Diabetes is a health problem in modern society, and obesity is a warning sign of diabetes. Neng Chun Yu, a well-known Taiwanese medical practitioner of more than 30 years and author of the best-selling book “Dr. Neng Chun Yu’s 133 Low-Carbohydrate Meal Plate,” shared his journey of finding and successfully practicing a natural and healthy way to control carbohydrate intake.
Neng Chun Yu, an endocrinologist who specializes in treating diabetes, was once troubled by obesity and diabetes.
He is 163 cm tall and weighed 78 kg in 2016, with a particularly obvious beer belly. That was his wake-up call. Neng Chun Yu got a blessing in disguise and embarked on the path to successful carbohydrate intake control.
Moreover, he has a relatively high fasting blood sugar level in the morning, which is classified as prediabetes, and a strong family history of diabetes.
As a physician, Neng Chun Yu knew that diet control is an important part of lowering blood sugar. As a “prediabetes patient,” he started to study in detail: what to eat and how much to eat to effectively lower blood sugar.
Neng Chun Yu personally experimented with various foods, from rice and pasta to milk and fruits, and he tested the changes in his blood sugar level after a type of food was eaten. Gradually, he created a diet that only has “one serving of carbohydrate” per meal, that is, the “133 low-carbohydrate meal plate” diet.
Following this method, Neng Chun Yu lost 20 kg in two years from 2016 to 2018. From then to this year, he lost a total of 24 kg. From the recent pull-up photo, his abs are clearly visible, and there is no flab on his body. His blood sugar is also at a healthy level.
Below, Neng Chun Yu gave a detailed explanation of the “133 low-carbohydrate meal plate” diet.
As a metabolic physician who specializes in treating diabetes, Neng Chun Yu conducts a lot of blood sugar tests on patients in my clinic, as well as tests the effect of food on blood sugar levels.
On top of that, his clinic does a lot of muscle and fat measurements. Neng Chun Yu’s clinic conducted more than 30,000 measurements on more than 5,000 people and found that those with normal muscle mass and low-fat ratio accounted for only about one-fifth; while the problems of obesity and low muscle mass were common among the tested subjects.
When it comes to fat loss and muscle gain, most people pay more attention to the latter, claims Neng Chun Yu. However, multiple tests have shown that both fat loss and muscle gain can lower blood sugar, and fat loss is more effective. Data from his clinic shows that losing fat is about three times as effective in lowering blood sugar as building muscles.
It actually makes sense, since insulin regulates the energy supply in different tissue cells in the body, including fat cells, he says. It allows fat cells to “occupy” insulin, thereby affecting insulin’s regulation of the blood sugar level.
Therefore, fat loss is essential to the overall balance of metabolism. Neng Chun Yu says that one of the things he is working on is figuring out how to maintain muscle growth while reducing body fat by adjusting his daily diet.
The “one” in the “133” diet refers to one serving of “sugar” (or “carbohydrate”), including starchy foods with a high glycemic index, such as rice and all wheaten food, and even fruits and dairy products. Take rice or dumplings as an example, a serving of carbohydrates means a quarter of a bowl of rice or three dumplings, he says. 
What should I do if I don’t feel full after reducing starchy foods? You can increase the number of other foods accordingly, says Neng Chun Yu.
The “three” in the middle of “133” refers to the number of vegetables. Three servings of vegetables are about 300 grams before cooking and about one bowl after cooking.
In the past, it was believed that vegetables would not provide carbohydrate nutrition. This is because people used to serve vegetables with rice, and the portion of vegetables was relatively small. If the amount of vegetables is increased to 300 grams, it provides the body with the same carbohydrate nutrition as one serving of starch, which is about a quarter of a bowl of rice.
The “three” at the end of the “133” refers to the amount of protein. Three servings of protein are about the size of a human palm, and a piece of meat the size of a palm is about three-fifths of a bowl. For men, the protein may have to be increased to four servings, which is four-fifths of a bowl, says Neng Chun Yu.
All of the above foods adding up can make you feel full.
Furthermore, the more diverse the foods, the better the nutrition. The “133” diet emphasizes the proportions of different types of food; there are no strict restrictions on cooking methods.
For instance, the western chefs on Neng Chun Yu’s team are developing all kinds of “one serving of carbohydrates” baked products: salted egg yolk pastries and cookies.
Even if you use a lot of oil for one meal, just make sure the next meal is less oily, he says.
The same goes for fruits. There are various types of saccharides in fruits, but we only pay attention to the total amount of “carbohydrates”–we can eat two servings of “1/2 carbohydrates” of fruits a day; if measured with a bowl, “1/2 carbohydrates” is less than half a bowl.
“Personally, I’m used to having fruits as my “one serving of carbohydrates” for breakfast,” says Neng Chun Yu.
Naturally, it is easy to adjust food calories while adopting the “133” diet, such as using less oil when cooking, and choosing meat with low-fat content. It is easy to keep the calories of one meal under 400 calories.
