Plant-Based Diets & Diabetes

Plant-Based Diets & Diabetes
4.46 (89.19%) 74 votes

We’ve known for a half century that plant-based diets are associated with lower diabetes risk, but how low does one have to optimally go on animal product and junk food consumption?


Decades ago we started to get the first inklings that a plant-based diet may be protective against diabetes. Studies going back half a century found that those eating meat one or more days a week had significantly higher rates of diabetes, and the more frequently meat was eaten, the more frequent the disease. And this is after controlling for weight. Even at the same weight, those eating plant-based had but a fraction of the diabetes rates, and if anything, vegetarians should have had more diabetes just because they appear to live so much longer so had more time to develop these kinds of chronic diseases–but no–apparently lower rates of death and disease.

Fast forward 50 years to the Adventist-2 study, looking at 89,000 people and we see a stepwise drop in the rates of diabetes as one eats more and more plant-based, down to a 78% lower prevalence among those eating strictly plant-based. Protection building incrementally as one moved from eating meat, to eating less meat, to just fish, to no meat, and then to no eggs and dairy either.

We see the same thing with another leading killer, high blood pressure. The greater the proportion of plant foods, the lower the rates of hypertension. The same with excess body fat. The only dietary group not on average overweight were those eating diets composed exclusively of plant foods, but again this same incremental drop with fewer and fewer animal products. This suggests that it’s not black and white, not all or nothing; any steps one can make towards eating healthier may accrue significant benefits.

Followed over time, vegetarian diets were associated with a substantially lower incidence of diabetes–fewer new cases–indicating the potential of these diets to stem the current diabetes epidemic.

What about eating a really healthy diet with just a little meat? Or is it better to eat none at all? We have new insight this year from Taiwan. Asian diets in general tend to be lower in meat and higher in plant foods compared with Western diet, but whether a diet completely avoiding meat and fish would further extend the protective effect of a plant-based diet wasn’t known, until now.

Traditionally, Asian populations have had low rates of diabetes, but a diabetes epidemic has since emerged, and appears to coincide with increased meat, animal protein, and animal fat consumption, but the Westernization of Asian diets also brought along a lot of fast food and junk. So these researchers at the national university didn’t want to just compare those eating vegetarian to typical meateaters; they compared Buddhist vegetarians to Buddhist nonvegetarians eating traditional Asian diets. Even the omnivores were eating a predominantly plant-based diet, consuming little meat and fish, with the women eating the equivalent of about a single serving a week, and men eating a serving every few days. That’s just 8% of the meat intake in the U.S., 3% for the women. The question: is it better to eat 3% or 0%?

Again, both groups were eating healthy–zero soda consumption, for example, in any group. Despite the similarities in their diet, and after controlling for weight, family history, exercise, and smoking the men eating vegetarian had just half the rates of diabetes, and the vegetarian women just a quarter of the rates. So even in a population consuming a really plant-based diet with little meat and fish, true vegetarians who completely avoided animal flesh, while eating more healthy plant foods, had lower odds for prediabetes and diabetes after accounting for other risk factors. They wanted to break it up into vegan versus ovo-lacto like in the Adventist-2 study, but there were no cases at all of diabetes found within the vegan group.

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 Jeff Filmore via Flickr.

Decades ago we started to get the first inklings that a plant-based diet may be protective against diabetes. Studies going back half a century found that those eating meat one or more days a week had significantly higher rates of diabetes, and the more frequently meat was eaten, the more frequent the disease. And this is after controlling for weight. Even at the same weight, those eating plant-based had but a fraction of the diabetes rates, and if anything, vegetarians should have had more diabetes just because they appear to live so much longer so had more time to develop these kinds of chronic diseases–but no–apparently lower rates of death and disease.

Fast forward 50 years to the Adventist-2 study, looking at 89,000 people and we see a stepwise drop in the rates of diabetes as one eats more and more plant-based, down to a 78% lower prevalence among those eating strictly plant-based. Protection building incrementally as one moved from eating meat, to eating less meat, to just fish, to no meat, and then to no eggs and dairy either.

We see the same thing with another leading killer, high blood pressure. The greater the proportion of plant foods, the lower the rates of hypertension. The same with excess body fat. The only dietary group not on average overweight were those eating diets composed exclusively of plant foods, but again this same incremental drop with fewer and fewer animal products. This suggests that it’s not black and white, not all or nothing; any steps one can make towards eating healthier may accrue significant benefits.

Followed over time, vegetarian diets were associated with a substantially lower incidence of diabetes–fewer new cases–indicating the potential of these diets to stem the current diabetes epidemic.

What about eating a really healthy diet with just a little meat? Or is it better to eat none at all? We have new insight this year from Taiwan. Asian diets in general tend to be lower in meat and higher in plant foods compared with Western diet, but whether a diet completely avoiding meat and fish would further extend the protective effect of a plant-based diet wasn’t known, until now.

Traditionally, Asian populations have had low rates of diabetes, but a diabetes epidemic has since emerged, and appears to coincide with increased meat, animal protein, and animal fat consumption, but the Westernization of Asian diets also brought along a lot of fast food and junk. So these researchers at the national university didn’t want to just compare those eating vegetarian to typical meateaters; they compared Buddhist vegetarians to Buddhist nonvegetarians eating traditional Asian diets. Even the omnivores were eating a predominantly plant-based diet, consuming little meat and fish, with the women eating the equivalent of about a single serving a week, and men eating a serving every few days. That’s just 8% of the meat intake in the U.S., 3% for the women. The question: is it better to eat 3% or 0%?

Again, both groups were eating healthy–zero soda consumption, for example, in any group. Despite the similarities in their diet, and after controlling for weight, family history, exercise, and smoking the men eating vegetarian had just half the rates of diabetes, and the vegetarian women just a quarter of the rates. So even in a population consuming a really plant-based diet with little meat and fish, true vegetarians who completely avoided animal flesh, while eating more healthy plant foods, had lower odds for prediabetes and diabetes after accounting for other risk factors. They wanted to break it up into vegan versus ovo-lacto like in the Adventist-2 study, but there were no cases at all of diabetes found within the vegan group.

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 Jeff Filmore via Flickr.

Doctor's Note

More on preventing and treating this terrible disease:

The reason I keep going back to that Adventist-2 study is that it’s not only the biggest study of those eating plant-based diets in North America, but the largest such study anywhere anytime. We owe those investigators a great debt (not to mention the 96,741 participants!). One thing I’m happy my tax dollars are going towards (via the National Cancer Institute and National Institutes of Health). More from the Adventists in Caloric Restriction vs. Animal Protein Restriction.

And check out my 2019 video: Plant-Based Diets Recognized by Diabetes Associations.

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

218 responses to “Plant-Based Diets & Diabetes

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  1. What i feel is wrong with some of these studies is that they group all vegans together. Vegans fall into two very different groups. Wholefood vegans who do not eat processed foods and other vegans who still eat junk food, processed food, etc. It would be very interesting to see studies done for diabetes and other diseases where junk vegans and wholefood vegans were seperated. As you video states at the end when studying wholefood diets, the vegans in those studies had no incidents of diabetes at all.

    My personal view is that if it needs a label on it to say it’s vegan then it’s junk food and not edible. An apple doesn’t need a vegan label.

    Just wondering what your thoughts are on this?

    Love your website – you should get a nobel prize for health or something – seriously! I discovered you through your Rich Roll podcast interview.

    1. Rip Esselstyn ( author of “My beef with meat”) has the same logic that you have in that the word vegan is not specific enough. Dr. T. Colin Campbell is usually pretty clear when describing his diet as a “whole food plant-based” and Rip just says he eats a plant strong diet, which is supposed to mean the same thing as whole food plant-based. Perhaps in the future there will be vegan subtypes, perhaps we can start it right here!

    2. Miss Creant, I agree with most of what you’ve written, but there is a middle ground between junk food and unprocessed fruits, veggies and grains/legumes. Few people will eat 100% unprocessed, so we all need to become better label readers. When I’m buying crackers, cereals, soups, nut butters, dips, etc., I’m scrutinizing the label for animal products, trans/sat fats, types of grains, sugars, salt, and other ingredients that are not only not-vegan but unhealthy.

      1. I agree. But there are still plenty of vegans drinking coca cola and eating food with HFCS and other adulterants added to it. Essentially, there are plenty of lazy vegans who only take notice of the label that says ‘Suitable for Vegans’ and only consider the ease with which they can cook and consume it. To group all vegans into one group totally destroys the science, IMHO. If there were studies done separating the vegan groups then people could make far more informed choices.

        If, as the studies suggest, that wholefood vegans showed no signs of diabetes at all whereas when all vegans were lumped into one group they did show evidence of diabetes then that clearly suggests that some vegan diets could still be very high in diabetes risk. These could be easily isolated and revealed for what they are by further studies.

        1. I’m totally with you here . . . I’ve got a friend who has been vegan for 10 years whose diet is mostly chips, boca burgers, fries, beer, and the like. Very few green items touch her plate. Or fresh fruit or legumes or beans or nuts or whole grains.

          1. That’s me. And I still have low blood pressure, stellar cholesterol, awesome triglycerides.

            I’ve changed it up since the beginning of the year, so I’m excited about that, but eschewing animal foods on it’s own has kept me relatively well.

        2. “To group all vegans into one group totally destroys the science, IMHO. ”

          Except that they’re studying the effect of animal protein, not processed foods.

        3. Agreed I eat modest amounts of fish and poultry. But I also eat large quantities of dark greens, red cabbage, berries, beets, beet greens, asparagus, turmeric, spices….etc–basically anything good I can get my hands on. I avoid junk food. You just can’t have me negatively pitted against vegans, whose overall diet choices are questionable.

          1. I think carnists, anatomical herbivores assimilated and coerced into the carnist culture because that’s what works for the medical, military and agribusiness economy, choices are questionable! Choosing, after years or decades of carnist indoctrination into the violence of eating other animals, is what is questionable, not eating the ideal nutrition for holistic health of both the human organism, animals and the earth, currently on a death spiral from animal agriculture… What child, given the fcts and truth about what their beloved animals endure in their short miserable lives, and tortured deaths, would CHOOSE to participate in such perversion? None I suspect since they all have an inherent kinship with animals and are encouraged by a morally duplicitous society to be kind to them… Before teaching them to eat them, hunt them, fish them and wear their skins… insane. and why human society is replete with a myriad of symptoms of carnism.predatory behaviors.

        4. Not sure “laze” is appropriate. There are many reasons people choose vegan, not all are for health. It is important to understand “plant based” as a distinction.

    3. The problem is most people confuse veganism with a dietary choice, when they really just mean a strict vegetarian diet or a whole foods plant based diet. Veganism is not specifically or wholly related to diet. Veganism is rather a lifestyle choice that seeks to limit the suffering caused to animals by a variety of means not only dietary.

      So really, vegans don’t fall into two groups. Veganism is specifically related to an ethical stance not dietary, though that is just a component of it. Perhaps we need a better term for strictly plant based food eaters or strict vegetarians who indeed are likely to eat either whole or processed or a combo.

      Personally, this is a real issue for me, as veganism is getting watered down to a dietary approach, when it was never only about diet but about ethics, and as such, the public is getting confused as to what a vegan really is.

      1. I do see still vegans as falling into two groups. You can still be vegan, ethically, and also focus those ethics to include your own health and wellbeing, not just be a junk food eating vegan because it’s nice for the animals. What’s the point in destroying your own health just to make an ethical point that can be even more validly made by looking after your own health.

        Junk vegans do nothing for their cause if they become ill because all it does is put others off becoming vegan – too many, ‘I knew a vegan once who….’ stories. A wholefood vegan promoting a totally healthy lifestyle supported by an incredibly healthy wholefood diet does encourage others to jump on board.

        I’m 50 years old and am training happily and easily towards my first full length triathlon this summer, and making fantastic progress through a wholefood vegan diet. I couldn’t do this on a junk vegan diet. People can see my health and fitness levels and what allows me to train like i do, and i happily spread the word about it without needing to get all political, while at the same time being ethical and caring about the environment and animals is an added bonus to one’s personal health, fitness and wellbeing.

        1. Miss Creant, your point is completely valid and inspiring: that studies should pursue optimal health rather than just throwing broad dietary patterns into a competitive pit. But comparing vegans alone is not interesting: It’s tautological that a healthy vegan is healthier than a junk food vegan. We’d really like to see that healthy vegans are healthier than healthy pescatarians and other ‘healthy’ carnivores. But in the name of true science we must be prepared to learn that perhaps even the healthiest vegan diet is not healthiest overall (despite our bets and hopes).

          1. Good point, Alex. I suppose healthy carnivores/Omnivores and vegetarians could all make the same complaint about being lumped in with the junk versions of the same. Would be an interesting experiment to isolate all these specific groups. I’d still put my money on the wholefood vegans winning out overall with junk meat eaters coming in last, but one never knows. I do think it would be fascinating to see where the rest would line up – would a junk vegan be healthier than a wholefood meat eater? Probably not! :-D

            1. My bet is the same as yours. Land flesh and egg eaters don’t have a chance in the health game. I expect after more investigation into heavy metals and toxic pollutants fish eaters will lose any advantages; Similar with dairy. As far as I know, all the later two groups have is n3 (EPA, DHA), calcium, and B12 — all intentionally obtainable through cleaner, safer, and healthier sources: algae, plant, bacteria, and synthetic.

