Food & Diet (keep "eye" on the "ball" [your insulin level]):
Summary: There are 3 aims of the natural-insulin management approach: [a] Learn what foods shoot your natural blood insulin levels up & avoid them (have your mind always on how to control your natural insulin... [b] Avoid between-meal snacking. And [c] quit eating when your hunger is satisfied. The following is a lifestyle change! (1) Tending to avoid white carbohydrates, sweets, sweeteners, eat the foods as close to their unprocessed, natural state (little or no sweeteners) as is reasonably possible. (2) When you eat, EAT what you choose until hunger is satisfied & then QUIT! (3) NO snacking between meals; (4) AVOID sweets & sweeteners & bread & pasta & potatoes. (5) Create intermittent FASTING periods to make sure your personal blood insulin drops down. (6) DO NOT go so "all in" that you don't enjoy life! It is estimated that 15-30% of Americans with pre-diabetes will progress to type II diabetes (losing weight & increasing physical activity are keys to prevention of progression & the cornerstone of type II diabetes prevention).
Side Note as to another approach: My cousin & her husband have had amazing success through the very comprehensive MUSC program; and you can go to that website & read (1) some testimonies which will help with any weight-control method that you chose and (2) some of the factors that result in excess weight gain!
Side note as to National Weight Control Registry: this registry (NWCR) tracks over 10,000 persons with long-term success at weight loss control! You can join. Their website summarizes keys to success & other interesting stuff.
Comment (insulin-awareness diet): As Jason Fung, M. D., a Canadian medical kidney specialist (nephrologist) treating kidney disease in large numbers of diabeticssays, a years-long success at weight control happens with primary focus on the key natural hormone (not the medication), INSULIN. The mental focus must be on hormones & not just calories. Many times, Dr. Fung points back to the evolutionary adaptations that humans underwent to deal with their 1000s-of-years of being hunter gatherers with an uncertain food supply and the subsequent need for various hormones related to hunger, hunger satisfaction, and maintaing of a weight that can keep a hunter active even when food supplies are low and irregular (the periods between food were unintentional fasting periods). Dr. Fung has an on-line blog (HERE) and a number of You Tube videos...here is one that is 56 minutes long, HERE...fasting discussion detail begins at just past 30 minute mark. Obesity is a hormonal dysregulation (dysfunctional regulation) of fat accumulation & is given a number grade with the BMI (BMI calculator, HERE). Drivers of "over-weight": (1) chronic stress, tension & anger all elevate your blood cortisol; and societally competitive sleep curtailment interfers with your daily normal evening-hours drop in blood cortisol. Both situations elevate your blood insulin level. And (2) various consumed foods & drinks increase (elevate) your blood insulin level. Remember that, if you really want to learn to play the piano, you have to be willing & determined to endure some struggle to learn...its the same with this lifestyle diet change.
He points out in his wonderful book, The Obesity Code, that all diets work in the short term. [Dr. Fung's diet is a sort of carbohydrate-restricting diet plus a planned pattern of intermittent fasting.] But nearly all fail after a year in over 90-95% of dieters. WHY??? They all focus on what you eat and never focus on when you eat. They also fail to focus on (1) the blood level of insulin (the agent of weight gain) triggered by stress & various foods & drinks and (2) the danger of insulin resistance (IR) and (3) the suboptimal "set" of your primitive brain controller called the "body weight set point". As Dr. Fung notes, ALL diets work briefly; but the brain (hypothalamus) "body weight set point" control mechanism pulls like gravity back toward what you were...beginning in about a year for most dieters...to the weight before the dieting attempt began. ALSO, some 66% of a person's own pre-diet strength of their "weight set point" has a familial/genetic component of influence. What do your parents & kin look like? The overweight type of diabetes is called Type II and hinges on the onset within your body of "insulin resistance" (IR)...the cells don't "hear" the insulin knocking its "message" on their doors (receptors) as well as normal (so, you need higher & higher insulin levels to get the cell to "let the insulin in". The trick is to control your insulin level with (1) food choices plus (2) intermittent fasting (a fasting pattern which assures that your insulin level regularly drops below your IR baseline insulin level).
