You Want To Know!
As a member of the LCDA, you should be proud knowing you are taking a proactive lead in healing the prediabetes or diabetes of yourself or a loved one or a patient. And, you have come to the right organization. By learning about The Eight Essentials, and how to bring positive changes to your diet, lifestyle, supplementation, you will learn information that may help you reverse prediabetes and can help you to reverse or control diabetes.
New Expert Interviews!
The low carb diet is the foundation diet for people who have prediabetes or diabetes. The LCDA promotes a nutritional, fun, tasty way to implement the diet.
The LCDA knows that change can be difficult! That is why we are here to help make sense of diabetes and help educate you about how simple life changes can have profound effects on your health and on reversing and controlling your diabetes. We know that you may start only dipping your toes into the water of healing. We are here to lend hope, support and offer answers and confidence in your success.
Quote of the Day:
“You never change your life until you step out of your comfort zone; changes begins at the end of your comfort zone”
~ Roy T. Bennett
Board Member Updates
Remember to order Dr. Morstein’s new outstanding diabetes book at Amazon: Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes
New Informative Interview
Dr. Morstein has added a wonderful interview with Dr. Joseph Pizzorno to the LCDA website under the Essential #6, Environmental Detoxification. Dr. Joe Pizzorno is a naturopathic physician with an expertise in environmental chemicals and discussed the horrors of those chemicals and in particular how they are related to developing and aggravating diabetes. Dr. Pizzorno lists simple ways to get started avoiding exposure to chemicals and how to begin a basic detoxification program. He is author of the book The Toxic Solution.
ULTA Labs Coming to the LCDA!
The LCDA will soon have a easy to use link to ULTA LABS on our website where anyone can order very inexpensive labs. If you do not have insurance or if your insurance still leaves you with significant laboratory charges, using Ulta Labs through the LCDA will save you significant money. The LCDA set this up to enhance comprehensive diabetic laboratory testing for patient with prediabetes and diabetes, and established a few panels, but you can order any lab you wish.
Ulta Labs is a company that has arranged with SonoraQuest labs to run very affordable blood work for physicians to order for their patients, or for people to order for themselves. This is a win-win set-up for everyone involved. The LCDA does get a little money from Ulta Labs for promoting lab tests through our website, but it goes straight to the non-profit to help us grow and offer more services for our members.
If you need upcoming labs, and are worried about a large lab bill, it’s easy to check out the prices on the Ulta Labs offered through the LCDA. Keeping on track of helpful lab values means your diabetes and risk factors are reducing, reducing your worry and stress! LCDA and Ulta Labs is a good mix!
Connect to Ulta Labs here: http://www.UltaLabTests.com/LCDA
Apple Cider Vinegar and Glucose Control
Essential #7: Supplementation
Vinegar is made from any fruit or any food containing some sugar, and consists of two separate fermentation processes. When using fruit, first the fruit is squeezed and the juices are extracted. In the first fermentation process, certain yeasts are added to the liquid and the apple sugars are turned into alcohol. In the second fermentation process, other specific bacteria are added call acetobacter, and the alcohol is converted into vinegar. This process produces acetic acid, and the vinegar then tastes tart.
Aside from acetic acid, vinegar also contains riboflavin (Vitamin B2), thiamine (Vitamin B1), and mineral salts.
Here are the most common substrates used to make vinegar:
- Apple vinegar or cider vinegar (AKA apple cider vinegar or ACV) is made from apples
- Wine vinegar is made from grapes
- Malt vinegar is made from barley malt
- Sugar vinegar is made from sugar syrup or molasses
- Rice or rice wine vinegar is made from rice sugars or a concentration of rice without distalilaion.
- Balsamic vinegar is made from grapes
- Spirit or distilled vinegar is made from dilute distilled alcohol
Vinegars that are sold in America will have an acetic acid concentration between 4-7%.