              FYI, the USDA’s 2015 Science Dietary Guidelines spell it out pretty clearly for any with open ears to hear and eyes to see: Increase veg and whole grains, and decrease sodium, sat. fats, and refined grains (Summary page 15 line 70). Limit or remove sugar-sweetened beverages, sweets, and desserts (line 72). Increase fruit and veg in schools and worksite (p18 line 226) and decrease energy-dense nutrient-poor foods and beverages in schools (line 231). Increase veg and fruit (p19 line 241). Lower sodium, added sugar, better sat. fat to polyunsat. fat ratio, reducing portion size in retail settings (p22 line 361).

              Current US diet is low in veg, fruit, whole grains, and high in sodium, calories, sat fats, refined grains, and added sugars (Recommendations page 38 lines 27, 44) and underconsumption of vitamin D, calcium, potassium, and fiber (p38 line 28). The overall body of evidence…a healthy diet…is higher in veg, fruits, whole grains, low-fat dairy, seafood, legumes, and nuts; moderate alcohol; lower red and processed meats, low in sugar and refined grains (p39 line 43). A Healthy diet is higher in plant-based foods, such as veg, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods…favorable environment (p40 line 86).

              Food pattern modelling process…hypothetical effect on nutrients…for example…lacto-ovo-veg eliminating legumes or choosing varying levels of fat as percent of calories (p64 lines 508-519, Appendix E-3 page 528).

              ( )

              While the 571 page report recommends increasing plants and reducing animals, it doesn’t go so far as to suggest that eliminating dietary animal is optimal. But we’re moving in that direction. There’s always 2020. :)

      2. I can see your point Donald. I have chosen a vegetarian diet (working towards vegan one day) for a multitude of reasons and obviously want to see less meat consumed around the world. I have always been conflicted about the best approach to promoting this change and have come to the conclusion that although ethical reasons are among the top reasons I don’t eat meat, convincing a meat eating person to stop eating meat or to decrease their meat consumption based on ethics just doesn’t fly and flawed logic such as “animals are bred to be eaten” is used to justify the meat eating position (What do they say about the puppy dogs in S.Korea bred to be eaten, does the fact they were bred to be eaten justify killing them for food)… however it is a LOT easier to appeal to one’s self interest rather than their compassion (or lack thereof).. and so while I would argue that ethics and environmental reasons are strong motivators for people like me, the dietary/health aspect is one that will most likely invoke change among the masses if any. Where does that leave us with the subtypes and labels? Good topic for discussion.

      1. Only the last study was wholefood vegans – no diabetes at all!!! The first studies just lumped all vegans in together, wholefood through to complete junk food – they did show evidence of diabetes.

    4. I just wanted to add that I have been vegan, mostly raw, all whole foods, for 3 years, and I have significantly reduced my need for synthetic insulin, I am a diabetic.

    5. I agree 100%! I feel exactly the same way about gluten free foods! If they are in a box with a label saying gluten free, it’s junk; eat Whole Foods that are gluten free!

  2. I’ve been primarily vegan for over 33 years, and yet have still managed to develop pre diabetes. It’s hard to say exactly how this happened, but my hunch is that because of a high metabolism and slightly hyperactive thyroid, my diet has been based on high levels of semi-processed carbs like whole wheat spaghetti, large bowls of rice, or vegan pizza for my primary source of calories, and to maintain weight. (BMI has always been low, around 21-22). I think the takeaway is that we vegans can still eat unhealthily if our carbs are excessive, and if they contain significant amounts of flour as many of my former selections did.

    I continue to be vegan today, but have replaced almost all of my grains with proteins like tofu, seitan, and lots of high-fat nuts and seed butters that don’t have significant impacts on glucose. Even though Drs. Esselstyn and Greger warn about excessive fats, these have not raised my inflammatory markers in the least. Carotid exams show zero plaque. Fingers crossed, but so far, so good… And a good lesson for those of us who overeat flour-based products, even if they are so-called “whole wheat”!

    1. What percentage of your calories comes from fats? Do you use coconut (oil, whole, ground, etc.)? Thank you. This is interesting to me that people are able to manage diabetes even on high fat plant foods.

      I am most interested in knowing….what did you consider high blood sugar readings when you were pre-diabetes? Did you get above 200 Blood sugar level on the skin prick blood test? How about a first thing in the morning blood sugar reading? And what do you consider a healthy range of blood sugar after one hour or two of eating?

      1. Yup, I tested at 206 at one hour, and 175 at two hours on the oral glucose tolerance test. Currently getting about 60% of my diet from fats but I avoid saturated fats as best I can (though I do get about 8-12 grams a day of them from nut and seed oils, avocados, seitan and tofu (which usually contain canola oil), but no coconut oil).

        My fasting glucose ranges from about 85 to 111, depending on what I ate the night before. A BIG salad will drive it WAY UP. But a small to moderate-size meal will hold it down nicely. I find the morning glucose test to be almost irrelevant though. The spikes are the biggest concern. Studies show that keeping under 140 at all times is the most important factor in preventing future disease. This can be done on a plant-based diet, and high-fat plant foods really help to control and slow the peaks.

        1. I am certainly no professional, but was diabetic. I was always a “near vegetarian” prior to my diagnosis, and ate a “healthier” diet overall than most, but was dramatically overweight. Finally hitting on the right food combinations caused my A1C to go from 7.5 to 6 in the next follow up appt. even before substantial weight loss, but 5 years and -150 lbs later, it stays in the low 5’s, my fasting blood sugars are around 80 and postprandial can be 120-130 but have gone as high as 160 on a bad day. In my research and subsequent personal trials I found that keeping a low fat, whole foods, vegan, program was the combo that worked best for me…high fat in any combo was problematic, not just animal, though that was the worst. Ideally I try to keep the fat <10% which means I never add free fat to anything, I only consume it as part of the food it is native to. Since I only eat whole unprocessed foods, all my carbs are complex, and can range from 50-75% of my diet and possibly more I would guess, if you include all plants, whose various parts make up my entire diet. Another key behavior I had to focus on was trying to consume smaller, more frequent meals, because my tendency was to skip meals and consume the majority of my daily intake in one or two sittings. When I neglect to do this, my readings are often higher.
          I feel so much better overall than I used to, and I'm thrilled I no longer have to rely on pharmaceuticals for control. Though initially I considered myself "cured" because I had no symptoms and take no medicines, I realize that I will always have to remain vigilant to my diet and at least occasionally monitor my status. Whatever you call it, it is wonderful because the change in diet has also liberated me from a host of associated issues such as: morbid obesity, high blood pressure, high cholesterol, IBS, edema, arthritis, back problems, fibromyalgia, depression, and so on. I know I'm preaching to the choir here, but changing your diet changes your entire world, your health, your outlook, everything! I had been on 12 medicines including narcotics, that I no longer need! Yet the people all around me, some who have already lost limbs to diabetes, go on as always, oblivious to my example except to flag my WPFB vegan diet as so EXTREME, totally missing the HUGE irony in their emphatic criticism! As if it is NOT extreme to lose limbs to a disease you can treat by altering your beloved dietary habits? I am so puzzled and clueless! And heart-broken. I am married to one of them. :(

          1. I enjoyed reading about your success. Congratulations. The clinical key is to realize that it is the fat in the diet that contributes most to type two diabetes. The fat gets into the blood stream causing insulin resistance and intracellular fats downregulate genes causing reduction of the mitochondria’s ability to burn the glucose… take home message… fats cause glucose processing problem. Dr. Kempner was reversing type two diabetes with white rice diet in the 1940’s as Dr. Greger has pointed out in previous video… see In my clinical experience it can take several months for sugars to normalize depending on where you start from and your diet, weight loss and exercise programs. You have to be careful if you are currently on medications for diabetes and go to low fat diet as they amount has to be reduced along with other meds such as those for blood pressure. Your example can prove to be a good lesson for those around you. Keep up the great work and good luck with your spouse.

            1. An interesting study published in the journal Diabetes Care echoes your message that too much fat within the liver and pancreas prevents normal insulin action and secretion, with the finding that it can be reversed by substantial weight loss.


              For those of us who are lean (my BMI is 19), WFPB vegans with glucose intolerance, losing weight obviously isn’t a solution. After carefully tracking my postprandial glucose spikes, I’ve found that a modified Eco-Atkins diet works very well for me, which necessitates a higher fat intake from nuts and avocados – no added, processed oils. My glucose meter is my guide to how many carbs I can handle in smaller, frequent meal, usually in the 30g range, to keep my blood sugars from rising over 140 after an hour. An essential part of this routine is also exercise, about an hour daily, which I’ve found has a wonderful effect on lowering and stabilizing blood glucose.

              Maybe other factors besides insulin resistance are in play for lean T2 diabetics? A recent article suggests that beta cell dysfunction precedes insulin resistance, other than that due simply to obesity, and is a product of both genetic and environmental or acquired factors.

              There’s much to ponder and wonder on our road to health!

              1. I am in the same boat as you!! My BMI is 18. I am a 47yo athletic female recently diagnosed with type 2. I was shocked, as I thought I had done everything to prevent it since my dad was type 2. I found this site after my diagnosis and jumped right in with the low fat plant based diet. I lost 9lbs. I felt very weak on the low fat. I added more nuts and seeds and avocados – no oils, and I feel way better. My numbers are good and I have way more energy and my weight has stabilized. Currently, I feel best getting 30 to 40% of my calories from fat. Do you think that thin type 2’s may need a little different approach? I don’t want to make things worse!!

                1. Asa, I’m in exact same situation with diagnosis, BMI, age, activity level. It just doesn’t make sense. I was diagnosed in 2004 and since then I’ve been on a very low carb diet and kept my 90 day H1c perfectly under control at a 5. However, I made the recent decision to go vegetarian and ultimately vegan (I hear it’s not great to go cold turkey?). My concern is that I’m going to go from 20-40 carbs a day to 100-200 or so carbs a day and gain a lot of weight and ruin my numbers. I can’t tolerate most beans or quinoa, so I’m sort of stuck. Anyone have any resources or ideas? I’m absolutely going to stick to my vegan mission guns, but I need some guidance from those in the know on the diabetes aspect.

                  1. I recently discovered einkorn, an ancient grain with a very high protein content and 15% less starch than most grains. It’s delicious and although it contains gluten, many with gluten sensitivity tolerate it well. I use it as the base in a meal-sized salad. My favorite is the Burrito Bowl recipe from Forks Over Knives.

            2. Thanks so much for your support and encouragement, it does feel good to hear from someone who “gets” it! I just wish I knew what the secret was to get my loved ones to realize that I’m not trolling for their compliments, I want them to join me in an adventure that isn’t the battle they perceive it to be!

            3. Dr. Forrester said, “… The clinical key is to realize that it is the fat in the diet that contributes most to type two diabetes. The fat gets into the blood stream causing insulin resistance and intracellular fats downregulate genes causing reduction of the mitochondria’s ability to burn the glucose…”
              Dr. Neal Barnard also is very strict about non-intrinsic fats, saying we get all the fats we need from the vegan diet. But what is “overindulgence” in natural, plant-based fats like walnuts? Barnard advised limiting plant-based fats, but his comment was not closely defined.

              1. alphaa10: I’ve heard so many experts on this topic that I can’t be 100% sure, but I’m pretty sure that I have heard Dr. Barnard say that 1 ounce of nuts a day is fine for healthy people. That 1 ounce is pretty much in line with recommendations that I have seen from most of the good doctors.

            4. Dr. Forrester said, “… Dr. Kempner was reversing type two diabetes with white rice diet in the 1940’s…”
              Which is all the more remarkable, since vegans are advised, like everyone else, to avoid the high glycemic index foods (usually refined), which include white rice. If Dr. Kempner clinically treated diabetics with a rice diet (they were called “ricers”), surely that advice about the glycemic index is an oversimplification. But I would like to clarify the point about rice, and in general, the use of glycemic index number as a dietary guide.

          2. ” Yet the people all around me, some who have already lost limbs to diabetes, go on as always, oblivious to my example except to flag my WPFB vegan diet as so EXTREME, totally missing the HUGE irony in their emphatic criticism! As if it is NOT extreme to lose limbs to a disease you can treat by altering your beloved dietary habits? I am so puzzled and clueless! And heart-broken. I am married to one of them. :(”
            It’s such a conundrum, isn’t it? You can say, “I went out last night, ate a whole bucket of KFC and drank a six-pack of beer” and people will say, “Sounds like fun!” but say you don’t eat animal products and you get, “where’s your protein/iron/B12 etc. That’s not healthy!”

          3. There was a story about two fellows at the wake of a deceased friend. “Ah,” says one, “what took him away so soon?” “Oh, it was the drink…cirrhosis of the liver don’t you know,” said the other. “Well, why didn’t he go to Alcoholics Anonymous?” The other replied, “Oh no,he wasn’t THAT bad!”

            1. LOL! Oh that is great! I raised two sons long ago in the inner city, and you develop a twisted sense of humor to deal with life, so I especially appreciate this brand of humor! We can never laugh enough! Thanks for sharing!

          4. I too am a type 2 diabetic. I’m a 71, active female. I was on a statin for awhile, but had to discontinue it because of muscle/joint pain. My total cholesterol went from 220 on the statin, to 401 off the statin!!! I’m going to try the Dr. Esselystein vegan diet, but how do I keep my blood sugars from soaring while eating all the carbs required? I weigh under 130 lbs., exercise almost daily, do weight training & take one Metformin a day. Any advise would be appreciated. By the way, my doctor doesn’t seem overly concerned about my cholesterol & says I don’t need to have it checked again until a year from now! Help!

