DIABETES

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magazine presents

DIABETES
by

MICHAEL T. MURRAY, ND

Copyright 2009 by Michael T. Murray, ND, and Active Interest Media, Inc. All rights reserved. No part of this booklet may be reproduced, stored in an electronic retrieval system, or transcribed in any form or by any means, electronic or mechanical, including photocopying and recording, without the prior written permission of the publisher, except for the inclusion of quotations in a review. Published by: Active Interest Media, Inc. 300 N. Continental Blvd., Suite 650 El Segundo, CA 90245 This booklet is part of the Better Nutrition Healthy Living Guide series. For more information, visit www.betternutrition.com. Better Nutrition magazine is available at fine natural health stores throughout the United States. Design by Aline Design: Bellingham, Wash. The information in this booklet is for educational purposes only and is not recommended as a means of diagnosing or treating an illness. All health matters should be supervised by a qualified healthcare professional. The publisher and the author(s) are not responsible for individuals who choose to self-diagnose and/or self-treat.

DIABETES
CONTENTS
Preface: A Message From Dr. Murray.......................... 4 Introduction: A Diabetes Primer..................................... 6 Chapter One: Reduce After-Meal Elevations of Blood Sugar Levels........................................................ 8 Chapter Two: Provide Optimal Nutrient Status..... 12 Chapter Three: Improve Insulin Function And Sensitivity......................................................................17 Chapter Four: Prevent Nutritional And Oxidative Stress................................................................. 20 Appendix: Glycemic Index, Glycemic Load, And Fiber Content of Selected Foods...................24 Selected References...............................................................31

Preface

A Message From Dr. Murray

his booklet provides recommendations that are specifically designed to support the proper utilization of blood glucose and insulin, as well as deal with some of the nutritional challenges and deficiencies that many diabetics suffer from. Optimal nutrition and effective blood sugar control is an absolute necessity for preventing the major complications of diabetes.

Table 1 Major Complications of Diabetes

Heart disease and stroke High blood pressure Blindness Kidney disease Nervous system disease Amputations Periodontal disease Pain Depression Autoimmune disorders

The program detailed in this booklet incorporates some of the key recommendations in my book How to Prevent and Treat Diabetes with Natural Medicine that I coauthored with Michael R. Lyon, M.D. I strongly encourage anyone with diabetes to get this valuable resource as it provides significantly more detailed information on dietary, lifestyle and supplementation strategies, as well as critical guidance people with diabetes need. This booklet will focus on some of the key nutritional considerations in the management of blood sugar issues to help: Promote balanced and normal blood sugar levels Support healthy and normal insulin function Provide optimal nutrient status specifically for people with diabetes  or blood sugar problems Before discussing how to accomplish these goals, lets take a look at what contributes to the challenges of diabetes.
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D I A B E T E S

Introduction

A Diabetes Primer

lthough we think of diabetes as a blood sugar disorder, it actually affects much more than blood sugar. It is also characterized by abnormalities in fat and protein metabolism, inflammation and immune system function. All of these disturbances stress normal physiological mechanismsthat is why diabetes wreaks such great destruction on the body and its organs. Diabetes can occur when the pancreas does not secrete enough insulin or if the cells of the body become resistant to insulin. Insulin is a hormone which promotes the uptake of blood sugar by cells throughout the body. When there is not enough insulin or when there is a lack of sensitivity to insulin, blood sugar cannot get into the cells. This failure can lead to serious complications. On the other hand, too much insulin, either through injection or the bodys own manufacture, contributes to the many longterm complications of diabetes.

Obesity is a major contributing factor to this loss of insulin sensitivity.

Diabetes is divided into two major categories: type 1 and type 2. Type 1 or Insulin-Dependent Diabetes Mellitus (IDDM) occurs most often in children and adolescents. For that reason it is often referred to as juvenile-onset diabetes. Type 1 diabetes is associated with complete destruction of the beta cells of the pancreas that manufacture insulin. Type 1 diabetics will require lifelong insulin for the control of blood sugar levels. The type 1 diabetic must learn how to manage their blood sugar levels on a day-by-day basis, modifying insulin types and dosages as necessary according to the results of regular blood sugar testing. Up to 10 percent of all diabetics are type 1. Type 2 or Non-Insulin Dependent Diabetes Mellitus (NIDDM) usually strikes after age 40 and is often referred to as adult-onset diabetes. It is generally thought that up to 90 percent of all diabetics are type 2. In type 2 diabetes, insulin levels are typically elevated, indicating a loss of sensitivity to insulin by the cells of the body. In type 2 diabetes there is usually plenty of insulinit is just not doing a very good job of unlocking the cells to allow the glucose to enter. As type 2 diabetes progresses, insulin levels can drop and insulin deficiency can magnify, the effects of insulin resistance.
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Obesity is a major contributing factor to this loss of insulin sensitivity. Approximately 90 percent of individuals with type 2 diabetes are obese. Achieving ideal body weight in the early phase of type 2 diabetes is often associated with complete restoration of normal blood sugar levels. Even if type 2 diabetes has progressed to the point where insulin deficiency is present, weight loss results in significant improvements in blood sugar control and dramatic reductions in other health risks such as heart disease.

Pre-diabetes, Hypoglycemia And Syndrome X

Pre-diabetes (also called impaired glucose tolerance) is a condition that occurs when a persons blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are almost as many people in the United States with impaired glucose tolerance as there are diabetics. Although many of these people are told that they just have a touch of diabetes, research suggests that impaired glucose tolerance is accompanied by serious health risks and it should be treated carefully. However, it is also clear that impaired glucose tolerance is usually reversible and, in most cases, diabetes can be completely avoided. Impaired glucose tolerance is also often accompanied by high cholesterol and blood pressure, inflammation and abnormal blood clotting. These abnormalities are associated with a serious increase in the risk of cardiovascular disease, stroke, and other health catastrophes. It is certainly not wise to ignore or minimize the seriousness of impaired glucose tolerance.

The Greatest Plague of The 21st Century

The dramatic increase in obesity around the world over the past 20 years is resulting in a catastrophic rise of diabetes, cardiovascular disease and other serious health problems. Science tells us that almost all of the health risks associated with increased body fat occur because overweight people develop insulin resistancea state in which insulin no longer works efficiently and the body compensates by producing higher than normal amounts of the hormone. Insulin resistance and elevated insulin levels exist in most people even in the early stages of being overweight, especially when that weight is around the belly. Insulin resistance results in elevated blood sugar, hypoglycemic food cravings, excessive appetite, overly efficient fat storage, increased blood pressure, damage to the heart and blood vessels, inflammation, and many other abnormalities. As many as 80 percent of American adults and an ever-increasing number of children now have some degree of insulin resistance. Re-establishing the proper responsiveness to insulin is critical in helping people not only achieve effective blood sugar control, but also permanent weight loss.
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Chapter One

Reduce After-Meal Elevations in Blood Sugar Levels

he first goal in the management of diabetes is to slow down the absorption of glucose from the intestinal tract to reduce after-meal elevations in blood sugar. The majority of glucose in the body is derived from carbohydrates. There are two groups of carbohydrates, simple and complex. Simple carbohydrates are naturally found in fruits and vegetables, but most of the simple sugars consumed in America are in the form of refined sugar. When high sugar foods are eaten, blood sugar levels rise quickly, producing a strain on blood sugar control. The body responds to the rise in blood glucose levels after meals by secreting insulin. Insulin lowers blood glucose by increasing the rate that glucose is taken up by cells throughout the body. Repeated spikes in aftermeal blood sugar levels greatly stress blood sugar control and contribute to loss of sensitivity to insulin. As a result, blood sugar levels can become persistently elevated. In people with diabetes, elevations of blood glucose levels after a meal can cause serious problems. Research indicates that an elevation in postprandial (after meal) blood sugar levels is perhaps the major contributor to the development of diabetic complications, especially heart disease and diseases of the small blood vessels within the eye, kidneys, and nerves. We hope that this startling research helps you understand why blunting the after-meal increase in blood sugar levels is such an important goal.

