diabetes and low-fat diet, was pudding question

[Guest guest]

To prevent the complications of diabetes, it's much more

important to avoid high-fat foods than to avoid sugar. High-fat foods

include all animal products, but also soy. What has been shown to help

is a low-fat, high-carbohydrate, plant-food-based diet.

 

Here's a recent journal cite:

Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L,

Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet

improves glycemic control and cardiovascular risk factors in a

randomized clinical trial in individuals with type 2

diabetes.?Diabetes Care. 2006 Aug;29(8):1777-83.

 

 

The information below just came in this week -- it's in support

of legislation in California.

 

_______________________

 

Read this McDougall DVD Announcement online: http://www.drmcdougall.com/misc/2009other/090414housebill.htm

 

Urgent: Support the Proposed New Law in California Requiring

Doctors to Provide Patients with Information on Diabetes and Heart

Disease

 

Patients often receive inadequate and/or incorrect information

from their doctors on diabetes and heart disease. Last month’s

newsletter was on the heart disease side of this bill. Concerning

type-2 diabetes, health professionals and pharmaceutical companies

disseminate incorrect and inadequate information on these four

important issues:

 

1) Patients are told diabetic medications for type-2 diabetes

will prolong life and prevent complications of diabetes, while

extensive scientific research says otherwise for the most commonly

prescribed oral medications.

 

2) Patients are told that their blood sugars (and hemoglobin A1c

levels) must be lowered as close to normal levels as possible.

However, all six major studies show intensive therapy increases the

risk of heart disease, death, and serious side effects.

 

3) The public receives almost no education about the role of the

rich Western diet in the cause of type-2 diabetes and about the right

way to eat to prevent this disease.

 

4) Patients are rarely told that changing to a healthy, low-fat,

plant-food based diet, exercise, and associated weight loss will

improve their health and often cure their type-2 diabetes.

 

Assembly Bill

1478 has been introduced by California state assembly member Tom

Ammiano, representing the 13th District, to require that a physician

obtain a patient's written acknowledgment confirming the receipt of

information, as specified, regarding treatment through medical

nutrition therapy prior to delivering nonemergency treatment for

type-2 diabetes. My supporting letter on this matter is provided

below. Last month’s newsletter (March 2009) has a similar

letter from me about heart disease treatments and a request for your

support.

 

 

 

 

Dr. McDougall’s Letter of Support for AB 1498:

 

Requirement to Inform Patients in Writing about the Adverse

Effects of Pharmaceutical Treatments and the Benefits of Nutritional

Therapies for Type-2 Diabetes.

 

The Patients’ Right to Informed Consent

 

Informed consent is a patient right guaranteed by the bylaws of

most hospitals. California law requires that a patient’s consent be

obtained in writing for several specific procedures and treatments,

including: sterilizations, hysterectomy, breast cancer, prostate

cancer, gynecological cancers, psychosurgery, and electroconvulsive

therapy, but not for type-2 diabetes treatments.1 California patients

with type-2 diabetes need to be informed in writing about the lack of

benefits and the real harms of current therapies with oral and

injectable medications. They also need to be told that the cause of

their diabetes is the rich Western diet and associated weight gain,

and that their condition is reversible with a change in diet,

exercise, and weight loss.

 

The Diabetes Epidemic

 

According to the National Institutes of Health (NIH) in 2007 a

total of 23.5 million, or 10.7 percent, of all people aged 20 years or

older in the US have diabetes at a cost of $174 billion.1a The

vast majority of this diabetes is type-2 diabetes, caused by

over-nutrition from the rich Western diet, and the associated weight

gain. Eighty-four percent of diabetics are on medications (insulin

and/or oral).1a Born in the year 2000, a male child’s lifetime risk

of developing type-2 diabetes is nearly 33%, and a female’s risk

will be 39% when following the Western diet.2 The escalating incidence

of type-2 diabetes clearly indicates that current efforts at

prevention and treatment are failing. The reason for this failure is

the almost exclusive emphasis on drug therapies, and the lack of

efforts to address the dietary and lifestyle causes and treatments of

type-2 diabetes.