            1. Honestly, complex carbs shouldn’t spike your blood sugar, it is the processed carbs that causes problems. I never have figured out the % of my carb intake because all vegetables as well as starches have carbs, so it is up there! In the beginning I was cautious because of the carb phobia, so I ate smaller portions more frequently and saw my numbers drop to non diabetic level in less than a month. Esselstyn, McDougall, Engine One, Campbell, Forks Over Knives, are all quite similar and all excellent. Because I tend to gain weight, I try to eat a lot of calorically spare foods to fill up on, but those starches are so satisfying! I was also taking statins but don’t seem to need them following the right diet! I wish I had known this YEARS ago, but it’s never too late. Really try to stick with whole foods, and avoid free fats and oils, which are just the caloric and fat portion of what was once a whole food. T2 diabetes is all about fat intake. Of course we need some, but get it from food…nuts, seeds, veggies, etc! Good luck!

    2. To me this is very scary and indicates there is something, maybe huge that is unaccounted for here.

      The “marketing” info always says eat vegan and in a few weeks or months your blood pressure will reduce and diabetes will go away. Well, that is quite disheartening for those of us who tried hard to do this and saw no change in things.

      I know you cannot know everything that is going on or the fix for everyone, but that is not what the endless health videos say. Everyone wants to see a miracle, and it ain’t there.

      Plus, it’s hard to eat Vegan when you are busy and don’t really cook.

      I have gone now as far as cutting out all refined sugar. I eat many more veggies and fruits, nuts, beans, etc than I did before, but I have not cut out all meat through I don’t eat it every day. No soda, sweets, which were my big problem with weight.

      Lots of people see huge hope when they see these and other videos, but to me they are kind of depressing because it is not so easy as the upbeat videos say, and as far as Essylsten I really do not like these guys, they are a business, and having bought their cereal product once, I was insulted by it. A plastic bag filled with broken up chances that were so small you could not tell what they were … looked like floor sweepings, and no taste. This is a scam in my opinion.

      Those of us who want to do better are just looking for the truth and something specific and possible to do to eat better.

      1. BruK, there’s a difference between someone with high blood glucose who is thin versus overweight. In the latter case, there’s actually quite a bit of hope as the problem may simply be insulin resistance. Once you reduce or eliminate carbs and sugars, you lose weight, and insulin response may return to normal or close-to-normal. In my experience, thin diabetics don’t usually have insulin resistance and therefore can’t “reverse” the condition.

        Esselytyn, Barnard, Ornish, and a few others recommend that diabetics or pre-diabetics go on whole grain, plant-based diets to “reverse” the condition, but they fail to note that the grain part may actually contribute to further deterioration, especially for those of us who are already thin.

        Bottom line: in my humble opinion, if you are overweight with the condition, start by reducing your weight and see what happens to glucose response.

        1. Russel, thank you for sharing your experience. I have come to the similar results and conclusions. I still don’t know how to fix this problem. If i eat starches and whole grains which are supposed to keep me full and maintain my weight I get a huge sugar spike after meals. If i cut out grains and starches and live mostly on fruits and vehetables i get weak, skinny and feel a constant feeling of light hunger.
          If i add fats to my diet i’m starting feeling a lot better. For me carbs are a root of all evil not fats.

          1. Just curious, are you thin or do you have some excess weight? If you are the former, then welcome to the club :-) three of us who follow the site regularly are eating between 45% to 65% fat and at least 20% protein. Carbs are actually the lowest part of our dietary mix, and in my case, under 15%. All of us have substantially dropped our A1 C readings because of this. For us at least, carbs and sugars (and I’m including fruit) were clearly not the solution. Now all we have to worry about are our LDL values… Fortunately, our HDLs are all over 75 so maybe it’s okay…

            1. I’m thin and never been overweight in fact have struggled to maintain my weight most of my life. So I think I’m definitely in the club you mentioned :)

              In my humble opinion, the vegan diet is not a good option for preventing diabetes type 1 if a person is genetically predisposed to it. It really can help with the type 2 though primarily due to weight loss.

      2. Adding to my earlier post in response to Charzie I would suggest two resources to help understand how to lose fat… Doug Lisle’s free You tube video… How to Lose Weight without losing your Mind and Jeff Novick’s DVD Calorie Density: How to Eat More, Weigh Less and Live Longer. My patients have found these two resources to be valuable in successful long term fat reduction. Jeff ties together exercise and weight loss better than anyone else I have seen. Once you have the concepts down you can move on to improving your eating habits via improved label reading, cooking, shopping and eating out. Of course the science is always changing and is proving to be interesting but clinically the successful approaches are pretty clear. Good luck.

      3. There IS more to the equation, I also struggled with it. For so many years I felt sorry for myself as I thought I so carefully monitored my food intake and diet, and yet I was still fat and unhealthy. In my case I had to eliminate ALL animal products completely, and ALL added fat that wasn’t already a natural component of food, and ALL processed crap. I’m not saying it was easy, but the rewards are so worth it! I don’t want to sound flip, but it’s all about attitude too. When I realized my boundaries, living within them became much easier once I embraced the idea instead of getting hung up and feeling resentful about my “limits”. There are so many easy, quick, and healthy vegan meals I would have never found if I was still stuck focused or pining about what I had to avoid! It’s all in my perspective, a choice each of us is free to make, or not. It really is not hard to eat vegan, and it has certainly cut the food budget in a big way! Cheap beans replace meat, no dairy, no eggs, no pricey packaged concoctions! I grow some greens in pots on the deck and do a lot of sprouting…takes seconds, costs pennies! When I have the time, I love to forage for wild greens too…we have tons of nopales around here that are more prolific than anything I try to grow! LOL! I live on a tight budget, but where there’s a will there’s a way!

    3. There is a video about the vegan paleo diet on, you seem to be following it.

      Your case is annecdotal though and doesn’t disprove the HCLF vegan diet that has been so succesful for so many.

      1. I thought my case might be anecdotal too, but then two other thin vegans from the Nutrition Facts postings told me they had similar glucose issues. We’re all now communicating directly off-line and following a high fat plant-based diet.

        Also, I agree that for many, a HCLF diet may be an ideal solution towards reducing BMI and insulin resistance. But I think the issue has a bit less to do with a plant-based diet per se, and a bit more to do with body weight than its proponents claim. Clearly, lower body weights are associated with much better insulin responses and lower A1c readings. How much is it the plant-based diets, and how much is the lower BMIs? Everyone is different, so its hard to know…

        1. I’m in the same situation–thin, pre-diabetic, and eating whole food plant based with relatively low fat hasn’t helped by blood sugar spikes or A1c. I’d like to begin communicating with the rest of you in a similar situation. Thanks.

          1. I have also problems with high A1c levels after following a WFPB low fat diet. I’m not overweight.i have type 2 diabetes and don’t want to start taking metformin again.
            Did you form a group for discussions about this, which I can join?

            / Jonas

            1. We do not have discussions about a particular health condition, here, Jonas. but as a moderator on this site I wanted to encourage you to follow this site and check out all Dr.Greger’s videos, including the comments where you issue of having high A!C despite following a WFPB diet and not being overweight. You may find some answers there and others may also post to your question. There are certainly discussion groups on the internet, but of course they may not be reliable, science-based or aware of WFPB nutrition. Do you have a local vegan Meetup that might provide some general support, Finding a dr knowledgeable about WFPB who will work with you supporting your diet before reaching for the metformin would help of course and I hope that’s what you’ve found.
              Best of health to you as you work to get the AIC down.

            2. I’ve eaten a WFPB diet for the last year and my A1C came back in pre-diabetic range. Perhaps WFPB works for those who are eating a terrible diet to start with, but it doesn’t necessarily work for those of us who have a genetic predisposition for diabetes (it’s rampant on my dad’s side). All starches, not just processed carbs, cause a rise in insulin levels. High insulin over time is what causes insulin resistance and weight gain. I’m going to switch to a low carb, high fat diet to see if I respond better. Something about WFPB doesn’t agree with my situation, and the proof is in the blood work.

              1. My doctor, who told me about this website, also told me about the book Plant Paradox by Gundry, which discusses many of the things you are talking about. I found this book to be very helpful and to make a lot of sense, even though some of the moderators on this site don’t share the same opinion.

              2. Sonny, you’re just eating the wrong foods and may be eating too much. Body fat percentage can be a huge contributor as well in those of us that create a lot of visceral fat. If you calculate your BMI (not a great indicator, but its a starting point) and list a typical day’s food, then we can help. People that eat an animal based low carb high fat diet have 30% increased death rate so you may want to rethink that strategy.

                Dr. Ben

    4. Russell,
      1. What to you mean by primarily Vegan?
      2. What is the source of your fat intake (very high)?

      Would be hard to consume more than 10-18 % fat (>3-5% saturated) on a whole food plant based diet unless eating a lot of seeds, nuts or avocados.


      1. Trent,

        I mean that over the years, I’ve occasionally had small amounts of dairy products, and an occasional fish, but many long periods when I had zero fish or dairy. My fat intake is primarily nuts, seeds, avos, and oils (lots of canola oil found in seitan and tofu products). I sometimes enter it all in, a very nice site for this sort of thing, and that’s how I arrive at my dietary intake numbers.

        1. Maybe your promblem, Russell, is that you were eating processed foods. The video is fairly clear that when wholefood vegans were checked there was no diabetes (final study), diabetes was only found in the studies where processed/junk food vegans were included.

          There seems to me to be too many people blaming a vegan diet for their illnesses when in fact they were eating a processed food diet (albeit vegan according to the label stamped on it by the food corporation that made it – which is no guarantee of anything). What you should be looking at is the processed foods you were eating and blaming processed foods.

          Seriously, you say you are/were pouring canola oil into your body and then suggesting a vegan diet is the cause of your problems? Can’t you see the absurdity of that? You, like a lot of vegans, eat tofu like it’s somehow guaranteed to be healthy. Tofu, like seitan, is a heavily refined, unnatural product that is not in any shape or form available in Nature. It’s not how Nature intended soya to be consumed by animals, ergo, it’s not Natural and it’s not healthy.

          1. You could be right, Miss Creant, and perhaps my consumption of oatmeal or granola for breakfast, whole grain veggie sandwiches for lunch, and whole wheat pastas for dinner were the causes of my pre-diabetes. But life without oats, sandwiches or pasta…? I don’t know many people, vegans or otherwise, who can do that unless there is a health problem. Are you really considering that a processed food diet??

            You misunderstood the canola oil part. I didn’t have many oils until just recently, and only now because I’m trying to find ways to get 2000 calories a day without glucose spikes above 140.

            Your third point, I just addressed to someone else — gotta get 50-60 grams of protein somewhere. Beans (similar to grains) spike my glucose a LOT. A half-cup of steel cut oats or brown rice sends me over 160 on the glucose meter. If you have other suggestions, I’m wide open.

            Btw, Dr. Greger has a video on tofu that suggests it is fine under 3-5 servings a day. Sounds like you agree with his diabetes analysis, but not his tofu analysis.

            1. Yes, i do consider those processed foods.

              I don’t agree with any analyses that says tofu is ok. It’s highly processed and has chemicals in it. If others wish to eat it then that’s up to them, i won’t put it in my body. It’s not what Nature made so it’s not wholefood. I think it rather silly to call something healthy if you’ve removed all the fibre out of it. I like my fibre, fibre is good!

              I accept your point that you need the protein without anything causing the glucose spikes because of your current condition, but why not whole soya? Whole nuts? Avocado? At least then you’re not losing the fibre that you do with tofu which slows carbohydrate absorption thus minimising the glucose spikes.

              I don’t eat wheat as i’m allergic to it. I don’t miss it whatsoever, even though i’m a fully qualified baker who can bake excellent bread the proper way. One thing i learned long ago, there’s plenty of better, and healthier, things to eat than bread and pasta. Anyone can live without them, i, and many others, can’t live with them.

              1. It would take four servings a day of nuts to get to 20 grams of protein, far below the minimum 55-60 needed, so other sources are required. Tempeh would definitely help as you point out, but the calorie-to-carb ratio isn’t ideal — about 350 calories for 24 carbs — a lot fewer calories than I need for a meal. At 5’10 and 142 lbs., I’d prefer to get higher caloric intakes if possible while staying under 20-30 grams of carbs. :) Seitan has double the calories-per-gram of carbs, and tofu has four times. Strangely enough, tofu doesn’t have many carbs, a plus for my situation.

                Anyway, I share some of your concerns about tofu… the science isn’t completely settled on this. Though I disagree with you on seitan. I like to take the wheat, wash out the bran and just bake it. That seems pretty natural to me and my body seems to like it.

                I’m with you on avocados, and have at least one daily. No protein, but lots of fiber and carbs and healthy fats with minimum carbs.

                In case you’re interested, here’s a comparison of nutrients in tempeh, tofu, and seitan:

                1. You just make me think that you don’t want any fibre in your diet. You wash out the bran from wheat as well as eating tofu. One of the biggest causes of insulin problems is lack of fibre in diet and you’re saying you’re washing the fibre out of the wheat and buying soya products (tofu) which also has the fibre taken out. Each to their own!

                  1. You’re right that my homemade seitan has almost no fiber, but I also eat commercial brands which have lots. Field Roast is a regular favorite, and it has more fiber (4grams) than a cup of brown rice (3.6 grams), but without the grains. I also have Wildwood Tofu burgers — one serving has the same fiber as a slice of whole wheat bread. So while I appreciate your concerns, I’m probably getting sufficient fiber from those sources as well as my daily salads and other veggie dishes.

                    Btw, insulin problems are not “caused” by lack of fiber — I think you probably meant that there may be a link to insulin resistance. There’s some good studies on this showing a possible link. Fortunately, my tests show that I don’t have insulin resistance.

                    Btw, you might find this Chris Kesser piece interesting. Kesser is controversial, but he makes the interesting claim that if anything, we are all getting too much fiber in our diets and that this is linked a a lot of bad health outcomes. I’m not agreeing or disagreeing, but just sayin’…. the jury is probably still out on the fiber issue.


