Defeating the Diabetes Epidemic

Defeating the Diabetes Epidemic

By Joel Fuhrman, M.D.

With the exploding number of Type 2 diabetics due to the rise in obesity, more and more physicians are called on to care for these patients. Physicians prescribe drugs that attempt to lower the dangerously high glucose levels, the high cholesterol and triglyceride levels and the high blood pressure typically seen in diabetics. Doctors are continually attempting to target these “risky” numbers that are predictors of damage and/or a pre-mature death.

What is wrong with this scenario is that the treatment of diabetes with medication gives a false sense of security to those with diabetes. Patients think they are fine now that their glucose levels are somewhat better controlled under the care of their well-meaning physicians.

What they do not know is that diabetes continues to damage their organs and heart. Medications give a false sense of security, providing implicit permission to continue the same disease-causing diet and lifestyle that allowed the development of diabetes. Inevitably, the patients worsen, develop complications, and die young. The tragedy is that all this suffering is unnecessary; adult-onset diabetes can be effectively and relatively quickly reversed in over 90 percent of patients. The key is nutritional excellence and exercise.

My motto is:

Don’t treat your diabetes.

Don’t control your diabetes.

Instead, make the commitment to get rid of it!

Understanding the Development of Type 2 (Adult) Diabetes

The heavier you are, the greater the risk you will develop Type 2 diabetes. For some susceptible individuals, even moderate amounts of excess fat on the body can trigger diabetes. Our body’s cells are fueled by glucose. When we have more fat on the body, more insulin is required to deliver glucose to the cells as the coating of fat around our cells makes it difficult for the hormone insulin to easily transport the glucose into the cells. The pancreas is then required to produce even higher amounts of insulin to accommodate the heightened insulin requirements.

Even five pounds of excess fat on one’s frame can inhibit the ability of insulin to carry glucose into our cells. Twenty pounds of extra fat and the pancreas may be forced to produce twice as much insulin to do the necessary job. Fifty pounds or more of excess fat on our frame and the pancreas may be forced to produce six to ten times as much insulin as a normal person who is lean.

What do you think occurs after ten or twenty years of overworking the pancreas? That’s right; it poops out and loses the ability to keep up with such huge insulin demands. The pancreas is still overworked, pumping out much more insulin than a thinner person might need, but still not enough to cover all that disease-causing body fat. Adult diabetes is a disease of insulin resistance, not of insulin deficiency.

The pancreas’ ability to secrete insulin continues to diminish as the diabetes continues and the overweight condition continues year after year. Total destruction of insulin secreting ability almost never occurs in Type 2 (adult-onset) as it does in Type 1(childhood-onset) diabetes. But the sooner the Type 2 diabetic can lose the extra weight causing the diabetes, the more functional reserve of insulin secreting cells in the pancreas will remain.

Giving Insulin to a Type 2 Diabetic is Dangerous

Even years before a person first develops diabetes, the higher than normal insulin production (as a result of excess body fat) was creating damage. Excess insulin promotes the deposits of atherosclerosis that eventually result in heart attacks and strokes.

Findings from numerous studies have shown that hyper-insulinemia promotes atherosclerosis even in non-diabetics. In one study of 154 treated diabetics, the prevalence of blood vessel disease was greatest in those with the highest levels of insulin. It made no difference whether the insulin was endogenous (self-produced) or exogenous (taken by injection).

Quite a few studies illustrate the dangers of giving insulin to the adult diabetic. When diabetic patients are given insulin, compared to those given metaformin (Glucophage) the risk of death from heart attacks tripled.1

When you give an adult diabetic who has been suffering from the damaging effects of excess insulin for years more insulin to drive the sugar down lower, you create more problems. Giving the diabetic patient insulin increases appetite, causes significant weight gain (often more than 20 pounds) and, as a result makes the patient more diabetic. This creates a vicious cycle that cuts years off a person’s life.

Exposure to insulin in bolus (injectable) form can create a blood vessel wall injury that is an early step in the formation of atherosclerotic lesions. Insulin blocks cholesterol removal and delivers cholesterol to cells in the blood vessel walls accelerating the creation of atherosclerotic plaque. It increases the risk of cardiac death in a disease that already causes early cardiac death. Almost 80 percent of all deaths among diabetics are due to atherosclerosis, particularly coronary artery disease.

You can get a blood test to check your insulin level; it corresponds with heart attack risk. But a tape measure around the waist does almost just as well as predicting insulin levels. As the ancient saying goes: The longer your waistline, the shorter your lifeline.

