Our current American diet is a problem both for what it contains—too much sugar, processed fats, salt, additives, hormones, pesticides, and genetically altered inflammatory proteins—and for what it doesn’t contain—omega-3 fats, fiber, magnesium, zinc, B and D vitamins, antioxidants, and more. Except for most omega-3 fats, all these come from a plant-based diet. Plants contain nearly all the vitamins, minerals, antioxidants, phytonutrients, and fiber in our diet. These are essential for keeping our biology in balance and, in particular, for regulating our metabolism and weight.
The paradox today is that the most obese children and adults are also the most nutritionally deficient.1 Rickets and scurvy are now being seen in obese children. Most of us don’t realize that the more calories you eat, the more nutrients you need—vitamins and minerals are the grease that lubricate the wheels of our metabolism and help all the chemical reactions in our bodies run properly, including those involved in regulation of sugar and fat burning. Our current diet is energy dense (too many calories) but nutrient poor (not enough vitamins and minerals). All these “empty calories” we consume cause our metabolisms to break down and disease and obesity to flourish.
The leading cause of diabesity is our SAD (Standard American Diet). Whole, real, fresh food that you cook yourself is the most potent medicine you can use to prevent, treat, and reverse diabesity.
Sarah, a nineteen-year-old girl, walked into my office with a “whole list” of complaints, including obesity, fatigue, and muscle pain. She had been sick and fat since she was eight years old. While many factors contributed to her poor health, her poor-quality diet (high in sugar, junk food, fast foods full of trans fats and high-fructose corn syrup) led to nutritional deficiencies that compounded her health and weight problems. The only colorful food she ate was Cheetos. The sugar and caffeine in sodas depleted her magnesium levels. And because she had hated fish her whole life, she had a severe omega-3 fat deficiency. She was so tired and sick that she never went outside; sitting on the couch watching television led to a serious vitamin D deficiency.
Slowly we got her off her junk food, sugar, and caffeine. We corrected her nutritional deficiencies with both diet and supplements of magnesium, fish oil, and vitamin D. Over the course of six months her muscle pain went away, she got her energy back, and she lost 54 pounds.
Our nutrient-poor, calorie-rich diet is the main factor driving the epidemic of diabesity. It has led to a nation of overfed but undernourished people. In this chapter we will look at some of the major dietary shifts that have led to the diabesity epidemic. Then I will explain the exciting new science of nutrigenomics, which promises to help us cure the problem by seeing food not just as calories or energy to burn but as information that provides instructions to our genes to gain or lose weight, get sick or get healthy.
But before we get to that, take the following quizzes to see where your nutritional imbalances lie. Take all the quizzes in Part II before you start the program and again after the six weeks are over to measure the “before and after” change in your health. You may need extra individualized support based on your scores; I explain this in Week 6 of the plan (see Chapter 24).
There are several important nutritional deficiencies that can lead to diabesity. The following quizzes will help you determine which you suffer from.
Magnesium is the relaxation mineral and helps regulate blood sugar. The following quiz will help you learn if you are deficient. For any symptom you have experienced in the last month, place a check in the “Before” box. Then find out how severe your problem is by using the scoring key below. Place a check in the “After” box after you’ve completed the six-week program to see how much you’ve improved.
Over 80 percent of Americans are deficient in vitamin D. The quiz below will help you learn if you are low in vitamin D. For any symptom you have experienced in the last month, place a check in the “Before” box. Then find out how severe your problem is by using the scoring key below. Place a check in the “After” box after you’ve completed the six-week program to see how much you’ve improved.
Over 90 percent of Americans are deficient in omega-3 fats, which are critical to control inflammation, blood sugar, and metabolism. The quiz below will help you find out if you need an oil change. For any symptom you have experienced in the last month, place a check in the “Before” box. Then find out how severe your problem is by using the scoring key below. Place a check in the “After” box after you’ve completed the six-week program to see how much you’ve improved.
Now that you have identified three of the most common nutritional deficiencies of our modern life, and those particularly important to metabolism and blood sugar control, let’s look at how we got into this terrible mess of being overfed and undernourished.
