By Dr. Mercola
According to the American Diabetes Association,1 more than 30 million Americans are living with diabetes, the majority of whom are Type 2 diabetics. Another 84 million Americans have prediabetes, meaning they could advance to the full-blown disease in less than five years. By 2035, diabetes is expected to afflict 592 million people globally.2
As I have often said, a healthy lifestyle not only can prevent Type 2 diabetes, but is also capable of reversing it. With proper attention to diet and lifestyle, Type 2 diabetes is, in most cases, a curable condition. In the majority of situations, it does not require medication.
Based on its influence on blood glucose levels, research has suggested a compound found in cocoa may help delay the onset of diabetes. If you are diabetic or prediabetic, and also a chocolate lover, this might sound like just the news you need to justify your sweet tooth. After all, cocoa is found in chocolate. Before you get too excited, however, let's take a closer look at the research.
Scientists Strive to Identify Potential Medical Interventions for Diabetes
Due to the growing prevalence of diabetes, scientists are working hard to identify medical interventions for people at risk of developing Type 2 diabetes. Given the statistics presented above, there is good reason for their interest. That said, everything that is proposed may not necessarily be beneficial to you.
One example comes from a team at the University of South Carolina that implanted polymer sponges in the fatty abdomens of obese mice. They suggest the presence of the sponges helped reduce blood sugar and staved off weight gain.3 From a health perspective, it's hard to understand why you'd want to depend on a foreign object implanted in your abdomen to regulate your blood sugar and weight, when you could achieve the same or better results by simply adjusting your diet and lifestyle.
In that context, let's consider the research involving cocoa and diabetes, first by reviewing some basics about diabetes. If you have Type 2 diabetes, your doctor has likely told you your body is less sensitive to insulin, a hormone produced, stored and released by beta cells in your pancreas. Contrary to what you've been told, the primary role of insulin is NOT to lower your blood sugar, but to store the extra energy (glycogen, a starch) for present and future consumption.
Its ability to lower your blood sugar is merely a side effect of this energy storage process. Ultimately, diabetes is a disease of insulin and of a malfunction in leptin signaling. That said, if your blood sugar level gets too high, it can damage your blood vessels and organs, but if it is too low, your body is not able to function properly.
As a Type 2 diabetic who is less sensitive to insulin, your body not only has to produce more of the hormone to achieve the desired effects, but also your beta cells are more susceptible to increased death rates.4 Given the sensitivity of your beta cells to oxidative stress — also known as free radicals — researchers from Brigham Young University and Virginia Tech set out to bolster beta cell performance.
They chose to study the impact of flavanol compounds found in cocoa on beta cells. These compounds contain antioxidants. The study,5,6,7 published in the Journal of Nutritional Biochemistry, found that rats receiving a high-fat diet that included the cocoa compound had lower obesity levels and an increased ability to manage higher blood sugar levels.
Cocoa Compounds and Your Mitochondria Team Up to Fight Diabetes
While scientists have investigated the relationship between flavanols and beta cell function for the better part of 10 years, this research is the first to center on a flavanol called catechin. Of all the flavanols tested to date, catechin has produced the most positive results toward enhancing the beta cells' ability to secrete insulin.
Researchers have not yet discovered how catechin, which is a single molecule and the smallest compound tested, actually makes improvements in your beta cells. Study author Jeffery Tessem, Ph.D., assistant professor of nutrition, dietetics and food science at Brigham Young University, explains what has been uncovered thus far:
"What happens is, [catechin is] protecting the cells, it's increasing their ability to deal with oxidative stress. The catechin monomers are making the mitochondria in the beta cells stronger, which produces more ATP (a cell's energy source), which then results in more insulin being released."
Because scientists observed an increase in the expression of genes promoting mitochondrial function and the body's response to oxidative stress, they have concluded epicatechin monomers strengthen the mitochondria within the beta cells. Your mitochondria are the "power houses" of your cells. Mitochondria are so vital to your health, I made Mitochondrial Metabolic Therapy (MMT) the central theme of my latest book "Fat for Fuel."
MMT is a complete program that includes eating a cyclical ketogenic diet, and aims to heal not only your mitochondria, but also the root causes of chronic disease and aging. Given my understanding of the significant role they play with respect to your overall health, it makes sense mitochondria would be called out in the diabetes study. About the research, co-author Andrew Neilson, Ph.D., assistant professor of food science and technology at Virginia Tech, stated:
"These results will help us get closer to using these compounds more effectively in foods or supplements to maintain normal blood glucose control, and potentially even delay or prevent the onset of Type 2 diabetes."
