The scourge of the obesity epidemic
One of the worst consequences of the obesity epidemic is skyrocketing rates of type 2 diabetes. In the U.S., around 26 million people have diabetes, and perhaps even worse, a full one third of the adult population is pre-diabetic, meaning that that they have abnormal blood sugar levels and are on their way to full-blown diabetes. Diabetes is rapidly spreading elsewhere too:
Once a disease of the West, type 2 diabetes has now spread to every country in the world. Once “a disease of affluence,” it is now increasingly common among the poor. Once an adult-onset disease almost unheard of in children, rising rates of childhood obesity have rendered it more common in the pediatric population, especially in certain ethnic groups. According to the International Diabetes Federation (1), diabetes affects at least 285 million people worldwide, and that number is expected to reach 438 million by the year 2030…
What is causing this? “Overweight and obesity are driving the global diabetes epidemic.” Obesity causes insulin resistance and the deposition of fat in internal organs, notably the liver and pancreas.
Diabetes is the pro-aging disease par excellence
The strongest anti-aging regimens known are calorie restriction, and its kinder, gentler form, intermittent fasting. Both of these result in improved insulin sensitivity and better (normal) blood glucose levels, and they have been shown to prolong life in a number of different experimental animals. Disease rates, such as for atherosclerosis, cancer, and dementia drop dramatically in animals subject to these regimens.
Diabetes might be considered the opposite of calorie restriction and intermittent fasting. Excess calories lead to the diabetic condition, which in turn means much higher rates of heart disease, cancer, arthritis, autoimmune disorders. Amputation of limbs due to poor circulation and infections is another lovely feature of diabetes. Alzheimer’s disease has been called “type 3 diabetes”, making its relationship with diabetes clear.
Calorie restriction and intermittent fasting on the one hand lead to longer life and less disease; excess calories lead to obesity, diabetes, shorter life and more disease.
Can diabetes be reversed?
The medical establishment thinks of diabetes as a disease entity that needs to be treated with drugs. Starting with oral hypoglycemic agents and ending up with insulin injections, the usual course for a diabetic is to become worse. Even with meds, diabetes is often poorly controlled, and the disease progresses, leaving the diabetic open to the disease’s ravages. But this need not occur, with a bit of effort on the part of the diabetic, and a bit of knowledge on the part of the doctor.
Consider that resistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. This study was specifically designed so that the resistance-training subjects did not lose weight. (One subject who lost 5% of his body weight, which one would think would be a normal occurrence in overweight people who start training, was excluded from the data analysis.) Liver fat was reduced by 13%, insulin sensitivity improved by 12%. If the subjects had also lost weight, no doubt the results would have been a lot better. The authors speculate that improved glucose control may be due to increased numbers of GLUT4 receptors in muscle. These receptors take up glucose, and are increased with exercise.
Next, consider that a very low calorie diet reversed diabetes. In this study, diabetic subjects ate only 600 calories a day for 8 weeks:
Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake.
So, here we see that diabetes was reversed. One hitch here is that it’s very difficult for most people to eat that small an amount of food daily. However, low-carbohydrate diets, even without weight loss, are effective against diabetes, and ought to be the first line of treatment.
- We present major evidence for low-carbohydrate diets as first approach for diabetes.
- Such diets reliably reduce high blood glucose, the most salient feature of diabetes.
- Benefits do not require weight loss although nothing is better for weight reduction.
- Carbohydrate-restricted diets reduce or eliminate need for medication.
- There are no side effects comparable with those seen in intensive pharmacologic treatment.
Even type 1 diabetes can sometimes be successfully managed and even reversed with a paleo diet.
As far as I can see, there’s no reason for anyone to have diabetes. It is easily managed and even reversed with resistance exercise, low-carb diet, and/or weight loss.
9 Comments
The single largest study on this question, the Look AHEAD randomized controlled trial, clearly showed that diet and exercise had no effect on diabetes. That was as close to an ideal study that one could practically implement, as the results were clearly negative.
Yeah, well look AHEAD was normal “healthy eating” advice, not any of the effective strategies here.
In the Look AHEAD study, participants lost an average 6.0% from baseline, controls 3.5%, an allegedly significant difference, but which seems nearly trivial to me. But leave that to one side, the diet was clearly high carbohydrate (fat <30%, protein >15%, which leaves carbs at ~55%). Also, the paper doesn’t seem to specify what kind of exercise was prescribed. My guess is walking or maybe treadmill or some kind of crap exercise like that.
So we know that a high carb diet combined with walking won’t cure diabetes.
So we know that a high carb diet combined with walking won’t cure diabetes…. combined with little weight loss. Participants in the study were required to be overweight to start, e.g. if taking insulin, a BMI >27. The average 6.0% weight loss achieved means that person with a BMI >27 is still overweight.
Also, back to exercise, resistance training appears to be effective because skeletal muscle makes up the largest fraction of any tissue in the body, and training improved glucose disposal in muscle.
Well, the results are in line with all other weight loss interventions, which all find (including low carb diets) little to no long-term weight loss.
The treatments are detailed in a supplemental appendix. Indeed, the diet appears to have been 30% fat, at least15% protein, and the rest carbohydrates.
The exercise was in the form of moderate intensity training such as brisk walking.
Indeed. That is all we know, however.
“That is all we know, however.” Not by a long shot. Maybe you didn’t see the studies cited in my post.
As you said about intermediate fasting.
The Mechanism of Diabetes Control After Gastrointestinal Bypass Surgery Reveals a Role of the Proximal Small Intestine in the Pathophysiology of Type 2 Diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856597/
I believe they said this was long term reversal of diabetes.
I may have made a mistake. That study I posted was about the surgery itself. I read another study…somewhere… , I should save these things, that it was the diet that caused the reversal. They go on a very limited diet for several weeks after the surgery. The claim was that maybe the fasting unstuck glands clogged by fat and got them working again, ending diabetes.