Beating Diabetes : The First Complete Program

Dr. David Nathan was one of the lead researchers of the landmark Diabetes Control and Complications Trial sponsored by the National Institutes of Health. It scientifically proved that the right program of nutrition and exercise can prevent diabetes in people on the brink of the disease. The same lessons can have a major effect in those who already have diabetes. Approximately 800,000 new cases of diabetes are diagnosed each year in the United States, and that number continues to rise sharply. The results of the Diabetes Control and Complications Trial received enormous media attention because this approach to lifestyle change offers real hope to the vast and growing number of people with prediabetes (40 million in the United States alone) and those with type 2 diabetes (16 million). Now, in Beating Diabetes, Dr. Nathan teams up with fellow Harvard Medical School expert Linda Delahanty to arm people at high risk for developing diabetes and those with type 2 diabetes with the first complete, clinically proven program of its kind. Readers get: Step-by-step, proven techniques to help them make real and lasting lifestyle changes by eating better and exercising regularly without becoming a health nut or spending hours in the gym Tasty, easy-to-prepare recipes and daily meal plans from the chief dietitian at the Massachusetts General Hospital Diabetes Center Guidelines for developing diabetes-busting exercise routines appropriate to all ages and fitness levels Help in identifying unhealthy, diabetes-promoting behaviors along with expert guidance on making crucial lifestyle changes and sticking with them

David M. Nathan, M.D., is the director of the Massachusetts General Hospital Diabetes Center and a professor of medicine at Harvard Medical School. An internationally recognized expert on diabetes and its complications, he pioneered the development of intensive therapies for diabetes and was one of the designers of the landmark Diabetes Prevention Program and the Diabetes Control and Complications Trial. Dr. Nathan has appeared on "ABC News," "CBS Evening News," and "The NewsHour with Jim Lehrer," as well as on the CBC and the BBC, and he has been featured in countless publications, including the Wall Street Journal and the New York Times.

Linda Delahanty, M.S., R.D., is the director of Nutrition and Behavioral Research and chief dietitian at the Massachusetts General Hospital Diabetes Center and an instructor in medicine at Harvard Medical School. For more than twenty years, she has conducted research in nutrition and the behavioral changes that lead to success with weight loss and improved control of diabetes. Delahanty is a nationally recognized, widely quoted expert in nutrition and diabetes who has counseled thousands of people with diabetes. She is the author of 101 Weight Loss Tips for Preventing and Controlling Diabetes.

Acknowledgments

xi

Introduction

xiii

The Basics: Diabetes and Prediabetes and Why They Are on the Rise

1

(20)

Blood Sugar and Insulin: The Basics

2

(3)

Type 1 and Type 2 Diabetes

5

(1)

Type 2 Diabetes: The Twentieth- and Twenty-First-Century Epidemic

6

(2)

Metabolic Syndrome: Diabetes Plus

8

(1)

Why Diabetes and Metabolic Syndrome Matter

9

(1)

Why Type 2 Diabetes Is Becoming More Common

9

(6)

How Our Lifestyle Has Made Us Vulnerable to Diabetes

15

(3)

Lifestyle and Type 2 Diabetes

18

(3)

Why We Gain Weight: The Arithmetic of Obesity

21

(8)

How We Turn Food into Fuel

22

(1)

How We Use the Fuel from Food

22

(2)

When Energy In Exceeds Energy Out

24

(1)

Weight Gain Myths

24

(2)

Why Weight Is Important to Diabetes Prevention and Treatment

26

(3)

Proof That Lifestyle Matters: The Diabetes Prevention Program

29

(12)

Observational Studies: The First Scientific Studies of Nutrition and Exercise

30

(2)

Why Randomized Controlled Clinical Trials Are So Important

32

(1)

The Diabetes Prevention Program

33

(2)

Lifestyle Changes Work in China and Finland, Too

35

(2)

Lifestyle Changes Also Work for Other Heart Disease Risk Factors

37

(2)

