The young man who took out milk tea at Dunton was suffering from diabetes
Author | Zhao Wanxi
Edited by Tan Shanshan
Title Picture: "Thin Men and Women"
Diabetes is getting closer and closer.
In 2021, about 537 million adults worldwide had diabetes, and it is estimated that by 2045, the number of people living with diabetes could reach 784 million. China is the country with the largest number of diabetic patients, with more than 30% of the world's diabetic patients in China, and diabetes and diabetic complications cause nearly 1 million deaths each year, of which nearly 40% are premature deaths under the age of 70.
On the other hand, diabetes is gradually getting younger. According to a survey in 2020, the prevalence of diabetes among people aged 18~29 in mainland China has reached 2%, and 6.3% among people aged 30~39, while in 1996, these two proportions were 0.56% and 1.36%, respectively.
Just because we don't have diabetes doesn't mean we're completely safe. More people are in the pre-diabetic period (referred to as "prediabetes", which is a stage between people at high risk of diabetes and people with diabetes).
In 2018, China's chronic disease and risk factor detection system showed that 50.1% of people in mainland China were in prediabetes or had diabetes. In other words, 1 in 2 people are potentially diabetic or are suffering from diabetes. If judged by the strictest standards, then on average 1 in 2 mainland adults are in the pre-diabetic stage, and these people may become diabetics if they go any further.
Blood sugar problems are hard to prevent. (Photo/"Moon and a Half Alice")
Song Jun, professor of nutrition and food hygiene at Shanghai CDC and a national registered dietitian, has been deeply involved in the field of nutrition for many years and has helped thousands of people get rid of blood sugar problems. She noted that people in the pre-glycemic stage have few symptoms, their fasting blood sugar levels are normal, or they are at a high borderline, and their blood sugar may be below the normal range at 2 hours after a meal. In fact, at this stage, the body's glucose metabolism function has been impaired, but because it has not yet developed to the stage of diabetes, the doctor's intervention means are limited, and it is difficult for people with prediabetes to find the corresponding department in the hospital.
We tend to focus more on diabetes than on the fact that each of us may be in a pre-glycemic crisis.
Recently, Song Jun published a new book, "My Blood Sugar, My Choice", which describes her experience in healthy eating and sugar control over the years. How do blood sugar problems in the human body form? How should we eat against pre-glycemic conditions? The following is Song Jun's own statement.
"My Blood Sugar, My Decision" by Song Jun and Sun Yuexuan
CITIC Publishing Group | Nautilus 2023-07
The source of diabetes: insulin resistance
According to the causes of diabetes, the World Health Organization (WHO) divides it into four categories: type 1 diabetes, type 2 diabetes, gestational diabetes and specific types of diabetes. Type 2 diabetes is the most common.
It is a metabolic disease characterized by elevated blood sugar caused by inadequate insulin secretion or impaired insulin utilization, and its source is insulin resistance.
What is insulin resistance? The carbohydrates we usually eat will induce blood sugar levels to rise, and the pancreas will secrete insulin after receiving the instructions for blood sugar rise, sending it to transport glucose in the blood to the mitochondria of cells, so that the mitochondria can produce the energy needed by our body, and the blood sugar level will return to normal.
Insulin is equivalent to a courier, when it works seriously, the body's metabolism is normal, when it does not work seriously and grinds foreign work, the cells will be slow to respond to the insulin in the body, and the pancreas will keep sending insulin out to work, which is "insulin resistance". This stage is what we usually call pre-saccharide.
Long-term irregular diet and overeating are the main causes of insulin resistance. Being overweight and obese often leads to insulin resistance, which also accelerates weight gain.
Many people with diabetes need insulin injections. (Photo/Unsplash)
Prediabetes is a stage between people at high risk of diabetes and people with diabetes.
People at high risk of diabetes, i.e., normal people who are at very high risk of diabetes. At the end of "My Blood Sugar, My Choice", there is a self-checklist for high-risk groups with diabetes, and if any of these conditions are met, they belong to the high-risk group of diabetes. For example, my blood sugar metabolism and blood levels are normal, but my father died of diabetes, then I am in a high-risk group. For this population, my recommendation is to check your blood sugar once a year.
