The issues of breakfast and optimal hydration are common to all three phases of Dr. Ali's plan for diabetes. So, I address them first.

Dr. Ali's Breakfast
I consider an optimal breakfast to be the first essential in any dietary plan for de- diabetization—and for the prevention of diabetic complications, when de-diabetization is not possible. I highly recommend Dr. Ali's Breakfast described below. I prepare my breakfast in about 75 seconds on five or six days a week. I am not a diabetic; however, I find it to be most valuable for individuals with insulin resistance, pre-diabetes, and diabetes.

Dr. Ali's breakfast is a protein shake that includes flaxseed, lecithin, and organic vegetable juice. Flaxseed, lecithin, and organic vegetable juice are my top prescriptions for the health of the brain, liver, and bowel respectively. Table 1 shows the specifics of Dr. Ali's Breakfast. I drink this protein shake in portions of six to eight ounces with my morning nutrient and herbal protocols during the period of my morning exercise, mediation, and preparation for work. No other food is necessary. I used to suffer from severe hypoglycemic (low blood sugar) recations before I organized my breakfast as described above, but now it (Dr. Ali's Breakfast) keeps my energy level sustained. I snack on water and usually stop for lunch at about 3 pm. In my guidelines for diabetes. I return to this subject for additional information concerning the primacy of breakfast in all plans for de- diabetization or for the prevention of complications of diabetes when de-diabetization is not possible.

Some of my patients find it more agreeable not to take the four components of the breakfast mixed together. For instance, one of them takes protein powder with lecithin and water and drinks organic vegetable juice with freshly grounded flaxseed.

Other Breakfast Options

Do what is right, habit will make it agreeable. This is crucial for diabetes. The habit one grows into for one's breakfast is as much a part of life as self-compassion. Taste is an acquired faculty. Organic vegetable juice added to my protein drink now appeals to me much more than any fruit juice. It was not so at first.

Some patients readily follow my breakfast plan closely, begin to savor it soon after, and report good results within weeks. Others take a slower approach, adopting my plan partially. Some patients initially find my prescription for breakfast unappetizing. The majority of them settle into it nicely weeks or months later. Yet others ask if they may replace organic vegetable juice with milk (cow, goat, rice or soy). Others wish to add one-half of a banana or peach or other varieties of fruit for enhanced taste. Except in patients with disturbing symptomatology related to rapid hypoglycemic-hyperglycemic shifts, I accept their modifications.

I wholeheartedly endorse an egg breakfast. Eggs have been maligned for decades by practitioners of drug medicine on the grounds that eggs raise blood cholesterol levels. I dismiss that as nonsense coming from ill-informed individuals. Not a single study has shown that eggs increase the incidence of cardiovascular disease. Indeed, some reports suggest that eggs—an excellent source of high-quality liver-friendly lecithin—actually lower blood cholesterol levels (see chapter 19 entitled "Darwin's Drones and Eco-Monsters.")

In some cultures, fish, poultry, and various meats are consumed for breakfast. Those items are very desirable sources of protein. The important point here is that such meats should not be highly processed, nitrated, or otherwise contain high contents of oxidized (rancid) fats. Plain yogurt with freshly ground flaxseed is an excellent breakfast. Oatmeal, once a favorite of nutritionists, is not suitable for people with insulin resistance or diabetes.

Optimal Lunch Foods for All Three Phases
Large salad with goat cheese, chicken, or fish (dressings without sugar)
Uncooked, steamed, or lightly stir-fried vegetables with chicken, turkey, or fish
Lentil soups (to be consumed in rotation)

Optimal Dinner Foods for All Three Phases
The ideal dinner for diabetes is vegetables with meat or fish. First, fill the plate with uncooked, steamed, or lightly stir-fried vegetables. Next, add proteins such as fish, poultry, turkey, lamb, organic game meats, or beef. Pasta, bread, rice and other starches should be taken in minimal amounts (just for taste) or preferably not at all. I ask my patients with diabetes never to allow bread to appear on the table (for them) before vegetables and animal proteins. In my experience, de-diabetization plans with only vegetarian diets generally yield poor results. Prudent intake of cheeses and creams can be included in the meal plan two to three times a week.

Water As a Snack
My preferred mid-morning and mid-afternoon snack is water. This may seem odd to some readers who may suffer from sharp hypoglycemic episodes caused by diabetes drugs. Indeed, in the early stages, diabetics may need other snack options given below. However, once the metabolic status is stabilized with the complete program outlined here, the water snack will make sense for many people.

Individuals with mid-afternoon fatigue often report dramatic benefits with the intake of four to six ounces of Dr. Ali's breakfast shake (prepared in the morning and carried to work). Another option is one-fourth to one-third cup of berries (blueberries and others) with one ounce of cottage cheese.

Sweeteners
The more sweet foods we consume, the more we want them. This is the way evolution designed the function of sweetness taste buds in the mout—when ready-energy foods (fruits and sweet vegetables) were available, the body want to take in more for storage for later use. For individuals with obesity and diabetes, the ideal way is a no-sweet way. For diabetics, at this time I can recommend only Stervia. For them and others, when something sweet has to be taken, I suggest blueberries that may be taken with cottage cheese or one-half of a green apple or a pear. On uncommon occasions, small quantities of natural sweeteners; raw honey and dates may be used for uncoked foods. For cooked dishes, natural syrups (maple, rice, and others) and fuit juices (apple, cranberry, and others) may be consumed.

