Type 2 Diabetes Keeps Fat People From Getting Even Fatter

Most peo­ple with type 2 dia­betes are at least pleas­ant­ly plump, so why do so many severe­ly obese peo­ple have no trou­ble with their blood sug­ar? I’ve known for decades that unex­plained weight loss is a com­mon sign of dia­betes. A few years ago, I began to sus­pect that type 2 dia­betes is what hap­pens when one of the body’s nat­ur­al defens­es against fur­ther weight gain gets out of con­trol. These sus­pi­cions were deep­ened when I real­ized that the drugs that are used to treat type 2 dia­betes often cause weight gain as a side effect. The drugs are dis­abling the body’s nat­ur­al resis­tance to fur­ther weight gain!

This inter­est­ing arti­cle from Endocrine Reviews argues that in type 2 dia­betes, the prob­lems with fat metab­o­lism start long before the per­son starts hav­ing abnor­mal blood sug­ar lev­els. It explains how too much fat in the body and too much fat from the diet could end up caus­ing type 2 dia­betes. It explains how eat­ing less and exer­cis­ing more could solve the under­ly­ing prob­lem.

The idea that type 2 dia­betes starts off as a prob­lem with fat metab­o­lism makes a lot of sense. It helps to explain some­thing that sci­en­tists have known since the 1930s: that you can cause insulin resis­tance in healthy vol­un­teers by feed­ing them a high-fat diet for a week. You can restore their insulin sen­si­tiv­i­ty by feed­ing them a starchy diet for a week. A switch to a low-fat, high-fiber, high-car­bo­hy­drate, pure­ly plant-based diet pro­duces a dra­mat­ic improve­ment in peo­ple with type 2 dia­betes, even before they have had a chance to lose much weight.

The tra­di­tion­al cure for type 2 dia­betes was to eat less and exer­cise more. A more sen­si­ble approach is to start off by eat­ing as much high-fiber, low-fat, plant-based food as you feel like eat­ing. This kind of diet will rapid­ly cor­rect your insulin resis­tance. As your insulin resis­tance improves, you’ll feel more like exer­cis­ing.

Of course, if you have any major health prob­lem or are tak­ing pre­scrip­tion med­ica­tions, you need to talk to a reg­is­tered dietit­ian and your pre­scriber before mak­ing any major change in diet. You may need to have your dosages adjust­ed, and you may be able to stop tak­ing some of your pre­scrip­tion med­ica­tion.

Note: I explain this top­ic in more detail in my book Thin Dia­betes, Fat Dia­betes: Pre­vent Type 1, Cure Type 2

Behind Barbed Wire_Print

Pho­to by 95Berlin

No, It’s a Low-Fat, High-Fiber Diet That Keeps Gorillas Lean!

A recent arti­cle in the New York Times argued that goril­las stay slim because they eat a high-pro­tein diet. While I’m glad to see some­one else point out that a plant-based diet pro­vides ade­quate amounts of pro­tein, I’m annoyed to see sci­en­tists and jour­nal­ists mis­un­der­stand and mis­rep­re­sent the real sig­nif­i­cance of this fact. It’s as if they haven’t read the basic lit­er­a­ture on nutri­tion and can’t under­stand arith­metic.

Yes, the gorilla’s nat­ur­al diet is high in pro­tein, as a per­cent­age of calo­ries. How­ev­er, the goril­las’ nat­ur­al food tends to be low in calo­ries, because the calo­ries are dilut­ed by water and fiber. Goril­las have to eat an enor­mous amount of food every day to get enough calo­ries. When human vol­un­teers tried to eat a goril­la-style diet for a short peri­od of time to see how it would affect their cho­les­terol lev­els, they had to spend more than 8 hours a day eat­ing, just to get enough calo­ries to keep from los­ing weight dur­ing the tri­al. Goril­las stay slim because of the high fiber con­tent and low fat con­tent of their food, not because of the bal­ance of pro­tein to car­bo­hy­drate in their food!

The biggest dietary chal­lenge for a goril­la, as for any leaf-eater, is to get enough calo­ries. When they eat a rel­a­tive­ly high-pro­tein diet, they just end up con­vert­ing the excess pro­tein to sug­ar and burn­ing it for ener­gy. Unfor­tu­nate­ly, pro­tein is “dirty sug­ar.” Burn­ing pro­tein for ener­gy pro­duces waste prod­ucts such as urea and sul­fu­ric acid.

