even more about diabetes (binder)

8/8/2019 Even More About Diabetes (Binder)

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MoreontheRightAttitude: SurvivingtheHolidayswhenYouHaveDiabetes: TopTenTipsfromLCA

One thing thats certain in our society is that every year, right around the time we are most

sedentary, the holiday season will come with all its attendant snacks, feasts, and stresses. As

children, many of us looked forward to the holiday season of fun, gifts, and treats with eager

anticipation. And even as adults it can still be a wonderful experience. But for some it can be a

sad and lonely time of the year. A number of factors can contribute to such feelings, including

increased financial stress, fatigue, recent personal loss, unrealistic expectations, inability to be

with family, memories of past holiday celebrations, change in diet, and change in daily routines.

These symptoms are almost identical to clinical depression: loss of interest in activities you

usually find pleasurable; unintentional weight loss or weight gain; inability to sleep, or sleeping

too much; feelings of worthlessness or inappropriate guilt; and a diminished ability to

concentrate. Doesnt sound like a very Merry Christmas, Happy Hanukkah or Good Kwanzaa.

If you struggle with the holiday blues there are some things that you can do, and ways

you can think, to alleviate some self-inflicted suffering:

1. Denial is not a river in Egypt. Try not to fall into thinking, Ill worry about my healthgoals after the holidays. As weve all experienced, the holidays can easily run

continuously from the Jewish holidays or Thanksgiving, through Christmas, Hanukkah

and Kwanzaa, and on through New Years (and some go even further through the

Superbowl! Why not just continue the season to St. Patricks Day while were at it?). If

your goal is overcoming insulin resistance, weight loss, maintaining your healthy weight,


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or keeping your blood sugars down, youre going to have to continue to monitor your

progressand follow your program of eating right and staying physically active, even

through the holidays.

2. Pencil it in. Stick to your usual schedule during the holidaysi. To the extent that youcan, dont mess up your usual routine (e.g. IT six days a week, etc.), which might allow

you permission to stray from your goals.

3. Weigh to go. A recent study in theNew England Journal of Medicineii found that dailyweighing was the key to keeping weight off. The study found that those who weighed

themselves every day were 82 percent less likely to regain weight they had lost. The

main factor here is not the weighing alone Hey, look, I gained another five pounds!

Pass the rum balls! but your willingness to make daily adjustments based on what the

scale tells. We encourage you to weigh yourself daily, even over the holidays, and use

this information to motivate you to go for an extra stroll, refrain from quite so much

snacking, and limit your portion sizes, especially during the evening meal. If, like many

people, you dont believe in daily weighing, consider weighing yourself weekly, at least,

and make adjustments accordingly.

4. Leave leftovers. We suggest you limit celebrations to one-day eventsand whatever youdo, dont keep leftovers around! Give food away, send it home with someone else, and if

you have to, dont be afraid to dump it. Remember: all excess food goes to either to

waste or to waist. You decide which. Studies show that the more side dishes and

little bowls of leftovers you bring out of the refrigerator, the more you will eatiii. Your

eating the extra food or keeping it temptingly around wont help a starving child

anywhere.


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5. Set limits. Before the celebration, determine what youre going to eat, and how much. Alot of problems come simply because we dont think before we act. The day of the

celebration, adjust your meals accordingly. For example, if you know youre going to a

house party at 4 p.m., eat a large, healthy, fiber-filled lunch at home at 2. Thats right:

break your mothers old rule and deliberately spoil your appetitewith good food.

Whenever possible, try to eat your main meal at lunchtime instead of suppertime. A

great way to ensure this happens at holiday time is to start hosting the parties yourself.

This way you can control the kinds of foods you eat and the time you eat them, as well as

introducing your loved ones to the wonders of the PBD. Well have some special holiday

recipes in the upcoming LCA cookbook, The 30 Day Diabetes Miracle Cookbook

coming out later this year from Perigee. You can also try keeping a journal of what you

eat and how much. Monitoring your behavior is a proven way of changing your behavior

positivelyivv. If youre planning to eat some sweets, make the portions as small as

possible, and load up on the good stuff (Sid Lloyd, the CEO of LCAs parent foundation

likes to say, That veggie platter at the end of the buffet is ALL FOR YOU!)

6. Keep it real. Keepyour expectations high, as we tend to rise to the level of our ownexpectations. But dontexpect that you mustbe perfect. Setting your specific

expectations too high (saying on Christmas day, Im going to lose five pounds before

New Years) can cause undue stress and anxiety.

7. Walk it off. Go for a stroll before andafter the celebration: keep up your physicalActivity Program. Burn those calories you intend to eat or youve just eaten.

8. USA! USA! Dont forget Unconditional Self-Acceptance. If you blow it, dont getdown on yourself. Acknowledge the mistake and move on. Get back on the scale the


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next morning, continue to monitor your blood sugars, and make the necessary

adjustments. As they say in the recovery business, dont let a lapse turn into a relapse.

9. Change it up. Create new, healthful holiday traditions. Sometimes hanging onto the pastcan trigger memories that contribute to a depressive moodvi. Certainly hanging onto past

holiday eating habits can sabotage your health plan.

10.Have fun. Remember the motivation triad? We are all motivated to seek pleasure andavoid pain, with as little energy output as possible. During the holidays, as ever, focus on

pleasure rather than pain. Focus on what you are getting by your new lifestyle (health,

vitality, strength, pride, longer life) and what gives you pleasure (gift-giving, family,

home and hearth)rather than on what you are giving up (pie, cookies, ham). If you

feel like you have to give something up, you will feel deprived. If you focus on what

youre getting and what youve got, you will find pleasure.

iCounseling Today, December, 2000.ii Wing RR, Tate DF, Gorin AA et al. A Self-Regulation Program for Maintenance of Weight Loss. NEJM. 2006,

33(15):1563-1571.iii Wansink, Brian.Mindless Eating. New York: Bantam Books, 2006, 76. This idea reminds us of an old

Lockhorns comic strip by Bunny Hoest and John Reiner (King Features Syndicate): Leroy looks up from his

dinner plate and asks Loretta, This side dish whose side is it on?ivKlemML,WingRR,McGuireMT,etal.Adescriptivestudyofindividualssuccessfulatlongtermmaintenanceof

substantialweightloss.AmJClinNutr.1997,66:239246.vBandini LG, Schoeller DA, Cyr HN, Dietz WH. Validity of reported energy intake in obese and nonobese

adolescents.Am J Clin Nutr. 1990,52:421-425.vi Counseling Today Dec 2000.


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AHistoryofVegetarianismNotwithstanding all our doom-saying about the Standard American Diet (SAD), the majority of

the worlds population is more vegetarian than not. Most indigenous cultures have historically

based their diets on plant foods, and those that ate meat tended to use it either as a condiment

(a very small side dish) or as a feast food for special celebrations, rather than a staple article of

the daily diet. Of course, most of the worlds vegetarians are not doing so by choice alone. Meat

is expensive, in more ways than one, especially for native peoples living off the land. In

addition, there are various religious and cultural constraints against the daily consumption of

meat.

The majority of Americans, on the other hand, are omnivores. We eat animal- andplant-

based foods. Its interesting that there are probably far fewer strict carnivores than strict

vegetarians in the world. Having said that, American omnivores orientation to food is very

much animal-based. Consider the typical answer to a common question, Whats for dinner?

The answer is usually something that had a face and a mother (Brisket, Steak, Chicken,

Pork chops, or Fish, for example), and the plant food is considered the sad little side dish. A

vegetarian, by contrast, finds it hard to give a one-word answer to the question, Whats for

dinner? because dinner has a lot more variety.

In the Western world, people tend to be vegetarians by choice. It would have to be a

choice, so strong are the cultural and economic incentives to subscribe to the SAD.

Just how many vegetarians are there out there? Thats harder to track than you might think.


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First, a little bit of history. The Greek philosopher and mathematician Pythagoras (yeah,

the triangle guy) is considered the granddaddy of vegetarianism. His cronies like Socrates, Plato,

and Virgil, were similarly inclined. For thousands of years, health, ethics, and piety were all

cited as rationales for deliberately not eating animal productsi.

The vegetarian movement did not take hold in American until the 1800s, where at first it

was largely church-related. Many Christians proposed that Adam and Eve were vegetarian; it

was the diet God intended. The Seventh-Day Adventist Church (SDA), co-founded by Ellen G.

White in the mid-19th Century, was a principle proponent of a plant-based diet, mainly for health

reasons. Mrs. White writes, Grains, fruits, nuts, and vegetables constitute the diet chosen for us

by our Creator. These foods prepared in as simple and natural a manner as possible, are the most

healthful and nourishingii. About 40 percent of todays SDA members are still vegetarian. As a

result, their health and longevity have been studied in great detail. Well talk more about that

later, but suffice to say, theyre in better shape than the general population.

