Diabetes

Definitions - Diabetes is a noun from the Greek word “diabainein” meaning to walk with the legs apart. It is a disease of excess sugar (glucose) in the blood. The cause of diabetes is an inadequate amount of insulin (type 1-diabetes) or inadequate response to insulin (type 2-diabetes). Initial symptoms may include excessive urination and thirst, weight loss, fatigue, blurring of vision and/or hunger.

Diagnosis of Diabetes - The diagnosis of Diabetes is made if the fasting blood glucose is 126mg/dl or greater on two occasions. "Prediabetes" is a blood sugar fasting of 110mg/dl to 126mg/dl. "Impaired glucose tolerance" is when the blood glucose is between 140mg/dl to 200mg/dl two hours after glucose ingestion (glucose tolerance test). Someone with a random blood sugar, on two occasions, above 200mg/dl is also considered a Diabetic.

Types of Diabetes
Type 1-Less than 10% of diabetics have this type of diabetes..
This type of Diabetes is caused by an insufficient amount of insulin. An abnormal autoimmune process damages the pancreas islet cells. Both milk protein and viral particles have been implicated in triggering antibodies that cause the autoimmune damage to the pancreas islet cells.
The treatment consists of replacing the insulin by injections of various types of insulin.

Type 2 – More than 90% of diabetics have this type of diabetes.
Cellular resistance to insulin causes this type of Diabetes. The muscle, fat, and other body cells do not respond adequately to insulin. Heredity, obesity and inactivity are implicated in causing the resistance.
Treatment consists of increasing the amount of insulin and/or decreasing the resistance in the body cells to insulin. Treatment includes diet, exercise and medications.

Prevention
Type 1 diabetes prevention is limited. Consisting of maintaining a healthy immune system and avoiding cows milk. Studies have demonstrated that the protein in cow’s milk is a immune trigger for pancreatic destruction leading to type 1 diabetes.
Type 2 diabetes prevention is vast. Normalizing weight, exercise and proper diet are the keys. Avoiding a high fat diet and refined carbohydrates is important.

Genetics are important especially in type 2 diabetes. Certain ethnic groups have a higher incidence, including Island people, Native Americas and Hispanic.

Metabolic syndrome
Many type 2 diabetics also have the “Metabolic syndrome”. This is a condition of high glucose, abdominal obesity, hypertension, and high Triglycerides. These conditions put the person at a very high risk for arteriosclerosis. There is a need in this syndrome for aggressive treatment of glucose, hypertension and the Triglycerides to prevent heart disease and strokes.

Treatments
Type 1 diabetes.
Insulins Humulag, Regular, NPH, Lente, Ultralente, Lantus.
Delivery methods include SQ shot, Insulin pump SQ
Type 2 diabetes.
Diet
Exercise
Medications
Sulfonaureas (Glucotrol, glyburide, etc., etc.)
Metformin (Glucophage)
Actose, Avandia
Herb, suppliments and alternative treatments

Diabetic Diets
Type 1 diabetic diet is mainly designed to match insulin level to food intake. Timing, amount and frequency are very important.
Type 2 diabetic diet is mainly designed for reducing weight, avoid refined and toxic foods. Types and quantities of food are the main issues.

Complications of diabetes:
Heart disease, strokes, blindness, kidney failure, nerve damage, amputations and infections.
These can be prevented to a large degree by maintaining a normal blood sugar, cholesterol, triglycerides and blood pressure.

The complications of diabetes include:
1. Eye damage
2. Kidney diseases
3. Arteriosclerosis (effecting the heart, brain, internal organs, and extremities)
4. Nerve damage
5. Skin diseases

Generally the person has diabetes for 10 year before the complications of diabetes become evident. Normalizing blood sugar, controlling blood pressure and lipids will prevent or delay these complications.
Glucose (blood sugar) is toxic at abnormally high levels. It directly damages pancreatic ilet cells (these produce insulin) causing less insulin to be produced. Less insulin causes a higher glucose causing more pancreatic ilet cell damage. A down hill spiral can result. Some of this toxic damage is reversible if the glucose is normalized. Sometimes a period of intensive glucose control can turn a poorly controlled diabetic into a well-controlled diabetic. Likewise a well-controlled diabetic who goes on a “food binge” may enter into the toxic spiral and become poorly controlled.
High blood glucose also causes toxic products to form, including oxidized lipids that cause arteriosclerosis. Some of these toxic products damage the small capillaries that surround the nerves in the feet. This we call peripheral neuropathy. This capillary damage is the mechanism for retinal damage, kidney damage, and skin disease. Additional high glucose in the blood causes glucose to react abnormal with proteins cause abnormal glycoprotien in the small muscular arteries contribution to the hardening of the vessels.
What can be done? Normalizing blood sugar, controlling blood pressure and lipids will prevent or delay these complications. This is the mainstay of prevention and treatment for the complication of diabetes.

