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Diabetes
What
is it?
Diabetes is a disorder characterized by high levels of glucose
(sugar) in the blood and deficient glucose in the cells.
Diabetes is epidemic in our country. Currently, 16,000,000
Americans suffer from diabetes and an estimated 80,000,000
more are at risk (one-quarter of the population of the United
States!). Complications of diabetes are the seventh leading
cause of death. These complications include blindness, peripheral
neuropathy, cardiovascular and kidney disease, and gangrene
of the feet and legs.
Complications
of diabetes
Blood sugar is a good thing in small doses but can cause
big problems in excess. A by-product of excessive glucose
is a sugar called "sorbitol". Excessive accumulation of
sorbitol in the eye leads to cataract formation. In fact,
diabetic retinopathy is the leading cause of blindness in
the United States, affecting one out of fifteen diabetics.
Excess sugar in the bloodstream contributes to atherosclerosis
or hardening of the arteries. Diabetics have a two to three
times higher risk of dying from heart attack or stroke than
the average person. Diabetes raises cholesterol and triglycerides
levels and also raises blood pressure. The reason for this
is that the body is unable to burn glucose efficiently in
the cells so the excess calories turn to fat and clog up
the arteries. Fat clogging up the blood vessels also decreases
the amount of oxygen available to the tissues. Red blood
cells have to fold to fit into capillaries one at a time.
Fat clumps blood cells together, preventing them from entering
the capillaries and causing oxygen deprivation in the tissues.
Increased fatty deposits on the artery walls also increase
the resistance to blood flowing through these vessels, causing
high blood pressure. High blood pressure and low tissue
oxygenation contribute to other health problems.
Kidney disease is also common in diabetics and is one of
the leading causes of death associated with diabetes. The
high sugar levels cause destruction of the cells of the
kidney that are responsible for filtering the blood and
excreting wastes as urine. High blood pressure from diabetes
also crushes the cells of the kidney leading to further
damage. Many diabetics have to undergo kidney dialysis to
replace the function of their damaged kidneys.
Male impotence is another effect of cardiovascular disease
associated with diabetes. An erection requires normal blood
pressure and the ability to shunt blood where it is needed.
The cardiovascular problems noted above reduce or eliminate
the ability to have erections sufficient to achieve orgasm.
The nerves that control function and tissue repair throughout
the body are also damaged in diabetes, particularly in areas
of poor circulation. Excess sorbitol in the peripheral nerves
causes destruction of these nerves, leading to numbness,
tingling and burning pain, especially in the legs and feet.
Complete destruction of these nerves, in conjunction with
reduced blood supply due to atherosclerosis, leaves the
tissues vulnerable to injury, infection and tissue death
(necrosis). Diabetic foot ulcers are an example of tissue
dying from lack of proper nerve and oxygen-rich blood supply.
In advanced cases of foot ulcers, the feet or even the lower
limbs may have to be amputated to prevent the spread of
gangrene (infection).
Types
of diabetes
There are two main types of diabetes. Type I is also called
"Juvenile onset" or "Insulin dependent" diabetes. Type II
is called "Adult onset" or "Non-insulin dependent" diabetes
mellitus. (NIDDM). A temporary form of diabetes sometimes
occurs during pregnancy and is called, gestational diabetes.
Type
I diabetes
As the name suggests, Type I or Juvenile onset diabetes
generally occurs in children and is caused by a failure
of the beta cells of the pancreas to produce insulin. Epidemiological
evidence suggests that the beta cells are destroyed in an
auto-immune reaction. Without beta cells, the body cannot
produce insulin. Without insulin, blood sugar is unable
to enter the cells of the body. The cells of the body are
thus starved while blood sugar levels remain dangerously
high. Symptoms of diabetes include increased thirst and
urination, constant hunger, weight loss, blurred vision,
and extreme fatigue. Since the brain requires glucose (sugar)
to survive, if the diabetes is not diagnosed and treated
with insulin, a person can lapse into a life-threatening
diabetic coma. Because their bodies cannot make insulin,
persons with Type I diabetes mellitus are called "insulin
dependent diabetics" and must take insulin injections daily
to control symptoms. This type of diabetes is also referred
to as Insulin Dependent Diabetes Mellitus or IDDM.
Can
anything be done to prevent Type I diabetes?
While the causes of Type I diabetes are not certain, risk
factors have been identified. These causes include; maternal
over-nutrition (excess calories), auto-immune reactions
triggered by milk allergy or viral attack, and environmental
toxins such nitrosamines found in cured or smoked meats.
