204;asrecommendedsaladvegetable,126;TropicalFruitSalad,218.Seealsolettuce

IGF-1(insulin-likegrowthfactor1):cancerlinkto,82,83;howproteinintakepromotes,82–84;refinedcarbohydratestopromote,84–85;vegandietand,81–82

insolublefiber,91insulindeficiency,27insulin-dependentdiabetes,12.Seealsotype1diabetesinsulinhormone:descriptionandfunctionof,10;asfacilitatingglucoseuptakeintobody’scells,26–27;howbodyfatoverworksthepancreasandimpactslevelsof,27,28–31;sulfonylureasincreasingbody’sproductionof,2,32,33;type1diabetesandinabilitytoproduce,11;type2diabetesandlimitedproductionof,10–11.Seealsoinsulinmedication

insulininsensitivity,11insulinmedication:advicetophysiciansonmanaging,181–82;asleastfavorablemedicationforusewithdietarytreatment,180;sideeffectsof,2,15–16,32;type1diabetesandmanagementof,178–82;type2diabetesanddecreasing,31–34.Seealsoinsulinhormone;medications

insulinresistance:freefattyacidspromoting,27;type2diabetesandheightened,27insulinsensitivity,81–82iodine,217IowaWomenHealthStudy,112iron,146–47

Januvia(sitagliptin),179,180JournaloftheNationalCancerInstitute,145juvenilediabetes.Seediabetestype1

kale:ANDIscoreof,49;CaliforniaCreamedKale,237;Dr.Fuhrman’sFamousAnticancerSoup,227;FrenchLentilSoup,229;GreatGreens,240;MediterraneanBeanandKaleSauté,242

ketoacidosis,12ketones,12kidneybeans:ANDIscoreof,49;EasyBeanandVegetableChili,238;GIandGLof,51;proteincontentof,132;resistantstarchof,99;YumGoodBeans,254

kidneydisease:ascomplicationofdiabetes,9;high-proteinlow-carbohydratedietassociationwith,72–73kiwi:GIandGLof,51;lowpesticidecontentof,204

lactobacillusacidophilus,105Lancetjournal,9,145,199–200lapbandprocedure,30LDL(bad)cholesterol:low-fatvegandietlowering,115;nutconsumptiontoincrease,111;plantsterolsupplementstolower,150

leeks:ANDIscoreof,49;Dr.Fuhrman’sFamousAnticancerSoup,227;GoldenAustrianCauliflowerCreamSoup,230;MushroomSoupProvencal,231–32;TomatoBisque,233

legumes:healthbenefitsofeating,91;long-livedpeopleassociationwitheating,99;uniquepropertiesofcarbohydratesin,94

lentils:Dr.Fuhrman’sFamousAnticancerSoup,227;FrenchLentilSoup,229;GLof,103;HerbedBarleyandLentils,241;No-MeatBalls,243;proteincontentof,86,132;RedLentilSauce,226;resistantstarchof,99;SaucyLentilLoaf,247–48

lettuce:ANDIscoreoficeberg,49;highpesticidecontentof,204;asrecommendedsaladvegetable,126;

Southern-StyleMixedGreens,250;TropicalFruitSalad,218.Seealsoiceberglettuce;romainelettucelifespan:diabeteshealthconsequencesandimpacton,6,8–9;hownutconsumptioncanextend,111–13;IGF-1(insulin-likegrowthfactor1)andlonger,81–82;nutritariandietandexerciseprogramtoextendyour,30–31,35–36.Seealsohealth

lifestyle:consensusstatement(2009)ontype2diabetesand,170–71;healthbenefitsofthenutritariandietandchanged,4–5,53–54,110–11,123–24

limabeans,229lowbody-fatpercentage,173low-carbohydratehigh-proteindiet,69–75,92low-fatfoods:examiningthemythsabouthigh-fatand,108–10;healthriskoffatdeficiency,117–21“ALow-FatVeganDietImprovesGlycemicControlandCardiovascularRiskFactorsinaRandomizedClinicalTrialinIndividualswithType2Diabetes”study,115

lownutrientdensityfoods:H=N/Cformulaon,3;howtoxinsarebuiltupby,62–63lunchmenus:comparingwithoutnuts/seedsandwithnuts/seeds,119–20;generalguidelinesfor,134–35;maindishrecipesfor,234–54;fornewlydiagnosedgestationaldiabetes,187–88;tipsforquickandeasy,197–98;Week1,210–13;Week2,213–16

lutein,128,130lycopene,128

macronutrients:descriptionof,44;H=N/Chealthequationonadequate,46maculardegeneration,130mammaliancircadiansystem,62mangos:BlendedMangoSalad,219;IslandBlackBeanDip,223;lowpesticidecontentof,204;MangoCoconutSorbet,256;TropicalFruitSalad,218

medications:Actos(pioglitazone),21,32,37,180;ADAontreatingdiabetesthrough,2,36–37;Amaryl(glimpiride),21,37,180;Avandia(rosiglitazone),21,32,37,180;Byetta(exenatide),179,180;cholesterol-lowering,173,174;Diabenese(chlorpropamide),21,37,180;Diabeta,21,37,180;endlesscycleofdiabetic,2–3;gestationaldiabetesand,184–85;glimepirmide,33;Glucotrol(glipizide),21,33,37,180;Glynase(glyburide),21,33,37,180;Glyset(miglitol),180;hypoglycemicreactionsfromoveruseof,21;Januvia(sitagliptin),179,180;lessfavorableforusewithdietarytreatment,180;metformin(Glucophage),15,179,180;mostfavorableforusewithdietarytreatment,180;overdependenceontreatmentusing,33–40;Prandin(repaglinide),179,180;Precose(acarbose),180;sideeffectsofglucose-lowering,2;Starlix(nateglinide),180;sulfonylureadrugs,2,32,33;thiazolidinediones,32;type2diabetesanddecreasinginsulinandother,31–34.Seealsoinsulinmedication;supplements/multivitamins

menu/eatingplan:additionalgeneralguidelines,137–40;breakfastguidelines,133–34;comparingwithoutnuts/seedsandwithnuts/seeds,119–20;dinnerguidelines,136;frequentmini-mealsvs.threedailymeals,142–43;generalguidelinesonthe,133–36,207–8;lunchguidelines,134–35;fornewlydiagnosedgestationaldiabetes,186–88;recipesusedfor,217–57;veganorflexitarianguidelines,209;Week1,210–13;Week2,213–16.Seealsonutritariandiet

metabolicrates,143–44,165,208metformin(Glucophage),15,26,179,180micronutrientdensity:ANDI(AggregateNutrientDensityIndex)tomeasure,46–50;descriptionof,45,46micronutrients:CMA(comprehensivemicronutrientadequacy),48;descriptionof,44–45;eatingmoreplantproteintoincreaseintakeof,85–87;H=N/Chealthequationondensityof,45,46;healthbenefitsofdiethighin,56;healthconsequencesofdietlowin,56–57.Seealsonutrients

miglitol(Glyset),180Milford,Martin,41milk:ANDIscoreof1%,49;nutritariandietdisallowanceofwhole,139millet:GLof,103;resistantstarchof,99

mini-meals,142–43multivitamins.Seesupplements/multivitaminsmushrooms:ANDIscoreof,49;cookingrecommendationfor,126;Dr.Fuhrman’sFamousAnticancerSoup,227;GIandGLof,51;MediterraneanBeanandKaleSauté,242;MushroomSoupProvencal,231–32;Pistachio-CrustedTempehwithBalsamicMarinade,244;asrecommendedsaladvegetable,126;SaucyLentilLoaf,247–48;SavoryPortobelloMushroomswithChickpeas,248;ThaiVegetableCurry,252;“unlimitedfood”statusof,125

nateglinide(Starlix),180NationalCancerInstitute,129NationalHealthandNutritionExaminationSurvey(2005–2006),8NationalHeart,Lung,andBloodInstitute,35NationalInstitutesforHealth,129,170navybeans:ANDIscoreof,49;GLof,103;MushroomSoupProvencal,231–32;resistantstarchof,99nectarines,204nervoussystemdisease,9NewEnglandJournalofMedicine,145,196nicotinewithdrawal,59nopalescactus,150Northernbeans:MushroomSoupProvencal,231–32;resistantstarchof,99No-MeatBalls,243Nrf2,130Nurses’HealthStudy,78,83,102,112–13,117,202nutrients:H=N/Chealthequationdependenton,3,45–46;macronutrients,44,46;phytochemicals,45,47,118,128;phytonutrients,50,57,61.Seealsomicronutrients

nutritariandiet:ANDItoolfor,46–50;cookingtechniquesandtips,140–42;cruciferousvegetablesincludedin,127–29;descriptionof,4–5,5;extendingyourlifespanbyadoptingthe,30–31,35–36;FAQs(frequentlyaskedquestions)about,191–296;greenvegetablesincludedin,129–33;healthbenefitsofthe,4–5,53–54,110–11,123–24;heartdiseasecasestudiesonhealthbenefitsof,174–78;high-nutrient,high-fiber,high-water-contentfoods/nosnackingon,143–44;howtruehungercycleisrestoredthrough,64;fornewlydiagnosedgestationaldiabetes,186–88;recipesusedfor,217–57;saladasmaindishinthe,125–27;supplementsandmultivitaminstoincludewith,144–52;type1diabetesandbenefitsof,12–13,14;understandingthenutrientbreakdown,44–46;unlimitedfoodsonthe,124–25.Seealsodietarytreatment;dietplans;menu/eatingplan;personalstories

