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May 1, 2009 – Evolving Appetites

Welcome to Evolving Appetites’ monthly newsletter. Short, informative and hopefully fun to read veggie bits. Let us know if we don’t deliver on this – we always love feedback from our readers. Contact info is at the bottom of the page.

In this issue:

• Veg health: Type 2 Diabetes - 100% preventable & reversible!
• Veg Heroes – Dr. Neal Barnard
• Recipe(s) of the month: Chilled Avocado Soup (Raw)
• EVENTS update

Veg Health – Type 2 Diabetes - 100% preventable & reversible

Type II Diabetes is crippling our health care system and contributing to the suffering of millions of people unnecessarily. If you missed my talk on April 28 at The Big Carrot, here’s a summary of what type II diabetes is, and how you can prevent it, or if you’ve been diagnosed, how you can reverse it.

More than 2 million Canadians have diabetes - 90% of them have type 2, an entirely preventable (and reversible) disease. This is expected to reach 3 million by 2010. It’s also the world’s 4^th leading cause of death.

The personal costs of diabetes may include a reduced quality of life and the increased likelihood of complications such as heart disease, stroke, kidney disease, blindness, amputation and erectile dysfunction.

• Approximately 80% of people with diabetes will die as a result of heart disease or stroke.
• Diabetes is a contributing factor in the deaths of approximately 41,500 Canadians each year.
• Canadian adults with diabetes are twice as likely to die prematurely, compared to people without diabetes.
• Life expectancy for people with type 1 diabetes may be shortened by as much as 15 years. Life expectancy for people with type 2 diabetes may be shortened by 5 to 10 years.

The financial burden of diabetes and its complications are enormous.

• People with diabetes incur medical costs that are two to three times higher than those without diabetes. A person with diabetes can face direct costs for medication and supplies ranging from $1,000 to $15,000 a year.
• By 2010, it’s estimated that diabetes will cost the Canadian healthcare system $15.6 billion a year and that number will rise to $19.2 billion by 2020.

Risk factors:

• Age - over 40
• Overweight
• High cholesterol
• High blood pressure
• A member of a high-risk group (Aboriginal, Hispanic, Asian, South Asian or African descent), you're at risk of developing type 2 diabetes

But first, what exactly is diabetes?

Diabetes is often misunderstood. People often jump to conclusions thinking it’s all about eating too much sugar and carbs. That’s only partially true. And we’ll get into the details of sugar and carbs a bit later. And we’ll distinguish between type 1 and type 2.

Unlike people with type 2, type 1 diabetics always need insulin. But they can use diet and lifestyle changes to keep doses to a minimum and reduce the risk of complications.

Symptoms:

It is important to recognize that many people who have type 2 diabetes may display no symptoms.

• Unusual thirst
• Frequent urination
• Weight change (gain or loss)
• Extreme fatigue or lack of energy
• Blurred vision
• Frequent or recurring infections
• Cuts and bruises that are slow to heal
• Tingling or numbness in the hands or feet
• Trouble getting or maintaining an erection

Here’s what’s going on: the fundamental problem is that sugar is not able to pass from your bloodstream into the cells of your body. From that single problem come a great many others.

The sugar we’re speaking of is glucose – one of the smallest and simplest sugar molecules. In this case, sugar is not just another word for junk food or empty calories. The cells of your body use this kind of sugar – glucose – as an energy source. Like gasoline for your car, glucose is your body’s fuel. It powers your movements, your thoughts and pretty much everything you do.

And that’s the problem – if the glucose is unable to enter your cells, they are deprived of their basic fuel, so you lose your energy. That is why you’re fatigued. If your muscles do not have the glucose they need for power, you get tired easily.

Meanwhile, the glucose that cannot get into your muscle cells builds up in your bloodstream. It becomes more and more concentrated in the blood, and eventually it starts to pass through the kidneys and ends up in your urine. And this is type 2 diabetes.

Now as glucose passes through your kidneys, it carries water along with it – lots of water, hence the frequent urination. What follows, naturally, is thirst – you are losing all those fluids. So fatigue, frequent urination and thirst are all symptoms of one problem – glucose having trouble getting into your cells. You may also lose weight – but this time, it’s not in a good way. You lose weight because your cells are in essence starving. Nutrients cannot enter your cells, so your body is malnourished.