Maternal
nutrition
One of the strongest risk factors for both Type I and Type
II diabetes is excessive food consumption by the mother
during pregnancy. A study supporting this association was
involved children born of mothers in post-war Berlin (1941-1948).
There was limited food supply in Germany at this time due
to post-war hardships and the cold war. Children born during
in Berlin during this time period have less than 50% of
the risk of diabetes as children born in other times. Another
study demonstrated a significantly lower incidence of childhood
diabetes during periods in which the blood sugar of the
mother was closely controlled. The bottom line is that pregnant
women should not over-eat.
Auto-immunity
The most widely accepted theory is that the body's own immune
cells mistake the beta cells of the pancreas for foreign
invaders and attack the beta cells when stimulated by a
viral or allergic trigger. The pre-disposing factor for
this immune system confusion is the genetic structure of
the protein coat on white cells. The protein coating allows
immune cells to tell the difference between "self" and "non-self".
Just as red blood cells can be typed into A, B or O, according
to their protein coatings, white blood cells can also be
divided into HLA (Human Leucocyte Antibody) types. The white
cell antibody type common in persons with diabetes is called
HLA B8. A blood test can be performed to determine HLA types.
Scientists think that a viral infection or allergy in sensitive
individuals can over-stimulate the immune system, causing
it to attack the beta cells of the pancreas.
Viruses
are capable of infecting beta cells of the pancreas, stimulating
an attack. Indirect evidence in support of this theory is
that the onset of Type I diabetes is more common from October
to March, the same period of time as viral infections are
most frequent. A protein in milk (bovine albumin peptide)
has also been linked to juvenile onset diabetes. Infants
under four months of age who were exposed to cows milk or
solid foods are 1.5 times more likely to develop Type I
diabetes than infants who were exclusively breast fed. This
is one more reason to breast feed your child. In families
with a history of Type I diabetes, it may be advisable for
nursing mothers to avoid consuming dairy products as the
protein can pass into the mother's milk.
Consumption
of smoked or cured meats containing N-nitroso compounds
may be a risk factor as well. A diet high in bacon, ham,
smoked salmon and similar products has been linked to Type
I diabetes. Nitrosamines and other chemicals in foods or
the environment have been implicated in beta-cell damage
through free radical oxidation. Anti-oxidants such as vitamins
A, E and C provide some protection against free radical
destruction.
Type
II diabetes
Type II diabetes ( also known as Non-Insulin Dependent Diabetes
Mellitus or NIDDM) is more common, comprising 90 to 95%
of cases of diabetes. It occurs as a result of over-consumption
of highly processed foods and a lack of exercise. Incidence
of Type II diabetes increases rapidly in persons over the
age of 40 and is most common in adults over age 55. About
80 percent of people with type 2 diabetes are overweight.
This form of diabetes is epidemic in our country and is
rapidly affecting more young people due to a refined food
diet and sedentary lifestyle. The most hopeful fact about
adult-onset diabetes is that it is both preventable and
at least partially controllable using good nutrition and
exercise.
The
reason Type II diabetes mellitus is also called non-insulin
dependent diabetes is because the problem is not a lack
of insulin as is the case with Type I diabetes. To the contrary,
Type II diabetics typically have as much as four times the
amount of insulin as their healthy counterparts. The problem
instead is "tissue resistance" to insulin. In other words,
insulin isn't as effective as it should be in getting glucose
into the cells. To understand what this means, it is necessary
to understand how insulin works in the first place.
Insulin
and the cell membrane
Each cell is bordered by a semi-permeable membrane which
serves to keep the cellular contents together and keep out
unwanted materials, including excess glucose. The cell membrane
is critically important in regulating what gets into and
out of each cell. Insulin is like a key that opens a doorway
in the cell membrane, allowing glucose to enter. Thus in
Type I diabetes, each cell starves for lack of glucose despite
high levels of glucose in the bloodstream.
So if
a Type II diabetic has enough or even excessive insulin,
why do Type II diabetics have a problem with blood sugar?
The answer is that insulin isn't the only factor in determining
how much glucose gets into the cells. Two other factors
are also important: tissue demand for glucose and tri-valent
chromium.
Obesity
and lack of exercise
If a cell doesn't need glucose, it will not accept it. This
lack of demand occurs with a sedentary lifestyle and obesity.
A cell that is composed primarily of fat (stored energy)
does not have any use for glucose. As obesity increases,
there is generally a decrease in the percentage of cells
such as muscle cells which are actively metabolizing glucose.