NutritarianFoodPyramidforDiabetics,52NutritionJournal,64nuts:almonds,49,86,132,223,224,225,255;besteatenraworlightlytoasted,120;BlueAppleNutOatmeal,217;comparingwithoutnuts/seedsandwithnuts/seedsmenus,119–20;eateninmoderation,121;GarlickyZucchini,240;howtheyprotectagainstcardiovasculardeath,111–13;nutritariandietandallowedconsumptionof,125,138;pecans,226,247–48;pine,240;pistachios,49,244;RedLentilSauce,226;RussianFigDressing/Dip,223;studiesonreversalofdiabetesandobesitybyeating,114–17;ThousandIslandDressing,224;walnuts,49,111–12,220,255.Seealsocashews;seeds

oatmeal:ANDIscoreof,49;BlueAppleNutOatmeal,217obesity:healthconsequencesof,3–4;increasingratesoftype2diabetesdueto,2,17–19;mythregardinggeneticsand,195;peerinfluenceon,196;prevalenceintheU.S.,17;studiesonnutandseedconsumptionforreversing,114–17;trendsamongU.S.adults(1990and2005),18;understandinghowbloodglucoselevelsareraisedby,27,28–31.Seealsobodyfat;weightloss

oliveoil:ANDIscoreof,49;frequentlyaskedquestionon,204–6omega-3(EPAandDHA),76,118,148

onions:ANDIscoreof,49;Dr.Fuhrman’sFamousAnticancerSoup,227;EasyBeanandVegetableChili,238;EggplantRollUps,239;FrenchLentilSoup,229;FreshTomatoSalsa,221;GarbanzoGuacamole,221;GIandGLof,51;HerbedBarleyandLentils,241;IslandBlackBeanDip,223;lowpesticidecontentof,204;MediterraneanBeanandKaleSauté,242;MushroomSoupProvencal,231–32;No-MeatBalls,243;QuickandCreamyVegetableBeanSoup,232;Ratatouille,245;asrecommendedsaladvegetable,126;RedLentilSauce,226;SaucyLentilLoaf,247–48;SavoryPortobelloMushroomswithChickpeas,248;SimpleBeanBurgers,249;SpeedyVegetableWrap,251;ThousandIslandDressing,224;TofuRanchDressing/Dip,225;TomatoBisque,233;“unlimitedfood”statusof,125;VegetableBurrito,253OpenJournalofPreventiveMedicine,5oranges:ANDIscoreof,49;GIandGLof,51;StrawberryPineappleSorbet,257organicfruit/vegetables,140,203–4

paleodiet,72pancreas:betacellsinthe,10,26;howbodyfatoverworksthe,29–31;howhighbloodsugaroverworksthe,94;insulinproducedbythe,27–28;sulfonylureadrugsincreasinginsulinproductionby,2,32,33

pancreaticcancer,85pasta.Seewhitepastapeaches:highpesticidecontentof,204;PeachSorbet,256peanutbutter:ANDIscoreof,49;ThaiVegetableCurry,252pears,257peas:ANDIscoreof,49;black-eyed,99,103,250;chick,86,132;Dr.Fuhrman’sFamousAnticancerSoup,227;English,126;GIandGLof,51;GLofgreen,103;lowpesticidecontentofsweet,204;proteincontentof,86,132;asrecommendedsaladvegetable,126;resistantstarchof,99;snap,126;snow,126;Southern-StyleMixedGreens,250;split,99,103,227

pecans:RedLentilSauce,226;SaucyLentilLoaf,247–48peerobesityinfluence,196peppers:ANDIscoreofredbell,49;TheBigVeggieStir-Fryredbell,235;FrenchLentilSoup,229;GarbanzoGuacamole,221;highpesticidecontentofbell,204;IslandBlackBeanDip,223;Ratatouille,245;asrecommendedsaladvegetable,126;RoastedVegetableSaladwithBakedTofuorSalmon,246;ThaiVegetableCurry,252;“unlimitedfood”statusof,125

personalstories:GlenPaulson,55–56;JaneGillian,7–8;Janie(age13),107;Jessica,67–68;JimKenney,25–26;LaverneStone,123;MartinMilford,41;RicardoPacheco,169–70;Robert(age11),107;SteveD.,153–54;SusanCarno,89–91;TonyGerardo,14–15.Seealsonutritariandiet

physicians:adviceonhowtoavoidhypoglycemicreactions,180–81;adviceonmanaginginsulinmedication,181–82;AmericanCollegeofLifestyleMedicinefor,189;dilemmaoverdiabetestreatmentfacedby,34–40;messageontreatingdiabetesto,189;tendencytoprescribedrugsby,33–40;type1diabetesandmanagementofinsulinadvicefor,17–182

Physicians’HealthStudy,78,112,113phytochemicals:cruciferousvegetablescontaining,128;descriptionof,45,47;howinsufficientfatcancompromiseabsorptionof,118;howNrf2isactivatesbygreenvegetable,130

phytonutrients,50,57,61pineapple:lowpesticidecontentof,204;StrawberryPineappleSorbet,257;TropicalFruitSalad,218pinenuts,240pintobeans,238pistachios:ANDIscoreof,49;Pistachio-CrustedTempehwithBalsamicMarinade,244plantsterols,150–51plaqueadhesionmolecules,112plums,49polyphenols,111–12

PolypPreventionTrial,98pomegranateextracts,150–51pomegranates/pomegranatejuice:ANDIscoreof,49;CreamyBlueberryDressing,220portion-controlled(calorie-counting)diet,65postprandialglucose,60potatoes:GIandGLofsweet,51;highpesticidecontentof,204;lowpesticidecontentofsweet,204;Nurses’HealthStudyfindingsonconsumptionof,102–3;white,49,51,103,138

potatoflour,99Prandin(repaglinide),179,180Precose(acarbose),180pregnancy,183–84.Seealsogestationaldiabetesprobiotics,105prostatecancer,83,129protein:comparinganimalandplant,131–32;decreaseanimalproteinandincreasevegetable,70;dietoflowcarbohydrateandhighanimal,69–75,92;IGF-1(insulin-likegrowthfactor1)promotedbyintakeof,82–84;increasingmicronutrientintakethroughplant,85–87;selectedplantfoodscontentof,86,132;vegetablesourcesof,79–81.Seealsoanimalproducts

pumpkinseeds,228

quinoa,GLof,103

radishes,126raisins:GIandGLof,51;nutritariandietoneating,138raspberries:ANDIscoreof,49;PoachedPearswithRaspberrySauce,257rawvegetables:saladasmaindish,125–27;“unlimitedfood”statusofall,124recipes:breakfast,217–18;desserts,255–57;dipsanddressings,220–25;greensmoothies,219;maindishes,234–54;sauces,225–26;soups,227–33

redbellpeppers:ANDIscoreof,49;TheBigVeggieStir-Fry,235;EggplantRollUps,239;FrenchLentilSoup,229;IslandBlackBeanDip,223;Ratatouille,245;RoastedVegetableSaladwithBakedTofuorSalmon,246;ThaiVegetableCurry,252;“unlimitedfood”statusof,125.Seealsogreenbellpeppers

redkidneybeans:ANDIscoreof,49;EasyBeanandVegetableChili,238;GLof,103;proteincontentof,132;resistantstarchof,99;YumGoodBeans,254

redmeats:groundbeef(85%lean),49;nutritariandietdisallowanceof,139;recommendedavoidanceof,77

redwine,201–2renaldetoxificationsystem,62repaglinidee(Prandin),179,180resistantstarch(RS):caloriesoffoodsourcesof,100;descriptionof,91,95;foodsourcesof,97–105;healthbenefitsof,95–97;prebioticnatureof,95.Seealsostarchyfoods

restauranteatingtips,198–99restrictedglucoseuptake,27,28rice:black,51;brown,51,86,99,103;No-MeatBalls,243;white,51,99,103RoastedVegetableSaladwithBakedTofuorSalmon,246rolledoats:BlueAppleNutOatmeal,217;BlueberryCobbler,255;dietaryfiberin,97;GIandGLof,51;GLof,103;QuickBananaOatBreakfasttoGo,217;resistantstarchof,99;SaucyLentilLoaf,247–48;SimpleBeanBurgers,249;SoakedOatsandBlueberries,218

romainelettuce:ANDIscoreof,49;BlackBeanLettuceBundles,236;BlendedMangoSalad,219;GreenGorillaBlendedSalad,219.Seealsolettuce

rosiglitazone(Avandia),2,21,32,37,180

SAD(standardAmericandiet):dangersofthe,8,9–10,41–42,87;excessiveuseofinsulinnecessitated

by,15–16;type1diabetesandsensitivityto,13.Seealsodietplanssaladdressings/dips:cookingtechniquesformaking,141–42;generalguidelinesfor,135;recipesfor,220–25;restauranteatingand,198

