Here’s my top 10 pieces of kit to help with remission:
A belt. Since t2 diabetes is closely tied to abdominal fat, keeping track of holes on a belt is a great way to track losing weight and to make sure it stays off when it’s gone.
Carbs and Cals – either the book or the app. It’s so important to know how much sugar is in various foods.
Bathroom scale. Like the belt, weight is a good benchmark. I use my scale every time I take a shower (clothes can change the results, so best to weigh without).
Kitchen scale (it should be able to do 1gm increments). It’s great to know how much sugar is in 100gm of any food, but what does 100gm look like?
Kitchen scale
Spice grinder. I use mine to grind chia seeds for pudding and to make nut butter. Here are some options.
Mixing stick. Handy for soups, broths, etc. Mine has a whisk attachment as well for super-smooth cream.
Food processor. Handy for making everything from low carb bread to salmon cream cheese to mashed cauliflower to pesto.
Ramekins. I have a set of 200ml ramekins and use them every day. They are an excellent way to portion and to bake single-serve anything.
Step counter. If you have one on the phone, great – use it. Otherwise invest in one.
Gratitude diary. Each night, write 3 good things that happened in the day. Or meditate. Or both. Keeping stress low and taking care of mental health high is half the battle.
I have created a small, free ebook on sugar for people with diabetes. Please let me know how I can improve it, things that don’t make sense, or what I have forgotten. Thank you.
There are arrows to click on the bottom left of the image below to scroll through the book.
I love food, and I love eating. I am a food professional, and cooking earned me a living. Well brought up, I never turned down the offer of food. Loving a challenge, I never surrendered when faced with a prodigious plate. I never refused chocolates, pastries, and other sweet treats when they tempted in a cafe or supermarket. Over time, I grew large, and then I became diabetic. The shock of the latter still resonates in my life, though I have reversed the disease. I did it with the advice of Dr. Jason Fung. If you are in a similar situation, I suggest two of his books, The Diabetes Code and The Guide to Fasting. Thanks in large part to him, I am thin again, and my blood glucose is healthy.
There were two parts to Dr. Fung’s advice. The first was to stop putting sugar in my body, which meant a low carb diet, for starches convert to sugar. That meant bidding farewell to a very long list that included cakes, cookies, candy, pizza, potatoes, corn, rice, pasta, sugar, wheat, honey, and most fruit. The second part was to get the sugar out of my body, and that required fasting. Although the idea of giving up many of my favourite foods depressed me, it was the second part that worried me. I had never fasted, and the thought of doing without food, the love of my life (don’t tell my wife), scared me silly. Fasting seemed alien and impossible. Could I do it?
Even a cursory study shows fasting is an ancient practice, and it is a part of most religions. If it were harmful, surely we would have heard by now.
I am writing these words on Friday. This particular Friday is the Friday before Yom Kippur. Yom Kippur is the day of atonement, the holiest day of the year for the Jewish faith. Observant Jews spend the day fasting and in prayer, repenting and atoning, and their 24 hour fast, from sundown to sundown, is strict – no food or water. As a child growing up in New York, my fasting friends amazed me with their fortitude. Half Irish/half German people like myself had no such fasting tradition, and we weren’t able for it, or so I thought.
In Hebrew, Friday is יוׄם שִׁשִּׁי which means ‘the sixth day,’ or the last day before the Sabbath. The English word ‘Friday’ comes from ‘Frigga’ or ‘Freya’ – the Germanic/Norse goddess of married love. Christians traditionally fasted on Friday, a practice still observed by some (my wife’s devout mother fasted from Thursday evening to Saturday morning each week – a 36 hour fast). Fasting on Friday is also half-remembered by other Christians who eat only fish.
King Henry VIII, known for his appetites and his girth, brought in the Reformation so he could divorce. A secondary benefit for the king was the ability to eat anything (and as much as he wanted) on Fridays, for Martin Luther wasn’t keen on fasting:
‘…with this fasting we serve the pope and the papists— and the fishermen.’