What is so important about vinegars that the LCDA is writing about them? There is one vinegar that stands out in diabetes care: Apple Cider Vinegar (ACV). Apple cider vinegar has some very interesting studies to discuss regarding diabetic patients. There have been some interesting studies on ACV related to lowering glucose levels after meals and lowering fasting glucose levels. Although all the ACV studies were done on very small groups of people, the results have been consistent and worth discussing.
The first study, done in 1958 by a Japanse researcher, showed that taking ACV before a higher carbohydrate meal reduced glucose numbers after the meal vs. a placebo. Other studies have replicated that finding, and shown that ACV also increase insulin sensitivity, so that less insulin is needed to reduce glucose levels. It seems, though, that it only occurs when people eat complex carbohydrates, such as in grains. When a study was done seeing if ACV could lower after meal glucose levels after people ingested straight sugar, it did not work, and glucose levels rose accordingly. So, what we see is that ACV can lower glucose levels after meals 20-33% if the meal contained non-sugar carbohydrates. ACV intake has also been shown to help with weight loss, a benefit for many overweight or obese diabetic patients.
Another study looked at giving ACV with a little bit of cheese (to keep the ACV from upsetting the stomach) right before bed, to see if it could lower morning glucose levels, and indeed, it did. Glucose levels decreased by 4-6%, which isn’t a lot, but can lower glucose from 100 to 95 mg/dL. The problem is figuring out what truly helped: was it the cheese, as in some patients eating a little protein before bed can lower morning fasting glucose, or the ACV, or both? It’s hard to tell but the ACV could have certainly contributed.
How is the ACV lowering the glucose levels? It seems that it may do so by slowing gastric emptying rates, like the non-insulin GLP-1 injections do. This means ACV might be contraindicated in T1DM or T2DM patients with gastroparesis, that is, damage to the vagus nerve in the stomach preventing normal functioning stomach movement and emptying.
However, another benefit to ACV include its ability to gently stimulate hydrochloric acid production in the stomach, which can then activate pepsin, the digestive enzyme that helps digest protein foods. As we age, it’s not uncommon that we produce a little less digestive enzymes. Signs of lower stomach acid production could be feeling that a chicken breast or steak, a solid type of protein, is not digested quickly and sits like a rock in your stomach. Another sign could be hearburn or GERD (gastroesophageal reflux disorder). Since increasing stomach acid is a benefit in promoting good stomach emptying, ACV may actually be helpful for patients with mild or moderate gastroparesis. Each patient needs to be analyzed differently with a comprehensive integrative physician.
Some people theorize ACV may also work by reducing the digestive enzymes that break down carbohydrates so they are in the intestines longer and enter the bloodstream in a slower manner.
Since ACV may produce some nausea or lead to dental enamel erosion, or irritation of the esophagus, it should always be diluted with water. It can also be mixed with olive oil and used for salad dressing. Since people with diabetes should not use balsalmic vinegar, as it may increase glucose levels, apple cider vinegar is a good alternative. Limiting ACV intake to 1-4 TBSP a day in water seems reasonable. Also, drinking the water/vinegar mix with a straw can help avoid washing one’s teeth with the acetic acid, another smart idea. Long-term use of higher doses of vinegar may reduce potassium levels in the body, so use vinegar with care and report you are using it to your comprehensive integrative physician. Potassium levels can be easily analyzed in blood work.
It makes sense to buy organic apple cider vinegar as apples are the #1 most agriculturally sprayed vegetable in America, and is definitely on the Dirty Dozen list at the Environmental Working Group’s list of most sprayed produce. Getting organic means a lot less chemicals come with your vinegar. Also, avoid the crystal clear versions instead choosing to buy unfiltered, unprocessed (or raw) vinegar that is murky looking and contains the “mother.”
The last comment the LCDA would like to make on this is first, eat a low carb diet. The LCDA does not recommend eating higher carbohydrates with meals and then taking ACV to prevent glucose elevation. The key is to learn to eat correctingly for diabetes, which is a low carb diet, and only use ACV when necessary: perhaps at a restaurant or party when eating a higher carbohydrate meal seems absolutely unavoidable; or, to help improve digestion in the stomach; or, at bedtime if morning glucose levels are not yet ideal.
