Can You Get Too Much Omega 3 Fatty Acid?

Late­ly, many peo­ple have been claim­ing that fish is health food. The Amer­i­can Heart Asso­ci­a­tion and the Amer­i­can Dia­betes Asso­ci­a­tion urge peo­ple to eat fish. Yet if peo­ple fol­low that advice, they’ll still be at risk for heart dis­ease and dia­betes and they might increase their risk for can­cer. The omega 3 fat­ty acids in fish oil can end up in the fat­ty deposits that clog people’s arter­ies. Like oth­er fats, they pro­mote insulin resis­tance. Also, eat­ing too much omega 3 fat­ty acid could pro­mote can­cer by sup­press­ing the immune sys­tem.

Con­tin­ue read­ing “Can You Get Too Much Omega 3 Fat­ty Acid?”

Scientists Know that Fatty Diets Cause Blood Sugar Problems

There’s a huge dis­con­nect between what sci­en­tists know about diet and what ordi­nary peo­ple are being taught about diet. Most peo­ple seem to think that peo­ple get dia­betes from eat­ing too much sug­ar or starch. How­ev­er, the sci­en­tists who wrote this arti­cle seem to think that it’s com­mon knowl­edge, at least among sci­en­tists, that peo­ple get type 2 dia­betes from eat­ing too much fat.

Behind Barbed Wire_PrintNote: To learn how fat­ty diets cause blood sug­ar prob­lems, read my book Thin Dia­betes, Fat Dia­betes: Pre­vent Type 1, Cure Type 2.

Meat, But Not Sugar, Increased the Risk of Type 2 diabetes

Most of the peo­ple I talk to seem to think that they’d be health­i­er if they ate less car­bo­hy­drate. Most of them seem con­vinced that a high-car­bo­hy­drate diet makes peo­ple fat. They know that if you eat starch, it gets bro­ken down into sug­ar. They know that when sug­ar flows into your blood­stream, your pan­creas is sup­posed to release insulin to enable the sug­ar to enter your cells, where it can be burned for ener­gy. That part’s true. How­ev­er, they think that if you eat a lot of sug­ar or starch, you’ll some­how wear out your body’s abil­i­ty to make or respond to insulin and thus you’ll end up dia­bet­ic. They couldn’t be more wrong. In real­i­ty, a high-carb, low-fat diet cures the most com­mon type of dia­betes.

If eat­ing a starchy, low-fat diet made peo­ple fat and caused dia­betes, then we’d see lots of fat, dia­bet­ic peo­ple in pop­u­la­tions that eat a starchy, low-fat diet. We don’t. Instead, we see that the peo­ple of Chi­na and Japan, whose diet is based heav­i­ly on rice and veg­eta­bles, tend to be slim and remark­ably free of dia­betes and heart dis­ease. We see the same thing in oth­er pop­u­la­tions that base their diets on oth­er starchy sta­ples. For exam­ple, the indige­nous peo­ple of Peru eat a diet based heav­i­ly on pota­toes. The Tarahu­mara of Mex­i­co eat main­ly corn and beans. The peo­ple in the New Guinea High­lands eat prac­ti­cal­ly noth­ing but sweet pota­toes. The sto­ry is the same wher­ev­er we look. In real­i­ty, the pop­u­la­tions that eat low-fat, starchy, high-fiber diets are thin and healthy. The peo­ple who eat lots of fat­ty ani­mal-based foods are the ones at risk for obe­si­ty, dia­betes, and heart dis­ease.

