The blood sugar solution

Dr. Mark Hyman on ‘The Blood Sugar Solution’

What can be done about the global obesity and diabetes epidemics? Mark Hyman, MD, a family physician and leader in the field of functional medicine, tackles that pressing question in his latest book, The Blood Sugar Solution. In this special Q&A with Everyday Health, Dr. Hyman talks about the issues involved and how to create both personal and societal change through healthier lifestyle choices.

Everyday Health: The Blood Sugar Solution includes a quiz that can help the reader determine whether he or she has “diabesity.” Can you explain what that is?

Dr. Mark Hyman: Diabesity, the continuum of health problems ranging from mild insulin resistance and overweight to obesity and diabetes, is the single biggest global health epidemic of our time. It is one of the leading causes of heart disease, dementia, cancer, and premature death in the world and is almost entirely caused by environmental and lifestyle factors. This means that it is almost 100 percent preventable and curable.

Diabesity affects more than 1.7 billion people worldwide. Scientists conservatively estimate it will affect 1 in 2 Americans by 2020, 90 percent of whom will not be diagnosed. I believe it already affects more than 1 in 2 Americans and up to 70 to 80 percent of some populations.

EH: You’ve said that we are becoming the United States of Diabetes. What do you mean by that?

MH: Diabesity is a national health disaster and everyone in this country is or will be touched by it.

The prevalence of type 2 diabetes in America has tripled since the 1980s. There are now 27 million Americans with diabetes (25 percent of whom are not diagnosed) and 67 million with prediabetes (90 percent of whom are not diagnosed). African Americans, Latin Americans, and Asians have dramatically higher rates of diabesity than Caucasians do. By 2015, 2.3 billion people will be overweight and 700 million will be obese. The number of diabetics will increase from 1 in 10 Americans today to 1 in 3 by the middle of this century.

Obesity (almost always related to diabesity) is the leading cause of preventable death in the United States and around the world. Gaining just 11 to 16 pounds doubles the risk of type 2 diabetes, while gaining 17 to 24 pounds triples the risk. Despite this, there are no national recommendations from government or key organizations advising screening or treatment for prediabetes.

EH: What are the major causes of this health crisis?

MH: As physicians, we are trained to offer medication or surgery to solve diabetes (and disease in general), when the real causes include poor-quality diet, nutritional deficiencies, hormonal imbalances, allergens, microbes, digestive imbalances, toxins, cellular energy problems, and stress. We think that treating risk factors such as high blood sugar, cholesterol, and blood pressure with medications will help. But we don’t learn how to identify and treat the real causes of disease. In truth, diabetes, elevated blood sugar, blood pressure, and cholesterol are simply symptoms that result from problems with diet, lifestyle, and environmental toxins interacting with our unique genetic susceptibilities.

EH: What do you think are the biggest myths about treating diabetes and obesity, and how are they contributing to the problem?

MH: As I outline in my book, there are seven myths about diabesity and obesity that keep us sick. These are:

  1. Diabetes is genetic — it isn’t. While genes may load the gun, diet and lifestyle pull the trigger. Diabetes is almost entirely induced by environmental and lifestyle factors.
  2. Diabetes is not reversible — it absolutely is. A groundbreaking study showed unequivocally that even people with advanced type 2 diabetes, when the pancreas has pooped out and the insulin-producing (beta) cells are damaged, can recover, and diabetes can be reversed in just one week — through dramatic changes in diet (very low glycemic, low calorie, plant-based diet).
  3. Prediabetes isn’t a problem until it turns into full blown diabetes. This is just pure hokum. Pre-diabetes is not “pre” anything. It is a deadly disease driving our biggest killers — heart attacks, strokes, cancer, dementia, and more.
  4. Once you start insulin there is no going back. Wrong! With aggressive lifestyle intervention and dietary change, you can reverse diabetes and stop insulin therapy under your doctor’s supervision.
  5. Lowering blood sugar with medication prevents death and heart attacks. This is a dangerous myth that is actually killing people. Avandia, the world’s number one blockbuster diabetes drug, contributed to the deaths of 47,000 people from heart disease in the first 11 years of its use (these data were hidden from the government and the public most of that time). We have to give up on the hope for the magic pill that will fix our problems.
  6. Heart surgery and angioplasty are good treatments for diabetics with heart disease. No way! A study in the New England Journal of Medicine showed that surgery and angioplasty for diabetics with heart disease work no better than medication in reducing heart attacks and death, and have higher risks.
  7. Weight loss is necessary for reversal of diabetes — not really. Sure, achieving optimal weight is desirable and a good goal for long-term health, but it is not necessary to rebalance your blood sugar. Perhaps more to the point, the rash of “weight loss surgeries” (i.e., gastric bypasses) do nothing to rebalance the underlying biochemistry that leads to diabetes in the first place. Changing your diet and lifestyle is the real cure.

The problem with these myths is twofold. First, we fail to adequately treat the disease by relying on medication, believing it can’t be reversed or blaming genetics. Second, we create more suffering as a medical community by buying into these myths. If our first imperative is to “do no harm,” we are failing miserably.

The way out of this epidemic is not surgery or pills — it’s addressing the underlying root causes of disease, which are driven by dietary and lifestyle choices.

EH: What’s the most important thing people can do right now to help their diabesity and start living a healthier life?

MH: Food is the most powerful medicine we have, and what you put at the end of your fork is much more powerful than what you find at the bottom of a pill bottle. The most important thing you can do to improve diabesity and start living healthier now is to improve your diet, as I outline in my 10 Rules for Eating Safely for Life.

