If you are or you know anyone with prediabetes or diabetes, this book by Dr. Jason Fung would have been heard by you. People swearing by God that it is an authority in managing Diabetes specially type 2. I being passionately related to Diabetes, read this book and this blog is a sincere effort to pen down an objective view for the benefits of reader. Here we go…
First of all, a few word about the author. Dr. Jason Fung is a practicing nephrologist (specializes in kidney care and diseases). He’s also an authority on the LCHF (Low Carbohydrate High Fat) diet, especially for treating people with Type 2 diabetes. The author of two bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’ he recommends the use of therapeutic fasting for weight loss and Type 2 diabetes reversal at his Intensive Dietary Management program.
Chapter 1: How Type 2 diabetes became an epidemic
This is a very interesting start. This chapter covers a plethora of diabetes treatments that have failed and continues to fail diabetes patients today. It is a very sobering introduction. Lots of information that will make you shudder.
Chapter 2: The Differences between Type 1 and Type 2 Diabetes
This is a bit of a weak chapter. Wish Dr. Fung had done a comprehensive table on the symptoms of Type 1 and Type 2. A better explanation of the ability to distinguish between the two type types of diabetes would have been useful though he cut short the arguments by saying, ‘This is a book about Type 2 diabete’.
Chapter 3: Whole Body Effect
What many Type 2 diabetics never consider, is that the condition can lead to many other diseases. That includes Alzheimer’s, cancer, heart disease, stroke, diminishing eyesight, skin conditions and even amputations. This is a very interesting chapter as it makes you aware that diabetes is not just one disease but a whole bundle of diseases rolled into one.
Chapter 4: Diabetes: The Calories Deception
This chapter is a must read for those people who consider themselves not overweight, except perhaps a very small tummy. He argued that body mass indicator is apparently not the best indicator of Type 2 diabetes. Rather, waist circumference is a far superior predictor of Type 2 diabetes.
Interestingly, removal of subcutaneous fat brought no metabolic benefit. Presumably that means no improvement in diabetes. The real culprit it seems is visceral fat. One could even have a normal BMI and still have diabetes. The chapter goes on to explain the difference between types of fat. This chapter also talk about the myth that calories is what drives obesity with solid evidence.
Chapter 5: The Role of insulin in Energy Storage
The best way to get fat? Take some insulin says Dr. Fung. This chapter starts with this dramatic claim but goes on to explain why that is so. Food energy is stored as glycogen and fats. Insulin is the signal to stop burning sugar and to start storing it as fat instead. When insulin goes our of whack, is when we hit trouble Dr. Fung says.
Chapter 6: Insulin Resistance: The Overflow Phenomenon
This is the chapter every Diabetic wants to read. What causes insulin resistance? We think sugars and carbs. As the chapter explain it is not so simple. Why are many obese people not diabetic is the question Dr. Fung poses. A very good point.
There apparently many types of resistance but the takeaway is that insulin resistance occurs when blood glucose levels remain high. How that develops is fascinating to read. It certainly gives you a very good understanding how Type 2 diabetes develops.
Chapter 7: Diabetes, a disease of Dual effects
According to Dr. Fung “ insulin resistance emerges on average almost thirteen years prior to type 2 diabetes ”. That is a sobering thought.
Apparently insulin resistance is due to a fatty liver which is also exported to other organs, most notably a fatty pancreas. This chapter looks at a whole host of inter related mechanism which create Type 2 diabetes. What was interesting was the statement that the body can either burn sugar or fat for energy but not both at the same time. This is sited as the reason that no amount of exercise will get you rid of fat you if have stored sugars in your system.
Chapter 8: The Fructose-Insulin Resistance Connection
This chapter starts with Dr. Robert Lustig’s famous lecture which went viral with 7 million views, to illustrate the dangers of sugar. It explains the difference between Fructose and Sucrose. It is certainly an eye opener, especially the deadly High Fructose Corn Syrup.
According to Dr. Fung fructose raises neither blood glucose nor insulin but has a hidden danger which is the slow accumulation of fat in the liver. He explains how a fatty liver goes on to create obesity and Type 2 diabetes.
Chapter 9: The Metabolic Syndrome Connection
So what is metabolic syndrome? The short answer is that it is abdominal obesity, low HDL, high triglycerides, high blood pressure and high fasting blood glucose. While these conditions are associated with stroke, cancer and other conditions it apparently has a major effect on diabetes.
Chapter 10 – Insulin; Not the answer for Type 2 diabetes
Dr. Fung postulates that giving insulin even for a Type 1 diabetics can and does lead to other complications including metabolic syndrome. Since there is no alternative yet for that, he leaves that alone.
