I have talked about diabetes incessantly over the years and it's been like beating my little head against the wall.

How has this almost completely preventable disease become practically an industry in our modern culture?

And how can we take back control of our wellness and our blood sugar levels?

It's easy and delicious.

Let's talk about creating a truly sweet life today.

on Christina Cooks, the Macroterranean way.

Underwriting for Christina Cooks is provided by Suzanne's Specialties, offering a full line of alternative, vegan and organic sweeteners and toppings.

Suzanne's Specialties, sweetness the way Mother Nature intended.

Jonathan's Spoons.

Individually handcrafted from cherry wood.

Each designed with your hand and purpose in mind.

Additional funding is also provided by.

Hi, I'm Christina Pirello and this is Christina Cooks, where each week we take fresh seasonal ingredients and whip them into amazing dishes.

Will they all be plant based?

Yeah.

Will they all be delicious?

Yeah.

You know, I talk about diabetes a lot.

It's an epidemic.

In 2019 alone, 463 million Americans were diagnosed with type two diabetes.

In 2021, that number jumped to 537 million.

That's more than half a billion people with type two diabetes, which is, I'm sad to tell you, largely preventable.

Now certainly, diet plays a big role, but the diet that's prescribed for people with diabetes very often doesn't really do the trick, because if it did, we wouldn't be in this mess.

So let's take a different approach and take another look at the way people manage diabetes.

The first thing we're told is there will be no sweets.

That could not be further from the truth.

Now, can you live on donuts and candy bars?

No, but we're going to make a chocolate pudding with oatmilk, a stevia sweetened chocolate, that's going to melt into this oatmilk.

And what we have here now is a dessert that's going to be largely free of saturated fat.

Something that's very important for you to note, is that the root cause of diabetes is not sugar or refined carbohydrates.

Do they aggravate the condition?

Yes.

The root cause is saturated fat, which clogs the cell membranes so that they cannot uptake sugar from the bloodstream, causing diabetes.

So we've used a fair trade stevia sweetened chocolate with a little cocoa butter.

So there's a tiny bit of saturated fat.

So that has melted and it looks like chocolate milk.

So now we're going to take cocoa powder, about a half cup, very alkalizing to the system, a half cup of coconut sugar.

And you're like, whoa, a half cup?

Yes, this is a low glycemic non-insulin trigger sweetener.

So relax, you can enjoy this and wait 'til you see the size of the serving.

You'll really know you can enjoy this.

A little cinnamon, because cinnamon is going to lift the cocoa onto your palate, but also help to balance your blood sugar.

A little bit of arrowroot, about two or three tablespoons.

This is going to help to thicken the pudding...a little more.

We're going to whisk that together just to combine it.

And this is going to go right into our melted chocolate and oat milk.

You can also use soy milk.

You can use almond milk.

I don't recommend you use rice milk because it's just not creamy enough.

And this is pudding.

This is dessert.

You're making a little bit of effort here to make a better quality dessert so that you're not feeling deprived.

You're not feeling like you want to go out for a donut because you're just sick of all this.

This is going to make you feel indulged.

This is a great dessert.

Even if you don't have diabetes, which I hope you don't.

I hope no one ever gets diagnosed with it again.

Now you see how this has gotten nice and creamy and it's starting to thicken?

You want to put this into its serving cup before it gets too thick so that it continues to thicken as it cools.

But you need to cook the arrowroot for about 30 seconds.

If you don't, your pudding will have a lovely color and a lovely looking texture and a chalky aftertaste.

Not so fun.

So, we're just about there.

You can see it's really creamy and smooth and yummy looking.

Now we add vanilla.

Try not to cook your vanilla for too long or it turns bitter.

So now we'll whisk that in, turn off the heat.

Now you're thinking, okay, this is a healthy pudding.

Just give me a spoon.

This looks good.

This is two cups of oat milk.

This is a lot of dessert.

This recipe makes about eight servings because a serving is about the size of an espresso cup.

Look at that texture.

That's just amazing.

Now you can indulge yourself a little further.

This is a nondairy whipped cream.

You heard me.

A couple of raspberries.

And you have the perfect, wonderful dessert.

Now we'll be talking with an endocrinologist who specializes in diabetes for some really good advice.

And then it's off to Rome to talk about healthy living with my girlfriend, Elisabetta Luti.

[Inaudible] I'm so confused.

I'm here today with Dr. Brian Levy, an endocrinologist from New York, who's going to talk to us about diabetes.

Bryan, I've known you for a long time.

I'm going to call you Bryan.

That's great.

So I have noticed in my own life and in my own work, that type two diabetes has become more common.

Am I wrong?

Are we just like having access to more information or are you seeing that?

And what do you think is the driving factor?

So the short answer is yes.

Okay.

So I'm not crazy?

No.