EH: Finally, what is the Blood Sugar Solution ?

MH: The Blood Sugar Solution is an 8-week diet and lifestyle change program that provides you with all of the steps you need to rebalance your blood sugar, overcome insulin resistance, and reverse diabesity. It will help you:

  • Boost your nutrition
  • Regulate your hormones
  • Reduce inflammation
  • Improve your digestion
  • Maximize detoxification
  • Enhance energy metabolism
  • Soothe your mind

These goals are achieved through a step-by-step weekly system that includes preparing the mind, body, and kitchen for change; getting tested; getting together in community; and basic nutrition education.

I encourage you to read the book and follow the program — it will help you take back your health.

The Blood Sugar Solution with Dr. Mark Hyman

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What disease affects EVERY other American and one in four kids? Type 2 diabetes or pre-diabetes. Type 2 diabetes in America has tripled since the 1980s, and researchers estimate one in three Americans will have diabetes by mid-century. More than one-third of American adults are obese1. And one in three Medicare dollars is spent on diabetes making it the biggest driver of our federal debt. Sadly, these numbers continue to increase. Overall, it’s not a pretty picture, and experts predict things will only become worse.

I use the term “diabesity” to describe the continuum of health problems ranging from mild insulin resistance and overweight to obesity and diabetes. Diabesity is the underlying cause of most heart disease, cancer, and premature death in the world.

Tragically, these conditions are also 100% preventable and reversible.

Most people believe diabetes is not reversible. That’s unfortunate, considering its numerous complications including kidney failure, amputation, stroke, and dementia. I’ve also heard experts claim obesity is difficult to treat and maintaining long-term weight loss is almost impossible.

I wholeheartedly disagree. Science shows diabetes and obesity are preventable and reversible with aggressive utilize nutrition and lifestyle modifications.

It is caused by the 152 pounds of sugar and 146 pounds of flour a year eaten on average by every American – that is a toxic drug dose of diabetes causing food.

It is well known that massively obese patients can reverse their diabetes within a few weeks of getting a gastric bypass, even if they haven’t lost that much weight. Why? Because food is medicine and when you take disease producing food out and put the right food in the healing happens quickly. I recently had a patient lose 45 pounds and get off 54 units of insulin and all his diabetes medication. I implement these seven strategies every day with patients to prevent, treat, and reverse diabesity without drugs and surgery.

Pull the sugar. A diet full of empty calories and quickly absorbed sugar, liquid sugar calories, and refined carbohydrates – all of which convert to sugar – creates high insulin levels, eventually leading to insulin resistance and Type 2 diabetes. Among the many problems of chronically high insulin levels include inflammation, high blood pressure, poor sex drive, increased risk for cancer, and depression. The most important thing you can do to reduce your risk of type 2 diabetes and obesity or reversing its impact is to eliminate or dramatically reduce sugar in all its many disguises.

Stock up on whole, unprocessed foods. Whole, unprocessed real foods balance your blood sugar, reduce inflammation and oxidative stress, and improve your liver detoxification to prevent or reverse insulin resistance and diabetes. Choose a rich variety of colorful fruits and vegetables, plenty of omega-3 fats, coconut butter and olive oil, legumes, nuts, and seeds. Whole, real foods turn on all the right gene messages, promote a healthy metabolism, reverse insulin resistance and diabetes, and prevent aging and age-related diseases like diabetes and heart disease.

Get the right nutrients. Supplements make your cells more sensitive to insulin and more effective at metabolizing sugar and fat. Combined with the right diet and lifestyle modifications, they can help you balance blood sugar and reverse or prevent diabetes. At the very minimum, I recommend:

  • A high-quality multivitamin and mineral
  • One to two grams of omega 3 fatty acids
  • 1,000 – 2,000 IUs of vitamin D3
  • 300 – 600 mg of alpha lipoic acid twice daily
  • 200 – 600 mcg of chromium polynicotinate
  • 5 to 5 grams of PGX, a unique type of fiber that controls appetite and blood sugar, before each meal with eight ounces of water

I’ve put together all the supplements I recommend for managing diabesity in a kit which you can find here. Other nutrients also play a role in balancing blood sugar and normalizing insulin levels, and I’ve discussed these more fully in my book, The Blood Sugar Solution or on this page.

Get the right exercise. You needn’t spend hours at a gym to get exercise’s benefits. Even a 30-minute walk can help. Vigorous is the key for effective exercise that helps balance blood sugar and lower insulin levels. Get your heart rate up to 70 – 80% of its maximum capacity for 60 minutes, up to six times a week. Step it up a few notches with high-intensity interval training (HIIT) and strength training.Studies show HIIT can benefit Type 2 diabetes2 and obesity3. Best of all, you can do it in just minutes a day.

Get sufficient sleep. Lack of sleep or poor sleep damages your metabolism, spikes sugar and carb cravings, makes you eat more, and increases your risk for numerous diseases including Type 2 diabetes. One study among healthy subjects found even a partial night’s poor sleep4 could induce insulin resistance. That’s why you must prioritize sleep so you get eight hours of solid, uninterrupted shuteye every night. Create a sleep ritual that includes herbal therapies, creating total darkness and quiet, and relaxing with my UltraBath.