Toward the middle of the 20th Century, protein was all the rage (and protein meant

meat to most people). Vitamins had recently been discovered, and they, too, were associated

with animal foods. Despite all that, a 1943 Gallup poll showed somewhere between 2.5 and

three million Americans, or two percent of the population, still identified themselves as

vegetarianiii. In 1944, the word vegan (pronounced vee-gun) was coined in England by

individuals who had become frustrated over the fact that vegetarians commonly consumed dairy

products. Vegan is derived from the first three and last two letters of the word vegetarian.

True vegans consume no animal products at all, whereas many people who call themselves

vegetarians eat dairy, eggs, and sometimes fish.


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The numbers of vegetarians steadily increased, especially during the health-conscious

counterculture in the 1960s and 1970s. Then the number of vegetarians in the U.S. doubled

between 1985 and 1992, when a Gallup polliv revealed that 12 million adults considered

themselves vegetarianv. The Vegetarian Resource Group conducted its own poll in 2000, and

discovered that about 4.8 million adults, or about 2.5 percent of the U.S. population, was

vegetarianvi. In a 2002 Time/CNN Harris Interactive survey, four percent of Americans polled

called themselves vegetariansvii. In 2003, another study showed that number of U.S. vegetarians

at around 2.8 percentviii. It seems safe to say that somewhere about 3 percent of Americans

generally dont eat meat. Its interesting to note, though, that upwards of 10 percent of

Americans call themselves vegetarian.

This indicates to us that a great number of people are leaning in a vegetarian direction.

You can now order a Veggie Burger at Burger Kingix, and similar vegetarian and vegan items

from most fast food and family style sit-down restaurants. Target, Wal-Mart, and nearly all

major grocery chains carry multiple products targeted to vegetarians. Health food stores and

natural markets are thriving. Soy milk has its own section in all the chain stores, and even Mom

and Pop stores sell it now. You can get vegetarian meals at Camden Yards and Comiskey Park:

in fact, more than half of all Major League ball parks now serve vegetarian burgers, veggie dogs,

or other non-meat main course optionsx. College and university food service managers report

that up to 40 percent of students request vegetarian food options. Many traditional Mexican

restaurants even those in the American heartland now serve refried beans made without lard.

On a recent visit to New York City, home of famous steak houses, eight-inch-high deli


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sandwiches, and hot dog vendors, we found one of the citys several vegan restaurantsxi packed

at 9 p.m. on a Wednesday night.

USA Today reported in 2004 that the vegetarian food industry was positively booming.

Total U.S. retail sales of vegetarian foods, including soy milk and other dairy alternatives had

been $730 million in 1998. By 2003, it had doubled to $1.6 billionxii. Despite the alarming

statistics we quoted about the SAD in chapter 2, the tide is turning toward healthier, more natural

foods. And that, as Martha Stewart would say, is a good thing.

Its not all whippersnappers embracing this vegetarian lifestyle, either. A 1992 pollxiii

showed that vegetarianism is not restricted to the young. More than 55 percent of self-identified

vegetarians in the U.S. were over age 40. This resurgence of interest since the 1980s and 90s is

mainly health-related, surveys show (plus we think the association vegetarianism used to have

with fringe and hippie cultures is largely gone in fact, it is possible those old hippies are

now CEOs of companies that are producing many vegetarian products!).

Why Plant-Based and Not Vegan?

Because weve bandied a few words around in this chapter, we want to clarify here what we

mean by plant-based diet. When we advocate a plant-based diet (PBD), we mean to say we

believe the best chance you have to combat diabetes and other diseases is to base as much of

your diet as possible on plant foods, and to eliminate or at least extremely restrict your intake of

animal foods, including beef, poultry, pork, fish, eggs and dairy. While this is by and large what


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many would consider a vegan diet, we dont generally use the term vegan at LCA for a few

reasons:

To some people, the term vegan means a total lifestyle of eliminating everything fromlife that is derived from an animal source. This not only includes animal products in

the diet, but also animal products used for clothing or any other purpose.

Some also associate the word vegan with certain political and social movementsthat are considered by many as extreme in nature.

Our purpose for recommending a total plant-based diet is strictly to improve yourhealth. Our philosophy is not based on any other ethical, political, or social reasons.

While we strongly recommend you follow a strict plant-based diet (in other words,vegan diet) to get the maximum health benefits, the term and concept of plant-

based allows for occasional flexibility. As T. Colin Campbell puts it, you should try

to avoid all animal products if you want to maximize your healthbut you shouldnt

obsessxiv

. Our intention in this book is to show you the evidence behind the

benefits of a plant-based diet on conquering diabetes, but then let you decide the

extent to which you want to follow that advice. If you really like a particular soup at

your favorite Thai restaurant, but you find out theres some fish in the stockyou

dont have to feel guilty for eating it. The amount of fish youd be eating is

nutritionally insignificant.

Even though we dont generally use the term vegan at LCA to describe ourselves,

others are more likely to use the term vegan than plant-based. When you are seeking

restaurants or menu items to order, shopping for various packaged foods and cooking


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ingredients, looking for dietary supplements, or buying cookbooks, youre nutritionally safe

when you trust the word vegan.

i Spencer, Colin. The Heretics Feast: A History of Vegetarianism. Havover, NH: University Press of NewEngland, 1995ii White EG. Diet and Health. In The Ministry of Healing. Altamont, TN: Harvestime Books, 1999, 194.iii Gallup poll #302 9/14/1943.iv Shelly Hankelovich and White/Clancy. The American Vegetarian: Coming of Age in the 1990s. A Study of theVegetarian Marketplace Conducted for the Vegetarian Times. Shulman, Inc., 1992.v Virginia Messina, Reed Mangels and Mark Messina. The Dieticians Guide to Vegetarian Diets Second Ed.Jones and Bartlett Publishers, 2004, 5.vi Vegetarian Resource Group (VRG) Zogby poll.

vii How Many Vegetarians Are There? A 2003 National Harris Interactive Survey Question Sponsored by theVegetarian Resource Group. Press Release July 1, 2003.viii Vegetarian Resource Group (VRG).ix How Many Vegetarians Are There? A 2003 National Harris Interactive Survey Question Sponsored by theVegetarian Resource Group. Press Release July 1, 2003.x Vegetarian and Vegan Foods at Major League Ball Parks. The Vegetarian Resource Group. Press Release, June1, 1999.xi Candle 79 on 79th Street and Lexington Ave. is the upscale second location of the longstanding Candle Caf, afew blocks south. The food is fantastic at both.xiiUSA Today. February 2004.xiii Shelly Yankelovich and White/Clancy. The American Vegetarian: Coming of Age in the 1990s. A Study of theVegetarian Marketplace Conducted for the Vegetarian Times. Shulman Inc., 1992, 242.xiv Campbell, T. Colin. The China Study. Dallas: BenBella Books, 2004, 242.


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Lies, damn lies, and advertising

Whats driving our constant, restless quest to be driven? Look no further than Madison Avenue.

Everything the advertising industry puts in front of us is deliberately More and Better that

the stuff we presently have. ItsBetterHomes & Gardens, after allnot So-so Homes &

Gardens Kinda Like Yours. The goal is to make you feel less satisfied. Less privileged.

Lesser.

Sid Lloyd, the CEO of LCAs parent foundation, puts it this way:

Ever gone through a model home? Theres no punch list on those babies. Everything is

immaculate, ergonomic, high-tech, and reeks ofquality. In the big, beautiful kitchen, theres the

requisite massive stainless steel fridge and Sub-Zero freezer. There are two ovens in many new

kitchens now. Just one oven? some prospective homebuyers must be saying, But how will I

cooktwo turkeys at once? The gas grills are enormous. The skylight is gorgeous. But theres

what youve been waiting for, right in the middle: an island (cue the opera music and heavenly

lights). Is that Dupont Corian in Winter Wheat? No. Its Italian marble. Built-in vegetable

sink. Oh, the things you could do with an island.

You could really use an island.

You needan island.

You deserve an island.

More. Better. Now.


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Of course you dont really needit. Youve just been looking at something designed to

make you feel unhappy with what youve already got. If you flip this process around and visit an

average home on Haiti or in Micronesia, youd probably be very thankful for the kitchen youve

got, even without the marble island. When youre wiping the scum off the pond to get your

drinking water, a bottle of Perrier would look like gold.

There are four basic lies that advertisers and marketers tell us about More and Better,

and recognizing them is a key to overcoming the forces coercing us to poor health.

Big Lie Number One is You Can Have It All! Really? Where would you put it?You know, we have the largest houses in history, per capita, by square footagei.

Yet one of the fastest growing industries is storage. So were working endless

hours to get more stuff, or to pay off the stuff weve already got, and meantime,

we have neither the time nor the space to enjoy or even use the stuff weve got.

And ironically, the most important stuff we have, our bodies, our health, is

usually the last thing on our list to take care of.

Big Lie Number Two is You Can Do It All! Yachting to Australia. Getting thatbig promotion.. Counseling the homeless. Working on that back swing.

Spending more time with your kids. Losing weight. Granted, were much more

productive than at any point in human history. But we must be intelligent,

thoughtful, and balancedabout where we spend the limited resource of time.