Hunger vs. cravings: There is a difference between hunger and cravings (carvings lead to conditions such as "sugar addiction").
HEALTH RISK: The metabolic syndrome of chronically high blood insulin TENDS to be in people with (1) easily visible obesity centered around the upper abdomen..."central obesity" (almost certainly an inherited obesity shape), (2) elevated blood pressure, (3) sustained elevated fasting blood glucose ("sustained" is confirmed by elevated blood hemoglobin A1C levels), and (4) an abnormal blood lipids pattern (dyslipidemia) of [a] elevated triglycerides and  low HDL cholesterol (polycystic ovaries may also reflect this syndrome...diagnosis is probable if you have any 3 of the 4)...and elevated HDL (good) cholesterol tends to be associated with lower average blood insulin levels. Slight urine loss of albumin and elevation of the inflammatory marker, blood hs-CRP, may be additional metabolic syndrome markers. With onset of IR, there is the added risk & likelihood of documentable type II diabetes which can additionally complicate "metabolic syndrome".
- Elevated insulin = weight gain ... if persistently high, you get IR...see below...(your cells become insulin desensitized & resistent to the stimulation to absorb glucose due to a given amount of insulin) related to a generally elevated insulin level.
- If get IR, it leads to fatty liver and metabolic syndrome & increased weight persists.
- Avoid high & powerful insulin spikes by attention to WHAT you eat: avoiding sugar, sweeteners, and highly processed carbohydrates.
- Avoid establishing persistently high insulin by WHEN you eat: establish a habit of regular FASTING cycles (Betty & I are trying the "only eat lunch & dinner & no snacking & fast from say 9PM to noon the next day each day"). Fasting is an ancient practice and part of all religions. See book pages 119, 120, & 122 and Appendix B (pages 256-265).
- GET RID of IR by giving your body regular breaks...insulin breaks...with the intermittent fasting and then it becomes possible for your brain's "weight set point" to adjust lower in the longer run.
Insulin resistance (IR) can be DEFEATED with patterns of intermittent fasting! We are talking about a more or less PERMANENT life-style change with Dr. Fung's strategy. BUT, don't let the chosen intermittent fasting pattern be so bone-headed & rigid as to cut you out of social occassions with family or friends...be willing to have exceptions in your schedule.
Mostly not OK carbohydrates: (but first: avoid Carbohydrates..."carbs"...sugar [sweeteners, too] & highy processed bread & grains = rice, pasta, bread, cereals) & FAVOR non-white vegetables & less-sweet fruits. Natural fruit sugar (sucrose) is chemically a pair of one glucose molecule and one fructose molecule. Watermelon is one of the worst to band the glycemic index UP. Digested, the absorbed glucose goes straight to all tissues; fructose ONLY goes to the liver. Once the liver glucose capacity is reached as glycogen, the excess is converted to fat. Fructose is converted to glucose (only if the liver is low on glucose) or converted to fat (not sure about strength of detrimental impact of natural fructose). Creation of fat causes fat cells to release the hormone leptin to let the brain (hypothalamus) know that caloric intake is sufficient. But with more and more liver fat accumulation in each liver cell, there is a lessening of the proportion of leptin given out by the fat (the "stop-eating" signal weakens).
Wine: Here. Sweet wines contain sugar. Dry wines may have very little sugar but may contain carbs.
Liberty Creek cabernet, 4 oz. (half cup), has no sugar but 4 grams of carbs.
OK fats: virgin olive oil, butter, lard, oil-containing fish (such as salmon), nuts.
OK protein: eggs, milk, cheese, nuts.
