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Carbohydrates (Starches) are Good for People with Diabetes

John McDougall, MD

PO Box 14039

Santa Rosa, CA 95402

www.drmcdougall.com

Disclosure Statement

Dr. McDougall’s Health & Medical Center Dr. McDougall’s Right Foods McDougall Adventures Inc. 12 National Best Selling McDougall Books

What Causes Diabetes?

Type-1 caused by insulin insufficiency

(Autoimmune damage, cow’s milk)

Type-2 caused by insulin resistance

(Insulin levels normal or high)

Obesity = Type-2 Diabetes

Excess body weight is the most important modifiable risk factor for the development of diabetes:

Risk ratios: 20.1 for overweight and obese 38.8 for morbid obesity

Overweight and obese (30 and 35 kg/m2) Morbid Obesity (> 35 kg/m2) Compared with a BMI <23 kg/m2

Nutr Met Cardiovasc Dis (2011), doi:10.1016/j.numecd.2011.03.009

Bariatric Surgery

A recent meta-analysis included 3188 patients with type-2 diabetes:

Am J Med. 2009 Mar;122(3):248-256.e5.

78.1% = complete resolution 86.6% = improved or resolved

Surgically-induced malabsorption and sickness

Type-2 Diabetes – the Expected Adaptation to Over-nutrition

Insulin Resistance

Definition: A state of reduced responsiveness to normal circulating levels of insulin Lipotoxicity: Abnormalities in fatty acid metabolism may result in inappropriate accumulation of lipids in muscle, liver, and beta-cells.

Hypertension. 2005 May;45(5):828-33.

Low-carbohydrate Diets (High-fat) *An apology: Non-starch, red, green, & yellow vegetables

Fat Protein

Meat, poultry, fish, cheese, and eggs

*

Origin of Low-Carb Diets

Nutr J. 2011 Mar 11;10:23.

…from 1915 until the discovery of insulin in 1922, prolonged fasting and permanent calorie restriction were championed in North America by Frederick Allen and Elliott Joslin.

Low-carb Diets to Rx Diabetes

“Meta-regression analyses show that hemoglobin A1c, fasting glucose, and some lipid fractions (triglycerides) improved with lower carbohydrate-content diets. Overall effect on weight was equivocal…”

J Am Diet Assoc. 2008 Jan;108(1):91-100.

Low-carb Induces Sickness

“Signs of improved health appear to accrue, as measured by

changes in a variety of “risk factors,” eg, cholesterol,

triglycerides, uric acid, glucose, blood pressure, and body weight.

Hence, the patient is declared healthier. However, this is not

necessarily a correct assessment. Similar benefits, for similar

reasons, are seen when patients undergo cancer chemotherapy,

and physicians do not brag about these results.”

John McDougall, MD

Mayo Clin Proc. 2004 Mar;79(3):431;

All Major Studies Show an Increase

in Disease and Death

from Low-carbohydrate Diets

No Studies of High-carbohydrate Diets Show Similar Effects

(1) Ignore the bulk of the science

Low-carbohydrate diets and all-cause and cause-specific

mortality: Two cohort Studies

Teresa T. Fung, ScD

Department of Nutrition, Simmons College; Department of Nutrition, Harvard School of Public

Health

Rob M. van Dam, PhD

Departments of Epidemiology and Public Health and Medicine, Faculty of Medicine, National

University of Singapore, Department of Nutrition, Harvard School of Public Health

Susan E. Hankinson, ScD and Meir Stampfer, M.D., DrPH

Department of Epidemiology, Harvard School of Public Health; Channing Laboratory, Department

of Medicine, Brigham and Women's Hospital and Harvard Medical School.

Walter C. Willett, M.D., DrPH and Frank B. Hu, M.D., PhD.

Department of Nutrition, Harvard School of Public Health; Channing Laboratory, Department of

Medicine, Brigham and Women's Hospital and Harvard Medical School

Abstract

Background—Data on the long-term association between low-carbohydrate diets and mortality

are sparse.

Objective—To examine the association of low-carbohydrate diets with mortality during 26 years

of follow-up in women and 20 years in men.

Design—A prospective cohort study of women and men, followed from 1980 (women) or 1986

(men) until 2006. Low-carbohydrate diets, either animal-based (emphasizing animal sources of fat

and protein), or vegetable-based (emphasizing vegetable sources of fat and protein) were

computed from multiple validated food frequency questionnaire assessed during follow-up.

