Neal Barnard, MD | A Nutritional Approach for Reversing Diabetes

hi i'm dr. neal barnard during the corona virus pandemic we have learned that certain people are at particular risk if they acquire the infection those are people who are over 60 or people who have chronic conditions one of which is diabetes now diabetes was bad enough without the fact that it can make you especially vulnerable to the effects of this virus well let's have a look at diabetes and see how we can tackle that condition so that we're healthier in the face of this virus but also healthier in general now if you talk to people about diabetes they might say well isn't that the disease that you get from eating sugar what what what they mean is that sugar and carbohydrates will increase blood sugar and so people with diabetes often avoid sugar and starchy foods like bread and potatoes and rice but if you look at Japan Japan in the 1960s and 70s had the thinnest healthiest longest the people on the planet and they had very very little diabetes what were they eating well they're eating rice rice was their main dietary staple yes they might have the occasional bit of meat or fish or other foods but those are really just small flavorings for the rice or noodles that were the mainstay of their diet if you looked at diabetes prevalence in adults over the age of 40 in Japan prior to 1980 diabetes was rare one to five percent of the population but what happened in Japan right around 1980 you guessed it burgers arrived McDonald's and the other fast-food chains came in to Tokyo and Osaka people were suddenly eating fried chicken and other unhealthy foods and by 1990 the prevalence of diabetes was now 11 to 12% genetics didn't change during that interval what changed was diet well who does better we've learned something from the Adventist Health Study - you probably know that seventh-day Adventists have been studied by researchers for a long period of time they're put under the microscope because frankly Adventists are researchers dream it's tens of thousands of people who are non-smoking for the most part teetotalers very health conscious but some of them eat meat some don't people follow different kinds of diets and that allows you to see their effects on health so in the Adventist Health Study 2 following almost 61 thousand people all over the age of 30 it turned out that non vegetarians I'm talking about typical meat-eaters had a diabetes prevalence of about 7.6 percent better than the average person but still fairly high then when we looked at semi vegetarians these were people who didn't eat meat every day but maybe less than once a week their prevalence was 6.1 percent then pesco vegetarians what's that pesco fish right so you're not eating any meat except for fish they were down to 4.8% better but better still lacto-ovo vegetarians lacto for milk ovo for eggs so they're eating milk and eggs and not eating other animal products they're down to three point two percent but who does the best now a vegan is not a person from the planet Vegas that's simply a person who doesn't need any animal products and their diabetes prevalence was 2.9 percent compare that to all the other groups the vegans have the least diabetes so our research team decided to test out this diet in people who had never done any kind of a vegan diet before and see what happened we brought in 64 women they were all overweight they had all tried every kind of diet Atkins and South Beach and Nutrisystem and Jenny Craig you name it they tried it and they were frustrated because whatever benefits they got from the diet just didn't last so we asked them to join one of two groups and they were assigned at random either a low-fat vegan diet or a more conventional diet and we had no calorie limits no exercise and they had to provide their own food so the conventional diet was limiting the amount of meat reducing fat but it wasn't a vegetarian or vegan diet for comparison the low-fat vegan diet was just what it sounds like it was no animal products and we kept oils very low the foods that we asked everyone to favor we're embodied in what we're calling the power plate that's fruits and grains and vegetables and legumes what are legumes beans peas lentils foods that grow in a pod and when we showed our participants the foods they could eat I gotta tell you they were surprised because they could eat pancakes they could have linguine as long as it wasn't topped with a meat sauce or alfredo sauce but oyster mushrooms artichoke hearts little marinara sauce fine when we bring research participants into a study we don't just say here's your diet come back in six months we actually get together every week and we meet and we work through challenges and I think it was the third or fourth week of this study that one of the participants came in and said dr. Barnard I found a treat that I could have on your low-fat vegan diet and she opened up her purse and she pulled out a pack of Twizzlers do you know Twizzlers those little red twisty things that they sell to 7-eleven it's true look at the packet the ingredients don't have any animal products in them they are vegan it's just sugary starchy artificially colored junk and she made sure that all the research participants knew that Twizzlers are unlimited and dr. Reinhard's diet anyway so our low-fat vegan twizzler fueled participants set off on their path to the unknown and what we discovered is that after 14 weeks the people on the vegan group had lost almost 13 pounds while the comparison group had lost only about eight pounds so the vegan diet was clearly better over the short run but then we tracked everybody for an additional two years and we discovered that the people who had adopted the vegan diet were skinnier at a year than at the beginning and skinnier at two years than at one year while the comparison group had lost weight and then they ended up putting it all back on so it looks like a completely plant-based diet is actually a great way not just to lose weight but to keep it off so you might be thinking why is that how is it that a vegan diet could help me lose weight because you're eating carbs you're not counting calories how does it work well the first reason is really a no-brainer everything you're eating is from a plant it's beans and vegetables and fruits and whole grains and plants have fiber and fiber fills you up with effectively no calories the second thing is that it's low in fat remember we're not adding a lot of grease and plants themselves are