Diabetic eye disease

A major concern for the diabetic is the eye sight. The retina is the neurovascular structure in the back of the eye that captures light images. High glucose blood levels and it toxic products damages the capillaries and small vessel in the retina. The Ophthalmologist dilates the pupil and evaluates the retina. Abnormalities include hemorrhages, aneurisms and new blood vessel formation.

Kidney disease

Kidney disease is caused by damage to the capillaries and small vessels in the kidney. High glucose blood levels and it toxic products damages the capillaries and small vessel in the kidney. Hypertension compounds the damage of diabetes. It is therefore more important to control the blood pressure in diabetic than in a non-diabetic.

Arteriosclerosis is a disease of narrowing of the arteries caused by an accumulation of fatty materials in the vessel wall. An accumulation of oxidized cholesterol and white blood cells on a damaged artery is the mechanism. Diabetes is also associated with excessive Triglycerides. The high glucose, and toxic products of high glucose, damage the blood vessel wall.
A type 2 Diabetic typically has an abnormal lipid profile with high bad cholesterol (LDL), low good cholesterol (HDL) and high Triglycerides. When this is present with hypertension and abdominal obesity it is referred to as the Metabolic Syndrome.
Symptoms occur when the artery narrows to such an extent that the organ it supplies becomes starved for oxygen. In the Brain it is a stroke. In the Heart it is angina or myocardial infarction. In the Legs it is claudication or gangrene. In the Liver it is Ischemic hepatitis. In the Kidney it is vascular hypertension. In the Intestines it is intestinal angina or infarcted bowel.
Treatment and prevention consists of normalizing blood sugar, controlling blood pressure and lipids. Diet, exercise, medications are all at times required to achieve these goals. End stage treatments of arteriosclerosis consist of stents, clot busting agents and surgery etc.

Peripheral Neuropathy is the most common nerve disease caused by diabetes. Other less common diseases diabetic nerve diseases include mononeuropathies. The nerves are damaged in diabetics by disease in the small blood vessels around the nerves. When the blood supply to the nerves decrease the person experiences pain and numbness. High glucose blood levels and it toxic products damages the capillaries and small vessels that supply the nerves.
Symptoms include numbness and pain in the feet and sometime the hands. The numbness can lead to a cut that go unrecognized and can get infected. Balance and walking may become a problem because of the pain and numbness.
Treatment and prevention consists of normalizing blood sugar, controlling blood pressure and lipids. Diet, exercise, medications are all at times required to achieve these goals. Treatments consist of contrast baths (hot and cold) to improve capillary circulation. Neurontin has been one of the most helpful medications for symptomatic relief. Omega 3 fatty acids and evening primrose oil may be helpful.

Skin diseases

There is a specific rash usually in the anterior leg area that is associated with diabetes. This is caused by high glucose blood levels and it toxins which damage the capillaries and small vessel in the skin. Diabetic Necrobiosis is the medical term.
The major skin problems in diabetics are diabetic skin ulcers. Diabetics heal slower because of poor circulation especially in the feet. High glucose is toxic to white blood cells slowing healing. The combination of poor circulation, poor immune function, and poor nerve function frequently result in infected diabetic foot ulcers.
Diabetics need to inspect their feet at least once a day.

Ischemic Heart Disease is the lack of blood to heart muscles. A myocardial Infarction or "heart Attack" is the sudden closure of the blood vessel supplying a portion of the Heart Muscle. There are 4 - 5 main arteries supplying the heart, an artery is a blood vessel that carries oxygenated blood from the heart. If an artery is narrowed, it is called ischemic. If an artery closes off then the muscle supplied by that artery dies, we call this a myocardial infarction. One half of the people who suffer a Myocardial infarction die before they get medical help.

Diabetes almost doubles (1.8 X) the risk for heart disease. Combine diabetes and hypertension and your risk is more than 5 times (5.4 X). If you have all thee risks (diabetes, hypertension and high cholesterol) and your risk is 22 times the risk as someone with none of these problems.
All these risk factors are potentially correctable. We can have a significant impact on the number one killer in the Western world – Arteriosclerosis Heart Disease.

Causes of Ischemic Heart Disease
1. Smoking
2. High Cholesterol
3. Lack of Estrogen i.e. being male.
4. Excess Homocystine
5. Hypertension
6. Diabetes
7. Obesity
8. Lack of fruit and vegetables
9. Lack of dietary fiber

Physiology
The Coronary Artery is the area of Concern. These are the blood vessels transporting oxygenated blood from the pumping chamber of the heart to the heart muscle.
There is muscle in the walls of the arteries. They relax and constrict to regulate a constant pressure and blood supply.

