BODY. Reversing Pre-Diabetes.
It has truly been an honor to witness numerous patients reverse their pre-diabetes (type-2) to healthy blood sugar values. For me, it is a testament to the resiliency of the human body and its desire to operate optimally when given the right ingredients. And also a testament to the human mind and its ability to overcome a profoundly backwards food system.
But first, some background on even the term pre-diabetes. While there are numerous ways to diagnose diabetes and pre-diabetes, the mostly widely used is through a blood marker called hemoglobin A1c (A1c for short). Hemoglobin is a part of the red blood cell, which recycles (on average) every three months. The average of how many sugar molecules are hanging off of the hemoglobin molecule over its three-month lifespan is what is being measured. To explain this to patients, I will phrase this as, “how frosted are your frosted flakes?” with the hemoglobin being the flake and the sugar being the frosting. A1c between 5.7% - 6.4%, is the land of pre-diabetes: a reversible condition. Once the threshold at 6.5% is crossed, the medical system will never take that label back. Personally, I begin to counsel my patients on blood sugar management if I see an A1c at 5.5% or higher.
What are some of the top easy tips I go to? They may not be what you think. I have found that making people feel deprived of food may be a recipe for change, but only for a short time. Instead, I think about ways to add whole-food nutrition or change eating patterns. Usually, the bigger changes follow.
Fiber. Add in a side of veggies with every meal. If you have toast with eggs in the morning, it’s easy to fold in a handful of spinach (no chopping required!). If you eat out for lunch, see if you can add a side salad.
Food Pairing. Eat protein, fat or fiber first on your plate. Take our first example of toast and eggs. Your brain will say, “eat the toast!” because it sends an evolutionary survival signal of a glucose spike (a satisfying dopamine hit). However, you know more food is coming later in the day. If you start with the eggs, it will help to insulate from a rise in blood sugar, keeping it lower overall. Even with snacks, think about pairing fruit with nuts or a small slice of cheese. Think in terms of “what will raise my blood sugar the least?” and start with that, first.
Passeggiata: medically termed post-prandial movement, but Italy coined this idea long ago with the word passeggiata. It essentially means, to take a stroll, generally after a meal. Blood sugar that has just spiked after eating will come down much more quickly if used by your muscles, looking for an easy source of fuel. 10-15 minutes of leisurely walking is enough to have this effect; washing dishes or sitting on the couch doesn’t.
As I outlined in the Hawthorne Effect article, sugar is addictive. It takes the brain some weeks, even months, to rewire its neural circuitry. For example, I have had numerous of these pre-diabetes reversal patients say something along the lines of, “I had that brownie at the grocery store I loved and used to always get. It was my first time in three months having it since all these changes. It was so sickly sweet, I couldn’t even finish it. I actually felt a little ill after.”
This is another example of swimming upstream and disobeying the algorithm of our own physiology, actually. I blame it on the evolutionary mismatch of our sugar-craving brain in a sugar-laiden world. These simple changes add up, are accessible to most and will change the amount of frosting on your frosted flakes. I have witnessed it time and time again.