The Glycemic Index And Glycemic Load

The primary diet strategy to reduce postprandial blood sugar levels involves avoiding foods that cause a rapid rise in blood sugar levels. Accomplishing this goal involves familiarizing yourself with two useful tools: The Glycemic Index and Glycemic Load. The glycemic index (GI) is a numerical scale used to indicate how fast and how high a particular food raises blood glucose levels. Refined sugars, white flour products, and other sources of simple sugars are quickly absorbed into the bloodstream, causing a rapid rise in blood sugar. But, even good carbohydrates can be harmful if over-consumed. While the GI
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Even good carbohydrates can be harmful if over-consumed.

is quite useful, it doesnt tell you how much carbohydrate is in a typical serving of a particular food. That is where glycemic load comes in. The glycemic load (GL) is a relatively new way to assess the impact of carbohydrate consumption. The GL gives a fuller picture of the effect that a food has on blood sugar levels because it takes into account a typical serving size. For example, beets have a high GI, but a low GL. Although the carbohydrate in beets has a high GI, you typically dont eat a lot of it. Because of this, beets have a low GL of around 5. (A GL of 20 or more is high, a GL of 11 to 19 inclusive is medium, and a GL of 10 or less is low.) Thus, as long as a person eats a reasonable portion of a low GL food, the impact on blood sugar is acceptable even if the food is high in its GI.

The Role of PGX

The effectiveness of fiber on reducing appetite, blood sugar, and cholesterol is based directly on the amount of water the fiber is able to absorb (water-holding capacity) and the degree of thickness or viscosity the fiber imparts when in the stomach and intestine. For instance, this water solubility and viscosity is why oat bran lowers cholesterol and controls blood sugar better than wheat bran. With this in mind, researchers have been seeking to identify and isolate dietary fibers with the highest viscosity and water-holding capacity. Although there are many varieties of soluble fiber, a completely new matrix known as PolyGlycopleX (PGX) is the most viscous and soluble fiber ever discovered. PGX has a higher level of viscosity, gel-forming properties, and expansion with water than with the same quantity of any other fiber. The PGX matrix is able to bind hundreds of times its weight
D I A B E T E S 9

in water resulting in a volume and viscosity three to five times greater than other highly soluble fibers like psyllium or oat beta glucan. To put this in perspective, a small five-gram serving of PGX produces a volume and viscosity equal to four bowls of oat bran. In this way, small quantities of PGX can be added to foods or taken as a drink before meals to have an impact on appetite and blood sugar control equivalent to eating enormous quantities of any other form of fiber. Detailed clinical studies show that PGX: supports healthy postprandial blood glucose levels when added to  or taken with foods; reduces the glycemic index of any food or beverage;  reduces appetite and promotes effective weight loss;   increases the level of compounds that block the appetite and promote satiety; decreases the level of compounds that stimulate overeating;  stabilizes blood sugar control in the overweight and obese; and  lowers blood cholesterol and triglycerides already within normal  range. Its important to note that PGX is not intended to treat, cure, or prevent any disease. It is a dietary supplement designed to assist with weight loss and support proper insulin sensitivity.

PGX Promotes Satiety

Most diets focus on eating less, but after a while it becomes too much effort to follow and we wind up losing motivation and gaining the weight back. PGX helps you to lose weight by helping you to comfortably eat less and by helping to reduce appetite. In addition to supporting healthy blood sugar levels already within normal range, when taken before or with meals, PGX absorbs large amounts of water to form a gelatinous mass. This waterbased mass helps you to decrease the portion size of your meals without feeling hungry. PGX helps you feel satisfied even after eating less. Another benefit of PGX is its viscosity which, when mixed with foods, slows digestion so that you stay full for longer after meals, reducing the need to eat again.

Effective Weight Loss

The single key ingredient to successful weight loss is the ingestion of PGX at major meals and perhaps at least twice more for those with an appetite more difficult to tame. PGX is available in a soft gelatin capsule, as granules to be added into food and beverages, and in a low carbohydrate, very low GI meal replacement drink containing undenatured whey
10 D I A B E T E S

protein, natural flavors, and sweeteners along with vitamins and minerals. Here is a quick checklist of how to use PGX in your daily diet: Take the PGX Weight Loss Drink Mix at least once per day as a  mealreplacement. If using PGX granules, take 2.5 to 5 grams in a glass of water before  meals. If you are using PGX in soft gelatin capsules, less PGX is required. Take 2-3 soft gelatin capsules with a glass of water before meals. Use PGX granules or in soft gel capsules when hungry between meals.  Drink water! While it is wise to drink at least 48 ounces of water  daily, it is vital to do so when taking PGX.

Safety And Side Effects

PGX has an excellent safety profile, and is suitable for long-term use for virtually everyone. People who should not use PGX includes: Anyone who cannot drink a large amount of water, such as  individuals with renal diseases and congestive heart failure. Pregnant or lactating women should discuss PGX use with their  health care practitioner. Anyone under 18 years of age should discuss PGX use with their  health care practitioner. If you are taking medication, take it one hour prior to or after taking PGX. If this recommendation is followed, PGX can be used along with any prescription medication. As PGX helps control blood glucose and may lessen the need for insulin or other diabetes medications over time, people with diabetes must monitor their blood glucose and adjust their medication accordingly. There is no problem taking PGX along with all of your supplements including essential fatty acids (EFAs) and multivitamins/multiminerals. PGX slows down the rate of absorption of foods, vitamins or supplements, but overall absorption of nutrients is enhanced because nutrients are more gradually introduced to the gastrointestinal system and blood sugar levels are balanced when taking PGX. Since, PGX is a super fiber matrix, it can take time for your body to adjust. To avoid minor side effects, such as increased gas, bloating, loose stools or constipation, it is best to start with small amounts of PGX and then gradually increase your intake as your body adjusts. If you take PGX consistently, and increase the dose gradually, it is likely that you will be able to consume a highly effective dose within a few days to a week. To decrease any possible side effects, it is important to drink a large glass of water with each dose of PGX. For more information go to PGX.com.
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Chapter Two

Provide Optimal Nutrient Status

hile a health-promoting diet is an essential component of good health, so too is proper nutritional supplementation. While some experts say that you can theoretically meet all of your nutritional needs through diet alone, the reality is that most Americans do not come anywhere near the optimal levels. During recent years the U.S. government has sponsored a number of comprehensive studies to determine the nutritional status of the population. These studies have revealed that marginal nutrient deficiencies exist in approximately half of the U.S. population and that, for some selected nutrients in certain age groups, more than 80 percent of the group consumed less than the recommended daily allowance (RDA). While it is theoretically possible that a healthy individual can get all the nutrition they need from foods, the fact is that most Americans do not even come close to meeting all their nutritional needs through diet alone. In an effort to increase their intake of essential nutrients, many Americans look to vitamin and mineral supplements. Current estimates are that more than 70 percent of Americans now regularly take vitamin or mineral supplements. It seems that taking vitamin and mineral supplements has become a way of life for most Americans. Unfortunately, most people taking a multiple vitamin and mineral formulas are still not getting what they really need because they are being misled into thinking that a one a day type multiple is meeting all their needs for optimum nutrition.