Medication to Prevent Diabetes

39

(2)

Applying Lifestyle Changes to Treat Diabetes and Associated Diseases

41

(24)

Type 1 Diabetes

42

(7)

Lifestyle Changes to Treat Type 2 Diabetes and Associated Diseases

49

(6)

Lifestyle Treatments for Hypertension

55

(3)

Lifestyle Treatments for High Cholesterol and Other Blood Fats

58

(7)

Activity and Exercise: Move, Move, Move

65

(14)

Fad Exercise Programs

66

(1)

Activity Versus Exercise

67

(4)

Exercise

71

(4)

Special Issues for People with Diabetes

75

(2)

Intensifying Your Workouts

77

(2)

How to Get Ready to Change Your Lifestyle

79

(12)

What It Means to ``Be Ready''

79

(3)

How You Can Gauge Readiness to Change

82

(9)

Preparing Your Environment for Change and Success

91

(16)

Your Physical Environment

91

(7)

Your Emotional Environment

98

(2)

Your Cognitive Environment: Changing Your Self-Talk

100

(4)

Ditching Old Habits

104

(1)

Are You Hungry or Are You Eating out of Habit?

104

(3)

Setting Weight, Activity, and Nutrition Goals and Tracking Your Progress

107

(14)

Setting Weight Loss Goals: How Much?

108

(2)

Setting Weight Loss Goals: How Fast?

110

(1)

Moving More: Activity Goals

111

(1)

Eating Well: Nutrition Goals

111

(3)

Self-Monitoring: Recording Your Weight Loss Progress

114

(1)

Self-Monitoring: Recording Your Food Intake and Activity

115

(6)

Solving Problems

121

(4)

Maintaining Your New Lifestyle

125

(12)

Follow-Up

125

(1)

Developing an Accountability Plan

126

(2)

Building a Positive Support System

128

(2)

Recovering from a Lapse

130

(1)

Steps in Preventing a Relapse

131

(1)

Knowing Your High-Risk Situations

132

(2)

Ending the ``Diet Mentality''

134

(3)

Popular Weight Loss Programs: Do They Work?

137

(30)

Basic Rules

138

(2)

Very-Low-Fat Diets

140

(1)

Low-Carbohydrate Diets

141

(5)

Healthy and Unhealthy Fats

146

(3)

Healthy and Unhealthy Proteins

149

(1)

Right-Food-Combination Diets

150

(3)

How Well Do They Really Work?

153

(5)

What About a Weight Loss Pill?

158

(1)

What About Weight Loss Surgery?

159

(2)

Summing Up

161

(1)

Putting It All Together

162

(5)

How to Change Your Eating Behavior

167

(14)

The DPP Lifestyle Program

168

(2)

The Sixteen-Session Diabetes Prevention Program

170

(11)

How Study Participants Did It: Three Stories

181

(20)

Sandra's Story

181

(2)

Kathy's Story

183

(4)

Bob's Tale

187

(1)

Lessons from Sandra's, Kathy's, and Bob's Experiences

188

(1)

Fat and Calorie Goals

189

(4)

Meal Replacements

193

(2)

Tips for Avoiding Dieting Pitfalls

195

(4)

What Has Happened to the DPP Participants?

199

(2)

Conclusion

201

(4)

Appendix A: Explaining Scientific Studies of Nutrition and Weight Loss

205

(6)

Appendix B: Lower-Calorie, Lower-Fat Cookbook Suggestions

211

(2)

Appendix C: Sample Shopping List

213

(2)

Appendix D: Sample Meal Plans for 1,200, 1,500, 1,800, and 2,000 Calories

215

(10)

Appendix E: Healthy Snack Choices and Ideas

225

(2)

Appendix F: Nutritious Recipes

227

(32)

Index

259

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Beating Diabetes : The First Complete Program Clinically Proven to Dramaticallly Improve Your Glucose Tolerance

Summary

Author Biography

Table of Contents

Supplemental Materials