How To Buy A Sauna
Essential #6: Environmental Detoxification
The LCDA has mentioned using saunas to help with environmental detoxification.
While work-out gyms tend to have saunas, not everyone belongs to a gym. What if you wanted to buy a sauna for daily, or several times a week, use in your home? There are few things you can do better for environmental detoxification and overall health.
Why do we need to sweat, deeply, as often as possible?
Sweating, or perspiration, is the release of salt-based fluid from your sweat glands. The human body has over three million sweat glands. Sweating helps the body with thermoregulation, that is, cooling the body when we it begins to overheat. This allows humans to live in hot areas, work out intensely, and break fevers. Sweating can also occur due to stress, eating hot/spicy foods, hormonal changes such as menopausal hot flashes, and perhaps from the side effects of medications or surgery.
The LCDA advocates sweating because it has been medically proven to show it cleanses the body of both environmental toxins (ET)–chemicals and heavy metals. Remember that ET are mostly stored in fat cells and when weight loss is occuring, are released into the bloodstream. If there are a lot of chemicals they can re-initiate or strengthen insulin resistance, stopping the weight loss and leaving a patient feeling frustrated and miserable. Sweating out those released environmental toxins may be a great way to maintain consistent weight loss.
Far infrared saunas penetrate up to 3 inches into the body. The light enters the body and is converted into heat energy. They are completely safe and are even used in hospitals to warm premature babies.
They help reduce cortisol levels which can help lower glucose levels and relax a person. They can increase blood to muscles, reducing tension in them. During a sauna, a person’s heart rate increases and so does one’s metabolism, helping one to actually burn calories. The infrared red energy in the cells breaks down the collected toxins in the fatty and watery tissues, and being smaller are able to be expelled through the pores of your skin.
Saunas historically were steam-based, but light-heated saunas are probably older than you think. Dr. Kellogg created a sauna using light bulbs in 1893, and although it wasn’t quite 100% infrared, there was heat created in that spectrum. By the 1920s, specific use of infrared light became more common.
Here is a Long List of Possible Contraindications:
Before you buy a sauna, the LCDA absolutely recommends you are medically cleared by your physician to safely use it. Ensure you are hydrated throughout the sweating process and afterwards. Add in an electrolyte to your water is recommended. The LCDA recommends using LoSalt Original for electrolyte replacement. Ask your integrative physician what dose you should add to your water, but it is generally around 1/2 teaspoon per liter. Start with lower temperatures for shorter durations to slowly build up your heat tolerance. If you have suffered an injury–bruise, sprain, laceration or surgery, and especially if there is any swelling, you should not use the sauna until your physician clears you to do so. If you are pregnant, do not sauna unless your Ob/Gyn clearly allows it. For breast-feeding women, since toxins can be released from tissues, they may wind up entering your breast milk. It seems prudent to avoid saunas while you are actively breast-feeding your baby. Women may also find it sensible to avoid saunas during their period. If you have any artificial implant, pacemaker or joint replacement, the LCDA recommends you check with your surgeon to see if Infrared sauna is best, although it scientifically is, as the materials in joint replacements tend to reflect not absorb this type of energy. Anyone with a bleeding disorder should avoid using a sauna, and anyone with advanced symptomatic heart disease and/or angina should not use a sauna unless the use is supervised by their doctor. Moderate sauna use is safe for seniors, although the LCDA strongly recommends all seniors are cleared for sauna use by their physician. As for children, none under 6 years old should use a sauna, and from 6 upward sessions should be brief, always accompanied by an adult.
Wait 1-2 hours after eating to use the sauna and do not engage in alcohol or recreational drug use before or during the sauna.
If you ever feel light-headed, faint, or racing of your heart, immediately end your sauna session.
Okay, so you do not have a contraindicaiton, and/or you have been cleared by your physician to buy and use a sauna to their specifications. How do you choose a good sauna? Saunas come in different sizes and range from $200 for portable ones to $25,000. They can be built for 1-4 people to use at a time.