Giving Your Body The Tools It Needs

For optimum health, a high quality multiple vitamin and mineral supplement is an absolute necessity. A high quality multiple is one that provides optimal levels of both vitamins and minerals. Your body needs all of the important building blocks in order to build health. A deficiency of any one of several key nutrients required for the proper manufacture and function of insulin can lead to impaired sugar metabolism. Especially important are the minerals magnesium, chromium, zinc, and manganese, as well as the B vitamins. To illustrate just how important a good multiple is to good health, one study showed that the use of a multiple vitamin and mineral supplement was associated with at least a 30 percent reduction of diabetes risk in men and a 16 percent reduction in risk for women.
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Nutritional Insurance
A high-potency multiple vitamin and mineral formula is an absolute must for people with diabetes to help deal with the increased need for many nutrients. Supplying the diabetic with additional key nutrients has been shown to improve blood sugar control, as well as help prevent or reduce the development of the major complications of diabetes. Taking a multiple vitamin and mineral supplement has also been shown to boost immune function and reduce infections in diabetics. Specific examples of key nutrients that the diabetic needs include chromium, vitamin C, vitamin E, certain B vitamins, manganese, magnesium, and zinc.

Chromium
An important trace mineral for blood sugar control is chromium. Chromium works closely with insulin in facilitating the uptake of glucose into cells. Without chromium, insulins action is blocked and glucose levels are elevated. There have been more than 20 clinical studies with chromium supplementation in diabetes. In some of these studies, supplementing the diet with chromium decreases fasting glucose levels, improves glucose tolerance, lowers insulin levels, and decreases total cholesterol and triglyceride levels while increasing HDL-cholesterol levels. However, it appears that chromium supplementation is likely to produce meaningful improvements in blood sugar control only in people who are deficient in chromium. Everyone needs at least 200 mcg of chromium each day in our diet. People with diabetes need a little bit moresomewhere between 200-400 mcg per day. Supplementing the diet at this dosage level seems very prudent. Chromium polynicotinate, chromium picolinate, and chromiumenriched yeast are suitable forms to use.

Vitamin C
Since the transport of vitamin C into cells is enhanced by insulin, many people with diabetes suffer from a deficiency, even if they consume an adequate amount of vitamin C in their diet. As a result, the individual with diabetes needs to take extra vitamin C. In addition to its role as an antioxidant, vitamin C is required in immune functions and the manufacture of collagen, the main protein substance of the human body. Collagen is an important protein for the structures that hold our body together (connective tissue, cartilage, tendons, etc.). Vitamin C is also vital for wound repair, healthy gums, and the prevention of easy bruising. A chronic, latent vitamin C deficiency leads to a number of problems for the diabetic including an increased tendency to bleed (increased
D I A B E T E S 13

capillary permeability), poor wound healing, elevations in cholesterol levels, and a depressed immune system. In addition, vitamin C supplementation exerts a mild effect in improving glucose control. Probably more important is the fact that vitamin C supplementation reduces the formation of compounds linked to the development of diabetic complications. In one double-blind study, 30 patients, 45 to 70 years of age, who not only had type 2 diabetes but also high blood pressure, were randomly assigned to take either 500 mg of vitamin C or a placebo daily for four weeks. Vitamin C supplementation decreased systolic blood pressure from 142.1 to 132.3 mm Hg and diastolic pressure from 83.9 to 79.5. Additional analytical methods also demonstrated significant improvements in arterial stiffness. These results indicate that vitamin C supplementation is effective in improving the elasticity and function of blood vessels in patients with type 2 diabetes. While vitamin C supplementation is necessary, do not rely exclusively on supplements to meet all of your vitamin C requirements. Vitamin C-rich foods are high in flavonoids and carotenes, which work to enhance the effects of vitamin C as well as exert favorable effects of their own. While most people think of citrus fruits as the best source of vitamin C, vegetables also contain high levels, especially broccoli, peppers, potatoes, and Brussels sprouts.

Vitamin E
Vitamin E functions primarily as an antioxidant, protecting cell membranes from damage. Nerve cells are particularly vulnerable to injury. Diabetics appear to have an increased requirement for vitamin E. Vitamin E not only improves insulin action, it exerts a number of beneficial effects when taken at dosages ranging from 400 to 800 IU. Whats more, vitamin E: prevents free radical damage to LDL cholesterol and the vascular  lining; improves the functioning of blood vessels and the cells that line the  blood vessels; increases the concentration of magnesium within cells;   decreases the level of C-reactive protein and other inflammatory compounds; increases the level of glutathione within cells;  improves the rate of conduction of the electrical impulse through  the nervous system; improves blood flow to the eye and improves diabetic retinopathy;  and improves kidney function and normalizes creatinine clearancean  indicator of kidney functionin diabetics with mild elevations.
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Be sure that the vitamin E that you take is a natural form. Such forms are designated d-, as in d-alpha tocopherol, while synthetic forms are dl-, as in dlalpha tocopherol. The human body recognizes and responds only to the d- form. In fact, the dl- form may actually prevent the d-form from entering cell membranes. Because of the way the body utilizes vitamin E, the individual with diabetes will require lifelong supplementation for maximum benefits.

Niacin
Niacin (vitamin B3) containing enzymes play an important role in energy production; fat, cholesterol, and carbohydrate metabolism; and the manufacture of many body compounds including sex and adrenal hormones. Niacin, like chromium, is an essential component of the glucose tolerance factor making it a key nutrient for hypoglycemia and diabetes.

Vitamin B6
Pyridoxine or vitamin B6 is an extremely important B vitamin involved in the formation of body proteins and structural compounds, chemical transmitters in the nervous system, red blood cells, and hormone-like compounds known as prostaglandins. Vitamin B6 is also critical in maintaining hormonal balance and proper immune function. Vitamin B6 supplementation appears to offer significant protection against the development of diabetic nerve disease (neuropathy). Individuals with long-standing diabetes or who are developing signs of peripheral nerve abnormalities should definitely supplement their diets with vitamin B6.

Magnesium
Like chromium, magnesium is also involved in glucose metabolism. There is considerable evidence that diabetics should take supplemental magnesium. The reasons: Over half of all people with diabetes show
D I A B E T E S 15

evidence of a magnesium deficiency, and magnesium may prevent some of the complications of diabetes like retinopathy and heart disease. Magnesium levels are usually low in diabetics. Clinical studies have shown magnesium supplementation (usually 400 to 500 mg per day) improves insulin response and action, glucose tolerance, and the fluidity of the red blood cell membrane in patients with diabetes. The recommended dietary intake for magnesium is 350 mg per day for adult males and 300 mg per day for adult females. The diabetic may need twice this amount because they tend to lose excessive magnesium through their kidneys. Most of the magnesium should be derived from the diet. Yet, the average intake of magnesium ranges between 143 and 266 mg per day. This is obviously far below the RDA. Food choices are the main reason. While magnesium occurs abundantly in whole foods, food processing removes a large portion of magnesium. The best dietary sources of magnesium are tofu, legumes, seeds, nuts, whole grains, and green leafy vegetables. Yet most Americans consume a low magnesium diet high in refined foods, meat, and dairy products. In addition to eating a diet rich in magnesium, the diabetic should supplement their diet with 300 to 500 mg of magnesium. For best results, use highly absorbable sources of magnesium like magnesium aspartate or citrate. Also, diabetics should be sure to get at least 25 mg of vitamin B6 per day as the level of vitamin B6 inside the cells of the body appear to be intricately linked to the magnesium content of the cell. In other words without vitamin B6 (as well as vitamin E), magnesium will not get inside the cell and will, therefore, be useless.

