Diabetics Should Take their Pulses

Diabetics Should Take their Pulses
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There’s a reason that professional diabetes associations recommend bean, chickpea, split pea, and lentil consumption as a means of optimizing diabetes control.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

How did doctors treat diabetes before insulin? Almost a thousand medicinal plants [were] described as antidiabetic agents,…most of [which] have been used in traditional medicine.” And, these included beans. Of course, just because something has been used for centuries doesn’t mean it’s safe. Other treatments for diabetes have included arsenic and uranium. Thankfully, many of these remedies fell by the wayside, but “[s]cientific interest in the antidiabetic potential of bean[s] never vanished completely, and even was raised in the past decade.”

“Health authorities from all over the world universally recommend increasing [the] consumption of whole grains and legumes for health promoting diets.” And, one of the reasons is that they may decrease insulin resistance—the defining trait of type 2 diabetes.

“Diabetes…[is] a global public health…epidemic. Although [oral hypoglycemic medications] and injected insulin are the mainstay…treatment[s] of diabetes and are effective in controlling [high blood sugars], they have prominent side effects and fail to significantly alter the course of diabetic complications.” [C]ommon side effects [include] weight gain, [swelling],…liver disease.”

But, I want to emphasize that second part. “[T]he mainstay [of diabetic] treatment fail[s] to significantly alter the course of diabetic complications.” Shouldn’t that be the whole point of treatment? Thankfully, “lifestyle modifications have proven to be greatly effective in the management of this disease.” And, if there is one thing diabetics should eat, it’s legumes: beans, chickpeas, split peas, and lentils.

The European Association for the Study of Diabetes, the Canadian Diabetes Association, and the American Diabetes Association all “recommend the consumption of dietary pulses as a means of optimising diabetes control.” What are pulses? They’re peas and beans that come dried, so a subset of legumes, so excluding green beans and fresh green peas, which are considered more like vegetable crops, and also excluding the so-called oilseeds—soybeans and peanuts.

This review compiled 41 “randomised controlled experimental trials,” including more than a thousand patients, corroborating the official “diabetes association nutrition guidelines recommending the consumption of pulses as a means of optimising diabetes control.” Any better than any of the others? Well, some of the strongest evidence came from the studies that used chickpeas, and in terms of beans, pintos and black beans may beat out kidney beans. Compared to the blood sugar spike of straight white rice, black beans and rice, and pinto beans and rice appeared to beat out kidney beans and rice. This may be because “dark red kidney [beans] [can] have lower levels of indigestible starch.” One of the reasons beans are so healthy is they contain compounds that partially block our starch-digesting enzyme, which allows some starch to make it down to our colon to feed our good gut bacteria.

And, in fact, the inhibition of this starch-eating enzyme, amylase, just by eating beans, approximates that of a carb-blocking drug, acarbose, sold as Precose, “a popular diabetes medication.” The long-term use of beans may normalize hemoglobin A1C levels (which is how you track diabetes) “almost as well as” the drug, without drug side effects, with names like “acute generalized exanthematous pustulosis.”

Please consider volunteering to help out on the site.

Images thanks to Osseous, k.landerholm, and Stacy Spensley via Flickr.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

How did doctors treat diabetes before insulin? Almost a thousand medicinal plants [were] described as antidiabetic agents,…most of [which] have been used in traditional medicine.” And, these included beans. Of course, just because something has been used for centuries doesn’t mean it’s safe. Other treatments for diabetes have included arsenic and uranium. Thankfully, many of these remedies fell by the wayside, but “[s]cientific interest in the antidiabetic potential of bean[s] never vanished completely, and even was raised in the past decade.”

“Health authorities from all over the world universally recommend increasing [the] consumption of whole grains and legumes for health promoting diets.” And, one of the reasons is that they may decrease insulin resistance—the defining trait of type 2 diabetes.

“Diabetes…[is] a global public health…epidemic. Although [oral hypoglycemic medications] and injected insulin are the mainstay…treatment[s] of diabetes and are effective in controlling [high blood sugars], they have prominent side effects and fail to significantly alter the course of diabetic complications.” [C]ommon side effects [include] weight gain, [swelling],…liver disease.”

But, I want to emphasize that second part. “[T]he mainstay [of diabetic] treatment fail[s] to significantly alter the course of diabetic complications.” Shouldn’t that be the whole point of treatment? Thankfully, “lifestyle modifications have proven to be greatly effective in the management of this disease.” And, if there is one thing diabetics should eat, it’s legumes: beans, chickpeas, split peas, and lentils.