A fat cell is "resistant" to insulin and glucose because
a fat cell has no use for additional excess energy. Even
in persons who are at a normal weight, lack of exercise
still results in a gradual change in body composition from
muscle to fat. People talk about "getting soft" especially
around the waist with age, even if weight remains the same.
This is because on average, people lose about half their
muscle mass (which is replaced by fat) between ages 20 and
70. Less muscle means fewer cells that need glucose. Weight
control becomes increasingly difficult as we get older precisely
because we have fewer cells to burn up our calories. A healthy
muscle cell that is at rest doesn't need much glucose either.
Exercise can create such a strong demand for glucose that
insulin isn't even needed to get into the cells. The glucose
can enter the cell by direct osmosis if the cell is sufficiently
depleted in glucose through exercise. Type II diabetes is
often reversed by exercising back into a normal weight range
and level of fitness.
The
type of obesity associated with diabetes is called truncal
obesity. This means that the fat is deposited on the trunk
or upper body, especially around the waist. A narrow waist
compared to the hips is attractive because it is a sign
of good health. When the waist equals or exceeds the width
of the hips, the person is at risk of diabetes and cardiovascular
disease. Fat cells send a signal to the brain by secreting
a hormone called leptin. This hormone signals the brain
to eat more when the fat cell is being depleted of fat.
These "hungry fat cell" signals are part of the reason it
is so difficult to lose weight. Leptin also Research suggests
that the amount of leptin in the blood is proportional to
the amount of insulin in the blood and that persons with
decreased insulin sensitivity therefor, have a harder time
losing weight.
Chromium
Another important factor in getting glucose into the cell
is chromium. This is because the cell membrane actually
requires two keys to open the door into the cell (the "door"
is called a sialic acid receptor). The other key is the
mineral tri-valent chromium. This mineral is naturally found
in whole grains and other natural foods but is refined out
of our diet when we choose to eat sugar or white flour products
such as white bread, pastries or pasta. In fact, eating
refined carbohydrates increases urinary excretion of chromium
by up to 300% This is one reason why Type II diabetes is
most common in countries with a high consumption of refined
carbohydrates.
Chromium
deficiency is common in the United States. Taking supplemental
chromium has been shown to significantly improve insulin
function, decrease fasting glucose, cholesterol and triglyceride
levels and also to increase beneficial HDL cholesterol.
The protective role of chromium is further supported by
the fact that diabetes is rare in Africa, China and other
countries where whole, unrefined foods are the staples in
the diet (other factors preventing diabetes in those countries
include high-fiber, low calorie diets and exercise). Taking
200 to 500 mg of tri-valent chromium (also called GTF or
"Glucose Tolerance Factor" chromium) can help control symptoms
in persons deficient in chromium but is not enough to completely
control or reverse diabetes. A good diet, exercise and possibly
other nutritional supplements are also essential.
Refined
carbohydrates, dietary fat and low fiber in the diet increases
risk.
Fats
A diet high in fat, particularly saturated fat is strongly
associated with increased risk of Type II diabetes. This
is because the cell membrane is made of protein and fatty
acids. The quality of dietary fat helps determine the quality
of the cell membrane. Saturated fats and especially trans
fats such as are found in margarine and many prepared foods
make poor quality cell membranes. Essential fatty acids
found in fish and flaxseed oil are needed to make the best
quality cell membranes. Eating cold-water, ocean fish such
as salmon, halibut and sardines twice a week and/or a TBS
of flaxseed oil or 2TBS of fresh ground whole flaxseed per
day will ensure an adequate supply of essential fatty acids.
Equally important however, is to reduce or eliminate hydrogenated
or trans fats and to reduce saturated fat and cholesterol.
These fats, found in meats and dairy products, are stiff
and hard at room temperature. Take a look in your frying
pan after it cools the next time you cook a hamburger. The
hard, white fat you see are saturated fats and cholesterol.
Th e melting point of cholesterol is 325 degrees F. It will
never be liquid in your body. Too high a cholesterol and
saturated fat level in your body will produce stiff, inflexible
cell membranes, unable to easily move materials into and
out of the cell.
Refined
carbohydrates
Sugar and refined carbohydrates increase risk of diabetes.