Setting—Nurses' Health Study and Health Professionals' Follow-up Study

Participants—85,168 women (aged 34-59 years at baseline) and 44,548 men (aged 40-75 years

at baseline) without heart disease, cancer, or diabetes.

Measurement—Investigator documented 12,555 deaths (2,458 cardiovascular, 5,780 cancer) in

women and 8,678 deaths (2,746 cardiovascular, 2,960 cancer) in men.

Results—The overall low-carbohydrate score was associated with a modest increase in overall

mortality in pooled analysis (Hazard Ratio, HR, comparing extreme deciles=1.12 (95%

CI=1.01-1.24, p-trend=0.14). The animal low-carbohydrate score was associated with a higher all-

cause mortality (pooled HR comparing extreme deciles=1.23, 95% CI=1.11-1.37, p-trend=0.05),

Corresponding Author: Address for reprint requests: Teresa Fung, Department of Nutrition, Simmons College, Boston, MA 02115,617-521-2712 (phone), 617-521-3002 (fax), [email protected] or Dr. Frank Hu at [email protected] mailing address:Teresa Fung: Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA 02115.Rob van Dam: Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore,10 Medical Drive, Singapore 117597Susan Hankinson: Channing Laboratory, 181 Longwood Ave, Boston, MA 02115Meir Stamfer: Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115Walter Willett and Frank Hu: Department of Nutrition, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115

NIH Public AccessAuthor ManuscriptAnn Intern Med. Author manuscript; available in PMC 2011 September 7.

Published in final edited form as:

Ann Intern Med. 2010 September 7; 153(5): 289–298. doi:10.1059/0003-4819-153-5-201009070-00003.

NIH-PA Author Manu

script

NIH-PA Author Manu

script

NIH-PA Author Manu

script

The animal low-carbohydrate score was

associated with a higher all-cause mortality.

Ann Intern Med. 2010 Sep 7;153(5):289-98


Low carbohydrate-high protein diet and incidence ofcardiovascular diseases in Swedish women:prospective cohort study

OPENACCESS

Pagona Lagiou professor1 2

, Sven Sandin scientist3, Marie Lof scientist

3 4, Dimitrios Trichopoulos

professor2 5

, Hans-Olov Adami professor2 3

, Elisabete Weiderpass professor3 6 7

1Department of Hygiene, EpidemiologyandMedical Statistics, Universityof AthensMedical School, 75M. AsiasStreet, Goudi, GR-11527, Athens,

Greece; 2Department of Epidemiology, Harvard School of Public Health, Boston, MA02115, USA; 3Department of Medical Epidemiology and

Biostatistics, Karolinska Institutet, SE-171 77, Stockholm, Sweden; 4Department of Clinical and Experimental Medicine, University of Linköping,

SE-58185Linköping, Sweden; 5Bureauof EpidemiologicResearch, Academyof Athens, Athens, GR-10679, Greece; 6Cancer Registryof Norway,

Montebello,N-0310,Oslo,andDepartmentofCommunityMedicine,UniversityofTromso,Tromso,Norway; 7FolkhälsanResearchCenter,Samfundet

Folkhälsan, Helsinki, Finland

Abstract

Objective To study the long termconsequences of lowcarbohydrate

diets, generallycharacterisedbyconcomitant increases inproteinintake,

on cardiovascular health.

Design Prospective cohort study.

Setting Uppsala, Sweden.

ParticipantsFromarandompopulationsample,43396Swedishwomen,

aged 30-49 years at baseline, completed an extensive dietary

questionnaire and were followed-up for an average of 15.7 years.

Main outcome measures Association of incident cardiovascular

diseases(ascertainedbylinkagewithnationwideregistries), overall and

bydiagnosticcategory, withdecreasingcarbohydrate intake (in tenths),

increasing protein intake (in tenths), and an additive combination of

these variables (low carbohydrate-high protein score, from2 to 20),

adjusted for intake of energy, intake of saturated and unsaturated fat,

and several non-dietary variables.

