What Causes Insulin Resistance?

What Causes Insulin Resistance?
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Prediabetes and type 2 diabetes are caused by a drop in insulin sensitivity blamed on “intramyocellular lipid,” the buildup of fat inside our muscle cells.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

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 the other half on a carb-rich diet, within just two days, this is what happens. The glucose intolerance skyrockets in the fatty diet group. In response to the same sugar water challenge, the group that had been shoveling in fat ended up with twice the blood sugar. As the amount of fat in the diet goes up, one’s blood sugar spikes. 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.

When athletes carb-load before a race, they’re trying to build up the fuel supply within their muscles. They break down the starch into glucose in their digestive tract. It circulates as blood glucose—blood sugar—and is taken up by our muscles, to be stored and burned for energy.

Blood sugar, though, is like a vampire. It needs an invitation to come into our cells. And, that invitation is insulin. Here’s a muscle cell. Here’s some blood sugar outside, waiting patiently to come in. Insulin is the key that unlocks the door to let sugar in our blood enter the muscle cell. When insulin attaches to the insulin receptor, it activates an enzyme, which activates another enzyme, which activates two more enzymes, which finally activate glucose transport, which acts as a gateway for glucose to enter the cell. So, insulin is the key that unlocks the door into our muscle cells.

What if there was no insulin, though? Well, blood sugar would be stuck out in the bloodstream, banging on the door to our muscles, and not able to get inside. And so, with nowhere to go, sugar levels 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 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 called insulin resistance. Our muscle cells become resistant to the effect of insulin. What’s gumming up the door locks on our muscle cells, preventing insulin from letting sugar in? Fat. What’s called intramyocellular lipid, or fat inside our muscle cells.

Fat in the bloodstream can build up inside the muscle cells, create toxic fatty breakdown products and free radicals that can block the signaling pathway process. So, no matter how much insulin we have out in our blood, it’s not able to open the glucose gates, and blood sugar levels build up in the blood.

This mechanism, by which fat (specifically saturated 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. And, that’s how scientists found that elevation of fat levels in the blood “causes insulin resistance by inhibition of glucose transport” into the muscles.

And, this can happen within just three hours. One hit of fat can start causing insulin resistance, inhibiting glucose uptake after just 160 minutes.

Same thing happens to adolescents. You infuse fat into their bloodstream. It builds up in their muscles, and decreases their insulin sensitivity—showing that increased fat in the blood can be an important contributor to insulin resistance.

Then, you can do the opposite experiment. Lower the level of fat in people’s blood, and the insulin resistance comes right down. Clear the fat out of the blood, and you can clear the sugar out of the blood. So, that explains this finding. On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

But, as the amount of fat in our diet gets lower and lower, insulin works better and better. This is a clear demonstration that the sugar tolerance of even healthy individuals can be “impaired by administering a low-carb, high-fat diet.” But, we can decrease insulin resistance—the cause of prediabetes, the cause of type 2 diabetes—by decreasing saturated fat intake.

Please consider volunteering to help out on the site.

Animation provided courtesy of Scientific Animations.

Image credits: Mohamed Ibrahim via clker, and Eugene Bochkarev and bowie15 via 123RF. Images have been modified.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

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 the other half on a carb-rich diet, within just two days, this is what happens. The glucose intolerance skyrockets in the fatty diet group. In response to the same sugar water challenge, the group that had been shoveling in fat ended up with twice the blood sugar. As the amount of fat in the diet goes up, one’s blood sugar spikes. 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.

When athletes carb-load before a race, they’re trying to build up the fuel supply within their muscles. They break down the starch into glucose in their digestive tract. It circulates as blood glucose—blood sugar—and is taken up by our muscles, to be stored and burned for energy.

Blood sugar, though, is like a vampire. It needs an invitation to come into our cells. And, that invitation is insulin. Here’s a muscle cell. Here’s some blood sugar outside, waiting patiently to come in. Insulin is the key that unlocks the door to let sugar in our blood enter the muscle cell. When insulin attaches to the insulin receptor, it activates an enzyme, which activates another enzyme, which activates two more enzymes, which finally activate glucose transport, which acts as a gateway for glucose to enter the cell. So, insulin is the key that unlocks the door into our muscle cells.

What if there was no insulin, though? Well, blood sugar would be stuck out in the bloodstream, banging on the door to our muscles, and not able to get inside. And so, with nowhere to go, sugar levels 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 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 called insulin resistance. Our muscle cells become resistant to the effect of insulin. What’s gumming up the door locks on our muscle cells, preventing insulin from letting sugar in? Fat. What’s called intramyocellular lipid, or fat inside our muscle cells.

Fat in the bloodstream can build up inside the muscle cells, create toxic fatty breakdown products and free radicals that can block the signaling pathway process. So, no matter how much insulin we have out in our blood, it’s not able to open the glucose gates, and blood sugar levels build up in the blood.

This mechanism, by which fat (specifically saturated 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. And, that’s how scientists found that elevation of fat levels in the blood “causes insulin resistance by inhibition of glucose transport” into the muscles.

And, this can happen within just three hours. One hit of fat can start causing insulin resistance, inhibiting glucose uptake after just 160 minutes.

Same thing happens to adolescents. You infuse fat into their bloodstream. It builds up in their muscles, and decreases their insulin sensitivity—showing that increased fat in the blood can be an important contributor to insulin resistance.

Then, you can do the opposite experiment. Lower the level of fat in people’s blood, and the insulin resistance comes right down. Clear the fat out of the blood, and you can clear the sugar out of the blood. So, that explains this finding. On the high-fat diet, the ketogenic diet, insulin doesn’t work as well. Our bodies are insulin-resistant.

But, as the amount of fat in our diet gets lower and lower, insulin works better and better. This is a clear demonstration that the sugar tolerance of even healthy individuals can be “impaired by administering a low-carb, high-fat diet.” But, we can decrease insulin resistance—the cause of prediabetes, the cause of type 2 diabetes—by decreasing saturated fat intake.

Please consider volunteering to help out on the site.

Animation provided courtesy of Scientific Animations.

Image credits: Mohamed Ibrahim via clker, and Eugene Bochkarev and bowie15 via 123RF. Images have been modified.

Doctor's Note

If this video sounds familiar, it’s because it’s a redux of a video that I put out last year. But, it lacked this fancy new animation, courtesy of Scientific Animations: www.scientificanimations.com. They contacted me, and graciously offered to donate an animation to us—I love it! If there is anyone else out there who would like to kindly offer their services to help us better help others, we’d love to see it.

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

I mentioned low-carb diets in the video. For more on their potential health effects, see videos like Low-Carb Diets and Coronary Blood Flow.    

Here are some of my most popular diabetes videos, for those who want to do a deep dive:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

411 responses to “What Causes Insulin Resistance?

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    1. I wouldn’t overload on the nuts. A few handfuls of a variety of nuts is ok. A few tablespoons of seeds is good too. The key is that your overall diet is low fat. We do need some fat (for ex) for better absorption of fat-soluble Vitamins (ADE). Just load up on FIBER foods and eliminate animal foods and you will not have any insulin and blood sugar issues.




      4
      1. Casper, has anyone related to this site done any research into Hemp seed hearts? It is a new product available at Costco. I think it is grown in Manitoba. I bought some, because I am always on the lookout for new whole grain stuff to eat. It tastes like a cross between walnuts and cashews–delicious.

        Relevance of this question comes from the thread here on this site concerning Omega-3’s and fats from nuts and seeds.




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        1. Dietitians Brenda Davis and Vesanto Melina, in their book “Becoming Vegan,” say that hempseed contains a form of omega 3s (stearidonic acid) that is more easily converted to long chain forms of 3s than other plant-based omega 3s.




          1
        2. I read in “Fats that Heal, Fats that Kill” by Udo Erasmus, the hemp seed and help oil contain a nearly perfect ratio of both Essential Fats, otherwise Omega 3 and Omega 6. There are few known foods that deliver both. I am looking into sources of hemp oil. Word of warning – hemp products will cause the consumer to test positive for marujuana. So, if your looking for employment, may not want to consume these products for weeks to months before.




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          1. Hemp seed has no (!) THC inside only the female blossom contain THC. If any hemp seed is tested positiv for tTHC, then only by contamination during handling. Because hemp seed in general is delivert by a factory the risk of contamination is very low. If you buy some hemp seed from a privat person the risk is 100 % higher. ;-)




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          2. Thank you. That’s at least a start. I will check out the scholarship of Udo. From a culinary perspective, I think you will find the raw, fresh husked seeds incredibly delicious. For example, I made a version of tabbouleh with arugula instead of parsley and with hemp hearts instead of cous cous.

            I keep a small amount of the husked seeds in a closed jar in the fridge, and the rest of the bag in the freezer. I would think that the pressed oil would very very fragile.




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          3. Just a heads up, the perfect ratio of whatever in a specific food is just marketing blather. What matters is the ratio in the DIET. Including hemp in a diet that has a high omega 6 to omega 3 ratio will not solve the problem. Not that help is a bad food, if you are trying to balance out a diet that is high in omega 6’s (which are abundant in the food supply) with more omega 3s (which are much more limited, especially in a vegan/vegetarian diet), then flax would be a better choice. So would reducing foods high in omega 6.

            Same is true for amino acids. Animal protein is touted as having high quality/complete proteins (all the essential amino acids in appropriate proportions) and plant based foods are disparaged for not having complete proteins (with few exceptions). But matters is the amino acids in the DIET, not in a particular food, and a well balanced vegan/vegetarian diet indeed does have all the essential amino acids in adequate proportions.




            1
      2. I switched to this diet, and within a few weeks, my blood sugars were high. High carb, low fat. No animal products or oils. Only whole plant foods. Didn’t work for me.

        Some people produce more insulin than others naturally. The range is quite wide (0.4-1.5).

        It’s fine for people with higher insulin to eat more carbs, not someone on the lower end of the scale.




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    2. If you search this site for nut related videos you’ll find Dr Greger has reviewed many studies showing no longer link to weight gain. In fact some showed a loss of weight due to the fiber. Watch them and you’ll see how healthy they are. My husband added them back a few years ago on advice of new doc as part of a bigger lifestyle plan and enjoys a mixed handful of raw/ dry roasted most days. He also loves avocado. His bloodwork is better then ever and he’s more plant based then ever. He’s also more sensitive to treatment of farm animals and he’s from a family of farmers. He still eats some local goats cheese, eggs and seafood but much less. Do your homework and check with Dr if needed then if you want enjoy your nuts (haha). My husband has his blood checked at least annually to make sure all is well. He just turned 65.




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    3. Thanks for your question.

      In this video, Dr Greger does an incredible job in explaining the effects of nut consumption on weight.

      And according to this review and I quote:

      “Through different mechanisms, some components of nuts such as magnesium, fiber, alpha-linolenic acid, L-arginine, antioxidants and MUFA may protect against inflammation and insulin resistance.”

      Hope this answer helps.




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  1. My nutritionist has warned me that high omega 3 seeds like flax and chia are actually immune-suppressive, and that this
    can can a bad thing at times for people who have conditions that require their immune system to be fully active and alert.
    (I am one such person). He says that both plant based and fish-based omega 3 will basically put to sleep the immune system.
    For certain people this isn’t good, as it opens them up to infection. Is there truth in this? Interestingly, I get very very tired
    whenever I eat flax, chia, walnuts, and other omega 3 sources. Vegan DHA pills also make me exhausted.

    Anyone with science and data to clarify?




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    1. Hi Guest
      When one of my health care people make claim like that I generally ask them for their sources. One of my doctors even enter the room with research articles printed out. Now that is service!

      But…I haven’t read anything about that before.




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    2. As the saying goes, it’s complicated. Low fat diets – if well planned – seem advisable.

      It is certainly true that fats can affect the immune system but other factors are also involved which can modify their effects. The source of the fats and amounts may also alter these effects.
      “Reduction in total fat intake has been found to enhance immune response (IR) in humans as noted in several studies.”
      “changing the level of LA from 3 to 13 en% had no adverse effect on several indices of IR tested, when the total fat contents of the intervention diets were maintained constant. Inhibition of IR may have happened if the increase in n-6 PUFA was accompanied by an increase in total fat intake. When the increase in LA intake was accompanied with an increase in total fat (22 to 28 en%), it did inhibit NK cell activity in the healthy men (Barone et al., 1989). In this study, inhibition may have resulted from the additive inhibitory effects of total fat and of n-6 PUFA. In general, these studies indicate that moderate levels of LA consumption have no adverse effects on human IR.”
      “A number of studies indicate inhibition of several indices of human IR, with an increased consumption of n-3 PUFA (ALA, EPA, and DHA).”
      https://www.nap.edu/read/6450/chapter/21#306

      [LA = linoleic acid IR = immune response NK = natural killer cells]

      See also eg
      http://ajcn.nutrition.org/content/77/5/1096.full
      http://www.fao.org/docrep/V4700E/V4700E0h.htm




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        1. Good point. My comment did beg the question, didn’t it?

          There is no universally agreed definition of low fat. The WHO recommends adults consume 20-35% of total calories as fat. So does the US Institute of Medicine. The WHO further advises that the minimum intake of fat should be 15%.
          http://www.who.int/nutrition/topics/FFA_human_nutrition/en/
          http://www.nationalacademies.org/hmd/~/media/Files/Activity%20Files/Nutrition/DRI-Tables/3_RDA%20AI%20AMDR%20Values_Total%20Water%20and%20Macronutr.

          My personal rule of thumb is therefore that anything under 20% is low fat. This is consistent with animal studies of dietary macronutrient ratios and lifespan where
          “”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.”
          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

          And another mouse study where
          “mice were fed with a HF diet (60% kcal/fat) or control diets (15% kcal/fat) for 27 months. ……… 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”
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922950/

          Of course, the traditional Okinawan diet, the Esselstyn diet and Ornish diet are all less than 10%.and do not seem to cause health problems.

          You may also find this interesting
          http://circ.ahajournals.org/content/98/9/935.full




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            1. Julot: I really like that chart! Do you have a source for the chart? I would like to be able to share this with others, but would need to be able to say where the data came from in each row before I could. Maybe the source would have the references. Thanks!




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              1. Sorry i dont have the source, i got it from a youtube video about health and food its a chart made by someone who is usually very accurate with datas(Andrew Perlot), it seems to be pretty accurate from my research, maybe Dr. Greger could confirm~




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          1. Thanks very much for the informative reply. I found your earlier ref.
            https://www.nap.edu/read/6450/chapter/21#306
            very enlightening, and will read the others.

            I asked because I know Dr. Fuhrman is critical of very low fat diets (~10%), and recommends fat be a minimum of 15% of cals and a max of 30%, mostly from nuts/seeds, but no oils, and depending on one’s BMI and level of activity.




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    3. Wow. Your nutritionist should be convicted of a crime. It’s simply amazing. He has it completely backwards!! You WANT a higher (or at least more balanced) ratio of Omega-3 to Omega-6. It is Omega-6 that increases inflammation in the body. This is NOT one of those questionable debates in the food wars. Any informed individual can easily research this and know it to be true. The fact that Chia and Flax are very high in Omega-3 makes them a excellent seeds to include daily in your diet. Plus, there are loads of other amazing benefits you’ll get out of them. I would considering firing your nutritionist if he can’t even get this simple fact correct. I bet he’s also telling you that lots of protein is good too.




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      1. It’s not that omega 3 seeds are bad, it is just that they, in some people, apparently can actually suppress the immune system. This alone is speculated to be why people often feel better when they eat high omega 3 flax and chia, because there immune system is actually being relaxed, turned down a notch. But for some people, we need our immune system in full force.




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        1. I must be in dreamland. Are we now saying that Omega-3 SUPPRESSES immune system and that is a GOOD thing? Am I misreading this? Why would anyone want to suppress their immune system!? Immune health starts in the gut. When you feed your body high fiber foods it translates into a healthier microbiome profile. This in turn supports a stronger immune system and prevents and reverses auto-immune disorders.




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          1. GUEST, I think you are confusing suppressing immune system and “reducing inflammation” in the body. Two completely different things. Yes, Omega-3 reduces inflammation in the body, but doesn’t suppresss our immune system.




            1
            1. At least some omega-3s e.g. EPA in high dose can suppress the immune system. Cf. e.g.

              Immunosuppressive effects of fish oil in normal human volunteers: correlation with the in vitro effects of eicosapentanoic acid on human lymphocytes.

              https://www.ncbi.nlm.nih.gov/pubmed/1833105

              But as MikeonRaw observed below, the does must be very high (in the study ~2.4 g/d EPA).




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          2. Casper, I just want to thank you! I’m reading the comments about Omega-3’s suppressing the immune system and thinking, “WHAAAAAT?!?!?!” I’m damn sick and tired of hearing about stuff being good, nay vital, for you, incorporating it religiously, and later hearing that info was all wrong after all. One e.g.: whether consuming lots of “good” fat (coconut oil, olive oil, MCT’s) is or is not good for you. Having been told repeatedly that it is, I’ve even taken to downing an extra swig or spoonful here and there just for good measure. Now that I’ve started following Dr. Greger instead of, ah, Dr. Mercola, it seems that’s not good after all. But: Omega 3’s? If I found out Omega-3’s were unhealthful, I’d just close my computer and never read another health article again.

            Maybe I should add this: I’m F, 69yo, look and feel about 45, still an “extreme” skier and pretty damn good hiker… No Rx meds, no health issues. This is what I eat every single day: Big green salad w/lots of raw veggies for breakfast (very little dressing), then a “power shake” with whey, massive berries, yogurt, kefir, fresh-ground flaxseeds, hemp hearts, chia & stevia. For lunch, something like 1/2 avocado w/black beans, tomatos and salsa. For dinner, steamed mixed veggies and maybe some lean chicken or salmon. For late-nite: more berries, half a banana, big chunk of dark chocolate, handful of walnuts, some gin-soaked raisins. Also 2 beers a day and a small glass of wine! I often nosh on about 9 all-natural potato chips, maybe 1/4 cup of low-sugar ice-cream or a few whole-grain seed crackers with hummus. I often eat quinoa with wild rice and garbanzos, drink lots of green tea, and have a large hibiscus tea/apple cider vinegar/tart cherry and pomegranite juice cocktail every night. I speedwalk 3 miles 4-5 times a week. Everything possible is organic, BPA-free, non-GMO. I only use olive oil and coconut oil, and I filter all my water.

            I also take mass supplements, all of them in conservative doses: bovine colostrum, NAC, Bacopa, Alpha-GPC, Acetyl-L-Carnitine, phosphotidal serene, Co-Q-10, mixed greens powder, turmeric, resveratrol, B-complex, vita-C, vita-D, vita-E, vita-K, magnesium malate, ALA, astaxanthin, cranberry, bilberry, cayenne, selenium, astragalus, ashwaganda, holy basil, pycnogenol, St. John’s wort, Zyflamend, folic acid and a bit of 5-HTP and melatonin before bed. Also a hair formula and a leg-vein formula but there aren’t any significant redundancies.

            I’m not asking for any detailed answer. But in general: How could l possibly be doing any better than that?! Still, I’m always trying to find out. Dr. Greger is now my main guru; it seems he has all the best info and I love his style. I just wish I was as astute and well-informed (in interpreting and critiquing the info) as you guys on his comment threads seem to be.
            Cheers! — from Cindy in Seattle




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        2. Hi, I wanted to explain in the light of what your nutritionist was probably cautioning you about was that
          Flaxseed is the richest dietary source of lignans, a type of phytoestrogen. A phytoestrogen is a plant nutrient that is somewhat similar to the female hormone estrogen. Due to this similarity, lignans may have estrogenic and/or anti-estrogenic effects in the body. Lignans are the nutrients that are at the center of the controversy regarding whether it is safe for certain women for example if the women has breast cancer to eat flaxseeds. Actually the research shows that the lignin can help suppress breast tumer growth. All cells have the ability to go through a process called apoptosis, or programmed cell death. It is believed that through this process, the body can prevent damaged cells from reproducing, and eventually developing into cancer. Researchers have shown that flaxseed sprouts can increase apoptosis (programmed cell death). Some cell and animal studies have shown that two specific phytoestrogens found in lignans, named enterolactone and enterodiol, may help suppress breast tumor growth.
          In the article it advises people to restrict intake through diet only, not supplementation. Only moderate amounts of ground flaxseeds, up to two to three tablespoons per day at most, should be eaten.

          Flaxseeds and Breast Cancer




          1
    4. Absolutely. I have reversed Autoimmune disease in myself and my patients using high omega 3s as a key ingredient. That argument makes no sense.




      0
      1. This video flies completely in the face of the high fat diets and paleo, etc. Ketogrnic diets can cure/ control epilepsy and cancer, in my experience eating a high fat diet has given me a lot of energy and improved mood and cognitive function. Obviously we are talking coconut oil, grass fed butter, fish oils, and avoiding omega 6 that are rancid or have been heated.




        1
        1. What other things changed in your diet? I ask because the effects you note from your high fat diet don’t seem to be backed by any credible research I’ve seen and that this site shows.




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        2. “This video flies completely in the face of the high fat diets and paleo, etc.”

          Yes, it does as do many other videos at NF.org because legitimate, rigorous nutritional science does not support high fat diets (including the Paleo Diet) as producing healthy outcomes. Granted, there are specific situations where a ketogenic diet is beneficial, such as preventing seizures in epilepsy. A ketogenic diet can also reduce hyperglycemia in diabetes, but as Thea details in her comment below it is not the wisest choice for the long term, diabetes or not. Addressing the cause of the disease, excess unhealthy fats in the case of diabetes, is better than merely treating the symptoms (hyperglycemia), especially if you can do both with the same intervention (http://www.pcrm.org/health/diabetes-resources).




          2
        3. That’s because the Paleo diet is a creation of marketers and not supported by rigorous, double-blinded research (the type of studies cited on this website).




          2
    5. (logging in with Nutritionfacts.org is not working)
      The reports I have seen for immune suppression seem to indicate that is with EXCESS omega 3 with excess in their tests being 2.4grams of EPA. I just looked at Vegan DHA/EPA pills and a single pill has 60mg to 80mg of EPA and 120g to 140g of DHA. That works out to .06g to .08g of EPA and .12g and .14g of DHA. Well below the tested 2.4grams of Omega 3.

      I would want to dig in further on what you are finding to make you tired. Doctors and nutritionists need to be wary of what they say to people. As we have seen in many studies, the placebo effect can be very strong.

      https://www.ncbi.nlm.nih.gov/pubmed/1833105




      0
      1. Thank you for this study link which is a study into fish oil consumption of volunteers. In this study their conclusion says, low doses of fish oil may have a mild immunosuppressive effect affecting both T and B cell functions.
        Similarly, the study blew which is invitro, that mean it is carried out outside the body, indicates that EPA (eicosapentaenoic acid ) and DHA(docosahexaenoic acid ) inhibits protein kinase C activity while LA (linoleic acid )had no significant effect. These results suggest that fish oil and its functional constituents (EPA and DHA) exerted an anti-inflammatory effect by down-regulation of lymphocyte activation, possibly by manipulation of intracellular signalling.
        So immunosuppresion affecting both T and B cell functions or down regulation of immune system could have anti inflammatory response.

        Effects of fish oil on lymphocyte proliferation, cytokine production and intracellular signalling in weanling pigs.




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          1. Thanks for your question. The immune system is amazing in keeping our body healthy. Yes they carry out inflammatory response (inflammation) when tissues are injured by bacteria, trauma, toxins, heat, or any other cause. The chemicals that are released by immune system in this situations including histamine, bradykinin, and prostaglandins. These chemicals cause blood vessels to leak fluid into the tissues, causing swelling. This helps isolate the foreign substance from further contact with body tissues.
            Then, another immune cells called phagocytes come and eat up the damaged cells this process is called phagocytosis.
            You mentioned innate immune response and those are the first line of defense system with which you were born. It protects us against all antigens. Innate immunity are barriers that keep harmful materials from entering your body. such as your skin, tears, mucus and stomach acid. Also they come as some protein chemical called innate humoral immunity such as interferon and interleukins.




            1
    6. My first check would be B12 (obviously) to make sure you’re ok there. And Dr. G. has suggested that you check not just your B12 but your (and I’m not sure I’ve got this correct) MMA (?). I’m sure someone out there knows what I”m trying to get at.
      My Father had malformed red blood cells that made him tired which B12 did not fix. So there may be other things going on. Your Doc should be willing to help you investigate this.
      Thanks to MikeOnRaw for his math on the amount of EPA, etc., below.




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    7. Hello, guest. I am Christine, a NF volunteer moderator. This subject has not, to my knowledge, been addressed on NF. I found no research to support the idea that flax and chia are immune-suppressive in a negative way. What I mean by that is that omega 3 can help with autoimmunity because it is anti-inflammatory. Your nutritionist may be assuming that, because it can help with autoimmunity, it is immune-suppressive in general. One study I found concluded that omega 3 supplementation was safe for critically ill patients on total parenteral nutrition http://www.mdpi.com/2072-6643/6/6/2148 If anyone needs a functioning immune system, it would seem these people do. I’m not sure why you feel tired after eating flax, chia, walnuts, or other omega 3 sources. Even if they did put the immune system to sleep, I would not think that would mean they put you to sleep. Do you eat them alone, or with other foods?




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    1. Replacing dietary saturated and trans fats with unsaturated fats appears to benefit insulin sensitivity (1, 2). However, I think its telling that all of the cultures with very low T2D incidence consume starch based diets very low in all fats, by comparison with Western intakes (3).




      2
  2. I have two brother-in-laws who are diabetic. One with type 1 and one with type 2. They are obese and struggling to manage their disease, but still receive information from their doctors to cut carbs and eat protein. They are not improving. They are gaining weight every year and using more and more medications. They are in danger of losing their feet, but they still believe changing their diet will not work. There are no plant-based doctors in their network. No matter how much information my husband and I give them, their current medical care enables them to eat the rich fatty diet they desire. Hopefully, there will be a doctor in their future who will prescribe a plant-based diet and work with them to not just manage their disease, but reverse it.




    1
    1. Infuriating to say the least BB! I have had T1 diabetes for 46 years and have never heard a single piece of useful nutrition information from one of my doctors. But none have said anything this egregious. (I did have an internist tell me to limit avocados because of the cholesterol but that was humorous rather than damaging.)
      My experience might be a useful anecdote for you. When I went with a WFPBD my insulin requirement dropped approximately 25%. I was surprised but then found that this is very common. In other words T1 diabetics also, on the standard American diet, also have insulin resistance.
      The change is important for many reasons but for diabetics the advanced glycation end products from eating animal products are an especial hazard. The AGEs cause further insulin resistance, atherosclerosis and many other unpleasant consequences such as inflammation. We diabetics will produce the AGEs because of elevated blood sugar and there is only so much we can do about that. But eating it is just stupid.
      So my insulin requirements are down because of lower fat, along with the elimination of branch chain amino acids from animal products. Exogenous AGEs are also down and that further reduces insulin requirements. At the same time my cholesterol is now down to less than 150 and my triglycerides are at 31. This is no accident!

      I owe this to careful wfpbd and frequent blood sugar monitoring. Furthermore I will submit that any T2 diabetic who cannot reverse the condition with diet has already suffered too much damage to the beta cell from the high fat high animal protein diet. So if your brother in law is not yet on insulin he likely could still reverse the condition entirely.

