Lipotoxicity: How Saturated Fat Raises Blood Sugar

Lipotoxicity: How Saturated Fat Raises Blood Sugar
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The reason those eating plant-based diets have less fat buildup in their muscle cells and less insulin resistance may be because saturated fats appear to impair blood sugar control the most.

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The association between fat and insulin resistance is now widely accepted–so-called ectopic fat accumulation–the accumulation of fat in places it’s not supposed to be, like within our muscle cells. But not all fats affect muscles the same. The type of fat–saturated or unsaturated–is critical. Saturated fats like palmitate, found mostly in meat, dairy, and eggs, cause insulin resistance, but oleate, found mostly in nuts, olives, and avocados may actually improve insulin sensitivity. What makes saturated fat bad? Saturated fat causes more of those toxic breakdown products and mitochondrial dysfunction, and increases oxidative stress, free radicals, and inflammation, establishing a vicious cycle of events in which saturated fat-induced free radicals cause dysfunction in the little power plants within our muscle cells, which causes an increase in free radical production and the impairment of insulin signaling.

Fat cells filled with saturated fat activate an inflammatory response to a far greater extent. This increased inflammation, along with eating more saturated fat, has been demonstrated to raise insulin resistance through free radical and ceramide production. Saturated fat has also been shown to have a direct effect on skeletal muscle insulin resistance. Accumulation of saturated fat increases the amount of diacylglycerol in the muscles, which has been demonstrated to have a potent effect on muscle insulin resistance. It doesn’t matter if the fat in our blood comes from our own fat, or from their fat.

You can take muscle biopsies from people and correlate the saturated fat buildup in their muscles with insulin resistance.

While monounsaturated fats are more likely to be detoxified or safely stored away, saturated fats create these toxic breakdown products, like ceramide, that cause lipotoxicity. Lipo- meaning fat, as in liposuction, and toxicity. This fat toxicity in our muscles is a well-known concept in the explanation of the trigger for insulin resistance.

I’ve talked about the role saturated and trans fats contribute to the progression of other diseases, like autoimmune diseases, cancer, and heart disease, but they can also cause insulin resistance, the underlying cause of prediabetes and type 2 diabetes. In the human diet, saturated fats are derived from animal sources while trans fats originate in meat and milk, in addition to partially hydrogenated and refined vegetable oils.

That’s why experimentally shifting people from animal fats to plant fats can improve insulin sensitivity. Insulin sensitivity was impaired on the diet with added butterfat, but not on the diet with added olive fat.

We know prolonged exposure of our muscles to high levels of fat leads to severe insulin resistance, with saturated fats demonstrated to be the worst. But they don’t just lead to inhibition of insulin signaling, the activation of inflammatory pathways, and the increase in free radicals. They cause an alteration in gene expression, leading to a suppression of key mitochondrial enzymes, like carnitine palmitoyltransferase–which finally solves the mystery of why those eating vegetarian have a 60% higher expression of that fat-burning enzyme. They’re eating less saturated fat.

So do those eating plant-based diets have less fat clogging their muscles and less insulin resistance too? There hasn’t been any data available regarding the insulin sensitivity or inside-muscle cell-fat of those eating vegan or vegetarian, until now.

Researchers at the Imperial College of London compared the insulin resistance and muscle fat of vegans versus omnivores. Now those eating plant-based diets have the unfair advantage of being so much slimmer, so they found omnivores who were as skinny as vegans to see if plant-based diets had a direct benefit, as opposed to indirectly pulling fat out of the muscles by helping people lose weight in general.

They found significantly less fat trapped in the muscle cells of vegans compared to omnivores even at the same body weight. They found better insulin sensitivity, better blood sugar levels, better insulin levels, and, excitingly, significantly improved beta-cell function–the cells in the pancreas that make insulin in the first place. They conclude that eating vegan is not only expected to be cardioprotective, helping prevent our #1 killer–heart disease–but that veganism may be beta cell protective as well, helping also to prevent our seventh leading cause of death–diabetes.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Djjewelz and Max Westby via Flickr, Kapa65 and WaltiGoehner via Pixabay, and Ljupco Smokovski via 123RF.

The association between fat and insulin resistance is now widely accepted–so-called ectopic fat accumulation–the accumulation of fat in places it’s not supposed to be, like within our muscle cells. But not all fats affect muscles the same. The type of fat–saturated or unsaturated–is critical. Saturated fats like palmitate, found mostly in meat, dairy, and eggs, cause insulin resistance, but oleate, found mostly in nuts, olives, and avocados may actually improve insulin sensitivity. What makes saturated fat bad? Saturated fat causes more of those toxic breakdown products and mitochondrial dysfunction, and increases oxidative stress, free radicals, and inflammation, establishing a vicious cycle of events in which saturated fat-induced free radicals cause dysfunction in the little power plants within our muscle cells, which causes an increase in free radical production and the impairment of insulin signaling.

Fat cells filled with saturated fat activate an inflammatory response to a far greater extent. This increased inflammation, along with eating more saturated fat, has been demonstrated to raise insulin resistance through free radical and ceramide production. Saturated fat has also been shown to have a direct effect on skeletal muscle insulin resistance. Accumulation of saturated fat increases the amount of diacylglycerol in the muscles, which has been demonstrated to have a potent effect on muscle insulin resistance. It doesn’t matter if the fat in our blood comes from our own fat, or from their fat.

You can take muscle biopsies from people and correlate the saturated fat buildup in their muscles with insulin resistance.

While monounsaturated fats are more likely to be detoxified or safely stored away, saturated fats create these toxic breakdown products, like ceramide, that cause lipotoxicity. Lipo- meaning fat, as in liposuction, and toxicity. This fat toxicity in our muscles is a well-known concept in the explanation of the trigger for insulin resistance.

I’ve talked about the role saturated and trans fats contribute to the progression of other diseases, like autoimmune diseases, cancer, and heart disease, but they can also cause insulin resistance, the underlying cause of prediabetes and type 2 diabetes. In the human diet, saturated fats are derived from animal sources while trans fats originate in meat and milk, in addition to partially hydrogenated and refined vegetable oils.

That’s why experimentally shifting people from animal fats to plant fats can improve insulin sensitivity. Insulin sensitivity was impaired on the diet with added butterfat, but not on the diet with added olive fat.

We know prolonged exposure of our muscles to high levels of fat leads to severe insulin resistance, with saturated fats demonstrated to be the worst. But they don’t just lead to inhibition of insulin signaling, the activation of inflammatory pathways, and the increase in free radicals. They cause an alteration in gene expression, leading to a suppression of key mitochondrial enzymes, like carnitine palmitoyltransferase–which finally solves the mystery of why those eating vegetarian have a 60% higher expression of that fat-burning enzyme. They’re eating less saturated fat.

So do those eating plant-based diets have less fat clogging their muscles and less insulin resistance too? There hasn’t been any data available regarding the insulin sensitivity or inside-muscle cell-fat of those eating vegan or vegetarian, until now.

Researchers at the Imperial College of London compared the insulin resistance and muscle fat of vegans versus omnivores. Now those eating plant-based diets have the unfair advantage of being so much slimmer, so they found omnivores who were as skinny as vegans to see if plant-based diets had a direct benefit, as opposed to indirectly pulling fat out of the muscles by helping people lose weight in general.

They found significantly less fat trapped in the muscle cells of vegans compared to omnivores even at the same body weight. They found better insulin sensitivity, better blood sugar levels, better insulin levels, and, excitingly, significantly improved beta-cell function–the cells in the pancreas that make insulin in the first place. They conclude that eating vegan is not only expected to be cardioprotective, helping prevent our #1 killer–heart disease–but that veganism may be beta cell protective as well, helping also to prevent our seventh leading cause of death–diabetes.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Djjewelz and Max Westby via Flickr, Kapa65 and WaltiGoehner via Pixabay, and Ljupco Smokovski via 123RF.

Doctor's Note

This is the third of a three-part series, starting with What Causes Insulin Resistance? and The Spillover Effect Links Obesity to Diabetes. I wish I could have fit it all into one video, but it would have just been too long.

Even if saturated fat weren't associated with heart disease, its effects on pancreatic function and insulin resistance in the muscles would be enough to warrant avoiding it. Despite popular press accounts, saturated fat intake remains the primary modifiable determinant of LDL cholesterol, the #1 risk factor for our #1 killer–heart disease. See The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

How low should we shoot for in terms of saturated fat intake? As low as possible, according to the U.S. National Academies of Science Institute of Medicine: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

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

170 responses to “Lipotoxicity: How Saturated Fat Raises Blood Sugar

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  1. This is all truly interesting but, in my case, I’m very frustrated with my results. I’ve been following a strict vegan diet for about 4 months now. My weight has dropped to 190lbs from 210 (I’m 6’1″) but my blood sugar still hasn’t budged from the 110-120 level that’s it’s been for several years now.

    Does it take a fair amount of time for the fat in my muscles to dissipate? Some encouragement would be appreciated.




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    1. Richard. I’m not qualified to answer your question from a professional standpoint but I would ask how you would characterize the term “strict vegan.” I’m not an ethical vegan. I adopted the change in my diet (for health reasons) approximately 4 years ago. During the first year, I continued to eat whole grain breads, some pasta, regular potatoes, white and brown rice, salt, oil, and sugar. Like you, my weight dropped but my fasting blood sugar levels remained constant. (In my case, in the 100-110 range)

      It is possible to be vegan but still eat very poorly. There are many processed foods that qualify as vegan (Oreos!?) but will not help you gain control over your blood sugar levels. Since that first year, I have become more focused on whole plant foods and I’ve virtually eliminated salt, oil, sugar, potatoes, pasta, rice. Over time, my levels have dropped further but my own research suggests that this will take some time to fix. After doing it all wrong for 55 years, I guess that makes sense. Here’s hoping someone can give you a bit more conclusive answer.




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      1. same here. In addition to what Jeff described I found that things improved when I stopped using a tomato based sauce (even though homemade with no added sugar) in any cooking. Raw tomatoes in salads for some reason does not affect my blood sugar though. Avoiding packaged food, bottled condiments etc and going whole food/homemade gave me more control over what I consume. Exercise helped immensely, minimum of 20 mins per day and when I have the time I exercise twice per day and train with weights. it’s definitely worth persevering long-term.




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        1. I’m glad things improved with you, and I can see why. Exercise goes leaps and bounds in improving insulin sensitivity, as does avoiding bottled condiments (absolute killer due to the sugar), and going more home made.