Over the long run, these problems can escalate to cause damage to nerves, eyes, kidneys and other parts of your body.

Diagnosis
Diabetes is diagnosed if you have the above symptoms and your blood glucose level is 11.1 millimoles per litre (mmol/l) or higher, regardless of the time of day or whether you are fasting, or

Your blood glucose level is 7.0 mmol/l or higher after an 8-hour fast.

Normal fasting blood glucose is less than 5.6 mmol/l. After a 2-hour glucose tolerance test, the value should be less than 7.8 mmol/l. If your values are above normal, but not high enough for a diagnosis of diabetes, your doctor will diagnose pre-diabetes (impaired glucose tolerance), which often precedes an eventual diabetes diagnosis.

A diagnosis of diabetes (or pre-diabetes) means the insulin in your body is not doing its job adequately. Insulin is a hormone that moves sugar from your bloodstream into the cells of your body, among other functions. It acts like a key, opening a door to the cell and allowing nutrients inside. When insulin arrives at the cell’s surface and opens the door, glucose is able to enter the cell, which uses it for power.

If for some reason your body is not making insulin, the result is raised blood glucose levels. Similarly, your blood glucose rises if your cells resist insulin’s actions – the key goes in the lock, but the door will not open.

Types of diabetes

There are 3 main types of diabetes: type 1, type 2 and gestational diabetes.

Type 1: usually manifests in childhood or young adulthood. Something has damaged the pancreas’s ability to produce insulin, and you need to get it from an outside source, typically by injection. However, implementing diet changes can dramatically reduce the risk of complications. The damage to the insulin-producing cells is caused by the biological equivalent of “friendly fire”. i.e. caused by the body’s immune system – the white blood cells attack the cells of the pancreas, destroying it is ability to produce insulin.

Type 2: Most people with this form still produce insulin, but their cells resist it. Diabetes drugs are designed to counteract this problem – some make your cells more responsive to insulin. Others cause your pancreas to release more insulin into the bloodstream or block your liver from sending extra glucose into the blood.

Gestational – similar to type 2, but occurs during pregnancy.

Reversing the disease (or preventing it from ever taking hold)

Until now, most diabetes diets have tried to compensate for the cells’ resistance to insulin’s action too. They limit the amount of sugar in your diet. They also limit starch (complex carbohydrate) because starch is actually made from many glucose molecules joined together in a chain.

New research has changed everything. We can now use diet changes to influence insulin sensitivity directly.

Best way to tell how you’re doing over long run is with a test called hemoglobin A1c or A1c for short. (Blood glucose indicates only how you are doing at the time you take the test.) A1c measures how much glucose has entered your red blood cells and become stuck to hemoglobin. Since red blood cells have a fairly short life span (about 4 months), the test indicates how well your blood sugar has been controlled over the preceding 3 months. ADA recommends A1c levels below 7%. Research shows however, that lower values cut the risk of complications, so many experts now call for targets of 6.5% or even 6%.

Carbohydrates do not cause diabetes – the problem lies in how your body processes them. When carbohydrates break down into glucose, your body’s main fuel, insulin helps it get inside the cell. But fat inside your cells prevents insulin from doing its job (as discussed earlier). Diabetes is the result. So it’s not the carbs that are doing the damage – it’s the fat.

Fat inside cells is different than fat around your waist – even if you’re slim, you may be accumulating fat within your muscle cells. The fat inside your cells is not a permanent fixture – when the influx stops, the fat inside the cells dissipates, and when that happens, the cells start to regain their normal function. Here’s how to achieve that:

• Set aside animal products (both for fat and animal protein, which can damage kidneys)
• Keep vegetable oils to a minimum (including olive oil!)
• Favour foods with a low glycemic index

Efficacy of these diet changes in studies by Dr. Barnard et al show that a vegan diet controls blood sugar three times more effectively than the previous “best” diet (i.e. the American Diabetes Association guidelines – using exchange lists). The study also demonstrated that a vegan diet is much easier to follow and stick to than the ADA guidelines. In the next issue, we’ll follow up with “Foods to Avoid” & “Foods to Include” charts.