Listen to time and motion expert, Brian Tracy, who reminds us that time is

inelastic, inflexible, irreplaceable, perishable, and equitableii. How do you figure

out how to spend your time? How do you choose from all those competing things


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you could do? How can you find the time to take care of yourself amid all the

rival obligations you have? Well, first, you must figure out what matters to you,

what brings you a sense of peace, success, and fulfillment. In short, what you

value. When it comes to your health, you must truly value it, or you will not find

the time to give it any attention.

Even in our hyper-busy culture, people who claim they have no time to

get active (or to prepare healthful meals, check their blood sugar, go to the doctor

regularly, food-shop more carefully, or read labels) are telling themselves and the

world a big lie, or what social psychologists call a fundamental attribution error.

Its not that you dont have enough time. Youre just spending that time on

something else. We spend our time according to what we value. Bet youd value

your life and health more and re-allocate your time correspondingly if you had

a massive heart attack, or went into a diabetic coma from high blood sugar ten

minutes from now. Suddenly your health would rise up your list of priorities,

wouldnt it?

Time management expert and inspirational speaker Stephen Covey calls

this the difference between doing things that are truly important and things that

are merely urgentiii. Important and urgent are not synonymous. Urgent simply

means it seems like it must be done now. A ringing phone is urgentbut seldom

is important. We spend most of our time on these urgent things, on putting out

fires. And as a result, we ignore the important stuff, the stuff that really matters.

Making time for meditation and inspiration. Eating right. Getting active.


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Sleeping properly. Drinking lots of water. Getting enough sunlight. Sadly, such

things seldom seem urgentuntil its too late, that is, or at least almost too late.

Instead you have to decide to concentrate on the important stuff. You

have to decide today that your health matters. That feeling good again matters.

Instead of staying late slumped at your desk tonight, eating greasy junk food

because of an urgent issue at work, consider making a different choice.

Concentrate on what really matters, whats important, what you value. How

about notdying of diabetes so you can stick around to spend time with and

support your family? How about having fun and weathering the hard times

together with good friends? Even we workaholics can adjust our thinking without

giving up our devotion to the office. How about extending and expanding your

career contribution by living longerwith more energy, enthusiasm, and clarity?

No time, you say? To take care of yourself? To feel good? To live? Dont

live the lie anymore. Choose differently. This principle is pretty obvious, of

course, but the vast majority of people dont practice it.

Big Lie Number Three is You Deserve it All! No, you dont. None of usdeserves a big screen TV and a stable of thoroughbreds any more than someone

else. But if we dont get those things, we feel like victims. If we dont get them,

we feel deprived, diminished. Look, that guys got a boat! Why shouldnt I have

a boat? And when we dont get the boat, we settle for a large bowl of ice cream

with sprinkles and chocolate syrup, until the hunger hits us again tomorrow.


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i Easterbrook, Gregg. The Progress Paraxox. New York: Random House, 2003, 18.ii

Tracy, Brian. How to Master Your Time. Audio program. Nightingale-Conant, 2003.iii

Covey, Stephen R. The 7 Habits of Highly Effective People. Free Press, 1990, 150.


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More on Microorganisms: Microbial and Mooing Menaces

We wrote in The 30-Day Diabetes Miracle about the dawn of the domestication of animals

beginning a new era in chronic diseases such as diabetes. But with this revolution came a whole

other nightmare. Health psychologist Douglas Lisle uses a nasty little term for it:

Micropredatorsi.

If you think as many modern scientists do, you can extend the scenario and directly

blame animal foods mainly the fat, protein, and concentrated calories for pretty much all of

our most serious problems. For example, there are dozens of strong studies supporting the idea

that early introduction of cows milk protein wreaks havoc on Baby Laypersonrrys body: the

pancreas treats the animal protein molecules as microscopic poison and calls on the immune

system to shoot to kill, often destroying its own insulin-producing beta-cells along the way, and

dramatically increasing Larrys chance of developing Type-1 diabetes as a childiiiii

iv

vvi

.

Who knows what further problems well create in the future by genetically modifying food, and

even by cloning food? Just after Christmas, 2006, the U.S. government declared that food fromcloned animals is safe to eat, and probably wont even require special labels by the Food and

Drug Administration. Heres a fun quote from the FDA that you can hang your health hat on:

Cloned livestock is virtually indistinguishable from conventional livestockvii

. You have tolove that word virtually. Sounds like the beginning of a Michael Crichton sci-fi movie to us.

Even if cloned animals are completely indistinguishable from conventional livestock, they would

still not make for an ideal diet for people with diabetes. We havell addressed more dangers ofeating animals in chapter 2.


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i Douglas Lisle and Alan Goldhamer. The Pleasure Trap. Summertown TN: Healthy Living Publications, 2003.

46.ii

Gerstein HC. Cows milk exposure and Type 1 diabetes mellitus: A critical overview of the clinical literature.

Diabetes Care. 1994, 17:13-19.iii Scott FW. Cow milk and insulin-dependent diabetes mellitus: is there a relationship?Am J Clin Nutr. 1990,

51;489-491.iv

Karjalainen J, Martin JM, Knip M et al. A bovine albumin peptide as a possible trigger of insulin-dependent

Diabetes Mellitus. NEJM. 1992, 327:302-307.v Akerblom HK and Knip M. Putative environmental factors and Type 1 diabetesDiabetes/Metabolism Revs.

1998, 14:31-67.vi Naik RG and Palmer JP. Preservation of beta-cell function in Type 1 diabetes. Diabetes Rev. 1999, 7: 154-

182.vii See: U.S. Food and Drug Administration Center for Veterinary Medicine. Food Consumption Risks 2007 and

USFDA FDA News press release, FDA Issues Draft Documents on the Safety of Animal Clones, Dec 28, 2006.

The Associated Press stories about this report ran on Dec. 29, 2006.


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More on Animal-Borne Diseases: Mad Cow

Theres another sinister disease transmissible to humans from animalsbovine spongiform

encephalopathy (BSE), more commonly known as mad cow disease. This disease is 100

percent fatal. It is has been shown to be transmissible from cows to a number of different animal

species, including humans. The incubation period for the disease ranges from two and a half to

eight years in cows, during which time they will show no evidence of the diseasei. This is

troublesome, because a typical beef cow is taken to market between 14 and 20 months of ageii

.

They may show no signs of illness, yet they could still harbor the disease and transmit it to the

consumer. The agent responsible for the disease is not destroyed by temperatures used for

cooking meat, so thorough cooking will not offer protection.

And its not just beef that poses a risk. Mad cow-like illnesses have been observed in

deer, elk, goats, and pigs

iii

. Theres a concern that fish, too, might be affected

iv

, especially

farmed fish given feed made with contaminated meat and bone meal. It remains legal in the U.S.

to place renderings from cows into the feed of chickens, pigs, fish, and household pets.

Likewise, it is permissible to place renderings of these animals into cow feed. This can result in

animals infecting each other in a roundabout fashion. Currently the U.S. tests for mad cow

disease in only one in 2,000 cows that are slaughtered: in fact, as amazing as it sounds, the

USDA has stopped private ranchers from testing their herds voluntarily and at their own

expensev!


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iBovine Spongioform Encephalopathy Mad Cow Disease Fact Sheet, USDA Food Safety and Inspection

Service.ii Ritchie HD,A review of applied beef cattle nutrition, Michigan State University Extension Beef Bulletins Jan 1,

1994.iii NeuroCenter, University of Bern, Switzerland. http://www.neurocenter-bern.ch/tse_e.shtml.iv News in Brief. The Lancet. 2003, 361.v McNeil, Donald G., Jr. U.S. Wont Let Company Test All Its Cattle for Mad Cow. New York Times. April 10,

2004.


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More on Caffeine and Diabetes-Could coffee be for you after all?

Everything we say about caffeine in The 30-Day Diabetes Miracle seems to imply that caffeine

makes diabetes worse, right?

Thats true, but only in the short-term, and only with high doses of caffeine. Other recent

studies suggest that there might be other substances in coffee besides caffeine

(trimethylxanthine, for one), which actually might help certain aspects of diabetesiii. One large

study in Finland (which has the highest per-capita coffee consumption in the worldiii) shows

long-term caffeine consumption is actually associated with a statistically significant lowerrisk

for Type-2 diabetesiv

. But we dont recommend using coffee as a way to moderate diabetes.

Besides increasing blood pressure and cholesterol, caffeine has other adverse effects. Caffeine is

an addictive substance, specifically a central nervous system stimulant in the same general

family as cocaine and methamphetamine. It keeps nerve fibers firing when they would otherwise

be quiet. This artificial overstimulation interrupts the natural sleep cycle, which is a bad thing,

especially if youre trying to lose weightv. Caffeine interferes with our ability to slow down

when we do eventually have time for reflection and meditation. Its been our clinical experience

that the coffee jitters can increase appetite, causing you to snack more.


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i Salazar-Martinez E, Willett WC, et.al. Coffee consumption and risk for type 2 diabetes mellitusAnn Intern Med.