          Most of the time it’s easier said than done. All people have to do is eliminate sugar and grains, that’s it. In theory though, its’ very difficult; in reality though once they do it, their blood glucose stabilizes.




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          1. I agree that cutting out added sugar is not enough , to reduce insulin sensitivity we needed to reduce white rice , potato and bread etc as well. It is not easy but worth it. Personally, Golden sweet potato on the other hand seems to have no ill effects on me, I remember Dr Greger recommending the purple variety but the lighter texture of the Golden variety is my favorite substitute for rice & bread. Exercise seems to speed up the process when we need to regain/maintain our energy throughout the day, and prevent insulin sensitivity.




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            1. I would imagine if you are trying to decrease starches, then sweet potatoes might be a better substitute for rice and bread. Another possibility is simply substituting brown rice for rice and whole grain bread (read the labels carefully) for bread and keeping portions modest. I think the recommendation of purple potatoes would have been for the antioxidant effects rather than the starch impact. But whatever works for you…




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              1. Thanks. I found that Basmati rice was the better one out of the other rice (white, brown) after experimenting. Black rice on the other-hand, tastes great, but results in a sugar spike.
                There was a video recently from Nutritionfacts.org about increasing the amount of fibre when serving rice, to minimize the sugar spike. This has been quite effective and I am better at balancing the meals now.
                Quinoa has been a great substitute for bread at breakfast as well. I cook it , drain and serve just like breakfast cereal or oatmeal. I guess we need to keep experimenting.
                As MyDiabetesisCured commented below, eating Raw vegan meals is the best personally, but I don’t have the discipline to stick with it 7 days a week. I eat Raw for lunch every day now, as that is the time that seems to influence the rest of the day.




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                1. exercise and if you are going to eat whole grains, eat some Ezekiel bread for your grain. I bet you won’t eat more than 3 pieces lol. You want sugar? eat a piece of fruit.




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      2. Just as I mentioned in the post above, same goes with you Jeff. If your having difficulties removing the glucose from the blood, you need to eliminate all forms of sugar, and in this case, all grains.

        The only way to clear out the glucose in the blood to stabilize it is to improve insulin sensitivity. You can’t eat foods that keep it chronically elevated like whole grain breads, pasta, potatoes and rice, and especially not sugar. Eat foods that have little to no effect on insulin like healthy fats and protein foods like fish, poultry, beef, and eggs. Green veggies are also vital. Spinach and broccoli should be replacing all those insulin elevating foods like I mentioned above.




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        1. It’s irresponsible to be telling people to “eat more meat, fish, dairy and eggs” without also pointing people to the environmental impact of our diet/lifestyle! Our health, economy, environment + our diet/lifestyle are all intricately tied together.

          It takes more land, water, produces more CO2 + environmental pollutants/waste to produce animal products. We drastically improve our health, economy, environment by changing our diet/lifestyle. Plus treat animals far better! This win-win-win-win situation (health, environment, economy, ethics) from a plant based diet is what’s so powerful/great about it! See this vid: nutritionfacts.org/video/diet-and-climate-change-cooking-up-a-storm/

          The fate of our species and life on earth depends on us changing our diet/lifestyle! Check out Richard Oppenlander’s talk “Comfortably Unaware: The Relationship Between Your Food And Our Future”: https://www.youtube.com/watch?v=fPd_SD7kGxo&t=365s

          Also worth watching this video about environmental impact of our diet from an ecologist & researcher: “William Ripple, PhD: Environmental Effects of Human Carnivory” https://www.youtube.com/watch?v=fnh9zT41wWo

          Once you’ve watched all these then consider what choice to make. We all need to be far more informed on the various ways our diet/lifestyle affects ourselves, others and this planet and our future generations + all life on earth..




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      3. I was having the same problem, and I was 10 years older. In my case exercise helped some, but I was fairly sedentary before. The big change came when I cut down on isolated soy products (fake meats, cheeses, etc.) and reduced my protein and fat intake. I did that by eating even more starches. I ate a lot of potatoes, sweet and regular, lots of rice and oatmeal and even breads. I don’t worry one bit about sugar, in fact, I can eat plenty – any increase in blood sugar is temporary for me. I also lost another 20 pounds doing this: eating plenty of starches and grains. And I eat a lot of fruit and nuts too. For me, starches are the key – the more the merrier. They somehow give me lots of energy, keep me slim, and improve all my blood vitals. I’m sorry it’s not working for you, but it sure does for me.




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      4. Hi Jeff. So I myself am not a ‘qualified professional’ either. Whatever that really means anymore. Lol. I’m athletic and always worked towards the healthy route in terms of diet tried lots of different ‘advice’ and ‘diets’. But I’ve found d my balance. Complex carbohydrates turn into sugar when you’re body breaks them down. So high complex carb diets keep your blood sugar up. At that point diabetes aren’t your worry. But creating an acidic environment for all those little bugs that live in us, allows a plethora of other issues to develop through another path ways. Eating no meat, dairy or eggs is not enough. The backbone must be a fresh food plant base diets with nuts and seeds. I myself cheat here and there. I live in northern Canada and hunt. I donate my meat but from time to time can’t help but indulge. But it’s the green foods that help are cells function optimally and clean out the unwanted waste. That’s what are systems ate for millions upon millions of years. Even nuts and seeds are relatively new. Meet and animal products are far too new for our bodies to deal with properly. Diesel in a gasoline engine.




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    2. I was able to reverse my severe diabetes in only 10 days by following low fat raw vegan. Eating 100% raw will help your body heal faster, focus on fruit and leafy greens. Do not add in nuts/seeds or overt fats or dates until the diabetes is completely gone. My blood sugar used to be in the 300s regular. Now, it stays in the 80s fasting.




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      1. How many grams of sugar do you ingest each day from the fruit? Can you provide us with a daily intake, on average, of the fruit you eat, kinds, amounts, pieces, etc.? Would be thankful to see this.




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        1. A fair amount. 2 apples, 1-1/4 cup blueberries, 1-1/4 cup mixed berries, 5 dates, 1 banana. Yes, that does seem to be a lot but from watching Dr. G’s videos, I thought it would be OK.




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          1. Richard, that is a lot of fruit!! You describe eating about 8-10 servings of fruit a day. That would be a lot of fruit for a non-diabetic.

            I put your list in the website cronometer and it reported that would be 151.9 grams of carbohydrates (provided medium sized fruit). Subtracting the fiber (22.8 g) you are left with 129 g (106.9 of which are sugars).

            And that is just from your fruit! What about the rest of your diet?

            You may want to consider cutting the fruit until your weight and blood sugar drop to a normal level.

            Best wishes,

            David




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            1. Hello David

              Your comment was 2 years ago but still relevant.

              Whole foods don’t effect sugar levels, actually the opposite :-)

              There are many videos on this website proving that sugar (refined) is not the same as whole foods sugar.

              I eat around 20-30 servings of fruit a day. My sugar levels are normal.

              Best regards,
              Arturas




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      2. 100% raw doesn’t work for those with a compromised digestive system (which is most Americans). Don’t tell people to focus on sugar looking to reverse diabetes, you mine as well tell them to consume table sugar.

        I would also get your blood sugar tested again as it’s well know that within 4-6 months after it’s stabilized that if not enough fat has been consumed, it will vault up to even higher levels.




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      3. It is possible that low-fat is more effective at eliminating saturated fats from the body than a mere low-saturated fat diet. It is good to see it apparently working in practice.




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    3. Hi Richard. I’m not a doctor and my comments are based on my own experience in turning around my pre-diabetes. First off, way to go! You’re doing great and don’t give up! Second, I highly recommend Dr. Neal Barnard’s book:
      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107

      While you’re waiting for this book, have a look at Dr. McDougall’s free plan for restoring health and being a successful plant-based person:
      https://www.drmcdougall.com/health/education/free-mcdougall-program/

      Finally, if you have not done so lately, consider having your hemoglobin A1C tested by your doctor. I hope you will be as pleasantly surprised as I was to learn that, while your blood sugar may seem elevated by doing home testing as I was, your average blood sugar is not as bad as you fear. (Based on all my reading and learning in the past few years, 110-120 ain’t all that bad, especially considering the margin of error in home testing technology.)
      http://diabetes.niddk.nih.gov/dm/pubs/A1CTest/

      All the best and keep coming back. Let us know how you’re doing if you choose to; we love success stories!




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      1. Does it matter what your blood sugar tests at one or two or three hours after eating, or just the fasting blood sugar when rising in the morning? Sometimes my blood sugar gets above 190 after eating just fruit, but 4 hours later it drops down to 95. I’m concerned that having it in the high 190’s for three hours long is a bad thing, causing tissue damage longterm and inflammatory disease, but others say this is not the case. Do you have any knowledge of if this is true or not?




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        1. Hi guest. I am not qualified to comment on your particular situation. But, here’s the advice I give to myself every day:
          1) eat high starch and high fiber plant foods enough to satisfy my hunger. Don’t use processed oils and take 2 tbls ground flax seed every day. Take a B12 supplement regularly. Minimize junk food (no one’s perfect, right?) Have a look at this master work of Dr. Greger’s. I think about this video every time I go to the grocery store to buy vegetables:
          http://nutritionfacts.org/video/1-anticancer-vegetable/
          2) get more daily exercise
          http://www.health.gov/paguidelines/factsheetprof.aspx

          If you want to get into the weeds regarding blood sugar, have a look at this paper. The discussion section has some nifty graphs and some numbers that may stimulate your thinking about the questions you pose. Good luck!
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/




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        2. What matters most in testing blood glucose is what happens in the first 2 hours after eating. there is a normal glucose curve and the peak is somewhere between 30 and 60 minutes. Diabetes is diagnosed when the fasting glucose is high, yet the imbalance has been going on for a long time before that. Ideally the peak is 110 or less and by 2 hours level is down to baseline. Studies show that peripheral nerve damage begins to happen at 120 and retinal damage at 140. some studies show even prolonged glucose above 100 damages the beta cells in the pancreas which produce insulin, which is likely part of why type 2 diabetics go from over production of insulin and insulin resistance to pancreatic insufficiency.

          So yes having your glucose 190 for hours is indeed a bad thing. SO i recommend my patients check their glucose curve on all their standard meals for a week. It requires testing every 15 minutes at first to capture the peak. if it seems to usually occur at approximately the same time after meals, you can slow it down.

          Then eat only the foods that keep it under 110 at peak for 30 days. The resutls are amazing.

          I have lots of resources on my website about this.

