Fat is the Cause of Type 2 Diabetes

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Fat is the Cause of Type 2 Diabetes

Studies dating back nearly a century noted a striking finding: If you take young, healthy people and split them up into two groups—half on a fat-rich diet and half on a carbohydrate-rich diet—we find that within just two days, glucose intolerance skyrockets in the fat group. The group that had been shoveling fat in ended up with twice the blood sugar. As the amount of fat in the diet goes up, so does one’s blood sugar. Why would eating fat lead to higher blood sugar levels? It would take scientists nearly seven decades to unravel this mystery, but it would end up holding the key to our current understanding of the cause of type 2 diabetes.

The reason athletes carb-load before a race is to build up the fuel supply within their muscles. We break down the starch into glucose in our digestive tract; it circulates as blood glucose (blood sugar) and is taken up by our muscles to be stored and burnt for energy.

Blood sugar, though, is like a vampire. It needs an invitation to come into our cells. That invitation is insulin. Insulin is the key that unlocks the door that lets glucose in the blood enter muscle cells. When insulin attaches to the insulin receptor on the cell, it activates an enzyme, which activates another enzyme, which activates two more enzymes, which finally activates glucose transport (as diagrammed in my video What Causes Insulin Resistance?).

What if there was no insulin? Blood sugar would be stuck in the bloodstream banging on the door to our muscles, unable to get inside. With nowhere to go, sugar levels in the blood would rise and rise. That’s what happens in type 1 diabetes: the cells in the pancreas that make insulin get destroyed, and without insulin, sugar in the blood can’t get out of the blood into the muscles, and so blood sugar rises. But there’s a second way we could end up with high blood sugar.

What if there’s enough insulin, but the insulin doesn’t work? The key is there, but something’s gummed up the lock. This is insulin resistance. Our muscle cells become resistant to the effect of insulin. What’s gumming up the locks on our muscle cells? What’s preventing insulin from letting glucose in? Tiny droplets of fat inside our muscle cells, so-called intramyocellular lipid.

Fat in the bloodstream can build up inside the muscle cells, creating toxic fatty breakdown products and free radicals that block the insulin signaling process. No matter how much insulin we have in our blood, it’s not able to sufficiently open the glucose gates, and blood sugar levels build up in the blood. And this can happen within three hours. One hit of fat can start causing insulin resistance, inhibiting blood sugar uptake after just 160 minutes.

This mechanism by which fat induces insulin resistance wasn’t known until fancy MRI techniques were developed to see what was happening inside people’s muscles as fat was infused into their bloodstream. That’s how we found that elevation of fat levels in the blood causes insulin resistance by inhibition of glucose transport into the muscles.

We can also do the opposite experiment. Lower the level of fat in people’s blood and the insulin resistance comes right down. If we clear the fat out of the blood, we also clear the sugar out. That explains the finding that on the high fat, ketogenic diet, insulin doesn’t work very well. Our bodies become insulin resistant. But as the amount of fat in our diet gets lower and lower, insulin works better and better—a clear demonstration that the sugar tolerance of even healthy individuals can be impaired by administering a low-carb, high-fat diet. We can decrease insulin resistance, however, by decreasing fat intake.

The effect is really dramatic–check out at least the end of my video What Causes Insulin Resistance? to see what happens as dietary fat intake drops.

The most concerning downside of low-carb diets, though, is heart health: Low Carb Diets and Coronary Blood Flow

This is the first of a 3-part series on the cause of type 2 diabetes, so as to better understand dietary interventions to prevent and treat the epidemic. In The Spillover Effect Links Obesity to Diabetes, I talk about how that fat can come either from our diet or excess fat stores, and then in Lipotoxicity: How Saturated Fat Raises Blood Sugar, I show how not all fats are equally to blame.

Here are some of my recent diabetes videos:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


469 responses to “Fat is the Cause of Type 2 Diabetes

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  1. Here’s my frustration: I’ve been pre-diabetic for a decade now – morning glucose 110-120. I started following Dr. G’s recommendations religiously about 3 years ago. I keep my added fat (XV olive oil) at a low level – maybe a tablespoon a day. Zero animal fat/animal products.

    Over those past 3 years I’ve lost around 20 lbs (yay!) with no effort at all and am at a BMI of 25 right now.

    And yet, my morning glucose is STILL around 110-120. Yikes. Fortunately my AIC is has been hovering just below 5.6% for those 3 years. My Dr. tells me not to sweat the glucose measurement but it bothers me a lot.

    What on earth do I have to do to get my glucose down below 100?

    I do eat a lot of fruit (2 cups mixed berries, and a couple of apples a day). But my understanding is that fruit is not the problem.

    Out of desperation I’ve embarked on the 5-2 fasting plan. We shall see.




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    1. Sounds frustrating, Richard W. Since your diet is low in fat with zero animal fats, diet most likely isn’t the problem. However, you may still have some fat in your muscle cells causing a little insulin resistance to remain. You mentioned that you’ve lost weight with a BMI of 25 which is awesome and must be helpful. How about exercise? Exercise is a fantastic way to train your body to burn fat, and reduce the fat in muscle cells that causes insulin resistance. Also fasting, like the 5-2 fasting plan you mention may help as well as fasting also helps train our bodies to burn fat. You can also try the other intermittent fasting plan when you fast for at least 13 hours per day and do not eat anything past 7 pm. New research shows this form of fasting reduces fasting blood sugar and inflammation. https://www.youtube.com/watch?v=8qlrB84xp5g (Although the title of this video sounds like it’s about breast cancer, since blood glucose and inflammation promote breast cancer there is plenty of info on how fasting reduces these, which helps with insulin resistance as well).




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      1. Uh Julie, time-restricted feeding is fine for people with normal blood sugar, in fact, I’ve been practicing it myself for many years, usually eating only between the hours of noon to 7 PM, but people with diabetes or per-diabetes may not be able to keep a level blood sugar and in fact, may experience a crash in their blood sugar level, resulting in in weakness, fatigue and even unconsciousness, a life-threatening situation. Although this may actually not happen to everyone with a blood sugar abnormality, it would be best for them to proceed with fasting with great care, monitoring their blood sugar frequently, just to make sure.




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        1. Time-restricted feeding works quite well for many T2Ds.

          Of course, crashes may happen IF you eat a low glycemic index, low insulin index diet AND you’re on meds (insulin or oral) that have hypoglycemia as a consequence of not reducing the dose in sync with diet.

          And of course you should monitor your blood glucose if you’re diabetic. But the fact that your BG may be at levels (high or low) that cause concern if you don’t doesn’t mean the sky is falling if you’re diligent about it.

          n=1 – I have watched my blood sugar steadily descend over the course of many months to the point where I’m hovering around 5.0 HbA1c. Restrictions on carbs, feeding time (fasting), and calories are to thank.

          Carbs (including non-berry fruit and legumes in more than a small quantity) and too much protein, on the other hand, spell trouble – for me. Eating 100g+ of carbs and/or 150g+ of protein leaves me around HbA1c = 7.5-8.0, even with the same cap on calories.

          The world of T2D is made up of many different animals; the trick is to treat yourself as your own science project and figure out which animal you are.




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          1. Thank you Ralf. I practice what you are talking about. I eat tons of vegetables, but I have figured out that the carb content of these veges has to be at minimal. I don´t waste my calories on starches and grains. I also include a reasonable amount of fats in my food, e.g, I never eat my vegetable, or anything for that matter without a fat source. Fruits are quite insulinogenic, so Im very careful with them.




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        2. If you are eating the wrong combination of foods, time restriction will fail. If one cannot go for more that 3hrs without food, or without a drastic crash in blood sugar, thats the ultimate sign that the body is using an inappropriate fuel…




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          1. That’s my experience, too. I have been testing my blood glucose 8-10x/day for about 10 months, which I believe/hope has helped speed up the process of trial and error. If only there weren’t so many variables!




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    2. Maybe go heavy on beans and super high fiber foods. Beans have been shown to normalize blood sugar even hours and hours after eaten. And maybe prefer bananas, mangos and berries instead of going heavy on apples that has a liiiittle sugar bump/spike. And maybe instead of olive oil start some using nut butters instead




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        1. Hi Ken, I am a volunteer for Dr. Greger. You would need to eat nearly 2.5 bananas to reach 60 grams of carbohydrates from bananas. In addition, that many bananas would have about 8 grams of fiber, which slows the absorption of the sugar from the banana into the bloodstream. Your doctor is likely misinformed on the nutritional literature. I encourage you to check out this video that shows that fruit consumption should not be limited in diabetic patients: http://nutritionfacts.org/video/how-much-fruit-is-too-much/




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    3. hi Richard, Im sure you will receive lots of helpful ideas today, as well as congratulations for your successes. When my weight /blood sugar creeps up (i am slim) , I take stock to make sure no manufactured foods have crept in my diet. If it comes in a package, its only a commodity ie coffee, tea, oatmeal. I eat fruit all day, vegies in salad, homemade soup, or beans and greens type of thing. Oatmeal every morning. No oil, avocado or nuts. The weight falls off, and blood sugars are low and stable.

      On this video http://nutritionfacts.org/video/lifestyle-medicine-is-the-standard-of-care-for-prediabetes/ Dr Greger suggests 2 tbsp flax with your oatmeal to bring blood sugars down. Wishing you continued success!




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    4. Actually, too much fruit may be a problem in some people who have a sensitivity to fructose. This may be why Dr. Mcdougall recommends only 3 servings of fruit a day. Two cups of berries is four servings, so you’re over that just from that one item. It may also be possible that a small amount of oil, either added by your chef or to packaged food can throw off some people as well. This may not be the case with you, but you might try tightening up your diet anyway, just to see how your body responds. You may also try lowering your BMI just a bit more to see if that makes a difference. On the other hand, like everyone else, you are unique. It may be normal for you to have somewhat elevated blood sugar. I have a similar problem: although I’d love to get my cholesterol below 150, the heart attack-safe level, no matter what I try, 165 is the best I’ve been able to achieve. Best of luck to you, Richard.




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      1. I’m not sure TC <150 would be considered heart-attack safe. If your goal is to lower it, then without knowing more, I'd have to say 165 sounds pretty good!




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    5. Have you tried giving up that olive oil completely for a week or two? I’d start there and see if it affects your morning glucose. Also, one thing that helps me is 10 minutes of exercise shortly after each meal.




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    6. Richard W: I want to echo susan’s kudos on your progress so far. It is hard to change one’s diet and you have done it!
      .
      As for that pesky pre-diabetes problem, the devil is often in the details. I would highly recommend a book from Dr. Barnard titled “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs” https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?ie=UTF8&qid=1479400823&sr=8-1&keywords=barnard+diabetes Dr. Barnard promotes a whole plant food based diet using the latest science just like Dr. Greger. Dr. Barnard points out the same causes of diabetes that Dr. Greger does. The reason I recommend the book is that a) you will some additional details and b) the back of the book consists of meal plans and recipes. The idea is that you can look at that information and figure out if there are places you can tweak your diet in order to specifically deal with the problem you are trying to fix.
      .
      Good luck!




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      1. Hi Richard
        So many great ideas! Have you tried losing a bit more weight? Or better yet how about body fat % which is more meaningful than BMI.




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    7. Please let us know if that works. My daughter has T2D and tried not eating for at least 15 hrs per day (pm to am), maybe longer, but found her morning glucose elevated to about the same levels as yours. My theory is that the liver thinks she’s starving and pumps glucose into her blood, which she cannot properly metabolize.




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      1. There is something called the “dawn phenomenon” which is the normal hormonal surge that occurs in the body just before waking up. It lowers insulin production and raises glucagon production which then causes a rise in blood sugar. I think of it as our body getting charged up for the day. With underlying insulin resistance, this may cause the morning glucose to be higher. The American Diabetes Association recommends eating dinner a little earlier and doing some activity at night may help.




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        1. I was for three years on lower in carbs – no grains and the medium starches. Lots of butter and ghee, olive oil, lard, liver, bone marrow , eggs – no problems with blood sugar of any kind whatsoever . I had some other still digestive troubles. But all my cholesterol and blood sugar we’re superb . Yes, I lost tolerance to carbs for that time. But I have severe reflux with grains and legumes, so not sure if legumes is the way to go.
          So, I still wonder if fat in particular is an issue. And quite frustrated with studies. Vikings ate lots of porridge and quite a bit of butter and were solders. I do not think our level of physical activity allows us for high carbs . I also do not think that removing dietary fat for the sake of hi carbs is great. Cells are fat. Brain needs fat. Nervous system needs fat. Please, tell me where I am wrong on that and why ketogenic diet are so good for many. And what is the length of short term and long term terms?
          Sincerely, Marina




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          1. Hi Marina, I am a volunteer for Dr. Greger. Thank you for your interest and questions. The research, according to Dr. Greger, and according to everything I have seen, suggests that the ratio of carbohydrates to fat to protein is not nearly as important as what TYPES of carbohydrates, fats, and proteins we’re eating. Research is overwhelmingly leading in the direction of indicating that high animal food diets significantly increase risk of diabetes, while whole, plant food diets decrease risk and can even reverse and cure diabetes.

            Of course, our body does need fat, but we can get fat from sources like nuts, seeds, and avocados. Ketogenic diets have been shown to create quite a range of issues. Check out this video for more information–http://nutritionfacts.org/video/the-problem-with-the-paleo-diet-argument/




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            1. Thank you, Cody. What I understand is the butter fat works especially well converting carotenoids into vitamin A, for instance. And yes, the link provided does not work. Would you, please re-post it? Also, are there any very recent studies on true whole foods ketogenic diets be bad for us? A science just emerging widely on that topic even though the diet have been used for a while. I would be interested to know.
              Sincerely, Marina




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            2. Nonsense, been on a very low carb, high animal fat diet for years. 65% fats – beef tallow, lard and ghee, 25% protein, 10% carbs from veg and my blood sugars and cholesterol are textbook perfect.
              I must be some sort of medical miracle according to this.




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    8. You need to look at your A1C which is the average. My blood glucose goes up and down but my A1C is OK. Usually after I fast for 12 hours before taking the blood test, my blood glucose shoots up and I had no foods. And depending on how well I sleep, my blood glucose and even blood pressure also vary.




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    9. High intensity exercise works well. The only problem here is that you need to be sufficiently fit to be exercising at high intensity, but a combination of cardio and strength exercises will work for most. Instead of jogging for 20 minutes you can try to run at a faster pace for, say 5 minutes, take a rest of a few minutes and then again run for 5 minutes etc..

      Cold exposure also seems to work well:

      http://www.nature.com/nrendo/journal/v11/n9/full/nrendo.2015.121.html




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    10. its the type of fats that’s what the doctor is not saying some types work the opposite

      Healthy Fats like avocado and this includes Animal fats as well are Healthy if not processed . im 50 i eat high fat high protein diet including animal fats and have low cholesterol and normal sugar levels i smoke and have very low blood pressure and my doctor say im not at risk for a hart attack or Diabetes i only eat Hole food natural Pink Salt Coconut oil some olive. i dont eat food with added Nitrates or GMO or MSG Natural food are not Poison lik e the good Dr some times likes to indicate animal protein is a natural food. and has been for at least 250 million years




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    11. Richard, just cut the sugars and starches by even half and sees what happens, that morning glucose will go down in just about a week. As I wrote before, vegans that enrich their foods with healthier fats (40-60%) and bring down their net carbs (say 15-30%) are so much healthier. my morning sugar is about 60-70 daily. I´m not a full vegan, I love meat. I love all the inputs from NutritionFacts, but I belief in Food for Life, not nutritionism.




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    12. I think, more important question is how you feel in this diet. how healthy you are.
      It’s a common doctor’s mistake to treat numbers at the paper, not patients.
      Many people die every year from this manner of dealing with illness.




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    13. I believe you may need to just really, really amp up how much fiber you are getting. And do it from a low glycemic food.
      Kale and greens and beans. Not just sprinkle, but heavy amounts.
      If you watch the videos on how little fiber humans get nowadays compared to what we used to (like nowhere close to minimal amount we should), there’s a direct correlation between really high fiber intake (especially beans) and blood sugar levels correcting.
      The more fiber going through the system, the more our issues begin to correct. That is my understanding.




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    14. Let me add my 2 cents. I know you have received a lot of advice. Sometimes it can be confusing when you are on the receiving end of so much advice especially when it is diet related. What I am going to share with you here is not ground-breaking but something to do on a practical level.

      Something that will help you a great deal is that you will have to go back to the basics.
      It is good that you already have a glucometer and you know how to test yourself. With this skill in hand, you will have to do 3 things.

      The first is simple journaling. You need to keep a record of what you are eating for about 3 – 4 weeks. keep a record of what you are eating. Along with keeping a record of what you are eating, you will also need to adopt what is described as ‘Eating To Your Meter’. Instructions on how to do eating to your meter is described here on that page.
      http://thedrjoe.com/wellness/eating-to-your-meter/

      The idea behind eating to your meter is to discover the uniqueness of each of us because what works for me may not necessarily work for you. Of course, certain principles can be applied generically but nuances of human nature means one or two things have to be customised and that’s what eating to your meter seeks to achieve.

      Secondly, you need to make yourself more insulin sensitive. Yes, losing weight does make you does make you less insulin resistant but you need to get rid of intracellular fat trapped in your muscles so the muscles can soak up more glucose readily when you eat as talked about here http://thedrjoe.com/wellness/increase-insulin-sensitivity/ and in particular as explained in this research paper https://www.ncbi.nlm.nih.gov/pubmed/26909307 you may need to embark on high intensity interval training. The beauty high intensity interval training as explained in that research paper is that it makes not just muscle cells insulin sensitive but also sensitizes your fat cells and your liver cells to be more insulin sensitive too. Imagine the health advantage of having your muscle cells, fat cells and liver cells more insulin sensitive.

      Thirdly, I know a lady who had a BMI of 24 but when she had an MRI Scan, she was surprised at how much visceral fat she had. I was shocked myself. How was it resolved? It was resolved by those first 2 steps above and more pulses were added to her diet. Visceral fat is particularly bad for glucose tolerance and must be dealt with. In your case, in the absence of an MRI Scan, it will be a harmless idea to assume you are still habouring significant amount of visceral fat which has to be dealt with. Do those 3 things and I would like to think that your fasting blood glucose will be down in the healthier range within 3 months.




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    15. Richard I truly get the frustration on the morning glucose. As a T1 diabetic I am very experienced with differing frustrations on glucose levels at different times of day. However, with an A1c of 5.6, you likely do not have too much to worry about.

      There is an explanation that occurs to me and that is the “dawn phenomenon.” In many of us the added release of cortisol early in the morning will cause neoglucogenesis and a consequent relatively elevated blood glucose level. For the past 40 years this has been a problem for me. With my insulin pump I must have my basal rate almost 100% higher from 6 am to 10 am to compensate for the phenomenon.

      Given that you have very good numbers and what appears to be a very good diet, you probably do not need to worry. I understand that a morning fasting blood glucose level greater than 100 would suggest pre diabetes but the less than 5.7 figure for A1C would suggest otherwise. Consequently I strongly suspect you have what might be termed an idiosyncratic quirk which in reality does not suggest prediabetes.

      Tracking blood glucose from midnight to 8 am might be very informative given my hypothesis but with that 5.6% A1C, it likely is not worth the trouble and expense.

      You indicated absolutely nothing that might be a problem in your diet. The 2 C berries and two apples a day do not suggest any problem whatsoever. I eat that much fruit daily and it produces absolutely no sustained rise in blood glucose. Your bmi of 25 could indicate some issue but you are getting closer to the point when that is no issue.

      Finally I gotta say that reading your post is a mood elevator for me. I know so many T2 diabetics and pre diabetics who will not take responsibility for their own health. You sir are a great contrast.




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    16. You really want to lower your blood sugars? Here’s the truth and given by a person without the letters “DR” before their name: to lower your glucose levels, you need to do both a Ketogenic Lifestyle and incorporate Fasting.

      A Ketogenic Diet restricts carb intake, and resorts the body to turn dietary (and body) Fat into the energy your body needs.
      Because Carbs turns into glucose in your body, you’ve now restricted your carb intake and now less glucose is produced in your body… MUCH LESS! Do keto long enough and you will experience natural hunger suppression, which can be embraced into Fasting.
      And with Fasting, you’re effectively mitigating Insulin levels and Insulin responses, as your body can heal and rebuild cells.

      Best of luck sir.




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        1. There is research to support it. Always read from the opposing viewpoint. It can be eye opening. Many people drop below 5.6 with a ketogenic diet. Do it. Don’t do it. It’s your choice.




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      1. Hello David,
        I am a volunteer moderator helping Dr. Greger answer questions/respond to comments on Nutritionfacts. I am also a dietitian nutritionist from Scottsdale, Arizona.

        Dr. Greger has some great videos on this site about fruit, fructose, and the ketogenic diet. How much fruit is too much? is a great reminder that science has demonstrated the healthful effects of eating fruit; it is not harmful to the body as many advocates of a ketogenic diet suggest.
        Dr. Greger reminds us that ironically, fat may be more of a problem when it comes to diabetes than sugar; see:

        What Causes Insulin Resistance?
        The Spillover Effect Links Obesity to Diabetes
        Lipotoxicity: How Saturated Fat Raises Blood Sugar

        Animal protein in any form is high in saturated fat. The science suggests that eating fruit in its whole form is a much better strategy for reversing diabetes than eating animal protein and vegetables.

        Enjoy looking at the research on this site, and thanks for writing!

        Lisa Schmidt
        THE Mindful Nutritionist
        Scottsdale, Arizona




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        1. Please cite your source for “science suggests that eating fruit in its whole form is a much better strategy for reversing diabetes than eating animal protein and vegetables.”




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    17. Try eating a no big fat fruit diet. (fatty acids in all fruits from what im aware). Others have lowered their numbers on this. Learn for yourself, don’t just follow/trust me blindly as im sure you won’t. Sent with care. blessings, Owen




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    18. Julie, this is all lies. Eating a diet high in healthy saturated fat has been clinically PROVEN to reverse diabetes in most cases.
      Please research the Ketogenic diet. It will change your life.

      Good luck!!

      Also, these videos are enlightening:

      This (44min) video is excellent (and very funny), The Wisdom Of Crowds: https://www.youtube.com/watch?v=KzPnnDDCIjo&list=PLl8mMLuhcnoAMOvBDMzbuot__Kz7VUS25
      Science For Smart People, (39min): https://www.youtube.com/watch?v=y1RXvBveht0&index=2&list=PLlw5TSc2N5rOf_BKpXv3Gbv5l5w1fTI3D
      Drier but fascinating: https://www.dietdoctor.com/the-food-revolution-2016

      And here are some links to get you going:

      Why Keto is the best thing for your – Diabetes:https://www.ruled.me/the-ketogenic-diet-and-diabetes/ AND https://www.dietdoctor.com/diabetes
      Health: https://www.dietdoctor.com/low-carb/benefits and https://draxe.com/truth-about-the-controversial-ketogenic-diet/
      Heart (cholesterol is GOOD for you): https://www.ruled.me/the-ketogenic-diet-and-cholesterol/
      Skin: https://www.ruled.me/guide-keto-diet/#benefits-of-keto
      Weight: https://www.dietdoctor.com/how-to-lose-weight




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    19. Richard, I have the same problem. My fasting blood sugar is 110-120 no matter what I do. It seems to be fat related. I’m down 60 lbs and I eat the Wahls protocol, which is lots of vegetables, just not extra fat. I’ve never eaten healthier. I excersize almost daily. I should not be Pre diabetic. And I’ve seen many doctors and no one can help me.




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    20. Eliminate all added fat, and eliminate high-fat foods from your diet, such as avocado and nuts. All oil is processed and is not nutritious as it only has one nutrient – fat – and is not used to break down fat-soluble nutrients. There is fat in everything we eat. There is enough fat in everything we eat to keep us healthy.
      Use one of the free nutrition websites to log your daily food intake and energy output, and you will be able to see that you are probably still eating too much fat.




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      1. This is simply not sound advice. A higher fat, lower carbohydrate diet is most certainly more healthy for a diabetic than high carbs. Now, I have T1D so not the same as T2 folks out there. But, you want to know what happens when I eat a carb-heavy diet? Blood sugar roller coaster! Been T1 for 29 of my 30 years of life, so I have a bit of experience with this disease and what different diets do to the body. My whole life has been a food and nutrition science experiment. And yes, there IS enough fat in everything we eat to keep us healthy, if we are eating healthy fats from natural sources such as animal products and things like avocado and nuts. Also, the “free nutrition websites” are not ones I think people should trust. So much misinformation out there on the web, people!