Results A one tenth decrease in carbohydrate intake or increase in

protein intake or a 2 unit increase in the lowcarbohydrate-high protein

score were all statistically significantly associated with increasing

incidence of cardiovascular disease overall (n=1270)—incidence rate

ratio estimates 1.04 (95%confidence interval 1.00 to 1.08), 1.04 (1.02

to 1.06), and 1.05 (1.02 to 1.08). No heterogeneity existed in the

association of any of these scores with the five studied cardiovascular

outcomes: ischaemic heart disease (n=703), ischaemic stroke (n=294),

haemorrhagic stroke (n=70), subarachnoid haemorrhage (n=121), and

peripheral arterial disease (n=82).

Conclusions Low carbohydrate-high protein diets, used on a regular

basis and without consideration of the nature of carbohydrates or the

source of proteins, are associated with increased risk of cardiovascular

disease.

Introduction

Overweightandobesityareriskfactorsforseveralcommon

chronicdiseases,1 andtheyhavebecomeendemicinmost

economicallydevelopedcountriesandbeyond.2 3 Increased

physicalactivityisonewayofcounteractingexcessiveenergy

intake,butreducingthisintakeisalsoimportant.4Manydietary

regimenshavebeenproposedasconducivetoweightcontrol,

invokingvariousmechanismsincludingincreasedsatiety.56The

mostpopularamongthesedietsemphasisereductionof

carbohydrateintake, therebyencouraginghighproteinintake,7

ashighfatdietsaregenerallyavoidedinmostWesternsocieties.

Lowcarbohydrate-highproteindietsmayhaveshorttermeffects

onweightcontrol,8 9 butconcernshavealsobeenexpressed,

notablywithrespect tocardiovascularoutcomes.10 11 Although

lowcarbohydrate-highproteindietsmaybenutritionally

acceptableiftheproteinismainlyofplantoriginandthe

reductionofcarbohydratesappliesmainlytosimpleandrefined

ones, thegeneralpublicdonotalwaysrecogniseandacton

thesequalifications.

Duringthepastfewyears,severalcohortstudieshaveevaluated

thelongtermhealtheffectsoflowcarbohydrate-highprotein

diets,withemphasisoncardiovasculardiseases.IntheNurses’

HealthStudyintheUnitedStates,dietslowerincarbohydrate

andhigherinproteinwerenotassociatedwithincreased

incidenceofischaemicheartdisease.12Threesmallerstudiesin

Europe,however,indicatedstatisticallysignificantincreasesin

cardiovascularmortalityinrelationtolowcarbohydrate-high

BMJ 2012;344:e4026 doi: 10.1136/bmj.e4026 (Published 26 June 2012) Page 1 of 11

Research

RESEARCH

Low carbohydrate-high protein diets, used on a

regular basis… are associated with increased

risk of cardiovascular disease.

BMJ. 2012 Jun 26;344:e4026.


Low-carbohydrate diets were associated with a

significantly higher risk of all-cause mortality…

PLoS One. 2013;8(1):e55030.

Elliott Joslin, MD

Elliott Proctor Joslin (1869–1962)

Prophetically wrote in 1927: “I believe the chief cause of premature atherosclerosis in diabetes, save for advancing age, is an excess of fat, an excess of fat in the body (obesity), an excess of fat in the diet, and an excess of fat in the blood. With an excess of fat diabetes begins and from an excess of fat diabetics die, formerly of coma, recently of atherosclerosis.”

Ann Clin Med 1927;5:1061.

Obesity Worldwide

Diabetes Worldwide

Meat Consumed Worldwide

Milk Consumed Worldwide

Diabetes Up 12 Times In 30 years

The estimated prevalence of diabetes among a representative sample of Chinese

adults was 11.6% and the prevalence of prediabetes was 50.1%. Projections

based on sample weighting suggest this may represent up to 113.9 million

Chinese adults with diabetes and 493.4 million with prediabetes. These findings

indicate the importance of diabetes as a public health problem in China.

The prevalence of diabetes was less than 1% in the Chinese population in 1980

JAMA. 2013;310(9):948-958

History of Starch Eating

High-carbohydrate Diets (Low-fat)

Starches (beans, corn, potatoes, rice, wheat, etc.)

Non-starch, red, green, & yellow vegetables and Fruits

Fat

Protein

Carbohydrate

Healthy Medical Students 2-days on carbohydrate-diet*

Arch Intern Med.1927; 40: 818-830.

*sugar, candy, pastry, white bread, baked potatoes, syrup, bananas, rice, oatmeal

Healthy Medical Students 2-days on high-protein diet*

Arch Intern Med.1927; 40: 818-830.