          Lastly, it’s more than just diet that controls glucose levels – sleep, stress, movement and even the timing of your meals makes a difference

          Dr. Ritamarie Loscalzo




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        3. Yes, it does matter. Blood sugar should not be higher than 140 one hour after eating or higher than 120 two hours after eating. You should avoid foods that cause it to go higher than this, or eat those foods in smaller amounts so your blood sugar does not spike. You can find much reputable information about this on the web. I also recommend a book titled “Blood Sugar 101” by Jenny Ruhl.




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      2. And I wonder if the pancreas eventually gets tired and run down from having to constantly pump out so much insulin for me to get it down from the 190’s to 95.




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      3. Bernard and McDougall are so anti-fat that they have thrown the baby out with the bathwater. The latest research supports benefits of small amount of nuts and seeds. Also Mcdougall’s high potatoes, rice, and grain approach is simply not optimal because of glycemic load and poor nutrient profile. Watch Dr Joel Furhman debate McDougall on YouTube before wasting your money on the books recommended.




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        1. The Okinawans are part of the Blue Zones (longest living populations on the planet) and their diet of old was 96% plant based by calories. 69% sweet potato. 12% rice. 7% was wheat, barley and grains. 6% legumes (soy and other beans). That’s 90% of calories from starch! I think McDougall knows what he’s talking about when he recommends a starch based diet. There’s a nutritionfacts video walking through the Okinawan diet: https://nutritionfacts.org/video/the-okinawa-diet-living-to-100/




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    4. I don’t know anything about your regular diet, but you may need to examine the glycemic impact of foods you eat. Many processed foods, including white flour, white rice, pasta, and so forth can have a dramatic impact on blood sugar levels. It might be worth doing some research about the glycemic index and evaluate how it applies to your diet (http://en.wikipedia.org/wiki/Glycemic_index). I have no medical background or professional qualifications on the matter, so my suggestion is based on my limited knowledge of the subject.




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    5. Richard: I think you have gotten some great responses to your post already. I just wanted to add to the discussion by framing the response slightly differently. I think what people are trying to say is that being “strict vegan” doesn’t tell us anything other than you aren’t eating animal products. That’s not the same thing as saying that you eat a diet that is optimal for fighting Type 2 diabetes. So, the suggestions that people have made to you, such as checking out Dr. Barnard’s book, could be really helpful. It could be that an additional tweak or two in your diet is all that you will need to make additional gains.

      That said, let’s pause and appreciate the gains that you have already made. And wow, changing one’s diet and being strict about it is very hard for a lot of people. You have stuck to a different diet for 4 months. That’s really great. And even if you haven’t met all of your goals yet, it seems like you are on your way. I’m going to keep my fingers crossed for you that you will make it all the way.




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      1. Again, many thanks. It’s actually been quite easy. My wife makes a variety of yummy bean soups which we slurp up gleefully. Her support has made all the difference.




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    6. For high blood sugar, this site has some specific recommendations. hibiscus tea, cinnamon, flax seed meal, amla, and beans

      Thule has produced another list of recommendations from this site:

      Indian gooseberries (amla), coffee, soy, flaxseeds, green tea, pulses (dried beans), chamomile tea, purple potatoes, sprouts, whole grains, vinegar, and beans. If you eat some of each of these foods two to three times a day you might be able to blunt any blood sugar spike you have from eating. Have you considered if your high blood sugar is a side effect of some medicine you are taking? Some of America’s most profitable medicines have high blood sugar as a side effect.




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      1. Thanks to all the responders. I basically follow the advice put forth in Dr. G’s plethora of great videos – including the Alma. I intend to keep at it (actually , it’s easy). Maybe I should cut back a bit on the fruit.




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        1. Fruit is a whole plant food so I would not cut back on it. The issue is not the amount of Glucose you consume but rather the amount of animal fat which causes the insulin resistance which causes high blood glucose. Get rid of the insulin resistance and the amount of fruit won’t matter. High Blood glucose is not the problem it is the symptom of the problem. Treating the symptom won’t help.




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        2. Richard, I read that you eat dates. I love dates and I make a spread out of dates and ground flax seed. You may want to try this too. I really like it. I remove the seeds from the dates, cut them up then gently simmer them in some water, let them cool then combine them in a food processor with the ground flax seeds. This way, I get some healthy lignans and ALA Omega 3s with my fruit…This keeps really well refrigerated.




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    7. You might like to watch “Raw for 30 Days”. It follows 6 diabetics (type 1 & 2) for 30 days. They are placed on a raw vegan diet and encouraged to be more active (eg go for a walk). Results are very positive.




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      1. Is that like the Cousens “reversing diabetes in 21 days” approach? In spite of this diet having a whole lot of fat, it still benefit diabetics (both type 1 & 2). The key difference is that the fat is all raw and plant based (avocado, nuts and seeds).
        When I switched to raw, my heart rate at rest dropped almost daily by a point for about 10 days, without any extra exercise. Then I went to a restaurant and ate ONE cooked (vegan) meal (wokked vegetables) and for the next two-three days, my heart rate went up, again with no change in exercise. Does anyone think this is interesting?




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    8. Congratulations on your success with your weight loss, Richard. Ideally, your strict vegan diet is composed of whole plant foods (vegetables, fruits, whole grains, legumes, with a bit of nuts and seeds) and you have omitted processed foods. If so, you may also consider emphasizing low glycemic sources of carbohydrates. This includes opting for the most intact whole grains (whole quinoa, barley, oats, for example) as opposed to flaked, ground, or puffed versions, choosing foods particularly high in fiber, especially legumes (beans, lentils, and peas), and avoiding refined sugars, flours, and similar products.




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    9. From my experience as a plant-based dietitian I found that in clients who were producing adequate amounts of insulin that it helped when they started removing all sources of added fats such as oils and increased their consumption of some of the foods that reduce insulin resistance especially beans and lentils and other whole starches as can be see here http://nutritionfacts.org/video/diabetics-should-take-their-pulses/. Not only are beans great to improve insulin sensitivity by they also protect against CVD one of the major risk factors for people with metabolic syndrome, pre-diabetes and diabetes type 2 as can be seen here http://nutritionfacts.org/video/beans-beans-theyre-good-for-your-heart/




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    10. Richard, I have given your situation a lot of thought though I have become a bit reluctant to enter anything because you have received so many good responses. But my perspective is a little different. I have type 1 diabetes. I control it well with diet, activity and insulin.

      First I should say that I have never known a doctor to
      mention insulin resistance when discussing type 1 diabetes. I think this is a serious problem. Yes my beta cells were kaput long ago, but the issue of insulin sensitivity still remains For many years I have consumed animal products at much lower portion of my total than the average and I was well controlled with an average insulin intake of 44 to 46 units per day. However, when I discovered the pressing need to go completely wfpbd, and did so, my insulin usage dropped to an average of 36 units a day. I don’t eat less and still don’t produce insulin, I just use it more efficiently.

      There is one comment here that you are consuming a lot of fruit. I need to keep a source of emergency glucose at all times due to the constant struggle to keep insulin and sugar at the right level. My preferred source is an apple. I know that one medium apple will raise my blood sugar about 50 mg/dl. This is not much of a rise and probably helps overall control due to the added fiber helping to move everything through the system more efficiently. The bottom line is, I consume lots of fruits as well. I have found that the effects of the sugar from fruit has a modest impact and the fiber probably more than compensates.

      Still, I do not consume even complex carbohydrates with a scoop shovel either. But I eat enough so that I never feel deprived. Excess consumption of complex carbohydrates at bed time may cause elevated overnight sugars but that leads to the question of insulin insufficiency (which is my problem). I assume you have looked at that so there are two more phenomenon to consider (that I know of).

      First is the“dawn phenomenon.” The first thing in the morningour bodies will release added cortisol which stimulates gluconeogenesis. This counters the overnight lows we all tend to develop simply as a result of an 8 hour sleeping fast. How much this happens seems to be different in everyone. I evidently release a lot of cortisol in the morning and therefore need about twice the insulin morning basal rate that I would have in the middle of the night and my insulin bolus will need to be fairly substantial as well. In other words, I am suggesting that your modest fasting highs might simply be a result of your release of morning cortisol rather than lingering insulin resistance.

      To answer this more fully a few middle of the night blood tests might be in order. It could also point to the possibility of insufficient insulin production which might suggest type 1.5 diabetes. From what you have said if type 1.5 is the case it would likely be in the early stages and might even be reversable.

      In any case good luck and congratulation on having a live in chef.




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    11. Hi Richard, I’m an RD and I can try to give you some advice, but it’s difficult for any medical professional to provide the kinds of answers you’re looking for in a forum such as this. My first question for you is whether the blood sugar numbers you referenced are fasting or following a meal? If you’re taking your numbers within two hours of eating, that is well within normal limits.

      Regarding your weight, there are many reasons It is quite common for people who controlling their diet well to “plateau” periodically and have difficulty losing additional weight. Often they can become discouraged, go back to old habits, and their weight can start going back up. Don’t let that happen! If you are incorporating regular exercise into your lifestyle, as you should be, here are several reasons you may not be seeing the changes you’d like to see on your bathroom scale. The most likely is that you are burning fat at the same rate you’re gaining muscle. Since muscle is more dense than fat, you may not see a difference in your weight, but you should start noticing clothing to fit more loosely, and maybe moving up a notch on your belt. Additionally,
      your body has likely adapted to your current routine and has become more efficient, meaning you’re able to do more work with fewer calories. It may be time to “mix things up” a bit so your body has something new to
      adapt to. This can be done in any of three ways: increasing the time you spend exercising (either length of individual workouts or number of times you work out during the week), increasing the intensity of each
      work out, or changing the activity you are doing.

      Check with your doctor to see if it’s okay for you to change your exercise routine in one of these ways. The easiest may be to add in different forms of exercise a few days per week. You could try a bike ride
      outside, or exercise to a workout video inside. You can easily find free workout videos on YouTube.

      Remember, keep up the good work, your body will thank you later!




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    12. In my clinical experience it varies between individuals and depends on how well you adhere to correct diet, exercise and weight loss. A tool you might use is a “run chart” which consists of values for fasting morning blood sugars measured each morning. Vertical numbers might range from 90 to 150. It is easiest to use one sheet per month giving the horizontal axis values of 28-31. This is the best way to display data over time. I would venture over to Dr. McDougall’s website and eat a diet emphasizing starches and whole foods (i.e. vegetables, fruit, starches and beans). Realistic weight loss is 1/2 to 2 pounds per week depending on diet and exercise. Once you have about 7 days of baseline data make a change and note on your chart. You might also benefit from reading his article, Fat Vegan, in his December 2008 newsletter. I have found that it can take several months for the fasting blood sugars to come down. Of course if you are on medications you need to work with your health care provider. If you still haven’t begun to see a downward trend you should check with your provider. Congrats on your weight loss thus far. Good luck.