2004, 140(1):1-8.ii

Van Dam RM, Reskens EF. Coffee consumption and risk of type 2 diabetes mellitus. TheLancet2002,

360:1477-1478.iii World Resources Institute. Earth trends data tables: energy and resources. Agriculture and Food Resource

Consumption: Coffee consumption per capita. http://earthtrends.wri.org/text/pdfs/data_tables/ene4_2003.pdf.iv

In this study, those who had seven or more cups of coffee a day were 34 percent less likely to develop diabetes

than drinkers of two or fewer cups a day. See: Tuomilehto J, Hu G, Bidel S, et al. Coffee Consumption and Risk

of Type 2 Diabetes Mellitus Among Middle-aged Finnish Men and Women.JAMA. 2004, 291(10):1213-1219.

Other population studies show that drinking five to six cups of coffee a day reduces diabetes risk by 61 percent for

women and 30 percent for men, and drinking 10 or more cups of coffee per day reduces diabetes risk by 79 percent

in women and 55 percent in men, regardless of age, weight, alcohol, or tobacco use. See: Nuovo, Jim. Type 2

Diabetes, in Chronic Disease Managementedited by Jim Nuovo. New York: Springer, 2007, 181v

Van Cauter E, et. al. Impact of sleep and sleep loss on neuroendocrine and metabolic function. Horm Res. 2007,

67 Suppl 1:2-9.


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MoreOnHowToUseCognitiveBehaviorStrategiesToMakeandMaintainMajorLifeStyleChange:(TheCaseStudyofNancy)

Our patient Nancys story provides just one simple example of how this kind of thinking

can help you.

Nancy came to LCA for much the same reason most people do. She was almost without

hope, and she told us we were her last shot. Its not infrequent that we hear this. Every

three weeks, we pick people up at the airports in Oklahoma City or Dallas, and many are

in bad shape: wheelchairs or walkers, some barely able to see us because of retinopathy

caused by sustained high blood sugar. Well, its fair to say Nancys blood sugar was out

of control. Her eyesight was failing fast. Her weight was way above where it should

have been. She also suffered from painfully inflamed nerve endings in her feet because

of long term high blood sugar.

Like many of our patients, her diet at home was pretty typical of Americans

SAD. So one of the first things we did was put her on a fast (dont try this yourself

without talking to your doctor first, especially if you have diabetes). The three day

complete fast was no sweat for Nancymost people find it not only surprisingly

tolerable after they get through the first day, but weirdly invigorating, too. Then the

fourth day came, and Nancy came down to break her fast with breakfast, looked at her

plate, and started sobbing. Her breakfast was the usual first meal we recommend after a

fast: a lovely plate of steamed vegetables. Nancy literally wept. I cant stand

vegetables, she whined.


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We consulted our behavior counselor, Lonnie Carbaugh. Lonnie thought, uh-oh,

our diet here is plant-based, and Nancy hates vegetables. Of course the food we serve

goes way beyond plates of plain, steamed vegetables. Its prepared by gourmet chefs.

But still, she claims she hates to eat veggies, so gourmet or not, there was a problem.

Nancy was hungry, though, so she nibbled with a sour expression on her face.

Then it came to light that Nancy had yet another problem, not uncommon in our land of

plenty. As a child, shed been taught by her mother to clean her plate (you remember the

old chestnut, There are starving kids in China? Well, that has to be updated now to,

There are obese kids with diabetes in China iii.) In any case, it was clear as Nancy

picked up a baby carrot and sniffed it, this was going to be a long day. Fortunately, there

was a hero at Nancys table. One of our doctors had already cleaned his plate, so he

switched plates with Nancy, giving her permission to leave the table, now that her plate

was empty.

Lonnies a very positive and open-minded guy, but even he came to the early

conclusion that Nancy was going to have a hard road ahead if she was going to make it

on our program. She was determinedthat was for sure. She muddled through, and saw

improvements in her diabetes and her overall health.

After Nancy left LCA, Lonnie called her every month, collecting information on

how many days a week she was sticking to the plant-based diet. Usually, even people

who are doing well have a slip-up and snag a burger or a candy bar every once in a while.

But after six months, Nancy still hadnt cheated. She was totally sticking to our diet


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and physical activity program. And after nine months, she was still going strong. But

she sounded really depressed. How are you feeling? Lonnie asked her.

I never felt so good in my life, she said. But she said it in a depressed way, like

Eeyore the donkey in Winnie-the-Pooh.

It sounds like theres some kind of disconnect here, said Lonnie.

Nancy said, I still cant stand vegetables.

Tell me about how youre planning your daily meals.

Well, I eat all my vegetables in the morning so I can get them out of the way. At

lunch, I have more of the things that I enjoy.

Lonnie had an idea: So how many minutes do you spend eating vegetables every

day?

Maybe about fifteen.

So youre telling me that for fifteen minutes a day youre miserable, but for the

rest of the day you feel better than you ever have before?

Hmm. I guess I am saying that. Put that way, it didnt sound so terrible.

Lonnie called Nancy back a year later: Ive never felt so great in my life! she

proclaimed.

She was sticking to the LCA plan. She had gone from a size 16 to a size 8. Her

eyes were back to normal, and her diabetic neuropathy (nerve pain and numbness in the


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feet and legs) was gone. She had tons more energy, too. Her life had changed

dramatically. Nancy reminded herself that prior to coming to LCA, shed felt quite a bit

more miserable, and for much more than 15 minutes a day.

There were three keys to Nancys success that you can learn from.

1. One was that she changed herbeliefs. She had to change her way ofthinking and talking to herself. She began to focus on why she wanted to

get better, why she wanted to regain control of her health. You should

start answering that question, too: good health for what? To dance at

your childs wedding? To fit into your favorite dress? To play catch with

your grandson? To climb the steps of the Parthenon on a cruise to

Greece? You can read a lot more about Good health for what in chapter

4.

2. Then Nancy began to work on her toxic self-talk. She started todeliberately minimize the misery of eating broccoli and squash. The

whole time shed been telling herself, Eating vegetables is the absolute

worst thing I could possibly endure, she was reinforcing that greatly

exaggerated version of the truth (the Holocaust would be worse. Death

would be worse. As a matter of fact, the overweight, blindness, and pain

shed been suffering were worse). The truth was, at first shed have

simplypreferredan ice cream cone to a stalk of celery. Most people

would, and even thatcan be overcome. But she didnt have to have the

ice cream, and she didnt have to hate vegetables. Now, the mind is a very


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powerful thing. Habits, beliefs, even moods can change when you know

how to change them. So in addition to conquering her diabetes, Nancy

also conquered what in drug and alcohol rehab theyd call her Stinkin

Thinkin. The sense of power and self-determination that came from that

change remains a vital force in Nancys life, and we want you to master it,

too. See chapter 8 for much more on toxic self-talk, and I would prefer

v. I must.

The other key to Nancys triumph, by the way, was the enormous variety

and quality of the delicious, natural foods we promote. Our plant-based

diet is not bunny food, by any stretch of the imagination. Every day at

the table in our gourmet restaurant, the Windcrest, and in our cooking

school, we watch skeptics undergo miraculous conversions. Halfway

through lunch, big, burly cattle ranchers from Texas look up from their

plate and say, Wow, doc! This stuff is really good. Again, its all about

trying new things (If you keep doing what youve been doing, youre

gonna keep getting what you got) and the power of positive thinking.

Dont look at our program as a restrictive diet, but look at it as an

adventure in new, more healthful, natural foods that will lead to optimal

health. And try to have a sense of humor about things, too.

Using her power to choose how she thought about it, even Nancy began to like

certain vegetables the way we taught her to prepare them.

And by the way, for most people, this process doesnt take a year.


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iChinese kids are 6.6 lbs. heavier than they were 30 years ago. See: Calum MacLeoud. Obesity of Chinas kids

stuns officials. USA Today. January 9, 2007.ii Li YP, Yang XG, Zhai FY et al. Disease risks of childhood obesity in China. Biomed Environ Sci. 2005,

18(6):401-410.


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MoreonFiberRemember that fiber refers to the part of plant foods that our digestive enzymes cant break

down. As a result, it passes through our gastrointestinal tract (thats the tube about 25 feet long

that runs from our mouth to our rectum), helping regulate the process of the digestion and

absorption of food, as well as the elimination of waste.

Dr. Arnott is right: fiber is everyones friend.

Some fiber is termed soluble, meaning it is dissolvable in water. Soluble fiber is what

gives some plant foods a gummy, sticky consistencythink of oatmeal, for example. Fiber thatcannot be dissolved in water is called insoluble, and it is this type of fiber that gives some food

its crunchy, chewy texture, such as almonds. Soluble and insoluble fibers are very important in

our diet. Both add bulk, which makes us feel full and satisfied, so we naturally consume fewer

calories when we eat high fiber foods. Soluble fiber also slows the digestion and absorption

rates of starches and sugars, thus slowing the rise of blood sugar after a meal. These two factors

make it important for people with diabetes to include lots of fiber in their diet. Thats one reason

we recommend beans twice a day for those with diabetes.

