The 10 year diabetes rule focuses on the twin killers; sugar and refined grains.
It's common knowledge, in every talk-show, newspaper and health magazine that 12% of people on the modern "industrial diet" are diabetic; one in five are undiagnosed and walking on a time bomb. 85 percent of these folk are obese.
Obesity rates started rising around 1980, 3 years after the McGovern Committee released its dietary recommendations; less animal fat and more whole starches.
They were not aware that fat provides satiety and secondly that whole, unrefined grains would become increasingly difficult to purchase. Within three years obesity rates started to climb; and continue to do so to this day.
On food low in fat, Americans were constantly hungry. By 1990, a mere ten years later the rate of diabetes started to climb.
Dr George Campbell famously framed the 20 year diabetes rule in South Africa; twenty teaspoons of sugar per day for two decades. That's how much there is in a couple cans of common colas and energy drinks.
The 10 year diabetes rule comes into play when the diet is high both in sugar and refined grains; together they release large amounts of glucose into the blood stream.
Whole grains have become increasingly difficult for the general public to purchase. 100% wheat flour and cornmeal simply cannot be found in the average grocery store.
The problem is greatly confounded by the big fat lie; millers are allowed by international law to call their products wholemeal provided they do not remove more than 40% of the goodies.
Your typical commercial wholemeal bread found in the grocery store is anything but the nutritious loaf it appears to be; much of the bran and germ have been extracted.
So whilst the McGovern Committee were not amiss in recommending that Americans eat more whole grains, they totally underestimated the deceit that exists in milling. In addition, the general public quickly grew to love refined carbs and began to eschew cereals that were high in fibre.
Patient suffering, social costs and morbidity are the hallmarks of obesity. For example, lower limb amputations have risen sharply in the USA since 1990; they had tripled to 150,000 per year by 2022. 80% of these are due to the complications of diabetes; and this despite the fact that the number of people smoking has dropped dramatically.
Obese patients have double the risk of needing knee replacement surgery.
Insulin resistance occurs when cells are no longer able to react adequately to the influence of the hormone. They are unable to absorbe the blood glucose that is beginning insidiously to creep upwards; unbeknown to the victim.
Blood pressure begins to rise as the great vessels stiffen and the liver turns the ever-rising tide of glucose into lipids. Raised cholesterol is the next sign; and triglycerides.
Disastrously then, so much glucose is entering the liver that it is unable to process the excessive carbohydrate consumption fast enough; it should turn the sugars into lipids for the blood stream. Instead the fat then begins to stack up in the organ causing hepatic steatosis.
This chronic fatty liver eventually scars the organ in the same way that excessive alcohol does; cirrhosis is a terminal condition. Kidney disease is the next complication.
The best test for blood glucose levels is not the fasting measurement taken first thing in the morning; it's the HbA1c. This averages out the level over the life of a red blood cell; about two months. It is independent of what you ate yesterday, whether you went for a long hike or recently been ill.
Normal is below 5.5%. For too long we have accepted that 6.5 percent is okay.
The medical options to escape the ravages of the 10 year diabetes rule would include the following.
Lifestyle modifications are by far the most difficult; most people are unwilling to ring in the changes that are necessary. But they are also the cheapest, most effective and have no side effects.
For those wanting simply to protect themselves from the insidious influence of the 10 year diabetes rule, the changes are not particularly onerous.
However once the disease is established everything becomes more difficult. Exercise is less effective in lowering blood glucose and causes the joints to hurt; and the thought of giving up sugar forever is a bridge too far. The tongue brought up on polished rice, delectable white scones and pasta does not take kindly to unrefined carbs.
Ever looking for shortcuts we instead seek out artificial sweeteners, obesity medications and bariatric surgery despite the huge cost, side effects and very real dangers. The search for a silver bullet seems to have no end; for effective and safe weight loss drugs.
The potential side effects of semaglutide, for example are serious; though minor when compared with the complications associated with obesity and diabetes, argue its advocates.
