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Diet and Diabetes:
The Meat of the Matter

by John McDougall, M.D.

Too Much Fat Causes Diabetes Type II diabetes is called adult-type diabetes because it is the most common type of diabetes seen in adults. Approximately 8% of American adults have this condition and in some subsections of our population, such as the American Indians, the incidence can be as high as 50%. The cause is unquestionably the rich American diet, chock-full of fat and deficient in plant foods. The association with fat and diabetes has been known for over 75 years. In 1927 Dr. E.P. Joslin, founder of the famous Joslin Diabetic Center in Boston, suspected a high-fat, high-cholesterol diet might favor the development of diabetes and its major complication, atherosclerosis.1 He prophetically wrote: “I believe the chief cause of premature atherosclerosis in diabetes, save for advancing age, is an excess of fat, an excess of fat in the body (obesity), an excess of fat in the diet, and an excess of fat in the blood. With an excess of fat diabetes begins and from an excess of fat diabetics die, formerly of coma, recently of atherosclerosis.” After 75 years of repeating the same message about diabetes, it is now the fastest-growing disease in Western nations. Three Major Studies This Past Year Tell of Cause and Prevention

  1. A study, published in the February 2002 Annals of Internal Medicine, of 51,529 male health professionals found those whose diets are rich in red meat, high-fat dairy products, and baked goods are 60% more likely to develop diabetes than are those who eat a more prudent diet of vegetables, fruits, whole grains and lean meats.2 When low physical activity is combined with a fatty diet, the risk of developing diabetes is doubled. Obese subjects have more than 11 times the risk of developing diabetes.
  2. In May 2001 an article in the New England Journal of Medicine reported on 522 middle aged overweight subjects who were divided into two groups.3 One group was encouraged to eat more plant foods, less fat and to exercise; the other subjects continued their old ways. The healthier group lost nearly 10 pounds and had less than half the chance of developing diabetes.
  3. A more recent study, in the February 2002 issue of the same journal, reported on 3,234 pre-diabetic individuals who went on a healthy diet and exercise program and reduced their chances of getting diabetes over the following 2.8 years by 58%.4

Worldwide and nationwide, the incidence of Type II diabetes is skyrocketing. Treatment with medications, including insulin and diabetic pills, does not cause the blood sugars to return to normal or eliminate the common complications, such as blindness, heart attacks and kidney failure. But all of this, and more, can be done with diet and an exercise program, and at no cost. Diabetes: An Adaptive Response The human body is a survivor. It does whatever is necessary to live and function at its highest level, confronted by all kinds of adverse circumstances. The severe malnutrition caused by the high-fat, low-fiber American diet places serious burdens on the body and requires it to make adaptations. The calories consumed in excess of our needs cause us to gain weight. As the body gains excess fat, it becomes resistant to the actions of the hormone insulin in order to survive.5 One of insulin’s jobs is to push fat into the fat cells – the fat is being saved for the day when no food is available (a day likely to be a long time coming). Once obesity has developed, in an effort to stem the rapid expansion of the body’s girth, the fat cells become less responsive to insulin. In other words, “insulin resistance” develops. This slows or stops the accumulation of fat so the person does not get as big as a house.

The next stage of adaptation occurs when the body becomes so resistant to insulin’s effects that it can no longer keep the blood sugar at normal levels. The sugars rise to a level above the kidney’s capacity to keep it in the body, and the sugar spills over into the urine like water falling over a dam. At this stage sugar is found in a urine test–a common way to diagnosis diabetes. This loss of sugar (calories) is the body’s adaptive response to excess calorie intake and storage (body fat). By losing calories through loss of sugar into the urine, weight loss occurs–all in an effort to correct the underlying diabetic condition. Unfortunately, almost all doctors prescribe medications that thwart the body’s efforts to make lifesaving adjustments. Medication Guarantees Diabetes Diabetic medications guarantee that all diabetics will remain diabetic. Insulin and diabetic pills (sulfonylureas) increase the amount of insulin in the diabetic’s body, causing the body to store more fat in the fat cells. Other medications (rosiglitazone) reduce insulin resistance and cause weight gain. Any of these medications may also lower the sugar levels below the kidney’s threshold for dumping excess calories. Thus a vicious cycle is created: The patient goes to the doctor, is diagnosed with diabetes, placed on medication and told to lose weight. The medication makes the person fatter and thus the diabetes becomes worse. The patient returns to the doctor and is given more medications because the sugars are higher, which makes the patient fatter and the diabetes worse. Curing Type II Diabetes In my practice I see people whose future is ever-worsening diabetes, obesity, loss of vision, kidney failure and vascular insufficiency, leading to gangrene. They have seen their doctors regularly, taken their medications faithfully, and still they get fatter and sicker. To break this downhill spiral I ask them to do the following:

  1. Stop or reduce their insulin or diabetic pills. This reverses the weight gain immediately. (The taking of insulin cannot be stopped in Type I diabetes, but the dosage can often be reduced.)
  2. Change to a low-fat, high-fiber, plant-based diet.
  3. Exercise.
  4. Check other risk factors for serious disease, such as cholesterol, triglycerides, and blood pressure. Then take diet and lifestyle steps to correct these (for example, less fruits and juices in cases of high triglycerides and less salt in cases of high blood pressure).
  5. Take medications carefully to correct symptoms and appropriate risk factors. (For example, with too much weight loss, insulin is sometimes necessary. Medications to lower cholesterol, triglycerides, and blood pressure are sometimes indicated in high-risk patients.)

It is no coincidence that the same diet that helps prevent or cure diabetes also causes effortless weight loss, lowers cholesterol and triglycerides, cleans out the arteries, and returns the body to excellent function. But no matter how much research appears saying the same thing over and over again, the tide is unlikely to change because of the economic incentives for the medical establishment of continued illness and profitable treatments.

As enlightened individuals, people can make a difference in their own lives and the benefits are seen almost overnight. Scientific research has shown over the past 75 years that half to three-quarters of Type II diabetics can get off insulin, and almost all can get off their diabetic pills (See the McDougall Program–12 Days to Dynamic Health, Plume 1991). Changing to oatmeal, bean burritos, and a daily walk are the easy ways compared to a short, painful lifetime of injections, complications, doctor’s visits and hospitalizations.

This article and much more life-improving advice can be found in the McDougall Newsletter. For a free subscription, go online to www.drmcdougall.com. Footnotes 1Joslin EP. Atherosclerosis and diabetes. Ann Clin Med 1927;5:1061.
2van Dam RM. Dietary Patterns and Risk for Type 2 Diabetes Mellitus in U.S. Men. Ann Intern Med. 2002 Feb 5;136(3):201-209.
3Tuomilehto J. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343-50.
4Knowler WC. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403.
5Bessesen DH. The role of carbohydrates in insulin resistance. J Nutr. 2001 Oct;131(10):2782S-2786S.