EAT & BEAT DIABETES WITH PICTURE PERFECT WEIGHT LOSS
Also by Dr. Howard M. Shapiro
Dr. Shapiro’s Picture Perfect Weight Loss
Dr. Shapiro’s Picture Perfect Weight Loss Shopper’s Guide
Dr. Shapiro’s Picture Perfect Weight Loss 30-Day Plan
Dr. Shapiro’s Picture Perfect Weight Loss Cookbook
Dr. Howard Shapiro’s Picture Perfect Prescription
EAT & BEAT DIABETES WITH PICTURE PERFECT WEIGHT LOSS
The Visual Program to Prevent and Control Diabetes
Dr. Howard M. Shapiro and Chef Franklin Becker
Photographs by Bill Milne
For Kay von Bergen Shapiro—a woman of exceptional intelligence and courage who loves to laugh at the craziness of life while reaching out to others with kindness and compassion. My constant support and true partner, she doesn’t just “make a life for me” in my mother’s words, she makes it wonderful.
—Howard Shapiro
For my children, Sean and Rory Becker, and my wife, Jennifer.
Without all of you, my life would be empty.
—Franklin Becker
ACKNOWLEDGMENTS
It is always a pleasure for authors to acknowledge the people who helped make their books possible and who have been companions along the route of conceiving, writing, editing and assembling the final works.
This book begins with our agent, Carol Mann, who brought us together with one another and with our publisher. In doing so, she also brought us to Donna Hayes, Harlequin publisher and CEO, who has been a consistent champion of our unique approach to fighting diabetes and living a sustainably healthy life.
We are grateful beyond words to our superb editor at Harlequin, Deborah Brody, who shepherded both book and authors gently through the process and offered exquisite understanding during some very difficult extenuating circumstances.
Deborah’s assistant, Alex Colon, set a new standard for organization and attention to detail. As point man for all the myriad pieces of the puzzle, he proved to be both a peerless professional and a pleasure to work with.
Also at Harlequin, we express our thanks to publicity genius Shara Alexander, who grasped our message, articulated it beautifully and saw at once how to get the word out; to product manager Amy Jones; to creative director Margie Miller; and to art director Tara Kelly, who created the design for packaging our message and oversaw its implementation brilliantly.
Production of the book was graced by an exceptional team, including the brilliant photographer Bill Milne, a man who is not only a superb professional but who also consistently went the extra mile to make this book just right. Bill was ably assisted by the very talented and gracious Paul O’Hanlon and by office manager Lisa Cichocki, who managed to juggle myriad schedules of myriad people and get all of us where we were supposed to be when we were supposed to be there.
As has been true of all of Dr. Shapiro’s books, Diane Vezza served as the food stylist for the many demonstrations that bring our message to life. Diane is sui generis in her work and calm under pressure on the job—no matter what. And kudos to Diane’s assistant, Joan Parkin, who did the food preparation that was so essential to the final result.
Phyllis Roxland, Dr. Shapiro’s longtime nutritionist, provided her expertise as always and worked tirelessly to make the book a success, while Susanna Margolis, another longtime team member, contributed her editorial skills. Dr. Shapiro would not have been able to devote the time needed to the book and run his practice without the support of assistant Alexandra Lotito, the office technology ace, who worked on the book even from her sickbed, while Gerri Pietrangolare, often assisted by Sharon Griffith, kept the office running.
Dr. Shapiro also expresses his thanks to his brother and sister-in-law, Michael and Andee Shapiro, for their support—when it was very much needed—during the writing of this book.
And Chef Franklin extends his gratitude to his parents for their ongoing support and to the sous-chefs and pastry chefs, past and present, who helped him perfect his trade and develop his diabetes-fighting recipes.
We both are grateful to all the chefs around the country who gave their time and effort and created recipes for this book.
CONTENTS
INTRODUCTION
The Diabetes Danger and the Team That Will Help You Beat It
CHAPTER 1
The Secret to Healthy Weight Loss, Diabetic or Not
CHAPTER 2
For Parents: A Warning and a Call to Action
CHAPTER 3
The Eat & Beat Diabetes Pyramid
CHAPTER 4
Vegetables: More Is Good, Even More Is Even Better
CHAPTER 5
Protein: Expanding the Possibilities
CHAPTER 6
Starches
CHAPTER 7
Fats and Oils
CHAPTER 8
Sweets
CHAPTER 9
Look and Lose
CHAPTER 10
Recipes for Beating Diabetes
CHAPTER 11
Beating Diabetes Every Day
About the Authors
INTRODUCTION
The Diabetes Danger and the Team That Will Help You Beat It
Nobody likes to pick up a book, open it to page 1 and get scared out of their wits.
Well, we’re not setting out to scare you, but we’re here to tell you that there is a danger out there that you and your family need to be aware of.
You need to be aware of it because it has the potential to affect you and everyone you know—your spouse, your friends, your relatives, the people you work with and, above all, your children.