They do so by causing a rapid rise in blood sugar levels,
requiring large amounts of insulin to push the glucose into
the cells. To compensate, the cells become less sensitive
to insulin over time. Refined carbohydrates also deplete
the body of needed vitamins and trace elements such as chromium
because all these valuable nutrients are refined out of
sugar and white flour products but are still needed by the
body to effectively utilize the carbohydrates. In addition
to white flour products such as breads, pasta, cookies,
cakes, etc. and sugars such as in soft drinks, sweets and
most fast food products, potatoes are absorbed as rapidly
as refined sugar. The faster a food reaches the bloodstream
as sugar the higher it is rated on the "glycemic index"
scale. Sugars and refined products such as those listed
above are called "high glycemic index" foods. To control
your blood sugar, you want to eat foods with a low glycemic
index. Carbohydrates with a low glycemic index include whole
grains, beans, vegetables, nuts and seeds. These foods are
low glycemic in part because they contain large amounts
of fiber.
Fiber
A diet low in fiber also contributes to diabetes. What is
fiber exactly? Fiber is the indigestible cell walls of plants.
Especially good are plant fibers that are water soluble,
such as are found in vegetables, beans, oat bran, nuts,
seeds, psyllium seed husks, pears, apples and other fruits.
Fiber is beneficial because it slows down the digestion
and absorption of carbohydrates, leading to a slower rise
in blood sugar levels. With a slower (and lower) rise in
blood sugar levels, little insulin is needed to absorb the
glucose into the cells. The cells then don't become desensitized
to insulin. Diabetics (and everyone else) should consume
enough fiber in their diet to produce one or two large (12
Ð 18 inch) bowel movements per day. Fresh ground flax seed
comes to the rescue again as it is six times more absorptive
than oat bran (which in itself is one of the very best sources
of fiber).
How
do doctors test for diabetes?
A blood test that measures the level of glucose is used
to diagnose the presence and severity of diabetes. After
a 12-hour fast, normal glucose levels range from 70 to 110
milligrams per dilution. Two measurements above 140 mg/dl
indicate diabetes. Since blood sugar levels fluctuate, this
test cannot measure occasional elevations above normal.
People who have occasional elevations are at increased risk
of developing adult-onset diabetes. The risk of developing
adult-onset diabetes can be measured with a blood test called
glycosylated hemoglobin. This test measures the amount of
blood sugar that has combined with the protein in red blood
cells. Since these cells live for 90 days, any elevation
of blood sugar in the past 90 days will leave its mark on
these cells. This combining of blood sugar with protein
is the way that diabetes produces it's damaging effects
on the body. Elevated glycosylated hemoglobin is one of
the best five-year predictors of diabetes, heart disease
and cancer.
How
can I test myself for diabetes risk?
The simplest way to assess your risk for adult-onset diabetes
is to measure your waistline. Essentially, your waist should
be narrower than your hips. For women, the waistline should
be no more than 80% of the measurement of the widest part
of the hips. For men, the waist should be no more than 95%
of the measurement of the widest part of the hips. Fat deposited
around the middle indicates high risk for diabetes, heart
disease and some forms of cancer. Being 30 pounds over-fat
is another well known risk factor. This is not rocket science.
What
can I do to control or reverse Type II diabetes?
Foods to avoid
Avoid sugar in all forms except for fresh fruit (not juice
or dried fruit). Avoid or limit other low glycemic index
foods such as white flour products and potatoes. Avoid trans
fats such as margarine and limit saturated fats and cholesterol
from meats and dairy products.
Avoid
smoking and other nicotine products Insulin resistance is
aggravated by smoking and other nicotine products. This
is one more good reason to avoid smoking.
Foods
to include
Fish, some chicken, turkey or other lean meats, whole grain
products, beans, vegetables, fruits, berries, nuts and seeds.
You can prepare many wonderful meals from this selection
of foods. If you take care to use only whole, unrefined
foods, cuisine's from Asia to the Mediterranean can be served
from this selection of foods. One of the key factors common
to each of these foods (in addition to a low glycemic index)
is that they all contain generous amounts of fiber.
High
fiber
Studies have been made of diabetics given supplemental fiber
in their diet. Insulin dosages of diabetics on fiber supplemented
diets can usually be reduced to one third the insulin dose
of diabetics on the American Diabetes Association diets.
Even more impressive is that approximately 60% of Type II
diabetics on a high-fiber, low sugar, low fat diet are able
to discontinue medication for blood sugar control while
the remaining 40% are able to significantly reduce their
dosage of medication. One of the best sources of supplemental
fiber is fresh-ground flaxseed. Flaxseed has the added benefit
of providing essential fatty acids.
