The Best Diet for Diabetes

The Best Diet for Diabetes
4.75 (95.09%) 106 votes

The case for using a plant-based diet to reduce the burden of diabetes has never been stronger.

Discuss
Republish

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

There are all sorts of different scoring systems to rate diet quality. My favorite, for its simplicity, is the “dietary phytochemical index”: a fancy name for a simple concept. It’s just the percentage of your calories from whole plant foods, so, 0 to 100. The average American diet has a score of 12. Twelve out of a hundred; so, like on a scale of one to ten, our diet is a one.

You can split people up based on how they score, and show how the higher you score, the better your metabolic markers when it comes to diabetes risk. There appears to be like this stepwise drop in insulin resistance and insulin-producing beta-cell dysfunction as you eat more and more plant-based. And that highest group was only scoring about 30—less than a third of their diet was whole plant foods, but better than the lowest, which was down around the standard American diet.

No wonder diets centered around plants, emphasizing legumes—beans, split peas, chickpeas, and lentils—whole grains, vegetables, fruits, nuts, and seeds, and discouraging “most or all animal products…are especially potent in preventing type 2 diabetes,” and as a little bonus, “have been associated with much lower rates of obesity, hypertension, hyperlipidemia, cardiovascular mortality, and cancer.” And not just preventing type 2 diabetes, but treating it as well. A systematic review and meta-analysis found that the “[c]onsumption of vegetarian diets is associated with improved [blood sugar] control.” But, how much improved?

Here’s one of the latest trials. The effect of a strictly plant-based diet centered around brown rice—it was done in Asia—versus the conventional diabetic diet on blood sugar control of patients with type 2 diabetes: a 12-week randomized clinical trial. For the diabetic control diet, they set up food exchanges, and calculated specific calorie and portion controls, whereas on the plant-based diet, people could eat much as they want—that’s one of the benefits. The emphasis is on food quality rather than quantity, and they still actually lost more weight. But, even after controlling for the greater abdominal fat loss in the plant-based group, they still won out. Of course, it only works if you actually do it, but those that pretty much stuck to the healthier diet dropped their A1c levels 0.9 percent, which is what you get taking the leading diabetes drug—but, of course, only with good side effects.

Yeah, but would it work in an underserved population? The impact of a plant-based diet support program on mitigating type 2 diabetes in San Bernardino, the poorest city of its size in California. A randomized controlled trial, but not of a plant-based diet itself as the title suggests, but of just an education program telling people about the benefits of a plant-based diet for diabetes. And then, it was up to them, and… still got a significant improvement in blood sugar control. Here are the numbers. Got a little better in the control group, but way better in the plant-based instruction and support group.

And, more plant-based diets are not just effective in the prevention and management of diabetes, but also its complications. Check this out. One of the most devastating complications of diabetes is kidney failure. This shows the decline in kidney function in eight diabetics in the one or two years before switching their diets. They all showed this steady, inexorable decline on a fast track, to complete kidney failure and dialysis. But then… they switched to a special supplemented vegan diet, and their kidney decline was stopped in its tracks. Imagine if they had switched a year or two earlier!

Most diabetics don’t actually end up on dialysis, though, because they die first. “Cardiovascular disease is the major cause of premature mortality” among diabetics; that’s why plant-based diets are perfect. “There is a general [scientific] consensus that the elements of a whole-foods plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of [processed] foods and animal products—are highly beneficial for preventing and treating type 2 diabetes. Equally important, plant-based diets address the bigger picture…by simultaneously treating cardiovascular disease [our #1 killer]” along with obesity, high blood pressure, lowering inflammation. And, we can throw cancer in the mix too—our #2 killer. The bottom line is that “the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.”

Please consider volunteering to help out on the site.

Image credit: Dustin Kirkpatrick.

Motion graphics by Avocado Video

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

There are all sorts of different scoring systems to rate diet quality. My favorite, for its simplicity, is the “dietary phytochemical index”: a fancy name for a simple concept. It’s just the percentage of your calories from whole plant foods, so, 0 to 100. The average American diet has a score of 12. Twelve out of a hundred; so, like on a scale of one to ten, our diet is a one.

