Jeff O’Connell is the author of “Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat It.” I discovered his book while browsing the shelves of my local library, and I could hardly put it down. Though I have type I diabetes and O’Connell’s book focuses on type 2, I found many of his thoughts applicable to my own health. His book is no doubt controversial, so I wanted to delve deeper into his daring claims and share his responses with the diabetic community. After reading my interview with Jeff, please leave a comment below to let Diabetes Health know what you think.
Rachel: Tell me about yourself, personally and professionally.
Jeff: I’m six-foot-six and weigh 190 pounds, so I’m hardly the poster child for diabetes or prediabetes. After graduating from UCLA in the late 1980s, I embarked upon a career in fitness magazine publishing. Along the way, I’ve been editor-in-chief at Muscle & Fitness, executive writer at Men’s Health, and, presently, editor-in-chief at Bodybuilding.com in Boise, Idaho. I’ve also co-authored four books, including the New York Times bestseller “LL Cool J’s Platinum Workout.” “Sugar Nation” is my first solo work, however. It was spun off from a Men’s Health feature of mine called “The Thin Man’s Diabetes.”
Rachel: How is Sugar Nation different from other diabetes books? Why did you decide to write it?
Jeff: Uniquely, “Sugar Nation” weaves together memoir, investigative journalism, and Men’s Health-style how-to writing about diabetes and reactive hypoglycemia. The publisher, Hyperion, calls it a prescriptive memoir, meaning that readers can learn how to better manage their blood sugar through the prism of my experience. I hope that the personal story is a bit of a page turner, one that almost seduces readers into learning about diabetes and metabolic syndrome by accident. A million things have been written about this disease, but often the information is tuned out as being boring and pedantic. If I can hook people into reading about my family’s experience with type 2 diabetes, a byproduct might be that they learn more about their own blood sugar.
That’s really why I decided to write “Sugar Nation”: to initiate the uninitiated. When I was diagnosed with prediabetes in 2006—on the heels of learning that my father had just lost a leg to the disease—I didn’t have a clue about how to combat this health threat, despite working for Men’s Health! Only because I had that position and those resources was I able to figure out a solution—one much different, by the way, from that suggested by the American Diabetes Association and other organizations. I thought, what chance does the average person who doesn’t work for Men’s Health have against this stealthy killer? I was incredibly fortunate and lucky, so I decided to share what I learned with others so that they might avoid my father’s fate.
Rachel: Diabetes organizations tend to put carbohydrates as the number one food source for people with diabetes—stating that the majority of our calories should come from carbs. Yet you say in your book, “The dietary advice for diabetics being dispensed by the highest US medical authorities isn’t just contradictory; it’s also nonsensical.” Explain what you mean.
Jeff: Diabetes is first and foremost a disease of glucose intolerance. Therefore, it seems logical to me to strictly limit the sources of that intolerance: sugar and other carbs that become glucose once digested. Yet the official guidelines basically tell diabetics to keep right on consuming the substance that’s become toxic to their body.
We don’t tell the lactose intolerant to keep drinking milk. So why do we tell the glucose intolerant to keep consuming glucose? No wonder one in three adult Americans now has diabetes or prediabetes. As one expert told me, this outcome is as predicable as a skin cancer epidemic would be if the official advice were as boneheaded as to bake in the sun.
A metabolic stress test called the glucose tolerance test has subjects drink a solution of 70 grams of pure glucose before measuring their blood glucose at selected intervals. But the official diabetes and dietary guidelines steer people toward a degree of carb consumption that approximates that amount at every meal! Granted, meals are usually mixed, which lowers their glycemic index, but that carb load is still overwhelming for the metabolic system of a vast swath of the population. So the pancreas is blitzkrieged every four or five hours for days, weeks, years, decades. No wonder diabetes is an epidemic.
Rachel: Diabetes is a confusing disease. It seems like everyone, from medical professionals to drug companies, homeopathic experts, dietitians, personal trainers, and everyday people, has “advice” for people with diabetes. Your book, however, seems to boil down to some very simple rules or guidelines. How do you simplify a complex disease?
Jeff: Insulin resistance characterizes type 2 diabetes. That is, cells become resistant to the hormone insulin, which should normally usher glucose into those cells. Without this guide, the glucose has nowhere to go. So it ends up where it shouldn’t, wreaking all sorts of havoc on the heart, brain, kidneys, eyes—you name it. That’s why diabetics urinate excessively. The body desperately tries to expel this extra glucose, knowing it’s toxic even in slightly elevated amounts.
One of the themes of “Sugar Nation” is that a lifestyle-induced disease begs for a prescription of lifestyle change: exercise, carb reduction, and weight loss when necessary. The answer isn’t pumping people full of drugs.
Rachel: You have kept your blood sugars stable despite being considered at high risk (your father had type 2 diabetes) by eating a low carb and high fat, protein, and fiber diet, taking supplements, and exercising. Is it really possible to sustain that discipline for a lifetime?
Jeff: I’m certainly a work in progress, but I believe the answer is yes. There’s a lot at stake, and I’ve seen the cost of noncompliance up close and personal. You wouldn’t wish a diabetic demise on your worst enemy, let alone a loved one or yourself. Daily exercise is something you should be doing anyway, and I actually enjoy my low carb diet immensely. I don’t feel deprived at all. All these strategies working in concert make me feel energized, fit, and attractive rather than tired and sick. Why not keep at it for life? I see no reason not too, but many reasons to continue on this course I’ve chosen.
Rachel: Many people with diabetes find the holidays particularly trying. There are so many opportunities to over-indulge, and holiday travel makes it difficult for them to stick to an exercise plan. What strategies help you get through the holidays happy and healthy?
Jeff: Yeah, that’s tricky for many people. Regarding exercise, keep in mind that you don’t need to be grinding away on a treadmill for hours on end. Simply training in a focused way for 20 minutes a day makes a huge difference. Just be consistent. The salutary effects of exercise on glucose metabolism have a half-life just like drugs do. Take a small-to-moderate “dose” of exercise every day.
Diet-wise, remember that protein and non-starchy vegetables are always fair game. You just need to avoid potatoes, stuffing, desserts, and the like. Wine, ultra-light beer, and diet soft drinks are all okay too, although you shouldn’t go overboard with any of them. There are also some great recipes out there for dishes like faux “mashed potatoes” made from cauliflower, which taste a lot like the real thing. Be creative; do your homework. This is a matter of life and limb. It’s worth the effort. Trust me.
Rachel: A diabetes diagnosis can be daunting and devastating. For the newly diagnosed, what hope and encouragement can you offer?
Jeff: There are actually many, many reasons to be hopeful and optimistic. You can reverse this disease by changing your lifestyle in fun and compelling ways. How great is that? Imagine if you were given that option after a cancer diagnosis. You’d be jumping for joy, right? There’s this semantic debate about whether you can “cure” type 2 diabetes, but what you can surely do is keep it in a stalemate almost perpetually. Maybe you’re not “cured” technically, because reintroducing too many carbs would jump-start the same disease process. But if diabetes remains in abeyance, what’s the difference? You’ve still won.
Rachel: Is your book receiving any attention from medical professionals or large health organizations? What is the general reaction?
Jeff: Not surprisingly, the book has been embraced by low-carb experts and practitioners, the paleo crowd, and alternative medicine devotees, but ignored by mainstream health and dietetic organizations, which is to be expected. The effort it took to write the book would have been worth it a thousand times over if only one person used it to avoid my father’s fate. Instead, I receive letters every day from individuals across the land who are taking back their health and body after reading Sugar Nation. That’s what matters to me.