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    13. Perhaps substituting beans for all all grains may help, since even wholewheat and rice are high glycemic compared to beans, quinoa and oats and barley may be lesser so, but none of these compare to beans just discover the comfort quality of (low glycemic ) split pea soup with a dollop of black beans with fresh onions on top, actually more comforting than bread.




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    14. I had pre-diabetes last year. Since i’ve been vegan i eat fruit smoothies in the mornings (4-6 bananas with mango/pineapple/berries and flaxseeds) and rice/potatoes/pasta/vegetable soup for lunch and dinner. Last i checked my blood glucose level was 79.28 mg/dl. In the first 5 months of eating vegan i lost around 20kg. Atm i weigh 77kg (180cm tall)




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    15. What you need to do is eliminate sugar from your diet completely. Forget the vegan approach, it’s dangerous, it’s causing a stressor response in your body, cortisol. The cortisol response your body is giving off due to this is causing your blood glucose to sky rocket. Here is a copy/paste statement on cortisol and it’s effects on weight loss:

      “Under stressful conditions, cortisol provides the body with glucose by tapping into protein stores via gluconeogenesis in the liver. This energy can help an individual fight or flee a stressor. However, elevated cortisol over the long term consistently produces glucose, leading to increased blood sugar levels.

      Theoretically, this mechanism can increase the risk for type 2 diabetes, although a causative factor is unknown.1 Since a principal function of cortisol is to thwart the effect of insulin—essentially rendering the cells insulin resistant—the body remains in a general insulin-resistant state when cortisol levels are chronically elevated. Over time, the pancreas struggles to keep up with the high demand for insulin, glucose levels in the blood remain high, the cells cannot get the sugar they need, and the cycle continues.”

      I’ll bet dimes to dollars Richard this is exactly what’s happening in your body. The vegan approach is causing undue stress in your body causing your cortisol to be chronically elevated. This is causing your cells to become insulin resistance which is causing your blood glucose to remain idol.

      What you need to do is eat primarily meat and veggies and healthy fats, and make sure eggs are included in your diet. Eggs are absolutely essential for funneling fat out of the liver. If your looking at a plate, 50% of it should be veggies, 30% meats, and 20% healthy fats. No fruit, at least not for a month or 2.

      If your also looking to improve insulin sensitivity to help clear the glucose out of your system, start intermittent fasting. The simplest way to do it is only eat between 10am and 6pm per say (depending on what your work schedule is). If you can handle it, start eating lighter throughout the day and loading up more food at night. Basically graze throughout the day (a bit of veggies, an egg or 2, but no more), then have a satisfying dinner at night. That will drastically improve insulin sensitivity.




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      1. What say you to the fact that the longest living populations on the planet (Blue Zones) eat a mostly plant based diet (95%+ of their diet)! They’re eating low fat, high carb diets. They lead longer, happier lives with more emphasis on community + purpose! http://www.nutritionfacts.org/video/the-okinawa-diet-living-to-100/ http://www.youtube.com/watch?v=ff40YiMmVkU

        The Loma Linda Californian Adventists are part of the Blue Zones and among these adventists the vegetarians have the longest life expectancy out of any formally studied population. The more plant based you go (if done right) the better your health should be!




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      2. It’s irresponsible to be telling people to “eat more meat, dairy and eggs” without also pointing people to the environmental impact of our diet/lifestyle! Our health, economy, environment + our diet/lifestyle are all intricately tied together.

        It takes more land, water, produces more CO2 + environmental pollutants/waste to produce animal products. We drastically improve our health, economy, environment by changing our diet/lifestyle. Plus treat animals far better! This win-win-win-win situation (health, environment, economy, ethics) from a plant based diet is what’s so powerful/great about it! See this vid: nutritionfacts.org/video/diet-and-climate-change-cooking-up-a-storm/

        The fate of our species and life on earth depends on us changing our diet/lifestyle! Check out Richard Oppenlander’s talk “Comfortably Unaware: The Relationship Between Your Food And Our Future”: https://www.youtube.com/watch?v=fPd_SD7kGxo&t=365s

        Also worth watching this video about environmental impact of our diet from an ecologist & researcher: “William Ripple, PhD: Environmental Effects of Human Carnivory” https://www.youtube.com/watch?v=fnh9zT41wWo




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    16. Try this juice that i had been using for more than 1 year already..visit the website http://www.primera.com.ph filled with 8 powerful herbs..even if i had not had strict vegan diet..my blood sugar is still in normal levels. here is my email add johnpaulcastillon_31@yahoo.com..jut email me for more inquiries regarding the product..I bet you will be surprised about this product, on how it will help you on your blood sugar level.




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    17. It’s the fat. Take your fat down to 10% of total calories and your insulin sensitivity will improve. Others here are suggesting giving up rice and potatoes, NOOOOOOOO!!!!!! It’s the fat!!!! Google intramyocellular lipids and insulin resistance.




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  2. Thanks for the great information!
    Could you also continue posting your videos on YouTube?
    The vimeo player is not running well on my computer.




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    1. Lauritz: NutritionFacts has had some problems with the YouTube site. So, what you are talking about may be related to those problems. I’ll forward your comments to the NutritionFacts staff.




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        1. Filipe: There have been two incidents with YouTube where something about our videos or features for our videos were suppressed–as I understand it. At least one of situations was explained to me, but I never quite understood the details. So, I don’t know if I’m describing things correctly even with this terribly vague statement. But I think I can safely say that due to actions of YouTube, we can’t rely on YouTube to make the NutritionFacts videos available. Vimeo may not have all the features that YouTube does, but it’s my understanding that we have more control over content on Vimeo. I’m not sure we have an ideal solution at the moment. I think we are just doing the best we can with the options available.




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  3. Can you please do a video about PCOS with insulin resistance? High insulin levels cause follicles in the ovary to become more sensitive to LH, causing cysts in the ovary instead of ovulation, which can lead to high testosterone and low progesterone. I think many women with PCOS could really benefit from whole food plant based diet and if you made a video explaining that, it would be very helpful. Thanks!




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    1. Unfortunately, there have been few studies on plant-based diets and PCOS. While researchers have suggested optimal diet for PCOS as one “low in saturated fat and high in fibre from predominantly low-glycaemic-index-carbohydrate foods”, the one feasiblity study of vegan diets in PCOS was small and had high dropout rates. The vegan arm reported higher quality of life after 6 months, but due to the study size these effects weren’t statistically significant.




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      1. I gave a presentation to a Ob/Gyn department on nutritional advantages to various diets a number of years ago. There is good literature to support going on a starch centered whole plant diet to treat PCOS. Darryl is correct that there aren’t alot of studies. When looking for appropriate studies I also go back historically. Alot of the best studies were done years ago when we didn’t focus so much on drugs…. see http://nutritionfacts.org/video/kempner-rice-diet-whipping-us-into-shape/. Weight loss, improved hormone levels and reduced insulin resistance are all to be expected on a proper diet. The mechanism is not clear. Inositol may be a factor. Low fat intake is certainly in the mix as is less per cent body fat. I reviewed the abstract for the feasibility study cited by Darryl. Intervening with a calorie restricted diet makes no sense. The low fat vegan diet is the ticket but in recruiting patients to follow the new diet it has to be done skillfully. Based on their results I doubt if that was done. Not only explaining the benefits of improved PCOS but also the concepts of calorie density as it relates to weight loss would improve their success… since obesity is clearly a major factor. The fact that they were using social media to help with compliance is a sign that they might be trying to keep their budget low by avoiding phone calls and face to face return visits with skilled health care professionals. I will admit to not reading the whole study but I would not pay $35 dollars to check it out. I would add my vote to PCOSgal for Dr. Greger to do a video on PCOS since it seems to affect between 5 and 10% of women. However until then there are plenty of video’s on weight loss and improving insulin resistance. Good luck.




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  4. Well for the benefit of my mitochondria and further inflammation suppression I’ll give full dietary vegan another go.
    And why wait,
    Once more unto the breach, dear friends, once more. ^^




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  5. Right on, Dr. Greger! A whole-food, plant-based diet is what works for me. But how do you respond to someone like Dr. Joseph Mercola, who claims a high success rate treating T2D with a low-carb, high-fat diet, and who recommends animal, dairy, and fish (albeit the organic, grass-fed, free-range, wild caught versions of these)?




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    1. One of the two is lying to you. Maybe watching the video linked below, can help you decide who of the two is the corporate tool.




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      1. Why does it have to be that one is automatically lying. Perhaps both are correct. Maybe the takeaway from all of this is that you your diet should be built around one energy source or the other for optimal health.

        If you eat high fat, you’ll be fine so long as you keep your carbs low and protein moderate. Your body will burn the fat instead of storing it in your muscles and causing lipotoxicity.

        If you eat a high carbs you’ll be okay as long as you keep your fats low and your protein moderate. With fats kept low, you never develop lipotoxicity.

        It seems as though a diet high in both fat and carbs causes the body to choose the source easiest to burn leading to an excess of the source that it uses less often which then starts to cause issues with how the body metabolises either.




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        1. Ray, there are two main energy sources as you know. Carbs and fats. Proteins could be a small source if you eat more than required to maintain cell repairs and building new muscle. Carbohydrates are converted to glucose, fats are not. Guess which one raises your BG. I agree with what you are saying about not eating high carbs and high fats, but I think the body choses to burn carbohydrates first to keep your BG down if it can. You ever wonder if it is because it is preferred or too much is toxic? I take it you are not diabetic or do not test your BG. IF you are diabetic, I invite you to read material on http://www.phlaunt.com/diabetes




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      2. There is no cure, if you don’t believe it then start eating bread, pasta, rice, etc and see what you blood sugar meter tells you.




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    2. I’d love to see a debate between Dr. Greger and Dr. Mercola on this issue; high carb vs high fat is where these two doctors vehemently disagree. In the end, it’s what works best for you, and from my family’s results Dr. Greger is closer to the mark.




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    3. You keep firmly fixed on the good scientific studies. When investigating claims by “experts” if they are not citing references then beware especially if commercial interests are involved. Everyone is entitled to their own opinion but not their own facts… although you have to understand statistics to help sort out the studies and even with a good statistics background it is hard to believe some studies. One doctor who is involved in legal issues says you can’t believe the data in studies unless it has gone through litigation.




