5.7 Carbohydrates: Diabetes

5.7 Carbohydrates: Diabetes


– WELCOME TO THE SEVENTH PART
IN OUR SERIES ON CARBOHYDRATES, A SECTION COVERING DIABETES. THE DEFINITION OF DIABETES IS,
A DISORDER IN WHICH BLOOD SUGAR, WHICH IS BLOOD GLUCOSE,
LEVELS ARE ABNORMALLY HIGH. THERE ARE TWO TYPES OF DIABETES,
TYPE 1 AND TYPE 2. AND WE’RE GOING TO GO OVER THE CHARACTERISTICS
OF EACH TYPE. TYPE 1 TYPICALLY
OCCURS IN CHILDHOOD, WHEREAS TYPE 2 TYPICALLY
OCCURS IN ADULTHOOD. BUT THESE ARE ONLY
GENERALIZATIONS. FOR EXAMPLE, JAY CUTLER, THE QUARTERBACK FOR
THE CHICAGO BEARS, DEVELOPED TYPE 1
DIABETES WHILE HE WAS PLAYING
PROFESSIONAL FOOTBALL. AND WE’RE INCREASINGLY
SEEING MORE CHILDREN DEVELOPING
TYPE 2 DIABETES. THE CAUSE OF TYPE
1 DIABETES IS THAT IT IS AN AUTOIMMUNE DISEASE. AND WHAT THAT MEANS IS, THE BODY ENDS UP
ATTACKING ITS OWN ORGANS. AND IN THIS INSTANCE, IT’S THE BETA CELLS
OF THE PANCREAS. IT RECOGNIZES IT AS FOREIGN. FOR SOME REASON IT
THINKS THAT IT’S A BACTERIA OR AN
INVADER IN THE BODY, CREATES AN IMMUNE REACTION
SPECIFICALLY FOR THESE CELLS, DESTROYING THE CELLS SO
THEY CANNOT SECRETE INSULIN. NOW IN TYPE 2, IT’S
MORE MULTIFACTORIAL. THERE ARE MANY FACTORS– OBESITY, ESPECIALLY
ABDOMINAL OBESITY, INSULIN RESISTANCE,
DIET, AND GENETICS. GENETICS DOES PLAY A ROLE, BUT
JUST BECAUSE YOU HAVE DIABETES THAT
RUNS IN YOUR FAMILY, DOESN’T MEAN YOU HAVE TO
DEVELOP DIABETES. BECAUSE YOUR LIFESTYLE
AND DIET AND HOW MUCH YOU WEIGH IS GOING TO BE
A MUCH GREATER FACTOR. IN TYPE 1,
WE LOOK AT THE PANCREAS. THERE IS AUTOIMMUNE DISEASE, THE BETA CELLS OF THE PANCREAS
ARE DESTROYED BY THE BODY. THIS USUALLY HAPPENS
IN EARLY CHILDHOOD, AND THE PANCREAS
CANNOT SECRETE INSULIN. WITH TYPE 2, THE CELLS,
FOR EXAMPLE, THE MUSCLE CELLS,
THE LIVER, OR OTHER CELLS THAT NEED ENERGY,
THEY DON’T RECOGNIZE INSULIN. NOW REMEMBER INSULIN HELPS
BRING GLUCOSE INTO THOSE CELLS. SO USUALLY TOO MUCH IS SECRETED,
INITIALLY, UNTIL THE BETA CELLS IN THE
PANCREAS WEAR OUT AND THEN THEY EVENTUALLY DON’T HAVE
ANY INSULIN LEFT TO SECRETE. BUT THAT’S IN THE LATER
STAGES OF TYPE 2 DIABETES. ABOUT 5-10% OF THE
CASES ARE TYPE 1. SO THAT MEANS MOST OF THE
CASES OF TYPE 2 DIABETES, 90-95% OF DIABETES,