GI Guidelines for a Plant-based Diet

Your goal is to plan meals that result in a small blood sugar rise by controlling the amount of

carb (Carb Counting) and choosing low glycemic (GI) carbs. A low GI diet is especially

important for people who have diabetes, are overweight, insulin resistant, prone to low blood

sugar (hypoglycemia), or have heart diseasei. Of course, if it is beneficial for these individuals, it

is also good for everyone who wants to prevent these disorders and stay healthy. Calorie for

calorie, high GI meals raise the blood sugar faster and higher, and stimulate more insulin

secretion than low GI meals. This will tax the insulin-making beta cells of the pancreas. These

factors, in turn, can lead to insulin resistance and bring on or worsen diabetesii. This process can


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start early. One recent study showed that in overweight Latino children nine to 13 years old,

those consuming the most sugar and sugar-sweetened beverages both high GI carbs signs of

early beta-cell death were already presentiii.

Fiber v. HFCS: Two Ends of the GI Range

The evidence is out there that we Americans are consuming a lot more carbs than we used to,

mainly the refined junk kind, and mainly in the form of high fructose corn syrup (HFCS) iv, a

main culprit in the obesity epidemic that began in the 1960s, and has since swept over a majority

of us. A diet full of this kind of rapidly-absorbed (high GI) carb is associated with a higher risk

of developing Type-2 diabetesv. One proven strategy to avoid those epidemics is to choose low-

GI foods naturally high in fiber. This will help your glycemic control, and if you keep it up, it

can be as useful to you as diabetes medicinevi.

iBrandMillerJC. Glycemicloadandchronicdisease.NutrRev. 2003,61:S49S55.iiLudwigDS.TheGlycemicIndex.PhysiologicalMechanismsRelatingtoObesity,Diabetes,andCardiovascular

Disease.JAMA..2002,287:24142423.iii Davis JN, Ventura EE, Weigensberg MJ, et al. The relation of sugar intake to cell function in overweight

Latino children. Am J Clin Nutr. 2005, 82:1004-1010.iv Bloomgarden, ZT. Diet and Diabetes. Diabetes Care. 2004,27(11):2755-2760.v Schultze MB, Liu S, Rimm EB et al. Glycemic index, glycemic load, and dietary fiber intake and incidence of

type 2 diabetes in younger and middle-aged women. Am J Clin Nutr. 2004, 80:348-356.vi Brand-Miller JC, Hayne S, Petocz P et al. Low-Glycemic Index in the Management of Diabetes. Diabetes

Care. 2003, 26:2261-2267.


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MoreonSmokingandDiabetesSmoking more than doubles the risk of heart attacki. Smoking also limits the hemoglobin

available to bind oxygen to the red blood cells. Because oxygen is essential to feed the heart and

working muscles during activity, smoking limits the progress of training, and jeopardizes the

safety of your program.

One more thing strange but true is that quitting smoking is simply smartliterally.

Did you know that better educated people are actually far less likely to smoke? Among adults 25

and older who smoke, 26 percent of those with no diploma are smokers; 43 percent of those with

a G.E.D. smoke; 23 percent of those with some college smoke; 21 percent of those with an

Associates degree smoke; 21 percent of those with a Undergraduate degree smoke; and only 7

percent of those with a Graduate degree smokeii. Mark Twain might have been the exception to

this rule. He certainly had more education than his famous character, Huck Finnbut they both

smoked. Twain reminds us that smoking cessation takes perseverance: Its easy to quit

smoking, he writes. Ive done it a thousand times.

More on Depression and Diabetes

Dr. Neal Nedley is a former member of the board of directors of the LCA. He has hosted two

18-day sessions at LCA for people with depressioniii. While there are many causes of depression

and many treatments we have found that a lifestyle approach is very helpful.

To us, it makes sense that people on a PBD and practicing a healthy lifestyle would be

less depressed than their counterparts on the Standard American Diet (SAD). A large study done

by Dr. Dean Ornish proved it. Dr. Ornish set out to demonstrate that a PBD could prevent heart


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disease (which he did!). But an interesting finding came from that study: one year after

adopting a PBD, the vegetarians studied not only felt better physically, but mentally as well,

contrasted to the control group of non-vegetarians. The people on the PBD had a decrease in

depression and anxiety, fewer problems with stress, even improved interpersonal relationshipsiv.

Vegetarians tend to enjoy life more, and even have a better social life than before becoming

vegetariansv. Other studies back this up: in one Puerto Rican study, vegetarians, when

contrasted to non-vegetarians, were significantly less depressed and anxiousvi.

In one study of non-Mexican-American Hispanic adults with diabetes, a full 78 percent of

patients believed they had diabetes because it was Gods willvii. This is good evidence for the

idea that when doctors address the whole patient with diabetes including their spirituality or

religious beliefs the patients health outcomes are betterviii. Treating diabetes and healing

from it are not necessarily the same activityix

. This might be why some diabetes education

programs sponsored by churches are so effectivex. But it neednt be a church doing the healing.

iHeart and Stroke Facts. American Heart Association.ii Tobacco Use Among Adults United States, 2005. Morbidity and Mortality Weekly Report, Centers for

Disease Control and Prevention in USA Today. February 20, 2007.iiiNedley, Neal. Depression: The Way Out. Ardmore, Oklahoma: Nedley Publishing, 2005. This list is adapted

from Dr. Nedleys chapters on diet and lifestyle treatments for depression, 65-97.iv

Ornish D, Brown SE et al. Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. The

Lancet. 1990, 336(8707):129-133.v Nedley, Neal. Depression: The Way Out. Ardmore, Oklahoma: Nedley Publishing, 2005, 76.vi

Rodriguez Jiminez J, Rodrigues Jr, Gonzelez MJ. Indicators of anxiety and depression in subjects with differentkinds of diet: vegetarian and omnivores. Bol Assoc Med PR. 1998, 90(4-6):58-68.vii Zaldivar A, Smolowitz J. Perceptions of the importance placed on religion and folk medicine by non-Mexican-

American Hispanic adults with diabetes. Diabetes Educ. 1994, 20(4):303-306.viii

Newlin K, Melkus GD, Chyun D et al. The relationship of spirituality and health outcomes in Black women

with type 2 diabetes. Ethn Dis. 2003, 13(1):61-68.ix Paik JE. No One an Island: The Geography of the Whole Patient. MS JAMA. 2000, 284(13).

Http://www.jama.com.


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x Samuel-Hodge CD, Headen SW, Skelly AH et al. Influences on day-to-day self-management of type 2 diabetes

among African-American women: spirituality, the multi-caregiver role, and other social context factors. Diabetes

Care. 2000, 23(7):928-933.


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More on Stress and Diabetes

Major stress increases blood sugar levels, whether you have diabetes or not. Extreme stress on

the body, such as occurs during serious illness or trauma, causes the body to release hormones to

keep enough sugar in your system as energy to weather the intense stressi. Thats why we react

to stress the way we doto survive immediate threats while remaining more or less in

equilibrium. But even moderate stress, largely because of its association with increased glucose

in the bloodstream, can prevent you from keeping your diabetes in check. Over the long haul,

this can seriously damage your body. For one thing, while youre stressed, some of the short-

term body processes that are less essential than survival things like sleep and digestion are

inhibited. And of course stress can also cause you to eat more, get physically active less often,

feel exhausted and depressed, and fall off your health program altogether. Alarmingly, extreme

stress seems to be one possible culprit in the onset of Type-1 diabetes, in which the part of the

pancreas that makes insulin essentially dies. Some of our Type-1 acute onset diabetes patients

report having gone through traumatic events in their lives the death of a spouse or the loss of a

job, etc. usually just a few months prior to their diagnosis. Theres controversy on this subject,

with some studies backing the claimii

, but at least one recent large systematic review of past

studies supporting the idea that stress and the diabetes process are relatedbut refuting the idea

that Type-1 diabetes is causedby stressful life events

Fleming, Alison. Motivational Issues from a Psychobiological Perspective. University of Toronto. 2007.

Shiloah E, Witz S, Abramovitch Y et al. Effect of Acute Psychotic Stress in Non-diabetic Subjects on -Cell

Function and Insulin Sensitivity. Diabetes Care. 2003, 26:1262-1467.


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More on the Cost of Diabetes

People with Type-2 diabetes comprise 6.3 percent of the American population, but they account

for 19 percent of all health dollars spent.i Diabetes makes up about 33 percent of the Medicare

budget, with drug costs doubling or tripling in the past few yearsii. In 2002, the government

estimated the total cost attributable to diabetes. It was $132 billion ($92 billion in direct medical

costs, and $40 billion in disability, work loss, and this is a fun government euphemism

premature mortality.)iii

The scariest part of that statistic is that its already six years old. The numbers are going

up. In 2004, hospitals alone spent $58 billion on the six million stays of patients with diabetesiv.