                    1. I browsed through that, thanks, and it seemed to be making the point that supplementing added processed junk undigestable stuff was the problem not wholefood natural fibre as in fruit and veg. Which i don’t find very surprising.

                      Do people really think that if mcdonalds add some kind of undigestable stuff (that they call fibre simply because it’s undigestable) to their toxic food, that it would make it healthy food? I suppose some people probably do.

                      Natural fibre in wholefood cannot be considered anything like the same as processed undigestable crap in processed junk foods. That is so obvious, so why would anyone even think it will work the same in the gut?

                      I will stick to my wholefood diet and take all the natural fibre it gives me.

                1. Yes, you can buy non-organic gmo free soya beans and also organic soya beans. Can range hugely in price depending on where you live and where you buy them. African/Asian grocers are usually the cheapest if you’re lucky enough to have any near you. Possibly even give eBay a try – surprising what gets sold on eBay these days.

                  1. Thank you. We have Asian grocers and I don’t know why I didn’t think of eBay which is usually the first place I go for anything.

            2. Dr. Gabriel Cousens does a raw food vegan diet and all 6 patients were of meds in 1 week. Raw for 30 is the name of the video. You can see it on you tube for free. Raw green foods with nuts and seeds, all you can eat. Sprouts and green juices and no fruit for a while. Raw food gives your pancreas a rest.

              1. Thanks Eric. Actually, I eat a lot of raw foods, avoid all sugars and fruits, and generally support this approach. But unfortunately, it is not a panacea. For example, when I have more than two cups of green salad with low-carb veggies, my glucose can get out of control, e.g. 140-200. So for me, the issue is more about limiting carbs to 20 grams a meal, and less about the actual food selection. That said, I think the raw food approach is excellent for those who are insulin resistant because they need to lose weight. For those who are lean already, this only works if you eat smaller-sized meals.

                1. Have you heard of Victoria Boutenko who healed her entire family through a raw diet. Her son had type 1 and reversed it on a raw high fruit and greens diet. Hope this will help.

                  1. I forgot about cinnamon, turmeric, american ginseng, pau’d arco, fenugreek,reishi mushroom, chaga, burdock root, and dandelion root is probably the best. Dandelion and burdock act like insulin in the body

        2. Hi Russell,
          Have you noticed any difference when weren’t eating processed tofu and seitan products? Some of the ingredients in those products are scary. I believe some ethical vegans don’t eat a particularly healthy diet and switching to the concept of a WFPB diet might be an interesting experiment for you to try.

          1. After I cut out whole grains and most bean products due to the huge spikes they caused to my glucose, I failed to add in tofu or seitan and within a few months, my energy dropped pretty badly and muscle strains wouldn’t heal after the gym or running. I discovered that I was only getting about 20-25 grams/day of protein, about half of what is needed. After adding back seitan and tofu, my energy and my body’s ability to heal returned. Lately, I’ve started making my own seitan, which is pretty easy, and there’s nothing unadulterated in there — just pure organic wheat gluten which thankfully, doesn’t seem to cause me any problems.

    5. Have you tried using beans and lentils as your primary protein source? These are supposed to help with blood sugar control, possibly in the way that they interact with you gut microbiome. I would try two servings a day and maybe throw in some barley, bulger, and sweet potatoes. And some people really need to exercise to keep their bodies working optimally as they age. For the most part it sounds like you are being very conscientious about your health, and there are definitely things about our bodies that we just won’t be able to control. Keep up the good work.

      1. Actually, I did try that as an experiment. Unfortunately, just a modest portion of beans sends my glucose soaring, so those are pretty much off the list. Same thing for grains, sweet potatoes, and other starchy vegetables. Basically, I can handle about 20-30 grams of carbs per meal and still keep my glucose in a healthy range. That’s three to four tablespoons of beans, not enough caloric content to maintain my weight. Anyway, I think the high fat approach is working pretty nicely. Thank you for your thoughts.

        1. That is really interesting. I think you have something unusual going on, it’s not your typical insulin resistance. Wish you could get in touch with one of the experts, sounds like it goes beyond being plant based and maybe they would be able to get it figured out. If nothing else it would be informative to see what happens with a strictly high fat, plant based diet. My best wishes to you.

          1. Not that unusual. There’s a bunch of us who are lean without insulin resistance but with glucose problems nonetheless. Its a beta cell burn-out thing… low insulin production either from previous diet, genes, or environmental sources, according to studies. Hard to determine which, for each individual. Thanks for your thoughts.

      2. I am also a lean vegan with glucose intolerance, like Russell, and I love beans, lentils, barley, and sweet potatoes, but need to limit them to 1/2 cup per meal. I’ve found through extensive self-testing of my post-meal glucose levels that I can eat 30-40 grams of carbs per meal before blood glucose goes too high. If I just eat that 1/2 cup of beans per meal, along with enough low GI veggies and fruits to reach my carb limit, then by the end of the day I’m short 500 calories. i can’t afford to lose any weight, but I can make up the extra calories with nuts, seeds, avocado, tofu, and seitan – all fairly low carb. My A1c is now down to 4.8, weight good, and lipids test fine. It works!

  3. I appreciate that most people with diabetes have type 2, but can we PLEASE make some distinction in these discussions between type 2 and type 1 diabetes?

    1. The simple explanation to my best understanding –
      Diabetes type 1 you are born with and is a problem that your pancreas cannot produce insulin.
      Diabetes type 2 is a result of the so-called metabolic syndrome where your body does not use the insulin your pancreas produces to break down sugar so you have high sugar in your blood.

      1. Type 2: that’s mostly correct, but for those of us who are already very thin and not insulin-resistant, it may be that a significant amount of beta cells have burnt out in the pancreas, and therefore there is insufficient insulin production to offset the glucose loads after meals.

        1. Are some of us going to have challenges with the insulin resistance issue no matter what we do, due to genetics ?
          I am between thin ~ normal weight and also have average BMI, so it is good to see that thin type 2 diabetics do exist. A doctor I once went to scoffed at the idea of someone with a normal weight having type 1 or 2 diabetes but I was doubtful.

          1. Lol, my endocrinologist was very reluctant to give me a 2-hr glucose challenge test, and he made me a bet that I was not pre diabetic. He lost the best, and apologized for his incorrect assumption.

            I’ve read somewhere that of all people with pre diabetes or diabetes, we thin-types only represent 4-5% of the totals. Anyway, I cannot address the genetics issue… its hard to tease out the genetics piece from the dietary piece.

              1. If you buy a glucose meter, and keep a log of your post-meal readings, you can probably convince your current endo that he or she needs to do a two-hour challenge test. That’s how I convinced mine.

                1. Thank you Russell, yes that will convince a Dr .
                  Needless to say I had to change my Dr.
                  It’s been nearly 10 years and the symptoms are still there.
                  The symptoms seem to show about 1 hour after eating if I am not careful about choosing low G.I ingredients, the symptoms which we know all too well show up. After an hour or so of eating, or if I’m late for lunch, and once it starts it takes a long time to recover even after replenishing with food.
                  Does this sound like what you experienced?
                  Perhaps I notice it more now because I improved things recently by cutting sugary food, dairy completely and also high G.I food as much as I can manage but I’m still going through a learning curb. It’s definitely time to test my glucose and see another Dr !

                  1. Sounds like you have hypoglycemia symptoms. I’ve never had those so really can’t help on this, but Bernstein’s books go into it in detail also. He’s a 70+ year old guy himself with Type 1, and was responsible for popularizing the glucose meter worldwide. As for your question below about starches, Bernstein convinced me to cut them out, so its pretty much salads with avocado, veggie stir fries, a handful of oats at breakfast mixed with almond or peanut butter (and flax!). Lots of veggie proteins especially seitan and tofu. Very limited diet actually, but the reward is seeing A1c dropping from high to low 5s. Its worth it. Dining with friends is a bit problematic, but everyone sort of understands when you stick to salads, or bring your own.

                    1. You should write a book or an ebook on kindle about how to survive and eat like this. I know I need it and many others probably do too. I end up eating lots of chinese food stir fry, or just raw whole foods, like tomatoes, lettuce, veggies, salads … but I buy most stuff in stores cause i don’t know how to cook really.

                    2. I’m not a big chef either, so lots of salads which are very easily thrown together at home in about four minutes flat. Just get a big bag of mixed greens, kale or spinach, lots of good organic veggies like mushrooms, tomatoes, cauliflower, broccoli, carrots, some nuts, avocados, tofu, summer squash, zucchinis, etc. and throw in the vinaigrette! You only need about four different items.. not all of these at once. And then test your glucose. Some people can handle two cups, some three or four. Everyone’s insulin challenge is different and you’ll find your balance.

                      I like to add a nice glass of red wine to the meal, which delays the glucose peak, but also adds lots of anti-oxidants.

                      Honestly, clean foods like this leave me feeling very refreshed and healthy. Just avoid the starchy veggies like potatoes, yams, winter squash and you”ll be okay.

                    3. I looked up the symptoms in the American diabetes association website, and I have all of the symptoms of hypoglycemia.
                      It’s surprising that people of thin to normal weight are more at risk of dying early if it is not managed properly , that is something I did not know. The glucose meter & carb counting books will help, since measurements do need to be taken into account.
                      I too hope that you’ll write an e-book ! Thanks.

            1. Russell, I do have another suggestion regarding your condition that you might check out. If you would see my post above regarding a combination of type 1 & 2. (I think it’s clear that you are mostly aware of this.)There is now being discussed something called type 1.5 diabetes. The doctors see what they think is insulin resistance and diagnose type 2 when in fact the patient is developing type 1 but isn’t there yet. It sounds to me like you pegged it correctly, that you normally are ok but do not have adequate insulin production for any post prandial glycemic load. Indeed that would seem to suggest beta cells under attack either now or in the past. How old are you and how long have you had this condition?
              If it has been a while and you have changed your diet significantly to something much less inflammatory, you might will avoid ever developing type 1. Still, alas we don’t yet know how to regrow those cells.

              1. Thanks Stewart. I’m 59 and was diagnosed a year ago after decades on a plant-based diet. Yes, I’ve read about Type 1.5 and your comment just prompted me to fire an email off to my endo asking for the type 1.5 tests, including islet cells, GAD, and insulin anti-bodies (there’s a good Wiki article on Type 1.5 mentioning all of these). Also a C-Peptide test to check out insulin production. Not that it necessarily matters because I’m probably doing all one can reasonably do to hold glucose down in the low 5s A1c range… plus I’ve got all the inflammatory markers down nicely… so we shall see. Btw, I assume you are familiar with Dr. Richard Bernstein’s work? I’ve basically adapted his super low-carb approach to a plant-based regimen. He’s been quite brilliant with his work. Obviously, you’ve done great work with your own diet as well to stay healthy!

                1. Russell what kind of starches do you consume?
                  I’m new to this and wondered how you manage to keep the inflammatory markers down. I’m also going to look up Dr R. Bernstein’s work, Thanks.

              2. Hi Stewart,

                I ‘ve seen similar researches from Japan, showing that some of us have a lower capacity to deal with insulin issues, some people have 50% less capacity than others apparently. This can also lead to gum disease as well as pre and type 2 diabetes according to them.

        2. Russell,
          Only reason you get type 2 diabetes is because you have insulin resistance.Being thin means insulin resistance is not as bad.Being thin also means loosing weight to cure Diabetes is not possible.

        3. I still do not think that is type-2, it is just type 1 caused later in life by a different problem. When the issue is your body does not produce insulin, it is type 1 … I think.

        1. Good point … type 1 is caused by a misfire, mostly i think autoimmune problem that destroys the insuling producing part of the pancreas. and it can happen at any age I suppose. i just listened to an audiobook on this so thought to answer. Have to be careful what i say! ;-)

      2. Gotta make a correction here Bruk. Type 1 is rarely something one is born with. It might well come at a very young age or rather later in life. I developed it at age 21. My business partner developed it at age 46. My brother’s step daughter developed it a age 3. You are certainly right that it is a problem of my beta cells not producing insulin. None the less it is predominantly a disease caused by diet. The development of type 1 depends on your body’s immune system. Generally it missfires and attacks your own parts. This can take many forms including lupus, arthritis, et al and type one diabetes. The dietary factors are numerous.

        I first noticed this when having had diabetes for over 30 years, I developed psoriatic arthritis. They wanted to put me on something to suppress the immune system and I refused. Instead I found that I had a gluten sensitivity. When I eliminated gluten the arthritis disappeared. The arthritis did return on any exposure and I continued to have some associated swelling.

        When I began reading about all the pro inflammatory factors in animal products, I made the decision to go with a whole foods plant based diet. Within 6 weeks all swelling disappeared as did the gluten sensitivity. Later I found that this is very common.

        Dr McDougall insists that it all stems from dairy. Indeed there is substantial evidence from numerous studies that dairy is frequently a factor. Still, the excess arachidonic acid, heterocyclic amines, TMAo and other pro inflammatory factors is animal products are, I believe, candidates as individual and collective culprits along with the leaky gut and molecular mimicry from dairy that McDougall emphasizes.

        OK so that was very complicated but what does it have to do with type 2 diabetes? Well you can have both. Type 2 and metabolic syndrome are characterized by insulin resistance. This has been shown repeatedly since 1922 to be substantially exacerbated a combination of animal protein and fats somehow working in tandem. High PUFA tend to have little impact on insulin resistance whereas the saturated fats do. Furthermore though, plant sources such as avocados seem to have little if any affect on insulin resistance. So is it just the animal protein?

