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Hey everybody, it's Dr. Matthew Hertert here again, founder of ThrivingDiabetes.com and
the Freedom from Diabetes programs, and today's Frequently Asked Question is, "What can I
do to prevent type 2 diabetes?" and it's a really good question. Usually people looking
for this answer have been recently diagnosed with pre-diabetes, or sometimes somebody who's
in a family with a lot of Type 2 diabetics, usually somebody who's overweight and is sedentary,
you're not getting that much exercise in your day-to-day life. We're going to give you three
simple answers, three simple things to do, not necessarily easy but very simple things
you can do that will essentially eradicate the chance that you will ever develop full-fledged
Type 2 diabetes or that you'll ever have to be on Metformin or shoot insulin or any of
that kind of stuff. In reality, these three keys are also foundational for Type 1 diabetics,
these are the same things Type 1 diabetics need to focus on, and really even people who
are non-diabetic or aren't at risk for diabetes should also be focusing on these three things.
It's something I don't hear talked a lot about in diabetes education, but I think it's an
important point of perspective: most of the time we've been on the planet, 75% of the
time we've been on the planet we have been hunters and gatherers, maybe walking around
you know 8, 12, 16 hours a day, looking for plants to eat, berries to eat, hunting animals
and trying to chase them down and kill them and then get meat back to the camp before
other predators come and eat the meat - I mean it's been very labor intensive, lots
of physical activity all day, every day, and very few calories in exchange for that. We
moved from that a few hundred years ago to an agrarian society where we started growing
crops, a little bit less on the hunting gathering end, but we traded it off basically for tilling
fields and building rock walls and harvesting crops - still a lot of physical labor and
a few more calories in exchange. But the world that most of us are living in these days,
certainly not everywhere on Earth, but a lot of places on Earth, we have abundant access
to way more calories than we have ever had before, and unfortunately most of us are intaking
way more calories than we ever had before and very few of us, at least most of us watching
this video, aren't needing to go out and labor 8, 12, 16 hours a day. Even people who do
physical labor, like I was a carpenter for years in the entertainment industry, every
once in a while we'd have a 12, a 16 hour day, most of the time we were working 8 hours
with an hour lunch break in there, that sort of thing, so the way we're using this machine
is very, very different and a huge percentage of the vast increase in Type 2 diabetes in
the last 10 or 15 years is due to this shift from being a physical species to being a mental
species. Most of us sit at desks, we do data entry, we answer telephones, we send and read
emails all day - a huge change in the way we use our machines, so even people who're
not diagnosed pre-diabetic or at risk for Type 2 diabetes should be focusing on these
three things, it would make us a healthier species overall. So let's get down to the
three keys and pay attention because there will be a test at the end! Really the three
things here are very simple and I don't think any of these will be a surprise to you: the
first is to make sure you're exercising, the second is to release some weight, and the
third is to change what you're eating, how you're eating, how much you're eating, okay?
So the first one, exercise: there are a couple of things that should be mentioned about exercise,
the first is that there are primarily two different types of exercise and one will benefit
you more than the other. Any kind of exercise is good as long as you're doing it safely
and wisely, and either kind will reduce your risk of Type 2 diabetes, but what we're talking
about here in terms of the difference is what's called aerobic exercise. Most of you have
probably heard of that, very popular in the '80s when I was a teenager, not so much anymore,
and then anaerobic exercise, and what those words aerobic and anaerobic mean are oxygen
or 'with oxygen' and anaerobic, 'without oxygen.' So an anaerobic exercise routine involves
things where your muscles burn sugar instead of burning oxygen, so aerobics tends to be
lots of repetitions, not necessarily involving weights - again, think Jane Fonda's Workout
from the 1980s, a great example of what that's like, or a step class or something like that,
where you're doing a lot of the same repetition - you're really just moving your body weight
around and that will tend to burn oxygen that's pulled out of your bloodstream whereas anaerobic
exercise which is like weight lifting, running at a higher intensity for a full 20, 30 minutes,
something like that. Being on a cycle, strongest output that you can, basically pushing yourself
as fast and far as you can, that's going to tend to burn oxygen for a short time but then
it'll move into where in order to keep up that pace, your muscles need to burn sugar,
and if you've watched my other videos or if you even have a cursory understanding of diabetes
you know that our problem is we've got too much sugar in our bloodstream because our
bodies aren't efficient at managing it - that's a simplified explanation but you get the point
here. So any kind of exercise is good but you want to, long term if not in the short
term (if you can do it in the short term do it now) but in the long term if you want to
set your sights on the things instead of life, I think the way a lot of people think of exercise,
a lot of lay people, is as 'things that can make me thin that I do a lot of reps with
little weight,' or, 'things that can bulk me up a little bit more where I'm doing fewer
reps, more intense for a shorter period of time.' In general, you want to lean towards,
you don't want to bulk yourself up necessarily, but you want to do things that are very labor,
exertion-intensive, okay, and you should do this in conjunction with your doctor to make
sure that you're safe to do particular kinds of exercise, okay - so let that be said. The
second thing that we want to talk about with exercise has to do with how much to aim for.