You can split people up based on how they score, and show how the higher you score, the better your metabolic markers when it comes to diabetes risk. There appears to be like this stepwise drop in insulin resistance and insulin-producing beta-cell dysfunction as you eat more and more plant-based. And that highest group was only scoring about 30—less than a third of their diet was whole plant foods, but better than the lowest, which was down around the standard American diet.

No wonder diets centered around plants, emphasizing legumes—beans, split peas, chickpeas, and lentils—whole grains, vegetables, fruits, nuts, and seeds, and discouraging “most or all animal products…are especially potent in preventing type 2 diabetes,” and as a little bonus, “have been associated with much lower rates of obesity, hypertension, hyperlipidemia, cardiovascular mortality, and cancer.” And not just preventing type 2 diabetes, but treating it as well. A systematic review and meta-analysis found that the “[c]onsumption of vegetarian diets is associated with improved [blood sugar] control.” But, how much improved?

Here’s one of the latest trials. The effect of a strictly plant-based diet centered around brown rice—it was done in Asia—versus the conventional diabetic diet on blood sugar control of patients with type 2 diabetes: a 12-week randomized clinical trial. For the diabetic control diet, they set up food exchanges, and calculated specific calorie and portion controls, whereas on the plant-based diet, people could eat much as they want—that’s one of the benefits. The emphasis is on food quality rather than quantity, and they still actually lost more weight. But, even after controlling for the greater abdominal fat loss in the plant-based group, they still won out. Of course, it only works if you actually do it, but those that pretty much stuck to the healthier diet dropped their A1c levels 0.9 percent, which is what you get taking the leading diabetes drug—but, of course, only with good side effects.

Yeah, but would it work in an underserved population? The impact of a plant-based diet support program on mitigating type 2 diabetes in San Bernardino, the poorest city of its size in California. A randomized controlled trial, but not of a plant-based diet itself as the title suggests, but of just an education program telling people about the benefits of a plant-based diet for diabetes. And then, it was up to them, and… still got a significant improvement in blood sugar control. Here are the numbers. Got a little better in the control group, but way better in the plant-based instruction and support group.

And, more plant-based diets are not just effective in the prevention and management of diabetes, but also its complications. Check this out. One of the most devastating complications of diabetes is kidney failure. This shows the decline in kidney function in eight diabetics in the one or two years before switching their diets. They all showed this steady, inexorable decline on a fast track, to complete kidney failure and dialysis. But then… they switched to a special supplemented vegan diet, and their kidney decline was stopped in its tracks. Imagine if they had switched a year or two earlier!

Most diabetics don’t actually end up on dialysis, though, because they die first. “Cardiovascular disease is the major cause of premature mortality” among diabetics; that’s why plant-based diets are perfect. “There is a general [scientific] consensus that the elements of a whole-foods plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of [processed] foods and animal products—are highly beneficial for preventing and treating type 2 diabetes. Equally important, plant-based diets address the bigger picture…by simultaneously treating cardiovascular disease [our #1 killer]” along with obesity, high blood pressure, lowering inflammation. And, we can throw cancer in the mix too—our #2 killer. The bottom line is that “the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.”

Please consider volunteering to help out on the site.

Image credit: Dustin Kirkpatrick.

Motion graphics by Avocado Video

Doctor's Note

If all a plant-based diet could do is prevent and reverse the number one killer of adults (heart disease), shouldn’t it be the default diet until proven otherwise? (See How Not to Die from Heart Disease.)  Yet the evidence for the benefits of a more plant-based diet continues to emerge for a variety of other life-threatening chronic diseases.

I’ve also discussed plant-based diets and diabetes in:

And what was that about stopping kidney decline in its tracks? See:

Learn more about the dietary phytochemical index I mentioned in Calculate Your Healthy Eating Score.

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

101 responses to “The Best Diet for Diabetes

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

  1. ‘The bottom line is that “the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.”’

    On the latter point, I came across the meta analysis abstract cited below earlier today. It discusses the association between gut microbial species and colorectal cancer around the world:

    “Here, a meta-analysis of eight geographically and technically diverse fecal shotgun metagenomic studies of colorectal cancer (CRC, n = 768), which was controlled for several confounders, identified a core set of 29 species significantly enriched in CRC metagenomes (false discovery rate (FDR) < 1 × 10−5). CRC signatures derived from single studies maintained their accuracy in other studies. By training on multiple studies, we improved detection accuracy and disease specificity for CRC. Functional analysis of CRC metagenomes revealed enriched protein and mucin catabolism genes and depleted carbohydrate degradation genes. Moreover, we inferred elevated production of secondary bile acids from CRC metagenomes, suggesting a metabolic link between cancer-associated gut microbes and a fat- and meat-rich diet."
    https://www.nature.com/articles/s41591-019-0406-6

  2. Staples should give their easy button to WFPB, along with their “That was easy.” slogan.

    I appreciate the clarifying videos.