        I find this particularly interesting since I monitor my insulin usage very carefully with my pump. When I did go whole food plant based, my average insulin usage dropped from 46 units per day to 35 units per day. I have since found that this too is not unusual. And I do eat plenty of carbohydrates. Mostly of my carbohydrates are complex. The simple sugars are from fruits, occasionally juice and occasionally emergency tubes of glucose.

        1. Yes … I should not have said born with … not a doctor OK.
          Basically there is some auto-immune problem that kills your insulting producing cells so you do not have insulin.
          Is that more in line with what you are saying?
          You can have this happen for various reasons I suppose at any stage in life, but usually they are younger.

          1. Didn’t mean to try to be hyper correct BruK. Indeed, in the past it would have seemed very reasonable to say that one was born with type 1 and it wasn’t discovered until a year or two latter. Regardless of the accuracy that was the perception. The reason this is important though is that we have a public health crisis going on today that is basically malnutrition with excess calories. As an economist I will say that this is likely the greatest single economic hazard facing the world. The onset of a growing number type 1 diabetes at any age and the massive numbers of type two diabetics we are now seeing are two different markers of the same underlying disease. And these are only two in a very very long list. Having had inflammatory arthritis in the past and having type 1 for the rest of my life I tend to want a comprehensive approach to all these things.

  4. I was a strict whole-foods vegan for 5 years and this diet absolutely wreaked havoc on my health. I had been a whole-foods omnivore my whole life and never struggled with any health issues. I have never been on any medications and will be 50 years old this year. As a vegan my diet included lots of fruits and vegetables, seitan, tofu, legumes, whole grain breads and pastas and some healthy fats, such as olive oil. I consistently was gaining weight – a problem I had NEVER struggled with before – and was suffering from fatigue, headaches, hypoglycemia, depression, and low libido. I had wonderfully low levels of blood glucose and cholesterol but I felt like crap. I thought, like many others, I was having thyroid problems and so went to a naturopath for some blood work. What we discovered was that I was deficient in many micronutrients: iodine, B12, Vitamin D2, selenium to name a few and despite supplementation. We also found that my morning cortisol level was in the tank and my Reverse T3 thyroid hormone was off the charts. I was in late stage adrenal dysfunction and seeing concurrent effects in thyroid hormone, sex hormones and blood glucose management. And herein lies my greatest complaint and disappointment with studies and posts like this: they are far too narrow. Not one word has been said about the drastic effects of the chronic high stress lifestyles we lead on metabolic processes. My personal and clinical experience as a functional nutritionist show time and time again that a diet composed of higher healthy fats from both plant and animal sources, high complex carbohydrates such as vegetables and some fruits, no to small amounts of grains and moderate proteins from both plants and animals restores adrenal rhythm, improves glucose and fat metabolism by dousing inflammation at the cell membrane, restoring receptor sensitivity and maintains muscle mass. Is this appropriate for everyone? Absolutely not, but for anyone who is suffering from the effects of chronic high stress on metabolic process, a plant-based diet, especially one that contains grains and high glycemic fruits, can be disastrous.

      1. Yes, because adrenal dysfunction was at the root of these other issues. Chronic stress is amazingly inflammatory and depletes essential nutrients. I was self-administering the supplements because I understood that as a vegan I needed to. But the amounts I was taking were not sufficient to replete very low levels and chronic stress. B12 is a primary donor of something call a methyl group which is needed for methylation, a reaction used in many processes in the body, including cell energy production and Stage II liver detoxification. Methyls are easily depleted by chronic stress (and by stress I mean physical, emotional or chemical stress). Now, whenever anyone comes to me with diabetes, high cholesterol or other metabolic dysfunctions, I always check the adrenals. This is of course also true with thyroid problems, sex hormone imbalances and neurotransmitter imbalances. It all works together.

        1. Thanks for this. This is a curious thing to me because from what you are saying, it seems, one could take in supplemental amounts of B12 and selenium that far exceeds that found in food and still not be able to get their levels up, but if these nutrients came from food, the levels would go up. This what you are saying?…..and any idea why you found people that were not able to fully benefit from an excessive amount of B12 in a vitamin pill (far higher than that found in food)?

          1. No, sorry to confuse you. Nutritional supplementation is not an exact science, that is to say, there is not a direct correlation of what we take in to what we find in the body. For example, even if you take 100mg of B12 a day, there are any number of factors that could influence how – or even whether – it gets used in the body. A leaky gut or bowel dysfunction, a micro biome problem or a genetic mutation for MTHFR, an enzyme used in the methylation cycle, for just a few examples could impact how much or even whether the B12 is available in the body. Adrenal or thyroid dysfunction can do the same thing. So, you could be eating foods that have these nutrients and even taking supplementation but still not have sufficient quantities to carry out metabolic processes. Does that make sense?

            1. Yes, that makes sense. My gratitude to you for taking the time here. I’ve had no choice (at this point) but to eat some shellfish for B12. Frustrating, but my reality. B12 pills and vegan B12 sources have not seemed to work for me.

              1. Yes, I understand. Given my susceptibility to stress, I can no longer eat a strict vegan diet, but have had to all but eliminate grains and simple carbs from my diet. I do eat some, but I try to keep it below 100mg a day, and less if I’m under a lot of stress. I’ve replaced those calories with healthy fats and with my plant-heavy (few legumes) and some fish, chicken and beef a couple times a week. It’s a tremendous conflict for me emotionally and spiritually, but I could find no way around it…and as a nutritionist, if there was one to find, I would have found it. You may want to try a sublingual form of B12 if you haven’t already. It will bypass the gut which is often a primary driver of symptoms in other systems. If you haven’t worked on gut integrity, could be a good place to look.

            2. I assume you mean 100 mcg of B12/day? 100 mg sounds like a huge dose. (Note to readers: Dr Greger recommends 250 mcg/day or 2500 mcg/week.)

              I sympathize with you. My wife went WFPB a couple of years ago, lost a ton of weight (not literally!) but developed hyperthyroidism in the fall. It could be totally unrelated to the diet (as vegans have half the rate of hyperthyroidism as I recall). In any case, her medication now seems to be helping greatly.

              1. Yes, I did…trying to type to fast. :-) Agree with Dr. Gregor’s recommendations, I was using that number only in the greater point I wanted to make about the unpredictability of nutritional supplementation. Your wife’s hyperthyroidism could be related to diet, but then again not. If you haven’t looked at adrenals, sex hormones and neurotransmitters as drivers of her thyroid dysfunction, highly recommend, especially as hyperthyroid can and often does progress into hypothyroid. Also, determine if the thyroid dysfunction is auto immune in nature by testing for antibodies. Good luck!

        2. I’ve been battle-ling with terrible imbalances past year.

          In that disqus thread @the bottom I talked a bit on how near vegan almost fried my brain.

          This psychiatrist paleo lady pointed me towards magnesium and new to me choline with really remarkable results stress wise.
          Resolving the choline deficiency especially was just amazing for me effect wise.

          While I’m still committed to cleaning up my circulation with WFPBD going a 100% is problematic for me like it was for you.
          I hope you can fill in a few blanks with the link and my story. Good luck to you!.

    1. How can one be deficient in selenium? I was warned to watch my intake due to selenium overdose. lol I have been whole food vegan for 6 years and have never felt better with more energy than ever before. The clinical studies have been done on b12 and availability does depend on the type and method of intake, but omnivores are still deficient in b12 despite their animal product consumption. I am always skeptical about the vegan diet wreaked havoc on my health story especially when it does not correlate with science.How can one be iodine deficient. Again I was warned not to overdose on iodine from too much seaweed. Oysters will concentrate their environment 70,000 times, how is this healthy all for some b12? Anyone can say I tried it and it didn’t work for me without any reasoning. People do it all the time with exercise saying the gym doesn’t work or lifting weights doesn’t work for me at building muscle as if their some anomaly of nature.

    2. > And herein lies my greatest complaint and disappointment with studies and posts like this: they are far too narrow.

      I think this too. These studies all sound great until you start to hear too many of them and they conflict or seem to indicate you must eat way too many individual expensive foods – more like a medical prescription to be sure to get the right nutrition. Humans never had to do that before and I don’t buy it now.

      Best I can see for me is that I should cut way way down on carbs and sugar stuff. I seem to be OK with fruit but I don’t eat to much of it, but carbs really bloat me and I can feel terrible for days and my stomach can hurt and my whole chest feels full and unpleasant. This is true of grains and rice.

      I can go to Chipotle and get a bowl with veggies or some meat and I feel good, but if I eat a burrito, ugh. Same with sandwiches.

      Plus I always feel better when I exercise,especially long walks at a moderate pace.

    3. Leslie,

      At what point during the 5 years did you suspect your diet
      was wreaking havoc on your health? Was it in the first year? And why would
      you then continue for 4 more years? Or if it was the 4th year, why
      did you continue for another entire year, and were the symptoms just too mild for that time to address? What is a functional nutritionist? Most nutritionists I have encountered do not advocate plant-based
      diets – what made you decide to try it?

      Thanks for your help. I’m two years eating nothing but
      plants, hardly any oil and limited processed foods. I’ve never felt better in
      my life and look and feel 10 years younger than when I started eating this way.
      But alas, I’m reaching 50 like you pretty soon, and perhaps I’m actually doing
      more harm than good, and don’t even know it.

      Note: I do not know what a chronic high stress lifestyle is,
      but I don’t think I have it; just medium stress. Could this be my saving grace?


    4. Of course high stress is an important consideration but in my clinical experience folks in high stress conditions are often time stressed as well. They eat very different in periods of stress… skip meals, more processed foods, more meals on the go or eating out. So the devil is in the details. Folks who are having symptoms need to seek evaluation by knowledgeable health care professionals. The interpretation of tests and the recommendation of supplements needs to be done correctly and based on the best science. I always start by reviewing the diet in detail and doing some preliminary blood testing before resorting to tests that are more difficult to interpret. I guess the devil is in the details. I have found Dr. McDougall’s newsletter article… The Sick Vegan… see his October 2002 newsletter on his website… to be of help to some of my patients. Of course Vitamin B12 needs to be adequately maintained… as outlined in Dr. Greger’s series of video’s from February 2012. I maintain that short of avoiding starvation the science doesn’t support consumption of animal products. Of course we can seemingly do well on low doses of just about any natural product but that doesn’t mean it is advantageous over the long haul.

      1. Yes, I see that too with regards to eating habits – it was my own personal experience and one I see frequently in my practice. In my case, my appetite diminished and I would skip meals, become hypoglycemic and then crave those vegan carbs such as bread and pasta, stimulate an insulin surge which would then become hypoglycemic again. And of course, this placed even more stress on my adrenals. A vicious cycle to be sure and one that only aggravated my already imbalanced sex hormones and neurotransmitters, especially serotonin. And I absolutely agree about assessing before addressing. I use Parmesan Labs and especially like their Comprehensive NeuroEndocrine panel to assess not only adrenal function but also neurotransmitter levels and sex hormones. I can add melatonin if sleep is an issue. Is there a specific panel you like? I’ll check out the newsletter for sure. I can’t say at this point that I agree about the complete avoidance of animal products from a nutritional perspective but tend towards your last statement. The research does support a plant-based diet as very beneficial for many chronic or degenerative conditions and I do use it in certain circumstances, such as cancer. But there is equally compelling research that supports the therapeutic benefits of a higher healthy fats, low carbohydrates, and moderate protein diet from both animal and plant-based sources. The source of our food is, of course, paramount to its ability to nourish and heal or poison and destroy and that is true regardless of what diet one chooses. The devil IS in the details! :) One of the things that I admire and am so appreciative of about this site is that healthcare professional, specifically MD’s, come here and are embracing nutrition as a major healing therapy for chronic and degenerative conditions. It is not the norm where I practice, which is frustrating, especially for patients who have taken your advice and sought out evaluation from their doctor, only to be told they are “fine” or sent home with a medication to alleviate a symptom, rather than a plan to really identify the root cause of their problem and heal. For many of my patients, I am their last resort.

    5. Bread and pasta is not a wholefood, neither is tofu, neither is olive oil. So you weren’t a strictly wholefood vegan. A wholefood vegan diet wouldn’t cause the problems you are claiming. And as you weren’t actually on a wholefood vegan diet then you can’t claim it did.

  5. Nice video. I will share it. I WISH, however, that you had specified in the first sentence or two that you were speaking of TYPE 2 diabetes.

    Not specifying leads to misconception about Type1 diabetes and very much hurts those people and their families.


    Lori Hopkins

    1. You are right Lori. But over time one generally learns to discern that if type 1 is not mentioned they mean type 2.

      Even so much of what he said here has been shown to be true with both types in terms of the dietary patterns and disease development. The auto immune phenomenon which causes type 1 has been repeatedly shown to be aggravated or even completely induced by animal products. This has been shown both in epidemiological studies and in cohort studies.

      My beta cells are gone and not coming back. But my insulin usage is down about 25% as a result of going WFPB. Also the side effects such as accelerated atherosclerosis, neuropathy, retinal neovascularization et al are much less likely with a whole foods plant based diet.

      So in defense, as a type 1 diabetic, I believe there is a great deal in this video and others on this site to give me a great sense of empowerment. I can control things better, I just can’t reverse this the way I did my arthritis.

      1. Given the comments that the families of T1 children endure, apparently many people know nothing. I believe specifying is better. Thanks.

  6. Hello, for all peoples with blood glucose problems, fat was the initial problem not carbs even for your current diet.

    Fruits is much better than grains(even whole) for everyone and even peoples with blood glucose problems, even better with a very low fat diet.

    “Whole” bread(the worst starchy food) and pasta doesnt exist because they are always made with
    flour which is never a whole food, does nutritionfacts scientists and
    researchers understand and agree with it?

