The success that low fat whole food plant based (WFPB) diets have in preventing and treating Type II diabetes is so strong, that The American Diabetes Association includes a low-fat plant based diet as an approved treatment approach.[1]
This should come as no surprise as diets high in fat and saturated fat have been linked to Insulin Resistance (IR).[2] Considerable evidence has identified IR as a strong predictor of Prediabetes and Type II Diabetes.
As you might imagine, the metabolic mechanisms that result in IR are extremely complex, but Dr. Michael Greger does an excellent job summarizing the processes leading to IR in these two videos:
- What causes IR
- Type II Diabetes as a disease of fat toxicity
- 2020 Update – Dr. Greger video on Saturated Fat and its effect on Insulin Resistance and Pancreatic Beta Cell function.
The cause of IR explains why low fat WFPB diets are so effective in treating Type II Diabetes. However, many recently diagnosed diabetics view all carbohydrates, even healthy carbohydrates like potatoes, sweet potatoes, whole grains and beans as enemies.
It’s understandable that people come to this conclusion as “carb counting” has been an approach that has been utilized in the treatment of Type II Diabetes for quite some time. It seems to make intuitive sense as carbohydrates are easily broken down to blood glucose and diabetics are rightly concerned about keeping their blood glucose to within normal levels.
Type II Diabetics are often prescribed diabetic medications and taught to follow a diet that requires limiting all carbohydrates as a means to control blood glucose levels. This approach can help the body to compensate for IR, but does not eliminate IR. Blood glucose may be kept in control, but the pancreas is still required to pump out more insulin than would otherwise be necessary for the body to move glucose from the blood into muscle cells. Over many years, IR eventually causes the pancreas to get pooped out and it pumps out less and less insulin. This is why many Type II Diabetics are eventually prescribed insulin.
The best chance Type II Diabetics have to eliminate IR is by following a low fat WFPB diet and by following a reasonable exercise regimen. This approach is not intuitive for most folks. I believe Dr. Greger’s videos help people understand why dietary fat and saturated fat cause the body’s carbohydrate metabolism to go awry.
A commenter named BB left this all too common lament for Dr. Greger about family members suffering from Type II Diabetes who are not doing what it takes to repair their body’s carbohydrate metabolism:
“This is an excellent video that gives a clear description of the cause of insulin resistance. I have several family members who are unstable diabetics and they have been advised by their doctors to go the low-carb approach. They try to shun sugar and carbs and often fail, all the while eating lots of fat in the form of oils and animal products. They don’t want to give up the animal products as the belief that they need protein (meat) and calcium (milk) is so ingrained. The only thing that would help them is a comprehensive in-house program such as Dr. McDougall provides. It is not so much what they have to learn as what they have to UNLEARN.”
Dr. Greger’s videos prompted me to create the following simplified flow chart showing the sequence of events that begin with an unhealthy diet and eventually lead to a diagnosis of Type II Diabetes. I’m hoping it will help people realize that treating Type II Diabetes is more than just looking at blood glucose numbers. It’s about eliminating Insulin Resistance by eating a diet dominated by whole and minimally processed plant foods.
Insulin Resistance (IR) Flow Chart
Diet high in fat and saturated fat (i.e. Standard American Diet)
↓
Results in Intramyocellular Lipids (fat deposits in muscle cells)
↓
Insulin Resistance in muscle cells
(fat deposits interfere with insulin’s ability to transport glucose from blood into the muscle cell)
↓
To prevent blood glucose from rising too high, pancreas releases more insulin (larger than normal insulin response to overcome IR in muscle cells)
↓
Blood Glucose levels can remain normal for many years
↓
Continued IR in muscle cells results in many years of high blood insulin levels
↓
High Blood Insulin Levels lead to Fatty Liver
↓
Liver Becomes Insulin Resistant
↓
Pancreas must release even more insulin
↓
Liver’s glucose releasing function becomes impaired (ie. Liver makes and releases glucose when blood sugar levels get low. After eating, the liver’s glucose production should be suppressed.)
↓
A fatty, Insulin Resistant liver keeps making glucose even after the person eats.
↓
Pancreas releases even more insulin
↓
Liver gets even fattier
↓
Liver offloads fat via Very Low Density Lipoproteins (VLDLs)[3]
↓
VLDLs Injure Insulin-Producing Cells of the Pancreas
↓
Pancreas releases less insulin
↓
Combination of IR and Less Insulin
↓
Diagnosis of Type II Diabetes
Taking oral diabetes medications and eating a diet that does not address IR is not the best way to reduce risks of developing diabetic complications. In fact, aggressive drug treatment to control blood glucose levels has been shown to increase mortality.[4]
IR appears to contribute to the clustering of cardiac risk factors such as hypertension, hypertriglyceridemia, low HDL-cholesterol and obesity thus may accelerate the development of cardiovascular disease.[5]
It just makes sense to attack Type II Diabetes with a diet that is known to reduce IR – a low-fat WFPB diet. [6] If you do so, your carbohydrate counting days are over.
[1] http://www.diabetes.org/food-and-fitness/food/planning-meals/meal-planning-for-vegetarians/
[2] http://www.foodconsumer.org/newsite/Nutrition/Diet/saturated_fat_insulin_resistance_0313131114.htm
[3] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163828/
[4] http://www.webmd.com/diabetes/news/20110302/aggressive-diabetes-threapy-may-raise-death-risk
[5] http://www.diabetesresearchclinicalpractice.com/article/0168-8227(94)90008-6/abstract
E Excerpt from Laurie Endicott Thomas’s amazing book Thin Diabetes – Fat Diabetes by clicking here!
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