Zinc
Zinc functions in more enzymatic reactions than any other mineral. Although severe zinc deficiency is very rare in developed countries, many individuals in the United States have marginal zinc deficiency. This occurrence is particularly true in the elderly population as well as in people with diabetes. Low levels of zinc are associated with an increased susceptibility to infection, poor wound healing, a decreased sense of taste or smell, or skin disorders. Zinc deficiency, like chromium deficiency, may also play a role in the development of diabetes. Zinc is involved in virtually all aspects of insulin metabolism: Synthesis, secretion and utilization. Zinc also has a protective effect against betacell destruction, and has well-known anti-viral effects. Diabetics typically excrete too much zinc in the urine and therefore require supplementation. Diabetics should take at least 30 mg of zinc per day. Zinc is also found in good amounts in whole grains, legumes, nuts, and seeds.
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Chapter Three

Improve Insulin Function And Sensitivity

he first step in improving insulin function and sensitivity is achieving ideal body weight. PGX has been recognized by many health care practitioners for its ability to support the body in this regard. In addition to promoting safe and effective weight loss, PGX also supports the normal sensitivity of cells throughout the body to insulin. In one double-blind study, PGX has shown significant improvement in whole body insulin sensitivitya phenomenal accomplishment unequalled by any other natural health product. Approximately 80 to 90 percent of individuals with type 2 diabetes are significantly overweight. If these people were not overweight, they would not have developed diabetes. That is the bottom line. When fat cells, particularly those around the abdomen, become full of fat they secrete a number of biological products that dampen the effect of insulin, impair glucose utilization in skeletal muscle, promote glucose production by the liver, and impair insulin release by pancreatic beta cells. Also important is that, as the number and size of fat cells increase, it leads to a reduction in the secretion of compounds that promote insulin action including a novel protein produced by fat cells known as adiponectin. Adiponectin not only is associated with improved insulin sensitivity, it also has anti-inflammatory activity, lowers triglycerides, and blocks the development of atherosclerosis (hardening of the arteries). The net effect of all of these actions by fat cells is that they severely stress blood sugar control mechanisms by reducing insulin sensitivity. Achieving ideal body weight is associated with restoration of insulin sensitivity and, in many cases, the reversal of type 2 diabetes.

Additional Recommendations
In addition to weight loss, it is important to make sure the body has all of the necessary essential vitamins and minerals that proper insulin sensitivity requires by taking a high potency multiple vitamin and mineral formula. Omega-3 fatty acids, nuts and seeds, and several herbal extracts have also shown promising results in blood sugar control, especially Gymnema sylvestre and mulberry extract.

D I A B E T E S

17

Omega-3 Fatty Acids And Insulin Action

Over 60 different health conditions can be either prevented or improved by diets providing higher amounts of omega-3 fatty acids from fish oils. These health benefits relate to how these fatty acids are incorporated in cellular membranes and the beneficial effects they have once they reside in cell membranes. Omega-3 fatty acids play a major role in helping cell membranes achieve a fluid-like nature necessary for proper cell function. Since dietary fat determines cell membrane composition, a lack of omega-3 fatty acids leads to reduced membrane fluidity which, in turn, causes reduced insulin binding to receptors on cellular membranes and/ or reduced insulin action. In addition to a lack of omega-3 fatty acids, too much margarine, shortening and other foods containing trans fatty acids appear to disrupt insulin action. One study estimated that eliminating margarines containing hydrogenated vegetable oil would reduce the likelihood of developing type 2 diabetes by a whopping 40 percent. In contrast to the dampening of insulin sensitivity trans and saturated fats, clinical studies have shown that monounsaturated fats and omega-3 oils improve insulin action. Adding further support is the fact that frequent consumption of monounsaturated fats such as olive oil, nuts, nut oils and omega-3 fatty acids from fish protect against the development of type 2 diabetes. All of this evidence clearly suggests that altered cell membrane composition and fluidity plays a critical role in the development of type 2 diabetes. Many people shy away from eating nuts because they are high in calories. While that is true, studies have shown that people who frequently consume nuts actually have less of a problem with obesity than those people that do not eat nuts. A recent study has also shown that consumption of nuts was inversely associated with the risk of type 2 diabetes, independent of known risk factors like a family history of diabetes. What was really amazing was that this relationship was seen even in women who were obese. In addition to providing beneficial monounsaturated and polyunsaturated fats that improve insulin sensitivity, nuts are rich in fiber and magnesium and have a low GI. Higher intakes of fiber and magnesium and low GI foods have been associated with reduced risk of type 2 diabetes in several population-based studies. Since nuts are very high in calories, I advocate eating them in moderation to promote optimal body weight (i.e. no more than one-fourth cup daily). I also recommend the use of mostly raw or lightly roasted fresh nuts and seeds rather than commercially roasted and salted versions.
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Gymnema sylvestre
Gymnema is a famous medicinal plant from India that has long been used as a treatment for diabetes. Recent scientific investigation has upheld its effectiveness in both type 1 and type 2 diabetes. Gymnema extracts enhance glucose control in diabetic dogs and rabbits. Interestingly, in animals that have their pancreas removed, gymnema possesses no apparent effects, suggesting it enhances the production or activity of insulin. The dosage for gymnema (standardized to contain 24 percent gymnemic acid) is 200 mg twice a day. No side effects have been reported from gymnema, however diabetics on insulin should be careful to monitor blood sugar when beginning this product because insulin dosages may have to be decreased to avoid hypoglycemia.

Mulberry Extract
The mulberry plant (Morus indica) is probably best known as the food for silkworms, but it has also been highly regarded in traditional Chinese and Japanese medicine. Mulberry possesses significant hypoglycemic effects in animal studies and it contains a very effective alpha-glucosidase inhibitor, along with other compounds that appear to improve blood sugar control. Mulberry extract has been studied in type 2 diabetes and the results are excellent. In one study, researchers decided to investigate its effect on blood and red blood cell lipids as well as compare its blood sugar lowering actions to the oral antihyperglycemic drug glyburide. Patients were given either 3g of mulberry per day or one tablet of glyburide (5 mg/ day) for four weeks. The mulberry therapy significantly improved diabetic control in type 2 diabetic patients. Compared to glyburide treatment, mulberry therapy significantly reduced fasting blood glucose concentrations of diabetic patients. However, no significant differences were observed in the blood glucose concentrations between pre- and posttreatments with glyburide. Mulberry extract was also superior to the drug in its ability to decrease hemoglobin A1c, total cholesterol, LDL and triglycerides. It also resulted in an increase in HDL (good cholesterol). Although these changes were not statistically significant, there are strong suggestions that this natural product is clearly superior to an established pharmaceuticalagent. In addition to the benefits on blood sugar levels and blood lipids, mulberry therapy reduced the amount of damage red blood cell membranes sustained, indicating a significant antioxidant effect. Additionally, mulberry therapy significantly decreased cholesterol levels in type2 diabetics.
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Chapter Four

Prevent Nutritional And Oxidative Stress

ncreased oxidative stress is a major factor in diabetes. Diabetics typically have elevated levels of free radicals and oxidative compounds, they are much more likely to suffer from their damage. These highly reactive compounds bind to and destroy cellular compounds. They also greatly increase the inflammatory process by increasing the formation of inflammatory mediators like C-reactive protein. One of the critical goals in nutritionally supporting individuals with diabetes is to flood the body with a high level of antioxidants to counteract the negative effects of free radicals and pro-oxidants. This is achieved by consuming a diet rich in vegetables and legumes as well as by taking nutritional antioxidants. In particular, it is important for diabetics to take alpha-lipoic acid, green drinks, and a flavonoid-rich extract.