Why I Do Not Recommend Agave And Other High-fructose Foods

Agave nector is heavily promoted as an "all natural" and "healthy" sweetner that is especially desirable for people with excess insulin (hyperinsulnism) and diabetes. I do not recommend its regular use for strong reasons. As available in the U.S., it is neither natural nor healthy. It is highly chemically processed, high-fructose item that carries all risks of other processed high-fructose items. So it is not a nector. Some agave brands have a higher content of fructose than high-fructose syrup. The promotion of fructose in agave as "natural fruit sugar" is also misleading, since fructose in most fruits occurs in much smaller amounts than glucose.

Humans have limited capacity for absorbing and metobolizing fructose. Much of fructose in high-fructose items reaches colon unchanged and is used as nutrients by the gut microbes. This explains many adverse bowel effects of fructose, including bloating, flatulence, cramps, and loose stools. People with history of malabsorption, colitis, irritable bowel syndrome, diverticulitis, and GERD should be especially careful about processed high-fructose items, such as agave and corn-derived sweeteners.

The serious adverse metabolic effects of fructose in processed high-fructose food items include: (1) elevated LDL cholesterol and triglycerides that contribute to plaque formation in arteries, and sets the stage for heart attacks, stroke, and kidney failure; (2) insulin resistance, hyperinsulinism, and diabetes; (3) cellular inflammation; and (4) obesity. Thus, the claim that agave is low-glycemic product and hence is suitable for diabetics is scientifically is not valid. Not unexpectedly, recent studies point to a hightened risk of gout (an inflammatory disorder) associated with high fructose intake, as with heavy use of carbonated beverages sweetened with fructose.

I include brief comments on the physiology of glucose and fructose in fruits and vegetables to shed light on toxicity of processed high-fuctose food items, such a agave and high-fructose corn synrup. Glucose rapidly enters cells facilitated by a family of specialized proteins that serve as glucose porters, and are appropriately called glucose transporters. Fructose, by contrast, is carried by only one member of this family called GLUT-5. A second member, GLUT-2, also facilitates fructose entry; however, glucose competes with fuctose for GLUT-2. The metabolic chemistry for fructose is also more complex and demaniding than that for metabolizing glucose.

I include few more comments here that I might interest individuals who are unable to avoid sweet foods in the early stages of the program. Again, sweet foods activate taste buds for sweetness and increase the urge for more sweet foods. The opposite also holds: the less sweetness in foods, the less the desire for such foods. So, the best strategy in diabetes is to train the body not to demand sweet foods. Until one reaches this state, my choice of sweeteners, in order, is: Stevia, saccharine., and Xylitol. Glutamate (Equal) and agave should be avoided.

PHASE I of Dr. Ali's Three-Phase Diet Plan for Optimal Insulin Function (for Diabetes, Excess Weight, Hypertension, and Related Metabolic Disorders)

The primary purpose of this plan is to seriously test the possibility of normalizing metabolism with ideal food choices. Specifically, the plan evaluates stresses on insulin and oxygen signaling, as determined by blood glucose, A1c, and insulin tests. This plan is designed to be restrictive for this purpose. On the positive side, with this plan overweight individuals usually lose some weight and their general health improves.

This plan is also eye-opening for many people who clearly see how foods affect their bowel function, mood, energy, sleep, menstruation, and other bodily functions.

Explanatory Comments for Phase I
1. See the section entitled "Dr. Ali's Breakfast" for details of protein shakes.
2. See www.majidali.com for recipes for Dr. Ali's lunch (lentil soup).
3 The order for rotating foods can be altered, if desired.
4. Sauces and marinades should be prepared without sugars and starches.
5. Everything sweet is considered sugar except stevia. Xylitol can be used sparingly.

PHASE II OF DR. ALI'S DIABETES PLAN
In Phase II, the objective is to investigate the effects on health and laboratory test parameters of including modest amounts of high quality starches in the food plan. These results, when compared with those obtained in Phase I provide a much clearer picture of the individuals metabolic uniqueness, as well as for designing the Phase III program for long-term use.

PHASE III OF DR. ALI'S DIABETES PLAN

Phase II plan is evidently less restrictive than Phase 1. Phase III is designed to test how far one can go to include less desirable foods and still positively influence metabolism, while addressing the underlying insulin and oxygen issues. This plan also gives insights about the affects of foods on bodily functions. Some individuals will experience a relapse of some symptoms, further validating the relationships between foods and their bodily consequences.

Explanatory Comments for Phase III
1. Some fruits, such as green apples and blueberries in small portions, may be included only if they do not adversely affect the blood sugar levels. The fruits should be taken fresh, not canned or dried.
2. Pasta, breads, or other starches are best avoided. They may be included only after the effects of this program on diabetic status are determined. If eaten, they must be taken in small amounts at the end of the meal, i.e., a dessert.

Return to Phase I
It is important to recognize that an individual's metabolic condition can change, often dramatically, in times of stress and require a more careful Phase I food plan. Such conditions include: (1) severe personal or business stress; (2) infections; and (3) a relapse of concurrent disorders, such as colitis.