Martin Luther, Candlemas Sermon on Luke 2:33-40
An Irish (and German) Tradition
Here in Ireland, ‘Friday’ is ‘Dé hAoine,’ pronounced ‘day heena.’ Growing up in New York, I didn’t know that ‘Dé hAoine’ means ‘the fast.’ That’s not all. ‘Dé Céadaoin’ (Wednesday) means ‘the day of the first fast’ and ‘Déardaoin’ (Thursday) means ‘the day between the fasts.’ As far as I know, Ireland has the only days of the week that reference fasting. So much for Irish people having no fasting tradition. I find the two days of fasting per week interesting, especially now that Dr. Michael Mosely’s 5:2 diet has become popular.
Ancient Irish Scales
Germans were more severe – they had a tradition of fasting for 40 days before Christmas that eventually shrank and became Advent. ‘Martinstag’ or ‘St. Martin’s Day,’ in honour of St. Martin of Tours, preceded the Christmas fast. The saint was a Roman soldier who cut his cloak to share with a beggar in a snowstorm. He may have also liked goose, for Germans stuffed themselves with that fowl before the privations began. In case you are wondering, the fast at Christmas was in addition to the 40 days fasting during Lent. So much for the German people having no fasting tradition!
Wisdom in a Widely Practiced Tradition
Across the world, fasting is more usual than unusual. Observant Coptic Christians fast for 200 days of the year. Muslims fast during Ramadan for daylight hours, and fasting is one of the five pillars of the faith. Buddhist monks abstain from food before daybreak and after lunch, which makes them an early adopter of intermittent fasting. Hinduism has regular fasting periods for various festivals and lunar phases.
I found fasting difficult to start and eased into it, simply not eating between supper and a late breakfast. Knowing that more than a billion Muslims can manage Ramadan, that Jews get through Yom Kippur each year, that some Christians still fast for up to 200 days of the year, and that Buddhists manage intermittent fasting just fine made my little struggles seem insignificant. I was also well aware that most of the struggle was mental. After I managed a fourteen hour fast, a fourteen hour fast soon didn’t seem so difficult. The same was true when I stretched it to sixteen.
Eventually, emboldened, I fasted for a full day (supper to supper the next day). 24 hours is a magic number, for it takes 24 hours for insulin to drain completely from the body, and insulin is the hormone responsible for fat. With insulin low, the body can use the sugar stored in the cells, and it starts burning fat. Sure enough, my excess weight melted away, and my next blood test confirmed my diabetes was in full remission.
Since I started fasting, I feel more clear headed, and I sleep better. I have saved quite a bit of time and money from all the meals I didn’t eat. My cravings no longer dictate my behaviour. In fact, it’s a relief to feel that now I can choose when to eat and when to skip a meal or two. It’s liberating. Best of all, fasting has reawakened my senses. Smells are more powerful, and food tastes so much better that sometimes I stop and marvel. As a foodie, I’ll say ‘Amen’ to that.
Everyone can perform magic, everyone can reach his goals, if he is able to think, if he is able to wait, if he is able to fast.”
― Hermann Hesse, Siddhartha
Disclaimers: 1. I am a patient, not a doctor or medical professional, and I do not write medical advice. 2. Anyone with health issues, and all those on medication, should consult their doctors before embarking on a fasting regime. 3. Eating disorders are serious illnesses that require medical supervision, and I didn’t write this for those suffering the same. 4. Many people are going hungry around the world, especially at the moment, and there is nothing acceptable societally about involuntary fasting. I’m writing about voluntary fasting.
When I was young, my parents worked in the health food industry, and they often brought me along on business trips. Bored senseless, I’d pretend to be an anthropologist and make mental notes of people we met. Among them was a gaunt, mournful-looking species who subsisted, I was told, on a diet of brown rice. They were common enough for regular scientific observation. Their languid movements fascinated me as did their extreme self-deprivation.
It seemed incomprehensible that someone would give up everything that tasted good and, to a child’s mind, live a life bereft of happiness. How little I knew!
Perhaps it shouldn’t surprise that I went the other way when I grew up and embraced sugar and culinary decadence. As a food professional, I created costly ice creams for work and ate in some of the world’s best restaurants. I considered myself a lucky gourmand. Tokyo? Check. Paris? Check. San Sebastian? Delhi? LA? Piedmont? Charleston? Copenhagen? Check. Check. Check. Check. Check. Check. Mmmm.
Over time, the weight piled on, but if my paunch betrayed excess consumption, what harm? Did my expanding waist and extra chin not proclaim my culinary zeal? Then my doctor diagnosed me with Type II Diabetes. For the first time, I felt fat. I felt ashamed. I felt scared, for Type II diabetes is a frightful disease. My health professionals weren’t shy about describing the unpleasant complications and grim, inevitable outcomes.