Although an elevated cholesterol increases mortality somewhat in the non-diabetic, a diabetic’s risk for death increases fivefold for each 20 points more that the cholesterol is elevated. The bottom line is this: if you have diabetes or know anyone with diabetes, they must get rid of their diabetes and not merely “manage it” by relying on standard drug methods of treating diabetes. You must lose weight and dramatically lower your cholesterol and triglyceride level. Aggressive nutritional excellence is the only effective way to remove this dangerous condition.

Conventional diabetologists are in a bind. They know that high glucose levels age the eyes and kidneys leading to devastating complications like kidney failure and blindness. They want to prescribe aggressive insulin therapy to get those blood sugars down. The problem is they also are aware that the extra insulin accelerates atherosclerosis leading to heart attacks and makes diabetics gain weight which eventually makes them more diabetic. Tightening blood sugar control with insulin is risky business.

I consider it malpractice, especially when you consider that patients are never given the option of nutritional excellence instead. In my opinion, all diabetic specialists who start giving insulin to Type 2 diabetics are endangering their patient’s lives, because they do not have the nutritional knowledge to offer their patients an effective life-saving alternative.

The American Diabetes Association and most dieticians and physicians offer dangerous advice to the diabetic. They give lip service to weight reduction and cholesterol lowering, but since the recommended diets are ineffective at achieving substantial weight loss and achieving a sustained ideal weight, their recommendations are generally worthless. Typical diabetes care focuses on general glucose control by monitoring blood glucose to determine when it is necessary to change insulin dosages or when more glucose lowering medication is warranted.

Here is a policy statement from a physician organization dictating diabetic care:

“It is nearly impossible to take very obese people and get them to lose significant weight. So rather than specifying an amount of weight loss, we are targeting metabolic control.”

This is double speak for — “Our recommended diets don’t work so we just give medications and watch patients deteriorate.”

The Safest and Most Effective Approach

So what can people with diabetes do? How can they lower the high glucose levels that are slowly destroying their bodies, lower their lipids, lower their blood pressure, lose weight and not take drugs such as insulin and sulfonylureas which cause weight gain and are dangerous?

Here is the simple answer — the best diet for humans to live longer in good health is also the best diet for one with diabetes. That is a diet with a high nutrient per calorie ratio as carefully described in my book, Eat To Live. When one eats a diet predominating in nature’s perfect foods — green vegetables, beans, eggplant, tomatoes, mushrooms, onions, garlic, raw nuts and seeds and limited fresh fruit, it becomes relatively easy for people to eat as much as they want and still lose their excess weight relatively easily. My experience has demonstrated that those choosing to follow my nutritional recommendation have their diabetes melt away astonishingly fast even before they have lost most of their excess weight.

I have achieved marked success with diabetic patients and the success at becoming “non-diabetic” or almost “non-diabetic” regularly occurs on the “vegetable-based” program, whether the patient follows a strict vegan diet or not. I describe the diet-style as a “vegetable-based” diet because the base of the pyramid is vegetables, not grains. Even though most animal products are excluded, patients can have the option of including a small amount of low-fat animal products once or twice a week and still achieve their goals.

A Grain-based Diet or a Cooked Starch-based Diet for Diabetics?

My clear message is that diabetics can’t just “eat better.” They have to go all the way and follow a vegetable-based diet described in my book, Eat To Live. It differs from the traditional Natural Hygiene diet because it has more cooked vegetables and beans and less fruit. Other popular styles of vegetarian diets are also not as effective or safe because they are typically heavy in cooked starchy vegetables such as bread, grains, and potatoes. Diabetics need to avoid baked-starchy vegetables and flour-based products. Most low-fat and vegetarian type programs are cooked starch and grain based, not (steamed) vegetable based. By utilizing more green vegetables, eggplant, mushrooms, peppers, to-matoes, cauliflower, beans, nuts and some fruit, one achieves more dramatic weight loss and more effective glucose lowering.

A vegetable-based dietary program is the only dietary intervention that has ever been shown in medical studies to lower cholesterol more effectively than cholesterol lowering medication. Other styles of plant-based dietary interventions, because they were grain and potato based, have been relatively ineffective at lowering cholesterol. Though the low-fat vegetarian diet did lower LDL cholesterol 16 percent, it raised triglycerides 18.7 percent and the LDL/HDL ratio remained unchanged reflecting minimal overall improvement.2

On the other hand, my dietary recommendations resulted in the LDL cholesterol dropping (33 percent) without unfavorable impact on HDL or triglycerides, reflecting sizable improvement in reducing the risk of heart attack. It simply is the most cardio-protective diet-style one can follow and that is crucially important in diabetics who are at such an increased cardiac risk.