Steps to Arteriosclerosis
1. Inner wall becomes irritated.
Caused by; 1. Curves, 2. High blood pressure 3. Sticky blood cell, 4. Free Radical damage
2. Inflammatory cell –Macrophages and other white blood cells invade into the artery wall/ muscular area.
3. Oxygenated Low Density Lipoproteins (transporters of Fat) carry Cholesterol into the Artery walls.
4. The Inflammatory cells in the Artery wall ingest the Cholesterol causing swelling and constriction of the Artery.
5. The narrowed artery creates more turbulence and pressure causing more irritation of the inner wall.
6. The irregular narrowed artery attracts clotting factors and platelets. This can form a clot causing a Myocardial Infarction.

Oxidation and free radicals Explained
It is the oxygenated cholesterol that damages the arteries. Oxidation and reduction reactions are the basis of energy transfer and heat. This is the basis of life. The intermediate forms of the chemical reactions consist of free radicals (molecules with an unpaired electron, which rapidly reacts with other molecules). Life would not exist without these chemical reactions.

When an atom or a molecule combines, or forms a chemical bond, with oxygen, it tends to give up electrons to the oxygen. Oxidation is defined as any reaction involving a loss of electrons. The molecule, that loses an electron to oxygen, is called a free radical.

Antioxidants slows oxidation. They stop unwanted chemical reactions. Antioxidants are in all fruits and vegetables.

Intervention
1. Stop Smoking – Causes artery constriction and clotting disorders
2. Lower LDL - Dietary intervention
3. Raise HDL - Exercise, Stop smoking, Lose weight
4. Prevent oxidation of LDL - plenty 5+ servings of fruits and vegetable daily
5. Control blood sugar and insulin levels;
There is a direct toxic effect of Glucose (at high levels) on the cells it contacts. This in theory may damage the arteries directly. High insulin level raises the cholesterol. The excessive Glucose level decrease the immunity to bacteria.
6. Control BP: decrease weight, increase fruit and vegetables, increase water, decrease sugar and salt, stop smoking, stop alcohol, stop harmful stress (anger, resentment).
7. Check and treat homocystine level if elevated. (treatment is with folate and B-vitamins)
8. Improve General Health- This will improve immunity thereby decreasing the likelihood of a Clamydial bacteria invading damaged blood vessels which cause arteriosclerosis.

Cholesterol reviewed
Cholesterol is an odorless, soft, waxy substance. The body needs cholesterol. It is component of cell membranes. It is part of the production of many hormones, vitamin D, and bile acids (which are important for the absorption of fat). Cholesterol is present in all parts of the body, including the brain and nervous system, muscle, skin, liver, intestines, heart, and skeleton.

Since fats do not dissolve in water, cholesterol (and other fats) travel in the blood in packages of phospholipids and protein (called lipoproteins). All lipoproteins are formed in the liver and carry cholesterol through the body. Blood cholesterol packaged in low density lipoproteins (LDLs) is transported from the liver to other parts of the body where it can be used. LDL is sometimes called "bad cholesterol" although it is not bad in proper levels.

Cholesterol is also carried in high density lipoproteins (HDLs). HDLs carry cholesterol back to the liver for processing or removal from the body. HDLs remove cholesterol from the blood, preventing the accumulation of cholesterol in the walls of the arteries. Thus they are often referred to as "good cholesterol."

The cholesterol panel will include.
1. LDL-cholesterol level.
2. HDL cholesterol level.
3. Triglyceride level.

A ratio of Lipoprotiens is helpful in determining risk of disease. Cholesterol ratio is actually just the total cholesterol or LDL-cholesterol divided by the HDL-cholesterol. For example, if a person's LDL-cholesterol level is 140 mg/dl and his or her HDL-cholesterol level is 35 mg/dl, the individual's cholesterol ratio is 140/35, or 4.

A person’s LDL and HDL levels provide more information on the risk of developing coronary heart disease than just the total blood cholesterol level.

A high LDL-cholesterol level or a low HDL-cholesterol level puts an individual at increased risk.

LDL-Cholesterol Levels: What Do They Mean?
Ideal : Less then 100mg/dl
Acceptable: Less than 130 mg/dl
Borderline: High Risk: 130 mg/dl to 159 mg/dl
High Risk: 160 mg/dl and above

A HDL-cholesterol level lower than 35 mg/dl is considered too low. Quitting smoking, losing weight, and becoming physically active may help raise the HDL-cholesterol level.

Diet and Lipid
Avoid Saturated fats- animal fats, butterfat, palm oil, coconut oil.
Avoid hydrogenated Vegetable oil it has the same effect as saturated fats.
Unrefined oils are best. It still contain antioxidants, fat soluble vitamin and other phytochemical. Virgin Olive Oil is the only commonly available unrefined oil.
Avoid Cholesterol – in animal products only
Avocados need not be avoided.
The oil in nut is generally good, peanut is the least beneficial but still better than animal source
Limit refined carbohydrates i.e. sugar deserts white bread.
Include dark green vegetable in diet
Eat freely of fruit and vegetable with few exceptions i.e. sweet corn can be over used.
Eat freely of whole grains and legumes.

