302: Food as Medicine: Managing Diabetes with Plant-Based Diets | DOCTOR IN THE HOUSE

Dr. Rizwan Bukhari  00:00

The other thing I want to point out about being able to use these CGM devices to get almost immediate feedback is that you can learn to level out your glucose because spikes in glucose lead to spikes in insulin. And as we talked about, insulin has more effects on the body than just monitoring and regulating glucose.

Maya Acosta  00:23

All right, welcome back to part four of our four-part series on diabetes. I'm Maya Acosta, and this is a healthy lifestyle solutions podcast. The segment with Dr. Riz is titled Doctor In The House. Welcome back, Dr. Ris. Thank you, we're gonna basically wrap things up, I kind of want to do a quick review for all of you. If you haven't been tuning in to the Monday episodes, I recommend you visit Monday, Dr. Riz is the guest expert every Monday. And so go back, I'm gonna put links in the show notes so that you can visit part one, part two, and part three of our series on diabetes. So part one, we basically define diabetes, type one, type two, pre-diabetes, and gestational diabetes, and we talk about symptoms and risk factors. In part two, we talk about managing diabetes, and the importance of early detection. In the third part, we talk about lifestyle modifications that you can make, including changing your nutrition and adding physical exercise; we're just going to sort of wrap up, provide some resources for listeners, and then I'm going to give you a couple, I'm going to show you a couple of books that I recommend. It's such

Dr. Rizwan Bukhari  01:34

a huge topic. And you know, we've we've had kind of this is our fourth episode on this topic, but and there's so much more that can be covered. But I think this is a great introduction for people. And it's a great resource to get people started. And so

Maya Acosta  01:49

I am actually going to start with one that's very reliable. If you're watching the video, you're gonna see me Hold up, Eric Adams. Book in his title healthy at last. Okay, do you want to say anything about Eric Adams before I read an excerpt from his book,

Dr. Rizwan Bukhari  02:05

I think we met him at one of the ACLM meetings pre-pandemic, he was a keynote speaker and his story was fascinating. And at the time, I think he was the president of one of the boroughs of New York, I thought it was fascinating that we had someone who believed in the plant-based lifestyle and who was going to be running for mayor of New York and also knowing that he was going to try to institute some healthy initiatives for the citizens of New York, which he has done since he's taken over as mayor,

Maya Acosta  02:36

I want to read from his introduction, Eric Adams starts off by saying that he was pretty much you know, he was the borough president for Brooklyn, he was 56 years old, felt like he was fairly healthy and doing well until one day he woke up and he was blind. He went to look in the mirror and couldn't really see. But he saw that one of his eyes was bloodshot red. And he went to his doctor, and we're going to talk about the one C, hemoglobin a one C, but normally, we want that to be less than 6.5. And when he went to his doctor, his doctor said he was at 17%. That's a very high number. And one of our earlier episodes, we talked about how people kind of default to process fast food because it's the easy thing, and people can't find comfort in those foods. So he said, as you know, having been first a police officer for many years in New York, and or Brooklyn, and then president of the borough of the Brooklyn Borough, that somehow you know, all the stress and the trauma that he suffered from living that lifestyle led him to pretty much every day on his way to work. And on his way home. He was stopped by one in the fast food restaurants. And he realized that what he was doing is that he was self-medicating. If that makes sense. You medicate with food. He said I needed food that would take the edge off. And Psychologists call this term vicarious trauma. It's also known as compassion fatigue. So there was tremendous anxiety that he was living with. And so in the book, not only does he share his story about his own recovery, but his mother who had been living with diabetes for 10 years, also improved her diabetes. And then if you see all the tabs I have in the book, the second part of the book is full of delicious and healthy comfort food and also southern food. And so I think you're gonna really enjoy it and learning his story, knowing who he is today as mayor of New York. I think it's pretty cool to have had this

Dr. Rizwan Bukhari  04:41

mentioned through changing his lifestyle and particularly his nutrition. He was able to reverse his diabetes and clear up his blindness.