salads:generalguidelinesfordinner,136;generalguidelinesforlunch,135.Seealsospecificrecipessalmon:ANDIscoreof,49;RoastedVegetableSaladwithBakedTofuorSalmon,246saltconsumption,141,199–201saturatedfats,28saucerecipes,225–26scallions:TheBigVeggieStir-Fry,235;BlackBeanLettuceBundles,236;FastMexicanBlackBeanSoup,228;FreshTomatoSalsa,221;IslandBlackBeanDip,223;asrecommendedsaladvegetable,126

scallops,139,252SCFAs(short-chainfattyacids),95–96,100seafood:fish,76,77–78,246;scallopsandshrimp,139,252seasalt,199–201seeds:ANDIscoreofall,49;besteatenraworlightlytoasted,120;TheBigVeggieStir-Fry,235;CaesarSaladDressing/Dip,220;comparingwithoutnuts/seedsandwithnuts/seedsmenus,119–20;eateninmoderation,121;FastMexicanBlackBeanSoup,228;fenugreek,150;GreenVelvetDressing/Dip,222;healthbenefitsofconsumptionof,111–13;nutritariandietandallowedconsumptionof,125,138;pumpkin,228;QuickBananaOatBreakfasttoGo,217;RussianFigDressing/Dip,223;sesame,132,220,222,235,236;SimpleBeanBurgers,249;SoakedOatsandBlueberries,218;studiesonreversalofdiabetesandobesitybyeating,114–17;sunflower,132,223,249.Seealsonuts

selenium,146–47sesameseeds:TheBigVeggieStir-Fry,235;BraisedBabyBokChoy,236;CaesarSaladDressing/Dip,220;GreenVelvetDressing/Dip,222;proteincontentof,132

shrimp,139,252sitagliptin(Januvia),179,180slowmetabolicrate,143–44,165,208snacking:nutritariandietrecommendationonthreemealsinsteadof,143–44;preventinghypoglycemicreactionsby,21

snappeas,126snowpeas,126sodiumintake,141,199–201solublefiber,91soups/stews:cookingtechniquesandtipsfor,140–41;recipesfor,227–33soybeanproteincontent,132spinach:ANDIscoreof,49;BlendedMangoSalad,219;Cauliflower,SpinachMashed“Potatoes,”237;GoldenAustrianCauliflowerCreamSoup,230;GreatGreens,240;GreenGorillaBlendedSalad,219;highpesticidecontentof,204;MushroomSoupProvencal,231–32;organic,140;proteincontentof,86,132;QuickandCreamyVegetableBeanSoup,232;TomatoBisque,233

splitpeas:Dr.Fuhrman’sFamousAnticancerSoup,227;GLof,103;resistantstarchof,99sprouts,126squash:butternut,51,103,246;GLof,103;RoastedVegetableSaladwithBakedTofuorSalmon,246;yellow,246

starchyfoods:generalguidelinesoneating,137;healthissuesof,91–92;whitewheatproducts,93–94.Seealsoresistantstarch

Starlix(nateglinide),180steamedartichokes,137strawberries:ANDIscoreof,49;GIandGLof,51;highpesticidecontentof,204;organic,140;StrawberryPineappleSorbet,257

strength-buildingexercise,165stringbeans,126sugar-freeproducts,93sugars(simple),93sulfonylureadrugs,2,32,33sunflowerseeds:proteincontentof,132;RussianFigDressing/Dip,223;SimpleBeanBurgers,249supplements/multivitamins:alphalipoicacid,149;calcium,147;chromium,151–52;folateandfolicacid,144–45,146;glucose-loweringplantsandherbs,149–50;iron,copper,andselenium,146–47;omega-3(EPAandDHA),76,118,148;plantsterolsandpomegranateextracts,150–51;thiamine(vitaminB1),148–49;vitaminA,145–46;vitaminD,127,147.Seealsomedications

sweeteneddrinks,138sweetpotatoes:GIandGLof,51;lowpesticidecontentof,204Swisschard:GreatGreens,240;SwissChardwithGarlicandLemon,251systolicbloodpressure,5

ThaiVegetableCurry,252thiamine(vitaminB1),148–49thiazolidinediones,32tofu:AsparagusPolonaise,234;TheBigVeggieStir-Fry,235;EasyBeanandVegetableChili,238;proteincontentof,86,132;RoastedVegetableSaladwithBakedTofuorSalmon,246;ThaiVegetableCurry,252;TofuRanchDressing/Dip,225

tomatoes:AlmondTomatoSauce,225;ANDIscoreof,49;EasyBeanandVegetableChili,238;EggplantRollUps,239;FastMexicanBlackBeanSoup,228;FrenchLentilSoup,229;FreshTomatoSalsa,221;GarbanzoGuacamole,221;GIandGLof,51;MediterraneanBeanandKaleSauté,242;QuickandCreamyVegetableBeanSoup,232;Ratatouille,245;asrecommendedsaladvegetable,126;SavoryPortobelloMushroomswithChickpeas,248;Southern-StyleMixedGreens,250;SpeedyVegetableWrap,251;TomatoBisque,233;“unlimitedfood”statusof,125;VegetableBurrito,253

toxichunger:bettereatingtobreakcycleof,59;causesof,57,58;howhealthyeatingbreakscycleof,63–64;typicalsymptomsof,58

toxins:acrylamides,50;agaritine(rawmushrooms),126;howlow-nutrientfoodsbuildupmore,62–63;howobesitybuildupextra,62–63;phytonutrientsroleinremoving,50,57,61;removalofbody’swasteproductsand,61–62

transfats,28,46triglycerides,118truehunger:causesof,57–58;howexercisehelpsyoutoachieve,162–63;postprandialglucoserolein,60;restoringhealthyeatingand,63–64;typicalsymptomsof,58;waitingtoeatwhenexperiencing,142–44

type1diabetes:body’sinabilitytoproduceinsulinwith,11;EattoLivedietbenefitsfor,12–13,14,16;long-termoutlookwithconventionalcare,13–14;qualityoflifebenefitsofcontrolling,6;understandingthecause,process,andtreatmentof,11–16;weightlossasbesttreatmentfor,3.Seealsodiabetesmellitus;insulin-dependentdiabetes

type2diabetes:ADAdietapproachtomanaging,21–23;ADAandEuropeanAssociationfortheStudyofDiabetesconsensusstatement(2009)on,170–71;decreasinginsulinandothermedicationsfor,31–34;dramaticincreaseof,2,16–17;fishconsumptionassociationwith,76;healthbenefitsofwell-managed,6,20–21;howthenutritariandietcancontrol,5;incorrectADAstatementsabout,36–37;insulinproducedincaseof,10–11;insulinresistanceconditionof,27;needtoemphasizepreventionof,9–10;obesityfactorinonsetof,2,17–19;racial/ethnicdifferencesin,17;studiesonnutandseedconsumptionforreversalof,114–17;understandingcauseandprevalenceof,16–20,26–28;weightlossasbesttreatmentfor,3.Seealsodiabetesmellitus

UnitedHealthGroup,9TheUnitedStatesofDiabetes:ChallengesandOpportunitiesintheDecadeAheadreport(2010),9

vegandiet:descriptionof,81–82;menu/eatingplanguidelines,209;studyonhealthbenefitsoflow-fat,115

“vegejunkarian,”67vegetables:advantagesofgoingveganorclosetovegan,81–82;cruciferous,127–29;generalguidelinesoneatingstarchy,137;heartdiseaseandgreen,129–32;organic,140,203–4;proteinfrom,79–81;recommendedsaladvegetable,126;saladasmaindish,125–27;saucerecipesforcooked,225–26;“unlimitedfood”statusofallcookedgreen,124;“unlimitedfood”statusofallraw,124.Seealsofoods;specificvegetables

vitaminA,145–46vitaminB1(thiamine),148–49vitaminC,128vitaminD,127,147vitaminE,128

walkingexercise,164,165,166walnuts:ANDIscoreof,49;BananaWalnutIceCream,255;CreamyBlueberryDressing,220;ellagitanninsabsorbedfrom,111–12

wasteproducts:normalredoxstatetoremove,61–62;phytonutrientsroleindetoxifying,50,57,61;renaldetoxificationsystemtoremove,62

waterchestnuts,126watercress:ANDIscoreof,49;ThaiVegetableCurry,252waterdrinking,138watermelon,51water-sautéingtechnique,140Week1menus,210–13Week2menus,213–16weight-bearingexercises,165weightloss:asbesttreatmentfordiabetes,3;eatinggreenvegetablesfor,130–31;gastricbypasssurgeryandlapbandproceduresfor,30;hownecessaryisexercisefor,166–67;introducingH=N/Cnutritionalplanfor,3;lowbody-fatpercentagegoalof,173;asonlyonefeatureofimprovinghealth,35;studiesonnutandseedconsumptionfor,114–17.Seealsoobesity;specificpersonalstories

whitebread:ANDIscoreof,49;GLof,103;nutritariandietdisallowanceof,138–39whitepasta:ANDIscoreof,49;GIandGLof,51;GLof,103;nutritariandietdisallowanceof,138–39;resistantstarchof,99

whitepotatoes:ANDIscoreof,49;GIandGLofbaked,51;GLof,103;nutritariandietdisallowanceof,138–39

whiterice:GIof,51;GLof,51,103;resistantstarchof,99whitewheatproducts,93–94wholewheatbread:ANDIscoreof,49;proteincontentof,86;SpeedyVegetableWrap,251wholewheatflour:GLof,103;resistantstarchof,99;SaucyLentilLoaf,247–48withdrawalsymptoms:nicotineorcaffeine,59;oftoxichunger,58

yellowsquash,246

zeaxanthin,130zinc,127ZoneDiet,50zucchini:TheBigVeggieStir-Fry,235;Dr.Fuhrman’sFamousAnticancerSoup,227;EasyBeanand