If eat­ing a lot of sug­ar caused dia­betes, then the peo­ple who eat the most sug­ar would be more like­ly than the aver­age per­son to devel­op dia­betes. On the con­trary, a study of near­ly 40,000 women age 45 and old­er in the Unit­ed States found that the women who were eat­ing the most sug­ar were no more like­ly to get dia­betes than the ones who were eat­ing the least sug­ar [1]. The women who were most like­ly to get dia­betes were the ones who were eat­ing the most meat! [2]

Ref­er­ence List

  1. Jan­ket SJ, Man­son JE, Ses­so H, Bur­ing JE, Liu S. A prospec­tive study of sug­ar intake and risk of type 2 dia­betes in women. Dia­betes Care 2003;26:1008–1015.
  2. Song Y, Man­son JE, Bur­ing JE, Liu S. A prospec­tive study of red meat con­sump­tion and type 2 dia­betes in mid­dle-aged and elder­ly women: the women’s health study. Dia­betes Care 2004;27:2108–2115.

For more infor­ma­tion about dia­betes, see my book Thin Dia­betes, Fat Dia­betes: Pre­vent Type 1, Cure Type 2.

Thin Diabetes, Fat Diabetes: Prevent Type 1, Cure Type 2

The Glycemic Index Won’t Help You Lose Weight

Late­ly, many nutri­tion gurus have been try­ing to tell me that eat­ing a diet with a low glycemic index is the secret to los­ing weight. But if that were true, then car­rots would be more fat­ten­ing than fudge is.

Unfor­tu­nate­ly, the glycemic index is being used to steer peo­ple away from the sort of food that can real­ly help them lose weight and con­trol their blood sug­ar: unre­fined starch­es and veg­eta­bles. If you sur­vey the world’s pop­u­la­tions, you’ll find that the peo­ple who are eat­ing diets based on unre­fined starch­es and veg­eta­bles have low risks of obe­si­ty, heart dis­ease, dia­betes, and breast cancer—even though the glycemic index of their diet is high. In con­trast, the peo­ple who are eat­ing the most fat and protein—both of which tend to decrease the glycemic index of a meal—are the ones who are get­ting fat and sick.

The glycemic index was orig­i­nal­ly devel­oped to fine-tune the sys­tem of car­bo­hy­drate exchanges that peo­ple with type 1 dia­betes use to cal­cu­late how much insulin they will need to inject after a meal [1]. The glycemic index mea­sures the effect that 50 grams of carbs from any giv­en food has on your blood sug­ar. For exam­ple, if you ate 50 grams of car­bo­hy­drate from beans, your blood sug­ar wouldn’t go as high as if you ate 50 grams of car­bo­hy­drate from pota­toes instead. In oth­er words, beans have a low­er glycemic index than pota­toes do.

Like pota­toes, car­rots have a high glycemic index. How­ev­er, you’d have to eat about 4 cups of shred­ded car­rot to get 50 grams of car­bo­hy­drate. Thus, if you ate just one car­rot, it would have only a small effect on your blood sug­ar. To cor­rect for this prob­lem, some peo­ple use the glycemic load, which is the glycemic index mul­ti­plied by the total amount of car­bo­hy­drate in the food.

The glycemic index and glycemic load are of sur­pris­ing­ly lit­tle val­ue to dieters. One rea­son is that the glycemic index of any giv­en food is so hard to pre­dict. For exam­ple, you could increase the glycemic index of a pota­to by mash­ing it. Then, you could decrease the glycemic index of the mashed pota­to by adding milk and but­ter. Fats and pro­teins tend to decrease the glycemic index of a food. Although adding but­ter to a food decreas­es the food’s glycemic index, the but­ter does not make the food less fat­ten­ing!

Even if you eat a meal that has a high glycemic load, that doesn’t mean that your blood sug­ar is going to go dan­ger­ous­ly high. It all depends on your insulin sen­si­tiv­i­ty. Peo­ple who habit­u­al­ly eat a low-fat, starchy diet tend to have much small­er blood sug­ar swings than peo­ple who eat a high-fat, low-carb diet. Sci­en­tists have known that fact since the 1930s! In fact, a diet based on high-glycemic-load veg­eta­bles and unre­fined starch­es can restore the body’s insulin sen­si­tiv­i­ty, thus cur­ing type 2 dia­betes, with­in a mat­ter of weeks.

