It’s the beginning of a new year, so it’s out with the old and in with the new. Let’s start with the most common disease in our modern world—type II diabetes mellitus. I like descriptive names but the term “diabetes mellitus” just doesn’t do the trick for me. For my New Years resolution I decided to look for a more descriptive and relevant term.
Let’s Look at the History
Unlike type I diabetes, type II diabetes isn’t so much a disease as a choice. The term diabetes mellitus evolved over thousands of years to mainly describe what we now call type I diabetes mellitus. This form of diabetes was first described in Egypt in around 1500 BCE. At about the same time Indians described the condition as “honey urine”. Don’t ask me how they knew that this urine tasted sweet! The term “diabetes” or “to pass through” was first used in 230 BCE by the Greek Appollonius Of Memphis. The term “mellitus” or “from honey” was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination.
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400-500 CE, with type 1 associated with youth and type 2 with being overweight. Although these two forms share certain characteristics, their pathophysiology and clinical course are really quite divergent. I am proposing that we simply leave type I diabetes alone—let’s simply call it “diabetes mellitus” to honor the work of our ancestors. This form of diabetes is an autoimmune disorder—more or less like getting struck by lightning. At the present time we know of no way of preventing this form of diabetes.
Type II diabetes is another matter. It is strongly associated with insulin resistance and obesity. In other words it’s a choice. People who choose to eat a diet loaded with modern processed foods are choosing to get this form of diabetes at some point in their lives. When you eat this “modern” food, type II diabetes will likely some day cross your path—it’s really only a matter of time. This form of diabetes is clearly triggered by eating a diet loaded with excessive fructose mainly from sugar and HFCS, high glycemic carbohydrates mainly from grains and excessive omega 6 fatty acids from vegetable oils. Of course this is typical modern processed food.
People who choose to eat this food (that would be most people) should know that they are signing up for a disease that will eventually destroy their metabolic health. It gets even worse. Consuming this type of food will also adversely affect your brain function. As David Perlmutter points out in his excellent book “Grain Brain”, consumption of processed food will increase your risk of developing many common brain disorders like Alzheimer’s disease, Parkinson’s disease, ADHD and similar conditions.
Go Ahead and Fry Your Brain
Even if you don’t develop one of these well-known disorders, regular consumption of processed food can adversely affect your brain function, eventually triggering a form of food-induced brain dysfunction called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. People with CARB syndrome will store excessive body fat at virtually any caloric intake even when they diet and undereat and their brain function will plummet to the point where they will have trouble functioning in the real world. We have now identified 22 symptoms associated with CARB syndrome and if you look around you, I suspect that you will see many of these symptoms in people you know. Serious metabolic problems and a brain that doesn’t work—its not a pretty picture.
It’s Time for a Name Change
Thus type I and type II diabetes are as different as night and day. For my New Years resolution I am proposing that we give type II diabetes a new name: “Carbabetes”. This name works because it reflects the triggers of the disease—simple sugars and high glycemic carbohydrates. You become a “betes” because of your food choices, not a lightning strike. The medical profession has tended to overlook this basic fact. When someone develops type II diabetes, they are happy to “manage” it with medications and insulin. This is what the American Diabetes Association has to say about carbohydrates:
“A place to start is at about 45-60 grams of carbohydrate at a meal. You may need more or less carbohydrate at meals depending on how you manage your diabetes. You and your health care team can figure out the right amount for you. Once you know how much carb to eat at a meal, choose your food and the portion size to match.”
Really. Eat a bunch of carbohydrates and then take some pills or insulin to “manage” your glucose. Can anybody say “dog chasing tail”? As a practicing physician, I am embarrassed by this standard advice that is still doled out to patients each and every day of the week. Type II diabetes needs a new name and the medical profession along with the American Diabetes Association needs to have their heads candled!