Peo­ple can stay very slim on a high-car­bo­hy­drate diet, if it is also high in fiber and low in fat. For exam­ple, when Chris Voigt of the Wash­ing­ton State Pota­to Com­mis­sion decid­ed to go on a pota­to-only diet as a pub­lic­i­ty stunt, he fig­ured that he had to eat 20 pota­toes a day. In prac­tice, he found it real­ly hard to eat his entire pota­to ration, because pota­toes are so fill­ing. As a result, he lost a lot of weight. Even when he made an effort to eat his entire pota­to ration every day, he con­tin­ued to lose weight. That’s because a starchy diet improves insulin sen­si­tiv­i­ty and thus revs up your metab­o­lism. Peo­ple who eat starchy diets burn more calo­ries than peo­ple on fat­ty diets. Voigt lost 21 pounds dur­ing his 60-day pota­to diet. His cho­les­terol lev­els, triglyc­eride lev­els, and even his blood sug­ar lev­els decreased!

Accord­ing to the New York Times, Dr. Rauben­heimer claimed that mod­ern soci­eties “are dilut­ing the con­cen­tra­tion of pro­tein in the mod­ern diet. But we eat to get the same amount of pro­teins we need­ed before, and in so doing, we’re overeat­ing.” What non­sense!

Nutri­tion sci­en­tists have known for more than 100 years that human pro­tein needs are mod­est and are eas­i­ly met by any rea­son­able plant-based diet. Also, the soci­eties with the biggest prob­lem with obe­si­ty are also the ones with the high­est pro­tein intake! Mod­ern soci­eties are con­sum­ing too much fat and too lit­tle fiber. Ani­mal foods are a big offend­er, because they con­tain fat but no fiber and usu­al­ly no digestible car­bo­hy­drate. Refined foods are also a big offend­er, because they rep­re­sent the con­cen­trat­ed calo­ries from plants–with the fiber and oth­er whole­some things stripped out.

The take-home les­son from the goril­la sto­ry shouldn’t have been that peo­ple need to eat more pro­tein. It’s that peo­ple need to eat plants. If peo­ple don’t want to spend 8 hours a day eat­ing leafy veg­eta­bles, they can eat some nice, fill­ing pota­toes or oth­er starchy sta­ples along with plen­ty of veg­eta­bles and fruit.

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.

The Imaginary Historical Decrease in Fat Consumption

Late­ly, I’ve seen many “experts” on nutri­tion claim that low-fat foods make peo­ple fat. As part of the “evi­dence” to back up this non­sense, they claim that the recent increase in pop­u­lar­i­ty of low-fat foods is an under­ly­ing cause of our obe­si­ty epi­dem­ic. They must think that I’m too lazy or stu­pid to look up the real data for myself.

I entered the term “fat con­sump­tion trends” into Google, and with­in a sec­ond or two I found this arti­cle: Trends in Intake of Ener­gy and Macronu­tri­ents — Unit­ed States, 1971–2000. This arti­cle reports the trends that the CDC found when they ana­lyzed data from four Nation­al Health and Nutri­tion Exam­i­na­tion Sur­veys (NHANES), the first of which was con­duct­ed in 1971–1974 and the last of which was con­duct­ed in 1999–2000. These sur­veys revealed that men and women were eat­ing more calo­ries and more fat in 1999–2000 than they had been eat­ing in the ear­ly 1970s. How­ev­er, they were also eat­ing so much more sug­ar that the per­cent­age of their calo­ries that came from fat went down slight­ly.

In oth­er words, peo­ple are get­ting fat­ter because they are eat­ing more calo­ries, includ­ing more fat. In con­trast, Japan­ese chil­dren have been get­ting fat­ter and run­ning a risk of type 2 dia­betes even though they have been eat­ing few­er calo­ries. It’s because of a shift from their tra­di­tion­al starchy diet to a more West­ern­ized, high­er-fat diet.

As I’ve explained in detail here, it’s easy to fat­ten on fat but much hard­er to fat­ten on starch­es.

Quick, but temporary weight loss! This time from France!