Control stress levels. In the face of chronic stress, our levels of insulin, cortisol, and inflammatory compounds called cytokines all increase. This drives the relentless metabolic dysfunction that leads to weight gain, insulin resistance, and eventually Type 2 diabetes. The links between stress, weight gain, mental disorders, and blood sugar imbalances show that managing stress becomes a critical component of obesity and diabetes management. You can’t eliminate stress, but you can learn to control it. Meditation, deep breathing exercises, yoga, massage, laughing, and dancing are among the best ways to manage stress and reverse Type 2 diabetes. Check out my blog to learn five ways to never be stressed again.

Measure to improve. Research shows that people who track their results lose twice as much weight and do twice as well. Begin by getting a journal to track your progress in. That could be as simple as a pad of paper, a notebook, a spreadsheet in your computer, or whatever is convenient and works for you. Now, what should you track? In addition to what you eat, you’ll want to get a baseline of all measurements: your weight, weight, waist size, body mass index (BMI), and blood pressure (optional).Many patients become inspired when they see their results on paper.

Would you like help in balancing your blood sugar, losing weight, preventing disease and feeling great? Check out The Blood Sugar Solution 8 week program.

Have you already implemented food and lifestyle modifications to reverse or prevent diabetes or obesity? Tell us your story! Share your comments below or on my Facebook fan page.

1 Centers for Disease Control and Prevention, Overweight and Obesity.
2Shaban N1, Kenno KA, Milne KJ., The effects of a 2 week modified high intensity interval training program on the homeostatic model of insulin resistance (HOMA-IR) in adults with type 2 diabetes., J Sports Med Phys Fitness. 2014 Apr;54(2):203-9.
3Gremeaux V1, Drigny J, Nigam A, Juneau M, Guilbeault V, Latour E, Gayda M., Long-term lifestyle intervention with optimized high-intensity interval training improves body composition, cardiometabolic risk, and exercise parameters in patients with abdominal obesity., Am J Phys Med Rehabil. 2012 Nov;91(11):941-50. doi: 10.1097/PHM.0b013e3182643ce0.
4Donga E1, van Dijk M, van Dijk JG, Biermasz NR, Lammers GJ, van Kralingen KW, Corssmit EP, Romijn JA., A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects., J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8. doi: 10.1210/jc.2009-2430. Epub 2010 Apr 6.

The Blood Sugar Solution by Mark Hyman, MD (2012): What to eat and foods to avoid

The Blood Sugar Solution (2012) is a book about reducing the risk of “diabesity,” the continuum from optimal blood sugar balance toward insulin resistance and full-blown diabetes. Food guidelines:

  • Eat natural, unprocessed foods
  • Eat moderate amounts of low-glycemic-load carbs – with stricter limits for the advanced program
  • Avoid dairy and gluten during the program to allow the gut to heal
  • 1 week preparation, 6 weeks program (basic or advanced)

Below on this page is a full description of the food recommendations. Preparation | General guidelines | Basic program | Advanced program | Boosting your nutrition | Reintroduction and diet for life. The book has a lot more information in it.

Get a copy of The Blood Sugar Solution for more information on the reasons behind the recommendations, hormone regulation, quizzes, supplementation, menus, recipes, resources and more.
Also, get The Blood Sugar Solution Cookbook for a detailed list of serving sizes and many more recipes for the Basic Program and the Advanced Program as well as Reintroduction, and a few desserts.

Note that this is the original book / basic plan – see also The Blood Sugar Solution 10-Day Detox Diet by the same author for his detox diet.

The reasoning behind The Blood Sugar Solution

This book encourages the use of functional medicine – asking the question “why?” – not just “what is the right drug for this disease?” The goal is to understand what disturbs the normal function of these systems, and how we can best create optimal function. It states that nearly all people who are overweight (over 70% of adult Americans) already have “pre-diabetes” and have significant risks of disease and death. Managing blood sugar and insulin levels through diet and supplements reduces this risk better than drugs.

The Blood Sugar Solution diet plan – food list

The book calls for 1 week preparation and a 6 week program, followed by a diet for life. There are two plans, the basic plan and the advanced plan – the advanced plan has a more restrictive diet for 6 weeks and a more comprehensive supplement plan.

This description combines The Blood Sugar Solution and The Blood Sugar Solution Cookbook. Because the cookbook was written a year after the diet book, which had been successful, there are some minor tweaks between the two. We’ve tried to note them here.

Preparation | General guidelines | Basic program | Advanced program | Boosting your nutrition | Reintroduction and diet for life

One week preparation

One week before the program, cut out addictive substances from your diet.

The Blood Sugar Solution 1 week preparation – what to eat

If it came from the earth or from a farmer’s field, not a food chemist’s lab, it’s safe to eat.

The Blood Sugar Solution 1 week preparation – foods to avoid

These are foods you’ll cut out completely:

  • Sugars and carbs
    • All sugar, with any name – including agave nectar, organic cane juice, cane syrup, honey, maple syrup, molasses, etc.; also high fructose corn syrup HFCS
    • Highly processed carbs that act like sugar, including all flour products, breads, pastas, etc. Especially foods with white flour and white rice. Check labels – there’s a lot of sugar in ketchup, for example
  • Processed foods and additives
    • Foods with labels and more than five ingredients, or with health claims on the label, or with ingredients you can’t pronounce
    • Foods with preservatives, additives, coloring, or dyes, “natural flavorings,” or flavor enhancers such as MSG (monosodium glutamate)
    • Foods with artificial sweeteners, e.g. aspartame, NutraSweet, Splenda, sucralose, sugar alcohols (end with “ol,” such as xylitol or sorbitol)
  • Unhealthy fats
    • Foods with the word “hydrogenated” on the label
    • Highly refined cooking oils such as corn oil, soy oil

Beware of foods without labels

And here are foods that you’ll cut out for 7 weeks – the preparation week plus the 6 week program:

  • Alcohol
  • Caffeine

General guidelines on food choices – for both basic and advanced programs

General – what to eat

If it came from the earth or a farmer’s field, not a food chemist’s lab, it’s safe to eat.

