Recently, I went to the hospital to visit my friend Jerry (name changed). He was recovering from heart failure. He’s also obese, a type 2 diabetic taking insulin and a slew of other meds for various conditions.
As I entered his room, he was in the middle of eating his lunch. I was shocked at what his medical team thought was a healthy meal. Now, remember, he’s a type 2 diabetic with heart disease, and he’s in a controlled setting (a hospital).
On his plate was a small piece of fish. It was a little dried out, but after all, it’s hospital food. Great so far.
But next to the fish was an ice-cream-scoop-size portion of rice and a medium sized hard roll. To wash down the meal, he was given some fruit juice. There was a little salad on the side too.
I was wondering when the dessert tray was going to be brought in.
Seriously, though, seeing Jerry’s lunch, I couldn’t help thinking, “Are they trying to heal him and kill him at the same time?” Had the hospital’s dieticians ever heard of something called a glycemic index (GI)? The GI reflects the effect a food will have on your blood sugar.
Everything that the hospital had served (except for the fish) was guaranteed to spike Jerry’s blood sugar. That’s something all of us should avoid but especially diabetics because of the inability of their insulin to cope with a sudden dump of sugar to their blood.
Here, Have Some Insulin With Your Chocolate Cake
I’m sure the hospital was monitoring Jerry’s blood sugar often, and it was under control. So why didn’t the rice, bread, and fruit juice adversely affect his blood sugar?
Right, because Jerry is on insulin. And if Jerry’s blood sugar went up all, the doctors would have had to do was…give him more insulin.
Do doctors ever stop to think what happens when they give a diabetic more and more insulin?
Remember those nature shows about the guy who keeps getting bitten by the cobra and after a while, he builds a resistance to the venom?
That’s what happens when doctors give patients insulin. The more insulin they give, the more an individual becomes resistant to it. And what happens when an individual becomes resistant to insulin? The doctor gives them more insulin. And so on and so on.
Why do doctors refuse to see that the problem in type 2 diabetes is too much insulin?!
So, in the hospital, Jerry is given his high GI lunch with a smile because they know they can regulate his blood glucose by immediately titrating his insulin.
But there are two important questions here.
First, why is the hospital serving Jerry a high GI meal in the first place? Second, what happens when Jerry goes home and starts consuming humongous amounts of rice and bread because, after all, that’s what the hospital gave him?
Let’s take one question at a time.
Why Did The Hospital Serve Jerry A High GI Lunch?
As I said before, the doctors in the hospital could monitor Jerry’s blood sugar so they weren’t worried about the danger of spikes. Also, their immediate concern was dealing with his heart failure.
However, that doesn’t explain why they gave him an insulin spiking lunch in the first place.
The answer, I believe, lies in the ostrich-like minds of the mainstream medical community and the experts who set dietary guidelines for the American people.
Let me explain.
Jerry’s tray contained about 70% carbohydrate, 18% protein, and the only fat containing food was the fat in the fish and perhaps what the fish was cooked in.
However, carbohydrates are broken down by the small intestine into glucose molecules. These glucose molecules then enter the blood stream.
We know that diabetics have trouble metabolizing glucose. That’s why doctors give them insulin.
So does it make sense to flood a diabetic’s blood with glucose? You would think not.
It does make sense though if one slavishly adheres to current medical and government dietary guidelines.
Current USDA Dietary Guidelines
The U.S. Department of Agriculture (USDA) advises that Americans consume 51% of their daily calories as carbohydrate, 32% fat, and 18% as protein (I know the numbers don’t add to 100%, but I took the numbers from the USDA site). They say that saturated fats should total less than 10% of total calories.
The FDA recommends a similar breakdown of 60% calories from carbs, 30% from fat, and 10% from protein.
The USDA recommends children over 9 years old and adults consume at least 1600 calories a day. Health.gov recommends that adult women consume 2000 calories a day and adult men 2400 calories a day.
Jerry’s Lunch Follows USDA Government Guidelines
Now let’s consider Jerry’s lunch. I realize I didn’t see Jerry’s meals for the whole day, but just by looking at his lunch, his meal would make sense in view of the government’s dietary guidelines.
His meal consisted of at least 10% protein, but, as I said, it was more like 25%. His carbs though were around 70%. That makes 95% of his calorie intake. So where was his 30% calories from fat?
Remember, Jerry has heart disease. The mainstream medical community has told us repeatedly for 40 years that fat, especially saturated fats, are a cause of heart disease. So the dietician probably increased his protein and carbs and cut down his fat.
I would also venture to say that the dietician had cut Jerry’s calories down. Compared to the portions I know most people eat, his lunch was on the smaller side.
In order to adhere to current healthy dietary standards, Jerry’s meal had to contain a high amount of carbohydrate and lower amounts of fat. Also by restricting his calories, it would theoretically help him to lose weight.
That seems to make sense, right? Well, not really. We’ll see why later.