Thats nothing contrasted to what the Veterans Administration incurred: more than $216 billion

in out- and in-patient expenditures over a four-year study periodv. And across the country, the

ranks of American diabetics have swelled by a distressing 80 percent in the last decade. Some

cities, like New York, have seen an explosion of cases: 140 percent more. There are 4,100

new cases of diabetes diagnosed every 24 hours in America.vi

iJackson, Derrick Z. Diabetes and the trash food industry. The Boston Globe. Editorial,January 11, 2006.

ii Agency for Healthcare Research and Quality (AHRQ). Proportion and Medical Expenditures of Adults BeingTreated for Diabetes, 1993 and 2003 inDiabetic Microvascular Complications Today Nov/Dec 2006, 9.

iii National Institute of Diabetes and Digestive and Kidney Diseases.iv Agency for Healthcare Research and Quality (AHRQ). Proportion and Medical Expenditures of Adults BeingTreated for Diabetes, 1993 and 2003 inDiabetic Microvascular Complications Today Now. 2006, 9.v Maciejewski ML, Maynard C. Diabetes-related utilization and costs for inpatient and outpatient services in theVeterans Administration. Diabetes Care 2004, 27 (Suppl 2): B69-B73.vi Kleinfeld, N.R. Diabetes and Its Awful Toll Quietly Emerge as a Crisis. New York Times. January 9,2006.


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MoreonTheDiseaseofKings:PoorUsWe have yet another take on the concept of the Diseases of Kings. See our chapter on The

Disease of Kings in the book. But this disease is a disease of the brain, and of the soul. Its

rampant in America today. Bear with us for a few pages herewe promise this will circle back

to diabetes in a very important way.

Brian Tracy, one of the worlds leading experts on time management and life balance,

tells us in many of his publications that the greatest poverty we face as a culture is time

poverty. Back in 1924, 87 percent of wives did more than four hours of housework a day. By

1977, it was down to 43 percent. In 1999, only 14 percent of housewives (themselves largely

diminishing as a class) did more than four hours of housework per day i. Now we suspect its

actually dropped off significantly again. This is not a treatise on how housewives are not

working hard enough; just the opposite. The whole time our hours- per-week of housework was

decreasing, all kinds of other demands on housewives were increasing (work outside the home,

for one thing, and chaperoning kids to soccer, dance, Karate, band, and everything else on the

menu for kids today). The great contradiction here, of course, is that those devices and systems

weve invented to save us time the Internet, PDAs and e-mail spring to mind are the very

things that enslave us, now ravenously consuming our time.

Our culture works more hours and produces more than virtually any other culture in the

history of the Earth. Seems like a good thing. But are we happier? Studies show were notiiiii.

Which is odd, because its not all toil for zero gain. We also have more money than ever before.

Fewer of us are poor. Many more of us are in the upper middle class than in previous


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generations, and more are superrich. Youd think thatd make us happy. It might or it might not

surprise you to know that in fact, it doesnt. Studies from all over the world show that unless

you start from true poverty and find enough money to lift you out, increasing wealth does not

correspond with increasing happinessiv. In fact, for many, its just the opposite: money breeds

misery. Just look at all those whining (and often deeply disturbed) Hollywood celebrities and

pop stars on the entertainment programs. Weve treated celebrities at LCA, and some of them

are well balanced. But many are not. These people have told us they were amazed when they

realized you can have many of millions of dollars, and an entourage treating you like a deity, but

you can still feel lower than a snakes belly.

What about choices? Thats a pillar of our democracy, a mainstay of the American way.

Just check out a recent issue ofConsumer Reports magazine, spend some time at a shopping

mall, or watch some TV commercials. There are some 220 new cars out this year; 250 cereals to

choose from; 35 shower heads to choose from; countless computers; infinite cell phones, and on

and on. But do we really wantthis stuff? We must, mustnt we? If no one were buying,

wouldnt the market disappear or at least shrink? Does all this freedom of choice make us

happy? Gregg Easterbrook, in his illuminating book, The Progress Paradox, says no. Most of

what people really want in life love, friendship, respect, family, stature, fun is not priced, and

does not pass through the market. If something isnt priced you cant buy it, so possessing

money may not help much

v

.

Go ahead and try asking at the Wal-Mart for five bucks worth of respect.

We have three times as much earning power as our grandparents did, and considerably

more choices, but we cant buy what we really want, which is peace of mind, love, health, and


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happiness. We have cultivated an advanced technological culture that keeps on progressing, but

unfortunately, it takes much of our lives to learn how to exist in it. Yet we consistently report

that were no happier. With every advance in society, our stress levels go up. And with every

passing day that we keep consuming but never getting what we really want, we become

increasingly stressed and restless. And thats where our health comes in.

In the 1980 movie, The Gods Must Be Crazyvi, a Kalahari bushman who never

encountered Western culture before stumbles on a glass Coke bottle thrown out of an airplane.

Long story short: at first the tribe relishes the artifact, and finds multiple, creative, time-saving

uses for it. Eventually, though and mainly because one Coke bottle is not enough to go around

the new gadget becomes a source of bitter in-fighting, even a potential culture-killer, which

they dub the evil thing. The tribe decides it must be thrown off the edge of the world. Havent

you ever wanted to do that with your cell phone or your laptop computer? We have. Studies

show the quantity of available information in the world doubles every 600 daysvii. There were

161 exabytes of digital data thats about 161 billion gigabytes generated in 2006, and that

amount is already rising fastviii

! What are we supposed to do with all that information?

The deeper question is, are we paying too high a price with our health to experience the

spoils of modern life? Does the pace and pressure of our existence contribute to disease? Well,

yes, if you really look at the etymology of that word disease. Has modern life caused a dis-

ease for most of us? The answer to that is simple.

A U.S. News & World Reporteditorial from 2000 reported that the average American

workweek has been increasing at a rate of two hours per decade, to 47 hours (we bet its already

up to 48). Forty-four percent of us consider ourselves workaholicsand many more of us dont


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even know we areix. And around 2000, a new term entered our lexicon: 24/7. Nowadays, we

dont so much start our day with an alarm, but a starting gun. We dash out five e-mails, respond

to a half-dozen text messages, fax some orders, join a conference call or two, make some cell

phone calls, and then before we know it, its time for breakfast! Most of us dont really everstop

workingnot at home, not during our commute, and not even while were on vacation. How

often have you said, You can reach me anytime on my cell? Can you imagine if a close

associate didnt respond to your messages within, say, two days? It wouldnt matter that she was

in Tibet. Cant she at least check her e-mail? youd wonder. This is important.

There have been some recent backlashes against this kind of stressful 24/7

connectedness. A few folks have eschewed their Crackberries for one day a week. Even

fewer have managed to avoid the Internet and e-mail. But most of just give up and join this rat

race, not only to compete, but to survive.

iEasterbrook, Gregg. The Progress Paradox. New York: Random House, 2004, 28.

ii Dan Baker and Cameron Stauth. What Happy People Know. St. Martins Griffin, 2004.iii Easterbrook, Gregg. The Progress Paraxox. New York: Random House, 2003.iv Dan Baker and Cameron Stauth. What Happy People Know. St. Martins Griffin, 2004.v Easterbrook, Gregg. The Progress Paradox. New York: Random House, 2004, 177.viThe Gods Must Be Crazy. Directed by Jamie Uys. 20

th Century Fox 1992.vii Deaton, Dennis. The Book on Mind ManagementSecond Ed. Mesa, AZ: Quma Learning Systems, Inc., 2003,

108.viii For perspective, thats the equivalent of about one million digital copies of every book in the Library of Congress,

or 213 gigabytes of information generated for each person in North Americain just 2006. See: Kessler, Michelle.

Days of officially drowning in data almost upon us. USA Today. March 6, 2007.ix Timothy Lamer. Stressful Leisure. U.S. News & World Report. 21(22) June 26, 2000.


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More on the Livers Function in Diabetes

Sugar Factory

We reviewed in this chapter the fact that the carbs we eat become blood sugar in our body. But

our body has another way of making sugar, called gluconeogenesis (gluco = sugar; neo = new;

genesis = creation) We make this sugar primarily in two organs. One is the liver. If were noteating, the liver produces enough blood sugar to keep us alive. And did you know the kidneys

are not just for making urine; they make sugar too. About 15 percent of the blood sugar thats

made in the body some of the sugar we dont get from our food is made in the kidneys. The

rest comes from the liver. This liver source of sugar kicks in when we fast or are involved in

vigorous prolonged exercise. Not only is the body able to manufacture blood sugar (the bodys

preferred fuel) both in the liver and the kidneys, it also has a number of ways ofstoring sugar

that is taken in as food but not immediately needed to fuel the cells activities. Fat is one of the

bodys ways of storing extra sugar. Another two places to tuck some extra supply of sugar is in

the liver and muscles. In the muscles, its stored in the form of glycogen, and can be freed up as

sugar almost immediately when an extra burst is needed. That glucose cannot get into the

general circulation to be used by our non-muscle cells.