Alpha Lipoic Acid

Alpha-lipoic acid (ALA) is a vitamin-like substance that is often described as natures perfect antioxidant. ALA is a very small molecule that is efficiently absorbed and easily crosses cell membranes. Unlike vitamin E which is primarily fat soluble and vitamin C which is water soluble, ALA can quench either water or fat soluble free radicals both inside the cell and outside in the intracellular spaces. Furthermore, ALA extends the biochemical life of vitamin C and E as well as other antioxidants. ALA has been an approved drug in Germany for the treatment of diabetic neuropathy for more than 30 years. The beneficial effects of ALA in diabetic neuropathy have been confirmed in several double-blind studies at a dosage of 300 to 600 mg daily. Although, ALAs primary effect in improving diabetic neuropathy is thought to be the result of its antioxidant effects, it has also been shown to improve blood sugar metabolism and blood flow to peripheral nerves. It also stimulates the regeneration of nerve fibers. ALAs ability to improve blood sugar metabolism is a result of its effects on glucose metabolism and an ability to increase insulin sensitivity. Its importance in treating diabetic neuropathy cannot be overstated.
20 D I A B E T E S

Green Drinks
I use the term green drinks to refer to green tea and a number of commercially available products containing dehydrated barley grass, wheat grass, or algae sources such as chorella or spirulina. Such formulas are rehydrated by mixing with water or juice. These productspacked full of phytochemicals like carotenes and chlorophyllare more convenient than trying to sprout and grow your own source of greens. An added advantage is that they tend to taste better than, for example, straight wheatgrass juice. Green foods such as young barley grass, wheat grass, spirulina, and chlorella are exceptionally high in nutritional value. Given their rich source of antioxidants, they are very important supplements for the diabetic. In addition, they may help improve blood sugar control based upon the results of a study with spirulina. In the study, two months of spirulina supplementation (2 g/day) produced a 27 percent decline in fasting blood glucose and a 34 percent reduction in the A1C levels, clearly indicating improvements in long-term blood sugar regulation. Triglycerides declined by 22 percent and total cholesterol dropped 11 percent. In another study, 36 type 2 diabetic patients received one of the following supplements daily for four weeks: 15 g barley leaf extract, 200 mg vitamin C and 200 mg vitamin E, or barley leaf plus vitamins C and E. The results indicated that the ingestion of the barley leaf extract along with the vitamins produced the greatest antioxidant protection compared to either barley leaf extract or vitamins C and E alone. Antioxidant protection was measured by looking at the effect that the supplements had on protecting different fractions of LDL cholesterol from oxidative damage. I recommend drinking one to two servings of a green drink daily. Try to consume these drinks 20 minutes before or two hours following a meal.

Flavonoid-Rich Extracts
One of the most important natural compounds to fight the complications of diabetes are flavonoids, a group of plant pigments responsible for many of the colors of fruits, flowers, and medicinal herbs. Flavonoids are sometimes called natures biological response modifiers because of their anti-inflammatory, antiallergic, antiviral, and anticancer properties. Recent research suggests that flavonoids may be useful in treating diabetes as well as in preventing long-term complications. The beneficial effects of flavonoids are numerous including the fact that, as antioxidants, flavonoids are generally more potent and effective against a broader range of oxidants than the traditional antioxidant nutrients vitamins C and E, beta-carotene, selenium, and zinc. Other beneficial
D I A B E T E S 21

Flavonoid-rich extract Bilberry extract (25% anthocyanidins) Ginkgo biloba extract (24% ginkgo flavonglyco sides) Grape seed extract or pine bark extract (95% procyanidolic oligomers)

Daily dose 160 to 320 mg 120 to 240 mg

Indication Best choice in diabetic retinopathy or cataracts. Best choice for most people over the age of 50. Protects brain and vascular lining. Very important in improving blood flow to the extremities, neuropathy, and foot ulcers. Systemic antioxidant; best choice for most people under age 50 especially if retinopathy, high blood pressure, easy bruising, and poor wound healing. Also specific for the lungs, varicose veins, and protection against heart disease. Best choice in the early stage of type 1 diabetes or if there is a family history of cancer. Best choice in heart disease or high blood pressure. Best choice if showing signs of impaired liver function. Least expensive choice, but may not provide the same level of benefit. Useful if no complication is present. Good choice if allergies, symptoms of prostate enlargement, bladder irritation, or eczema are also present.

150 to 300 mg

Green tea extract (60-70% total polyphenols) Hawthorn extract (10% procyanidins) Milk thistle extract (70%silymarin) Mixed citrus flavonoids

150 to 300 mg

150-300 mg 100 to 300 mg 1,000 to 2,000 mg

Quercetin

150 to 300 mg

22

D I A B E T E S

effects include increasing intracellular vitamin C levels, decreasing the leakiness and breakage of small blood vessels, preventing easy bruising, promoting wound healing, and providing immune system support. Good dietary sources of flavonoids include citrus fruits, berries, onions, parsley, legumes, green tea, and red wine. In individuals with diabetes that are already showing signs of long-term complications, it is extremely important to take a flavonoid-rich extract. Because certain flavonoids concentrate in specific tissues, it is possible to take flavonoids that target specific body tissue. For example, because the flavonoids of bilberry (Vaccinium myrtillus) have an affinity for the eye including the retina it is probably the best choice in a diabetic already exhibiting signs of diabetic retinopathy. Identify which flavonoid or flavonoid-rich extract is most appropriate for you and take it according to the recommended dosage.

Final Comments
Knowledge and awareness are the greatest allies for people with diabetes. A diabetic who makes a strong commitment to learn about their conditionand who accepts the lead role in a carefully supervised monitoring programgreatly improves the likelihood that they will lead a long and healthy life. On the other hand, individuals who remain ignorant about their disease and who refuse to undergo regular testing or self monitoring are far more likely to face years of unnecessary suffering and, more often than not, catastrophic health problems. Utilizing the nutritional guidelines provided in this booklet may lead to definite improvements in blood sugar control. These improvements will subsequently be demonstrated by the results of monitoring tests, especially self-monitored blood sugar levels. At the present time, individuals with type 1 diabetes absolutely require conventional treatment with the hormone insulin. I consider this approach consistent with natural medicineafter all, the goal is simply to provide the body with a critical natural hormone. When using PGX or any of the other nutritional recommendations given in this booklet, type1 diabetics will need to work closely with their physician and adjust insulin dosages accordingly. In individuals with type 2 diabetes, when blood sugar levels cannot be controlled satisfactorily with weight loss, exercise and diet therapy, oral antihyperglycemic agents or insulin are utilized for additional support. The type 2 individual will need to work with their physician in adjusting the dosage of any medications. The ultimate goal in type 2 diabetes, however, is to achieve satisfactory blood sugar control without the aid of drugs.
D I A B E T E S 23

Appendix

Glycemic Index, Glycemic Load, And Fiber Content of Selected Foods

O
Food

ne key strategy for losing weight and improving blood sugar control is to choose carbohydrates wisely and to consume modest portion sizes. Two tools to help you in this goal are the glycemic index and glycemic load (see page 8 for more information). It is recommended that you keep the glycemic load for any three hour period less than 20. Another useful goal is to consume 35 grams of dietary fiber from foods each day.
Glycemic Glycemic Load Index 1.6 2 4.2 4.8 5.1 5.3 cup cooked, 85 g 5.4 5.7 5.8 6.3 6.7 7.1 8 10 10 4 4.5 6 6 7
1/2 1/2

Fiber grams 7 2 6 7.3 4.7 3.7 4.5 7 6.7 5 7.3 6 4.7 8.8 5 1.4 1.5 0.4 1.4 0.4

BEANS (LEGUMES) Soybeans, cooked, 1/2 cup, 100 g Peas, Green, fresh, frozen, boiled, 1/2 cup, 80 g White navy beans, boiled, 1/2 cup, 90 g Kidney beans, boiled, 1/2 cup, 90 g Peas, Split, yellow, boiled, 1/2 cup, 90 g Lentils, 1/2 cup, 100g Lima beans, baby,
1/2