*lean meat, whites of eggs

Healthy Medical Students 2-days on high-fat diet*

Arch Intern Med.1927; 40: 818-830.

*olive oil, butter, mayonnaise (egg yolk, 20% cream)

One Healthy Medical Student high-fat vs. high carbohydrate diet

Arch Intern Med.1927; 40: 818-830.

Sugar Makes Diabetes Better

180

Seru

m G

luco

se m

g/d

L.

N Engl J Med. 1971 Mar 11;284(10):521-4.

“These data suggest that the high carbohydrate diet increased the sensitivity of peripheral tissues to insulin.”

45% vs. 85% Carbohydrate: FBS fell, OGT improved, fasting insulin lower

Classic Research, BMJ 1940

Br Med J. 1940 May 4;1(4139):719-22

Sugar Makes Diabetes Better

180

Seru

m G

luco

se m

g/d

L.

N Engl J Med. 1971 Mar 11;284(10):521-4.

“These data suggest that the high carbohydrate diet

increased the sensitivity of peripheral tissues to insulin.”

45% vs. 85% Carbohydrate: FBS fell, OGT improved, fasting insulin lower

(Over 10 days of feeding of formula feeding – dextrins and maltose)

Fruit Does Not Make Diabetes Worse

Eating less fruit had however no effect on HbA1c, weight loss or waist circumference.

“We recommend that the intake of fruit should not be restricted in patients with type 2

diabetes.”

Blood Sugar Non Toxic

JAMA. 2014;311(3):279-286.

Medication = Weight Gain = Diabetes

Downward Cycle

Diabetic Management

“…it is important to remember that ‘diabetic control’ means a lot more than ‘blood sugar control.’” T.D.R Hockaday, 1987

Mortality and Morbidity Heart disease Eye disease

Kidney disease

Scand J Gastroenterol Suppl. 1987;129:124-31.

Lessons from the Past, Directions for the Future

The WWI Starch Solution for Denmark

(1862-1945)

Served as the

manager of the

Danish National

Laboratory for

Nutrition Research in

Copenhagen and

food advisor to the

Danish government

during World War I.



Madsen after 1 year of

eating potatoes and a little

fat

“Minimum need for protein was so

low for man that it could not be

reached; therefore, removing

meat would be of no adverse

consequence.”

From the book, Fuldkommen Sundhed og Vejen dertil (Perfect

Health and the Path to Get It), 1934 by Mikkel Hindhede

WWI: Britain &Germany

Blockade North Sea



Note: People of all ages showed reduction in death


Mortality from Diabetes in England and Wales during Wars

YEARS

Diet in the Etiology of AODM

During war, diabetic death rate falls due to food shortages England and Wales (pre- and post insulin use)

Proc Roy Soc Med. 1949; 42:323

Pritikin Longevity Center

J Appl Physiol. 2005 Jan;98(1):3-30.

James Anderson, MD University of Kentucky, College of Medicine

Metabolic Ward Study

Weight Maintaining Diet

Insulin Usage:

Average reduction

26 to 11 units daily

11 of 20 lean patients

discontinued insulin

CHO Initially = 43%

7 days average

CHO intervention = 70%

16 days average

Am J Clin Nutr. 1979 Nov;32(11):2312-21.

Neal Barnard, MD

Vegan diet = (10% of energy from fat, 15% protein, and 75% carbohydrate)

ADA diet = (40 % fat, 20% protein, 40% carbohydrate, < 200 mg cholesterol

Vegan ADA

Reduced Medication 21/49 13/50

HgB A1c* -1.23 0.38 P=.01

Weight (Kg) 6.5 3.1 P=.001

LDL (% change)* 21.2 10.7 P=.02

Urine protein 15.9 10.9 P=.013

*No medication changes

Randomized Clinical Trial in Individuals With Type 2 Diabetes

Diabetes Care. 2006 Aug;29(8):1777-83.

The Ultimate Diet

Am J Med. 1948 Apr;4(4):545-77

Walter Kempner, MD

Walter Kempner, MD

(1903 – 1997)

The Rice Diet

Duke University

Durham, NC

Decrease in heart size, improved kidney function, and hypertensive retinopathy reversal

Reversal of obesity, diabetes, hypertension, and heart failure.

Am J Med. 1948 Apr;4(4):545-77

Morbid Obesity Reversed

Retinopathy Reversed

Postgrad Med. 1958 Oct;24(4):359-71.

