Not that I should luxuriate in writing blogs while I am finishing my diabetes book, but to call attention to the problems with wheat – on this occasion I just have to do it.
Since this is my big theme presently, let me roll up the whole gluten conundrum from the diabetic side: Ninety percent of people with diabetes type II are overweight; ten percent are not. Now – what gives the ten percent their diabetes?
Genes, of course. But genes account only for part of the puzzle. Most slim diabetics have either type I diabetes (which I will not discuss here), or they have gluten intolerance. Disclosure: I am one of those ten percent, and while I don’t yet have full-blown diabetes with all the dismal consequences down the road like blindness, kidney failure, amputations, neurological damage, my number always hover at the upper border of normal or the low border of diabetes. For somebody who has brittle diabetes and ends in the hospital frequently, this seems a good place to be, and sure it is. BUT: By the time people are diagnosed with diabetes, a good third already shows sign of end-organ failure. Which means: They really already have advanced disease. I don’t want to wait doing nothing and closing my eyes.
So, what do I do? I move, for starters. I don’t go to the gym, but I work in the garden, play my cello, go for a walk after dinner with my husband, and do tiny exercises every time I get up from my chair during my long writing sessions (aaah – writing a book about health is not such a healthy thing, after all).
And I eat healthily. Fresh vegetables, fresh herbs, some fish, much less meat (but meat I do eat – and recommend), no dairy, no sugar, no sweeteners either, no trans-fats, and basically, nothing processed.
But back to gluten. We pray for our daily bread – and are not aware how recent the “daily bread” was invented – not longer than five to ten thousand years. Which is nothing in terms of evolution and our genes. Actually, our “daily bread” is around not much longer than monotheism – the belief in a single, singular god. I find that interesting: When we were hunter and gatherers, eating and nibbling and plucking from Nature wherever we went, we had multiple gods – the ones that were hidden in the groves, in the deep lakes, in the skies – and everything was whispering to us: Holy, holy, holy.
Then agriculture was invented with cattle and sheep husbandry, and we learned to sow and to reap, and suddenly there was that one stern god over us, telling to adhere to his rules – one obviously needs rules and timetables and schedules and order to be a farmer.
Forward a few thousand years to Mr. Kellogg, who gave us our breakfast cornflakes, and modern scientists who gave as bigger kernels of wheat, and then all the abundance that came with industrialization and prosperity – and here comes the modern American wave of obesity and diabetes. Where for millions of years always was scarcity – and that is what our bodies were adapted to for millions of years – now we can get the whopping calories of a burger for one dollar. Without to move out into the woods and hunt and gather.
If gluten is at the root of those ten percent of slim diabetics – so what! you exclaim, because you are fighting the pounds for most of your life. Gluten makes a few of us very sick – with celiac disease. Gluten makes a lot of us fat, with sickness down the road from the excess pounds.
Celiacs have no immune tolerance for gluten; they might get diarrhea, skin rashes, bloating, and all kinds of weird symptoms – including neurologic and psychiatric. Half of the symptoms are not showing in the belly, which is one reason gluten intolerance is still one of the widely under-diagnosed disease – even that the last ten years has turned the tide a bit.
The funny thing is: Wheat does not want to be eaten. Like basically all nuts and seeds, the wheat grain contains a family of compounds called lectins that are there to protect the grain from being eaten. The wheat plant has no interest, so to speak, to be gobbled up and extinguished. On the other hand, from the wheat’s point of view, of course, it is extremely advantageous that farmers everywhere now growing this seed that originally had a very narrow distribution, namely the Fertile Crescent of Mesopotamia. Somehow we managed to spread it more or less worldwide – or did the plant entice us to do its business?
Not sure. But nuts and seeds contain lectins that hinder digestion and make people sick with arthritis, depression, heart disease, cancer, diabetes, and so on – the celiac who runs to the bathroom ten times a day is only the tip of the iceberg. And it shows the wisdom of our bodies: To get rid as fast as possible of a toxic substance.
Wheat is addictive – it contains morphine-like substances that play with your brain and your longings just as cocaine and heroin do. I always picture how the first farmers, sitting placidly and satisfied in their hovels, invited the last hunters who came in from another fruitless hunt for something to eat (the rise of agriculture happened parallel to the extinction from overhunting the very large ice-age mammals – they had bison the size of elephants, and deer like cows at that time. The rise of monotheism happened at the same time … did we feel guilty for the overhunting??). The hunters got their bowl of gruels or their flat breads; it must have seemed heaven to them. As they never got enough of it, they came back for more and more, until they one day decided to plough a piece of land, and settle down as farmers themselves.
So, if you want to get healthy and/or slim, you first have to break the wheat (and corn! And sugar! But those are other topics …) addiction. You don’t die of starvation, if you leave out bread and pizza and cakes and cookies and muffins. You just get healthier. The food to eat: Vegetables, vegetables, vegetables. And some brown rice, as rice does not seem so addictive as wheat. It just doesn’t taste so yummy, yummy that you want more and more of it.