Hope and Research
Instead of giving up, I applied the same sense of curiosity and adventure to my illness that I previously used discovering ingredients and unearthing restaurants. Almost immediately, I determined that the outcomes aren’t inevitable. 50% of people with Type II diabetes can achieve remission if they cut carbohydrates and quickly lose weight. That gave me hope.
I read the excellent Diabetes Code by Dr. Jason Fung and work by Dr David Unwin, Dr Malcolm Kendrick, and Tom Jelinek, PhD. I learned three methods seem to work best for losing weight quickly.
They are:
A low carbohydrate diet
A severely restricted-calorie diet
Intermittent fasting
I decided to combine low carb and fasting. The fat melted away. In just three months, I lost 21kg and brought my blood sugar into the normal range.
In many ways, that was the easy part. When the stakes are high enough, anyone can change their behaviour for a while. I must sustain the behaviour into the long term or risk the diabetes returning. In doing so, I don’t want to become a gaunt and mournful creature, for if I did, I would give up. For my happiness, I need to keep my love of food alive. I need to enjoy eating it. How? By celebrating food and seeking out luxury.
Spoiling yourself is key to success. Joy and gratitude will keep you healthy in a way that deprivation never can.
When I changed my diet, I naturally missed the ice cream, pastries, pasta, rice, potatoes, and bread, so I concentrated on the foods I could eat. I planned and cooked delicious meals that satisfied not only my hunger but my soul. I continued to eat out (occasionally and carefully). To reward myself for staying thin, I spend the money I save by fasting on culinary luxuries. Fillet steak? Lobster? Of course. It’s hard to feel sorry for myself when eating lobster. Instead, I feel like a lucky gourmand.
Six Luxury Foods That Help Keep the Joy Alive
These work for me. Your luxuries might look different. For all I know, brown rice gives you spiritual bliss, and that’s fine of course if you’re not trying to cut carbs. In any case, pamper yourself to whatever degree you can afford.
1. Butter
Butter might seem a simple thing to list as a luxury, but luxuries don’t have to be expensive. Butter makes almost everything taste better and more gourmet. For example, lobster without butter is good, but lobster with butter is fantastic. The same is true with many dishes. Green beans are fine. Green beans drenched in butter, with crunchy, sliced almonds toasted with butter, are exquisite.
Butter has played a part in most of my favourite foods — croissants, mashed potatoes, cookies, cake, and toast with melted butter. Sometimes I wonder whether those foods were just an excuse to eat butter, and I can still do just that. When I mash cauliflower with enough butter and cream, I (almost) don’t miss the potatoes. It’s like losing the wrapping paper but keeping the gift.
Some things I do with butter:
Add to coffee.
Add to sauces or use instead of sauce.
Top toasted nuts, especially pecans.
Spread on low carb psyllium bread
Make garlic butter.
2. Caviar
Next time a friend mentions the deprivations of a low carb diet, serve them caviar. They will quickly change the conversation. Roe (fish eggs) are among the most expensive foods globally, and roe of the sturgeon — caviar — are the most costly of all. Do not purchase illegal wild or poached caviar for obvious reasons. Luckily the endangered fish are now farmed and no longer killed to extract the roe.
Low carb ways to serve caviar:
On a spoon.
Spread on fresh, crunchy cucumbers.
On homemade cheese crackers.
Spooned on eggs.
As caviar butter (gently blend caviar and butter).
3. Chocolate
As an unrepentant chocoholic, chocolate is the treat I’d hate most to lose, and guess what? I haven’t. This ambrosia of the Mayans tantalises and satisfies in a way few other foods do. If you weren’t a chocolate snob before, it is time to become one. Milk chocolate is full of sugar, so gravitate toward the dark varieties (85% or higher) to keep the carbs down. Low in carbs and high in fat, a small amount of chocolate goes a long way.
Other varieties of chocolate: Cocoa nibs are worth seeking out; they add a nice crunch. Pure cocoa gives tremendous flavour to cream or puddings and in small amounts adds few carbs (make sure you’re not buying cocoa with sugar added). Cocoa butter is a luxurious fat, a guilt-free way of adding chocolate flavour, and by adding vanilla, you can make sugar-free white chocolate.