 

The Failure of Non-emergency Diabetic Medications

 

Diabetic medications are approved by the FDA for market based

upon their ability to lower blood sugar levels, not based on any

improvements in the quality or quantity of the patients’ lives.3 In

a major study, a popular diabetic medication, Avandia (rosiglitazone),

given at a dosage of 4 mg twice daily, on average, decreased

hemoglobin A1c levels by 1.5 percentage points, reduced fasting plasma

sugar by 76 mg/dL (4.22 mmol/L), and reduced insulin resistance by

25%.4 These improved numbers should have meant healthier patients, but

they didn’t. On May 21, 2007 the New York Times reported,

“…patients taking Avandia had 66 percent more heart attacks, 39

percent more strokes and 20 percent more deaths from

cardiovascular-related problems.”5,6 Since 1972, the

Physicians Desk Reference (PDR) descriptions of most diabetic pills

have included two paragraphs in heavy black print that begin with:

“Special Warning on Increased Risk of Cardiovascular Mortality.”

This warning is because a very commonly prescribed oral medication,

called sulfonylurea, increases the risk of cardiovascular death by 2½

times compared to diet treatment alone.

 

Mediations (oral and injectable) for type-2 diabetes are

prescribed aggressively by physicians with the unfounded belief that

better control of blood sugar will result in better long-term outcomes

for the patients. All six major studies published over the past 13

years have shown otherwise. Three major studies published between 1996

and 2000 found more weight gain, higher cholesterol, triglycerides,

and blood pressure; and more heart disease, stroke, and/or death with

“aggressive” treatment compared to less treatment.7-9

 

This past year, 2008, three landmark studies, ACCORD, ADVANCE,

and VADT, were published in the New England Journal of Medicine.

All three showed aggressive treatment does more harm than

good.10-12 On February 6, 2008 the National Heart, Lung, and Blood

Institute (NHLBI), stopped the ACCORD study (Action to Control

Cardiovascular Risk in Diabetes) when results showed that intensive

treatment of diabetics increases the risk of dying compared to those

patients treated less aggressively.13 Patients in the intensive

group were oftentimes taking four shots of insulin and three pills

daily, and checking their blood-sugar levels four times a day.10

 

The Veterans Affairs Diabetes Trial (VADT) was based on 1791

military veterans with type-2 diabetes.12 Patients were assigned to

receive either intensive- or standard-glucose control and studied for

5.6 years. The intensive-therapy reduced their hemoglobin A1c

levels to 6.9%; compared to 8.4% in the standard-therapy group. A

weight gain of 18 pounds occurred with the intensive-treatment,

compared to 9 pounds with standard-therapy. There were 95 deaths from

any cause in the standard-therapy group and 102 in the

intensive-therapy group. In the intensive-therapy group, the number of

sudden deaths was nearly three times the number of those in the

standard-therapy group (11 vs. 4). More patients in the

intensive-therapy group had at least one serious adverse event,

predominantly hypoglycemia, than in the standard-therapy group.

 

The Efficacy of Diet-therapy

 

Drug therapy has consistently failed patients with type-2

diabetes, making search for an alternative treatment imperative.

Since the rich Western diet is agreed to be the cause of this

epidemic, should diet not be the first place to look for the

prevention and the cure?14 Studies on the benefits of a low-fat,

high-carbohydrate, plant-food-based diet on type-2 diabetes date back

to 1930.15 Several published studies demonstrate how type-2

diabetics can stop insulin and get off oral diabetic medications with

a change in diet.16-18 Heart disease accounts for 70% of the deaths in

diabetics. By great fortune, this same low-fat, low-cholesterol diet

(successfully used for diabetes therapy) has been shown to prevent and

treat heart and kidney disease, and prevent many common forms of

cancer.

