My Notes From The Diabetes Summit
Deanna Minich PhD, CNS
The Importance of Detoxification for Blood Sugar Health
Personalized lifestyle medicine is really looking at how we personalize all of the aspects of lifestyle. Typically when we think of eating it’s how do we personalize it for that person a particular dietary pattern. What if we were not just personalizing food but also physical activity, stress modulation practices, how we are exposed in the environment and creating a personalized approach to environmental toxicity. Dr. Bland and I published about this back in 2013 in the Scientific World Journal called Beyond Macronutrients, this is a twenty first century idea of personalizing all aspects of health. Even though we are all very similar as human beings there are different facets to our physiology and psychology that make us unique. So how do we tweak small parts of our lifestyle, our way of eating so we can get better more magnified effects.
With the human genome project we are now researching how nutrition effects gene expression, how are we changing cell signaling, how do all the little parts of the cell talk to one another based on the messages that are received from the outside of the cell. In my article beyond macronutrients looking at the different phytonutrients for metabolic syndrome. A type 2 diabetic will go the their physician and they might hear about carbohydrates, fiber or stop having so much sugar and use artificial sweeteners, I hope they don’t do that. What I think we need to focus on is the positive message that what we can we be getting in the diet in order to facilitate healthy cell signaling. One study said that just one serving a day of green leafy vegetables that is only a half cup cooked steamed greens, that alone over time reduced the incidence of type 2 diabetes by 15%.
If your getting a lot of plant foods everything starts taking care of itself it’s when we start to veer off the track with processed foods we get more chaotic in our eating, we start making more convenient in our food selections. We are not getting the phytonutrients we need to help with inflammation and insulin signaling. What we need to do is stick to whole plant based foods and it’s not just fruits and vegetables I’m also talking about nuts, seeds and legumes for certain people. Also herbs and spices, one of the bigger things I speak on when I’m talking about phytonutrients is spices so we have a pharmacy in the kitchen and it’s your spice rack. Looking at the basics you have turmeric that does so many things, cinnamon among others have insulin sensitizing effects and are very protective of the cells. I think the Mediterranean diet and a lot of the ethnic diets are so successful is because they do incorporate a lot of these medicinal spices and herbs. The standard American diet is typically devoid of those very important substances, seemingly small but very impactful at the level of the cell. That’s what we focus on with phytonutrients, small but big results.
For a diabetic and personalizing the diet first zoom out and look at what your eating, look at the colors that your taking in. Write down all the whole foods your taking in of fruits and vegetables then take a marker or a crayon and draw the corresponding color through each one and see what colors you have. Most find it’s brown, yellow and white foods, where are the reds, orange, green, blue and purple you need a rainbow. You can start small with one green smoothie a day and focus on one thing and making it consistent, you can have this for breakfast it’s convenient. You will feel more energy and feel invigorated this can help you with the energy to do more. Good choices for in a green smoothie if your a type 2 diabetic start with a protein base and not to be juicing unless combining it with a meal otherwise use a pulverizer like a ninja or nutriabullet. A protein could be a nut milk, I don’t recommend rice milk because it tends to be higher glycemic and higher arsenic and arsenic is one of those contaminants in our environment at very low levels has been shown to leas to diabetic changes within cells. Coconut milk if you can’t tolerate the nut milk, it’s not high in protein but it’s good in good quality fat so that will delay the release of blood sugar as well as lead to delayed gastric stomach emptying. Then we want to add some kind of fiber, flax is good for that, fiber has to changed regularly.
What I have found in some people is that they can develop a sensitivity to certain fibers if they continue to do the same one over and over again. People can develop am intolerance to psyllium if they don’t have healthy gut function and most people don’t. Change up your fiber source, change up your protein source, I like to have them change up their smoothies every three to four days and use your creativity. The other thing for type 2 diabetics I like to recommend as a fruit source is organic blueberries, it’s the exception to no fruit for diabetics. The color that people lack most is blue/purple. There was a study done in fifteen hundred people showed that 88% did not get blue/purple and the reason why they are important for diabetics is a lot of these proanthocyanidins compounds that are in blueberries are needed for healthy brain function. In a study they found these proteins go into the part of the brain responsible for learning and memory, they physically go there and change the cell signaling pattern. They help with neurotoxicity and cellular regeneration, they do a lot more than being just a general antioxidant, we are starting to learn about what more they are doing.