ARE TYPE 2 DIABETES. SO MOST OF THE DIABETES YOU SEE TODAY IS ACQUIRED DIABETES,
TYPE 2. I WANT GO BACK AND REVIEW BLOOD
GLUCOSE REGULATION QUICKLY, SO I CAN EXPLAIN HOW DIFFERENCES BETWEEN TYPE 1 AND
TYPE 2 DIABETES. AND I’M GOING TO START WITH
SOME CARBOHYDRATE-BASED FOOD. AND REMEMBER THAT WHEN YOU EAT
THE CARBOHYDRATE-BASED FOOD, THAT STARCH IS DIGESTED
TO GLUCOSE CHAINS, TO MALTOSE, TO GLUCOSE. SO, WHAT HAPPENS? WE GET A HIGH BLOOD GLUCOSE, INCREASED GLUCOSE
IN THE BLOODSTREAM. THE PANCREAS RESPONDS
BY RELEASING INSULIN, AND INSULIN THEN ASSISTS
THE GLUCOSE INTO THE CELLS. AND I DIDN’T HAVE THIS
IN MY PREVIOUS LECTURE, BUT I DO WANT TO POINT OUT
IN THIS DIAGRAM THAT INSULIN ALSO ASSISTS GLUCOSE
BACK INTO THE LIVER. ALSO IN THE MUSCLE, AND THEN IT WILL HELP US STORE
GLUCOSE AS FAT IN THE FAT CELLS. SO ONCE INSULIN
DOES THAT ACTION, YOU CAN SEE THE GLUCOSE GOES
INTO THESE STORAGE AREAS, AND WHAT DOES THAT DO? THAT LOWERS THE BLOOD GLUCOSE. SO WE GET BACK TO A
NORMALIZED BLOOD GLUCOSE. SO THAT’S NORMALLY HOW
IT’S SUPPOSED TO WORK. SO LET’S LOOK AT
TYPE 1 DIABETES. AGAIN, WE’LL START WITH
A CARBOHYDRATE-BASED FOOD AND IT’S NOT
AS IF WE’RE ALL EATING JUST CARBOHYDRATES OR JUST
PROTEIN OR JUST FAT, BECAUSE THERE IS
SOME PROTEIN IN THE BAGEL THAT I HAVE
DIAGRAMMED HERE. AND I ALSO WANT TO
POINT OUT THAT BOTH FAT AND PROTEIN WILL ALSO
CAUSE A RELEASE OF INSULIN, IT’S JUST THE MOST DRAMATIC
RESPONSE OF INSULIN IN THE BODY IS FROM A REALLY
REFINED CARBOHYDRATE. SO ANY SORT OF FOOD
THAT WE’RE EATING IS GOING TO HAVE SOME RESPONSE. BUT IF WE LOOK AT A
CARBOHYDRATE-BASED FOOD. REMEMBER, THE CARBOHYDRATE
IS BROKEN DOWN, IT ENDS UP HAVING THE GLUCOSE
ABSORBED INTO THE BLOODSTREAM, AND THEN THE PANCREAS IS
SUPPOSED TO RELEASE INSULIN. BUT WHAT HAPPENS
IN TYPE 1 DIABETES? THE INSULIN IS NOT THERE. REMEMBER, IT’S AN
AUTOIMMUNE DISEASE, TYPE 1 IS AN AUTOIMMUNE DISEASE. THE BODY DESTROYS THE BETA
CELLS OF THE PANCREAS, SO NO INSULIN CAN BE RELEASED. SO WHAT DOES THAT MEAN? GRADUALLY, WE DON’T
HAVE ANY INSULIN, AND THAT MEANS THAT NO
INSULIN IS GOING TO BE ASSISTING GLUCOSE INTO
THE LIVER OR THE MUSCLE. AND EVEN A HARDER
TIME IN STORING FAT. SO TYPE 1 DIABETICS ARE
ACTUALLY TYPICALLY FAIRLY LEAN. OKAY, SO WHAT ABOUT
