Dr. Mehmet Oz

Photo: Ruven Afanador

Before I begin most cardiovascular surgeries, I look into the eyes of the patient lying on the table and wonder, "What led her here? Could she have avoided this operation?"

The majority of people who end up in my OR are overweight or obese, and many have type 2 diabetes. The fact is, diabetes has become an epidemic. There are now nearly 26 million diabetics in this country; and at least one in five girls and one in four boys born in the year 2000 will be diagnosed with diabetes in their lifetimes. Type 2 diabetics are up to four times as likely to die from heart disease. It's estimated that women diagnosed by the time they're 40 will lose 14 years, on average, from their lives; men, almost 12.

But here is a source of great hope: A study published in the New England Journal of Medicine determined that more than 90 percent of type 2 diabetes cases can be prevented by lifestyle changes. The disease is often triggered by poor diet and inactivity, because fat interferes with the body's ability to use insulin, the hormone that ferries glucose from our bloodstream into our cells. When glucose can't get into the cells, it builds up in the blood and can lead to problems ranging from poor circulation to nerve damage, kidney failure, and blindness. Over the course of my career, I've watched patients who were destined for diabetes completely rewrite their fate by losing weight and getting in shape. In fact, even if you already have diabetes, drastic changes in your habits can put you into remission, as long as those changes are permanent.

I have developed a four-week strategy to help at-risk patients start down a healthier path. It's a gradual process, with each week building on the last. Just remember: This isn't a simple diet-and-exercise plan. It's a whole new philosophy that could save your life.

Next: The best thing about week 1: You can keep your coffee!

Illustration: Greg Clarke

Week 1: Eat Wisely
Cutting back on sugar is crucial—but that's only part of the story.

Go with Whole Grains
Eating two servings of whole grains per day can reduce your risk of type 2 diabetes by 21 percent, according to research. A diet high in processed grains (like white rice and the flour in white bread), on the other hand, has been strongly associated with an increased risk of the disease. These refined carbohydrates are easily digested, causing a rapid spike in blood sugar.

Fill Up on Fiber
The rough stuff—found in veggies, fruits, beans, nuts, and seeds, as well as in whole grains—slows the flow of glucose from the intestines into your bloodstream, which helps keep your blood sugar steady. A study of prediabetic subjects found that a high-fiber diet could reduce a patient's progression to diabetes by 62 percent. Craving something sweet? Have a handful of fiber-rich raspberries or blueberries.

Enjoy Your Java
(Just go easy on the sweetener.) People who habitually drink coffee (caffeinated or decaf) have a much lower risk of diabetes. One study found that they were 60 percent less likely to develop the disease. Coffee may reduce blood sugar levels and has been shown to improve metabolism; its wealth of antioxidants may even protect insulin-secreting cells from damage.

Yoga Illustration

Illustration: Greg Clarke

Week 2: Sweat it Out
Even a little exercise can go a long way at first. Push yourself harder over time.

Get Your Heart Rate Up
Aim to reach 50 to 85 percent of your maximum heart rate (the number 220 minus your age) for at least 30 minutes, five days a week. For example, if your maximum heart rate is 170 beats per minute, you'd want to strive for 85 to 145. Exercise impacts your blood sugar in two ways: Physical activity boosts levels of GLUT4, a protein that helps insulin do its job. And when your muscles need extra fuel, they absorb more glucose from the bloodstream.

Build Muscle
In a study of nearly 14,000 subjects, researchers found that each 10 percent increase in muscle mass correlated to a 23 percent drop in prediabetes. Just a few minutes of strength training every other day can make a difference. If you don't have time for weights or push-ups and planks, just skip the elevator: Climbing stairs targets some of the largest muscles in your body—the glutes and thighs.

Practice Yoga
Add diabetes prevention to the ancient art's long list of health perks. Studies show that yoga increases the rate at which glucose moves from the blood into our cells. It also reduces levels of stress hormones, which can cause an accumulation of abdominal fat and interfere with the secretion of insulin.
Cinnamon illustration

Illustration: Greg Clarke

Week 3: Start Supplementing
The right dietary extras can help arm your body against disease.

Fortify with Magnesium
This powerhouse mineral helps regulate hundreds of enzymes in our bodies—including many involved in glucose metabolizing. A meta-analysis of studies published in the Journal of Internal Medicine suggests that adequate levels of magnesium can decrease a person's risk of diabetes by 15 percent. The mineral is found in whole grains, beans, nuts, and leafy green vegetables—but to make sure you get enough, I recommend taking 400 milligrams a day.

Sprinkle on Cinnamon
About two teaspoons a day may lower your blood sugar levels by up to 29 percent. The spice appears to increase levels of GLUT4, as well as insulin receptors on cells—facilitating the movement of glucose out of the blood. You can eat cinnamon any way you like, but for a double-whammy, add a dash to your coffee or oatmeal. I like to use it as a substitute for sugar.

Add Alpha-lipoic Acid
This antioxidant mobilizes an enzyme (AMP-activated protein kinase) that reduces levels of triglycerides (fats carried in the blood). Lower levels of triglycerides, in turn, can help trigger a 20 percent boost in cells' sensitivity to insulin. But that's not all: Alpha-lipoic acid also helps protect the retinas against damage from excess glucose in the bloodstream—one of the most common causes of blindness in patients with type 2 diabetes. To get the greatest benefit, take 600 milligrams daily.

Sleeping Illustration

Illustration: Greg Clarke

Week 4: Take Care of Yourself
Changes in attitude are some of the most important you can make.

Try to Relax
A 2009 British study found that middle-aged women who experience low social support and high levels of stress at work are twice as likely to develop diabetes. I know that reducing stress can itself seem stressful. But you don't have to reinvent your life—even listening to a few favorite songs when you're feeling agitated can help. Study after study has revealed the restorative power of music.

Be Mindful of Your Health
Twenty-seven percent of diabetes cases in the United States are undiagnosed; if you're 45 or older, get tested every three years. In the meantime, keep an eye out for velvety, brownish gray patches of skin—called acanthosis nigricans—under your arms, on the back of your neck, and around the groin. This kind of discoloration is associated with abnormal insulin levels. The earlier you detect a problem, the faster you can solve it.

Get Better Shut-eye
Because insulin levels are strongly linked to melatonin (the sleep hormone), interrupted z's can cause fluctuations in blood sugar. In addition, sleep deprivation leads to cravings for high-calorie, high-carb (diabetes-danger) foods—as you may remember from your last all-nighter. Practice good sleep hygiene: Aim to go to bed and wake up at the same time every day, and avoid watching TV or surfing the Web while you're under the covers. If you need a reason to get more rest, protecting yourself from diabetes is a great one.

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