The Foolishness of Carbohydrate Counting
The standard recommendation for people with type II diabetes is to limit carbohydrate intake to 45-60 grams of carbohydrates at every meal. The ADA goes on to promote the idea that it’s the total amount of carbohydrates that count, not the type of carbohydrates. If you want to eat that sugary dessert, you can substitute if for other carbohydrates in your diet like potatoes, starchy vegetables or grains. They call this process “carbohydrate counting”. There’s only one problem with this approach—it’s based on science that is 20 years out of date. They promote the idea that sugar (sucrose) is just another carbohydrate and it is no more harmful than other carbohydrates as long as you don’t eat too much of it.
Focus on the Fructose
Although it is true that sucrose doesn’t raise glucose levels any more than most other type of carbohydrates, they are missing a key point. The fructose in sucrose feeds directly into the pathology of carbabetes by driving insulin resistance, first in the liver and later in other organs. Richard Johnson has outlined this process in his books “The Sugar Fix” and “The Fat Switch”. Robert Lustig also covers the topic nicely in his book “Fat Chance”.
Toss Out Both Sugar and Starch
Once you have insulin resistance, eating any carbohydrate will elevate glucose levels, but the key to health is to focus on reversing insulin resistance rather than just focusing on glucose levels. If you already have some insulin resistance like most people living in modern societies, you need to restrict your intake of both fructose and carbohydrates. At this point consumption of carbohydrates will also contribute to the pathology of carbabetes as outlined in Gary Taubes’ excellent books “Good Calories, Bad Calories” and “Why We Get Fat”. The take home message is that to prevent or treat carbabetes you need to restrict your intake of both simple sugars and starchy carbohydrates. One way of doing so is to consider eating a ketogenic diet where your cells learn to use ketones for energy rather than glucose. Jimmy Moore is the master of ketogenetic diets and soon will be coming out with a book on the topic called “Keto Clarity”.
If you already have carbabetes, you need to do a few simple things. You need to drastically reduce your intake of sugar and HFCS and I also recommend that you reduce or eliminate grains from your diet, especially wheat. Grains tend to be pro-inflammatory and inflammation plays a key role in carbabetes and CARB syndrome. It would also be wise to increase your intake of anti-inflammatory omega 3 fatty acids and reduce your intake of omega 6 fatty acids from vegetable oils. The easiest way to do this is to drastically reduce your intake of processed food and increase your intake of whole foods from nature.
Fat is often targeted as one of the drivers of carbabetes (type II diabetes) but it only does so when fats are added to processed foods. The natural fats, including saturated fats from whole foods, will likely protect you from developing carbabetes. Healthy fats like coconut oil, olive oil, avocados and the oils from nuts should be a core part of any healthy diet.
Supplement Your Way to Health
There are also several supplements that can play a role in preventing or treating carbabetes and CARB syndrome. The cardinal symptom of both conditions is craving sweet and starchy foods, pushing people to consume more of the very food that is destroying their metabolism and frying their brain. The safe amino acid L-glutamine can help to reduce these pesky cravings, making it easier to stick with a healthy diet. I also like a concentrated form of cinnamon called Cinsulin and the supplement chromium picolinate. Both help sensitize your cells to insulin.
Walk Away From Carbabetes
One of the most effective ways to protect yourself from the ravages of carbabetes and CARB syndrome is to exercise on a regular basis. You don’t need to run marathons or train for the Olympics to gain these benefits. A simple walking program will often do the trick. I suggest starting with 20-30 minutes of walking every day and over time you can gradually increase the speed and length of time of your walking. If you throw in a little strength training your metabolism and brain will really thank you for it.
I am asking you to join me in my crusade to dump the term type II diabetes and replace it with carbabetes. I suspect that a more descriptive term will help people focus on the real issue—the type of food they are putting in their mouth. Carbabetes is a disease caused by sugar and starch, so the key to success is reducing these elements in your diet. Let’s join together in the Campaign for the switch to Carbabetes.