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Hi! I'm Stelios Pantazis. I'm a doctor and I specialize in medical nutrition and metabolic disorders. Today, I'd like to present the ideal diet for diabetes mellitus through an amazing study that was published in 2017, divides the diet into food groups and shows how each dietary group affects the risk of diabetes mellitus. The study was published in 2017. It was based on data from 88 different studies each of which had been carried out on thousands of people, therefore we're talking about hundreds of thousands of cases in total. It divided foods into 12 groups. And it concluded that when people often choose bad foods, the risk triples, while when they choose healthy foods, they reduce the risk of Type 2 diabetes mellitus up to 42%. You can find the link below, if you're brave enough to find the data of this presentation. I'll be glad to discuss it with you. I'll start presenting the groups that were studied one by one. I'll explain each group and how it affected the risk of diabetes mellitus. To understand the results immediately, when the group is green, this means that it's good, when it's red, this means that it's not good, it includes foods that we should avoid as much as possible. I'll start with non-processed cereals. What does this mean? Oat, wheat, barley, rye, quinoa, millet, amaranth, all these as they are produced, without having been altered, namely in seeds or barely processed, such as oat flakes, which is oat that has just been compressed, so that it can be absorbed more easily. Quinoa, which is eaten like rice. Groats, which also accompanies some dishes, some vegetables etc. Brown rice, not white rice. Millet, which is also eaten like rice, you can make stuffed peppers with it. Pop-corn, which is also not altered. And whole-grain pastries, only when the ratio of fibers to carbohydrates is 1:5. If you don't know about this, watch the respective video, in order to find out, because this is really important, which whole-grain pastries are really whole-grain. This food group seems to be mainly beneficial to our health. Number 1 on the left means that this food has no effect, positive or negative. Below 1, at 0,9, 0,8, 0,7, it means that the effect is positive and the lower we go, the more positive the effect. The horizontal line is the gr/day. Approximately 40-60 gr of non-processed cereals per day give us the maximum benefit, although, up to 100 gr, the benefit barely reduces. Therefore, the amount plays a role too. But the truth is that if you eat more, the benefit barely reduces. Non-processed cereals is a group of foods that you can eat relatively freely. The protection is up to 25%, namely the risk of the disease reduces by approximately 25%. The second group, in red obviously, is processed cereals, all the cereals I mentioned before, but when they've been ground. Essentially, we're talking about pastries, whole-grain or not, with less than 1:5 fibers, namely the conventional pastries that you mainly find in bakeries, supermarkets etc., pasta and white rice. For every 200 gr you consume, the risk increases linearly, and when the amount exceeds 600 gr per day, it reaches approximately 25% increased risk of diabetes. Therefore, try to eat as little as possible. Zero is better than a little. The measure here is 0. Okay? Because sometimes we talk about measure, and we don't know what we mean. Here, we know what we mean. The risk increases from the first gram. Therefore, the measure is 0. Here, we see the vegetables. This is the study's Achilles' heel. It includes vegetables that don't have the same qualities in the same group. You can't put lettuce, spinach and kale in the same group as tomato, potato and carrot. However, this is what researchers managed to do. We should respect that and congratulate them, but this creates the problem of the curve, which shows a small benefit, first of all, namely, in the best case, with 200 gr of vegetables per day, the benefit is 8%, which is very small. Non-processed cereals seem to be better than vegetables, but this is not true based on what we generally know from other studies. And, after 250 gr, the benefit slowly disappears and, when we consume 600 gr of vegetables, the benefit is 3-4%, very small indeed. This is one of the weakest points of the study, that it includes spinach, kale etc. in the same group of vegetables as tomato, potato etc. Or it doesn't separate sweet potatoes from traditional white potatoes the nutrients and effect of which on diabetes are very different. However, vegetables are certainly beneficial, as we've known, and this is confirmed. Let's go to fruit. The same problem applies in fruit too. Up to 200-250 gr of fruit, the benefit reaches 10% protection. However, after that, it slowly disappears. At 600 gr, the benefit barely exceeds 5%. What does this mean? That, when you eat more fruit, it's harmful? It depends. Sometimes it is, other times it's not. But "more" raspberries are not as harmful as more watermelon, which has an increased glycemic index and increases insulin a lot more. Therefore, let's keep in mind that fruit are beneficial and their excessive consumption may not be useful. But, here too, we need to clarify what we mean by "fruit". Let's go to the next group, which is the only group that exhibits a bipolar relation, nuts. Nuts in small amounts seem to be beneficial, that's why we see a part of the line, up to 20 gr/day, in green, but any more than that is harmful. The reason is that nuts have a lot of calories. Excessive amounts can make you fat. But the picture here is not clear. However, the researchers clarify that the result on nuts is not certain. They wonder if they're useful themselves, mainly because the studies were small, the nuts were very specific, peanuts in most studies, not the "good" nuts, such as walnuts, cashew nuts, nuts that are traditionally known to be very healthy, such as almonds. However, I like this picture, namely a few nuts are good, a lot of them are probably not. Therefore, I'm keeping it, I like it. Without taking 20 gr too seriously, the message is clear and powerful. Yes to nuts, no to large amounts. The same does not apply in legumes. Legumes are beneficial almost from the beginning. And the larger their amount, the bigger the benefit. At 200 gr of legumes per day, the benefit is 10%. And it possibly goes on like that. Eggs. Recently, many people have been asking on my channel if eggs are beneficial and if they're superfoods etc. As far as diabetes mellitus is