 

A study recently published in Diabetes Care found a low-fat,

plant-food-based diet improved the health of people with type-2

diabetes even more than the American Diabetes Association (ADA) Diet

did.19 Forty-three percent of the plant-food group and 26% of

the ADA group participants reduced their diabetes medications.

Reductions of hemoglobin A1c, LDL “bad” cholesterol, and urine

protein were greater in the plant-food group, than those on the ADA

diet. People following the plant-based diet could eat unlimited

amounts of food, while those on the ADA diet were required to control

their portion sizes—and compliance was better on with the

plant-food-based diet. Exercise did not play a role in this

study.20

 

Low-carbohydrate, high-protein diets have also been shown to

cause people to lose weight and reduce their blood sugar levels.21

However, these kinds of diets are also high in fat, high in

cholesterol, and very low in dietary fiber; therefore, they cannot be

recommended. The American Heart Association, because of their

disease-causing effects, has condemned low-carbohydrate diets.22

 

Cost Savings to the State of California

 

Over 2 million Californians currently have diabetes, and the

number of Californians with diabetes is expected to double by 2025.23

In California in 2003, the total direct and indirect costs of diabetes

were estimated to be more than $17.9 billion per year.24 Obesity

threatens to surpass tobacco as the leading cause of preventable death

among Californians and obesity costs the state $28.5 billion in health

care expenses, lost productivity, and workers' compensation.23 A

cost-benefit analysis published in the October-December 2006 issue of

the University of California’s California Agriculture journal has

determined that every dollar spent on nutrition education in

California saves between $3.67 and $8.34 in future medical costs.25

The current drug therapies for type-2 diabetes promote both obesity

and heart disease—widespread utilization of diet-therapy will reduce

the costs and incidence of all three epidemics (diabetes, obesity, and

heart disease), saving California billions of dollars.

 

Sample Letter to Assembly Member

 

Dear Assembly Member (their name):

 

I am writing to ask you to vote for AB 1478. Chronic

diseases like heart disease and diabetes are epidemic in America and

California. From my personal experience I know that while drug

medication can be of value in emergency situations, drugs ultimately

never cure the disease – they only suppress the symptoms of the

disease. This is an expensive way to treat diseases. Our state

cannot anymore afford the high cost of treating patients with drugs

and surgery alone. Diet and lifestyle changes have been found to be

helpful in arresting and even curing heart disease and diabetes, and

are very inexpensive compared to drugs and surgery. I feel

doctors should give their patients the option to be referred out for

diet advice and nutrition therapy for their non-emergency heart

disease or diabetic condition. Doctors also must be required by

law to tell the truth about the limitations of current treatments.

 

Thank you very much for your support for AB 1478.

 

Sincerely,

 

Your name, address, and e-mail

 

 

 

References:

 

1) http://www.calpatientguide.org/ii.html

 

1a) http://diabetes.niddk.nih.gov/DM/PUBS/statistics/

 

2) Narayan KM. Lifetime risk for diabetes mellitus in the

United States. JAMA 2003; 290: 1884-90.)

 

3) http://www.medscape.com/viewarticle/585593

 

4) Lebovitz HE, Dole JF, Patwardhan R, Rappaport EB, Freed MI;

Rosiglitazone Clinical Trials Study Group. Rosiglitazone

monotherapy is effective in patients with type 2 diabetes. J Clin

Endocrinol Metab. 2001 Jan;86(1):280-8.

 

5) http://www.nytimes.com/2007/05/22/business/22drug.html?pagewanted=print

 

6) Nissen SE, Wolski K. Effect of rosiglitazone on the risk of

myocardial infarction and death from cardiovascular causes. N Engl J

Med. 2007 Jun 14;356(24):2457-71

 

7) Purnell JQ. Effect of excessive weight gain with

intensive therapy of type 1 diabetes on lipid levels and blood

pressure: results from the DCCT. Diabetes Control and Complications

Trial. JAMA. 1998 Jul 8;280(2):140-6.