naturally low in fat and here's why this matters a gram of fat no matter where it's from has nine calories nine calories per gram but a gram of carbohydrate wherever it's from whether it's from bread or rice or even pure sugar has only four calories per gram so when I get away from those fatty foods I get away from a lot of unnecessary calories but there's something else your metabolism increases when you follow a plant-based diet how can that be well we bring the researchers into our laboratory and we're measuring their metabolism the way we do it is they lie down on a table and we put a plastic shell so you sort of feel like a like a space traveler it goes over your face and your shoulders and it's capturing the carbon dioxide that you're breathing out and it measures the oxygen that you're breathing in and with some pretty simple arithmetic I can tell you how fast your body is burning calories but it's six o'clock in the morning your metabolism is really slow your body is not burning a lot of calories but then I give you a breakfast now in our research studies it's a liquid breakfast we know exactly what's in it and everybody's metabolism rise is it always rises after breakfast because your body is absorbing the nutrients in it to start burning things a little bit more quickly then you go to a totally plant-based diet you follow it for another 14 weeks or so you come back in you lie down in the very same table I put the very same shield over your face and I'm measuring once again your metabolism but when I discover your metabolism is not the same it's faster roughly 15% faster four three four five hours even after the meal now that's not much it's just a small change but it's after breakfast and after lunch and after dinner and even after snacks you're burning calories a little bit more like you did when you were 14 years old your metabolism is speeding up getting rid of unwanted weight is a great thing for anybody but if you have diabetes it also means that your diabetes is likely to improve so back in 2003 the National Institutes of Health gave our research team a grant to try to find a better diet for type 2 diabetes what we did is we compared a conventional diabetes diet that was based on counting calories and limiting carbohydrates we compared that to a completely plant-based diet now the conventional Dieteman limiting calories carbohydrates rarely steady I don't eat too much bad fat but the plant-based diet was completely vegan no animal products it kept oils very low and one other thing we favored what I'm going to call low GI foods low glycemic index foods what that means is let's say I take some white bread that will make my blood sugar rise pretty quickly but if instead I have rye bread the effect on my blood sugar is more gentle it doesn't rise so quickly if I have pumpernickel bread the rise in my blood sugar is even more gentle if I had beans more gentle still so the rye bread or pumpernickel is that's those are more of a low GI food compared to the white bread which is high GI high glycemic index got it so vegan low-fat and favor the healthier carbohydrates and to cut to the chase the test that we look at to see how people do with diabetes it's called a1c or hemoglobin a1c it's just a measure of your blood sugar control and if you have diabetes I'd like to see it below about seven at the beginning our participants were not below seven they were on average right around eight and the red line on this graph is the control group the people on the conventional diet they did well their a1c dropped about 0.4 absolute percentage points that's good that's what a medication might do but that blue line those are the people on the vegan diet look what happened they had a drop of about one point two absolute percentage points that is HUGE if you had a medication that did that invest that is a great medication but this is called asparagus beans and it's simply the effect of a healthy vegan diet so how does that work okay let me show you what causes type 2 diabetes this is very very important if you're watching this with just half an eye let me have your full attention for just the next couple of minutes it's big blue oval that's a cell one of the cells in your body and your cells are powered by sugar glucose glucose is a natural sugar that goes through those funny little purple channels into the cell and the glucose gives them fuel it gives them energy but your muscle cells your liver cells they can't get the glucose into the cell at all without a key and the key is called insulin insulin is made in your pancreas it's a hormone it goes into your bloodstream it arrives at the cell and it acts just like a key it opens up the cell to let the glucose ensigns specifically when the insulin arrives it you see those red receptors there once the key arrives into the receptor just like a key in a lock it's now opening up those purple channels and there's the glucose coming right inside if you've got type 2 diabetes you've got glucose trying to get into the cell you've got insulin trying to let it in what's gone wrong the problem is inside the cell you see those yellow blobs that's beef fat chicken fat pork fat corn oil olive oil extra virgin olive oil extra extra virgin olive oil maybe there's some 1040 motor oil in there I'm not sure that's unhealthy grease that's packing up the cell and now the insulin key can't work because the cell is gummed up with fat I speaking a little simply but it's by analogy very much like if you arrived home and somebody had put chewing gum in your front door lock there's nothing wrong with your key but it's never gonna open up that lock until we clean it out your cells aren't filled with chewing gum they're filled with fat now doctors hate words like fat it's only got three letters so we're gonna call it intra Myo cellular lipid well that's a mouthful isn't it intra means inside Myo means muscle Myo cellular means a muscle cell and the it means fat intra Myo cellular lipid is fat inside your muscle cells that's making your insulin not work and that causes a condition called insulin resistance the muscle cell is not behaving it can't respond to insulin so what do I do on a low-fat vegan diet how much animal fat is there none right and if I keep the oils low what happens is the fat starts to drain out of that cell it dissipates it goes away and now the insulin can start working again like it did when you were younger researchers at Yale University did a fascinating study they brought in 26 healthy