Suggestions to start
Stop Smoking
Begin walking
Be sure and eat at least 5 servings of fruits and vegetable daily
Drink 8 glasses of water daily.

Diabetes nearly doubles the risk for heart disease, add hypertension and your risk are more than 5 times that of someone with neither diabetes or hypertension.

Blood pressure is a test of cardiovascular health. Elevated blood pressure is a sign of disease of the cardiovascular system.

Hypertension or high blood pressure is an increase in the fluid pressure of the blood in the blood vessels. Increased fluid pressure is what happens in a garden hose that is kinked. It can happen because of increased resistance (squeezing) of the blood vessels or because of an increase pressure at the pump (heart) or both.

Most hypertension is classified as essential or primary. About 10% of hypertension is classified as secondary i.e. it is secondary to another disease. Secondary causes of hypertension include:

      1.      Kidney diseases (most commonly narrow arteries to the kidney).
2.      Adrenal tumor (aldosterone producing, cushings disease or Pheocromocytoma)
3.      Hyperthyroidism

Essential hypertension is not causeless is it’s name implies. Genetics and lifestyle are the major considerations. Regarding genetics African Americans have a higher prevalence and should be screened closer.

The goal in a diabetic is a systolic (top number) below 130. In a non-diabetic below 135 is acceptable. The idea systolic blood pressure is below 120.

Lifestyle factors

Don't smoke cigarettes or use any tobacco product. The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster, which raises your blood pressure.

If lifestyle changes are not enough then medications will need to be used. Can these medications ever be discontinued once begun? The answer is yes. If a hypertensive person on medications stops smoking or losses weight, they are frequently able to stop some or all of their mediations. Occasional if a person is in an abusive relationship or job and makes a change the medications will no longer be needed. These persons need, however to monitor their blood pressure closely. The common types of blood pressure medications are:

The ACE inhibitors and Angiotensin blockers are especial helpful in that studies have shown they help prevent diabetic related kidney failure.

Obesity is the main cause of type 2 diabetes and is epidemic in the USA. Obesity causes insulin resistance in the fat cells (and other cells) by altering the insulin receptors. Insulin levels are increase to compensate. The pancreas eventual becomes unable to produce enough insulin to keep the blood sugar down and diabetes is manifested. High insulin levels inhibit the breakdown of fat making it more difficult to loose weight.

In the U.S. 60% of adults are overweight or obese, 35% of American adults are overweight, and 26% are obese. Type 2 diabetes and hypertension are now developing in many children because of obesity. These conditions were considered adult diseases a generation ago. Type 2 diabetes used to be called “Adult Onset Diabetes”. Type 2 diabetes in children and youth has increased by 10 fold, comparing 1982 to 1994 statistics, and is still on the rise.

"We live in a toxic environment," says Kelly Brownell, director of the Yale University Center for Eating and Weight Disorders. "Physical activities have been engineered out of day-to-day life, and the food environment grows worse by the day. We took Joe Camel off the billboards, but we celebrate Ronald McDonald." 1

Weight gain occurs when someone consumes too many calories and expend too few. This is a fundamental truth.

The average calories consumed have gone up, from 3,100 calories per capita per day in the 1960s to 3,700 in the 1990s, according to the U.S. Department of Agriculture (USDA). The average level of activity and exercises has decrease during this time period.

The brain hormone leptin has been shown to be involved in controlling our weight. Leptin decrease appetite and increases thermogenesis that is a key to maintaining weight balance. The body signals more leptin to be releases as our weight/ fat increases. For the normal weight this is a wonderful system. In obesity a resistance to leptin develops which is similar to insulin resistance. The hypothalamus fails to respond appropriately to leptin

The hypothalamus regulated the pituitary hormones and other body functions in an attempt to maintain a study body weight. We must cooperate by proper diet and exercise or the system can be overwhelmed by calories excess.

Thermogenesis is the body mechanism for burning extra calories. It works by causing restlessness and an increased body heat production. Increasing blood flows to the outer layers of the skin in an effort dissipate heat. Excess calories are burned.

Obese people tend to have the most calorie efficient systems, which might be an advantage in a society where the food supply is undependable.

The Obese person’s hypothalamus becomes accustomed to elevated level of leptin and establishes this higher weight as “normal”. Their hypothalamus fights to maintain this abnormal high weight.

The Obese person have overwhelmed their natural "set point" weight readjusting it higher with:
1. High fat diet
2. Low fiber diet
3. Nutritional depleted food
4. High concentrated sugar diet
5. Excess total calories

Fat are the most calorie dense foods, 9 calories per gram compared to 6 for carbohydrates . One therefore can exceed the calorie threshold of thermogenesis easier with a high fat diet.

Sometime the body is deficient of essential nutrients and cry for more food in an effort to supply the lack. Vitamins and essential fatty acids are in this category.

The fast food industry has increase the size and calories of it product to attract customer. The customers desire to "get ones monies worth" come with a hidden price called obesity.