Now if you poke around the internet and look on a lot of diabetes-related sites you'll
see a very common recommendation that's probably just been cut and pasted from site to site
which is 30 minutes, five days a week, and that's great, if that's what you can do, if
that's what you want to do, do it. In my opinion you should be exercising every day, you should
be doing it even days a week, 30 minutes a day and the really two reasons for that - number
one, you think about what our bodies are really wanting or what they've developed to do, which
we talked about a little bit earlier, the other thing to consider here is that diabetes
management, whether it's Type 1, Type 2 or trying to avoid developing Type 2, is about
keeping your blood sugar even, about keeping it even keel. The easiest way to do that is
to have as few variables, as little variation from day to day in terms of what you're eating,
when you're eating it, and your exercise, your activities, so the more consistent you
are with your exercise and your diet in your life, the better-managed diabetes you're going
to have. So yes, we all just want to kick back on a weekend and relax and drink a beer
and watch TV or whatever, I mean everybody has that kind of instinct, but you're really
going to do a lot better if you force yourself to just do that exercise daily. Now that being
said, if you're new to this, particularly if you're somebody who's just gotten a diagnosis
of pre-diabetes and you're trying to wrap your head around all this stuff, you don't
want to over-commit. A lot of people fall in the trap with new behaviors and new routines
(and this applies to the other two thing we're going to talk about so pay attention this),
a lot of people fall into the trap of the 'New Years Resolution,' so they're like, "Well,
gee, I really want to exercise seven days a week, 30 minutes like Dr. Matthew said,
so I'm going to start doing that," that can be pretty foolhardy for most people, especially
if you've not been exercising in a long time. It's much smarter to sit down and say, "Okay,
what do I absolutely know in my heart of hearts I can commit to doing every week? I know I
can do two days. I know can commit to that." Commit to two days! If you have an easy week
you can always do more, you can always do three or four days in a week, but if you set
yourself up for failure by committing to too much what's going to happen is after a week
or two goes by you start to lose enthusiasm, you 'fall down' that one week and then the
whole thing starts like,"Oh I never do what I say I was going to do. I don't even know
why I try," that whole defeatist attitude is going to set in so start smaller and work
your way up. Set goals like, "Okay, I'm going to do two days a week for the next six weeks
and then I'm going to go up to four days a week," however you want to set that up for
yourself. The third thing about exercising, and I have yet to run across an exception
to this, adding exercise into your day changes the kinds of foods that you want to put in
your mouth, it changes your cravings, I'm not saying there isn't an exception out there
but in about 30 years of coach- well, that's not quite right, 25 years of coaching people
and talking about this kind of stuff, I've yet to meet somebody that didn't say this
was true for them. When I get done with good exercise at night, the last thing I want to
do is stick carbohydrates in my face, I just have no interest, I don't want crackers, I
don't want toast, I don't want a bowl of cereal, I thirst for something healthy, like a bowl
of greens. You know I often have a bowl of kale with a little bit of olive oil, a little
bit a vinegar on it and just a sprinkling of parmesan cheese or something and that feels
good to eat, it's what my body wants to eat after a workout, sometimes I want a little
meat with it, too. So that's sort of another conversation but the point is that exercise
starts to change your chemistry and you start to crave better things to eat which makes
this whole thing easier, okay? So the first one is exercise, the second, again not a surprise,
releasing weight. Now same advice here as with exercise particularly if you're somebody
who has a lot of weight to release you want to do this in conjunction with your doctor
so they can help you do it wisely, there are ways that are unhealthy to release weight,
there are ways where you'll release weight too quickly and it can make you sick (some
of the biochemistry that you produce when you drop weight really quickly), so don't
be a tough guy or don't be a tough girl, do it in conjunction with somebody who can give
you some assistance with this even if it's like a personal trainer or something like
that. But there are also three major benefits here to weight release, the first is when
you're releasing weight you're releasing fat cells, usually you're releasing fat, well
you're not releasing the cells, the cells get smaller, you're releasing the percentage
of your body that is fat and increasing the percentage of your body that is muscle. A
lot of people don't know fat increases your resistance to insulin, which is really the
cause of Type 2 diabetes, your body can't use the insulin so your pancreas has to make
more and more and eventually your pancreas just gets tired and poops out, so decreasing
the percentage of your body that's fat and moving into a more muscular state, even if
it's not more muscular, if you're just releasing the fat it's going to decrease your insulin
resistance. Particularly if you're a pre-diabetic watching this, which I expect most of you
are, then it's also going to increase the efficiently of your pancreas in producing
insulin because you don't have as much insulin resistance, so again it decreases the chance
you're ever going to need anything like Metformin or insulin or any of that kind of stuff, it
really simplifies that whole process. The third thing about releasing weight - and the
number attached to this varies depending on how much you're starting off at, what kind
of weight you're starting with - if you're in the three or four hundred pound range you
may not notice the difference in feeling of losing five pounds or seven pounds: if you're
250, 280 and under, almost everybody's going to start to notice once they drop five pounds,
seven pounds, which you can do in a week. The point is that after a week you're going