volunteers and they gave them a glucose tolerance test did you ever have that test you drink 75 grams of a syrupy solution and then we track your blood sugar over the next couple of hours and some of the participants were what we call insulin sensitive meaning when they drank this sugary solution their blood sugar went up but it quickly went right back down because the insulin was able to tuck the sugar into their cells their insulin sensitive but there were others who were insulin resistant meaning when they took in that sugary solution the sugar was in their blood but it couldn't get into the cells where it belongs because maybe something was gummed up inside their cells they were insulin resistant so let's look at their age they're young people 28 and 26 years of age and the two groups and look they were thin 132 pounds 141 pounds and if you look at their hemoglobin a1cs this will not be on the test but those are normal numbers these people didn't have diabetes or prediabetes they were healthy however then everybody went into a scanning device the technique is called magnetic resonance spectroscopy and now what we're doing is we're looking inside the cells of the body and what we see is frightening here is the data every dot here is an individual and if you look at the control subject in other words those who were insulin sensitive they had relatively low levels of intra Myo cellular lipid they didn't have much fat in their cells but look at the insulin resistant participants they had much more fat in their cells and now we look at something else do you remember mitochondria from your high school biology those are the burners inside your cells in the control subjects their mitochondria they were active they were burning fuels as they should and in the insulin-resistant participants their mitochondrial activity was shut down it was lower meaning the cells were sluggish they weren't doing what they're supposed to so here's what is happening these were young healthy people but fatty foods that they were eating were packing fat into their cells making them insulin resistant so even though they were young and they didn't have diabetes yet if they were insulin resistant now because of the fat building up in their cells that predicts that they are gonna have diabetes later on maybe 15 years 20 years down the road it starts when you're young so what's our prescription no animal products minimize the oils favored the low GI foods now I know what you might be thinking that people imagine that on a plant-based diet it's hard to know if there's protein in it well it turns out there's lots of protein in plant foods beans grains vegetables have more than enough protein even for athletes calcium do you need milk or calcium answer is no cows actually don't make calcium they get calcium that came from the earth into the roots of grass and when they ate the grass the calcium that it originally come out of the earth now ends up in their bodies in their milk and if you drink milk you'll get some calcium but you only absorb about 32 percent of it instead have green leafy vegetables yourself hopefully not grass but broccoli and collards and kale great sources vitamin b12 is something that you should have you need it for healthy nerves and healthy blood and it's not made by animals or plants it's really made by bacteria and some people speculate that over the millennia in the past the traces of bacteria on our soil or on our vegetables or maybe even on our fingers or in our mouths would create traces of b12 well that's certainly not the case today if it ever was take a supplement go to the drugstore the health food store you'll see vitamin b12 pills there the smallest one that they have and you'll be set it's also in every multiple vitamin that you ever took now there are a few special considerations that I want to mention one is hypoglycemia low blood sugar I can hear what you're thinking I've got diabetes I've got high blood sugar how could I ever have low blood sugar here's why if you're using insulin or any of the sulfonylureas rug's they are designed to bring your blood sugar down but now you're switching your diet to a healthy low-fat completely vegan diet that also brings your blood sugar down the combination can end up being too much for you so let your doctor know that you're about to start a healthy diet and your doctor can ratchet you back on the insulin or other medications that you may be taking and when the time is right don't do this on your own the second thing is hypotension what's that low blood sugar I can imagine what you're saying wait a minute I've got high blood sugar and you might even be taking medications for it that's exactly the issue when you're on a healthy plant-based diet it's loaded with potassium that's in vegetables and that lowers your blood pressure a little bit also when people go on a vegan diet they tend to lose weight and that lowers your blood pressure too and so if you're still on all the same old medications your blood pressure at some point can get it kind of low so you're sitting at a table you stand up a little too fast you get woozy because your blood pressure is not low don't throw your medications away instead just let your doctor know that you're changing your diet and your doctor can ratchet you off your medications if and when the time is right one more special consideration and that's an anticoagulant medication that you might be using it's called warfarin or coumadin and some doctors in the past would say don't eat a lot of vegetables while you're on this medication because the vegetables have vitamin K that will counteract the effect of the anticoagulant but of course people want to have vegetables because vegetables are really healthy for them here's the answer eat lots of vegetables but keep the amount fairly constant from day to day if it doesn't vary a whole lot then the doctor can find the right dose of your anticoagulant and things will be fine and of course nowadays a lot of doctors are using more modern medications and they discover that there isn't any issue about their diet at all so there you have it we always want to get diabetes under better control improve it or even get rid of it if we can and a low-fat plant-based diet is the best way to get you there

Channel: Physicians Committee

Views: 658,372

Rating: 4.8123121 out of 5

Keywords: diabetes, #diabetes, health, diet, treatment, blood sugar, A1C

Id: tAiXvrIMIIE

Length: 20min 23sec (1223 seconds)

Published: Thu Mar 26 2020