      OK OK, this topic usually gets me going. I hope you find something useful in that. By the way, I am 67 and have no side effects from the diabetes.




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      1. I just loved reading about your accomplishment and point of view. Thank you for sharing it with us.
        My friend, Type II diabetic for over 10 years, “got it” after reading the usual books – China Study, Esselstyn, Barnard, Ornish, et. al., and changed to a WFPB diet. He did really well at first and got off all of his medications – for a while. But he does not exercise – sits at a computer, then sits in front of the tv watching movies for entertainment and his recreation is a sitting option. He also eats at restaurants and NEVER asks for steamed vegg or meals made without fat. He insists the Asian food he eats (he does not cook) is not prepared with oil. So although he thinks he is WFPB he is NOT low fat. And he has slowly been put back on his diabetes medications. Not as many as before, but he is disappointed that he is not medication free. He won’t learn to make the simplest at home meals. And he is disappointed.
        My point: – restaurants are a part of the larger food industry. They are not necessarily our friends. Unless we specifically ask them to help us out and request no-added-oil.




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        1. I agree Rhoda. Everyone who I’ve talked to who has worked at a Chinese restaurant has said the same thing-it should be the healthiest food you could eat, but in reality, it’s amazingly bad for you how they prepare it.
          JohN S




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    2. BB – My father, who is 78 and has been a Type II diabetic for over ten years, continues to receive the same type of dietary advice from the endocrinologist that he sees, i.e., low-carb with an emphasis on meat. Just today, I happened to run across (on Facebook) an article from a registered dietician giving the same low-carb, high-fat, meat-based advice (see http://robbwolf.com/2017/01/05/why-wont-we-tell-diabetics-the-truth/ ). No wonder Type II diabetics struggle!




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    3. oh,how sad………I feel you and I also feel them not understanding ,it is so much brain-washing and control through food,that their minds cannot think clear.Sending them much light and comfort with their health !




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    4. When I went WFPB and reversed diabetes and a slew of other issues I never guessed were dietary, I was awe struck and thrilled, but aghast that my doctors refused to question the dogma! I tried the diet after seeing Forks Over Knives out of desperation, because I felt terrible and all medicine had to offer were drugs. I told one doctor about it and she said it would be dangerous to eat that diet! (But the ADA diet she gave me that did nothing to help was fine?) So I tried it on my own and I monitored my blood sugar carefully, and was able to wean myself off all the pills in a few weeks. When my A1c was consistently below 5.7 for a few visits, and I was actually dropping excess weight, she was satisfied the meds were giving me excellent control…until I told her I wasn’t taking them and what I did. At first she thought I was joking, but when she realized I was serious she got gruff and insisted she had never seen anyone reverse diabetes before, and I needed to continue on the drugs to be “safe”, including a diuretic to “protect” my kidneys! Long story short, I didn’t go back, I still haven’t found another doctor and never felt better, but I still would like to find a good one. We are in desperate need of change, the truth can’t spread fast enough!




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      1. Yes, when I told my doctor about all the plant foods, mushrooms and herbs I was eating, all he could say was, “You’re going to die anyway.” Thanks for the helpful comment.
        John S




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      2. I think the tipping point is coming (for some physicians at least), I work in dialysis and some of the Nephrologist I work with are getting on board with plant based diets.. I am so excited to see the shift!!




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    5. Dear BB: There is an on-line summit about to happen on reversing type 2 and improving type 1 issues with a whole food plant-based diet. Google it and send your 2 BIL the link. Hopefully they will watch. Also give them the link to Dr. Barnard’s book on reversing diabetes. They do not have to suffer the way they are suffering.




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    6. your brothers don’t need a plant based doctor to immediately switch over to a No Oil WFPBD this very minute.

      oatmeal, fruit bowls, rice and beans (beans at each meal), whole grain pasta primavera, bean burritos on corn tortillas or whole wheat if you can find it without oil, refried beans on a romaine lettuce wrap packed with onions, salsa, green peppers, whole wheat bread without fat, salt or sugar, etc. and then more fruit.

      within a week they will be off insulin if they’re on it and are actually following this to a “T” and reading labels on everything they consume.

      get the book by dr esselstyn, “prevent and reverse heart disease” and read it in an afternoon (same diet for all our ailments cures all, seriously). one could literally read the book in the morning and the other in the afternoon its that simply written.

      the body will literally begin healing itself THE MINUTE you change diet. been there, done that. terminal 6 years ago and within 3 days my T2 diabetes was history.

      no more excuses now.

      if they get their feet amputated then it’s their choice because you just got the answer.

      tell them NOW!

      ps, i missed the part that one brother had T1 but the same thing still applies.

      go to youtube, search for “Type 1 Diabetic Raw Vegans” and “Type 1 Diabetic Vegans” and you will get more info.

      i can specifically picture a young popular guy in the field who has his T1 completely under control on a Raw Food Vegan Diet and it would be of benefit to study up and make changes BEFORE the feet are amputated unnecessarily.

      .




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  3. The animation was really well done and helpful to understanding the subject.

    I saw an interesting video about how animations (particularly line drawings) can also be helpful in persuasion since they increase cognitive ease, as does clear, crisp audio. This may explain why a lot of ads use simple cartoon drawings these days (apart from being cheaper than filming live actors). Also, I wonder if some of the vloggers I like that use strong enunciation (e.g, CGP Grey) are doing so deliberately; I had always thought I liked their style of speech since I have problems parsing speech. I can’t find the video in my history, but there are many on the topic of cognitive ease.




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  4. good job Scientific Animations, very well done ! I thought the concepts were made clear, more easily understood, and enjoyable to watch. ty dr greger!




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  5. Great video, but something that is not clear is if any of this applies also (and if yes, to what measure) to non-saturated fat. Does someone know the answer?




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    1. Insulin resistance occurs with high amounts of fat, whether saturated or non-saturated. However, saturated fat does a much “better” job at producing insulin resistance than other fats do. http://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/
      On a personal note, my daughter, a type 1 diabetic, will get about the same amount of insulin resistance with 10 grams of dairy fat as she will with 40 grams of avocado/nut/seed fat.




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  6. seems to me that the bad combination is high fat AND high carbs (and it doesn’t take much to be high carbs). In the ketogenic diet, carbs are suppressed very low as are the corresponding sugars. So ….. does the data hold up and does the scenario described still work as described if blood sugars are significantly lower on high fat diets?




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    1. I think that the scenario still holds up. It’s just that when you don’t eat any carbs, there is no need for insulin, so you can’t tell that it’s not working.




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  7. I am thoroughly convinced by the argument in this presentation that fat in the blood causes insulin resistance. Can you help me make the connection / correlation between all saturated fats in the diet ( both animal and plant based) and fat levels in the blood.
    There is much comment around these days from Dr Hyman et al that the fat in your diet DOES NOT necessarily correlate with the fat circulating in our bodies. Many thanks




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    1. Hi Kevin, I would ask anyone who supports what Dr Hyman is teaching to show you the science. Dr Hyman phrases much of what he says in his book in a way that makes it appealing to people who want to justify eating something that’s not good for them. I can find no other reason for this than that it sells books. I have met Dr Hyman, I trained under Dr Hyman and I credit him in many ways with helping to bridge the gap between integrative/lifestyle medicine and conventional medicine, something that has been desperately needed for decades. But on the fat issue he sold out in my opinion and I’m frankly disgusted by it. I wish I could give you a more dignified answer but unfortunately that’s the best I can do. By the way, I don’t believe he himself eats the way he is telling others they should eat in his book. As I said I’ve been in conferences and dining halls with him and all I’ve ever seen him eat is a mostly plant based diet. Back in the days when no one knew who Mark Hyman was, a former president with heart disease by the name of Bill Clinton went to him and he taught Bill to eat a plant based diet. To this day Bill Clinton credits him with saving his life.




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    2. From the transcript of that video: “but those who are obese are constantly spilling fat out into their bloodstream. But we can reach those same levels in our blood eating a high-fat diet. So a skinny person eating a low carb diet can have the same level of fat in their blood as obese people do. Similarly, being obese is like eating some horrible bacon-and-butter diet all day, because obese persons are constantly spilling fat into their bloodstream no matter what goes in their mouth.”

      http://nutritionfacts.org/video/the-spillover-effect-links-obesity-to-diabetes/




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  8. The last sentence of the video suggested we reduce our “Saturated” fat intake? Based on these studies, shouldn’t we work to reduce all fats in our diet? I didn’t see where the studies were specific for saturated fat.




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    1. Put it this way (and I know this because aside from all the scientific evidence out there I actually do it and my numbers reflect the evidence)… of you eat a diet rich in a variety of plants, which is inherently low-fat, and you also include fats from Avocados/Nuts/Seeds (which may contain some SAT FAT), you’ll still get amazing results and also benefit from all the minerals and phytonutrients from the Nuts/Seeds group. The key is: if you’re going to have some SAT fat, make sure the food is loaded with other important nutrients, phytochemicals, fiber, etc. and it’s not going to have a negative impact on your health or processes that occur in your body. The problem with animal foods (with SAT FAT) is that they contain too many other harmful components to make it worth getting (for ex) some B12 or minerals. The high protein is bad, the hormones are bad, the heme iron can be bad, the type of SAT fat is bad, the amino ratio (high methionine,etc.) is bad, zero fiber and zero phytochemicals are bad, Low Magnesium amd Potassium are a problem too, and so on. Plant foods do not have ANY of these concerns. Make sure to eat HIGH FIBER foods (50-100g/day) and your health will be amazing and your numbers will improve dramatically within weeks or a couple of months.




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      1. thanks so far…I´m almost in, but I really LIKE some olive oil over my steamed green vegies and I can´t think of leaving this out!! It es even not so easy to stick on this kind of eating, but without some rapseed/olive oil it is really really unimaginable for me! Everything else ist just finde, but this point is qualitiy of for me! I was a butter and heavy cream lover before so a little bit of fat is very important to me..




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        1. these 2 guys “liked” their plant fats too, olive oil, nuts and seeds until they had a stroke and one was a 17 year long RAW VEGAN! who thought he was doing everything right.

          they both got very lucky, most likely because of the protective effects of their WFPBD even though it was loaded with fat.

          *ANY* added oils or nuts/seeds will disrupt your omega 6:3 ratio which ideally should be under 4 to 1.

          the japanese were (used to be) down into the 1.5-2.5 to 1 ratio with virtually no disease.

          i would just throw out a complete guess that yours is in the 8-10 to 1 range based on the short paragraph you wrote. you could ask your doc for a omega 6-3 ratio blood test if interested.

          after a completely strict, NO oil, fat, nuts, seeds or fatty plants WFPBD, at about 4 years mine was still a disappointing 4.9 to 1.

          that should give you some perspective and i did all of this to reverse my inoperable, terminal, progressive brain disease which i did accomplish in 20 months.

          bottom line is that if you want to be in prime health, you NEED to be on a “NO FAT” WFPBD and it’s nonsense that it’s difficult once you get past the 1-3 months where your taste buds finally change back to normal and you can enjoy the real taste of real food again.

          one way to get past this “sticking point” and retrain your taste buds quicker is to make a big fruit bowl (or two) every single day and eat it. mine consists of 1/2 canteloupe, apple, orange and raisins. same for my wife and mom can only get thru half of that per day but as she’s getting more and more into this lifestyle, she’s eating more and more.

          i’m not sure if you saw/received this last email and article from Dr G but it’s chock full of good info in the comments section. it would be worth your while to read it.

          http://nutritionfacts.org/2017/01/10/benefits-of-nuts-for-stroke-prevention/?utm_source=NutritionFacts.org&utm_campaign=3834426323-RSS_BLOG_DAILY&utm_medium=email&utm_term=0_40f9e497d1-3834426323-23317021&mc_cid=3834426323&mc_eid=e1f87fce02

          here are the videos, the first being a 10 minute short version and the second is the complete 100 minute interview:

          https://www.youtube.com/watch?v=zn4Pfd06rhE

          https://www.youtube.com/watch?v=AbrYzjRjfe4




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            1. sorry renate, but i’m not here to debate or argue my position of my own life experience.

              i only want to pass on my real life story of going from terminal to completely cured with no evidence of disease and let people draw their own conclusions. i’ve pretty much explained my entire life story over the last few months in these comments sections if you are really interested.

              this is not an area where we are going to find a double blind, placebo controlled study done on rural indigenous peoples or No Fat WFPBD people who are not poisoned by a high fat diet to disrupt the results.

              because of that you have to study everything you can find even if it’s anecdotal like the info i gave you above and come to your own conclusions because a trial like that will never happen.

              i wrote you a compelling, well thought out post above yet you come back with resistance and aggressiveness and i just don’t have the time to argue with anyone so negative when i’ve personally helped so many people who actually want to be helped.

              if i could remove the post i wrote for you i would but i’m going to leave it for anyone else who may wish to learn something from it.

              good day.

              donald.

              ps. please get back with us sometime and let us know if your omega 6/3 ratio is in the healthy 1.5-3 to 1 range, i’d really like to know the result.

              .

              .




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              1. AZ DONALD

                You can eat a high fat diet and still have an optimal 6:3 ratio.

                I personally eat around 100g of fat per day (avocado, chia, flax, walnuts, almonds), on a 2600 calorie diet, and my ratio is less than 3:1.

                Anecdotal as well.




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  9. What about Coconut Oil?
    Yes, it is a saturated fat, but it is reported to be good for you.
    Is it generally ok?
    Do I need to limit the quantity?
    I don’t eat meat and I think my level of fat intake is pretty low, but I do cook leafy greens in coconut oil about 2 times a week. I love them prepared this way. Cooking greens with broth is not so appealing to me.
    Your thoughts about this would be greatly appreciated.
    Helen




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    1. Helen: Coconut oil has a very effective marketing industry. However, the science does not seem to back up coconut oil as being healthy in general. Here is what NutritionFacts has on the topic: http://nutritionfacts.org/?fwp_search=coconut+oil&fwp_content_type=video
      .
      We must of course, put it into perspective with your situation. If it is a choice between cooking your greens in coconut oil and not eating greens at all, that’s a lot harder as judging from what I have learned about greens, they are an extremely important food group. I’m not an expert, but my opinion is that if you can start finding ways to wean yourself off the coconut oil while still enjoying your greens, that would be the better option.
      .
      Have you ever tried cooking your greens in a cashew cream that you make out of whole cashews and water? Dr. Greger recommends 1/4 cup nuts and seeds or 2 tablespoons nut butter each day. I’m wondering if you can find a way to substitute the coconut oil for something that is still rich, but a little healthier. Though I have to say I don’t know what harm might come if you are heating the cashew cream to a high heat. I’m just trying to come up with an idea you could try IF you are interested in trying.




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      1. Hey Ms T..
        I mix up a salad dressing of about 10-12 oz cauliflower florets and 3/4 cup of cashews in the blender.. Add a bit of lite miso or spices you like (turmeric and pepper) and I’m good to go.. If I’m gonna eat fat I’ll eat it with the fiber it came with.. Olives, avocado, nuts and seed in moderation.. Even moderation in moderation!!
        m




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    2. Despite the advertising hype and resultant popularity, I would avoid all oils as they are just a high caloric waste product left behind after the nutrients and fiber are processed out. If you need to use fat, use a whole food source like Thea suggested, with the nutrients intact. Or try steaming your greens and adding just a touch of a flavored oil afterwards and gradually omitting it. I used to slather all veggies in butter, so I know what you mean, but it is doable!




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    3. Helen take a look at my postings above regarding coconut oil and olive oil.
      Also, Dr G has previously commented on coconut oil and advocates against using it – precisely because of its extremely high saturated fat content.
      Hype does not fact make.
      Thank you.




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  10. I have a technical question. If you click on this video it goes to this youtube video:
    /watch?v=5uA-_YpkPSo
    Yet if you are subscribed on youtube there’s the exact same video but on a different link, with different comments etc.
    /watch?v=Aw8hufhIDu0&t=2s
    Why the two different links? Seems like it splits the NF community in two and if they were under the same link the video would be more popular.




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  11. You mentioned saturated fats but can any/all fats lead to insulin resistance? What are your thoughts on coconut oil, avocado and nut oils as contributors? (My daughter has been diagnosed insulin resistant for over 10 years and she insists on eating these fats daily as a good thing) Yes she is obese.




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    1. hi Barbara, this link is a video and article resource list which you may find useful to explore
      http://nutritionfacts.org/topics/diabetes/ Within the video collection you will find obesity is mentioned numerous times as being a risk factor not just for diabetes, but for a myriad of chronic disease conditions like heart disease, stroke, high blood pressure, various cancers etc. This video on the benefits of a plant based diet in reversing type 2 diabetes may be particularly of interest http://nutritionfacts.org/video/plant-based-diets-and-diabetes/ Best wishes




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    2. Her results speak clearly. When she modifies her diet to exclude added fats and animal parts, she’ll soon be on the path to recovery. BEST of luck getting her to latch on to this idea.

      Fats (all oils) are processed foods and therefore not WFPB. I minimized them in my diet (and lost weight). Some doctors of nutritional note are dead against any added fats, at all ever. I’m not so strict with myself so long as the scales are happy and I’m feeling good.

      Here’s a bit more info: https://www.youtube.com/watch?v=1vk68e_xv5k




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    3. Any oil is not considered food, just empty calories with all the fiber and nutrients taken out. It’s basically advertising propaganda and not to be believed. The fats we need we should get from whole food.




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    4. Oils are not a whole food. Coconuts, avocados, nuts, are a whole food. This site advocates eating a Whole Food Plant Based diet. A friend of mine once commented “If I’d had any idea how fattening olives were I’d have stopped eating them years ago (he’s very Italian)”. But he regularly pours olive oil all over his food thinking its healthy for him. I then explained to him that it takes approximately 44 olives to make 1 Tablespoon of olive oil. Would you eat 44 olives? I asked my friend. The answer was no, 2 or 3 at most. Then why pour the equivalent of (not less than) 44 olives over your food. He regularly poured more than 1 Tbs of olive oil on his food thinking it was healthy.
      It takes about 25 coconuts to make one litre of oil – that equates to 1/2 coconut (approximately) per Tbs of oil. Would you sit and eat 1/2 of a coconut with your meal? Probably not.
      My suggestion is that before one pours oil over their food or cooks with it they might want to consider how much food they could actually eat if they consumed the real food rather than the oil from the food.
      Oil is not and never will be a whole food. It just isn’t.




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    5. Hi Barbara,
      All fats eaten in excess can contribute to insulin resistance. Coconut oil is a saturated fat and is as harmful as butter. http://nutritionfacts.org/video/is-coconut-oil-good-for-you/
      Although the fat in avocado and nuts is poly and monounsaturated fat it is still fat and for someone with obesity or insulin resistance can be problematic especially if eaten in large quantities. Also processing these fats as is done when creating avocado and nut oils makes the fats more likely to produce inflammatory substances that contribute to insulin resistance and vascular disease. It would be best to consume the whole avocado or nut, not it’s oil and even then, sparingly, especially if you are overweight or have insulin resistance.




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  12. Fantastic animation that has greatly improved my understanding of the mechanisms of the insulin resistance problem. I will send this video to so many people and now can explain this in my work so much more effectively. Love the CME on Nutritionfacts.org. Thank you.




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  13. For the people who ask about plants fat:

    “And not just any fat; saturated fat. The predominant fat in olives,
    nuts, and avocados gives you a tiny bump in death protein 5, but
    saturated fat really ramps up this contributor to beta cell death.
    Saturated fats are harmful to beta cells; harmful to the
    insulin-producing cells in our pancreas. Cholesterol too. The uptake of
    bad cholesterol, LDL, can cause beta cell death as a result of free
    radical formation.”

    http://nutritionfacts.org/video/what-causes-diabetes/




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  14. It is one thing to hear/listen to facts. Now I have seen those facts play out in living color. It is like a different part of my brain has been educated. I feel so motivated to redouble the effort. NO OIL!
    So I repeat, Thank YOU Dr. Greger.




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    1. This 5 min video describes the biochemical mechanism for insulin resistance. It is one part of an over-arching principle centred on a whole-foods-plant-based eating plan. The Harvard article is about the negative effects of replacing fatty foods with refined carbohydrates. At no point does the article say anything about ending experiments early for patient safety.




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        1. Let me quote from your article from the NYTimes:

          “The participants stayed with the Mediterranean diet, the investigators reported. But those assigned to a low-fat diet did not lower their fat intake very much. So the study wound up comparing the usual modern diet, with its regular consumption of red meat, sodas and commercial baked goods, with a diet that shunned all that. ”

          Per their own comments in the article, this was not a comparison, after all, of a high fat diet with a low fat diet but was actually a comparison of the Standard American Diet (SAD, filled with junk food and other unhealthy components) with a Mediterranean Diet, which is naturally lower in fat than the SAD diet.

          I’m wondering if you read your own article that you posted?




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          1. At the start of the study that where those were the conditions. After interceding to make sure that the control group was eating less fat it changed nothing, the higher fat Olive Oil Mediterranean diet was superior,




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            1. I stand by the conclusion of your own article at the end of the article as I quoted (your article) above. Their conclusion is that the research shows no comparison to a high fat or low fat diet but a healthier or unhealthy diet by virtue of soda, processed food, processed meats – their words, not mine.
              Thank you.




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    2. Your link doesn’t say anything about ending experiments for patient safety. By the way, many these Harvard position papers are pushed by Dr David Ludwig a low carb advocate of dubious nutritional understanding. When Atkins and Taubes are your buddies, well … say no more.

      More to the point, typical diets in Blue Zones (populations with notable longevity) consisted of low fat and ample carbohydrates and were eaten throughout their long lives. Those “experiments” certainly didn’t end early.




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  15. A low fat diet is best for optimum health for many reasons but I would be surprised if plant based fats have the same effect as animal fats in promoting insulin resistance. I’d like to see a comparison. Lumping all fats together seems like bad science.




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  16. More confusion…there are other studies and books which say exactly the opposite: you want to lower insulin resistance? Go to Low Carb, High Fat. And there’s nothing wrong with saturated fat, either. Lard is good. Butter is good. In fact, man-made oils (vegetable like corn, safflower, canola) are bad, bad, bad. Olive oil and animal oils are fine. I’ve been doing LCHF for almost a year. Weight way, way down. Cholesterol, Triglycerides back to normal. Blood pressure lower than “normal”. I feel great, don’t need naps, and don’t eat any grains or sugar.




    1
    1. I think the general premise is that any added refined fats into the diet, vegetable or animal, are unnecesary and are therefore both bad. I’m vegan for over half my life, and I used to think animal fats were bad, and refined concentrated vegetable fats were good. I now think both are bad so don’t add them to my diet.




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    2. Actually, the peer reviewed papers I’ve seen advocating LCHF for T2D are very upfront that their approach doesn’t improve insulin sensitivity. Their argument is that by reducing hyperglycemia (as measured by HbA1c) they’re reducing the diabetic complications responsible for most harm. Its possible that the high protein content of some of these diets aids weight loss, but increased protein intake during weight loss also impairs insulin sensitivity.

      As I see it, the choice is really between a low-fat starch based (peasant) diet that, in most patients, restores the ability to cope with dietary carbs; or a low-carb diet which, while likely having adverse effects on insulin sensitivity and total mortality, does keep HbA1c down (so long as the diet as maintained). Comes down to whether you want to cure T2D by eating one restricted diet, or exacerbate T2D pathology but delay complications, with a diametrically opposed restricted diet. While I have no prediabetic issues, for me the decision came down to the other effects of LCHF diets in increasing CVD and other non-metabolic disease mortality. So much easier to just eat the peasant diet.




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    3. I’m curious as to why you designate corn, safflower, and canola oils as man-made, but don’t so classify olive oil. Also, I don’t think I’ve previously encountered the phrase “animal oils” — what are they?

      BTW, I’ve been doing WFPB (HSLF, i.e., high-starch low-fat) for four years; weight fine, blood lipids way below normal (if normal denotes average American), and none of the angina that used to limit my cardio exercise.




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      1. Man-made refers to the significant and necessary processing to produce the oils. Olive oil has been around for thousands of years because it’s easy to obtain. But modern vegetable oils are a relatively new product (100 years or so) and have to be manufactured through complex chemical processes. The problem as I have read it is that the human body doesn’t recognize these Franken-oils and reacts badly. Animal oils are lard (from pigs), suet (beef), fish oils, etc. It’s great that the WFPB works for you – I’m one of those carb-sensitive people and as much as I like things like oatmeal and beans, it just triggers an insulin response and the pounds come on. Frustrating.




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  17. Brilliant animation! I shared and specifically mentioned that fact.

    How many years until we get “may cause diabetes” labels on fatty food products? (not holding my breath)




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  18. It would seem that the insinuation and statement that a ketogenic diet can cause or exacerbate type 2 diabetes is based on a flawed premise. Specifically, that dietary fatty acids cause corresponding increases in serum fatty acids. This assumptiion has been extensively tested and found false. The studies you cite in this video involve ffa infusion as a means of raising ffa levels.

    Unless you are implementing your ketogenic diet intravenously it is an extreme and unwarranted stretch to impune LCHF diets. The single citation that involves diet is 70 years old!

    Please address this descrepancy. Thank you.




    1
    1. Yes, I’d love to see a reply to this question. Thanks for posting it. I am living proof that LCHF/Ketogenic diets work to put Type 2 Diabetes into remission. As are TONS of others. So this video makes absolutely no sense!




      1
      1. Truc Giarc: As others have pointed out elsewhere on this page, no one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat diet. If you don’t put any glucose into the blood to begin with, it’s true that you will not have any blood sugar spikes. Moderator Darchite did a great post on this topic not too long ago. She covered the two ways to address type 2 diabetes: a very high fat diet or a very low fat diet. Here is the post that is worth a read: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730. Note that this is all consistent with the information provided in this video.
        .
        So what if you choose the high fat route? It “works,” so why not? When you choose the high fat route, you are not treating the actual cause of type 2 diabetes (see video: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087604266 ). You are just addressing the symptom, blood sugar spikes. You still have the underlying disease, insulin insensitivity. What’s more, you are eating a diet linked to increase mortality (dying sooner). Following is a post from Tom Goff sharing some of the science that links low carb diets to increased mortality. Even this little post has a long list of studies: http://nutritionfacts.org/2016/12/13/whats-the-optimal-cholesterol-level/#comment-3064114115. For further research, note that NutritionFacts has lots of videos on the topic of high fat diets. By watching these videos, you can see that such diets are not good for long term health from multiple angles.
        .
        Here’s an analogy that may not be the best, but might help: Some people smoke because it keeps their weight under control. We all agree that keeping weight under control is generally a good thing. The problem is that smoking is bad for maximizing chances of long term health. There are healthy ways to keep weight under control. So, you can choose a method that is likely to provide for long term health or one that raises your risk of dying sooner. The same applies to dealing with type 2 diabetes.
        .
        If you are interested in learning how to treat the cause of type 2 diabetes and maximize your chances of long term health, I have some great resources to share. Let me know if you are interested. Good luck.