Am J Med. 1959 Aug;27:196-211.

42-year-old male with an 18-year history of diabetes mellitus. Dietary compliance for 26 months.

Classical diabetic retinopathy: aneurysms, punctuate, preretinal or vitreous hemorrhage,

waxy exudates, neovascularization, and retinitis proliferans. Average observation 22 months,

20 of 44 diabetics showed improvement.

Retinal Physician April 2008

Retinopathy Rx Low-fat Diet

Postgrad Med. 1958 Oct;24(4):359-71. Am J Med. 1959 Aug;27:196-211.

Severe Kidney Disease Reversed

Nephropathy 1946, Thomas Addis argued from personal clinical experience that reduction in renal "work" by judicious dietary protein restriction was effective in minimizing further loss of kidney function in patients with chronic kidney insufficiency from a variety of causes.

J Clin Invest. 2006 Feb;116(2):288-96.

Thomas Addis, MD Stanford University

1881-1949

Nephropathy

Annu Rev Nutr. 1997;17:435-55.

A low-protein diet reduces the progression of their

kidney disease and death on average by 33% to 50%.

Coronary Insufficiency Reversed

Heart Enlargement Reversed

Severe Hypertension Reversed

*White sugar may be used as desired (ad libitum); on average a patient takes in about 100 grams

daily (400 calories) but, if necessary (to maintain body weight), as much as 500 grams (2000

calories) daily has been used.

Composition of the Rice Diet White Rice, Fruit, Juice, and Table Sugar (Vitamins)

Biography of Walter Kempner, MD

The McDougall Diet vs. The Rice Diet

Walter Kempner, MD was very influential on my career.

His published work showed me the power of diet therapy

and that nutritional deficiencies do not occur with simple

plant-based diets (even with the addition of lots of

sugar).

The McDougall Diet vs. The Rice

Diet

Before I was born (5-17-1947), Dr. Kempner had

disproven concepts that are still held as true by most

medical doctors today, such as:

“Diet has little to do with heart disease.”

“Additional protein improves health.”

“Carbohydrates cause diabetes.”

The McDougall Diet vs. The Rice Diet

The diet I recommend, the McDougall Diet, is for the

“living.”

The Rice Diet is one that I reserve for the

“nearly dead.”

10-Day Residential Program

Starch-based Meal Plans

Light Exercises

No Meditation, etc.

Medical Care

Medications Are Reduced

Can Be Held in Any Hotel

All-You-Can-Eat

(cafeteria style)

Weight Loss In 7 Days - Women

0

1

2

3

4

5

6

7 n = 1102

All 140-179 180-239 240-279 > 280

pounds

s

t

a

r

t

i

n

g

3.1

cafeteria-style eating

Weight Loss In 7 Days - Men

0

1

2

3

4

5

6

7

8

9

All 160-199 200-260 260-320 > 320

n = 580

pounds

s

t

a

r

t

i

n

g

3.6

cafeteria-style eating

Cholesterol Reductions In 7 Days n = 1692

mg

/dL

0

20

40

60

80

100

120

140

160

180

200

Day 1 Day 7 Average Maximum

22.3

Cholesterol Reductions In 7 Days

0

5

10

15

20

25

30

35

40

45

50

180-200 200-220 220-240 240-260 260-300 > 300

n = 1692

mg

/dL

s

t

a

r

t

i

n

g

The sicker they are

the better they get

BP Reductions in 7 Days

0

5

10

15

20

25

30

>160/100 140/90 to 160/100 120/80 to 140/90 110/70 to 120/80

mm

Hg

s

t

a

r

t

i

n

g

Systolic

Diastolic

23.9

14.5

High and

In need of Rx The sicker they are

the better they get

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

50.00

Bas

elin

e

Mo

nth

1

Mo

nth

2

Mo

nth

3

Mo

nth

4

Mo

nth

5

Mo

nth

6

Mo

nth

7

Mo

nth

8

Mo

nth

9

Mo

nth

10

Mo

nth

11

Mo

nth

12

Po

st-6

wk

Po

st-6

mo

Fat

as a

pe

rce

nta

ge o

f C

alo

rie

s (%

)

Compliance Over 1 Year Based on % Fat

Diet Group

Control Group

OHSU Diet for Multiple Sclerosis Study McDougall Diet

OHSU / McDougall Diet & MS Study

166

168

170

172

174

176

178

180

182

Baseline Final Visit

172.4

174.3

181.1

171.1

Wei

gh

t (l

bs)