The incretin hormones, GLP-1 and GIP, and other newly discovered ones, are produced by cells in the gut in response to food; they act on the pancreas to start producing insulin and others chemicals. They also influence the brain to bring on a sense of satiety.
The subject is extremely complex with over 100 prohormones produced by cells in the gut, having differing targets both in the intestine and distant to it; for example in the brain.
Obesity medications that target just two of these hormones are likely to have potentially serious unintended consequences; side effects.
The Look AHEAD and DIRECT studies have shown that even a 5% loss of weight has benefits. As further pounds fall off there is a progressive drop in blood pressure, the dreaded HbA1c test and lipid levels. Perhaps most important the quality of life improves dramatically. Over 40 percent went into remission after twelve months; zero diabetes medication.
One thing is certain; whichever program the sufferer chooses it must be sustainable for the rest of one's life. Anything less is a complete waste of time and energy; and extremely depressing for the patient.
Many patients regain weight after bariatric surgery; diabetes returns. Lifestyle changes that are not permanent have little value. There is no cure; only remission.
The pharmaceutical industry of course is rubbing its hands in glee; huge profits are being made. So too the bariatric surgeons are waiting in anticipation, ready to convince you that weight loss is impossible without medical interventions. You are suffering from a disease.
If obesity is truly a disease, then why did the pandemic only start in 1980? Did the recommendation to change to high carb coupled with low fat have nothing to do with it?
I am unashamedly a disciple of Hippocrates, the Father of Medicine.
For safe and effective weight loss I will show you a better way; one that costs almost nothing. Your quality of life will start to improve within a month and it will be sustainable for the rest of your life.
Acknowledge that sugar and refined grains are straight from the Devil's Pantry. He lurks like a waiting lion, just waiting to devour you.
Abandon them forever.
Some twenty years ago I was 10kg heavier. I was prediabetic; my systolic blood pressure soared over 180 when I was stressed. My lower back troubled me regularly. Last week at a blood donor drive it was 123/81; the BP of a teenager, half way through my eighth decade.
The first and most difficult step was to give up commercial bread forever. It meant purchasing a stone mill and grinding my own flour. Baking is not simple; it's a journey. Sloth may be intimidated by the hill ahead.
Today we bake the best sourdough bread in the world made with 100% real flour; light and wholesome, it's the envy of many.
It takes less than five minutes to mix the dough, including grinding the flour and the loaf costs less than half a dollar; it's not in the slightest heavy. Need I say more?
The second difficult step, made far easier I will admit because I am a beekeeper was to give up sugar for ever. Natural homespun honey has a low GI; not so that from the grocery store. For you I recommend hunting for a small apiarist; better still a few hives of your own.
It's a journey; slowly, one step at a time one climbs a mountain only to find that it is a whole range of hills. The next was to start eating at least 7 coloured foods every day; then homemade probiotics like kefir and sauerkraut, and on it goes.
The next was to get more active. After dinner nearly every evening I make 12 laps around the swimming pool instead of moving directly to the computer or TV; nearly half a mile.
Last month I had my HbA1c tested; a very satisfactory 5.4%.
You can do it too; start your own journey. Make only changes that are sustainable. Giving up sugar for a month is a completely waste of time; for ever, or not at all.
Turning away from cake flour, cookies and cake was revolutionary. Baking our own bread, and now stone-milled grits too have been revolutionary.
Yes, I am a Believer. Finally I grasped that our bodies are the temples where God dwells; we must take care of them.
Otherwise where else am I going to live on this earth until my time comes?
In short lifestyle modification brings peace of mind, not just in facing the 10 year diabetes rule, but in many other facets of wellness; that which obesity medication and surgical procedures can never do.
I have been greatly influenced by the folk living in the five Blue Zones of the world; a busy and zestful ninety is the norm and ten times as many achieve 100 with their marbles intact. There are no old age homes.
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