    Tom,

    Thanks for sharing.

    I have a friend who has colon cancer. She had surgery for that, but I just heard that she needs more surgery. The person who told me wasn’t sure whether it was a hysterectomy or not. Breaks my heart.

    I told her about WFPB almost a year before her diagnoses. I hate culture wars.

  3. I have a plant based diet. BUT, it has to have further qualification. To control my blood sugar (I have T2D), i avoid food with concentrated starch and other sugars, and fructose. In my experience, applying an understanding of the glycemic index and load is also essential.

    1. Are you presently taking medication for T2D? Through plant based, are you keeping your carbohydrate count on the lower end? Has you diet significantly lowered your blood sugar, and A1C? I appreciate your input. Thank you.

    2. Philip,

      You are using words like starch and I am confused about what you are doing.

      Dr. McDougall has success reversing Diabetes using The Starch Solution and says that they have to have the people’s doctors involved at the beginning because they have to lower their meds almost immediately once they do the diet.

      Have you followed Dr. Barnard’s study where he removed animal products, oils, sugar and refined carbs and had most of the people off of their meds in a few weeks? (And by sugar, I mean sugar, I am not talking about the macro carbs.)

      You mention fructose, Dr. Greger has videos on studies testing fruit intake and blood sugar.

      If you don’t go low enough oil and animal products and sugar, you can’t get the same results as the WFPB doctors get.

      1. Yes, these doctors all try to ‘reverse’ diabetes to an HgA1c of 6-7.
        Problem is, at that range blood sugar is still too high! I have people told that these numbers are ok who are having heart problems, fungus infections, neuropathy, what have you. But when they get down into the lower 5’s these problems clear up.
        Need to get down to 5.5 or lower. Why don’t doctors understand that that 6 and higher isn’t a normal blood sugar?

        Phillip is correct, diabetics need to avoid those foods that raise their blood sugar. Most of the time carbs like rice, potatoes, higher glycemic fruit. Beans are usually fine, as are raw vegetables. More fiber makes the difference. And adding nuts, avocados to meals helps as the fat in the meal slows absorption of the carbs.
        Not all carbs are the same. Patients can use the glycemic load (better than index) but only as a guide. Then see how their blood sugar is after eating a specific food, or certain combination of foods.
        One person will go too high after certain fruits, another potatoes or rice. Bananas seem to be a problem for everyone.

    3. There’s probably some disconnect when reading this, “plant based diet” vs “whole foods PBD”. A PBD could simply mean vegan or vegetarian, which often includes a lot of processed foods. When you eat an apple you don’t have to worry about concentrations as studies show; potentially due to the fiber content. Apple juice on the other hand can be a completely different story, especially because many of these store bought products include added sugars.

      1. Thanks for sharing, Tom!! That is some exciting and hopeful news. Great article. I’ve sent to someone I know who has long followed the glycemic index/load approach.

  4. At 0:54: “…the highest group was only scoring [a Dietary Phytochemical Index of] about 30….” There’s something strange about a study where the the 4th quartile is still eating a very healthy diet, even if the studies conclusions point in the right direction.

    We just need to find a rich WFPB billionaire who will fund some studies that include in their sample modern, educated, healthy people, eating good food. What a radical concept!

    1. oops! meant to say “a very unhealthy diet” in the second sentence.

      (Another vote for editing capability in the comments section!)

      1. Agree. Just like all the ridiculous observational studies on people eating SAD, french fries and baked potatoes smothered in dairy fat, showing that potatoes are unhealthy. Same for salt. It would be nice to see some studies on people eating WFPB diet but where do you find the subjects? The China study was probably one of the best.

    2. Love the form name, BTW!

      I also found this portion of the study to be exceptionally interesting. Please report on more studies where they categorize percentages of WF PBD, and the high end should not be 30%, but at least 90+% . If you want to find the keys to optimal health, it’s likely that’s where it will be found.

