The Growing Cost of Diabetes

In 2013, the American Diabetes Association published a study that showed that the national cost of diabetes had increased to an estimate of $245 billion, a 41% increase from a study done in 2007.  If this trend remains steady, the national cost of diabetes could be nearing $350 billion by 2018.  Let's give that some perspective:

• $1,100 per person per year in America
• The cost to build 33 Gerald Ford class aircraft carriers (every year)
• The cost to pay the salaries of all US military personnel for 28 months
• The cost to fund the entire national transportation budget for 3.5 years
• 26 years of revenue for the NFL (based on 2016 estimated revenue)

That is a lot of money and this is just for diabetes.  If you were wondering why the cost of your insurance is going up, it is not just price gouging by the medical industry.  It is also due to that national epidemic of people consuming poor quality foods who's profitability is being subsidized by federal agricultural policy and very effective marketing.  

Now for the good news...it would cost individuals with diabetes very little to get most of this money back.  If people make the decision to vote with their dollars (and stomachs), most of this expense could be recovered by simply adopting a low carbohydrate, healthy fat, appropriate protein diet.  Many people, including me, have put their diabetes into remission by simply eliminating most processed foods and refined carbohydrates from their diet and replacing them with mostly whole unprocessed foods.

Kresser Describes Cholesterol on JRE

Chris Kresser describes "Good" vs. "Bad" cholesterol to Joe Rogan.  I think he does a great job explaining what the lipoproteins do and their relationship to the actual cholesterol they transport around your body.  Starts at 2:02:55.

Video Link

Potential Effect of Fasting on LDL-C Measurement

I was recently listening to a "Livin' la Vida Low-Carb" podcast where Jimmy Moore was interviewing Dave Feldman from the Cholesterol Code blog.  Dave is testing a hypothesis that his LDL-C measurement is inversely correlated to the amount of fat he consumes in his diet during a few days prior to his lab work.  He believes that the liver upregulates the production of vLDL in response to the drop of chylomicrons carrying dietary fat in the blood (@ 14m 57s).  During the podcast the idea of the the LDL concentrations in the blood increasing as the length of the fast done before a test is done increases is also discussed.  Jimmy questioned if longer fasts would result in higher LDL concentrations (@ 32m 28s).  Dave speculates that LDL concentration increases would still be seen with fasting periods around 72 hours but that he has not done any testing to support this hypothesis yet.

Coincidentally, a few weeks before I had heard this podcast, I had decided to do a 24 hour fast before my routine lab work to see if that affected any of my tests.  I was shocked to find that my LDL-C had shot up 99 mg/dl in my June testing after it had been testing exactly the same on my two previous rounds of lab work.  After hearing the podcast with Jimmy and Dave, I paid for another lipid profile out of pocket to see if my LDL-C results would come back down after a 14 hour fast.  My LDL-C did drop back down by 67 mg/dl with  a 13 hour fast.  It would be interesting to see how the LDL-C changed day to day during a continuous 7 day water fast.  For now though, I will stick with the 12-14 hour fasting period prior to my lab work.

Here are the results from my blood lipid tests discussed above.  Note that all other measurement stay relatively consistent compared to the large jump in LDL in June after the 24 hour fast:

Cinnamon Paste for Blood Glucose Control and Lower Lipid Concentrations

I heard a reference to taking cinnamon to help control blood glucose in a podcast I was listening to. The research I was able to find was not the best but there appears to be some evidence supporting cinnamon's ability to help increase insulin sensitivity and reduce triglycerides and LDL particles.  Cinnamon seems to be a fairly safe, inexpensive and tasty supplement so I have started a personal experiment to try it out. The dose I decided on was 6g per day based on one study I looked at. I take it 3g in the morning and 3g before bed. There are some forms of cinnamon that have higher concentrations of a liver toxin so you should look into ordering some Ceylon cinnamon or supplement capsules if you plan to try this yourself.  I have only been trying this a few days so it is hard to say what the long term efficacy will be but the first few days I have tried it, I am seeing about a 12% drop in my average daily blood glucose. That could be partially due to many other factors so I will have to monitor my glucose for a few weeks to see if there is a trend. I will also be getting some blood work done in a few weeks to check my lipids. 

If you are going to try this you have the option to take it in pill form or as a loose powder. Powder is much less expensive so that is my preferred option. One problem is that cinnimon is not really soluble in liquids and tends to create a protective shell when you pour something over it. Anyone who has seen anyone take the "Cinnamon Challenge" is familiar with this phenomenon.  If you are following a high fat diet and you are not sensitive to dairy, you can try my cinnimon paste recipe. It is fairly tasty and effective.  I also add cocoa powder, which has its own potential health benefits, however I am am using it in this recipe to help thicken the paste and to improve the flavor.