Good.

The incidence of type two diabetes continues to grow.

Okay.

I think what your viewers probably know is all this talk recently in the last couple of years about the COVID pandemic.

We've forgotten that we're in a diabetes epidemic.

Right.

And we can't forget about that.

Right.

So to give you a sense of how it's growing, currently, about one in ten Americans will develop type two diabetes.

That often, like that many?

Yeah.

But this is the more astounding thing.

Babies born today, one in three babies will develop type two diabetes.

And if it's a baby of color, one in two babies.

So that gives you a sense of the increased incidence.

And, and are you in agreement with me that our food has devolved is what I like to say, so much in the last 50 years, that is that even mother's milk is helping to contribute to that or is it all the formulas and the other things that are being fed to our babies now?

Well, I can't really speak to the pediatric aspect.

Right.

But the adult aspect, yes.

The diet has really changed.

Right.

As you know, a lot better than me.

You know, processed foods, fast foods, portion sizes all have contributed to the increased incidence of type two diabetes.

And in addition, it's the inactivity of people.

Everyone is sitting at their desks or at their computer terminal or on their iPhone or in their car.

So it's not like the old days where the farmer worked in the fields all day and came home and ate unprocessed food.

Right.

That's that's really the major changes that we're seeing in today's society.

So one of the things I notice is that at least in my experience, I don't see as much incidents in the countries in Europe where I kind of hang out as I do here.

And I'm wondering how much of that has to do with.

well, first of all, the smaller portion sizes, but they also walk a tremendous amount more than we do.

And and are those really driving factors, would you say?

Absolutely.

I mean, when you manage a person with type two diabetes, no matter where they are in their journey or on their journey, you always have to focus on how to increase activity and how to teach about portion control and the kinds of foods you eat.

Okay, so pick for me the top things that people can do to prevent going down the type two diabetes road.

I know there's always a risk, but the most that they can do to prevent this even becoming, you know, them becoming a statistic, shall we say?

Sure.

So you can't do anything about genetics.

Right.

Type two diabetes is a genetic disease.

It is.

Oh, yes.

Again, I love giving examples.

You take identical twins.

If one twin develops type two diabetes, there's a 90% concordance that the other twin will develop type two diabetes.

Even if they live a different lifestyle?

Correct.

Wow.

So prevention.

Well, the first thing is regular medical checkups.

I have to say that.

Okay.

You want to screen people every year.

Okay.

For pre-diabetes.

What's pre-diabetes?

It's lower blood sugars than diabetes, but higher than a normal person.

Okay.

Right.

Because you want to act then.

It's all about prevention.

Right.

Right.

So after the medical checkup, the patient needs to focus on lifestyle.

Okay.

And lifestyle is two components.

Physical activity and the kinds of foods that you eat.

And when you say physical activity, is there a threshold they should meet?

No.

30 minute walk every day?

So it has to be...get up every hour?

It has to be individualized.

Okay.

You're not going to take someone who sits in a chair all day and make them a marathon runner.

Right.

And at the same time, you're not going to take an athletic marathon runner and tell them to walk two miles a day.

Okay.

So you have to know what their exercise tolerance is and what they do and then put them on a program that slowly increases it and builds endurance.

Okay.

So between that and managing the kinds of food they eat, they kind of have a shot at preventing it?

Absolutely.

And that's probably the best news for all of us.

Yeah.

The problem is screening..Yeah.. in that so many people do not have appropriate screening in our current health care system.

Okay.

Well, there you go.

You want to prevent diabetes, get screened, be active, watch what you eat and don't eat quite so much.

Thank you, Dr. Levy.

You're very welcome.

Nice to have you.

Good to be here.

Ciao, Elizabetta, what a place!

You like it?

Wow.

Yes, I love it.

I think it's nice.

I've never seen anything like this.

Special.

It's special.

What is it?

I mean it's a coffee shop seat.

It's a coffee shop, but It's a kind of little museum.

Of?

It was the ateliers.

Okay, workshop for Canova.

Canova was on a sculpture.

Yeah, very famous one, neo-classic style.

You see these big statues reminding of mythology?

That's neo-classic.

It's amazing.

Yeah.

So then it just, they just made it a coffee shop?

Made a coffee in the middle of the.

Yeah.

And there is a restaurant, too, upstairs with beautiful rooms.

Wonderful.

Also very quiet.

You get inside like very charming and intimate.

Yes, I like it.

So I, the reason I wanted to meet with you...

I always want to meet with you.

We've been friends for how many years?

[speaking Italian].

20 years.

Maybe more?

I think 20.

One of the things that, you know, the work I do is we work a lot with people to try to manage diabetes and mostly type two, of course, which is different than type one.

Yes, but still diabetes.

Yes.

But you have been type one since... For almost 50 years.

Yeah.

