Part 4, Patient Mysteries: Can Diabetes be Reversed?

3. Don’t I need to eat every 3-4 hours? No, you don’t. 2,000 calories in two meals in 24 hours counts the same as 2,000 calories in over 4-6 meals in 24 hours. In fact, the number of calories we eat has risen by more than 20 percent in women and approximately 10 percent in men following the 6 meal a day recommendations that were made in the mid-1980s. On the flip side, a 2007 retrospective study of daily energy intake, physical activity, weight loss, and smoking during the Cuban economic crisis of 1989 through 2000, resulting in a 35 percent reduction in caloric intake netted an increase of physically active adults from 30-67 percent, a 1.5-unit shift in the body mass index distribution, a 100 percent decline in obesity, and significant declines in mortality due to diabetes (51 percent ), coronary heart disease (35 percent), stroke (20 percent), and all causes (18 percent).

4. Is fasting for everyone? No, it’s not. Children, pregnant and breastfeeding women, and those individuals that are moderately-to-severely malnourished should not fast.

5. I will lose muscle mass. No, you won’t. When eating, we burn carbohydrates, sugar for fuel. After an 8-12 hour fast, those calories are gone, and any further caloric needs are derived from our fat stores. If we have enough protein on board, 1.0-1.5 grams per pound, muscle mass is preserved.

6. I’ll be too hungry, obsess about food, and make things worse. Eh, you might. However, if you occupy your time with meaningful activities, hydrate adequately with water, sea salt and/or bone broth, be kind to yourself, if you slip, get back on the horse, don’t go hog wild after the fast is over, and choose a fasting schedule compatible with your lifestyle, it will be easier to stick to. If your hunger is overwhelming, especially at work, driving or any task requiring your undivided concentration, consuming 8-10 ounces of water flavored with lemon or lime and mixed with 1⁄2 tsp of sea salt, coffee, tea or even a handful of nuts and seeds will usually get you past the crisis.

7. What about medications? Medications are always an issue. Our goal is to safely reduce, with an eye to eliminating, as many medications as we can. NSAIDs, aspirin, Motrin, Advil and others of similar ilk need to have some sort of food or liquid to protect against GI irritation. Always check with your healthcare provider.

There exists a plethora of over the counter vitamins, mineral, herbs and nutraceuticals that perform the same function, often at less expense, and without the GI upset, as the above- mentioned drugs. If we can’t switch out the GI irritants, we recommend changing your medication time to the first full meal of the day.

For diabetics, it is important to monitor your blood sugar. If dropping, or you feel faint or light-headed, have a snack of nuts and seeds on hand in case your sugar drops too low. This is a good sign, a signal that you need less medication, one of our overall goals.

To protect your stomach from the harmful effects of gastrointestinal irritation, the conventional wisdom is to use a PPI like omeprazole or Prilosec. These medications are fraught with their own problems, most notably bone thinning, especially in the teeth, jaw, and hip.