Some things I do with chocolate:
Savour it dark and sparingly (3gm).
Add 25g pure, organic cocoa butter to a cup of coffee. Blend.
Whip with cream and top with cocoa nibs (above).
Make delicious, satisfying mole sauce — no sweeteners, of course.
Shave over a handful of raspberries and whipped cream.
4. Cream
Could anything be more luxurious? The word ‘cream’ signifies the best or something special — la crème de la crème, the cream of the crop, the cat that got the cream. Give me decadent Irish cream, and I’m like that cat. In Irish, ‘cream’ is ‘uachtar,’ and our president is ‘Uachtarán.’ I imagine the president has an abundance of luscious, thick Irish cream in the presidential fridge.
I do too — cream makes up for many foods I’ve put aside. Forget what you’ve heard about it being unhealthy — it has half the sugar of milk. Look for the highest fat content you can find — half and half means it has more sugar. Buy cream often, and rummage around the back of the shop fridge to make sure it’s the freshest. Use it liberally and enjoy every minute. Cream satisfies in a way that few foods do.
We all have our weak moments. We have times when we feel our path is too hard. Before I started a low carb diet, I’d reach for a candy bar or something else sweet at delicate moments. Now, when I feel a wobble approach, when I feel overwhelmed or just a bit down, I know it’s time to pamper myself. Since I live by the sea and lobster is abundant here, it is a luxury that isn’t out of reach if I cook it myself.
Because we vacationed in New England when I was a child, lobster is a nostalgic dish for me. It transports me back to sea breezes, sunburns, plastic bibs, and unpretentious lobster shacks with wooden picnic tables. In other words, it feeds my soul. Of course, like any treat, it is best not to overdo lobster. In Irish, there is a saying, ‘An rud is annamh is iontach’ — ‘What is seldom is wonderful.’ Keep it special.
Top 5 low carb lobster dishes:
Steamed lobster with butter.
Lobster salad.
Grilled lobster.
Lobster bisque.
Lobster Newberg.
6. Truffles
George Sand called truffles ‘the fairy apple,’ and Alexandre Dumas called them ‘the holy of holies for the gourmet.’ They grow wild in forests in Piedmont, Tuscany, Marche, and in the Périgord region of France. Specialist truffle hunters use dogs or pigs to find them. The Italians prefer the former, for dogs are less likely to swallow the precious find.
Truffles come in principle colours — white and black, and there are two seasons for each — summer truffles and winter truffles. Both reach peak flavour late in the season when they have matured. White truffles have a notoriously short shelf life — they must be consumed within a few days of harvesting. Black truffles last a bit longer. Although white truffles are perhaps most famous paired with tajarin pasta, they are also sliced and served on eggs and carpaccio of beef.
While I have cooked with truffles, I haven’t done so with great success. This is one ingredient I leave to the professionals and enjoy out of the house.
2.7 billion years of human life could be saved for 211 million people by reversing Type II diabetes. Why are we slow to act on a proven solution?
I am nothing special. Or I am very special. Depending. Like you, perhaps. I’m an ordinary person. I’m a father, son, husband, brother, and lover of family. I’m an impatient patient. I’m a businessman, which means I’m practically minded and a questioner of things, or so I like to think. I’m a man with Type II diabetes or a man without diabetes, depending. I say this because most people believe Type II diabetes is a life sentence – an incurable, progressive disease with inevitable, grim outcomes. This defeatist paradigm informs the usual treatments – an ever-increasing amount of drugs, half-hearted, often contradictory attempts to modify what patients eat, and a dose of scare tactics and blame. Studies show the drugs don’t work, and the half-hearted changes to diet don’t help much either. As demoralised patients progress to grim outcomes, the failure of their treatments isn’t questioned. Instead, with circular logic, the failure reinforces the paradigm.