Maya Acosta  04:49

Yes, as a matter of fact, he talks about when he lost weight, when his partner said to him, I'm worried about you. And he said, Well, I've lost it. some amount of pounds over the last 90 days since I adopted this way of living, but you're used to seeing a heavier part of me like that's become the norm for you to see me this way. But he actually looks great. Another book I want to mention if you want to continue to do your own research, and all of that is mastering diabetes. And these two individuals actually have type one diabetes and are thriving in life. And the foreword and this one is by Dr. Neil Barnard. And it's very detailed, goes into a lot of great information, and also has some recipes. What I wanted to add Dr. Was said I don't know if we mentioned is that sometimes when people adopt this way of living upon based diet, and they start to add starchy foods into their diet, they may actually see a little bit of a rise in their insulin resistance. And that's because the blood sugar is still there. And so the body is, you know, still adjusting to the changes, but you have to give your body time to make the change, and you're going to see your blood sugar begin to normalize. So it's not like you want to give up on things right away.

Dr. Rizwan Bukhari  06:05

Yeah, I mean, I think when you make a change from our kind of standard American diet to a healthier diet, it does take time, it's not going to happen overnight. In fact, when people do switch over to a whole food plant-based diet, or predominantly whole food plant-based diet, sometimes they'll say, I felt worse, I felt, you know, for the, you know, when I started it for the first few days, I felt worse. And the reality of what I try to explain to them is that the reality is it's not the diet that's causing that it's the actual withdrawal or toxicity from the previous diet that's causing them to feel bad. Yeah. And if they can break through that, then they're gonna start to feel better. Similarly, it takes some time, but not a lot, for the improvements in all of our biometrics to start occurring, blood pressure, cholesterol, sugar levels, and things like that, yes,

Maya Acosta  06:58

on my Thursday solo episodes, I cover concerns that people have so I have a whole episode on protein, a whole episode on carbohydrates, and a whole episode on fiber. And, and we talk about these things. For example, taking in fiber slowly, especially beans, as the gut bacteria is learning to break down some of those things that are happening. And then I did have a gut specialist on the show who talked about, you know, she treats SIBO. Many times. IBS is misdiagnosed when it's actually SIBO. And she was telling me that fermented foods, while they're great for us, we want fermented foods to feed our gut microbiome. If you're dealing with SIBO, it can actually aggravate that. So those these little kind of complications, and I say little because they can be improved over time with if you're working with the right specialists, but these kinds of things cause people to give up on the diet. And so that's why we mentioned that hold on, you know, I'm going to also tell you about doctors that are available via telehealth. So in this book, insulin resistance influences your risk for the development of a number of chronic health conditions in addition to diabetes.

Dr. Rizwan Bukhari  08:17

As I mentioned earlier in one of the episodes, insulin is a hormone, which it's one of its primary issues that we've identified it as doing is regulating our blood sugar, but it does do so many other things in the body. And so it's not just the insulin isn't just for blood sugar.

Maya Acosta  08:37

Yeah, yeah, this one's a great one, Dr. Michael Greger who is also the founder of nutritionfacts.org. He wrote, How Not To Die. There's a whole chapter on diabetes, how not to die from diabetes. And so, and then half of the book is all about the foods that you should eat. He mentions the Daily Dozen. Also check out my Thursday episodes, because I have a whole episode on the Daily Dozen and his recommendation. So this is another great book. There are lots of books. I mean, I can continue, but these are three great books to consider. And then I wanted to mention Dr. Riz. I said in an earlier episode that we really encourage people to visit the Physicians Committee for Responsible Medicine. It's one organization we like to endorse, they have tons of resources by category. But if you're looking for a plant-based physician, that's where you'll find one. In the past. They have also offered eight-week classes called fight diabetes with food. And we participated in those we've been guests in those where it's literally every week on a Tuesday you meet with a group of experts that help you to figure out how to meal plan, how to do groceries, what staples to have and all of that. Do you want to share anything about that experience?