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      1. Dr. Forrester, I feel like there’s a lot of information thrown at us in this video but insufficient explanation of the logic behind the various mechanisms. For example, Dr. Greger discusses a ” vicious cycle of events in which saturated fat induced free radicals causes dysfunction in the little powerplants within our muscle cells, which causes an increase in free production and impairment of insulin signaling.” Could you clarify how the free radicals induced by saturated fats affect the mitochondria of muscle cells? Is it just muscle cells that have impaired mitochondria due to sat fats? And how then does impaired mitochondria lead to an increase in free radicals and impairment of insulin signaling? I’m trying to understand what is going on within the body. Thanks for your wisdom.

        On the final point you raise in this post, I like to keep an eye on the Retraction Watch website, led by NYU’s Dr. Ivan Oransky. http://retractionwatch.com/about/




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    4. Being a type 2 diabetic that now controls his BG with diet and exercise, I feel somewhat qualified to respond to this. I tried Dr. Barnard’s book’s recommendations and it failed me horribly. I think it fails everybody if they would only test. Carbohydrates are converted directly to glucose, and if you test you your BG immediately before eating eating and every thirty minutes until your BG gets back down, you will see what the carbs do to your BG. High GI, big quick spike, low GI lesser but LONGER increase. If your BG goes over 140 at anytime you are causing damage. There is also damage occurring at lower levels. Want proof, then I dare anyone to refute the research you can get at http://www.phlaunt.com/diabetes/14045678.php Read the research directly from the studies that are linked on this page. For everybody that wants to avoid diabetes complications I also invite you to read all of bloodsugar101 (the site I just showed you and to go to http://www.dietdoctor.com/lchf.

      IF you want to flame me, do it with scientific studies that prove me wrong. That keeps the list short to nil.




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    5. Thomas, being a type 2 diabetic that now controls his BG with diet and exercise, I feel somewhat qualified to respond to this. I tried Dr. Barnard’s book’s recommendations and it failed me horribly. I think it fails everybody if they would only test. Carbohydrates are converted directly to glucose, and if you test you your BG immediately before eating eating and every thirty minutes until your BG gets back down, you will see what the carbs do to your BG. High GI, big quick spike, low GI lesser but LONGER increase. If your BG goes over 140 at anytime you are causing damage. There is also damage occurring at lower levels. Want proof, then I dare anyone to refute the research you can get at http://www.phlaunt.com/diabete… Read the research directly from the studies that are linked on this page. For everybody that wants to avoid diabetes complications I also invite you to read all of bloodsugar101 (the site I just showed you and to go to http://www.dietdoctor.com/lchf.

      IF you want to flame me, do it with scientific studies that prove me wrong. That keeps the list short to nil. Just because you can’t show any proof I am wrong doesn’t mean you have to delete my post as spam.




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  6. Hello dear people! As always, when I have a question about nutrition I run to this awesome forum here on NutritionFatcs and to the great minds that hang out here. The question is: I know that real published research about treatment (not prevention) of cancer with a plant-based diet is still scarce (maybe because the corporations that have the money to found this kind of study don’t want to know about a cheap way to win the “war” on cancer), however I wanna know what are your opinions about this topic.




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    1. Dean Ornish published research demonstrating that a WFPB diet can reverse prostate cancer. Dr. Ornish was working with men that had opted to take a “wait and see” approach, which is pretty common for prostate cancer as it is usually very slow growing and often benign. Many states have laws prohibiting the treatment of cancer with anything other than conventional therapies (surgery, radiation etc) so it has been difficult to set up clinical trials for nutrition. To be fair, if those laws didn’t exist every quack in the country would claim that they could cure cancer with a variety of non-effective treatments and many people would die unnecessarily (although many people are being injured from conventional therapies). I personally know of several people that have reversed prostate and breast cancer with various forms of a plant based diet.




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      1. Yes, I already knew about the Ornish study on prostate cancer and I am excited to see the final results! Thank you for the reply masobel! I agree with your personal view, however I think in terms of plant based diet, there are already so much amazing results in health care, that we could do more research on cancer, but as I heard, is really expensive to do without fundings from governments and others institutions.




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      2. I wonder about a few questions in regard to success treating or working with cancer, when it comes to fruit.
        I have been to the Optimum Health Institute, and there, if someone is suffering from, or recovering from, cancer, they have them on a strict, raw, vegetable diet, without any fruit. Their explanation is that cancer grows in a sugar environment. (don’t even get me started about the misunderstanding of “sugar” and fruit.) Dr. Greger’s view is that fruit (particularly berries like blueberries) are so high in antioxidants that they are a powerhouse against cancer.

        My feeling is that leaving out berries and fruit is a flawed concept when battling cancer. Also, vegetables are great, but there are many problems with eating only raw vegetables, without any fats (except they (OHI) give you an occasional chunk of Avocado) which help you absorb the actual nutrients from the veggies. So you may be getting a ton of fiber from all those raw vegetables, and stuff is moving through your system and cleaning out your colon and other parts, but you aren’t getting the health benefits of them, nor of any high antioxidant fruits. Plus I haven’t ever seen a single berry served there, it is always melon or citrus.

        I know this is a complex subject, but I still find it problematic that so many places tell you they have “the answer” when it comes to health, healing, and food, yet they are just readjustments to fit their own theory, and not necessarily backed by much science.

        OHI pushes Colonics like it is THE answer to all of life’s ills, yet I do not agree one bit. I believe the body is a master at cleaning and ridding itself of problematic items, in its own time and way, and inserting some foreign object into your body and then shooting water up inside to “clean it out” like we are a giant metal oil drum, is just the most insane idea. And never has it been proven, or even supported by science that colonics help or do anything positive.




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  7. In the video Dr. Greger mentions that palmitic and stearic acid increase insulin resistance more than other fatty acids. While meat, dairy and eggs are high in these saturated fats so is chocolate! Cocoa butter contains over 50% palmitic and stearic acid.




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  8. This is why cheese is EVIL!

    After finding Dr. Greger’s site I decided to go vegan except for cheese (I would eat those big frozen pizzas you cook yourself and microwave nachos all the time). I was eating more cheese than ever before since I replaced my meat with it. So my saturated fat consumption went up. But all my other foods were extremely healthy.

    Well my back pain got worst and my cardio got worst (sore muscles wouldn’t heal).

    Of course, I saw Dr. Greger’s video showing cheese to be the number one course of saturated fat and wanted to slap myself. And this one makes even more sense for my situation.

    Giving up meat was super easy (don’t miss it at all), but cheese is so hard! I crave it so much. :(




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    1. Don’t be hard on yourself. Casein… the main protein in milk is converted to casomorphins and absorbed into the body. So many of my patients have alot of trouble with getting off dairy more so than meat. So in addition to being associated with a number of disorders see… http://nutritionfacts.org/video/cows-milk-casomorphin-and-autism/ including asthma see http://nutritionfacts.org/video/is-milk-and-mucus-a-myth/ the casomorphins in some respects act like an addictive substance.




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      1. What about the opiates (or similar type stuff) in wheat? I am vegan, and am not bashing grains, but boy are there a lot of references out there regarding opiates in wheat. I’m going to assume you’ve read them if you also come across the one’s on dairy. And the addictive properties of grains, because of this. What do you think? Some people feel the mind-numbing subside when they get off wheat.




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        1. I wasn’t aware of studies demonstrating that wheat products contain opiates or stimulate the release of endogenous opiates. I did a PubMed search and couldn’t come up with anything. That said, there are some interesting issues with wheat such as the industries use of spraying pesticides days before harvest to increase yield and of course processed wheat is very calorie dense. There are also some folks who don’t have celiac disease but don’t do well on wheat. Let me know if you have a citation.




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          1. http://www.ncbi.nlm.nih.gov/pubmed/4048359

            “Abstract

            Hypotheses generated from animal studies that the endogenous opioid system is an important modulator of food intake suggest that blockade of the system in humans should affect eating behavior. To assess this hypothesis, seven normal volunteers were given 2 mg/kg naloxone or placebo on separate days in a double-blind, random but balanced cross-over experimental design.

            “Compared to placebo, naloxone was found to reduce significantly total food intake from preselected prepared trays served 2.75 and 7.75 hours after drug administration (p less than 0.02). The reduction was considerable (28%), and although the magnitude varied greatly among individuals, reduction occurred in each.”




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            1. Thanks for the link I enjoyed the article. Interesting date 1979. It is amazing how many interesting studies have been done in the past. The first time I have read a study about gluten possibly having addictive properties. This might help explain my “interest” in bread products. My first exposure to studies involving food addiction was reading the studies cited in Neal Barnard’s book… Breaking the Food Seduction. Interesting articles on casomorphins from dairy and evidence for release of endorphins in the brain on consumption of ham and tuna plus interesting study involving sugar dipped pacifiers and smiles. Be well.




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              1. Disruption of the wheat “exomorphin” addiction cycle might explain why low-carb diets are so successful at enabling weight loss. Of course, it’s a case of throwing the baby out with the bath water, IMO.

                You might be interested in taking a peek at the Davis “Wheat Belly” book (where I found the link to the study). If you can overlook Davis’s continual (maddening) liberties with the truth, there is, never-the-less some interesting information n there.

                BTW, This lipotoxicity video is one of Greger’s very best. I learned SO much here!




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                1. I have looked at it previously but briefly. I don’t spend much time on “pseudoscience” especially if it is making a profit for folks at the expense of other folks health. I stick to the science and use websites like NutritionFacts, PCRM and McDougall to keep me informed. Another good website is Plant Positive. Keep tuned and invite your friends since you never know when Michael will come up with another “very best” to add to your list.




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                  1. Ah, yeah, I understand. I ignored Wheat Belly when it first came out for just that reason. But I recently got interested in Perlmutter after seeing him in a video with Dale Bredesen, from the Buck Institute. They were discussing the multiple problems with wheat, and so I wanted to go back and see what Davis put into the wheat conversation vs what these guys were adding. I’m in the wonderful position of no longer having to scramble to put food on the table, so I have the time to read whatever strikes my fancy and don’t have to be so selective.

                    I was actually surprised by how much good information was in the Davis book (along with all the crap). You can call it pseudoscience if you like, but he is referencing (albeit at times misinterpreting, misrepresenting and overstating) the same pubmed journals everyone else is.