That said, both Tessem and Neilson were quick to dismiss any notions that eating sugary, high-fat chocolate will help protect you against diabetes. For sure, if you are diabetic or prediabetic, Tessem notes you would "probably have to eat a lot of cocoa" to intake sufficient epicatechin monomers to achieve the desired effect on your blood sugar levels. "It's the compound in cocoa, [not the chocolate], you're after."8
Seven Steps You Can Take Today to Control Your Blood Sugar
Rather than depend on future scientific developments to improve your health related to diabetes or prediabetes, I suggest you consider the following seven steps you can take today to control your blood sugar.
Increase your fiber: Many whole foods, especially fruits and vegetables, naturally contain both soluble and insoluble fiber. Soluble fiber, like that found in blueberries, cucumbers and nuts has been shown to be beneficial for Type 2 diabetes because it slows down your digestion.
Insoluble fiber, found in carrots, celery and dark green leafy vegetables does not dissolve and therefore adds bulk to your stool to promote regularity. I recommend getting 40 to 50 grams of fiber for every 1,000 calories you eat.
A study conducted at Imperial College London suggested participants with the highest fiber intake (more than 26 grams a day) had an 18 percent lower risk of developing Type 2 diabetes than those with the lowest intake (less than 19 grams a day).9
Reduce net carbs: A low-net-carbohydrate diet of 50 grams a day or less will help reduce inflammation, stress on your body and the amount of insulin required to transform the food you eat into energy. You can calculate net carbohydrates simply by taking the total grams of carbohydrates you've eaten and subtracting the number of grams of fiber. A high-fiber diet will help your body lower the amount of insulin it needs to produce.
Eat high-quality fats: When you reduce your carbohydrates, you should replace them with high-quality fats. Your body thrives on healthy fats because they are necessary for mitochondrial health, which affects your entire body, and lowers your disease risk. Healthy fats include avocados, coconut oil, organic grass fed butter and meat, authentic virgin olive oil, organic pastured eggs and raw nuts.
Get more exercise: While exercise does not seem to have any effect on the amount of leptin secreted in your body, it has a significant impact on the resistance your body builds up to this important hormone,10 which is discussed more thoroughly below. The more you exercise, the more sensitive your cells become to leptin. As your body becomes sensitive to leptin, you reduce your potential resistance to insulin, and therefore your risk of diabetes.
Stay hydrated: When you become dehydrated, your liver will secrete a hormone that increases your blood sugar. As you hydrate, blood sugar levels lower naturally. You can easily monitor your hydration by observing the color of your urine during the day. It should be light yellow, unless you take B-vitamin supplements, which renders your urine a bright yellow.
Reduce stress: When you become stressed, your body secretes cortisol and glucagon, both of which affect your blood sugar level. You may be able to lower your stress levels through exercise, meditation, prayer, relaxation techniques or yoga. The Emotional Freedom Techniques (EFT) is also an effective way to address stress.
Get enough sleep: Sufficient quality sleep is necessary to feel good and experience good health. Poor sleeping habits may reduce insulin sensitivity and promote weight gain.11 Sleep is so important, I will address it again later in this article.
Insulin Is Not the Only Hormone Influencing Your Risk of Diabetes
While you're likely to hear a lot about insulin and its role with respect to diabetes, it's important to become familiar with two other hormones — leptin and ghrelin — that also influence the disease. Beyond having too much sugar in your blood, diabetics struggle with insulin resistance at a cellular level. When your cells become resistant to insulin, glucose (sugar) stays in your blood, raising your blood sugar level.
As mentioned, another component of Type 2 diabetes is the malfunction of leptin signaling. Leptin, also referred to as the "obesity hormone," controls hunger and feelings of satiety. Leptin is a hormone produced by your fat cells involved with energy expenditure, food intake, immune function, metabolism and neuroendocrine function.12
The third hormone intimately involved with diabetes is ghrelin, your "hunger hormone," which is secreted by your stomach lining. This hormone is responsible for telling your brain you're hungry. Ghrelin, it appears, may also act on your brain's "pleasure centers," driving you to reach for another bowl of ice cream simply because you remember how good the first one tasted and made you feel while you were eating it.
These are the three main players in the development of diabetes. With a malfunction of leptin or ghrelin signaling, you may eat too much food for your activity level and the rate of your metabolism, resulting in weight gain and obesity. With obesity often comes resistance at a cellular level to insulin, which translates to you having chronic high blood sugar. Then, it's only a matter of time before you receive a diagnosis of diabetes.