    1. I wouldn’t trust this Nick Delgado ( ) character in general. He claims somewhat impressive background and apparently worked for the Pritikin center at one time, but is also open about kitting himself out in other forms of pseudoscientific care such as Neuro-Linguistic Programming and Time Line Therapy ( ). What he’s doing in that video looks like Live Blood Analysis, a form of quackery which has been around at least since the days of Chronic Lyme. What people showing you the pretty pictures on the screen won’t tell you is that there is a confounding factor which can also cause blood to clump up: just focus on the edge of the slide where the smear is starting to dry out.

      Now, maybe this isn’t what he’s doing, but because he’s also not doing much to acknowledge the fact that triglycerides and blood sugars rise after any large meal, he’s not being sufficiently forthcoming with the best forms of evidence in that video. And, true to form, he has a website hawking patent supplements:

      So while he may perhaps be a charismatic fellow, there are plenty of them in the WFPB world. It’s better to stick with one who’s also good at sticking to the facts.

  7. It makes sense that even a small amount of meat contributes to diabetes and illness. In one of Dr. Greger’s previous videos about meat eating he quotes a study which proved that each time you eat even a little amount of meat it shocks your arterial system for 6 hours! (Don’t recall which video, was within the last 6 – 9 months or so, but I’ve never forgotten this.)

  8. In this video, Dr. Greger says that “Vegetarians live so much longer.” One study found that they live ten years longer. If vegetarians live “so much longer,” how do Americans justify eating meat? In this video, Dr. Greger shows that vegans have a 78 percent lower risk of diabetes, 75 percent lower risk of hypertension, 5 BMI lower index, that’s maybe 20-40 pounds. It seems clear meat causes diabetes, perhaps via long term exposure to IGF-1. People who didn’t eat a single serving of meat a week had half for men or a quarter for women the risk of diabetes compared to someone who ate one piece of meat a week. There doesn’t seem to be any safe amount of meat. There were no cases at all of diabetes in vegans in one study.For diabetes this site would recommend hibiscus tea, cinnamon, flax seed meal. amla, 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.

    1. The study you mention, where the vegans had absolutely no diabetes, was the only study with only wholefood vegans. The other studies included junk food/processed food vegans thus elevating the risks. I would love to see a study done with vegans alone that seperated them into their various diet types. I think it would be incredibly interesting.

      Let’s be clear, some vegans think that coco cola is vegan. Some vegans eat food with HFCS in it. Hardly surprising to me that some vegans are still prone to get diabetes and become obese.

    2. Cinnamon makes my heart race, so I have been avoiding it. Is there any scientific reason for this? People tell me it’s my imagination, bu it is real.

      1. Are you taking cinnamon to beat diabetes? I find my heart races when I am eating a nutrient I need. I do not know why cinnamon could make your heart race. This site has some recommendations for diabetes. Indian Gooseberries (amla) , coffee, soy, flaxseeds, green tea, pulses (dried beans), Chamomile tea, purple potatoes, sprouts, whole grains, vinegar, and beans. The book Nutritional Medicine by Alan Gaby recomends Chromium, biotin, Vitamin E, Niacinamide, Vitamin D. There are similarities between diabetes and beriberi disease, for which thiamine (B1) is a treatment.

      2. I just recently learned all about the world of cinnamon and it blew my mind as i’ve consumed it regularly for years for its amazing health benefits. You should look it up sometime. Apparently there are 2 types, Ceylon or Cassia. And Cassia can be harmful as it is often synthetic and can do weird things to your blood. (what the heck!) So of course, I wasted no time checking my cinnamon and emptying my spice rack (of courseeee I had the bad one) and purchased Ceylon cinnamon asap. Hope this shed a little light on cinnamon for you:)

  9. ok but there risks too.

    from pubmed…


    Mini-Mental State Examination (MMSE) scores were positively correlated with serum IGF-1 concentrations as well as mean blood pressure or body mass index and were negatively correlated with age, serum low-density lipoprotein cholesterol and lipoprotein(a) concentrations, and carotid IMT. Serum IGF-1 concentrations had a significant inverse correlation with carotid IMT. Analysis across the IGF-1 quartiles revealed a threshold effect of low IGF-1 on MMSE score in subjects with the IGF-1 levels of 140 ng/mL or less (50% percentile) versus those with IGF-1 levels greater than 140 ng/mL. Multiple logistic regression concerning AD and VaD retained serum IGF-1 concentrations of 140 ng/mL or less and carotid IMT of 0.9 mm or more. Patients with AD and VaD had significantly lower IGF-1 concentrations and greater mean IMT than nondemented controls.


    These results suggest that decreased serum IGF-1 level and the progression of carotid atherosclerosis could play a role as independent risk factors for dementia.

  10. risks of dementia from pubmed


    To relate serum insulin-like growth factor-1 (IGF-1) to risk of Alzheimer disease (AD) dementia and to brain volumes in a dementia-free community sample spanning middle and older ages.


    Dementia-free Framingham participants from generation 1 (n = 789, age 79 ± 4 years, 64% women) and generation 2 (n = 2,793, age 61 ± 9 years, 55% women; total = 3,582, age 65 ± 11 years, 57% women) had serum IGF-1 measured in 1990-1994 and 1998-2001, respectively, and were followed prospectively for incident dementia and AD dementia. Brain MRI was obtained in stroke- and dementia-free survivors of both generations 1 (n = 186) and 2 (n = 1,867) during 1999-2005. Baseline IGF-1 was related to risk of incident dementia using Cox models and to total brain and hippocampal volumes using linear regression in multivariable models adjusted for age, sex, APOE ε4, plasma homocysteine, waist-hip ratio, and physical activity.


    Mean IGF-1 levels were 144 ± 60 μg/L in generation 1 and 114 ± 37 μg/L in generation 2. We observed 279 cases of incident dementia (230 AD dementia) over a mean follow-up of 7.4 ± 3.1 years. Persons with IGF-1 in the lowest quartile had a 51% greater risk of AD dementia (hazard ratio = 1.51, 95% confidence interval: 1.14-2.00; p = 0.004). Among persons without dementia, higher IGF-1 levels were associated with greater total brain volumes (β/SD increment in IGF-1 was 0.55 ± 0.24, p = 0.025; and 0.26 ± 0.06, p < 0.001, for generations 1 and 2, respectively).


    Lower serum levels of IGF-1 are associated with an increased risk of developing AD dementia and higher levels with greater brain volumes even among middle-aged community-dwelling participants free of stroke and dementia. Higher levels of IGF-1 may protect against subclinical and clinical neurodegeneration.

  11. Cocoa has positive effects on health.
    Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study
    In this study, the authors show that after 15 years, cocoa intake was inversely correlated with blood pressure and all cause mortality. (More intake meant lower blood pressure and less all cause death).
    Chocolate consumption is inversely associated with calcified atherosclerotic plaque in the coronary arteries: The NHLBI Family Heart Study
    People who ate chocolate has less hypertension and clinically diagnosed CHD (Chronic Heart Disease). The more chocolate the research subjects ate the less calcium or hardening their there was in their arteries.
    In the discussion of this paper the authors summarize a report that diabetics who were fed cocoa had a 30 percent increase in blood flow to their brachial artery.
    Balzer J, Rassaf T, Heiss C, Kleinbongard P, Lauer T, Merx M, et al. Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. J Am Coll Cardiol 2008;51:2141e9.
    They also summarize a report that dark chocolate reduces risk of heart disease by 40 percent in medium levels of consumption.
    Buijsse B, Weikert C, Drogan D, Bergmann M, Boeing H. Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults. Eur Heart J; 2010 [Epub ahead of print].
    Another study shows that chocolate is inversely correlated with prevalent heart disease and eating it 5 times a week can reduce your risk of heart disease by 57 percent.
    Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.

    Chocolate is a very heart healthy food, even for diabetics.

      1. Chocolate may not have that effect on memory, but it does have pronounced effect on heart health and heart disease. Fifty percent or more reduction in heart attack risk and heart disease at moderate levels of consumption. Fifty percent or more reduction in mortality (all risk) in a fifteen year study. Beans and exercise are thought to be just as effective but did not have those results. Chocolate is a life saver and favored as a medicine for the smiles at least. If there was chocolate without saturated fat, it would be one of the healthiest foods in the world.

        1. Mathew: re: ” If there was chocolate without saturated fat…”
          You may know this already, but cocoa powder is essentially chocolate with the fat removed. And no sugar added, so it is not editable as-is. But there are recipes around with cocoa powder and no fat. For example, for a while, I was making a chocolate oatmeal dish for breakfast that was made up of stealcut oats, bananas, cocoa powder and dates. As you can see, no fat. Some people also like to make a “chocolate soft serve” out of ground up frozen bananas with cocoa powder added. So, you can work in the benefits of the cocoa beans without the saturated fat and sugar drawbacks if you want.

          Just some ideas/thoughts for you.

          1. Thank you so much for your comment. Heart disease is sudden, 50 percent of people who die from heart disease die suddenly. Dark chocolate may be (my opinion) one of the most effective means of eliminating that risk based on the 50 percent reduction presented here. Walnuts, beans, green tea, and berries might also be effective, but people might remember to keep up the dark chocolate.

            1. In addition to Thea’s delicious suggestions, I would also add: cocoa powder mixed into mashed/whipped sweet potatoes for pudding, mixed into chia/non dairy milk pudding (though added sugar is required for this one), and one of my favorites, adding cocoa powder to any heavily seasoned “tex-mex” style food, e.g. chili. I always add 1 Tbsp cocoa powder to chili. You can’t really taste any chocolate flavor, but it does contribute to a very subtle enhancement in the undertone of the dish.

              You can also get ground cocoa beans in the same manner as ground coffee beans, and brew them the same. Though a longer brew such as using a french press is necessary for full flavor. It’s completely bitter, just like black coffee, without sugar or whitener. I tried it and loved the flavor, but it made my head a little fuzzy the same way too much coffee or very dark chocolate does. I got the Crio Brü brand which I can vouch for being delicious, though I’m not sure if it would be any different from the regular cocoa nibs in the bulk section of my co-op.

              1. b00mer: Great ideas! I was thinking about mole (a Mexican sauce with cocoa) later that night after I wrote my post. You covered the general idea with your post. And so much more.

                I have to say that I think it takes a brave person to drink brewed cocoa beans straight. I’m impressed.

              2. Thank you very much for your comment. Did you know that Dr. Greger said that people who are at low risk for heart disease are very likely to die from it? I think this means everyone should eat cocoa or dark chocolate with its benefits presented here to prevent the disease and put them in a prevented risk category.

          2. For cocoa benefits without the fruit sugars, dissolve a half-tablespoon of dark baking chocolate into a coffee cup with hot coffee.

            For those who like coffee during even the summer heat, either heat-prepare or cold-steep the coffee, and then serve cold. In the summer, iced coffee is really good.

      1. Chocolate has an ORAC value in the top ten and its specific complement of antioxidants and flavinoids can benefit any diet they are very stress responsive properties. Chocolate, specifically pure chocolate or dark chocolate is one of the most nutritious foods in nature based on the ORAC chart. If you go to the research and read the claims for yourself you can see it is a very youth inducing food. Yes, I think this is authority nutrition.

  12. So why is it that when I eat an omlette for breakfast, I feel more sated and in a less cranky mood than when I eat oatmeal with some fruit topped with nuts?

    1. Because all that protein and fat sends different signals to your brain than carbs. Also, if you eat eggs regularly your microbiome will be suited to that food, so if you occasionally eat wholefood vegan breakfast with an egg fed microbiome you’ll upset your microbiome and therefore feel cranky.

      If you only ate wholefood vegan meals then your brain would adjust to the new signals (it takes a few weeks to do this) and your microbiome would also change (again, a few weeks) and you wouldn’t feel cranky at all after a few weeks, totally the opposite, you’d feel totally energised.

  13. Much as I respect Dr Greger’s work, I think his comments about the Taiwanese Buddhist study are a little misleading. The vegetarian and omnivore groups differed in several dietary respects other than just meat consumption, with the vegetarians eating more vegetables, whole grains, nuts, soy products, fibre, calcium, magnesium and so on. These differential factors were not controlled for in the analyses. So it is highly likely that the difference in diabetes rates is attributable to those differences in diet, rather than, or in addition to, the difference between the groups in meat consumption. It is clear from the Discussion of the paper that the authors think so too. This study takes us no closer to determining the answer to the question of whether a 100% vegan diet has advantages over a 95% vegan diet matched in all respects other than a serving or two per week of animal products.

  14. Dr. Greger, is there any mention of type 1 vs type 2 in this study? My friend who is type 1 responded that “This may apply to Type 2 diabetes, but not Type 1.” when I linked the video. Is this true or false and why?

  15. I am a thin diabetic. I was thin before my diagnosis. Most advice is associated with losing weight and early less. What recommendations do you have for someone who is already thin.

  16. Please bear with me, this was the most appropriate board I found to ask my question.
    My partner and I have been following a WFPBD for about seven months. He is type 2 diabetic and has reduced his A1C to 6.1 so far so good right?
    However, now we are being told by the dietician who runs our local diabetic clinic that there is no advantage to try to reduce itany further, that this is the optimum level. How then does he get off insulin?? Any thoughts out there?

    1. Gumbootgoddess: I’m not an expert, but this doesn’t sound right to me. I have read that below 5.7 is “normal” and that 5.7 to 6.4 is considered “pre-diabetes”. So, how could someone say that 6.1 is the optimum level?

