John McDougall spoke about current practices in diabetes
treatment, a topic I have recently studied and given presentations about.
Diabetes drugs and monitoring devices are a huge business, one of the major
profit sources for the medical industry. In recent years many of these products
have increased dramatically in price as pharmaceutical companies try to
increase profits. The strength of big pharma’s relationship to government has
prevented control of unjustifiable prices in the United States.
The following is a combination of my findings and McDougall’s:
Diabetes prevention and treatment are among the greatest
tragedies of modern medicine. As we have developed brilliant diagnostic tools
and surgical techniques we have failed in the management of chronic diseases,
especially diabetes. Diabetes is typically divided into type 1, a disease of
insufficient insulin production and type 2, a disease of insulin resistance
where cells cannot effectively use insulin. Recently, more people have
developed a combination of the two types in which there is less than optimal
insulin production plus insulin resistance, a condition sometimes referred to
as type 1.5 diabetes. All types have increased blood sugar plus very high rates
of premature death, many vascular diseases, cancer and dementia. This is a
terrible disease.
When insulin was discovered in the early 1920’s people with
type 1 diabetes were no longer doomed to early death due to high blood sugar.
In that era type 2 diabetes was much less common (the western diet was not as
bad as it is now) and not understood as a separate disease. A few years after
insulin became available doctors were shocked that their diabetic patients were
still dying prematurely just as before insulin was available- only a few years
later in life. Even with glucose (blood sugar) lowering, diabetes of both types
predisposes to aggressive vascular disease in large vessels (heart attacks,
strokes, amputations) and small vessels (kidney failure, blindness,
neuropathy.) Elliot Joslin,
a famous diabetologist of the early 20th century, said that diabetic patients formerly died
of too much blood sugar but now died of too much fat in the blood which caused
fatal forms of vascular disease. We’ve known this for 90 years but
little has been done to effectively fix the problem, and diabetics are still
dying prematurely and suffering from heart attacks, strokes, amputations,
kidney failure, blindness and neuropathy. The assumption that control of blood
sugar with insulin and oral drugs would prevent these diabetes complications has
turned out to be false. In fact, all of the drug treatments for diabetes have
major side effects which often over-shadow the advantage of their blood sugar
lowering. Multiple reviews have concluded that there is little advantage to
intensive blood sugar monitoring and treatment. Intensive monitoring fills the
patient’s life, preventing joy in day to day activities. Intensive treatment
often leads to episodes of hypoglycemia (too low blood sugar) which are
dangerous, even fatal.
A major multi-university study in 1970 concluded that diabetic
patients would be just as well off if they had no treatment at all! Little has
changed since then. Oral drugs are more sophisticated and much, much more
expensive but offer little benefit.
Since this area is such a huge, profitable business the medical
industry does not acknowledge this proven fact, and most doctors are trained to
give these drugs in large quantities. Type 1 diabetes will always require
insulin; type 2 diabetes is curable by diet alone. Some patients with type 1.5
diabetes will require small doses of insulin even on a healthy whole food plant
based diet. McDougall emphasizes that he gives no one oral diabetes drugs
since, with a healthy diet, their glucose lowering effect is not necessary and
they may lead to dangerous hypoglycemia and other serious side effects.
First line oral therapy is usually metformin, chosen because
it has the least side effects. But multiple reviews of this drug have failed to
show increased longevity and there is only questionable minimal improvement in
some complication rates. Other common drugs, sulfonylureas and Avandia, have
increased rates of cardiovascular disease and other serious side effects.
Avandia is still heavily marketed and prescribed in spite of a $3
billion fine for poor reporting of results, and there are over 50,000 lawsuits
pending due to serious complications from this drug. https://www.drugwatch.com/avandia/lawsuit.php
You can imagine the profits made by these drugs if they are still
selling one with this track record. A few new drugs are reported to offer a
very small decrease in cardiovascular disease but with serious drug side
effects and at great expense. Drugs are approved by the FDA and heavily
prescribed if they lower blood sugar, but the problem with diabetes is
premature death, terrible vascular complications, increased cancer and dementia
rates which drugs do not help. Only a whole food plant based diet allows
diabetics good health and longevity!