Dr. Rizwan Bukhari  10:00

No, I think it's a wonderful resource that they do on a repeating basis. And they have guest experts who are able to contribute to those topics. And they carry they cover a wide range of topics. So it really is applicable to the beginner. So someone who wants to learn is, that's a great place to start. And they have so many resources available.

Maya Acosta  10:24

Yeah, exactly. So check that out. I want to mention a study conducted by Dr. Neal Barnard and his colleagues at the Physicians Committee for Responsible Medicine. And what they found is participants with type two diabetes who followed a low-fat vegan diet for 22 weeks experienced significant improvements in blood sugar control, weight loss, and cholesterol levels compared to those who followed a conventional diabetes diet. So we're not just talking about, you know, yes, listen to your doctor, take your medications, but also, in addition to that, consider food as medicine.

Dr. Rizwan Bukhari  11:03

Absolutely. And what I'd like to really point out about that study is that it was a whole food plant-based diet versus the diet recommended by the American Diabetes Association.

Maya Acosta  11:17

Okay, yes. And in addition to that, we have seen that in short jumpstart programs, whether they're seven days or 10 days, and we've seen this in documentaries, like Forks Over Knives, which is another movie, I have another resource that I recommend Forks Over Knives, the plant pure nation movie by Nelson Campbell, there's also the most recent one from food to freedom. That one also shows a short 10-day study. And we have seen that within 10 days of only eating this way, not even exercising, but eating this way, within 10 days, you can see improvements in your cholesterol in your, blood pressure, and in your blood sugar.

Dr. Rizwan Bukhari  12:02

Right? Well, I think that's something that is extremely meaningful to me, and still surprises me to this day, after having been whole food plant based now for six going on seven years and teaching this stuff. When you change your diet, you see changes, positive changes within weeks, okay, two weeks, three weeks, four weeks, and you see x extremely significant positive changes. On the other hand, if all you do is take a pill, you're number one, you don't see the same extent of changes. But number two, the pill isn't actually solving the problem. All the pills are doing is managing the disease. You still have the disease if you're taking a pill. But if you change your lifestyle and you change your diet, you're actually improving. And even sometimes getting rid of the disease.

Maya Acosta  12:59

Yeah, exactly. This is wonderful. We've given you a lot of resources. I mentioned three books. I've mentioned two documentaries, the website pcrm.org. That's the Physicians Committee for Responsible Medicine, France, we're going to take a pause right now for me to explain that while we were doing this recording, we accidentally touched the computer, and our microphones were affected, at least mine. So from this point on, you will notice that I'm not connected to the main microphone. But the conversation was so valuable that I went ahead and kept the rest of the conversation. So you'll again notice a difference in the volume and the quality of the audio. But that's okay. You might just want to turn it up from this point on as we continue the conversation about diabetes. If you're living with type two diabetes, how often should you be checked for hemoglobin once,

Dr. Rizwan Bukhari  13:58

if you have already diagnosed with diabetes, it's likely that your doctor is going to check your hemoglobin one see every three to six months.

Maya Acosta  14:06

Oh, wow. And we want our number to be less than 6.5%.

Dr. Rizwan Bukhari  14:10

Well, 6.5 is a is a really good goal for someone with type two diabetes, that actually kind of gets you to what we call the pre-diabetic level, okay? And that non-diabetics have a hemoglobin a one C of 5.9 or less, between 5.9 and 6.5. Make is that pre diabetic level, and then above 6.5 is diabetes. And then you can see a variety of levels above 6.5 depending on how well or how poorly controlled your diabetes is. Oftentimes, many physicians will shoot for a goal of seven, depending on the extent if you've got a diabetic, let's just say like, like Eric Adams who came in with hemoglobin a one C of 17 and you get them down to seven. You've committed a miracle. Okay, okay. And so Oh, you know, there's just different, there's different goals. And I think these are achievable if people are aggressive in their lifestyle changes, and in monitoring and making the right choices based on what they find. Okay. And that might be actually a good segue into monitoring.