                    Re PlantPositive – I love him (her?). My goal is someday to have watched everyone of his videos. And, yep, I sometimes catch PlantPositive in mistakes too.




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    2. I know what you mean; cheese and yogurt seemed hard to give up :( but then I did, and my taste buds changed so I don’t crave it anymore and don’t miss it since I keep an abundance of whole plant foods around for easy consumption. Everything tastes cleaner and better now without cheese, even vegan cheese, on top :)




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  9. Sometimes a Strick Vegan diet can also mean eating foods that are high in sugars: White foods like white rice, pasta, bread and even potatoes. Try to cut these out from your diet and if you cannot then at-least try to eat these foods a whole -grain products that also contain the fibre.

    Remember, sugar is found in most foods, whilst of-course, refined sugars are usually found in processed and industrialized foods that are not natural foods found in nature. Fruits do have sugar, but their sugar contents is very low (around 2-6%), except for bananas (18-20%) that has natural sugar. Try to eat foods that contain high amounts of fibre with sugar and i presonally never peel the skins of fruits (apples, pears, peaches, etc). the skins of fruits contain the highest amounts of nutrients and antixoidants, including dietary fibre.

    Remember, at Michael greger said ” Saturated fat, refined fats and refined sugars are the real enemies towards diabetes and the risk of heart disease, etc.

    Also remenber that not all people are the same, as some are more resilient to disease than others and some persons have lower/highter LDL receptors than others, that may being forth the risk of atherosclerosis and plague formation.




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  10. I’ve had this discussion before on this blog. There are still reports about exercise at a high level being counter productive, such as this one. http://content.onlinejacc.org/article.aspx?articleID=2108914 I think it is IF the person is eating a lot of saturated and trans fats and refined carbs, because as stated on the video about Paleo diets and exercise http://nutritionfacts.org/video/paleo-diets-may-negate-benefits-of-exercise/, any bad diet, including the Paleo diet can negate the positive effects of exercise. I lost a lot of weight by exercising a lot by bicycling, but since going into weight maintenance close to 5 years ago, have increasingly become plant based while continuing to exercise everyday. I lost even more weight, my LDL went down even further and my glucose levels, even though normal, have gone down even more. I wonder if these studies that purportedly show how harmful a lot of exercise is really control for DIET. I would bet those who eat a whole foods plant based diet (a la Scott Jurek) don’t show any deleterious effects from doing a lot of exercise. Darryl mentioned O’ Keefe, who is a Paleo advocate who even stated that exercise causes plaque buildup in arteries. It is HIS HIGH ANIMAL FAT diet that causes the plaque build up. The exercise just cannot overcome the ill effects of the diet that he advocates and is himself on. If a person eats a lot of animal fat, the exercise by itself won’t clean out the arteries. And because the clogged arteries make the heart have to work harder, then a lot of exercise can become unhealthy. Exercise can also help reduce insulin resistance, but it can’t totally overcome the effects of a high animal fat diet.




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  11. I’m eating mostly vegan, only occasional cheese or egg that might be in something. I do eat a lot of coconut. Is the saturated fat in coconut as bad as the saturated fat in animal products?




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    1. Hi Pat, there are some other helpful videos on this site which you might want to check out. In this video Dr. Greger gives a great summary of some of the recent studies on coconut oil, which seems to be as harmful as other saturated fats on our arteries. The one difference may be that a single meal with coconut oil does not have the same immediate inflammatory effect as meat does, because this may be caused by factors other than saturated fat. Another video looks at coconut milk (which also has a harmful effect) and whole, flaked coconut which seems to be harmless in populations that eat a lot of whole coconut.

      The good news is you are already doing a lot to protect your health by eating a mostly plant-based diet and you can definitely pick up many more useful tips for optimizing your diet on this website!




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  12. Dr. Greger. This is terribly confusing. There is a respected popular medical site, now run by Medscape: http://www.medscape.com/viewarticle/839360
    which is confusing the public with articles claiming that the jury is still out with regards to saturated fat. It goes so far to claim milk fat is protective. As a lay person, I can only do so much to clarify this obfuscation. All of your painstaking research can be blunted and set back in terms of public education unless you respond to these outlets of doubt.




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        1. Genetics plays a role. So does the aging process. My mother didn’t become pre-diabetic until her 70’s, my father, never, while my 30 year-old son already is. As I understand it, insulin resistance builds up over time as one constantly assaults the body with sugar and fat in the Western diet. I think Dr. Greger explains it pretty well.




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          1. Well – I don’e eat a standard western diet. All my meat is purchased at local farms – grass fed/finished. Drink raw goat milk, goat milk kefir, duck eggs, nuts, seeds, fruit, etc.




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            1. Sounds like you’re in pretty good shape compared to the rest of us on western diets. One of the messages from this site is that if you do eat lots of plants, many of the deleterious effects of eating animal products can be blunted.
              There are the ethical and environmental sides – such as buying meat from local farms is not possible to sustain if everyone did it. And killing animals for our pleasure is difficult to justify. But this is a health-focused site…




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          2. Genetics don’t play a roll in blood sugar unless your pre-disposed to diabetes due to your insulin receptors being partially resistant due to your parents (if that’s even possible).

            Insulin receptors get resistant over time due to the constant flood of insulin in the body. This is in response to foods that get converted to glucose quickly like sugar. We know carbs convert quickly, so obviously using common sense, carb foods like grains are the issue.




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            1. Yes, some folks are more susceptible than others. From what I’ve read here and elsewhere, insulin resistance is due to the blocking of the transfer of sugar into the cells by the presence of fat in the cells despite the presence of insulin. I suppose if one overeats with too many calories from any source, protein, carbs and especially saturated fat to the point of adding body fat, this would lead to insulin resistance. So you need to support your claim that carb foods are the issue. Its pretty easy to look up – Wikipedia for starts.




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        2. Maybe it doesn’t raise it because you are eating very little sugar. However, when a person eats a lot of saturated fat, as you do, any sugar that you eat will raise your blood sugar more than it would otherwise and your body will become less able to handle it. Jimmy Moore (a famous low carber) is on a high saturated fat, high cholesterol diet and he is very insulin resistant. He even gets a bad reaction to spinach. If a person doesn’t eat carbs, glucose intolerance isn’t an issue temporarily. Possibly many low carbers are opposed to grains, because they eat so much saturated fat, that they become more glucose intolerant and unable to handle the grains.




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          1. You are correct, his fasting blood glucose is lower because he eats little sugar (imagine that).
            Our bodies were also not meant to handle grains. Experts have already said it would take our bodies millions upon millions of years to evolve to eat grains and sadly we are no where even close to that yet.

            In regards to Jimmy Moore, Cortisol. It also manifests itself as insulin resistance. Instead of me going into that, look it up yourself, it’s quite interesting. It’s what the body secretes in response to stress.




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            1. Prehistoric man did not become a serious meat-eater until the invention of weapons for hunting. The ability to “handle” grains, nuts, seeds and vegetables existed prior to that.




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    1. Considering the average life expectancy of the USA is 79 that doesn’t mean a lot if you’re ok right now..? You could be on your way to poor (or good) health.. A lifetime of poor diet/lifestyle choices catch up with us especially between ages 40 – 80..? That’s when the cancer, heart disease, diabetes, alzheimers, arthritis and our other top killers all come knocking on our doors..?

      I look to the the longest living populations on the planet (Blue Zones) for inspiration – they eat a mostly plant based diet (95%+ of their diet)! They’re eating low fat, high carb diets. They lead longer, happier lives with more emphasis on community + purpose! http://www.nutritionfacts.org/video/the-okinawa-diet-living-to-100/ http://www.youtube.com/watch?v=ff40YiMmVkU

      The Loma Linda Californian Adventists are part of the Blue Zones and among these adventists the vegetarians have the longest life expectancy out of any formally studied population. The more plant based you go (if done right) the better your health should be! Best of luck.




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      1. Let’s not forget the environmental impact of our diet/lifestyle! The fate of our species and life on earth depends on us changing our diet/lifestyle! Check out Richard Oppenlander’s talk “Comfortably Unaware: The Relationship Between Your Food And Our Future”: https://www.youtube.com/watch?v=fPd_SD7kGxo&t=365s

        Also worth watching this video about environmental impact of our diet from an ecologist & researcher: “William Ripple, PhD: Environmental Effects of Human Carnivory” https://www.youtube.com/watch?v=fnh9zT41wWo

        It takes more land, water, produces more CO2 + environmental pollutants/waste to produce animal products. We drastically improve our health, economy, environment by changing our diet/lifestyle. See this vid: nutritionfacts.org/video/diet-and-climate-change-cooking-up-a-storm/




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  13. The largest source of saturated fats are the tropical fats: palm, palm kernel, coconut. The FAO Food and Nutrition Paper 91, “Fats and Fatty Acids in human nutrition”, report of an expert consultation held in Geneva, 10-14 November 2008 (published in 2010, available online: http://www.who.int/nutrition/publications/nutrientrequirements/fatsandfattyacids_humannutrition/en/), shows that three fatty acids are atherogenic: lauric, myristic and palmitc (12, 14 and 16 carbon atoms, respectively) and that lauric is the most effective in raising blood cholesterol. Now, palm kernel and coconut fats are about 70% atherogenic fatty acids (about 45% lauric), while palm is 43% (mainly palmitic). This is more than any animal food. We should avoid also these (widely used by the industry), albeit they are of plant origin.
    I have one question, though. While the atherogenic effect of lauric and myristic acid is proved, do we have studies about their effect on the blood sugar, as it is for the palmitic acid? Also, stearic acid is rather neutral from the atherogenic viewpoint, while it seems to have a negative impact of blood sugar. A bad news for chocolate lovers, then?




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  14. You guys should look into the blood viscosity theory of cardiovascular disease. It answers the question why everything seems to be a cofactor in heart disease, but nothing seems to be the single factor. Its because everything alters the viscosity of the blood. Everything IS a cofactor. If you have chronic elevated viscosity, over time the arteries are stressed and toughen up.
    As to the debate between vegetarian high carb and low carbers. Its obvious at this point that the body can utilize carbs efficiently or fats efficiently, but struggles when fat and carbs are eaten in high amounts together. The blood fills up with fat AND sugar, becomes toxic. But this also seems to be the combination that gives you that High after you eat. Think about it… a baked potato is good by itself. Cheese n butter is ok by itself I guess. But a baked potato doused in cheese n butter? Eyes roll up in the head good. Foodgasm. You get a high from eating it. And in nature, what animal ever eats carbs and animal fat simultaneously? Milk is the only thing I can think of. So is a low carb diet just as good as a vegetarian diet? Nope. Totally unsustainable over the long term. Works great in the short term but lack of fiber n nutrients will eventually destroy you. As to the vegans and vegetarians. Same thing. Occasional animal fat and meat is extremely healthy. And so many lifelong vegans have had to just stop due to the exact same health problems surfacing.
    And why are any of us still so confused about what we should be eating? The largest ‘study’ in human history has already been done proving what the best diet is. Its called JAPAN. Where they have amazingly low rates of cardiovascular disease, dementia, multiple sclerosis, obesity, skin problems…. you name it. Everything they eat seems to thin the blood. natton, veggies, ginger… And they eat a high carb mostly vegetarian diet, but also with healthy animal proteins and meats. I always hear about the Mediterranean diet. What about the Japanese?