Our diet has changed dramatically within the last 100 years. It has changed even more dramatically in the last 30–50 years. The biggest change has been our increased sugar consumption. Our Paleolithic ancestors ate 22 teaspoons of sugar per year.2 At the beginning of the 1800s, the average person consumed 10 pounds a year. And now the average American eats 150–180 pounds per year. That’s almost half a pound of sugar per person per day!3 All sugar is harmful when consumed in those pharmacologic doses. When one 20-ounce HFCS-sweetened soda, sports drink, or tea has 17 teaspoons of sugar (and the average teenager often consumes more than 20 ounces a day), we are conducting a largely uncontrolled “drug” experiment on the human species.
In the last 30 years, the sugar calories we consume from high-fructose corn syrup (HFCS) have increased from 0 percent to 66 percent, mostly in the form of liquid calories from soft drinks and other sweetened beverages. And we know that liquid calories in the form of sugar pile on the pounds much more than solid calories do. Following are four reasons why we need to eliminate HFCS from our diet:
High-fructose corn syrup is an industrial food product and far from “natural.” It is extracted from corn stalks through a chemical process and is a biochemically novel compound that is sweeter and cheaper than cane sugar (sucrose).
There is no chemical bond between the glucose and the fructose that make up HFCS, so no digestion is required and it is more rapidly absorbed into your bloodstream. Fructose goes right to the liver and triggers lipogenesis (the production of fats like triglycerides and cholesterol), which leads to a major cause of liver damage—called fatty liver—in this country affecting 70 million people. The rapidly absorbed glucose triggers big spikes in insulin. Both these features of HFCS lead to increased metabolic disturbances that drive increases in appetite, weight gain, diabetes, heart disease, cancer, dementia, and more.
Research done at the Children’s Hospital Oakland Research Institute found that every molecule of free fructose from HFCS* requires more energy to be absorbed by the gut and soaks up two phosphorous molecules from ATP (our body’s energy source). This depletes the ATP required to maintain the integrity of our intestinal lining.
Little “tight junctions,” or connections, between the intestinal cells in the gut cement each intestinal cell together, preventing food and bacteria from “leaking” across the intestinal membrane and triggering an immune reaction and body-wide inflammation. High doses of fructose have been proven to literally punch holes in the intestinal lining, allowing nasty by-products of toxic gut bacteria and partially digested food proteins to enter your bloodstream and trigger inflammation. Naturally occurring fructose in fruit is part of a complex web of nutrients and fiber and doesn’t exhibit the same biological effects as the high fructose found in corn sugar.
Cane sugar and the industrially produced, euphemistically named corn sugar are not biochemically or physiologically the same, despite millions of dollars of television commercials by the corn industry claiming otherwise.
An FDA researcher asked corn producers to ship a barrel of high-fructose corn syrup to her so that she could test for contaminants. Her repeated requests were denied until she claimed she represented a newly created soft drink company. She was then promptly shipped a big vat of HFCS, which was used in a study that showed that HFCS often contains toxic levels of mercury because of chlor-alkali products used in its manufacturing.4 Poisoned sugar is certainly not natural.
When HFCS is run through a chemical analyzer or a chromatograph, strange chemical peaks show up that are not glucose or fructose. What are they? Who knows? But it calls into question the purity of this processed form of supersugar. The exact nature, effects, and toxicity of these compounds have not been fully explained, but shouldn’t we be protected from the presence of untested chemical compounds in our food supply, especially when the contaminated food product provides up to 15–20 percent of the average American’s daily calorie intake?
The corn industry’s happy-looking websites www.cornsugar.com and www.sweetsurprise.com bolster their position that cane sugar and corn sugar are the same by quoting, or should I say misquoting, experts.
Barry M. Popkin, PhD, Professor, Department of Nutrition, University of North Carolina at Chapel Hill, has published widely on the dangers of sugar-sweetened drinks and their contribution to the obesity epidemic. In a review of HFCS in the American Journal of Clinical Nutrition,5 he explains the mechanism by which free fructose may contribute to obesity. He states that:
The digestion, absorption, and metabolism of fructose differ from those of glucose. Hepatic metabolism of fructose favors de novo lipogenesis. In addition, unlike glucose, fructose does not stimulate insulin secretion or enhance leptin production. Because insulin and leptin act as key afferent signals in the regulation of food intake and body weight [to control appetite], this suggests that dietary fructose may contribute to increased energy intake and weight gain. Furthermore, calorically sweetened beverages may enhance caloric overconsumption.