Lack of Quality Sleep Impacts Ghrelin and Leptin
Now that you know how ghrelin and leptin play a role with diabetes, I wanted to mention how these hormones are affected by lack of sleep, mainly because insufficient sleep seems to be a growing problem worldwide. You may not be aware that a lack of consistent, high-quality sleep wreaks havoc on both ghrelin and leptin, thereby putting you at risk for diabetes.
Chronic lack of sleep can cause ghrelin to skyrocket, making you feel hungry when you don't really need to eat. Late-night eating is of particular concern. If you are caught in a cycle of late-night eating, you are very likely tempted to indulge in foods high in carbohydrates, and these extra calories are likely to be stored as fat.
When you eat a sugary dessert your production of insulin increases so the sugar in your blood can be taken to your cells and used for energy. It also increases your production of leptin. Because leptin is secreted by fat tissue, if you are overweight, you likely have higher than normal levels of leptin, which may lead to leptin resistance. High leptin levels have been tied to heart disease, high blood pressure, obesity and stroke, as well as blood sugar problems.13
If you are leptin resistant, your body will likely receive signals leading you to continue eating even when you've actually had enough. Researchers involved with a sleep disorders study involving more than 1,000 participants, which sought to uncover a link between sleep problems and metabolic hormones, concluded:14
"Participants with short sleep had reduced leptin and elevated ghrelin. These differences in leptin and ghrelin are likely to increase appetite, possibly explaining the increased BMI observed with short sleep duration."
If you want to help yourself along to better hormone balance among insulin, ghrelin and leptin, one step you can take today is to get better sleep. After reviewing more than 300 studies to determine how many hours of sleep most people need to maintain their health, an expert panel concluded most adults need around eight hours per night to function well. Children and teenagers require even more.
How to Limit Your Sugar Consumption
Sugar, in its natural form, such as that found in fruit, is not inherently bad when consumed in amounts that allow you to burn fat as your primary fuel. However, you should avoid all sources of processed fructose, particularly processed foods and beverages like soda and bottled juices. According to SugarScience.org, 74 percent of processed foods purchased from the grocery store contain added sugar.15 Other sources have suggested it may be as high as 80 percent.
For that reason and more, I advise you to eat a diet composed chiefly of naturally occurring whole foods, with 10 percent or less coming from processed foods. I recommend severely limiting your consumption of refined carbohydrates found in bread, cereal, pasta and other grain-based foods, as they break down to sugar in your body, which increases your insulin levels and contributes to insulin resistance.
As a general recommendation, I suggest you keep your total fructose consumption below 25 grams per day, including fructose from whole fruit, and as low as 15 grams per day if you have diabetes or other chronic disease. Keep in mind that while fruits are rich in nutrients and antioxidants, they naturally contain fructose. If consumed in high amounts (especially if you are not burning fat as your primary fuel), fructose from fruit worsens your insulin sensitivity and raises your uric acid levels.
Be sure to avoid artificial sweeteners like aspartame and sucralose due to the health problems associated with them. In my opinion, the risks associated with those toxic substances are worse than those you may face with corn syrup and sugar. As mentioned above, your best bet is to replace the sugary carbohydrates in your diet with healthy, high-quality fats. Some of my favorites are avocados, grass fed butter, raw macadamia nuts and wild Alaskan salmon.
If you feel you might be addicted to sugar, and many people are, I strongly advise you to consider using EFT to break the grip sugar has on your life. In the video below, Julie Schiffman demonstrates how to tap your way free from a sugar addiction.
Cyclical Ketogenic Diet and Intermittent Fasting Can Reduce Your Diabetes Risk
Simply stated, a ketogenic diet seeks to minimize net carbohydrates, replacing them with healthy fats and adequate amounts of high-quality protein. Almost everyone can benefit from a cyclical or targeted ketogenic diet, where you increase carbs and protein on the one or two days a week you are strength training — once you are able to burn fat for fuel.
By implementing a cyclical ketogenic approach, you can reduce your risk of developing Type 2 diabetes and a host of other chronic diseases. In a study16 published in Nutrition & Metabolism, researchers noted that diabetics who ate low-carbohydrate ketogenic diets were able to significantly reduce their dependency on diabetes medication.
They stated, "The … ketogenic diet was more effective for improving glycemic control than the low glycemic diet. Lifestyle modification using low-carbohydrate diet interventions are effective for improving obesity and type 2 diabetes."