Maya Acosta  15:20

Yes, it really is. And I just before we talk about daily monitoring, can you explain again, hemoglobin a one C? What is that? What is it telling us? Because that's a little different than the daily blood

Dr. Rizwan Bukhari  15:32

sugar. Yeah, so the daily blood sugar just tells us what is the level of sugar or glucose in specific specifically in our blood. And the glucose in our blood varies up and down all day long, based on what we're eating and then absorbing through our intestines, and then it gets into our bloodstream, and we release insulin, and then that causes it to go into our organs. And so the blood sugar by very various times, from 70, to 200, depending on what just happened, if you just ate a meal, it could be 180 200. Or if you've been fasting overnight, it could be less than 100. So when we when we test typically test for a glucose level, we ask people to do a fasting test. And we so we'll say don't eat anything overnight. And before you eat anything in the morning, we'd like you to come in and get your glucose tested. For that person, the blood sugar should be less than 100. Okay, if it's over 100, then that's a sign that there may be some sort of diabetic issue going on. And then that will lead to further testing. Okay, now, the hemoglobin a one c is an indication of what your blood sugar level has been over the last three months. So what we're actually doing is testing the glycosylated hemoglobin, which means what is the sugar that is attached, attached itself to the hemoglobin in your blood, okay, okay. And so we know that a normal person with a normal blood sugar has a certain percentage over time, okay. And the reason we use 90 days for testing is because red blood cells recycle every 90 days. Okay, so it doesn't do any good to check a hemoglobin AOC every month because you still have red blood cells from two months ago, which might have had a high blood sugar. So when you make changes, you need to wait about 90 days before retesting to see the impact of those changes. And so a hemoglobin a one C is reflective of what's the last 90 days of glucose exposure within the blood,

Maya Acosta  17:51

I say, that really helps us to understand and then you we're going to move on to sort of a daily monitoring system. So

Dr. Rizwan Bukhari  17:59

monitoring in general. Okay, so that's where monitoring comes in. Feedback allows you to make choices, okay? If you don't, if you don't have anything to give you feedback, then how do you know that the choices that you're making are positively or negatively impactful upon your blood sugar, and your diabetes? So some people prick their finger every day, okay, and they get a blood sugar. And they can check them at different times, and based on Okay, so let's say the ears ate a certain type of lunch, and then they check their blood sugar two hours later, and they see what their blood sugar is. And then now they know what kind of effect that lunch has. And then the next time they eat a different type of lunch, and they prick their finger and check their blood sugar. And and you might get a different impact, can you begin to learn what different types of foods have different impacts on your blood sugar, okay. And we also know this scientifically, that's why you can do a lot of reading. And already, you don't have to prick your finger every time to figure these things out. You already have a lot of data and information available in these resources that you've provided that tell people what are the good foods to eat in order to control your blood sugar better. So that's the finger-picking method. Now there's the hemoglobin a one C, as we said, tells you how well you've done over a three-month period. Okay, but then something I really like is something called CGM, continuous glucose monitoring. And these are relatively new devices. They've been around for a few years. And basically, and many of you out there may have seen this where there's a little circular device that's on the back of somebody's arm, or maybe on their belly, or on the back of their shoulder. Depending on the device. There's different places you could put it. And what that does is it's continuously sampling your interstitial fluid glucose, and that's directly related to your blood best Oh, glucose, okay. And so then you get continuous readings. So you can check that every minute, you can check it every hour, you can check it, you can eat a meal, and check it, you can see what your morning coffee and muffin does versus oatmeal. And what it does, and you can get really great feedback on a on very quick basis on what different diet dietary changes do to your blood glucose. And then you can learn to control your blood glucose better and keep it down. The reason I like it is you don't have to stick your finger all the time. Okay. And, and when I've, I've done the math, if somebody sticks the finger four or five or six times a day, that ends up costing nearly the same as CGM devices, it was monitoring system, I think for very much the same price or maybe just a little bit more, you can have this really wonderful tool that's available to you. And, and insurance do cover this for diabetics, they do Absolutely. Now it may not cover the entire cost, but it can offset a significant amount. Like for example, I know that there's this one device that one-month monitoring costs $75. Well, the diabetic supplies for a month may run you $75. And so you know that, for me the convenience of not sticking my finger would trump that and I would want a CGM device. The other thing I want to point out about being able to use these CGM devices to get almost immediate feedback is that you can learn to level out your glucose, because spikes in glucose lead to spikes in insulin. And as we talked about, insulin has more effects on the body than just monitoring and regulating glucose. And some of the other things that have to do with our lipo Genesis, which is creation of fat has to do with the regulation of amino acids, which is our proteins. And in particular, high insulin or hyperinsulinemia. has been associated with multiple cancers. So for people who keep getting these high spikes of insulin, I think that that may be one of the reasons that they're they can be more prone to cancers. Yeah. So getting this feedback on a continuous basis helps you regulate. And so your blood sugars are just nice and calm. And within this nice way within range instead of way up, way down, way up, way down. Way up. Way down.