Advanced Glycation End Products (AGEs)

Another reason why typical vegetarian diets are not ideal for diabetics is they are not designed to avoid exposure to advanced glycation end products (AGEs). There is a huge body of literature documenting that the high sugar in the bloodstream in diabetics promotes the formation of AGEs in the body as the sugars react with body proteins. The formation of advanced glycation end products (AGEs) on connective tissue and within cells stiffens and ages our blood vessels and accelerates aging throughout the body. AGEs are an important cause of the horrible side effects of diabetes, such as blindness, kidney failure, heart attacks and strokes. The chemical modi-fications to cells from the accumulation of AGEs as we age is one of the primary hallmarks of aged and diseased tissues.

But AGEs are not only increased in the body from increased sugar; they are also formed when starchy foods are cooked at higher temperatures causing molecular rearrangement. Acrylamides are an example of AGEs that occur from cooking carbohydrates such as potatoes and grains in the absence of water. The higher the temperature, the more these toxic compounds are formed. Steaming vegetables or cooking vegetables in soups do not form acrylamides and other AGEs.

Refined carbohydrates in bakery products and processed foods can cause heart attacks even in people who are not diabetic, but for the diabetic, they are particularly more sensitive to the damaging effects of AGEs.3 Vegetarians (my wife calls them “vegjunktarians”) who ate more cooked starches and honey were found to have higher measurable levels of AGEs, when compared to those on a more omnivorous diet.4 Vegetarian diets — to be lifespan promoting and diabetic reversing — must be designed to minimize exposure to large amounts of cooked starches and simple sugars. The diets, in addition, must be very high in fiber to maximize glucose lowering. These are the criteria I meet when designing high nutrient diets for diabetics.

A Meat-based Diet for Diabetics?

Many authorities and authors recommend watching the intake of refined grains and simple sugars in diabetics. Some people have bought the faulty logic that if sugar and refined grains and other high glycemic foods raise blood sugar and raise triglycerides that we should eat more protein instead of carbohydrates. They attempt to solve the triglyceride-raising problem seen on those eating typical high-carbohydrate diets by recommending a diet based on animal products and are often called “high-protein diets.” These carbohydrate-restricted diets rich in animal products can offer some short term improvement in glucose control and weight loss.

The problem is that the increased protein intake promotes the progression of diabetic kidney disease and the higher saturated fat intake raises cholesterol and promotes heart disease. I have observed numerous diabetic patients over the years that caused significant damage to their kidneys attempting improved diabetic control with such high-protein, carbohydrate-restricted diets.

High-protein, carbohydrate-restricted diets are also heart disease unfavorable. One comprehensive study on the Atkins approach showed the blood flow to the heart diminished by an average of 40 percent after one year and in-creased inflammatory markers that predict heart attacks.5 The low levels of plant fiber, phytochemicals and antioxidant nutrients on these unbalanced, low produce diets place extra risks on the diabetic patient. High-protein diets may be short-term diabetic favorable, but they are long-term dangerous.

The low-glycemic benefit of a high-protein diet is achieved with the very high fiber vegetable/bean/nut based approach that I recommend, without the disadvantage of eating animal products. Because the nutritional quality of the entire diet is so high, with so much fiber and micronutrients per calorie, the glycemic index of the whole diet is favorable overall. Although some individual fruits on the diet may have a higher glycemic index, triglycerides and blood sugars fall dramatically.

Conclusion — the dietary style I recommend for diabetics is de-signed to maximize nutrient density. It is the most effective treatment for those with diabetes. For a Type 2 diabetic, this approach has resulted in complete reversal of the diabetic condition in the vast majority of patients, and for a Type 1 diabetic it solves the problems with excessive highs and lows and prevents the typical dangerous complications that too frequently befall those with this medical condition.

Of course, no dietary approach to diabetes will succeed without attention to other risk factors, especially sedentary lifestyle, smoking, and lack of sleep. The road to wellness involves making the commitment to significant and regular exercise as well.

References

1. Zoler ML. Insulin may boos cardiovascular risk in type 2 diabetes patients. Family Practice News May 15, 2001. p6.

2. Barnard ND, Scialli AR, Bertron P, et al. Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women. Am J Cardiol 2000 Apr 15;85(8):969-72

3. Kanauchi M, Tsujimoto N Hashimoto T et al. Advanced glycation end products in non diabetic patients with coronary artery disease. Diabetes Care 2001;24(9):1620-1623.

4. Krajcovicova-Kudlackova M, Sebekova K, Schinzel R, et al. Advanced glycation end products and nutrition. Physiol Res 2002;51:313-316.

5. Fleming RM. The effect of high-protein diets on coronary blood flow. Angiology 2000;51(10):817-826.