I'm not telling you what, otherwise the way you know exactly my age.

But I do, but that's okay.

Okay.

The whole world doesn't need to know.

Almost 50 years.

But I want you to to talk to me about because many, many people struggle in the US about how to manage, how to day to day manage without.

I think from when I began it was really nothing.

It was we consider it very [inaudible] times for diabetes care because we had nothing, no devices, no tests, nothing.

Right.

So what did keep track?

We only kind of guess, we were.. How you felt?

How we felt.

Okay, but the problem was that you only felt very severe hypo.

Hypo or hyper.

Hypo.

The hyper is a harder to to feel.

Okay.

So that was terrible.

Now we have devices that help you always see these.

When I go around, I do these every, I don't know, ten times a day, maybe 20.

And it tells about the...

But it helps you stay balanced.

Yes, oh yes.

It's a hard life.

It is.

But you can make it.

I mean, you have to calculate a little bit to the carbs.

Mm hmm.

We are.

We need carbs.

Of course.

That's something I am totally against is no carbs.

But, yeah, we die without carbs.

Of course.

And then kind of manage it and eat Italian food is I mean, maybe it helps, probably.

we have.

I think so, yes.

I don't know.

We have less sugar, hidden sugar inside food.

Less processed food.

Less processed.

That's that's I think.

Yeah.

And having been with you on so many trips in so many ways, I notice that you are very...I don't want to say ..disciplined.

And it's because you don't want and don't have any of the illnesses that come with many years of diabetes.

I don't know if it's thanks to me or I've also been lucky probably that my eyes are okay.

Yeah.

My kidneys, everything is okay.

Skin, everything.

Yeah.

No neuropathy?

No, no, no, nothing.

And we are checked regularly and we can also eat some sugar now.

Yeah.

So you have to calculate to, know if I'm having let's say a huge gelato beautiful one today.

Okay, maybe I just have a salad before and that together makes a meal that's possible.

So you just have to calculate to keep balance.

So if you want to have a bowl of pasta.

Yeah.

Then you will have that once, not twice a day.

Yes, exactly.

Or but some carbs.

Every meal we have to have carbs center.

Right.

Breakfast, lunch.. That's a misconception that we have in America.

No carbs, no carb, no carbs with diabetes.

It's, it's, it's forbidden in Italy except for for diabetic people not to have carbs.

Because it helps balance glycemia.

And it to work.

It's for the brain, too.

Yeah, of course.

Without carbs, the brain doesn't work.

It's hard to think.

And do you regulate fat or no?

I only use oil, usually, because in this region, in this area we use more oil.

And to the fats as protein gives, this is very technical, but... Go ahead.

Sugar goes faster high after carbs.

Yes.

The protein and fat give speed, a push to the glycemia after 3 hours so you know that.

So it's slow.

Slow.

I have these I know what's happening and then maybe I inject another unit of insulin.

That's it.

And if you are low, you take sugar?

I take sugar.

I take sugar.

Because it's quicker than if you were to eat nuts or something.

We have we have all diabetics know or should know the reason [speaking Italian} it means the rule of the 15.

15 means 15 grams of carbs.

Okay.

So that we know we've we we are told, it's either three max like this.

So because each one is five grams or a hundred grams of Coca-Cola.

Okay.

Because in Italy it contains 15 grams of sugar.

Real sugar?

Real sugar.

Sugar, yeah.

And fruit juice regularly sweetened.

Not, we do not use unsweetened stuff.

Right, but regularly sweetened with fruit sugar?

Si.

Not even sugar.

Doesn't matter because you read to the carbs.

You want the grams You want the 15 grams.

That's very important.

And the 15 grams is what makes balance.

Yes, that's the thing.

That's the thing.

They discovered that.

Yeah.

And do you find that weather is an issue?

This is again a little technical.

That's okay.

The density when you sweat.

Mm-hmm.

It changes a little bit.

It's liquid.

So liquidy, they are liquids.

So it's [inaudible] Because then your sodium potassium balance changes because you're sweating.

And these things work less with very hot and very cold temperature outside.

So you know that.

How do you... Hey, you, you learn, you learn, you try, you always have something to eat in your bag.

And not only sugar, but maybe also some.

I don't know what's the name of that?

Slow carbs like sugar.

Like nuts, or something like that.

Or bread.

Or bread.

Ok, something that's a little bit slower, but will... and the way you manage, you kind of keep your, I always say on a slow burn, a constant carbohydrate like, you know what I mean?

So that you're not... Si, si.

So you're saying that even though it's a challenge, it's a, it's a difficulty.

It's a, it's a life.

You have to be aware every minute.

Every minute.

Okay.

Yes.

Okay.

[Inaudible] Okay.

But what you laugh a lot.

Oh, yes, of course.

[Speaking Italian] Thank you.