      When you eat a WF PBD, it’s also less likely to over eat. Over eating alone, is the cause of many illnesses.

      1. They could even create some form of dietary score, for example:
        No meat; minimal; no limits
        99 50 0

        No dairy; minimal; no limits
        .9 .5 0

        vegetables, fruits, other eaten as whole foods (% of diet)
        .099 to .000

        So someone doing a WF PBD would score
        99.9.90 (no meat. no dairy. 90% plant based) or
        0.0.10 (meat no limits, dairy no limits, 10% whole foods or in other words the SAD)

        1. So when someone asks my diet I could say reduce – lacto vegetarian, with very minimal dairy and largely WF PBD to 99.5.80 (i.e. no meat, minimal dairy, 80 percent whole foods)

          1. Michael,

            I agree knowing exactly what they mean helps lessen the confusion.

            For cancer they have narrowed it to 5% animal products.

  5. This has nothing to due with this topic but I was directed here as I have a question. One of my patients who is a recovering addict claimed he helped an opioid addict through withdrawal symptoms by feeding him a plant passed diet. He claimed the addict experienced little to no pain throughout withdrawal. Are there any studies using diet to help alleviate withdrawal symptoms?

    Thank you!

    1. G. LeRoy Gallenstein, I would imagine there would be a lot of factors of a plant based (particularly whole foods plant based) diet that would assist in going through withdraw. I don’t know how much this might help, but there’s a video on here showing how a whole foods plant based diet effects brain chemistry. I can’t rememver the title, though, and I’m on my phone so it would be difficult to link.

      Good question, not sure if there’s been any studies on that but that would be a really good study.

  6. The relative associated advantage studies… Does these studies include all diets that are known to support better sugar control? If not why? Is there any reason not to include or is this just cherry picking suitable info that supports your greater good? Define what you accept as good science when only some of the food alternatives are included. Meta analysis studies are for the lazy and can be rolled to any angle to show whats suitable. If you state that you only accept good science lets see that also.

    1. Books are way too long though, and require extended concentration. People have much more important things to do ~ like pick up supper at the drive-thru, and pick up those prescriptions the doctor just wrote.

    2. Bernt

      Treating diabetes is not solely about managing blood sugar levels, just as treating cancer is not just about managing pain.

      Symptom control is important but not everything. Other diets eg keto/low carb may be effective at lowering blood sugar but are believed to have long term side effects such as increased cardiovascular risk, increased kidney disease risk and other T2D complications including diabetic ketoacidosis. As Greger says, WFPB diets only have beneficial side effects on these risk factors.

  7. Yes, there was some improvement in HgA1c on this brown rice diet, but down to 7.1% in 3 months? That is still an average blood sugar of approximately 155 round the clock! That is too high even just after a meal. Normal HgA1c is below 5.5, or below 100.

    Fasting blood sugar in non-diabetics is about 85, and anything over 92 predicts diabetes.
    After large meals no higher than 120. (This was a large Swiss study using implanted glucose monitors by a doctor who wanted to see what normal numbers really are).

    That is what diabetics need to be aiming for with blood sugar control.
    Keep in mind cardio complications become common with A1c over 6.0. And, yes, I know the ADA says that number is just fine. But it isn’t if you want to avoid heart disease, neuropathy, etc,

    Just doing WFPB will not enable all diabetics to have normal numbers. They also need to test blood sugars to see what particular foods cause their blood sugar to spike. Those foods will not be the same for everyone.

    1. It is NOT true that healthy subjects don’t go over 120. I have researched this extensively and there have been multiple studies with continuous glucose monitors showing that that’s not true.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/
      http://care.diabetesjournals.org/content/32/7/1188
      Just two quick examples, you can find more and more. They’re a dime a dozen. Perhaps your study with Swiss subjects used calorie-restricted 18-year-olds?

      But it’s certainly true that you can find people on the internet who say that blood sugar should never go above 120, or 140, or another low target like that. My concern is that the data doesn’t show that, and when people make that claim, then health-conscious people who are very healthy and are never going to get pre-diabetes or diabetes will be freaked out and frantically trying to eat lower carb so that they can meet those targets. When actually, as the China Study and so much info here on NF show, the healthiest diet is a WFPB diet which is naturally high carb. (A low carb diet will lower your average blood sugar in the short term but is bad for diabetes in the long term.)