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    1. The longest living populations on the planet (Blue Zones) also eat a mostly plant based diet (95%+ of their diet)! They lead longer, happier lives with more emphasis on community + purpose! They’re better than the Japanese when it comes to health.. http://www.nutritionfacts.org/video/the-okinawa-diet-living-to-100/ http://www.youtube.com/watch?v=ff40YiMmVkU

      The Loma Linda Californian Adventists are part of the Blue Zones and among these adventists the vegetarians have the longest life expectancy out of any formally studied population. The more plant based you go (if done right) the better your health should be!




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  15. Richard:
    I just want to add one other option that I did not see mentioned here — FASTING. Done properly it is AMAZING for overcoming insulin resistance. It can clear out the receptors and literally “reboot” your system — in a fraction of the time it would otherwise take if you just ate optimally. You can read Joel Fuhrman’s book on this, “Fasting and Eating for Health.” to get a great introduction. Then I would encourage you to visit True North Health Clinic http://www.healthpromoting.com If you go to their website and fill out the intake information, you can then have a free phone consultation with the director and he will answer all your questions and together figure out if their program would be helpful to you. I’ve sent many people to them — but they have not encouraged all of them to come — but those that they have, had amazing results. They are also quite affordable too. I think the cost is about 150/day which covers the basic program (lodging, food, consults, educational program) Your wife can go with you and just eat their health-promoting diet and take the cooking and exercise classes (included).




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  16. What about the difference in odd-chain (found in dairy) and even-chain saturated fat (formed by de nova lipogenesis in response to for example alcohol). Apparently the odd-chain have an inverse association with Type 2 diabetes in contrast with even-chain ones. This would explain why dairy is not associated with diabetes at all.

    “With its varying
    dairy products intake, the EPIC-InterAct study reported
    that intake of total dairy products, or of milk, was not related
    to future diabetes risk, but the consumption of combined
    fermented dairy products (yoghurt; cheese; thick fermented
    milk) was associated with a reduced risk of incident diabetes
    (HR 0.88, 95 % CI 0.78, 0.99) [21].”

    http://download.springer.com/static/pdf/310/art%253A10.1007%252Fs13668-014-0098-y.pdf?auth66=1424596189_073a1d6af601657d8d8b76d511e58f65&ext=.pdf

    Especially yoghurt seems to have a inverse association.




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  17. I guess I knew this series had to be too good to be true. I find it disappointing to see this third video promoting unsaturated fat, relying on a “study” using indirect metrics and loosely controlled control groups. By far, the best test subject for insulin resistance is a Type-1 diabetic. The only difference between a Type-1 diabetic and everyone else is the inability to make their own insulin. This makes their metabolism control open-loop, which means all of their insulin must be injected and so is
    directly metered. The Type-1 diabetic also must test their blood-sugar in order to calculate their required insulin dose making the ratio between blood-insulin and blood-sugar a direct metric – without a functioning pancreas dulling the results.
    In all my years of 24-7 direct measure experience as a Type-1 diabetic, I have never, ever experienced any fat, even avocado, that did not elevate my insulin resistance and certainly has never reduced it.




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  18. Could fat buildup in the muscle cells, thus increased Insulin resistance be a causation for elevated triglyceride levels in people switching from a standard american diet to a Vegan diet high in fruit? I.E. would the increased insulin resistance lead to excess calories in the blood that the liver would be changing to triglycerides? Thus you could have low cholesterol from a low fat, high carb diet, but still have high triglycerides?




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  19. I agree! But I have a friend with Type 1 diabetes who swears that low carb high fat diet makes it easier to control her blood sugar. Can this be true?? Seems like it can’t be healthy. She says her cholesterol is low and her LDL. Any thoughts?




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    1. wrong, you have no idea what you are talking about. Carbs are great! I eat 80% carbs and i’m doing just fine. Saturated fat most definitely DOES raise blood sugar and the cause of insulin resistance. You need to stop going to lame non medical blog sites for your information.




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    1. Thanks for sharing the study. Not sure what kind of feedback you are looking for? I don’t think this study from 1981 is reason to change saturated fat requirements for Americans or other countries with high risk of heart disease. Similarly, in the Marshall Islands where folks ate more calories from fat they did not have more risk of disease. However, now their diets are so filled with added sugars, trans fats, and sat fats that their levels of type 2 diabetes are skyrocketing at alarming rates.




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  20. “The association between fat and insulin resistance is highly accepted” no it isn’t. Scientists have been trying to prove this for 60 years and have been unsuccessful. Every single study that tried to prove this went unpublished because the researchers were displeased with the results. Furthermore, those who funded the research (corporations) refused to do comparison tests to show that sugary and high carb foods are associated with it.

    “Saturated fats cause insulin resistance whereas unsaturated fats improve insulin sensitivity”????? How old is this video? I mean come on. This is such a crock.

    Fats have little to no effect on insulin, while protein foods have a moderate effect because it’s needed to drive amino acids into the muscles. Carbs have a much larger effect on insulin depending on what type you consume. Simple carbs spike it while complex carbs are a bit slower. Fats blunt the insulin response just as proteins do, and that is exactly why all the SUCCESSFUL weight loss diets out there choose a paleo approach that combines CARBS with PROTEIN foods to minimize the insulin response. The protein foods always contain some saturated fats in them for that very purpose.

    It is still very hard to believe that some doctors to this day still try to lay out this garbage on the populace. Even most run of the mill doctors now (ones you’d expect to follow the food pyramid) tell people saturated fats are ESSENTIAL to create the right hormone balance in the body for weight loss.




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  21. Saturated fat does not raise blood sugar the way a carbohydrate does. Glucose enters the blood stream thus increasing blood sugar. So obviously foods with more sugar in them or those that get converted more rapidly (like carbs as everyone will agree), create a much larger blood sugar spike.

    Now the problem with videos like this is it gives false information & doesn’t cover side effects. You see, the body’s primary source of fuel is fat, that is why we store so much of it. If carbs were are primary source, we’d store more of it than fat, but we don’t. The average 185lb male only holds about 225-250 grams of total carbs (70 in the liver and rest in the muscles).

    Now the body has a natural tendency to want to stay in balance, this means if it’s lacking in one area, it will use something from another to compensate. What this means is if you deprive your body of fat it will think it’s starving itself and the end result is your body will not burn off fat but choose protein instead. It’s not as simple as just eliminating one nutrient to prevent it’s storage. The body is a complex structure that constantly struggles to maintain homeostasis.

    What this ultimately means is you cannot starve your body of fat, otherwise it won’t burn it’s primary fuel source (fat). You can’t starve your body of protein because it needs it for it’s muscles and organs. Your body in fact doesn’t need carbs, only your brain requires a bit of glucose and it can take that from your fat stores because your body can indeed convert fat into glucose.




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    1. Gosh the amount of half truths and rubbish in this.. Where to start. Fat might be the primary STORAGE unit of the body. Doesn’t mean it’s the preferred source of fuel and that we should be consuming it all the time. The longest living populations on the planet (Blue Zones) eat a mostly plant based diet (95%+ of their diet)! They’re eating low fat, high carb diets. They lead longer, happier lives with more emphasis on community + purpose! http://www.nutritionfacts.org/video/the-okinawa-diet-living-to-100/ http://www.youtube.com/watch?v=ff40YiMmVkU

      The Loma Linda Californian Adventists are part of the Blue Zones and among these adventists the vegetarians have the longest life expectancy out of any formally studied population. The more plant based you go (if done right) the better your health should be!




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  22. My understanding had been that, regarding atherogenicity (clogging arteries), stearic acid -18- had been given a pass (but not lauric -12-, myristic -14-, and palmitic -16) . Even if that is true, I now see that stearic acid does not get a pass for type 2 diabetes and insulin resistance. Is that correct?

    On a related matter; it is my understanding that, when faced with excess dietary carbohydrates and protein, the body synthesizes it into stearic acid for storage. True? If true, it’s another good reason not to eat too much.




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    1. I generally say avoid it because it is such a rich source of saturated
      fat with 12 grams per table spoon. I feel that it is too easy to get way
      too much saturated fat considering we should strive to comprise only
      5-7% of calories. Perhaps sparingly for the seasoned whole food plant
      plant based Dieter, but many that visit this website are coming
      from poor dietary backgrounds. Moderation is generally poorly adhered
      too because of its loose definition. Jeff Novick has
      very interesting thoughts on moderation too if you have not already seen
      his article.
      http://www.jeffnovick.com/RD/Articles/Entries/2010/10/26_The_Myth_of_Moderation_Pt_1__Do_All_Foods_Really_Fit.html
      http://www.jeffnovick.com/RD/Articles/Entries/2011/3/6_The_Myth_of_Moderation_Pt_2__The_Impact_of_Just_A_Little_Oil!.html
      http://jeffnovick.com/RD/Articles/Entries/2008/4/10_Marketing_Junk_Food__Dont_Go_Cuckoo_Over_Coconut_Oil.html




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    2. I agree with Rami. Coconut oil fits into the category of saturated fat, which can raise LDL cholesterol. However, as Rami said, if your LDL is super than perhaps a small amount would be okay? Check out the links Rami listed! IN one of the transcripts Dr. Greger says: “Walter Willett’s recommendation from Harvard, if you are going to use it use it sparingly. Now look, if you’re eating so healthy that your LDL cholesterol is under 60 or 70, then I don’t see coconut oil as a problem. Unlike saturated animal fats, coconut oil doesn’t cause that spike inflammation immediately after consumption of animal foods, which makes sense because as you’ll remember it may be the dead bacterial endotoxins in animal products ferried into the body by saturated fat that are to blame. ”

      There are 3 videos in the “Doctor’s Note” section that discuss animal fat and endotoxins. I think they may helpful, as well. Jeff Novick RD is a colleague and has valuable information, too.