I just heard about a “new” diet: the Dukan diet. It’s from France! It promis­es four steps to per­ma­nent weight loss! It promis­es that peo­ple will lose weight while eat­ing as much as they like! The prob­lem is that this “new” diet isn’t real­ly new. It’s just South Beach with a French accent. The quick results from the first phase aren’t from fat loss. Nor will your weight prob­lem be per­ma­nent­ly cured by the end of the pro­gram, regard­less of what Dr. Dukan says. It’s just more false hope for des­per­ate peo­ple.

Like many fad diets, the Dukan diet starts with a low-carb phase. As if by mag­ic, this phase caus­es peo­ple to lose sev­er­al pounds very quick­ly. Unfor­tu­nate­ly, the weight that peo­ple lose so quick­ly does not rep­re­sent fat. Instead, it rep­re­sents the loss of the body’s glyco­gen stores. Glyco­gen is a starch that is stored in the liv­er and mus­cles. When the body needs quick ener­gy, the glyco­gen is bro­ken down into glu­cose, which is a sug­ar that is the body’s favorite fuel.

Like oth­er car­bo­hy­drates, glyco­gen pro­vides about 4 calo­ries per gram of dry weight. How­ev­er, the glyco­gen in the body isn’t dry. Each gram of glyco­gen absorbs about 2.7 grams of water. As a result, each gram of wet glyco­gen in the body rep­re­sents rough­ly 1 calo­rie of stored ener­gy. If you sud­den­ly deprive your­self of car­bo­hy­drates, your body will run through its glyco­gen stores very quick­ly, releas­ing water that will leave the body through the kid­neys. You would have to burn up almost 9 times as many calo­ries to lose that much weight from fat.

The rapid weight loss that results from cut­ting out car­bo­hy­drates may be thrilling to the frus­trat­ed dieter, but it is mean­ing­less. Nobody is over­weight from hav­ing too much glyco­gen, and your body will replace that glyco­gen and water as soon as it can. What peo­ple real­ly want to lose is fat. Besides, los­ing your glyco­gen can make you feel crum­my. When marathon­ers “hit the wall,” it’s typ­i­cal­ly because they’re run out of glyco­gen.

So the first phase of the Dukan diet or the South Beach Diet will cause a quick but tem­po­rary and mean­ing­less weight loss that could end up zap­ping your ener­gy. If the Dukan diet even­tu­al­ly helps you lose fat, it does so by mak­ing your body think that you are starv­ing or seri­ous­ly ill. Dur­ing a sud­den fast, the body’s sup­ply of car­bo­hy­drates is cut off. The body has to rely on its fat stores and the pro­teins in its tis­sues instead. A low-carb diet mim­ics this con­di­tion. The body may respond to this emer­gency by sup­press­ing the appetite. The per­son may then lose weight the old-fash­ioned way, by tak­ing in few­er calo­ries than he or she burns up.

The Dukan diet is based on a lie: that peo­ple get fat from eat­ing a high-carb diet. In real­i­ty, fat is fat­ten­ing, and starch­es are slim­ming. That’s because starch, like glyco­gen, holds water. It’s actu­al­ly hard to fat­ten your­self on starch­es. For exam­ple, con­sid­er what hap­pened when the head of the Wash­ing­ton State Pota­to Com­mis­sion went on an all-pota­to diet to protest the exclu­sion of pota­toes from the fed­er­al Women, Infants, and Chil­dren (WIC) pro­gram. He lost 21 pounds in 60 days, even though he was eat­ing about 20 pota­toes per day. He also cut his total cho­les­terol by over a third, and low­ered his blood sug­ar. In oth­er words, he also improved his health.

A starchy diet works on both sides of the weight loss equa­tion. You end up eat­ing few­er calo­ries, because the starchy foods are so bulky. Boiled starch­es often pro­vide only 1 calo­rie per gram, where­as fat pro­vides 9 calo­ries per gram. You also end up burn­ing more calo­ries on a low-fat, high-carb diet, because you become much more sen­si­tive to insulin. If you still man­age to have a few calo­ries left over, it’s hard for your body to store them as fat. You’d lose about 30% of the calo­ries in the con­ver­sion process, so your body just gen­er­al­ly revs up your metab­o­lism to burn off the excess. You may end up doing more activ­i­ty, or sim­ply gen­er­at­ing more body heat.

For­get Dukan’s false promis­es. The only proven way to achieve healthy, per­ma­nent weight loss is to switch to a low-fat, high-fiber, high-car­bo­hy­drate diet. That’s because it’s the kind of diet that is appro­pri­ate to the human body. If you sim­ply train your­self to eat­ing the right kinds of food, you can eat as much as you like and still stay slim.

