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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
- 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.
- 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.
- 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:
- 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.)
- Change to a low-fat,
high-fiber, plant-based diet.
- Exercise.
- 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).
- 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.
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