Maya Acosta  22:39

Yeah. Alcohol consumption affects the blood sugar as well.

Dr. Rizwan Bukhari  22:44

Absolutely. Yeah. Alcohol is a sugar. Yeah, people don't I don't know if people understand that. But alcohol is sugar. Yeah. And so that's why there's calories in in alcohol, whether it's wine or, or liquor,

Maya Acosta  22:57

yes, anything else that we want to say about the glucose monitoring system.

Dr. Rizwan Bukhari  23:01

So I think that the glucose monitoring is wonderful in the sense that, again, it's provides you very, very quick feedback. And it also allows you to make dietary choices that are better for your health. And you can learn things like I do promote to people to eat some servings of non starchy vegetables before you eat your meals. So that would mean like, what I do on a regular basis is I eat a green leafy vegetable salad. Okay. And, and, and so that then as it's being absorbed, and then you follow that with the other foods that mitigates the spikes in your blood sugar, because you're adding some food in there with some fiber beans, for example, or another great choice because they have so much fiber. So high eating some high fiber foods also help mitigate those spikes in in blood sugar.

Maya Acosta  23:57

Awesome. I'm so glad you said that. And I do. I have an episode on fiber. And and that's I mean, almost any condition we have could be helped by can be improved by eating more fiber because it does. It regulates the blood sugar, it helps to detox the body. I mean, it's just miracle.

Dr. Rizwan Bukhari  24:16

I say I'm a beans and greens guy. Because those two particular food groups have so many beneficial effects on the body.

Maya Acosta  24:26

Yes, yes. And then if you're eating whole foods, most likely the food you're eating has fiber. The problem with the processed foods is we take the fiber away, and then we add a bunch of preservatives and additives and other things that make us salt and oil. Yeah, okay. We talked about hemoglobin a one C and then we talked about continuous glucose monitoring. And by the way, if you're interested in seeing reviews or leaving a review, simply go to healthy lifestyle solutions.org and go to the tab that's titled reviews. Click on it. You'll see by To reviews and also you have the option of leaving a review on Apple podcasts or on Spotify.

Dr. Rizwan Bukhari  25:05

I agree. I said this on a previous episode that I would love to hear from you guys on on multiple fronts. Number one, are we giving you information that's valuable? Number two, if there's questions that we're not answering, go ahead and ask and we would love to answer your questions because we're speaking a narrative here and having a conversation, but we may not meet all of your needs in that conversation. If there's something you want to know reach out, and we will certainly try to address it.

Maya Acosta  25:36

Yep. Anything else before we wrap up? Nope. Once again, thank you Dr. Oz for joining us.

Dr. Rizwan Bukhari  25:42

It was a lot of fun. Thank you for having me.