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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 middleaged
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, eople 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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