The Biochemistry of insulin yields some clues to obesity. Your brain, muscle and most other cells run on Glucose. Insulin's main function is to maintain a normal Blood Glucose (sugar) level by reducing the sugar in the blood.

Insulin causes glucose to be converted to fat and stored in fat cell.
Insulin prevents the conversion of fat to glucose.
Insulin signals the liver to make cholesterol.
It causes glucose, amino acids, and free fatty acids move into cells where potential energy is stored as fat and glycogen to be used later.
Glucose is the major stimulus for insulin secretion
It activated an enzyme, lipoprotein lipase, that promotes the removal of triglycerides from the bloodstream and their deposition in fat cells. Another word it promotes fat Storage.

Because of higher insulin levels and higher glucose load to the liver diabetics have significantly higher total cholesterol and triglycerides than the average population.

The consumption of refined sugar has been increasing from very little a 100 years ago to about 150 lbs. of refined sugar per person in U.S. per year.

Carbohydrates, starches/ white bread/white rice, can contrary to some commonly held beliefs, be digested and absorbed nearly as fast as the more simple carbohydrates, such as table sugar.

The Indians in the southwestern United States and the island people in the Pacific have the some of the highest incidence of diabetes in the world. Hybridized corn, white rice and table sugar are believed to be the cause, along with a heredity predisposition. Prior to the introduction of these refined carbohydrates to their diet, diabetes was rare.

The incidence of diabetes in the U.S. has nearly tripled since 1960. The average amount of fat in the diet has not risen. We cannot blame the rise in obesity on fat consumption.

Refined sugar and processed grain products, stripped of the coatings or husks, are almost immediately absorbed in a very concentrated fashion, resulting in rapid secretion of large quantities of insulin.

In fruits Fructose is the main sugar and stimulate approximately one third of the insulin secretion stimulated by glucose.

"Fructose supplementation in diabetes mellitus was advocated before insulin was discovered. Fructose elicits a lower glucose and insulin response in healthy individuals and in individuals with diabetes."² This is because fructose must be converted to Glucose to be utilized and this slows the rise in blood glucose levels in much the same way that fiber slows the absorption of sugars and prevents the insulin stimulating Sugar spikes.

Refined carbohydrates (sugar, white bread, white rice, process grains, cream of wheat, etc.) clog the system by causing excess insulin therefore excess fat deposition, excess cholesterol production.

For obesity treatment carbohydrate are to be reduced and fiber should be increased. Fructose in fruit is the preferred sugar.

What then shall we eat?
1. Food as grown unprocessed, non-hybridized, unrefined.
2. Avoid harmful fats. (Saturated, refined, fried or hydrogenated)

It is essential to exercise daily and increase baseline activity.

Unfortunately 95% of people that diet do not keep the weight off. A recent study was done on what did the 5% that were successful at keeping the weight off for 5 years or more had in common. They were:

Basic Nutrition

1. Oxygen
2. Water
3. Light
4. A source of energy (usually complex carbohydrates or sugar)
5-12. Eight amino acids (10 for children)
Isoleucine
Leucine
Lysine
Methionine
Phenylalanine
Threonine
Tryptophan
Valine
(Histidine- for children)
(Arginine- for children)
13+14. Two fatty acid
Alpha Linolenic Acid (LNA)
Linoleic Acid (LA)
15-27. Thirteen vitamins
The water soluble vitamins
Thiamine (B1)
Riboflavin (B2)
Niacin (B3)
Pantothenic Acid (B5)
Pyridoxine (B6)
Biotin (B7)
Folic Acid (B9)
Cobalamin (B12)
Vit C
The fat soluble vitamins
Vit A (Carotene)
Vit D
Vit E
Vit K
27-46 Twenty minerals
Calcium (Ca)
Phosphorus (P)
Potassium (K)
Sulphur (S)
Sodium (Na)
Chlorine (Cl)
Magnesium (Mg)
Silicon (Si)
Iron (Fe)
Zinc (Zn)
Copper (Cu)
Selenium
Manganese (Mn)
Iodine (I)
Nickel (Ni)
Molydenum (Mo)
Colbalt (Co)
Chromium (Cr)
Boron
Germanium (Ge)
47. Fiber
48. Friendly bacteria
Conclusion

There are at least 48 essential known element for life. These are listed in the column on the left. The underlined words are active, click them to advance to the topic.

Oxygen

Generally not a problem unless you smoke have lung disease or live in Houston. Deep breathing and exercise increase oxygen and vitality

. Water

Two and 1/2 Quart to 3 Quart per day for optimal health. Thirst a poor guide.

. Light

Sunlight is the source of all energy. Mostly we get the suns energy 2nd hand from plants. But optimal health required direct sunlight exposure to our skin on a nearly daily basis. 15 min per day of sun exposure to the hands and face is probable adequate.