It’s the sixth most potent killer of Americans, and 8 percent of us have it right now—including one of the authors of this book.
It’s the leading cause of blindness, amputations and kidney failure.
It can triple our risk of heart attack and stroke, and it routinely damages sight, hearing, sleep, mental health and sexual performance.
It is the disease that can eat us alive.
It is diabetes, and it is stealing our health, our well-being, our longevity and our ability to enjoy our lives to the fullest.
Every day, another 2,200 Americans are diagnosed with this disease. It is projected that a third of the population born in 2005 will contract diabetes. It afflicts nearly a quarter of all Americans sixty and older.
If you’re a woman who was diagnosed with diabetes before the age of forty, your life span is likely to be shortened by fourteen years. If you’re a man, lop off eleven years.
Don’t have the disease? Not yet, anyway. For in addition to the 24 million of us diagnosed with diabetes, the Centers for Disease Control and Prevention estimate that some 57 million people are prediabetic—with abnormal blood sugar levels—but don’t know it.
Anyone who is obese or even overweight is at risk for the disease. Since our own Department of Health and Human Services says that 64 percent of us—129.6 million Americans—are overweight or obese, that means that most of us are in danger of getting diabetes.
And just when you thought the news couldn’t get worse, it does. Thanks to the stunning increase in childhood obesity, we are seeing a substantial rise in the occurrence of diabetes in young children—as young as eleven and twelve. In general, in fact, the disease is showing up earlier and earlier. Between 1990 and 2000, for example, while the prevalence of diabetes in adults increased 33 percent overall, it rose a staggering 76 percent among people between the ages of thirty and thirty-nine. Meanwhile, college students and even teenagers are suffering the kind of heart ailments typicall
y reserved for the elderly—thanks to the lowering age of diabetes onset. It means, unfortunately, that all these young people will have more time to accumulate the damage diabetes causes to the blood vessels and nerves—and more time means more damage.
We can sum it all up in this awful truth: diabetes and the excess weight that so often lead to it are a major cause of the reality that today’s rising generation is the first ever expected to have a shorter life span than that of its parents.
It’s a costly truth, too, and we’re all going to pay for it. Today, we shell out an estimated $105 billion per year for the direct and indirect costs of diabetes. That’s nothing compared to what we’ll be spending to pay for the disastrous, debilitating and doubtless chronic health problems of the future.
If you’re diabetic now, you probably already know most of this. You also know you have a tough row to hoe.
* * *
A SPECIAL NOTE FROM THE DOCTOR
If your routine blood test shows an abnormal level of sugar, your doctor is likely to order a number of other tests. Three tests in particular are typically used; here’s what doctors look for in the tests as possible signals of diabetes.
* * *
TEST
LOOKING FOR
Random plasma glucose
Glucose ≥ 200 mg/dL
Fasting plasma glucose (tested following a fast)
Glucose ≥ 100 mg/dL
Two-hour plasma glucose (tested two hours after ingesting 75 grams of glucose)
Glucose ≥ 200 mg/dL
* * *
If you think you’re free and clear of the disease, think again. Get your blood sugar level checked at your next physical to make sure you’re not walking around with a prediabetic condition you just don’t know about.
And if you are overweight or obese, it’s time to admit the truth to yourself: you’re at direct risk of contracting a killer disease.
Did we scare you enough? Well, here’s the good news: we know who can control and even cure your diabetes if you’re diabetic today, and who can prevent you from ever getting the disease if you’re not.
You.
With no other medical condition is the power for cure as clear-cut. With no other medical condition is the responsibility as explicit. It’s simple: you’re in charge. All you have to do is follow the principles we’ll outline in this book. When you do, you’ll beat diabetes and all its complications—and you’ll achieve and maintain a healthy weight loss. And in this book, we’ll tell you how to do it absolutely deliciously.
DIABETES AND YOUR WEIGHT
What is diabetes, and why is weight so central a factor in getting the disease—and therefore so pivotal an issue for controlling or curing it?
In a way, it’s all about energy—the energy the body uses for getting out of bed in the morning, running a marathon, doing the work we’re paid to do, focusing on our studies, dancing our socks off at a party. As we all remember from high school biology, the digestive process breaks down the food we eat into the various chemical substances our cells need to work properly. One of those substances is glucose, which is basically a sugar, and which just happens to be the body’s main energy source. Some of the glucose derived from the digestive process is used right away—say, for getting out of bed and sprinting to work—and some is stored for future use, such as the socks-peeling dancing later tonight.
The regulation of glucose levels—how much gets released into the bloodstream now for the sprint to the office, how much gets held back in storage for the dancing later—is dictated mainly by the gland known as the pancreas, right behind the stomach. The process by which the glucose is controlled is a highly complex interaction of chemicals and hormones, including two hormones—glucagon and insulin—that are manufactured in the pancreas and which work in opposition to each other. Glucagon takes glucose out of storage and sends it into the bloodstream, thus raising the level of blood sugar, while insulin moves glucose from the bloodstream into the cells, thus lowering the blood sugar level. When everything is working normally, the pancreas produces just enough of both hormones to keep the amount of glucose in the bloodstream perfectly balanced.