The Magic Realism of a Healthy Diet

Mag­ic Real­ism is a lit­er­ary style that explores the seem­ing­ly mag­i­cal effects of com­mon­place things. Con­sid­er, for exam­ple, the fol­low­ing scene from One Hun­dred Years of Soli­tude, by Gabriel Gar­cía Mar­quez. Melquíades is an old gyp­sy who nor­mal­ly comes to the vil­lage once a year with a group of gyp­sy ped­dlers who sell won­drous and mag­i­cal goods and ser­vices, such as mag­nets and mag­ic car­pet rides Melquíades looks old­er than his true age because he has lost his teeth to scurvy. Yet one year, Melquíades shows up with his teeth mag­i­cal­ly restored. To everyone’s amaze­ment, he can actu­al­ly take the teeth out of his mouth, along with his gums, mak­ing him­self look old again. He can put the teeth back in, mak­ing him­self look young again.

The read­er knows that there’s noth­ing mag­i­cal about a set of false teeth. How­ev­er, the vil­lagers have nev­er seen any­thing like it before. Den­tures are out­side the scope of their per­son­al expe­ri­ence. There­fore, the trans­for­ma­tion pro­duced by a set of den­tures seems like mag­ic to them. Sim­i­lar­ly, a tru­ly healthy diet is sim­ply out­side the scope of per­son­al expe­ri­ence for the aver­age Amer­i­can. As a result, we think that it’s nor­mal for peo­ple to get fat and sick in mid­dle age. We think that it’s nor­mal for mid­dle-aged and elder­ly peo­ple to have to take a fist­ful of pre­scrip­tion med­ica­tions every day. Thus, the effects of a tru­ly healthy diet might seem mag­i­cal to us.

A tru­ly healthy diet would rep­re­sent a rad­i­cal change from the way that Amer­i­cans have been taught to eat. When I was in home eco­nom­ics in sixth and sev­enth grade, I was taught that peo­ple are sup­posed to eat two serv­ings of meat and three serv­ings of dairy prod­ucts every day. Oth­er­wise, we’d sup­pos­ed­ly run a risk of pro­tein and cal­ci­um defi­cien­cy. Even today, I still see warn­ings against “fad” diets, which are usu­al­ly described as diets that “elim­i­nate entire food groups.” Unfor­tu­nate­ly, the “experts” who ped­dle this advice are not experts in nutri­tion. In con­trast, the Amer­i­can Dietet­ic Asso­ci­a­tion has come out with a posi­tion paper that pro­vides sup­port for a pure­ly plant-based diet.

A tru­ly healthy diet for a human being would get less than 10% of its calo­ries from fat and would be based exclu­sive­ly on high-fiber plant mate­r­i­al. It can include plen­ty of unre­fined starch­es, such as pota­toes, rice, or corn. In oth­er words, peo­ple real­ly ought to elim­i­nate two of the “basic food groups.” Some peo­ple also need to avoid par­tic­u­lar plant foods. For exam­ple, peo­ple with celi­ac dis­ease can’t eat wheat, rye, or bar­ley.

To see the seem­ing­ly mag­i­cal effects that this rad­i­cal change in food choic­es can have on ordi­nary Amer­i­cans, look at the “Star McDougallers’” page on Dr. John McDougall’s Web site. Many peo­ple show how they’ve man­aged to reverse sup­pos­ed­ly incur­able dis­ease sim­ply elim­i­nat­ing two of the basic food groups and cut­ting way back on fat. It’s not mag­ic. It’s mag­ic real­ism.

High-Fat Diet Causes Alzheimer’s Disease

Even Late in Life, a Low-Fat Diet Helps

The more fat you eat, the more like­ly you are to lose your mar­bles in your old age. This graph came from an arti­cle that explains why it’s rea­son­able to con­clude that the fat in the diet is the cul­prit. It also explains that even late in life, a change to a bet­ter diet is ben­e­fi­cial.

The arti­cle men­tions that in Europe and North Amer­i­ca, high­er fish con­sump­tion seemed to pro­vide some reduc­tion in risk. That may be because the fish were sim­ply replac­ing foods that were even more dan­ger­ous. It doesn’t mean that a health-opti­miz­ing diet for a human being would include fish.