TYPE 2 DIABETES? WELL, TYPE 2 DIABETES
IS GOING TO START WITH INSULIN RESISTANCE. THIS IS THE PRECURSOR
TO THE DISEASE. SO LET’S GO THROUGH THIS AGAIN. WE START WITH OUR FOOD,
CARBOHYDRATE-BASED FOOD, THAT LENDS TO GLUCOSE
INTO THE BLOODSTREAM. NOW WHAT HAPPENS,
NOW NORMALLY, REMEMBER, WE GET THE INSULIN RESPONSE,
AND INSULIN IS GOING TO DRIVE THE GLUCOSE INTO THE
MUSCLE AND TO THE LIVER, AND THEN IT WILL HELP
WITH FAT STORAGE. BUT IN THE INSTANCE
OF INSULIN RESISTANCE, A PREDIABETES STATE, THE CELLS ARE NOT
RECOGNIZING INSULIN. SO IT’S A VERY SLOW
PROCESS FOR THE GLUCOSE TO GET INTO THE LIVER,
OR TO GET INTO THE MUSCLE. THE CELLS ARE
ESSENTIALLY SAYING, “THERE’S TOO MUCH INSULIN,
I DON’T RECOGNIZE IT ANYMORE.” IT’S ALMOST LIKE THE
BOY WHO CRIED WOLF. WE THINK ABOUT SOMEONE
WHO’S CONSTANTLY, YOU KNOW, SCREAMING FOR HELP,
SCREAMING FOR HELP, BUT THEN IT ISN’T A PROBLEM. THE BOY WHO CRIED WOLF,
RIGHT? SO EVENTUALLY YOU
HEAR THAT SCREAM FROM THAT CERTAIN INDIVIDUAL, AND YOU DON’T BELIEVE
HIM ANYMORE, RIGHT? YOU JUST KIND OF IGNORE HIM. IT’S ALMOST LIKE THE CELLS
ARE DOING THE SAME THING. IT’S LIKE BECAUSE THE SUGAR
IS CONSTANTLY SO HIGH, AND THE INSULIN
IS AROUND SO MUCH, THAT THE CELLS AREN’T
RECOGNIZING IT AS MUCH. SO IT’S A VERY SLOW
PROCESS TO BRING IN THE GLUCOSE INTO THE CELLS. NOW WHAT RESULTS IN
THE INITIAL STAGES, IS THAT THE BLOOD SUGAR WILL
ACTUALLY GO BACK TO NORMAL. BUT LOOK HOW MUCH
INSULIN IS THERE. SO IN THE INITIAL STAGES THERE
IS A NORMAL BLOOD GLUCOSE, BUT A HIGH INSULIN LEVEL. UNFORTUNATELY, THIS LEADS
TO STORING A LOT MORE FAT. BECAUSE INSULIN IS OUR
FAT STORAGE HORMONE. SO [ INAUDIBLE ] MOST OF THE CELL, IT’S HARD TO BRING IT INTO
THE MUSCLE AND TO THE LIVER, BUT IT’S EASY TO BRING IT
IN AND STORE IT AS FAT. SO THIS IS, IF YOU
WERE TO GET A BLOOD TEST AND YOU HAVE
INSULIN RESISTANCE, YOU WOULD INITIALLY HAVE A
NORMAL BLOOD GLUCOSE LEVEL, THROUGH THE LAB, BECAUSE
INSULIN IS DOING ITS JOB. SO THERE’S A LOT OF INSULIN,
AND IT’S OVERCOMPENSATING BECAUSE THERE IS SO MUCH
GLUCOSE IN THE BLOODSTREAM. OKAY, SO, AGAIN, SLOWLY
BRINGING IT INTO THE MUSCLE, BUT THEN IT DOES ALLOW FOR
MORE FAT STORAGE. THIS IS THE EARLIER
STAGES OF DIABETES, SO ALMOST A PREDIABETIC STATE. NOW ONCE TYPE 2