VegetableChili,238;FrenchLentilSoup,229;GarlickyZucchini,240;Ratatouille,245;asrecommendedsaladvegetable,126

RecipeIndex

BreakfastBlueAppleNutOatmealQuickBananaOatBreakfasttoGoSoakedOatsandBlueberriesTropicalFruitSalad

GreenSmoothiesBlendedMangoSaladGreenGorillaBlendedSalad

Dips,Dressings,andSaucesCaesarSaladDressing/DipCreamyBlueberryDressingFreshTomatoSalsaGarbanzoGuacamoleGreenVelvetDressing/DipHerbedWhiteBeanHummusIslandBlackBeanDipRussianFigDressing/DipThousandIslandDressingTofuRanchDressing/DipAlmondTomatoSauceRedLentilSauceSesameGingerSauce

SoupsDr.Fuhrman’sFamousAnticancerSoupFastMexicanBlackBeanSoupFrenchLentilSoupGoldenAustrianCauliflowerCreamSoupMushroomSoupProvencalQuickandCreamyVegetableBeanSoupTomatoBisque

MainDishesAsparagusPolonaiseTheBigVeggieStir-FryBlackBeanLettuceBundlesBraisedBabyBokChoyCaliforniaCreamedKaleCauliflower,SpinachMashed“Potatoes”EasyBeanandVegetableChiliEggplantRollUpsGarlickyZucchiniGreatGreensHerbedBarleyandLentilsMediterraneanBeanandKaleSautéNo-MeatBallsPistachio-CrustedTempehwithBalsamicMarinadeandShiitakeMushroomsRatatouilleRoastedVegetableSaladwithBakedTofuorSalmonSaucyLentilLoafSavoryPortobelloMushroomswithChickpeasSimpleBeanBurgersSouthern-StyleMixedGreensSpeedyVegetableWrapSwissChardwithGarlicandLemonThaiVegetableCurryVegetableBurritoYumGoodBeans

DessertsBananaWalnutIceCreamBlueberryCobblerCantaloupeSlushMangoCoconutSorbetPeachSorbetPoachedPearswithRaspberrySauceStrawberryPineappleSorbet

Acknowledgments

I am grateful for my loving family, my wife Lisa and our three daughtersTalia,Jenna,andCaraandoursonSean—andtheirunderstandingduringmyboutsofextremeworkhours,especiallywhencompletingabooksuchasthis.IappreciatetheirenthusiasmandsupportofwhatIdotohelpothersinneed.IwouldliketothankmyentireteamatDrFuhrman.com,whoseworkisnot

merelyajobbutapassionsupportingamissionofcaring,enablingsomanytoimprovetheirhealth.Forthisbookspecifically,thankstoLindaPopescu,RD,our food scientist, who assists me with nutritional calculations and scoring,andwho helpedme choose and tweak the recipes, andDeana Ferreri, Ph.D.,our cardiovascular nutrition scientist who aids me in compiling andcomparingresearcharticlesandtheirfindings.IwouldalsoliketoacknowledgethepublishingteamatHarperOne,whose

professionalism and expertise has enabled the broad distribution of thisinformation, especially Gideon Weil, who had a vision and unwaveringenthusiasmforthevalueofmywritingstohumanity.Additionalthanksfortheexpert production management of Lisa Zuniga, and Melinda Mullin thedirectorofpublicity,forhergreatefforts.I would like to express my appreciation for the hundreds of progressive

medicaldoctorswhohavestartedusingmyworksintheirmedicalpractices.Iappreciatetheiropennesstolearnsomethingnottaughtinmedicalschoolandstrongdesiretodowhatisbestfortheirpatients.Iamextremelymovedwhentheyexcitedlycontactmeaboutthesuccessesthey’vehadwiththeirpatients.

AbouttheAuthor

JOELFUHRMAN,M.D.,isaboard-certifiedfamilyphysicianandnutritionalresearcher who specializes in preventing and reversing disease throughnutritional andnaturalmethods.He is the authorof severalbooks, includingthe New York Times bestsellers Eat to Live: The Amazing Nutrient-RichProgram for Fast and Sustained Weight Loss and Super Immunity. He is agraduate of the University of Pennsylvania School of Medicine and theresearchdirectoroftheNutritionalResearchFoundation.Dr.FuhrmanisalsoonthescienceadvisoryboardofWholeFoodsMarket.

Visit www.AuthorTracker.com for exclusive information on your favoriteHarperCollinsauthors.

ALSOBYJOELFUHRMAN,M.D.

SuperImmunityEattoLiveEatforHealthDisease-ProofYourChildFastingandEatingforHealth

Notes

Introduction:ALetterofHope1. Dunaief D, Fuhrman J, Dunaief J, Ying G. Glycemic and cardiovascularparameters improved in type2diabeteswith thehighnutrientdensity (HND)diet. Open Journal of Preventive Medicine 2012; 2: 364–71. doi:10.4236/ojpm.2012.23053.

Chapter1:TheFirstStep—UnderstandingDiabetes1. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectalcancer:ameta-analysis.JNatlCancerInst2005;97(22):1679–87.2.EconomiccostsofdiabetesintheU.Sin2007.DiabetesCare2008;31(3):596–615.3.TheUnitedStates ofDiabetes:Challenges and opportunities in the decadeahead.UnitedHealthCenter forHealthReformandModernization.WorkingPaper 5, Nov 2010.http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper5.pdf.4. Type 2 diabetes—time to change our approach. Lancet 2010; 375(9733):2193.5.ZolerML.Insulinmayboostcardiovascularriskintype2diabetespatients.FamilyPracticeNewsMay15,2001:6.6. Madonna R, et al. Insulin enhances vascular cell adhesion molecule-1expression in human cultured endothelial cells through a pro-atherogenicpathway mediated by p38 mitogen-activated protein-kinase. Diabetologia2004; 47: 532–6. Taegtmeyer H. Insulin resistance and atherosclerosis,commonrootsfortwocommondiseases?Circulation1996;93:177.7. Experts call for further research into the relationship between insulintherapy and cancer. http://www.eurekalert.org/pub_releases/2010-03/w-

ecf030210.php.PollakM,Russell-JonesD.Insulinanaloguesandcancerrisk:causeforconcernorcausecélèbre?IntJClinPract2010Apr;64(5):628–36.8.AkbaralyTN,KivimäkiM,BrunnerEJ,etal.Associationbetweenmetabolicsyndrome and depressive symptoms in middle-aged adults. Diabetes Care2009; 32(3): 499–504. Harish K, Dharmalingam M, Himanshu M. Studyprotocol:insulinanditsroleincancer.BMCEndocrDisord2007;7:10.9. Laitinen JH, Ahola IE, Sarkkinen ES, et al. Impact of intensified dietarytherapy on energy and nutrient intakes and fatty acid composition of serumlipids in patients with recently diagnosed noninsulin-dependent diabetesmellitus.JAmDietAssoc1993;93:276–83.Eilat-AdarS,XuJ,ZephierE,etal.Adherencetodietaryrecommendationsforsaturatedfat,fiber,andsodiumis low inAmerican Indians andotherU.S. adultswith diabetes. JNutr 2008;138(9):1699–704.

Chapter2:Don’tMedicate,Eradicate1.MonashUniversity. Critical link between obesity and diabetes discovered.Science Daily 9 July 2009. 16 August 2009http://www.sciencedaily.com/releases/2009/07/090708090917.htm.2. Yang Q, Graham TE, Mody N, et al. Serum retinol binding protein 4contributes to insulin resistance in obesity and type 2 diabetes.Nature 2005;436(7049):356–62.3.RisérusU,WillettWC,HuFB.Dietaryfatsandpreventionoftype2diabetes.ProgLipidRes2009;48(1):44–51.4.WilliamsonDF, ThompsonTJ, ThunM, et al. Intentionalweight loss andmortality among overweight individuals with diabetes. Diabetes Care 2000;23(10):1499–1504.5. Carter P, Gray LJ, Troughton J, et al. Fruit and vegetable intake andincidence of type 2 diabetes mellitus: systematic review and meta-analysis.BMJ2010;341:c4229.6. Ruige JB,Mertens I, Considine RV, et al. Opposite effects of insulin-likemoleculesandleptinincoronaryheartdiseaseoftype2diabetespreliminarydata.IntJCardiol2006Jul28;111(1):19–25.7.ZolerML.InsulinmayboostcardiovascularriskintypeIIdiabetespatients.FamilyPracticeNewsMay15,2001:6.CaoW,NingJ,YangX,LiuZ.Excessexposuretoinsulinistheprimarycauseofinsulinresistanceanditsassociated

atherosclerosis.CurrMolPharmacol2011Nov;4(3):154–66.8.HarishK,DharmalingamM,HimanshuM. Study protocol: insulin and itsrole in cancer.BMCEndocrDisord2007;7: 10.BowkerSL,MajumdarSR,VeugelersP, Johnson JA. Increasedcancer-relatedmortality forpatientswithtype2diabeteswhouse sulfonylureasor insulin.DiabetesCare2006;29(2):254–8.9.TzoulakiI,MolokhiaM,CurcinV,etal.Riskofcardiovasculardiseaseandall cause mortality among patients with type 2 diabetes prescribed oralantidiabetes drugs: retrospective cohort study using UK general practiceresearchdatabase.BMJ2009;339:b4731.10. Jancin B. Sulphonylureas may cause increased mortality risk. FamilyPracticeNewsAug2012;34.11.SchauerPR,BurgueraB,IkramuddinS,etal.EffectoflaparoscopicRoux-enYgastricbypassontype2diabetesmellitus.AnnSurg2003;238(4):467–84;discussion84–85.12.HarderH,DinesenB,AstrupA.Theeffectofarapidweightlossonlipidprofileandglycemiccontrolinobesetype2diabeticpatients.IntJObesRelatMetabDisord2004;28(1):180–2.

