Class 1A Diabetes Class Curriculum

Class 1a: Introduction

Definitions:

Diabetes:
Diabetes is a disease in which the body fails to properly use insulin.

Insulin:
Insulin is a protein hormone secreted by the islets of Langerhans in the pancreas. It helps the body use carbohydrates, which are the starches and sugars found in the food we eat.

Types of Diabetes:
Type 1: A chronic condition in which the pancreas produces little or no insulin.
Type 2: A chronic condition that affects the way the body processes blood sugar (glucose).
Gestational Diabetes: A form of high blood sugar affecting pregnant women.

Symptoms of Diabetes:

  • Frequent urination
  • Excessive thirst
  • Extreme hunger
  • Unusual weight loss
  • Extreme fatigue
  • Irritability
  • Blurred vision
  • Poor wound healing

Insulin Resistance:
In type-2 diabetes the pancreas is synthesizing normal and sometimes excess amounts of insulin. However, in this case the problem is not with the pancreas; the problem is that the cells throughout the body have become resistant to the actions of insulin. This peripheral resistance results in less sugar entering the cells and more remaining in the blood. The development of insulin resistance is a normal adaptive mechanism the body uses to ward off extreme fat accumulation when faced with the rich Western diet. See more at Dr. McDougall on this article on Simple Care for Diabetes  and two videos on McDougall Moments: Diabetes and  How to Prevent and Treat Diabetes, Part 1.

Insulin resistance syndrome (aka metabolic syndrome or syndrome X):

  • High blood pressure
  • Abdominal fat, high blood fats
  • Low HDL
  • Obesity
  • High uric acid

Insulin resistance can be corrected with:

  • weight loss (class 7) 
  • exercise (class 4)
  • reducing saturated fats in diet  (class 2)

The more effort you put into making necessary lifestyle changes, the greater the results will be.

Here are  great videos of Dr. Neil Barnard on Neil Barnard program for Reversing Diabetes and Reverse Diabetes Part One and Tackling diabetes with a bold new dietary approach.

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Class 1B Diabetes Class Curriculum

Class 1b: Drinks

Key Messages:
Drink water instead of sugary drinks.
Record what you eat to keep track of how many calories you take in.

Class Information covered:
Why is weight management important?
Body Mass Index (BMI)
Track your food at one of these sites: SuperTracker or MyFitnessPal or Lose It!

Activity:
RYD How much sugar?
RYD Calculations Key Drink Label Cards
Rethink Your Drink Pledge Card (English/Spanish) 

Handouts:
10 tips make better beverage choices
10 tips make better beverage choices in Spanish
10 tips focus on fruits
10 tips focus on fruits in Spanish
Weekly Meal Planner

Recipe:

For more recipes visit the Rethink Your Drink website or www.eatfresh.org

Video:
Defeating Diabetes 

Homework:

Write out a weekly menu and shop for ingredients.

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Class 2 Diabetes Class Curriculum

Class 2: Saturated Fats and Trans Fats

Saturated Fats

Definition Saturated Fat:
A fat that contains only saturated fatty acids, is solid at room temperature, and comes chiefly from animal food products and tropical oils. Saturated fats are abundant in meats, dairy products, chicken, eggs, coconut oil, and palm oil, tending to raise cholesterol levels in the blood and one of the chief causes of insulin resistance.

Look on page 19 of the pamphlet from the American Diabetes Association What can I eat?  available by calling 1-800-DIABETES (800-342-2383). It says that saturated and trans fats increase your risk of heart disease and stroke. Which are the worst offenders? Click here.

USDA 2015-20120 Dietary Guidelines state that less than 10 percent of calories per day should come from saturated fats.
The World Health Organization states that no more than 7% of total daily calorie intake for people with type 2 diabetes should come from saturated fats.
The American Hearth Association states that no more than 7% of total daily calorie intake should come from saturated fats.
The McDougall Program recommends no more than 5% of total daily calorie intake come from saturated fats.
What does that translate to? Click here.

Trans Fats

Through the process of hydrogenation (adding hydrogen under pressure) and the addition of flavorings, vegetable oils are made to look and taste like hard animal fats. Margarine was designed to replace butter and shortening to replace lard. The process of hydrogenation changes the configuration of some of the nutritious unsaturated fats in the oil to a damaging form called “trans fatty acids.” Trans fatty acids act far more like saturated fats than unsaturated fats. In The Nurses’ Health Study trans fatty acids were strongly associated with an increased risk of type 2 diabetes, while polyunsaturated fats were associated with a reduced risk. Where are they found? Microwave popcorn, French fries, cookies, donuts, shortening, cake, margarine, crackers, potato chips, granola bars,  all deep-fried foods, and in small amounts naturally occuring in meat and dairy products according to the National Academy of Sciences’ Institute of Medicine.