The LCDA does not recommend the portable saunas that are very low cost, for example, found on amazon.com. The LCDA recommends buying a wood sauna from a reputable company.
Here are some guidelines for buying a quality sauna:
- Have the sauna be a far infrared heater. This type of heater is the best for raising core temperature and thus initiating sweating, as well as lowering blood pressure and helping in weight loss. Infrared heat safely penetrates deeper into the body.
- You want a sauna that have a high emissivity level–that means, it delivers a high concentration of the infrared waves.
- You want a sauna with low Electromagnetic Field energy waves. EMF waves are high from power lines, cell phones, broadcast towers, electrical security systems, and more. EMF waves are associated with different health risks, as they disrupt the natural EMF fields in body cells. They are even associated with increasing the risk of certain cancers. Having a sauna be low or non-existent in EMF production seems mandatory to having it really maximize health without harming it.
- Made from safe, non-toxic materials, and wood that is sustainably gathered and hypoallergenic. Obviously, with a goal of detoxifying, sitting in a sauna made from toxic materials seems counter-productive! Ensuring that the materials used are green and emit no dangerous gasses is important.
- Looks, Ease of Use and Durability–buying a sauna is an investment into your current and long-term heatlh, and it makes sense to want to buy one that looks nice, is comfortable and will last for years. Saunas can also have good acoustics for listening to music, to enhance the detoxification process. You might wish to have a sauna that is safe for indoor and outdoor use, to enable you to place it where you wish for ultimate enjoyment and convenience.
- Safety certification–since we are mixing wood, sweat, with electricity, it is certainly important that a sauna have a great safety certification record.
- Solid warranty–like any other purchase, having a good warranty to protect yourself from any problems is necessary.
Companies that make good saunas: (the LCDA is not associated with any sauna company listed below)
- Sunlighten Saunas: www.sunlighten.com
- Rocky Mountain Saunas: rockymountainsaunas.com
- Medical Saunas™: www.medicalsaunas.com
This is the best on-line article the LCDA found clearly discussing what to look for and avoid when buying a sauna. The LCDA recommends you DEFINITELY read this if you are serious about buying a sauna. http://www.saunas10mistakestoavoid.com
2017 ADA Standards of Medical Care In Diabetes
There are some interesting items that are focused upon the new ADA Medical Care guidelines for physicians.
These guidelines came out earlier this year and the LCDA did find some aspects of them worth discussing. The guidelines are created by a panel of twelve leading experts in diabetes care, including physicians, diabetes educators, registered dietitians and others that have knowledge in pediatric and adult endocrinology, epidemiology, publish health, lipid research, high blood pressure, and pre-conception and pregnancy care.
Here are a few highlights about the new standards:
- The ADA recognizes that there is an increase risk of mental/emotional stress and disorders in patients with diabetes, and the standards created screening guidelines for youth and adults to try to diagnose problems as expediently as possible. In particular checking for anxiety, depression, eating disorders and other concerns related to living with diabetes. The LCDA easily agrees with this concern and focus for comprehensive integrative physicians seeing diabetic patients.
- The standards enhanced the importance of assessing each diabetic patient for any concurrent problem they have, such as mental/emotional disorders, eating disorders, positive HIV status, ad auto-immune diseases. The LCDA agrees with this guideline.
- The ADA standards includes more treatment drug options for diabetic patients with hypertension. Considering on average a Type 2 diabetic patient in conventional care with high blood pressure will be on 3-4 medications to lower their blood pressure, it is helpful to realize on the LCDA program of The Eight Essentials®, many if not most patients who are compliant may very well be able to reduce or remove their blood pressure medications.
- In diabetic patients with cardiovascular disease–history of stroke or heart attack, acute cornary syndromes, angina, or periperal artery disease–they are at an increased risk for death. As a result, the ADA recommends adding other drugs into their protocol, liraglutide, a GLP-1 injection, or empagliflozin, an SGLT-2 inhibitor oral medication.
