Many terms have come to define the complex symptom set and chronic disease inter-relationship that is generally recognized as the metabolic syndrome, a precursor to the modern scourge, adult- onset diabetes. Encompassing elevated lipids and glucose, high blood pressure, central adiposity and other signs and symptoms, this is the clinical manifestation of the American obesity epidemic. Nutrition texts refer to a toxic food environment.
Each quarter, I explain to students that this phrase has a dual meaning. We live in a predominantly couch-friendly, TV marketing environment that is toxic, with ads featuring highly refined foods. At the same time, we are eating food that is, in fact, toxic, adding to the metabolic burden on our bodies. Though modern medicine relies on various pharmacological therapies, reversing diabetes and obesity must focus foremost on education, prevention and lifestyle change. Diet and exercise ought to lay the groundwork with herbs, specific phytochemicals and nutritional supplements playing supporting roles.
There is no question that our diet has changed drastically over the past 75 years. Factory food production has been geared towards corporate profits, with food preservation and refinement taking the lead, while nutrients have been stripped from the finished product. In more recent decades, greater sums of flavorings, colorings, stabilizers and preservatives have become part of factory food recipes, not to mention pesticides, agricultural – chemical residues, and of late, modified genes (GMO). The government and academic institutions have been complicit as well.
Take for example the old Department of Agriculture food pyramid with grains as the base; a recipe for diabetes. The new pyramid, laid out differently, is little improved. I advise my students to put vegetables, legumes, other plant foods, wild and grass-fed animal proteins, and some fruit near or at the base, and move grains (way) up the pyramid, if they choose to use this illustration at all. An entertaining online pursuit is perusing mypyramid.gov and then mypyramid.org, the former being, of course, the official site. The latter is a parody brought to my attention by a former student.
A decade ago, I attended an organic farming class at Rutgers, the State University of New Jersey. It took place in the Center for Advanced Food Technology and Nabisco Advanced Food Technology Institute. Clearly, industry money is influencing research, especially in an environment of financially strapped state colleges. In fact, a recent study on nutrition research out of Boston showed that four out of five studies funded by food industries were biased to show results favorable to their sponsors. In food processing, one of the first macro-nutrient components to be removed was dietary fiber, the matrix that holds plants together and incorporates key phytochemicals in its structure.
There is a direct relationship between the inclusion of dietary fiber in meals and the bodys glycemic response to specific foods. Soluble, viscous fibers especially slow glucose absorption by slowing transit of food through the upper gastrointestinal tract. Found in legumes, citrus whites, apple skins, berries, various fruits, grains and other food, pectin, gum and mucilage can also lower blood cholesterol by binding with bile acids and aiding their excretion.
Much research is being conducted on how the body utilizes both soluble and insoluble fiber. Many think fiber goes unused. However, soluble fiber is partially broken down in the gut, yielding energy, vitamin manufacture and immune enhancement by nourishing flora and by extension, colonocytes. Insoluble fiber aids passage through the lower digestive tract and plays other roles. By eating more fibrous foods in general, we are likely to consume more health-promoting constituents in addition to phytochemicals. Lignans, for example, perform phenomenal tasks in the body though a lesser role in lowering risk of diabetes. For 75 cents per pound, one can purchase lignan-laden flaxseeds that may prevent and control breast, prostate and other cancers.
Several companies have combination formulas of powdered, soluble fiber-rich blends. These are often a considerable step in quality above commercial brands and are sometimes made without psyllium and oats, to which some individuals are intolerant/allergic. Encapsulated products are also available, though more costly, but may boost individuals adherence to a nutritional program. Powdered fiber products are invaluable for increasing overall fiber consumption and slowing glucose absorption. In fact, some individuals would get more fiber in 1 or 2 scoops of a particular fiber formula than they may get in an entire days diet. The FDAs daily value for fiber is set at 25 grams; however, few Americans consume this quantity. It is telling that traditional cultures, many of which ate 3-5 times as much fiber, had no diabetes. Compare these quantities to the average Americans daily intake of added sugar, approximately 30 teaspoons per day.