        1
          1. Following is a really great book I have read more than once. The book is based on solid, published research. Dr. Barnard has done studies on diabetics where he only changed the diet. Dr. Barnard got published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity following the diet. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
            .
            The book is called “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?s=books&ie=UTF8&qid=1480632167&sr=1-1&keywords=barnard+diabetes The diet can be labeled as a low fat, whole food plant based (WFPB) diet. The beauty of this diet is that you not only get the benefits of treating the type 2 diabetes, but you also get the benefits of maximizing your chances for long term health. As evidence for that statement, I’ll note that this is same diet which is great for preventing or reversing the top 15 killers of Amercians (http://nutritionfacts.org/video/how-not-to-die ). It is also mirroring the eating patterns of the longest lived and healthiest populations on the planet. The traditional Okinawans are an example of this: http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/.
            .
            Here is the practical side: Dr. Barnard’s book contains both sample meal plans and recipes at the back. So, you will get a lot of support. You will not be on your own to try to figure out what to do. I imagine that once you start, you will want more ideas. Dr. McDougall’s recipe books should all be in line with this diet. You might try The Starch Solution for starters. The Happy Herbivore series of cookbooks is very popular and tasty and at a glance, the recipes all look to me to be in line with the diet. Once you have a sense of what kinds of dishes fit in a low fat WPFB diet, you can really branch out for recipe sources, tweaking recipes as needed. One of my favorite cookbooks for recipes is: Vegan On the Cheap. I just have to tweak a few of the recipes sometimes. (That’s easy to do once you learn some tricks.)
            .
            Would you like more hand holding than cookbooks offer? Dr. Barnard heads a group called the Physcian’s Committee for Resposible Medicine (PCRM). PCRM offers a free 21 Day Kickstart on-line program. The 21 Day Kickstart is recommended by Dr. Greger in his book How Not To Die. The 21 Day Kickstart is super great for beginners because they hold your hand for 21 days – including grocery lists, meal plans, recipes, cooking videos, inspirational e-mails, and a forum moderated by an RD where you can ask all sorts of questions. If you are interested, click the green button on the following page to register: http://www.pcrm.org/kickstartHome
            .
            One thing to keep in mind is that some people can go “cold turkey” and change their diet in a day and be very successful. There are some good benefits to this route. However, other people need to transition over time, both to let their bodies and their minds adjust to the healthier diet. I have heard PCRM’s director, Dr. Barnard, say that initially, people are not ready to make a change. There needs to be some planning and finding out what foods you like. Maybe try some new dishes mixed in with your regular ones until you are feeling confident/not overwhelmed about making a change. Here is a page from PCRM that talks about how to make a plan (if you don’t want to do either of the above ideas or you want to combine all of these ideas): http://www.pcrm.org/health/diets/vsk/vegetarian-starter-kit-three-step
            I don’t know which approach is best for someone who wants to transition from a ketogenic diet to a low fat WFPB diet. You might think about both approaches and work with a knowledgeable doctor or registered dietician???
            .
            A ***CAUTION*** FOR PEOPLE ON DIABETES (and/or high blood pressure) DRUGS: I am repeating what I have seen the expert doctors caution for: Eating a healthy diet can sometimes result in rapid healing. In those cases, it may be necessary to work with a doctor who understands this so that you can be quickly and safely weaned off your meds. (Yes, people make the transition by themselves and are fine. It’s just safer to work with a doctor. I wanted to be clear about this.)
            .
            Sorry for the length. You asked so nicely, I wanted to give you my best answer. I hope this helps!




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        1. Hi Thea
          Its very interesting that you say “no one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat diet.” ie reduced fasting blood sugar. IWhat do you make of the video “What causes insulin resistance” which clearly states that a very high fat diet will do the oposite? It claims that a very high fat diet will cause your fasting blood glucose to skyrocket. Why does the video make that claim?




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          1. Steve Byrne: I’m not seeing the same thing you are seeing. Here is a quote from the video:
            .
            “If you take young, healthy people and split them up into two groups, half on a fat-rich diet, and the other half on a carb-rich diet, within just two days, this is what happens. The glucose intolerance skyrockets in the fatty diet group. In response to the same sugar water challenge, the group that had been shoveling in fat ended up with twice the blood sugar. As the amount of fat in the diet goes up, so does one’s blood sugar spikes.”
            .
            Notice the part about the “sugar water challenge”. They weren’t looking at fasting blood sugar. The researchers fed the participants sugar…
            .
            So, here’s what I was saying: What if you were on such an carb-poor diet that all you ever ate was pretty much fat? What if you didn’t get that sugar water / natural carb intake? In other words, what if you were on a ketogenic diet? In that case, you could not have a blood sugar spike. You would not be putting anything in your body to generate the “sugar”/glucose in your blood. Such a diet is a cheat to address the symptom of type 2 diabetes – ie, too much glucose in the blood – by not eating the glucose in the first place. The problem is that the underlying pathology – the ability for insulin to get the helpful fuel/glucose into the cells – remains.
            .
            Where are you seeing the part about fasting blood sugar in the video or my explanation? What am I missing?




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            1. Yes I know they were not looking at fasting blood sugar, my mistake for mentioning that. The video said what you said, as fat in the diet goes up so does ones blood sugar spikes. My blood sugar has dropped dramatically on a keto diet.

              I also do not see where they were just fed sugar water. The video shows the transcript which indicates a variety of foods for both groups of people. But obviously neither diet would be applicable to any healthy diet.

              Your comment “What if you didn’t get that sugar water / natural carb intake? In other words, what if you were on a ketogenic diet?” What does that mean? Are you suggesting that the keto diet contains no carbs? A keto diet has plenty of carbs. My daily fresh and raw veggie intake exceeds 1 kg and that does not include nuts and seeds.




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              1. Steve Byrne: By definition, a very high fat diet, one so high that you do not get any blood sugar spikes, means that you are getting very little carbs.
                .
                You say that you are getting “plenty” of carbs. You and I have very different definitions of plenty. My definition of plenty is an eating pattern that matches the longest and healthiest lived populations on the planet. Populations which don’t get type 2 diabetes in the first place. The traditional Okinawan diet is such an example. (See link in my post above.) They ate 85% of their calories from carbs. (And 6% fat.) “Plenty” of carbs probably doesn’t *have* to be quite that high, but the healthy level is probably a lot higher than what I’m guessing you are eating.




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                1. Hi Thea,

                  Your definition is interesting but clearly can not apply to my keto diet. My diet is between 75% & 78% fat and I don’t get blood sugar spikes. However, my intake of fresh and mostly organic veggies exceeds 1 kilo every day and fermented veggies are 200g each day (thats not “very little carbs”). Most of the remainder of my diet consists of nuts and seeds along with some animal sources. I track all my micro nutrients and get in excess of my RDA each day very easily as you could imagine with the variety of foods the keto diet allows.

                  I find that the keto diet is dismissed without any knowledge of what a keyo diet actually is.

                  My original point was very simply that each individual needs to determine his/her optimum diet and that no single diet could be optimal for all people. And rather than using blind faith on a diet that makes sense I feel understanding the actual effects of that diet on your body is key. For the layman searching for answers we find many answers that seem to make sense but contradict other answers. Following with beleif in one answer over another can not be as good as following what you know to be true for yourself through careful testing.

                  So, I point out that the keto diet is proving over 8 months to be wonderful for me. It resulted in lower fasting blood sugar (55 – 60) lower blood pressure (105/60) and better triglyceride/HDL ratio (.9) as well as a wonderful sense of mental calmness and clarity.

                  My experience is what I know to be true for me. To give up my feeling of superb wellness based on simply “belief” in something else does not make any sense to me.




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                  1. Steve Byrne: We know exactly what a keto diet is. You just showed us a good example of a keto diet: one that has an excessive amount of fat. With 75% fat, I’m guessing that you are getting maybe 10% or so carbs? That trivial amount of carbs explains why you are not getting blood sugar spikes. As explained, your situation does not mean that you have fixed your type 2 diabetes. It means that you are not eating enough carbs to get a blood sugar spike to begin with.
                    .
                    Your lack of spikes is nothing to brag about, because eating such a diet also means that you are taking a huge risk. That low carb diet you are consuming is linked to early death (increased mortality). For an early indicator: If memory serves, you are the person who shared his total cholesterol and LDL levels, and they are very high levels/definitely in the danger zone. If that was you, then that’s one way in which we already know that you are harming yourself. In other words, even if we were go to with your hypothesis that humans across the board have dramatically different needs and we all can just figure out our own individual needs, you have not found that healthy sweet spot for yourself even in this short term experiment. The other thing to keep in mind is that I keep bringing up “long term” outcomes, because that is usually the biggest issue with unhealthy diets. They rarely kill you in just a few years.
                    .
                    One thing I agree with is that we should not do something based on belief. What we should do is start with what the science says. The science says that eating a diet high in fat causes type 2 diabetes as well as other diseases, such as our number one killer, heart disease. There is nothing you have posted that would lead us to believe your particular biology or diet is any more different for you than they are for the vast majority of other humans.
                    .
                    Note that I’m not suggesting that you should change your diet. You seem very happy with your decisions. That said, you might want to become aware of the risks you are taking for yourself. That’s what this site is about. We educate, and then it is up to the individual to decide how much risk they want to take. I would say that from an ethical perspective, it would be important to be honest and clear about the risks involved if you share your situation with others. Making sure that you do not mislead others would be one reason why you might want to educate yourself on all the risks of eating such a low carbohydrate diet.
                    .
                    Best of luck to you!




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                    1. Thanks for your concern. I do watch the science and as you are aware the science is contradictory. Your site sticks with the science that does not contradict and I understand why that is.

                      I have never been close to being a diabetic. All my life I have enjoyed good health.

                      With my 75% fat diet my total carb intake acounts for 16% of my diet. Don’t trivialize that amount since it is 2 huge raw salads each day plus nuts and seeds.

                      I will continue to check everything available on this site because I enjoy the pursuit of my health and can’t do that without hearing all sides to the story.




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                  2. Steve, I don’t see how you can eat 1 kg of veggies and stay below 20-50g of carbs needed to be in ketosis.

                    I am in the middle of a ketogenic diet experiment. I “fasted” for 3 days only consuming 100-200 kcal per day in the form of MCT oil and exogenous ketones (blood ketones of 2.9 and 3.6 mmol/L on the 2nd and 3rd day, respectively). Then In switched to a classical ketogenic diet (70-85% kcal from fat).

                    A SINGLE dinner consisting of butter lettuce, avocado, olive oil, coconut oil, feta cheese, and smoked alaskan salmon, put me at 19 g of carbs. This is with very little vegetables and not a full day of eating !! I don’t see how you can consume that much veggies and stay even close to below 20-50g of carbs per day.

                    I have been a slim 155-160 lbs my whole life, with excellent blood lipids and a low body fat. I am just doing this experiment for fun. I am thinking of aborting early because I don’t feel any extra “energy” than my regular ~85-90% plant based diet. (probably 50c-30p-20f) macro split. Thoughts?




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      2. Sure. I have a lot of respect for Dr. Greger and the work he is doing but it would seem that equating dietary FFA’s with serum FFA’s is surprisingly out of touch with recent research. It would be nice to say that plant based diets are the be all and end all but some researchers seem to become overly attached (i.e., Ansel Keys) to a single theory and can wreck havoc. I DO NOT believe this is the case with Dr. Greger, but I’m also getting similar results to yours with huge weight loss. It’s a sustainable diet that I have been on for two years and certainly prefer as a life-long solution to health problems including diabetes (T2), cancer, neuro-degenerative diseases including Parkinsons, Altheimers, etc. One could say that the problem is serum FFA’s but as Dr. Jason Fung states — it (can be viewed) as a disease fueled by insulin. I prefer this viewpoint with is also consistent with Dr. Greger’s animations and the magnetic resonance studies he cites here.




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        1. Howard Jachter: NutritionFacts has some good information on Alzheimer’s: http://nutritionfacts.org/topics/alzheimers-disease/ After viewing that information, I would not eat a high fat diet if I were interested in preventing Alzheimer’s.
          .
          NutritionFacts has also addressed Parkinsons several times: http://nutritionfacts.org/?fwp_search=parkinsons&fwp_content_type=video I don’t see anything to suggest that a high fat diet would help prevent or treat that disease.
          ,
          Various cancers have been addressed on NutritionFacts in great detail. The body of scientific evidence supports a low fat whole food plant based diet as the best diet for preventing various cancers. Here is the topic page: http://nutritionfacts.org/topics/cancer/ Here are some videos to start learning about this: http://nutritionfacts.org/?fwp_search=cancer&fwp_content_type=video . Rather than drown in all those videos, I would recommend to someone interested i the topic that they start by reading Dr. Greger’s book How Not To Die and focusing on the cancer chapters for a nice coherent way to address this topic.
          .
          The only disease I’m aware of that a high fat diet might help with is epilepsy. However, while a high fat diet might be necessary to help prevent very serious seizures, the approach comes at the cost of increasing chances of harming long term overall health.




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        2. –“It would seem that the insinuation and statement that a ketogenic diet can cause or exacerbate type 2 diabetes is based on a flawed premise. Specifically, that dietary fatty acids cause corresponding increases in serum fatty acids. This assumptiion has been extensively tested and found false.”–
          Howard, would you please provide some original scientific references for your conclusion so we can read and evaluate them? If this has been studied extensively it shouldn’t be difficult to provide 2 or 3 references.

          Are you saying that dietary fat content does not affect postprandial blood lipids, or are you specifically limiting your statement to serum free fatty acids (FFA)? You are aware that lipids are transported in the blood a variety of ways, not just as FFA? If you are saying that *fasting* blood lipids aren’t affected by the fat content of the last meal, that is the type of game the American Egg Board plays,
          http://nutritionfacts.org/video/how-the-egg-board-designs-misleading-studies/
          but it proves nothing and ignores the important postprandial period, especially as people are in a postprandial state for half to 2/3 of the day.

          –“The idea that plant based diets are evolutionary mandated is dubious.”–
          I assume you mean for humans. Are you saying that great apes are carnivores? Observation of their diet shows it to be 97% plant or more. Here are two articles that may shed some light on the subject.
          https://www.scribd.com/doc/94656/The-Comparative-Anatomy-of-Eating
          http://michaelbluejay.com/veg/natural.html
          However, Dr Greger’s point of view is that even if humans are evolved to eat plants it doesn’t matter to him. What he is concerned about is what does the science say is the optimal diet for modern man? In his opinion that is whole plant food with a few supplements due to a contemporary lifestyle.




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  19. I think the new animation technique in this video really adds a lot to the explanation. I went back and re-watched the first video and although both have the same excellent content and are both easily understandable, this one is much more captivating and the mechanism of what’s going on inside cells seems much more realistic! Of course, the content of the message is the important part, but the visual techniques certainly add to the total experience of watching the videos and understanding and remembering the details. Is this going to be a continuing feature or is this a one time event?




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  20. purified food fat/oils contain saturated fat. 10 grams ( less than a tablespoon) of Olive oil delivers 1.4 grams of saturated fat. Now that I’ve broken my fat addiction the thought of smearing my fresh whole food with purified fat is revolting.




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  21. Thea, is it possible to contact you, another NF Moderator, or the staff that makes the videos to suggest looking at data that may significantly change the animation of this video and correct a widespread misconception that still appears in textbooks?




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    1. Gatherer: When I see a post that looks like someone is raising a legitimate correction to the information provided, I pass it onto staff. Would the information you want to share be appropriate to include in a post that I could pass on? If you prefer to directly e-mail someone, I will ask around how to make that happen.
      .
      You clearly know your stuff, so I’m sure any assistance you can provide will be appreciated.




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      1. My suggestion would not alter the take home message of this video, just the background information for how insulin (mainly) exerts its effects on glucose homeostasis. Is there a way to send my email address to NF without making it public?




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        1. Gatherer: As an administrator, I can see your e-mail. I will pass both of these posts, along with your e-mail, to staff and ask them to contact you. I can’t promise what will happen as I don’t know their priorities. But I will give it a shot.




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      2. No one from the NF.org staff has contacted me yet, so I’ll write my suggestion here. The video above, “What Causes Insulin Resistance?” prompts this comment, but one or several other videos on diabetes by NF.org display the same ‘misdirected point of emphasis’ for the action of insulin. That is, the inhibitory effects of insulin on the liver appear to be of far more importance physiologically than the stimulatory effects on muscle.

        From the video transcript (paragraphs 2-6) and video animation (1:11-3:06) it appears that Dr Greger and I both were incorrectly taught in physiology classes that in blood glucose homeostasis insulin’s primary effect is to stimulate glucose uptake by peripheral tissues, mainly muscle, thereby accelerating glucose clearance from the blood. However, apparently this stimulatory role of insulin is a minor one yet has been described, primarily between 1960 and 1980, as the major role. This widespread misconception still appears in textbooks.

        The major role for insulin in glucose homeostasis is to inhibit glucose appearance (output) from the liver. The mistake in understanding was to take data from excised rat muscle where the stimulatory role of insulin was fairly obvious and apply those results to the intact human where the inhibitory role of insulin was more difficult to identify. In vivo tracer studies were the primary way in which the inhibitory role of insulin was revealed.

        British Journal of Anaesthesia 85 (1): 69-79 (2000) (link to pdf provided below)
        –“Things have been confused, however, by a 20 yr `black age’ of endocrinology (between approximately 1960 and 1980), where leading scientists through extrapolating beyond their new discoveries confused scientific thinking and teaching. They formulated new hypotheses based for the first time on hard scientific evidence but they got it badly wrong through extrapolating (incorrectly) from in vitro experimental data in rat tissues to in vivo metabolism in humans. The effects of this `black age’ are still with us because these incorrect hypotheses have, with the passage of time, been turned into dogma and become cast into `tablets of stone’ in undergraduate textbooks. They are also carried forward into postgraduate teaching. For example, even in well respected texts it is still common to find statements such as `The basic action of insulin is to facilitate glucose entry into cells, primarily skeletal muscle and hepatocytes.’ “–

        Perhaps Dr Greger may be aware of the newer, more complicated role for insulin and merely wanted to simplify the explanation for the lay public. I say more complicated because insulin regulated hepatic glucose production is a balance between glycogenolysis and gluconeogenesis from internal (hepatic) and external (peripheral tissues) sources of carbon. That said, the newer understanding of insulin’s role in hyperglycemia has implications for treatment, and for that reason I think it important to get the word out, especially since so many of us have or had learned it incorrectly.

        In the review paper “Molecular Pathophysiology of Hepatic Glucose Production” by Kfir Sharabi, et al, they write:
        http://europepmc.org/articles/PMC4674831?pdf=render
        “Therefore, in the diabetic state it is hepatic insulin resistance and the consequent increase in hepatic glucose production that is the major contributor to postabsorptive and postprandial hyperglycemia.”
        and
        “… suppression of HGP [hepatic glucose production] by metformin is currently the gold standard for clinical treatment of T2DM.”

        Again, the executive summary is that insulin mainly acts on the liver to inhibit glucose production. Hyperglycemia with insulin resistance is due to the lack of inhibition of hepatic glucose production, and glucose disappearance from the blood is not significantly affected.

        Instead of me further regurgitating passages and data from various papers, you can read a good discussion at the Carb-Sane Asylum blog site:
        http://carbsanity.blogspot.com/2013/10/the-cause-of-hyperglycemia-in-type-2.html
        At the beginning of the blog is a point by point summary. Within the blog post two review articles are discussed. Here are the links to those articles.
        http://bja.oxfordjournals.org/content/85/1/69.full.pdf
        http://diabetes.diabetesjournals.org/content/59/11/2697.full-text.pdf

        I hope this helps further our understanding of insulin (and glucagon) and diabetes.

        [Disclaimer: Glucose homeostasis, insulin resistance, and diabetes are not my areas of expertise.]




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        1. Gatherer: I got permission for you to e-mail Dr. Greger directly, but that happened after you had already posted. So, I personally just forwarded your post above directly to Dr. Greger along with your e-mail address in case Dr. Greger has a reply. I don’t know if Dr. Greger will be able to reply or not, but I promise you that the big man will see your post. Thank you!




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          1. Thanks Thea. Go ahead and delete my comment if that prevents confusion. As I said before, it doesn’t change the recommendation to avoid saturated fat.




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  22. Dr. Greger should know better. Frankly, I am a bit disappointed that people will listen to this and believe it.
    Here is a simple example: One on a ketogenic diet, who eats 70-85% of calories from PURE FAT, has the lowest baseline serum glucose and insulin levels out of any diet, including a vegan diet. There arelittle to no insulin spikes on this diet, blood glucose can measure as low as 35-40 mg/dL at baseline, and insulin levels at 1.5 mmol or less. This is a diet consisting of lots of fat — both animal and plant fats and oils. A high level athlete can sustain this diet for months or years, in fact.
    A ketogenic diet usually cures Type II diabetes within 2 weeks, often faster than a vegan diet. I know Dr. Greger likes to simplify things for the masses, but this video is a GROSS oversimplification of the biochemistry.




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    1. Its interesting that theory described in the latter half of this video verifies what I said about how a ketogenic diet is the best diet known for stabilizing blood glucose and eliminating post-prandial insulin spikes. Going on a ketogenic diet (NOT a low carb diet), results in so much fat oxidation, and such a high degree of body fat loss, no wonder its virtually impossible to be diabetic on this diet!




      1
      1. Hi Andrey,

        In a metabolic trial comparing a ketogenic diet to a low-fat diet
        https://www.ncbi.nlm.nih.gov/pubmed/27385608
        The ketogenic diet led to less body fat loss and increased loss of muscle mass.
        When you speak of Athletes could you please specify which study you had in mind? If it’s the one by Stephen Phinney that’s one my favorites. Because it’s one of the few studies where they fed the subjects enough to maintain body-weight, where the subjects were healthy at baseline too. I eat a WFPB diet not because I am ill and wish to regain my health, but rather because I feel good on it and I want to maintain good health. So if I compare different diets I am also interested in the effects on healthy people who are not overweight or diabetic. The results of Phinney’s experiment, even though often seen as positive by low-carbers, do not seem very convincing to me. The athletes never quite got back to their previous level of explosive performance and their LDL cholesterol kept increasing until the study was ended. Which is a shame because I was curious how high it could actually get.




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    2. So if you eat basically no glucose or very little of it you’re surprised the levels of glucose circulating in ones blood stream is low and we should be surprised by that?
      Anyway, who wants to go into ketosis and have bad breath etc from the metabolic waste products? In the way described above we can eat as much tasty healthy whole foods as we want and achieve the same thing. I know what I would do :-)




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      1. WFPBrunner: I understand the feeling, believe me. Sadly, I can’t play favorites. Either you have to remove the line about not being properly schooled or I have to delete the whole post. I hate deleting… :-(
        .
        Also: Maybe you meant to say “can’t” ? Not “can” in the first sentence? Although, I know your diet has set you up so you *can* take anything! ;-)




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        1. Thank you Thea! It is driving me crazy. If someone doesn’t have the time to educate us than please! I do that all the time. I want to make a point but don’t have time to find the reference so I don’t make the point. Trust me I have a ton of opinions.




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  23. Wow this one went everywhere and that is so cool; people talking and thinking about health- nothing could be better. As for me, I keep real simple in my puny mind.

    Just how long would I have stayed in denial about the absurd spin that somehow and someway ancient humans could go from chasing, catching, processing and sharing scarce sources of animal protein and their saturated fat to HUGE quantities of the same and even further deny that lifestyle choice would not add up to some difficulty my body? What were we thinking? Animal protein in triple portion sizes, 3 times a day plus snack, 24/7? and we are concerned with what? Gosh we have to chuckle at ourselves sometimes. Happy New Year!




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  24. Just diagnosed with T2D (A1C = 6.7) and had the training at Kaiser Hospital last night. Emphasis was on low carb plus animal protein plus non-starchy veggies. When I said I wanted to eat vegetarian as much as possible, she told me ‘well there are soy products’ but beans had too much carb. I am so confused. I have been trying to eat WFPB about 90% of the time but my A1C has not budged in 2 months although I feel much better. So confusing and so scary. I guess testing my blood and being my own scientist is the way to go.




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    1. Guest: I can totally sympathize. It really is a scary situation when you get conflicting information for a topic that affects your health and well-being. My recommendation is to read the book I talk about below.
      .
      Following is a book I have read more than once. It is really great. It’s about plant based eating and is consistent with what you learned in today’s NutritionFacts video. The book is based on solid, published research. Dr. Barnard has studies on diabetics where he only changed their diet. He published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
      .
      The book is called “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”. It is a whole food plant based diet, so you don’t have to worry about anyone pushing you to eat meat. The opposite! In addition, the book contains meal plans and recipes at the back of the book. So, you will get a lot of support. You may have to go more than 90%. But you can do it if you want. Note, Dr. Barnard is also part of a free 21 Day Kickstart on-line program I could tell you more about if you are interested and want more hand-holding than the book has.
      .
      Here’s the book: https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1480632167&sr=1-1&keywords=barnard+diabetes




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  25. Dear Dr Greger. Thanks for your daily videos. I include my comments on today’s What causes Insulin resistance?
    I will appreciate your response.
    This study makes sense. It says to me that when healthy individuals eat a high fat meal (a higher source of energy and calories compared to sugars) the body has a mechanism to transiently and partially close the door to sugar as the main source of energy. This response prospectively and preferentially prevents the excess energy coming from sugar to be deposited in fat cells. This short term effect of fat on Insulin effectiveness in healthy individuals (by creating short term resistance) is a brilliant and protective normal response. This rather acute Insulin resistance to ketotic diets in healthy individuals seems to be different to the chronic Insulin resistance of overuse and down regulation of pre-diabetics that are chronically overeating sugar, protein and fat (or worse, using low fat diets that facilitate Insulin spikes, fat deposition, weight gain, inflammation and disease). Thus, the conclusion that avoiding fat will benefit pre-diabetics and type 2 diabetics contains the same backward logic approach that 60 years ago led some to conclude that a low fat diet was essential to prevent obesity and cardiovascular disease. We all know the consequences of that conclusion. The greatest benefit to pre-diabetics comes from decreasing the main cause, the excess sugar in their diet, combined with a comprehensive plan of habits of health. In other words; Insulin resistance is the natural consequence of a high fat or a high sugar diet, but not the cause of pre-diabetes or type 2 DM.




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    1. What kind of carbs though? If they’re refined they’ll spike and crash your blood sugar, and you will be hungry again “right away.” Whole-food carbs will keep you satiated much longer.




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        1. Thea, one of the moderators here, recommended a video that I found very enlightening: Whole Grain Hierarchy…

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

          Not that I don’t eat whole grain bread, or whole-grain pastas (I do), but some formats of whole grains are definitely better than others. Maybe you need bigger portion sizes…?

          I add nuts to my breakfasts as well, so that probably helps (almonds with quinoa, and walnuts with my steel-cut oats). I usually have some type of beans with my brown rice, pot barley, or whole-grain pasta, as well.




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    2. I find that with wholefoods it takes me longer before I feel satiated. I’m guessing that it might be because they digest slower. But usually if I wait about 30 minutes after eating the satiation kicks in.

      But also there is nothing wrong with having a bit of avocado or a few nuts (which trigger a satiation effect, but also help with vitamin absorption).




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  26. SO how does this relate to a ketogenic diet? Not atkins but a diet thats puts you into ketogenesis? Not ketoacidosis.
    Cos if fat is an issue for blood sugar, eating a keto diet which has hardly any sugar in it to get into the keto state, blood sugar wouldn’t be a problem would it?? As there will be less sugar on the one hand plus the muslces will be supplied with energy from the ketones??