- The ADA believes that glucose levels less than 54 mg/dL be considered a serious episode of hypoglycemia. The LCDA can easily agree with this designation.
- The ADA believes that a newly diagnosed T2DM diabetic patient with an A1C equal to or greater than 10% and/or blood glucose levels over 300 mg/dL should be placed right away on insulin, and if the insulin doesn’t work to lower the glucose levels substantially, then adding in more medications should occur. The LCDA believes that first engaging the patient in a low carb diet and the other key Essentials can easily, within a week, significantly lower glucose levels to much safer levels, avoiding the need for using insulin, a problematic drug for T2DM patients.
There are many beneficial aspects to the ADA. Their advocacy of diabetes has enabled people with diabetes to care for themselves as needed at schools, in workplaces, and has allowed diabetic patients to join professions, such as being a fireman, for example, which historically was not open to them. The ADA funds a lot of research on diabetes, as well. Unfortunately, even today, the ADA is still attached to medications–including terrible, designed to fail recommendations for dosing insulin in T2DM patients–a higher carb diet, and doesn’t acknowledge the value of any of The Eight Essentials®. That is why the LCDA exists and has such a strong mission to connect diabetic patients with comprehensive integrative physicians, so T2DM can be put into remission, and all diabetic patients can have excellent control with the least, not the most, amount of medications.
If you wish to read the entirety of the ADA 2017 Standards they can be found here.
How To Not Sit All Day
Essential #2: Exercise
Dr. James Levine of the Mayo Clinic associated with Arizona State University is noted as being the originator of the phrase “Sitting is the new smoking.”
There are many studies appearing showing some serious consequences of sitting too much. Sitting regularly for long periods of time is associated with obesity and metabolic syndrome, and increases one risk of dying from cardiovascular disease. Too much sitting is associated with higher blood glucose levels, hypertension, and elevated cholesterol levels. These are all aspects of T2DM.
One study compared adults who spent less than two hours a day to those who spent more than four hours a day in front of a TV or other screen-based activity. Those who had the most screen time had 1) a nearly 50% increased risk of death from any cause
2) about 125% increased risk of having an event associated with cardiovascular disease. Diabetic patients have a 2-4x increase risk of dying from cardiovascular disease than non-diabetic people. Adding in sitting too much seems extra dangerous!
Too much sitting may increase the risk of cancer, as well.
How much is too much sitting: It seems it is equal to or more than 6-8 hours a day.
Unfortunately, it’s not only recreational sitting that is a problem; sitting in your car or at work for long hours every day seems to be equally problematic.
How can a person then begin to break away from their chair? Even standing more is good. Standing can burn more calories, increase HDL (good) cholesterol, help with weight loss, and can enhance mood and energy.
Here are a few easy suggestions:
- Stand up, and even better pace, when on the phone with someone.
- Stand up during lunch, and even better, eat quicker and go for a walk during the rest of the lunch period.
- Ask your company to give you a standing desk, and ensure you are standing at your own computer or desk at home. You do not need to buy an expensive set-up for that; Dr. Morstein has her laptop sitting on a lot of books on her desk in her study, allowing her to stand and work in a very inexpensive way!
- Even better, get a desk treadmill, and walk during your work periods. Companies sell treadmills with desks attached, or you can also buy a portable treadmill and insert it under your desk. Lifespan sells those type of treadmills: https://www.lifespanfitness.com
- Walk when shopping–park far from the store entrance and walk; take stairs not escalators; park furthest from the store you wish to visit in the mall.
- Watch TV on an exercise bicycle or at least stand during commercials and pace or do some stretches or calisthenics.
- Take activity breaks from your desk or work station.
- Walk the dog, the child, the spouse, whoever and whatever you can!
- Engage in more active hobbies, such as gardening, dancing, painting, writing, photography, etc. where you can spend time standing or moving in ways that pass quickly, are enjoyable and creative.
Yet, studies are also showing that just standing up isn’t good enough and engaging in physical exercise is a key vital part of the plan to not sit.
Being healthy is today understood to spend less time sitting, and more time exercising, both aerobically and with resistance or weights; working on flexibility, balance and agility; and, last, being less sedentary.