A source of energy

The body runs on glucose (sugar). Carbohydrates (sugars and starches) are the cleanest sources of energy. Proteins and fats will convert to glucose but produce waist products (urea and ketones respectively). Carbohydrate come packaged with fiber, vitamins and phytochemical to prevent disease states. Refined carbohydrates are generally unhealthy.

Eight essential (not made by humans) amino acids (10 for children)

Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan, Valine, (Histidine- for children), (Arginine- for children). Amino acids are the building blocks of Protein. We have essential no protein deficiencies in the USA, unless the person is unable to eat.

. Two essential fatty acid

Alpha Linolenic Acid (LNA)
Linoleic Acid (LA)
These are frequently deficient in the western diet and deserve a more extensive discussion. Please see the discussion on Fats.

. Thirteen vitamins

Thiamine (B1), Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5), Pyridoxine (B6) Biotin (B7), Folic Acid (B9), Cobalamin (B12), Vit C, Vit A (Carotene), Vit D, Vit E,
Vit K.
Vitamins have been extensively studied so a few comments on each is in order.

The water soluble vitamins
Thiamine (B1)
It is a coenzyme (work with an enzyme in chemical reactions). Work in a least four different reactions in the extraction of energy form glucose and other sugars. Sugar without vitamins ( i.e refined) does not work well.
Sources - Unrefined cereals and grains. Also in beans, nuts and seeds.

Riboflavin (B2)
It is a coenzyme. It is needed in the digestion and metabolism of proteins and carbohydrates.
Sources- Unrefined cereals and grains. Also in brewers yeast, dark green vegetables such as spinach and broccoli.

Niacin (B3)
It is also a coenzyme. It is involved in the metabolism of fats and sugar. It part of an enzyme involve in the transport of oxygen.
Sources- Grains, dairy foods, avocados and meat.

Pantothenic Acid (B5)
It is another coenzyme. It is also involved in the metabolism of sugar. In addition it protects hemoglobin, muscle tissue and nerves. It help the immune system in it fight against infections.
Sources- Unrefined grains, beans. and meat.

Pyridoxine (B6)
It a compound that works with the enzymes that metabolize proteins and fats. It is important in the metabolism of Homocysteine. Homocysteine like cholesterol is a risk factor in coronary artery disease.
Sources-Brown rice, unrefined grains, beans, nuts, seeds and dark green vegetables.

Biotin (B7)
It is a component of the enzymes that transport carbon and oxygen between cells. It is needed for the synthesize of fatty acids and amino acids. It is required in the metabolism of sugars and fats.
Sources- Brewers yeast, nuts beans, eggs

Folic Acid (B9)
Important in the synthesis of DNA. Birth defects related to deficiency of Folate. Also needed in the metabolism of proteins and synthesis of amino acids. Deficiencies cause macrocytic anemia.
Sources- Fruits and vegetables. Also in beans, brewers yeast.

Cobalamin (B12)
Needed for red blood cell production and the myelin that covers your nerves. A deficiency will cause anemia, fatigue and/or neuropathy. Contains the mineral cobalt.
Is made by friendly bacteria in the small intestines.
Sources- Meat, fish, poultry, milk, eggs.

Vitamin C (Ascorbic acid)
A antioxidant that prevents free radical damage. Helps the immune system. Essential in the production of connective tissue. Promotes wound healing. Many body chemicals and hormone require vitamin C for synthesis.
Sources- Fruits and vegetables especially citrus, strawberries, peppers broccoli and tomatoes

The fat soluble vitamins
Vitamin A (Carotene)
It is needed for the growth of bones and teeth, the immune system, the retina in your eyes and the skin and mucous membranes. Carotenoids are chemical that are transformed into the actual vitamin A or retinoids. It is preferable to get vitamin A in the carotenoid form to prevent toxicity because of excess of the retinoids..
Sources- Yellow red and dark green fruits and vegetable are the preferred source the animal source contain mainly the retinoids.

Vitamin D
It is required to build bones and teeth. Come in three natural forms: Calciferol, cholecalciferol, and ergocalciferol.
Sources-Calcererol in fish (or fish oil), and eggs. Cholecalciferol is made in the skin when sunlight causes a chemical reaction with certain steroid compounds. Ergocalciferol is derived from plants.

Vitamin E
It is one of the antioxidant vitamins that help prevent unwanted damaging chemical reactions. Detoxifies free radicals. It prevents the formation of toxic product formation from polyunsaturated fatty acids (see fats).
Sources-Vegetable oil, nuts and seeds.

Vitamin K
It is a essential factor for blood clotting. It is also involved in bones and kidneys. It is manufactured by friendly bacteria in the intestines.
Sources- Dark green vegetables (chard, turnip greens, kale, lettuce, spinach, broccoli, and cabbage).