    Any ideas on this?? i read the book keto clarity and am about to read cholestrol clarity. the evidence in it seems compelling but doing it plant based is impossible as im finding out.

    Veganism helped but only so far, still have issues of health and been vegan for 4 years and eat mostly home cooked foods, although i do enjoy crisps and dips




    0
    1. Hi Dale,
      I have been keto adapted for several months and am mostly on a plant based diet. I average more than 1 kg of fresh or fermented veggies each day. I find it very easy to keep my net carbs well under 40g each day




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      1. Good morning Steve. It is impossible to be on a “mostly plant based diet” and eat 75-78% fat. Unless your diet is primarily nuts, seeds, avocados, olives etc. Right?

        You talk about this experiment you have been doing for 8 months. What were you eating before that? Processed junk? You definitely would be feeling better if you dropped the junk.

        I suppose you are most concerned about your diabetes so you gravitated to a high fat diet. But doesn’t it make sense to cure your diabetes? And at the same time get that great cholesterol level back? One last question. Are you overweight?

        I personally am running away from heart disease. Low fat-WFPB.




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        1. Hi WFPB

          About 20 years ago I discovered that I had problems with wheat and corn products. Mostly mental fogginess and diminished memory. Nothing serious but enough for me to change my diet. So that resulted in almost a complete elimination of all processed food just due to wheat and corn being in almost everything processed. I also at the same time eliminated all added sugar. So my diet has been very good for many years and has always included large amounts of fresh veggies each day and a fairly low amount of animal products. I have never had any health issues that required medication. Since giving up wheat and corn and sugar (20 years) I have been feeling wonderful.
          I have never been close to having diabetes. My fasting blood sugar when tested was no higher than 95 for all my life.
          Since decreasing my carbs 8 months ago my fasting blood sugar is 55 to 60. I feel more consistantly calm and relaxed. I wake up feeling that the body is ready for a great day. Its quite an interesting experience. The most noticeable effect is that I don’t get hungry at all.
          My weight has never been a problem either. I am actually surprised that I lost 12 pounds since going low carb, from my original multi year 150 pounds.

          My total cholesteral has risen but my Triglycride/HDL ratio has dropped about 20% (.9 now) which depending on who you trust is a much better marker than total cholesteral. Also my cholesteral test was done during the transition to keto adaptation and needs to be done again to see what my numbers are while being completely keto adapted.

          I do confess to not knowing anything about type 2 diabeties. I would have assumed that having low blood sugar was a good plan since I thought there was no cure. If there is a cure why would so many people with type 2 be on medication?

          You are right that on a mostly plant based diet and a low net carb diet means consuming things like olive oil, coconut oil, nuts and seeds and well over 1 kg of fresh/fermented veggies each day.

          The only big difference for my diet now from 8 months ago is that I no longer eat any grains and I replaced that with more olive oil on my salads and coconut oil in my coffee. So it was not a major change to how I have been eating for 20 years.
          Best of luck with your health!!




          0
          1. It’s not “who you trust” it’s about what the research demonstrates. Now you can believe the people whose income depends on book sales. Or you can look at the data. So are you of the belief that the Heart Association and cardiologist are all full of crap?

            I personally have too much heart disease in my family to not believe the data. It wouldn’t be very smart for me to eat high fat and end up needed a stent now would it?

            As you know there are pages and pages of videos from nutritionfacts.org. I like to read the articles posted with the videos to see how good the data is.

            I am confused why you are even concerned about diabetes. Could it be that you read a book and thought this is a concern?

            Oil? Ewww. Processed junk.




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            1. Hi WFPB,

              I certainly have no concern about getting diabeties and like I said I actually don’t know much about it at all.

              I have never had a health issue to deal with so I cant imagine the challenge to regain health like you are doing. I sincerely hope you can eliminate your health issues.

              I only made a comment on this video because my actual results of being on a keto diet for an extended period of time are at odds with the video. I have very low blood sugar. My blood pressure is now never higher than 105/60 when tested in the mornings. I am active and fit at 58.

              I pay attention to health issues because nothing is more important to me than waking up and feeling great. I seem to be coming close to the right balance to accomplish that very consistantly. Keep in mind that my diet before going keto was excellent also for me but the keto experience gives me a noticeable improvement along with dramatically lower blood sugar. And I completely understand that others find a different approach that works just as well for them. I would be very doubtful of a one diet for all idea.
              I haven’t any knowledge of what the heart association has to say since again I am fortunate not to have issues like that. It is interesting though about the sudden change of concern about dietary cholesteral in the latest food guidelines




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              1. Oh I don’t have any health issues. My father died of a massive heart attack at 51. His brother 38.

                I am perfectly healthy thanks to my WFPB eating!

                The video is The Cause Of Insulin Resistance. He is helping people understand what breaks our normal glucose uptake system.




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                1. Thats great to hear that your diet has made you perfectly healthy!!
                  I can understand how that can happen without any problems with the diet you are on.
                  I understand the video. My point is lost because I am not in full agreement based on my demonstrated results.
                  Is low blood sugar such a big deal provided you are in ketosis?




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                    1. I have never had ill health requiring medication. Why is it a concern that I want to maximize my health and feeling of well being why must I have some hidden illness like epilepsy to motivate me? Are you saying that it would be rediculous to be on a WFPB Diet if you were not suffering from problems already? I am almost entirely whole foods plant based with no problems and feel fantastic how can that be a problem? I really feel fantastic and don’t plan to give that up but will continue to do things that demonstrate a benefit and remove things that take away from that.
                      I completely understand how wonderful you must feel on your diet. My previous 18 year diet sounds similar to yours. No processed foods, no added sugar, large quantities of fresh organic veggies every day. It felt great and I was healthy. I then made a small change to that diet and feel noticeably better (big surprise becase the previous diet made me feel very well) plus my blood sugar and blood pressure as well as cholesteral ratios are all improved. I just don’t know why that is clearly bad.
                      Feeling great each day is good for me. Its a little unfortunate that many would agree with you that it seems so strange.




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                    2. I have never had any health issues. Epilepsy? I am not hiding any conditions. Why does it seem strange to want to pursue maximum sense of wellbeing and improved health from a starting point of good health. I know many beleive that is strange but to me it is a normal process and has given me such a good life.
                      Avoiding things that take away from my health and wellbeing and doing things that improve my health and wellbeing is a wonderful pursuit.




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                2. The reason I mentioned blood glucose is due to the video mentioning blood glucose. There is no obsession and no other reason to have mentioned it




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  27. I would like to add that your video may be misleading since you target levels of dietary fat as the problem and the ketogenic diet as a problem as well. I would bet there are many sources of fat that are quite harmful…but not all fat and not all saturated fat.

    Rather than picking what diet I beleive in and eating on faith I have conducted my own experiment. I have switched to a very high fat diet and have become keto adapted. So far its 8 months since the experiment started. Fasting blood glucose levels started at 95 and are now mostly under 60 each morning. And even though my weight has never been a concern I have lost 5 kg and find that I never have any cravings.

    I eat a lot of saturated fats including 30g of butter and 35 g of coconut oil every morning.

    All fats are not the same. And one diet is not likely ideal for everyone. The ketogenic diet when done correctly each day and for more than a month had dramatic effects on my feeling of wellness as well as my actual numbers such as huge drops in blood glucose levels.

    The only way to know is to accurately experiment and to trust your results.




    0
    1. You could also try crack cocaine for a month and see how you feel,

      But how you feel then isn’t necessarily a good pointer to the long term health consequences. What does the science show about the long term health consequences of a high fat diet?




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      1. Hi Tom,

        I totally agree that my feeling of wellness can not be a direct indicator of health. But I have a clearly much calmer and steady and sharper mind than previously. So I am satisfied with the way I feel. I messure my glucose daily and it has dropped dramatically. My blood pressure has dropped to 105/60 vice 115/70 before.
        I wake up in the morning and I feel great. I will be having another full blood test and doctor appointment later to further check if I should have any concerns.

        I read the book “The Art & Science of Low Carb Living” recently and got the impression that authors have been practicing this way of life for several years without a problem.




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      1. Martin K: Some thoughts for you: Note that Steve said that he lost weight. When someone loses weight, their cholesterol numbers usually go down relative to what the number had been before losing weight. You can have your cholesterol numbers go down from cancer too, but that’s not a healthy long term condition to have…
        .
        Another thought is that while cholesterol numbers may go “down”, I’ve never heard of someone eating like that having actually healthy cholesterol numbers. People on this type of diet will tell you that they have healthy cholesterol numbers, but when you get the actual numbers, they have high/dangerous cholesterol.
        .
        This is not to come between you and Steve in having a conversation if he wants and is able to answer your question. I just thought I would share some perspective on the matter.




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        1. Appreciate the feedback Thea – and what you said makes sense. I personally think US cholesterol guidelines are way too hi, and most of us would be far healthier with numbers below 150.
          Cheers




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          1. WFPBRunner: I would characterize the LDL as going from not-so-good to disaster, but I share your general reaction. I wrote my post before he responded, because I felt my points were important regardless of this particular anecdote.
            I do want to say that I give him points for being brave and honest enough to share the numbers.
            .
            He said in a recent post to me that he did not even have type 2 diabetes when he started eating this way. I wonder if he has it now? I hope not.




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            1. I wonder why he started eating high fat? When I see a % like 75 it literally makes my mouth water–and not in a good way.

              Did you see the post “there are two kinds of cardiologists- those who are vegan and those who don’t know the data?” That’s a good one.

              Ok. Off for a run.




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      2. Hi Martin K,
        My first post high fat blood test showed that my total cholesteral went up from 130 to 226. My Triglyceride/HDL ratio dropped nicely to under .9. My LDL increased quit a lot but I did not have the HDL particle size checked. I suspect that my LDL is healthy. Anyway I was very happy to see the higher total cholesteral numbers as I beleive this could be important for better brain health.




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          1. Its up over 140 from a reading of 76. Not concerned about that as it was early in my ketone regime and there is a significant amount of debate about what the levels mean as well as debate about what LDL particle size means.
            The next blood test will be of more interest since I will have been keto adapted for many months.

            My point though is that blind faith in a particular diet does not need to happen. Plus no diet is likely best for everyone. Therefore I tried a precisely correct keto diet and I see that my results are dramatically better than what nutritionfacts says would happen. Low blood sugar, lower blood pressure (105/60), feeling great, and steady and calm mood each and every day are nice. Plus my diet does include at least 1 kg of fresh and mostly organic veggies every day.




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            1. Hi Steve
              Have you spent much time watching the videos on this website and linked research articles? After reading your posts my first thoughts were I hope he is young so there is plenty of time to reverse the damage. Good luck with your experiment.




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              1. Hi WFPBRunner
                Yes I have spent quite a lot of time on this site wayching the videos and learning what I can. I also have spent time reading other points of view.
                I am not sure what you would mean by reversing the damage. I am 58 years old and feel great and my mind is sharp and clear. Fasting Blood sugar goes from 95 to 55…bad news?? Blood pressure steady for many years at 115/70 now 105/60…sign of damage?? Triglyceride/HDL ratio from 1.15 to .9…..scary???
                I don’t read and beleive because that is obviously dangerous. I get a variety of well argued opinions and check to see what effect their ideas have on me. One crazy idea would be that only one diet is correct for all so even if a diet is perfect for my friends how could that possibly mean its perfect for me? I need the proof not the beleif. The proof I get from monitoring and testing blood/ blood sugar/blood keytones/blood pressure as well as the diets effect on my wellbeing and sleep.




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    2. I’ve tried a vegan diet and having gained weight despite everything, I went to a High Fat Low Carb diet and have done very well. There’s so much conflicting data and information that you just don’t know who to believe anymore. But one book really nails it: The Big Fat Surprise. Get it, study it and you’ll kiss Veganism goodbye forever.




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      1. AZ Cowboy: It turn out that that book is a Big Fat Lie. Following is a review where someone actually checked Nina’s references. From Part 2: “Unfortunately there are quite a few instances of inaccuracies in the book ranging from simple citation errors to deliberate misrepresentations of scientific studies to outright plagiarism. These are bold claims that I am leveling against the author. I don’t take these lightly, and I stand by them. I have checked many of her references and the results of my efforts are below.”
        .
        Part 1:
        https://thescienceofnutrition.wordpress.com/2014/08/10/the-big-fat-surprise-a-critical-review-part-1/
        .
        Part 2:
        https://thescienceofnutrition.wordpress.com/2014/06/30/the-big-fat-surprise-a-critical-review-part-2/




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        1. And yet the BMJ disagrees with you:

          Dear Friends,
          The good news to announce today is that last Friday, The BMJ announced that it is not retracting the article I wrote critiquing the science behind the Dietary Guidelines. The BMJ stood strongly by the article, including this comment by BMJ Editor-in-Chief, Fiona Godlee:
          We stand by Teicholz’s article with its important critique of the advisory committee’s processes for reviewing the evidence, and we echo her conclusion: ‘Given the ever increasing toll of obesity, diabetes, and heart disease, and the failure of existing strategies to make inroads in fighting these diseases, there is an urgent need to provide nutritional advice based on sound science.’

          The retraction request was written by the DC-based advocacy group, Center for Science in the Public Interest (CSPI), which then organized 180+ scientists to sign on—truly one of the biggest-ever retraction efforts in recent history. (CSPI was also the group that earlier this year maneuvered my dis-invitation from that National Food Policy Conference panel, an issue for which many of you signed a petition :) – though sadly, I was not re-invited.)
          In the end, the errors in my BMJ article were trivial and did not alter any assertions in the piece.
          What was so dangerous in my article that it needed to be deleted from the scientific record? Its main findings – which have now been thrice peer-reviewed and confirmed as correct – are that:
          The expert report on which the Dietary Guidelines are based is comprised of non-rigorous reviews of the science.
          The majority of rigorous clinical trial science has been ignored (and has been for decades).
          Reviews on key issues — including saturated fat and the low-carbohydrate diet — were not properly conducted.
          The government-recommended diets are based on only a “minuscule amount of rigorous data that these diets can prevent diseases such as obesity, diabetes, and heart disease.”
          In particular, the newly introduced “vegetarian diet,” is based on evidence that the expert report itself judges to be “inconclusive,” which is the lowest grade assigned to available evidence.
          Other findings from the article are listed in my comment published in The BMJ. Thus, despite enormous scrutiny, the article stands, and it provides vital information for how we might better fight the diseases that cripple our nation.




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          1. AZ Cowboy: I’m not talking about a BMJ article. I’m talking about the book and the references not actually backing Nina’s claims. If you look at the review I provided, you will see what I’m talking about. Bottom line is that you have been mislead. Quoting Nina’s defense of her own writings and repeating her claims does not change that.
            .
            We have some reason to think that the BMJ article was actually a paid placement. Tom Goff links to a Carb Sanity article which in turn goes into details about the BMJ article in the following post: http://nutritionfacts.org/?post_type=video&p=35563#comment-3043493116




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              1. Thanks Gatherer! It was not just you. I don’t know what went wrong, but I fixed the link in the original post. Also, here it is again: http://nutritionfacts.org/video/should-we-all-take-aspirin-to-prevent-heart-disease/#comment-3043493116
                .
                Also, because the entire post is so good and to make up for my mistake above, I’m copying the whole thing here so you don’t have to click and find Tom’s post. Just to make sure proper credit is given, I’m going to state again that this is Tom Goff’s post:
                ****************
                Thanks Todd.
                .
                I am not sure that either Taubes or Teicholz did an immense amount of research as you describe it. Possibly they did. It is easy enough however to copy a whole pile of citations from a relatively small number of secondary sources. Many undergraduates do exactly this without bothering to read (let alone understand) the listed citations.
                .
                Taubes and Teicholz may also have done this. The ridiculous stories they tell in their books about Ancel Keys and the Seven Countries Study certainly suggests so. The Seven Countries study is still operating and has its own website. How much “research” would it have taken award-winning investigative journalists to fact check the allegations? But, hey, the guy’s dead so who cares? And of course T&T are not alone in denigrating Keys. Nor is the Teicholz article the only example of the BMJ apparently(?) accepting money to publish articles, The BMJ Open Heart offshoot charges a fee to publish articles
                http://openheart.bmj.com/site/about/faqs.xhtml#4
                http://carbsanity.blogspot.com.au/2015/02/ancel-keys-its-time-to-appreciate-real.html
                .
                It is, though, particularly disappointing to consider the BMJ’ role in all this. Especially since there is some reason to think that the Teicholz article was a paid placement. I don’t know about the Taubes article.
                http://carbsanity.blogspot.com/2015/10/nina-teicholz-bmj-nutrition-coalition.html
                .
                That said, the US Dietary Guidelines Advisory Committee did do a rebuttal of Teicholz’s BMJ article
                http://www.bmj.com/content/351/bmj.h4962/rr-1
                .
                You might also say that their books have in effect already been refuted by major reports on nutrition and health. Going through T&T’s books/articles to provide a point by point refutation would also be a waste of a serious professional’s time. It would give their arguments a dignity they don’t deserve and give the mistaken impression that there is a genuine debate about the evidence. Wasn’t it Samuel Clemens who wrote never argue with a fool, onlookers may not be able to tell the difference? Delete the word “fool” and insert the term you prefer, but the principle is the same.
                .
                Most professionals are also busy enough already. There are dozens of similar books published each year by people with a lot more credibility than a couple of journalists, including cardiologists and tenured academics. Responding to all of them would be impossible but, like cleaning the Augean Stables. it’s far better to just let the evidence itself flush them away..
                .
                Further, both Taubes and Teicholz are media savvy and very well connected, so getting into a public debate with these people is not an attractive proposition. It would also just provide more publicity for their books.
                .
                I think that, in addition to Plant Positive, the scienceofnutrition website has however done a fairly detailed refutation of T&T’s claims eg
                https://thescienceofnutrition.wordpress.com/book-reviews/




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      2. Thanks AZ Cowboy. I will take a look at that book.
        But I also enjoy keeping an eye on sights like nutritionfacts which have ideas completely different from mine. There is lots of info out there and I feel better knowing the opposite views and actually checking my results against those ideas. For my body its clear that my blood sugar level is my choice. If I want lower blood sugar then I know how….if I want higher blood sugar then I can cause that to happen as well. Its really been quite a good education but only because I tested all of this on myself




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        1. Keep in mind that the thoughtful high fat doctors are still urging us to eat a larger volume of leafy greens, berries and low starch vegetables than fat. When I think about someone on a long term diet of high fat and no vegetables, I get worried about their nutrition. Herbs and spices are also high nutrition, low carb. I’m not on a low carb diet, but I think we should make sure that we are getting nutrition whether we are low carb or high carb. Some high fat foods have nutrition and fiber, like avocado, olives, nuts and seeds. Resetting with high fat is different than long term high fat and low veg/nutriion.
          John S




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          1. Hi John
            I guess you didn’t read what I said. My diet consists of more thann 1 kg of fresh raw veggies and fermented veggies each day. I have a small amount of animal based food in my diet. I even have an app that tracks my micronutrients and I get well over 100% for all the RDAs. Its extremely easy to do on a high fat diet. You might be thinking of including large amounts of protein?? High intake of protein is absolutely not an aspect of a ketogenic diet




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            1. Sorry Steve,
              I didn’t see anything about vegies on that post. I mostly meant it for the entire discussion, but I didn’t know how to reply to the whole discussion without replying to a particular individual. It sounds like you’re doing an awesome job of getting all of the nutrients. I agree with you about avoiding excessive protein.
              John S




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      3. A High Fat Low Carb diet might make the all of the usual markers look good, but what’s the point in the numbers looking good if you end up eating yourself into another disease, namely cardiovascular disease.

        It’s similar to the target fixation concept, it’s important to actually be healthy overall, because that’s what keeps us alive, rather than focusing on one aspect of body or just the statistics of one disease.

        If you had gained weight on a vegan diet there was reason (it’s quite easy to overlook something, especially if you were eating processed foods, they hide all sorts of stuff in there).




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        1. Apparently you are unaware of scientific studies which make it clear: ingested cholesterol has no impact on cardiovascular health. The data is clear. You can eat bacon, butter, fatty meat, cheese… and it will not mess us up your cardio system. You know what will? Carbs. Sugar. It’s those poisons that cause cardio disease. Sugar is the problem. I’m no scientist, and the information out there is bewildering to say the least. But the last time I checked in with my cardiologist all he could say was “keep doing what you’re doing”. Weight down. BP down. Cholesterol fine. Triglycerides excellent. EKG so good it was boring. Then I took a dose of some radioactive stuff, ran on a treadmill, they did a scan and arteries free and clear. He had NO concerns at all. And I’m old. I grew up thinking that trans fats were ok because the Gov said so. I paid attention to the food pyramid – even though now we know it, too, is horribly flawed. Trust me, I eat plenty of green, leafy veggies, drink copious amounts of green tea, limited fruit. But for me LCHF has worked well. I can bicycle 25-30 miles a day and I never bonk anymore like I did before. Since I’m in continuous ketogenic state, I get all the energy I need from stored fat and don’t need to rely on carbs. My breath is not stinky – that’s short term phase. I gained weight on a vegan for one reason: carbs increase insulin and insulin makes you store fat. My carb load now is low – 20 gram or so at most. And I ate supposedly healthy carbs. After all the reading and research, I can confidently say that the Paleo and LCHF gurus are on to something, and the vegan crowd needs to get out of their closed mind set and listen. I’m done with this thread.




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          1. Given that even the fittest of men in their 20s have signs of atherosclerosis, I find it very improbable that as an older gentleman you would have arteries which are “free and/or clear”.

            I would however believe that your arteries are “in good condition for your age”, which certainly is something to be proud of, and indeed this will delay heart-disease, or stroke. But why delay the disease, when you can avoid it altogether? That’s something that has only been proven on a WFPB diet.




            1
          2. Dr.William Roberts the editor of the American Journal of Cardiology and the Executive Director of the Baylor Heart and Vascular Institute has published over 1000+ research articles and 10+ books.. He’s one of the world’s most renowned Cardiologists.. He disagrees with you… https://nutritionfacts.org/video/optimal-cholesterol-level/ He says that atherosclerosis has a single cause, namely cholesterol, and that the other so-called atherosclerotic risk factors are only contributory at most. In other words, we could be stressed, overweight, smoking diabetic couch potatoes, but if our cholesterol is low enough, there may just not be enough cholesterol in our bloodstream to infiltrate our artery walls and trigger the disease. Thus, the only absolute prerequisite for a fatal or nonfatal atherosclerotic event like a heart attack is an elevated cholesterol level. -> taken from the transcript of that video.

            He says that we’re herbivores hence why we get atherosclerosis and heart disease from meat + fat.. He’s telling us to go vegetarian/vegan. Dr.Roberts obviously isn’t qualified enough so please tell us more about your high fat/paleo/low carb diet and the people you follow and how good it is… https://youtu.be/yUa814suU9A




            1
    3. There are no long term studies on the ketogenic diet. What about how your body will be 10 years from now? You have no idea if you are causing atherosclerosis on a high fat diet.




      0
      1. Also check out Dr.William Roberts – the editor of the American Journal of Cardiology and the Executive Director of the Baylor Heart and Vascular Institute who has published over 1000+ research articles and 10+ books.. He’s one of the world’s most renowned Cardiologists.. He says that we’re herbivores hence why we get atherosclerosis and heart disease from meat + fat.. He’s telling us to go vegetarian/vegan. https://youtu.be/yUa814suU9A

        Let’s look at the Blue Zones (longest living populations on the planet) and notice they’re 95%+ plant based and eat low fat, high carb diets.. No long living population eats a high fat diet.. https://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ https://www.youtube.com/watch?v=ff40YiMmVkU

        I read some news the other day about a tribe with the cleanest arteries ever found or something like that. What did they eat? High carb, low fat diets. I’ve taken a few paragraphs from a news article (linked below): “A high carbohydrate diet of rice, plantain, manioc and corn, with a small amount of wild game and fish – plus around six hours’ exercise every day – has given the Tsimané people of the Bolivian Amazon the healthiest hearts in the world.”

        “Their diet is high in unrefined carbohydrates (72%) with about 14% protein and it is very low in sugar and in fat – also 14%, which amounts to about 38g of fat a day including 11g of saturated fat.”

        ““This study suggests that coronary atherosclerosis [hardening of the arteries] could be avoided if people adopted some elements of the Tsimané lifestyle, such as keeping their LDL cholesterol, blood pressure and blood sugar very low, not smoking and being
        physically active,” said senior cardiology author Dr Gregory S Thomas from Long Beach Memorial Medical Centre in the US.”

        Backs up the same as the Blue Zones. Mostly plants. High carb, low fat. Mostly whole foods not refined carbs or junk food..

        Here’s the article: https://www.theguardian.com/society/2017/mar/17/tsimane-of-the-bolivian-amazon-have-worlds-healthiest-hearts-says-study

        This research has been published in the prestigious Lancet medical journal..

        Note though: cleanest arteries doesn’t mean longest living or happiest population.. “Two thirds of them suffer intestinal worms (from dirty water + meat..?) and they have a very hard life, without fresh water, sewerage or electricity,” he said. Rates of diseases other than heart disease were much higher in the Tsimane than in the West, particularly for infections like tuberculosis, added Dr Chico. http://www.independent.co.uk/life-style/health-and-families/health-news/tsimane-people-indigenous-bolivian-healthiest-arteries-world-study-south-america-lancet-a7635411.html

        So Blue Zones for the win!




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  28. What % of calories from “all fat” is ok? I read 5-15% of saturated fat from daily calories is ok, but I’m not sure about total fat. I was diagnosed pre diabetic but I want to work on diet to stave diabetes off. Still got to do more tests. Thanks!




    0
    1. Teesha: You might do better to simply emulate the diet that has been proven to reverse type 2 diabetes rather than worry about percentages. So, how do you do that? Following is a book I have read more than once. It is really great. It’s about plant based eating to prevent or reverse type 2 diabetes. It is based on solid, published research. Dr. Barnard has studies on diabetics where he only changed their diet. He published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
      .
      The book is called “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”. The book contains meal plans and recipes at the back of the book. So, you will get a lot of support. You will know exactly what to eat.
      .
      There’s also a free 21 Day Kickstart on-line program I could tell you more about if you are interested and want more hand holding than the book offers.
      .
      Here’s the book: https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1480632167&sr=1-1&keywords=barnard+diabetes




      0
    1. Hi Michael,
      If you read the study you cited in it’s entirety and you look at the foods that comprised the meals that the test subjects were given, neither of the two groups were given meals that would comprise a WFPB diet. In this study, the researchers gave two groups of people bad diets and they manipulated the macronutrients so that one diet was higher in carbohydrates than the other. They called one the high carb group and the other the low carb group but in reality the kinds of foods (mostly animal products and processed carbohydrates and oils) were the same. One group (in this case the “high crab” group) was simply given more of the worst foods. For example, the high carb group was given vanilla ice cream and pretzels where as the low carb group was given almonds.
      What I found most interesting is that the so called “high carb” group which seemed to fare the worst in terms of insulin sensitivity were given the most animal products and most highly processed carbohydrates. So the results in this study actually substantiate everything in Dr G’s video today.
      This is why it is important that the emphasis not be placed simply on macronutrient percentages in the diet but on the actual foods in the diet. The “high carb” group in this study in no way resembles a high carb whole foods plant based diet.