Lipotoxicity:
When we have excess fat in our cells insulin does not work as well. As little as five pounds of excess fat on our frame can interfere with insulin’s ability to carry glucose into the cells. Free fatty acids released from the fat cells is one of the mechanisms promoting insulin resistance in liver and muscle in a phenomenon called lipotoxicity.

Insulin Resistance:
With type 2 diabetes, insulin production isn’t the problem. The key (insulin) is there to open up the cells to store glucose in the cells. Something gums up the lock. Intramyocellular lipid, fat inside our muscle cells prevent insulin from letting glucose into the cells. Fat in our bloodstream, either from our own fat stores or from our diet, can build up inside our muscle cells, where it can create toxic breakdown products and free radicals that block the insulin-signaling process. No matter how much insulin you produce, your fat-compromised muscle cells can’t effectively use it.

Here are a few websites  and videos for more info:

Vegetable & Fish Oils
Published Scientific Results of McDougall Program

From Oil to Nuts by Jeff Novick
Going Nuts over Nuts by Jeff Novick

Videos on Insulin Resistance at NutritionFacts.org
Videos on Saturated Fats at NutritionFacts.org

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Class 3 Diabetes Class Curriculum

Class 3: Take out the Trash, Part 2

Avoid refined carbohydrates. Eat healthy carbs.

Food Demo: Oat and Apple Cookies

Class 3 Curriculum (coming soon)

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Class 4 Diabetes Class Curriculum

Class 4: Take out the Trash, Part 3

Limit sodium and alcohol. Increase exercise.

Food Demo: Sweet Potato Salad

Class 4 Curriculum (coming soon)

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Class 5 Diabetes Class Curriculum

Class 5: Pile on the Protectors

“It takes time to make new habits, but your patience and persistence will pay off in the long run.”
American Diabetes Association Learning How to Change Habits pg 19 in Choose to Live pamphlet

In their  book Defeating Diabetes Brenda Davis, RD and Tom Barnard, MD white that “While getting rid of unhealthy foods is an extremely important first step, it is only half the battle. Fortunately, the other half is much more pleasant- adding a wide variety of delightfully delicious and nutritious foods. Begin by building a solid foundation of whole plant foods- foods that shift the balance away from harmful components that promote disease toward those constituents that will nourish and protect you.” page 55

Protectors:

  • Phytochemicals
  • Antioxidants
  • Carotenoids
  • Vitamin C
  • Vitamin E
  • Glutathione
  • Fiber

Phytochemicals

“Phytochemicals are natural substances that regulate growth, defend against attacks by insects or fungi, and provide flavor, color texture, and odor to plants. When we eat [whole] plants, these powerful little protectors go to work on our behalf and their potential for human health is simply remarkable.” Davis page 55

Informative websites and videos: 

The End of Diabetes and Super Immunity by Joe Fuhrman, M.D.

Lifestyle Changes for Heart Attack Prevention on the American Heart Association website

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Class 6 Diabetes Class Curriculum

Class 6: Pile on the Protectors, Part 2

“Good food and good health is simple.” – T. Colin Campbell pg 242 The China Study and “eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt and added fats.”

Eat Plant Proteins

Why should we eat plant proteins?
According to Brenda Davis, RD and Tom Barnard, MD in their book Defeating Diabetes “Several studies suggest that vegetable proteins may be less toxic than animal protein and more protective of kidney function. In addition to concerns about kidney function, excessive protein increases calcium losses in the urine, potentially contributing to osteoporosis. Animal protein also raises blood cholesterol levels about 5 percent, while plant protein lowers it about 5 percent. Foods rich in animal protein come packaged with saturated fat and cholesterol- two dietary constituents associated with elevated blood cholesterol levels and heart disease.”

What are the advantages of plant protein?

  • Plants are high in fiber
  • Most plants are naturally low in fat
  • Plants are cholesterol-free
  • The protein in plants lowers blood cholesterol levels
  • Plants come conveniently packaged with many protective phytochemical
  • Plants provide calcium
  • High protein intakes from meat can compromise kidney function, while plant protein appears to be protective

Where do I find plant protein?

