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The Diabetes Reset: Avoid It. Control It. Even Reverse It. A Doctor's Scientific Program Hardcover – January 13, 2015
"Enlightenment Now: The Case for Reason, Science, Humanism, and Progress"
Is the world really falling apart? Is the ideal of progress obsolete? Cognitive scientist and public intellectual Steven Pinker urges us to step back from the gory headlines and prophecies of doom, and instead, follow the data: In seventy-five jaw-dropping graphs, Pinker shows that life, health, prosperity, safety, peace, knowledge, and happiness are on the rise. Learn more
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“A down-to-earth, holistic approach to obesity and diabetes through eight strategies, including a compelling case for the Rural Asian Diet, from a world-renowned scientist-physician. Dr. King’s friendly style makes you feel that you are in his office. I recommend this book for anyone who wants to learn more about managing diabetes or prediabetes.” —Edward A. Chow, MD, President of the San Francisco Health Commission, San Francisco Department of Public Health
“A clearly written book, with compelling advice on the prevention and control of type 2 diabetes that is backed by sound medical evidence.” —Wilfred Y. Fujimoto, MD, Professor Emeritus of Medicine, University of Washington, and a pioneering researcher on diabetes among Asian Americans, Pacific Islanders and Hawaiian natives
“The Diabetes Reset takes a look at diabetes from a new perspective. It offers insight into the challenges facing patients, and a lot of practical suggestions about how to tackle them.” —C. Ronald Kahn, MD, Past President, Joslin Diabetes Center; Mary K. Iacocca, Professor of Medicine, Harvard Medical School
From the Back Cover
Based on cutting-edge research from Dr. George King and his colleagues at the Joslin Diabetes Center, this book presents eight evidence-based strategies that—simple though they may sound—will dramatically change your life. The science proves it.
Implement only one, and your type 2 diabetes will improve. Pursue all eight, and you can not only stop type 2 diabetes in its tracks but turn it around—effectively resetting your body’s glucose metabolism for a long, healthy life.
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Essentially the premise of the "RAD" diet introduced in this book is that the fat in your meals creates insulin resistance, so by eliminating most fat from the diet and replacing with high-fiber carbs you should theoretically reduce your insulin resistance while minimizing the blood sugar spiking. In a healthy person this is not terrible advice, but this book tries to argue that everyone should be following this, regardless of their current state of diabetes/prediabetes. However the book outright claims that many Type 2 diabetics won't be able to reverse their diabetes on this diet, just to cover their butts essentially.
Here is the fundamental problem with this RAD diet - Type 2 diabetes is a disease of TOO MUCH INSULIN. And by eating the majority of your calories from carbohydrates (regardless of their nutrient content or fiber content) you will be RAISING YOUR INSULIN. Sure your insulin sensitivity will be much better if you limit the fat, that is a fact, but you're not fixing the root cause of the diabetes which is TOO MUCH INSULIN. See a trend here? There are many many other ways of improving insulin sensitivity, many of which are covered in the book! You shouldn't do it simply by lowering your fat intake and screwing up your hormonal balance and brain health.
Low-glycemic and high-fiber carbs do not lower your insulin very much, they just delay the blood glucose spiking a little bit. Sure they are better than pure sugar or starch, but they still raise your blood sugar and they still raise your insulin. Fiber also makes your stomach full and the "Chinese restaurant effect" causes your liver to dump extra glucose into the blood from your expanded stomach. The book even covers this and tells you specifically not to eat enough so that you feel too full, yet the book claims you shouldn't limit your calories. They're doing the old trick of telling you to eat a calorie-limited diet for weight loss but trying to disguise it and make it seem like you're not really restricting yourself. But you are, if you follow all of the rules they lay out in the book, which makes it very disingenuous.
They also talk about reducing your inflammation, and cover why it's so important to reduce it. Which is absolutely true. Yet they don't talk about the #1 source of inflammation being CARBS. I can't believe they would act like brown rice and "whole grain" won't raise your blood glucose, when we know both of them are very high on the glycemic and insulin indexes.
They vilify the "high fat diet" as a treatment for T2D, however they fail to make the distinction between a high fat diet and a well formulated "high fat, very low carb diet", which is what is commonly advocated for diabetes. Of course a high fat diet is going to be the worst thing if you're not cutting down the carbs to ketogenic range, but nobody is saying to do that. This book goes well out of its way to craft a straw man argument.