NOTE: Before making any dietary changes, consult your doctor or other health care practitioner – make sure they fully understand what you’re doing, so they can work with you to adjust your medication dosages as the changes start to occur. Dietary changes outlined above can cause a drop in blood sugar (hypoglycemia) within 2 weeks – the effects are dramatic. Your health care practitioner MUST help you navigate these changes in a safe manner.

Evolving Appetites and its owner accept no liability for any injury arising out of the use of material contained herein, and make no warranty, express or implied, with respect to the contents of this publication.

Veg Heroes - Dr. Neal Barnard - Founder/President of PCRM

From time to time, we’ll feature a person who has played a significant role in helping us understand the connection between diet and disease, or the connection between our food choices and the environment, or both. I hope their stories will inspire you to make a change, or if you’re already living a plant-based lifestyle, that you’ll be moved to help others do the same. For as long as 96% of North Americans are still consuming a largely meat-centered diet, we have lots of work to do. While these heroes are doing an outstanding job of educating, informing and inspiring, they need our help and support to advance their work. We can all play a role in dispelling myths and being living examples of their teachings.

This month’s veggie hero is Dr. Neal Barnard – founder and president of the Physicians Committee for Responsible Medicine (www.pcrm.org). He is the author of more than 14 books, including the one on diabetes mentioned above, as well as hundreds of research papers published in such prestigious medical journals such as Lancet Oncology and American Journal of Cardiology. He is also editor-in-chief of Nutrition Guide for Clinicians.

He founded PCRM in 1985, an organization of medical, nutrition and lay persons that is dedicated to preventative medicine and alternatives to animal experimentation. He’s also the president of PCRM subsidiaries, The Cancer Project and the Washington Center for Clinical Research.

Dr. Barnard received his M.D. from George Washington University School of Medicine, where he now serves as an adjunct associate professor of medicine. He’s a board certified psychiatrist, who switched careers to focus on nutrition, research and advocacy.

His achievements are too numerous list, but among them is his success in pressuring 85% of US university med schools to drop animal labs, and a large percentage in Canada as well. He continues to pressure the remaining archaic organizations to follow suit, and adopt more humane and effective teaching tools (computer simulation and other high tech devices now readily available).

What amazes and inspires me most is the fact that Dr. Barnard started at the opposite end of the spectrum of veganism. He grew up in Fargo, North Dakota, into a family of cattle ranchers and physicians (his dad is a retired doctor, while uncles and cousins are in the cattle business). When you listen to him describe how his mother collected bacon grease to use for frying eggs, one cannot help but marvel at his current lifestyle (both his parents are now also vegan). He was also a heavy smoker while he was in med school. Yet, through his various life experiences, studies and research, he is now amongst the staunchest advocates of a low fat, high fibre, vegan diet to prevent and reverse disease.

And just in case you think this isn’t quite enough, he’s also a talented musician – he plays electric guitar, keyboards and sings! I have the utmost respect and admiration for this remarkable man.

Chilled Avocado Soup (RAW) – Serves 4

While I patiently wait for warm weather to arrive (we’ve had a few nice days in April, but otherwise, it’s been unseasonably cold and wet in Toronto), I’m gearing up to eat more raw and living foods through the summer. Here’s a very filling, satisfying and nutritious raw recipe that I can eat by the vat.

1/3 English cucumber (don’t need to peel)

Blend all of the above until smooth. Chill and serve.

Events update:

Thursday, May 14

I’ll be participating in the Windfall Ecology Festival again, this year representing both, Evolving Appetites and the Toronto Vegetarian Association. We’ll be doing several cooking demos throughout the weekend of June 13 & 14 at Fairy Lake Park in Newmarket - and it’s all FREE! Hope to see you there.

Next issue: June 1, 2009

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DISCLAIMER: This site does not provide medical advice. This website is for information purposes only. The nutritional information on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please seek the advice of your physician or other qualified health practitioner with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website.

Evolving Appetites and its owner accept no liability for any injury arising out of the use of material contained herein, and make no warranty, express or implied, with respect to the contents of this publication.