Q: You learned you were prediabetic at age 43. Were you eating right?
I was eating a lot of junk food. It was wreaking havoc on my energy levels, but I never gained any weight, so I assumed I was fit. That's why I didn't do cardio at the gym. I only pumped iron. I'd always equated being thin with being healthy, but it turns out that, if you're predisposed to diabetes, size isn't the only thing that matters.
Q: In the United States, one in ten adults has diabetes and some 79 million are prediabetic. All together, that's more than a third of the population. How did we get here?
The average American consumes more than 150 pounds of sugar a year—and that's a diet our bodies weren't designed to handle. Food technology moves much faster than human evolution. If we were still foraging for food as our ancestors did, we'd have a hard time finding enough calories to cause type 2 diabetes.
Q: Your book points out that carbohydrates—which break down into sugar—are hidden everywhere. What are some of the culprits?
A typical fast-food meal has 194 grams. According to the American Diabetes Association, that's more than a diabetic should consume in a day. Milk has 11 grams. Add it to a bowl of cereal, that's 35. Energy bars can have 30 to 50 grams. An eight-ounce energy drink, 14 to 25. The numbers add up fast.
Q: Yikes. So what should we be eating?
We should reduce our intake of refined carbs (sugary foods, pizza, ice cream, bread and pasta made from white flour) in favor of "complex" carbs found in whole foods (like oatmeal, lentils, spinach, and soybeans). And we should try to front-load those healthy carbs in the morning and afternoon; when you eat them too close to bedtime, you may be more prone to weight gain.
Q: How did you take control of your own blood sugar?
Eighty percent of what I used to eat is now off the table. I try to limit myself to 80 grams of carbs a day. But I definitely miss dessert. I have a huge sweet tooth.
Q: How does fitness work into the equation?
Exercise is the closest thing to a cure for type 2 diabetes. Insulin is the main way for glucose to get into your cells, but there is a second way that's activated by exercising. If you work out, glucose can go through this secondary channel without insulin's help.
Q: What's the most important thing you've learned about your disease from writing this book?
I left my book project incredibly pessimistic that we as a society will be able to prevail against diabetes, but incredibly optimistic that any one person can beat it.
*Type 2 diabetes is often triggered by obesity and inactivity, because fat interferes with the body's ability to use insulin, the hormone that moves glucose into cells to be metabolized. As a result, glucose builds up in the blood, which can lead to symptoms from poor circulation to nerve damage.
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