  • Meal guidelines
    • Always have breakfast, with proteins such as eggs, nuts, seeds, nut butters, or a protein shake
    • Eat 3 meals a day with 2 snacks. Eat every 3-4 hours, and try to schedule meals at the same time every day. Have small, frequent, fiber-rich meals throughout the day. Stop eating at least 3 hours before you go to bed
    • Each meal can have up to 15 grams of carbohydrates, and each snack can have up to 7.5 grams. If you exercise regularly or increase your exercise routine while on this program, you can slowly begin to increase these amounts. But have no more than 30 grams of carbs at a meal unless they come from low-glycemic vegetables. As your insulin sensitivity improves, you can increase your consumption of natural carbohydrates to 30-50 grams per meal. Choose nonstarchy vegetables, whole grains, legumes, and lower-glycemic fruit such as blueberries, raspberries, apples, and pears. You should eliminate refined carbs and sugars for the first 6 weeks on the program, then you can have an occasional small treat once a week if it doesn’t trigger sugar or carb binging
    • Eat a low-glycemic-load diet, to avoid spiking blood sugar and insulin (the restrictions above will automatically lead to this)
    • Combine good protein (fish, organic eggs, small amounts of lean poultry, nuts, whole soy foods, and legumes), good fats (fish, extra virgin olive oil, unrefined coconut oil, olives, nuts other than peanuts, seeds, and avocados), and good carbs (in moderation) (beans, vegetables, whole grains, and fruit) at each meal to balance your blood sugar
    • On half of your plate, put low-starch vegetables (you can refill this part as much as you want). On one quarter of your plate, put some lean protein (following the guidelines above). On the other quarter, add either ½ cup of whole grains (ideally brown or black rice or quinoa) or ½ cup of starchy vegetables such as sweet potato or winter squash. If you are on the Advanced Plan, make your plate 75% low-starch vegetables and 25% protein; skip the grains and starchy vegetables
    • Eat a wide range of produce – red, yellow, and orange fruits and vegetables; dark green leafy vegetables; dark blue, purple, or red fruits and vegetables; cruciferous vegetables; allium vegetables; citrus fruits; sea vegetables; low-glycemic fruits and vegetables; konjac
    • If you have advanced diabesity or are on the advanced program, make vegetables ¾ of your plate and protein ¼ – until your metabolism resets and you become more insulin-sensitive, about 6 weeks to 12 months
    • Eat more: whole foods, fiber, omega-3 fats
    • Look for foods with a low glycemic load (GL) and a high phytonutrient index (PI – colorful fruits and veggies)
    • Practice mindful eating: Take 5 slow breaths before a meal; offer gratitude before your meal; bring your attention fully to the food; put your fork down between bites, and chew your food well
  • Eat local and seasonal food where possible – support your farmers market and CSA
  • Vegetables
    • Eat organic if you can, especially the EWG’s dirty dozen
    • Green carbs – eat freely: artichokes, arugula, asparagus, avocado, bean sprouts, beet greens, bell peppers, bok choy, broccoli, broccolini, broccoli rabe, broccoli sprouts, Brussels sprouts, cabbage, red cabbage, cauliflower, celery, chard, chile peppers, Chinese broccoli, collard greens, cucumbers, dandelion greens, eggplant, endive, garlic, ginger root, green beans, fennel, hearts of palm, jicama, kale, kohlrabi, leeks, lettuce, mushrooms, mustard greens, napa cabbage, onions (all types), peppers (all types), radicchio, radishes, scallions, seaweed/sea vegetables (e.g. arame, dulse, hijiki, kombu, wakame, etc.), shallots, snap beans, snap peas, snow peas, spinach, summer squash, Swiss chard, tomatoes, turnip greens, watercress, yellow squash, zucchini. Serving size: 3 cups salad greens, 1 cup raw or ½ cup cooked – but these are essentially free foods, eat as much as you’d like
    • Red carbs – eat limited amounts (avoid on the advanced program): starchy, high-glycemic cooked vegetables, e.g. beets, butternut squash, carrots, corn, delicata squash, peas, potatoes, pumpkins, spaghetti squash, sweet potatoes / yams, turnips, winter squash. Serving size: 1 cup winter squash, ½ sweet potato
    • There are some starchy vegetables listed in the book but not defined as starchy so the guidelines aren’t clear: carrots, turnips, yams
    • Superfood vegetables: arugula, avocado, beets, broccoli, Brussels sprouts, cabbage, collards, kale, kohlrabi, cilantro, dandelion greens, onions, parsley, sea vegetables, shiitake mushrooms, shirataki noodles (made from konjac, not soy), sprouts (especially broccoli sprouts), sweet potatoes, watercress
  • Poultry
    • Serving size 4 ounces
    • Look for organic, pasture-raised and antibiotic- and hormone-free
    • Remove the skin before cooking
    • Chicken, turkey
    • Mark Hyman’s favorite sources for high-quality poultry: Bell & Evans, local farmers’ markets, Murray’s Chicken, Plainville Farms, Whole Foods Market
  • Seafood
    • Serving size 4 ounces
    • Look for small, wild, or sustainably raised cold-water fish. For guidelines on low-mercury fish, visit to download a wallet card you can carry with you for reference when you are shopping. Also see for information on which fish may be in danger because of depleted stocks or nonsustainable harvesting practices
    • Fish – e.g. cod, anchovies, butterfish, catfish, croaker (Atlantic), flounder, haddock (Atlantic), hake, herring, mackerel/chub mackerel (North Atlantic), mullet, perch (ocean), plaice, pollock, wild salmon (canned or fresh), sardines, shad (American), sole, tilapia, trout (freshwater), white fish, whiting. Cod and halibut are also included in recipes
    • Shellfish – e.g. clams, crab (domestic), crawfish/crayfish, mussels, oyster, scallops, shrimp, squid/calamari
    • Mark Hyman’s favorite sources for safe fish: CleanFish, Crown Prince Natural, EcoFish, SeaBear, Vital Choice
    • Superfood fish: sardines, wild salmon (fresh or canned)
  • Meat
    • Serving size 4 ounces
    • Look for pasture-raised, grass-fed, and antibiotic- and hormone-free; also local if possible
    • There are no meat recipes in the diet book and only a couple in the cookbook; it looks like it’s discouraged but there’s nothing saying so
    • The only meat listed in the book is lamb – beef and pork and other meats are not ruled out but not listed
