Oh, you shouldn’t test, you’ll scare yourself

The pocket glucose meter is an indispensable tool of grass roots diabetes treatment. It empowers an individual to study precisely what effects food and medications have on their blood sugar. Everyone becomes independent of bad dietary advice and can test their blood sugar for their own reference.  The chief source of bad dietary advice comes from the official diabetes associations around the world. E.g., Dr. Biffa criticizes the iatrogenic nutrition advice of Diabetes UK in a post:  If Diabetes UK wants to help diabetics, I suggest it stops recommending a diet that I think is utterly unsuitable for diabetics

At the end of the post, Helen Howes comments:

When diagnosed (after a sudden descent into Type 2 caused by steroids, quite expected) I was given a wonkily-printed one-side-of-A4 diet sheet which said things like “Don’t eat tinned fruit in syrup, eat the fruit in juice” and “Eat porridge (or unsweetened cereals) for breakfast every day.”
The diabetes nurse said pretty much the same:
Nurse “You should eat porridge for breakfast”
Me “I tried that, numbers went 4.5 (before) then 30, 1.6, 28, 2.5, 12, then it’s lunchtime*

* For Americans 80, 540, 28, 500, 45, 215 etc..

Nurse “Oh, you shouldn’t test, you’ll scare yourself”

A low carb approach (all over the web like a rash, I wonder why) stabilised and sorted my A1c, weight, and blood sugars so quickly.. I asked very sweetly if the local branch was “trying to keep itself in work” and got thrown out.. My doctor suggested I was no longer diabetic.. I offered to eat a bun and sit in the waiting room testing every 15 minutes..

So, it’s like Weightwatchers. If it worked really well (or at all, in the long run) it would do itself out of a job sooo quickly..

And the list of sponsors..?

UK doctors kill their diabetes patients with their dietary recommendations. If diabetes is carbohydrate intolerance than why do physicians and nurses around the world tell patients to eat a diet that primarily consists of carbohydrate? Why? Ancel Keyes and fat phobia. Nutrition science is turned on its head because we ignore all the evidence that diabetics tolerate fat very well–Ignore your glucose tester at your peril. The nurse told Helen to stop testing herself after the recommended high carb meals, because she’ll scare herself. This is an ostrich approach and it is necessary because the high carb meals that the diabetic associations around the world recommend causes blood sugar to spike. But then when you receive most of your funding from wheat and sugar interests, well it’s hardly surprising that you tell people not to stop looking at their glucose meters. This is a scandal of enormous proportions.

Paleo Kim Chee

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Wahl’s protocol lunch: lamb liver, kidney, beet greens and mushrooms, paleo kim chee and crushed nori

Kimchee is probiotic fermented food which is exceptionally good for digestion and for avoiding constipation, but don’t overdo it unless you’re used to it–trust me on this one. Fermented vegetables are also a component of the Wahls Protocol which I am adopting to heal, hopefully, my remaining health issues.

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I had a severe flare up of quadriceps tendinitis while in Kirkwall, Orkney Islands

This is how I make paleo kimchee (preparation time 5 hours; ~1 hour labour):

  1. Peel one daikon radish. Cut into small cubes (~3/4 inch sides). Salt (more salt makes end product more salty).
  2. Separate and wash leaves of one Napa cabbage. Salt* leaves and let stand for 4 hours.
  3. Mince in small food processor fresh peeled ginger (ca. 1/4 or more if you like ginger), add to salted daikon cubes;
  4. Mince garlic (at least one full bulb peeled), add to diakon cubes
  5. Add one or two bunches of green/spring onions cut 1/4 inch pieces.
  6. Add fresh red chilis or dried red chili flakes–3-9 tablespoons, depending on tolerance and preference of spiciness.
  7. Rinse* salted Napa leaves and cut lengthwise into one inch pieces. Mix with salted daikon cubes.

Let sit 7-10 days in refrigerator or cold area (do not let freeze). A cupboard in England is usually sufficiently cold but the fermentation will smell very powerful and so an entry way or garage is to be preferred. A separate fridge is good because the fermentation gasses can leech into other foods, especially mild flavored foods like butter. Yuck. Traditionally, Koreans buried their kimchee in large pots. This protected it from freezing and from marauders.

*Salt breaks down the cell membranes of cabbage and begins the fermentation process. Rinsing the salt off the leaves decreases the saltiness of the end product. Saltiness is a question of taste–South Korean kimchee is saltier because it was traditionally needed as a preservative in the warmer Southern climate. My grandmother was from the North and thus rinsing salt is a part of the recipe. We also put kimchee in mondu, a Northern custom. She emigrated from Korean to Hawaii in 1905 at the age of three.

Commercial kimchee has added sugar and starch. Hence, this is a paleo kimchee recipe.

Pre-Insulin treatment of diabetes: the non-pharmaceutical approach

My first introduction to diabetes specialist Richard K. Bernstein was from a YouTube video in which he debates registered dietician Hope Warshaw.  Bernstein handily puts Ms. Warshaw in her place. It is no injustice to Warshaw to characterize her approach to diabetes treatment as a pharmaceutical approach: “The vast majority of people with diabetes need medication.” But Bernstein says, “Large doses of insulin don’t work in a predictable fashion.” Bernstein’s solution is to greatly limit the intake of carbohydrate and protein, and to permit the patient to eat fat to make up any calorie deficit. This is quite clearly because protein and carbohydrate require an insulin response. But as he explains in his book, Diabetes Solution, the absorption rate of doses of insulin above 7 cc is unpredictable, and therefore it is necessary to keep numbers low: small amounts predictable quantities of protein and carbohydrate accompanied by small doses of insulin will help type 1 diabetics (and type 2 diabetics needing insulin) to maintain glucose control. In this manner, a type 1 diabetic has the best ability to eliminate diabetic complications and to live out a full and healthy life. Thus, Bernstein recommends that both type 1 and type 2 diabetics eat no more than 30 gm of carbohydrate, and also only enough protein in the diet to provide satiation.

