This article originally appeared as an opinion article in The Jerusalem Post on 31 Oct. 2024: https://www.jpost.com/opinion/article-826879
During the last month, as Jewish people worldwide celebrated the high holidays. It is a time of eating traditional, delicious food. Lots of food. Even the fast day of Yom Kippur includes a lot of eating before and after the fast. Unfortunately, the choices of food consumed are usually those that lead to health problems of many varieties. Holiday foods are typically laden with saturated fat and cholesterol. Meals often include large amounts of animal proteins such as meat, chicken and fatty fish. It’s also a time when fatty and sugary desserts are consumed frequently. All of this can contribute to processes that lead to chronic diseases such as heart disease, Western cancers, high blood pressure, Alzheimer’s and type 2 diabetes. It’s the type 2 diabetes that is the focus of this article.
Too popular
I’m not sure any disease is more misunderstood than type 2 diabetes (T2D). But before we get to that, it is important to realize just how prominent this disease has become and what the ramifications of the disease are. According to the Center for Disease Control (CDC) in the United States, 10.5% of the US population has T2D and another 34.5% have prediabetes. These numbers represent a frightening upward trend. According to the World Health Organization, the total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030.
High glucose in the blood stream can cause damage to blood vessels and nerves, potentially bringing catastrophic results. Heart disease and stroke, nerve damage, kidney disease, foot problems (neuropathy), eye disease, gum disease, along with sexual and bladder problems are among the unfortunate possibilities. In addition, many type 2 diabetics get fatty liver disease. To both prevent and treat T2D in a successful way, we need to have a basic understanding of the cause of the disease.
Misunderstood
If you ask anybody what causes T2D, the common response is the word “sugar.” While high glucose in the blood is certainly a result of diabetes, consumption of sugar is not the main cause. Dr. Neal Barnard and his colleagues at the Physicians Committee for Responsible Medicine have thoroughly investigated the causes of T2D. They also know the best ways to prevent and reverse the disease.
Read carefully on how they describe the disease:
Many people believe type 2 diabetes is a result of eating too much sugar, but it’s a lot more complex than that. Insulin is a hormone secreted from the pancreas, in response to rising blood sugar levels after we eat. Insulin then acts as a key to “unlock” the cells so that the glucose can move from the blood into the cells, where it can be used to produce energy. Most of the glucose gets taken up by our muscles and liver cells. Too much fat stored inside our muscle and liver cells, as well as elevated free fatty acids in the blood and the resultant inflammation, prevent these cells from functioning normally. For example, when there is too much fat inside our muscle cells, they are less responsive to insulin and become insulin resistant, which means they take up less glucose, leading to higher levels of glucose in the blood. This can be due to consuming too many calories in total, and too many calories from saturated fat.”
It’s not so much sugar, but fat is the main culprit! What Dr. Barnard is describing is insulin resistance. But what is the standard treatments for T2D and do they work?
Diabetes treatment
Typically, a doctor will prescribe one or more medications to regulate blood sugar. 88% of people with T2D are taking multiple medications. Aside from insulin, there are now 11 classes of medications for use in treating the disease. Many are grossly expensive. In 2022, a respected medical journal, The Journal of Family Practice, published a supplemental edition in cooperation with the American College of Lifestyle Medicine. This should be a must-read for every family doctor in practice. It can guide doctors treating patients with all chronic and autoimmune diseases.
When I was going through the section on T2D, I was blown away when I read about a meta-analysis of data from 13 randomized controlled trials. All the intensive glucose-lowering treatment showed no benefit on all-cause mortality. There was actually a 43% increase in death from cardiovascular events. Yes, you read that correctly.
So, if the standard treatment is not as effective as we thought, what can we do?
Lifestyle changes
Dr. Barnard has conducted several studies and cites other studies showing the benefits of lifestyle changes. A whole food plant-based diet along with minimizing oils can prevent diabetes, arrest the progress of the disease, and even roll it back into remission. That sounds wonderful but does that really work? It does!
Over the last several years, many people have come to my clinic frustrated after carefully following diets recommended to them by dieticians or their endocrinologist. They are taking medications, yet their A1C, the primary marker of blood glucose, stays stubbornly high. If you watch advertisements on American television, they talk about getting an A1C to 7% using meds. That may be a slight improvement, but THAT’S STILL DIABETES.
I’ve seen people switch to our program, or similar disciplines, and reverse this dreaded disease, often putting it into full remission. Amazingly, it sometimes happens in less than one month. I have personally watched people with an A1C well over 7% stop using medication and ultimately lower their A1C to under 5%–all with lifestyle changes.
Other causes
It is important to note that there are compounds present in certain foods that have also been linked to an increased risk of type 2 diabetes. These include nitrates and nitrites (natural compounds commonly used to preserve meat), heme iron (the type of iron in meat, eggs, and dairy products), and advanced glycation end products. None of these are present in whole, plant foods.
As I have written in the past about heart disease, we have the prevention and we even have the cure. We simply need to implement it. Medicines can certainly serve an important purpose in the short term. But to truly conquer type 2 diabetes, a disease that shortens life and greatly diminishes quality of life, we must implement lifestyle changes. Studies have overwhelmingly shown this to be the single most effective treatment. It is imperative and will “add hours to your days, days to your years and years to your lives.”
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