Chapter3:StandardAmericanDietVersusaNutritarianDiet1. Kanauchi M, Tsujimoto N, Hashimoto T, et al. Advanced glycation endproducts innon-diabetic patientswith coronary arterydisease.DiabetesCare2001;24(9):1620–3.Krajcovicova-KudlackovaM,SebekovaK,SchinzelR,etal.Advancedglycationendproductsandnutrition.PhysiolRes2002;51:313–6.2.GrundySM,CleemanJI,MerzCN,BrewerHBJr,ClarkLT,HunninghakeDB, et al. Implications of recent clinical trials for the National CholesterolEducation Program Adult Treatment Panel III guidelines. Circulation 2004;110: 227–39. American Dietetic Association. Hyperlipidemia MedicalNutrition Therapy Protocol. Chicago: American Dietetic Association, 2001.U.S.PreventiveServicesTaskForce.Behavioralcounselinginprimarycaretopromoteahealthydiet:recommendationsandrationale.AmJPrevMed2003;24:93–100.3. Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables ofglycemic index and glycemic load values: 2008. Diabetes Care 2008 Dec;

31(12):2281–3.4. Raben A. Should obese patients be counseled to follow a low-glycaemicindexdiet?No.ObesRev2002Nov;3(4):245–56.5. Raatz SK, Torkelson CJ, Redmon JB, et al. Reduced glycemic index andglycemicloaddietsdonotincreasetheeffectsofenergyrestrictiononweightloss and insulin sensitivity in obese men and women. J Nutr 2005 Oct;135(10):2387–91.6. Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fibervegetable,fruit,andnutdietonserumlipidsandcolonicfunction.Metabolism2001;50(4):494–503.

Chapter4:ReversingDiabetesIsAllAboutUnderstandingHunger1. Vives-Bauza C, Anand M, Shirazi AK, et al. The age lipid A2E andmitochondrial dysfunction synergistically impair phagocytosis by retinalpigmentepithelialcells.2. Patel, C, Husam G, Shreyas R, et al. Prolonged reactive oxygen speciesgenerationandnuclearfactor-Bactivationafterahigh-fat,high-carbohydratemealintheobese.JClinEndocrinology&Metabolism2007;92(11):4476–9.3. Peairs AT, Rankin JW. Inflammatory response to a high-fat, low-carbohydrate weight loss diet: effect of antioxidants. Obesity 2008; 16( 7):1573–8.4.ScanlanN.Compromisedhepaticdetoxification incompanionanimalsanditscorrectionvianutritionalsupplementationandmodifiedfasting.AlternMedRev2001;6Suppl:S24–37.5. Levi F, Schibler U. Circadian rhythms: mechanisms and therapeuticimplications.AnnuRevPharmacolToxicol2007;47:593–628.6. Patel C, Husam G, Shreyas R, et al. Prolonged reactive oxygen speciesgenerationandnuclear factor-bactivationafterahigh-fat,high-carbohydratemealintheobese.JClinEndocrinology&Metabolism2007;92(11):4476–9.7. Peairs AT, Rankin JW. Inflammatory response to a high-fat, low-carbohydrate weight loss diet: effect of antioxidants. Obesity 2008; 16(7):1573–8.8.FuhrmanJ,SarterB,GlaserD,AcocellaS.Changingperceptionsofhungeronahighnutrientdensitydiet.NutritionJournal2010;9:51.

Chapter5:High-Protein,Low-CarbCounterattack1. Best TH, FranzDN,Gilbert DL, et al. Cardiac complications in pediatricpatientsontheketogenicdiet.Neurology2000;54(12):2328–30.2. Best TH, FranzDN,Gilbert DL, et al. Cardiac complications in pediatricpatientsontheketogenicdiet.Neurology2000;54(12):2328–30.3. Stevens A, Robinson DP, Turpin J, et al. Sudden cardiac death of anadolescentduring(Atkins)dieting.SouthernMedicalJournal2002;95:1047.4. Newgard CB, An J, Bain JR, et al. A branched-chain amino acid-relatedmetabolicsignature thatdifferentiatesobeseand leanhumansandcontributestoinsulinresistance.CellMetabolism2009;9(4):311–26.5.SluijsI,BeulensJWJ,VanDerADL,etal.Dietaryintakeoftotalanimalandvegetable protein and risk of type 2 diabetes in the European prospectiveinvestigation into cancer andnutrition (EPIC)-NL study.DiabetesCare 2010;33:43–48.6.TonstadS,ButlerT,YanR,FraserGE.Typeofvegetariandiet,bodyweight,andprevalenceoftype2diabetes.DiabetesCare2009;32:791–6.7. Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fibervegetable,fruit,andnutdietonserumlipidsandcolonicfunction.Metabolism2001Apr;50(4):494–503.8. Fleming RM. The effect of high-protein diets on coronary blood flow.Angiology2000;51(10):817–26.9.LagiouP,SandinS,LofM,etal.,Lowcarbohydrate–highproteindietandincidence of cardiovascular diseases in Swedish women: prospective cohortstudy.BMJ2012;344:e406.10.KnightEL,Stampfer,MJ,HankinsonSE, et al.The impact of proteinonrenal function decline in women with normal renal function or mild renalinsufficiency.AnnIntMed2003;138:460–7.11.Atkinsdietraisesconcerns.CortlandForum2004(April):22.12. American Kidney Fund press release, April 25, 2002, http://www.kidneyfund.org/AboutAKF/newsroom–020425.htm.13.KaushikM,MozaffarianD,SpiegelmanD,etal.Long-chainomega-3fattyacids,fishintake,andtheriskoftype2diabetesmellitus.AmJClinNutr2009;90:613–20.

14.QiL,VanDamRN,Rexrodek,HuFB.Hemeironfromdietasariskfactorforcoronaryheartdiseaseinwomanwithtype2diabetes.DiabetesCare2007;30(1):101–6.15. Hu FB. Associations of dietary protein with disease and mortality in aprospective studyofpostmenopausalwomen.AmJEpidemiol2005;161(3):239–49.KelemenLE,KushiLH,JacobsDR,CerhanJR.Plant-basedfoodsandpreventionofcardiovasculardisease:anoverview.AmJClinNutr2003;78(3Suppl):544S–551S.16.LutseyPL,SteffenLM,StevensJ.Dietaryintakeandthedevelopmentofthemetabolicsyndrome.theatherosclerosisriskincommunitiesstudy.Circulation2008;117:754–61.17.GardnerCD,CoulstonA,ChatterjeeL,etal.Theeffectofaplant-baseddietonplasmalipidsinhypercholesterolemicadults:arandomizedtrial.AnnInternMed 2005; 142(9): 725–33. Tucker KL, Hallfrisch J, Qiao N, et al. Thecombinationofhighfruitandvegetableandlowsaturatedfatintakesismoreprotective againstmortality in agingmen than is either alone: theBaltimoreLongitudinal Study of Aging. J Nutr 2005; 135(3): 556–61. Campbell TC,ParpiaB,ChenJ.Diet, lifestyle,and theetiologyofcoronaryarterydisease:theCornellChinastudy.AmJCardiol1998Nov26;82(10B):18T–21T.18.DiousseL,GazianoJM,BuringJC,etal.Eggconsumptionandriskoftype2diabetesinmenandwomen.DiabetesCare2008;10:2337/1271.19.NettetonJA,SteffenLM,LoehrLF,etal.Incidentheartfailureisassociatedwithlowerwhole-grainintakeandgreaterhighfatdairyandeggintakeintheatheroscerosis risk incommunities (ARIC)study. JAmDieteticAssoc2008;108(11):1881–7.20. Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of eggconsumption and risk of cardiovascular disease in men and women. JAMA1999;281:1387–94.21.TrichopoulouA,PsaltopoulouT,OrfanosP,etal.Dietandphysicalactivityinrelationtooverallmortalityamongstadultdiabeticsinageneralpopulationcohort.JInternMed2006;259:583–91.22.Spence JD,EliasziwM,DiCiccoM,et al.Carotidplaquearea: a tool fortargetingandevaluatingvascularpreventive therapy.Stroke2002;33:2916–22.23.DjousseL,GazianoJM,BuringJE,etal.Eggconsumptionandriskoftype