to start feeling different in your body, you're going to start to feel better and that does
two really important things. Number one it gives you a new reference point, it gives
you a new sense of how good you can feel and what you can actually weigh, how good you
can feel in your body at this other weight. The other thing it does is it undermines that
part of you that doesn't believe you can do it. A lot of people I have worked with other
the years, particularly people who are much heavier in their weight, are scared to try
and release weight because they're afraid they won't be able to do it, or if they can
do it then that weight is going to come back, and that they're going to feel crushing disappointment
and never be willing to try it again, so they just don't even want to go in that direction
in the first place. As you start to release it, that voice will get quieter in your head,
or you'll be able to say, "Hey, shut up. We know what we're doing here. We're feeling
better," so that weight release is a really key thing and of course it makes it easier
to exercise, you feel better in your body all the time so you want to exercise. You
know you're excited about the new clothes, et cetera, et cetera and you want to eat better,
too, because the healthier your body is, the better you're going to want to eat. Which
brings us to the third one. and the third one of course is a better diet - I had a lot
of fun drawing this one, this is my best attempt at celery, which I don't know if it looks
like kale or somebody was logging in the forest, I don't know what it looks like, but I had
fun drawing the celery and the fish - he's happy even though we're going to eat him,
and I don't know if you saw what I did here with a little skull and crossbones - I like
to have fun drawing these things for you guys - and our unsung hero on the cup. So I've
really simplified this here, I've shown a transition from fast food to fresh fish and
greens, but it's really not that simple. If you've watched any of my other frequently
asked question videos or if you've done any reading about diabetes, you know that carbs
are a killer for us, they are hard even on non-diabetic's bodies, never before in the
history of our species walking around the planet have we had access to carbohydrates
like we do now, you go back a couple hundreds years we didn't even have potatoes, well maybe
it's more than a couple hundred years now but that's even a relatively new thing for
our species. You know a lot of these things are new, particularly the processed ones,
particularly the processed ones that we add sugar to, it's just not something that our
body knows how to deal with, so certainly get away from the fast food. I think everybody
knows that fast food is not particularly good for you but for a lot of people it's been
so long since they had a good, simple, fresh home cooked meal, steamed broccoli and fresh
fish, maybe with a little bit of olive oil and vinegar on it or something, you know that's
a very healthy protein source with really good omega 3's which is a healthy fat that
your brain needs to work properly, and other parts of your body too, and then fresh greens.
So my diet, for example, is about 60, 65% vegetables, particularly fresh greens and
then about 30% protein and then that nook is filled in with maybe a little bit of dairy
here and there, more processed dairy like cheeses and that kind of thing, which is ultimately
protein, but a lot of people break dairy out as separate, so I've mentioned it that way.
So this kind of food shift is important also for a couple reasons, number one if you were
not to focus on exercise or releasing weight but just changed the way you're eating and
cut those carbs out, you would start to release weight right off the bat, okay, so this has
an immediate effect on how many calories you're putting in and how those calories behave inside
your body. When you put carbs in, they pretty much turn into fat right away unless you're
exercising which you're probably not or you wouldn't be watching this most likely, so
you're going to see a weight release immediately. Second of all, you're going to feel better
because you're eating better nutrients, and third of all by making a shift like this in
your diet you are going to vastly decrease your risk of heart problems, of stroke, of
atherosclerosis, of cholesterol problems, of high blood pressure, of heart attack so
that in and of itself can be a big change. So again, do this in an informed way, do it
with a partner or find somebody to coach you or assist you in developing a meal plan and
if you need to take baby steps to go in that direction then do that. So how do I prevent
Type 2 diabetes, exercise reasonably, release weight responsibly, and eat healthfully - that's
really it. If you do those three things, then the condition will be in remission for you
or will be dormant, really, and if you start to slip on these three things you're going
to get back into a territory where you're at risk for Type 2 diabetes again, so this
is a lifestyle change, is really what it is, which I why I encourage people to approach
it slowly, this is not a two-week crash diet and then go back to what you were doing. So
leave your comments and questions below, I love the community that that develops, I love
being able to cheerlead for you guys and answer your questions whenever I can. Click on the
link below, take the quiz, there really was a quiz, that wasn't a joke, particularly if
you're newly diagnosed with pre-diabetes and you're getting a lot of information thrown
at you and you're feeling fearful or resistant or overwhelmed, these three basics are pretty
much all you need so you want to make sure you get these anchored in your peanut and
taking a quiz or a little test, especially when nobody is going to grade it and yell
at you, you'll get it graded and you'll get feedback about what the right answers are,
but doing this kind of thing helps you anchor this stuff so you really remember what's important
and you can use it in a way that will benefit your life - so go take the quiz. Come visit
us at ThrivingDiabetics.com, check out some of the educational materials and coaching
programs we've got there to be of some support for you, and most important, have a great
day, go out there, be well, and leave your comments and questions below. I will see you
soon for our next Frequently Asked Question.