Low
amount (but high quality) of fats
The foods listed above are all low in fat, and the fats
they contain are generally very high quality. The highest
quality fatty acids are found in fresh, cold-water fish
(sushi!) and flaxseed oil. Care must be taken with these
beneficial oils to keep them fresh as they are easily damaged
by heat, or prolonged exposure to light or air. You can
use the flaxseed oil in salad dressing and serve the fish
on the rare side. The reason these essential oils are good
for you is that they keep the cell membranes fluid. By contrast,
saturated fats (solid at room temperature) make cell membranes
that are stiff and resistant to both glucose and insulin.
Olive
oil is safe to heat and is the best oil for cooking (Virgin
coconut oil is also excellent but more difficult to obtain).
Monounsaturated fats such as olive oil have the added benefit
of reducing body fat around the waist. In a study comparing
persons consuming whole grains, vegetables, fruits, lean
meats and monounsaturated fats, there was improved insulin
sensitivity and decreased body fat in the upper body compared
with individuals on the same diet but with less fat and
more carbohydrate. Since obesity in the trunk is associated
with Type II diabetes, this reduction in this type of body
fat should improve insulin resistance and lower the risk
of diabetes. Some tropical oils such as macadamia nut oil
are also rich in monounsaturated fatty acids and could be
used in place of olive oil.
Macronutient
balance
The balance between carbohydrate, fat and protein in the
diet can affect body composition and insulin resistance.
In one study, a diet of 25% protein, 45% carbohydrate and
30% fat resulted in weight loss and fat loss were almost
double that of a 12% protein, 58% carbohydrate and 30% fat
diet. The higher protein group also enjoyed a greater reduction
in triglycerides than the higher carbohydrate group.
Supplements
Chromium
A t a dose of 200 to 500 mcg, two times per day has been
shown to help reduce blood sugar levels in diabetics who
are deficient in chromium (see above).
Vitamin
C
At doses of 2,000 mg per day have been shown to reduce sorbitol
accumulation in the cells of diabetics. Researchers have
found vitamin C more effective than the aldose reductase
inhibiting drugs in lowering sorbitol levels. Vitamin C
is also needed to support good immune function and healthy
connective tissue, among other things. Taking 2,000 to 3,000
mg per day of vitamin C is also recommended to prevent atherosclerotic
plaque buildup on the arteries.
Niacin
or niacinamide
Use of niacin in the early years of Juvenile onset diabetes
(IDDM) has resulted in lower insulin requirements, improved
metabolic control and increased beta cell function. Some
newly diagnosed Type I diabetics have shown a complete remission
of their diabetes using 100 to 200 mg per day in children
(the dose is 25 mg per kilogram). Niacin is also useful
in lowering cholesterol levels. High doses of niacin produce
a flushing of the skin that can feel like a sunburn. Many
patients find this uncomfortable and prefer to take the
slower-releasing form of niacin, called niacinamide. In
cases where very high doses are desirable, such as to lower
elevated cholesterol levels, a form of niacin called, inositol
hexaniacinate is even better as dosages of 600 to 1,800
mg per day have not produced any side-effects. This dosage
of inositol hexacianate has produced an 18% reduction in
total cholesterol, a 26% reduction in triglycerides and
a 30% increase in the beneficial HDL cholesterol.
Omega-3
fatty acids.
Supplementation
with fish oils or flaxseed oil, 1-2 tablespoons per day
is essential for diabetics. In both animal and human studies,
these fatty acids produced significant improvement in diabetes.
These essential fatty acids work by making the cell membrane
more sensitive to insulin and glucose.
Vitamin
B6
Supplementation with vitamin B6 can protect against diabetic
neuropathy. In fact, the symptoms of diabetic neuropathy
and B6 deficient neuropathy are the same. In one study of
women with gestational diabetes, ingestion of 100 mg of
B6 for two weeks resulted in complete remission of the diabetes
in 12 of 14 women in the study. The high sugar levels in
diabetics causes the glucose to attach to proteins in red
blood cells and other tissues. This process, called glycolysation,
makes the proteins less functional. The amount of red blood
cell glycolysation is also used to monitor the risk and
progression of diabetes. B6 prevents or reduces the glycolysation
of proteins.
Biotin
Another B vitamin, biotin enhances insulin sensitivity at
the cell membrane and also increases the activity of glucokinase.
Glucokinase is a liver enzyme that helps break down glucose,
thus reducing high levels of blood sugar.