      0
  29. Another way of saying all this is- consume sugar in the absence of fat, e.g. via fruit and you will get blood sugar spikes and then crashes. In other words, fat regulates the rate of sugar absorption and so protects against spikes and crashes. That’s good isn’t it? Think about it, folks.




    0
    1. No, it’s not good. Did you listen to video or read the transcript?

      “Fat in the bloodstream can build up inside the muscle cell, create toxic fatty breakdown products, and free radicals that can block the signaling pathway process.

      And, that’s how they found that elevation of fat levels in the blood “causes insulin resistance by inhibition of glucose transport” into the muscles.”

      So (excessive) fat consumption causes insulin resistance. Not the sugar. But sugar will certainly not help if you already have insulin resistance. The crashes you mention are already a sign of insulin resistance.




      0
      1. Hi Scott
        You jumped from fat in the bloodstream causing insulin resistance to excessive fat consumption causing insulin resistance. That conection is not likely close to being valid.
        Check out a proper keyogenic diet. Art and science of low carb eating is probably a good one




        0
        1. A vegan whole food plant based high carb life is for me Steve. Having lived that way for 8 years (vegan only 1) and constantly reviewing and researching and reading output from credible doctors such as Dr G I am convinced that is the best way to eat for human health… and your own sanity as keto diets are, amongst many things, hard on ones mental state. I tried it years ago and it was awful. And a number of friends also tried it and whilst weight loss was achieved in the short term the diet couldn’t be sustained.




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    2. Consume fruit and you will consume fiber that the bacteria feed on and that will provide phyto-nutrients and a great biome your gut. Fruit is good for you. Fruit juice is not good for you and will cause a blood sugar spike.




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  30. I hope someone sees this because it seems like there are people who know a lot about blood sugar here. I am a 35 year old woman with really bad health anxiety. I had borderline gestational diabetes once but I had another baby after that one and had totally normal blood sugar that time. I am 5’2 and weigh 120, and have been mostly WFPB for several months now. I took my blood sugar after a rare binge of pizza and cookies a month ago and caught my blood sugar at 165 after 1 hour 40 minutes. Who knows how high it was at an hour. That freaked me out A LOT. Actually I’ve been having miserable anxiety ever since. It went down quickly from there and was at 100 at 2 hours. So I’ve been trying to eat with all of this information from Nutrition Facts in mind ever since then but I also have a bladder problem where I’m doing an elimination diet and can’t eat beans, fruit, vinegar or several other things right now — hoping to add those back in soon but I have had to really restrict my diet to get interstitial cystitis symptoms under control (they are getting a lot better!)

    Sorry long story, but so I have two questions. One, will I be able to avoid diabetes since I’m catching the problem early and eating WFPB? My fasting blood sugar is 85 so that’s not affected yet. The second question is whether I need to avoid brown rice or other foods with a highish glycemic index. I checked my blood sugar after eating oatmeal and vegetables for breakfast too and it was 95 after an hour so oatmeal’s fine, but when I checked after dinner when I ate 1.25 cups of cooked brown rice (and 1/4 cup sunflower seeds and a lot of raw broccolini), my sugar was 159 after 45 minutes — then 138 at 1 hour — and at 2 hours I took it twice in a row and one time it said 88 and the other 107. ( I don’t know why the monitor seems so inaccurate, it’s a brand new One Touch mini). Does having a higher peak like that mean that food is not a good choice for preventing diabetes?

    Thank you so much!




    0
    1. Hi Andrea, To answer your first question of whether you will avoid diabetes, as you know, arming yourself with a healthy diet/lifestyle will give you the best chance of living longer and healthier. Dr. Neal Barnard has a great book referenced earlier in this thread “Neal Barnard’s Program for Reversing Diabetes”, that provides a great explanation as to why a WFPB diet works. As far as your second question, even non-diabetics will have a post prandial meal spike after consuming a high carbohydrate meal. Theoretically, if you were to test your BG 45 minutes after several different meal that are patterned differently (proportion of grain, vegetables, greens, beans, etc)… You may find there is a meal “pattern” (for lack of a better word) that gives you more a more moderate spike and one that results in a bit higher of a glucose spike. My husband has been playing around with his sugars as well. I believe he has the One Touch too. He is seeing exactly what you are seeing. However, even with an occasional higher spike.. his A1C has much improved.




      0
      1. Hi Joan thanks for your reply! So do you think the numbers I described are worrisome enough for me to actually avoid brown rice or can I eat it in moderation? Do you think I should keep testing a lot? What i would love to do is just follow the recommendations in the Barnard book or the Fuhrman book (I have that one from the library already) and not test. Testing makes me have panic attacks. But if these sound like pre-diabetic numbers and I need to test, I’ll just have to make myself do it.
        I know you’re not giving me like medical advice but what would you advise a friend in this situation?




        0
        1. Andrea, I recognize in you some of the worries I used to entertain with accompanying panic. However, from reading and listening to Dr. Greger, Dr. Campbell, Dr. Esselstyn, and Dr. Fuhrman, among others, I have come to think and really believe that my body, treated properly, with good WFPB nutrition and moderate exercise, wants to heal itself and WILL heal itself. I think that as you come to Dr. Greger’s site and continue to read, you, too, will trust your body and not have panic moments. Does this make sense? (I still go to the doctor, but more for an accident, a broken bone, for blood work to check how I am doing, or etc.)

          Wishing for you a peaceful and confident mind,
          Johanna




          0
          1. Thanks very much Johanna — it’s really good and encouraging to hear from anyone who has dealt with health-related anxiety and come through to the other side. Glad I checked back on the thread!




            0
            1. Andrea, eat right and trust your body to heal. Your body will be healthy if you treat it right as evidenced by societies that DO eat right. You shouldn’t be any different. Go to the doctor if you need to go. You should not worry about health. It will likely come with the right foods and exercise.




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        2. I would not avoid the brown rice, but maybe reduce the portion when you eat it. Dr Greger’s Daily Dozen is a great app that helps to put into perspective portion, balance and optimal number of servings of each category.. if you get your A1C drawn every few months, that may be a better “overall” indicator of your glucose control.




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    2. hi again Andrea, here is a video which may answer your question re preventing diabetes.
      http://nutritionfacts.org/video/How-to-Prevent-Prediabetes-from-Turning-into-Diabetes
      There are other good ones listed above under today’s video. re the IC, I think you are maybe over complicating things (imo).. start with the milk products and animal products , and obviously highly acidic foods to eliminate first. After your body heals, you probably will be able to add back some vinegars in small amounts diluted. Fruits are usually ok, but not citrus. You get the gist here. Best wishes




      0
      1. Thanks so much – I’ve watched that video before and it’s really encouraging. Thanks also for the advice about foods and IC. I am feeling quite a bit better since eliminating dairy and also I got some ph strips and learned that the water coming out of my whole house water filter is ph 6 – I’ve been adding a pinch or two of baking soda to bring it to 7 or 8 and that may be helping too. I can’t wait to start eating more foods again.




        0
        1. Thats awesome Andrea, Im so glad you are feeling a bit better.. I did the ph strip thing too.. I ended up avoiding many herbal teas, but a mug of camomile was neutral for me. Also, strangely, I got flares with some bread products, (alao other small signs of allergy) so after I went wfpb, I tried gluten free with great success. The doctor had given me a copy of the FODMAP diet , and not surprisingly, milk products and wheat topped the list. Now, if I stick to whole foods I dont worry.. and I can eat oranges etc in moderation. Wishing you continued success Andrea!




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  31. Hi All,
    What about whole plant based foods with high fat like Avocados and Olives?
    Nuts and seeds? I saw an answer but is there anything Dr Gregger had to say about it?

    Thanks,
    Ron




    0
    1. So I was wondering about the method they used and here is one concern from the study.
      “The main limitation of our study was that SFAs were measured at one timepoint only, and intra-individual variation over time is likely.” Right? So if I eat a melted cheese sandwich prior to going in to have my blood work that will affect the data. (Say versus a lemon dressed green salad)
      And-
      “Our findings provide strong biological evidence that individual SFAs are not homogenous in their effects, and lend support to the importance of recognising differences between the differential health effects of subtypes of blood SFAs.”

      They aren’t saying SFAs aren’t associated with diabetes but that some subtypes may play a bigger role than other.

      If I had diabetes I would go on low fat diet high in fruit, veggies, beans, and whole grains.




      0
      1. hi WFPBRunner, I totally agree on your choice of foods there.. think I would be all over it if I was diagnosed with pre diabetes too. Also, think I would try out the ‘second meal effect’ dr greger described on beans stabilizing blood sugars.. like trying out a beans and greens recipe for breakfast, then again for dinner.. with heaps of great veg for lunch,. Heack, I might try it anyway..




        0
        1. Marsha Carter: Sometimes disqus doesn’t scroll properly. Here is the post copied and pasted for your convenience:
          .
          As others have pointed out elsewhere on this page, no one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat diet. If you don’t put any glucose into the blood to begin with, it’s true that you will not have any blood sugar spikes. Moderator Darchite did a great post on this topic not too long ago. She covered the two ways to address type 2 diabetes: a very high fat diet or a very low fat diet. Here is the post that is worth a read: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730. Note that this is all consistent with the information provided in this video.
          .
          So what if you choose the high fat route? It “works,” so why not? When you choose the high fat route, you are not treating the actual cause of type 2 diabetes (see video: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087604266 ). You are just addressing the symptom, blood sugar spikes. You still have the underlying disease, insulin insensitivity. What’s more, you are eating a diet linked to increase mortality (dying sooner). Following is a post from Tom Goff sharing some of the science that links low carb diets to increased mortality. Even this little post has a long list of studies: http://nutritionfacts.org/2016/12/13/whats-the-optimal-cholesterol-level/#comment-3064114115. For further research, note that NutritionFacts has lots of videos on the topic of high fat diets. By watching these videos, you can see that such diets are not good for long term health from multiple angles.
          .
          Here’s an analogy that may not be the best, but might help: Some people smoke because it keeps their weight under control. We all agree that keeping weight under control is generally a good thing. The problem is that smoking is bad for maximizing chances of long term health. There are healthy ways to keep weight under control. So, you can choose a method that is likely to provide for long term health or one that raises your risk of dying sooner. The same applies to dealing with type 2 diabetes.
          .
          If you are interested in learning how to treat the cause of type 2 diabetes and maximize your chances of long term health, I have some great resources to share. Let me know if you are interested. Good luck.




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          1. Thank you. Ah, yes! No sugar, no spike. You are exactly right and, as all health on this type diet, everything continues to worsen. Thank ou and thank you for the resources.




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  32. Really loved the animation….very helpful for me to be able to visual so easily the details given concerning insulin resistance. Hope we can get more of these….thanks!




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  33. I showed this to my neighbour who is heading into trouble at a young age. He wants to know which saturated fatty acid causes resistance. He wants to know which one to avoid. I told him that he was splitting hairs and advised him to buy “How Not to Die”. This video is only one (incredibly strong) pillar among others about the causes and cure for most of the diseases plaguing those eating SAD.

    This man listens to me because he has seen me go from near-death and grossly fat now restored to my former beautiful and godlike physique… pretty much ; ) And I make no secret how i got here: WFPB and moving my carcass for a good bit every day.




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  34. I really enjoyed the cell visualization. My ears normally gloss over when you start taking about the science/biochemistry behind things, but this made it much easier to follow along. I really enjoyed it. Thanks!




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  35. I assume that a higher triglyceride level as per a blood test would indicate the amount of circulating blood fats…in my case maybe due to being overweight by 20 lbs. My A1C is 4.9…so not so much issue with higher blood sugar.

    So…I’m wondering how does exercise tie in with insulin resistance…..does exercise force glucose into the muscle cells in some way?

    Any studies relating insulin level to fats vs carbs vs exercise vs BMI?




    0
    1. Fred,

      Exercise will reduce your insulin resistance and has been one of the best methods coupled with diet. Nice HgbA1C….but elevated triglyceride levels are not good. You may want to evaluate your intake of simple carbs as it is one of the most common sources of increasing triglycerides. Remember whole grains not refined or often times even ground will be a better option.

      Now for some science: Speaking of triglycerides and insulin resistance http://europepmc.org/articles/PMC3158147 (note how the liver function was positively affected by exercise, reducing the overall lipid load) For a deeper dive into the hormonal controls and fat relationships consider:
      http://physrev.physiology.org/content/86/1/205.full (In essence exercise is a positive impact and we now know about a few more of the modulators in our body) http://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts.A7819 (take away even minimal motion counts)

      Many of the current studies include lots of data on the adipokines and their being influenced by a host of inputs, exercise being high on the list resulting in changes in our circulating fat composition and insulin resistance.

      Dr. Alan Kadish moderator for Dr. Greger




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      1. I am mostly vegan for several years now (except for small amounts of dairy in breads, desserts when I eat out) and as of almost 2 years ago my blood glucose was low and I didn’t do anything about it. I have been consuming quite a bit of sugar the last several months and I have gotten progressing low glucose symptoms. I am now going to cut out sugar cane almost completely (only add to unsweetened baby oatmeal, when I make a dessert which is not often at all, and maple syrup with pancakes roughly once a week) and eventually want to get completely off all added sugars. For at least 6 months now I have been eating organic plain (no sugar added) peanut butter like crazy and Peanut Larabars (no added sugar is just dates, peanuts and sea salt), is this because the saturated fat in it is helping to raise my low glucose level?? I also have Hypothyroid (which I haven’t done anything about other than add iodine (seaweed) to my diet and I just learned that 95% of people with Hypothyroid also has low blood sugar/glucose)..I don’t want to take prescription drugs because they cause me a lot of harm so I haven’t been doing much about my conditions. One other thing: I recently watched an online video from a Dr. on Hypothyroid and he says to take Chromium to help steady low blood sugar do you agree with this? (I have ordered chromium to see how it makes me feel) I appreciate any help/advise you can give. Thank you!




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    2. https://www.ncbi.nlm.nih.gov/pubmed/28053201
      “Low-carbohydrate high-fat (LCHF) diets are a highly contentious current topic in nutrition………..
      Blood total cholesterol and LDL-cholesterol concentrations show a
      variable, highly individual response to LCHF diets, and should be
      monitored in patients adhering to this diet. In contrast, available
      evidence from clinical and preclinical studies indicates that LCHF diets
      consistently improve all other markers of cardiovascular risk-lowering
      elevated blood glucose, insulin, triglyceride, ApoB and saturated fat (especially palmitoleic acid) concentrations, reducing small dense LDL particle numbers, glycated haemoglobin (HbA1c)
      levels, blood pressure and body weight while increasing low
      HDL-cholesterol concentrations and reversing non-alcoholic fatty liver
      disease (NAFLD). This particular combination of favourable modifications
      to all these risk factors is a benefit unique to LCHF diets. These
      effects are likely due in part to reduced hunger and decreased ad
      libitum calorie intake common to low-carbohydrate
      diets, allied to a reduction in hyperinsulinaemia, and reversal of
      NAFLD. Although LCHF diets may not be suitable for everyone, available
      evidence shows this eating plan to be a safe and efficacious dietary
      option to be considered. LCHF diets may also be particularly beneficial
      in patients with atherogenic dyslipidaemia, insulin resistance, and the
      frequently associated NAFLD.”




      0
      1. Here is what Tim eats:
        Typical Breakfast, Lunch & Dinner Meals For Noakes

        To get an idea what the Tim Noakes eating plan looks like these are examples of what he eats during a typical day…

        Breakfast – according to Noakes he has eggs, bacon & sausage for breakfast or cheese, yoghurt as well as a protein-fat meal leftover from the previous evening’s meal.
        Lunch – for lunch he snacks on cheese, nuts, biltong (fatty, biltong is even better)
        Dinner – For dinner he chooses one of the delicious meals from his book, The Real Meal Revolution, which will invariably include either meat, fish or chicken with a good serving of healthy vegetables.
        According to Noakes there is absolutely no need to eat more than ~200g of carbohydrate per day even if your are extremely insulin sensitive & able to metabolize carbs without any issues – this even applies to elite athletes




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  36. Would love to see a back and forth discussion between Dr Greger and Dr David Ludwig (Always Hungry, Harvard endocrinologist). Dr Ludwig touts a moderate protein, high fat (both animal and vegetable sources) and fairly low carb diet with excellent patient response–his patients are obese and/or diabetic. According to Pew Research Center, Americans are eating less beef, eggs and milk but considerably more grains, seed oils, chicken and cheese…as we increase and/or maintain our levels of obesity. Levels of saturated fat (from animal sources) have actually decreased since 1970:

    http://www.pewresearch.org/fact-tank/2016/12/13/whats-on-your-table-how-americas-diet-has-changed-over-the-decades/

    Further data:

    Americans have been adhering to federal dietary guidelines for the past 40 years

    Fat consumption by U.S. adults has decreased from 45% to 34% between 1965 and 2011

    Carbohydrate consumption has increased from 39% to 51% over this same period

    There is a high correlation between the change in diet and the rise of obesity

    The percentage of overweight adults has increased from 42% to 66% since 1971

    Very confusing to say the least.




    0
    1. Gonegirl,

      Perhaps some clarity….. one of the issues not addressed by the findings includes the increasing amounts of endocrine disrupting chemicals and other toxic materials creating a host of obesogens and other toxicants that influence our behaviors and might be some of the rational between the increasing overweight conundrum.

      Also on a completely different note, do I even need to say a word about adherence to the federal dietary guidelines that have been industry “mandated and manipulated” for the last 40 years.

      Carbohydrate consumption is indeed elevated, however …. keep in mind which carbs. Veggies…no…simple carbs yes.

      Fat consumption is indeed down however we have substituted a number of constructed carbohydrates to substitute for the mouth feel of fats and the “confusion” on the part of the consumer regarding what constitutes a good vs bad fat continues, possibly with the exception of saturated fats now finally restricted by legislation.

      Just some thoughts to ponder when we look at the diet check for more factors than solely the overview. Dr. Alan Kadish moderator for Dr. Greger




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      1. Gonegirl, you say(correctly I believe) “Carbohydrate consumption is indeed elevated, however …. keep in mind which carbs. Veggies…no…simple carbs yes.”. However, if we eat almost nothing but vegetables, or vegetable with various amounts of fat and protein, aren’t we in effect eating a low carb diet? After accounting for fiber, most vegetables are pretty darn low in carbs compared to bread and pasta. (although, I love both bread and pasta)
        Bill




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        1. many people make the mistake of thinking that “carb” means processed carbs. So I eat very little processed carbohydrates but my diet is made up primarily of carbohydrates. Does that make sense?




          0
        2. Bill388, Your absolutely correct, however my statement was not intended to be exclusive to veggies vs the nuts/seeds/fruits and other products made . Thanks for being part of the conversation.

          Dr. Alan Kadish moderator for Dr. Greger




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    2. A better debate would be between Greger and Dr. Jason Fung. Dr. Fung is a nephrologist (kidney specialist) who has a lot of clinical experience treating type 2 diabetes. In his practice, he has routinely reversed type 2 diabetes (specifically insulin resistance) by using both LCHF diets and intermittent fasting. In this last segment of his six part series, he discusses dietary fats: https://youtu.be/QetsIU-3k7Y . Here’s another presentation on reversing type 2 diabates: https://youtu.be/mAwgdX5VxGc Needless to say, Fung has come to very different conclusions than Greger. Does Greger have any actual clinical experience like Dr. Fung?




      0
      1. John Rodgers: I don’t know about Dr. Greger, but I understand that the following people have had actual clinical experience reversing T2 diabetes using a low fat, whole plant food diet: Dr. Barnard, Dr. Klaper, Dr. McDougall, Dr. Furhman, and Brenda Davis RD. These are just the famous people who come to my mind quickly. Also note that both Barnard and Davis have published studies to this effect in peer reviewed medical journals in addition to directly treating patients.




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  37. I’m insulin resistant. While on a low carb high fat and protein diet my blood sugar has plummeted. You say just the opposite. How can this be?




    0
    1. hi Jean, if you scroll down in the comment section to a conversation between NF moderator ‘Thea” and Marsha Carter, I believe your question is answered in Thea’s comments




      0
    2. Jean: If you do not put (much) sugar/glucose/carbs into your body to begin with, you would expect the results you are seeing. The problem is that your method to address the symptom of type 2 diabetes comes with serious long term health risks–and you have done nothing to address the actual disease – insulin resistance. I responded to someone else on this page with details about what is happening and some of what you are risking (including early death). If you are interested: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087759785




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  38. I know this is just one study, but I have seen many others like it over the years. Not the slightest increase in diabetic markers between very high fat vs very low fat diets with about 2100 calories, over 12 weeks:
    https://www.ncbi.nlm.nih.gov/pubmed/27903520
    “……. Both groups improved dyslipidemia, with reduced circulating
    triglycerides, but showed differential responses in total and
    low-density lipoprotein cholesterol (decreased in LFHC group only), and
    high-density lipoprotein cholesterol (increased in VHFLC group only).
    The groups showed similar reductions in insulin, insulin C-peptide,
    glycated hemoglobin, and homeostasis model assessment of insulin
    resistance. Notably, improvements in circulating metabolic markers in
    the VHFLC group mainly were observed first after 8 wk, in contrast to
    more acute and gradual effects in the LFHC group.

    CONCLUSIONS:

    Consuming energy primarily as carbohydrate or fat for 3 mo did not differentially influence visceral fat and metabolic syndrome in a low-processed, lower-glycemic dietary context. Our data do not support the idea that dietary fat per se promotes ectopic adiposity and cardiometabolic syndrome in humans. This study was registered at clinicaltrials.gov as NCT01750021.

    © 2017 American Society for Nutrition.




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    1. This study considers low fat as 30% of consumed calories. That’s a joke really.

      [quote]Forty-six men (aged 30-50 y) with body mass index (in kg/m2) >29 and waist circumference >98 cm were randomly assigned to a very high-fat, low-carbohydrate (VHFLC; 73% of energy fat and 10% of energy carbohydrate) or low-fat, high-carbohydrate (LFHC; 30% of energy fat and 53% of energy carbohydrate) diet for 12 wk. The diets were equal in energy (8750 kJ/d), protein (17% of energy), and food profile, emphasizing low-processed, lower-glycemic foods. Fat mass was quantified with computed tomography imaging.[/quote]




      0
      1. it’s an absolute joke, OV.

        i eat an Oil Free WFPBD and assume my fat intake is in the 4-6% range.

        that’s not a LOW fat diet that’s a NORMAL fat diet :o)

        30%??

        what a joke and exactly why the vast majority of studies are flawed.

        they might as well compare a HIGH SMOKER consuming 50 cigarettes a day to a LOW SMOKER of 40 cigarettes a day, lol.
        .




        0
    2. From the study: “Forty-six men (aged 30-50 y) with body mass index (in kg/m2) >29 and waist circumference >98 cm were randomly assigned to…”

      This study tells us only about overweight folks. But it also doesn’t tell us that we wouldn’t find a similar result for healthy individuals, leaving the question open. I am still unclear about the relative merits of HF or HC for healthy people, assuming high-quality, WFPB sources all around. Part of the question in my mind are the relative benefits of higher HDL vs lower LDL; a topic I would love to see taken up on a NF video. (NCEP says, “ATP III continues to identify elevated LDL cholesterol as the primary target of cholesterol-lowering therapy”, suggesting that they believe LDL is the more important of the two. https://www.nhlbi.nih.gov/files/docs/guidelines/atp3xsum.pdf )

      From a general evolutionary perspective, our bodies are likely able to adjust to varying proportions of fat/carb, assuming an un-processed diet with “normal” calories and exercise. For now, I am thinking high-quality WFPB with exercise is the main objective, and not worrying a lot about exact fat/carb ratios.




      0
      1. Michael: You wrote: ” Part of the question in my mind are the relative benefits of higher HDL
        vs lower LDL; a topic I would love to see taken up on a NF video.” I have suggested that this be a topic of future videos. In the meantime, below is some information I’ve gathered about HDL which may be helpful to you.
        .
        ****************
        I am not an expert on the topic of HDL, but some of my favorite NutritionFacts forum members and some experts have had a thing or two to say on the matter. BOTTOM LINE: I synthesize the information below to mean we do not need to worry about HDL levels or HDL falling in the context of a whole plant food based diet, when LDL goes down or is already at a healthy level.
        .
        In other words, if you have high/unsafe cholesterol levels (total and LDL) overall, then also having high HDL can be protective (especially if you got that high HDL through exercise or some other healthy behavior rather than diet). But in the face of healthy LDL levels, the HDL level doesn’t seem to matter. I may be wrong about this, but see what you think.
        ************************************
        .
        First, check out the following article from heart health expert Dean Ornish. He does a great job of explaining the role of HDL and when we need to worry about it’s levels vs when we do not. http://www.huffingtonpost.com/dr-dean-ornish/cholesterol-the-good-the-_b_870655.html “A low HDL in the context of a healthy low-fat diet has a very different prognostic significance than a low HDL in someone eating a high-fat, high-cholesterol diet.”
        .
        Two of our more knowledgable forum particpants, Gatherer and Darryl, have put together for us some of the strongest evidence–a list of good studies. Gatherer wrote (from comment http://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/#comment-3098014284 ) :
        .
        “”Don’t put too much stock in HDL levels. Here is a news release
        “Raising ‘good’ cholesterol doesn’t protect against heart disease after all, study finds” https://www.statnews.com/2016/10/31/hdl-cholesterol/
        that provides an overview of the study
        “High-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions”
        http://www.onlinejacc.org/content/68/19/2073 LDL and non-HDL cholesterol appear to be better indicators of health status than HDL.”
        .
        Darryl wrote (from comment: http://nutritionfacts.org/video/how-do-we-know-that-cholesterol-causes-heart-disease/#comment-3098365137 )
        .
        “Meta-analysis of 108 randomized controlled trials effecting HDL levels (statins, fibrates, resins, niacin, n-3 fats, ACAT inhibitors, ABCA1 inthibitors, CETP inhibitors, PPAR activators, diets, bariatric surgery): No effect. (http://www.bmj.com/content/338/bmj.b92.full ) Subsequent AIM-HIGH niacin trial No effect. (http://www.nejm.org/doi/full/10.1056/NEJMoa1107579#t=abstract ) ABCA1 gene loss of function No effect (http://archneur.jamanetwork.com/article.aspx?articleid=182020 ), LCAT gene single nucleotide polymorphisms (SNPs) lowering HDL: No effect. (http://press.endocrine.org/doi/full/10.1210/jc.2011-1846 ), composite HDL effect from 20 SNPs No effect (http://www.sciencedirect.com/science/article/pii/S0140673612603122 ), 19 SNPs affecting HDL from a genome wide association study (which don’t simultaneously affect LDL) No effect. (http://eprints.gla.ac.uk/91036/1/91036.pdf )
        .
        … One reason that HDL appeared protective in epidemiology may be that a number of lifestyle factors (like exercise, or moderate alcohol intake) both increase HDL and reduce cardiovascular risk by independent mechanisms. Or perhaps only a subfraction of HDL is active, one which isn’t increased by either clinical interventions or genetic variants affecting aggregate HDL levels. It seems likely that that most dietary interventions that increase HDL would not offer the benefits calculated from a reduced LDL/HDL ratio, particularly when they also increase LDL.”
        .
        .
        WHICH MATTERS MORE, LOW LDL OR HIGH HDL?
        Moderator Rami found some great information for us. Here is what he shared with us some time ago:
        “Low LDL matters far more than raised HDL. 108 randomized trials involving nearly 300k participants at risk of cardiovascular events. HDL levels found to play no significant role in determine risk. Primary goal remains to lower LDL.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645847/
        Genetic studies of high HDL, high LDL, and low LDL. High genetically raised HDL not protective, while high LDL is damaging. Low LDL is protective
        http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960312-2/fulltext
        http://www.ncbi.nlm.nih.gov/books/NBK174884/
        http://www.sciencedirect.com/science/article/pii/S0735109712047730
        http://www.nejm.org/doi/full/10.1056/NEJMoa054013#t=articleTop
        In this animal model study, atherosclerotic lesion growth regressed in a low LDL environment, but did not with high HDL.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098380/
        Quote from the comment: http://nutritionfacts.org/2016/03/22/the-effects-of-dietary-cholesterol-on-blood-cholesterol/#comment-2630127562
        .
        .
        WHAT ABOUT TRYING TO INCREASE HDL?
        There are healthy ways to increase HDL (such as through exercise) and unhealthy ways to increase HDL (such as through eating saturated fat–see explanation from Ornish above). Exercise is a great idea for a bazillion reasons and may be helpful in a heart protective way if someone is having trouble getting to healthy cholesterol levels. However, in general, increasing HDL does not “…reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths.”
        .
        .
        WHAT ABOUT FALLING HDL?
        When some people switch to a WFPB diet, both their LDL and their HDL goes down. Do people need to worry about HDL going down? I thought that Dominic (a participant on this site) had a really great post on this topic. Here’s a quote I find compelling: “In populations where CAD is just about nonexistent, people have both low LDL and HDL levels. These populations follow diets that are higher in whole plant foods and lower in fat and saturated fat than the typical western diet. Studies have shown that it does not appear that low HDL levels provide any vascular risk in individuals who attain very low concentrations of LDL – through diet alone or on extensive statin therapy.3,4.” To see the full post: http://nutritionfacts.org/video/paleo-diets-may-negate-benefits-of-exercise/#comment-1849535796 This post also includes a guideline (not sure where it came from) on how to better judge your cholesterol numbers rather than worrying about HDL levels by themselves.
        .
        Dr. McDougall also has an article on the topic in one of his older newsletter articles: https://www.drmcdougall.com/misc/2003nl/sep/030900pugoodcholesterolworsens.htm The article includes these quotes:
        .
        “Worldwide (comparing people who eat different diets) those who have the lowest HDL levels (like people in rural Japan, China, and Africa) have the lowest rate of heart disease…”
        and
        “HDL cholesterol is a risk factor – not a disease. No one dies of low HDL – they die of rotten arteries.”
        and
        “When you adopt the McDougall Program, you will watch your total cholesterol fall dramatically. As it does, both LDL and HDL levels will drop, as well. And as they do, so too will your risk of heart disease. And your health will improve dramatically. Unfortunately, because HDL doesn’t go up with a healthy diet some unenlightened physicians – acting like puppets for the pharmaceutical industry – give their patients a totally undeserved hard time.”