Twenty minerals

Calcium (Ca), Phosphorus (P), Potassium (K), Sulphur (S). Sodium (Na), Chlorine (Cl), Magnesium (Mg), Silicon (Si), Iron (Fe), Zinc (Zn), Copper (Cu), Selenium, Manganese (Mn), Iodine (I), Nickel (Ni), Molydenum (Mo), Colbalt (Co), Chromium (Cr), Boron
Mineral are essential for life. We will discuss these in brief.

Calcium (Ca)
Calcium is on of the most important and most misunderstood mineral in the human body is discussed in Calcium and Osteoporosis.
Deficiency signs- Fractures, poor teeth, aching joints, heart palpitations, hypertension, muscle cramps, nervousness, arthritis, tooth decay, depression, delusions, and hyperactivity.
Sources- Dark green vegetable, dairy products.

Phosphorus (P)
Phosphorus is in balance with calcium. Like calcium it is essential in bone formation. It is involved in regulation of the acid/ base balance. It is involve in the metabolism of carbohydrates, synthesis of proteins and transporting of fatty acids.
Deficiency signs- A rare problem except in alcoholism. Anxiety, bone problems, fatigue, irregular breathing, numbness, skin sensitivity, trembling, weakness, (similar to calcium deficiency).
Sources- Nearly all foods except alcohol and "Junk foods".

Potassium (K)
It is involved in the function of muscle tissue including the heart. It is needed for digestion and synthesize of carbohydrates and proteins.
Deficiency signs- Palpitation, edema, muscular fatigue, weakness, and nervousness.
Sources- Bananas, citrus and many other fruits

Sulphur (S)
It is involved in many important biochemical reactions. It is in hemoglobin which carries oxygen. It is needed in the synthesis of connective tissues.
Deficiency signs- Premature aging.
Sources- Brussels sprouts. beans, cabbage, eggs, meat, fish, onions, soybeans.

Sodium (Na)
It is one of the major mineral in the blood. Salt is Sodium-Chloride. It is involve in sending electrical message in the cell (an electrolyte). It is essential in many body process including digestion and pH balance of the blood.
Deficiency signs- Low blood pressure.
Sources- Table salt.

Chlorine (Cl)
It is the other half of salt. It is an electrolyte. It is part of hydrochloric acid, which helps digest food in the stomach.
Source- Table salt.

Magnesium (Mg)
Is part of the structure of bones. It is part of many enzymes. It is involved in the transport of nutrients into cells. Like the electrolytes it is involved in sending messages. It is important in DNA replication. The heart beat is irregular in deficiency.
Deficiency signs-Heart irregularity, fatigue, seizures, irritability and irritable bowel syndrome.
Sources- Dark green vegetables, bananas, seeds, nuts, beans and grains.

Silicon (Si)
It is necessary for bone and collagen formation. Silicon helps maintain flexible arteries thus preventing vascular damage. It may counteract the effects a Aluminum and have a role in preventing Alzheimer's disease.
Deficiency signs-Premature aging, vascular diseases.
Sources- Whole grains, beets, alfalfa, bell peppers, dark green vegetables and soybeans.

Iron (Fe)
It is part of the proteins that transport oxygen (hemoglobin and myoglobin). Many enzymes also contain iron.
Deficiency signs- Anemia, brittle or loss of hair, digestive disturbances, dizziness, fatigue, inflammation of the mouth, nails that are spoon shaped or have ridges, pallor and slowed mental reactions.
Sources- Raisins, nuts, seeds, whole grains, potato skins, meat, eggs.

Zinc (Zn)
It is needed for optimal immune function. It is need in manufacture of the male hormones testosterone. Zinc is need in the brain and nerve tissues.
Sources- Whole grains, nuts, seeds, beans, meat and eggs.

Copper (Cu)
It is part of certain enzymes that are antioxidants. Copper is needed in bones and nerve tissues. Organic copper compounds are essential for health, whereas metallic copper in significant amounts can be toxic.
Deficiency signs- Hair loss, diarrhea, general weakness, and skin sores.
Sources- Beans, nuts, seafood and meats (especially liver).

Selenium
Selenium protects the heart and strengthens the immune system, thereby reducing the risk of cancer.
Deficiency signs-Vascular diseases, infections, cancer, liver disease and digestive abnormalities.
Sources- Fruits and vegetable grown in selenium-rich soil. Also found in animal products.

Manganese (Mn)
It is part of some of the enzymes that metabolize carbohydrates and manufacture fats. It is needed in the bones, hormonal glands, reproductive system and cartilage.
Deficiency signs- Nerve and muscle disorders including irritability, memory loss and seizures. Hypertension.
Source- Whole grains and most fruits and vegetables.

Iodine (I)
Iodine is a essential component of the thyroid hormones.
Deficiency signs- Hypothyroidism, goiter, fatigue and weight gain.
Sources- Plants grown near the ocean. Seaweed and seafood. Iodine is frequently added to salt.