      1. Carrot, the study was done with a cross section of people of various ages, men and women after eating a high carb meal.
        And no one needs to ‘freak out’ if their A1c is in normal range. But going high after a high carb meal should make them realize that they need to be monitored. Some people just don’t make enough insulin to eat that way. Then, overtime, they damage the pancreatic beta cells. High blood sugars alone cause insulin resistance, that’s about 20% of diabetics.
        Everyone also needs to pay attention if their fasting sugar is over 92.
        I work with diabetic patients Carrot.

        1. Perhaps you could cite the Swiss study? The studies I linked to were of healthy American and Chinese subjects. I agree with you about fasting sugar above 92. I do not agree that postprandial sugar above 120 indicates cause for concern or a need for monitoring. I disagree both because I’ve seen numerous studies that showed healthy, young, normal subjects whose blood sugars were all over the place after high carb meals, and also because I asked this question of Dr. Joel Fuhrman and he said it was a myth that blood sugar should never spike above 140. Much less 120. I’d love to convince you of this since you work with diabetics. I have a few friends who are diabetic and who have set really low targets like this, and incur repeated dangerous lows because they are phobic of going above 120 and phobic of carbs. The phobia of going above 120 since “normal people don’t” (But they do) drives them to eat low-carb, high-fat diets that over time will increase insulin resistance or add insulin resistance to the T1 they already have.

      2. Most top Dr’s are seeing the old A1c scores, that were considered normal as way to high, and should be much closer to 5. My understanding is the higher the a1c the more likely to have higher inflammation. The higher the inflammation, the higher the risk for cardiovascular diseases, and kidney failure and all the other typical western SAD plagues.

  8. The whole plant diet with minimal processed foods is the best way to eat to avoid and improve insulin resistance. The science around diabetes is all very interesting but stands to be focused on the most important approaches. For me as a recently retired Family Medicine clinician the science is best summed up by two NutritionFacts.org video’s.
    1. https://nutritionfacts.org/video/the-spillover-effect-links-obesity-to-diabetes/
    2. https://nutritionfacts.org/video/what-causes-insulin-resistance/
    So it is the fat in the diet and the “fat” on our bodies that leads to insulin resistance. At the McDougall Clinic where I enjoyed seeing patients for the last 7 years it was easy to get the fat out of the diet for 8 days of the residential corporate programs. Getting the fat off the body takes longer as anyone who has attempted to lose fat knows. The healthiest approach is the consumption of low energy dense foods. The best introduction to that is Jeff Novick’s Calorie Density: Eat More, Weigh Less and Live Longer available for free on YouTube. My patients feel great once they have achieved “Normal fasting blood sugars” of under 100. Normal is not necessarily the “healthiest” targets. There is little population data on fasting blood sugars in healthy populations as there is for blood pressure. Most of my colleagues would weigh in at less than 90. I asked Dr. T. Colin Campbell who said “There is no individual data but the means for groups of 50(half male, half female) for 130 villages were 35-79.” It is important to note these values are on individuals who are not on medications and have been eating a “whole food plant based diet” in rural China all their lives. Having a value whether blood glucose or blood pressure on medication is not the same as one on no medications at all. In my opinion to be healthy means on no medication. For folks on medications especially for blood pressure and diabetes they need to work with their clinicians as they improve their diet. My patients have found that Dr. John McDougall’s 12/2009 newsletter article entitled, Simple Care for Diabetes, is useful as they work with their clinicians. Remember everyone is “their own experiment of one” due to population variability. Keep up with the latest science and good luck.

    1. Hey Don, Thanks for the information on that China study by Dr Campbell. Very interesting information. It’s currently hard to get access to large groups of people who are on no medications and eat WFPB. Dr Campbell certainly has put in a lot of years of research and contributed greatly to our knowledge of nutrition.

    2. “In my opinion to be healthy means on no medication” Don Forrester MD

      This needs to be the mantra of every MD in the world. Thank you Dr. Don!

  9. What is remarkable about these findings was that compliance with the WEPBD was poor. Can you imagine the outcomes in those who adhere to a WFPBD in a fairly strict manner?