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  39. And again: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107710/
    “However, high-carbohydrate rich (CHO) diets increase postprandial peaks
    of insulin and glucose. Triglyceride-rich lipoproteins are also
    increased, which interferes with reverse cholesterol transport lowering
    high-density lipoprotein cholesterol. In addition, CHO-rich diets could
    move fat from peripheral to central deposits and reduce adiponectin
    activity in peripheral adipose tissue. All these are improved with
    monounsaturated fatty acid-rich diets. Lastly, increased portions of ω-3
    and ω-6 fatty acids also decrease triglyceride levels, and complement
    the healthy diet that is recommended in patients with MetS…….”.

    I have seen so many studies like this over the years. All of which are consistent with the idea that insulin is produced primarily in response to carbohydrates, and somewhat in response to protein, and not at all in response to fat. So, I love Dr. Gregor and watch all his videos and read his book, but I am having a hard time with this idea that fat causes diabetes, and carbohydrates do not.




    0
    1. Hi Bill
      Are you overweight? Is that why you are concerned about Metabolic Syndrome? If so I highly recommend any work by Dr. Furhman. He does a great job of explaining and guiding one through the process of losing weight. I ran into a friend at a Christmas party after not seeing her for a couple of years. She went from 350 plus pounds to normal weight after reading one of his books.




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    2. Bill388: From what I can tell, these studies you are posting are *not* inconsistent with what the NutritionFacts video on this page is explaining. Someone else on this page said something like: “I’m eating a very high fat diet and my blood sugar is just fine. That is the very opposite of what this video is saying, isn’t it?” I’m copying my reply to you below in the hopes that it will help you make sense of the various studies you are seeing. The information below, combined with re-watching the NutritionFacts video might help.
      .
      **************************
      As others have pointed out elsewhere on this page, no one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat diet. If you don’t put any glucose into the blood to begin with, it’s true that you will not have any blood sugar spikes. Moderator Darchite did a great post on this topic not too long ago. She covered the two ways to address type 2 diabetes: a very high fat diet or a very low fat diet. Here is the post that is worth a read: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730. Note that this is all consistent with the information provided in this video.
      .
      So what if you choose the high fat route? It “works,” so why not? When you choose the high fat route, you are not treating the actual cause of type 2 diabetes (see video: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087604266 ). You are just addressing the symptom, blood sugar spikes. You still have the underlying disease, insulin insensitivity. What’s more, you are eating a diet linked to increase mortality (dying sooner). Following is a post from Tom Goff sharing some of the science that links low carb diets to increased mortality. Even this little post has a long list of studies: http://nutritionfacts.org/2016/12/13/whats-the-optimal-cholesterol-level/#comment-3064114115. For further research, note that NutritionFacts has lots of videos on the topic of high fat diets. By watching these videos, you can see that such diets are not good for long term health from multiple angles.
      .
      Here’s an analogy that may not be the best, but might help: Some people smoke because it keeps their weight under control. We all agree that keeping weight under control is generally a good thing. The problem is that smoking is bad for maximizing chances of long term health. There are healthy ways to keep weight under control. So, you can choose a method that is likely to provide for long term health or one that raises your risk of dying sooner. The same applies to dealing with type 2 diabetes.
      .
      If you are interested in learning how to treat the cause of type 2 diabetes and maximize your chances of long term health, I have some great resources to share. Let me know if you are interested. Good luck.​




      0
  40. I’m just not sure this is as cut and dry as some of us are thinking it is:
    https://www.ncbi.nlm.nih.gov/pubmed/26602244
    “Very-low-fat diets may be associated with increased risk of metabolic syndrome in the adult population….

    BACKGROUND & AIMS: Although fat intake has often been targeted to decrease the prevalence of metabolic syndrome;
    however decreasing dietary fat intake has not had this result. We
    studied the association between fat intake and the prevalence of metabolic syndrome……………………………..

    RESULTS: Surprisingly, the prevalence of metabolic syndrome was significantly higher in the ≤15% fat intake group (OR = 1.277),
    accompanied by lower daily energy intake compared to the reference group
    (≥25% fat intake). Higher daily fat intake was associated with
    significantly lower ORs for four components of metabolic syndrome………………..
    CONCLUSIONS: Low fat intake, <15%, was associated with a higher incidence of metabolic syndrome……….."

    If fat(rather than too many carbs) is the cause of insulin resistance and diabetes, how can studies like the ones I have supplied even exist? I remain very confused about all of this.




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    1. You can still get fat on a low fat diet. Its all about calorie balance. If you overeat, then the body will accumulate fat. That is what will disrupt insulin function, not the ratio of macros.




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  41. Can someone please explain how Dr. Greger claims that fat causes insulin resistance and how proponents of the ketogenic diet claim that a high carb diet leads to insulin resistance? In other words, which one is correct??




    0
    1. Suzanne: My 2 cents is: The science Dr. Greger presents speaks for itself. As for why proponents of ketogenic diet think it is good for preventing diabetes, I would guess (based on the comments we are seeing on this page) that such proponents are confusing the diabetes symptom (increased blood sugar) with the actual disease (insulin insensitivity). They are probably also confusing diets high in refined carbohydrates (and likely high in fat too) with diets of low fat whole plant foods.




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      1. Thanks for your response, Thea! I understand your first sentence, but then I’m a little confused at the rest of what you said. Could you, please, explain it again in a different way? Sorry. . .I’m just not clear on what you’re trying to say!




        0
        1. Suzanne: No problem. I recently replied to someone who said something like: “I’ve gotten great results with my blood sugar by eating a very high fat diet. How do you explain that?” Below is my detailed answer. I’m hope this is more clear. Before you read that part, though, maybe a recap (to the best of my lay person’s ability) of this NutritionFacts video’s info might help:
          .
          1) It is perfectly normal and non-harmful to have some insulin and blood sugar spikes in your blood after eating–as long as the spikes are not too high or last too long.
          2) Your body makes insulin in response to eating carbs (and protein if I understand correctly)
          3) The purpose of the insulin is to get that glucose/sugar (what your body makes when you eat carbs) into the cells of your body.
          4) When your cells are clogged up with fat, the insulin can not do it’s job of getting the glucose into the cells. Thus, when your cells are clogged with fat, the blood sugar spikes go higher than normal (ie, the glucose stays in the blood), because the insulin can’t get the glucose into the cells like the insulin is supposed to do. This is referred to as having low insulin sensitivity or being insulin INsensitive. If the insulin sensitivity is low enough (if there is so much fat in your cells that the insulin can’t do it’s job), the condition is called type 2 diabetes.
          .
          Thus, if you eat a lot of fat, you can give yourself type 2 diabetes (as I suspect one commenter on this site has sadly done on purpose). At the same time, if you eat a diet extremely low in carbs and extremely high in fat, you might be able to manage the main symptom of diabetes (the high blood sugar), but the actual disease (insulin INsensitivity) would still be there and keep progressing.
          .
          These keto proponents focus a huge amount of concern and effort on blood sugar spikes and controlling that symptom while ignoring that a) addressing the blood sugar spikes by eating high fat does nothing to address the cause of the disease and b) we have proven ways to address the cause of the disease.
          .
          With that in mind, I hope the following copy of a previous post also helps to fill in the picture:
          .
          ***************
          As others have pointed out elsewhere on this page, no one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat diet. If you don’t put any glucose into the blood to begin with, it’s true that you will not have any blood sugar spikes. Moderator Darchite did a great post on this topic not too long ago. She covered the two ways to address type 2 diabetes: a very high fat diet or a very low fat diet. Here is the post that is worth a read: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730. Note that this is all consistent with the information provided in this video.
          .
          So what if you choose the high fat route? It “works,” so why not? When you choose the high fat route, you are not treating the actual cause of type 2 diabetes (see video: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087604266 ). You are just addressing the symptom, blood sugar spikes. You still have the underlying disease, insulin insensitivity. What’s more, you are eating a diet linked to increase mortality (dying sooner). Following is a post from Tom Goff sharing some of the science that links low carb diets to increased mortality. Even this little post has a long list of studies: http://nutritionfacts.org/2016/12/13/whats-the-optimal-cholesterol-level/#comment-3064114115. For further research, note that NutritionFacts has lots of videos on the topic of high fat diets. By watching these videos, you can see that such diets are not good for long term health from multiple angles.
          .
          Here’s an analogy that may not be the best, but might help: Some people smoke because it keeps their weight under control. We all agree that keeping weight under control is generally a good thing. The problem is that smoking is bad for maximizing chances of long term health. There are healthy ways to keep weight under control. So, you can choose a method that is likely to provide for long term health or one that raises your risk of dying sooner. The same applies to dealing with type 2 diabetes.
          .
          If you are interested in learning how to treat the cause of type 2 diabetes and maximize your chances of long term health, I have some great resources to share. Let me know if you are interested. Good luck.​




          0
    2. Im sorry you have fallen for low-carb bullshit lies. It has been known for decades that fat disrupts insulin resistance. On the other hand, even PURE WHITE SUGAR improves insulin resistance. Carbs improve insulin sensitivity.

      The only way carbs can disrupt insulin function is to get converted to fat (de novo lipogenesis) and even that isnt upregulated much even after days of overeating on carbs.




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    3. Hi Suzanne

      I can’t say which is correct but I have done both diets so I know that for me after a few months into keyo adaptation my fasting blood sugar has dropped from 95 to 55 to 60. And blood pressure is steady at or below 105/60 each morning when tested. I felt great on both diets but the keto diet generates a feeling of much better mental energy calmness. But those are my results. Many people do very well on either diet. So it made sense to me to try the keto doet and get blood tests before and after keto adapted for a couple of months

      I read the book The Art & Science of Low Carb Living. Its a good place to look if you are interested in different ideas and explanations.
      Good luck




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    4. Suzanne: To follow up on what Steve said: That story is a perfect example of confusing the importance of fasting blood sugar levels (a marker of good health only in the relevant circumstances) with actual diseases. Also, what Steve did not mention to you, but has admitted elsewhere on this page, is that Steve’s total and LDL cholesterol levels have shot up in the short time he has been eating an extremely high fat and low carb diet. Steve truly believes that he is in good health, but we know nothing about his insulin sensitivity and we know that his cholesterol levels are firmly in the danger zone. This is all a perfect example of what I was explaining in my previous posts.




      0
      1. Hi again,
        My LDL level has gone much higher but there are scientists who claim that LDL by itself is not a good marker due to the unknown size of LDL. I did not have my LDL particle size tested. A ratio that does commonly get high marks for importance is Triglyceride/HDL ratio. My ratio dropped almost 20% from an already healthy ratio.
        My fasting insulin at the time of that blood test was 2.92.
        Remember that Alzheimer’s is often refered to as diabeteis of the brain and it is thought that lower than 100 fasting blood sugar is wise to help with brain health.
        And to be honest I am quite satisfied with professional reports indicating preferance with the 2 main cholesteral ratios for determining risk factors, both ratios remain very low in my case




        0
        1. Interesting study.

          Conclusions: High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.

          http://bmjopenbeta.bmj.com/content/6/6/e010401.full




          0
          1. Steve Byrne: Your study is referring to a well-known phenomenon called reverse causation and is in no way inconsistent with the lipid hypothesis. Reverse causation means that disease caused low cholesterol, not that low cholesterol caused disease and higher mortality. Pointing to studies which measure reverse caution is a well known trick used by cholesterol deniers. Tom Goff did an excellent post on this topic : http://nutritionfacts.org/2016/04/28/egg-consumption-and-ldl-cholesterol-size/#comment-2648441956 The article that Tom linked to includes this quote:
            .
            “Among nearly 6000 healthy Japanese-American men enrolled in the Honolulu Heart Study, they measured total serum cholesterol at two time points, with mortality follow-up extending for up to 16 years. Results showed the expected association of elevated cholesterol with coronary disease. In addition, falling levels of cholesterol were linked to an excess risk of hepatic disease and cancer in particular, whereas low (<4.7 mmol/L, <180 mg/dL) but stable levels over time were not associated with excess risk. Their findings provide evidence that the association previously reported between low cholesterol and noncoronary mortality probably reflected the cholesterol-lowering metabolic consequences of long-term subclinical disease rather than a hazard associated with low cholesterol per se."
            .
            This is a very important concept to understand if you are going to be analyzing cholesterol studies. For a really good review of the concept of reverse causation and how it applies to cholesterol, check out these awesome videos: http://plantpositive.com/blog/2012/3/27/cholesterol-cancer-and-depression.html
            http://plantpositive.com/blog/2012/3/25/tpns-40-41-playing-games-with-your-heart.html
            (And for an in-depth look at LDL check out the three parts on this page: http://plantpositive.com/blog/2012/3/26/tpns-43-45-anything-but-ldl.html )
            .
            Hope that helps to clear up your confusion. The bottom line to understand is that: When people maintain the cholesterol levels they are born with (total 150 or below and LDL 70 or below), they do not get heart disease. (There is at least one NutritionFacts video on this topic, http://nutritionfacts.org/video/optimal-cholesterol-level/. I believe there is another also, but I can't find it right now. Hopefully you can find it if you are interested.) FYI: These are the same levels that other primates maintain. On the other hand, if people eat foods that allow their cholesterol levels to go above the safe levels, these people incur the risk of dying from the number one cause of death in America.




            0
        2. Steve Byrne: People who downplay the role of LDL in heart disease exist, but they are misleading you. Take that LDL particle size issue for example. NutritionFacts has covered what the science really says about that matter: http://nutritionfacts.org/video/does-cholesterol-size-matter/ It’s also no surprise that your triglycerides went down since you lost weight and don’t eat sugar or refined foods.
          .
          I have no issue with you being happy with your results or even telling people you are happy. It is just important that people not be mislead about what the science says about what is actually happening short term and what the risks are for long term health.




          0
          1. I haven’t eaten added sugar or refined foods since late 1995. I am not trying to agrue. All I am doing is replying to your inagination about me. And I said my Triglyceride/HDL ratio improved to a very good .9. My triglyceride level actually increased but not so much compared to the bigger jump in my HDL. So I had a weight drop and increased triglycerides but much improved ratio.




            0
      2. I guess I keep going back to the fact that diabetes cases shot up during the years where it was okay and encouraged to eat anything as long as it didn’t contain fat. People were pounding down the SnackWell’s, pasta, breads and cereals like they were going out of style. Can someone, please, give their opinion on this?




        0
        1. Suzanne: My understanding for this period of time was that a) the public misunderstood the advice (ie, the advice was never about eating anything as long as it didn’t have fat) and b) the public did not actually follow the advice of eating less fat. From what I have seen of the data, the average American ate the same amount of fat absolute-wise. We just started eating more calories total – ie, more simple carbs in those cookies and breads you are talking about while eating the same amount of fat and protein. Percentage wise, we ate less fat. That is misleading when total calories goes up.
          .
          This makes sense from what I remember of the time. People still slathered butter on bread, drenched pasta in olive oil, etc. They just added more cookies (sometimes lower fat) and more total calories. Humans can get fat/weight on our bodies by eating too much calories regardless of where those calories came from. And as Dr. Greger has explained in another video, we can get fat in our blood as a spill over effect (gets pushed out from your cells) when we are over weight. http://nutritionfacts.org/video/the-spillover-effect-links-obesity-to-diabetes/ That leads us back to this video where fat is one of the causes of insulin resistance.
          .
          The bottom line is that I don’t think the period of time you are talking about is in conflict with the information in this video. What do you think?




          0
          1. Thea: I think you basically just corroborated my theory. You say percentage-wise, we ate less fat but total calories went up during that time. The extra calories must have been coming from carbs. If the green light was given for eating whatever one wanted, as long it was low-fat, extra calories had to come more from carbs rather than protein because I think most people know that there is fat in animal protein, therefore they were reaching for extra bread, fat-free chips, cookies, etc. What I think is that the general population eats way too many carbs compared to fat, and it seems that diabetes is a result of too many carbs.

            With regard to cholesterol, you do know that high cholesterol numbers don’t necessarily mean that someone will get heart disease and/or have a heart attack, right? Have you heard of autopsies being done on car accident victims and discovering that they had fully blocked arteries? Have you heard of people having high cholesterol and upon getting a carotid artery scan and/or a heart artery scan they find 0% plaque build-up? And I’m sure you’ve heard of people having heart attacks who have perfectly “normal” cholesterol levels. I believe heart disease and heart attacks are caused from something other than high cholesterol, and I think this era of lowering everyone’s cholesterol levels whether by drug or diet is going to prove to be a problem later on.




            0
            1. Suzanne: re: “What I think is that the general population eats way too many carbs
              compared to fat, and it seems that diabetes is a result of too many
              carbs.” No, you completely missed the point about what the data is showing. People were eating the same amount of fat. They were eating more total calories and thus were getting over weight/fat. Fat in the cells spills into the blood. And this in turn causes insulin resistance / diabetes. It is not a matter of diabetes being a result of too many carbs in the sense that I understand you to be are saying. People are getting diabetes from eating too many calories period. The whole point is that people did not cut back on fat at all. They just ate more total calories making themselves fat and that is one of the causes of insulin resistance.
              .
              To try to make the situation really clear: If people ate a low fat diet of whole plant foods like say the traditional Okinawans, they would be eating 85% carbs and 6% fat (http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ ) They would not get diabetes. Diabetes is not a carb issue per say.
              .
              Your information about cholesterol is a misunderstanding of the data. For example, people with human-normal levels of cholesterol basically do not get heart attacks. What you wrote is incorrect. The only time “experts” can get away with saying that people with “normal” cholesterol get heart attacks is when they twist the meaning of the data and “normal” is defined as average levels in a sick society where the number one killer is heart disease. People who have human-normal levels of cholesterol (total under 150 and LDL under 70) are extremely unlikely to have a heart attack.
              .
              It sounds like you have been listening to cholesterol confusionists. If you would like to learn what the science says on the matter here are two good resources. 1) NutritionFacts: http://nutritionfacts.org/topics/cholesterol and 2) for a complete addressing of the confusionist misinformation, check out the videos from Plant Positive: http://www.plantpositive.com. You will get a detailed education by going through those videos.




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              1. Thea: Thank you for setting me straight on the insulin resistance and for the links; I read them all! Plus, I’m now fascinated with Plant Positive and his videos (already watched several), even though he seems completely biased. I searched his website for a video on Vegan Betrayal by Mara Khan, but I couldn’t find anything. If you happen to know if he’s critiqued her book, I would love to hear what he has to say about it. Have you read it, by chance? I highly recommend it!

                Regarding being confused about cholesterol, that might be true to some degree even though I feel like I know quite a bit, but I’m always open to learning more which is why I reviewed both links you sent. However, I wasn’t incorrect in saying that people with low cholesterol levels can and do have heart attacks. What’s more telling about whether someone will or won’t have a heart attack is their apoB/apoA-1 ratios. Even Plant Positive mentions the importance of these ratios in one of his videos I watched.




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                1. Suzanne: I give you full, sincere props for actually looking at the links. Most people don’t bother. Out of respect for you, I made myself take some time and do some research to give as good a reply as I can. (Anyway I have to because I know you click the links. ;-) )
                  .
                  I had not heard of the book Vegan Betrayal before. I appreciate you bringing it to my attention as I like to be aware of what is out there. I checked Plant Positive’s site too just to be sure, and I agree with you that he does not cover the book. I like to think I’m at least generally aware of my strengths and weeknesses. One of my weeknesses is that I know I’m not going to do a whole lot of fact checking on a book like that. So, before I read it, I need to know that people who are good at fact checking have done so to verify that the claims in the book are generally true. For a book like that, I especially need to know that the studies cited actually say what the author of the book claims is said. I found a review of the Vegan Betrayal book where someone did that sort of fact checking. It looks like Mara Kahn did not cite sources that back up her claims. Mara may not have actually read the studies at all, at least in some cases. Here is that review if you are interested: https://sciencebasedmedicine.org/betraying-the-science-on-vegan-nutrition/
                  .
                  I thought I would also take the time to not just make a claim about cholesterol, but give you some references. So, in my previous post, I claimed that people with total cholesterol under 150 (ie, who have human-normal cholesterol levels) are extremely unlikely to get a heart attack/heart disease. I found the NutritionFacts video which discusses and links to the some of the evidence backing up this claim: http://nutritionfacts.org/video/everything-in-moderation-even-heart-disease/ You can click the Sources Cited button to check the sources if you want. Also note that in societies where people keep the same cholesterol levels they are born with (ie, total below 150 and LDL below 70), they do not get heart attacks. The following video covers some important the evidence regarding LDL and why the 70 figure is often used. Though really it looks like LDL needs to get to 55 or under before there are zero heart attacks: http://nutritionfacts.org/video/optimal-cholesterol-level/ The next video doesn’t get into cholesterol numbers, but details a very interesting study of a population that eats a largely plant based diet (lots of carbs) and essentially did not get heart disease, diabetes and other diseases: http://nutritionfacts.org/video/one-in-a-thousand-ending-the-heart-disease-epidemic/
                  .
                  Of course, you are under no obligation to check any of this out. I just thought you might be interested. Take care.




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                  1. Thea: You can’t send me links and even remotely think I’m not going to read them – hahaha! I guess if I were completely, 100% certain of my beliefs, I would just ignore them, but I’m not 100% certain of anything. So, thank you, again, for sending these.

                    I did read the review of Vegan Betrayal in the middle of reading the book, and after finishing the book, I feel that Science Based Medicine’s review was also a little cherry-picked. You’d have to read the book for yourself to see what I’m talking about, but I do agree that the same observations that SBM mentions were kind of ridiculous. That being said, many of her facts were eye-opening. (Too many to go into here.) In Khan’s defense, she does have 19 1/2 pages of sources in what looks like an 8 point font, and I would think that at least some of them are valid.

                    Oh! Another thing. . .Can you explain the French Paradox and/or do you have any good links that do? Nothing to do with current French heart disease trends because I hear that they are catching up to the US in that area, but instead the era of when the French Paradox was first discovered? This is something that completely fascinates me!

                    Thanks for taking the time with my questioning!!




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                    1. Thea: Thanks for the video. I LOVE the wine glasses and the French flag at the beginning! Anyway, what caught my attention were two things: 1.) Marion Nestle saying that the French only started eating this way in recent years, and 2.) Doctors in France under reported CHD as cause of death. But even when adjusted for under reporting, I noticed that France was still super low for CHD deaths which is illustrated in this more thorough study on the French paradox where it
                      mentions that if, in fact, French doctors under report CHD and
                      corrections are made for this bias, it remains a low bias:
                      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768013/

                      Anyway, I couldn’t believe that the French only started eating “this way” in recent years, so I did some checking. Here is the first article I came across: http://www.nytimes.com/1992/04/01/garden/l-french-paradox-174192.html It points out that Marion Nestle was incorrect and that her information “was based on food-supply calculations rather than actual food intake data.” The people investigating the French paradox used data from the MONICA Project of the World Health Organization: https://www.ncbi.nlm.nih.gov/pubmed/3335877

                      Also, wouldn’t you think that the people of France would be fatter than Americans because of the way they eat? In fact, they are less fat and also have less diabetes overall. Also, I have read several different articles of Americans claiming to go to France, adopt France’s eating style and then find that they’ve lost weight. I still believe there is a French paradox, and I’m willing to bet it has more to do with red wine.




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  42. For the sake of a healthy academic debate, I would like to add current scientific literature that includes random control trials (RCT) and peer reviewed studies regarding the content of Dr. Gregor’s video, “What Causes Insulin Resistance”.

    The American Diabetes Association’s article, “Fatty Acids, Obesity, and Insulin Resistance: Time for a Reevaluation” (2011) disputes the simplified theory that all fat increases insulin resistance (IR), the mechanisms are much more complex than Dr. Gregor’s video as well as the scientific journals from the 1990s that he uses as his sources.

    Rather than paraphrase the ADA’s article, I will include several paragraphs that express the complexities of nonesterified fatty acids (NEFA), also called free fatty acids (FFA) and their role in IR.