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      1. Za: That article is referring to a study known as the PURE study. The reported conclusions of the PURE study have been thoroughly debunked. Here are two reviews which explain the errors made by the PURE researchers:
        From PCRM: http://www.pcrm.org/media/news/pure-study-killer-carbs-or-poor-living-conditions
        From Dr. Katz: https://www.linkedin.com/pulse/diet-health-puzzling-past-paradox-pure-understanding-david?trk=mp-reader-card&utm_content=bufferf15a6&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

        Well respected poster on NutritionFacts, TG, also wrote the following:
        “…it is worth bearing in mind that McMaster University has a history of producing studies which show dairy foods in a favourable light and/or which defend saturated fat consumption. What is more, they receive grant funding from the Canadian dairy Industry (and occasionally the US Dairy Council). Dairy Farmers of Canada calls McMaster University a “partner”.
        https://www.dairyfarmers.ca/who-we-are/our-partners

        Consequently, I tend to look closely at the study design of anything coming out of McMaster. In this case, comparing outcomes for people across different countries eating carbs with people eating fat etc, can often end up simply comparing the mortality rates of poor people in underdeveloped countries who eat primarily cheap low quality carbs with the mortality rates of people in wealthy developed countries whose diet is generally richer in fats etc. Not controlling for such factors would be expected to produce results exonerating saturated fats or implying that they are healthful. In fact, saturated fat and cholesterol apologists have been doing this same sort of thing for years. Plant Positive discusses this misleading approach here
        http://plantpositive.squarespace.com/blog/2012/3/25/tpns-40-41-playing-games-with-your-heart.html

        Like TG, the first two reviews above also point out the flaw of comparing two different economic groups with access to different amounts of calories and health care. What’s great about TG’s post is that he points out that this strategy has been used for *years* in order to twist the data and confuse people. Plant Positive is a great resource. If you haven’t checked out that work yet, it is worth doing.

        The Bigger Picture: Faulty study methods has been a big problem of meta studies in general. The following commentary published in JAMA explains the why and how of it: “The misuse of meta-analysis in nutrition research.” http://jamanetwork.com/journals/jama/fullarticle/2654401

        “Controversial conclusions from meta-analyses in nutrition are of tremendous interest to the public and can influence policies on diet and health. When the results of meta-analyses are the product of faulty methods, they can be misleading and can also be exploited by economic interests seeking to counteract unflattering scientific findings about commercial products”

        IE: It’s good to keep that information in mind when you see headlines about research that seems to do nothing more than give you good news about foods you know are bad for you.




        0
  2. Where is the source for this finding: “That explains the finding that on the high fat, ketogenic diet, insulin doesn’t work very well.” ?? Thanks




    3
      1. This will be taken down quickly as it disagrees with the author using facts and may harm his bood sales, but oh well. Unfortunately, the only link highlighted about fat is https://www.ncbi.nlm.nih.gov/pubmed/0010480616 which uses drugs to lower serum fat. However studies show triglycerides are the raised by eating carbohydrates not by eating fat. There are no studies which show dietary fat being linked to serum fat. There are also no studies linked above that show high fat diets raise insulin resistance.




        5
        1. Bubba this won’t be taken down. You haven’t said anything disparaging to anyone. But now remember that when you make a statement you should link a reference. That makes it interesting for us.




          0
    1. When I listen to the vast majority of other doctors citing studies on this subject, they say the exact opposite of what Dr. Greger says: Processed carb is really what causes diabetes, not fat.
      John S




      4
      1. This is my frustration too, I am getting opposite recommendations to Dr G’s advice eg Dr Mark Hyman recommends fat over carbs, her in the UK low carb diets are being promoted such as the 8 week low carb by Michael Moseley.




        3
    2. HI Alexandre – the source is found in Dr. G’s video here: http://nutritionfacts.org/video/what-causes-insulin-resistance/
      The specific article is: Overnight lowering of free fatty acids with Acipimox improves insulin resistance and glucose tolerance in obese diabetic and nondiabetic subjects. – PubMed – NCBI
      Diabetes. 1999 Sep;48(9):1836-41. Clinical Trial; Controlled Clinical Trial; Research Support, U.S. Gov’t, P.H.S. (13KB)
      (https://www.ncbi.nlm.nih.gov/pubmed/0010480616)




      0
      1. Joanne thank you but “Overnight lowering of free fatty acids with Acipimox improves insulin resistance” doesnt seem to be the same as ” on the high fat, ketogenic diet, insulin doesn’t work very well.” Am I missing something?




        0
        1. HI Alexandre. Sorry for the ridiculously long wait … had to check into a few things to better answer your very good question! Dr. G. is using the term ketogenic diet to refer to a diet that is very high in fat. The studies referenced in the video are not ketogenic diet studies per se but rather studies looking at the impact on diabetes/insulin resistance after consumption of high amounts of dietary fats. Hope that clarifies things.




          0
  3. Energy intake exceeding expenditure can lead to fatty liver and other modern diseases.
    Fat/oil intake takes you to exceed your energy expenditure faster than carbohydrates.
    It’s not just fat. Protein too.




    0
    1. Thanks for your question.

      Olive oil or any other oil is not exactly a healthy source of fat, even though it’s plant based (see here and here).

      Avocado appears to have a good/neutral effect but also has some concerns (see here).

      Nuts are very healthy (see here) and seeds are too (see here).

      As you can see the effect on diabetes will depend on the type and source of fat, regardless of being plant based or not.

      Hope this answer helps.




      0
  4. Does the type of fat matter? I feel I eat a greater proportion of nuts/avocado and I do use small use avocado and olive oil in cooking. Would this be harmful to health or not because it is plant based?




    0
    1. Thanks for your question Lindsey.

      That is certainly a complex matter but I will have to say that type and source of fat is more important. Dr Neal Barnard has found a diet that lacks animal fat and oils to be helpful in diabetes (see here).

      Olive oil or any other oil is not exactly a healthy source of fat, even though it’s plant based (see here and here).

      Avocado appears to have a good/neutral effect but also has some concerns (see here).

      All in all, PCRM recommends to consume <20g of fat per day for diabetics (see here).

      The quantity of fat also matters but there is a lot of controversy in the scientific community to whether having a diet rich in so called “healthy fats” like nuts, seeds and avocado is a good strategy. However, Dr Greger and other plant based advocated do seem to support a low-fat diet (which I also personally agree) – see here why.

      Hope this answer helps.




      0
      1. Forgot to include that I’m not diabetic…. Maybe this would allow me to eat slightly higher portions of fat? I am an athlete so it is possible that those with greater activity demands can eat more plant-fat and it have no effect.




        1
        1. If you are an athlete, you fat cells is almost empty I think, so they can effectively remove extra amount of oil from the body. You also have an extra exercise. I’m not a doctor, I’m biologist, but I don’t think you have to avoid any fat just because people who living office-life have problems with that. you can handle more of it and you also need more of it, so completely removing is not a good choice.
          I also see some vegan-athletes and bodybuilders, they have problems with power and mass of muscles, and soon move to less strict diet.
          I’m still looking for an optimal amount of fat and meat for me, I can’t be strictly vegan too.




          0
          1. Helga_R: Vegan athletes are breaking world records and winning world competitions right and left, including body builders. Below is a sampling of what vegan athletes are doing. Be sure to check out the last story of a vegan woman who set a weight lifting record in Iceland.
            .
            I don’t know why you think you have to eat meat. From a biological perspective, most people are set to do best on a whole plant food based diet. For the evidence for that statement, I give you the information here on NutritionFacts.org.

            **************************
            (article from meatout mondays)
            Vegan Bodybuilders Dominate Texas Competition

            The Plant Built (PlantBuilt.com) team rolled into this year’s drug-free, steroid-free Naturally Fit Super Show competition in Austin, TX, and walked away with more trophies than even they could carry.

            The Plant Built team of 15 vegan bodybuilders competed in seven divisions, taking first place in all but two. They also took several 2nd and 3rd place wins.

            For More Info:
            http://www.plantbuilt.com/

            ———————
            When Robert Cheeke started VeganBodybuilding.com in 2002, being the only vegan athlete he knew of, he may not have imagined that the website would quickly grow to have thousands of members. Robert says, “We’re discovering new vegan athletes all the time, from professional and elite levels… to weekend warriors and everyone in between.”

            For More Info:
            http://www.veganbodybuilding.com/
            —————–
            There was that other guy who did a world record in weight lifting. “Congratulations to Strongman Patrik Baboumian who yesterday took a ten metre walk carrying more than half a tonne on his shoulders, more than anyone has ever done before. After smashing the world record the Strongman let out a roar of ‘Vegan Power’…” For more info:
            http://www.onegreenplanet.org/news/vegan-strongman-patrik-babaoumain-breaks-world-record/
            another article on the same guy: http://www.thestar.com/news/gta/2013/09/08/vegan_strongman_shoulders_550_kg_a_record_perhaps_at_vegetarian_food_fest.html
            And another article: “I got heavier, I got stronger, I won the European championship title in powerlifting, I broke three world records so everything was going perfect … my blood pressure went down, and my recovery time was so much faster so I could train more.” http://edition.cnn.com/2016/07/06/health/vegan-strongman-patrik-baboumian-germany-diet/
            —————–
            Here’s a story about a bodybuilder who doesn’t use any supplements. Just eats whole plant foods:
            http://www.forksoverknives.com/vegan-bodybuilder-plant-based-diet/?mc_cid=b8b1865825&mc_eid=09aaf03269
            —————–
            Mr Universe – “Since going vegan, he has actually gained even more mass, now at 107 Kilos…”
            http://www.thediscerningbrute.com/2015/07/14/mr-universe-goes-vegan/
            —————–
            Bite Size Vegan has a youtube channel
            “In this video series, you’ll hear from various vegan athletes from all walks of life and athletic abilities speaking to such topics as vegan athletic performance, building muscle on a vegan diet, vegan endurance running, bodybuilding, body image, and more!”
            https://www.youtube.com/playlist?list=PLmIqdlomtuSv9FQJgdj3Bwg9Nh9MNjKg4
            —————–
            Here’s another site that I like:
            http://www.greatveganathletes.com/

            I found this story on the above site: “Pat Reeves has set a new world powerlifting record at the WDFPA World Single Lift Championships. The 66 year old lifter, who has been vegan for 46 years, lifted 94 kg to set a record for the under 50.5kg weight class while competing in France in June 2012. The lift was more than 1.85 times her bodyweight, which is exceptional for her division. Pat is now officially the oldest competing weightlifter in Europe.”

            Hope everyone finds this helpful.

            ————————-
            Story of Mac Denzig, winner of season six of The Ultimate Fighter
            http://www.ufc.com/news/Mac-Danzig-Diet-The-Truth-About-Vegan
            http://www.sherdog.com/fighter/Mac-Danzig-3396
            http://www.mikemahler.com/online-library/articles/mma-training/ufc-fighter-mac-danzig-vegan-diet.html
            ————————–
            Book: Vegan Bodybuilding And Fitness by Robert Cheeke
            http://www.amazon.com/Vegan-Bodybuilding-Fitness-Robert-Cheeke/dp/0984391606/ref=sr_1_1_title_0_main?s=books&ie=UTF8&qid=1396982744&sr=1-1&keywords=vegan+bodybuilding
            ——————————
            And another article from Meetout Mondays:

            Vegan Figure Skater Takes Silver
            Canadian Olympian Meagan Duhamel and her partner Eric Radford won a silver medal in pairs figure skating at this year’s Olympic games in Sochi, Russia.

            Duhamel proudly took to Twitter announcing that she is an “Olympian, vegan, yogi and nutritionist.” Wonderful! Congratulations to Meagan for being an outspoken and shining example of what healthy vegan eating looks like. …

            —————–
            (from Meetout Mondays)
            Plant-Powered Athlete: Griff Whalen [NFL Player]
            His teammates say he has the most enviable body on the team. They say he consumes an average of 6,000 calories and 200 grams of protein a day. They also say, he does it all by eating plants!

            In a recent interview on IndyStar.com, Indianapolis Colts’ wide receiver Griff Whalen, talks about his vegan ways.

            “I feel a lot lighter, faster, quicker on the field. There isn’t that heavy feeling, that groggy feeling after I eat,” says Whalen.

            Hooray for another plant-powered athlete for us to cheer on. w00t! w00t!

            Read the full article on :
            org2.salsalabs.com/dia/track.jsp?v=2&c=X9u7eAG%2FDmVet3kwZgrmHD5TipkEhWa4
            ****************
            (from Meetout Mondays)
            NFL’s David Carter on Living Vegan: In an interview last month on Rich Roll’s podcast, 27 year old Chicago Bears’ defensive lineman, David Carter spoke of a day in the life of the NFL, what he eats daily, his vegan journey, and his commitment to animal advocacy.

            “I can honestly say that being vegan is not only the most efficient way to be full-body strong, it’s also the most humane; everyone wins,” Carter said on the podcast.

            Carter is also the founder of The 300 Pound Vegan, a lifestyle blog where the NFL player writes about his journey through veganism and shares plant-based recipes. If nothing else, Carter shows us that living on plants is not just for endurance athletes or yogis but can positively impact heavy hitters in terms of their size, speed, agility, power, and quickness. Aww, yeah! Thanks for being so rad, David. We love it!

            Listen to the full interview on Rich Roll: http://www.richroll.com/podcast/david-carter-300-pound-vegan/
            Or for a written story with sample menu plan: http://www.gq.com/story/vegan-diet-of-nfl-player-david-carter

            ——————————
            And another article from Meetout Mondays:

            Record Setting, 92 Yr Old Vegan Runner

            Mike Fremont has been vegan for over 20 years, and has been setting single age marathon running records just as long.

            “At age 88 [Mike] ran a 6H5M53S marathon in Cincinnati Ohio and at age 90 ran a 6H35M47S marathon in Huntington West Virginia. [He] also set a single age world record for 90 years old in the half marathon in Morrow Ohio in August 2012,” said Veg World Magazine.

            According to an interview with Veg World Magazine, Fremont credits his vegan lifestyle for his continued record setting runs, at his age.

            We love seeing vegans making positive media waves, and what better way to showcase the health benefits of plant-powered living than Mike’s awesome running career. Here’s to you Mike, and vegan athletes of all ages!

            Learn more about Mike Fremont a VegWorldMag.com.
            http://www.vegworldmag.com/amazing-92-year-old-vegan-runs-another-half-marathon/

            ——————————
            from Meatout Mondays:

            World’s First Vegan Pro Soccer Team

            The Internet went wild last week as the news that English soccer (A.K.A football) team, the Forest Green Rovers, announced that the entire team and club is going completely vegan.

            “We stopped serving meat to our players, fans and staff about four seasons ago,” said club owner Dale Vince (via a recent article on Edition.CNN.com). He continued, “We’ve been on a mission since then to introduce our fans to this new world.” The article explains that while the club has been vegetarian for the past few years, they’ve decided to take the next step in going fully vegan (including their beer and cider options). Also cool to know: the club’s field is organic and they collect rainwater to use for irrigation. This is seriously super cool, you guys. Keep it up!

            Read the source article on: http://edition.cnn.com/2015/10/30/football/world-health-organization-meat-vegan-football/

            ——————————–
            from Meatout Mondays:
            Vegan Arm Wrestler: Rob Bigwood

            “Some of his opponents say that since going vegan Rob is stronger, his stamina grew, and he became more difficult to pin,” notes an interview-style Facebook post by ‘Starry N Ight.’

            A competitive arm wrestler since 2000, Rob Bigwood has been making a name for himself in the arm wrestling community—not only as the one to beat but also as the guy who eats plants. Rob has said, “I was concerned at first [about not eating meat for strength] but didn’t care. I made a conscious and ethical decision to give up meat…It is more important to practice what I believe in than to worry about being a strength athlete. I have never felt better in my entire life and it was one of the smartest decisions I ever made.”

            Check out one of Rob’s interviews on http://www.scribd.com/doc/39221267/Interview-with-a-Vegan-Arm-Wrestler

            ——————————–
            from Meatout Mondays:
            Vegan Bodybuilder Bucks Stereotypes

            Vegan bodybuilder Joshua Knox shares his game changing and inspiring vegan story during a TEDxFremont, California presentation.

            In this five-minute long video, shared by Mercy for Animals, Knox talks of his ‘meat and potatoes’ upbringing and what led him to give veganism a try. The results were nothing short of wonderful.

            “Not only was I able to continue increasing my strength and performance but also saw massive gains in endurance as well… [and] rather than feeling like I was missing out on foods I really felt that I was opening my mind to so many things I would have never put on my plate…” Knox said during his presentation. Joshua also noted a drop in his cholesterol, while experiencing mental and emotional health improvements as well. Rock on, Josh! Thank you for sharing your story

            Watch the short video on Mercy for Animals’ youtube channel: https://www.youtube.com/watch?v=43f2qWARXnA

            ——————————–
            from Meatout Mondays:
            Vegan Breaks World Record in Push-Ups

            A vegan from Kerala (a South Indian state) has just broken the Guinness World Record for knuckle push-ups (press ups). K.J. Joseph—a manager of an ayurveda centre in Munnar—completed 82 push-ups in 60 seconds, beating out Ron Cooper from the US who held the record at 79 push-ups in 2015. “Joseph has already entered the Universal Record Forum by doing 2092 push-ups in an hour. He is currently the record holder in the India Book of Records,” notes OnManorama.com. Thanks for making us vegans look good, Joseph. And congrats on your win!

            Check out the original story: http://english.manoramaonline.com/lifestyle/society/vegan-most-knuckle-push-up-guinness-world-record-joseph.html

            ———————————
            from Meatout Mondays:

            Professional Bodybuilding Couple Celebrate Veganism
            Named 2014 Mr Universe, Barny Du Plessis and his fiance, named UK’s strongest woman, Josie Keck are excited to share and to celebrate their one year vegan anniversary this month. In a comprehensive interview by British publication, Daily Mail, the vegan (literal) power couple are “…serious about [their] crusade to save the Earth, the animals, [themselves], and our dignity as a species,” said Barny. The articles noted that, “Barny is on a mission to destroy the idea that eating meat is associated with manliness.” He said, “I’m living proof that you simply don’t need to eat meat or animal products to make great gains, be strong, healthy, fit, and feeling mighty.” We couldn’t agree more, Barny. Congratulations to you both on your anniversary! We’re so jazzed you’re passionate about veganism.

            “When training for competitions Barny eats up to 4,500 calories a day, while Josie consumes 2,200 of vegan food. While preparing for a competition their typical diet consists of a wide variety of vegetables; fruit such as apples, bananas, dates and berries; grains such as basmati rice, quinoa and tapioca, pulses like chickpeas and brown and red lentils; as well as powders such as rice protein, hemp protein and vegan protein blend.” And the article includes a sample daily menu for each of them. http://www.dailymail.co.uk/femail/article-3495676/Obese-woman-met-fiance-gym-vegan-bodybuilders.html

            ——————-
            From PCRM Weekly News Update:
            What do the world’s top male and female tennis players have in common? They love vegan food! In a new Huffington Post piece, Dr. Barnard talks about plant-powered Novak Djokovic’s recent win at the French Open. http://new.www.huffingtonpost.com/neal-barnard-md/plantpowered-novak-djokov_b_10282348.html

            ——————-
            from meetout Mondays

            Weightlifting Record Set by Vegan

            With a record-setting deadline of 452 pounds, Iceland native Hulda B. Waage says it was her vegan diet that helped her pull out the win. “You can be strong without eating meat and animal byproducts,” she said. “I’ve reached the age when the body produces more swelling. I believe my diet helps with this, and I recover more quickly after practices.” Hulda has her sights set on the 2023 World Weightlifting Championships. Awesome, Hulda! Way to represent vegan athletes in a most wonderful way. And thank you for all you do to help inspire and forward a cruelty-free world. http://org2.salsalabs.com/dia/track.jsp?v=2&c=FiCd30wCeTG%2FBmw0po%2FMQXpx0aVdsgbp




            0
            1. You take some cases and made ”a proof”, but it’s just your cases against my, it’s not a science.

              How about this vegan that go to Everest and die. If we use just cases to proof smth, I prof that vegan is killing thing, hah? Case doesn’t proof anything.

              And I’m good in a biology (at least my diploma says it), and all what I know doesn’t support 100% vegan lifestyle, it’s quite controversy thing.

              80-95% vegan – yea, but not 100%.

              still too little researches about what damage can do 100% vegan non-oil diet.
              Yea, it cure some illness that people have in a bad western diet, but it’s not a big deal for me – they just eat garbage and die from this. Not eat garbage and don’t have garbage-associated problems doesn’t prove 100% safety of strictly vegan diet, it’s only prove that garbage is bad.
              But vegan can made some other problems, we don’t really know, too.
              It takes dozens of years to find it – for example eating white rice made big harm and kill so many people before we find the vitamins B thing.
              We already have B12, ferrum, iodine deficiency problems for vegan and who know how many other problems we don’t know?
              You have to wait for at least 30 years from a moment when vegan became common in population to find out what’ wrong with it, that conclusion easy to make from the history of medicine and science.

              So I don’t see any reason to made it 100% vegan.
              98% vegan is not a big difference, but it can save you life and health in some bery-bery-like situation.

              You don’t eat bugs and germs in your daily food. It’s important source of animal substances for our ancestors.
              Most of apes also have a very strong attach to animal food. whenever they find it – insects, thins like larvae of wood-eating bugs, or eggs – they find it delicious and never reject to eat. It’s not a coincidence, it’s a result of evolution – you have receptors for meat and you find it very tasteful because someone who don’t like it already eliminated from chain, they were too unhealthy and weak to made us 100% vegan population.

              You just don’t need too much of it, same as you don’t need to much of vitamin A and can get problems with it. But if you get hypervitaminosys of vit A and decide that it’s bad and completely remove it from diet – you’ll be quite wrong isn’t it?

              Evolutionary humans can grow up their brain so big thankfully meat-eating. So, naturally we need some additional sources of food, and it’s not only protein which you successfully can replace by vegan diet, it’s much more – and may be even some unknown vitamins and substances. Our body consist of hundreds different substances, and need almost all of Mendeleev table so you can’t predict what else would be necessary for 100% vegan.

              Until we have a really good researches about every side of it, to recommend 100% vegan is too early.




              1
              1. Helga_R: You are correct that I just provided you anecdotes/”cases”. However, you seemed to be unaware of that information, and it is some pretty powerful anecdotes. These people are breaking world records and winning high level competitions even though they are in the minority.
                .
                Anecdotes are helpful when they illustrate the science. I agree that the science has to be there first. That’s where this site comes in handy. It educates people on what the science says. If you haven’t had a chance to watch Dr. Greger’s latest summary talk, you might want to check it out: http://nutritionfacts.org/video/how-not-to-die




                0
                1. I don’t see any powerful results – someone made something on greens, but he could be even better at greens + little more food, whe never know.
                  I dont see real trials on athletes with/whithout vega diet, I don’t see trials with athletes that eat not farmed (whith all that chemical stuff), but grown up in normal environment chicken.
                  And as a byologyst I gave reasonable conserns about restrictions in food.
                  So for me this examples is nothing, like those when someone drink and smoke and live for a 100 years.
                  Are you gonns smoke just becose someone outlive other smokers and unsmokers?




                  2
    2. In general (and similar to CVD), saturated and trans fats impair insulin sensitivity, while unsaturated fats are thought to play a protective role (1). This is supported by mechanistic studies, where long-chain saturated fats play the pathogenic role (2, 3).

      That said, the populations with negligible diabetes risk consume traditional agrarian diets, where starches predominate and little fat of any sort is consumed (4).




      0
    3. Pritikin Longegivity Center say’s, There are only two fruits she and her colleagues at Pritikin caution against: avocados and coconuts.

      Avocados are problematic if weight loss is your goal. They’re high in fat and therefore dense with calories. Coconuts are high in heart-damaging saturated fat.




      0
  5. My frustration comes from so many qualified doctors that I respect saying opposite things. Dr David Ludwig says eat more fat to balance blood sugar and Dr Greger says to lower your fat. Personally, I tried low fat for many years and my blood sugar kept creeping up. After lowering carbs and increasing protein I lost 20 pounds and all test results are great. Is it possible that one size does not fit all? My heart and soul do not like the idea of eating animals but my body seems to want it.




    3
    1. Kathryn Rogers: I sympathize with your confusion and frustration. As for your experiences, I would say that the devil is in the details. What exactly was your low fat diet? (No need to tell me, I’m just making a point.) Your diet may not have been the same diet that Dr. Greger and Dr. Barnard (one of the leading experts on diabetes) are talking about.
      .
      The nice thing about eating a whole food plant based diet for diabetes is that it is also the diet that is good for the other top 14 diseases leading to early death in America. It is an all around healthy diet. If you decide you want to give the diet a try again, you could check out Dr. Barnard’s book in order to get the fine details. The book includes meal plans and recipes. https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?ie=UTF8&qid=1479403562&sr=8-1&keywords=barnard+diabetes
      .
      I also have a couple of recommendations for achieving healthy weight loss if you are interested. Check out these free and entertaining talks: https://www.youtube.com/watch?v=xAdqLB6bTuQ and http://www.jeffnovick.com/RD/Calorie_Density.html




      0
    2. Thanks for your comment Kathryn.

      In addition to what Thea said, I would like to say what I have commend before…

      It seems strange but here is what Dr Garth Davis recently spoke on the topic (find original post here):

      ” I always tell people that it is very difficult to turn carbs to fat, a process called De Novo Lipogenesis (DNL). This is in fact true. In your average person if you eat bread, for instance, your body will store it as glycogen in your muscle or utilize it for energy.

      There is a very important exception to this rule. If you are insulin resistant, then your body will greatly increase conversion of carbs to fat (DNL). So if you are very overweight (my patient population) then you are likely insulin resistant, and therefore, carbs can make you fat.

      Now that does NOT mean you should not eat fruit or carbs. What it means is that you need to address the cause of insulin resistance. Insulin resistance seems to be due to 2 main issues. First, our cells thrive on sugar. cellular metabolism is driven by glucose. Now, to get sugar into the cells, you need insulin receptors. Problem is that certain amino acids and fats cause fat to enter the cell and disrupt the ability of the cell to make insulin receptors. Without insulin receptors the sugar cannot get in the cell to be utilized as fuel. The body will start pushing out more and more insulin in an attempt to get the sugar in the cells. The high insulin suppresses the cells ability to release fat, and more fat is stored in the cells creating a vicious cycle.