One thing that’s really good is green tea, I steep it until it becomes very bitter because that means you have more of the epigallocatechin gallate EGCG, and other catechin that’s very good for type 2 diabetes. Researchers at the University of Washington showed that we have receptors in our small intestine that taste bitter and these bitter taste receptors of which we have many, like twenty five different types and probably more they just haven’t been identified. These bitter taste receptors when they plug into bitter compounds can change the motility of the gut, change metabolism, can change pancreatic enzyme secretion and gastric acid production. In essence these bitter compounds are good for type 2 diabetics because they are plugging into things in the gut that are going to help with metabolic flexibility. There are bitter taste strips you can get on Amazon.
We did a study at the Functional Medicine Research Center where we looked at whether or not people that taste bitter tend to lose weight easier and faster when their on a whole foods diet and we did find a correlation. A strong bitter tasting ability might be preferred and people that can’t taste bitter very well tend to have increased body mass index, tend to be bigger and heavier for their stature, they tend to have increased trifold thickness and in general not be as metabolically robust.
Bitter foods include green tea, the longer you steep green tea the more bitter it becomes, It’s good to squeeze a lemon in it because the flavonoids in the lemon help to keep the catechins from the green tea working in your liver longer for detox. Green vegetables like arugula not only has that bitter taste it’s also high in dietary nitrates that occur naturally in plants. What they do is they convert through our saliva to nitrites which then convert to nitrous oxide and helps our vasculature, our vessels open up so we feel relaxed we have better circulation. Green bitters in general, any type of bitter herbs impact the liver and detoxification pathways so things used in traditional medicine like berberine is extremely bitter it’s one of the key liver herbs for detoxification. Some are astringent and a little bitter like pomegranate, a lot of vegetables fall into that category a lot of the cruciferous vegetables their not quite as bitter as the leafy greens like chervil, rocket and arugula. We are not talking sour were talking bitter, in Asian cuisine it’s kind of a revered taste but in American cuisine sweet supercedes bitter in popularity. Bitter melon is great, it’s almost to bitter to just eat but you can make a soup with it and that can be useful.
Sodium nitrate and nitrite are used as preservatives in processed meat products, if you look at the literature on processed meat products you tend to see some bad things that are associated with over consumption of a lot of processed meat. If you look at studies on cooked meat without it being processed the same way it doesn’t look like there’s the same connection, especially for cardiovascular disease and type 2 diabetes. I wonder if it’s really the sodium nitrites or the other things in processed meats that could be problematic. One of the things we know about animal products is they tend to be deposed for toxins because they tend to be higher in animal fat and animals live longer than plants typically, what we see over time in an animal is accumulated toxicity. Toxins love fat they like to sink right into that and a lot of these processed meat products that are sitting around for a while with all these different preservatives you might start to see some reactions occur, some metabolites, who knows if there are toxins that’s an issue. Sodium nitrite is typically used as a preservative when it occurs in plants the nitrate is a simple nitrogen containing compound then again what happens,
this is why I tell people to chew their green smoothies not just guzzle them down, your going to digest it but it really starts in the mouth because this microcosm of the mouth leads to direct conversion because of the bacteria in the mouth from the dietary nitrates to the nitrites and this is a good healthy form of nitrites that we want in our body. Then our blood vessels are going to take this up and through enzymes will convert it into the gas that opens up our blood vessels. This is good for people with cardio metabolic and diabetic type indications having that. We know with diabetes there is a lot of issues with circulation you can also find nitric oxide strips on Amazon from Berkley Test Labs to see if you produce enough nitric oxide, you just place one on your tongue and it’s color coded. Maybe it’s one of the reasons you don’t have a lot of energy or fatigued it’s because your not producing enough nitric oxide. The green leafy vegetables lead to more production of noxide, exercise is another good thing for type 2 diabetes that will help in the production of nitric oxide. That’s why when people are very physically fit and I test them with these strips they tend to be off the charts. People who are not physically active are not priming those enzymes letting the enzymes get lazy, enzymes are inducible meaning they can change depending on how we need them and when we need them. If we are lazy they are not going to get kicked into gear and their not going to work for us unless we exercise them. We have to exercise our body to exercise those enzymes.