    “It is also argued that the process of fatty acid mobilization from adipose tissue, normally suppressed by insulin, itself becomes insulin resistant—thus, lipolysis is further increased, potentially leading to a vicious cycle. Although we have also accepted this model for many years, recently there has been a steady accumulation of data, both in the literature and from our own research, that has forced us to realize that this simple story is not always true.”

    “It is clear that insulin resistance, even severe insulin resistance, can exist in obesity without elevation of NEFA concentrations. It is also clear that elevated NEFA concentrations are not necessarily associated with insulin resistance. Two commonly seen examples are women versus men and younger versus older subjects. Women have very significantly raised NEFA concentrations compared with men, yet tend to be more insulin-sensitive and to have better lipid profiles.”

    I look forward to your comments.

    Sincerely,

    Kim Allen, MSN, RN, CEN
    PhD Student

    Reference
    Fredrik Karpe, Julian R. Dickmann, Keith N. Frayn (2011). Diabetes Oct 2011, 60 (10) 2441-2449; DOI: 10.2337/db11-0425. Retrieved from http://diabetes.diabetesjournals.org/content/60/10/2441.full




    0
    1. Here are two other reviews for your perusal that discuss potential causes of insulin resistance.

      The focus of this first review is lipid metabolism.

      Samuel VT, Shulman GI. Mechanisms for insulin resistance: common threads and missing links. Cell. 2012; 148(5):852–871.
      https://www.ncbi.nlm.nih.gov/pubmed/22385956

      This second review discusses several potential causes of insulin resistance: inflammation, lipid metabolism, and the gastrointestinal microbiota.

      Johnson AM, Olefsky JM. The origins and drivers of insulin resistance. Cell.
      2013 Feb 14;152(4):673-84.
      https://www.ncbi.nlm.nih.gov/pubmed/23415219

      Both reviews were published in Cell, one of the top two biomedical journals in the world.




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  43. I have a hard time getting enough calories so I eat a lot of nuts and seeds. I probably eat 20 grams of ALA a day, do you think this is unsafe? Please, only qualified professionals answer. Thank you for the feedback.




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  44. I’ve been using the low carbohydrate ketogenic diet to manage my type 2 diabetes for two years with excellent results with guidance from two books by researchers Jeff Volek, PhD, RD and Stephen Phinney, MD, PhD, and the Low-carb Diet Forum in the UK.

    Went from an A1c of 9.9% to 5.4% so am now in remission. I do not and have never used insulin or taken medications used to manage diabetes. All of my health markers significantly improved as evidenced by lab tests, including my lipid profile and hsCRP. I’m seeing some very strong opinions shared here.

    I have a question for those who do or do not support use of the low carbohydrate ketogenic diet here. Do you or have you had type 2 diabetes? If yes, what has been your experience with one or both diets: LCKD and/or WFPB diet?




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  45. I’d love to see this study cited in the video

    J Shirley Sweeney. DIETARY FACTORS THAT INFLUENCE THE DEXTROSE TOLERANCE TEST A PRELIMINARY STUDY. JAMA Int Med, Dec, 1927, Vol 40, No. 6.

    But I find it hard to believe that a 1927 medical study is still not available for free to the general public :-(
    Is there any way to access this one without having to pay $30??




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  46. Off topic but can Dr Greger confirm his role as expert on new version of Biggest Loser? Hope this site continues to be science based without commercial ties. I also hope he continues to advocate for and educate about animal rights including farming practices.

    Here’s an interview he did in March last year where he was asked about the Biggest Loser. They definitely could benefit by Dr Grerger’s advice but there’s still concern about the exercise load.




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  47. I love the break down of these complex topics!

    Has anyone come across any current research on the efficacy of Selective androgen receptor modulators (SARMs) use to decrease fat levels and indirectly treat type two diabetes?




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    1. so jason fung came to the conclusion that all of the peer reviewed, medical journal articles, charts and graphs used in the presentation are incorrect?




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  48. I’d like to hear peoples opinions on this thread about the work of Dr Jason Fung and his work outlined in his book “The Obesity Code” i.e. that high insulin (largely from lots of refined carbohydrate induced insulin spikes) causes insulin resistance, and that fat is not the enemy as stated by Dr Gregor – https://www.youtube.com/watch?v=YpllomiDMX0




    1
      1. I wonder how many people on here have watched the YouTube series i linked to in its entirety or if everyone on here believes that same as AZ Donald? Let me know your thoughts if you want to discuss. Thanks, Chris




        0
        1. Obesity is a pretty complex subject. Here are my thoughts:
          Dr. Fung has good points and bad points. He mentions heart disease started to go up in the 1950s. That places the diet preceding this by 20 to 30 years. So what happened in the 1920s and 1930s? War and increased stress? Increase in Saturated fats in the diet? Likely both factors were involved. He mentions carbs make us fat. Well that is not true at all as we see people on high carb diets do well. Well what happens to others on high carb diets that do gain weight? Oh, Carbs as a term don’t mean anything. Twinkies and white potatoes are both expressed as carbs but they are very different. What happens to the gut microbiome? Does it play a role? Evidence seems to suggest this.

          Diets as diets will not work in the long run. This we can agree on.
          Reducing caloric intake as a mean to weight loss is poor way to address Obesity. This we can agree on.
          Increasing exercise will not lead to weight loss in the long run. This we can agree on.
          Insulin will cause weight gain along with cortisol. This we can agree on.
          High protein diets do not promote health in the long run. I think this we can agree on as well.
          Processed foods (note the term processed) are detrimental to health. This we likely can agree on.
          A good diet would eliminate processed foods and eat real food.
          A better diet would eliminate or greatly reduce saturated fats. What diet can do this? WFPB diet (as a way of eating and not a diet per se). This will address the gut microbiome as well as insulin resistance which leads to increased insulin. This also reduces exogenous hormones from animal flesh. Best of all worlds and addresses the problem but does require a mind shift. It is a new paradigm. Dr. Fung doesn’t have a new paradigm but tries to work with people that will make some changes but not entire mind shift. He also promotes intermittent fasting as I recall correctly.




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          1. Hi,
            Yes, excellent points
            To any others reading I’ll address the “carbs make you fat” issue from my understanding.
            I think by carbs an WFPB advocate may be thinking eating veggies, chickpeas et al 3 x per day. This will obviously not make you fat.
            Dr Fung is talking about eating Hi GI refined carbohydrates (i.e. sugary food & heavily refined pasta / rice etc) 3 x per day PLUS sugary snacks in between (the new western diet) which keeps insulin levels constantly elevated (leading to insulin resistance) and never allows glycogen stores to be depleted and fat to be burnt (this is why he advocated fasting by the way)
            Carbs from these modern sources are worse than from veggies as they are more calorie dense and have no fibre (which is seen as a protective buffer against the high insulin spike of these processed junk foods)
            There is a lot to agree on and maybe we’re just splitting heirs, but the saturated fat point is an interesting one in that most WFPB advocates condemn saturated fat, but there is a large swing from demonising fat to demonising sugar and this point is addressed in the video series I linked to before.
            PS This relates mostly to saturated fat (animal fats or coconut oil) as opposed to trans fats (vegetable oils etc) that are widely seen as horrific.
            Here’s the link to the saturated fat (& cholesterol) point (with lots of studies quoted) if anyones interested:
            https://www.youtube.com/watch?v=QetsIU-3k7Y
            Would like to hear peoples reaction to this…




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            1. Unfortunately this video is way off. Dr. Fung here repeats multiple times that dietary cholesterol and blood cholesterol have no relation. This is false. What we do know is that people who follow low carb diets are frequently told not to worry that their LDL will rise and it is the large fluffy particles that will increase.

              We also know that WFPB eaters have lower cholesterol from the average numbers. If you start with a false premise, you end up with false ending.

              He brought up women, mortality rates, and cholesterol levels. He brought up the Framingham study. He brought up role of statins and he acknowledges they lower cardiac events. He brought up the Nurses study. All these studies are really reporting on the genetic variations rather than Cholesterol. What I mean by this is that were no cohort eating a WFPB diet. So the studies compare people eating more saturated fats or less saturated fats in the setting of a typical diet which doesn’t say much.

              Omega 3 fatty acids are beneficial and in the setting of veganism, omega 3 levels are low. The ratio of Omega 6 to Omega 3 is worst among vegans likely as we are using more processed “vegan” food which contain plant oils. A good WFPB diet eliminates processed food including oils. Dr. Greger recommends supplement of Omega 3. I prefer the supplement personally rather than eating fish since there is bio-magnification of toxins as we go up the food chain. Best to eat low on the food chain. Keep in mind that there are no naturally vegan human populations in the world but the Okinawan population eats 96% plant based diet with about 4% animal products and they do well health wise. Also the Adventist study showed benefit in vegans. Real food is good. Manufactured food products are not.




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  49. If insulin resistance is based on too much sugar in the body, it doesn’t make any logical sense that saturated fat would be the reason for insulin resistance. High carb diets have sugar in them such as whole grains and other forms of sugar. Why have I been able to lose weight eating less? Also, my cholesterol test scores were “average” and that is with six eggs a day with butter on them. Can someone explain why my test would not be high if the science documents state otherwise?




    0
    1. Darren: Cholesterol goes down for most people just for losing weight. Your cholesterol can go down for a variety of reasons, including getting cancer. So, the question is: Are you choosing a path that leads to long term health or raising your risk of dying early? Low carb diets are known for increased mortality (dying early).
      .
      You wrote: “If insulin resistance is based on too much sugar in the body…” I don’t think you understand what insulin resistance is. I recommend watching the video on this page. If you need some additional help, the following recent blog post also explains insulin resistance. It might make more sense to you: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/
      .
      Finally, there is a world of difference between table sugar and intact grains, beans, and other starchy foods. You can learn about the health promoting aspects of these foods on this site. Here is a good place to start: http://nutritionfacts.org/topics/grains/




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      1. Our brains are made out cholesterol. Carbohydrates are calories which adds stress to the body more than low carbs. Calories burn within the body, ever notice a building with sugar and how hard it is to put out the fire?

        Ever hear of the phrase “beer belly”? They don’t say it because of table sugar, they are referring to the sugar in the grains of beer that helps add weight especially around the waist.

        If fat is the link to diabetes, why are cells made up of fats and require fats? Fat and sugar are not the same thing. I don’t know any fat individual who eats just “fat”. If anything their diet consists of sugar. Grains and other starches contain sugar.

        Thanks for the links but I prefer not to use logical fallacies and prefer to get my sources of information from someone who has studied things like the cells of the body as well as the chemistry of the cells. The information provided is not accurate.




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        1. Darren: Your sources are feeding you a lot of misinformation. So much so, it would take too long to correct all the errors of your post. This site is a great place to get valid scientific information. I would encourage you to spend some time on this site. Also, http://www.plantpositive.com goes through the claims you have made from your likely sources and has checked the actual studies behind those claims. Most of the studies do not actually back up the claims or ignore the body of scientific evidence. The only logical fallacies in play here are from the sources you are listening to.
          .
          If you are not interested in the science, this site will not interest you.




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          1. So is my body a poor source for information? LOL Don’t you find it interesting that you only share links that provide a one sided argument regarding a plant diet? I don’t actually get my sources from those who have a bias but rather are clearly educated in how the chemistry of the body works. Ironically, you are saying that if I am not interested in the science that the site will not interest me but hate to break to you but science requires further research and learning. Have you ever heard of the 7 liberal arts and sciences? What can you tell me in your own words about what you know about biochemical individuality?




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        2. 8+ years ago I had similar beliefs to those you are sharing here. But then I researched in the right places (credible studies and research) and opened my mind to learn more. I realised I was wrong and indeed what you are telling us is misinformation.

          Thea has given you more than enough help and information to be better informed.

          The cognitive dissonance you are exhibiting is holding you and your health back.

          Good luck.




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          1. Scott, do you know what your argument in regards to “credible studies and research” indicates, it shows a logical fallacy based on the appeal to authority. The only authority regarding the chemistry of the body is the creator itself. I use what I learn and apply it, I have had positive results. Since we are on the topic of cholesterol, can you give me a medical explanation then why my cholesterol levels were “average” in the medical test given and that is with six eggs a day with butter.




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      2. Cancer uses insulin and sugar to feed it. How can you say that it is cholesterol. If you actually study some of the cancers, you will find that it is insulin/blood sugar that does this. Insulin and blood sugar are connected. Being fat physically is a form of insulin resistance and it feeds the cancer with sugar aka toxin. Yes…sugar is a toxin.




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        1. Darren: See my previous answer. You have been fed a lot of baloney. It’s too bad, because I’m sure you are very interested in your health.
          .
          In case you are curious, the following NutritionFacts video presents evidence on how cholesterol feeds breast cancer cells (which is a different topic than I was raising before, but since you bring it up): http://nutritionfacts.org/video/cholesterol-feeds-breast-cancer-cells/
          .
          If you want to learn about cancer in general and what foods promote and what foods hinder the disease, the following NutritionFacts topic page is a good place to start: http://nutritionfacts.org/topics/cancer You can click through to the links and the video pages all include a ‘sources cited’ button so that you can check the sources for yourself if you want.
          .
          No one is saying that table sugar is good for us, but you are overblowing the problems, misinformed about the workings of whole plant foods high in carbs, and ignoring the science around eating a high fat diet, especially one that is made up of a lot of animal products.




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          1. How can cholesterol which is something in the body and regulated by how much you eat, feeding cancer? You do realize that there are medical institutions that have stated that insulin/blood sugar is a culprit when it comes to feeding cancer.

            I prefer to have you say things in your own words rather than just providing me links. It seems that there is a cult of worship regarding this website and a lack of further learning going on. Again, do you know what calories do to the body? We are fat burners and not sugar burners. Take a look around over the past 100 years, cancer rates have risen not gotten lower. My ancestors were eating fat and not constant sugar.

            Have you read the book “Fats that kill, fats that heal” by Udo Erasmus?




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            1. Darren: I provide links because this site is about the scientific evidence. The links I provide to you explain the information *and* also give the references to the scientific evidence. In other words, I’m doing the very opposite of “cult of worship” and lack of further learning. You on the other hand, have not provided any evidence to back up any of your claims.
              .
              Concerning the new and unsupported claims you have made in this latest post: Once again, you are sadly misinformed. If you would like to educate yourself, the resources I already provided are a great start.
              .
              Bottom Line: It makes no sense for me to repeat a bunch of information in a post for you, when NutritionFacts has already done all the work. If you don’t want to help yourself and check out these very easy-to-understand resources, nothing I type up for you is going to help. Good luck.




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      3. Please explain to me how my weight stayed the same with me eating eggs and butter and my cholesterol levels are “average”. I understand that this website is a page for “health” but what have you personally learned about biochemistry? I am going to take advice from someone who has a better understanding of cells and how they work before I go and listen to a site from a doctor. You do realize that most doctors don’t even learn that much about nutrition in school and they clearly don’t have enough knowledge regarding biochemistry. It is the pharmacist that knows more than the doctor does. You do also understand that when someone gets cancer, they lose weight and body fat has nothing to do with cholesterol but with sugar and toxin.




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        1. Darren: This one is easy! Why are your cholesterol levels average? 1) Because you live in a sick society. High/dangerous cholesterol levels are the average. 2) Cholesterol levels tend to level off after getting into the dangerous zone. In other words, you may not see much difference when you add a few eggs to your diet if your cholesterol levels were already high.
          .
          You wrote: “You do realize that most doctors don’t even learn that much about nutrition in school…” This is true! We are very aware here that most doctors receive very little if any nutrition information in school. In fact, there are a couple of videos on NutritionFacts that covers that sad state of affairs. Happily Dr. Greger has done a ton of research over many years so that doctors can begin to educate themselves if they wish. Dr. Greger literally reviews thousands of studies on nutrition every year and then shares the relevant information with us. This site has been a good resource for many doctors.
          .
          As for your other claims, you keep repeating them, but provide zero scientific evidence to back up your claims. You can take your advice from whoever you want. Why are you here if you think this site has nothing to offer? I invite you to learn if you are interested. If you are not interested in learning the information on this site, there is no point in this conversation.




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  50. Hi Dr. Greger. I started following you last year. I am currently reading your book. My husband was told that he has insulin resistance, and I showed him this video. His dr. recommended him to follow a Ketogenic diet. My husband sent this video to his dr., and he replied about it. I am 80% WFPB, but each day gets harder and harder. I am surrounded by people who follow high fat or high protein diets. The following is his e-mail :

    —–
    Here is a commentary that explains some of the problems with Dr. Gerger’s presentation.
    Sincerely,
    Dr.Zink

    Does fat intake cause insulin resistance? (self.ketoscience)

    submitted 2 years ago by terppderpp

    http://nutritionfacts.org/video/what-causes-insulin-resistance/ looks legit, done by a Dr., you guys always seem to love an antifat study to discredit.

    The first study he cites was over a course of two days. What the researchers do is feed one group fats and the other group carbs. The researches then administered a blood sugar test which showed the fat group getting a blood sugar of near 200.

    The study can be seen here

    So the study then was all about influencing the dextrose tolerance test. The dextrose tolerance test is about giving the subjects dextrose and then seeing how their blood glucose reacts.

    Consider this then, for two days the high fat group had been having almost no blood sugar spikes. It didn’t need to secrete much insulin. All of a sudden they dumped a huge amount of sugar in the blood. You can obviously see what happens.

    I think this is dishonest to apply to the ketogenic diet. Someone on keto will never dump sugar into their blood like that. It just doesn’t make any sense.

    Meanwhile the sugar group has had a steady stream of carbs and higher insulin production for two days. They’re already going to have lots of insulin ready to go for the dextrose test.

    I don’t even see how this test is applicable for the man’s argument.

    He then goes on to talk about athletes carb loading so that they can increase their glycogen stores. He says insulin is the key to let sugar in. That’s true. Insulin is the key to building fat deposits as well, and storing fat.

    He’s so far into the glycosis model he doesn’t even consider how the body works differently in ketosis. One is obviously only producing a small fraction of the glucose that he is in glycosis.

    Moving on he then blames intramyocellular lipids on insulin resistance which is as far as I can tell correct.

    So what should we be wondering now? What causes intramyocellular lipid build up? He blames it completely on free fatty acids citing a 6 hour study where they took healthy individuals and observed if glycogen production was hampered by free fatty acids.

    It seems rather courageous to me to try and infer that FFA in the blood permanently impair insulin resistance from one 6 hour test and to top that off its only from FFA due to dietary intake of fat.

    Twice now he seems impressed by the fact that things happen quickly (in the short term) rather than bothering to present us with a long-term study. Again he’s completely disregarded the fact that someone on the ketogenic diet does not need insulin in the same way someone on a regular diet does or in the same amounts.

    He also is agnostic to body fat, lipogenesis from carbs, and the fact that carbs contribute to fatty acids in the blood. If you eat too many carbs you will cause this insulin resistance phenomena he is talking about. The difference is your blood glucose will also be raised as well meaning you need even more insulin.

    He then says you can do the opposite, clear the fat out of the blood and you clear the sugar (because you MUST have sugar in your blood! Ketones obviously don’t exist).

    The real hilarious part is the final part

    on a ketogenic diet insulin doesn’t work very well

    Because it doesn’t need to. Stop giving dextrose tests to people in ketosis. That isn’t a marker of anything.

    He then draws the conclusion that if we have less fat INTAKE then insulin resistance decreases, ignoring lipogenesis completely. Ignoring the VLDLP that is spawned from lipogenesis which is the plaque that sticks to your arteries and kills you. Ignoring his results are from giving sugar to someone whose body isn’t in a state to metabolize sugar. Ignoring that all of his results are mypotic in their length compared to a diet over the course of a life time.

    Just one single long term dietary study please.




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  51. Hello Irnsngh,
    This whole topic of ketogenic (Atkins-type) diets vs. low fat diets plant-based diets has been extremely controversial for a number of years. I am a family physician with a private practice in lifestyle medicine, and a volunteer moderator for this website. I will try to give you some useful, understandable information.

    First of all, the doctor who you quote, above, is not looking at the results of actual published nutritional studies to address the issue of the health effects of different diets, rather he argues that his understanding of the biochemisty of glucose, fatty acids, and insulin doesn’t jibe with what Dr. Greger is saying. Don’t be confused by this; I call this a “hand-waving” argument.

    Another point to remember is that an Atkins diet does indeed help people lose weight. The problem is that (a) this type diet is bad for you, and (b) almost nobody can stick to an Atkins diet long-term, because our bodies were designed to metabolize diets high in complex carbohydrates. Just talk with people who have tried to stay on an Atkins diet for a long time: they almost all wind up going off the diet, and re-gaining all their weight.

    Dr. Greger has done several videos which look at the health effects of very low-carb (Atkins-type) diets:
    This one describes a study of 100,000 people by researchers at Harvard which “found that low-carb diets were associated with higher all-cause mortality, higher cardiovascular disease mortality, and higher cancer mortality.” The study also looked at whether or not the harmful part of an Atkins diet (high meat, high animal fat, low carb) is the low carbs or the animal component: it found that “A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.”
    Here is one which showed that patients on low-carb diets had impaired flow of blood in their coronary arteries.

    I also checked in PubMed — a free database of medical articles. I found:
    This study in mice, which showed that “long-term KD (ketogenic diet) causes dyslipidemia, a proinflammatory state, signs of hepatic steatosis, glucose intolerance, and a reduction in β- and α-cell mass, but no weight loss. This indicates that long-term high-fat, low-carbohydrate KD lead to features that are also associated with the metabolic syndrome and an increased risk for type 2 diabetes in humans.”

    Finally, you should know that there are powerful lobbies for the meat, dairy, and egg industries, all of which want us to believe that eating saturated animal fat is not bad for us. In this video, Dr. Greger points out that “Conflicting messages in nutrition cause people to become so frustrated and confused they may just throw their hands up in the air and eat whatever they want, which is exactly what saturated fat suppliers want–but at what cost to the public’s health?”

    I hope this helps a little. Dr. Jon (Sheline), volunteer moderator for NutritionFacts.org.




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  52. Fantastic and very convincing video. I have been told by a friend that wants me to go low carb and eat fatty meat that fat has very little effect on insulin levels so this is not what I expected to see. I showed it to my friend and he was not convinced.

    1) The first paper the video shows is from 1927 I think, and is pretty old. Is there something newer that repeated the same test? My friend says this is very old research to be relying on. In addition where can I read this whole paper so that I can convince him with more detail?
    2) Secondly, he also says that eating carbs or fat makes no difference to the presence fat in your blood. You can put on weight with either a low fat or high fat diet and carbs are fattening. He says Insulin resistance can come from carbs or fat cause its about fat in your blood and not what you eat. He says the fat from carbs is trigyliricides (very bad) and also that sugars are really bad for causing fat in your organs. You don’t have sugars from fruit on low carb.

    I am tempted to try low carb but I have been vegetarian for ten years and this would mean probably eating meat again. My friend has lost a lot of weight and turned his diabetes around on low carb. I am pre-diabetic and need to do something. Can you help me with some info as I don’t want to ignore his advice without reasons and I need to decide what to do.




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    1. Brenda: Your friend has been listening to a lot of misinformation. Rather than try to address the incorrect points raised by your friend, I’ll just talk to you about addressing the issue you are facing: pre-diabetes. A problem where you are starting to get insulin resistant – but not enough yet to have a full diagnosis of diabetes.

      Following is a really great book. This book is based on solid, published research on humans with diabetes. Dr. Barnard has studies where he only changed the person’s diet. Barnard published in peer reviewed, respected medical journals and was able to prove that his diet is 3 times more effective than the ADA diet. Both in research and on this website, people have reported being able to reverse their insulin sensitivity. What’s more, note that Dr. Barnard is not the only researcher who has proven that the diet works.
      .
      The book is called “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs”. It is a whole food plant based diet, so you don’t have to worry about anyone pushing you to eat meat. The opposite! In addition, the book contains meal plans and recipes at the back of the book. So, you will get a lot of support. There’s also a free 21 Day Kickstart on-line program I could tell you more about if you are interested.
      .
      Here’s the book: https://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1480632167&sr=1-1&keywords=barnard+diabetes

      No one denies that you can address one of the main symptoms of type 2 diabetes by eating an extremely high fat (and low carb) diet. If you don’t put any glucose into the blood to begin with, it’s true that you will not have any blood sugar spikes. Moderator Darchite did a great post on this topic not too long ago. She covered the two ways to address type 2 diabetes: a very high fat diet or a very low fat diet. Here is the post that is worth a read: http://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-type-2-diabetes/#comment-3007013730. Note that this is all consistent with the information provided in this video.
      .
      So what if you choose the high fat route? It “works,” so why not? When you choose the high fat route, you are not treating the actual cause of type 2 diabetes (see video: http://nutritionfacts.org/video/what-causes-insulin-resistance/#comment-3087604266 ). You are just addressing the symptom, blood sugar spikes. You still have the underlying disease, insulin insensitivity. What’s more, you are eating a diet linked to increase mortality (dying sooner). Following is a post from Tom Goff sharing some of the science that links low carb diets to increased mortality. Even this little post has a long list of studies: http://nutritionfacts.org/2016/12/13/whats-the-optimal-cholesterol-level/#comment-3064114115. For further research, note that NutritionFacts has lots of videos on the topic of high fat diets. By watching these videos, you can see that such diets are not good for long term health from multiple angles.
      .
      Here’s an analogy that may not be the best, but might help: Some people smoke because it keeps their weight under control. We all agree that keeping weight under control is generally a good thing. The problem is that smoking is bad for maximizing chances of long term health. There are healthy ways to keep weight under control. So, you can choose a method that is likely to provide for long term health or one that raises your risk of dying sooner. The same applies to dealing with type 2 diabetes.
      .
      If you are interested in learning how to treat the cause of type 2 diabetes and maximize your chances of long term health, I have some great resources to share. Let me know if you are interested. Good luck.​




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    2. Hello Thea,

      Thank you for such a full reply. It is what I love about this site but you didn’t really answer my question.

      It is a shame you could not provide more details about the research in the video which is what I asked for. My friend says that the 1927 research is not reliable as the response after two days of eating fat is what you would expect and is not insulin resistance- just low insulin. If you can’t tell me where to get the paper to look at with him, can you at least counter that?

      He also says that fat you eat does not end up in your blood the same. That you can eat a lot of fat and it doesn’t make your cholesterol worse. I saw the fatty foods he ate and his cholesterol tests improved. He also says that fat made out of too many carbs does end up in your blood and is the worst fat of all.

      Do you think I could try vegetarian low carb? I do like butter, yogurt, eggs and cheese. Would that still work do you think? Do you have any charts comparing low carb results with vegan so I can see which is the best? I need to make a decision.

      Thanks,

      Brenda




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      1. Brenda: OK, I’ll take another stab at answering you and the claims made by your friend.

        I’ll start with, “That you can eat a lot of fat and it doesn’t make your cholesterol worse.” Human blood has such a predictable increase in cholesterol from eating saturated fat that the scientists were able to make an equation. There are several pages on this site that covers the link between the fat we eat and the cholesterol in our blood. Here’s a really good one: http://nutritionfacts.org/video/the-saturated-fat-studies-set-up-to-fail/

        re: “He also says that fat you eat does not end up in your blood the same.” I don’t know what he means by “the same”, but the fat you eat most definitely ends up in your blood. I’ve seen lots of stories for example of people who talk about even the color of the blood changing for people who eat high fat diets. For a scientific backing that the fat you eat most definitely ends up in your blood, you might look up the video on this site which talks about how eating oils (which are pure fats and thus no one can claim that somehow a carb is responsible) stiffens the arteries. If that fat was not ending up in the blood, it could not have an effect on the blood vessels. Note that this negative effect is true even for olive oil.