      Secondly, the fat that enters the cells creates a problem with storing glucose as glycogen. Fat basically competes for utilization in the cell with glucose. If glucose cannot be stored or transported into cell than you get hyperglycemia and the resulting hyperinsulinemia creates hypertriglyceridemia. Top that off with the fact that the cells aren’t getting their usual fuel and will need t get fuel from fat. Hence there is increase in conversion of carbs to fat.

      This can easily be cured. Exercise greatly improves glucose utilization and insulin receptor production in the cell. Weight loss, obviously, reduces intramyocellular and intrahepatic fat, and thereby increases insulin sensitivity.

      When it comes to diet for insulin resistance there are 2 diets that seem to work. All fat or really low fat. This may sound contradictory, but think about it. If you are eating nothing but fat your odd will run out of glycogen and turn to utilizing fat for fuel. Without eating any carbs, minimal insulin will be secreted. You may still be insulin resistant but if you are not eating carbs, and mainly eating fat, you won’t exhibit high insulin and high sugar.

      As you know, this is not my preferred method of treatment because I find it limits many nutrient dense foods (fruits), may have negative effect as far as cancer, cardiac disease, and inflammation.

      The opposite, a high carb/low fat plant based diet, is my treatment of choice. Basically, by eating a high fiber diet you get slow release of sugar into body and the foods are low in calories so you tend to lose weight. You also are not getting the high amounts of fatty acids and amino acids that enter the cell and interfere with insulin receptor production and glycogen formation.

      Interestingly, it appears, if you are insulin resistant, the answer is in the extremes. You cannot really do some of both. Fat by itself, if not in ketosis, is harmful. Likewise, excessive carbs, in a diet that contains saturated fat, is harmful. The magic seems to be in the extremes.”

      Hope this answer helps.




      3
      1. Darchite:
        Thank you! This is the best explanation I have ever seen of the dichotomy about fat and carb for diabetes. I had to read it a few times to really get the part about people who have insulin issues have to be more careful. Excellent job of showing us the details.
        John S




        0
      2. Amazing! That is exactly what I am finding with my body . HOWEVER, how do you convert fat soluble vitamins without good fat, etc. may be a devil in some sort of between? Low starch and fat? In between I call owns body level of carbs that can be taking and still allow fat without comprise ? Or this is utopia? There is no such point? I do not talk here about so called balanced diet, rather find what carbs you can tolerate and still get micronutrients (if they still present in our berries and vegetables ) so it allows fat to be eaten too? I personally find that many starches give me super dry mouth and found it is not because of its acidity and in absence of any animal food. More lighter vegetables, fat and not much of protein – in my case I tolerate fish better then meat- might be a way. It may not be ketosis Per Se, but still… What are your thoughts? Thank you!




        0
    3. Yes, indeed – one size doesn’t come close to fitting all (as many low-far and low-carb experts recognize), and there are vegans and carnivores in both camps.

      Keto-advocate Steven Phinney, for example, readily admits that low-fat will work for some folks, low-carb for others. My personal experience was the same as yours. I was not able to achieve near the same control over my blood sugar and insulin levels with low-fat as I have been with low-carb, moderate protein, higher fat.




      0
    4. It could be good in a short term for some peple and in the same time be bad in a long term.
      It’s also could be two different mechanisms – one make it good and other make it bad. In a particular body may be win one or another.
      In a comments of high keto diet you can see two types of comments – “it’s cool” and “it’s really bad for me” so it could be just two types of people :)
      It’s only in science we have “normal range” in real life usually people more split up in different group.

      and also don’t forget that the only thing their diets have in common – is just a name. each person create his own keto diet, some could be very green, some meaty/ and they obviously get different results.




      0
      1. It certainly doesn’t hurt to look for frequent commonalities, of which there are many – up with fresh, green leafy vegetables, down with processed and refined foods!, for example.




        0
  6. Dr. Greger, I understand high fat would cause insulin resistance and the cells don’t open to allow glucose to enter muscles. WHAT I DON’T understand, is if you’re diabetic and you take insulin shots to lower your sugar, how exactly does that work if fat in the blood is not letting your manufactured insulin work?




    0
    1. With insulin resistance, because insulin (both what the body produces and extra that is injected) is not working very well you need loads of it to get any results. A normal person may require 20 units of insulin per day, while an insulin resistant person may require 100+ units. So yes, the fat is not letting the insulin work very well. The insulin still works but is really inhibited from optimal by the fat.




      0
    2. Hi Dale – insulin resistance doesn’t mean that insulin is not effective at all, it just means that a person with diabetes needs more insulin to overcome the resistance and allow sugar to enter the cells. Hope that makes sense.




      0
  7. I guess this is why diabetes has skyrocketed the last 50 years as consumption of dietary fat has been reduced from 45% of calories down to 31% and been replaced by grains and other carbohydrates. Why is there not a single medical study referenced. I can provide at least 2 dozen studies in peer reviewed journals that show the exact opposite of what is claimed in this article. The ONLY explanation for why you would get these results is if you have high carb intake along with the fat intake. As someone who has been diagnosed with T2D and brought my A1c down into the normal range using a low cab diet and with my fat intake being between 65% and 75% of my calories, I know this article is NOT based on facts. I am also not the only person I know personally know with these results.




    1
    1. Cliff Hansen: Darchite addresses your point in this comment here: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730 (Look for the comment that starts with: “Thanks for your comment Kathryn.”) In short, you may be addressing an aspect of your diabetes, but you are not addressing the cause and you may be putting your health at risk in other areas. It is a risky approach.

      Also, to address your question about referenced medical studies in the article above. There are a ton of references. Just click on the green hyperlinks to see those references.




      0
      1. Yes Mark Hyman and many others talk with worry about the combo of high processed carbs and fat he calls sweet fat-a disaster for diabetes.
        John S




        0
      2. I’m not believe in this numbers. Look around how many fat people do you see? they eat more than 50 years ago just because they weight more.
        We aslo have more money, more food today and much more tasty high-carbon food, than 50 years before. kids and adults leave less moving life so we can’t be at the same range of consumption.




        0
    2. Wow…!

      A fat intake of 65 -75% is hard for me to believe. I strive for a fat intake of 6 – 10%, and a body fat number of currently 9.5%. I don’t know how you do it.




      0
      1. Fat is is dense food. You do not fill 3/4 of a plate with a butter or tallow, you can have a tablespoon. With vegetables lighter in carbs. Or any carbs if weight and blood sugars not an issue




        0
    1. Cliff Hansen: I deleted your post because it breaks the posting rules for this site. If you can post your comment without the name calling or any ad hominen attack, you are welcome to do so. We welcome the chance to help people understand the science presented on this site. You might start by reviewing the information I gave you in my previous post.




      0
    2. Your link is broken. And please no name calling here, please. Plenty of respected doctors and scientists agree with Dr Greger. You need to let down your defenses, and open your mind.




      0
      1. We should all keep open minds, as contemporary views of nutritional truth have generally not fared very well in hindsight.

        Still, the bold declaration that is the title of this article, “Fat is the Cause of Type 2 Diabetes” hardly sets the right tone.




        0
  8. I can’t get my head around this. I tried – very seriously – a vegan diet for one year. I didn’t lose one pound. In fact, I gained 20 pounds! My blood pressure went up. My LDL went UP. My HDL went UP. My blood work was awful. So screw it. The vegan, plant-based diet had too many carbs for me. So I read a great book, The Obesity Code, and tried it. High Fat, Low Carb is great! In ONE MONTH I lost 25 pounds, my blood pressure is low – so low I stopped taking meds. Just had a blood panel last week – came back “excellent” according to my doctor. Then I read this article today and it goes against everything I’ve been doing. Insulin resistance is my problem, and it was exacerbated by plant-based foods. I’m down to 20 grams or less of carbs – all healthy, green veggies and NO sugar in any form. Someday, someone will settle this science once and for all, but in my experience, the plant-based diet sold by Dr. Greger doesn’t work for everyone. Caveat emptor.




    2
    1. AZ Cowboy, I’m glad you lost weight, although as references above indicate, you may also loose years of life. I don’t know what version of a vegan diet you followed. My unprocessed whole food plant diet doesn’t give me enough calories to gain anything like 20 pounds, especially with exercise. The only way I could gain that much weight eating vegan is to scarf lots of sugary, processed foods with added oil. That would also explain the screwed up blood levels that you had.




      0
      1. Here’s what I’ve picked up from various sources: it’s not carbs that make you fat, it’s insulin. But carbs raise insulin levels. I was using some of the popular recipe books that vegans recommend. I used recipes on this site. But too many beans, tortillas, too much fruit, isn’t going to help. I was eating supposedly healthy oatmeal almost every morning. Big mistake. I wasn’t consuming junk food, rarely went out to restaurants, exercised daily. Calories don’t matter – insulin does. I feel better than I have in many years, never get hungry…it’s been great. Eggs, steak, bacon, chicken, fish – they do a body good. When I get down to what I think I should weigh, I’ll reintroduce some healthy carbs and see what happens. In any event, I’m off sugar for life.




        1
        1. ” I feel better than I have in many years, never get hungry…it’s been great. Eggs, steak, bacon, chicken, fish”.

          ‘Swing low sweet chariot
          comin’ for to carry me home…’




          0
  9. I am wondering if anyone kows about the validity of muscle cells pulling glucose out of the blood stream independent of insulin during vigorous exercise. I had heard this several years ago, and know of someone with type one diabetes who has to be careful during vigorous exercise because her blood sugar levels can drop too low. If it is true that muscles do this, it might help explain why her levels drop so much and why vigorous exercise helps control blood glucose levels so well. I did find an affirmation to this idea:

    “During exercise, the muscles deplete their individual glucose reserves. To help restock their glucose supplies, the muscles change in two important ways: They become more sensitive to insulin—a hormone that escorts glucose from the bloodstream into body cells—and they also start to absorb glucose on their own, independently of insulin.” Reference site:
    http://www.diabetesforecast.org/2010/jul/the-science-of-exercise.html?referrer=http://www.google.com/




    0
    1. Yep, I think you’ve answered your own question with an informative quote. My sister is Type 1 and exercise sure does reduce her need for insulin–both before and up to 24 hours after exercise. Intense exercise seems to be especially effective. Exercise is a healthy way to lower your insulin needs–great for anybody whether diabetic or not.




      0
      1. Thank you. When I don’t readily find enough confirmation, I question the validity of information. Almost everything I’ve read talks about muscles needing insulin to access blood sugar. There is very little easily found information regarding the way muscles pull sugar out of the bloodstream independent of insulin. Anyway, I now wonder how vigorous the exercise needs to be, and for how long that level of intension needs to be sustained for the muscles to do this.




        0
        1. Taking a walk after eating will help lower the insulin needed for that meal. Fairly intense exercise like jogging or biking for 30 minutes should improve insulin sensitivity for 24 hours or so. Increase exercise time or intensity further and you’ll require even less insulin. Point is exercise daily–anything is better than nothing.




          0
        2. This is what Dr. Mirkin says at
          http://www.drmirkin.com/weekly-ezine-page/sugar-for-prolonged-hard-exercise.html

          “It is usually safe to take sugared drinks while you exercise because blood sugar levels rarely rise too high during exercise or for an hour afterward.Contracting muscles do not require insulin to take up sugar and therefore draw sugar so rapidly from the bloodstream that there is no sharp rise in blood sugar. This protection lasts maximally for up to an hour after you finish exercising.”.

          Here
          https://www.ncbi.nlm.nih.gov/pubmed/16036907
          is the reference he cites in another discussion
          http://www.drmirkin.com/public/ezine101710.html

          From the above study: “Exercise/muscle contraction activates glucose transport. The increase in muscle glucose transport induced by exercise is independent of insulin. As the acute effect of exercise on glucose transport wears off, it is replaced by an increase in insulin sensitivity.”

          I think Dr. Mirkin is generally careful in what he says.




          0
    2. Yes, during exercise insulin-independent glucose transport by muscle increases. In fact, much if not all (it depends on the study) glucose uptake above resting rates is due to insulin-independent pathways. The effects of insulin and exercise on glucose transport are additive. For example, muscle contraction activates GLUT4, the main glucose transporter in muscle, from different intracellular stores than insulin does.

      An older, but good review is in Advances in Experimental Medicine and Biology, Vol 441, 1998. “Skeletal Muscle Metabolism in Exercise and Diabetes.”




      0
    3. Hi kathy – yes, exercise is an extremely effective way to pull glucose out of the bloodstream independent of insulin and the beneficial effects can last for 2 days afterwards. Exercise, like insulin, acts by pulling the GLUT4 receptor to the surface of the cell which allows for the uptake of glucose into the muscle cell.




      0
    1. Jonathan: Darchite answers this question in the post here: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730
      .
      Also, a low carb diet has been shown to increase mortality. (See this comment from Tom Goff: http://nutritionfacts.org/video/how-not-to-die-an-animated-summary/#comment-2970719327) Better to stick with a diet that is good for health all-around instead of just treating the symptom of a disease and not the cause.




      0
      1. Thea – What does this general statement mean?

        If a low-carb diet brings a single individual (as opposed to every T2D) improvement in BG, A1c, insulin levels, triglycerides, body fat, CRP, and other indicators, in what way, specifically, is the diet nevertheless still not working?

        What proof would you accept that for some people, LCHF is a good option? (For the sake of discussion, let’s assume it’s a high-fiber vegetarian diet with plenty of vegetables….)

        Thanks for any clarification!




        1
        1. Ralf: I don’t know what statement you are talking about.
          .
          As for your interesting question: “What proof would you accept that for some people, LCHF is a good option? (For the sake of discussion, let’s assume it’s a high-fiber vegetarian diet with plenty of vegetables….)”

          Off the top of my head, I have three responses. First: if the diet in question is truly low carb and high fat diet, it is unlikely that it has plenty (or enough) vegetables or fiber by definition — based on the current body of scientific evidence.
          .
          Second, I would focus in on your use of the word “some”. There are “some people” with certain specific conditions who may be forced to eat a high fat diet, even if it is not the best diet for overall health. For example, a ketogenic (high fat) diet has been shown to be helpful for children with epilepsy. That doesn’t mean that ketogenic diets are healthy. It just means that a diet that is generally sub-optimal may be their best bet for their condition. There are also some type 1.5 diabetics who argue that they need a high fat diet. That may be, but the same caveaut applies. It is a risky diet to do long term and is not ideal for the general population. However, this page is talking about type 2 diabetes. I see no evidence that a high fat diet is optimal/healthy long term for people with type 2 diabetes.
          .
          My third thought is to address the gist of your question which I see as: What would convince me that a true low carb, high fat diet was actually good for at least a portion of the general population? The answer is: a body of scientific evidence supporting such a diet. For starters, it would be necessary to see such a diet reverse (open up arteries) heart disease in published peer reviewed literature. There is no such study at this time. (There are studies, however, of low fat whole plant food based diets doing exactly that.)

          It would also be good to see such a diet working within a population long term and resulting in lower mortality and lower risk for diseases such as cancer and autoimmune disease etc. To my knowledge, there is no such *body* of evidence at this time. Low carb, high fat diets increase mortality as shown in the post I linked to above.
          .
          That’s my best answer. But it’s not about me. I would refer you to the article/blog post on this page for an answer from an expert. I would also refer you to Dr. Barnard’s book on preventing and reversing diabetes for the latest and best science regarding healthy reversal and management of type 2 diabetes.




          0
          1. Response 1 – doesn’t apply, because we’re talking high-fiber, high-vegetable. In fact, it is possible (if you count net carbs and thus exclude fiber).

            Response 2 – I’m not talking about oddities, I’m looking at a significant subgroup of T2Ds that fares better on a ketogenic diet than on low-fat. Are you unwilling to concede such a group exists? If not, what metrics would you need to see in order to assert that everyone in this subgroup who has personally attested to improvements is in fact misguided?

            Response 3 – Dr. B’s approach may be right for some, but the universe of T2Ds is not all unicorns or leprechauns. It’s wildly diverse, and there’s no reason to think one size fits all.

            Plus, there’s plenty of contrary recent, good science that points the other way. The studies may be hard to reconcile, but we’re barely in the foothills of understanding metabolic disorders and personalized medicine, and it’s best not to put all your eggs in one theoretical basket.




            0
              1. Darchite says, quoting Dr. Davis,

                “When it comes to diet for insulin resistance there are 2 diets that seem to work. All fat or really low fat. This may sound contradictory, but think about it. If you are eating nothing but fat your odd will run out of glycogen and turn to utilizing fat for fuel. Without eating any carbs, minimal insulin will be secreted. You may still be insulin resistant but if you are not eating carbs, and mainly eating fat, you won’t exhibit high insulin and high sugar.

                As you know, this is not my preferred method of treatment because I find it limits many nutrient dense foods (fruits), may have negative effect as far as cancer, cardiac disease, and inflammation.”

                I must be missing something….




                0
                1. Ralf: You might focus on these parts: “You may still be insulin resistant…” and “…it limits many nutrient dense foods (fruits), may have negative effect as far as cancer, cardiac disease, and inflammation.” To summarize: you are treating the symptom (high insulin and high sugar), but you are not treating the cause when you eat a high fat, low carb diet. Things may seem OK for a while because you *are* treating the symptom. However, there are known, serious long term health risks associated with such approach –for example, cancer, etc.
                  .
                  You can learn more about all of these topics here on this site. If you notice the end of the blog post on this page, Dr. Greger provided one link to get you started: “The most concerning downside of low-carb diets, though, is heart health: Low Carb Diets and Coronary Blood Flow” http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/




                  0
                  1. Insulin resistance is pretty much my main focus, and I eat a plant-based diet low on the insulin index and high in nutrient density, and generally low-carb. It has worked for me as far as I can discern.

                    I haven’t had a thorough, comparative insulin assay at beginning and end points, but the decrease in my CRP, blood glucose, and triglycerides would seem to point to enhanced insulin sensitivity (decreased insulin resistance), if my endo isn’t mistaken (not ruling that out). There are correlations between high BG and Alzeimer’s and some types of cancer, both of which are present in my family, so I consider this a plus. And lower CRP suggests lower inflammation, though there could be confounding factors with regard to individual test points.

                    I haven’t had a follow-up coronary calcium scan since I switched from plant-based LF to plant-based LC. My scan showed minor – but present – calcium in one artery after years of LF. I’m not anxious to take on the radiation blast a second time, and experts disagree about the significance of the test and what to do about it.

                    At some point, if you have a serious, chronic disease, and a lifestyle seems to be working to ameliorate that condition and you feel good, you need to have something more concrete than “it may be harmful” to go in a different direction. That’s a true statement, of course, and I don’t have a crystal ball, but why should I think that’s true in my personal circumstances, given my history and apparent progress?

                    Therein lies the rub.




                    0
                    1. Ralf: I’m not trying to get you to do anything. If I recall correctly, you started this by asking me a question…

                      One of the reasons I took the time to answer you, explaining the science and risks of the choices you made, is so that others who read this discussion and are facing this problem will be able to make educated choices. The “it may be harmful” is backed by some pretty massive and compelling evidence, sort of like the evidence backing “smoking may cause lung cancer”. You say you are content to take that risk rather than find a safer way. OK then. I respect that and wish you luck.




                      0
                    2. I’m still not able to make out what the risk is. The lines you quoted don’t really establish it. I’m looking for solid reasons to change what I’m doing, precisely because I have no reason to think I have it down.




                      0
                    3. Ralf: I took a little time before replying to you, because I wanted to think about the entire situation, your experience as well as what I know about the data.
                      .
                      I’ll start with saying something that I say often but can’t remember if I’ve said it to you or not. I’m not a medical expert nor an expert in the data. I’ve done a fair amount of research and consider myself pretty good at filtering good data from bad. That said, it’s entirely possible that you have some kind of special condition or situation where the diet you are eating now is just right for you. Not being an expert, I wouldn’t know.
                      .
                      What I can do is share with you what some of the evidence is regarding the risks you are taking with your diet. These are probabilities, like I mentioned in the previous post. ex: Smoking raises the risk that you will get cancer. It doesn’t mean that you will get cancer. We have all heard stories about so and so who smoked a pack a day for decades and lived to be a healthy 100. You could be the person who wins that type of lottery too.
                      .
                      Sadly, in the context of this conversation, I don’t think there is a “smoking gun” or set of smoking gun studies that would adequately answer your question. Just like there isn’t a single or handful of studies linking smoking to cancer that would convince anyone. It is about the thousands of studies linking smoking to cancer that is convincing. The same is true for trying to explain all the ways in which we have a pretty good idea that eating your diet is not optimal for long term health.
                      .
                      Of course, it is not fair to stop there. I just want explain why I am about to give you a bunch of references for further study as the answer to your question.
                      .
                      For starters, I would suggest you mull on the answer you just got today from Tom Goff. I’m talking about the post that includes studies showing how low carb diets are linked to increased mortality (dying sooner). That post is here: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3009975633 You might also want to check out Dr. Greger’s book Carbophobia. It is available free somewhere. I can find a link for that if you can’t find it yourself.
                      .
                      Also, I saw a previous post of yours where you describe your diet. It sounds to me to be a diet frightfully high in animal protein. You can learn more about the risks of animal protein from the NutritionFacts topic page: http://nutritionfacts.org/topics/animal-protein/ The fish you are eating (several times a week – yikes!) comes with risks: http://nutritionfacts.org/topics/fish As does the dairy: http://nutritionfacts.org/topics/dairy/ And all that saturated fat is a big concern: http://nutritionfacts.org/topics/saturated-fat/
                      .
                      There is no smoking gun, but there are a bazillion and one (valid) studies showing that a pattern of eating that is high in fat and includes a significant amount of animal products comes with risk for various diseases. For a great all around summary talk highlighting some of the evidence, you might check out Dr. Greger’s recent summary talk How Not To Die: http://nutritionfacts.org/video/how-not-to-die
                      .
                      Your diet does not sound like like the worst diet out there. But given the evidence, I don’t think your diet is long term health promoting either. Good luck. I hope this post helps answer your question.




                      0
                    4. Thanks so much. I’m fresh off an hour with Dr. G. He’s quite a force!

                      Thanks for taking the time to compile the reading list. It will take a month of bedtimes to get through it, but it will be a pleasure, if not a challenge.




                      0
                    5. I am curious about what you actually eat. It sounds to me like you are eating a variant of Dr. Fuhrman’s Nutritarian diet – very high in nonstarchy veggies, very low in starchy veggies, very high in nuts / seeds and avocado. I know he now recommends fat cals be in the range of 15-30%, and that eating lots of nuts and seeds is fine as long as one is not overweight. What is your rough ratio of fat, carb, protein?




                      0
                    6. Hi, David. It’s not that exciting, but here you go.

                      I aim for 30-40g net carbs, 80-110g protein, and the balance in fat.*
                      I eat as you suggest (avocado, pumpkin, chia, and flax seeds, almonds, pecans, macadamias, olives, and some coconut (both the food and the oil, when available). I also have small amounts of cream for coffee, some live probiotic, full-fat yogurt, and aged, or otherwise low-GI cheese, plus small amounts of wild caught salmon, sardines, or tuna several times a week. (NB: I may eat low carb, but I don’t touch burgers or bacon.)

                      _________
                      * “The balance” in fat because I also watch approximate total calories, which vary depending on how active I am on a given day. At present, I’m still in slow weight-loss mode, aiming for about 2-3 lbs/month, so my fat targets are around 100-130g. If I fall below that, even substantially, it’s no big deal, but I do try to keep a close eye on net carbs and protein.




                      0
                  2. Lowering your insulin reverses insulin resistance.

                    Also, I don’t see how you can view Insulin resistance as a symptom. If that were so, then according to you, what is the cause?




                    0
  10. This article seems to be lacking any proper scientific references. It looks like it is just the doctor’s opinion I am afraid. I am sorry but after trusting people and going on a low fat diet for 40 years I got T2DM. Now you need to show me the evidence.




    0
    1. Brenda Johnson: The references are linked to by the words that are green in the article above. For those green links which reference videos on this site, the videos contain “Sources Cited” button which will display links to the actual studies below the video. Have fun.




      0
        1. broccoli: I’m not seeing any evidence of cherry picking. Anyway, there are references to scientific articles. That was the question that I answered. Please review Brenda’s original post.




          0
          1. I’m tired of broccoli’s reference to dates. Maybe she won’t believe men walked on the moon in the 50’s because THAT was from the FIFTIES. Or maybe she can’t accept gravity? Or that the earth is round–since these were discovered so long ago? Give me a break! A good study is worth its weight in gold–no matter what year it was done.




            0
          2. Re broccoli’s reference to dates: Maybe broccoli won’t believe men walked on the moon in the 50’s because THAT was from the FIFTIES. Or maybe she can’t accept gravity? Or that the earth is round–since these were discovered so long ago? A good study is worth its weight in gold–no matter what year it was done.




            0
            1. Johanna: I couldn’t agree with you more. There are times when we learn something new and it explains how old studies are invalid. An example of that is old studies which compared say butter to traditional margarines, which have a lot of trans fat. If the margarine came out looking worse in some study, it turns out that it didn’t mean that butter was healthy or vegetable oils (in their natural state) were less healthy than butter–no matter how the authors interpreted the data. It just meant that we didn’t understand how bad trans fats from magarines (and meats) really are.
              .
              On the flip side, there’s only so many decades we need to test an idea before doing so any more is counter productive. For example, we don’t need thousands more studies to show us that smoking is bad for us. Those “old” studies on smoking are perfectly good and tell us what we need to know.
              .
              The trick is being able to distinguish between the two types of situations. Sadly, lay people have a very difficult time making those distinctions when it comes to nutrition. And I can see why. It’s confusing and difficult to filter information properly when there is a host of “experts” who are not being honest about the data or are confused themselves.
              .
              That’s my 2 cents anyway. Thanks for bringing up this important point.