Ref­er­ence List

  1. Jenk­ins DJ, Wolever TM, Tay­lor RH et al. Glycemic index of foods: a phys­i­o­log­i­cal basis for car­bo­hy­drate exchange. Am J Clin Nutr 1981;34:362–366.

Note: For more infor­ma­tion about the con­trol of weight and blood sug­ar, see my book Thin Dia­betes, Fat Dia­betes: Pre­vent Type 1, Cure Type 2.

Behind Barbed Wire_Print

Thin Diabetes, Fat Diabetes

What’s in a name? A rose by any oth­er name would smell as sweet. But when we are talk­ing about dia­betes, we should choose names that make sense. The French do. They use the term “thin dia­betes” (dia­bète mai­gre) to refer to a cat­a­stroph­ic dis­ease that results from fail­ure of the pan­creas. They use the term “fat dia­betes” (dia­bète gras) to refer to a milder, cur­able cause of high blood sug­ar. Fat dia­betes tends to occur in over­weight peo­ple, and it’s made worse by fat in the diet.

When peo­ple talk about dia­betes, they almost always mean dia­betes mel­li­tus, which is some­times called sug­ar dia­betes or just plain sug­ar. Dia­betes insipidus is an unre­lat­ed con­di­tion in which the body can’t con­serve water.

The most obvi­ous symp­tom of untreat­ed dia­betes mel­li­tus is exces­sive thirst and fre­quent uri­na­tion. The word dia­betes came from the Greek word for siphon, because water seemed to pass right through these patients. Their urine was loaded with sug­ar. Because they were los­ing calo­ries through their urine, they tend­ed to lose weight.

By the 1870s, doc­tors in France divid­ed dia­betes mel­li­tus into two cat­e­gories. Thin dia­betes was a rel­a­tive­ly rare but cat­a­stroph­ic, incur­able dis­ease that tend­ed to hap­pen in chil­dren and young adults who tend­ed to be thin to begin with. These patients rapid­ly went into a coma and died, regard­less of treat­ment. At autop­sy, it was often clear that some­thing had gone wrong with their pan­creas. In con­trast, fat dia­betes was a com­mon, rel­a­tive­ly mild con­di­tion that tend­ed to hap­pen in mid­dle-aged to elder­ly adults. It could be cured if the patient ate less and exer­cised more.

Eng­lish-speak­ing doc­tors didn’t like the terms thin dia­betes and fat dia­betes. Instead, they used the terms juve­nile dia­betes and adult-onset dia­betes. These terms are mis­lead­ing because “juve­nile” dia­betes can strike adults, and “adult-onset” dia­betes can occur in an over­weight child. After the dis­cov­ery of insulin in the 1920s, Eng­lish-speak­ing doc­tors start­ed to refer to thin dia­betes as insulin-depen­dent dia­betes mel­li­tus and fat dia­betes as non–insulin-dependent dia­betes mel­li­tus. Peo­ple with thin dia­betes would die with­out insulin ther­a­py. In con­trast, patients with fat dia­betes often respond­ed poor­ly to insulin ther­a­py.

Now that so many peo­ple with fat dia­betes are tak­ing insulin, it’s con­fus­ing to refer to their con­di­tion as non–insulin-dependent. Instead, Amer­i­can and British doc­tors now refer to thin dia­betes as type 1 dia­betes. Fat dia­betes is called type 2 dia­betes. Unfor­tu­nate­ly, these names are mean­ing­less to the lay­man.

In the 1930s, a British researcher named H.P. Himsworth found that he could induce a con­di­tion that resem­bled fat dia­betes in healthy vol­un­teers by feed­ing them a high-fat diet for only a week. After a week of eat­ing a high-fat diet, the vol­un­teers were giv­en a glu­cose tol­er­ance test. This meant that they were giv­en a dose of glu­cose in water and had their blood sug­ar mea­sured every 15 min­utes for sev­er­al hours. When the vol­un­teers had been eat­ing a fat­ty diet for a week, they got a huge spike in blood sug­ar after drink­ing the glu­cose; but when they’d been eat­ing a starchy, low-fat diet for a week, their blood sug­ar lev­els stayed low and sta­ble after they drank the glu­cose. Himsworth’s review of these exper­i­ments was pub­lished in the British Med­ical Jour­nal in 1940 [1].