  • Legumes like beans, lentils, dry peas
  • Products made from legumes like tempeh (whole food) and tofu (more processed and not whole any more), edamame
  • Soymilk
  • Higher-protein grains, nuts and seeds such as quinoa, amaranth, almonds, peanuts, and pumpkin seeds

How much protein do we need?It is recommended that about 10-15% of calories come from protein. On a 2,000 calorie diet that would translate to 200-300 calories from protein, which would be 50-75 grams of protein. (1,600 calories = 40-60 grams of protein)Video: Simply Raw

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Class 7 Diabetes Class Curriculum

Class 7: Maintain a healthy weight

Key to maintaining a healthy weight is to eat high nutrient-dense, low energy-dense foods such as fruits and vegetables. Foods high in fiber like legumes (beans, lentils, dry beans) and whole grains provide a feeling of satiety. Though a diet of whole-plant based foods that is naturally low in fat (few nuts and seeds and 1 tablespoon of ground flaxseeds per day) is the optimal diet, you can include animal foods into your diet and still maintain a healthy weight by applying the concepts of Volumetrics. Developed by Barbara Rolls, a researcher at Pennsylvania State University. Volumetrics is a way to choose foods that trigger satiety- the sense of fullness after meals- and how to plan meals to bring on a feeling of satiety earlier.

Eating More to Weigh Less

Diabetes Reversal: Is it the Calories or the Food? 

Nutrient-Dense Approach to Weight Loss

Diabetics Should Take Their Pulses

WHtR:

A person’s waist-to-height ratio (WHtR), also called waist-to-stature ratio (WSR), is defined as their waist circumference divided by their height, both measured in the same units. The WHtR is a measure of the distribution of body fat. Higher values of WHtR indicate higher risk of obesity-related cardiovascular diseases; it is correlated with abdominal obesity.

Wikipedia Info on WHtR
Waist-to-Height-Ration Calculator  http://www.whtr.org

Foods That Make You Thin by Jeff Novick

How to Lose Weight Without Losing Your Mind with Doug Lisle

Healthy Approaches to Weight Control, Reversing Diabetes, and the Best of Health by Dr. Neil Barnard

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Class 8 Diabetes Class Curriculum

Class 8: Diet to prevent and reverse diabetes

Google Talk on How Not To Die
Here you can listen to the main points on how not to die from the leading causes of death (including diabetes at 23.54 minutes and kidney function at 27 minutes) from Dr. Greger’s famous book How Not To Die. ONE DIET CAN FIX IT ALL!

On page 107 of his book How Not To Die Dr. Michael Greger has a figure about the prevalence of diabetes among non vegetarian, semi vegetarian, pescovegetarian, vegetarian, and vegan. As diets become increasingly plant based, there appears to be a stepwise dropin diabetes rates. Please see Table 1 on page 2 of the full report of Vegetarian diets: what do we know of their effects on common chronic diseases in American Journal of Clinical Nutrition. (You can also see the drop in BMI and Hypertension the more the diet is plant based)

Rx for Type 2 Diabetes: A Low-Fat Vegan Diet

The Power Plate: Lose Weight, Lower Cholesterol, Tackle Diabetes

Following the guidelines of the American Diabetes Association (ADA) helps reduce people’s A1C, an index of long-term blood glucose control, by 0.4 points. However, eating a plant based diet can lower hemoglobin A1C by 1.2 points, three times the change in the ADA group.

A 2006 study, conducted by the Physicians Committee for Responsible Medicine with the George Washington University and the University of Toronto, looked at the health benefits of a low-fat, unrefined, vegan diet (excluding all animal products) in people with type 2 diabetes. Portions of vegetables, grains, fruits, and legumes were unlimited. The vegan diet group was compared with a group following a diet based on American Diabetes Association (ADA) guidelines. The results of this 22-week study were astounding:

  • Forty-three percent of the vegan group and 26 percent of the ADA group reduced their diabetes medications. Among those whose medications remained constant, the vegan group lowered hemoglobin A1C, an index of long-term blood glucose control, by 1.2 points, three times the change in the ADA group.
  • The vegan group lost an average of about 13 pounds, compared with only about 9 pounds in the ADA group.
  • Among those participants who didn’t change their lipid-lowering medications, the vegan group also had more substantial decreases in their total and LDL cholesterol levels compared to the ADA group.

This study illustrates that a plant-based diet can dramatically improve the health of people with diabetes. It also showed that people found this way of eating highly acceptable and easy to follow.
For more details read about Diet and Diabetes: Recipes for Success 

Quick-Swap Guide To Your Comfort Food Favorites

Cooking Whole Plant Foods- Advice by Mary McDougall

Making the Change
Making the Change Part 2
Making the Change Part 3

Stocking Your Kitchen
Thanksgiving Planning
 

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