      My advice to a family member in a similar situation would be to get a different dietician. Someone who understands how to use diet to get off diabetes meds/insulin. It may not be possible to get of completely, but it sounds like both you and your partner are committed to eating a healthy diet and that it has already gotten your partner part way to his goal. I would keep going.

      And I would also make sure to work work with a professional who can help monitor things to know when different meds can be reduced. Sometimes the WFPB diet works very well, very fast. Another recommendation is to read the book: “Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs” This book will give you details, as well as menu plans and recipes that might help you tweak your diet a bit further to get even better results.

      I also highly recommend watching all the videos on this website concerning diabetes. You would be able to pick up advice about specific foods that could further help in tweaking the diet in order to meet your partner’s goals. Here is the topic page for diabetes:

      Hope this helps. Let us know what happens.

      1. Thank you Thea for taking time out of your busy day to address my concerns.
        Living in a small Canadian town does have some drawbacks when it comes to choosing professional help. Not only do we see people in their work but socially too. I will for sure order Dr Barnard’s book and I have already watched the videos about T2D on this website many times over.
        I tried Amla powder for the first time today, I couldn’t get over how bitter it was, now I have to find a way to disguise it for someone who doesn’t drink smoothies HMMMM.
        I am so grateful to the people such as yourself for your comments on this site. The depth of knowledge for people like me who are trying to stay strong and healthy is invaluable. Keep up the good work, I look forward to reading more.

        1. Gumbootgoddess: I’m rooting for you both.

          I too did not like the taste of amla. (And that’s putting it mildly!) But I know some people who don’t mind the taste, so it was worth trying.

          In addition to trying to sneak it into smoothies, another idea is to make your own pills. There is an inexpensive pill making “machine” you can get and then put whatever you want in the capsules. I got one as a present for a family member and he really likes it. He fills up capsules with turmeric and pepper to meet his needs. It is called “The Capsule Machine” and I spend $27 (American) for both the machine and the first 1000 capsules.

          Depending on how well your partner swallows pills, this could be a good solution. The “machine” comes in different pill sizes. So, you would need to research it and figure out how many pills your partner would have to take and if it would be worth it or not. I’m not saying this is the best idea. I’m just offering another option.

          For a while, I was putting a small amount of the stuff in my morning oatmeal. That worked in terms of me not tasting it. But it wasn’t enough to be theraputic. But maybe if your partner eats oatmeal, you could start small and build up quantities? I understand that people can develop a taste for the stuff.

          1. Whata great idea, I think I’ll try the oatmeal way first then order the pill machine from Amazon. As you say, it will be a great way to get our dose of turmeric in too. Thank you for all the good thoughts.

      2. Since you recommend Dr. Barnard a lot, my question concerns his advising starch as a main ingredient in the diet. He says to eat white potatoes, corn and other starches, but this goes against everything I’ve ever learned about nutrition. I didn’t find this recommendation in “How Not to Die” and use this book as my health bible. Is Dr. Barnard’s advice controversial or for real?

        1. patcee14: You are not alone in your understanding of starch. I would say that there
          is a lot of misinformation out there on the topic of starches. But I also need to say that the devil is in the details. Not all starches are the same.
          re: “Is Dr. Barnard’s advice controversial or for real?” From what I can see, Dr. Barnard’s advice is pretty much the same as Dr. Greger’s advice. If you take the Daily Dozen and roll them up to the categories used by the PCRM “Power Plate”, it’s about the same. PCRM stands for Physician’s Committee for Responsible Medicine, a group that Dr. Barnard heads up and which would be the general ratios for the book I recommended above. Here’s what the Power Plate Looks Like: .
          So, the Power Plate is about half starch-based foods. Same as Dr. Greger’s Daily Dozen (about). Dr. Greger just provides more details. Note that Dr. Greger includes corn and potatoes in the ‘other vegetables’ category.
          Note that Dr. Greger has covered Dr. Barnard’s clinical research in at least one video on this site. Here’s an example:
          Speaking of Dr. Barnard’s clinical research, his studies on diabetes have been published in very respectable medical journals. The low fat, whole plant food diet that Dr. Barnard used in the studies got 3 times better results than the ADA diet. Many people in the study got off their diabetes meds in addition to experiencing a great deal of other health improvements (lost weight, better cholesterol, etc). This is another part of the answer to : Is Dr. Barnard’s advice for real? You bet!
          As far as I know, all of Dr. Barnard’s diet recommendations for people who have diabetes are right in line with what Dr. Greger recommends.
          As I said above, however, the devil is in the details when it comes to starches. For example, what I remember from reading Dr. Barnard’s book on diabetes, he does not recommend most breads, including whole wheat bread. Flour products typically have a different effect on our systems over the intact grain. (There are two breads that sort of make it into the OK category. The book has some really great info for diabetics.) I felt that your description of Dr. Barnard’s diet was a bit off. I took a look at the recipes in the back of the book. One recipe I saw called for pasta, but it specified whole grain pasta. It has a recipe for lentil potato stew, but it specifies sweet potatoes. Etc. I’m not saying that Dr. Barnard never has a white potato in his recipes, but the more processed starches are not something that he pushes.
          I hope this helps. If you are able to get that book on diabetes, I think you will find that you have a second bible and a great set of recipes to use to tweak your diet to be even that much healthier. Good luck!

  17. Is there a link or video for information on type 1 diabetes in particular, and the specific dietary studies that have been done regarding that? There’s is an almost concerning focus on type 2 diabetics with I love this site, but I’m always at a loss for solid info to give my friend about his type 1 diabetes, other then, “hey eat whole plant foods”

  18. It was the biggest medical mystery of the century.

    Every year, thousands of people’s Type 2 Diabetes disappeared…and not even their doctors could say why! Finally, in 2013, a rogue researcher found the answer: An “at-home” solution, to naturally and safely reverse your Type 2 Diabetes permanently

  19. Dr. Greger,

    I was recently admitted to NYU Hospital Emergency Room after an episode of almost fainting. I was diagnosed with High Blood Pressure, Atrial Fibrillation and Diabetes.

    As I left the hospital with 4 prescriptions, I immediately bought your book in both audio and kindle format. It’s been two weeks since I’ve switched to a whole food, plant-based diet and I’m feeling good. I’ve lost 6 lbs and I’m on my way to a much healthier lifestyle.

    My question is, having the above conditions, is there anything in your book that I should avoid or be cautious of? I’m specifically thinking of the fruit recommendations.

    “How Not to Die” has become my health bible and I thank you with my deepest sincerity for providing the knowledge and motivation that so many of us require.

  20. hello friends, my name is maria burgos i want to testify on how i was cured of my diabetes by herbal doctor chima okereke, i have suffered from diabetes for years and have been to different hospitals for cure but all effort was in vain. so while i was on net i saw so many testimony’s about doctor chima okereke on how he cured so many diseases and virus so i decide to contact the said doctor and explain to him about my diabetes so he promise to cure me after all arrangements have been made he prepared the herbs and sent to me in my country and i took it behold i was totally cured,now i’m happy to testify that i’m cured of my diabetes, so if you are suffering from diabetes and you want a total cure contact Doctor chima okereke on or call him on +2347067847693

  21. I suffer from reactive hypoglycemia. On the site, it is recommended to follow a low carb diet. Vegan diet I follow now is very high carb, based around vegetables, beans, fruits, whole grains, nuts, seeds. Should I change my diet to some kind of low carb vegan to cure my hypoglycemia?

  22. Hi from South America. Please look into the importance of fat (veg oils) to prevent age-related memory loss, Alzheimer’s and other brain incapacities. Foods over knives and the like put all their tokens on weight loss and fitness, but they ignore long-term deficiencies. Another example: egg yolks and macular disease. Love,

    1. Coni: Whether your concern is Alzheimer’s or macular diseases, a low fat, whole plant food diet still wins every time. I know that you can find lots of pages on the internet that will tell you otherwise. But if you are interested in what the science has to say about it, you are in the right place here at NutritionFacts.

      To learn about Alzheimer’s:

      To learn about macular degeneration:

  23. Dear Dr Greger,
    My Uncle, has diabetes and due to his diabetes his foot has suffered to the level that his toes have been removed. My concern is his sugar level doesn’t go down how can we help him bring his sugar level to a balance. Please advise.

    1. Nancy: I’m sorry to hear about your uncle’s foot. Diabetes is a very serious condition. If you follow the information here on NutritionFacts, you will generally see that a whole plant food based diet is generally very effective at treating T2 diabetes. It can be so effective that a person starting such a healthy diet would need to work with his doctor so that meds could be adjusted quickly as needed.
      If you think your uncle would like to move in this direction or if you would just like to learn more, I highly recommend a book called: Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs The information in the book is right in line with the information here on NutritionFacts, but the book includes only information specific to T2 diabetes and the second part of the book is recipes that will help you and your uncle put the information into practice.
      I hope this helps. If your uncle gives it a try, let us know how it goes.

  24. I would love to see videos about type 1 diabetes. My best friend has type 1 diabetes. I am trying to gently get her even half as “into” this website as I am. It would be easier if there was more type 1 info. The breadth of topics discussed here is amazing. However, when I search for diabetes, it’s mostly about type 2. My friend would call this “typist.” Now, I love this website and I would never insinuate that Dr. Greger is a typist. Perish the thought! Perhaps there were just fewer studies done about type 1. Don’t get me wrong. Some of my best friends are type 2ers. But they have their videos. I need some type 1 videos to help lure my BFF into my WFPB addiction. Thanks for reading.

  25. I am Type 2 and find the conflicting advice out there so confusing.
    I used to do the Low Carn diet and did lose a lot of weight but felt hungry a lot of the time.
    I am now trying more carbs but have put on a lot of weight. However I have still been eating fish will now cut it out.
    Do I have to also stop eating the following as well:
    Bio culture yogurt?
    Is bismati rice safe to eat and if so do I have to limit the amount of it and things like green bananas and sweet potatoes I eat?
    I really would be grateful for the advice as hear so many conflicting things!

    1. Hi Sharon, I am a volunteer for Dr. Greger. Sometimes I think we all get a bit too carried away with counting calories, watching fat intake, or carbohydrate intake. While some research suggests that a low-fat whole food, plant-based diet is effective at treating and reversing diabetes, whole food, plant-based diets in general are extremely effective. In other words, the ratio of macronutrients (fat, protein, and carbohydrates) is not nearly as important as the SOURCES of your nutrients.

      I would recommend making the simple switch from bismati rice to brown rice. To my knowledge, bismati rice is slightly processed and may cause you to miss out on nutrients and experience bigger blood sugar variances. Also, bananas and sweet potatoes would be excellent to eat. Avocado, nuts, and seeds would be fine in moderation, but the focus of the diet should be fruits and vegetables. Also, don’t forget about beans and lentils, as these foods have been found to have incredible effects with maintenance of healthy blood sugar levels. I would also not recommend dairy products, as many of the harmful effects from milk and cheese would likely also hold true for yogurt.

      Overall, focus as much of your diet as possible to whole plant foods, especially fruits and vegetables, but also including legumes (beans and lentils), whole grains (brown rice, qunioa, 100% whole wheat, etc.), nuts, and seeds. If you need more information or advice about Type 2 Diabetes, check out the other diabetes videos on by typing “diabetes” into the search bar or finding it under the list of topics.

      I truly believe that the stronger you adhere to a whole food plant-based diet, the more you will see your body begin to heal. I wish you the best of luck! You can do it!

    2. Sharon Johnson: I have suggestion that should clear up any confusion. There is a book from a well respected plant-based doctor who has done clinical trials published in top peer reviewed journals. His diet is clinically proven to be 3 times more effective at helping Type 2 diabetics than the ADA diet. The book is by Dr. Barnard and includes a bunch of recipes in the back. Here is a link in case you are interested:

    1. John C: Insects *are* animal protein. But they may be the least harmful form of animal protein. NutritionFacts covers insects as food in this video:
      Even with the information in the above video, I would step back and ask why you would want to eat crickets. Assuming the answer has to do with protein, I’d recommend reading the following article which is a really great protein 101 lesson:
      If you get your protein from say crickets, then you are not getting your protein from say kale or beans. And then you miss out on all the fiber and phytonutrients / benefits that come from the plant foods. Something to think about.

  26. I am diabetic and have been on a whole foods, plant-based diet since reading “How Not to Die” in October. In three months, I have only lost 5 lbs. and my doctor has advised me to cut out whole grains because they are so calorie dense, and to substitute a handful of walnuts each day. I have done this for four days and today I felt awful. No energy, not even hungry. What do you think about cutting out whole grains as a vegan? Two hours after lunch of a bowl of vegetable soup, my blood sugar was 120. I am getting confused and thought I was doing well before my last doctor visit, except for no big weight loss.

    1. patcee14: It’s bizarre to me that a doctor would recommend that you skip whole grains because they are calorie dense, but then tell you to eat walnuts. Walnuts are way more calorie dense than whole grains. Also, adding high fat foods is the last thing you want to do if you have diabetes. I do recommend getting that Dr. Barnard book that we just discussed in your other post.
      As you know, Dr. Greger would not recommend cutting out whole grains. He recommends 3 servings of whole grains a day. However, the devil is in the details. You may want to skip that whole grain bread, as I mentioned in the other post. Not only is whole grain bread not the best choice for diabetics, but bread (like all dry goods) has a high calorie density.
      Following is an article from well respected RD Jeff Novick. The article has a table that gives you calorie densities by food category. Chef AJ (someone who works with people with food adictions to help them lose weight) recommends that such people eat only foods that less than 700 (? I’m not sure of the exact number) calories per pound. So, you can use the chart in the following article to make sure you are eating those foods which truly are low calorie density. (FYI: Choosing foods based on calorie density is also the method that Dr. Greger recommends for losing weight. You will see that in his How Not To Die book as well as on this website. )
      I have additional resources that explain more about calorie density if you are interested. Good luck!