2diabetesinmenandwomen.DiabetesCare2009;32:295–300.RichmanEL,KenfieldSA,StampferMJ,etal.Egg,redmeat,andpoultryintakeandriskoflethal prostate cancer in the prostate-specific antigen-era: incidence andsurvival.CancerPrevRes(Phila)2011;4:2110–21.24.HelmanAD,Darnton-HillI,CraigWJ,etal.Ironstatusofvegetarians.AmJClinNutr1994;59(suppl5):1203S–1212S.25.RoseW.Theaminoacidrequirementsofadultman.NutritionalAbstractsandReviews1957;27:631.26. Hardage M. Nutritional studies of vegetarians. Journal of the AmericanDieteticAssociation1966;48:25.27. Bartke A. Minireview: role of the growth hormone/insulin-like growthfactorsysteminmammalianaging.Endocrinology2005;146(9):3718–23.28. Laron Z. The GH-IGF1 axis and longevity: the paradigm of IGF1deficiency.Hormones(Athens)2008;7(1):24–27.BerrymanDE,etal.Roleofthe GH/IGF-1 axis in lifespan and healthspan: lessons from animal models.Growth Horm IGF Res 2008; 18(6): 455–71. Van Bunderen CC, et al. Theassociation of serum insulin-like growth factor-i with mortality,cardiovasculardisease, andcancer in the elderly: apopulation-based study. JClinEndocrinolMetab2010.29. Kraemer WJ, Ratamess NA. Hormonal responses and adaptations toresistanceexerciseandtraining.SportsMed2005;35(4):339–61.AllenNE,etal. Lifestyle determinants of serum insulin-like growth-factor-I (IGF-I), C-peptideandhormonebindingproteinlevelsinBritishwomen.CancerCausesControl2003;14(1):65–74.30. Gualberto A, Pollak M. Emerging role of insulin-like growth factorreceptor inhibitors in oncology: early clinical trial results and futuredirections.Oncogene2009;28(34):3009–21.31.SalvioliS,etal.Whydocentenariansescapeorpostponecancer?theroleofIGF-1,inflammationandp53.CancerImmunolImmunother2009;58(12):1909–17. Chitnis MM, et al. The type 1 insulin-like growth factor receptorpathway.ClinCancerRes2008;14(20):6364–70.32. Rinaldi S, et al. IGF-I, IGFBP-3 and breast cancer risk in women: theEuropean prospective investigation into cancer and nutrition (EPIC). EndocrRelatCancer2006;13(2):593–605.33. Hankinson SE, et al. Circulating concentrations of insulin-like growth

factor-Iandriskofbreastcancer.Lancet1998;351(9113):1393–6.34.LannD,LeRoithD.Theroleofendocrineinsulin-likegrowthfactor-Iandinsulininbreastcancer.JMammaryGlandBiolNeoplasia2008;13(4):371–9.AllenNE,etal.Aprospectivestudyofseruminsulin-likegrowthfactor-I(IGF-I), IGF-II, IGF-binding protein-3 and breast cancer risk. Br J Cancer 2005;92(7):1283–7.FletcherO,etal.Polymorphismsandcirculating levels in theinsulin-like growth factor system and risk of breast cancer: a systematicreview.CancerEpidemiolBiomarkersPrev2005;14(1):2–19.RenehanAG,etal.Insulin-likegrowthfactor(IGF)-I,IGFbindingprotein-3,andcancerrisk:systematic review and meta-regression analysis. Lancet 2004; 363(9418):1346–53. ShiR, et al. IGF-I and breast cancer: ameta-analysis. Int JCancer2004;111(3):418–23.SugumarA,etal.Insulin-likegrowthfactor(IGF)-IandIGF-binding protein 3 and the risk of premenopausal breast cancer: ameta-analysis of literature. Int J Cancer 2004; 111(2): 293–7. Baglietto L, et al.Circulating insulin-likegrowthfactor-Iandbindingprotein-3and theriskofbreastcancer.CancerEpidemiolBiomarkersPrev2007;16(4):763–8.35. Davies M, et al. The insulin-like growth factor system and colorectalcancer: clinical and experimental evidence. Int JColorectalDis 2006; 21(3):201–8.SandhuMS,DungerDB,GiovannucciEL.Insulin,insulin-likegrowthfactor-I (IGF-I), IGF binding proteins, their biologic interactions, andcolorectalcancer.JNatlCancerInst2002;94(13):972–80.36. RowlandsMA, et al. Circulating insulin-like growth factor peptides andprostatecancerrisk:asystematicreviewandmeta-analysis.IntJCancer2009;124(10):2416–29.37.HiranoS,etal.Clinicalimplicationsofinsulin-likegrowthfactorsthroughthe presence of their binding proteins and receptors expressed ingynecologicalcancers.EurJGynaecolOncol2004;25(2):187–91.MenuE,etal. The role of the insulin-like growth factor 1 receptor axis in multiplemyeloma.Arch PhysiolBiochem 2009; 115(2): 49–57.RikhofB, et al. Theinsulin-likegrowthfactorsystemandsarcomas. JPathol2009;217(4):469–82. Parker AS, et al. High expression levels of insulin-like growth factor-Ireceptor predict poor survival among women with clear-cell renal cellcarcinomas.HumPathol2002;33(8):801–5.38.GiovannucciE,etal.Nutritionalpredictorsofinsulin-likegrowthfactorIand their relationships tocancer inmen.CancerEpidemiolBiomarkersPrev2003; 12(2): 84–9. Thissen JP, Ketelslegers JM,Underwood LE.Nutritional

regulationoftheinsulin-likegrowthfactors.EndocrRev1994;15(1):80–101.39. Qin LQ, He K, Xu JY. Milk consumption and circulating insulin-likegrowthfactor-Ilevel:asystematicliteraturereview.IntJFoodSciNutr2009;60Suppl7:330–40.40. Fontana L, et al. Long-term effects of calorie or protein restriction onserum IGF-1 and IGFBP-3 concentration in humans.AgingCell 2008; 7(5):681–7.41.KaaksR.Nutrition,insulin,IGF-1metabolismandcancerrisk:asummaryof epidemiological evidence. Novartis Found Symp 2004; 262: 247–60;discussion 260–68.McCartyMF.Vegan proteinsmay reduce risk of cancer,obesity,andcardiovasculardiseasebypromotingincreasedglucagonactivity.MedHypotheses1999;53(6): 459–85.CannataD, et al.Type2diabetes andcancer: what is the connection? Mt Sinai J Med 2010; 77(2): 197–213.Venkateswaran V, et al. Association of diet-induced hyperinsulinemia withacceleratedgrowthofprostatecancer(LNCaP)xenografts.JNatlCancerInst2007;99(23):1793–800.

Chapter6:ThePhenomenalFiberinBeans1.OmieaI,Lazcano-PonceE,Sanchez-ZamoranoLM,etal.Carbohydratesandthe risk of breast cancer among Mexican women. Cancer EpidemiolBiomarkersPrev2004;13:1283–9.2. Finley JW,Burrell JB,Reeves PG, et al. Pinto bean consumption changesSCFAprofilesinfecalfermentations,bacterialpopulationsofthelowerbowel,andlipidprofilesinbloodofhumans.JNutr2007;137(11):2391–8.3.RobertsonMD,CurrieJM,MorganLM,etal.Priorshort-termconsumptionofresistantstarchenhancespostprandialinsulinsensitivityinhealthysubjects.Diabetologia2003;46(5):659–65.4.HigginsJA,HigbeeDR,DonahooWT,etal.Resistant starchconsumptionpromoteslipidoxidation.Nutrition&Metabolism2004;1:8doi:10.1186/1743-7075-1-8.5. Carter P, Gray LJ, Troughton J, et al. Fruit and vegetable intake andincidence of type 2 diabetes mellitus: systematic review and meta-analysis.BMJ2010;341:c4229.6. Behall KM, Howe JC. Effect of long-term consumption of amylose vsamylopectin starch on metabolic variables in human subjects. American

JournalofClinicalNutrition1995;61:334–40.JenkinsDJ,VuksanV,KendallCW,etal.Physiologicaleffectsofresistantstarchesonfecalbulk,shortchainfattyacids,bloodlipidsandglycemicindex.JournaloftheAmericanCollegeofNutrition1998;17:609–16.7.LanzaE,HartmanTJ,AlbertPS,etal.Highdrybeanintakeandreducedriskof advanced colorectal adenoma recurrence among participants in the polyppreventiontrial.JNutr2006;136(7):1896–903.8. Singh PN, FraserGE.Dietary risk factors for colon cancer in a low-riskpopulation.AmJEpidem1988;148:761–74.AuneD,DeStefaniE,RoncoA,et al.Legume intake and the risk of cancer: amultisite case-control study inUruguay. Cancer Causes Control 2009; 20(9): 1605–15. Agurs-Collins T,SmootD,AffulJ,etal.LegumeintakeandreducedcolorectaladenomariskinAfrican-Americans. J Natl Black Nurses Assoc 2006; 17(2): 6–12. Lanza E,Hartman TJ, Albert PS, et al. High dry bean intake and reduced risk ofadvanced colorectal adenoma recurrence among participants in the polyppreventiontrial.JNutr2006;136(7):1896–903.9. Blackberry I, Kouris-Blazos A, Wahlqvist ML, et al. Legumes: the mostimportantdietarypredictorofsurvivalinolderpeopleofdifferentethnicities.AsiaPacJClinNutr2004;13(Suppl):S126.10.WuAH,YuMC,TsengCC,PikeMC.Epidemiologyofsoyexposuresandbreastcancerrisk.BrJCancer2008;98(1):9–14.11.BednarGE,PatilAR,MurraySM,GrieshopCM,MerchenNR,FaheyGCJr.Starchandfiberfractionsinselectedfoodandfeedingredientsaffecttheirsmall intestinal digestibility and fermentability and their large bowelfermentability in vitro in a caninemodel. J Nutr 2001 Feb; 131(2): 276–86.MuirJG,O’DeaK.Validationofaninvitroassayforpredictingtheamountofstarchthatescapesdigestioninthesmallintestineofhumans.AmJClinNutr1993Apr;57(4):540–6.12.SluijsI,etal.Carbohydratequantityandqualityandriskoftype2diabetesin the European Prospective Investigation into Cancer and Nutrition–Netherlands (EPIC–NL) study.Am JClinNutr 2010; 92(4): 905–11.BarclayAW,etal.Glycemic index,glycemic load,andchronicdisease risk—ameta-analysis of observational studies. Am J Clin Nutr 2008; 87(3): 627–37.GnagnarellaP,etal.Glycemicindex,glycemicload,andcancerrisk:ameta-analysis. Am J Clin Nutr 2008; 87(6): 1793–801. Sieri S, et al. Dietaryglycemic loadandindexandriskofcoronaryheartdisease ina largeItalian