    • Mark Hyman’s favorite sources for high-quality meat: community-supported agriculture (CSAs), Eatwild, local farms or farmers’ markets, Whole Foods Market. See for a guide to eating meat that is both good for you and good for the planet
  • Eggs
    • Omega-3 eggs or free-range eggs
    • Whole eggs are okay
    • Up to 8 a week
    • Mark Hyman’s favorite sources for high-quality eggs: Organic Valley, Pete & Gerry’s Organics
    • Superfood eggs: omega-3 eggs
  • Legumes
    • These are yellow carbs – eat in moderation (and it looks like they can be eaten in the advanced program). Serving size 1/3 cup limit if you are on the Advanced Plan, cooked or canned
    • Beans – e.g. adzuki beans, black beans, butter beans/baby lima beans, cannellini beans, fava beans/broad beans, Great Northern beans, kidney beans, mung beans, navy beans, pinto beans
    • Lentils, e.g. red lentils, brown lentils, green lentils
    • Chickpeas/garbanzo beans, garbanzo bean flour
    • Dried peas,e.g. black-eyed peas, and split peas, e.g. green split peas, yellow split peas
    • Whole soy products, including edamame, soybeans, tempeh, tofu, silken tofu, miso, and natto (serving size not given). Plain unsweetened soy yogurt is included in the cookbook
    • When buying canned beans, seek out BPA-free cans – or better yet, cook with dried beans from the bulk section of your local market
    • Superfood legumes: adzuki beans, black beans, edamame
  • Nuts and seeds
    • Servings size: ¼ cup or one small handful or 10-12 nuts, once or twice a day
    • Raw – not fried, cooked in oils, or salted. Lightly toasted is okay
    • Nuts – e.g. almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios, walnuts. Optionally soak in water overnight
    • Seeds – e.g. chia seeds, flaxseeds, hemp seeds, pumpkin seeds/pepitas, sesame seeds, sunflower seeds
    • Mark Hyman’s favorite source for high-quality nuts and seeds: Artisana, Barlean’s Organic Oils, Eden Foods, MaraNatha, Omega Nutrition, Once Again, Pacific Foods, Spectrum, WhiteWave
    • Nut butters – e.g. almond butter, cashew butter, macadamia nut butter, peanut butter, pecan butter, sunflower seed butter, tahini (serving size not given)
    • Nut flours – e.g. almond meal, coconut flour. Mark Hyman’s favorite source for high-quality flour alternatives: Bob’s Red Mill
    • Superfood nuts and seeds: All, especially almonds, Brazil nuts, pine nuts, walnuts, chia seeds, flax seeds, hemp seeds, pumpkin seeds, sunflower seeds
  • Herbs and spices
    • Herbs, fresh or dried – e.g. basil, bay leaf, chives, cilantro, dill, mint, oregano, parsley, sage, rosemary, sage, thyme
    • Spices – e.g. black pepper, cayenne pepper, chili peppers, chili powder, Chinese 5-spice powder, chipotle powder, cinnamon, coriander, cumin, curry powder, fennel seed, garam masala, garlic powder, ginger, mustard seed, nutmeg, onion powder, paprika, red pepper flakes, smoked paprika, sea salt, sumac, za’atar spice mix
    • Mark Hyman’s favorite source for high-quality seasonings: Edward & Sons, Flavorganics, Frontier Natural Products Co-Op, Penzeys Spices, Rapunzel, Seeds of Change, The Spice Hunter
    • Superfood spices and foods: cacao (raw), chiles, cinnamon, garlic, ginger, green tea/matcha, miso, turmeric
  • Fats
    • Extra virgin olive oil, coconut oil, flaxseed oil, grapeseed oil, sesame oil (light or dark), sunflower oil (not listed in the cookbook), walnut oil. Peanut oil is also included in recipes
    • Avocados and avocado oil
    • Olives
    • Coconut butter
    • Tahini
    • Butter is listed in the diet book but excluded in the cookbook, which has recipes with ghee/clarified butter
    • Mark Hyman’s favorite source for high-quality oils: Artisana, Barlean’s Organic Oils, Spectrum
    • Superfood fats: extra-virgin coconut butter, extra-virgin olive oil
  • Beverages
    • Drink 6-8 glasses of clean, fresh, pure water a day. The best option is to filter your own water
    • Matcha green tea
    • Small amounts (1/4 to ½ cup) of alcohol in cooking are fine
  • Condiments and pantry
    • Bragg’s Liquid Aminos, capers, chili paste, red chili paste, coconut milk, dill pickle, hot sauces, mirin, mustard, olives, gluten-free low-sodium stock/broth, wheat-free tamari, tomato paste, sriracha, sun-dried tomatoes, tahini, tamari, tomato paste, tomato sauce, cooking wine, Vegenaise, vinegar (apple cider, balsamic, brown rice, rice wine), wasabi paste, Worcestershire sauce
    • Unsweetened applesauce, aloe vera juice, arrowroot, baking powder, cacao nibs, cacao powder, konjac powder, pomegranate molasses, vanilla extract
    • Unsweetened soy milk, almond milk, coconut milk
    • Protein shake powder – rice protein, pea protein, hemp protein, chia protein, or soy (from whole soy foods with isoflavones) protein powder; any good quality plant protein powder
    • Spirulina powder, green powder, maca powder, bee pollen
    • Some of the recipes include raw honey, although it’s listed as a food to avoid; pomegranate molasses and hoisin sauce are also in recipes
  • Fruits
    • Eat organic if you can, especially the EWG’s dirty dozen
    • Lemons, limes, goji berries, and pomegranate are included in the recipes, but there are no guidelines about how freely to eat them
    • Yellow carbs – eat in moderation (avoid on the advanced program, except ½ cup dark berries daily): dark berries (blackberries, blueberries, cherries, raspberries); stone fruit (apricots, plums, peaches, nectarines, etc.); apples and pears. Serving sizes: 1 medium piece, 1 cup berries, ½ cup mixed fresh fruit, ¼ cup dried fruit. Strawberries and grapefruit are also listed in the cookbook
    • Red carbs – eat limited amounts (avoid on the advanced program): high-sugar fruits, including melons, grapes, pineapple – limit to a ½ cup treat once a week.
    • Avoid all fruit juice or fruit packed in juice
    • Other high-sugar fruits are listed in the recipes but it’s not clear whether they’re yellow carbs or red carbs: bananas
    • Superfood fruits: apples, berries (especially wild, organic blueberries, acai, and goji), kiwis, lemons, pomegranates
  • Grains and carbs
    • These are yellow carbs – eat in moderation (avoid on the advanced program). Serving size 1/3 cup cooked
    • Whole grains – brown rice, black rice, wild rice (avoid wheat for the first six weeks)
    • Pseudo-grains – amaranth, buckwheat/kasha, millet, quinoa, teff
    • Cracked grains – corn grits, polenta
    • Organic tortillas
    • Mark Hyman’s favorite sources for gluten-free grains: Arrowhead Mills, Hodgson Mill, Lundberg Family Farms, Shiloh Farms