Sugar and Spice
I often ask students to consider the historic availability of sugar (and most commonly used vegetable oils). I once heard the respected herbalist, David Winston, speak of the same. Obtaining sugar was a difficult, seasonal process at best. Sugar was available certain times of the year from whole foods, fruits and vegetables, not in soda, juice, and an array of cookies and candies. It was prized and stored in the whole food matrix, dried, used to ferment, etc. The takeaway: instruct your patients and clients to step out of the box and eat whole foods rich in fiber and phytochemicals. Furthermore, we can take advice from NYU nutritionist Marion Nestle and walk the perimeter of grocery stores. The healthier foods generally live along the walls, and there appears to be less shelf-talking advertising.
Our ancestors knew there was more to spice than flavor. Cinnamon, like flaxseed, is an inexpensive food that can have profound health effects. Studies show that a gram or two per day of cinnamon may lower serum glucose, triglycerides, LDL cholesterol and total cholesterol. More than 170 million people worldwide suffer from diabetes, and for many, drugs or other forms of treatment are unavailable. It may be possible that many of these people could benefit from readily available natural products such as cinnamon, according to Don Graves, Adjunct Professor of Molecular, Cellular, and Developmental Biology from the University of California at Santa Barbara. Using advanced imaging techniques, Graves and other researchers found a proanthocyanidin compound in cinnamon that can affect insulin signaling in fat cells, thus proposing that cinnamon has insulin-like activity. This may not be news to many practitioners, but it is likely to be surprising and interesting to the average patient who has no idea that a simple kitchen spice can be so powerful.
Preliminary studies from the Japanese National Institute of Health Sciences show that chocolate may slow or prevent pancreatic carcinogenesis. Chocolate also contains proanthocyanidins and has diverse health benefits. Raw, sugarless cacao powders are available on the market. These can be mixed with chai, which usually contains cinnamon (and other phytochemical-bearing herbs), or concentrated foods such as solid extracts of berries.
Common to the Southwest, the prickly pear (Opuntia spp.) may offer promise in diabetes treatment and management. Mexicans eat the pads of this cactus, a notable source of gut-soothing mucilage, as nopalitos. The plants range is actually quite far-reaching as I have seen it on barrier islands off the Jersey Shore. In Spanish, the fruit of prickly pear is called tuna. It is rich in quercetin, a neuro-protective flavonoid common to many vegetables, fruits and herbs. Prickly pear may at least provide a demonstrative link for those with Type 2 diabetes. Traditional and available ethnic foods, including okra – another mucilage-bearing food can be used in preventing diabetes because the mucilage slows the absorption of sugars. Meal planning may include soluble fiber rich Anasazi or black beans, lima beans, or black eyed peas, along with nopalitos or okra.
Distinct medicinal food-herbs are also valuable dietary options. Herbs high in mucilage are slippery elm (Ulmus rubra) bark and marshmallow (Althea officinalis) root. Made into an unboiled tea, an infusion, the herbs thicken into a goo that provides a slimy, protective layer to the lining of an irritated digestive tract or sore throat. Moreover, diabetics should eat sources of complex sugars such as inulin found in Jerusalem artichokes (Helianthus tuberosus) instead of potatoes. Complex sugars from Helianthus and other foods, such as asparagus and salsify (Tragopogon porrifolius) digest more slowly, thus less sugar builds up in the bloodstream. These foods also fortify the lower digestive tract by nourishing gut flora.
Nutrient and Phytochemical Supplements
Prevention and management of diabetes can be enhanced with nutrients and phytochemical supplements. Alpha lipoic acid, for example, is a versatile nutrient for diabetic treatment. In addition to inhibiting glycation and therefore helping to prevent diabetic complications, such as diabetic neuropathy, lipoic acid performs other roles in antioxidant recycling and manufacture, and promotes efficient cellular energy production. For treatment purposes, 600-1,200 mg daily are recommended, while 100-300 mg daily may be recommended for prevention. Alpha lipoic acid is also helpful in treating chemotherapy-induced neuropathy and may offer hope to those with fluoroquinolone antibiotic-induced neuropathy as well.
Other nutrients critical to diabetes prevention and management are B vitamins, which are needed for metabolism of all macronutrients, and may also aid in treatment of neuropathy. Trace minerals such as vanadium and chromium play crucial roles, and few strategies for ongoing wellness are complete without additional magnesium and zinc, as they are vital to numerous enzymatic reactions and are frequently deficient in aging populations.