The European Association for the Study of Diabetes, the Canadian Diabetes Association, and the American Diabetes Association all “recommend the consumption of dietary pulses as a means of optimising diabetes control.” What are pulses? They’re peas and beans that come dried, so a subset of legumes, so excluding green beans and fresh green peas, which are considered more like vegetable crops, and also excluding the so-called oilseeds—soybeans and peanuts.

This review compiled 41 “randomised controlled experimental trials,” including more than a thousand patients, corroborating the official “diabetes association nutrition guidelines recommending the consumption of pulses as a means of optimising diabetes control.” Any better than any of the others? Well, some of the strongest evidence came from the studies that used chickpeas, and in terms of beans, pintos and black beans may beat out kidney beans. Compared to the blood sugar spike of straight white rice, black beans and rice, and pinto beans and rice appeared to beat out kidney beans and rice. This may be because “dark red kidney [beans] [can] have lower levels of indigestible starch.” One of the reasons beans are so healthy is they contain compounds that partially block our starch-digesting enzyme, which allows some starch to make it down to our colon to feed our good gut bacteria.

And, in fact, the inhibition of this starch-eating enzyme, amylase, just by eating beans, approximates that of a carb-blocking drug, acarbose, sold as Precose, “a popular diabetes medication.” The long-term use of beans may normalize hemoglobin A1C levels (which is how you track diabetes) “almost as well as” the drug, without drug side effects, with names like “acute generalized exanthematous pustulosis.”

Please consider volunteering to help out on the site.

Images thanks to Osseous, k.landerholm, and Stacy Spensley via Flickr.

Doctor's Note

What about avoiding metabolic derangements in the first place? See Preventing Prediabetes by Eating More.

What else might help?

What might hurt?

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62 responses to “Diabetics Should Take their Pulses

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  1. That’s something the paleo quack movement won’t tell you, and don’t want you to hear. That beans are certainly the most healthful food to eat, contrary to fraudulent paleo dogma. They don’t like beans because it’s a better, healthier, safer, cheaper alternative to meat, which they praise upon. The whole point of cherry picking the paleolithic time frame – and not something else – is a bias in itself.

    http://www.youtube.com/watch?v=McJjIf7x2mk




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    1. Adrien: I love Plant Positive! I haven’t seen all of his stuff yet, though and I hadn’t seen the one that you linked to. I think it is a really good one. The jokes and turn of phrase in this one remind me of Dr. Greger.

      Between Dr. Greger’s many videos on beans and info from Plant Positive, it blows the mind that anyone would think beans were bad for the typical human.

      Thanks for the link!




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  2. And even better – if you eat a mostly whole foods plant based diet, combined with a little exercise, you probably wont get diabetes in the first place. Diabetes is a serious condition – diabetic complications include heartattack, stroke, blindness, kidney failure, impotence, painfull neuropathy, amputation, skin ulcerations. No steak with gravy is worth that!




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    1. Does the severity of Type II diabetes correlate with weight in a given individual? It seems like a continuum rather than a “limit” that, beyond which, you are diabetic.




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  3. What can you do, for people that say, “I dont care if its bad for me. Everybody is going to die anyways?”
    what if you care for someone who have this mindset?




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    1. I have a DVD of Forks over Knives sent to loved ones and friends. Its very cheap. Most people will sit through and absorb the gist of it. In the end, setting a good example is the most powerful persuasion.




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      1. You are so right about setting a good example. I am diabetic and I have several diabetic relatives, one of which is now experiencing increasing insulin resistance and diabetic complications. All of this is occurring after years of carefully following their doctor’s advice and taking their medications.

        He lost weight from walking every day and eating “better”, avoided sweets and took his medications. He progressed to eventually go on insulin. Now doctors are having trouble getting his sugars under control at all and he is starting to show some kidney damage. But how can this be?

        He traded in the carbs for fat. Meat, cheese, yogurt etc have all been his staples. I was diagnosed recently. My sugars have been improving on a plant-based diet without the use of any medications. I believe he can still turn things around, but I don’t believe he will listen if I don’t show him. My desire to motivate him keeps me on track.

        If you’re worried about a loved one, be their inspiration. If you can’t be, find someone who can. Brow-beating doesn’t work, but I believe good information and inspiration definitely can.




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        1. Penny T: Thanks for your post. I think this will make you a roll model for a lot more than just your family.

          Best of luck to you.