You could have chocolate, at least 70% cocoa, no more than 2 ounces a day – but ideally you should save this for after the first 6 weeks

General – foods to avoid

  • Meal guidelines
    • Avoid eating within 3 hours of bedtime
  • Foods that trigger allergic reactions – avoid
    • Gluten – avoid it for the first six weeks of the program (see Diet for Life below for reintroduction). Obvious foods containing wheat, barley, einkorn, kamut, oats, rye, spelt, tritacale; flour-based foods such as bagels, bread, cakes, cookies, crackers, muffins, and pizza; also hidden sources such as soba noodles, tamari, miso, seasonings, broth – look for gluten-free options
    • Dairy – avoid it for the first six weeks of the program (see Diet for Life below for reintroduction). Obvious foods containing milk, butter, cheese, yogurt, cream, and other dairy foods; also hidden sources such as mayonnaise, chocolate, “natural” flavors, and anything that has casein
    • Any other foods that trigger allergic reactions for you
  • Don’t drink your calories
  • Avoid all flour products, even gluten-free
  • Highly processed and artificial foods – avoid
    • Industrial processed foods, fast food, and junk food
    • Limit foods that come in a box, a package, or a can unless they are unprocessed. Look for the ingredient list and the nutrition facts.
    • Foods with names you can’t recognize or pronounce
    • Foods with preservatives, additives, coloring, or dyes, “natural flavorings,” or flavor enhancers such as monosodium glutamate MSG
    • Foods and drinks containing artificial sweeteners and low-calorie sweeteners including stevia, aspartame, NutraSweet, sucralose, sugar alcohols such as xylitol and maltitol, and all of the other heavily used and marketed sweeteners
    • Processed industrial soy products, such as those found in deli-meat replacements, soy cheese, or typical meal-replacement bars
    • Beware of foods with health claims on the label
  • Sugars and carbs – avoid
    • Dietary sugars, including sugar, agave nectar, artificial sweeteners, organic cane juice, sugar cane crystals, cane syrup, fermented sugars, dried fruit, fruit juices, honey, liquid sweeteners, malted, maple syrup, molasses, “natural sugars,” refined sugars, sorghum, syrup – check ingredient labels for any foods containing sugars and avoid them. Note that the less processed sugars listed here are included in the dessert recipes in the cookbook, which are for occasional treats only
    • Refined grains – white rice, white flour, and even whole grain flour – including breads, pastas, and other highly processed carbs that act like sugar
    • All flour products (even gluten-free)
    • High fructose corn syrup HFCS
    • Sodas, including sugar-sweetened and artificially sweetened
    • Fruit juice
    • Dried fruit – dried cranberries, currants, dates, raisins, etc. However, there are dried fruits in a number of recipes in the recipe book
  • Processed fats – avoid
    • Any food with the word “hydrogenated” on the label – trans fats
    • Highly refined cooking oils with large amounts of omega-6 fats (soybean and corn oil)
    • Toxic fats and fried foods
  • Unnatural natural foods – avoid
    • Animal products containing antibiotics, hormones, and pesticides. Choose pasture-raised, grass-fed animals instead
    • Fish that are high mercury or contain other contaminants in large amounts – large predatory fish and river fish. Choose small, wild, or sustainably farmed fish instead
    • Plants treated with pesticides and chemical fertilizers. Choose organic instead, especially for the EWG’s dirty dozen
    • Foods transported long distances and/or stored for a long time. Choose seasonal, local food instead.
  • Packaging and processing – avoid
    • Water from plastic water bottles (which contain phthalates)
    • Cans (containing bisphenol A BPA) are not proven to be safe
    • Don’t microwave your food. Warming may be okay, but not cooking
    • Charbroiling foods (grilled over charcoal) may be carcinogenic

