I've been researching the most common and devastating diseases Americans are dealing with, with the aim of finding a common thread running throughout both cause and reversal. As it is now, one out of every two of us will get cancer or heart disease, and one out of every three children born after the year 2000 will be diagnosed with type 2 diabetes. These are devastating diseases, certainly to those who are burdened by them, but also to a health care system that is struggling to keep up.
The extraordinary doctors and nutritional scientists I've talked with seem to be saying - and saying fervently - the same thing: a diet high in animal protein is disastrous to our health, while a plant-based (vegan) diet prevents disease and is restorative to our health. And they say this with peer-reviewed (the gold standard of studies) science to back them up. Even the very conservative ADA (American Dietetic Association) says: "Vegetarian diets are often associated with a number of health advantages, including lower blood cholesterol levels, lower risk of heart disease, lower blood pressure levels, and lower risk of hypertension and type 2 diabetes. Vegetarians tend to have a lower body mass index (BMI) and lower overall cancer rates."
Diabetes does not just mean you take a pill or injection every day. It means you can lose a decade of life. And you while you inch toward that uncomfortable end, you deal with an increased risk of heart attack, blindness, amputation, and loss of kidney function. It's a very serious disease. The good news is that diabetes can be halted and reversed in a very short time through some diet modifications.
To understand diabetes better, and to learn how to reverse it, I've talked with Dr. Neal Barnard, president of The Physician's Committee for Responsible Medicine. He is an adjunct associate professor of medicine at the George Washington University School of Medicine, and the author of numerous scientific articles in leading peer-reviewed journals, and a frequent lecturer at the American Diabetes Association's scientific sessions. His diabetes research was funded by the National Institutes of Health, the U.S. Government's research branch. He is also the author of Dr. Neal Barnard's Program for Reversing Diabetes.
KF: Why is type 2 diabetes suddenly so prevalent?
NB: Diets are changing, not just in the U.S., but worldwide. Diabetes seems to follow the spread of meaty, high-fat, high-calorie diets. In Japan, for example, the traditional rice-based diet kept the population generally healthy and thin for many centuries. Up until 1980, only 1-5% of Japanese adults over age 40 had diabetes. Starting around that time, however, the rapid westernization of the diet meant that meat, milk, cheese, and sodas became fashionable. Waistlines expanded, and, by 1990, diabetes prevalence in Japan had climbed to 11-12%.
The same sort of trend has occurred in the U.S. Over the last century, per capita meat consumption increased from about 150 pounds per year (which was already very high, compared with other countries) in the early 1900s to over 200 pounds today. In other words, the average American now eats 50 pounds more meat every year, compared with a century ago. In the same interval, cheese intake soared from less than 4 pounds per person per year to about 32 pounds today. Sugar intake has gone up, too, by about 30 pounds per person per year. Where are we putting all that extra meat, cheese, and sugar? It contributes to body fat, of course, and diabetes follows. Today, about 13% of the U.S. adult population has type 2 diabetes, although many of them are not yet aware they have it.
KF: What causes diabetes?
NB: Normally, the cells of the body use the simple sugar glucose as fuel, the way a car uses gasoline. Glucose comes from starchy or sweet foods we eat, and the hormone insulin escorts it into the muscle cells to power our movements. Glucose also passes into our brain cells to power our thoughts. In type 2 diabetes, the cells resist insulin's action, so glucose has trouble getting into the cells.
KF: What happens to the body when one develops diabetes? What's the fallout?
NB: If glucose can't get into the cells, it builds up in the blood. It is as if gasoline coming out of a gas pump somehow can't get into your gas tank, and it ends up spilling over the side of your car, coming in through your car windows, and dribbling all over the pavement. It is a dangerous situation. The abnormally high levels of glucose circulating in the bloodstream are toxic to the blood vessels, especially the tiny blood vessels of the eyes, the kidneys, the extremities, and the heart.
KF: Is it really that serious, or can we just take a drug for it?