DIABETES HAPPENS AND, AGAIN, WE GO FROM OUR
CARBOHYDRATE-BASED FOOD TO INCREASED BLOOD GLUCOSE, INSULIN IS RELEASED
FROM THE PANCREAS, AND INSULIN NORMALLY
TRANSPORTS THIS GLUCOSE INTO MUSCLE
AND THEN THE LIVER. BUT AT THIS POINT, NOT ABLE
TO GET INTO THE MUSCLE CELLS, SO WE’RE NOT GETTING THAT
ENERGY INTO THE MUSCLE. SO IF THE INSULIN CAN’T BRING
THE GLUCOSE INTO THE MUSCLE, THEN THE RESULT IS A
HIGH BLOOD GLUCOSE. ELEVATED BLOOD GLUCOSE. BUT ALSO, ELEVATED
INSULIN AS WELL. SO WE HAVE HIGH INSULIN,
HIGH BLOOD GLUCOSE, AND THE MUSCLE
CELLS NEED ENERGY. THE QUICK FORM OF ENERGY IN
THE MUSCLE IS WITH GLUCOSE. SO A PERSON WHO WANTS TO DO,
YOU KNOW, EXERCISE IS GOING TO
FEEL REALLY FATIGUED, IS NOT GOING TO HAVE THAT EXTRA
ENERGY TO MOVE THEIR MUSCLES. IN ADDITION, INSULIN IS
OUR FAT STORAGE MOLECULE. SO EVEN THOUGH FAT CELLS CAN
DEVELOP INSULIN RESISTANCE, THEY DO SO AT A LATER TIME, USUALLY THE MUSCLE
IS AFFECTED FIRST. BUT, BECAUSE INSULIN WANTS
TO PROMOTE FAT STORAGE, THE FAT THAT’S IN THE
FAT CELLS CAN’T GET OUT. SO AT THIS POINT SOMEONE WITH
DIABETES HAS A HIGH BLOOD SUGAR, A HIGH INSULIN LEVEL, IT CAN’T GET ENERGY
INTO THEIR MUSCLE CELLS, THE GLUCOSE TO USE FOR ENERGY, NOR INTO THE LIVER SO THEY CAN
RELEASE IT INTO THE BLOODSTREAM, AND THEY HAVE A HARD TIME
GETTING ENERGY OUT OF THE FAT. SO THE FAT OUT OF
THE FAT STORES. SO WHAT YOU’RE LEFT WITH IS
FEELING VERY LOW ON ENERGY. THERE’S NO DESIRE,
REALLY, TO EXERCISE. AND YOU HAVE A LOT OF STORES
OF ENERGY IN YOUR FAT CELLS, YOU JUST CAN’T GET THEM OUT. SO WITH TYPE 1 AND
TYPE 2 DIABETES, THE CAUSE IS DIFFERENT. BUT THE RESULTS ARE THE SAME– HIGH BLOOD GLUCOSE. THESE ARE A SERIES OF
SLIDES FROM THE CDC. AND IT TALKS ABOUT THE DIABETES PREVALENCE BETWEEN
2004 AND 2011, AND THIS IS THE MOST RECENT
INFORMATION THEY HAVE. AND I WANT TO LOOK BACK TO 2004. SO LOOK AT THE VERY LIGHT
AREAS AND LOOK HOW MUCH LIGHT AREAS WE HAVE IN HERE,
LIGHT YELLOW, A LITTLE BIT OF ORANGE. THIS IS LESS THAN 6.5%
OF INDIVIDUALS IN EACH COUNTY WITH DIABETES,
AND YOU CAN SEE IT’S A LITTLE BIT CONCENTRATED IN MORE OF
THE SOUTHERN STATES HERE, ESPECIALLY ON THE EAST COAST,
AND THROUGH THESE REGIONS YOU DON’T SEE AS MUCH