              0
        2. Just received today from PCRM–RECENT STUDY! Quote:
          “Recommendations to Avoid Saturated Fat Confirmed

          Dietary saturated fat is linked to developing heart disease, according to a new study published in The BMJ. Researchers followed 115,782 participants from the Health Professionals Follow-up Study and the Nurses’ Health Study who were free of heart disease at the beginning of the analysis. After adjusting for multiple factors, including weight, exercise, and family history, people who consumed the most saturated fat had an 18 percent increased risk for developing heart disease, compared with those who consumed the least, after approximately 21-26 years of follow-up. Replacing saturated fat in the diet with healthier foods, including whole-grain carbohydrates, was associated with a reduced risk for heart disease. The authors conclude that current recommendations to avoid saturated fats are necessary to prevent heart disease.

          Zong G, Li Y, Wanders AJ, et al. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ. 2016;355:i5796.”




          0
      1. The first article is from 1999.
        The second article compares insulin insensitivity between African American and Caucasian.
        The third article is from 1999.
        The fourth link does not exist.
        The fifth article is from 1999.

        I give up after the 5th one.




        0
        1. Broccoli can you link your current research articles that you are referring to that demonstrates that a high fat diet is helpful. I hate to be the nasty person here but I would venture to guess that most of the people up in arms today are overweight or obese. And don’t exercise.




          0
            1. Hi Luke
              First article is interesting. About a 50% drop out rate. That speaks to the very complete topic of diet with over weight and obese people. Such a complicated issue. But that being said to really dig into them I need a fresh brain.

              One of my previous classes required going through and critiquing many research article weekly. Hours to do one right. Not tonight!




              0
          1. The first link has issues. Only 9 volunteers, eight males one female? Can’t make any statistically significant predictions with such a small sample size.

            Second one isn’t relevant.

            Third is again, a small sample group of 7 males not to mention paywalled. Refer to first sentence for explanation.

            Fourth is non-existent.

            Fifth link again has a small sample size but nonetheless was interesting. Lots of info out there points to high carb (mainly bad carbs, sugars etc…) coupled with fat (think donuts) will raise Triglycerides. When you eat LCHF they naturally come back down again. High trigs are a great indicator of metabolic syndrome. Far better than LDL-C or total cholesterol ever was.

            The sixth link doesn’t suggest that high fat is bad. It suggest that in normal (non insulin resistant) people the system works well. In T2D people the increase in carbs, the increase in insulin, and resistant cells means that more fat is produced and because it can’t get into the cells it is deposited anywhere it can be (eyes, legs etc…).

            I can’t see how any of these studies point to a culprit or not.




            0
      2. Thanks VegGuy, Very helpful. I clicked on “lipotoxicity:how saturated fat raises blood sugar” highlighted in green in the article for example and see many studies listed , mostly recent. Its really interesting what plant base diet can do, both from a preventative as well as a therapeutic point of view. Im going to have to read Dr Barnard’s book




        0
        1. susan: Dr. Barnard’s book is awesome. And his diet is clinically proven to be 3 times more effective at dealing with diabetes than the ADA diet. That’s some pretty powerful data. Hope you enjoy the book as much as I did.




          0
      3. The last article talks about mitochondrial dysfunction which is a completely different subject. Mitochondrial dysfunction is the cause of many diseases such as cancer, Alzheimer’s, heart disease, diabetes, etc, but fat has nothing to do with diabetes. Otherwise it’s like saying that eating is bad because it can cause indigestion (which is caused by a different reason and not necessarily what you eat).

        Insulin resistance condition is associated to the development of several
        syndromes, such as obesity, type 2 diabetes mellitus and metabolic
        syndrome. Although the factors linking insulin resistance to these
        syndromes are not precisely defined yet, evidence suggests that the
        elevated plasma free fatty acid (FFA) level plays an important role in
        the development of skeletal muscle insulin resistance. Accordantly, in
        vivo and in vitro exposure of skeletal muscle and myocytes to
        physiological concentrations of saturated fatty acids is associated with
        insulin resistance condition. Several mechanisms have been postulated
        to account for fatty acids-induced muscle insulin resistance, including
        Randle cycle, oxidative stress, inflammation and mitochondrial
        dysfunction. Here we reviewed experimental evidence supporting the
        involvement of each of these propositions in the development of skeletal
        muscle insulin resistance induced by saturated fatty acids and propose
        an integrative model placing mitochondrial dysfunction as an important
        and common factor to the other mechanisms.




        0
        1. Broccoli look at your post. In a discussion section one will find some background information. What you posted agrees with today’s blog. It then goes on to say but wait-could fatty acid induced muscle insulin resistance also be do to mitochondrial dysfunction as well as the other things listed.

          Are you referring to vegGuy’s link with your second sentence?




          0
          1. If you have mitochondrial dysfunction then fat can induce insulin resistance. But it’s not the same as saying that fat is bad.

            Similarly eating kale when you have digestive problem can cause diarrhea.




            0
            1. They were conducting research to see if mitochondria dysfunction could possibly contribute to insulin resistance. And they go on to say, “evidence suggests that the elevated plasma free fatty acid (FFA) level plays an important role in the development of skeletal muscle insulin resistance.”




              0
              1. You are learning from Dr Greger to cherry pick one sentence out of one article. Please read the whole thing.

                “Several mechanisms have been postulated
                to account for fatty acids-induced muscle insulin resistance, including
                Randle cycle, oxidative stress, inflammation and mitochondrial
                dysfunction.”

                One trivial example I gave is that it you develop diarrhea while eating kale because you have a digestive issue then it does not mean that kale is bad for you.




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    2. What most people consider low-fat isn’t. 90% of Westerners consume diets with more than 26% of energy from fat. Societies with low diabetes incidence, like rural China, post-war Japan, and traditional societies in Africa, Mexico, and New Guinea, consume far less fat, in the range of 6-14% of calories.

      High saturated fat diets have been used to induce insulin resistance or metabolic syndrome in thousands of animal studies. Numerous human studies demonstrate saturated and trans fats have similar effects in humans (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14). A number of prospective studies link high intakes of saturated fats and low intakes of starch and fiber with diabetes risk (15, 16, 17, 18). Clinical trials with true low-fat, starch based diets have proven consistently effective at improving carbohydrate tolerance, in many cases reducing or eliminating drug requirements (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 12, 30, 31, 32).

      Dietary fat isn’t solely responsible, as added-sugars also appear to contribute, as does the free fatty acid “spillover effect” from obesity. Most of the effects of dietary fat are markedly attenuated when BMI is controlled for.




      0
      1. I’m wondering though how many of these studies compared isocaloric diets. It seems to me that’s the only way to make the argument that fat or at least sat fat per se increases risk for diabetes. Your last para seems consistent with the view that it is fat in the body (specifically in the liver, pancreas and muscle cells that causes type 2 diabetes) and so one might suspect that the key element in reversal is losing sufficient weight to get rid of the fat in those areas, and that the dietary components are not very important.




        0
        1. Yes and no. Any weight loss helps. But current science holds that its dietary saturated fat and fructose that cause intestinal dysbioses culminating in non-alcoholic fatty liver (a key element of metabolic syndrome), so its not true that all calories are equal.




          0
            1. Our cell membranes are phospholipid bilayers, with a wide variety of structural, transport, and receptor proteins floating about in them. The membrane isn’t randomly ordered. Its spacially divided into domains high in cholesterol and phospholipids with saturated fatty acid side chains, which exclude unsaturated phospholipids. These lipid rafts are more ordered and less fluid than the surrounding membrane, and protein complexes of receptors into active multimers and their associated signal tranducers concentrate in rafts and their associations upon activation are more stable. In other words, a more saturated membrane means larger rafts, greater co-location of receptor proteins and transducers, and stronger signalling responses to stimuli.

              https://www.researchgate.net/profile/Robert_Romanelli/publication/5603005/figure/fig4/AS:281827274182669@1444204266123/Figure-5-Lipid-rafts-promote-the-formation-of-receptor-signaling-complexes-Saturated.png

              Several cell culture studies indicate that saturated fatty acids increase lipid rafting, dimerization of pathogen recognition receptors like TLR4, together into complexes with their associated signal transduction proteins, and both amplify responses to highly inflammatory bacterial component endotoxin, as well induce inflammatory activation when endotoxin is absent (1, 2, 3). Some studies dispute that saturated fats can induce inflammation in the absence of endotoxin (4, 5). My hunch is that the major effect of SFAs on inflammation is to increase intestinal permeability to endotoxins from the gut, and to amplify inflammatory responses through lipid rafting, with only a small effect on innate immune cell activation in the absence of endotoxin.




              1
        2. David, I think the mechanisms of free fatty acid induced skeletal muscle insulin resistance (type 2 diabetes) are extremely fascinating. I recommend this article which reviews the how’s and why’s.
          https://www.ncbi.nlm.nih.gov/pubmed/24373240

          The link i provided gives only the abstract, I think it is critical to see the full article. Visit sci-hub.bz (open access) and enter the DOI to view the full article: 10.1016/B978-0-12-800101-1.00008-9




          0
  11. This article is completely misleading. Fat does not cause diabetes but it is obesity that is associated with but it is 2 different things. Eating fat does not make one obese. In fact, there is a diet called ketogenic diet which people eat a high fat, moderate protein, low carb, low sugar diet and they claim it fixes diabetes among cancer and other things. I am not into this diet myself but I read a lot about it. Anyway, there is no scientific evidence linking fat and diabetes type 2. Yes there is a link between obesity and diabetes but that is a completely different thing.

    http://www.medicinenet.com/script/main/art.asp?articlekey=39840

    https://www.ncbi.nlm.nih.gov/pubmed/22327367




    0
    1. But broccoli how can you say it is misleading and no science links dietary fat with diabetes 2 when the first paragraph cites this work:

      Studies dating back nearly a century noted a striking finding: If you take young, healthy people and split them up into two groups—half on a fat-rich diet and half on a carbohydrate-rich diet—we find that within just two days, glucose intolerance skyrockets in the fat group. The group that had been shoveling fat in ended up with twice the blood sugar. As the amount of fat in the diet goes up, so does one’s blood sugar.




      0
      1. That does not alter that fact that for some T2Ds (not all), a LCHF diet is simply more effective at controlling all the indicia of trouble that an endocrinologist might find of concern.

        I don’t see how anyone can argue with someone’s personal attestation that LCHF has worked for them as individuals. ??




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    2. The real problem is the combination of fat and carbs. High carb – low fat diets and ketogenic diets work in different ways for people who has type 2 diabetes. In the ketogenic diet, despite fat prevents insulin from working properly, you are not getting almost any glucose into your body. In the high carb – low fat diet, you get a lot of glucose, but your insulin is working at 100% and can manage it. In my opinion high carb is the better option of the two. It allows your body to work how it is supposed to and you avoid all the other health risks associated to animal products consumption.




      0
      1. I do eat a high carb diet because a lot of nutritious foods happen to have high carb. But high fat low carb diet may work for some people. In particular, accusing fat of causing diabetes is incorrect. It ts obesity and not fat which causes diabetes, 2 different things.




        0
        1. I agree. Fat decreases your insulin sensitivity and can contribute to it but it isn’t the main cause. Sendentary lifestyle and high body mass index are greater risk factors.




          0
          1. From my reading I conclude that the underlying cause of type 2 diabetes is fat in the liver, possibly pancreas and in the muscle cells that disrupts the insulin system. Any diet that results in sufficient weight loss to remove enough fat from those areas restoring insulin sensitivity can reverse the disease. How much weight loss is required is variable (perhaps depending on the amount of beta cells in one’s pancreas, as that is also variable). Lifestyle is only relevant if it contributes to being overweight to an extent that one becomes diabetic. High BMI is a risk factor because for most people it means you’ve accumulated too much fat in the muscles, liver and pancreas to remain insulin sensitive. Calorie restriction works because it gets rid of the fat from those areas. Cf. the Newcastle diet.




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        2. Just a quick physiological question for me to understand. When we eat hi carb pancreas is working to the fullest. When we have hi fat low web gallbladder/liver works. Is that right ? If so, is it a good idea to put some burden on gallbladder so it works and it needs fat to work? Any thoughts?




          0
        3. There are plenty of people that are not obese that have developed II Diabetes. Tom Hanks, the actor, is one. I have two friends, both within normal BMI ranges who are II Diabetic. Obesity is certainly not THE primary or only cause of Type II diabetes.




          0
  12. “Blood sugar, though, is like a vampire. It needs an invitation to come into our cells.” How is blood sugar like a vampire? Count Dracula needed no invitation to bite his victim on the neck. Is it that blood sugar sucks the life out of us?




    0
    1. June: I think the reference is talking about one of a vampire’s feature (in some books) where a vampire has to be invited into your home in order to be able to enter the home.




      0
  13. I’ve tested my glucose levels regularly every year for 10 years and or 10 years: rate protien, high fat, low carb, sibo, extreme gut problem with sibo




    0
  14. Hi everyone,
    I’ve tested my fasting glucose regularly over ten years and it’s always been the same ‘normal’ level despite high fat, low fat, high carb, low carb, extreme gut dysfunction, sibo, extreme adrenal dysfunction, chronic infection and I’m not young. I think this study reflects the bodies ability to manage blood sugar and not the cause of diabetes.




    0
    1. But did you have your fasting insulin tested during all of these changes? Yes our bodies work very hard to keep blood sugar stable whatever is going on. However, some situations will require less insulin, which is ideal,




      0
      1. Hello VegGuy, cute name. Good question. Fasting Insulin was ‘normal’ whilst on [low fat, high carb whole grain and veg, high veg] and was extremely low on [high fat, low real food carb, high low carb veg]. I guess this topic was not really mentioned as part of thr study.

        I think the study reflects only the changes the body makes to compensate for dietary changes alone. That is it. I think drawing a conclusion that fat causing diabetes, from this particular study and even related studies mentioned is quite a big leap. I think we will find in time the mechanism is more complicated.




        0
        1. I like your point. This article is only concentrating on one of the many things that can lead to type 2 diabetes and insulin resistance. As with most everything, it’s multi-factoral and complex.

          Very interesting that your insulin levels were lower on high fat/low carb than they were on low fat/high carb.




          0
  15. Please share the medical research backing this claim as all the research I can find shows exactly the opposite – at least that which is in peer reviewed medical and nutritional journals. All the research I can find shows carbohydrate intake, especially sugar and refined carbohydrates, correlate to T2 Diabetes. There is research showing fat on the liver can cause insulin production to be reduced. Fructose (which is a sugar) is shown to be a cause of fatty liver disease as it is processed in the liver and does not increase insulin production like glucose and other sugars.

    However, the claim that fat reduces insulin sensitivity is a claim I can’t find as that is a condition where the liver ends up over producing insulin and therefore would not correlate to fatty liver where insulin production decreases. Given fat does not cause an insulin response, eating fat without carbohydrates would not lead to a rise in blood glucose, so the statement that the fat would lead to excess blood glucose because it inhibits insulin secretion doesn’t make sense. If you aren’t eating carbohydrates, or are eating only a very low amount, then your BG clearly would not become elevated.

    Please help me square the circle you have stated in this article of eating high fat low carb raising blood sugar when the blood sugar comes from eating carbs.




    1
  16. “The group that had been shoveling fat in ended up with twice the blood sugar.”

    What a rude and unprofessional way to phrase that. Totally necessary. Kinda makes me think I’ll be clicking the Unsubscribe link right after this comment.




    0
    1. It might make you feel better put in context. This wasn’t personal choice as the study subjects in the high fat group were given the fatty foods to eat– a diet of olive oil, butter, egg yolks and cream.




      0
      1. Thank you, VegGuy – that does help to make the comment more acceptable to me. I believe Dr. Greger has much invaluable info. to impart, and I was rather dismayed by the comment. Thanks to you and broccoli for taking the time to address my concern.




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  17. This comment is meant for the NutritionFacts.org staff.

    In the Doctor’s Note below the video “Low Carb Diets and Coronary Blood Flow”
    http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/
    Dr Greger writes, “The reason I have so few videos about low carb diets, is that I already wrote a whole book about it! Carbophobia is now available free online full-text at AtkinsExposed.org.”

    I think it is a mistake not to create a series of videos about low carb diets. Numerous comments made at NutritionFacts.org come from low carb proponents and trying to respond individually to those true believers is a waste of time. What is not a waste is to educate people who are truly seeking good health and are in the process of gaining an understanding. So Dr G, bring on the low carb videos!




    0
    1. Goes against everything that Greger preaches here and I’m sure the data and findings would look very favourable for the Low Carb community. Also, it isn’t to say the Greger approach is wrong, just that I like many others do extremely well on Low Carb, High Fat whereas I would struggle with just plants.




      0
      1. “I’m sure the data and findings would look very favourable (sic) for the Low Carb community.”

        Ahhhh, no (as detailed in Carbophobia). When the low carb eaters show up as Blue Zone populations then you’ll have a platform to speak from.




        0
    2. There are religious true believers and scientific true believers.

      I would have to say that the view of folks who reject anything that smacks of low-carb, whether it’s poetry or solid research by professional researchers, etc., borders equally on the same unscientific, religious attitude as that of the “true believers” who insist they have found The Answer.

      I suspect with the aid of hindsight in another 20 years, the best position will have been that it was best to keep an open mind and admit the possibility that the truth is much more complex and individually nuanced than these simplistic, polar opposite “My way is the ONLY way” attitudes can tolerate.




      0
      1. I think what time will show is that it really is all about the calories. All the studies that I have read that purport to show better improvement of hard and soft markers in a population consuming a “high-fat” diet invariably are also a weight loss diet with a greatly reduced number of total calories as well. In fact if you look at the diets not as a percentage of calories actual total calories from each of the three macronutrients, those eating a “high-fat” diets are actually fewer total fat calories than they were on their baseline diets.

        So if the subjects eating a “high-fat” diet saw an improvement in their biomarkers were those changes due to them eating a higher percentage of their calories from fat or from a reduction in total calories from fat. I am thinking it is most likely the latter. And since most of these studies are weight loss studies with obese subjects they are already on the sick end of the spectrum and even a small reduction in pressure pushing them towards illness can cause an improvement in the biomarkers. This is can often be seen the fact that all diet groups see an improvement and the difference in improvement is often quite small. The worst example I am familiar with is the recent 2014 study “Effects-of-Low-Carbohydrate-and-Low-Fat-Diet” by Bazzano at Tulane University purported to show that a high fat diet was healthier than a “low-fat” diet. It failed by every measure.

        Also a reduced calorie diet is not sustainable indefinitely. If we really wanted to see the health effects of a low-carb/high-fat diet the study would exclusively use healthy subjects at or near their ideal body weight and then feed them diets with the same number of total calories as their baseline diet such that they neither gain nor lose any weight. If those who increased their total number of fat calories while reducing the total number of carbohydrate calories saw their blood pressure, blood sugar, total and LDL cholesterol, and triglyceride numbers go down DOWN and stayed down for a year, then I might put some stock in the claims of the low-carbers that saturated fat is not only not unhealthy, but actually good for your health.

        Until then short term studies with all subjects representing a sick population eating a reduced calorie diet that results in a reduction in total fat calories even while the percentage of calories increase are simply not very persuasive.




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  18. Dr Gregor, I purchased your book and I appreciate all you do when it comes to food education. However, I am pulling my hair out here.

    First off, yes I am biased here. I have been happily eating a high-fat, low carb diet for 4 years now. I lost 20 lbs and all of my bloodwork (including A1C) and biomarkers are perfect.

    The low-fat diet experiment has proven to be a dismal failure, and now more and more doctors are recommending a high-fat, low-carb approach — to treat various metabolic disease — e.g. Dr David Ludwig, Dr Jason Fung, Dr Mark Hyman, Dr Aseem Malholtra, Dr Carrie Diulus… to name a few.

    With such dissent within the medical community, how in the world do patients know who to believe and what to believe?




    2
    1. Hi Kiana
      You shouldn’t believe the doctors. You should believe the data. Do they link research to substantiate their claims? Could it be the 20 pounds you lost?




      0
      1. It is more complicated than that — we as non-scientists rely on the so-called experts to analyze and interpret the data for us, since the data can be highly complex to the untrained eye. Now, it looks like momentum is building towards the LCHF way of eating, among the experts. Dr Gregor is not on this bandwagon.

        Yes I did lose 20 lbs — weight that I had struggled and struggled to lose while eating a low-fat vegetarian diet. I was never successful until I switched my diet to LCHF. My numbers improved at the same time. I have absolutely no doubt that in my case, LCHF is good for my health.




        1
      2. Read Dr. Jason Fung’s book…The Obesity code…available on Amazon…he quotes peer reviewed research and clearly demonstrates that too much insulin causes insulin resistance…has cured type 2 for over a thousand patients and counting…people who have had diabetes for decades and on 100+ units of daily insulin and multiple meds…all done away with…off insulin, off meds…simple really…




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    2. “The low-fat diet experiment has proven to be a dismal failure”

      That is a lie repeated without merit by people like Dr Hyman. What do Blue Zone diets have in common? Low saturated fat, low animal protein, low sugar and refined carbohydrate, and high complex carbohydrate content. Is living a healthy long life a “dismal failure”?

      A low carb high fat diet will display improvements in some CV and metabolic parameters especially if you lose weight. But what is happening to your arteries over the long term?




      0
      1. Look at what has happened to the American population since the low-fat experiment picked up in popularity in the 80s. Have we become any healthier? Leaner? Less incidence of heart disease?

        My arteries are doing great thank you. 4 years in and my HDL/LDL ratio is greatly improved, my blood pressure is low, I am extremely fit and I am in all around good health…I feel amazing and I have no problems keeping the weight off anymore. I will never go back to a low-fat vegetarian diet.

        Another case study: my 70 year old mother began eating LCHF 10 years ago, and I thought she was on the wrong track… until I saw her lose 60 lbs. She is now back to her high school weight — and yes, all of her numbers look great — after 10 years on the diet! She struggled with her weight as long as I can remember — she was always very health-conscious and ate low-fat and she couldn’t figure out why she was overweight.

        Note: eating LCHF does not mean over-consuming animal products. I eat a ton of vegetables, small portions of high-quality meat, eggs, nuts, and some fruit and legumes. (no dairy)




        2
        1. Kiana: You wrote: “Look at what has happened to the American population since the low-fat experiment picked up in popularity in the 80s.” If you look at the actual data, you will see that as a population, we are not eating any less fat. As gatherer pointed out, that’s a lie perpetrated by people out to sell fad diets. We are eating more calories, so there is a way to twist the data and make it look like we are eating less fat. But we are not actually doing so.
          .
          As gatherer pointed out, the longest healthiest populations on the planet are people who eat low fat whole plant food based diets. As tom has pointed out on this page, low carb diets are associated with higher mortality (dying sooner). You can lose weight on just about any diet that results in lower calorie intake. You can also lose weight if you get cancer. Cholesterol levels are known to go down when you lose weight. This happens with people who get cancer. They tend to have their cholesterol levels go down. The point is, losing weight and seeing lower cholesterol levels is generally a good idea. But losing weight in and of itself is not necessarily an indication that what you are doing is healthy long term.




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          1. Hi Thea…trigs dropping by over 50%, HDL increasing by 40% A1C dropping from 6.5 to 5.6 in 3 months….really…this isn’t proof enough? Not just in one patient, but a thousand upward and counting?

            I am a pure vegetarian…I eat a plant based diet, I was still on the cusp of type 2. I reversed it out any meds…LCHF (Not even Keto though I aspire to it).




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      2. I think any high fat diet is a dismal failure, as Dr. Esselstyn also of the Cleveland Clinic is very adamant about NO OIL. He doesn’t promote weight loss from fat.




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    3. Well said Kiana…I am so happy to see so many patients responding to this moronic article…my life has changed eating LCHF and Keto…I kicked my previous GP on his ass…these idiots are just big pharma servants…out to make a quick buck…patients and their health be damned…




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  19. I believe that they should have been specific with type of fat. Good fats..olive oil..avocado..extra virgin coconut oil.. as opposed to bad fat…canola..corn..soybean. You get the picture. Unadulterated good fats will not cause disease (Mediterranean diet consumes abundant healthy fats) but bad fats such as the ones I mentioned early will definitely clog your arteries and cause DIS-EASE in your body. When posting these studies you must be precise in documenting what types of fat and so on. Your major organs..heart and brain..run on fat. Fat is a clean fuel. Carbs are a dirty fuel. So your body will benefit by eating healthy fat in moderation. I have 2 autoimmune diseases and have started to turn my health around along with millions of others by incorporating healthy fats in my diet. Also..women should definitely be eating healthy fat to regulate their hormones. I suffered from insomnia…and the cure was to eat more fat. Sorry..but these studies need to be more specific as to not give the wrong information to people. Any fat whether healthy or unhealthy should be eaten in moderation and fat should be eaten with vegetables so you can absorb the nutrients that is why salad has a dressing and most vegetables need olive oil or butter to absorb nutrients from that vegetable. Look it up if you don’t believe me. Just sayin’.