In all of this, I haven’t even talked about what they do nowadays once the too-big, overinflated-by-starch wheat kernel is harvested: They mill it and grind it and take the good stuff out, namely the coarse outer layers that contains vitamins and ls . The make white flour from naturally brown flour, and because it is known that white flour contains nothing healthy and leads to deficiency diseases down the road, the “fortify” the flour with vitamins and iron.
Believe me, nothing is as well “fortified” as the original grain. I mean the really “original” grain which we cannot retrieve anymore because the first grains were so puny – not much more then a few hard nibs in your mouth while you were searching for the really belly-filling rabbit or root. If you want to do wheat at all (and if you are a celiac, you can’t have it ever again! Also not rye and barley; perhaps not even oats), at least stick to dinkel and kamut, some of the older grains. Not as old to go back to the dawn of times, but going back a few thousand years, to the first cultured strains. They contain more hulls and “waste”, less gluten and starch. You also can try sprouted breads where most of the gluten has been used up in the process of sprouting.
Our modern degenerative diseases have to do with mostly four culprits: Wheat, dairy, sugar, trans-fats. Our redemption lies in the plant world: vegetables, herbs, fruit. A few beans, a few nuts. Some fish. And occasionally … a rabbit. Read More
Blog: On Health. On Writing. On Life. On Everything.
How to Measure Diabetes
July 21, 2010
In ancient times, diabetes was diagnosed by licking the urine of the patient. If it tasted sweet, a diagnosis of diabetes mellitus (“honeysweet flow”) was made. As a physician, I am glad we have advanced to better tests...
There are basically four different tests to diagnose diabetes (I am talking here mostly of type II):
• Spot blood sugar. Since sugars rise and fall depending what and when you ate, this is a very unreliable test.
• Fasting blood sugar. Does only take a bit of blood, is cheap and fast – but still can vary with what one ate the day before. However, if your fasting numbers are up consistently, you should pay attention!
• Oral Glucose Tolerance Test: a complicated procedure where one drinks an awfully sweet fluid before blood will be drawn in half-hour intervals to ascertain how fast the sugar load is cleared out. It’s complicated, and very time-consuming for the patient. I object of giving a patient a drink 75 to 100 gm of unpalatably sweet glucose solution – which can’t be healthy if there is a disease caused by sugar. My suspicion is that this test is still be used because doctors can bill the most for this.
• Glycosylated hemoglobin, also called A1c: An easy blood test that gives a rough average of your sugars through the last month. I like this one the best because the usual ups and downs of sugar are not interfering with the test, but going into the overall measuring. With frequent episodes of hypoglycemia (too low blood sugars), the test might come back falsely low or normal. In iron-deficiency, A1c are higher than they really are, suggesting diabetes where there might be none. Every time one eats sugar, it “glycosylates” (adding a sugar to the molecule) a protein on the surface of an erythrocytes (red blood cells), and the chemical process is never reversed as long as the blood cell lives. Red blood cells live about three months; blood we draw is always a mixture of very young cells, newly released into the bloodstream from the bone marrow, and older cells, soon to be discarded. Measuring blood glycosylation therefore represents a fair mirroring of recent sugar intake and over time, those numbers can be compared: A lower A1c means you have done something right lately.
In conventional medicine, A1c is called normal if it is below 6.0. A1c is measured in percent of how much of the blood is “sugared”. Starting at 6.1, you have diabetes. That in it itself is rather absurd: A little step upward from 5.9 to 6.0 does not give you diabetes – you had it coming all along. In Natural Medicine, we think that between 5.0 and 6.0, one has “latent” (developing) diabetes. Why that number of 6.0? Because if one would chose 5.0 as the cut-off point, most Americans would have to be diagnosed with the disease.
The Oral Glucose Tolerance Test is more sensitive to detect cases of diabetes – but only if the cut-off point for diabetes is set at 6.0 A1c.
Arbitrarily putting the number to 6.0 does not make a person healthier. In fact, at the date of diabetes diagnosis, I good proportion of patients have already end-organ failure, namely eye problems, kidney failure, neuropathy – to name a few.
Just looking around tells us that many people are overweight and have some of the telltale signs of diabetes: belly fat, scant hairs on arms and legs, rosy cheeks. One sign alone does not make the diagnosis – but several together gives me an idea. But one can be very overweight and never develop diabetes, because in order to get the disease, you have to have the genes AND an unfortunate lifestyle.
Don’t think that genes are an excuse. Because diabetes type II does not strike, if one lives frugally. For instance, after World War II in Europe, basically nobody had it (but people died in droves of tuberculosis then…). Ten years later, with ballooning economies and waistlines, diabetes was back.
But you don’t have to starve yourself, to heal diabetes. You need a mixture of moderate movement (walking, swimming, biking – or dancing; whatever you like) and a diet without sugars, white starches and bad fats.
In diabetes drug studies, diabetes often is called “controlled” if the blood sugar stays within the limits if 7.0 to 10.0 A1c. We can be sure that at those numbers the damage done by high sugars is continuing in the body. I personally favor an approach that does not “manage” the patient’s diabetes, but gets rid of it. And in many cases it can be done, with exercise, better nutrition – and determination on the patient’s side. Read More