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MoreontheRightAttitudeforOvercomeDiabetesIt goes without saying that it takes introspection to overcome our lack of conscious awareness

about the connection between lifestyle decisions and their outcomes. Introspection can become

so all-absorbing that we might come to think that its All About ME. Max Lucado, a well

known inspirational writer, wrote a worthwhile book with this as a title: Its Not About Mei. His

point is that there is a balance worth seeking that keeps us from becoming narcissistically self-

absorbed. One decision in the interest of experiencing that balance is to share. Consider

getting involved. You might decide to volunteer your time and effort to another person, get

involved in a service group, be a pink-lady volunteer at the local hospital, or join an active

church group. Sharing is one way to keep us in balance and gives us a reason to maintain good

health. Sharing what youre learning and practicing about lifestyle medicine and diabetes can

also increase its benefits to you, even while helping others, through a process known as Super-

learningii.

Here some wise aphorisms that we think can help you in your struggle:

Freedom and happiness consists of understanding one principle: There are certain

things you control and certain things you cant. It is only after you have learned

to distinguish what you can control from what you cannot, that inner harmony and

outer effectiveness become possible.iii


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If you see a difference between where you are and where you want to be

consciously change your thoughts, words, and actions to match your grandest

vision. This might require tremendous mental and physical effort. It will entail

constant, moment-to-moment monitoring of your every thought, word, and deed.

It will involve continued choice-makingconsciously. This whole process is a

massive move to consciousness. What you will find out if you undertake this

challenge is that youve spent half your life unconsciousiv.

if you really want to be self-helping, wise, and rational, decide that you will

ONLY rate your acts, deeds, thoughts, feelings, and other behaviors and that you

will not yes, NOT, -- rate your SELF, your being, your essence, your totality, at

all. Yes, preferably not at all, though this may be somewhat unrealistic because

you and the rest of us humans seem to have a biological tendency to rate both our

behaviors and our self.v

To believe that I need something requires, by definition, that I also believe that I

cannot be okay without that something. It may be an object or an experience that

I demand. In this view of reality, if I dont get it, that very not-getting threatens

my well-being, my hopes of happiness, my ability to be okay. When I use

unhappiness in order to help myself get what I want, or to get you to give me what

I want, I live in that need. That experience is self-extinguishingit is the state of


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non-being. The very thing I do to help myself cripples me, choking my life force

and my ability to create. The experience of preferring is self fulfilling. It allows

happiness now. It permits a sense of well-being, of okay-ness. It simply

acknowledges, more would be welcomed, this is the more that I welcome. vi

REBT [Rational Emotive Behavior Therapy] shows that when you believe, I

preferably should succeed and win the approval of significant others, you

explicitly or tacitly include buts and alternative solutions to your desires, such as

But if I dont succeed, I can try harder next time. But if Im not approved of

too bad, its not the end of the world. When your prefer[ances] are not fulfilled,

REBT holds, you normally feel healthily sorry, disappointed, and frustrated

(rather than unhealthily panicked, depressed, and self-hating). On the other hand,

when you strongly believe, Because I want to succeed and be approved of by

significant others, I absolutely, under all conditions and at all times must do so,

you create anxiety when you may not do well and severe depression when you do

not act well or win others approval. For with your absolute, under all conditions

shoulds and musts, you allow yourself no alternative solutions to your desires,

box yourself in, and needlessly make yourself miserable.vii


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If you would stop, really stop, damning yourself, others, and unkind conditions,

you would find it almost impossible to upset yourself emotionallyabout

anything. Yes, anything.viii

Socrates used to say that he was the smartest man in Athens because he knew he

was really dumb. When it comes to controlling our diets, strength requires

knowing that we will be weak. Recognizing our future weaknesses allows us to

minimize how frequently we will fail and to limit the damage done when we are

feeling weakest.ix

For some immediate inspiration, consider the sage advice of the Buddha: The secret of

health for both mind and body is not to mourn for the past, nor to worry about the future, but to

live the present moment wisely and earnestlyx. This puts the will within us, and reminds us that

we have a responsibility to look after ourselves, even when we believe firmly in God. Again, the

Buddha: Every human being is the author of his own health or diseasexi

.


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i Lucado, Max. Its Not About Me: Rescue from the Life We Thought Would Make Us Happy. Integrity Publishers,

2004.ii

See the works of Brian Tracy for other tips on how to accelerate your learning of this and any other practice. See

also, the originator: Sheila Ostrander and Lynn Schroeder. Super-learning 2000: New Triple Fast Ways You Can

Learn, Earn, and Succeed in the 21stCentury. New York: Dell (reissue ed.), 1997.iii Epictetus. Enchiridion.iv

Walsch, Neal Donald. Conversations with God. New York: Putnam Adult. 1996, 77.vEllis,Albert. ReasonandEmotioninPsychotherapy.1994.vi Mandy Evans. Joe Vitale. Emotional Options. Garden City: Morgan James Publishing, 2004viiExcerptfromGeneralSemanticsandRationalEmotiveBehaviorTherapybyAlbertEllis.Amherst,NY:PrometheusBooks,2004.viiiEllis,AlbertandRobertA.Harper. AGuidetoRationalLivingThirdEdition.Chatsworth:WilshireBookCompany,127.ix

Terry Burnham and Jay Phelan. Mean Genes. New York: Penguin Books, 2000, 45.x Attributed to the Buddha .xi Attributed to the Buddha.


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More On The Why Our Government Has Failed Americans With Diabetes

The sole purpose of the USDA is not to protect the health and well-being of the American

citizenry. It has a major, competing agenda, which is toprotect and uphold the economic health

and viability of American agriculture. Unfortunately, thats a conflict of interest, and it means

the USDA remains shy of 100 percent trustworthy when it comes to its recommendations for

what we should eat. Whenever you look at what it recommends, you should ask yourself, just

whose interests are they protecting? Whos number one?

Do you know how you get on the board of an influential government agencymaking national nutritional recommendations? Usually, only huge, powerful,

money-making lobbies, such as the National Cattlemens Association, the

American Meat Institute, and the Grocery Manufacturers of America, as well as

sugar, fast-food, and junk food industries get a say. In the past, new guidelines

and new versions of the Food Pyramid have been delayed while the meat, dairy,

and egg lobbies jockeyed for positioning. The resulting message has been that if

you want to get enough protein, you had better eat enough meat, dairy and eggs.

Thats just nutritional nonsense.

There is some hope, though. We say that big business and lobby groups usuallydominate the food guidelines process, but the power of the people can be quite

a juggernaut, too, once it starts rolling. This is a consumer-based economy, after

all. As long as consumers keep clambering for white bread and fried pie (yes, its

a real thing), theyre going to be abundantly available. But as soon as people


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became convinced of the perils of trans fat, customers used the power of the

pocketbook and the tide started to turn. First the Food and Drug Administration

called for food manufacturers to list trans fat on their labels starting in 2006.

Then in January, 2007, Starbucks rolled out no-trans fat recipes in half of its

5,600 American stores, and started scrambling with local bakeries who supply

ingredients in the remaining marketsi. In July, 2007, the largest restaurant market

in the U.S., New York City, began phasing in a ban on all trans fat. A strong

word of caution: it will be possible forii

restaurants to avoid trans fat in their

menus by using interesterified fats, which may be worse for you than trans fat.

The safest option is to avoid fast food restaurants, as well as fried foods in general

(plant-based or not).

i Arndt, Michael. How KFC Went Trans-Fat Free. http://www.BusinessWeek.com. January 3, 2007.

http://businessweek.com/innovate/content/jan2007/id20070103_466580.htm.ii Wansink, Brian. Mindless Eating. New York: Bantam Books, 2006, 187.


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More on Trans-fats and Interesterified Fats

Saturated fats like youll find in steak, butter, and ice cream, are naturally-occurring, and come

mainly from animal sources (meat and dairy). Saturated fats raise blood levels of triglycerides,

total cholesterol, and LDL cholesterol (aptly named bad cholesterol because it blocks arteries).

Because of this, having them in your diet will increase your risk of heart attack and other

vascular diseases.

Unsaturated fats are also natural, and you can find them mainly in plant-sources of foods,

like whole grains, avocados, nuts, olive and canola oil. Their carbon atoms are not totally

saturated with hydrogen. Theyre better for you, and are even associated with lowering total and

LDL (bad) cholesterol, thus reducing your risk of coronary and other artery blockages.

Lastly, trans fats are those unnatural, manufactured fats that behave like saturated fats in

our bodies. In fact, they are more dangerous, because not only do they raise triglycerides, total

cholesterol, and LDL (bad) cholesterol, but they also lower HDL (good) cholesterol. They

have also been shown to increase the risk of developing Type-2 diabetesi.

In our experience weve found that of all the things we teach patients during our 18-day

residential program, the single most important marker for long term weight loss (and therefore,

for lowering insulin resistance and keeping diabetes in check) is sticking to a total plant-based

diet. The fewer the number of days our patients stay on a plant-based diet once they go home,

the less weight they are able to lose and keep off. When the number of days gets to zero (the

patients revert to eating meat or dairy again daily) they start to put weight back on. It is true,

though, what they say about red meat. In our follow-up studies, we find that patients who ate


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even small and infrequent amounts of red meat (equal to less than one day a week) were less

likely to have successful weight loss than those who ate no red meat at all.

Since the inclusion of trans fat on nutrition labels, and the removal of trans fat from some

fast food restaurants and municipalities, youd think we were in the clear. Not so. In some

commercial food products, unhealthy trans fats have now been replaced with another kind of

manmade modified fat called interesterified fat,which has been shown to be as dangerous to our

health as trans fat.

The study discovered that interesterified fats, like trans fat and saturated fat, raised the

ratio of LDL/HDL cholesterol significantly. Interesterified fat also increased fasting blood

glucose and depressed insulin, which are both common precursors to diabetes. In fact,

interesterefied fat raised fasting blood glucose levels as much as 20 percent in one month as

contrasted to the natural saturated fat used in the study (palm oil). That was even more than

trans fat.

So far in America, theres no legal requirement to list interesterified fat on the Nutrition

Facts Panel along with the saturated and trans fat, but you will be able to find it in the ingredient

list. It will be listed as interesterified or fully hydrogenated fat. Bottom line: its time to

choose another product if you run across any of the following terms in the ingredient list:

partially hydrogenated oil (trans fat), interesterified fat, or fully hydrogenated oil.

Just a sample of some foods currently sold using interesterified fats:

Sunbelt Fudge Dipped Chocolate Chip, Chewy Granola Bars with whole grainoats

ii.


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Pepperidge Farm, soft baked sugar cookies Pepperidge Farm Chocolate Delight Seville Triple Chocolate Cookies Little Debbie German Chocolate cookie rings with caramel and coconut

More on Animal-Borne Diseases: Mad Cow

Theres another sinister disease transmissible to humans from animalsbovine spongiform

encephalopathy (BSE), more commonly known as mad cow disease. This disease is 100

percent fatal. It is has been shown to be transmissible from cows to a number of different animal

species, including humans. The incubation period for the disease ranges from two and a half to

eight years in cows, during which time they will show no evidence of the diseaseiii

. This is

troublesome, because a typical beef cow is taken to market between 14 and 20 months of ageiv

.

They may show no signs of illness, yet they could still harbor the disease and transmit it to the

consumer. The agent responsible for the disease is not destroyed by temperatures used for

cooking meat, so thorough cooking will not offer protection.

And its not just beef that poses a risk. Mad cow-like illnesses have been observed in

deer, elk, goats, and pigsv. Theres a concern that fish, too, might be affected

vi, especially

farmed fish given feed made with contaminated meat and bone meal. It remains legal in the U.S.

to place renderings from cows into the feed of chickens, pigs, fish, and household pets.

Likewise, it is permissible to place renderings of these animals into cow feed. This can result in

animals infecting each other in a roundabout fashion. Currently the U.S. tests for mad cow

disease in only one in 2,000 cows that are slaughtered: in fact, as amazing as it sounds, the


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USDA has stopped private ranchers from testing their herds voluntarily and at their own

expensevii

!

Salmeron J, Hu FB, Manson JE, Stampfer MJ, et al.Am J Clin Nutr. 2001, 73:1019-1102.

Wow! Whole grain oats? These mustbe good for you.iiiBovine Spongioform Encephalopathy Mad Cow Disease Fact Sheet, USDA Food Safety and Inspection

Service.iv Ritchie HD,A review of applied beef cattle nutrition, Michigan State University Extension Beef Bulletins Jan 1,

1994.v

NeuroCenter, University of Bern, Switzerland. http://www.neurocenter-bern.ch/tse_e.shtml.vi

News in Brief. The Lancet. 2003, 361.vii McNeil, Donald G., Jr. U.S. Wont Let Company Test All Its Cattle for Mad Cow. New York Times. April 10,

2004.


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More on Nature v. Nurture and the Diseases of the West

So what we have here is an interesting, and not at all balanced, combination of nature and

nurture. These diseases of the West are the result of our bodies natural adaptive responses to

their environments. T. Colin Campbell, who conducted the single largest study of human

nutrition ever undertaken, has shared the results of his landmark research in a remarkable book

called The China Study. In it he proves that in addition to diabetes and coronary artery disease,

even cancer (leukemia, breast, colon, lung, stomach, liver, childhood brain) is directly related to

what he calls the Wests nutritional extravagancei. The prevalence of Type-2 diabetes among

adults in rural, traditional communities in the developing world is less than 3 percent but among

their counterparts who live in more Westernized cities, theres a five to ten-times higher

prevalenceiiiii! In the U.S., the rates are increasing every year.

In other words, in impoverished places, and places that havent been infiltrated by

McDonalds and company, people dont get these diseases nearly as much. Why? Well, a small

part of it might be genetics. But the overwhelming part has to do with dietary habits. iv. While

well argue strongly in this book that diabetes is a lifestyle disease, largely under your control,

its clear that there is a minor genetic factor at play, as well.

As the adage goes, though, genetics only loads the gunlifestyle pulls the trigger. But

we believe that genetics plays only a small part. The good news is that puts a lot in your hands.

Heres a good example of how that works: The Pima are genetically very similar to brethren in

various tribes across the border in Mexico. The Pimas Mexican counterparts live a more

traditional (less American) life, and eat a more traditional (more rural Mexican) diet. As a result,


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the incidence of Type-2 diabetes among them is far lower, almost non-existent. Ian spent time

writing on a Native American reservation, and he witnessed the abrupt changes in lifestylev

that accounts for the difference between the native North Americans on either side of the border.

Among many tribes, economic, geographic, and political conditions have led to fast food,

alcohol, and the ubiquitous government surplus cheese and its ilk becoming staples. The

American couch potato culture is another culprit. Of course the science backs up this anecdotal

evidence. The adoption of an Anglo diet and lifestyle play a major role in the development of

diabetes among the Pima and across the globe

Campbell, T. Colin. The China Study. Dallas: BenBella Books, 2004, 76.

Janet E Fulton.and Harold W Kohl III. The Epidemiology of Obestiy, Physical Activity, Diet, and Type 2

Diabetes Mellitus, inLifestyle Medicine, edited by James Rippe. Malden, MA: Blackwell Science, 870.

Harris MI. Epidemiological studies on the pathogenesis of non-insulin-dependent diabetes mellitus (NIDM). Clin

Invest Med1995, 18:231-239.

Ravussin E, Vlanecia ME, Esparza J et al. Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes

Care. 1994, 17(9):1067-1074.

Ravussin E, Vlanecia ME, Esparza J et al. Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes

Care. 1994, 17(9):1067-1074.


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FinalThoughtsonMasteringOurThoughtsWed like to end this section with some relevant quotes weve found helpful over the years:

Behavior is mind driving body in fulfillment of dominant thoughti.

It is time to make a choice. What will it be for you, responsibility or non-

responsibility? You cannot have it both ways. Either you are a helpless product

of genetics and environment wherein you accept the Nature-Nurture Doctrine as

your constitution, or you accept the Doctrine of Choice and Responsibilityii.

All that we are is the result of what we have thoughtiii

.

Of all the tools at your disposal, none is as powerful as your example. It is hard

for someone to argue about how dangerous a vegan diet is if you are the only one

in the office that doesnt have a serious health problem, such as high blood

pressure, high cholesterol, or diabetes. Myths about vegans having trouble getting

enough protein will evaporate if you are the fittest person in your circle of friends

or business associates. Instead of trying to convince someone that vegan foods

taste wonderful, invite them over or bring something special to the company get-

together. It is amazing what you can accomplish without saying much at alliv

.

Eat, drink, and be merry, for tomorrow you may die! has its distinct limitations,

for tomorrow you will probably be alive with a hangover! Maximum self-

actualizationv can, therefore, largely be achieved by peoples aiming for intensive

and extensive pleasures today andtomorrow; and where the former (as in many


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addictions) sabotage the latter, immediate gratification had often better be avoided

and long-range hedonism sought out and abettedvi.

i Deaton, Dennis. The Book on Mind Management. Second Ed.Mesa, AZ: Quma Learning Systems, 2003, 41.ii Deaton, Dennis. The Book on Mind Management. Second Ed.Mesa, AZ: Quma Learning Systems, 2003, 47.iii Attributed to the Buddha.iv

Brenda Davis and Vasanto Melina. Becoming Vegan: The Complete Guide to Adopting A Healthy Plant-Based

Diet. Summertown, TN: Book Publishing Company, 264v This term was coined by Dr. Abraham Maslow. It refers to our desire for fulfillment, to become actually what you

arepotentially. A musician must make music, an artist must paint, a poet must write, if he is to be at peace with

himself.vi

Ellis, Albert. Achieving Self-Actualization. New York: Albert Ellis Institute:http://web.archive.org/web/19981205062817/rebt.org/essays/achieve1.html.