He concludes by saying that “the increase in consumption of HFCS has a temporal relation to the epidemic of obesity, and the overconsumption of HFCS in calorically sweetened beverages may play a role in the epidemic of obesity.”
The corn industry takes his comments out of context to support its position, that “all sugar is the same.”
True, large doses of sugar of any kind are harmful, and in the end it might be the pharmacologic doses of any type of sugar that kill you. But the biochemistry and the effects on absorption, appetite, and metabolism are different and Dr. Popkin knows that.
The last and most important reason to avoid products that contain HFCS is that they are a marker for poor-quality food full of empty calories and artificial ingredients. If you find “high-fructose corn syrup” or the new term “corn sugar” on the label, you can be sure it is not whole, real, fresh food full of fiber, vitamins, minerals, phytonutrients, and antioxidants. Stay away if you want to stay healthy. We must reduce our overall consumption of sugar, but with this one simple dietary change (cutting out HFCS), you can radically reduce your health risks and improve your overall health.
Along with our increased sugar consumption, our fiber consumption has decreased tremendously. Our Paleolithic ancestors ate 50–100 grams of fiber per day. We now eat fewer than 15 grams per day.6
Fiber is important because it slows the absorption of sugar into the bloodstream from our gut, makes us feel full, and reduces cholesterol. The fiber in our diet comes predominantly from plant foods such as fruits and vegetables, including nuts, seeds, whole grains, and beans. Those who eat a refined, processed diet out of boxes, packages, or cans typically get less fiber than those who eat whole, real foods.
The lack of fiber in our diet has enormous implications for our health. It contributes to heart disease, diabetes, obesity, cancers, and many other chronic diseases.7 In fact, studies show that the addition of high levels of fiber to the diet is as effective as diabetes medication in lowering blood sugar, without any of the side effects.8
In America, we eat more than we ever have, yet we are nutritionally depleted. As a result, we now see the epidemic of diabesity and many other chronic diseases.
A number of nutrients are particularly important in the prevention and treatment of diabesity, including vitamin D,9 chromium,10,11 magnesium,12 zinc,13 biotin,14 omega-3 fats,15 and antioxidants such as alpha lipoic acid.16 These are necessary for proper control and balance of insulin and blood sugar. When these are deficient, our biochemical machinery slows down and can grind to a halt. We become more insulin resistant, our blood sugar swings out of balance, and we gain weight.
We generally think of food as a way to get energy, a means to feed our bodies the fuel they need to function. However, new science has shown that food literally speaks to our genes. The information your body receives from the foods you eat turns your genes on and off. This provides your body with instructions on how to control your metabolism from moment to moment and day to day, every time you take a bite of food. This is the science of nutrigenomics, or how food talks to your genes, and it is the nutritional approach that underlies The Blood Sugar Solution. In fact, Dr. Dean Ornish showed that after just three months on an intensive lifestyle program including a whole-foods plant-based diet, over 500 genes that regulate cancer were beneficially affected, either turning off the cancer-causing genes or turning on the cancer-protective genes.17 There is no medication that can do that. Recently, scientists found the genetic material of plants in the blood of humans. Think about it for a minute—plant genes are telling our genes what to do—this is revolutionary.
To illustrate how powerful this approach is, let me share a remarkable study that shows how quickly and powerfully the quality of the food you eat affects your genes, independent of calories, carbs, protein, fat, or fiber. This study focused on people with pre-diabetes. They were divided into two groups. Each group was fed exactly the same amount of calories, with equivalent amounts of protein, fat, carbohydrates, and fiber, for 12 weeks.18
The only difference between the groups was this: One group was fed whole-kernel rye bread and rye pasta; the other group was fed oats, wheat, and potatoes as its sources of carbohydrates. After 12 weeks, the researchers performed a subcutaneous fat biopsy, looked at gene expression, and gave the participants in the study a glucose challenge to assess how their blood sugar and insulin were affected by these dietary changes.