14 48 38 27 32 28 32 45 45 42 52 79 22 48 42 43 31 48 53 73

Black beans, canned, 1/2 cup, 95 g Pinto beans, canned, 1/2 cup, 95 g Chickpeas, canned, drained, 1/2 cup, 95 g Kidney beans, canned and drained, Broad, frozen, boiled, 1/2 cup, 80 g Peas, Dried, boiled, 1/2 cup, 70 g Baked beans, canned in tomato sauce, 1/2 cup, 120 g Blackeyed beans, soaked, boiled, BREAD Multi-grain, unsweetened, 1 slice, 30 g Oat Bran & Honey Loaf, 1 slice, 40 g Sourdough, rye, 1 slice, 30 g Stoneground wholewheat, 1 slice, 30 g Wonder, enriched white Bread 1 slice, 20 g cup, 120 g cup, 95 g

24

D I A B E T E S

Food Sourdough, wheat, 1 slice, 30 g Pumpernickel, 1 slice, 60 g Wholewheat, 1 slice, 35 g Healthy Choice, hearty 7-grain, 1 slice, 38 g White (wheat flour), 1 slice, 30 g Healthy Choice, 100% whole grain, 1 slice, 38 g Gluten-free multigrain, 1 slice, 35 g French baguette, 30 g Hamburger bun, 1 50 g Rye, 1 slice, 50 g Light rye, 1 slice, 50 g Dark rye, Black, 1 slice, 50 g Croissant, 1, 50 g Kaiser roll, 1 roll, 50 g Pita, 1, 65 g Bagel, 1, 70 g BREAKFAST CEREALS Oat bran, raw, 1 tablespoon, 10 g Bran with psyllium, 1/3 cup, 30 g Bran, 1/3 cup, 30 g All-Bran Soy n Fiber, 1/2 cup, 45 g All-Bran, 1/2 cup, 40 g Oatmeal (cooked with water), 1 cup, 245 g Shredded wheat,
1/3

Glycemic Glycemic Load Index 7.5 8.6 9.6 10 10.5 11 12 14 15 15 16 16 18 18 22 25 4 5.6 8 8.5 9.2 10 12 12 13 13 15 15 15 15 16 16.7 17 17.6 18 18 54 41 69 56 70 62 79 95 61 65 68 76 67 73 57 72 55 47 58 33 42 42 67 58 39 69 74 55 75 56 72 76 71 80 74 72

Fiber grams 0.4 0.5 1.4 1.4 0.4 1.4 1.8 0.4 0.5 0.4 0.4 0.4 0.2 0.4 0.4 0.4 1 12.5 14 7 6.5. 1.6 1.2 4.4 6 2 2 1 1 1 2 2 2 2 2 2

cup, 25 g

Mini Wheats (whole wheat), 1 cup, 30 g All-Bran Fruit n Oats, 1/2 cup, 45 g Weet-Bix, 2 Biscuits, 30 g Cheerios,
1/2

cup, 30 g

Frosties, 3/4 cup, 30 g Corn Bran, 1/2 cup, 30 g Honey Smacks, 3/4 cup, 30 g Wheatbites, 1 cup, 30 g Total, 3/4 cup, 30 g Mini Wheats (blackcurrant) 1 cup, 30 g Puffed wheat, 1 cup, 30 g Bran Flakes,
3/4

cup, 30 g

Crunchy Nut Cornflakes (Kelloggs) , 1 cup, 30 g

D I A B E T E S

25

Food Froot Loops, 1 cup, 30 g Coco Pops,

3/4

Glycemic Glycemic Load Index 18 20 20.5 20.75 21.6 21.8 22 22 22.6 23.5 24 25.5 33.3 11.5 14.7 19 20.5 21.6 22.6 24.4 25 35.75 83 7.8 9.2 9.4 11 11.4 12.5 14 16 17 69 77 82 83 60 84 82 89 87 62 77 73 71 67 46 73 38 47 54 42 87 65 92 87 71 67 69 67 74 78 74 82 cup, 30 g

Fiber grams 1 1 1 1 2 0.3 0.3 1 1 2 2 4 2 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 3 2 3 1 0 0 1.4 0.4

Team, 1 cup, 30 g Corn Chex, 1 cup, 30 g Just Right, 3/4 cup, 30 g Corn Flakes, 1 cup, 30 g Rice Krispies, 1 cup, 30 g Rice Chex, 1 cup, 30 g Crispix, 1 cup, 30 g Just Right Just Grains, 1 cup, 45 g Oat n Honey Bake, 1 cup, 45 g Raisin Bran, 1 cup, 45 g Grape Nuts, 1/2 cup, 58 g CAKE Cake, Angel food, 1 slice, 30 g Cake, Sponge Cake, 1 slice, 60 g Cake, CupCake, with icing & cream filling, 1 cake, 38 g Cake, Chocolate fudge, mix, (Betty Crocker), 1 slice cake, 73 g cake + 33 g frosting Cake, Banana Cake, 1 slice, 80 g Cake, Pound Cake, 1 slice, 80 g Cake, French vanilla, (Betty Crocker), 1 slice cake, 73 g + 33 g cake frosting Cake, Lamingtons, 1 slice, 50 g Cake, Flan, 1 slice, 80 g Cake, Scones, made from packet mix, 1 scone, 40 g CRACKERS Crackers, Corn Thins, puffed corn cake, 2, 12 g Crackers, Kavli, 4, 20 g Crackers, Breton wheat crackers, 6, 25 g Crackers, Ryvita or Wasa, 2, 20 g Crackers, Stoned Wheat Thins, 5, 25 g Crackers, Premium soda crackers, 3, 25 g Crackers, Water crackers, 5, 25 g Crackers, Graham, 1, 30 g Crackers, rice cake, 2, 25 g

26

D I A B E T E S

Food FRUIT Cherries, 20 cherries, 80 g Plums, 3-4 small, 100 g Peach, fresh, 1 large, 110 g Apricots, fresh, 3 medium, 100 g Apricots, dried, 5-6 pieces, 30 g Kiwi, 1 raw, peeled, 80 g Orange, 1 medium, 130 g Peaches, canned, natural juice, 1/2 cup, 125 g Pears, canned in pear juice, 1/2 cup, 125 g Watermelon, 1 cup, 150 g Pineapple, fresh, 2 slices, 125 g Apple, 1 medium, 150 g Grapes, green, 1 cup, 100 g Apple, dried, 30g Prunes, pitted, 6 prunes, 40 g Pear, fresh, 1 medium, 150 g Fruit cocktail, canned in natural juice, 1/2 cup, 125 g Apricots, canned, light syrup, 1/2 cup, 125 g Peaches, canned, light syrup, 1/2 cup, 125 g Mango, 1 small, 150 g Figs, dried, tenderized (water added), 50 g Sultanas,
1/4

Glycemic Glycemic Load Index 2.2 2.7 3 4 4 4 4.4 4.5 5.5 5.7 6.6 6.8 6.9 6.9 7.25 8 8.25 8.3 9.4 10.4 13.4 16.8 17.6 18 27.8 0.57 4.25 8.52 10.6 16 18 26 29 29 30 22 39 42 57 31 52 44 38 43 72 66 38 46 29 29 38 55 64 52 55 61 56 55 64 103 19 25 71 48 50 65 72 69 58 54

Fiber grams 2.4 2.2 1.9 1.9 2.2 2.4 2.6 1.5 1.5 1 2.8 3.5 2.4 3.0 3.0 3.1 1.5 1.5 1.5 2.0 3.0 3.1 2.4 3.1 3.0 1 6 1 3.5 1 1 0.2 0.2 0.2 3.5

cup, 40 g

Banana, raw, 1 medium, 150 g Raisins, 1/4 cup, 40 g Dates, dried, 5, 40 g GRAINS Rice bran, extruded, 1 tablespoon, 10 g Barley, pearled, boiled, 1/2 cup, 80 g Millet, cooked, 1/2 cup, 120 g Bulgur, cooked, 2/3 cup, 120 g Brown rice, steamed, 1 cup, 150 g Couscous, cooked, 2/3 cup, 120 g Rice, white, boiled, 1 cup, 150 g Rice, Arborio risotto rice, white, boiled, 100 g Rice, Basmati, white, boiled, 1 cup, 180 g Buckwheat, cooked, 1/2 cup, 80 g