Average Weight Change in 1 Year

Control Group

Diet Group

N=29 N=32 N=27 N=26



150

155

160

165

170

175

180

185


172.4 174.3

181.1

162.0

Wei

gh

t (l

bs)

Average Weight Change in Compliant Patients

After 1 Year

Control Group

Diet Group

N=29 N=32 N=27 N=22

OHSU Diet for Multiple Sclerosis Study McDougall Diet OHSU / McDougall Diet & MS Study

0

20

40

60

80

100

120

140

160

180

200


112 106

56.2 56.8

89.2 86.8

186 180

LDL HDL Triglycerides Cholesterol

N=29 N=2

7

OHSU Diet for Multiple Sclerosis Study McDougall Diet OHSU / McDougall Diet & MS Study

Control Group Average Lipid Changes in 1 Year

0

20

40

60

80

100

120

140

160

180


101

83.6

57.8 57.1

95.0 91.7

178

159

Diet Group Average Lipid Changes in 1 Year

LDL HDL Triglycerides Cholesterol

N=3

1

N=2

2



Ad Libitum Starch Diet

10 Months 210 to 120 pounds 160/100 to 122/70 mmHg Glucose: 113 to 79 mg/dL Cholesterol: 181 to 123 mg/dL

http://drmcdougall.com/stars/elizabeth_teselle.htm


10 years ago 150 pounds Weight loss took 4 years

http://drmcdougall.com/stars/cathy_stewart.htm


http://drmcdougall.com/stars/mike_teehan.htm

331 to 165 Two years Cholesterol: 192 to 140 mgdL


http://drmcdougall.com/stars/joyce_rainwater.htm

Lost 110 pounds In 1991 (20 years ago)


Lost 149 pounds in 2 years Four years ago 146/86 to 105/64 mmHg Cholesterol:250s to 163 mg/dL

http://drmcdougall.com/stars/nettie_taylor.html

Ad Libitum Starch Diet Lost 77 pounds

http://drmcdougall.com/stars/donna_byrnes.html


http://drmcdougall.com/stars/karen_barron.html

Lost 100 pounds 7 years ago Cholesterol 281 to 142 mg/dL Glucose 103 to 78 mg/dL 140/90 to 115/75 mmHg


http://www.drmcdougall.com/stars/cloudy_rockwell.htm

Lost 92 pounds

In 2 years

1 ½ pounds a week

size 26 in jeans, to a size 4

Resolved stomach pains

knee and hip arthritis gone

"enough syndrome”

“not food approach”

John Figlar

John Figlar (MAPTB) Oct. 2010

372 pounds 120 Units Insulin One Diabetic Pill Three BP pills

Program Date: October 31, 2010 Weight 372.2 Blood sugar 131/219 Cholesterol 122/101 Triglycerides 113/101 Meds: Humunlin N 30 Humulin R 30 Actos 30 mg Varapamil 240 mg bid Benicar 40 mg Simvistatin 40 mg

John Figlar

April 11, 2011: 6 months Lost 98 pounds 142/84 mmHg Blood Sugars = 150 to 250 mg/dL No Medications

Drew Powell, 56

Drew Powell, 56

May, 2011 276 pounds Kombiglyze XR 5-1000 (metformin ER 1000mg / saxagliptin 5mg Blood sugars = +200 mg/dL HbA1c was 9.0 (04/21/2011)

Drew Powell, 56

Drew Powell, 56

August 12, 2011 In 90 days Down 30 pounds No Medications Blood sugars = 100 mg/dL HbA1c= 5.6 %

Drew Powell, 56

January 27, 2012 My HbA1c is 5.2% No medication My weight is 215 lbs. 37 inch waist My sleep apnea is gone I no longer use CPAP

Benjamin Eksouzian

Program Date: March 5, 2011 Weight: 313.4/310.2 Glucose: 152/129 Cholesterol 185/122 Triglycerides: 167/65 Medications: Glipizide: 5 mg bid Metformin 1000 mg bid Lisinopril 20 mg bid Lipitor 40 mg qd

Benjamin Eksouzian

4 Months later: July 12, 2011 268 pounds Lost 50 pounds No Medication Blood Sugars = 100 mg/dL Cholesterol = 202 mg/dL

Benjamin Eksouzian

Fat vs. Carbohydrate

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