Toxins come from outside the body and inside the body they are produced by certain bacteria, we don’t think of them that way exogenous and endogenous so their everywhere. If we look at the toxins on the outside of the body and their relationships with type 2 diabetes there is so much, the work of Dr. David Jacobs at the University of Minnesota on persistent organic pollutants. Ask yourself do you get your home sprayed with pesticides, herbicides or insecticides, are you close to areas that do this because these types of things seem to have an impact on pathways in the body that connect to type 2 diabetes. The other one would be heavy metals think of things like arsenic, lead has a lot of cardiovascular implications. A lot of cognitive and neurological symptoms correlate with a lot of these toxic exposures.
One that I have been doing a lot of research on is mold, mold is present everywhere in the environment, the question is are you living in a house full of mold and don’t realize it because you have walls covering it up or because you have had water damage in your house. For many people you can see when they have this mold exposure they feel better when they go out of the house or on vacation getting out of that environment. It also depends on your occupation, gas station workers tend to have greater levels of type 2 diabetes. I had a patient that was a Vietnam Vet and he developed type 2 diabetes and he had an extensive exposure to agent orange and dioxins it’s no surprise that eventually everything coincides, the stress, PTSD, dioxins, bad diet and viola. I don’t know if toxins themselves can just fuel these processes in a very robust constitutional phenotype but in circumstances where you’ve got all these things where all cylinders are activated or a number of them you can start to see more risk. It’s important you start to pay attention to these outside toxins.
Dr. Steven Jennas at the University of Alberta did some compelling work looking at twenty normal healthy people and did the BUS study blood, urine and sweat. What he found is there are many ways we remove toxins from the body we naturally detox if were pooping right, urinating if all of our functions are working right. You would think that we get it all out but we don’t always have the genetic where with all to make sure that things are moving through. One of the things that he found that was most effective for getting toxins out whether it was metals, phthalates or bisphenol A which has been connected to type 2 diabetes risk, was sweating having a sauna. It’s immense what we can lose with sweat, we don’t realize the capacity of the surface area and what we can lose through the skin. It’s one of the largest organs and why if were not physically active were not sweating I tell people exercise to the sweat level that’s where you want to be. Some people don’t sweat and this is an issue, some people have some mineral deficiencies or constitutionally have some issues with sweating so how are they getting their toxins out, how are they maximizing their physiology to get toxins out. Sweating is not to be underestimated there is good research on it.
Internally I think of the liver and the gut as the key organs but a lot of organs in the body have these little transporters that are constantly working to transport toxins out, the brain even has these transporters, the reproductive tract and the lungs do. Our whole body is primed to get these things out it’s just that our environment is inundated so now when we start to manufacture toxins within we create an even higher body burden. One of the first places to start is looking at the gut, when we have dysbiosis and many diabetics do have poor intestinal microflora, an imbalance of good to bad bacteria. With more bad bacteria working than good that can change your body weight and composition, it can change your propensity to inflammation it can change the function of your immune system. Some of the bacteria that we call bad are going to produce metabolites that are even more toxic, they get in and start changing our metabolic machinery our mitochondria, they start making us fatigued and low in energy.