OK other stuff: coffee and teas (unsweetened), non-sweet red wine; nuts, beans, seeds, vegetables, fructose (peaches, strawberries, mangos, apples, oranges, grapefruit, melons; NOT fruit juices). Maintaining a beneficial gut population of bacteria (that is, using a probiotic suppliment keeps your gut "microbiota/microbiome" healthy) is helpful; metformin is the rare diabetes medication that does NOT raise insulin levels and, thereby, contribute to weight gain. Foods rich in fiber are good because fiber retards digestion and absorption so that your blood does not receive a "sledgehammer dose" of glucose, etc..
Hungriness cutters: (page 193-200)...while many of the following elevate insulin, they stop hungriness quicker = potatoes, proteins.
In each of the following three parameters, ordinary white bread is the reference point with a value of 100. In general, higher GI values = worse (in 1 & 2) & lower values = better (except in 3). The (1) glycemic index (GI), glucose score, or glycemic index (GI) is a number associated with a particular type of food that indicates the food's effect on a person's blood glucose (also called blood sugar) level. A GI below 55 is better. The GI reflects the carbohydrate content; that is why you won't find foods like fresh meat, chicken, fish, eggs and cheese in GI lists (unless they contain some flour or sweetener). While most cheese has an index of 1 for 50 grams, the index for feta 5; other foods HERE and HERE.
The (2) glycemic load (GL) of food is a number that estimates how much the food will raise a person's blood glucose level after eating it. This is like a hammer the bell carnival (HERE) both where you pay to make an attempt to hamer the pad & whip the pellett up to ring the bell. A low glycemic load is like a little boy swinging the hammer; a high load like a muscular man banging the hell out of the pad & ringing the bell with ease!
The (3) satiety index (satiety score...satiety value) indicates how long your appetite is satisfied (satiated) after a given amount of a particular food & is the opposite of hungriness (how to think about it, HERE; if the score is over 100, it satifies that much more than white bread; under 100, it satisfies less). The rise of the hormone, ghrelin, stimulates the brain to sense "hunger". When hungry, a person eats and is satisfied...his/her hungriness is satiated. Satiety is mediated by the rise of hormones peptide YY (in response to carbs) and cholecystokinin (in response to fat & protein) which stimulate in the brain a sensation of satiety. "BEST" is food with high satiety score and low insulin score (example, eggs) in the linked table, next paragraph.
Since insulin is the devil, here is the insulin index (or insulin score) & link with foods and the above 2 indices. The Insulin Index (II) of a food (table HERE) represents how much it elevates the concentration of insulin in the blood during the two-hour period after the food is ingested. If driven by the bell hammer (see above) of a food with a high glycemic load, the insulin elevates similarly whoppingly like the bang by a muscular hammer swinger.
NOTE #1: Highly processed foods in the above 3 categories (1) make carbs more rapidly digestible, giving extra-whopping intensity of rises in insulin & "highly processed" reguires industrial processes (for example, to get high fructose corn syrup) with chemicals and/or stabilization for extending shelf life and adding of insulin-raising sweeteners to enhance tastiness & drive over-consumption. (2) Fat & oil "highly processed" extraction reguires industrial processes with chemicals and/or stabilization for extending shelf life. (3) Protein "highly processed" extraction reguires industrial processes with chemicals and/or stabilization for extending shelf life.
NOTE #2: Meals of celebration (Thanksgiving, Christmas, get-togethers with family/friends) allow deserts and exceptional food if you like. One might consider extra fasting times after such exceptions or celebrations.
NOTE #3: The DASH diet is in this arena and is supposed to reduce hypertension numbers mildly.
NOTE #3: The carbohydrate issue (I sw this in a Consumers Report email) may be reduced if resistant starch is the carbohydrate consumed (such as cold pasta rather than cooked & served hot). There are numerous YouTube videos about it, EXAMPLE.
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[posted: about 5 May 2017; latest addition 2 January 2018]