    1. Yes, in one the people were only eating 30% WFPB. One they only gave education about WFPB.

      Those studies aren’t what would happen if people do a serious WFPB, very low fat, very low glucose diet. They are what happens when people just aim in the right direction.

      1. I remember before I came across WFPB, my friend was diagnosed with Diabetes and I came across Gabriele Cousens documentary where people ate raw WFPB and by the end of the first week all of them (except for one of them who was T1D) got off of all of their meds.

        I am not raw-oriented and most of them hated the food. It just did strike me that it was a group of morbidly obese people who had Diabetes for decades and before they lost any weight at all, their blood sugar became normal.

        That was my first hint that there were easy ways of doing things.

        Imagine my surprise when there was a way of doing it without going raw.

        Laughing.

        Right now, I eat so many raw vegetables because it is even easier than cooking and cleaning up, but I do like that programs like The Starch Solution and Daily Dozen and Dr. Barnard and Dr. Ornish and Dr. Esselstyn all have programs. I will add Dr. Fuhrman in but he has a sense of humor where he said that he eats his 5% meat just to add more fun to his life. Laughing. I don’t judge him for eating the meat, but I have compassion for the animals and have a brain where I can’t separate what happens to them. When he said the word “fun” I could see the images from “Eating You Alive” flash before my eyes. I have a poor cognitive memory, but a near photographic emotional memory. It didn’t look fun.

  10. I do have a question. But i don’t know where to put it so i ask it here. I am a type 2 diabetic and already found out by experience how positive this works for that.
    But… i was also tested in the early stages of Kahler’s disease. Is there something that works als well as this diet does for my type 2?

    1. It’s my understanding that the multiple myeloma information sites do not recommend a specific diet, just a “balanced diet” and trying to maintain (or attain) a healthy slender body weight. We know from the research that strict vegetarians (vegans) are on average the only dietary group to naturally achieve a human normal BMI. We also know from the research that the more vegetarian your diet is the lower your overall cancer risk. Therefore, if I had multiple myeloma and T2D I would eat a WFPB diet. Is there a reason related to multiple myeloma why you wouldn’t want to eat a WFPB diet, especially since you’ve had success with your diabetes?

  11. I am 73, I have been a vegetarian for over 30 years. I have just been diagnosed with type-2 diabetes!
    Any comments? I drink alcohol, but at normal levels; I don’t exercise much.

    1. Kevin, what do you mean “any comments?” Like a challenge to the science because you were diagnosed with diabetes and also were vegetarian? Or am I misunderstanding your post?
      My comment would be that the term “vegetarian” diet is ambiguous. Even a vegan diet can be an unhealthy one made up of refined foods, margarine, palm oil, coconut oil, refined sugars, fried foods, etc. And “vegetarian” can also means including dairy in the diet and eggs and sometimes people say they’re “vegetarian” but eat fish or/and chicken, etc. When I was a vegetarian before going vegan, I ate so much dairy.

      1. S, I agree with you: it’s very tough to know what someone means when they say they are “vegetarian’ or “vegan,” or worse, “eat healthy.”

        I’ve been a vegetarian for 47+ years, most of those ovo-lacto — eating eggs and dairy products. And I ate processed foods. Eventually, I was overweight. I did lose the weight, not by exercise (though I did get much more fit), but by changing my eating habits, by making healthier choices and practicing portion control. It was a slow weight loss (25 pounds over 18 months), but I’ve kept it off. Because I never went back to my old eating habits.

        But a few years ago, my husband and I transitioned to plant based whole foods eating — no animal products, minimal to no processed foods. And then to low to no added sugar, oil, salt. And we lost weight without trying or meaning to — we had thought our weights were fine! I lost 5 pounds, and my husband lost 15.

        So I’ve learned to ask: What do you actually eat? Give me examples.

      2. Keven,

        My comment would be that if I drank alcohol, ate cheese (and maybe crackers), eggs, was overweight by 20+ lbs and didn’t exercise, I would be practically inviting type 2 diabetes. Here are some videos you might enjoy watching and find helpful:

        https://nutritionfacts.org/topics/diabetes/

        https://nutritionfacts.org/video/plant-based-diets-for-diabetes/

        “Vegetarian” can be a far cry from whole food plant based eating. Nutrition Facts is full of resources to explain the differences and offer encouragement.