The frequency of diabetic vascular complications is much
lower in those on a whole food plant based diet. Isidore Snapper, a famous physician-researcher of the
mid 20th century, was chief of medicine at the Rockefeller Institute hospital
in Beijing (then called Peiping.) He wrote that, none of the patients
in his large diabetes clinic had any complication of the disease and concluded
that their diet of rice and vegetables with little animal products or vegetable
oils (they were too poor to afford these foods) protected them from the ravages
of diabetes which most western civilization patients suffer. Ironically,
the mainstay of their diet was white rice, a relatively low nutrient food which
is frequently vilified as a cause of health issues. Vascular disease and all
its sequelae are the result of too much animal product food and refined
vegetable oils, not carbohydrates. Refined grains (wheat, rice) and sugars
including honey and agave are unhealthy foods but do not cause diabetes or
diabetic complications. If combined with animal products and refined oils they
will add to the problem. Experimental animals and people fed sugar don’t become
diabetic; those fed a high fat diet do.
John McDougall also spoke on “Does Sugar Feed Cancer:”
Proponents
of low carb diets claim that sugar is the major culprit in the development and
progression of cancer. The scientific literature contradicts this.
A review by a national study group concluded that high fat
diets are the problem in cancer and that there is not good evidence that carbohydrates
promote cancer. A possible mechanism is the slowing of blood flow caused by a
high fat meal. (Vegetable oils like olive oil cause even more slowing than than
animal product fat.) A typical American high fat meal leads to a 20% decrease
in the amount of oxygen delivered to body tissues for several hours, often up
until the next high fat meal. The theory that low oxygen levels promote the
development and progression of cancer was proposed by the Nobel winning
biologist, Otto Warburg, and later confirmed in cell cultures and experimental
animals. Clinical studies have confirmed that a whole food plant based
diet (which will be low fat) significantly increases longevity in people with
known cancer and the American Cancer Society now states this in its patient
information literature.
Kevin Hall, the lead researcher on obesity at the NIH, discussed
his findings:
Drastic diets change the perception of what you need to eat
and so participants in THE BIGGEST LOSER TV series all are long term failures.
They revert quickly to normal eating habits and back towards previous weight.
Most think they are still dieting since the effort not to eat even more is very
high. Very severe calorie restriction plus heavy exercise always fails because
of this reprogramming of appetite levels.
A modest number of those on true low fat or true low carb
diets do succeed at long term weight control but it’s currently not possible to
predict who will succeed on either. Hall mentions other issues like longevity,
cardiovascular disease and cancer due to diet but doesn’t discuss them. As he
points out, weight is a marker for health and is not the bottom line. Of
course, this is where a whole food plant based diet shines, with overwhelming
evidence that it is good at avoiding/treating many diseases regardless of the
relative value of different diets for weight loss.
Ironically one of his studies was partially funded by the
Taubes group to help prove the carb-insulin model of insulin secretion.
Proponents of low carb diets have claimed that carbohydrates cause insulin
secretion (true) and therefore lead to promotion of obesity and poor health
(totally false.) In metabolic ward studies (research subjects live in the
research lab where all their food intake and activity are monitored) Hall’s studies showed that a low
fat diet resulted in more body fat loss than a low carb diet which led to loss
of more muscle tissue, not fat- exactly the opposite of what Taubes and other
low carb advocates have been claiming. It’s a devastating study for this
movement since it destroys the major scientific basis of their diet. In
addition to being bad for health (CV, auto-immune, cancer, overall longevity)
the low carb diet is also bad for fat loss versus muscle loss. In spite of this
research, none of them have retracted their dangerous advocacy of high fat and
protein diets. Even worse, the popular press parrots their advice like gospel.
