The End of Diabetes is largely intended for Type 2 Diabetes, which nutrition and exercise can actually cure. But it speaks directly to those with Type 1 Diabetes about increasing quality of life and preventing the many health complications associated with diabetes.
A nutritarian diet typically requires half the insulin as an American Diabetes Association diet.
Many of the complications actually come from the insulin injections rather than diabetes itself. While excessive insulin promotes plaque and heart disease risk, green vegetables can prevent and remove plaque, in addition to providing you a ton of vitamins, minerals, and phytochemicals.
Dr. Fuhrman states his nutritarian plan typically cuts the insulin needed in half; controls glucose levels and lipids; and, reduces swings for a happier and healthier life.
The book recommends starting with a strict phase with the first goal of reducing insulin:
- Avoid high carb foods for the first few weeks, aside from about a cup of beans daily. Cauliflower is a good substitute where you crave carbs.
- Aim for eight servings of non-starchy veggies (i.e. greens, tomatoes, eggplant, peppers, mushroom, onion). They have the highest nutrient density and are always unlimited.
- Of those eight servings, aim for one of which is a raw cruciferous vegetable and one a cooked cruciferous vegetable (i.e. broccoli, cabbage, Bok Choy, radish, watercress, kale, collards, Brussels sprouts, arugula, mache, mustard greens). Cruciferous veggies repair, protect, and have the most anticancer effect.
- One ounce of nuts and seeds per day is the main source of healthy fat. In addition, aim for 1 Tbsp ground flax seeds and 4 walnut-halves daily. This meets omega-3 needs without trans-fatty acids or saturated fat. Half an avocado is good occasionally, but avoid all oils because they are refined, low-nutrient and high-calorie without fibre.
For an easy salad dressing, mix equal parts nut butter, vinegar, and water.
Of course, work closely with your doctor because you will need to reduce insulin when eating this way – that’s the goal! In the first few days, Dr. Fuhrman says glucose readings should run 125-175. Any time a reading goes below 120, you should be reducing your insulin dose. Running a little high during transition is safer than risking hypoglycemia.
To mimic a normal pancreas, he recommends a 24-hour shot before dinner or at bedtime and a short-acting insulin immediately before each of the three meals. For a typical patient, he’s seen the long-acting dose move from 40-50 to 15-25, and the short-acting from 6-9 to 3-5. His objective is to make insulin requirements physiological instead of pathological in order to avoid fluctuations and hypoglycemia.
Note in the beginning you may feel unpleasant symptoms unrelated to diabetes. The big change in your eating can cause lightheadedness, fatigue, headaches, increased urination, sore throat, flatulence, and maybe even a rash and itching. I felt pretty awful for about a week and am nowhere near diabetic. To minimize these symptoms, Dr. Fuhrman recommends taking it more gradually with raw vegetables, cruciferous especially; spreading out your beans between lunch and dinner; and, increasing the amount you chew.
After a few weeks in the first phase, you can move to a more flexible approach that should still keep your insulin needs as low as a non-diabetic. The main changes will be:
- Continue to avoid all refined carbs, both sugar and starch, but you can have a daily serving of whole grains or starchy vegetable like sweet potato, corn, or carrots
- Increase beans to a maximum cup with lunch and one cup with dinner
- Add up to one or two fruits with breakfast, one with lunch, and one with dinner
- Keep avoiding added sugar (including non-calorie sweeteners, honey, agave nectar, fruit juice) – instead, sweeten with whole fruit, occasional dried fruit, or spices like cinnamon, nutmeg, and allspice
- Keep avoiding added salt (sodium intake should stay below 1,200 mg/day)
- If you want to eat animal products, 1-2 ounces for flavour should be safe up to three times per week, favouring fish, nonfat dairy, and occasionally poultry
An example meal plan looks like this:
Breakfast: 1/2 cup cooked oats (not quick oats), ground flax seeds, walnuts, and two low-sugar fruits (i.e. berries, kiwis, oranges, green apples)
Lunch: A huge salad with nut-based dressing, bean soup, and any fruit
Dinner: Raw veggies with bean dip, a big dish of steamed greens and various veggies, plus a fruit sorbet for dessert
Raw oats have more resistant starch than cooked oats, so try soaking steel-cut oats overnight in the fridge for a soft (uncooked) breakfast the next morning.
Type 1 diabetics are advised to maintain three meals, each around the same calories. Also balance each lunch and dinner with greens, beans, and nuts. Instead of counting carbs and adjusting insulin, this approach stabilizes diet and insulin. You can find more information on Dr. Fuhrman’s website!