Is Type II diabetes a life sentence? Incurable? If so, why are an increasing number of patients reversing the disease? According to the paradigm, that is impossible. Yet trials, including DIRECT (sponsored by Diabetes UK), show a remission rate of up to 50%. The ramifications of this are staggering, for an estimated 422 million people worldwide suffer diabetes. The financial cost is $825 billion per annum. The human cost is higher. It is the leading cause of non-traumatic amputations, with a million legs lost a year, and the leading cause of adult-onset blindness. Diabetics have a 50% greater chance of depression. Men suffer more erectile dysfunction. Diabetics develop cancer, stroke, dementia, and Alzheimer’s in higher numbers. We are twice as likely to die of heart, liver, and kidney failure, and are more likely to die from COVID-19. We are more likely to die of all causes, with a life expectancy 13 years less than the general population. That’s 5.486 billion years of lost life and a world of heartache for loved ones.
I was diagnosed eight months ago and heard the usual, ‘Diabetes is a life sentence (but don’t lose heart, it’s not a death sentence – with a bit of luck you can push off the worst parts for a good few years).’ I was given the usual prescription and contradictory advice. I was informed that carbohydrates raised blood sugar, then I was told I should eat them at every meal. I was warned about sucrose (white sugar) but encouraged to enjoy desserts (in moderation). I was admonished to switch from white bread to brown bread, even though carbohydrates are similar in both and brown bread often is made with sugar or molasses. I was instructed to eat less and get off the couch, even though I was already exercising daily. I was told to lose weight (but not too fast) as if I hadn’t tried. I was warned about strokes, heart attacks, and ulcers and urged to inspect my feet every night for wounds that could lead to amputation. I was given an appointment for retinal screening to check whether I was going blind. I asked a few questions, but not many. I felt too dispirited and pinch-faced with worry to do so.
When I came home, I sulked for two weeks. I am, however, an impatient patient, and questions I didn’t ask began to bother me to the point that I stopped sulking and started researching. I soon discovered online a chorus of joyful individuals who had put their diabetes into remission. How did they avoid the life sentence? Simple. By rapidly losing weight, especially fat around the abdomen. ‘Ha, ha,’ you might laugh. ‘Losing weight simple? Have you tried? Everyone knows how hard it is.’ What if it was simple, though? What if our failed attempts were due not to our shortcomings but incorrect advice? Dr Jason Fung starts his book The Obesity Code as follows:
‘The art of medicine is quite peculiar. Once in a while, medical treatments become established that don’t really work. Through sheer inertia, these treatments get handed down from one generation of doctors to the next despite their lack of effectiveness. Consider the medicinal use of leeches (bleeding) or routine tonsillectomy. Unfortunately, the treatment of obesity is also one such example.’
Jason Fung, MD, The Obesity Code, Greystone Books, 2016
The treatment of Type II diabetes is another example.
Dr Fung also wrote The Diabetes Code, and both books are among the most carefully argued and thoroughly researched I have ever read. For diabetics, he suggests a high fat, low carbohydrate diet combined with intermittent fasting to reverse the disease. It worked for me. I lost 21kg of weight and brought my blood sugar into the normal range in three months. Most surprisingly, I didn’t find it especially difficult. Of course, I missed the sugar, especially in the first weeks as my body adjusted. Of course, I missed the pasta, bread, rice, and all the other delicious foods with which I used to stuff myself. However, I’m practically minded, so I set about finding, preparing, and enjoying foods I could eat. When I wobbled, I thought of the thirteen additional years of life I’d have to love my family if I persisted. I would have a higher chance of walking with them with both my legs and seeing them with eyes that could still see. I’d have a better chance of avoiding dementia, and I wouldn’t wish that on anyone.
There weren’t many wobbles, though, especially once the fat started melting away. Again, I didn’t find it especially difficult. The numbers back that up. As stated earlier, studies show that significant changes to diet (very low calorie, low carb, fasting, or a combination of the three) put up to an astonishing 50% of diabetics into remission. That means they maintain healthy blood sugar without the need for medication, just as they did before their diagnosis. ‘Wow!’ you might say. ‘50% of 422 million is a potential of 211 million people whose health could be transformed for the better. It’s a potential savings of up to 2.743 billion years of human life and $413 billion in medical costs. Surely that has galvanised the entire health community? Surely they are rapidly rolling out an entirely new way of treating diabetes?’ Well…no. Why? Vested interests, perhaps. Or inertia, as Dr Fung says. Habits become entrenched, and paradigms can prove resistant to evidence, leading to denial.