6 weeks program – basic

The basic program can be followed by anyone. It claims to balance your blood sugar, reduce insulin spikes, balance hormones, cool off inflammation, improve digestion, boost your metabolism, enhance detoxification, and calm your mind and nervous system.

There are several quizzes in the book to check for medical conditions – if you qualify for self-care or medical care in more than one step, stay on the program for an additional 6 weeks and add the recommendations for each step you scored high on.

The Blood Sugar Solution 6 week basic program – what to eat

  • General foods to eat – see list above

The Blood Sugar Solution 6 week basic program – foods to limit

  • Limit fruit of any kind to 2 pieces per day; limit melons, grapes, and pineapple to ½ cup once a week
  • Limit starchy, high-glycemic cooked vegetables (winter squashes, peas, potatoes, corn, root vegetables, beets) to up to ½ cup per day and ideally in the context of other foods that reduce the overall glycemic load of the meal

The Blood Sugar Solution 6 week basic program – foods to avoid

  • General foods to avoid – see list above
  • Alcohol
  • Caffeine

6 weeks program – advanced

The advanced program is designed for people with more severe cases of diabesity, including all those who have been diagnosed with diabetes, and it is designed to help with more serious biochemical and metabolic imbalances. It is a more restrictive diet for six weeks

There are several quizzes in the book to check for medical conditions (see “boosting your nutrition” below) – if you qualify for self-care or medical care in more than one step, stay on the program for an additional 6 weeks and add the recommendations for each step you scored high on.

The Blood Sugar Solution 6 week advanced program – what to eat

  • General foods to eat – See guidelines above, and note where it says foods should be excluded on the advanced program

The Blood Sugar Solution 6 week advanced program – foods to avoid

  • General foods to avoid – see list above
  • Alcohol
  • Caffeine
  • All grains
  • All fruit
  • All starchy vegetables

Boosting your nutrition

There are a number of quizzes in the book; you can also access them on the Blood Sugar Solution quiz page on the website (registration required). Depending on how you scored, focus on adding these foods (as well as the supplements in the book):

  • Magnesium deficiency
    • If you scored over 3 on the Magnesium Quiz, focus on eating more of these foods:
    • Dark green leafy vegetables
    • Legumes/beans of all varieties
    • Nuts – especially almonds
  • Vitamin D deficiency
    • If you scored over 3 on the Vitamin D Quiz, focus on eating more of these foods:
    • Mackerel, herring
    • Porcini or shiitake mushrooms
  • Omega-3 fat deficiency
    • If you scored over 4 on the Essential Omega-3 Fats Quiz, focus on eating more of these foods:
    • Sardines, herring, wild salmon, mackerel
    • Flaxseeds, walnuts
  • Thyroid
    • If you scored over 3 on the Thyroid Quiz, focus on eating more of these foods:
    • Seaweed or sea vegetables for iodine
    • Fish, especially sardines and salmon, for iodine, omega-3 fats, and vitamin D;
    • Dandelion greens for vitamin A
    • Smelt, herring, scallops, and Brazil nuts for selenium
  • Sex hormones
    • If you scored over 9 if you are a woman or over 4 if you are a man on the Sex Hormones Imbalance Quiz, focus on eating more of these foods:
    • Whole traditional soy foods such as tofu, tempeh, miso, natto, and edamame, which contain isoflavones
    • Ground flaxseeds, which contain lignans – 2 tablespoons a day
  • Inflammation
    • If you scored over 6 on the Inflammation Quiz, follow the elimination/reintroduction diet after the six weeks are over:
    • Follow Dr. Hyman’s UltraSimple Diet
  • Digestion
    • If you scored over 8 on the Digestion Quiz:
    • For 6 weeks, eliminate foods from your diet that ferment and produce gas in your gut (beans, grains, and all sugars, including all artificial sweeteners, especially sugar alcohols) – this will starve out the bad bugs
    • Eat slowly, chew your food, and sit down when you eat
    • Take the recommended supplements, enzymes, probiotics, and nutrients
  • Toxicity
    • If you scored over 6 on the Toxicity Quiz, focus on eating more of these foods:
    • Cruciferous vegetables: broccoli, kale, collards, cabbage, etc.), garlic, green tea, turmeric, whole eggs. Add them to your diet daily
    • Other great detox foods are cilantro, celery, parsley, dandelion greens, citrus peels, pomegranate, and rosemary

Reintroduction and diet for life

There are suggested recipes in the cookbook for reintroduction of dairy and gluten – see guidelines below.