The truth is, a well formulated LCHF diet will reduce the amount of insulin your body requires to process your food. Period. If you are eating at a caloric deficit you will also improve your insulin sensitivity significantly (which is the only real argument this book makes against a high fat diet). The ONLY time you wouldn't get an improvement in insulin sensitivity on a LCHF diet is if you are eating to caloric excess, and that's simply because you're eating more fat in that case which will exacerbate your insulin resistance.However it is very hard to eat this many calories on a well formulated LCHF diet because the diet is so satiating - Unlike with a high-carb diet that will still allow rapid spikes of glucose/insulin, rebounding hypoglycemia and hunger pangs.
While I do think the diet proposed in this book is a better solution than the standard American diet (both high fat AND high processed carb), I think it's extremely disingenuous that the book tries to demonize high-fat low carb diets in a downright deceiving way.
Not to mention the book makes a bunch of really dumb points about wearing cooling vests to "activate your brown fat" and other such nonsense. REALLY dumb. The book doesn't do an adequate job of explaining the PRIORITIES necessary to eliminate diabetes. They just throw a bunch of stuff at the wall and hope something sticks.
John Przybylski MD
In all, an awesome book!
I also like the chapters on exercise, stress reduction and the importance of sleep. I especially like the chapter on boosting the antioxidants that the body makes for itself (in contrast to vitamin C or E for example that you take as supplements) and how you must eat vegetables and fruits to get the phytonutrients from which these antioxidants are made.
However, I found the logic of why the Rural Asian Diet (RAD) was used as the template for restoring health to those suffering from insulin resistance seemed half baked. King explains that the RAD has been successfully keeping East Asian cultures free from diabetes for thousands of years, and acknowledges that once the Asians move to the cities, they suffer from diabetes. He assumes the downfall is totally because they are eating less fiber and more refined carbohydrates. He spends very little time ever considering the types of fats people eat, and in the case of the Asians, he totally misses the fact that when they leave the rural setting, they abandon the custom of cooking with saved animal fats, and begin eating food cooked in factory-derived, seed-based unsaturated fat, such as soybean oil. In fact his entire book emphasizes that one's reduced fat component (down to 15% of the diet) should minimize saturated fats and consist more of unsaturated fats. I think this is a huge error on his part, in that he seems to have never explored in any depth the health values of different types of fat. He has not one listing in the index on unsaturated fat. His short section on the "bad fats" singles out saturated and trans fats. What a reader might be left with after reading his book is the assumption that for the 15% of one's diet allocated to fats, refined seed oils such as canola, soy, corn, safflower and sunflower may be perfectly acceptable. For anyone studying the effects of adulterated, if not hydrogenated, seed oils, his lightweight treatment of fats and oils is a bright red flag.
Likewise, in spite of all the warnings out there, and the rising awareness of the dangers of wheat gluten, and grains in general, King pushes grains as an important source of fiber, without even acknowledging that there is a debate on the safety of wheat gluten. He also ignores the data that shows that any products made from flour tend to have a higher glycemic load than pure sugar, and are therefore more demanding of insulin, and this is in conflict with his main premise that one should eat more fiber in order to reduce the damand for insulin. This for me is another red flag. This book seems to have been written with too little research on the current understanding of the effects of different foods on human nutrition.
Overall, if you buy this book, the main value is King's emphasis on getting a large percent of one's food from high fiber foods. What he doesn't mention as he focuses on how high-fat, low-carbohydrate diets are not a good long-term diet, is that one can actually eat a lot less carbohydrates, that provide a lot less than his recommended 70% of calories, and still get his recommended quantities of fiber. And this will leave a lot more room for healthy fats in the diet. Fats such as butter, lard, coconut oil (all highly saturated) and even olive oil (monounsaturated mostly). If a person wants to stick to a diet more heavily based on fat, (maybe 40-50%), and less on carbs, (maybe 30-35%), they can still follow his advice and get the carbs from fiber rich foods. Those foods will still look like a bulk of the diet, as they can be leafy greens, etc. They just won't provide many calories, but mostly fiber, vitamins, minerals, and enzymes -- very important for health and recovery from leaky gut, chronic inflammation, and diabetes.
Definitely, "The Diabetes Reset" has some good points, but it needs to be read with some awareness of what some of the other diabetes authors are saying. As far as diet is concerned, I don't consider that this book adequately covers all the bases.