While exercise is always beneficial, it may not always undo all the negative aspects of otherwise sitting a great deal. 30-60 minutes of exercise cannot in and of itself make up for sitting twelve hours a day!
The key is being active on a regular basis, moving one’s body as much as possible, as constantly as one can, throughout the working day, the off work time at home, and via exercise. In these ways patients with diabetes can have more success in having lower glucose, losing weight, enhancing mood, and having more energy, all extremely important goals to achieve.
So, the next time you are sitting around walking TV, maybe realize you can instead stand around, or can pace around, or can do sit-ups, or can turn the TV off and go outside for a walk. Developing a new mindset of movement is a way to develop a new way of helping to control your diabetes.
Books: (All are found on Amazon.com)
- Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes. Dr. Mona Morstein
- Apple Cider Vinegar by Patricia Bragg
- The Vinegar Book by Emily Thacker
- Dr. James Levine and NEAT: http://www.mayoclinic.org/documents/mc5810-0307-pdf/doc-20079082
- Dr. James Levine YouTube Video on moving: https://www.youtube.com/watch?v=S6eIvxqaezE
LOW CARB RECIPES
Recipe #1 | California Spicy Crab Stuff Avocado
Total Time: 10 minutes
These avocados are stuffed with lump crab, cucumbers and spicy mayo topped with furikake and drizzled with soy sauce.
* 2 tablespoons light mayo (I used Hellmans) *for whole30 use compliant mayo
* 2 teaspoons sriracha, plus more for drizzling
* 1 teaspoon chopped fresh chives
* 4 oz lump crab meat
* 1/4 cup peeled and diced cucumber
* 1 small Hass avocado (about 4 oz avocado when pitted and peeled)
* 1/2 teaspoon furikake (I like Eden Shake or use sesame seeds)
* 2 teaspoons gluten-free soy sauce (or Bragg’s amino acids or coconut aminos)
1. In a medium bowl, combine mayo, sriracha and chives.
2. Add crab meat and cucumber and chive and gently toss.
3. Cut the avocado open, remove pit and peel the skin or spoon the avocado out.
4. Fill the avocado halves equally with crab salad.
5. Top with furikake and drizzle with soy sauce.
Yield: 2 servings
Serving Size: 1/2 stuffed avocado
Amount Per Serving:
* Calories: 194
* Total Fat: 13g
* Sodium: 746mg
* Protein 12 g
* Carbohydrates: 7g
* Fiber: 4g
* Total Carbs 3 g
Recipe #2 | Grilled Flank Steak With Tomatoes
Total Time: 30 minutes
* 2 lb flank or london broil steak
* kosher salt and fresh pepper
* garlic powder
* 1 tbsp extra virgin olive oil
* 2 tbsp balsamic (generally the LCDA recommends avoiding balsamic vinegar but in this recipe it does not appreciably increase the carbs)
* 1/3 cup red onion, chopped
* 3-4 tomatoes, chopped (about 3 1/2 cups)
* 1 tbsp fresh herbs such as oregano, basil or parsley
1. Pierce steak all over with a fork. Season generously with salt, pepper and garlic powder and set aside about 10 minutes at room temperature.
2. In a large bowl, combine onions, olive oil, balsamic, salt and pepper. Let onions sit a few minutes with the salt and balsamic to mellow a bit. Combine with tomatoes and fresh herbs and adjust seasoning if needed.
3. Heat grill or broiler on high heat. Cook steak about 7 minutes on each side for medium rare or longer to taste. Remove from grill and let it rest on a plate for about 5 minutes before slicing.
4. Slice steak thin on the diagonal; top with tomatoes and serve.
Yield: 8 servings
Serving Size: 3 oz steak + 1/2 cup salad
Amount Per Serving:
* Calories: 198 kcal
* Total Fat: 9 g
* Sodium 71 mg
* Protein 25 g
* Carbs 3 g
* Fiber 0.5 g
* Total Carbs: 2.5 g