However he believes that using insulin to treat Type 2 diabetics is unnecessary and foolish. Especially given the severe side effects as well as the fact it simply does not work. He argues that reducing blood sugar alone will not cure Type 2 diabetes. Rather you have to lower both blood sugar and insulin to properly cure type 2 diabetes.
Dr. Fung’s hypotheses is that we have to address the root cause of excess insulin; diet and the frequency of insulin spikes caused by eating too many times. Control the insulin spikes and you reverse Type 2 diabetes.
Chapter 11: Oral Hypoglycemic: Not the Answer
Apparently a stunning 50% of Americans has diabetes or prediabetes. It goes on to explain how the medical industry has used diabetes as an opportunity make money. The billions made from selling insulin is staggering. Thirty new diabetic drugs between 2004 and 2013 were introduced to the market. Dr. Fung states ‘lowering blood sugar levels with medication as opposed to diet and lifestyle is not necessarily beneficial’.
Apparently health outcomes for Type 2 diabetes have only worsened, even as newer insulin medications have become more widely prescribed. This chapter goes on to explain the various types of diabetes medication and their side effects, which is disturbing. People faithfully dependent on Doctors don’t realize the deep troube they get into?
Chapter 12: Low Calorie Diets and Exercise: Not the answer
This chapter explores the mechanics of why they don’t work. Dr. Fung fingers the American Diabetes Association as well as the USDA and the Dept of Health and Human services for giving bad advice and rightly so. In fact it blames governments all over the World for this mess of recommending a low calorie diet and plenty of exercise.
HOW TO EFFECTIVELY TREAT TYPE 2 DIABETES
Chapter 13 – Lessons from Bariatric Surgery
This chapter starts with siting scientific relation between bariatric surgery and it’s effective in treating Type 2 diabetes. While it may be a solution for some severe diabetics, Dr. Fung believes it is usually NOT the right solution and goes on to explain why, chief among them, huge cost and complications from surgery.
Chapter 14 – Carbohydrate-reduced Diets
This is the crux of the solution as presented by Dr Fung, completely reversing Type 2 diabetes naturally. A low carbohydrate high fat (LCHF) diet alongwith Intermittent Fasting are important part of the solution.
Dr. Fung strongly suggests that the advice of the WHO, The American Diabetes Association (ADA) and the American Heart association is wrong. If you go to the American Diabetes Association web site, you will find a web site full of things they want to sell you and little free advice. A virtual whose who of the big drug companies. AstraZeneca, BD Medical-Diabetes Care, Boehringer Ingelheim Pharmaceuticals, Eli Lilly, Janssen Pharmaceuticals, Medtronic, Merck, Novo Nordisk, Pfizer and Sanofi. They have no interest in curing your diabetes. They want to keep selling you drugs and milk your wallet dry.
Chapter 15 – Intermittent Fasting
In the back of our minds we always knew that the concept of fasting was a good. After all why would all religions recommend it, if it harmed their flock? This is the argument Dr. Fung puts forward and goes on to explain why fasting works and works spectacularly well for Type 2 diabetes. Especially combined with a Low Carbohydrate High Fat Diet.
Fasting is not a calorie restriction Dr. Fung says. Eating four, five or six small meals according to Dr. Fung is the worst thing you can do, and provides compelling evidence why it is a very bad idea.
We have all done it all wrong, and this is a sobering realization when you look at the evidence. 99.5% of portion control diets fail. It all has to do with the metabolic rate, which goes down with a calorie reduction diet, while the metabolic rate does not go down in an intermittent fasting program.
If everyone followed Dr. Fung’s advice, 95% of Type 2 diabetes would be cured! Well, How long it takes to reverse diabetes type 2 diabetes is the only conundrum. It could take as little as three months on a LCHF diet combined with intermittent fasting and maybe longer for someone who has been a Type 2 diabetic for twenty years or so. The time period for recovery apparently depends on each patient but definitely achievable.
But the problem is the human condition. As we get older we get more stubborn and less willing to try innovative solutions. We like our routines, even if it means the routine of taking medicine. The vast majority of us have weaknesses that are hard to overcome. We know that. The addiction to sugar, love of alcohol and stuffing ourselves on carbs. Of course it is not all over our fault entirely. If we were not presented with such temptations, and lived in a remote jungle village we will make do.
So at the end, the book covers lot about Diabetes type 2. In my observation, one explanation which missed the mark is why some of us eating same bad food and even those who are fat never get Diabetes. The causal relationship to food consumption and insulin spike somehow fail to explain what initiate pancreas to produce more or less insulin and what mechanism stops cells to accept glucose for use as energy. What is causing the long duration of increased sugar in blood and for what purpose? What role stress plays in raising Cortisol which in turn is also known to have adverse effect on the functioning of pancreas? Why suddenly Sugar spike in blood falls abruptly without any explanation?
Thses few question could carry the key to understanding diabetes in totality.
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