Generally, for those with insulin resistance, 10-40 mg of supplemental zinc and 100-300 mg magnesium are sufficient for enhancing immune response and reducing cardiovascular risk, respectively. Both minerals also contribute to bone health. Various studies show that chromium stabilizes blood sugar by enhancing insulins activity. In other studies, individuals who took additional chromium (200 mcg per day) gained muscle and lost fat in greater sums than controls. Improved body composition, body mass index and shrinkage in waist circumference (central adiposity) are directly linked to better outcomes for diabetes patients.
Many of the nutrients critical to blood sugar management are often combined in quality formulas available through healthcare practitioners. They now often contain vanadium, which decreases plasma glucose levels and has an insulin-like effect. Insulin and glucagon are not the only important hormones related to diabetes. According to Donald Yance, excess insulin in the bloodstream promotes the production of estrogen and reduces the level of sex hormone binding globulin (SHBG). SHBG is a plasma protein that binds and transports sex hormones, including estrogen and testosterone. SHBG receptor interaction depends on the occupancy of the steroid binding site. It is recommended to measure total testosterone, free testosterone, SHBG, DHEA sulfate and a thyroid panel.
Low testosterone with high estrogen can also cause an increase in fat storage. Studies have found that serum testosterone is decreased in markedly obese males. This is due to a reduction in SHBG. This can cause peripheral conversion of testosterone to estradiol, which can cause fat accumulation as well as lean muscle loss.
SHBG is also critically important to proper insulin control, as well as estrogen. A reduction in SHBG is associated with hyperinsulinism and insulin resistance. High fasting insulin levels are noted to be an independent predictor for ischemic heart disease in men. According to a recent study, low androgen levels in men correlated with increased risk of atherosclerosis. Yances Natura Health Products offers a supplement called Night Gain. It combines testosterone-boosting and estrogen-metabolizing nutrients and phytochemicals with amino acids such as arginine for cardiovascular benefits. Night Gain enhances sexual function and sleep and is helpful to both sexes, with or without insulin resistance.
Generally, I recommend 2-6 caps in divided doses in the evening. Milk thistle (Silybum marianum) offers promise in treating diabetes. In a recent study found in Phytotherapy Research, moderate dosing of roughly 600 mg silymarin daily has shown to lower various markers associated with diabetes including hemoglobin A1c (HbA1c). Using milk thistle is especially advantageous because of its protective effect upon the liver, an organ greatly stressed in obese individuals. It may also prevent prostate cancer and is currently being used for treating the disease.
Liquid herbal extracts are especially useful for diabetes management because of their relatively rapid digestion and absorption. A useful liquid formula for mild insulin resistance is Pancreaid, a product from Herbalist and Alchemist, formulated by herbalist David Winston. The blend contains dandelion root (Taraxacum off.), blueberry leaf (Vaccinium spp.), gentian root (Gentiana lutea), Devils Club root bark (Oplopanax horridus), Gymnema (Gymnema sylvestre) and cinnamon (Cinnamomum cassia). Bitters like dandelion and gentian roots have traditionally been used to normalize blood sugar levels and to help the beta cells in the pancreas to utilize endogenous insulin. Blueberry leaf, Devil’s Club and Gymnema have been used throughout the world for adult onset diabetes. Studies on Gymnema show a pronounced amphoteric effect on the Isles of Langerhans in the pancreas—nourishing, strengthening and normalizing function, according to Winstons manual, Herbal Therapeutics: Specific Indications for Herbs and Herbal Formulas.
The leaves of blueberry are not the only useful part. The pigments that come from blueberries (bilberries), black currants and other berries, as well as the skins of some vegetables anthocyanins have marked therapeutic effects. I recommend a highly concentrated 80 mg anthocyanin capsule (MEDOX Optimal) for any client with diabetes to slow the multisystemic degeneration associated with the condition.
MEDOX is a veg-encapsulated anthocyanin extract from wild Norwegian bilberries (Vaccinium myrtillus) and black currants (Ribes nigrum). MEDOX is produced in Norway by MedPalett Pharmaceuticals and the Biolink Group. Consumed in Norway and throughout the European Union as a phytoceutical sold in pharmacies and doctors offices, MEDOX is now a powerful botanical ally for Americans. Existing in a phytochemical color spectrum that moves through red to purple and deep blue, the pigments in MEDOX contain unique biological activity in humans. Few, if any other, products on the worldwide market have the intensity of color that indicates such a threshold of powerful and concentrated anthocyanins.