DIABETES, RIGHT? AND WHAT ABOUT THE RED? LOOK AT THE AREAS OF RED. YOU CAN SEE A LITTLE
BIT OF RED IN HERE, THIS IS OVER 11%
OF THESE COUNTIES, AND YOU CAN SEE THEM REPRESENTED
BY COUNTY AND THEN STATE, THAT HAVE DIABETES. SO LET’S WATCH AS THE PREVALENCE
INCREASES THROUGHOUT THE YEARS. NOW LOOK AT THE
INCREASE IN THE RED, AND WE’RE WATCHING THE
YELLOW ALMOST DISAPPEAR. SO WHAT STATE HERE?, WE GOT COLORADO, THAT HAS THE
LOWEST PREVALENCE OF DIABETES. WE HAVE SOME OF THE
WESTERN STATES HAVE LESS, BUT LOOK IN THROUGH THE
SOUTH AND THROUGH HERE. THIS IS GREATER THAN 10%. SO IT’S A DRAMATIC,
DRAMATIC CHANGE. AND JUST IN THE
LAST DECADE OR SO. THERE ARE NOW 29
MILLION AMERICANS ESTIMATED WITH DIABETES. AND REMEMBER, MOST CASES
ARE TYPE 2 DIABETES. SO WHEN I’M GIVING
YOU THESE STATS, IT’S MOSTLY FOR TYPE 2 DIABETES. SCARY IS THAT 1 IN
4 DON’T KNOW IT YET. 86 MILLION HAVE PREDIABETES,
SO THAT’S INSULIN RESISTANCE. SO NOW WE’RE GETTING INTO
THE 86 AND 29, YOU KNOW, WE’RE GETTING TO 30%
OF OUR POPULATION WITH EITHER DIABETES
OR PREDIABETES. AND THIS IS A
STATEMENT BY THE CDC. IN 2012, DIABETES AND ITS
RELATED COMPLICATIONS ACCOUNTED FOR 245 BILLION,
WITH A “B”, IN TOTAL MEDICAL COSTS,
LOSS OF WORK AND WAGES. SO WHAT ARE THE COMPLICATIONS? WHY WOULD YOU NOT
WANT TO GET DIABETES? BESIDES THE FACT THAT YOU’D
HAVE TO TAKE A PILL EVERY DAY AND YOU’D HAVE NO ENERGY,
AND BE OVERWEIGHT, POTENTIALLY INJECT INSULIN,
THERE ARE A LOT OF COMPLICATIONS THAT ARE
ASSOCIATED WITH DIABETES. EYE PROBLEMS, KIDNEY PROBLEMS, HIGH BLOOD PRESSURE,
NUMBNESS IN THE FEET, THIS IS SOMETHING
AS A PODIATRIST THAT I SEE ALL THE TIME,
AND IN FACT, WHAT’S REALLY INTERESTING IS,
I SEE INDIVIDUALS IN THE PREDIABETES RANGE WHO HAVE
DEVELOPED NUMBNESS IN THE FEET. THEY HAVEN’T EVEN BEEN
DIAGNOSED WITH DIABETES YET, AND THEY’RE ALREADY
DEVELOPING THE COMPLICATIONS ASSOCIATED
WITH DIABETES. SO [ INAUDIBLE ] HOW IMPORTANT IT IS TO
KEEP THE BLOOD SUGARS LOW, BECAUSE THAT EFFECT OF
BLOOD SUGARS ON YOUR BODY. THAT’S WHAT IT IS. BLOOD SUGARS ARE CONTRIBUTING
TO THESE COMPLICATIONS. THAT IMPACT CAN CAUSE
THOSE COMPLICATIONS TO DEVELOP EVEN
BEFORE DIAGNOSIS. WHICH IS REALLY SCARY. OPEN SORES. THIS IS A RESULT