One of the easy things is to work on the gut to make sure were eliminating properly, that we have a good energy level after we’ve eaten., that were taking probiotics this is one of those things that is a staple. A study that came out in 2014 showed that certain probiotics that can help with the transformation of different toxins so we can have the microflora working for as much the same way that our different organ systems are. These little bacteria can convert the different toxins into inactive forms and we get rid of them through elimination. Working on the gut and getting our bile moving as much as possible is good because bile releases fat soluble substances into the gut and hopefully we don’t reabsorb them that they go right into the stool, anything that stimulates bile is good. Some use keto regulation, using deliberate amounts of fats to stimulate the release of the gall bladder to release the bile so were getting rid of those things and then we compliment it with rice bran and other types of fiber in order to bind these things up so that they are excreted. The gut is one of the biggest organs that determines how toxic we are from the inside and the outside.
I am currently working on a book about the brain, for many years I have been looking into the research on type 3 diabetes which is a new term. This is diabetes of the brain, the brain is very unique and we have protective mechanisms to prevent anything bad as much as possible from happening to the brain we have a very particular blood brain barrier. What hey were finding in cases where there was high blood sugar over long periods of time, not necessarily type 2 diabetes just chronic hyperglycemia but moving toward type 2 diabetes they found the blood brain barrier stopped taking up insulin and blood sugar to some degree. This is important because there is a cascade that happens in the brain, when we don’t have insulin in the brain to help with the glucose metabolism what happens is we see the activation of a number of different proteins and these proteins lead to the production of more of these unhealthy types of proteins in large amounts. Things like amyloid Beta, one of the hallmarks of Alzheimer’s disease is when you have amyloid beta aggregating in the brain, they have found this under autopsies.
With increased insulin resistance you get increased amyloid beta aggregation and production and what happens as a result of amyloid beta aggregating in the brain you get more inflammation so more things that are inflammatory get turned on in the brain, Jeff Bland called it brain on fire. There is this inflammation that happens it upregulates thing like TNF alpha which is one of the things that caused big inflammation I call it the monster for inflammation. Eventually what happens is all of these inflammatory signals come back and make the insulin resistance even worse they shut off the phosphate group on the insulin receptor substrate which is normally there to take in the signal of insulin. What you have is this perpetuating cycle where overall it’s hard to stop. We either have to work on the inflammatory aspects or we have to work on the insulin resistance aspects but without insulin we have difficulty clearing that amyloid beta. Amyloid beta is usually present in our bodies it’s just a protein but under these circumstances where we have a lot of it it’s not so healthy. In these studies what they especially found was patients with Alzheimer’s disease were given intranasal insulin it helped them with their cerebral spinal fluid levels of glucose and amyloid that they were able to see an improvement there. These were clinical studies not just cell studies, the molecular mechanics are connected to the cell studies, but they have gone further into looking at clinical trial with this.
If your concerned about your brain health and your cognition the biggest thing you can do is watch your blood sugar insulin levels and make sure that’s well monitored. Studies have found that when you have a high glycemic meal that’s going to spike glucose levels right after you eat it impairs cognition right afterwards, some of that can be impacted by just taking some vitamins along with that meal. It doesn’t justify the consumption of some of these high glycemic foods but it does show the oxidative stress that can occur that turns on inflammation that changes cognition relatively soon right after that meal.
If you don’t have any reason for not working on reversing your diabetic condition, focus on your brain or what ever will make you feel motivated, type 2 diabetics have a 2-4 times increase of dementia relative to people that are not diabetics. Even people that are normal glycemic that have normal blood sugar levels they can be having these changes at the cellular level without even knowing. There was even a study where normal glycemic mice were given a high sugar load for seven days after that they had epigenetic changes to different genes that were responsible for blood sugar from just one meal. Think about how we go from one sugar meal to the next eventually what happens is we create this cellular memory and it’s going to become more difficult to unwind all of these epigenetic changes, not that it’s impossible but the sooner we jump on this especially with blood sugar and insulin because they do tie in with genetic expression so tightly. This is pivotal to our existence, our survival as human beings.
On my webpage I have free recipes, infographics and different webinars that I have done.
Deanna Minich web page foodandspirit.com
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M. Scherker medical researcher