D I A B E T E S

27

Food Rice, Instant, cooked, 1 cup, 180 g Tapioca (steamed 1 hour), 1 cup, 100 g Tapioca (boiled with milk), 1 cup, 265 g Rice, Jasmine, white, long grain, steamed, 1 cup, 180 g ICE CREAM Ice cream, low-fat French vanilla, 2 scoops, 50 g Ice cream, full fat, 2 scoops, 50 g JAM Jam, no sugar, 1 tablespoon, 25 g Jam, sweetened, 1 tablespoon, 25 g MILK, SOY MILK, AND JUICES Milk, full fat, 1 cup, 250 ml Soy milk, 1 cup, 250 ml Milk, skim, 1 cup, 250 ml Grapefruit juice, unsweetened, 1 cup, 250 ml Nesquik chocolate powder, 3 teaspoon in 250 ml milk Milk, chocolate flavored, lowfat, 1 cup, 250 ml Orange juice, 1 cup, 250 ml Gatorade, 1 cup, 250 ml Pineapple juice, unsweetened, canned, 250 mL Apple juice, unsweetened, 1 cup, 250 ml Cranberry juice cocktail, 240 mL Coca Cola, 12 oz, 375 ml Soft drinks, 12 oz, 375 ml Milk, sweetened condensed, 1/2 cup, 160 g MUFFINS AND PANCAKES Muffins, Chocolate, butterscotch, 1 muffin, 50 g Muffins, Apple, oat and sultana, 1 muffin, 50 g Muffins, Apricot, coconut and honey, 1 muffin, 50 g Muffins, Banana, oat and honey, 1 muffin, 50 g Muffins, Apple, 1 muffin, 80 g Muffins, Bran, 1 muffin, 80 g Muffins, Blueberry, 1 muffin, 80 g Pancake, buckwheat, 1 medium, 40 g Pancake, enriched wheat, 1 large, 80 g

Glycemic Glycemic Load Index 33 38 41 42.5 5.7 6.1 6 8 3 3.7 4 7.7 7.7 7.8 9.7 11.7 12.4 13.2 23 25.2 34.7 55 15 15 16 18 19 20 24 30 39 87 70 81 109 38 61 55 48 27 31 32 48 55 34 46 78 46 40 68 63 68 61 53 54 60 65 44 60 59 102 67

Fiber grams 0.2 <1 <1 0.2 0 0 <1 <1 0 0 0 1 0 0 1 0 1 1 0 0 0 0 1 1 1.5 1.5 1.5 2.5 1,5 2 1

28

D I A B E T E S

Food PASTA Pasta, Tortellini, cheese, cooked, 1 cup 180 g Pasta, Ravioli, meat-filled, cooked, 1 cup, 220 g Pasta, Vermicelli, cooked, 1 cup, 180 g Pasta, Rice noodles, fresh, boiled, 1 cup, 176 g Pasta, Spaghetti, wholemeal, cooked, 1 cup, 180 g Pasta, Fettucini, cooked, 1 cup, 180 g Pasta, Spaghetti, gluten-free in tomato sauce, 1 cup, 220 g Pasta, Macaroni and cheese, packaged, cooked, 1cup, 220 g Pasta, Star Pastina, cooked, 1 cup, 180 g Pasta, Spaghetti, white, cooked, 1 cup, 180 g Pasta, Rice pasta, brown, cooked, 1 cup, 180 g SUGARS Fructose, 2 teaspoons, 10 g Honey, 1/2 tablespoon, 10 g Lactose, 2 teaspoons, 10 g Sucrose, 2 teaspoons, 10 g Glucose, 2 teaspoons, 10 g Maltose, 2 teaspoons, 10 g SNACKS Corn chips, Doritos original, 50 g Snickers, 59 g Tofu Frozen Dessert (non-dairy), 100 g Real Fruit bars, strawberry, 20 g Twix cookie bar (caramel), 59 g Pretzels, 50 g Mars Bar, 60 g Skittles, 62 g SOUPS Tomato, canned, 1 cup, 220 ml Black bean, 1 cup, 220 ml Lentil, canned, 1 cup, 220 ml Split pea, canned, 1 cup, 220 ml

Glycemic Glycemic Load Index 10.5 11.7 15.7 17.6 17.75 18.2 18.5 19.2 21 23 52 2.3 4.6 4.6 6.5 10.2 10.5 13.9 14.3 15 15.3 16.2 18.3 26.6 38.5 6 6 6 8 50 39 35 40 37 32 68 64 38 41 92 23 58 46 65 102 105 42 41 115 90 44 83 65 70 38 64 44 60

Fiber grams 2 2 2 0.4 3.5 2 2 2 2 2 2 0 0 0 0 0 0 <1 0 <1 <1 <1 <1 0 0 1.5 3.4 3 3

D I A B E T E S

29

Food VEGETABLES Carrots, raw, 1/2 cup, 80 g Low glycemic vegetables: Asparagus, 1 cup cooked or raw Bell Peppers, , 1 cup cooked or raw Broccoli, 1 cup cooked or raw Brussels sprouts, 1 cup cooked or raw Cabbage, 1 cup cooked or raw Cauliflower, 1 cup cooked or raw Celery, 1 cup cooked or raw Cucumber, 1 cup Eggplant, 1 cup cooked Green beans, 1 cup cooked or raw Kale, 1 cup cooked, 2 cups raw Lettuce, 2 cups raw Mushrooms, 1 cup, cooked or raw Spinach, 1 cup cooked, 2 cups raw Tomatoes, 1 cup, cooked or raw Zucchini, 1 cup cooked or raw Carrots, peeled, boiled, 1/2 cup, 70 g Beets, canned, drained, 2-3 slices, 60 g Pumpkin, peeled, boiled, 1/2 cup, 85 g Parsnips, boiled, 1/2 cup, 75 g Sweet corn on the cob, boiled 20 min, 1 medium, 80 g Corn, canned and drained, 1/2 cup, 80 g Sweet potato, peeled, boiled, 1 medium, 80 g Sweet corn, 1/2 cup boiled, 80 g Potatoes, peeled, boiled, 1 medium, 120 g Potatoes, with skin, boiled, 1 medium, 120 g Yam, boiled, 1 medium, 80 g Potatoes, baked in oven (no fat), 1 medium, 120 g Potatoes, mashed, 1/2 cup, 120 g Potatoes, Instant potato, prepared, 1/2 cup, 120 g Potatoes, new, unpeeled, boiled, 5 small (cocktail), 175 g Cornmeal (polenta), 1/3 cup, 40 g Potatoes, French fries, fine cut, 1/2 cup, 120g Gnocchi, cooked, 1 cup, 145 g YOGURT Yogurt, lowfat, artificial sweetener, 1 cup, 200 g Yogurt, with fruit, 1 cup, 200 g Yogurt, lowfat, 1 cup 200 g