      1. Thank you for responding. I am going to re-read that part of Dr. Greger’s book to try to find out the importance of whole grains to a healthy diet. I am just concerned that I have not lost much weight since starting this way of eating and I had expected I would. I am eating far fewer calories than I was before starting on plant-based.

  27. Do you have any insight for a skinny 47 yo. recently diagnosed type 2? So much focus has been placed on the typical overweight, inactive type 2. I am neither. I was eating paleo at the time of diagnosis, I have since gone plant based, low fat, and have gone from 135 to to 122lb over the last 3 months, I am a 5’9″ female athlete, so this diagnosis was very surprising. My dad was type 2 and died of complications. I will soon go in for an A1c test again to see where I am at. I am hoping that my tests look better, since I cannot lose any more weight! I have recently added more whole seeds and nuts and avocados to my diet to bump up my energy. I have read your book and many others and there are so many opinions! I was very low fat at first, but really didn’t feel energetic. I have since added more fat in the form of seeds, nuts and avocados and I feel much better, but if fat causes insulin resistance, then I am at a loss. I seem to feel best eating 30-40% of my calories from fat – no oils, just seeds, nuts and avocados. My Kaiser Dr. is not very helpful. Any advice would be much appreciated!

    1. Hi, I have practiced WFPB no added fat for almost a year. I’m not overweight. I Was on metformin but my a1c is still too high. After last exam i had high on the ” bad” fat in blod. (HDL?) I’ve had some problems with a knee and the exercise was not so frequent as it should be.
      Have you found out something to mange your a1c levels? I’m trying to don’t eat too much fruit because i’ve read that the simple sugars can easy increase lipid levels in the blood.


      1. Avoiding fruit might actually be your problem! Fruit helps increase insulin sensitivity, which is the goal for reversing non-insulin dependent diabetes. There is no limit to how much fruit you can eat. See this video from Dr. Greger or this video from Mastering Diabetes. If you are truly following a LOW FAT whole food plant based diet, and your HbA1c level continues to be too high, you might have type 1 or type 1.5 diabetes. Visit your doctor to confirm if you have type 1, type 1.5, or type 2.

  28. The word vegetarian actually means a 100% plant based diet. I think we should use that word instead of vegan which means a lifestyle choice of minimizing animal suffering. Then there is lacto/ovo-vegatarians who wants plant based + dairy/eggs. I’m vegan myself but that means I don’t buy leather shoes etc.. Anyway regardless of the labels it’s wonderful people are adopting vegetarian diets. We as humans are frugivores and designed to eat primarily fruits like other primates.

  29. Since this is all new to me, I have a question of how to keep blood sugar level if I don’t eat meat and eggs and those types of protein. If I have rice and vegetables doesn’t that make my blood sugar go up? Thanks.

    1. Hi Cynthia! Thanks for your question. Rice will affect your blood sugars, but it can still be included as part of a healthy, diabetic diet. Non-starchy vegetables will not affect your blood sugar – it’s a good habit to fill at least half your plate with these types of foods. I think you’ll find this section of our website to be helpful, especially the video found here.

  30. I began a plant based diet two months ago. Right away my numbers dropped and I had to cut my medication. However, in the last week my numbers have jumped and now we are looking to put the medication back in. It’s very frustrating. A simple salad or bowl of organic oatmeal sends it sky rocketing all of a sudden. I have lost 10 lbs. I am not overweight and I work out 3-4 days a week. Any thoughts?

  31. I just watched Sarah Hallberg’s TED talk from May 2015 on reversing diabetes with diet. Although she doesn’t distingusis between plant based and animal based, she advocates for very low carbohydrate diet with higher fat and protein content. I would appreciate your views on this as it seems to go against what I have learned from your website and also from Dr. McDougall. She seems to be having success treating diabetes and the diet she claims is also good for cardiovascular health?

    1. Eating a low carbohydrate diet can keep blood glucose within the normal range — at least during the honeymoon phase of the diet. Keeping blood glucose low due to avoiding carbohydrates is very different than actually reversing diabetes. When diabetes is reversed, carbohydrates can be eaten without producing a large spike in blood glucose. The only way to actually reverse diabetes is to improve insulin sensitivity (the effectiveness of the body’s insulin to escort glucose from the blood into the muscles for energy), and a low carb diet cannot do this. A very low fat, high carbohydrate, plant-based diet is the only was to actually improve insulin sensitivity and reverse diabetes.

      Dr. Jamie Koonce

    2. I am wondering if there is some confusion that happens with the word “carbohydrate.” I did not see that TED talk but many times people advocating what you mentioned are not talking about restricting plants but instead the typical American diet carbohydrates such as bread when they refer to a low carbohydrate diet.

      1. Thak you for the reply. The TED talk of Dr. Hallberg I thought was worth listening to although it did confuse me:

        – * (*Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU)

        She seems to specialize in treating diabetes and does not go out of her way to distinguish between processed carbs and whole plant food. She really advocates for lots of fat and minimal carbohydrates if I interpret her right. It goes against what I have learned from Dr. Greger’s wonderful website and Dr. McDougall.

  32. I got a question, when iwas on the American diet my blood fasting glucose was 86, been on a vegan diet for a year and its 113 wth. My a1c was 5.2 im 3o years old not overweight at all. Anybofy understand

  33. Jesse,

    Could be a whole slew of issues from aging to lower carb loading, while on the SAD diet and let’s not forget the many years of eating poorly inevitably take a toll on the body. On the vegan diet are you using a fair amount of juices or other highly glycemic products ?

    May I suggest that you please see your PCP and have them check insulin resistance, changes in your testosterone levels and do a diet assay.

    Dr. Alan Kadish moderator for Dr. Greger

    1. I was juicing nightly prior to my bloodwork. The night before the last test I juiced as well but still waited the recommended 8hr npo before testing. Do you think my reading could still been elevated from that? In your opinion what’s a better predictor of future diabetes, A1C or fasting blood glucose? Should I be worried?

    2. I was juicing nightly prior to my bloodwork. The night before the last test I juiced as well but still waited the recommended 8hr npo before testing. Do you think my reading could still been elevated from that? In your opinion what’s a better predictor of future diabetes, A1C or fasting blood glucose? Should I be worried?

      1. Hi Jesse! If there was an 8+ hour span between, it should not be affected. A1C is typically a better predictor of future diabetes. However, as shown in this video, if you are consuming a plant-based diet you are significantly lowering your risk of diabetes!

  34. I was all excited to see my new biometric numbers today at my work screening event, after having read Dr.Greger’s book and having switched to a wfpb diet cold turkey about 2 months ago. But I have some mixed results. I lost about 5lbs, my total cholesterol dropped by 12 points to 146, but my fasting glucose rang in at 108. It’s the highest it’s been in the last 4 years. My non-fasting glucose level was 100 in December, and 94 the year before.I feel like I’m on the right course, so I am just curious as to what explanation there may be for the jump and what I may need to change.

  35. Hi and thanks for your question. My recommendation would be to focus on eating as much as you want of non-starchy vegetables like greens, mushrooms and cruciferous vegetables while eating beans as your main source of starch. In addition, an ounce of walnuts or other raw nut and berries are great choices. A day of food could be plain whole oats with berries and walnuts, large green salad with colorful vegetables for lunch and dinner along with a vegetable soup for one of the meals. I hope this helps!

  36. What about those who have diabetes and other auto immune disorders? I went 3 years gradually reducing meat and dairy consumption from at least once or twice a day to less than once a week. Minimal processed food, and whole food plant based, with as much organic as available. I seemed to do well at first, felt healthier, especially enjoyed the increase in fruits. At about 8 months, even though Id lost another 20 pounds … slowly… my blood sugar measurements srarted going through the roof. I had always been pretty well managed with diet and metformin w average at 7.0 ish, but suddenly my a1c was 9.6, and daily morning readings over 10, sometimes up to 13! … I’ve never had numbers that high, my internist very concerned. I could not find a source except # of carbs.
    So for 6 weeks as a test, I’ve reintroduced a little meat and cheese in very small portions, reducing some complex carbs namely, no pasta so far, much less rice or bread and less potatoes.
    Morning checks are now between 7,7 and 8.8. Still too high, but a signal that the numbers are coming down.
    I don’t know what to do now, I am very confused. I have heard of vegans also going lower carb, but I really cannot imagine being able to do that deep a restriction. I cannot find studies for complicated diabetes, or what to do when anomalies occur.
    Any advice? THANKS so much,

  37. Hello Joana, and thank you for your question.

    I am a family doctor with a private practice in lifestyle medicine, and also a volunteer moderator for this website. First, to clarify for American readers, your glucose readings are in mmol/lit (the European system), whereas in the US we use mg/dl. So, your morning readings: 7.7 = 138 mg/dl, 8.8 = 158, 10 = 180, and 13 = 234 mg/dl. (Those readings are all high, and the last three are unacceptably high).

    It is very difficult for me to advise you based on the information you’ve provided. If you came to see me, I would want a complete 3-day diet history of everything you ate or drank, both during your mostly vegan stage, and currently. It is very possible that you were eating foods that were too high in simple carbohydrates, or worse, saturated fat.

    The diet I recommend to Type 2 diabetics, is completely vegan, with minimal saturated fat and minimal simple carbohydrates, including sugar. Your diet should be high in legumes (beans, lentils), vegetables — especially cruciferous veggies and leafy green veggies, whole grains — as unprocessed as possible (and if you are gluten sensitive, then obviously you would cut out wheat products, barley, and rye), and moderate fruit intake is OK, but better to minimize fruit with high glycemic index such as grapes, cherries, watermelon, and oranges.

    Some good references for you:
    1) — good general video by Dr. G about benefits of plant based diets for diabetes
    2) — this discusses mechanisms by which plants help improve/prevent diabetes
    3) — about the problem with saturated fat, and animal foods
    4) — this is a link to Amazon, to order Dr. Neal Barnard’s excellent book about reversing diabetes.

    I hope this helps.
    Dr. Jon
    Health Support Volunteer for

  38. I am coming from a vegetarian family. We use milk in our coffees and drink buttermilk. Apart from those we dont use any other diary products. We have been vegetarians for generations, but still number of people having diabetes is increasing among my relatives. After reading the book How Not to Die, I started calculating the number of cancer patients. To my surprise, that is very very rare in my community. But there are a lot of diabetic patients at various stages. I would like to know if you have an explanation for that.

  39. My wife had gestational diabetes during her last pregnancy. That was 2 years ago. She’s really concerned about her health, being diabetes seems to run in her family, her uncle lost a toe last month, and now he’s having a hard time seeing. She’s 5 foot 3, and up until 2 weeks ago she was 210 pounds. She’s since started a whole food plant based diet. I’m a vegan and after much persuasion she’s started it. And she was hardcore shes down to 193 and she looks better and has a ton of energy but her sugars are high than ever. Most evening they are anywhere from 9 to 13.
    what’s going on? Is it safe for her to continue? Videos I’ve seen on your website have said people get off of diabetes meds in 13 days. She’s at that point now and any Dr. Would probably give her meds? Can she continue a plant based diet? Or rather, should she?

  40. Hello Wayne and thank you for your question,

    I’m a family physician with a private practice in lifestyle medicine, and also a volunteer for Dr. Greger on this website.

    I’m sorry to hear that your wife’s glucose levels have not responded to her vegan diet. First, a clarification for other readers. The units you are using for glucose levels is mmol/lit, whereas in the US we use mg/dl. So, in our units, your wife’s evening glucose level of 9 to 13 translates to 162-234 in mg/dl. [You multiply by 18].

    So, those are clearly not very healthy levels, although they’re not outrageously high, if 13 mmol/lit is the highest they get.

    You say she is eating a “whole food plant based diet”, but it is very difficult for me to comment unless I know exactly what your wife is eating. It would be helpful for her to do a complete 3-day listing of everything that passes her lips, and go over this with a provider who is trained in plant-based nutrition. But in any case, here are some suggestions that usually help:

    1) Increase the amount of fiber in her diet: usually means eating more leafy greens, more whole grains, and more legumes (beans, lentils); beans are particularly important;
    2) Avoid simple carbohydrates — e.g. refined sugar;
    3) Drink lots of water — at least eight 8-oz. glasses per day; be sure NOT to drink fruit juice — which is loaded with sugars;
    4) Avoid any high-calorie beverages, such as beer, and certain plant milks (coconut, rice); an adage we use in nutrition advice is “Don’t drink your calories — EAT your calories.”
    5) Minimize intake of saturated fat, even if it comes from plants: almost all vegetable oils contain some saturated fat but some are especially bad, including coconut, palm, and palm kernel oils. See this video by Dr. Greger about saturated fat and diabetes:

    I hope this helps.
    Dr. Jon
    Health Support Volunteer for

  41. PS: It’s not clear if you realize that your wife easily meets the clinical definition of diabetes — not just gestational diabetes in the past. Also, I didn’t answer all your questions. I would say that it is almost certainly safe for her to continue with a whole foods plant based diet, if she follows my suggestions (above). I’d be interested to know what her glucose levels were before she went on a WFPB diet, though. I don’t think starting medications at this time is necessary, but that depends a little on what her average glucose levels are, as measured by a test we call the “hemoglobin A1c”. Dr. Jon.

  42. Please, if you are going to put out this information, differentiate between the two major Types. Obviously a Type 1 has no choice of having this disease and it cannot be cured by diet, huffing cinnamon, eating turmeric root, or drinking your own urine. (to name a few)
    Misinformation and stigma rule this territory.

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