  • Stick with the general food recommendations for life
    • Keep sugar, flour, and processed foods to a minimum
    • Include high-quality, whole-food carbs, protein, and fats at every meal
    • Compose your meals according to the 50-25-25 principle (50% vegetables, 25% lean high-quality protein, 25% whole grains)
    • Eat protein for breakfast and don’t eat 2-3 hours before bedtime
    • Limit your intake of addictive substances such as caffeine and alcohol
  • Dairy and gluten – two alternatives: you could stay off them, or you could add them back in
  • To reintegrate dairy and gluten:
    • Start with unprocessed dairy
    • Eat it at least 2-3 times for 3 days
    • Track your reactions for at least 72 hours (weight gain, cravings, fluid retention, nasal congestion, chest congestion, headaches, brain fog, difficulty remembering things, mood problems such as depression, anxiety, anger, sleep problems, joint aches, muscle aches, pain, fatigue, changes in your skin such as acne, changes in digestion or bowel function such as bloating, gas, diarrhea, constipation, reflux
    • If you have a reaction, stop dairy immediately
    • Wait 3 days
    • Now try unprocessed gluten. Follow the same process you did for dairy: Eat it 2-3 times for 3 days, track your reactions for at least 72 hours, and quit if you notice a reaction

Health benefits claimed in The Blood Sugar Solution

The book claims to help prevent or alleviate chronic diseases, including: acid reflux/GERD/heartburn, acne, ADD/ADHD, allergies, ALS/Lou Gehrig’s Disease, Alzheimer’s disease, anorexia, anxiety, arthritis, asthma, autism, binge eating disorder, bipolar disease, breast cysts, bronchitis, bulimia, cancer, canker sores, celiac disease, chronic fatigue syndrome, chronic pain, cold sores, colitis, constipation, dementia, depression, diabetes, type 1 diabetes, type 2 diabetes, prediabetes, diarrhea, edema, environmental allergies, fatigue, fibromyalgia, food addiction, food allergies, chronic fungal infections, gingivitis, gluten sensitivity, gout, Gulf War syndrome, hair loss, headache, heart disease, high blood sugar, high blood pressure/hypertension, hypoglycemia, hypothyroidism, infertility, inflammatory bowel disease IBD, insomnia, insulin resistance, irritable bowel syndrome IBS, kidney stones, leaky gut, liver failure/fatty liver, lupus metabolic syndrome, migraines, mood swings, muscle fatigue (chronic), muscle pain, night sweats, obesity/overweight, osteoarthritis, osteoporosis, Parkinson’s disease, polycystic ovarian syndrome PCOS, premenstrual syndrome, prostate cancer, psoriasis, restless leg syndrome, rheumatoid arthritis, rosacea, schizophrenia, seasonal allergies, sensitivity to cold, sinusitis, sleep apnea, stroke, syndrome X, thrush, uterine fibroids, yeast infections

Get a copy of The Blood Sugar Solution for more information on the reasons behind the recommendations, hormone regulation, quizzes, supplementation, menus, recipes, resources and more.
Diet book
Also, get The Blood Sugar Solution Cookbook for recipes.
Also see for an online community, online course, videos, quizzes, success stories, recipes, and more

How has this diet worked for you?

The Blood Sugar Solution With Dr. Mark Hyman

In this 60-minute public television special, Dr. Mark Hyman explains what “diabesity” is, outlines the underlying causes that drive the problem, and provides a personalized, four-step plan to help you overcome diabesity. He explains how we can all take back our health as individuals, as a community, and as a society.

Join the UltraWellness Community

Get healthy together and connect with people like you!

The UltraWellness Quiz

Take the quiz and find out the real cause of your health condition and how to fix it.

Healthy Living Resources

Browse healthy living resources to get your health back on track

Recipes to Reverse Diabesity

Get recipes for delicious meals the whole family can enjoy!

Success Stories

Read over 100 success stories from people just like you!

The program will radically change the way you think about your body, your lifestyle, and the power you have to change your health.

Dr. Hyman identifies the seven keys to achieving wellness-optimize your nutrition, balance your hormones, cool off inflammation, fix your digestion, enhance detoxification, boost your energy metabolism, and calm your mind-and outlines the steps needed to personalize your approach to healing.

His six-week action plan will help viewers identify and address the unique causes of their own health and weight issues, and he offers exercise advice, stress-reducing strategies, a menu plan with delicious recipes, and much more.

Mark Hyman, MD is dedicated to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach called Functional Medicine. He is a family physician, a four-time New York Times bestselling author, and an international leader in his field.

Through his private practice, education efforts, writing, research, and advocacy, he empowers others to stop managing symptoms and start treating the underlying causes of illness, thereby tackling our chronic-disease epidemic.

Mark Hyman, MD is on Facebook, and you can follow @markhymanmd on Twitter. Visit his YouTube channel to watch videos.

This program is part of our TV Membership Campaign. Support quality programming you depend on from KPBS. Join or renew today!

The Blood Sugar Solution by Dr Mark Hyman

The Blood Sugar Solution from Dr Mark Hyman on Vimeo.

The Blood Sugar Solution Workshop by Dr Mark Hyman

Blood Sugar Solution Home Study Course from Dr Mark Hyman on Vimeo.

The Blood Sugar Solution Workshop: UltraHealthy Tools for Overcoming Diabesity – this powerful home study course teaches you exactly how to overcome your diabesity.


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