The Diabetes Reset: An Interview With Diabetes Expert George L. King, MD

In his recently published book, The Diabetes Reset, George L. King, MD, Research Director and Chief Science Officer at the Joslin Diabetes Center and professor of medicine at the Harvard Medical School, outlines eight simple, specific lifestyle steps you can take to prevent, control or possibly even reverse type 2 diabetes. We interviewed King to find out how and why he developed this program, and what it can do for anyone who is insulin resistant, pre-diabetic or has been diagnosed with diabetes.

QH: Your reset program features a Rural Asian Diet (RAD) plan. Is this a diet based on Asian food?

Dr. King: Not necessarily. The idea is to mimic the nutritional mix of food types that make up the rural, or traditional, diets of China, India, Thailand and other Asian nations. That means mostly plant foods with small amounts of meat and fat. It can be any ethnicity, as long as the food group proportions are similar.

QH: The RAD diet is 70% carbohydrates, and 15% each fat and protein. It is very high in carbohydrates, which is a radical change from the traditional diabetic diet, which is much lower in carbs. How is a high-carb diet good for someone who is developing or has diabetes?

Dr. King: First of all, not all carbs are bad for diabetics, or anyone else. You have to distinguish between complex carbs and simple carbs. Simple carbs are foods that are low in fiber and high in added sugar and white flour that’s been stripped of its bran. Many processed foods fall into the simple carb category. Those are “bad” carbs, which should be eaten in only very minimal amounts, if at all. I’m talking about complex carbs—whole grains, legumes, vegetables, and fruits—that are high in fiber and key to this diet plan. Many studies suggest that a high fiber/high complex carb diet is the healthiest diet you can eat and, in scientific studies, this type of diet has been strongly linked to better glucose (sugar) metabolism and lower risk of diabetes.

QH: One of your strategies for patients is to increase the activity of brown fat in their bodies. What is brown fat and what does it mean to increase its activity?

Dr. King: Brown fat is metabolically active, meaning that, unlike regular white body fat, its function is to burn calories and generate heat for the body. It may also play a role in glucose control. Most people have small pockets of brown fat that are activated by exposure to cold, among other things. There is no hard science yet that associates diet with brown fat activity, but there is evidence to suggest that a high complex carb, low-fat diet may give it a boost. Exercise helps convert regular body fat into a type of “beige” fat, which is also more metabolically active than white fat.

QH: Although you point out that no pill can provide the nutrients and other essential substances found in whole fruits, veggies and grains, you also give natural supplements, such as fish or flaxseed oil for inflammation; sylmarin (contained in the herb milk thistle) to boost the activity of antioxidant vitamins found in food; and GABA (gamma-aminobutyric acid, a natural sleep enhancer), a place in the RAD diet. Can we depend on supplements to get what we need?

Dr. King: In an ideal world, everyone would eat whole foods and live natural lives all of the time, but that’s just not practical for most people these days. That’s where supplements can help. Some supplements can fill nutritional gaps in the diet, activate brown fat in the body, help ensure a better night’s sleep, fight inflammation and supply nutrients that are difficult to get from food. For instance, it is difficult to get enough vitamin D from the diet [the Recommended Dietary Allowance, or RDA, for vitamin D is 600 international units for most people ages 14-70] so supplements can be helpful, especially for people not exposed to a lot of sunlight, such as those living in cold climates or shut-in living conditions. All of these are important for controlling diabetes. Since supplements can act like drugs and, in some cases, interfere with the action of other nutrients, or with prescribed medications, patients should always discuss their supplement regimens with their physicians.

QH: Your twelve-week plan is comprehensive—it includes healthy eating, various types of exercise, losing weight if necessary, fighting inflammation, getting the right amount of sleep, de-stressing, and activating brown fat in your body. Change is hard for most people, and trying to make multiple lifestyle changes at once can be overwhelming. What do you suggest to your patients?

Dr. King: I definitely suggest a gradual, step-by-step approach and, just as importantly, I point out that it isn’t necessary to make drastic changes. For instance, if you’re not exercising at all, walking is a great start. My family has a history of type 2 diabetes and my father was taking multiple medications before I put him on this plan. When it came to exercise we just got him to do some moderate speed walking every day. After a year and half, he was off his medications, and he stayed off for twelve years. I was pre-diabetic myself, but no longer, because I follow this plan to the best of my ability. It’s a very individual thing; one person may need to focus a little more on exercise and sleep, while another may be getting regular exercise and need to focus first on diet and stress reduction.

George L. King, MD, reviewed this article.

Sources

King, George L. Phone interview February 25, 2015 and e-mail message to author March 5, 2015.

King, George L. The Diabetes Reset. New York: Workman Publishing, 2014.

"How Does Fiber Affect Blood Glucose Levels?" Joslin Diabetes Center. Accessed March 4, 2015.