I believe this diet is healthy for most individuals, whether you have a chronic health problem or not. I say that because the ketogenic diet will help you optimize your health by converting from burning carbohydrates to burning fat as your primary fuel. Your body should be able to burn both sugar and fat for fuel, but most people have lost the ability to burn fat, thanks to eating a diet too high in sugars. Regaining this metabolic flexibility is foundational for optimal health and weight.
One of the most common side effects of being a sugar-burner is that you end up with insulin and leptin resistance, which is at the root of most chronic disease, including diabetes. Since your body has lost its ability to burn fat for fuel, you'll also find weight loss is a struggle. Once you regain the ability to burn fat, you'll likely find your weight will normalize automatically.
Adopting the ketogenic diet along with intermittent fasting may further boost your results. Intermittent fasting is one of the most effective strategies I know of to shift your body from burning sugar to burning fat for fuel. While there are many strategies, the one I personally used to become fat adapted involves restricting your daily eating to a six- to eight-hour window. This means you'll be fasting for about 16 to 18 hours each day.
It may take time for you to work up to that period of fasting. Start by pushing your breakfast out a little later until you are able to skip it altogether. You can use intermittent fasting to help you gradually transition to a ketogenic diet. It is especially useful to help you break your body's addiction to glucose. You'll find that eliminating sugar cravings is one of the most welcomed side effects of intermittent fasting.
More Advanced Fasting May Also Be Helpful
Over time, you may be able to fast even longer. I have been doing 14- to 16-hour daily intermittent fasts for 18 months. Over the last two months I increased that to 20- to 21-hour fasts, and I've also started experimenting with four-day water fasts.
In all my clinical experience, I have never seen a more effective intervention than multiday fasts where the only thing you consume is water and mineral supplements, and no other food or drink. I had previously been opposed to fasting if one was already at an ideal body weight. However, I failed to realize that there is metabolic magic that simply won't occur in any other setting.
I now view this type of extreme fast as taking out the trash. It allows your body to seriously upregulate autophagy and mitophagy and remove most of the damaged senescent cells in your body. This, of course, would include premalignant cells. It is a magnificent way to help cancer-proof your body. It is also outstanding for helping you achieve optimal body weight, and it can improve your health and extend your life span.
I will be interviewing experts on fasting in the future to go into more detail of all the benefits that are provided, but until then, I would strongly encourage you to seriously consider increasing your daily intermittent fasting toward the 18- to 20-hour range so you will be able to painlessly do water fasting and then feast like a king afterward.
Getting Started With the Ketogenic Diet
Regardless of whether you're intermittently fasting or not, the following food guidelines will help you regain balance in your eating and shed unwanted weight — two important steps if you are a diabetic. Start by focusing on the following. For more tips on implementing a ketogenic diet, check out "A Beginner's Guide to the Ketogenic Diet: An Effective Way of Optimizing Your Health."
1. Avoid processed foods, refined sugar and processed fructose in excess of 15 grams per day, and grains
2. Eat whole foods, ideally organic
3. Replace grain carbohydrates with:
◦ Large amounts of organic vegetables
◦ Higher amounts of healthy fats (you may benefit getting as much as 50 to 85 percent of your total daily calories from high-quality, healthy fats — saturated and monounsaturated fats from animal and tropical oil sources)
◦ Low-to-moderate amounts of high-quality protein
Satisfy Your Sweet Tooth With This Healthy Chocolate Truffle Recipe
If the thought of giving up sweets is holding you back from making the dietary changes you know your body longs for and needs, consider this healthy alternative to store-bought chocolate truffles, courtesy of Jennafer Ashley of Paleohacks. It contains healthy, delicious ingredients and is easy to prepare.
Chocolate Fat Bomb Truffles Recipe
Prep Time: 10 minutes
- 1 tablespoon Dr. Mercola's vanilla extract
- 2 small ripe organic avocados
- 1 cup raw cacao powder
- 2 tablespoons raw cacao powder for dusting
- 3 tablespoons Dr. Mercola's coconut oil, melted
- 2 tablespoons Dr. Mercola's raw honey or 1 tablespoon monk fruit sweetener
- 1-2 drops of stevia (optional)
- In a mixing bowl, combine the melted coconut oil, avocado, honey and stevia, if you are using it. Use a hand mixer on medium speed to mix the ingredients until they reach a smooth consistency.
- Gradually mix in 1 cup of raw cacao powder until it completely combines with the other ingredients. Place in the freezer for 10 minutes.
- Using a tablespoon, scoop out the mixture and roll it into balls. Dust with the reserved cacao powder.
- Store in the refrigerator, then serve once chilled.
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