FROM THE NUMBNESS. I SEE THIS ALL THE TIME AS WELL,
WHICH SOON DEVELOP INTO INFECTIONS AND
RESULT IN AMPUTATIONS. STROKE, HEART DISEASE. THIS IS NOT A COMPLETE LIST,
EITHER. SO THESE ARE JUST SOME OF THE COMPLICATIONS ASSOCIATED
WITH DIABETES. AND LASTLY, I’M JUST GOING TO
BRING UP MENTAL HEALTH ISSUES. DEPRESSION AND
DEMENTIA ARE TWO MENTAL HEALTH ISSUES ASSOCIATED
WITH DIABETES. SO WHAT ARE THE RISK FACTORS? AND T2-DM IS JUST
AN ABBREVIATION FOR TYPE 2 DIABETES,
AND I GOT THIS PICTURE HERE, BECAUSE IT REALLY DOES
SHOW THE ABDOMINAL OBESITY THAT’S
ASSOCIATED WITH DIABETES. AND THIS ABDOMINAL
OBESITY GENERALLY DEVELOPS AS A RESULT
OF DIET AND INACTIVITY. YOU CAN HAVE A GENETIC PREDISPOSITION TO
TYPE 2 DIABETES, BUT IT DOESN’T
MEAN YOU’LL GET IT. IF YOU ARE EXERCISING,
YOU’RE STAYING LEAN, YOU ARE EATING A HEALTHY DIET,
VERY ACTIVE, THEN EVEN IF YOU HAVE A
GENETIC PREDISPOSITION, YOU’RE NOT GOING TO
GET DIABETES. AND IF YOU HAVE DIABETES, YOU CAN MANAGE IT VERY WELL
WITH DIET AND EXERCISE. THEN ONE LAST POINT
IS THAT [ INAUDIBLE ] AND THE PRECURSOR AS WELL AS
THE KEY ARE THE CHARACTERISTIC OF TYPE 2 DIABETES IS
INSULIN RESISTANCE. OKAY, SO, IF WE
LOOK AT HOW YOU CAN GET INTO THIS HORRIBLE CYCLE,
START WITH, YOU KNOW, THIS HIGH-SUGAR,
HIGH-STARCH, REFINED CARBOHYDRATES,
LOW-FIBER, YOU KNOW, LOW IN FRUITS AND
VEGETABLE TYPE DIET. PHYSICAL INACTIVITY,
SO BEING SEDENTARY. AND THEN THERE’S GENETICS, SO THOSE WHO ARE
PREDISPOSED TO IT. THIS GENERALLY LEADS TO OBESITY. SO WEIGHT GAIN. WEIGHT GAIN LEADS
TO MORE FAT MASS, SO WHERE THERE’S MORE FAT MASS, THERE’S ELEVATED BLOOD LIPIDS,
THOSE ALSO CONTRIBUTE TO HEART DISEASE AS WELL AS
INSULIN RESISTANCE. LOW-GRADE INFLAMMATION,
WE’LL TALK ABOUT THIS LATER. SO HAVING MORE FAT ON YOUR BODY, HAVING MORE CIRCULATING
LEVELS OF BLOOD LIPIDS, AND THE DIET CONTRIBUTE
TO INSULIN RESISTANCE, AND THEN THE DEVELOPMENT
OF TYPE 2 DIABETES, WHICH IS REALLY A
HORMONE IMBALANCE, THERE’S TOO MUCH INSULIN,
THERE’S TOO MUCH SUGAR, THERE’S INSULIN RESISTANCE. THIS MEANS THAT
THERE’S AN INABILITY TO USE GLUCOSE [ INAUDIBLE ]. SO REMEMBER, IF YOU DON’T
HAVE THE INSULIN TO DRIVE THAT GLUCOSE INTO THE MUSCLE,
INTO THE LIVER, THEN YOU END UP NOT
HAVING ANY ENERGY. AND THERE’S ALSO