Jason Fung points to another possible reason – that we view obesity (and, by extension, diabetes) as a defect of character. Since it’s a moral failing, perhaps we don’t deserve better outcomes. That makes sense to me, for I was the first to blame myself for getting fat and for my diagnosis, and I have heard the disparagement and judgement in the language surrounding Type II diabetes. It’s a ‘lifestyle disease’ for ‘ignorant’ people who make ‘bad’ choices. You’re ‘lacking in willpower.’ You ‘let yourself go.’ You can’t ‘resist’ sweets or alcohol or both. You must be eating the ‘wrong’ things and not doing the ‘right’ things. You’re ‘unwilling’ or ‘too stubborn’ to exercise more or eat less. You ‘don’t try’ hard enough. You ‘give up.’ Such talk shifts the blame for poor outcomes from the dietary advice and medical care to the patients. After all, the treatments and dietary advice might work if we weren’t so lazy/stupid/weak/unmotivated/gluttonous/dissolute.
Of course, such language creates a problem in understanding lazy/stupid/weak/unmotivated/gluttonous/dissolute people like me who do improve their lot – who manage to lose weight and reverse diabetes. The answer, for those who don’t fit a paradigm, is usually that we must be exceptional. Special. That keeps the model intact. When I told friends and relatives how my blood test came back normal, several complimented my ‘exceptional willpower.’ Others said the same when they saw how much weight I lost. I shrugged, annoyed. Doesn’t calling me ‘exceptional’ by definition exclude and demoralise the many who might wish to try to reverse their disease? I don’t think I have exceptional willpower. Otherwise, wouldn’t I have lost weight earlier and avoided diabetes completely? I’m an ordinary person. I’m both lazy and industrious. I’m weak and strong, depending. I’ve been thin and fat and thin again. I developed and reversed diabetes. I didn’t become a better person to achieve remission. I didn’t solve any character defects to do so.
I succeeded simply because I found good advice and explanations that made sense. I learned from Dr. Sarah Hallberg, Dr. David Unwin, Dr. Malcolm Kendrick, Dr. Roy Taylor, Dr. Michael Mosely, and Tom Jelinek, Ph.D. I learned about the futility of the ‘eat less, exercise more’ mantra. I learned about how counting calories makes little sense – 100 calories of spinach equals 100 calories of candy. Really? I learned that too much protein is problematic. I learned that dietary fat is healthy and necessary. I learned about ketosis. I learned about the harm of snacking since it keeps insulin high and doesn’t give the body a chance to recover. I learned about how carbohydrates convert to sugar and how excess fructose is especially dangerous since only the liver metabolises it. I learned how hormones drive behaviour and how insulin and cortisol (the stress hormone) impact body fat and blood sugar. I learned about insulin resistance – the real cause of both obesity and diabetes. Insulin resistance is caused by too much insulin, which itself is caused by too much sugar.
Once I knew all of this, and once I knew what to do (put less sugar in the body through diet and get sugar out through intermittent fasting), the solution was simple. Not easy, but not especially difficult. I went from sulking to feeling lucky – lucky that my diagnosis came when it did. If I had been diagnosed five years earlier, I’d probably still be dispirited and pinch-faced with worry, on medication that doesn’t help, following half-hearted, contradictory diet advice, and wondering which leg I’d lose first. Instead, books and online sources with clear guidelines on how to reverse Type II diabetes appeared just before I needed them and offered an alternative to the life sentence. The pioneering patients who came before me, the chorus of joyful individuals in remission, gave me hope. My love of family gave me the motivation I needed. Now, I’m lucky I can add my voice to the others who succeeded. I hope our clamour soon becomes so loud that every diabetic in the world hears it.
I also hope more government officials and health professionals begin to drive the changes needed. Health professionals see first hand the ravages that Type II diabetes brings. Surely, as scientists, more will question the paradigm as evidence continues to mount. For those who are open-minded, I ask, ‘Why wouldn’t you test it for yourself and see if you can help a patient or two?’ Instead of inspecting deteriorating bodies of patients pinch-faced with worry, wouldn’t it be satisfying to help people like me lose 21kg in less than three months and help them achieve remission? Instead of writing prescriptions that don’t help, wouldn’t it be more fun to save 2.43 billion years of life and ease a world of heartache? Picture your patients and millions of other patients around the world, surrounded by loving families, joyful after normalised blood tests. Imagine them shrugging, modestly, and saying, ‘Every one’s doing it. I am nothing special.’