concerned, they're not beneficial. The first gram is bad, it increases the risk of diabetes mellitus, and at 60 gr, there's a 20% increase in the risk of diabetes mellitus, which is a very high percentage. The next group is dairy, a group that most people love. The study does not distinguish between milk, yoghurt, cheese. Yoghurt is the champion here. Cheese... Yes, but... Milk is a special case, because of intolerance etc. However, this is a group that clearly protects you from diabetes mellitus, therefore, you should consume dairy too. In fact, up to 2,000 gr/day... I suppose it doesn't mean 2 kg of cheese. This is a weak point of the research, which includes milk and cheese in the same group, because 2 l of milk are different from 2 kg of cheese. Anyway, the picture is clear. Dairy protects. If someone doesn't have intolerance or other similar problems with dairy, I'd recommend dairy in their diet, because I believe that they protect from diabetes mellitus. The next group is fish, which came as a surprise to me. We know that Omega-3 fatty acids in fish protect the heart. But they don't seem to protect you from diabetes mellitus, although the effect is almost neutral. The background is red, but the truth is that the increase of the risk of diabetes mellitus is 3%, which is almost zero. Therefore, when someone tells me they want to eat fish, I agree. If they don't, no problem, I won't insist on their eating fish. But I believe that fish have other benefits for the heart and vessels, with their Omega-3, so I encourage their consumption, without being too persistent with people that don't want to eat fish for any reason whatsoever. The next group is red meat. This relation is linear. From the first gram, the risk spirals. At 200 gr/day, there's a 40% increase of the risk of diabetes mellitus. This is the first really high percentage we've seen so far. We'll see more later. But this is a really high percentage. It's linear. Gram per gram, the risk increases. It's impressive. This may seem strange to some people who believe that since meat doesn't contain carbohydrates, it protects from diabetes, while the opposite is true. Because as we've said in a previous video, protein increases insulin as much as carbohydrates do, namely a grilled steak without sauce increases insulin as much as a plate of pasta does. We want neither of these. I don't want you to choose between them, I want you to choose neither. Or in very small amounts. However, already from 200 gr... We're not talking about extreme amounts, and many people eat much more than 200 gr of red meat a day, namely in the morning, afternoon and evening, therefore the risk is high and you should be careful. Consume meat moderately. The next group is processed meat products. We all know they're carcinogenic. We've said it many times here. The WHO has also said it. We repeat it. The risk increases by 40% at about 100 gr of processed meat. Processed meat is bacon, sausages, ham, what we put in sandwiches, poached turkey etc. Therefore, be careful. One slice is 30 gr, it's not a small amount. At 60 gr, two slices, the percentage reaches 30%. 30% increased risk of diabetes mellitus. The next group is the one we all knew, beverages sugary drinks. Mainly soft drinks are included here, but tea with sugar is the same. If you make tea at home and you add two tablespoons of sugar, it's not different from a soft drink. This relation is almost linear too. This is the first group where we see ml/day, and not gr/day. Half a litre of a soft drink increases the risk by approximately 30%. We know that two halves double the risk, which reaches 50%, from other studies, and this is confirmed here. Soft drinks and sugary drinks in general have a really bad effect. Another weak point of the study is that it doesn't distinguish sugar-free drinks with other sweeteners, but what we learn from the study is significant and useful. Let's see the strong points of the study. We've seen the 12 food groups. The overview is based on 88 studies, which is a very high number. All those are high-quality studies. They were filtered, in order to be the best the researchers could find by then. It was published in a very high-quality journal, a notable journal. This means that it was examined and evaluated by leading experts of the industry, therefore it's considered to have influenced the nutrition science, when it was published. It highlights the protection fruit and vegetables provide, despite their specificities. It warns about the risk coming from meat. This is very significant, because I see patients all the time that follow a diet for diabetes mellitus that's full of meat, or fish, chicken etc., which is not the best option, it may be the worst one. And another strong point of the study is that it includes the amounts, it clarifies what risk there is with every amount. Therefore, it clarifies how much a little is and where the measure is. When the risk increases already from 1 gr/day, the measure is 0, not what each one of us has in mind. It's defined by studies. Let's see the weak points of the study. The main one is what we've said many times. The groups are very vague. It doesn't include chicken. It doesn't clarify if the group of red meat includes chicken or not. It mixes leafy and non-leafy vegetables, while we know that they have very different qualities. I can't understand why spinach and potato are in the same group. They're not the same. If we tell a kid to eat vegetables, we don't mean ketchup. All fruit are also in the same group. This poses some difficulties too and it concerns me as a researchers' choice. I suppose they were forced to do this, they didn't do this on purpose. There was nothing else to do. In general, the group of vegetables seemed very problematic to me. And the final thing that I noticed and concerned me is that although it's great that amounts are included, they're in gr/day. Does the same apply for someone who's 150 kg and someone who's 50 kg? It doesn't. Ideally, we'd want gr/kg/day, in order to see what someone has the "right" to eat according to their weight, in order to reduce the risk. That's all from this great study that was published in 2017 in the European Journal of Endocrinology. This was a very significant and useful study. If you thought this was interesting, please give us a thumbs up. Share it with people who you think might find it interesting and suggest subjects in the comment section. That's all from me. Thank you very much!

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