NB: A person with diabetes loses more than a decade of life, on average; about three-quarters will die prematurely of a heart attack. It is also a leading cause of blindness, amputations, and loss of kidney function. Many drugs are available, from insulin to oral medications and an ever-increasing variety of other medications. In order to protect the heart, many patients are also put on medications to lower cholesterol and blood pressure. A person with diabetes who walks into my office is typically using $3,000 to $5,000 worth of medications each year. And yet these medications only slow the progression of the disease; many people have serious complications despite being on medications.
Let me emphasize that this grim scenario does not have to occur. If an unhealthy diet is the cause, a better diet can provide the answer to this problem.
KF: How can we avoid it?
NB: The key is to help our body's insulin to work normally. So long as your body's insulin can escort glucose into the cells normally, diabetes will not occur. The resistance to insulin that leads to diabetes appears to be caused by a build-up of fat inside the muscle cells and also inside the liver. Let me draw an analogy: I arrive home from work one day, and put my key in my front door lock. But I notice the key does not turn properly, and the door does not open. Peering inside the lock, I see that someone has jammed chewing gum into the lock. Now, if the insulin "key" cannot open up the cell to glucose, there is something interfering with it. It's not chewing gum, of course. The problem is fat. In the same way that chewing gum in a lock makes it hard to open your front door, fat particles inside muscle cells interfere with insulin's efforts to open the cell to glucose. This fat comes from beef, chicken, fish, cooking oils, dairy products, etc. The answer is to avoid these fatty foods. People who avoid all animal products obviously get no animal fat at all, they appear to have much less fat build-up inside their cells, and their risk of diabetes is extremely low. Minimizing vegetable oils helps, too.
And we can go beyond prevention. When people who already have diabetes adopt a low-fat vegan diet, their condition often improves dramatically. In our research, funded by the U.S. Government, we found that a vegan diet is more effective than a traditional current diabetes diet, and is much safer than a low-carb diet.
KF: What about the claim that a vegetarian diet has too many starches, which raises blood sugar?
NB: Starchy foods, such as whole grains, beans, and vegetables, are healthful foods, and the body is designed to use the glucose that they hold. In type 2 diabetes, the body has lost some of this ability. But the answer is not to avoid starches, but to restore the body's ability to use them. After all, cultures whose diets are traditionally high in carbohydrate--Japan, China, Latin America, etc.--have had very low diabetes rates until meat, cheese, and other fatty foods displace their healthy carbohydrate-rich diets; only then does diabetes becomes more common.
The Atkins fad unfortunately left many people imagining that carbohydrate (that is, starch) is somehow risky. That notion is as unscientific as suggesting that water or oxygen is dangerous. The body needs all these things for good health.
A similarly persistent but misguided idea is the blood-type diet approach. A popular book on this subject said that people with type A blood should follow a vegetarian diet but that people with type O blood should not. Unfortunately many readers with type O blood followed this advice, which turned out to be quite wrong. The fact is, people with type O blood do as well as everyone else on a plant-based diet. A vegan diet is helpful and effective, regardless of blood type.
KF: Can diabetes be reversed?
NB: Yes. When people begin a healthful diet, most see big improvements in weight, cholesterol, and their blood sugar. Their need for medications diminishes, and some may not need medications at all. In some cases, you would never know they had had diabetes. However, I caution people not to simply throw their medications away. They need to speak with their doctors so they can alter their medication regimens only when and if it is appropriate.
Let me describe a case: A man named Vance joined our study. His father was dead by age 30, and Vance was 31 when he was diagnosed with diabetes. As our study began, he started a low-fat, vegan diet and gradually lost about 60 pounds over a year's time. His blood sugar control returned to normal, and his doctor discontinued his medications. Imagine what it feels like to see family members assaulted by this disease, but then to realize that you have effectively tackled it by making healthful adjustments to your diet.
Vance also encouraged me to mention that it is not only blood sugar that gets better, his erectile dysfunction also improved dramatically, too--in case anyone needs an extra motivator.
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