cohort:theEPICORstudy.ArchInternMed2010;170(7):640–7.13.BuykenAE,ToellerM,HeitkampG, et al.Glycemic index in thediet ofEuropean outpatients with type 1 diabetes: relations to glycated hemoglobinandserumlipids.AmJClinNutr2001;73(3):574–81.14.HaltonT,WillettWC,LiuS,etal.Potatoandfrenchfryconsumptionandriskoftype2diabetesinwomen.AmJClinNutr2006;83(2):284–90.15.HodgeAM,etal.DietarypatternsanddiabetesincidenceintheMelbournecollaborativecohortstudy.AmJEpidemiol2007;165(6):603–10.VanDam,RM, et al.Dietary patterns and risk for type 2 diabetesmellitus inU.S.men.AnnInternMed2002;136(3):201–9.16. Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables ofglycemic index and glycemic load values 2008. Diabetes Care 2008 Dec;31(12):2281–3.Foster-PowellK,HoltSH,Brand-MillerJC.Internationaltableofglycemicindexandglycemicloadvalues:2002.AmJClinNutr2002Jul;76(1):5–56.

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function in hypercholesterolemic subjects: a randomized crossover trial.Circulation2004;109(13):1609–14.7.EllsworthJL,KushiLH,FolsomAR.Frequentnut intakeandriskofdeathfrom coronary heart disease and all causes in postmenopausal women: theIowaWomen’sHealthStudy.NutrMetabCardiovascDis2001Dec;11(6):372–7. Li TY, Brennan AM, Wedick NM, et al. Regular consumption of nuts isassociatedwitha lower riskof cardiovasculardisease inwomenwith type2diabetes.JNutr2009;139(7):1333–8.8. Albert CM, Gaziano JM, Willett WC, Manson JE. Nut consumption anddecreased risk of sudden cardiac death in thePhysicians’HealthStudy.ArchInternMed2002 Jun24;162(12):1382–7.FraserGE,Sabaté J,BeesonWL,Strahan TM. A possible protective effect of nut consumption on risk ofcoronaryheartdisease.TheAdventistHealthStudy.ArchInternMed1992Jul;152(7): 1416–24. Hu FB, Stampfer MJ, Manson JE, et al. Frequent nutconsumptionandriskofcoronaryheartdiseaseinwomen:prospectivecohortstudy.BMJ1998Nov14;317(7169):1341–5.BrownL,RosnerB,WillettWC,SacksF.Nutconsumptionandriskofrecurrentcoronaryheartdisease.FASEBJ 1999; 13:A538.Ellsworth JL,KushiLH, FolsomAR. Frequent nut intakeand risk of death from coronary heart disease and all causes inpostmenopausal women: the Iowa Women’s Health Study. Nutr MetabCardiovascDis2001Dec;11(6):372–7.9.ZelmanKM.It’sfulloffatandhelpsyouloseweight.WebMD.http://www.webmd.com/diet/features/its-full-of-fat-and-helps-you-lose-weight.10.YuenAW,SanderJW.Isomega-3fattyaciddeficiencyafactorcontributingto refractory seizures and SUDEP? a hypothesis. Seizure 2004 Mar; 13(2):104–7.11.CoatesAM,HowePR.Ediblenutsandmetabolichealth.CurrOpinLipidol2007; 18(1): 25–30. Segura R, Javierre C, Lizarraga MA, Ros E. Otherrelevantcomponentsofnuts:phytosterols,folateandminerals.BrJNutr2006;96Suppl2:S36–44.12.RajaramS,SabatAJ.Nuts, bodyweight and insulin resistance.Br JNutr2006;96Suppl2:S79–86.SabatAJ.Nutconsumptionandbodyweight.AmJClinNutr2003;78(3Suppl):647S–650S.Bes-RastrolloM,SabatAJ,Gamez-GarciaE,etal.Nutconsumptionandweightgain inaMediterraneancohort:theSUNstudy.Obesity2007;15(1):107–16.Garcia-LordaP,MegiasRangilI,Salas-Salvada J.Nut consumption, bodyweight and insulin resistance. Eur J

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33.48.AviramM,RosenblatM,GaitiniD,etal.Pomegranatejuiceconsumptionfor 3 years by patientswith carotid artery stenosis reduces common carotidintima-media thickness, blood pressure and LDL oxidation. Clin Nutr 2004Jun;23(3):423–33.49. Balk EM, Tatsioni A, Lichtenstein AH, et al. Effect of chromiumsupplementation on glucose metabolism and lipids: a systematic review ofrandomizedcontrolledtrials.DiabetesCare2007;30(8):2154–63.

Chapter9:TheSixStepstoAchievingOurHealthGoals1. JancinB. Fitness sharply cut death in high-BMI diabetics. Family PracticeNews2008;Oct1:19.

Chapter10:ForDoctorsandPatients1.AmericanDiabetesAssociation. Economic costs of diabetes in theU.S. in2007.DiabetesCare2008;31:596–615.2. Centers for Disease Control and Prevention. 2011 National Diabetes FactSheet.http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.3. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity andtrends in thedistributionofbodymass indexamongU.S.adults,1999–2010.JAMA2012;307(5):491–7.AbdullahA,StoelwinderJ,ShortreedS,etal.Theduration of obesity and the risk of type 2 diabetes. PublicHealthNutr 2011;14(1): 119–26. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linkingobesitytoinsulinresistanceandtype2diabetes.Nature2006;444(7121):840–6.4. Nathan DM, Buse JB, Davidson MB, et al. Medical management ofhyperglycemiaintype2diabetes:aconsensusalgorithmfortheinitiationandadjustmentoftherapy.DiabetesCare2008;32(1):193–203.5.KoroCE,BowlinSJ,BourgeoisN, et al.Glycemic control from1988 to2000amongU.S.adultsdiagnosedwith type2diabetes.DiabetesCare2004;27:17–20.6. ADVANCE Collaborative Group. Intensive blood glucose control andvascularoutcomesinpatientswithtype2diabetes.NEJM2008;358:2560–72.7. Fonseca V. Effect of thiazolidinediones on body weight in patients withdiabetesmellitus.AmJMed2003;115Suppl8A:42S–48S.

8.Russell-JonesD,KhanR.Insulin-associatedweightgainindiabetes—causes,effectsandcopingstrategies.DiabetesObesMetab2007;9(6):799–812.9. Ward S, Lloyd JM, Pandor A, et al. A systematic review and economicevaluation of statins for the prevention of coronary events. Health TechnolAssess2007;11(14):1–178.10. Löbner K, Knopff A, Baumgarten A, et al. Predictors of postpartumdiabetes in women with gestational diabetes mellitus.Diabetes 2006; 55(3):792–7.