Dave's Cinnamon Paste:

Ingredients (includes affiliate links)

• 3g (roughly 0.5 tbls) Ceylon Cinnamon 
• 3g (roughly 0.5 tbls) Unsweetened Cocoa Powder
• 30g (roughly 1 floz) Heavy Whipping Cream

Instructions

1. Add all ingredients to a small container
2. Slowly begin to mix the dry powders with the cream using a small whisk or spoon.  (You do not want to mix too aggressively until all the cinnimon is suspended in the cream or you might start to see puffs of dust coming out of the container)
3. Continue mixing more vigorously until you achieve a thick consistency.  (You may need to add a little more coco powder to thicken your paste up)
4. Enjoy your paste slowly using a spoon 

-THE SCIENCE- 

Article:  Cinnamon and Diabetes: An Update
              "Cinnamon may indeed be effective, at least for some people, in lowering blood sugar levels. Yet many diabetes medicines do a better job."

Study:  Cinnamon improves glucose and lipids of people with type 2 diabetes
              "intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes"

Study:  Cinnamon Use in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis
              "The consumption of cinnamon is associated with a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, LDL-C, and triglyceride levels, and an increase in HDL-C levels"

Reading Essential - A Sweet Conspiracy

"If everyone began burning more body fat, which can literally happen overnight by eliminating sugar from the diet, the world would be more than a better place, eventually." ~ Dr. Phil Maffetone

In this article, Dr. Mafetone lays out why changing the sugar economy will probably never happen from the top down and how we can only change it through taking personal responsibility for what we put in our bodies.

Text

Healthy Meal Idea: Sausage, Salad, Olives, & Cheese

Menu:

• Salad
• 100 g. Power Greens Mix
• 30 g. Asiago (fresh grated)
• 1 tbls. Avocado Oil
• 0.5 tbls. Balsamic Vinegar
• Entree
• 6 oz. Pork Sausage
• 1.5 tbls.  Mayo/Mustard Sauce
• Sides
• 4 oz. Brie 
• 5 Kalamata Olives
• 3 Jalapeno Stuffed Green Olives
• 2 Banana Pepers

Nutritional Breakdown:

My Current List of Supplements and Prescriptions

This is not intended to be a recommendation of anything you should do.  I just want to share what I have developed for my personal treatment so that you can be inspired to look into what you may need.  I recommend that you search for studies that support any supplement you may be considering and then discuss it with your primary healthcare provider.  I will try to publish links to the studies I have found for anything I am taking in the future.  I am including links or affiliate links for all the products I am using.  These links are for your convenience but they should not be considered an endorsement of any of the products.  I will often change brands for price, availability or reputation purposes.  The prices were good as of 5/26/2016:

Taken	Pill / Product	Quantity	Cost
AM	Vitamin C	2	$0.12
	Test Strip	1	$0.16
	Probiotics	1	$0.17
	SAM-e	1	$0.53
	Creatine M.	5	$0.09
Lunch	Lancet	1	$0.03
	Test Strip	2	$0.16
Dinner	Fish Oil	4	$0.52
	Glucosamine/MSM	1	$0.06
	Turmeric / Curcumin	1	$0.16
	Test Strip	1	$0.16
	Vitamin C	2	$0.12
	Creatine M.	5	$0.09
	B50 Complex	1	$0.07
Bed	Pure Vitamin Club Magnesium	1	$0.28
	Vitamin D3	0.20	$0.06
	Pure Vitamin Club Multicap	1	$0.28
	Test Strip	1	$0.16
	Magnesium L-Threonate	1	$0.17
	Phosphatidyl Serine	1	$0.39
Totals	Daily>>	33	$3.80

Reading Essential - The Sugar Conspiracy

“If only a small fraction of what we know about the effects of sugar were to be revealed in relation to any other material used as a food additive, that material would promptly be banned.” ~ John Yudkin

This is from a well written and long-form article written by Ian Leslie for the Guardian.  It presents a good overview of the history of how "low fat" became pervasive in nutritional science.  

Text or Audio

Video Essential - Dr. Terry Wahls: Minding Your Mitochondria

Dr. Wahls does a extraordinary job of describing how resilient our bodies are when we feed them the correct food:  

Minding Your Mitochondria - TEDx 11/30/2011

Falim: Real gum, no sugar

I am a long time gum chewer. Most gum that I chewed was "sugar-free" already, however, after I had been limiting my carbohydrate intake for a while, I started to notice that I would obsess about chewing it. I also theorize that some of the "sweet tooth" cravings I was having on the weekends were due to teasing my reward system with the simulated sweetness of the gum.  I decided to stop buying the gum to test my theory and, whether it was placebo or not, I have been having less cravings for sweets.

Though I was pleased with the result of giving up the artificially sweetened gum, I missed chewing my gum.  I did a quick search at Amazon for unsweetened gum and I came across Falim gum.  It is made by a company in Turkey who's website has no English option so I am not sure what information is available there.  I decided to order some of the mint and give it a try.  It turned out to be just what I was looking for.  It has a subtle mint flavor and the chewing consistency is the best I have ever experienced. Additionally, the flavor and feel remain the same for as long as you want to chew it.  The sweetened gums I use to chew would usually start to taste bad and soften after I chewed it for a while.


If you are a gum chewer and you are looking for something with no sugar or sweeteners, I can recommend you give this a try.  Their are several flavors available but I have only tried the mint at this point so that is the only flavor I can recommend.  I would expect the other flavors to be good as well.