    0
    1. >>Your major organs..heart and brain..run on fat. Fat is a clean fuel. Carbs are a dirty fuel.
      Can you be precise about what you mean by “clean fuel”, “dirty fuel”? I cannot fathom what you mean, and it sounds like some kind of unscientific slogan. Also there’s a world of difference between complex carbs from intact whole grains, and highly processed carbs. So I do not see how it makes sense to simply say “Carbs are a dirty fuel”. I doubt you can provide any peer-reviewed studies backing up this claim.




      1
      1. When you burn fat for energy you burn ketones. Ketones when burnt for energy are more energy dense meaning you only need a small amount to get the energy you need to do whatever you need to do. Ketones produce less carbon dioxide and free radicals when compared to glucose.




        0
        1. Thanks for the clarification. I don’t see why producing CO2 would matter. What about the acetone caused by ketosis (causing so-called keto breath)? Free radicals, on the other hand, might be an issue. But since I am admittedly ignorant about this issue, I’ll look into it more.




          0
  20. Hi, this confuses me no end. I’ve been reading a lot of research about diabetes and i keep coming across conflicting information. What i’m reading increasingly is that a high fat lower carb diet is the way to beat diabetes. I’m vegan so that’s tricky. It makes sense though because prior to receiving insulin Type 1 diabetics are very thin and very hungry so are usually eating even five times the ‘normal’ number of calories. Once they start taking insulin they rapidly put on weight. So doesn’t that mean that you need insulin to store fat and not the other way around. it seems that insulin resistance in type 2s occurs because of a similar mechanism: too many carbs (and we’re talking white flour products, refined white rice and pasta, sugar etc) drive up insulin. When insulin is present the body doesn’t metabolise fat and stores it instead so if insulin is driven up too high more fat is stored and you put on weight. Soon after people have bariatric surgery they’re still carrying a huge amount of fat but their insulin drops anyway because they’re not eating much anymore.So it seems to me that you can eat a high fat diet as long as high GI carbs are kept to a minimum so you don’t drive up insulin. Or you can eat a high carb diet but you have to keep your fat intake low or you’ll store fat because of your increased insulin needs. I wish this could be sorted out once and for all. There seem to be too parties. One party advocating for no animal products therefore trying to tell us that a high carb diet is fine for diabetes (in the absence of fat for reasons outlined above) and the high fat party who are sick of low fat and want to eat more satisfying and filling food who have to lower their carbs because of their high fat intake. All this leaves the rest of us out there completely bamboozled. One thing i do know is that before insulin pumps became available diabetics were treated successfully with a high fat low carb diet and there are many cases of type 1 diabetes living well into their 80s without developing any of the serious complications often seen with diabetes




    1
    1. Debbie could you link the research you are talking about and I will read the articles and see if I can help with your confusion.

      I am a tad bit concerned about people using the word carbohydrate when discussing this topic. Of course all simple refined carbs are off the table. But don’t forget that vegetables and other high fiber foods are carbohydrates.




      0
      1. This is where the issue comes in. When people refer to a LCHF diet a lot of the time people think they are meaning a no carb, high protein diet which is not the case. Lots of healthy veggies are eaten with moderate amounts of protein and higher amounts of fat when compared to the low fat alternative diet.

        I do eat carbs, just not starchy, highly processed, sugar laden carbs. Plenty of leafy greens and other veggies that grow above ground.




        1
            1. Interesting. Any data on people who have not lost weight (weight remained the same) and got rid of diabetes? It seems most of the articles posted today include weight loss.

              I do have a couple of cousins who are obese and were able to use less medication if they walked. Unfortunately they didn’t stick with it.




              0
              1. I offer my unscientific n=1 as someone whose numbers improved on LC over the same regimen (exercise, calories) on LF.

                Alas, there are many, many variables, and I certainly wouldn’t rule out the possibility that a properly-formulated LF diet calibrated over the course of months, might be just as effective in the long run. My problem in the many years I ate plant-based LF, I was not able to hit on a formula that controlled my blood glucose, triglycerides, and CRP. However, I don’t know that, under ideal conditions, I wouldn’t have better success if I tried LF again today; I’m older, retired (less stress, less cortisol), and sleep around an hour more a day.

                Perhaps St. Peter will have some insights.




                0
    1. Broccoli! That is an article on losing belly fat “Conclusion: A modest reduction in dietary carbohydrate has beneficial effects on body composition, fat distribution, and glucose metabolism.”

      The subjects lost fat. Did that cause beneficial response to glucose metabolism?




      0
  21. Here’s my confusion…I just watched some of Dr. Mark Hyman’s “Fat Summit” where they declare fat safe and necessary, including animal fat (but they do caution against some types of fat). He is a “pegan” (paleo-vegan) and it confusing to listen & watch all of the articles and videos from Dr. Greger, and then have Dr. Hyman (and all the folks speaking at his summit) tout the benefits of fat (also using scientific data). Who do I believe?




    0
    1. Ellen: When all is said and done, Hyman is citing studies, but he is misleading people in various ways when he does it. VegCoach found the following 4 minute video about one of Mark Hyman’s claims that demonstrates my point. https://www.youtube.com/watch?v=RovJRlTbsgw&feature=youtu.be
      .
      Also, the following post from Tom Goff looks into some of the other of Hyman’s claims. http://nutritionfacts.org/2016/03/22/the-effects-of-dietary-cholesterol-on-blood-cholesterol/#comment-2584872026
      .
      I agree that it *is* terribly confusing for most people. I hope that these references give you something helpful in resolving the conflict.




      0
        1. Anyone read this article?
          http://www.science20.com/news_articles/do_saturated_fats_really_cause_heart_disease-131862

          Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, which helped fund the study, said, “This analysis of existing data suggests there isn’t enough evidence to say that a diet rich in polyunsaturated fats but low in saturated fats reduces the risk of cardiovascular disease. But large scale clinical studies are needed, as these researchers recommend, before making a conclusive judgment.




          0
      1. Kevin Hall and his associates have done this before. They twist the findings to suite their narrative. If you actually look at the study in its entirety you can quickly pick holes in it. For starters the study was only 2 weeks. Those in the know will tell you that when going from whatever diet you were previously on to one that is higher in fat it can take anywhere from 2 – 6weeks to adapt. Even longer in some people.

        The second hole I found was that the diet that was considered low carb still had 140g of carbs. Again, anyone in the know will tell you that this is not low carb. Low carb / Keto is traditionally falls around 20 – 50g of carbs. Only when you have reached your goal weight / health do you start to increase the amount of carbs. The so called low carb diet in this instance was just under 30% carbs, 20% protein and 50% fat. A traditional Keto diet is 5 – 10 carbs, 70 – 75% fat and 20 – 25% protein.

        I found those in minutes. So many issues with the way Kevin Hall conducts himself.




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      2. I watched the video and see where you are coming from regarding the one article and the discrepencies in it. However, if you saw the line-up of his Fat Summit (and watched any or all of the talks), you would recognize plenty of the names – well known doctors (Tom O’Bryan, David Perlmutter, etc.) and other knowledgeable people in the field who also promote eating more fat. My particular question concerns more of the controversy over cooking with oils (olive, coconut, safflower, etc – supposedly the more “healthy” fats and oils) which are discouraged by most vegans including Dr. Greger but seem to be embraced by Hyman and his supporters. And I am not talking calories here, I’m just curious from an overall health perspective if the cooking oils themselves are helpful, harmful or neutral. That’s where the confusion lies for me. I’m curious in what Dr. Greger’s thoughts are about Dr. Hyman in general. The Cleveland Clinic (where Hyman works) is a very well respected hospital.




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        1. Ellen: I’ve never seen Dr. Greger say what he thinks about someone like Dr. Hyman in a personal sense. But you can see what Dr. Greger thinks about the information that Dr. Hyman spreads by looking at the information on this website and in Dr. Greger’s book How Not To Die.

          For example, here is information about olive oil: http://nutritionfacts.org/?fwp_search=olive+oil&fwp_content_type=video If you follow those videos, you will see that the health damage from oils goes far beyond just calories.

          ——–
          I understand your point about the video mostly covering one mistake (though a huge one…). But did you notice in the clip that Dr. Hyman promoted bacon? That’s a probable carcinogen. Also, did you see Tom Goff’s post that I linked to? Dr. Hyman’s claims are easily refuted and what he promotes is flat out dangerous. I can understand why you think where Dr. Hyman works is relevant, but it is not. NutritionFacts has several videos covering how little doctors are taught about nutrition. Hospitals are not equipped to evaluate nutrition statements made by doctors.
          .
          I do not recognize Tom O’Brian, but I am very familiar with David Perlmutter. Anyone following David Perlmutter might want to educate themselves with the information on the following page first: http://nymag.com/scienceofus/2015/06/problem-with-the-grain-brain-doctor.html This article from Dr. McDougall might also be helpful: https://www.drmcdougall.com/misc/2014nl/jan/smoke.htm
          ———-

          I so sympathize with your confusion and frustration. It is really hard to figure this stuff out when all sides seem equally credible and you don’t have a way to filter out good from bad information. I don’t know if this will help any, but one bit that I find helpful is that Dr. Greger does not take a penny from this website, his books, his DVDs or his speaking engagements. He donates it all to charity (which is currently just this website). Dr. Greger has no financial conflict of interest when it comes to educating the public.




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        2. The Fat Summit had a lot of interesting content.

          I particularly liked Prof. Ronald Krauss, a leading lipid researcher, was interviewed by Mark Hyman for the Fat Summit. It was fascinating, to say the least.

          Hyman tried to pin him down on general principles a few times, but Prof. Krauss avoided taking firm positions on broad propositions, explaining that it may turn out to be that ratios of individual fats, such as satfat A to satfat B, or satfat C to polyunsaturates, etc., will prove to be important for certain population subgroups. In practical terms, some olive oil may be better than a lot or none (especially if it’s replaced with bacon, bread, or beer).

          Krauss also discussed problems inherent in many studies – that compared populations have a dissimilarity that is more significant than originally thought; the same is true for foods that replaced the nutrient under investigation.

          Things are rarely as simple as they seem!




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          1. You might also want to check out Dr Krauss before automatically accepting his views on these matters. One of the criticisms made of his position relates to the substantial funding he has received over the years from the dairy (and meat) industry. Dairy is apparently the major source of saturated fat in the US diet. Dr McDougall is one his most trenchant critics eg

            https://www.drmcdougall.com/misc/2014nl/mar/krauss2.htm




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            1. I was more interested in his reluctance to say saturated fat was ok, actually. I wasn’t aware of his funding connection, though, which is certainly interesting……

              McDougall also seems to have biases, such as refusing to give any credence to individual accounts of success with low-carb diets (which need not incorporate animal products).




              1
              1. Well, I think it is important to fact check everything that anyone says – even Dr G. Following gurus instead of researching the subject may be a convenient short cut nit it has risks.

                On the other hand, I am personally very wary of low carb diets. Some people here do follow completely vegetarian low carb diets but they tend to have a relatively rare form of diabetes.

                My concern really relates to several facts. One is that most of the studies showing benefits appear to have been done only on obese and (pre)diabetic individuals. Two is that the benefits shown in the studies can often be attributed to the effects of weight loss. A third issue is that most long term human and animal studies of low carb diets appear to show an association with increased mortality.




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                1. Actually, Steve Phinney and Jeff Volek have done numerous studies on elite athletes and found LCHF beneficial.

                  I would look at the data underlying those long-term studies and see which populations were used and what the comparisons were.

                  Dr. Bernstein, still ticking with T1D in his 80s (!), often says he have been dead years ago had he not personally figured out that LCHF was the only way to control his BG, and his kidney disease actually improved after switching.

                  Sorry for the length, but here are representative vids from Phinney and Volek:
                  https://youtu.be/USTf3pFUrvg
                  https://youtu.be/JgU8z-h3IKY




                  1
                  1. Thanks Ralf.

                    Yes, Phinney and Volek gave been active for a while. I don’t put a lot of credence in their work for two main reasons.

                    One is the poential financial conflict of interest. They have been part of the Atkins organization for quite a while which could possibly bias the design of their studies to obtain results favourable to LCHF approach.
                    http://www.atkins-hcp.com/advisory-board
                    https://www.amazon.com/New-Atkins-You-Ultimate-Shedding/dp/1439190275

                    The second is that I am not an elite athlete and in any case suspect that some ways of boosting athletic performance (possibly including the P&V approach) may actually be inimical to healthy longevity. I don’t know for sure because I have never really researched it since dietary hacks for boosting athletic performance are of no personal interest.

                    If you want to look at the associations between low carb diets and mortality, you could start here
                    http://www.bmj.com/content/344/bmj.e4026
                    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989112/
                    http://jaha.ahajournals.org/content/3/5/e001169.full
                    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/

                    I am not aware of any very long-term studies of human beings adopting the high fat, low carb diet. However, I see that a Brazilian team published a study in 2013 using a mice model for the diet which provides some clues as to the likely outcome. Its results make disturbing reading:

                    “C57BL/6J mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. One-half of the mice on the HF diet developed obesity (diet-induced obese (DIO) mice), whereas the remaining mice were diet resistant (DR). At 8 months of age, both DIO and DR groups had increased hyperglycemic response during a glucose tolerance test, which was normalized in 16-month-old mice. At this latter time point, all groups presented similar performance in cognitive tests (Morris water maze and inhibitory avoidance). The survival curves of the HF and control diet groups started to diverge at 15 months of age and, after 27 months, the survival rate of mice in the DIO and DR groups was 40%, whereas in the control diet group it was 75%.”
                    Source:
                    High saturated fat and low carbohydrate diet decreases lifespan independent of body weight in mice
                    Longev Healthspan. 2013; 2: 10.
                    Published online Jun 3, 2013. doi: 10.1186/2046-2395-2-10
                    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922950/

                    There was another interesting mouse study published in 2014:
                    ‘The team put mice on 25 different diets, altering the proportions of protein, carbohydrates and fat. The mice were allowed to eat as much food as they wanted to more closely replicate the food choices humans make.
                    “The healthiest diets were the ones that had the lowest protein, 5 to 10 to 15 per cent protein, the highest amount of carbohydrate, so 60, 70, 75 per cent carbohydrate, and a reasonably low fat content, so less than 20 per cent,” Professor Le Couteur said.
                    “They were also the diets that had the highest energy content.
                    “We found that diluting the diets to reduce the energy intake actually made the animals die more quickly.”
                    The mice that ate a high-carbohydrate, low-protein diet lived about 50 per cent longer than those on the low-carb diet.”
                    http://www.abc.net.au/news/2014-03-05/low-carb-diet-may-shorten-your-life-study-finds/5299284
                    http://www.cell.com/cell-reports/fulltext/S2211-1247(15)00505-7
                    http://www.cell.com/cms/attachment/2032903762/2049230860/mmc2.pdf




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                    1. First, just as you’re not an elite athlete, I’m not a mouse. (In fact, I’ll bet you’re closer to what you’re not than I am to what I ain’t.)

                      I don’t particularly care about the elite athletes, either. But I do care about how both LF and LC can work for diabetics, my ultimate goal being to keep my feet and eyesight, and to avoid Alzheimer’s, CVD, and other diseases for which diabetics are at heightened risk.

                      (I spent years attempting unsuccessfully to fine tune a LF diet in order to get my blood glucose under control. I reluctantly agreed to try LCHF, which for me, at this point of my life, has worked surprisingly well, and there are a surprising number of elements that can be incorporated in both – like Greger says, “what can’t you improve with green, leafy vegetables?”)

                      Second, dismissing the work of Phinney and Volek (and Krauss) due to posited bias is reminscent of the carnivore wing of the LC folks, who write off people like Pritikin, Ornish, McDougall, Greger etc., because they’re perceived to reject anything out of hand that doesn’t align with their “vegetarian agenda.” (Greger would be viewed with skepticism, since he’s got a financial conflict arising from his employment in the animal welfare sector; McDougall’s hardly free from business interests, etc.)

                      Phinney is a heretic going back 30+ years – not in any sense an establishment guy – who left a tenured academic appointment to remain independent, and Volek is an established academic researcher. Both of them started in the LF camp but independently made their way to LC due to experiences with diabetics (not just mice or athletes). Like Bernstein, they observed that feeding carbs to the carbohydrate intolerant didn’t work very well. (I would have been a case in point.) If you listen to their talks, it is pretty hard to come away with the conclusion that they’re not sincere and calling things as they see them. In fact, they do not beat the drum loudly for meat and dairy, and they’ve got better things to do than speak at conferences in the hope of subliminally drumming up demand for animal products.

                      Bernstein is a diabetes pioneer and perhaps the most prominent ADA contrarian in the country. (Try opening an ADA publication and see who pays for the fancy full-page ads, and that’s just the tip of the conflict iceberg…..) Bernstein has consistently advocated against the ADA for setting blood glucose goals for diabetics that are far higher than for non-diabetics, and he’s treated tens of thousands of diabetes patients for many decades. He thus speaks not for one person, but for a multitude of diabetics whom he has treated successfully with individualized, carb-restricted diets and as few meds as possible (insulin for T1Ds and metformin, if needed). His significant contributions, too, have simply been dismissed without examination…..

                      It seems that the real challenge ought to be to figure out just what makes some people respond better to LC and others to LF.

                      That day might come quicker if both camps could lay down their swords and shields and look for commonalities, rather than nit-picking accounts of success on either side and hypothesizing reasons to say “yes, but….. .”




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                    2. I didn’t “dismiss” their work, I simply said that I was wary of it and did not see what relevance it had to my situation.

                      I do not think that anybody doubts that some people can get short term health benefits from LCHF diets including weight loss and improvements in biomarkers. This is certainly true when it comes to cholesterol lowering.
                      https://www.ncbi.nlm.nih.gov/pubmed/16256004

                      Also, as I have said previously, there are some people here with type 1.5 diabetes (or LADA) or perhaps some with other rare forms of diabetes, who report that they can only manage their diabetes on a LCHF diet. They are also strict vegetarians. I don’t have a problem with that. Perhaps you have an unusual form of diabetes too. You might want to check it out?
                      https://www.diabetes.co.uk/diabetes-types.html

                      Also managing diabetes symptoms in people who have T2D by controlling carbs is also mainstream and works. The counter argument of course is that this is merely symptom management and does not address the root cause of T2D.

                      However, that is not the main issue I have been talking about. My concern is that there is no evidence of a long term mortality benefit from LCHF diets, while there is some suggestive evidence that they increase mortality for most people. Therefore claiming that LCHF diets are an equally valid long term option for the MAJORITY of people is in my opinion not supported by the evidence. I think this is also the position of the NF site although I am just a visitor here and cannot speak for Dr G and NF.




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      1. I can barely keep up!

        Increased Dietary Intake of Saturated Fatty Acid Heptadecanoic Acid (C17:0) Associated with Decreasing Ferritin and Alleviated Metabolic Syndrome in Dolphins.

        Dr Hyman posted an article on Dolphins with fat waists? And used that to sell a high fat diet?




        0
            1. Geez, there are 39 research articles referenced in that article and you said that it someone opinion. Are you some kind of rocket scientist by any chance?




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              1. And so we go full circle….
                Dr. Greger’s blog above links research articles and videos he has made that are very well documented and linked to research articles. You have decided this exhaustive article is bogus. Based on your name I am assuming you eat a lot of broccoli but refuse to believe that animal fat plays a role in Type 2 diabetes. Just saying. If you had diabetes you would choose to eat fat regardless of all the information above. I would pick fruit and veggies etc., exercise and maintaining a healthy weight.




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    2. Based on what was written in this article (if true at all) you could quickly find out if fat is bad for you or not. Try it for a month, have your bloods tested and see if your blood sugars are elevated. For me, someone that has been LCHF / Keto for close to a whole year now have normal blood sugar levels. Not only that, my HDL levels are good, my Trigs are low and I have lost 16kg of weight. I know I have lost fat because I have lost 18cm around my waist.

      Also note, not all diets would be beneficial for each individual. LCHF may work for me but not for you just as what they preach here probably isn’t sustainable for me may be for you.

      Research, research and research more. You will find what works for you and who you should believe.




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      1. “Here is a scientific article from Dr Hyman. He is not the kind of doctor who throws out all these ideas about fat without scientific evidence.”
        Of course he is. He knows his market though, I will give him that.




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    3. I looked at a couple of Hyman’s YouTube videos. My impression is that he is very selective in the evidence he uses or doesn’t use. I jotted down some notes as I watched them ,,,,

      He makes a lot of false claims and cites no evidence. For example he claims or at least implies that the evidence that (saturated) fat promotes heart disease is solely epidemiological/observational. Just associations, as he puts it, and it is all down to Ancel Keys’ 7 Countries Study. It isn’t. That is a blatantly indeed ludicrously false claim.
      http://www.nel.gov/evidence.cfm?evidence_summary_id=250189

      He also claims that the warnings against added sugar in the latest US dietary guidelines are a big “turn-around” from all previous guidelines since they first began in 1980. They aren’t. Guideline 5 in 1980 was “Avoid Too Much Sugar”. Ditto 1985. In 1990, they said “Use Sugars Only in Moderation”, in 1995 “Choose a Diet Moderate in Sugars”, in 2000 “Choose beverages and foods to moderate your intake of sugars.”, in 2005 “Less refined grains, total fats (especially cholesterol, and saturated and trans fats), added sugars, and calories.” and in 2010 “Reduce the intake of calories from solid fats and added sugars”
      http://health.gov/dietaryguidelines/history.htm#5
      http://health.gov/dietaryguidelines/dga2010/dietaryguidelines2010.pdf

      And he is still claiming that that small dense cholesterol particles are dangerous but large fluffy cholesterol particles are protective. This is false and has been known to be false for years………….

      “Previous studies showing that smaller low-density lipoprotein (LDL) size is associated with greater atherosclerotic risk did not adequately control for small and large LDL particle correlation. …….. Both LDL subclasses were significantly associated with subclinical atherosclerosis, with small LDL confounding the association of large LDL with atherosclerosis.”
      http://www.atherosclerosis-journal.com/article/S0021-9150(06)00259-0/fulltext

      This subject has been extensively studied over the years. A major review in 2008 found “In summary, only LDL particle concentration, as measured by NMR, was consistently found to be associated with incident CVD after adjustment for lipids (and other risk factors). Other specific measures have been found to be associated with incidence or progression of CVD by only a minority of studies.”
      http://www.ncbi.nlm.nih.gov/books/NBK254170/

      and “Limited evidence suggested that LDL subfraction analysis is not a consistently strong predictor of CVD compared to other known risk factors”
      http://www.ncbi.nlm.nih.gov/pu

      More recently, Dr Greger has produced a good video on the topic also which refers to relevant research since 2008:
      http://nutritionfacts.org/video/does-cholesterol-size-matter/

      This video is also worth watching:
      https://www.youtube.com/watch?v=_wmidN8rYkU

      The best one can say about Hyman is that he tells a lot of half truths as well as simply making false claims. In short, don’t believe guys on YouTube videos selling fad diet books. It’s far better to look at reports on nutrition and health from genuine world class experts who have looked at all the evidence and aren’t just trying to sell some sensational diet book claiming to unveil stunning revelations about what to eat eg
      http://www.who.int/nutrition/publications/nutrient/en/
      http://www.dietandcancerreport.org/expert_report/index.php
      http://www.health.gov/dietaryguidelines/2015-scientific-report/
      http://www.nel.gov/evidence.cfm?evidence_summary_id=250189
      http://foris.fao.org/preview/25553-0ece4cb94ac52f9a25af77ca5cfba7a8c.pdf




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      1. Thanks Tom. Another top level post. I really appreciate the time you put into this one. The question of Dr. Hyman comes up often. I will be linking people to your post in the future. :-)




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          1. :-) Oh. I knew it was familiar since I had linked above to a similar post from you. But I had thought that you had updated it. :-O Sometimes the text is better than a link because people don’t want to link through. So, I still thank you for the post. :-)




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  22. To people who feel confused: I too WAS confused. Now I look at it this way. In ancient Greece people looked to wise people for the truth. If someone, say Aristotle, could present a reasoned argument that had the “ring of truth” then it was taken as fact. The practice held until the advent of Galileo and the new breed of scientists who unleashed the Scientific Method.

    Now we don’t need to take anyones wise words as facts. We have the power of science and our own critical-thinking brain. If someone tells you to eat a certain way…consider what evidence they’ve presented. Is it solid work using good protocols? Who paid for the work? Who are the stakeholders? aka “Follow the money”.

    If you are confused, dont take my word or Dr. X’s word…it is all there for you. If is important and urgent to you then you should be able to find the time to learn to evaluate for yourselves. Just because someone posts one or a hundred links …that does not constitute a logical argument. When people accuse others of taking their bad science “out of context” your BS alarm should go ring-a-dingy. If someone nit-picks minor details while ignoring the preponderance of the evidence..that is a sign someone is blowing smoke.

    Finally, whats the big deal? If you try eating one way for 3 weeks and your are happy then you’ve found your way to truth. Need I say more…don’t worry, I usually do : )

    Best wishes and good luck on your journey to clarity.




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  23. This is all fascinating stuff.

    What are the arguments? One of them appears to be, in effect, I have smoked cigarettes for 10 years and I do not have lung cancer. Therefore this “proves” cigarette smoking does not cause lung cancer.