It does, however, answer our first question of why the hospital served Jerry a high GI meal.
But you should be scratching your head now and asking what happens when Jerry goes home.
What Did Jerry’s Doctors Teach Him About Healthy Eating?
Jerry left the hospital about 3 weeks ago. He said he’s feeling much better, and he lost about 25 pounds. The doctor told him it was mostly water weight. He’s still on insulin.
I asked him if his doctor gave him any healthy eating guidelines. He said they gave him some papers to read with no instructions.
But what did he learn in the hospital? He learned that a healthy diet can include a high percentage of refined carbohydrates like bread and rice.
So Jerry will go home thinking that eating bread, rice, and pasta is perfectly fine. After all, they’re not dangerous saturated fats. Oh, he may cut down the calories a little, but he’ll continue to get a majority of his calories from carbs.
But remember what those high GI refined carbs do to his blood sugar. Not to worry, though. If at his next doctor’s visit his blood sugar is up, it can be controlled with more insulin.
Jerry’s now 65 years old and still very overweight. Explain to me how the doctors made him better for the long haul. He still has type 2 diabetes, obesity, hypertension, and heart issues with no cure in sight for these health problems.
Will Jerry Get Better If He Just Eats Less?
Some people might be tempted to say that Jerry should go on a diet. If he eats less he’ll lose weight and eventually that will help his diabetes.
Okay, perhaps he should restrict his calories. Let’s say he lowers his calorie intake from 2400 kcal/day to 1500 kcal/day and he doesn’t worry about specifics.
In other words, he’s not concerned with a particular macronutrient breakdown concerning carbs, fat or protein. He just counts calories.
What do you think will happen to Jerry’s? He’ll start to lose weight. After all, everyone who diets loses weight.
But what eventually happens? How many people do you know who went on a diet, lost weight, and then a year later put it right back on?
Do you remember that TV show The World’s Biggest Loser? The dirty little secret is that every participant from the first season regained almost all the weight they lost in spite of their efforts to keep it off.
Researchers were startled when they discovered that and even more startled when they found out the reason.
Apparently, it has to do with what’s called your body set weight. See here and here.
Your Body’s Set Weight
Your body’s set weight is an optimal weight that your body attempts to maintain. For example, if you’ve been 200 pounds for 10 years, your body will fight to maintain that weight.
It does this by slowing down its metabolism. Therefore, even if you maintain the same calorie restricted diet, you’ll eventually gain the weight back.
Dr. Michael Schwartz, an obesity and diabetes researcher who is a professor of medicine at the University of Washington, said,
The key point is that… you can lose enormous amounts of weight, you can go on for six years, but you can’t get away from a basic biological reality. As long as you are below your initial weight, your body is going to try to get you back.
This is why all calorie restricted diets fail.
Even if Jerry went on a diet and lost weight, he would eventually gain the weight back. And he would still be on insulin and in danger of further metabolic complications.
So what’s the answer? Is Jerry doomed to spend the rest of his life getting heavier and sicker and relying on more and more insulin to keep him alive?
Isn’t there something his doctors could do to help him?
Let me first say that Jerry’s doctors did a magnificent job of repairing his heart. Our doctors are the best in the world at surgically repairing our bodies.
But when it comes to preventing and healing chronic diseases, they seem to have tossed their skills overboard.
People like Jerry can be healed. But, first, it requires knowing why Jerry got sick in the first place.
The answer is staring the mainstream medical community right in the face, but they refuse to see it.
The Real Problem With Obesity And Type 2 Diabetes
Obesity is not a problem of overeating. It’s a hormonal problem. Remember Jerry is taking insulin. Why? Because his body’s own insulin is not working properly. It’s not that he doesn’t have enough insulin.
He has too much insulin.
A type 1 diabetic doesn’t have enough of their own insulin. So they need insulin.
However, a type 2 diabetic has enough insulin. The problem is that their cells have become resistant to the insulin they have. So doctors give patients insulin hoping that more insulin will solve the problem.
Well, it does solve the problem of high blood glucose, but it doesn’t solve the problem of why blood glucose is high in the first place. More insulin treats a symptom and not a cause.
The problem is insulin resistance caused by too much insulin.
Researchers today recognize that insulin resistance is associated with obesity, type 2 diabetes, metabolic syndrome, and a host of other metabolic diseases.
In order to provide an answer for Jerry’s disease, we’ll have to dig a little deeper into the concept of insulin resistance. After we do that, it’ll become clear where the answers lie.
I’ll cover that in my next post.
Oh, and by the way, Jerry is out of the hospital and he says he feels great. And he’s still losing weight. But he’s not dieting. He’s discovered a new way of eating. More on that next time: Part 2: Winning the Battle
This post originally appeared on progressingpilgrim.com, John’s personal blog.
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lisa says
Nice Post DR. JOHN BIANCHI
lisa says
thankyou for sharing the great article , i like it , waiting for your next post.love to read this.