If there’s not enough insulin, however, the body’s cells won’t get the message about absorbing glucose. Or there may be enough insulin, but the cells may not be working right; they’re suddenly not responding to the insulin message. Either way—whether the insulin is insufficient or ineffective—the glucose gets stuck at the point where it normally enters the body’s cells. In other words, the body’s ability to regulate its indispensable source of energy, glucose, is disrupted. That’s diabetes.
What happens when the glucose can’t enter the cells? It builds up in the blood instead, then passes through the kidneys and overflows into the urine. That’s why one of the classic symptoms of diabetes is frequent urination, and it’s also where diabetes gets its official name, diabetes mellitus—from an ancient Greek verb, diabainein, meaning “to pass through,” and from a later medieval Latin addition, mellitus, meaning “honeyed,” indicating the sweetness of glucose passing through the body.
If the disruption to the glucose-regulation mechanism goes untreated, the blood sugar will continue to rise. What can result is a chronic illness comprising a range of health problems and presenting the risk of even worse medical complications. What it means to be a diabetic is that you are constantly working to control these problems and cure the illness.
The complications can be very profound indeed. Hardening of the arteries leading to heart attack and stroke, blood vessel disorders that often lead to kidney failure or blindness, nerve damage, infections that in the worst case can require the amputation of limbs: all the organs of the body are at risk because of the damage diabetes does to the blood flow, and all sorts of disease and debilitation can result.
Until recently, doctors used to talk about “juvenile” and “adult” diabetes. No more. Now, the spread of “adult” diabetes among younger and younger individuals—a direct effect of that rise in childhood obesity—has rendered the two terms imprecise if not obsolete. Instead, medicine speaks of type 1 diabetes, in which the pancreas produces either not enough insulin or none at all, and type 2 diabetes, the type we will focus on in this book, in which the body’s cells simply don’t respond to the insulin.* We call such cells insulin-resistant, and what makes them insulin-resistant is that the individual is overweight or obese.
That’s why there’s that special relationship between being overweight and becoming diabetic. Here’s how it works.
Once the insulin factory in the pancreas produces insulin, it needs to be captured by the body’s cells. For that purpose, each cell has a highly sensitive area that almost literally attracts insulin as it circulates. These areas are called receptors—specifically, insulin-binding cell receptors, because they grab the insulin and bind it with glucose so the glucose can enter the cell and produce energy. As body fat increases, however, the number of those insulin-binding receptors goes down. The sensitivity of the receptors also declines. Bottom line? The insulin receptors stop functioning adequately, the pancreas simply tires out from trying to produce ever bigger amounts of insulin to compensate for the receptors’ inadequacy and the body becomes unable to produce enough insulin to maintain a normal blood sugar level.
What this suggests, of course, is that if the person lost weight, the insulin-binding receptors would start functioning again. Then the blood sugar level would return to normal, the health problems would go away and the medical complications might even unwind and conceivably go into reverse.
In fact, that’s exactly what happens. And that’s the really good news about diabetes today.
Healthy weight loss has long been the first line of attack against the disease of type 2 diabetes. It is the first line of defense in preventing it, and it is the cure for people who already have it. Lose weight, and the symptoms disappear; maintain the weight loss, and the symptoms will not reappear. Regain weight, however, and the disease com
es back.
For years, healthy weight loss for diabetes meant avoiding certain foods. Diabetics did not have to give up everything they loved, but their eating was confined: the range of ingredients and styles of cooking was necessarily limited. Today, however, the latest laboratory research provides some very, very good news for diabetics who take care to eat in a way that keeps their disease under control or prevents its occurrence. What the researchers have found is that there are particular nutrients that actually fight the disease over the long term. Their names aren’t a secret—fiber, phytonutrients, soy protein, and the so-called good fats: monounsaturated, polyunsaturated, and omega-3 fatty acids—but think of them as secret weapons in the battle against all the complications of diabetes. Clearly, the foods that contain these diabetes-fighting ingredients should be part of every diabetic’s eating plan, and we’ll show you how in this book—deliciously.
But the best news of all is that the kind of eating that leads to healthy weight loss and the kind of eating that controls diabetes are exactly the same. Here’s why. Diabetes is not just a disease; it is also a risk factor. It is a component of what doctors have labeled metabolic syndrome—a combination of medical disorders including high blood pressure, high total cholesterol, high LDL cholesterol (the bad cholesterol), low HDL cholesterol (the “good” cholesterol), high triglycerides and overweight or obesity. The more of these components of metabolic syndrome a person has, the greater his or her chances of suffering life-threatening complications. But having even one component puts a person at risk for these complications. The eating principles you’ll learn in this book—and the weight loss that can follow—address all the components of metabolic syndrome.
Eat & Beat Diabetes with Picture Perfect Weight Loss Page 1