        Conversely, let’s talk about carbs for a minute. Carbs only end up as fat if you take in more calories than you need. Your body does not like to convert carbs into fat. That conversion is a complex and energy intensive process (meaning your body burns some of those carbs just to do the conversion process). If you are taking in more calories than you need, then of course you are going to end up fat. That’s not really saying anything helpful. What is helpful is to know that fat laden foods are what is known as “high calorie dense”, which often leads people to overeat.

        There are people like your friend who managed to lose weight by eating diets of extreme high fat, but as I mentioned, it’s not a healthy long term solution. The long term healthy way to lose weight is to eat foods that are low calorie density whole plant foods. This is the method that Dr. Greger and others recommend. I can give you a really good post for information on how to lose weight in a healthy way if you are interested. The good news is that the same diet that is good losing weight is the same diet that is good for type 2 prediabetes which is the same diet that is good for long term health, etc. The other way to accomplish the goal of losing weight (other than learning about and focusing your efforts on low calorie dense foods) is to get the book from Dr. Barnard that I recommended above. You could follow the meal plans and recipes in that book.

        Consider that one of the longest lived, healthiest populations on the planet was the traditional Okinawans. They have so many people who get to 100 that they have a group party where the birthday girls and boys march down the street… Their diet was 85% carbs, 6% fat and 9% protein. About 4% of their calories came from animal products. http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ I’m not saying you need to exactly imitate the Okinawans to be healthy. I’m trying to drive home the point that carbs from whole plant foods are not a problem. Also, patterns of healthy eating involve lower amounts of fat, not higher.

        re: “I saw the fatty foods he ate and his cholesterol tests improved.” The answer to this is in your first post. Your friend lost weight. The very act of losing weight causes cholesterol levels to drop. So does some types of cancer. And while improved cholesterol levels are a good thing, I don’t know anyone who would seek out cancer just to improve cholesterol levels. Cancer is not good for long term health. You can look up high fat and low carb diets on this website and learn about the long term health risks for going that route.

        re: “Do you think I could try vegetarian low carb?” There is some reason to believe that a diet that is all plant foods but also happens to be high fat may not be as detrimental as a diet that is full of animal products. There’s a video on this site about that. However, if I was heading toward type 2 diabetes, I personally would not eat foods that feed the cause of type 2 diabetes. I’m not an expert, so you can take that advice for what it’s worth. As for your question about eggs, butter, yogurt and cheese, keep in mind that diary is aptly named “liquid meat” for a reason. Dairy has the same (or worse) impact on your health as meat. Here are just a few of the problems with dairy: http://nutritionfacts.org/topics/dairy (FYI: Dairy is also just as problematic ethically and for the environment.) In addition, there is a giant amount of evidence linking eggs to a range of diseases. Eggs are a good way to bring on diabetes and cancer and … Here’s a look at some of the health risks that come with eggs: http://nutritionfacts.org/topics/eggs

        re: “…the 1927 research…” In my response to you, I was trying to help you understand something that I repeat often: When it comes to nutrition, understanding what the science says is almost never about one study. It is about the body of scientific evidence as processed by people who actually understand scientific evidence. I’m not qualified to say anything about the study you are referring to. (From what your friend believes, he is *not* qualified either.) However, I can say that I think that focusing on a single study is missing the point. We have a body of scientific evidence that backs up the claim that eating a high fat diet causes insulin resistance. As evidence to back up that claim, I suggested looking at Barnard’s research. Barnard has done recent experiments on people who have been T2 diabetic for years and gotten fantastic results by getting those people on a diet of low fat whole plant foods. These results have been replicated by other researchers. If I were pre-diabetic, I’d want to follow the plan of people who actually fixed their problem in a long term healthy way.

        That said, if you want to review the details of the 1927 study, it’s possible that your library or the library of your local medical school would have it. If you click the “sources cited” button next to the video, the list of sources appears under the video. Most of the studies listed are links to the studies themselves. In this case, you can only see some of the study, but when you click the link to see the full study, there is an option to buy it. You will also notice that the list of sources cited includes more recent studies than 1927. For example, there are studies from 2008 and 2013 which back up the claim made in this video. Again, I would point out that it is the body of scientific evidence which is usually important, not a single study.

        Hope that helps.




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  53. A couple of things to add to the party here! What a confusing subject indeed. But having read almost this whole thread, one thing that stands out to me is how defensive those are who are on a high fat, high protein diet. It’s almost as if they have to work SO hard, to prove their point. But my overall very unscientific opinion is that we need to get away from extremes. It’s extremes and imbalance (as far as diet and lifestyle are concerned), that have gotten us into this sick predicament in the first place. Eating too much of anything is not a good idea – it’s not what our bodies were designed to digest. Surely a diet full of whole primarily, plant-based foods (eaten in moderation), and a lot of exercise, is the way to go for most individuals. I know that there is not a one-size-fits all, and that there are a lot of serious health issues (on this thread), but I am talking in very general terms here. Most of us know that processed foods of all kinds (oils, fats, sugars, carbs and proteins) are not healthy – this is not rocket science here. We also understand that too many sugars are not a good thing either.
    Anyway, I did what to throw an interesting podcast “Insulin Resistance not cholesterol causes heart disease” by Dr. Gerber http://highintensityhealth.com/jeffry-gerber-md-insulin-resistance-not-cholesterol-causes-heart-disease/ into the mix here. Something I heard today, and one that speaks directly to the whole ketogenic trend. Would love to hear anyone’s opinion on this – particularly Thea or Dr. Gregor himself.




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    1. sophie: I’m not the best person to listen to a podcast and comment on it. What I can say is that the NutritionFacts website covers heart disease in detail, and I don’t remember insulin resistance being a cause. Here’s an overview of the heart disease topic: http://nutritionfacts.org/topics/heart-disease/

      We also know that there is a giant amount of confusion out there concerning insulin. It doesn’t surprise me that yet one more person tries to make insulin out to be the bad guy. To illustrate what I mean about “confusion”, following is a well researched article explaining the common myths around insulin: http://weightology.net/weightologyweekly/index.php/free-content/free-content/volume-1-issue-7-insulin-and-thinking-better/insulin-an-undeserved-bad-reputation/

      A ketogenic diet is just an extreme, high fat diet. This website covers the issues with high fat diets and low carb diets in general, including this very page we are on, which covers how high fat diets cause insulin resistance to begin with. There’s a lot of information on this website about high fat and low carb diets if you want to learn more. Here are some videos covering low carb diets: http://nutritionfacts.org/?fwp_search=low+carb&fwp_content_type=video

      What NutritionFacts does not have a lot of is pages on that super extreme diet where someone is eating so much fat, they enter a ketogenic state, a state our bodies generally go into during starvation (as I understand it). I know that Dr. Greger plans to have videos in the future which address intermittent fasting. When people ask about intermittent fasting, they often bring up the issue of being in ketosis. It’s possible that Dr. Greger will be addressing that specific issue in the future as well. So, if the topic of ketosis interests you, stay tuned.




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  54. We know that there are very bad consequences like amputation, blindness for people who has diabetes. What causes that?

    Is it the sugar in the blood that thickens the blood because of the insulin resistance so the little arteries can’t get enough blood supply and them they necrose?

    An other question related to diabetes is: why my mother in law, who has type 1 diabetes, gets low blood sugar and it makes her feel weak? Where the sugar go?

    Thank you!




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  55. Help! I was vegetarian for 13 years but I gained a lot of weight over time, so I finally tried the Atkins Diet. It worked pretty well for me, but I returned to vegetarianism because I feel it is morally wrong and unnecessary to kill animals for food, and I just can not stand to support the factory farming industry. Unfortunately my weight is now higher than ever, and I am now pre-diabetic with high blood lipid profile as well. I don’t even eat a lot, definitely not a lot of junk, very few eggs and little dairy and I am fairly active (though I could probably exercise more). I don’t eat much soy either, due to Stage 4 endometriosis. Not sure if the weight is related to hormonal imbalance, aging, wrong diet or something else. I do not want to start eating meat again but I feel like the vegetarian diet is making me fat. Does anyone have any ideas or suggestions?




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    1. Hello Wild1,
      Thank you for your question. I am a family physician with a private practice in lifestyle medicine and also a volunteer moderator for this website. You mention that you still eat SOME junk food, some eggs, and some dairy. What I would advise is that you do a 3-day dietary history, where you write down EVERYTHING you put in your mouth, both food and drink, for a full 72 hours. Then visit a nutritionist or physician who is trained in plant-based nutrition and have them go over that with you. My guess is that you are eating too much fat and too many “simple carbohydrates” — i.e. sugary food or starchy food with a high “glycemic index” (gets quickly metabolized into sugar).

      To find someone trained in plant-based nutrition, you can try one of these websites:
      PlantBasedDoctors.org, or
      VegDocs.com
      OR, there is a website where you can pay a monthly fee (I think $34/month) to get unlimited on-line/telephone access to a plant-based nutritionist:
      Lighter.World.

      I hope this helps.
      Dr. Jon
      PhysicianAssistedWellness.com




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  56. This is 100% NOT true. Fat doesn’t cause insulin resistance. Intramyocellular fatty tissue may be associated with insulin resistance but the first thing you need to realize as a scientist is that correlation does NOT equal causation. Constantly spiking insulin from sugar and other high glycemic carb consumption desensitizes your insulin receptors over time while storing fat in the process. Desensitized insulin receptors means your pancreas needs more insulin to lower blood sugar, storing even more fat in the process and it’s a downward spiral. This vegan movement is getting out of hand to the point where they make stuff up in terms of science to push an agenda. Humans evolved to eat meat and that’s very easy to prove.




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  57. I am curious about the research from the dietdoctor.org and the promotion of the high fat low carb diet. They have tons of research supporting this. I am so confused how to eat now. Is there anything certain? I am 270 pounds and 40 and sick. Please help




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    1. Unfortunately, the only thing certain is that our bodies need food to survive. There are so many studies on various diets that you can find support for almost anything. It really just depends on what is right for your body. Do you mind me asking if you’ve tried dieting in the past?




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      1. I have tried so many different things. I did weight watchers and belly fat cure and ketogenic and Mediterranean and low car high fat. The only thing I lost eight doing was medifast but then it triggered like a breakdown as I lost 100 pounds in 5 months. I was a college soccer player and was so athletic. My body feels broken. I just want to heal.




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        1. I am so sorry to hear that nothing has worked for you. I can imagine how frustrating it would be. I think you need to start from the beginning. I don’t know what your current diet looks like but I would start with a sugar detox. No sugar in any form. This means you need to read labels and make most food at home. After about a week you should stop having cravings (if you have them at all). I would see what this does for you.




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          1. I don’t eat much sugar at all right now. I don’t crave it. I actually don’t have much appetite. I eat 2 meals a day. Scrambled eggs with spinach and onion for lunch and then for dinner ground chicken and lettuce and a little cheese. I eat a banana, Orange and usually apple or plum for snacks. Are there any simple recipes you recommend? And thank you




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  58. I just read “H P Himsworth. The dietetic factor determining the glucose tolerance and senility to insulin of healthy men. Clinical Science 2, 67-94.”. Contrary to what you said in the video, the subjects were not students, but rabbits. Why did you show the text for that study in the background while talking about some experiment performed with student participants?




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  59. hi everyone.

    I had a cousin who is having some insulin problems. She is producing too much insulin. So what really got me thinking is that her doctor told her to avoid a vast varity of vegetebles and fruits and also told her to eat meat and chiken. I thinks that diet is called the paleo diet, but avoiding a vast amount of vegs and fruits. I would like to have your opinion about how to cotrol high levels of insulin and what you think of what the doctor is saying.

    Thanks.




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  60. Honestly, all this talk is enough to make me go crazy. I was also directed here from the “What The Health” website, with questions about the authenticity of the sources. Obviously, your diet is your own choice, but I think we all need to think about the bigger picture: choosing a plant-based diet is for us, not to try to ineffectively boycott the inhumane meat and poultry industry.

    I am a data-driven person, so I say go out and try the fully plant-based diet yourself, and measure your blood levels yourself. There are devices to do this, and diabetics use them all the time. Seriously, stop reading these comments, and act on your own data.




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  61. It’s stated in this video that there’s a traffic jam of sorts between glucose and fat trying to enter the cells and that that is what causes insulin insensitivity and all of the fat from a ketogenic diet is helping to cause it. But on a ketogenic diet there’s so little glucose and therefore insulin, this doesn’t happen because it’s pretty much ketones that are driving fat into the cells for fuel. So I’m not understanding this traffic jam of sorts this is referring to.




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    1. Excellent question Ivan! Here’s the thing: the ketogenic diet might induce the physiologic state you outline of minimal glucose and minimal insulin if the subject did nothing but drank peanut oil all day, but that is rarely the case. Most advertised ketogenic diets include plenty of animal protein which can be turned into glucose via the gluconeogenesis pathway, such that serum glucose is within the normal range. You can actually see this yourself (don’t try this if you’re a diabetic or prediabetic!!) if you induce ketosis and test your blood glucose levels with the over-the-counter test kits commonly available at drug stores. In addition, ketones are not driving fat into cells. Ketones are created from fat by the liver and then circulated as an alternate energy source to glucose since your brain cannot metabolize fat, but can metabolize ketones. The ketogenic diet is not harmful per se, its the animal/saturated fats (and animal protein) that are the problem, and have been shown to increase death and disease, while the plant based ketogenic diet attains the same goals without an early death as outlined by Dr. Greger in this great vid: https://nutritionfacts.org/video/plant-based-atkins-diet/

      Thanks for reading!
      Dr. Ben




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      1. A nutritionally formulated ketogenic diet does not induce gluconeogenesis from protein because protein is moderate at 20% to 25%. This is a moderate protein diet. And no one has to ‘drink peanut oil’. Saturated fats are not a problem because they are being utilized as fuel and are not as present in the blood because of the absence of glucose and because carbohydrates are kept at 50 net grams per day. The fats one would want to keep at a minimum are polyunsaturated fats like soybean and corn and others. If you look at the data from studies of indigenous people or when we were hunter gatherers we ate animals (and they were the preferred food source) and we ate the fattiest parts. You’ve got to figure we were in ketosis quite a bit during the winter months when nuts and seeds and plants weren’t available. I’ve been on this diet for 3 months and my blood work is better than ever…




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  62. But the “common knowledge” is that diabetics should lower their carbs and not worry about fat and protein. The video makes sense (especially with the cool animation). So why is there such a strong ketogenic bias among physicians and dietitians on the best diet for diabetics and pre-diabetics?




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    1. The reason you keep fat at 70% to 75% and protein at a moderate 20 to 25% is that protein gets converted into glucose if it’s any higher. The reason the ketogenic diet works for pre diabetics and diabetics is that glucose is no longer the dominant fuel source. It’s not a “bias” it’s just the way it works.




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        1. If you’re interested in learning about the ketogenic diet you can find Dr. Stephen Phinney on the Low Carb Down Under channel. He’s an expert on this diet along with Jeff Volek…




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    1. Clogged arteries and plaque are caused by inflammation. There are less fatty acids in the blood because they are being ushered into the cells by ketones and used as fuel. It’s believed that the ketogenic diet is the most anti-inflammatory diet you can do because of the absence of glucose. Fat is a clean burning fuel that is a steady source of energy. If someone tolerates carbohydrates well and is insulin sensitive there’s no need to be on a ketogenic diet other than it’s probably a healthier diet in the long run. It slows the degradation of mitochondria, athletes have a much larger supply of energy and don’t bonk once they’re keto adapted, it’s anti-cancer, anti-aging etc…




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  63. Avocado is one of my most favorite food. However, I had to take it off my plate because of the high saturated fats. I just want the Facts. Can I eat avocado safely in moderation. What’s the Scoop?




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  64. Here is my case: 58yo, 5.7″, 106pounds. So I am very thin and no liver or muscle fat is an issue for me. I have been vegan and WF since I was 50yo and not planning to go back and eating animals in any form nor processed food of any ind (I cook everything at home from scratch). I have been doing intermittent 16:8 fasting for about a year now. No noticeable results occurred except mornig fasting BG that since Feb went from 65-75 ml/dL to 79/90 ml/dL. However, post prandial BG never got higlrt than 115ml/dL. About three weeks ago a started a one-meal-a-day (22:2) intermittent fasting according to Yoshinori Nagumo, and a 36hs/week fasting after a rather feasting Sunday ( :-) ). WOW what a change !!! I feel soo good. Still fasting BG higher than it used to be, but after breakfast (my only meal) no significant BG spikes. However, the carbo percentage has decreaed form 75% to less than 35%, proteins remained less than 20% but obviously fats increased !!! No fat coming from oils, most coming from nuts and nut butter as well as tofu, natto and tempeh (home made from soy beans).
    I never managed to get into a ketosis state. I would like to try it, just to see how it feels, but apparently, vegan diet does not really allow to get you to that (and I am not planning to eat animals ever again). Long preample for my simple question:
    what is your opinion about The Obesity Code book by Jason Fung?
    How does it compare with what Dr. Greger says in this video?
    It would be nice to have an analythical comparison. Thanks in advance




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    1. Hey Rita, thanks for writing. As a Moderator, I volunteer to answer questions for Dr. Greger, but you can imagine that he does not have time to read every book that is published on diet and health; he sticks mainly to scientific papers. You are too thin to even consider a ketotic diet – it could be harmful in someone who is 15 lbs. below her ideal body weight range. In fact, when one looks at the mortality statistics, the risk for dying prematurely is about as great for people who are significantly underweight as it is for people who are significantly overweight. One reason is because when people develop a bad respiratory infection, they typically use skeletal muscle and body fat as fuel to fight the germ. Without enough of either you can easily succumb to a secondary, life-threatening infection. Take care of yourself, and thanks again for writing and watching!




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  65. Dr. Greger, my wife and kids and I have switched to a plant-based diet for over a year now. Our health has improved significantly as a result!
    However, my mother was just diagnosed with Type 2 Diabetes and high-cholesterol. Her doctor informed her not to eat oatmeal and eat good quality salmon, among other questionable diet suggestions. I can hardly believe it. I would like to try and sit down with this doctor with my mother in the room, and bring with me studies and information suggesting that a plant-based diet can treat and hopefully reverse both conditions. Do you think this a good approach? What studies and information should I bring with me that a doctor would not be able to deny? Please, any tips you can provide would be so helpful. Thank you!!! I also plan to seek out a plant based doctor if I can.




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    1. Derek Santos: One suggestion for you: The following book from Dr. Barnard is extremely well researched and shows that there is clinical proof that a low fat, WFPB diet is 3 times more effective at fighting T2 diabetes than the ADA diet. The book includes references – and recipes. I found it to be a quick and enjoyable read. I don’t know if you would be able to get either your mother or her doctor to read the book, but if you can, it should be a big help. If the book feels like too much for the situation, it would provide you with a list of studies that you could hopefully find and bring with you. (You might also look up the studies that NutritionFacts references on the pages which talk about T2 diabetes. There are even often links to the studies themselves.)

      The book is: “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?s=books&ie=UTF8&qid=1503604900&sr=1-1&keywords=barnard+diabetes

      To further bolster your case, you can get a parallel book that does for heart disease what the above book does for diabetes. You can point out that the same diet works for fixing both conditions. “https://www.amazon.com/Prevent-Reverse-Heart-Disease-Nutrition-Based/dp/1583333002/ref=sr_1_1_twi_pap_1?s=books&ie=UTF8&qid=1503604948&sr=1-1&keywords=esselstyn+prevent+and+reverse+heart+disease”

      As for what is a good approach? I’m not an expert, but I think a big meeting might backfire. I think the doctor is more likely to react defensively in that case, especially if he/she hasn’t had time to review the data. Perhaps the following approach might have more success? : Write a cover letter expressing your concern and attach the two books. Offer to answer any questions. List NutritionFacts as a resource. (And explain that many doctors use NutritionFacts as a resource.) Include one or two vital points that show that the doctor’s advice was wrong. For example, show the data on oatmeal. Let doctor know what date you will follow up on. Bring or send the package to the doctor. Then contact office and see if the doctor has had a change of heart. If so, then a big meeting with the doctor and your mother should work well.

      Whatever happens, know that you are not alone. So many people on this forum struggle with family members who either won’t listen or who listen to their doctor’s misinformed advice. In the end, there is only so much you can do. There are lists out there somewhere where you can obtain a plant based doctor. That would really be your best best. If you get desperate and can’t find anyone, another option is to use Dr. Michael Klaper, who does phone consultations. Good luck.




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      1. Thea, thank you so much for your prompt response! I will get both books. I like your suggestion of writing a cover letter with the books/studies attached. I will try this approach if I can. I will respond with hopefully positive results as things progress. Again thanks so much!




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    2. If your mother is not taking any medications for her type 2 diabetes, you don’t necessarily need a doctor’s approval for her to begin eating a low fat whole food plant based diet. However, if you must convince the doctor, you may refer her to this study conducted by Dr. Barnard and colleagues. If you can’t find any plant-based doctors in your area who are promoting a low fat plant-based diet for the prevention and reversal of type 2 diabetes, there are many who teach educational courses online for diabetic patients.




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      1. Thank you for the reply Jamie! She is on a low dosage of medication, plus quite a lot of other medications for other things as well. For that reason I’d like to do it with the doctors awareness so she can be monitored. That all said, she has begun eating less and less animal products and more plant based foods which is a good start!




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  66. This idea of fat causing diabetes is very new to me and requires a complete change in my thinking. Just to understand, I was wondering if you could speak to the idea of certain populations such as Inuit people who ate mostly fats. I don’t think they had any problems until the white man diet was introduced to them.Thank you.




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    1. The reason it may seem new to you is because it’s not true. This video is a joke. You’re right about the Inuit although there is data to suggest while their diet is high in fat and protein they weren’t in ketosis as much as we’d think. This is because they eat meat raw too and could get a certain amount of carbohydrates straight from the blood of the animals. Either way though they still ate a predominantly low carb diet and therefore don’t have to secrete as much insulin as we do in our culture with all of the high grain high sugar foods we eat in our diet. If you’re interested in science based data and research (as opposed to ideologically based science) look into the work of Dr. Stephen Phinney (he’s been studying ketosis for over 30 years) and Dr. Jeff Volek or Dr. Jacob Wilson PhD and Ryan Lowery who work with athletes and have a research lab in Florida.




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    2. Cynthia Moussas: Your question is a good one. Lots of people share it. The discrepancy is in your belief that traditional Inuit were healthy. Below in information I share with people who have this question. A bit of looking into those links, and you will see that the data on the Inuit and similar populations is consistent with the information provided in this NutritionFacts video.

      —————
      If you are thinking that Eskimos and Massai are examples of people who thrive on meat, it is actually a myth. People from those native cultures which consume a lot of meat do not live very long generally due to the harsh conditions in which they live. But even by the time they reach the early ages in which they die, the people show signs of heart disease. We even see this in ancient mummies who could not have been influenced by modern diets/products.

      Here is a copy of a post from “xfjea” that is very helpful:
      “The idea of excellent cardiovascular health among inuits is probably based on inaccurate data. See this review from 2003:
      http://www.ncbi.nlm.nih.gov/pubmed/12535749

      And here is what Graham wrote:
      “Autopsy data on pre-westernised Inuit shows lots of data for atherosclerosis in the Inuit.
      http://www.meandmydiabetes.com/wp-content/uploads/2010/03/Atherosclerosis-in-Pre-Westernized-Inuit.pdf

      In short, there is no Inuit Paradox. Even ancient Inuit mummies show signs of heart disease (and cancer). NutritionFacts has covered this topic as well. As usual, you can click the Sources Cited button to read the studies highlighted in the video if you want: http://nutritionfacts.org/video/omega-3s-and-the-eskimo-fish-tale/

      If this topic interests you, Plant Positive has some wonderful details and source materials on the topic. Search for words on the following link/page such as: masai, alaska, eskimo, etc. Then click the links to watch the videos. You can also click in his search box for “inuit”. Or even better, go to the top of the list of the “Primitive Nutrition” series and watch the whole thing. :-) It’s *very* educational.
      http://plantpositive.com/

      Hope that helps.




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  67. The video confuses insulin resistance with temporary depressed insulin secretion due to increased fat intake. The increased blood glucose is only the result of physiological insulin suppression, which is a defense mechanism of the body when it does not have enough glucose to ensure glucose is used in the brain where it is essential (muscles can function on fatty ketone bodies). Once the glucose deprivation is removed, the insulin response goes back to normal.

    This has nothing to do with insulin resistance, which is an acquired, long-term condition which is not reversible within a couple of days. I am assuming the video is promoted by the corn and grain food industry which call all fats evil in an attempt to bring the attention away from carb-rich diets, which is the true cause of long-term insulin resistance.

    It also completely ignores the fact that glucose is converted into fatty acids by the body anyways (increased blood glucose will result in elevated tryglycerides).




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  68. Laurent: Thank you!

    I keep seeing various references to Himsworth from the 1930’s (pointers to here and here) which seemed to contradict insulin resistance. (Even though this was very old work, the apparent contradictions were troubling.)




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  69. Two points need to be made.
    Firstly, the subjects in Sweeney’s study were not divided into 2 groups as Dr Gregor stated, but 4 groups. The additional groups were a high protein diet and a 2 day fasting group. The blood glucose levels in the GTT results of these other groups fell between the high fat and the high carbohydrate group. As Laurent has correctly stated these results reflect short term glucose response, not insulin resistance, which takes years or decades to develop. It becomes very difficult to interpret the results of a group that fasted for 2 days before the GTT, were due to the fat content of their diet.
    Secondly, in a later paper, Sweeney agreed with other authors who concluded : Langer and Fies ” have shown very definitively that diets deficient in carbohydrate, result in abnormal glucose tolerance curves. (Glucose necessary to stimulate insulin production. JS Sweeney, JN Tunnell, Rose Tunnell,)

    G




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  70. Here is my confusion. On I high fat/low carb diet I lost over 40lbs. (Since regained) All the doctors that taut this type of diet had their studies,test, credentials,etc. backing their claims and suggestions. Better triglyceride count, lower blood pressure, cholesterol improvement and an irresistable glow of incredible health and well being. You know the names; famous authors, respected journalist, surgeons,heart specialist, ad neuseum. My simple question. How can the medical profession claim,and seemingly demonstrate, the same,or at least very similar, results and be so diametrically opposed in their approach. HELP ME UNDERSTAND, PLEASE!!!




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    1. Gary: It’s a fair question. Here are some thoughts for you:

      1) “…backing their claims and suggestions…” – I would suggest that this is not actually true. These people you are talking about do provide with references, but the references often fail to back up their claims. Here are some reviews that give examples on this point:
      >>> On The Big Fat Surprise Part 1: https://thescienceofnutrition.wordpress.com/2014/08/10/the-big-fat-surprise-a-critical-review-part-1/
      >>> Part 2: https://thescienceofnutrition.wordpress.com/2014/06/30/the-big-fat-surprise-a-critical-review-part-2/
      >>> On Good Calories Bad Calories and a whole bunch of others: