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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

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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.

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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.

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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.

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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.

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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.

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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.