    2. Kevin…
      Get yourself a blood glucose monitor and measure your blood glucose every 15 minutes or so after eating or drinking anything for 1 hour. Then measure every hour for the next 2 hours, recording ALL measurements ideally in some kind of spreadsheet. After a week or two you will have a pretty good idea of what is really happening to your blood glucose after ingesting various food and drink. You will then be able to determine yourself what foods raise your blood sugar levels unacceptably and what don’t. You then adjust your food intake accordingly. Do not blindly believe what others say works, use that blood glucose measuring device to verify what is REALLY happening in your body. I am 71 and my MBA tells me that there is a lot of “fluff” in the business of type 2 diabetes management.

        1. Easily understood scientific evidence is largely sparse and/or manipulated in current attitudes regarding effective treatment for type 2 diabetes, as any internet search will reveal many conflicting ideas and methodologies. Monitoring your own blood glucose levels before and after ingesting any food or drink will enable you to personally verify any treatment regime’s effectiveness on your own body. A personal blood glucose monitor is not a panacea for type 2 diabetes treatment, but it is an effective tool that is unbiased.

          1. I never suggested that monitoring your own blood sugar wasn’t good advice. But simply stating that following the scientific evidence (based on well-designed studies as Dr. Greger teaches to look for and recognize) does not constitute as “blindly listening to someone.”

            As pointed out by someone in another comment, there’s more to diabetes than blood sugar. Certainly testing your blood sugar is a very useful tool, it was never my point that it wasn’t.

            1. Sorry for misunderstanding your “Definitely not “blindly”,” response. I was not denigrating ANY suggested course of action when trying to improve one’s type 2 diabetes status, but rather to emphasize the importance of acquiring and using your very own blood glucose monitor to verify that any food or drink taken helps reduce or at least minimizes changes in your body’s blood glucose levels.

              Many people with type 2 diabetes initially do not really understand how vitally (life and death) important it is to know what foods exacerbate their existing serious issues with blood sugars. It is also important to realize that not all people metabolize and convert foods in the same time frame as others.

              Type 2 diabetes remediation efforts are in fact, all about blood glucose levels and lowering them in a healthy way to as close to generally accepted normal levels as possible. The severe consequences of not being successful at lowering these blood glucose levels are catastrophic health issues and premature death.

              The growing body of experiential evidence that changing our diets and reducing obesity are usually the most cost effective and medically successful type 2 diabetes interventions is slowly changing mainstream medicine’s approach to managing this terrible affliction.

              The scientific evidence likely has always been known, but manipulated by various organizations for their own purposes, not for the good of the average type 2 diabetes sufferer. We the public must rely on others to analyze, interpret and effectively communicate the results of these scientific studies to us. We then attempt to intelligently summarize and “bottom line” these results as recommendations to the real world of type 2 diabetes management.

              Once these recommendations for managing type 2 diabetes have been verified to be personally effective and your blood sugars and weight are approximately normal (healthy), you are free to follow any eating, exercising or psychological activities that you desire understanding that they align with maintaining your good health.

              In summary, use your blood glucose monitor to verify that the actual results of any type 2 diabetes management plan are in fact approximately as expected. If there are major differences, then investigate why and implement appropriate changes to successfully control your blood glucose levels.

              I hope this clarifies my previous posts.

              1. Eric, thanks for clarifying. In regards to my blood sugar comment, I was referring to a point made in the above comments by Mr. Fumblefingers which should better clarify what I meant.

  12. There’s no question Plant based eating manages and cures type 2 diabetes, but how significant of a role can it play in managing type 1 diabetes? There does not seem to be much research out there for type 1 diabetes and vegan diets, unless I’m mistaken?

    1. It helps type 1, but of course there are limits to what food and the body could do, especially when your pancreas has completely failed to do its job.

  13. One thing I’ve learned over the years is to not take anyone’s word about what they eat and what they say hasn’t worked for them regarding plant based approaches. Often people blame the wrong food, for example they’ll say “ya know I’ve been trying to do this plant based diet, but starches just work against me, they make me tired and gain weight”… meanwhile they fail to mention they still haven’t cut out cheese and some meat, oils, etc… and they don’t realize plant based for diabetics must eliminate all oils, meat, cheese, eggs, etc to make it a low at diet. Once they go low fat, the diabetes reverses.

