On November 13, 2013, Ben Hirschler for Reuters in London reported that the battle with diabetes and its disabling, life-threatening complications is being lost. This article notes that the number of people affected has “soared to a new record” this year, the majority of cases being type 2 diabetes – “the kind linked to obesity and lack of exercise”; the kind that follows as a population that once ate healthy whole foods adopts “Western, urban lifestyles.” As shown in this blog, this means they begin to consume processed and packaged, convenient food engineered to promote eating too much.

After reporting many alarming changes in death and disease rates in millions of people worldwide due to diabetes, the report states “a strategy involving all parts of society [is] needed to improve diets and promote healthier lifestyles”.

Our blog is a small part of this strategy. We share information on research that validates healthy eating and life-style approaches and recipes and foods that work to promote good health. Today’s post zeros in on a fairly easy but high impact tactic – cutting back on fruit juice and eating more whole fruits, among twelve other ideas for keeping the diabetes monster away from your door.

Not very many posts to the Dr. Grandma’s website fail to mention eating fruit and vegetables as a key component of a healthy diet. There are many reasons for this advice, but at the top of the list is that eating lots fruits and vegetables is an important way to fill our tummies with very nourishing, fiber filled food without filling our cells/bodies with lots of stored energy (We humans, of course, store energy as fat.) The fact is that fruits and vegetables help us get full, without a large load of calories. Having said that, which sounds so very simple, the ramifications of actually choosing to consume lots of fruits and vegetables is far-reaching and complex.

Just this August, Qi Sun, MD, ScD of Harvard School of Public Health and Brigham and Women’s Hospital, and his colleges published the results of their findings in the British Medical Journal (BMJ). They looked back on three longitudinal studies. What the data unveils is that, when people eat whole fruit (this study found blueberries, grapes and apples to be especially helpful) the people had a significantly lower risk of developing Type 2 diabetes. They found that the risk went down as the whole fruit consumption went up. The same study found that drinking fruit juice was associated with an increased risk of Type 2 diabetes. Both eating whole fruits and drinking very little juice have been advised repeatedly in this blog, but it’s always nice to have it validated in the current research. The Harvard researchers are still looking for exactly what is in the fruit that causes the risk of diabetes to fall; one of their ideas is a waxy substance in the skins of apples, grapes and other fruit may protect from diet-induced glucose intolerance. So far, their investigation into the different types of flavonoids have not explained how different fruits vary the risk reduction.

The above-mentioned study, is just one of hundreds. The fact is that the diabetes epidemic has not gone away. The early symptoms are subtle; one of three people with Type 2 diabetes doesn’t know they have it. If you’re lucky enough to be diabetes-free, you, like me, may hope to remain diabetes-free for as long as possible. If you have been told that you have pre-diabetes or even have been diagnosed with Type 2 diabetes, you may create your own good luck where nature hasn’t been so kind, as Dr. Grandpa, Victor Bunderson has done. By managing his weight, diet and exercise he has kept the diabetes monster away from his door for almost nine years without the use of medications. Today I decided that maybe I’d review what is known, and then share some steps to help you keep that diabetes monster away from your door too.

The problem of Type 2 diabetes frequently starts with weight gain. The pancreas is called upon to produce more and more insulin to manage extra blood sugar and eventually the system breaks down – the cells become resistant to insulin and the sugar circulating in the blood rises beyond a healthy level – a damaging level. When there are periodic highs or even lows in blood sugar, the physician may call it prediabetes, which is usually a big wake up call. The message of prediabetes is that it’s time to do something; or the individual is headed for diabetes. Sometimes like in Dr. Grandpa’s situation, he went from not knowing he had it – to full-blown diagnosis of diabetes. Looking back, he had frequent infections that had difficulty in healing, but at the time he never connected it to the possibility of diabetes. This is not uncommon; remember one in three – 33% of diabetics don’t know they have it.

There are steps that you can take to delay or even to prevent Type 2 diabetes.

