The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes
By Frederic Vagnini, M.D., F.A.C.S., and Lawrence D. Chilnick,
Fair Winds Press, 2009
Review by Ellen Bailey, Doctor of Pharmacy candidate, University of Florida College of Pharmacy
The purpose of this book is to educate individuals with diabetes or prediabetes about their disease; to motivate them to take charge of their disease; and to understand what factors are within their control. Perhaps more importantly the book provides ideas on how to make changes. Although the title implies the focus is on weight loss, there are many other features and topics included. The authors take the time to explain why diabetes develops while making sure the reader understands that they are not alone. They never blame or “talk down” to the reader but do provide valuable insight into the disease and what is within their patients’ control. The authors make the point that diabetes can cause weight gain, and that by taking weight off, there is a better chance of preventing pre-diabetes from progressing to diabetes. For those that already have diabetes, the diet suggested can help control their blood sugar levels. The book is organized into five steps, focusing on tearing down metabolic roadblocks, medications, losing weight, exercise and lifestyle changes.
The authors spend a laudable amount of time on education mostly in Step 1. They discuss the pathophysiology of diabetes, and what is happening to the metabolism of a diabetes patient. Dr. Vagnini is a cardiovascular surgeon and his thorough knowledge consequently makes the pathophysiology explanation very accurate. Furthermore, the book explains why a diabetes patient might have additional difficulty losing weight, but also emphasizes why weight loss is a critical step . The authors use of medical lingo (which the patient probably hears in their doctors offices, but is too embarrassed to ask what it means) and explanation of the terms’ meaning is extremely beneficial. They also discuss when checkups and tests should occur, what each means, what their doctor should explain and discuss, and what questions the patient should ask.
Step 2 in the book focuses on medications, explaining the different classes of diabetes medications, their mechanism of actions, expected side effects, and suggestions for cutting costs for the patient.
Step 3, Conquer Nutritional Roadblocks, stresses that “diet is the keystone of diabetes control.” This is the weakest section in the book. The diet the authors are recommending is a combination of low-glycemic foods, reduced carbohydrates, and a modified Mediterranean diet. This is based on healthy portions, minimal amounts of unsaturated fats, use of monosaturated fats, fiber, salads, vegetables, nuts and seeds, whole grains, olive oil, and limited red wine. Only a few pages are spent on suggested meal plans, which are not explained well, and hard to follow. The remaining portion of this chapter focuses on supplements, called nutraceuticals. They discuss and recommend 13 supplements, but these nutraceuticals should not be recommended for everyone; they can cause medical interactions and are also not necessary for all individuals. Each patient should discuss these potential dietary supplements with their physician.
The remaining 2 steps are: Step 4 (“Exercise”) and Step 5 (“Discover a New Lifestyle”). Step 4 stresses the importance of exercise in diabetes management, and reviews various options to get moving. Step 5 focuses on lifestyle changes, making permanent changes and forming a support system.
Overall, the book was an enjoyable read, informative, and accurate. The authors do a good job at relating to the reader with personal stories, while still providing education. From a scientific viewpoint, they used many statistics and studies to illustrate their point. Although the book would not be of much value to a Type 1 diabetes patient — much of the book is focused on weight loss and exercise — it would be excellent for someone who is prediabetic or recently diagnosed with Type 2 diabetes. It could be especially beneficial to those patients that are eager to learn and make changes in their lives, or who are looking for motivation to make changes.