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        2. hi penny, is so sad to hear about your relative[s luck.
          I believe that you are doing the right thing.
          I would like to hear from you in a couple of months, let us know your improvements! your HbA1c levels should be dropping by then… that would be encouraging!




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      2. FOK saved my butt and I am always recommending it! It is hugely important for people to see this, even if they “file” it for future reference, like I did. The first time I saw it I did appreciate the message, but didn’t act until confronted with a diabetes diagnosis. SAD but true. We each have our “straw”, but having this important info stored is the difference between floundering in defeat or getting off your butt and taking the positive actions.
        It’s so frustrating being surrounded by so many people who could benefit dramatically but are oblivious to the extent they could nullify their own medical problems, or even to believe they could. I always hear it’s genes, fate, whatever. Even those who know my history seem resolute in believing is was my isolated success and not that they could expect the same. I guess that’s easier than acting…I was there myself. I wish we could somehow implant that key element that finally motivates our loved ones into action, but knowing what to do comes first. Lately I am encouraged to see that WFPB finally seems to be gaining momentum so I’m not the only “weirdo” talking it up! Now we have lots of great info out there (huge plug for “How Not to Die!) to inspire and encourage and make the “new weirdos” the ones who continue to abuse themselves with the S.A.D. that has become ubiquitous!




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        1. Yep, I notice the same thing… the word is spreading. But I am sorry to say this but there are more than a few who have decided that they are going to enjoy life in misery(!) and have the food they love so much. As my dear and departed mother in law told me, “Son you will live til you die” as if it was all out of our hands. So on we go. Thats why I say, teach your children (and grandchildren) well…one good way is to set a good example. Thats what you do Charzie. Party on.




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        2. My shrink told me that going on WFPB no added fat was “too extreme” but since I’ve lost 40 lbs (and still losing) and got off insulin (still taking meds but that should change soon), he’s changed his tune. He’s about to do a 21 day kickstarter for himself, and is having no luck convincing his other patients to try it in spite of their numerous complications. The problem with treating depressed diabetics is that food is their one comfort, and it’s hard to convince them to give it up. Maybe once my shrink is WFPB himself, he’ll have better arguments!




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    2. I always tell them it’s about the quality of life while you’re here. You could die tomorrow but until then, don’t you want to be energetic, flexible, strong, mindful, autonomous, and not hooked on prescription drugs?




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    3. Not only that, but your life and health was a gift from your mother. Why treat your mother like dirt by disrespecting her greatest gift to you?




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  4. Mung lentils, or specifically the yellow split “moong dal” lentils, have become my favorite pulse though they are not usually sold in any of the markets that I visit. (This Google search link shows images of this lentil: http://j.mp/1lvp4ai). Using the pressure cooker, I simply add one cup of lentils with three cups of water and throw in a few mustard seeds and cumin seeds, which I image only add a bit of flavor and fiber and aren’t digested or included in calorie counts…). Pressurize for 8 minutes, and then 8 more on the cooling cycle, and then stir briskly to form a creamy texture. It’s the easiest, most tasty bean that I’ve come across… Into the frigo for daily consumption over the next few days…




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    1. Tobias: Nice! Thanks for sharing. I think I’ve seen those beans in the bulk section of the store I usually visit. Now I’m tempted to give them a try. I have a pressure cooker and those seeds you mentioned. It sounds simple. Why not! Thanks again.




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      1. I would suggest trying them in sambar: https://en.wikipedia.org/wiki/Sambar_%28dish%29

        There are many incredible recipes for sambar, are easily adapted (no oil or
        ghee) The result is wonderful. But my favorite lentil is still masoor daal (red lentils) for it. :)

        And they happen to be the better ones. http://nutritionfacts.org/video/the-healthiest-lentil/

        With Madras curry (I like Sharwoods) besides more spices. And I am still in
        love with basmati rice… Many variations possible.




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      1. It tastes great plain but seasonings that I’ve used include: Pepper, nutritional yeast, curry, soy sauce, garlic, ginger… Sometimes I cook it initially with tomatoes.




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      2. Try sprouting them too, IF they are whole, obviously. Easy and an amazingly versatile ingredient for stir fries, salads, soups, sandwiches, you name it!




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    2. Yellow split moong dal is widely used in South Indian dishes and is easily available in large quantities in an Indian grocery store. For more ideas on how to cook them, google to Indian cuisine recipes online.




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    3. Mung green beans are also my favourites. I get them usually in Indian shops in zone 3 in Upton Park in London. They come in 4 varieties: whole small, Whole big, crushed with skin left, and with no skin. The latter one cooks in no time. The other three need a good soaking 12 hours. I was told by an Indian mum it is better to follow this soaking methods as there is no ‘gas’ formation during digestion time. The red ones are also great. I have bought them whole only. These mung beans are so versatile I find them a delicacy. Bon apetit!




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    4. Shopping in a local Indian/Asian market with their primarily vegetarian selection has become my favorite destination in stark contrast to the gamut of challenging dichotomies in navigating the standard grocery stores! I guess I have pretty adventurous tastes because I have always loved shopping at ethnic markets to sample new ingredients, but it’s always helpful, and was often difficult, to have a clue what best to do with them. Despite being affordable, if they weren’t utilized to their potential, a waste of (potentially) good food and money. With the internet, that sure is not a problem anymore! In fact, it’s become a new habit and a kick for me to just purchase a new item that piques my interest, and once it’s home, learn about it, try different recipes, taste them, expand my horizons! Through this experimenting, I’ve yet to hate or waste any “new” ingredient, and have actually garnered a slew of new and exciting staples that I probably would have never encountered otherwise. Kind of the poor woman’s version of global exploration since I have learned so much, not just about the food itself, but also about cultures, geography, history, traditions…you name it! I think anything we can do to reinforce and encourage our healthy choices and behaviors has a whole avalanche of other positive attributes to increase our joy of this amazing journey!




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  5. I use a lot of canned beans (red and white kidney, chickpeas), and I cook from scratch lentils, split peas and mung beans. Does anyone have a comment on the digestibility/palatability of beans cooked to a “mush,” versus “firm” beans as you might find in a can? Thanks.




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    1. I’ve read that long slow cooking makes beans more digestable but don’t know for sure. Only know that I really like soft beans in their own nice thick juice.




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    2. About digestible thank you of beans has more to do with your digestive system than the beans themselves. Actually it is a great diagnostic tool to know the state of your digestive system, add beans




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    3. I prefer beans as mush as long as it’s got flavor. One of my standards is “refried” beans: beans slow-cooked with onion, garlic, and spices, then mashed with a potato masher. I can’t really provide comparative data on digestibility, but I have no problems after eating 8-12 oz. of the mush.

      (Despite what some say, there are really only two food groups: the mushy group and the crunchy group.)




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    4. I think what’s best for YOU is which ever way will get you to consume them regularly, since I think sometimes our enjoyment of eating plays a role in how we actually process it during digestion. Wolfing something down because its “good for you”, almost has to less “digestible” than something you savor because you actually enjoy it. Not exactly science I know, but I sure find it to be true.




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    1. Beans are great, but for those with Type 1 or 1 1/2 Diabetes, and kidney disease, too much protein (even though veggie protein is less harmful than animal) can be a problem…Mike




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  6. My 91 year old mother has type II diabetes and is on dialysis. Must restrict potassium especially. Is a bean diet out of the question for her?




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    1. Hi Paul, thanks for your thoughtful question :)) Beans are not particularly high in potassium: http://nutritionfacts.org/questions/which-foods-have-the-most-potassium/ and can be safely (and healthfully :) eaten by patients with both Type 1 and Type 2 diabetes. As for you mother’s dialysis-dependent kidney disease, check out this piece: http://nutritionfacts.org/video/treating-kidney-failure-through-diet/ Hope this helps your mother :))




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      1. Hi Jen, that being said, what happens when your renal function is impaired? Can you eat them without any adverse side effects? Though beans do not have particularly high potassium levels, they are considered high for someone with chronic kidney disease.




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    1. low carb diets only hide the insulin resistance not cure it. its a smoke and mirrors scam. people need to be warned to not get suckered into the dangerous low carb fad.




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    2. The above question was posted in 2014. In June 2017, the president of the American Heart Association released an updated report and statement on saturated fats: http://circ.ahajournals.org/content/early/2017/06/15/CIR.0000000000000510

      Lowering your saturated fat intake does not improve health, if you are replacing that saturated fat with refine carbohydrates.

      However, replacing saturated fats with polyunsaturated fats does improve health – cardiovascular disease is reduced by about 30%.
      .




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  7. The only way to really know the effect of beans on one-self is using a glucometer. In my experience they are pretty bad for post-prandial sugar. On the other hand, I don’t undertand what’s supposed to show the graph of minute 3. This graph compares beans with white rice. The latter rises quite a lot the blood sugar. So yes, comparing beans with white rise, or directly with table sugar, they don’t look awful for sugar control.