Coffee with Fat

Having coffee with healthy fats can help you in achieving some specific health goals.  I have used coffee with added fat for specific nutritional reasons.  Initially, I used it to control my hunger during the day and reduce the amount of time I spent feeding myself while at work. I found that I would make poor food choices during the day at work. Beyond birthday cakes, doughnuts, breakfast tacos and lunch out with coworkers even going out on my own, I would often be drawn in by the Golden Arches or promises of "all I can eat."  For me, the best strategy ended up being to control my hunger during the day and politely decline all the offers of social food with the assistance of coffee with butter and MCT oil in it.

Since then, I have embraced a low carbohydrate and appropriate protein lifestyle where the coffee allows me to fill in my daily calorie deficit with healthy and nutritious fats.  It also allows me to lower my endogenous insulin requirements, since fat causes little to no insulin response as far as I have found in my research, which has additional health benefits that are beyond the scope of this guide.

I have included shopping links for some of the items you will need at the bottom of this page.

-SUPPLIES-

Fats:  Any combination of at least two of the following:

     Unsalted grass-fed butter: Kerrygold brand should be readily available at most grocery stores for about $3 per half pound. I have found it at Trader Joe's, Walmart, Kroger, HEB. DO NOT get salted butter!  It will taste horrible. 

     Organic coconut oil:  check for your local grocery house brand. I get a big 32 oz vat from from my local grocery store for around $14. 


     MCT oil (medium chain triglyceride): you can find it in stores but it is expensive. Best deal I have found is on Amazon. 



 
Decent coffee:  whatever you like whole bean or ground but try to find something locally roasted for freshness. I use what I can find in whole beans in the $4-7/lb range. Don't spend more than $10/lb unless you are really into your coffee. There is no health benefit difference in the final brew once you get past $4/lb. (you may need to adjust the price for your location)

Coffee machine:  drip, French, percolator, anything will work

Blending container:  I use the carafe that goes with my coffee maker or you can use something like an Anchor Hocking 2 Quart Glass Batter Bowl.
 

Mixing device:
  
     Blender:  DO NOT try to use your standard blender. I tried twice and it resulted in an explosion of butter and coffee all over my wall. If you have $400-$800 dollars to blow on a very good blender, you should consider getting a Vitamix or Blendtec.

     Immersion blender:  I use something like this Cuisinart Hand Blender at home.  


     Milk frother:  I use one of these when I make the coffee at work with my French press. You should be able to find one locally for pretty cheap or you could get one like the Ikea Milk Frother on Amazon: 

 
Thermos:  if you plan to exist all day at work on the coffee, you can get one of these Thermos Stainless Steel King 40 Ounce Beverage Bottle and make it the night before. It will still be hot enough to burn you until lunch the next day.  

 

-INSTRUCTIONS-

Large serving

     1)  Make Coffee (see below for my single cup French press recipe I use at work)

     2)  Add fats:  any combination of any two above (see below for proportions).

     3)  Blend:  in the pot, Pyrex bowl or coffee cup.

     4)  Drink or pour into thermos:  in general it is not good to leave coffee in the pot in the warming plate or in a percolator. This is especially true when you have added your fats in. Coffee by itself will start to burning once the brewing stops. When fat is present, they will burn as well and ruin the flavor of your coffee.

Single serving French press:

     You will need a French press similar to this one:  Bodum 8-Cup French Press Coffee Maker
 
     1)  4 tablespoons of grounds.

     2)  Fill about 1/4 of the way and add grounds.

     3)  Stir the grounds and let sit for 1 minute.

     4)  Add the rest of the water up to a little past half way, to account for the volume lost by the grounds when pressed to the bottom, and leave a little above the filter so that I can avoid dumping the last dirty bit of water in your cup.

     5)  Let the brewing continue for another 3 minutes (4 minutes total)

     6)  Pour the coffee over the fats, up to half way up the cup.

     7)  Blend the ingredients until homogeneous.

     8)  Add the rest of the coffee and blend again.

 
-PORTIONS-

A good place to start in general:  half and half butter and coconut oil, 3 tbls (1 tbls) each per pot (cup)

For appetite control with higher carb diet:  You want to play around with the levels of fat and caffeine that allow you to go throughout your day without feeling hungry and without making you jittery or keep you up at night. You want the lowest levels of everything you can get by with.

For insulin control and calories with low carb, low protein diet:  You want to increase the amount of fat needed to fill in any calories you are not able to get while you are eating at night while keeping the caffeine as low as needed to prevent being jittery during the day.

-VIDEO-

I have posted a video on YouTube where my wife shows you how we make our coffee:

• Pot of Gold Coffee Instructions

-SCIENCE-

"Supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity"

Benefits of lauric acid found in coconut oil

Health benefits of Medium Chain Triglycerides (MCT)

"Why butter is better" 

"13 evidence based benefits of coffee"

-PRODUCT LINKS- 

Below are links to products mentioned above.  Most are items I have used but some are just for convenience:

MCT Oil
Glass Bowl
Immersion Blender
Milk Frother
40 oz. Thermos
French Press
Coconut Oil
Self Grinding Coffee Maker
Drip Coffee Maker
Percolator