A unique and patented technology provides for large amounts (80 mg) of anthocyanins per capsule. The capsules are processed using chromatographic membrane technology. The special processing allows free and complete anthocyanins to quickly penetrate plasma at an affordable cost per milligram yielding sustained levels in connective tissue. The absorption and beneficial effects of MEDOX have been clinically documented at Scandinavian university hospitals and clinics.
Anthocyanins have proven efficacy for a range of modern medical problems, especially those related to the cardiovascular system, nervous system and eyes. MP865, the anthocyanin blend found in MEDOX, is also known to regulate healthy cell proliferation, blocking progression of cancer at various stages. Anthocyanins have demonstrated to be powerfully anti-leukemic. Preventing invasion of cancer by reinforcing the strength of collagen and blood vessels, anthocyanins from MEDOX induce apoptosis, organized cancer cell death. They also discourage angiogenesis and inflammation, major factors enabling cancer to spread. In this sense, MP865 from MEDOX is carcinostatic and anti-metastatic. Studies have been/are being conducted on anthocyanins and MEDOX for prostate, lung, brain, gastric, esophageal and colon cancer, though it may prove to be effective on a wide range of cancers.
Anthocyanins from bilberry are perhaps best known for the roles they play in protecting the eyes from injury related to oxidative stress and poor capillary microcirculation, such as macular degeneration and cataracts. Bilberry anthocyanins improve night vision and retinopathies. Mitigating and reversing complications related to diabetes and insulin resistance is a unique domain of anthocyanins in that they protect the blood vessels, eyes and kidneys. Furthermore, studies from Ulleval University Hospital in Norway indicate that 2 caps daily of MEDOX Optimal lowered C-reactive protein (a marker of inflammation) by 28% after two weeks. Though this study was performed on a small sample size, compare the results to 17% reduction for statin drugs, which bear considerable side effects.
Other as yet unreleased studies from Ulleval show significant decreases in resting heart rate and blood pressure after short-term MEDOX therapy. Anthocyanins (from MEDOX) are safe and effective and have no known side effects or contra-indications. In practice, I have clients pair MEDOX with blueberries (and other berries), which contain the soluble fiber, caloric and other nutritive components. In the colder months, I also recommend blueberry solid extract, a delicious concentrated paste made by Herbalist and Alchemist that clients can spread or mix in smoothies.
Anthocyanins are efficient atherosclerosis fighters through their ability to counter oxidants. Studies have shown anthocyanins to lower oxidative LDL levels, which are significant risk factors for cardiovascular diseases. Anthocyanins have a proven ability to protect the integrity of the endothelial cells lining the blood vessels. They regulate nitrogen oxide synthesis, offering further cardiovascular and erectile support. The resulting effect of taking MEDOX anthocyanins is smoother, better dilated, more flexible and stronger blood vessels.
In theory, MEDOX and anthocyanins paired with magnesium supplementation should greatly reduce risk of sudden cardiac death and stroke, thus I often recommend them in combination. The preceding interrelationships of anthocyanins’ benefits offer promise for improvement in the big picture of the diabetic tangle.
Patients and practitioners are looking for new ways to manage various chronic diseases, including those related to insulin resistance and diabetes. A multi-faceted approach must ultimately be part of diabetes treatment. We can start with education for prevention, diet, lifestyle modification and exercise. Supportive nutritional and botanical therapies can also play vital roles before reliance on multiple medications (polypharmacy) and more costly interventions.
Michael C. Altman, CN, RH (AHG)
Adjunct Professor, Nutrition, Southern Oregon University, College of the Siskiyous, NorCal
Certified Nutritionist, Registered Herbalist (American Herbalists Guild)
ABOUT THE AUTHOR
Michael is a certified nutritionist, registered herbalist and nationally registered emergency medical technician (NREMT). His interest in the medicinal and food value of wild plants brought him to a greater understanding of and interest in nutrition and the link between our health and that of the environment. Michael works at the Centre for Natural Healing in Ashland, OR and Norwalk, CT, and Ventana Wellness and Rogue EMC-Endocrinology and Metabolic Clinic in Medford, OR. He also teaches nutrition “three ways.” He offers a live, in-person class at Southern Oregon University and teaches a distance teleconference class for College of the Siskiyous, NorCal, from SOU’s Ashland campus. Lastly, he teaches an internet class for College of the Siskiyous.