Nickel (Ni)
Nickel is involved in the transmission of the genetic code, DNA and RNA etc. It is present in the enzymes that metabolize sugar. Nickel is needed in the productions of the pituitary hormone prolactin.
Sources- Whole grains especially oats, vegetables, and some fruits (such as bananas and pears).

Molydenum (Mo)
Molydenum is required for optimal metabolism of proteins.
Deficiency signs- Mouth and gum disease, cancer, and impotence.
Sources- Beans and grains. Dependent on soil content of farm land.

Colbalt (Co)
f. Cobalt (Co): 1) Function - required as a nutrient for the microorganisms in ruminants. 2) Deficiency signs - lack of appetite, loss of weight, rough hair coat, and death in extreme cases. 3) Sources - legume forages and salt containing Colbalt

Chromium (Cr)
Necessary for the proper function of insulin. Only small amounts needed.
Deficiency signs- Fatigue, glucose intolerance or worsening diabetes, and vascular disease.
Sources- Broccoli, wheat germ, yeast and liver.

Boron
It is needed for parathyroid function thereby affects calcium, magnesium, and phosphorus balance. It is needed for proper bone formation.
Deficiency signs- Osteoporosis caused by poor calcium, magnesium, and phosphorus absorption from the intestines.
Sources- Fruits, leafy greens, legumes, and nuts.

Germanium (Ge)
Improves cellular oxygenation. Needed in the immune system. Needed in the process of detoxification.
Deficiency signs- Infections and cancer
Sources-Garlic, onions, aloe vera

. Fiber

Friendly bacteria

Conclusion

The 48 items can be condensted to 10
1. Oxygen
2. Water
3. Whole Grains (Rice, Corn, Wheat etc)
4. Dark Green Vegetables
5. Fruits Vegetables
6. Nuts and Seeds
7. Beans (legumes, soybeans, Tofu)
8. Garlic and Onions.
9. Sun Light
10. Friendly bacteria
*A Vitamin B12 supplement is currently advised in a strict vegetarian

Nationwide Food Consumption Survey estimated the following (highlights) :
Nutrient % who get less than the RDA
Calcium 68%
Magnesium 75%
Iron 57%
Vitamin B6 80%
Chromium 90%
Selenium 60%
Alpha Linolenic Acid (Omega 3) 95%

Over half the calories in the normal American diet comes from food from which much of the minerals, vitamins, essential fatty acids and fiber has been removed.
Polished rice has lost between 26 and 83% of each mineral present in brown rice.
White bread has lost between 20 and 95% of the minerals and vitamins of whole wheat bread.
Sugar has lost nearly all the vitamins and minerals of raw sugar.
Skim milk has lost all its manganese, selenium and fat soluble vitamin.
Refined oil has lost most of the minerals, fiber and vitamins.

BREAKFAST: Choose two (2) foods from the GRAIN category
choose one (1) food from the FAT category
choose two (2) foods from the FRUIT category

LUNCH: Choose two (2) foods from the VEGETABLE category
choose one (1) food from the RAW FOOD category
choose one (1) food from the GRAIN category
choose one (1) food from the FAT category
choose one (1) item from the THERAPEUTIC category (as per order)

DINNER: Choose two (2) foods from the FRUIT category
choose one (1) food from the GRAIN category
choose one (1) food from the FAT category

ADDITIONAL-DIRECTIONS: ____________________________________________________________________________________________

The "couch potato syndrome" has become epidemic. 70% of the adults are sedentary or under active, and nearly half of America's youth (aged 12-21 years) are not involve in any regular physical exercise. Obesity has increased by 57% in US adults from 1991 to 1999. More than 60% of American adults and 25% of American Youth are overweight or obese. The majority of overweight children have one or more cardiovascular risk factor's (such as elevated cholesterol, elevated blood pressure, or increased triglycerides).

Have the Physicians and Health educator in the USA failed to adequately prescribe and recommend exercise? What about the fast food industry that encourages a high fat, high sugar diet? What about our schools have they failed in encourage exercise to those at risk? Have the parents that let the kids vegetate in front of the TV or Internet? Yes these are all true. We must do better.

Many people with chronic health problems have felt that they are not able to exercise. The evidence is just the opposite; those with chronic health problems will benefit the most by exercise. Surprisingly, a recent medical study comparing exercise to rest for patients with severe congestive heart failure and found that the exercise group had a better outcome.

With few if any exceptions, every person with a chronic stable medical condition will benefit from exercise.

It is well recognized that exercise is of primary importance in the treatment plan of diabetes, obesity, hypertension and low back pain.

Supervised rehabilitation exercise program are available in many hospitals for post Myocardial infarction patients and chronic lung diseases (asthma, emphysema and others). Pulmonary rehab exercise programs improves heart and lung fitness without changing lung function.

Diabetic eye disease

Kidney disease

Skin diseases

Lifestyle factors

Naturopathic treatments of Diabetes Mellitus

Herbal Medicines

Classification

Examples

Classification

Examples

Effectiveness