Prediabetes is actually the period of insulin resistance. Insulin resistance is not a disease, it is just a symptom, and it is normal for people with insulin resistance to have physical examination indications. There is no specific drug, but if it is allowed to continue to develop, it is very likely to develop diabetes, and people will become clinically indicated diabetic patients.
Gong Biao in "The Long Season" suffers from diabetes all year round.
Insulin resistance is like a source of fire, which can burn to different places, such as developing metabolic diseases such as type 2 diabetes, hyperlipidemia, fatty liver, high blood pressure, arthritis, elevated uric acid, gout, cancer, etc.
For example, data shows that there are about 120 million people with chronic kidney disease in mainland China, of which 16.4% are caused by diabetic nephropathy - about 25% of diabetic nephropathy patients will develop kidney failure within 6 years as the diabetes progresses. As another example, people with hyperglycemia have twice the risk of fractures compared to people with normal blood sugar, even though their bone density does not deteriorate.
Diabetes is not an isolated disease, but a component of metabolic syndrome that brings on or along with many other diseases.
It all starts with eating
China, India, and the United States are the three countries with the highest prevalence of diabetes, and compared with the latter two, the reason for the high prevalence in China is due to the particularity of their dietary structure.
With the development of industrialization and urbanization, food is also undergoing industrial transformation to adapt to the faster and faster pace of life. More and more industrial, ultra-processed staple foods are occupying our tables.
In order to meet the taste of the public, many staple foods are now refined and processed, such as refined white flour, fine wheat flour, and fine flour, and pre-packaged staple foods, such as instant cereals, have also been removed from dietary fiber. This has led to a significant reduction in our dietary fiber intake.
Foods that are high in dietary fiber, low in calories, and digest more slowly can help people control blood sugar, increase satiety, lose weight, and avoid gaining weight. In contrast, refined grains digest more quickly and cause blood sugar levels to rise rapidly when consumed.
Carbohydrates are a major culprit in glycemic growth. (Photo/"Hometown, Don't Come Unharmed")
Not only that, the difference between ultra-processed foods and natural foods is that in addition to the lack of nutrients that are beneficial to our body, a large number of food additives such as preservatives, color enhancers, flavorings, and improvers are added. These substances cause a rapid rise in the body's insulin, leading to insulin resistance.
Studies have found that when we eat 1/5 of our total food intake with ultra-processed foods every day, it may affect the cognitive ability of the brain. A 10% increase in the daily intake of ultra-processed foods in total food intake is associated with a 15% increased risk of type 2 diabetes, a 13% risk of metabolic disease, and a 13% risk of being overweight.
One of the reasons why I don't recommend eating pre-made dishes and pre-made sauces (such as soy sauce) is that they have some sugar substitutes in them instead of white sugar. Everyone thinks that sugar substitutes are healthy and that they reduce energy and sugar intake, but the problem is that they don't reduce insulin secretion, which is a confusing phenomenon. It is better to eat white bread and sugar substitutes than to eat white bread and boiled water, because eating white bread will only raise one blood sugar and one insulin, and if you add sugar substitutes, you will increase two parts of insulin, which is very tricky.
In addition, the complex phosphate in ultra-processed foods is also a big problem. The soup of our noodles is not muddy, the quick-frozen dumplings and quick-frozen wontons will not age or crack if left overnight, and the steamed bread and bread are the same, and they are still so elastic overnight - all because of the compound phosphate in them. Every time we eat a man-made chemical, the side effects on the human body are immeasurable. However, almost all the foods on the market now contain improvers, so in order to avoid improvers, I don't buy tofu outside, and buy some beans to soak and make soy milk to drink.
Most staple foods on the market are fortified with amendments. (Photo/Picture Worm Creative)
How to eat healthier
It's not that ultra-processed foods can't be eaten, it's just that if you must eat them, it's best to eat them according to a certain dietary ratio.
My son and I co-invented the Blood glucose balancing plate (BGB plate): 50% leafy vegetables, as well as colored fruits and vegetables, 25% protein, chicken, duck, fish, meat, eggs and milk, 20% staple food, containing all starchy grains and vegetables, and finally 5% fruits.