      Best to you,
      Joseph




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  23. Dear Doctor: natural saturated fat is not linked to heart disease, sugar is. There is a lot of evidence, artificial carbs and trans fats are the real enemy of our health.




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    1. You mean the saturated fat in meat that IS linked to heart disease and a top tier carcinogen as reported by the WHO? Saturated fat from animal origin is most definitely linked to heart disease and meat is also the only natural source of deadly trans-fat. You’ve been on too many quack blog sites.




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  24. Hi there! I am so confused, I have been bombarded with the message that fat doesn’t make you fat, sugar (carbohydrates) makes you fat. That your body doesn’t release the fat storage hormone (insulin) in the absence of carbohydrates. Have I been bombarded with lies and if so how isthis message so prevalent and mainstream? Please help!




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    1. happylittlevegan: I don’t blame you for being confused. I agree that the misinformation out there is blasted at people to the point where reality is very hard to figure out. There are many reasons for this situation beyond what I could properly cover in a post. The reasons include human history, western culture, conflicts of interest at the government and other levels, humans who love good news about bad habits whether that news is true or not, and a failed media who cares more about sensationalism and making money than spreading the truth.
      .
      I find that carefully picking a set of experts I can follow and learn from is very helpful in making sense of the morass of conflicting and misinformation. Dr. Greger is one such expert that I follow. Watching the NutritionFacts summary videos can be a great place to start. These talks can very quickly help you to get a good grasp of what is supported by evidence and what is not. The new book, How Not To Die, has been helping a great number of people because the information is so well organized and presented. I highly recommend the book. The summary talks are free and can be found at the bottom of the home page. Here is the first one:
      http://nutritionfacts.org/video/food-as-medicine
      .
      Take a look and let us know if this helps.




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  25. This video implies that fats from whole plant foods are better yet goes on to warn of the dangers of saturated fat. What about the saturated fat in nuts. Is that plant-derived saturated fat somehow less harmful and therefore something one should not worry about? Or should nuts and seeds be limited too? I speak as someone who has healthy blood sugar but is interested in optimum health, and helping others achieve optimal health. I’m personally interested from a general health perspective but I’m interested in the effect of nuts and seeds on insulin sensitivity for the benefit of people I know.




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  26. I’m wondering why e.g the ADA or other influential organizations don’t push an all plant food diet. Is it just because they do not think many people would follow the advice (just like for heart disease or general health) and so settle for a compromise, hopefully addressing some key dietary problems, or is it (also) that the science is considered uncertain? I ask because my daughter has T2D and I’m having a hard time persuading her to ignore her doctor and the ADA…




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    1. David J: I can’t answer your first question, but I have a thought about your daughter. Is she old enough to read? If so, see if you can get her to read Dr. Barnard’s book. He shows how his diet is clinically proven 3 times more effective at fighting T2D than the ADA diet. It’s all there in black and white, including recipes at the back of the book (if your daughter is grown and cooking).

      Here’s the book if you are interested: “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=1473461000&sr=1-1&keywords=prevent+and+reverse+diabetes

      Good luck!




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      1. Thanks – that’s a very good suggestion. I have both Dr. Barnard’s book and Dr. Fuhrman’s (The End of Heart Disease) but forgot Dr. Barnard compares his diet to the ADA diet. Yes, my daughter is grown and cooking (and raising 3 children) so the recipe suggestions might help. Also, she lives in Baltimore and so, if I could motivate her to look at more options, could go to the Barnard Medical Center (I think that’s right). I had recommended she go to them but have yet to convince her to get a second opinion. Thanks again!




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  27. LDL is not the number one risk factor heart disease, in fact ApoB/ApoA1 ratio is a far better predictor if you want to worry about your lipids. Sadly so many people are walking around with their LDL in the basement thinking they have nailed it with regard to avoiding heart disease. It is also hard to find a case for saturated fat causing HD as well as this study amongst many reports

    https://www.ncbi.nlm.nih.gov/pubmed/26791181

    I think the real culprit is sugar and simple carb’s, in other words the bread, pasta, cakes, pasties and of course pure sugar we take via drinks. Cut these out and you will see an immediate impressive response by your body weight, a sure sign you are doing something right.




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    1. I think this line says it all “Residual confounding by cholesterol-lowering therapy and trans fat or limited variation in SFA and PUFA intake may explain our findings.” If the low saturated fat group in this study consumed more trans-fats, or if the high saturated fat group were on statins it would hide the relationship. The Harvard cohorts adjusted for more confounders and found a clear relationship.
      http://www.bmj.com/content/355/bmj.i5796
      Hope this clears things up.




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  28. This lines up nicely with the zone diet and explains why 40% low glycemic load carbs, 30% monounsaturated fat and 30% low fat protein works so well. The right amount of the right type of foods.

    I mention the Dr Sears zone diet because it has worked for me for almost 15 years. Not hungry and blood tests in the optimal range (a tighter range inside the reference range). Like he says “try it for 2 weeks and see if it works for you”. I gave it a month and haven’t looked back since.




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  29. Dear Dr. Greger

    Trying to eat less omega 6 oils (more omega3) I allowed some coconut oil into my diet, while it is vegan it is also a saturated fat. Does it have all of problems found with saturated animal fats?

    Thanks,

    alr




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  30. Why don’t triglycerides cause the same sort of insulin sensitivity? My understanding is that they are stored in fat cells and in parts of the muscles.. so wouldn’t that in turn cause them to block glucose from being taken in to the muscles too? Everywhere I read however says that triglycerides don’t cause diabetes but are only a telling sign that diabetes is around the corner.




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    1. Peripheral tissues is the main consumer of glucose in the body. Fat cells to a lesser degree in theory. Meaning that even if fat cells will become insulin resistant it will not be a primary problem, because by then muscle tissue will be a lot more insulin resistant causing a lot more of glucose in the blood.

      In a case of already insulin resistant both peripheral tissues & fat tissue 3 things will will happen prior to triglycerides reaching an elevated level in the bloodstream 1) It starts with peripheral tissues – since it is IR it will not absorb glucose and glucose will remain in the bloodstream leading to elevated glucose blood levels 2) Body will recognise elevated glucose levels and immediately will send excess glucose to liver, thinking that once this excess glucose will get converted into triglycerides it will then be stored in adipose tissue. So liver then converts excess glucose into triglycerides and shuttles it back to the bloodstream thinking again that these triglycerides will safely be stored in adipose tissue 3) But since fat tissue is also IR newly converted triglycerides are not being stored in the adipose tissue and simply remain in the blood stream. As a result you get an elevated level of triglycerides in the blood stream. Which as yopu have correctly mentioned is a sign of IR and good chance of getting diabetes.

      So in the case of nutrition caused IR it is mainly the peripheral tissue that is causing over-production of triglycerides making fat cells insulin resistant and not the other way around. This is the reason why every nutritionist or doctor is putting exercise as a number 1 priority in fighting IR – you need to starve you muscle tissue (and make it more insulin sensitive) first before fat in adipose tissue will get burned. exercise = increased consumption of glucose = improved peripheral tissue insulin sensitivity = less triglycerides because excess glucose got burned and liver didn;t have to convert it into triglycerides = improved adipose tissue insulin sensitivity.

      Also a cascade of other positive processes will be launched by the improved insulin sensitivity – the liver will not be stressed by constantly converting glucose into triglycerides and metabolism of nutrient for detoxification phase inside the liver will improve and so will the overall body detoxification. Then again because liver will have more stamina (and more nutrients necessary for bile production) bile production will improve. Bile is crucial for gut bacteria because bile neutralises acidic food coming from the stomach. Acidity is good in the stomach because stomach is made to tolerate acid, but acid in the gut will wipe off bacteria like a round of antibiotics. So if liver function will improve once insulin resistance is addressed, it is very likely that gut bacteria balance will improve as well. This is one of the explanations of why many people out there are not responding to pro-biotics very well.

      Obviously this is very basic explanation of everything, there a lot more things going on there.

      P.S. I am not a doctor, but am very well educated and well informed. Also struggling with IR myself and trying to figure out a way out of it.
      Hope this helps




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  31. I get severe crashes after whey protein. This is to the point where I can’t keep my eyes opened. But then I tried hemp protein and don’t get anything negative responses at all. Sometimes I would go as high as 60 grams of hemp protein and I feel absolutely fine, whereas as little as 20-30 gr of whey will put me to sleep in the matter of minutes.

    Crashes from whey are probably due to insulin spikes. But then again hemp is also protein and theoretically supposed to be causing same spikes as whey? Or odes it not? Is it because because the composition of amino acids acids is different? Really curious to figure out why this is happening.

    I am insulin resistant and my body will negatively react (fatigue & muscle weakness) to animal protein and saturated fat. I am feeling a lot better (though not perfect) on a 80/10/10 diet.

    Really curious to figure out this hemp/whey thing of mine. Any guesses?




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    1. Hi Alex! I’m Corey one of the moderators here at NF.org. Your question is an interesting one! I’m not sure I have the exact answer you want but I’m willing to point you to some other information on the site that may add to your understanding of what’s going on. In short, I think the difference you’re experiencing may be linked to the difference in the way your body uses plant protein versus animal protein. Take a look at these links to some of Dr. Greger’s “older” protein information.

      https://nutritionfacts.org/topics/protein/
      https://nutritionfacts.org/video/higher-quality-may-mean-higher-risk/
      https://nutritionfacts.org/video/which-type-of-protein-is-better-for-our-kidneys/

      While they don’t specifically address your question they hint at some reasoning that may apply. I hope this helps a little. Thank you for visiting the NutritionFacts.org site!




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  32. This is bollocks. So you promote sugars instead of fats? Sugars are the culprit in insulin resistance and diabetes type 2! Fat doesn’t make you fat, it is sugar (carbohydrates). Ketogenic diet results speak for this. Sugar raises your insuling levels and the more sugar the more insulin resisntat you’ll become. Look at the young kids in the US becoming insulin resistant. It’s the sugar. This article is going back to the lipid hypothesis which has long been debunked.




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  33. Can anyone help me explain why I hear people say that they cured their diabetes with a 70-80% fat intake (Ketogenic) diet? Is this just short term while losing weight or does this last? Is it because they start using up the intracellular lipids? I get the theories, but I haven’t seen the studies pan out. And yet I get these anecdotal stories. Also, is there any experience or studies on the Vegan Keto diet? Anyone?




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