    Ah, and the phytates in the beans don not make them specially attractive.




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    1. i believe is the glycemic index in lentils, for example (which by the way lentils have one of the lowest glyc indexes), that helps in avoiding those nasty hyperglycemic peaks




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  8. I developed diabetes 2 several years ago when I weighed around 210 at 5’8″. I have been eating vegan for 3 years and my weight has dropped to around 168. I go to the Y for exercise every day and my last blood glucose reading was 95. I no longer take Metformin.




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  9. Thanks you Dr. Greger for your awesome work in raising awareness. I have followed your diet and specially adding legumes lowered my husband’s fasting glucose from 150 to 105. I do not have words to show my sincere gratitude to Dr. Greger. God bless him. May everyone find there cure through food.




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  10. Doctor Greger – at 2:13 you mention that fresh green peas are considered more like vegetables – however if that same green pea gets dried, it becomes a pulse. How?? How does the simple absence of moisture change the nature of a pea from veg to pulse?




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  11. What about Lectins? I’m working on environment allergies to things like grasses, trees, weeds, and cats, chronic fatigue and inflammation. Cutting out grains has significantly reduced, even eliminated gut pain. Eating no dairy, grain or nightshades, cashews, peanuts, and only occasional tempeh reduces diet choices. I read Dr. Gundry strongly suggests eliminating most beans because of Lectins. HIs description of how lectins coat blood cells matches the sensations of getting sticky inside with allergies and inflammation. I don’t see Lectins addressed anywhere on Dr. Greger’s site. What is the latest information or view on Lectins?




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  12. “the inhibition of this starch-eating enzyme, amylase, just by eating beans, approximates that of a carb-blocking drug, acarbose, sold as Precose, “a popular diabetes medication.””
    How about just eating as much as possible low GI foods to reduce the blood spike and monitoring ? This is clear example of cherry picking article.

    The study with bean and rice show on average by “eyeballing” a postprandial blood glucose around 7 nmol/l or 126mg/dl after an hour.

    With low GI food, you can obtain result on average 6 nmol/l or 108mg/dl. It is based on personal experience with my mother (an others) by using a glucometer. We have check her glucose level more than 500 times
    so we have a clear idea about the impact of her food preference on her BS.

    We have tried white rice, beans, chickpeas, you name it. But on with low GI food she was able to really reduce it that much +60mn.

    With that simple modification (not starches: potatoes, rice, beans…), plenty of low GI vegetables (not paleo) she was able to reduce her hba1C by 1 point (from 7% to 6%) with medication unchanged.
    She was even able to removed he low blood pressure med and now she has a average 100/60 with only food and metformin unchanged at 60 years old.

    Even the surprised endocrinologist check it twice for confirmation.

    I am not saying that beans should not been eaten by diabetic. Only that BS may vary from individual and individual and all diabetics should evaluate their own glucose tolerance regarding their hbac1/bs objective and preferences and do not rely solely on studies (see SGBM) and drug-funded diabetic association promoting deathcare around the world (eg: the ADA received in 2008 2.3millions from Takeda Pjarmaceuticals see http://web.archive.org/web/20100508033356/http://www.diabetes.org/assets/pdfs/2008-revenues-received-by-ada.pdf ) .

    Also an recent study from Israel has already demonstrated that the BS vary greatly depending on the subject with the exact same food. So measuringis key.




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  13. I am a community health home visitor and I need a one-page or two-page food guide for my diabetic clients. Can someone at NutritionFacts.org create this, please? White rice is a staple in their diet and I think they need to switch from white rice to brown rice but that’s not totally clear because of the rice-arsenic data recently found. Maybe they should just switch from white rice to purple sweet potatoes? Also, should I suggest they get 20 minutes of sun (we are near in the tropics) or take a vitamin D supplement? Also, what are the plant-based options when it comes to sandwiches to take to work, other than peanut butter and jelly? I’m guessing a tofu sandwich might be a hard sell. I like refried bean sandwiches but a lot of people would think that’s really weird.




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    1. Hello healtheducator: Thank you for your comment. You can find a PDF of Dr. Greger’s Daily Dozen here. I love chickpea salad sandwiches! Stay tuned for the How Not to Die cookbook that’s coming out later this year. In the meantime, I would recommend searching the recipes on Forks Over Knives or Engine2.




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