The BGB plate is developed from the Mediterranean diet, which is currently the most recognized plate model in the world. In the course of my research, I found that there is inflammation in type 2 diabetes, so I put foods that have anti-inflammatory effects in them and remove foods that do not have anti-inflammatory effects. Later, I made some improvements based on the local eating habits in Shanghai, and slowly developed into the current plate model.
There is no such thing as bad food, only bad processing. We should not reject food, but think about how to rationalize our diet and consume it in moderation and balance.
Vegetables are important in eating and drinking. (Photo/colorhub)
There is also an order to eat, eating vegetables first, then protein, and finally a colorful staple food. When you are seven or eight minutes full, you will not eat. It's best to eat each meal for about 20 minutes, because it takes 20 minutes for the brain to receive the signal that you're full.
When cooking, it is recommended to mix various oils alternately, and you can use more olive oil. Because olive oil is rich in Omega-9 fatty acids, it can balance Omega-3, Omega-6 and Omega-9. The oil we eat outside is almost always an oil that contains Omega-6, which causes inflammation. Omega-3s can be obtained from fish, such as sardines and sea bass, which are high in Omega-3 content. We can also take fish oil supplements directly. When "3, 6, 9" is in equilibrium, the inflammatory state is the lightest.
If you want to have some nuts and fruits on your plate, try to choose tree fruits rather than herbs, such as large walnuts, blueberries, and raspberries. Compared to herbaceous plants, tree-borne plants have fewer pesticide residues. At the same time, I recommend drinking 1800 ml of water a day and not drinking too much milk, because milk also raises insulin.
Many people lose weight through meal replacements and abstaining from staple foods, which I don't recommend. After a person endures hunger and loses weight quickly, the first problem is that they will lose muscle, so that the basal metabolic rate will decrease, and once they return to three meals a day, the weight will definitely regain. Moreover, eating meal replacements, although the total energy goes down, but to return to the original total intake, it is equivalent to the need to eat more, which is not conducive to weight loss.
Moderate exercise helps with metabolic recovery. (Photo/Unsplash)
I also don't recommend taking vitamins and dietary supplements every day. Because it is a synthetic substance after all, if you eat too much, your body will be lazy and raise your background. For example, if I consume 800 mg of vitamin C, I can maintain a person's normal functioning, but when I take supplements, I may need 1,500 mg to maintain the body's functioning.
For me, I would use good vitamins as medicine. For example, when I was "coronavirus", I barely ate three meals a day, but when it came to meals, I would take 1,500 mg of vitamin tablets, so that I could consume 4.5 grams of vitamin C every day. When the human body is in a state of illness, it needs a large dose of nutritional supplements, which can be supplemented according to the individual's physical condition and specific problems under the advice of doctors and nutritionists. Usually, it is best to fish for three days and eat in the nets for two days.
It is a long and continuous process from a perfect score of health to an invisible imbalance, to a severe functional imbalance, and finally to the onset of disease. It takes 5~10 years for the human body to develop diabetes from normal metabolism. After receiving my plate diet advice, most people are able to recover their metabolism.
Professor Song took over the case of reversing blood sugar. (Photo/Provided by the interviewee)
My junior high school classmate, Professor Qian, is an "old sugar friend" for more than 20 years, who suffers from glycofoot and ketoacidosis, and has to take 4 injections of insulin a day, which has had a serious impact on his life. For a long time, he didn't know how to eat. After I learned about this incident, I intervened directly through WeChat to eat three meals, and now he has returned to his normal life, and the dosage of topical insulin has dropped by half. In the second half of this year, he went to Japan for a study tour and stayed for more than half a month, which was a very big gain for him.
There is also the son of one of my senior brothers, who is only 15 years old, who was diagnosed with diabetes in June this year and spent two months in the hospital. I also helped him with his eating patterns, and now he doesn't have to take medication and has lost his diabetic hat. I am very touched when they tell me through words and photos that their physical condition has improved.
Proofreading: Yang Chao
Operations: Ono
Typesetting: Zhao Wanxi