Glycemic Glycemic Load Index 1 16

Fiber grams 1.5

1.4

20

1.5

1.5 3 4.5 8 8 8.5 8.6 10 10 11 13 14 14 15 20 20 36 48 2 8 8.5

49 64 75 97 48 55 54 55 87 79 51 93 91 83 78 68 75 68 14 26 33

1.5 1 3.4 3 2.9 3 3.4 3 1.4 2.4 3.4 2.4 1 1 2 2 1 1 0 0 0

30

D I A B E T E S

Selected References
Alarcon de la Lastra C, et al. Mediterranean diet and health: biological importance of olive oil. Current Pharmaceutical Design. 7:933-50. 2001. Althuis MD, et al. Glucose and insulin responses to dietary chromium supplements: a meta-analysis. American Journal of Clinical Nutrition 76:148-55. 2002. Andallu B, et al. Effect of mulberry (Morus indica L.) therapy on plasma and erythrocyte membrane lipids in patients with type 2 diabetes. Clinica Chimica Acta;.314:47-53. 2001. Barbagallo M, et al. Role of magnesium in insulin action, diabetes and cardio-metabolic syndrome X. Molecular Aspects of Medicine. 24:39-52. 2003. Barringer T, et al. Effects of a multivitamin and mineral supplement on infection and quality of life. Annals of Internal Medicine. 138:365-71. 2003. Brynes AE, et al. A low glycemic diet significantly improves the 24-h blood glucose profile in people with type 2 diabetes, as assessed using the continuous glucose MiniMed monitor. Diabetes Care. 26:548-9. 2003. Carabin IG, et al. Supplementation of the diet with the functional fiber PolyGlycoplex is well tolerated by healthy subjects in a clinical trial. Nutrition Journal. 8:9. Feb 5, 2009. Chandalia M, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. New England Journal of Medicine. 342:1392-8. 2000. Guilherme A, et al. Adipocyte dysfunctions linking obesity to insulin resistance and type 2 diabetes. Nature Reviews: Molecular Cell Biology. 9:367-77. May 2008.. Heitzer T, et al. Beneficial effects of alpha-lipoic acid and ascorbic acid on endotheliumdependent, nitric oxide-mediated vasodilation in diabetic patients: relation to parameters of oxidative stress. Free Radical Biology & Medicine. 31:53-61. 2001. Jenkins DJ, et al. Glycemic index: overview of implications in health and disease. American Journal of Clinical Nutrition. 76(1):266S-73S. Jul 2002. Jenkins DJ, et al. Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Current Opinion in Lipidology. 11:4956. 2000. Jiang R, et al. Nut and peanut butter consumption and risk of type 2 diabetes in women. Journal of the American Medical Association. 288(20):2554-60. 2002. Montori VM, et al. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 23:1407-15. 2000. Nelson KM, et al. Diet and exercise among adults with type 2 diabetes: findings from the third national health and nutrition examination survey (NHANES III). Diabetes Care. 25:1722-8.2002 Ogden CL, et al. Prevalence of overweight and obesity in the United States, 1999-2004. Journal of the American Medical Association. 295(13):1549-55. Apr 5, 2006. Parikh P, et al. Role of spirulina in the control of glycemia and lipidemia in type 2 diabetes mellitus. Journal of Medicinal Food. 4:193-9. 2001.

D I A B E T E S

31

Porchezhian E, et al. An overview on the advances of Gymnema sylvestre: chemistry, pharmacology and patents. Die Pharmazie 58:5-12. 2003. Rader DJ. Effect of insulin resistance, dyslipidemia, and intra-abdominal adiposity on the development of cardiovascular disease and diabetes mellitus. American Journal of Medicine. 120(3 Suppl 1):S12-8. Mar 2007. Rivellese AA, et al. Type of dietary fat and insulin resistance. Annals of the New York Academy of Science. 967:329-35. 2002. Salgueiro MJ, et al. Zinc and diabetes mellitus: is there a need of zinc supplementation in diabetes mellitus patients? Biological Trace Element Research.; 81:215-28. 2001. Skyrme-Jones RA, et al. Vitamin E supplementation improves endothelial function in type I diabetes mellitus: a randomized, placebo-controlled study. Journal of the American College of Cardiology. 36:94-102. 2000. Tschritter O, et al. Plasma adiponectin concentrations predict insulin sensitivity of both glucose and lipid metabolism. Diabetes. 52(2):239-43. 2003. Vuksan V, et al. Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care. 23:9-14. 2000. Vuksan V, et al. Viscosity of fiber preloads affects food intake in adolescents. Nutrition, Metabolism and Cardiovascular Disease. 2009 Jan 20 Willett W, et al. Glycemic index, glycemic load, and risk of type 2 diabetes. American Journal of Clinical Nutrition. 76:274S-80S. 2002. Woodman RJ, et al. Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension. American Journal of Clinical Nutrition. 76:1007-15. 2002. Yu YM, et al. Effects of young barley leaf extract and antioxidative vitamins on LDL oxidation and free radical scavenging activities in type 2 diabetes. Diabetes & Metabolism. 28:107-14. 2002.

For more references on this information refer to Dr. Murrays most recent books:
What The Drug Companies Wont Tell You And Your Doctor Doesnt Know and Hunger Free Forever.

For more information about the author of this booklet, visit

www.doctormurray.com.

32

D I A B E T E S

What the Drug Companies Wont Tell You and Your Doctor Doesnt Know
Book by Michael T. Murray, N.D.
From one of todays leading authorities on natural medicine comes a provocative look into how the pharmaceutical and medical industries have created our current health crisis and a practical guide to the holistic treatments that may help you and your loved ones. Modern medicine offers many wonders, but an ever-present reliance on medications to cure what ails us is at the core of Americas health crisis. What the Drug Companies Wont Tell You and Your Doctor Doesnt Know offers a close look at the way the American healthcare system has evolved in the last fifty years and examines the roles of the FDA, the pharmaceutical monopolies and the medical community in producing what has become a failing healthcare system with little accountability. Dr. Murray illustrates how a nationwide dependence on pills has hobbled health in America and resulted in a national wellness epidemic as lifestyle, ignorance and politics collide in our medicine cabinets. Both a call to arms and a practical guide to the natural treatments that could revolutionize both your health and the well-being of the entire nation, What the Drug Companies Wont Tell You and Your Doctor Doesnt Know provides clear guidance on the steps needed to help you lead a fitter, happier and healthier life. Fully documented and referenced with an extensive bibliography and a 40 page Appendix on healthful products.

DIABETES
DOCTOR-RECOMMENDED FOUR-PART PLAN

magazine presents

n this booklet, one of the worlds leading authorities on natural medicine provides an effective plan for people who have been diagnosed with diabetes or those who are at high risk. Dr. Michael Murray outlines his program, which is designed to accomplish four key goals: Reduce after meal elevations of blood sugar; gain optimal nutrient status; improve insulin function and sensitivity; and prevent nutritional and oxidative stress. By accomplishing these goals, people can improve their health while helping to prevent the serious complications associated with diabetes. Descriptions of key nutrients are provided, as well as practical dietary and lifestyle advice.

ABOUT THE AUTHOR OF THIS BOOKLET

Michael T. Murray, ND, is President and CEO of Dr. Murray Natural Living and is Director of Product Development and Education for Natural Factors, a major manufacturer of nutritional and herbal supplements. Dr. Murray is a former faculty member and serves on the Board of Regents of Bastyr University, where he received his doctorate in Naturopathic Medicine. He is co-author of How to Prevent and Treat Diabetes with Natural Medicine. He has also written over 25 other books including The Encyclopedia of Healing Foods and What the Drug Companies Wont Tell You and Your Doctor Doesnt Know.

What the Drug Companies Wont Tell You and Your Doctor Doesnt Know
Book by Michael T. Murray, N.D.
I S B N 978-1-935297-25-3

From one of todays leading authorities on natural medicine a 5 0comes 495 provocative look into how the pharmaceutical and medical industries have created our current health crisis and a practical guide to the holistic treatments that may help you and your loved ones. Modern medicine offers many wonders, but an ever-present reliance on
betternutrition.com
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