Title: Plant Based Diet for Prediabetes
"Is fruit bad?" My initial reaction was to ask, "compared to what?", but I understood what they were asking. There is this common misconception that all carbohydrates are "bad" and that we can't eat fruit if we have prediabetes. Those are myths that come from a poor understanding of what is fundamentally going wrong in the body.
To be clear, fresh and frozen fruit are great choices when we have prediabetes. In fact, I not only encourage my patients with prediabetes to eat fruit, I ask them to eat it on their oatmeal in the morning. Let me explain...
We are each born with a certain amount of energy storage cells in our body. This number is based on our genetics and varies from person to person. When we exceed that storage amount for our body, the body starts looks for other places to store it. And it's only choice is to put our storage where it doesn't belong.
Think of it like a naughty room-mate. A room-mate that packs their room full of junk from floor to ceiling, and then asks you if they can put a few things in your room. You say "no", but when you're out, your roommate gets extra naughty and they hide some of their stuff under your bed. Then, when you get home, you discover their stuff and you toss it back into their room... but there's no room in their room... so it ends up in the kitchen. That's sort of what is happing when we have pre-diabetes.
In pre-diabetes, we've filled our rooms. We no longer have a safe place to store our extra calories. And so we start to store those calories in the liver, the pancreas and the skeletal muscle. But storage doesn't belong there... so just like we tossed our roommate junk in the kitchen, these organs start tossing the extra calories into the blood stream. So our blood sugars run high, even after we've been fasting all night. Our bodies are working extra hard to get rid of the extra storage. But that sugar in the blood isn't just from sugar that we eat, it's from all of the macronutrients, and the excess of calories that we are consuming. We need to somehow find a way to feel full on less calories to reverse this. And that's where a plant based diet comes in.
If you're following along, then you'd see that the obvious answer is to somehow get rid of all of the things we've stored... to make more room. And that is also the case with pre-diabetes. Weight loss is the biggest predictor or remission and reversal of the underlying cause (insulin resistance).
The fascinating thing is that, anecdotally, we tend to see a normal A1c after transitioning towards a plant based diet, even before most of us actually see meaningful weight loss. The answer appears to be twofold: (1) less processed foods and calories that don't actually make us feel full, and (2) significantly less saturated fat. Saturated fat appears to be especially troublesome for our liver and pancreas. These are some of the reasons that a plant based diet works so well to reverse prediabetes. It treats the underlying cause.
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