In recent years, there have been many trending diet methods, such as the ketogenic diet and 16:8 intermittent fasting (eat within 8 hours and fast for 16 hours a day), and these diets have sparked a lot of debate, says Neng Chun Yu.
“In my opinion, the above diet methods are feasible for pure weight loss purposes, but they are not suitable for long-term use.”
Neng Chun Yu says he did a comparison between the ketogenic diet, the 16:8 intermittent fasting, and the “133” diet.
“For instance, a friend of mine adopted the 16:8 intermittent fasting method for a period of time and also exercised regularly, but a muscle and fat test found that his muscle mass was too low,” says Neng Chun Yu.
This is because he only ate two meals a day during the 16:8 intermittent fasting period, and it is easy to overlook the protein intake, he explains. The truth is, even if you consume all the daily requirements in one meal, it is not easy for the body to fully absorb and utilize protein, so it is better to divide it into three meals.
Neng Chun Yu says that there are many diabetic patients over the age of 75 in his clinic. “It is dangerous for diabetic patients taking medication to carry out intermittent fasting for the purpose of lowering blood sugar, because the medicine still works during fasting, and there is a risk of hypoglycemia.”
As for the ketogenic diet, the total carbohydrate intake per day is less than 50 grams, the vegetable intake is minimal, and a large amount of meat and fat must be consumed, so many food choices need to be given up, says Neng Chun Yu.
Compared with the 16:8 intermittent fasting and ketogenic diets, the “133” diet is more balanced in nutrition, and it is also a more moderate approach to eating, he claims.
As defined by nutritional science, a daily carbohydrate intake of fewer than 130 grams is considered a low-carbohydrate diet. The total amount of carbohydrates in the “133” diet is 90-120 grams a day. Vegetables also provide some calories, which serve as conditions for maintaining basal metabolism and muscle growth.
On top of that, the protein intake of this diet is also adequate.
“I have successfully treated many elderly diabetic patients with the “133” diet,” says Neng Chun Yu.
About half of these patients needed to take a medicine that stimulates insulin secretion before starting a low-carbohydrate diet. After the dietary adjustment, Neng Chun Yu needs to reduce the dosage of the patients’ medication. After four or five years, only five percent of these patients need to continue taking medication. Some diabetic patients can stop receiving insulin injections after adopting the “133” diet.
The “133” low-carbohydrate diet can also be promoted to the general population, encouraging them to adopt this diet in a long-term manner, says Neng Chun Yu.
However, if a diabetic patient wants to try a new diet in order to achieve the goal of lowering blood sugar, it is necessary to consult a physician, as it involves diet changes and adjustments to blood sugar-lowering medicines.
In addition to diet, exercise also plays an important role in improving health and should become a lifestyle habit. For most people, Neng Chun Yu promotes a pyramidal approach to exercising.
First of all, he recommends avoiding prolonged sitting; standing whenever you can, and walking whenever possible; the faster you walk, the better. As the Chinese saying goes: “Take 10,000 steps a day, stay healthy forever.” Neng Chun Yu considers “taking 10,000 steps a day” as the bare minimum, and suggests that more is better.
The middle levels of the pyramid are stretching and balance, as well as strength training. In the past two or three years, the COVID-19 pandemic has prevented many people from going to the gym. These trainings can actually be done at home.
Strength training doesn’t necessarily refer to the way weightlifters train. Lifting a bucket or pouring water into a dehumidifier in daily life is considered strength training; squats, sit-ups, and push-ups are also basic strength training, he says. “I encourage people to use resistance bands, as it is a great tool for strength training.”
Aerobic exercise is at the top of the exercise pyramid, but Neng Chun Yu thinks that does not mean that less of it should be done; it means that with good stretching, balance, and strength training, you will get better at aerobic exercise, and your cardiorespiratory endurance will also improve over time.
“According to my clinical experience, many people have been able to achieve better health through dietary adjustments and exercise,” says Neng Chun Yu.
He explains that a gentleman once came to his clinic in October 2021, weighing 154.3 kg. By September 2022, which is less than a year, his weight had dropped by 50 kg to 104.1 kg. He will return in a few months, and his weight is expected to drop below 100 kg by then.
“He was not hyperglycemic when he came in, but there are many people in his family who have diabetes,” says Neng Chun Yu. He is almost certain to develop diabetes in the future if he continues to gain weight without intervention.
Another gentleman was used to eating 10 dumplings for breakfast, which is more than three times the amount of carbohydrates in the “133” diet. Neng Chun Yu explains that after the diet adjustment, the gentleman’s weight dropped from 80 kg to 72 kg within four months; his health indicators like glycated hemoglobin level (i.e. A1C level) and body fat percentage also improved significantly.
“There is a lady whose A1C level originally was 6.4 percent, which is close to the range of diabetes. She dropped from 49 kg to 44 kg within 6 months, and her A1C level also dropped to 5.9 percent.”
In fact, some patients with Type 2 diabetes do not have a high body mass index, but they still need to lose fat in order to treat their diabetes, says Neng Chun Yu. Such patients need professional guidance to lose weight healthily while maintaining normal muscle mass.
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