When I talk to peo­ple who have fat dia­betes, they typ­i­cal­ly don’t remem­ber whether their dia­betes is type 1 or type 2. Some of them have been tak­ing insulin at least occa­sion­al­ly, so the term non–insulin-dependent makes no sense to them. Most of them have been told that they have to cut back on eat­ing car­bo­hy­drates. Unfor­tu­nate­ly, that means eat­ing lots of pro­tein and fat instead. Trag­i­cal­ly, that also means that they are injur­ing their already dam­aged kid­neys with the over­load of waste prod­ucts that come from burn­ing pro­tein for ener­gy. It also means that they are prob­a­bly mak­ing their insulin resis­tance worse, by eat­ing too much fat.

One solu­tion to this mad­ness is to start using the term fat dia­betes to refer to type 2 dia­betes. The sec­ond solu­tion is to shift the focus in the man­age­ment of type 2 dia­betes. Instead of telling patients to avoid eat­ing car­bo­hy­drates to avoid blood sug­ar spikes, shouldn’t doc­tors be teach­ing their patients to shift to a low-fat, high-car­bo­hy­drate diet to restore their nat­ur­al sen­si­tiv­i­ty to insulin? As the results of Himsworth’s stud­ies sug­gest­ed, clin­i­cal stud­ies of a high-car­bo­hy­drate, low-fat diet have shown great suc­cess in help­ing peo­ple with fat dia­betes shed pounds, con­trol their blood sug­ar, and reduce or elim­i­nate their need for pre­scrip­tion drugs [2,3].

One warn­ing: If you have dia­betes or any oth­er health prob­lem or are tak­ing pre­scrip­tion med­ica­tion, talk to a dia­betes edu­ca­tor, reg­is­tered dietit­ian, and your pre­scriber before mak­ing any major change in diet.

Ref­er­ence List

1. Himsworth HP. Insulin defi­cien­cy and insulin inef­fi­cien­cy. Br Med J 1940;1:719–722.
2. Barnard ND, Cohen J, Jenk­ins DJ et al. A low-fat veg­an diet improves glycemic con­trol and car­dio­vas­cu­lar risk fac­tors in a ran­dom­ized clin­i­cal tri­al in indi­vid­u­als with type 2 dia­betes. Dia­betes Care 2006;29:1777–1783.
3. Barnard RJ, Jung T, Inke­les SB. Diet and exer­cise in the treat­ment of NIDDM. The need for ear­ly empha­sis. Dia­betes Care 1994;17:1469–1472.

Note: You can find more infor­ma­tion about dia­betes in my book Thin Dia­betes, Fat Dia­betes: Pre­vent Type 1, Cure Type 2.

Behind Barbed Wire_Print

French and Japanese Paradoxes

By now, you’ve cer­tain­ly heard about the “French Para­dox,” a dream that entered Amer­i­can con­scious­ness in 1991, when it was described on the tele­vi­sion pro­gram 60 Min­utes. Accord­ing to this dream, drink­ing red wine will pro­tect you from heart dis­ease, even if you eat lots of high-fat, high-cho­les­terol food. Although the risk of heart dis­ease was low­er in France than in Britain, the dif­fer­ence was not due to some mag­i­cal prop­er­ties of wine. It was due part­ly to under-report­ing of coro­nary artery dis­ease as a cause of death and part­ly due to a time-lag effect. It takes a while for a fat­ty diet to clog up your arter­ies, and the French hadn’t been eat­ing as much fat as the British had been eat­ing for as long as the British had been eat­ing it. These expla­na­tions had been pub­lished in the British Med­ical Jour­nal in 1999. You can read the arti­cle for free here.

If you want to elim­i­nate your risk of heart attack, not just decrease it a lit­tle, you’d eat a low-fat, pure­ly plant-based diet.