Chapter11:FrequentlyAskedQuestions1.ChristakisNA,FowlerJH.Thespreadofobesityinalargesocialnetworkover32years.NEJM2007;327(4):370–9.2.ObarzanekE,SacksFM,MooreTJ.Dietaryapproachestostophypertension(DASH)—sodium trial. Paper presented at AnnualMeeting of the AmericanSocietyofHypertension2000;NewYork,NY.3. Itoh R, Syuyama Y. Sodium excretion in relation to calcium andhydroxyproline excretion in a healthy Japanese population. Am J Clin Nutr1996;63(5):735–40.4. Tuomilehto J, Jousilahti P, Rastenyte D. Urinary sodium excretion andcardiovascularmortalityinFinland:aprospectivestudy.Lancet2001;(9259):848–51.5. Dallongeville J, Marecaux N, Ducmetiere P, et al. Influence of alcoholconsumptionandvariousbeveragesonwaistgirthandwaist-to-hipratioonasampleofFrenchmenandwomen.JObesRelatMetabDisord1998;22(12):1178–83.6.DumitrescuRG,ShieldsPG.Theetiologyofalcohol-inducedbreastcancer.Alcohol2005;35(3):213–25.7. Boyle P, Boffetta P. Alcohol consumption and breast cancer risk. BreastCancerRes2009;11Suppl3:S3.8.ChenWY,RosnerB,Hankinson SE, et al.Moderate alcohol consumptionduring adult life, drinking patterns, and breast cancer risk. JAMA 2011;306(17):1884–90.9. Frost L,Vestergaard P.Alcohol and risk of atrial fibrillation or flutter: acohortstudy.ArchInternMed2004;164(18):1993–98.MukamalKJ,Tolstrup

JS,FribergJ,etal.Alcoholconsumptionandriskofatrialfibrillationinmenand women: the Copenhagen City Heart Study. Circulation 2005; 112(12):1736–42.10. SandersonWT, TalaskaG, Zaebst D, et al. Pesticide prioritization for abraincancercase-controlstudy.EnvironRes1997;74(2):133–144.ZahmSH,BlairA.Canceramongmigrantandseasonalfarmworkers:anepidemiologicreviewandresearchagenda.AmJIndMed1993;24(6):753–66.11.WorthingtonV.Nutritional quality of organic versus conventional fruits,vegetablesandgrains.JAltComlMed2001;7(2):161–173.Grinder-PedersonL, Rasmussen SE, Bugel S, et al. Effect of diets based on foods fromconventionalversusorganicproductiononintakeandexcretionofflavonoidsandmarkers of antioxidative defense in humans. J Agric FoodChem 2003;51(19):5671–6.12.SariI,BaltaciY,BagciC,etal.Effectofpistachiodietonlipidparameters,endothelial function, inflammation, and oxidative status: a prospective study.Nutrition2010;26(4):399–404.13.Bes-RastrolloM,WedickNM,Martinez-GonzalezMA, et al. Prospectivestudy of nut consumption, long-term weight change, and obesity risk inwomen.AmJClinNutr2009;89(6):1913–9.AlperCM,MattesRD.Effectsofchronicpeanutconsumptiononenergybalanceandhedonics.IntJObesRelatMetabDisord2002;26(8):1129–37.

Praise

“As a practicing internal medicine physician who treats multiple chronicillnesses, I have had great success in treating patients with therecommendationsmade by Dr. Fuhrman inEat to Live. I hope we are nowstarting tosee thebeginningof theendofdiabetesasDr.Fuhrmanshowsusthat we have a cure and don’t have to settle for control any longer. If thepharmaceutical industry developed a medication that prevented thedevelopmentoforreversedmultiplechronicmedicalillnesseswithvirtuallya100percentsuccessratewithoutanysideeffects,itwouldbemalpracticenottoprescribe it. Dr. Fuhrman reveals this powerful intervention within thesepages.”

—ChristopherParrish,D.O.diplomate,AmericanBoardofInternalMedicine

“I completely agree with Dr. Fuhrman that diabetes can be prevented andreversedbyanutrient-densediet.HisANDIscoreandnutritariandietconceptsare spot on. This book is a real solution for the millions who sufferunnecessarilyfromdiabetes.”

—AmyMyers,M.D.,medicaldirectoratAustinUltraHealth

“DiabeteshasbecomesoprevalentthatwhenIdiagnoseapatientwithdiabetes,they hardly seem surprised or shocked.They are ready to go straight to thepharmacy to pick up theirmedication and get started on a lifelong battle oftakingmedications,sufferingthesideeffects,andyetneverbeingcuredofthisdiseasethatslowlybutsurelyeatsawayatourbodies.Dr.Fuhrmanbrilliantlypointsouthowsadandunnecessarythissituationhasbecome.Diabetesisnotinevitableandamedicinecabinetfullofharmfuldrugsisnottheanswer.Readthisbookandyouwillfindthattheanswerisonyourplate!”

—GarthDavis,M.D.,TheDavisClinic,authorofTheExpert’sGuide

toWeight-LossSurgery

“Ihavetreatedmanydiabeticswhoaregovernedbytheerroneousnotionthatrestrictingcarbohydratesofalltypesisthekeytosuccessfultreatmentoftheirdisease.Inthiseminentlyreadablebook,JoelFuhrmandemonstratesthat it isnot the calorie type but the calorie quality that determines its value in themaintenance of health and treatment of diseases, including diabetes. Sweetloversofallshapesandsizeswillbethrilledtoknowthattheycanenjoytheirfavoritefruitsnotonlywithoutguiltbutintheserviceoftheirhealth.WithTheEndofDiabetes,Dr.Fuhrmanonceagaindeliverscutting-edgemedicineinaformatthatisenjoyableandentertaining.”

—AdamDave,M.D.,authorofTheParadigmDiet

“Dr. Fuhrman’s plan is being used routinely in my prevention clinic forcardiac and obesity patientswith remarkable results.His plea for a nutrient-denselifeincludinglivingrawfoodspackedwithenzymesandmicronutrientsis theanswer toaworldoverwhelmedwithdisease-producing toxiccalories.Thankyou,Joel.”

—JoelK.Kahn,M.D.,medicaldirector,PreventiveCardiologyandWellness,DetroitMedicalCenter,clinicalprofessorofmedicine,

WSUSchoolofMedicine

“If only all of us could read and incorporate these simple concepts into ourdaily life,wecouldbe freeofdiabetes,heartdisease, andcancer, and leadahealthier,happierlife.Amust-readforallpatientsandprimarycarephysicians.I believe this book should be part of the curriculum for medical studentsduringtheir introductiontoclinicalmedicine.AsapracticinginternistIhaveincorporatedtheseteachingsintomypracticeandIhavehadamazingresults.”

—ShobanaSenthilnathan,M.D.,internalmedicine,NorthCarolina

“Dr.Fuhrmanprovidesaclearlywrittenroadmapsothatanyonewithdiabetesor at risk of developing diabetes can dramatically improve their health and,withmedical supervision, reduceorpotentiallyeveneliminate theirneed formedication. The End of Diabetes is a timely and valuable asset given thecurrentexplosionofobesity,diabetes,andcardio-metabolicdisease.”

—DeniseLin,M.D.,assistantprofessorofpsychiatry,UniversityofNewMexicoHealthSciencesCenter;formerowner,Advanced

PsychiatricCareofSantaBarbara

“In his book The End of Diabetes, Dr. Fuhrman drives home the liberatingmessage that a rational lifestyle canbothprevent and reverse the scourgeoftype2diabetes.Hisphilosophyofhealthisinstarkcontrasttothosewhorelyonmedicationstohelptheirpatients‘livewith’diabetes.Iplanonsharingthistitle with my patients who could benefit from Dr. Fuhrman’s simple yetprofoundpremise:eatanutrient-densedietandexercisedaily.”

—RobertH.Granger,MBBS,DrPH,MPH,FlindersMedicalCentre

Credits

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Copyright

THEENDOFDIABETES:TheEattoLivePlantoPreventandReverseDiabetes.Copyright©2013byJoelFuhrman,M.D.AllrightsreservedunderInternationalandPan-AmericanCopyrightConventions.Bypaymentoftherequiredfees,youhavebeengrantedthenonexclusive,nontransferablerighttoaccessandreadthetextofthisebookon-screen.Nopartofthistextmaybereproduced,transmitted,downloaded,decompiled,reverse-engineered,orstoredinorintroducedintoanyinformationstorageandretrievalsystem,inanyformorbyanymeans,whetherelectronicormechanical,nowknownorhereinafter

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*To determine theANDI scores, an equal-calorie serving of each foodwas evaluated.The followingnutrients were included in the evaluation: fiber, calcium, iron, magnesium, phosphorus, potassium, zinc,copper,manganese, selenium,vitaminA,beta carotene, alphacarotene, lycopene, lutein andzeaxanthin,vitaminE,vitaminC, thiamin, riboflavin,niacin,pantothenicacid,vitaminB6,folate,vitaminB12, choline,vitaminK,phytosterols, andglucosinolatesplus theORACscore.ORAC(OxygenRadicalAbsorbanceCapacity) is a measure of the antioxidant, or radical, scavenging capacity of a food. For consistency,nutrient quantities were converted from their typical measurement conventions (mg, mcg, IU) to apercentageoftheirReferenceDailyIntake(RDI).FornutrientsthathavenoRDI,goalswereestablishedbasedonavailableresearchandcurrentunderstandingofthebenefitsofthesefactors.Pointswereaddedif the food itemwas antiangiogenic or containedorganosulfides, aromatase inhibitors, resistant starch, orresveratrol.Tomakeiteasiertocomparefoods,therawpointtotalswereconverted(multipliedbythesamenumber)so that the highest ranking foods (leafy green vegetables such as mustard greens, kale, and collards)receivedascoreof1,000,andtheotherfoodsreceivedlowerscoresaccordingly.

* If he was my patient I would have also lowered the metformin dose by this point, or perhapsdiscontinuedit.

*Mushroomsarebestcooked,evenstewed,forafewminutes.Theycontainamildtoxincalledagaritine,thatdissipateswithevenlightcooking.Tobeconservative,becauseitisunknownifagaratinehasnegativehealtheffects,Idonotrecommendeatingmuchrawmushrooms.Nevertheless,mushroomshavepowerfulanticancereffects,andthosepowersarelikelyenhancedbycookingthem.

*Thiswasover15yearsago.Iamnowespeciallycarefulinwatchingbloodpressure,particularlywhenpatients are onACE inhibitors and can drop their blood pressure too low and injure their kidneys if themedicationsarenotreducedorstoppedintime.