Let's finish our cocoa.

Yes.

We get a lot of email questions.

And so I thought I'd take a couple of seconds and answer one.

This one's from Rick from South Texas.

And Rick wants to know about carbohydrates, because all he hears is that carbohydrates are evil.

Well, the problem with that thinking, Rick, is that carbohydrates are something that we need.

The body wants to break everything we eat down into glucose, which fuels our brains.

So eating carbohydrates are good for us.

Of course, it depends on the quality of that carbohydrate.

If you're eating white bread, white flour, white sugar, not so good.

If you're eating whole grains, some beans, vegetables that are a little starchy, like carrots and winter squash, whole grain breads, whole grain pastas, you're going to do just fine when it comes to carbohydrates.

Many people struggle with type two diabetes and they're not sure what to do with carbohydrates.

And that's going to be individually based on your condition and how you manage your blood sugars in your life naturally, whether you use medications or not.

But carbohydrates are not the bad guy.

It's the quality of the carbohydrate, how we eat them, and of course, how much.

So you have to keep your carbohydrates in check and then you should be just fine, Rick.

So enjoy a bowl of pasta now and then.

You know, the key to managing type two diabetes or preventing it all starts with digestion.

It's all about the function of your gut and the health of your gut.

So we're going to make a really quick, really easy salad that's going to help you to improve the quality of your digestion so that you can manage or better yet, prevent getting type two diabetes.

This will really help.

This is fennel.

Fennel has a very sort of anis-like, licorice-like--if you will--taste.

And it's excellent for digestion.

Now, if you're thinking, I don't really like the flavor of anise or licorice, then maybe this salad is not for you.

But this salad will be great.

And when we're done flavoring it, the anise flavor will be muted so you can enjoy fennel.

You can also roast fennel in the oven if raw is not for you.

But this salad is so fresh tasting and so yummy, and has so many flavors going on for as simple as it is, that you're really not going to mind the fact that there's fennel and that it has a fennel flavor.

So the fennel is sort of the base.

I'm going to do another one or at least a half.

You want a nice thick layer of fennel.

And what you're doing is you need a sharp knife for this because you really have to slice the fennel thinly.

Now, you could use a mandolin if that's your groove.

But for me, I'm moderately terrified of mandolins, so I don't tend to use them.

My husband does.

I don't.

This is a Granny Smith apple.

That's our second ingredient.

And Granny Smith apples are sour and a little more astringent and really good for digestion.

They're also like all apples, high in pectin and really, really, really good for your heart.

Take the core out.

About a half apple will be good because the fennel are small.

They're like spring fennel.

And then you just lay these on top.

This sort of a layered--not sort of--it's a layered salad.

Let's be real.

And then, now you have to kind of move on this so your apple doesn't turn.

You're going to pull some of the fennel up top so that you see it.

This is, this is really a composed salad, if you will, in French terms of cooking.

All right.

So now we're going to season it with a little bit of extra virgin olive oil for richness and also to help you digest, a little sprinkle of salt to help to start to break down the rawness of this.

Like that.

And then a little fresh parsley on top.

And then my favorite, favorite, favorite, favorite kitchen hack that I just found out is also my assistant director's favorite kitchen hack.

So, Terry, come on up and play.

Come on, Terr.

Terry said to me just before we started shooting, I love that frozen lemon thing.

So Terry, grate away.

Oh, great.

Okay, so you're going to cover this with a nice layer of frozen lemon so that when you take the fennel, the apple, it's like the perfect bite.

Perfect.

You're amazing.

Thank you.

Go for it.

Thanks, Terr.

And so there you have it.

The perfect end dish to this lovely way to manage and work with type two diabetes.

We've gotten some great information today, so I hope that you can take it and, use it to benefit your wellness.

So what are you waiting for?

Let's get back to the cutting board and I'll see you next time on Christina Cooks, The Macroterranean Way.

Underwriting for Christina Cooks is provided by Suzanne's Specialties, offering a full line of alternative vegan and organic sweeteners and toppings.

Suzanne's Specialties, sweetness the way Mother Nature intended.

Jonathan's Spoons, individually handcrafted from cherry wood.

Each designed with your hand and purpose in mind.

Additional funding is also provided by.

You can find today's recipes and learn more by visiting our website at Christina Cooks.com and by following Christina on Instagram, Facebook, Twitter and Pinterest.

The companion cookbook, The Macroterranean Way, Volume Two combines the Mediterranean diet with the ancient wisdom of Chinese medicine, allowing us to understand how food affects us, so we can cook deliciously while creating the wellness we want.

To order your copy for $19.95 plus handling, call 800-266-5815.

Add Back to the Cutting Board and Christina's Iconic Glow, a prescription for radiant health and beauty and get all three books for $49.95, plus handling.

Call 800-266-5815.