    Fat and especially saturated fat consumption increases risk for T2D. Of course, so do other things like obesity. and physical inactivity. According to the World Health Organization
    “Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body’s ineffective use of insulin 3. Type 2 diabetes comprises the majority of people with diabetes around the world 3, and is largely the result of excess body weight and physical inactivity.”
    http://www.who.int/mediacentre/factsheets/fs312/en/

    If you go on a weight-loss high fat diet and exercise you can lose weight and manage your blood sugar symptoms so you no longer need drugs
    “Managing your weight and having a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight. This does not mean that their diabetes is cured. They still have diabetes.”
    https://medlineplus.gov/ency/article/000313.htm

    Nevertheless, fat consumption increases risk
    “The relationship between dietary fat and glucose metabolism has been recognized for at least 60 years. In experimental animals, high fat diets result in impaired glucose tolerance. This impairment is associated with decreased basal and insulin-stimulated glucose metabolism. Impaired insulin binding and/or glucose transporters has been related to changes in the fatty acid composition of the membrane induced by dietary fat modification. In humans, high-fat diets, independent of fatty acid profile, have been reported to result in decreased insulin sensitivity. Saturated fat, relative to monounsaturated and polyunsaturated fat, appears to be more deleterious with respect to fat-induced insulin insensitivity.”
    http://www.sciencedirect.com/science/article/pii/S0021915099005043

    Saturated fat is a particular risk.
    “Substitution of unsaturated fat for saturated fat not only reduces LDL cholesterol but contributes also to reduce plasma triglycerides in insulin resistant individuals.”
    http://www.clinicalnutritionjournal.com/article/S0261-5614(04)00026-3/fulltext

    “Epidemiological evidence and intervention studies clearly show that in humans saturated fat significantly worsen insulin-resistance, while monounsaturated and polyunsaturated fatty acids improve it through modifications in the composition of cell membranes which reflect at least in part dietary fat composition. A recent multicenter study (KANWU) has shown that shifting from a diet rich in saturated fatty acids to one rich in monounsaturated fat improves insulin sensitivity in healthy people while a moderate alpha-3 fatty acids supplementation does not affect insulin sensitivity.”
    http://www.ncbi.nlm.nih.gov/pubmed/15297079?

    It is because of studies like these (and many more) that the US National Evidence Library study on the role of saturated fat concluded
    “Strong evidence indicates that dietary saturated fatty acids (SFA) are positively associated with intermediate markers and end-point health outcomes for two distinct metabolic pathways: 1) increased serum total cholesterol (TC) and LDL cholesterol (LDL-C) and increased risk of cardiovascular disease (CVD) and 2) increased markers of insulin resistance and increased risk of type 2 diabetes (T2D). Conversely, decreased SFA intake improves measures of both CVD and T2D risk. The evidence shows that a five percent energy decrease in SFA, replaced by monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA), decreases risk of CVD and T2D in healthy adults and improves insulin responsiveness in insulin resistant and T2D subjects.”
    http://www.nel.gov/evidence.cfm?evidence_summary_id=250189

    The idea that carbohydrates cause diabetes is a strange one that could only be entertained in inward-looking high fat consumption countries. A moment’s reflection would remind us that in traditional high carb diet cultures, and indeed in entire civilsations that subsisted on carbs for thousands of years, type 2 diabetes is and was unknown except among the rich who ate appropriately rich foods. But it is true that some carbohydrates almost certainly do increase T2D risk. However, unless you are trying to sell fad diet books and the like, nobody would argue that because refined carbs and processed foods increase T2D risk, this must prove that saturated fat is harmless.
    “With insulin resistance being a key factor in type 2 diabetes, the same risk factors for type 2 diabetes generally apply for insulin resistance.
    Diets high in saturated fats, trans-fats, refined carbohydrates and processed foods have been closely linked with chronic inflammation disorders and insulin resistance.”
    http://www.diabetes.co.uk/insulin-resistance.html

    “Individuals with T2DM consumed a high saturated-fat diet, with a higher total-fat, MUFA, PUFA and protein content and a lower GL, carbohydrate, fibre and sugar content than ND individuals …… Dietary education needs to emphasise and regularly reinforce the importance of higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources, in energy balanced conditions, throughout the lifespan of T2DM.”
    http://www.nature.com/nutd/journal/v4/n2/full/nutd20142a.html

    If people really want to go high fat despite all the evidence showing it is risky, then the safest route is probably the high monounsaturated fat approach epitomised by the Mediterranean diet (promoted by the Great Satan Ancel Keys). However, this is not optimal
    .http://nutritionfacts.org/?fwp_search=mediterranean&fwp_content_type=video




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    1. On your last point, there’s probably something to be said for David Jenkin’s “Eco-Atkins” approach (1, 2), which uses high vegetable protein to suppress appetite and high phytosterol unsaturated fats (nuts/avocados/etc) to improve lipid markers. Anything to reduce obesity offers immediate risk reduction for metabolic disease.

      Alas, the adverse effect of high protein intake on longevity and cancer risk (3, 4, 5, 6, 7, 8) suggests even Eco-Atkins may not be ideal for the long term. Other means of suppressing appetite, like low energy density (9) and low glycemic index (10), appear closer to “optimal” for weight maintenance.




      0
      1. Yes. There is some evidence that low fat high carb diets are at least as beneficial in managing T2D disease markers as high monounsaturated fat diets. They may even be superior because they deliver greater weight loss.
        http://ajcn.nutrition.org/content/80/3/668.long

        Unfortunately, I am not aware of any head to head trials of WFPB diets v high monounsaturated fat diets for T2D management. In the study above, for example, .refined sugar provided 10% of the calories in both diets,




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    2. Tom, your analogy of smoking cigarettes and not getting cancer with eating fat and not getting heart disease is wrong. Because people who were diabetic or have high sugar who went on eating a high fat low carb diet did get off diabetes. But you don’t smoke cigarette and get better. Apple and orange. Furthermore there are an equal population in the world who eat fat and who don’t who don’t have heart diseases. So fat has no correlation to heart diseases.

      What people are confused about is that obese people have heart diseases, cancer, diabetes, etc. and they associated it with fat. First of all, eat fat does not necessarilly make one obese, and secondly eating too much calorie which fat has, will tend to make people obese and therefore sick, and that’s the problem.

      But it is not as simple that any fat will make you fat. Good fat including cholesterol does not make you fat. Transfat and processed foods make people fat. Sugar makes people fat.

      Lastly, plant foods have a lot of phytonutrients that prevent and cure diseases and so people who eat a lot of plant foods don’t usually get sick, but they tend to be lean because they eat less calorie and so again, fat is wrongly associated with diseases and it is not.




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      1. “But it is not as simple that any fat will make you fat. Good fat
        including cholesterol does not make you fat. Transfat and processed
        foods make people fat. Sugar makes people fat.”

        I meant to say:

        “But it is not as simple that any fat will make you fat. Good fat
        including saturated fat does not make you fat. Transfat and processed
        foods make people fat. Sugar makes people fat.




        0
        1. Scientist don’t share your opinions. When they want to induce obesity in animals they feed them high fat diets.
          “Such animals are fed a high-fat diet (as high as 60% fat (kcal)), which causes diet-induced obesity (DIO). According to the literature, standard Sprague-Dawley® and Long-Evans rats are the two most common outbred animal stock used for DIO studies. When conducting these studies though, one must keep in mind that there are obesity responders and obesity non-responders. Just like humans, some animals can consume a high-calorie diet and remain lean whereas some put on weight easily due to genetic predispositions.”
          eureka.criver.com/animal-models-of-obesity-a-crash-course/

          And calling saturated fat a good fat is simply wishful thinking as you know.
          “Strong evidence indicates that dietary saturated fatty acids (SFA) are positively associated with intermediate markers and end-point health outcomes for two distinct metabolic pathways: 1) increased serum total cholesterol (TC) and LDL cholesterol (LDL-C) and increased risk of cardiovascular disease (CVD) and 2) increased markers of insulin resistance and increased risk of type 2 diabetes (T2D). Conversely, decreased SFA intake improves measures of both CVD and T2D risk. The evidence shows that a five percent energy decrease in SFA, replaced by monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA), decreases risk of CVD and T2D in healthy adults and improves insulin responsiveness in insulin resistant and T2D subjects.”
          http://www.nel.gov/evidence.cfm?evidence_summary_id=250189




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      2. This a nice story, B, but where is the evidence of long term benefits of such diets as opposed to some improvements in eg weight and blood sugar levels? Also where is the evidence for your other claims? My impression is that scientists and researchers have convincingly demonstrated your claims to be wrong. Refer to the papers cited in my previous post for this but there are plenty of others.

        Your criticism of the analogy I used is also a bit forced. I am not sure I understand it but I dare say people with diabetes who take up smoking but concurrently lose weight and give up processed foods would also show improvements. Would this show smoking reverses dtabetes?




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          1. There has been some research done on this over the years. The WHO report on fats and fatty acids in human nutrition published in 2010 briefly summarised and discussed the evidence. More studies have been published since then of course.
            http://foris.fao.org/preview/25553-0ece4cb94ac52f9a25af77ca5cfba7a8c.pdf

            To answer your question, my position on this is that we should look at the totality of the evidence.

            However, we eat foods not macronutrients or individual fatty acids, Elaborate technical discussions about individual micronutrients, or biochemical pathways, can lead us astray if they cause us to ignore all then other factors in particular foods.




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        1. Tom, since you know everything, can you educate us in scientific terms, why saturated fat cause heart diseases?

          Chemically, saturated fats are fatty acids that have all their carbon (C) atoms fully “saturated” with hydrogen (H) atoms. So what special about it that cause arteries clogging?

          Lastly, can you comment on the following scientific findings:

          https://www.ncbi.nlm.nih.gov/pubmed/20071648?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2%20Am%20J%20Clin%20Nutr.

          RESULTS:

          During 5-23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results.

          CONCLUSIONS:

          A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

          A meta-analysis published last year, which pooled data from 21 studies and included nearly 348,000 adults, found no difference in the risks of heart disease and stroke between people with the lowest and highest intakes of saturated fat.

          In a 1992 editorial published in the Archives of Internal Medicine, Dr. William Castelli, a former director of the Framingham Heart study, stated:

          “In Framingham, Mass., the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol. The opposite of what… Keys et al would predict…We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active.”




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          1. broccoli: Even though Tom is debating with you, he gave you a respectful reply. Your reply back started with snark. Please review the posting rules for this site, which you can find by clicking the green Comment Etiquette button above the comments area. I won’t delete the post above, but continued posts in that line may be deleted. I hate deleting posts, so please keep it respectful.




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          2. Well, B, I certainly do not know everything but I am old enough to have seen most of the false claims, half-truths, half-baked speculations and other tricks used by the snake oil merchants and cranks to get people to buy their books and potions or sign up to their websites. You seem to be trying to post most of them here.

            One of the most common tactics of these people is to offer some complex technical sounding explanation for why dietary eg saturated fat or cholesterol etc should be either harmless or health promoting (when both the observational and experimental evidence shows that the actual outcomes of consuming large amounts of these thing, are harmful). For example, “Chemically, saturated fats are fatty acids that have all their carbon (C) atoms fully “saturated” with hydrogen (H) atoms. So what special about it that cause arteries clogging?” This is just a fairly obvious attempt to blind people with science and distract attention away from the actual evidence through a discussion of isolated biochemical properties and pathways.

            The real answer of course is that saturated fat raises blood cholesterol levels in most people, which is how arteries get clogged.
            http://www.nel.gov/evidence.cfm?evidence_summary_id=250189
            However there are other effects of saturated fat consumption. For example, it causes damage to the endothelium
            http://atvb.ahajournals.org/content/25/6/1274.full
            http://www.sciencedirect.com/science/article/pii/S0735109706013386
            http://www.medscape.com/viewarticle/803568
            http://www.ajconline.org/article/S0002-9149(14)01311-3/abstract
            It also adversely affects brain functioning
            http://www.sciencedaily.com/releases/2015/07/150714112424.htm
            https://www.sciencedaily.com/releases/2010/07/100713011053.htm
            It can additionally cause cell death and directly damage the heart itself
            http://www.sciencedaily.com/releases/2015/04/150427101527.htm
            Asnd promote inflammation
            http://www.sciencedaily.com/releases/2015/09/150903131408.htm

            As for the Siri Tarino analysis you, quoted, are they still trying to claim that this shows saturated fat consumption is harmless? The Siri-Tarino article has a number of major weaknesses that mean it can’t be used to argue that saturated fat consumption is harmless or even healthy. For example, it did not attempt to measure what people ate when they did not eat saturated fat. In the US and other Western countries, this is likely to be junk foods (white bread, chips/fries, margarines, Oreaos and other food high in trans fats and sugars). These are just as unhealthy as saturated fats (perhaps even worse) so it’s not surprising that this study found no evidence of harm. It’s perhaps not also surprising that one of the lead authors has been a long time recipient of multiple grants from the dairy and meat industries. Another key weakness is that it did not reference a whole range of studies which had very different findings. This was particularly egregious. There have been many studies of what happens when you replace saturated fats in the diet by less unhealthy alternatives like polyunsaturated fats. there have been at least 3 meta-analyses and systematic reviews of all these many studies. They found that when people consumed polyunsaturated fat in place of saturated fat, cardiovascular events and mortality declined.
            http://www.ncbi.nlm.nih.gov/pubmed/20351774
            http://www.ncbi.nlm.nih.gov/pubmed/19211817
            http://www.karger.com/Article/Pdf/229002
            This US NEL paper I cited eearlier also discusses these
            http://www.nel.gov/evidence.cfm?evidence_summary_id=250189
            In fact, there were so many problems with the Siri Tarino paper that the journal ialso published an accompanying editorial discussing these problems:
            http://ajcn.nutrition.org/content/91/3/497.full

            As for the Castelli quote, this exemplifies another favourite tactic – the selective quotation. They fail to mention for example that Castelli added “The opposite of what one saw in the 26 metabolic ward studies, the opposite of what the equations provided by Hegsted et al2 and Keys et al3 would predict. Only the international comparisons showed that the world could be lined up on cholesterol intake or saturated fat intake, and it would correlate with the rate of CHD.4 Of course, since these countries differed in many other ways, the possibility that some unidentified factor might explain the rate of CHD, loomed in one’s thoughts. Eventually, diet intervention trials were done, and where the follow-up got out beyond 3 years, they all show the same thing. The larger the percentage fall in cholesterol, the larger the percentage fall in CHD.5″
            and the comment ” In Framingham, for example, we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least, and were the most physically active.” means that the comparison did not control for either BMI or exercise.
            http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/616375

            And do the people who selectively quote Castelli also mention that Castelli became a vegetarian as a result of his experiences on the Framlingham project?
            http://www.nytimes.com/1994/02/08/science/scientist-at-work-william-castelli-preaching-the-gospel-of-healthy-hearts.html?pagewanted=all




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  24. I would be nice if the doctor would use full disclosure of what type of fat . polyunsaturated Fat trans Fat . Hydrogenated Vegetable fats what kind of fat are we discussing Doctor ?




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    1. “Taken together, the evidence suggests that replacing saturated fats and trans fatty acids with unsaturated (polyunsaturated and/or monounsaturated) fats has beneficial effects on insulin sensitivity and is likely to reduce risk of type 2 diabetes. Among polyunsaturated fats, linoleic acid from the n-6 series improves insulin sensitivity. On the other hand, long-chain n-3 fatty acids do not appear to improve insulin sensitivity or glucose metabolism. In dietary practice, foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products. Consumption of partially hydrogenated fats should be minimized”
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654180/

      .




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  25. What was not reported here from the 1927 paper was that subjects who starved for 2 days (instead of eating either carbohydrate, protein or fat ) also had an equally high blood glucose response during the dextrose tolerance test, to that of the fat eating group.
    Clearly, this is not explained by fat intake and presumably fasting is not a cause of diabetes. Perhaps, just not eating carbohydrate for 2 days (either by eating just fat or nothing at all) is sufficient to down-regulate the insulin response to a bolus glucose/dextrose load.




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  26. Do you think you could do a video on the ketogenic diet and it’s proposed health benefits? Maybe a comparison to a high-carb plant-based diet? It seems like people are love with keto and it would be great to hear some more information about it. It seems like a big health based to reason for people to keep animal products in their diet.




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      1. I have yet to read a pro-vegetarian book where the author does not at some point tip his or her hand to reveal an agenda to “save the planet” or eliminate world hunger by drastically reducing meat consumption. I will be looking into this, in part because of the “heads I win, tails you lose” comments about why high fat/low carbohydrate and high carbohydrate/low fat approaches both work but moderation is a disaster, but I approach any advice to cut cholesterol, fat and meat consumption and eat like a rabbit with extreme skepticism, in part because of the food pyramid and “lipids kill” frauds. You may be right about eating plants (the great ape diet argument enunciated elsewhere on this blog is very plausible), but too many flakes have been crying “Wolf!” about cholesterol and fats for too long for me to feel easy about jumping on that particular bandwagon at this late date. I thank you all for a confusing discussion.




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        1. The “Flakes” and “frauds” are the people who ignore the science to claim that dietary cholesterol and saturated fat are harmless even healthy. Try researching the science instead of just believing the clams made by snake oil merchants and writers of sensational mass market diet books.

          The idea that the vast majority of the global scientific community consists of flakes and frauds is preposterous. .




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        2. “At this late date.” It is never too late to get healthy. But with a first name of Craig I would guess you are not over 50. It is to bad that you are confused but not surprising. “If we all continue to say smoking is healthy the public will believe it.” Look how many years it took for all that to be reversed!!

          I have found that people who need some basic information do really well with Dr. Furhman’s approach. He basically says eat the most nutrient dense foods. And those just so happen to be greens veggies etc.

          I highly recommend Eat For Health for those of you who are confused.




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      1. Tom, your first video is totally unscientific and it is just a scare monger tactic. Explain to us scientifically why fat takes away oxygen from your cells? I don’t bother to look further at your next videos. They all probably sound scientific but they are just a bunch of meaningless theories.




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  27. A bit misleading…Why not make people understand that it´s the excess sugar and starch consumption that causes the build-up of intramuscular fat. Some fats will do this too, but starches and sugar do so big time; I have been studying trans-differentiation and intramuscular fats for some time now. Excess starch and sugar causes fat productions, which causes diabetes…. that´s one way of looking at it. Vegans who eat more healthy fats and reduce the load of starch and sugar has more lean muscle, less fat in the body and lower LDL cholesterol? Why don´t we make most vegans understand this???




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    1. Because it appears to be untrue as a generalisation.

      Refined carbs and processed foods generally are a risk factor for TLS. Yes. But saying starches and sugars in whole foods cause diabetes is, to my knowledge, not correct.

      Have you any evidence to support your opinions? Or did you just get these ideas from the internet?




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      1. People get carried away by the idea that when its whole and natural its fine. It´s not that easy hen you already have a sugar problem. Even hen you don´t have a sugar problem, try swooping in sugars and starches, just because they are natural and in hole foods, you easily end up with sugar problems. The biochemistry of the body gives all the evidence, I don´t know what evidence you have in mind, because there are peered reviewed articles over the place about people not being able to control their blood sugar by just eating an apple or a plate of rice.




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        1. Once people already have damaged their endocrine systems, then eating an apple or rice may cause blood sugar fluctuations.

          However, that was not your original claim. You wrote “Excess starch and sugar causes fat productions, which causes diabetes”. I would like to see some evidence that eating a lot of apples and/or boiled potatoes for example causes diabetes.

          Researchers seem to agree that ” Dietary education needs to emphasise and regularly reinforce the importance of higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources, in energy balanced conditions, throughout the lifespan of T2DM.”
          http://www.nature.com/nutd/journal/v4/n2/full/nutd20142a.html

          The dietary problem appears to be high fat diets and processed foods (including refined carbs)




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          1. I still stand by my original claim. Eating a lot of apples and/or boiled potatoes for example is a facilitator for diabetes. That is ho it all started with folks that didnot have a damaged endocrine system. (why is their endocrine system damaged, by the way??)
            You need evidence, look around you; most people following the traditional recommended style of eating is on the same path, which is sugar dysregulation and eventually diabetes (damaged endocrine system too). ” higher fibre, fruit, vegetable and wholegrain intake and the substitution of monounsaturated for saturated-fat sources”…seem to work for some diabetics, not all. I believe personalized nutrition for every individual will do a better job. People with less knowledge of nutrition will go graping any kind of fruit; just reinforcing fruits is not good enough, so is the case with vegetables, wholegrain and so on. What can one use tons of review articles that mix concoctions of lipids and sugar-containing foods for animal and human studies, and then conclude that the fats had a negative impact, for? Absolutely nothing, other than total confusion for the lay public. My grandma as doing just fine, until big heads came around and told her to skew up her fruits and grains and trash off the fats, she has ended up with diabetes and Parkinson. Each time she is worse, we cut off the grains and the fruits (and the intolerable foods) and the lady becomes lively and minimal symptoms again. But as you well know, the medical system play semi-gods, so she is kind of doomed.

            People get extremely confused when i tell them, they´ve got to ups their veges many times and restrict their carbohydrates, meanwhile. They also have to get good fats in. It´ts very doable.
            I researched milk and foods for many years and cannot tell you how many consumer-useful information went to the bin. Today, my research is consumer-based and the story is clear, don´t mess with sugar and starches in foods. The amounts exposed to the body is way out of proportion.




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            1. Brita: You haven’t provided any evidence, just an anecode. We are looking for actual scientific studies which back your claim. As “look around you” is easily disproved as Tom and others have done already with the studies that have been provided on this page–not to mention the studies Dr. Greger linked to above. That’s a whole lot of very compelling evidence.




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            2. For thousands of years, the great majority of the human race has obtained the bulk of its calories from starches. Rice in Asia, wheat, barley, oats etc in Europe and the Middle East, maize and potatoes in the Americas for example. Elsewhere, sweet potatoes, yams, millet, cassava etc were the dietary staples. If starch caused diabetes, the majority of the human race throughout recorded history would have been diabetic. It hasn’t been. It appears to have been relatively rare until modern times.




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            1. Interesting question.

              I think most people would agree that obesity is a risk factor for T2D. The World Health Organization, for example, has concluded that excess body weight and physical inactivity are the two major causes of T2D
              http://www.who.int/mediacentre/factsheets/fs312/en/

              To the extent that excess calories cause excess weight then excess calories alone would be a relevant factor in diabetes. However, while many people are subject to diet induced obesity, others appear to be “diet resistant”. On this point, something I posted earlier is relevant
              “”Such animals are fed a high-fat diet (as high as 60% fat (kcal)), which causes diet-induced obesity (DIO). According to the literature, standard Sprague-Dawley® and Long-Evans rats are the two most common outbred animal stock used for DIO studies. When conducting these studies though, one must keep in mind that there are obesity responders and obesity non-responders. Just like humans, some animals can consume a high-calorie diet and remain lean whereas some put on weight easily due to genetic predispositions.”
              eureka.criver.com/animal-model…

              “Limiting saturated fat could help people whose genetic make-up increases their chance of being obese. In a new study, researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University identified 63 gene variants related to obesity and used them to calculate a genetic risk score for obesity for more than 2,800 white, American men and women enrolled in two large studies on heart disease prevention. People with a higher genetic risk score, who also consumed more of their calories as saturated fat, were more likely to have a higher Body Mass Index (BMI), the ratio of body weight to height.

              “We already know there are certain genes that interact with dietary fat and affect BMI,” said senior author José M. Ordovás, Ph.D., director of the Nutrition and Genomics Laboratory at the USDA HNRCA and a professor at the Friedman School of Nutrition Science and Policy at Tufts University. “In the current study, we analyzed dozens of variants of those genes and other genes frequently associated with obesity risk and saw that, while total fat intake was related to higher BMI, people who were genetically predisposed to obesity and ate the most saturated fat had the highest BMIs.””
              now.tufts.edu/news-releases/saturated-fat-intake-may-influence-person-s-expression-genetic-obesity-risk

              Of course, looking beyond just diabetes, there appears to be some credible evidence that calorie restriction offers health and longevity benefits …. but that is a whole new can of beans.




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  28. There was one other group in the study. This fourth group fasted/starved for the 2 days that the other groups consumed their mainly single macronutrient diets. Surprisingly, the group who fasted had a similar pattern to those on the fat diet. The intermediate response to the protein diet likely was due to the gluconeogenic conversion of protein to glucose in the liver.
    Could it be that not being exposed to substantial (fat diet) or nil (fasting) carbohydrate for 2 days has some effect, possibly temporarily, on the insulin response during the dextrose/glucose tolerance test?
    Or should the heading to this article have been “Fat and fasting are the causes of diabetes?”




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  29. I realize the following example is nothing more than a “study of one” but it also happens to be the “one” study that I care about the most. My wife, Robyn, has had type 2 diabetes for several years and she’s also been about 40 pounds overweight. She managed to keep her A1C in the range of 7.5 to 8.5 without injecting insulin (she hates needles) by following an extremely low carb diet (in the 15-20 range per day). Her cholesterol was around 195 with the help of a statin which is acceptable by medical standards but her triglycerides were significantly elevated at 255 with medication (gemfibrozil) and her blood pressure was around 130/85 with two medications (atenolol and lisinopril).

    We both started a WFPB diet in July and have continued on it to the present. Robyn voluntarily but without doctor consent (please, no lectures), discontinued all of her medications in July with the exception of metiformin which we are hoping has benefits beyond diabetes. We are eating no animal products and using minuscule amounts of oil in our cooking. Also, absolutely no refined or processed foods which is the best way to sabotage this way of eating.