Alco­holic bev­er­ages, includ­ing wine, can have sev­er­al effects that influ­ence a person’s risk of dying of a heart attack. Winos who die of cir­rho­sis of the liv­er often have amaz­ing­ly clean arter­ies. That’s because their liv­er lost the abil­i­ty to make cho­les­terol. Even mod­er­ate intake of alco­holic bev­er­ages can have sev­er­al effects on coro­nary artery dis­ease. The antiox­i­dants in some alco­holic bev­er­ages, includ­ing wine, could pre­vent LDL cho­les­terol from becom­ing oxi­dized, and thus could help reduce the buildup of ath­er­o­scle­rot­ic plaque. Of course, you could get these same antiox­i­dants from plant foods that haven’t been fer­ment­ed. Alco­hol can also thin the blood, and thus help to decrease the chance of a fatal heart attack or ischemic stroke. On the oth­er hand, it would increase the risk of a fatal hem­or­rhage. I haven’t seen any con­vinc­ing evi­dence that adding any form of alco­hol to a low-fat, plant-based diet would pro­vide any health ben­e­fits.

The French para­dox turned out to be a myth. How­ev­er, there are some Japan­ese para­dox­es that are real. One involves cig­a­rette smok­ing. The oth­er involves obe­si­ty and dia­betes.

Japan­ese smok­ers are less like­ly than Amer­i­can smok­ers to get lung can­cer. This is called the Japan­ese Smok­ing Para­dox. Some peo­ple think that it’s because Japan­ese are smok­ing safer cig­a­rettes or have some mag­i­cal pro­tec­tive genes. The more ratio­nal expla­na­tion is that the Japan­ese have been eat­ing less fat and ani­mal pro­tein and more veg­eta­bles than Amer­i­cans have been eat­ing. Eat­ing the tra­di­tion­al Japan­ese diet, as opposed to the stan­dard Amer­i­can diet, helps to pro­tect peo­ple against many kinds of can­cer, not just lung can­cer.

Anoth­er para­dox involves Japan­ese chil­dren. Over the past few decades, Japan­ese chil­dren have been get­ting fat­ter, and the inci­dence of type 2 dia­betes among Japan­ese chil­dren has been going up. This has been hap­pen­ing even though their calo­rie intake hasn’t increased sig­nif­i­cant­ly. They have been eat­ing a lot more fat and ani­mal pro­tein. In oth­er words, they’ve been get­ting a small­er per­cent­age of their calo­ries from car­bo­hy­drates, which were main­ly in the form of white rice. So why do the low-carb gurus keep telling me that we need to eat more fat and less car­bo­hy­drate? Is this anoth­er para­dox? If so, what should we call it?

To Cure Obesity, “Eat Less Fat and More Starch”

Here’s an inter­est­ing arti­cle about the Pima Indi­ans of Ari­zona.

For about 2000 years, the Pima had been grow­ing corn, beans, and squash on irri­gat­ed land in Ari­zona. As a result, their tra­di­tion­al diet was high in starch and fiber and low in fat (~15% by calo­rie). After white set­tlers divert­ed the Pima’s irri­ga­tion water, the Pima had to fall back on the lard, sug­ar, and white flour sup­plied to them by the U.S. gov­ern­ment. After World War II, the Pima adopt­ed a diet that close­ly resem­bles the stan­dard Amer­i­can diet. It is low in fiber and gets about 40% of its calo­ries from fat. As a result, they have hor­rif­i­cal­ly high rates of obe­si­ty and type 2 dia­betes. In con­trast, their blood rel­a­tives in Mex­i­co who have kept more or less to their tra­di­tion­al diet have rel­a­tive­ly low rates of obe­si­ty and dia­betes.

Some low-carb gurus have tried to twist the Pima’s sto­ry into a jus­ti­fi­ca­tion for eat­ing less car­bo­hy­drate and more fat. In real­i­ty, it pro­vides strong encour­age­ment for peo­ple to eat more starch and fiber and a lot less fat.