The results were groundbreaking. Remarkably, people in the group that ate rye had smarter, smaller fat cells and were more insulin-sensitive. Diabesity-reversing genes were switched on because of the information contained in the rye (a phytonutrient called lignans) independent of calories or grams of carbs eaten. In other words, it didn’t matter how many calories or grams of carbs this group ate—it was the kind of carbs that was important. The quality of our food matters as much as the quantity we eat.
Even more amazing was how much their genes had changed in such a short time. Dozens of genes that had made participants fat and diabetic were turned off, and dozens of genes that would help them become healthy and thin were turned on. Seventy-one genes that promoted insulin resistance and cell death were turned off in the rye group. The foods they ate beneficially affected their genes, turning off the very genes that predisposed them to diabesity.
On the other hand, 62 genes that promote diabesity were turned on in the group that ate oats, wheat, and potatoes, and that led to increased stress molecules, increased inflammation, and increased oxidative stress, or free radicals. All this, in turn, causes diabesity.
Remember, these two groups ate exactly the same number of calories and exactly the same percentage of fat, protein, carbohydrate, and fiber. The only difference was in the type of carbohydrates they consumed. This one study (among many others that point to the same conclusions) illustrates that food is not just calories. Food is information.
If you want to turn off the genes that lead to diabesity and turn on the genes that lead to health, the key is the quality and type of food you eat, not necessarily the number of calories you consume or the ratio of protein to fat to carbohydrate in your diet.
You need to put your genes on a diet. As David Ludwig, one of the leading obesity researchers at Harvard Medical School, said, “Molecular pathways involved in hormone action [like insulin resistance] have been the target of a multibillion-dollar pharmaceutical research effort. However, many of these pathways may normally be under dietary regulation. The results of the present study [on nutrigenomics] emphasize the age-old wisdom to ‘use food as medicine’—in this case, for the targeted prevention and treatment of obesity, diabetes, and heart disease.”19
Shifting from a nutrient-poor diet to a nutrient-rich diet that is abundant in plant foods such as fruits, vegetables, nuts, seeds, beans, and whole grains improves the expression of hundreds of genes that control insulin function and obesity. An optimal diet to prevent and treat diabesity also includes healthy fats such as olive oil, nuts, avocados, and omega-3 fats, along with modest amounts of lean animal protein. This is commonly known as a Mediterranean diet.20 It is a diet of whole, real, fresh food that has been prepared in a kitchen, not a factory. This way of eating has been shown to prevent and even reverse diabesity. It has broad-ranging benefits for our health, and beneficially affects our entire physiology, reducing inflammation, boosting detoxification, balancing hormones, and providing powerful antioxidant protection—all things that fix the underlying causes of disease.
What you put on your fork is the most powerful medicine you can take to correct the root causes of chronic disease and diabesity.
In addition to these dietary changes, you also need a full complement of vitamins and minerals, and you may need to individually correct specific deficiencies, including deficiencies in chromium, biotin, vitamin D,21 magnesium,22 zinc, alpha lipoic acid,23 and omega-3 fats.24,25 We need these additional nutrients because our soils, farming, food processing, and food distribution systems result in nutrient-depleted foods.
Sir Albert Howard, who started the organic agriculture movement, said in his landmark book, The Soil and Health, that we must “treat the whole problem of health in soil, plant, animal, and man as one great subject.”
Even with a perfect diet, the combination of our depleted soils, the storage and transportation of our food, genetic alterations of traditional heirloom species, and the increased stress and nutritional demands resulting from a toxic environment make it impossible for us to get the vitamins and minerals we need solely from the foods we eat.26 The evidence shows that we cannot get away from the need for nutritional supplements.27
In Part IV, you will learn precisely how you need to eat and what supplements you need to take to reverse diabesity. For now, just keep in mind that our common ideas about food being no more than a source of energy are very limited. Nutrigenomics is the future of medicine. It will help us both understand and successfully treat diabesity.