    We are eating roughly 8-10 times more carbs than before. Robyn is down nearly twenty pounds but, more importantly, her blood pressure is now down around 118/75. In two months, her cholesterol dropped to a phenomenal 147 and her triglycerides plummeted to 110. Her last A1C which was only six weeks after starting the diet was already down to 6.8 so I’m sure it’s dropped plenty more since then. There was also no change in her exercise or activity level during this period.

    From my limited experience, I can’t say that this way of eating works for everyone but it damn well worked for my wife and it worked for me as well (lost 20 pounds and cholesterol went from 225 to 176) and I thank Dr. Greger along with Dr. Fuhrman, Dr. Barnard and Dr. McDougall for their diligence in promoting this style of eating and living. When it came to the most important indicators of health, low carb failed us. As far as the whole food plant based diet goes, my wife and I are both believers.




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      1. I wish someone had a story how they reduced their nighttime trips to bathroom to pee. I’m in my 80’s, still on meds but want off. Don’t tell me saw palmetto.




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        1. I don’t have a direct solution, but when I went WFPB 3.5 years ago, I did notice an improvement in that plus, of course, just a better overall feeling of health. I’m in my 70’s (chronologically) and take no meds and have no major health issues. I now eat the “daily dozen” from Dr G’s book, “How Not To Die”, plus the recommended spices (turmeric, etc.) and the few supplements recommended by Dr G. I’ve never tried saw palmetto. My approach is to eat according to the science and let the chips fall where they may. As pointed out by T. Colin Campbell, the human body is very complex and nutrition must be approached by looking at the “whole” rather than taking a reductionist approach to the extreme. After going WFPB 3.5 years ago, I am still seeing small improvements in health. I think some aspects of the body machinery take more time than others to get in balance. BTW, NutritionFacts.org is what got me started on a WFPB diet, so I’m grateful for all Dr G’s and his staff’s hard work in producing this website.




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        2. Well, only in my mid 50s, but I noticed that my night time trips have dropped from once or twice a night to once or twice a week. It could be the diet in general, but there are a couple of videos on this site that show a connection between flax seeds and prostate health, not to mention how healthy flax seeds are for you in general. So we make sure to put a couple tablespoons in our morning smoothies or on our oatmeal. Plus we use them as egg replacement for things like pancakes or corn bread.

          Also there is evidence of good effect of turmeric on the prostate in addition to being a strong anti-inflammatory (what can’t turmeric do?). So we make up a small glass of “golden milk” in the evenings by blending about 1/4-1/2 tsp of turmeric into 3-4 ounces of vanilla flavored plant milk along with a grind or two of black pepper (I know, sounds weird, but the piperine in the black pepper helps with absorption and retention of the turmeric). I also like to include a pinch or two of cardamom, nutmeg and cinnamon. I think the combination kinda/sorta tastes like eggnog! I now make up a small jar of preblended spices to make it easier.

          Oh, and that same spice blend tastes great in oatmeal made with half water, half vanilla plant milk with some raisins and chopped dates (or date sugar). The warm spices combined with the sweet of the fruit makes a great start to the day.




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          1. I did eliminate caffeine and only use some water to swallow pills after 8. I’m think of adding a supplement from Life Extension, only problem is that I can’t eliminate the meds until I know it works or not. I tried one for about a month but wasn’t working. There’s another I will try and take it same time as the meds. I can take 3 months .




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            1. Thanks Ron. I hope you find something that works for you.

              I’d still suggest trying a 5pm cut-off instead of an 8pm cut-off for a couple of days to see if there is an effect. However, I understand that what works for me might not work for someone else.




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    1. You can count me in as a believer. What is so popular now but so wrong for your health is the popularity of healthy fat, most likely less healthy fat. I like Dr. C. Esselstyns and Dr. McDougall who both say NO OIL. I know the brain is mostly fat and you need Omega 3 but avoid whatever saturated fat clogs the arteries.




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      1. I have to share this story again because well–I love it.

        A patient of mine had a friend that “was waiting to die” from heart disease. She said she would really like to do something for him. I said waiting to die! That’s crazy! I said give him a gift to Dr. McDougall. She did and guess what! He is very much alive, has lost 100 pounds and walks 10 miles per day. He is beyond ecstatic and a true believer. He is off 22 meds too. No more diabetes and on the road to a healthy heart.




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              1. And another patient has gone from 3 daily meals that include animal to just one! And yesterday I said how about just one meal every other day? He wasn’t quite ready for that but said he was moving that way. And this is an athlete who used to quote body building magazines for the need for animal for building muscles, working out etc. (He is reading How Not To Die now)

                I am thinking one more month and he will be pretty much be off the stuff.




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                1. WFPBRunner: What a great example. I’m of the impression that there are more natural “weaners” out there than “cold turkey-ers”. For someone who has already made the transition to healthy eating, seeing someone eat animal products every day could look like any old SAD eater. But when you explain where this person started, it is clear that this person is on a path to healthy eating and just weaning himself at his own pace. Woo hoo!




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                2. Even if your patient isn’t ready to not eat some meat/cheese/egg everyday, maybe as a next step he can move those foods to the side of the plate and fill the majority of his plate with a healthy whole starch so that the large majority of even that one meal’s calories come from plant foods. Or use a small amount of something like bacon to flavor a large pot of beans. The animal foods then stay for their comfort factor and familiar flavor rather than as a significant portion of the meal.

                  Also some people hesitate to drop meat entirely because of the fear of criticism or rejection in social eating situation with friends or family, or even just the inconvenience factor of having to work harder to stay animal product free when eating out. What my wife and I do is that we have drawn a bright line around our house and no animal products cross it. So we are 100% WFPB at home and we then eat at home 90% of the time. When we eat out we do our level best to eat at places with plant based items on the menu or work with the server to try to play some menu jazz and improvise something plant based from bits and pieces of other dishes. But if the only choice is eat nothing while everyone else is eating or eating something with some animal foods in it, we eat the animal foods. Now that doesn’t mean we take that as license to order up a big steak or big ham and cheese omelette. We order something with as little animal products in it as possible and just enjoy ourselves.




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      2. The NO OIL approach is a NO BRAINER. There might be no health detriments to certain oils like olive oil but it’s still just empty calories that will do nothing to help you achieve your optimum weight.

        As for omega 3s, they are essential to a healthy diet so we are taking Dr. Greger’s approach and taking our flaxseed daily. I’m also eagerly looking forward to seeing Dr. Greger’s upcoming final video in his omega 3 series.

        I will say it was hard to give up the fish oil capsules we’ve been taking for years, primarily because of the misplaced sense of comfort it gives you when you believe that you are improving your health just by the simple act of swallowing a pill. If life were only that simple.




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        1. I’ve always taken fish oil capsules since I don’t eat fish, only a tuna sandwich every other week. I also use 2 tablespoons flaxseed in every smoothie, sometimes chia or hemp seed. No saturated fat.




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          1. @disqus_yOIkDtHSLK:disqus and @randyhenke:disqus, Dr. Greger does recommend getting some preformed EPA and DHA long-chain omega-3 fatty acids. Your body can convert the short-chain ALA found in plant foods to these long-chain version, but there is some uncertainty as to whether in today’s food environment (even when following a WFPB diet) that enough will be converted. So he suggest taking an EPA/DHA supplement.

            BUT, it doesn’t have to come from fish. Fish get most of their EPA and DHA directly or indirectly from marine algae (the one type of plant that directly makes the long-chain omega-3s). The good news is that these algae are easy to grow in controlled vats so that we can, as Dr. Greger says, avoid the middle fish, not to mention avoiding the terrible “fish burps” that come with fish oil capsules. As an added benefit it removes the need to strip mine the oceans and wiping out the very last wild fish stocks just so we can squeeze a little bit of fat out of their bodies.




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    2. First of all, congrats to you and your wife, you made it and found a diet that works for you.

      In general, I don’t buy into the idea that every diet works for everyone.

      I am looking at the ketogenic diet with a selective eye. Yes I agree with them that we need to replace glucose with fat for our energy and metabolism. And fat does not make you fat.

      But I don’t like the wholesale approach of eliminating all carbs, especially the beneficial carbs.

      It could be that you and your wife found a solution for your problems because you eat the right kind of foods that happen to have high carb, such as bean, sweet potato, ancient grain, etc. While these foods have a lot of phytonutrients by themselves, they are also beneficial for the probiotics. Could be the probiotics solve your problems.

      Just stick with whatever diet works for you and only look at other diets from an educational purpose.




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      1. Agreed. Everyone needs to weigh the evidence for themselves. Unfortunately, it is so confusing trying to sort out truth from fallacy when it comes to nutrition. These days, you can find evidence to support almost anything you want to believe. If you want to believe in unicorns, there is probably a website out there making that claim and plenty of ardent believers rallying behind it.

        It took us years to finally figure out what worked for us. We sincerely wanted to believe in the low carb approach. I’ll probably always have cravings for bacon and fried chicken. But we’ve seen the results of what a plant based diet can do so there’s no going back now.

        It’s a small sacrifice to give up a few things you enjoy to reclaim your health and discover a whole new world of food choices that taste every bit as delectable but don’t leave you feeling like you have a brick in your stomach which, in retrospect, is how eating a rich animal fat-laden meal made us feel.




        0
        1. You nailed it. Some people are unable to give up the bacon, BBQ pork, and steak. So rather than go down that road they find any bit of information supporting their beliefs. I promise you Randy you will continue to feel better and healthier everyday.

          And don’t forget to start that walking program. It’s the fountain of youth.




          0
          1. My wife and I both lift weights. She also walks several times a week and I run so we do get some exercise. An interesting aside is that I was experiencing exercise-induced PVCs last spring and actually took a stress test to be sure there were no cardiac issues (other than my mechanical heart valve that I’ve had for ten years). The cardiologist told me they were benign and to just keep exercising so I have.

            But, oddly enough, within a few weeks of starting our new diet, I realized the PVCs had completely vanished. Maybe it’s just coincidence and they would have resolved anyway but it makes me suspect that my improved health and nutritional status might be responsible.




            0
  30. I’m not quite sure why the Facebook link to the blog post stated “On a high fat, ketogenic diet, insulin doesn’t work very well. Our bodies become insulin resistant.” Fat is not the thing that drives up insulin, sugar is. High insulin levels over a long period lead to insulin resistance. Lowering the insulin levels helps to reduce insulin resistance, and the most effective ways to do that are fasting and eating foods that don’t raise insulin as much (fats, fiber). See all the work by Jason Fung, a Toronto based nephrologist, for an in-depth explanation of Type 2 diabetes and insulin resistance.

    https://intensivedietarymanagement.com/new-paradigm-insulin-resistance-t2d/




    0
      1. Fung is just another LCHF promoter with a typically sensational and provocative book to sell. You will only ever hear one side of the argument from such people.

        I suggest that you follow up some of the references in Dr G’s articles and videos and also check out the professional literature for yourself/




        0
    1. I honestly do not understand why you and the people you listen to choose to ignore the evidence and the scientific literature showing that fat drives up insulin requirements. A number of relevant studies are referenced by Dr G and it is not hard to find others eg

      “Dietary fat and free fatty acids (FFAs) are known to impair insulin sensitivity and to enhance hepatic glucose production (3,4). Furthermore, pharmacologic interventions that lower FFA levels in nondiabetic and type 2 diabetic individuals lead to both improved insulin sensitivity and glucose tolerance (5,6).
      http://care.diabetesjournals.org/content/36/4/810

      Nor do I understand why you don’t question the logic that “if X drives up insulin, then Y cannot.” This is obviously a false dichotomy. You don’t need to be a scientist or a philosopher to understand that there is more than one way to skin a cat.




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  31. Well then explain how I have lost 53 lbs and lowered my A1C from 7.2 to 5.4 in less than 90 days by eating a low carb high fat diet? Starting out having been on insulin for 6 years and 90 days later not needing insulin at all?




    0
    1. Jack Hunt: There are all sorts of ways to lose weight. But not all methods for losing weight are healthy long term. Also consider that you are treating the symptoms of your disease, not the cause (though losing weight in and of itself might be considered treating the diabetes). One problem with the route you chose is that low carb diets are associated with higher mortality (people die sooner). It’s something to consider since you have an alternative that not only treats the actual cause of t2 diabetes, but is safe long term and is good for all around health.
      .
      Moderator Darchite did a great post that explains why you got the results you did. Check out this very helpful post: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730




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      1. If you check the 1927 article mentioned above you will find that the young healthy people were not split into 2 groups as stated but into 4 groups. One of the additional groups ate largely protein for the 2 days and the other group fasted for the 2 days that is ate nothing but drank water. Most interestingly, the group that fasted had a similar response to the dextrose tolerance to the fat group.
        Does this mean that fasting is a cause of diabetes?
        Or perhaps, going without carbohydrates for 2 days is long enough to disrupt the normal insulin and glucose responses to a large dose of pure dextrose during the dextrose tolerance test.
        Either way, this disregarded part of the study casts some doubt that the abnormal response to fat makes it the genuine cause of diabetes.




        0
        1. John James Kellett: It is definitely an interesting thought that one must have continuous carbohydrates to have normal insulin action. Thank you for sharing that.
          .
          But I disagree with your conclusion about “casts doubt”. There can be multiple causes of insulin and glucose problems. Just because fasting may be a problem does not mean that fat consumption is also not a problem. And we have to eat eventually. The question we are trying to answer here is, when we eat, what causes type 2 diabetes? Also keep in mind that it is almost never about just one study. Figuring out how the body works in regards to nutrition and disease requires looking at a body of evidence. This one study you are focusing on is just one bit of evidence in the pool presented.
          .
          From what I have seen in this article and reading about Dr. Barnard’s and Brenda Davis’s research into type 2 diabetes, I agree with Dr. Greger that we know the main cause of type 2 diabetes.




          0
          1. I trust a study involving 347,000 people over 23 years more than Dr Barnard or Brenda Davis’s “research”.

            https://www.ncbi.nlm.nih.gov/pubmed/20071648?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2%20Am%20J%20Clin%20Nutr.

            OBJECTIVE:

            The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies.

            DESIGN:

            Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD.

            RESULTS:

            During 5-23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results.

            CONCLUSIONS:

            A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.




            0
            1. broccoli: Ummm, Dr. Barnard and Brenda Davis have done research into *diabetes*, not heart disease. I was clearly talking about diabetes in that post and you give me a study about heart disease…
              .
              If you want to talk about saturated fat and it’s effect on heart disease, you will have to do it with someone else. We have seen ample evidence over the last few days of the inadequacy of your sources and logic. I have no interest in conversing with someone who has firmly made up her/his mind and is not interested in learning about the body of scientific evidence regarding nutrition.




              0
              1. Real research of effect of saturated on any kind of diseases: NONE.

                http://www.bmj.com/content/351/bmj.h3978.full

                Conclusions Saturated fats are not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but the evidence is heterogeneous with methodological limitations. Trans fats are associated with all cause mortality, total CHD, and CHD mortality, probably because of higher levels of intake of industrial trans fats than ruminant trans fats. Dietary guidelines must carefully consider the health effects of recommendations for alternative macronutrients to replace trans fats and saturated fats.




                0
                1. Yes, people should read this study. It most definitely does not exonerate saturated fat as you seek to claim by using selective quotation. For example, it explicitly states
                  :
                  “Risks associated with higher or lower intakes of macronutrients are sensitive to choice of replacement nutrient(s). In a pooled analysis of 11 prospective cohort studies (not included in our quantitative syntheses to avoid duplication of data), replacement of saturated fats with polyunsaturated fat reduced coronary risk by 13%,111 consistent with results of randomized controlled trials112 113 114”
                  http://www.bmj.com/content/351/bmj.h3978.long

                  That is why this study concludes (as shown in your very own quote!)

                  “Dietary guidelines must carefully consider the health effects of recommendations for alternative macronutrients to replace trans fats and saturated fats.”

                  Clearly, you either do not understand what the study shows or you slipped up by including in your quote the article’s conclusion which directly refutes your claim.




                  0
            2. This was merely a meta analysis of epidemiological studies. The article, and a related one by the same authors, were so ….. controversial ……. that the publishing journal decided to publish an accompanying editorial which was quite scathing in its discussion of these papers
              http://ajcn.nutrition.org/content/91/3/497.full

              It may or may not be relevant that at least one of the authors of this study has/had long standing financial relationships with meat and dairy industry associations.




              0
      2. Thea, I am closing in on 65 yrs of age. Been overweight literally my entire life. I have tried it your way for years and I’m standing here healthy without the need for insulin telling you that your way does not work for many people. Being overweight is associated with mortality. Being overweight is also associated with diabetes. Finally being overweight and diabetic is associated with excessive carbohydrates n particular wheat flour and refined sugar. What you are telling me is the same as the American Diabetes Ass. , that I need to eat more of the foods that actually spike blood sugar levels so I can continue to try to survive on higher and higher insulin dosages. I bought into that line for years. I know several people who have reversed diabetes, who were once insulin dependent and are now not. I will agree with you that too severe a restriction of carbs is not healthy but what is healthy is much less than the ADA guidelines suggest, think I’ll ditch the refined wheat flour & sugar and stay off insulin.




        0
        1. Jack Hunt: If you were eating sugar and flour products, then you were not trying the diet the type 2 diabetes experts recommend. I am talking about a diet that is clinically proven to be 3 times more effective than the ADA diet. Clinically proven in published, peer reviewed scientific journals.
          .
          I think you bring up a big part of the problem around trying to communicate what a healthy diet for type 2 diabetes looks like. Lots of people think they have tried a healthy diet, but they really haven’t.
          .
          It’s great you have ditched wheat flour (even ditching all flours would be great, whether refined or not) and sugar. The issue comes in when we look at what you replaced those processed foods with. I’ll point out again that low carb diets are associated with higher mortality (dying sooner). High fat diets typically involve more saturated fat than is healthy, increasing risk for diseases such as heart disease. High fat and/or protein diets typically include animal products, which is highly linked to various diseases, including some common cancers.
          .
          There are healthy ways to lose weight and attack the actual cause of diabetes as opposed to the symptom. Of course, it is up to you. I’m just explaining that your chosen route comes with risks which are not associated with the other diet type proven to reverse type 2 diabetes.

          In case you ever decide you want to learn about the diet which is proven to be three time more effective than the ADA diet and which comes with other health benefits (as opposed to the risks you face now), check out the book: https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?ie=UTF8&qid=1479705523&sr=8-1&keywords=barnard+diabetes




          0
  32. Dear Dr. Greger,
    I eat 250 grams (a few handfuls) of Macadamia nuts a day. I am concerned that the amount of saturated fat I am getting from them may be too much. Besides the saturated fat I get from eating a lot of chickpeas regularly, Macadamia nuts are my only source of saturated fat. Is the amount of Macadamia nuts I am consuming too much or is it safe for me to continue doing that everyday? Would it also be fine if I ate chickpeas regularly as a staple food? (I often eat 500 grams of dried chickpeas in a day, which I soak and boil.) I would be very grateful if you could give me some advice.




    0
      1. Thank you for the link. After I entered the numbers into the diary, Cron-o-meter is also telling me that I am getting too much saturated fat from macadamia nuts. Other statistics displayed such as the amount of calories and manganese I am getting also look really scary.




        0
    1. Here is a link to the specifics on macadamia nuts:
      http://nutritiondata.self.com/facts/nut-and-seed-products/3123/2 As you can see, 1 Cup of macadamia nuts has 962 calories, 102 grams of fat, 16 of which is saturated fat. If you look at the amino acid (complete protein) graphic, you will see that it is not a complete protein, 11 grams incomplete. 12 grams fiber. It is, so far, the only plant food that I have seen that truly is not a complete protein. Cauliflower, broccoli, asparagus, kale, etc. all have more complete protein profiles than macadamia nuts.

      Chickpeas, 1 Cup, have 286 calories,3 gram fat, 0 saturated fat. 11grams fiber, 12 grams of 100% complete protein.
      http://nutritiondata.self.com/facts/nut-and-seed-products/3123/2

      Thought I’d post the above for those who do not want to take the time to look at difference between macadamia nuts and garbanzo beans.

      You can use this site to look up specific info on lots of different foods.
      Thank you to WFPBrunner for the cronometer link.




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  33. Everything does seem to have fallen into place. Better health, more energy, and even a more positive outlook. The depression I’ve had the last couple of years is lifting and I think that is in large part because of the psychological impact of our lifestyle change. At our age (mid-forties) you begin to realize that if you don’t start taking better care of yourself, things can fall apart quickly.

    We are now healthier than we’ve been in years and I find myself dwelling less on all of the bad things that can befall people as they grow older.

    Of course, I’m under no false illusions that we couldn’t get hit by the proverbial bus tomorrow but it’s all about the odds and I think we’re doing the best we can now to live long and active lives.




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  34. Just read this on Pritikin Center, there are only two fruits she and her colleagues at Pritikin caution against: avocados and coconuts.

    Avocados are problematic if weight loss is your goal. They’re high in fat and therefore dense with calories. Coconuts are high in heart-damaging saturated fat.




    0
  35. BREAKING MEDICAL NEWS (from PCRM)
    .
    Value of Tight Glycemic Control in Type 2 Diabetes Questioned
    .
    Tight glycemic control may not be the most effective method for diabetes management, according to a review published in Circulation: Cardiovascular Quality and Outcomes. Researchers from the Mayo Clinic reviewed meta-analyses, position papers, guidelines, and other publications on glycemic control and diabetes complications over the last decade to assess current recommendations. The majority of the literature endorsed tight glycemic control, mostly achieved through medications, as a primary method for diabetes management, despite little or no impact on health outcomes such as neuropathy, blindness, renal disease, or death from heart disease. These findings highlight the limitations with some pharmaceutical interventions for people with type 2 diabetes and call into question the recommendations for tight glycemic control.
    .
    Rodríguez-Gutiérrez M, Montori VM. Glycemic control for patients with type 2 diabetes mellitus: our evolving faith in the face of the evidence. Circ Cardiovasc Qual Outcomes. 2016;9:504-512.
    .
    ————
    I just thought this would be of interest to the people commenting on this page. I think it is fascinating.




    0
    1. I believe that sugar consumption is not necessarily the root of diabetes type 2. However it is the constant feeding of sugar when one feels tired or hungry that creates the up and down effect in the body that eventually leads to insulin resistance. That’s why I believe one needs to replace sugar with fat as source of energy.

      However, I don’t completely agree with the low carb theory. Because there are a lot of beneficial carbs one needs to eat, but there are also bad carbs one needs to avoid such as processed wheat, corn (because it has lots of sugar).

      So eat a certain amount of fat, avoid the bad carb, eat the good carb, avoid sugar, eat fat when you feel tired or hungry instead of sugar, eat a lot of plant foods, and if you do eat meat then eat the meat from grass fed, natural grown animals, and according to our ethical value, we should limit animal consumption. Doing all of these and you will be healthy.

      Don’t believe in the fat scare because it is based on bad sciences.




      0
      1. broccoli: Ummm, Dr. Barnard and Brenda Davis have done research into *diabetes*, not heart disease. I was clearly talking about diabetes in that post and you give me a study about heart disease…
        .
        If you want to talk about saturated fat and it’s effect on heart disease, you will have to do it with someone else. We have seen ample evidence over the last few days of the inadequacy of your sources and logic. I have no interest in conversing with someone who has firmly made up her/his mind and is not interested in learning about the body of scientific evidence regarding nutrition.
        .
        As for a “fat scare”, there is none. Dr. Greger is educating us on how much and which types of fat are healthy. Anyone who is familiar with Dr. Greger’s nutrition recommendations via the Daily Dozen knows that Dr. Greger is not fat-phobic. Too much of anything is bad for you. It turns out that too much fat is a huge risk factor for type 2 diabetes. I appreciate knowing that so that I can consume the amount of fat that is healthy for me. That doesn’t mean that Dr. Greger is attempting to scare anyone.




        0
        1. I was replying to your post about tight glycemic control to cure Diabetes type 2. The article questioned if glucose is the root cause of diabetes type 2 and they said that it is not and I agree. Because it is the up and down consumption of sugar that causes insulin resistance eventually and not sugar itself. Various researches have pointed out that one needs to replace sugar with fat which is harmless if not beneficial if one consumes the right kind of fats.




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  36. Wow this is enlightening. Until now I thought the opposite, that by getting most of one’s calories via healthy fats and minimized calories through carbs was an effective dietary way of dealing with pre-diabetes. Now I understand that I need to increase my carbs and decrease the healthy fats! Thank you dr. G! Not…




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  37. Is fat of vegetable origin (e.g. nuts) different than animal fat? I remember seeing an article saying yes, but I don’t see why it would be. Thanks




    0
    1. Yes, fat from vegetable sources such as nuts, is usually mono and poly unsaturated fat. Where as animal fats tend to be saturated fats and trans fats.




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  38. This article is a crock. Pretty much all of it is misinformation. High fat, low carb diets are not detrimental to you. On Keto diet, your blood sugar levels remain at normal levels. You can literally reverse diabetes on Keto. Don’t buy into this nonsense.




    1
    1. Yeah,all that science stuff is such a crock. And nonsense to boot. We should believe people selling fad diet books and crank websites instead. Thanks for setting us straight.




      0
      1. No, thank YOU for setting me straight. I am now smarter for having read your comment. All this is propaganda. Do the diet yourself and find your own answers. I bought into it as well until I tried keto. I was pre diabetic, now, clean as whistle. High fat no carbs. Take care and stay healthy, everyone.




        0
            1. No they didn’t. The US Dietary Guidelines have always said cut back on sugar. The high fat crowd make a lot of false claims like that. Also, try researching what are the long term effects of a high (saturated) fat diet.