B12
Vitamin B12 is another useful nutrient in preventing or
palliating peripheral neuropathy. Like B6, B12 deficiency
also produces a form of peripheral neuropathy similar to
that found in diabetics. Doses of 1,000 to 3,000 mcg per
day are generally sufficient when taken by mouth, though
more severe cases may require vitamin B12 injections.
Vitamin
E
Cell membranes are made of lipids (fatty acids) which are
vulnerable to oxidation by free radicals. Vitamin E is a
powerful anti-oxidant that stabilizes cell membranes. Vitamin
E also prevents the free radical oxidation that scars artery
walls, setting the stage for arteriosclerosis, a common
cause of death in diabetics. Diabetics appear to have a
higher than normal requirement for vitamin E, probably in
the range of 800 to 1,200 IU's per day. Subjects taking
1,350 IU's per day of vitamin E improved insulin sensitivity
and glucose tolerance. Another study demonstrated persons
with low dietary vitamin E intake were 3.9 times more likely
to develop diabetes than persons with adequate vitamin E
intake.
Magnesium
A normal mineral, magnesium is commonly deficient in the
American diet and is essential in the energetic processes
of the cell.Magnesium
deficiency can increase the risk of diabetic retinopathy
and heart disease. B6 is necessary for magnesium to get
into the cells, so both must be taken for best effect.
Potassium
Another normal mineral, potassium is found primarily in
fresh fruits and vegetables. Potassium improves insulin
sensitivity and secretion. Potassium also reduces the risk
of heart and vascular disease and also cancer. The only
caution is that diabetics with kidney disease need to be
careful about consuming excessive amounts of potassium.
A diet in whole foods that includes plenty of vegetables
should provide adequate potassium. Supplemental potassium
should only be taken under supervision of a physician or
other health provider.
Manganese
This trace element is a cofactor in many enzyme systems
involved in blood sugar control. Diabetics typically have
about one-half the manganese levels of normal individuals.
A dose of 30 mg per day should be adequate.
Zinc
This trace element is involved in nearly every stage of
glucose metabolism, from synthesis, secretion and utilization.
Zinc helps control excessive blood sugar and has a protective
effect against beta cell destruction. Additionally, zinc
is very important for wound healing and this is essential
in diabetics as they have notoriously poor wound healing
ability.
Flavenoids
These are vitamin C like molecules found in fresh fruits
and vegetables. One flavenoid, quercetin, promotes insulin
secretion and inhibits sorbitol accumulation in the cells.
30 to 60 mg per day is commonly used to supplement diabetics.
As you
may have noticed, a diet rich in fresh, whole foods provides
the vitamins and minerals noted above, though not always
in the quantities described. Taking supplements alone is
not enough to make up for the effects of a deficient diet
or a diet full of refined carbohydrates and damaging fats
described earlier.
Exercise
As noted earlier, exercise increases glucose uptake in the
cells, which helps to stabilize blood sugar levels. Exercise
also builds increased muscle mass. The more muscle you have,
and the more efficient it is in utilizing glucose and fatty
acids, the better you will be able to control blood sugar
levels and reduce the risk of cardiovascular disease. A
30 minute walk, twice a day can do a great deal to lower
blood sugar levels and improve well-being. Strength training
with weights or other means can increase your lean body
mass and provide more cells hungry for glucose. One of the
best ways to reduce your risk of diabetes or to correct
Type II (NIDDM) is to exercise to the point of reducing
your waistline to 90% of your hip measurement (for men.
The ratio for women is that your waist should not exceed
80% of your hip measurement). Nothing can make you feel
good as quickly as exercise. Exercise is truly the fountain
of youth.
Diet
summary
Whole grains, fresh fruits and vegetables, cold-water fish,
skinless poultry, beans, nuts and seeds. Use olive oil for
cooking, flaxseed oil on salads.
Exercise
summary
Mild aerobic activity such as walking 30 minutes, twice
a day. Strength training two to four times per week. Supplement
summary (check with your health care provider before beginning
any supplements) GTF chromium 200 Ð 500 mcg per day Vitamin
C 2,000 Ð 3,000 mg per day Niacinamide or Inositol hexacianate
600 Ð 1,800 mg per day Vitamin B6 100 Ð 200 mg per day Biotin
400 mg per day Vitamin B12 1,000 Ð 3,000 mcg per day Vitamin
E 800 Ð 1,200 mg per day Magnesium 200 mg, three times per
day Manganese 30 mcg per day Zinc 30 Ð 60 mcg per day
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free to email us at: office@drwells.net
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