INCREASED FAT STORES, BECAUSE INSULIN WON’T,
IT’S LIKE A LOCK AND A KEY, IT WON’T LET THE FAT
OUT OF THE FAT CELLS, ‘CAUSE IT WANTS TO STORE IT. REMEMBER, INSULIN IS A
FAT STORAGE HORMONE. AND THAT CONTRIBUTES
TO MORE OBESITY. AND THEN WE GO THROUGH
THE CYCLE AGAIN. SO HOW CAN WE PREVENT THAT? WELL, IF YOU START WITH,
YOU KNOW, A LOW-SUGAR, LOW-STARCH,
LOW-REFINED-CARBOHYDRATES, HIGH-FIBER, WHOLE FOODS DIET, ADD PHYSICAL ACTIVITY,
REMAIN LEAN, YOU HAVE A LOW FAT MASS,
NORMAL BLOOD LIPIDS, LOW INFLAMMATION,
INSULIN SENSITIVITY, MEANING YOUR CELLS ARE
SENSITIVE TO INSULIN, THAT DOES NOT RESULT IN
THE HORMONE IMBALANCE, YOU CAN USE THAT
GLUCOSE FOR ENERGY, AND THERE ARE FEWER FAT STORES. NOW WE’VE SEEN THIS BEFORE. BUT I’M GOING TO SHOW
YOU HOW THE TYPE OF DIET AND LIFESTYLE THAT WILL
HELP PREVENT DIABETES. SO WE ALREADY TALKED ABOUT THIS: WHOLE VEGETABLES,
NOT PROCESSED. WHOLE FRUITS, NOT FRUIT JUICE, SO NOT PROCESSED,
WHOLE FRUITS. WHOLE GRAINS, I HAVE MINIMAL
ON HERE BECAUSE YOU DON’T WANT SOMETHING YOU CAN’T EAT,
WHOLE GRAINS, BUT WHOLE GRAIN BREAD
IS NOT A WHOLE GRAIN, REMEMBER THAT’S A HIGHLY
REFINED FOOD, SO, I MEAN, LIKE, WILD RICE WOULD BE A
WHOLE GRAIN THAT YOU CAN EAT. GOOD FATS, MODERATE
CALORIE INTAKE, PHYSICAL ACTIVITY,
LIMITED PROCESSED FATS, AND WE’RE GOING TO
TALK ABOUT FATS NEXT WEEK. SO THIS MEANS PROCESSED FOODS. IF YOU’RE EATING
PROCESSED FOODS, I DON’T CARE WHAT
TYPE OF FAT IS IN IT, IT’S NOT GOING TO
BE GOOD FOR YOU. LIMITED PROCESSED MEATS, ALTHOUGH MEAT WHEN
IT’S A WHOLE MEAT, ESPECIALLY IF IT’S
FROM A GRASS-FED STORE, SO IT HAS EXCELLENT
LIMITING-PROCESS MEAT, IT’S VERY GOOD. AND MOST IMPORTANTLY,
LIMITING REFINED GRAINS. I MEAN, THIS IS WHAT WE
TALKED ABOUT DURING WEEK ONE, IT’S WHAT I’VE BEEN
EMPHASIZING THE ENTIRE LECTURE, IS EATING WHOLE FOODS, STAYING AWAY FROM REFINED
AND PROCESSED FOODS, YOU CAN SEE IT’S NOT THAT
MUCH DIFFERENT WITH DIABETES. WHAT I DON’T HAVE ON HERE
IS SPECIFICALLY SUGAR, BUT THAT GOES UNDER
LIMITING REFINED GRAINS. AND THIS WILL NOT
ONLY HELP TO PREVENT, BUT IT ALSO HELPS
WITH THE TREATMENT AND MANAGEMENT OF DIABETES. AND THAT’S IT!  

Add a Comment

Your email address will not be published. Required fields are marked *