• By far the most effective way to keep the diabetes monster under control is to lose weight. Note: Dr. Grandpa, Vic, lost approximately 40 pounds and has maintained that weight loss for the nine years. He has to be diligent in his efforts. His weight will fluctuate up and down about 5 pounds; but all in all, the 40-pound weight loss has been maintained.
• Physical activity is the number two behavior adopted by Vic. He has been dedicated to doing physical activity six days per week. His activity goal is to exercise for about 40 minutes, but the reality of life is more of a range of 20 to 45 minutes, 5 – 6 days a week.  The Diabetes Prevention Program (DPP) suggests 150 minutes per week can significantly delay or prevent Type 2 diabetes. Don’t forget, as noted in past blog posts, that physical activity also improves insulin sensitivity. Although weight loss is the most potent weapon, exercise has its own benefits; including: keeping cells healthy and using calories, which contributes to weight management.

Although Dr. Grandpa, Vic, didn’t have genetics going in his favor, as related to diabetes, he did/does have a few things in his favor. Among those is his openness to make changes in his diet and lifestyle behaviors.

• Number one – he never denied that he had diabetes; he acted and learned all he could from the beginning. He ‘dug in’ and began making changes. He continues to check his blood sugar each morning, even though the physician says that he no longer has diabetes. Vic knows that if he gains weight and doesn’t exercise his blood sugar will creep back to dangerous diabetes levels. Vic’s motivation to not become a victim of diabetes was a great benefit in his amazing success.
• Certainly, getting rid of his old habit of skipping meals and grabbing candy in his desk drawer would have to top the list in my mind. And it did.  It was replaced by better habits early in the process.
• After he was diagnosed with Type 2 diabetes he changed to choosing whole grain products, although at first he preferred white flour products. Also, he began drinking nonfat milk. He switched out his morning glass of grapefruit juice for vegetable juice. He still enjoys grapefruit; he just eats the fruit – not the juice.
• Vic cut back his portion of rice and starchy foods and doubled up on vegetables and whole fruit.
• He has the sweetest tooth, speaking candidly. Foods that I find too sweet are just fine for him. So he began limiting the portion size and frequency of sweet treats. Let’s be realistic here. He greatly enjoys sweets, so we make some with zero calorie sweeteners that will not affect his blood sugar. He strives to keep his intake of sugar-sweetened treats below 150 calories a day. One habit that has helped is substituting nuts, which he enjoys as some of his snacks/treats.
• He recognizes that he’s fortunate to have a Registered Dietitian, who plans most of his meals and cooks with very little meat, enough whole grains and lots of fruits and vegetables.
• Extra virgin olive oil became the fat of choice in our home.
• The most important facet of his consumption transformation was that he did not go on a diet, but gradually learned and changed to accommodate a different way of eating. There was no diet to go on and then off. The way Vic eats has evolved and changed permanently, which is in large part why he has sustained success for so many years.
• Cheese intake was dramatically decreased; particularly hard cheeses. So recipes like his favorite, stuffed peppers, which were traditionally loaded with cheese, white rice and red meat, where changed to use brown rice, part skim milk ricotta, and a lot more vegetables. The fat in recipes is controlled by the cook, so for him that change was not too difficult.
• Research has shown that the dietary acid load from eating meat impacts diabetes negatively. The resulting change was becoming a flexitarian. This change extended the ratio change in the amount of vegetables and animal protein. Many of our meals do not have meat; we eat fish fairly frequently and even poultry becomes secondary to vegetables. If the change is thought of as a lifestyle change and not a diet, more and more old menu items can be transformed. As a side note: It is sometimes surprising how delicious and enjoyable meals can be that contain very little animal protein.
• From the beginning he adopted the idea that there are really no forbidden foods; it was a helpful strategy. Ice cream, for example, has never been removed from the list of favorites. It is more likely to not be full fat, and sweetened with added sugar, but it is still enjoyed – yes, the portions have shrunk and it appears less frequently than pre-diabetes, but it is still enjoyed even occasionally the full fat, sugar-sweetened varieties.
• Lastly, we continue to remain informed of new research.

Your first thought may be that this is a big undertaking; you would be correct. But it is possible – it can be done. It’s a process – a doable process. Don’t get discouraged; just take the first steps to make changes that will support better health.  You just might decide that changing your morning glass of juice for whole fruit is a good place to start.