              0
            2. Good morning Josh

              Sugar has never “been good for us”. Fruit, well that’s different. Eat your fruit. Eat your veggies. Stop processed foods.

              Lose weight. And presto! Healthy.




              0
            3. Hi Josh – I don’t ever recall ever seeing any double blind studies whose conclusion was a hypothesis that sugar was good for us. I’m assuming you must have some access to such. Would you please post it for us here so that we may all see what you’re looking at?




              0
          1. “I prefer to rely on what the science shows thanks.”

            With due respect, Yes sciences is sometimes based on bad sciences. It is a bad theory by some bad scientists in the 1970 and so why do we keep getting stuck with this misconception?

            https://www.youtube.com/watch?v=Pue5qVW5k8A

            12 studies involving 340,000 people have shown that saturated fat has no effect on any diseases, none. In fact, researchers have found that saturated fats are even PROTECTIVE for diabetes type 2, quite the opposite.

            http://www.bmj.com/content/351/bmj.h3978.full

            Type 2 diabetes

            We found no association between trans fats and type 2 diabetes, though the interpretation of this finding is complicated by heterogeneity. Inconsistency has also been noted in randomized trials of the effects on glucose homeostasis.150 Two cohort studies reporting strong associations between trans fats and type 2 diabetes73 74 were generally similar to those that did not with respect to measures of exposures, outcomes, and most covariates, except that the three studies that failed to show an association adjusted for fiber and magnesium,72 75 76 which might protect against diabetes,151 152 while the two studies that showed an association73 74 did not. Pooling estimates without adjustment for magnesium and fiber yields a 16% increased risk of type 2 diabetes with high trans fat intake (four studies; risk ratio 1.16, 95% confidence interval 0.95 to 1.41; I2=82%; Phet<0.001); when we limited analysis to the three studies with no serious risks of bias,73 74 76 this became a 28% increased risk (three studies; 1.28, 1.16 to 1.41; P<0.001; I2=0%; Phet=0.87).

            The role of trans-palmitoleic acid in prevention of type 2 diabetes could represent an important new direction for fatty acid research. It is important to note, however, that the exposure levels to this nutrient are typically low. In the three included studies, trans-palmitoleic acid represented >>> The biology of a potential protective effect of trans-palmitoleic acid against type 2 diabetes could relate to its ability to mimic the role of cis-palmitoleic acid, which is protective against diabetes in animals.153 <<<<<




            1
            1. http://www.cell.com/cell/abstract/S0092-8674(08)01014-3?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867408010143%3Fshowall%3Dtrue

              Dysregulation of lipid metabolism in individual tissues leads to systemic disruption of insulin action and glucose metabolism. Utilizing quantitative lipidomic analyses and mice deficient in adipose tissue lipid chaperones aP2 and mal1, we explored how metabolic alterations in adipose tissue are linked to whole-body metabolism through lipid signals. A robust increase in de novo lipogenesis rendered the adipose tissue of these mice resistant to the deleterious effects of dietary lipid exposure. Systemic lipid profiling also led to identification of C16:1n7-palmitoleate as an adipose tissue-derived lipid hormone that strongly stimulates muscle insulin action and suppresses hepatosteatosis. Our data reveal a lipid-mediated endocrine network and demonstrate that adipose tissue uses lipokines such as C16:1n7-palmitoleate to communicate with distant organs and regulate systemic metabolic homeostasis.




              0
              1. Interesting paper you brought to our attention, broccoli.
                http://www.cell.com/cell/abstract/S0092-8674(08)01014-3?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867408010143%3Fshowall%3Dtrue
                Cell is considered one of the leading journals of biological/biomedical sciences.

                That said, if you are trying to make the case that this research paper refutes the theme of Dr Greger’s video, “Fat is the Cause of Type 2 Diabetes”, then you are badly mistaken. Quite the opposite!

                Take this quote is from the introduction for example:
                “Epidemiological and clinical studies indicate that dietary lipids affect and sometimes even determine the course of development of metabolic syndrome (Warensjo et al., 2005). Despite a growing body of evidence supporting the key role lipid metabolism plays in metabolic diseases, the underlying mechanistic details by which alterations in tissue-specific lipid metabolism are directly integrated into systemic metabolic homeostasis are not well understood.”

                In other words, the purpose of the study was to investigate the biochemical mechanisms of how fat metabolism contributes to “metabolic diseases such as diabetes, fatty liver disease, and atherosclerosis that often form a disease cluster referred to as metabolic syndrome.”

                In order to investigate specific mechanisms of fat metabolism, the researchers created heterozygous knockout mice for two lipid chaperone genes of the fatty acid-binding protein family. This allowed them to identify a potential regulator molecule for fat metabolism. We can discuss the details of this intricate study, but the paper in no way refutes Dr Greger’s video.




                0
            2. Sorry B but there are so many false claims in this video that it is simply laughable. Well it would be if it weren’t encouraging people to eat dangerously unhealthy diets.
              Why don’t you fact-check the claims it contains instead of just blindly accepting them. The lies told about Ancel Keys alione are breathtaking.




              0
            3. The video you linked to is full of false claims. It would be laughable if it didn’t encourage so many people to adopt dangerously unhealthy dietary practices. The lies told about Ancel Keys alone are breathtaking. Even the lies contain lies within lies.

              The producers say that Keys ignored data from certain countries and if he had looked at 22 countries for which some data was available, the association between fat and CVD would have disappeared. Quite false on several levels. Keys didn’t cherry pick data. And , they said. In fact, if you actually look at the analysis of the 22 countries, there was still an association between total fat and heart disease. However, the greatest association with heart disease came from animal protein and animal fat ……
              ” In the paper they actually do some comparisons with heart disease and animal fat vs. plant fat and animal protein vs. plant protein and find that fat from animals and protein from animals each has a much stronger association with heart disease than simply total fat. They go on to say that their analysis shows that plant fat and plant protein is actually negatively associated with heart disease mortality. In other words, fat and protein from plants might have some sort of protective effect against heart disease?”
              Curiously, the video does not mention this claiming instead that …The results were all over the place.!!!

              If people want to get the facts about Keys instead of just listening ro the endlessly repeated lies found on crank websites and in dodgy, highly sensational books, they could look here :
              https://thescienceofnutrition.wordpress.com/tag/hilleboe/
              http://plantpositive.com/display/Search?moduleId=19496100&searchQuery=keys
              http://carbsanity.blogspot.com.au/2015/02/ancel-keys-its-time-to-appreciate-real.html
              See also
              http://circ.ahajournals.org/content/5/1/115.full.pdf
              http://circ.ahajournals.org/content/23/6/805.full.pdf




              0
            4. I am glad that you mentioned the 2015 study published in the BMJ. This is the most thoughtful analysis of all those studies looking at saturated fat consumption in large Western populations. It is important to read the full paper not just the abstract. The snakeoil merchants will tell you that it means saturated fat is harmless. But if you read the full paper, it becomes clear that that is not the take-home message by any means.

              The paper states that it solely analysed observational studies. It notes however that:
              “Measurement error is often serious in epidemiologic studies of diet and disease, which can bias such associations towards the null.”
              and
              “A Cochrane review of randomized trials of reduced saturated fats and cardiovascular events found a 17% reduced risk with lower saturated fat intake (risk ratio 0.83, 95% confidence interval 0.72 to 0.96; 13 studies with 53?300 participants; moderate GRADE).8 Methodological advantages of randomized controlled trials over prospective cohort studies include the balancing of known and unknown confounders and better measurement and finer control of dietary fat levels.”
              It also noted:
              “Risks associated with higher or lower intakes of macronutrients are sensitive to choice of replacement nutrient(s). In a pooled analysis of 11 prospective cohort studies (not included in our quantitative syntheses to avoid duplication of data), replacement of saturated fats with polyunsaturated fat reduced coronary risk by 13%,111 consistent with results of randomized controlled trials112 113 114”
              http://www.bmj.com/content/351/bmj.h3978.long

              This is precisely why the study concludes ” Dietary guidelines must carefully consider the health effects of recommendations for alternative macronutrients to replace trans fats and saturated fats.”

              This is deliberately never mentioned by the saturated fat advocates who pretend the study demonstrates saturated fat is harmless,

              And of course Dr G has done a video on this topic already
              http://nutritionfacts.org/video/the-saturated-fat-studies-set-up-to-fail/




              0
              1. You can cheery pick whichever studies that fit your belief all you want. But this is a very comprehensive research involving many studies and 347,000 people over several years and they have mixed results, but overall it points out that fats have no effect in any type of diseases whatsoever. The study is scientific, fair and impartial and so they show results from all angles. It’s not cherry picking and biased for sure.




                0
            5. As for the speculated protective association between TPA and T2D, how you would translate this into dietary practice beats me.
              You are still going to be consuming saturated fat in dairy. Which raises T2D risk. So the protection is only relative to what? People eating sat fat but no TPA?

              And if you go for low fat dairy, then presumably, you will be removing the TPA trans fat along with the saturated fat




              0
        1. Propaganda to get you to eat your veggies? Well that’s crazy! Or propaganda to get you to eat what the cattle industry sales? Not that makes more sense.




          0
  39. Kiana: As I said, just losing weight is not necessarily a good thing. Also, looking at HDL/LDL ratios may not indicate much in terms of mediating disease risk. So, “working” is the question. Especially long term. Good luck to you and your mom. I hope it does work out for you long term.
    .
    FYI: To be heart attack proof, you need total cholesterol levels below 150 and LDL below 60 or 70. Good luck.




    0
  40. Latest researches:

    The role of dietary coconut for the prevention and treatment of Alzheimer’s disease: potential mechanisms of action.

    https://www.ncbi.nlm.nih.gov/pubmed/25997382

    Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.

    https://www.ncbi.nlm.nih.gov/pubmed/25287761

    Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826507/




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    1. Your first link is to a review article on coconut and Alzheimer’s. Review articles are generally written after a substantial body of evidence has been published over time. This “review” is weak to say the least. Below is the last sentence. If I had written a paper based on small clinical trials and anecdotal evidence I would have been laughed out of my department.

      “It must be emphasised that the use of coconut oil to treat or prevent AD is not supported by any peer-reviewed large cohort clinical data; any positive findings are based on small clinical trials and on anecdotal evidence; however, coconut remains a compound of interest requiring further investigation.”

      It is not worth the effort to look at your other links.




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      1. There are several on going clinical trials on the use of coconut oil to treat Alzheimer’s. They are testing on humans, not mice. Wait for the results to see if it works or not rather than dispelling everything that has to do with saturated fat (which is not harmful whatsoever if not beneficial).

        http://health.usf.edu/byrd/~/media/Files/Byrd%20Alzheimers%20Institute/CoconutOilStudyFlyer62013.pdf

        https://www.nia.nih.gov/alzheimers/clinical-trials/coconut-oil-alzheimers-disease




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      1. broccoli: You claim it is a “fact” that a ketogenic diet will “cure” many diseases. But your link does not back up your claim. These words do not mean we in “fact” have a “cure”, at least not to me: “…the ketogenic diet can provide symptomatic and disease-modifying activity…” “This review summarizes the … evidence indicating that the ketogenic diet could have beneficial effects…” “Controlled clinical trials are required to confirm the utility of the diet as a disease-modifying…”

        Also, note this quote from the abstract: “As the underlying mechanisms become better understood, it will be possible to develop alternative strategies that produce similar or even improved therapeutic effects without the need for exposure to an unpalatable and unhealthy, high-fat diet.” >>>>> “unhealthy, high-fat diet.”

        They even give some ideas of why it is unhealthy: “Moreover, a better understanding of the mechanisms may provide insights into ketogenic diet-inspired therapeutic approaches that eliminate the need for strict adherence to the diet, which is unpalatable, difficult to maintain, and is associated with side effects such as hyperuricemia and nephrolithiasis, and adverse effects on bone health and the liver (Freeman et al., 2006).”

        Bottom Line: The article claims some evidence for some symptom relief (not a cure) and the article acknowledges that the symptom relief comes with a side effect of potential causing other diseases.

        —————-
        Please read the studies you link to before choosing to post on this site. You are posting too many posts like the one above. –Moderator




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        1. I will stop posting on this subject for this blog/video. I have said enough and those who will believe will, and those who don’t will not. There is no point to convince anyone.

          P.S. The word “cure” is used loosely just like we say that eating plant foods can reverse diseases. Is it a cure?




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    1. Jenny, the video below by Dr Greger addresses your question of what types of fats are problematic.

      “Lipotoxicity: How Saturated Fat Raises Blood Sugar”
      http://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/

      The executive summary is to avoid (or limit) saturated and trans fats, which are found in animal products (meat, dairy, eggs) and partially hydrogenated and refined vegetable oils. [Note: If you value your long term health I would also avoid any advice the poster “broccoli” puts forth.]




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  41. Hello Dr. Greger,

    I just bought your book. Very interesting so far… I also have read real meal revolution by Professor Tim Noakes and your stances on sugar, processed carbs and so on seem to be the same. However he talks about how a diet with high fat, medium protein and low carbs is healthy. Things like butter and eggs he suggests are like superfoods.

    http://realmealrevolution.com/real-food-lists

    http://realmealrevolution.com/the-facts

    who is right? Both of you make good points in your arguments… I know nothing about nutrition and want to know what to do?

    Jesse




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    1. Hi Jesse- It’s great to hear you are so interested in learning about nutrition for yourself. Dr. Greger and NutritionFacts.org believe the scientific literature supports a whole foods, plant based diet as the healthiest for humans. What particularly draws me to Dr. Greger’s work is that he sites all his sources for each video so I can check out the data myself. He has many videos on this site that explain why a WFPB diet is healthier than the higher fat, high protein diet. You can type protein or fat into the search box above and get more videos than you’ll have time to watch in a sitting. Dr. Greger has also done some introductory videos that you may find useful: WFPB Intro (this is a link to one of the series, but the rest are listed underneath). Hope this helps!




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    2. If you look at major reports on health and nutrition by panels of expert scientists, you will find that after reviewing all the evidence they all conclude essentially that we should eat more fruit, vegetables and whole grains. None of them recommend that we should eat (more) butter, eggs, cheese, steak etc. Some reports, and guidance based on those reports, are here
      http://www.who.int/mediacentre/factsheets/fs394/en/
      http://www.who.int/nutrition/publications/nutrient/en/
      http://www.dietandcancerreport.org/expert_report/index.php
      http://www.health.gov/dietaryguidelines/2015-scientific-report/
      http://www.nel.gov/evidence.cfm?evidence_summary_id=250189

      Dr Greger’s case is consistent with those. Professor Noakes’ case is not. Unfortunately, there is a big market of people who want to be told that butter, eggs, cheese and steak are healthy – and there are always people willing to supply that market.




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  42. Kiana have you ever put your food into a diary like https://cronometer.com ?

    The reason I ask is because your diet doesn’t look high fat? Unless you eat a ton of nuts and seeds? Maybe you call it LCHF because you have started eating healthfully. I say that because when people talk about carbs they are generally talking about giving up the muffin.

    Your diet kinda sounds like mine before I completely gave up meat. I was eating only Whole Foods. No sugar, no processed grains(muffins), no dairy and small portions meat a few days a week. It consisted of mainly fruits and vegetables, beans nuts and seeds. (If I ran a ton of miles in a week more nuts and seeds or I lost too much weight)

    Just curious. Sounds like you cleaned up your diet and lost weight?




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    1. Fair enough, but I definitely try to eat a lot of fat — all those veggies are cooked in plenty of olive oil or coconut oil. I also eat macadamia nuts, avocados, a few eggs, and small fatty portions of meat.

      I don’t maintain a food diary…trying not to to obsess (even more) about food.




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  43. These 2 type diabetes made me want to eat more beans but not in a same way manner like same dishes all day. I was scrolling through my google account and searched different ways how to cook beans when I look unto a product called Bentilia. It is a pasta made up of beans alone and nothing else. It can prevent diabetes and heart problems. So I grabbed the opportunity to buy and try Bentilia and just as I expected it’s pasta is deliciously made taste like a real pasta and it’s low fat. So I guess I would stick to this Bentilia after reading this article.




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  44. Is fat itself the problem? Or fat in the context of a high carb/high processed food? …. for example, would a high fat, moderate whole food carb diet be a problem? … or high fat high carb? …. are there distinct advantages to a high carb low fat? please help me understand how fat interacts with the other macronutrients.




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    1. Hi G, Yes, fat itself is the problem. It’s fat that causes insulin resistance. Insulin resistance is when there is plenty of insulin around but it can’t get into the muscle cells to do it’s job because fat is blocking the insulin receptor sites. One of the problems with low carb diets is that when you lower you carb intake you must replace the carbs with something. That usually ends up being animal protein which is full of fat. Another big problem is trying to structure your diet based on macronutrient percentages. If you consume a whole foods plants based diet that includes a variety of plant foods, you never have to worry about macronutrient percentages and all of your dietary requirements will be met. Fat should be gotten from whole food plant based sources like nuts, seeds and avocados as opposed to animal sources and processed plant sources like vegetable oils and hydrogenated oils.




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    2. G, I more or less asked the same question yesterday, based on the many studies I have read ( after a search at pub med) showing basically the opposite of “fat causes diabetes/insulin resistance”, and also comparing it to my personal experience. Which did not include a measure of insulin resistance while eating relatively high fat/moderate protein/low carb(emphasis on the low carb). So I can not say for sure, but almost all other cardiovascular parameters improved vastly, gut disappeared, weight came off. The “bad” LDL worsened slightly, but was overwhelmed by the increase in “good” HDL and triglycerides dropping from over 200 to 49. Though I can not remember exactly what my blood sugar did, it certainly did not get worse. I don’t doubt the studies Dr. G is presenting, but I am somewhat baffled at how they seem to conflict with some other studies and my personal experience. I certainly eat much more in Dr. G’s recommended ways these days, but weight has been a problem and I am considering going back to the tried and true(for me) at least until the weight is off once again.But the studies do seem contradictory. For example, though this was more for gastric reflux/hart burn, look at insulin resistance in this study of 144 women: https://www.ncbi.nlm.nih.gov/pubmed/27582035
      “In response to high-fat/low-carbohydrate diet, reduced intake of sugars was associated with reduced insulin resistance…………….”




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      1. Bill388: It is not contradictory if one understands the mechanisms in play. One approach, high fat and low carb, treats the *symptoms* of T2 diabetes. Since the diet can lower some people’s weight, the diet also can have some other benefits like initially lower cholesterol (any time you lose weight, cholesterol goes down – even if you just get cancer). The question is: Is this diet good for long term health? The best body of scientific evidence we have says, “no”.
        .
        The other diet that is good for T2 diabetes, the one highlighted on this website, is a low fat, whole plant food based WPFB diet, such as the one that Dr. Barnard and others have clinically proven is effective at reversing T2 diabetes. (https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1480957108&sr=1-1&keywords=barnard+diabetes ) This diet gets at the cause of diabetes, reverses heart disease, etc: ie, is generally all around good for long term health.
        .
        Darchite has a great post that explains the two methods, including how an extreme high fat diet can be helpful for T2. See here for Darchite’s post: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730




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        1. Thank you, Thea, I am just seeing your responses. I will have a look at those links. I hope I don’t come across as trying to start an argument, I follow Dr. G. all the time and have read his book, and surely have increased a great deal my consumption of hopefully healthier whole foods. But I do find the studies contradictory sometimes. I liked your explanation of how the studies change day to day, but the body of evidence does not change much. Still, if not already in the links you provided above(have not red yet), do you know of a study showing insulin to be raised by a low carb/high fat diet compared to a low fat/higher carb diet? Especially if the carbs are really lowered, like between 20-50 gms per day? And isn’t it still true that the body produces insulin in response to carbs, and not to fat? How about triglycerides, those are important, right? Every study I’ve seen TGLs are slashed when carbs are dropped significantly, just like mine went from over 200 to under 50. Any way, there is a lot to consider, and I will now look at those links you provided. Thanks again!




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          1. Bill388: I appreciate your clarification of where you are coming from. Your post makes me think that the following friendly recap would be helpful.
            .
            I’m not an expert, but here is my understanding in lay person’s terms: The primary natural fuel/food for our cells is glucose. We get glucose in a healthy way when we eat complex carbohydrates, especially starchy foods. One of the longest and healthiest lived populations is the traditional Okinawans. They routinely lived to 100+ and were doing great. Did you know that 85% of their diet was carbohydrates? 69% of their diet was sweet potatoes. To learn more: http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/
            .
            The trick is getting that glucose from your blood into your cells. Here’s how it works (when it is working right): When the glucose in your blood hits a certain level, your pancreas releases insulin. The job of insulin is to open a gate in the cells that allows the glucose to get inside. When the insulin is working correctly, you are said to have good insulin sensitivity.
            .
            When Things Go Wrong – Type 2 Diabetes: If your cells get clogged up with fat, the insulin stops working correctly. The insulin is not able to open that gate. If the glucose in your blood can’t get into the cells, it stays in the blood and your body goes, “uh oh, I need to produce *more* insulin. Go ahead and do that please pancreas.” If your body has to produce a bunch of insulin to try to force open the gate, then you are said to be insulin resistant. That’s bad. Glucose isn’t getting into your cells and your body is producing too much insulin.
            .
            Putting This Into Perspective: As you can see from this story, fat does not cause your body to produce more insulin. However, fat is the *cause* of the problem to begin with. When all is going well, it is natural/appropriate for your body to produce some insulin after you eat starches so that your body can get the glucose into your cells. You really, really want that glucose to get into your cells. That’s a good thing.
            .
            So, there’s no doubt that you can eat a diet that is overwhelmingly made of fat and prevent your body from producing a lot of insulin. The problem is that you would be treating the symptom of type 2 diabetes (too much insulin), but you are not addressing the cause of the problem.
            .
            Here’s another consideration for your high fat approach: You are a complete and complex organism with a lot more things that could go wrong than just insulin resistance. I am not aware of any population of long lived, healthy people who routinely eat low carb–not a healthy population like the traditional Okinawans. In other words, for over all health (for your heart, your immune system, etc), a low fat diet of whole plant foods is the way to go, both treating the type 2 diabetes AND your overall health. You have read Dr. Greger’s book, so you know what I’m talking about in terms of the vast evidence behind the overall benefits of a diet of “low” (low is relative in this conversation) fat whole plant foods.
            .
            Just to drive home the point: What harm could eating a low carb diet really do? Low carb diets have been shown to lead to early death (increased mortality). Tom Goff has a good post on this that I can point you to if you are interested.
            .
            Why did I write all this? Because you wrote: “…do you know of a study showing insulin to be raised by a low carb/high fat diet compared to a low fat/higher carb diet?” I hope you can see in light of what I’ve written here is that that question is missing the point. I hope this post has helped.




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      2. Bill388: Two more thoughts for you. One, if you would like some help/resource for eating healthy and keeping the weight off, I have some great talks and other resources I can share. Only if you are interested. I’m not pushing.
        .
        Also, I noticed you give a lot of emphasis to HDL going up and minimizing that your LDL has gone up. I thought I would share that in societies where heart disease is so rare that the doctors are shocked when a heart disease case walks in the door, total cholesterol is below 150 and LDL is below 60 or 70. There are a lot of references on NutritionFacts for verifying this if you are interested. I don’t know what your numbers are, and I’m not asking you to share. :-) I’m just sharing this information so you can use it to evaluate your heart attack risk if you want.
        .
        Good luck!




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  45. *** BREAKING MEDICAL NEWS *** (from PCRM)

    Recommendations to Avoid Saturated Fat Confirmed

    Dietary saturated fat is linked to developing heart disease, according to a new study published in The BMJ. Researchers followed 115,782 participants from the Health Professionals Follow-up Study and the Nurses’ Health Study who were free of heart disease at the beginning of the analysis. After adjusting for multiple factors, including weight, exercise, and family history, people who consumed the most saturated fat had an 18 percent increased risk for developing heart disease, compared with those who consumed the least, after approximately 21-26 years of follow-up. Replacing saturated fat in the diet with healthier foods, including whole-grain carbohydrates, was associated with a reduced risk for heart disease. The authors conclude that current recommendations to avoid saturated fats are necessary to prevent heart disease.

    Zong G, Li Y, Wanders AJ, et al. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ. 2016;355:i5796.




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    1. Is that going to be the final word, do you think? That means everyone is correct going back many years to avoid saturated fat. But is there a healthy saturated and an unhealthy saturated fat? For instance, coconut oil?




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      1. ron: I’m glad you asked this question, because it gets at a common issue that many people share. Due to science education in schools and the way media reports on scientific news, the general public is under the impression that each new study sort of wipes out any study that came before. Say that yesterday there was a study or article in favor of say butter, then you would see those headlines and think that the latest and greatest WORD from science is that butter is healthy. And then tomorrow, when another study comes out showing that butter is indeed unhealthy, there is another headline and people think that the latest “word” is that butter is now unhealthy. Another problem is that because people think the latest study is the latest word and since studies are not all going to agree, people think that the science keeps flip flopping and get frustrated with that. The media makes this worse by only reporting studies that they can make appear to be a “flip flop” as the media makes money off of eye catching headlines.
        .
        But that’s not how science actually works. When done in good faith, science is about hitting a subject from a whole bunch of different angles and attempting to replicate results multiple times. Understanding that life is messy and it’s extremely difficult (impossible?) to create perfect studies for subjects as complex as nutrition on long term health, we *expect* that not all the studies will agree with each other. However, over time, if we do our job, we can also expect that the *body of scientific evidence* will paint a fairly clear picture. I say all the