Thus, Bernstein’s approach puts nutrition on equal footing with pharma–indeed, a higher footing in the case of type 2 diabetics and “prediabetics”  who can often control their diabetes through diet alone.

Now Bernstein’s approach is fully integrative of the old and the new.  It is entirely reductionist to believe as Warshaw that a pharmaceutical approach will make it possible for diabetics to eat what she calls healthy carbohydrates, e.g., fruit and whole grains.  While diabetics may “deserve” to be able to eat such things, before insulin, treatments of diabetes recognized the toxic nature of carbohydrate and protein in the diet, and therefore, placed very strict limits on the quantity of each.

In the pre-insulin study, The Starvation Treatment of Diabetes (1915), Massachusett’s General Hospital physicians, Hill and Eckman, explain their treatment of both adult (type 2) and juvenile (type 1) diabetes. The therapy consisted of starving diabetic patients on a strict diet of coffee and whiskey until they  stopped peeing sugar. At that point, they would gradually introduce extremely limited carbohydrate and protein into the diet of their patients until once again they urinated glucose, at which point they would once again cut back protein and carbohydrate from their diet to the point that sugar no longer appeared in the urine tests. The bulk of the calories which the patients would need for their daily energy requirements would come from fat. The whiskey therapy is a curiosity, but we can now scientifically verify its usefulness: the liver busily converts the alcohol to triglycerides (fat), thus reducing concomitantly the liver’s production of glucose from protein (gluconeogenisis). Now, when the patients left the hospital, their dietary profile might look something like:  “Carbohydrate, 20 grams. Protein, 40 grams. Fat, 200 grams.”  This equals 80 calories from carbohydrate, 160 calories from protein, and 1800 calories from fat for a total, 2040 calories: certainly enough to live on. These numbers are similar to those in Bernstein’s Diabetes Solution.  Only today, we can also add drug therapy to greater enhance glucose control.

In 1922, 14-year old Leonard Thompson, was the first patient to receive insulin to treat his diabetes. This was an unquestionable breakthrough in diabetes treatment, and insulin treatment is undoubtedly, along with antibiotics for the treatment of infectious diseases, what has greatly established the reputation of the medical profession today. Child patients, who would otherwise die within a brief time, could now live into adulthood, and even carry out a normal life, almost. A devastating consequence of this breakthrough is the vast ignorance of the dieticians regarding the toxic effect of carbohydrate in the diet of diabetics.  As Warshaw suggests, just take insulin, and you can eat the food you deserve.  This approach has led diabetics to suffer decades of diabetic complications and death, because of still uncontrolled blood sugars.  Bernstein, in his own testimony (in Diabetes Solution), said that he developed his method in order to eliminate the multitude of diabetic complications from which he suffered, and his method has been very successful.

How great has the supplanting of the dietary approach been?  In her Diabetic Cookery (1917), Dr. Ruth Oppenheimer lists baking ingredients that even the internet knows not from what they are made: Casoid flour and Aleuronat flour. She writes regarding the former:

Casoid takes the first rank as a flour for diabetics, and therefore a special chapter is devoted to its use in the preparation of Bread, Muffins, Desserts, etc. Casoid, to a great extent, has solved the problem which confronts the cook as to a substitute for wheat bread, and, as a diabetic naturally craves bread, the substitute must come as near to the real article as possible.

Oppenheimer also employed ground almond, which is the most common substitution for wheat in today’s Wheat Belly cookbooks, and she claims that Casoid flour is better. So why would Casoid and Aleuronat flour have disappeared from our usage and knowledge? My guess is that apparently no one still saw the need for the best substitutions for wheat flour, because diabetics could, as of 1922, eat standard bread and shoot themselves with insulin. They weren’t going to die right away. But eventually, with such an approach, their unregulated blood sugar levels would cause them to die either of a diabetic coma from fatally low blood sugar or too high regular blood sugar which leads to such complications as retinopathy, kidney disease, peripheral neuropathy, cancer, heart disease and Alzheimer’s disease, to name a few. Clearly, an integrative approach, which implements the strict dietary approach of the pre-insulin treatment and judicious usage of insulin and other drug therapies, is superior. Hats off to Dr. Bernstein!

BMI: Body Mass Index and the reification of a mathematical formula that makes health professionals look stupid and philosophically unscientific

Health professionals:  Please, stop using BMI as a means of assessing the health of patients and clients.  Everyone can look at a person and see if he or she is overweight, obese, morbidly obese, or underweight and in need of some muscle and fat on their bones.  But when you apply arbitrary numbers into a formula, you’ve created an abstraction, and when you use it to assess whether a person is underweight, normal, overweight, or obese, you are guilty of reificiation (for those professionals who have never heard this word, please, it is a logical fallacy).

My BMI is 32.  I am thus obese, as you can see from my recent photo:

slimmer me

Oops.  I am not supposed to look like that.  Here is what I’m supposed to look like (slightly smaller than the guy on the right):

It is time to dispense with BMI.  Stop using it because it makes you sound stupid, philosophically unsophisticated and intellectually lazy.  Is that what you want?