 

8) Colwell JA, Clark CM Jr. Forum Two: Unanswered

research questions about metabolic control in non-insulin-dependent

diabetes mellitus. Ann Intern Med. 1996 Jan 1;124(1 Pt

2):178-9.

 

9) Gustafsson I, Hildebrandt P, Seibaek M, Melchior T,

Torp-Pedersen C, Kober L, Kaiser-Nielsen P. Long-term prognosis

of diabetic patients with myocardial infarction: relation to

antidiabetic treatment regimen. The TRACE Study Group. Eur Heart

J. 2000 Dec;21(23):1937-43.

 

10) Action to Control Cardiovascular Risk in Diabetes Study

Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT,

Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr,

Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive

glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun

12;358(24):2545-59.

 

11) ADVANCE Collaborative Group, Patel A, MacMahon S, Chalmers J,

Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee

D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C,

Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R,

Travert F. Intensive blood glucose control and vascular outcomes in

patients with type 2 diabetes. N Engl J Med. 2008 Jun

12;358(24):2560-72.

 

12) Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven

PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S,

McCarren M, Vitek ME, Henderson WG, Huang GD; the VADT Investigators.

Glucose Control and Vascular Complications in Veterans with Type 2

Diabetes. N Engl J Med. 2008 Dec 17.

 

13) BMJ 2008;336:407,

doi:10.1136/bmj.39496.527384.DB

 

14) Bulletin of the World Health Organization 80:952-958. http://www.who.int/bulletin/archives/80(12)952.pdf

 

15) Rabinowitch I. Experiences with a high carbohydrate-low

calorie diet for the treatment of diabetes mellitus. Can Med Assoc J

23:489, 1930)

 

16) Kiehm T. Beneficial effects of a high carbohydrate, high

fiber diet on hyperglycemic diabetic men. Am J Clin Nutr 29:895,

1976.

 

17) Singh I. Low-fat diet and therapeutic doses of insulin in

diabetes mellitus. Lancet 1:422, 1955.

 

18) Barnard R. Response of non-insulin-dependent diabetic

patients to an intensive program of diet and exercise. Diabetes Care

5:370, 1982.

 

19) Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L,

Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet

improves glycemic control and cardiovascular risk factors in a

randomized clinical trial in individuals with type 2

diabetes.?Diabetes Care. 2006 Aug;29(8):1777-83.

 

20) Barnard ND, Gloede L, Cohen J, Jenkins DJ, Turner-McGrievy G,

Green AA, Ferdowsian H. A low-fat vegan diet elicits greater

macronutrient changes, but is comparable in adherence and

acceptability, compared with a more conventional diabetes diet among

individuals with type 2 diabetes. J Am Diet Assoc. 2009

Feb;109(2):263-72.

 

21) Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar

SK, Behbahani AI, Al-Zaid NS. Beneficial effects of ketogenic diet in

obese diabetic subjects. Mol Cell Biochem. 2007

Aug;302(1-2):249-56.

 

22) St. Jeor S, Howard B, Prewitt E. Dietary protein and

weight reduction. A statement for health professionals

from the Nutrition Committee of the Council on Nutrition, Physical

Activity, and Metabolism of the American Heart Association.

Circulation 2001;104:1869-74.

 

23) http://gov.ca.gov/pdf/press/Governors_HC_Proposal.pdf

 

24) California DHS, Fast Facts on Diabetes, August 2003.

http://www.publichealthadvocacy.org/printable/CCPHA_RDiabetes.pdf

 

25) http://news.ucanr.org/newsstorymain.cfm?story=875

 

 

 

©2009 John McDougall

McDougall Wellness Center P.O. Box 14039, Santa Rosa, CA

95402

http://www.drmcdougall.com