    But I’ve heard this type of thing so many times and they never ever blame they real culprits behind intramyocellular lipotoxicity. They also make the conversation about them as if they’re somehow a unique human being that just can’t handle starches well. It’s rubbish.

    1. Casper,

      That is true.

      People don’t know what is causing problems.

      I have friends with food allergies and one of them hasn’t figured things out in a decade.

      I was allergic to the chemical used on green grspss and had no idea what was causing my problems.

      It is hard to figure it out without learning enough.

      For the six months before going WFPB I mostly ate eating salads with cheese.

      I had gone off pretty much every sugar and carb because I knew I had Diabetes symptoms. Then, I listened to Dr Greger and Dr Barnard and other doctors and slowly got rid of dairy and added in searches but it still took months to lower oil.

      I didn’t lose weight, at all until I went off cheese and oil, but I can gain it back on processed food.

    1. YR

      The problem is that Macro studies don’t tend to get the right answer.

      That is how Whole Food Plant Based was invented.

      I have seen so many studies which they combine healthy and unhealthy carbs as if it was about macros, but I noticed that the people who did those studies separated healthy fats from trans fats to say that fats are better than carbs.

      Refined carbs and refined fats need a which is worse for you head-to-head.

      1. YR,

        If you add the word ”refined” in, you have a true statement. If you leave the word ”refined” out, your sentence is false.

        1. YR

          You have shared that you est a small amount of fish and that you drizzle a little oil.

          It sounds like you do a very modest level and you might not have to worry about it, but if your A1C goes off, it will be fats and sugar and refined carbs you need to examine.

          1. ” but if your A1C goes off, it will be fats and sugar and refined carbs you need to examine.”
            – – – – – –

            You deduce this because I follow the diet I do? One that has so far kept me healthy, active and drug free? Okay, Deb….whatever.

              1. You are saying that you have to watch carbs and I am saying that you actually might have to watch carbs because you aren’t watching fats, so if you have insulin problems from the fat, you will need to watch carbs versus someone from a truly WFPB diet can eat very high carb and not have it affect them.

                1. I say it because there is a channel I have watched and a man is doing higher fat and he can’t eat even a little sweet potato without his blood sugar rising, even if he cooks them beforehand.

                  So he can’t do all whole foods. I contrast that to the documentaries I have watched where whole groups of people get off their meds and can eat sweet potato. He needs to do a different set of rules because his diet is different.

                  1. WNPR today said that the world is sick because they eat too many starches.

                    The thing is, if you listen to the announcers on WNPR talking about what they eat, they couldn’t possibly conceive of what Dr. Barnard accomplished and probably do have A1C issues and probably have to watch their starches.

                    My cousin is the same way. He is on dialysis but never did go low fat. He went low carb the macro and when his kidneys failed he still isn’t allowed things like potatoes or corn, where Dr. McDougall was able to bring people off of insulin having people eat starches, but they couldn’t go off their meds without lowering animal products and oils, too. That is where the whole mind-set and belief system and big picture matters more than the Macros and more than the individual foods.

                    They didn’t even mention The Starch Solution. Starch is their enemy. But in the hands of Dr. McDougall it is a healing solution and people lose weight eating starches and they get off of Diabetes meds, and yet fixing blood sugar and insulin and obesity are some of the things the WNPR experts would point to as why to avoid them and if the people aren’t going to do The Starch Solution, they may be right that they can’t eat potatoes or corn or rice and yet Dr. Kempner could heal people and have them lose 100 pounds eating white rice.

          2. I have tested out fats a few times and did it again the past 2 days and I gained 3 pounds in 2 days adding Veganaise to my vegetable wraps.

            3 pounds!

            I did it because I wanted to see what had caused me to gain 10 pounds after having lost so much.

            I ate a higher fat vegan diet.

            I had an Ezekiel English muffin with peanut butter, a package of air-dried beets, a package of air-dried kale, 2 low-carb, 60-calorie veggie wraps with avocado, veganaise, broccoli slaw, cabbage, mushrooms, grape tomatoes, tricolor peppers, onions, and cauliflower and a bean burrito for lunch and a cup of berries with some coconut milk whipped cream

            I gained a little over a pound the first day and 2 more the next day. Well, I figured out which version of my eating causes weight gain. I didn’t use a ton of peanut butter or veganaise but might have used too much avocado. Or just having all 3 in one day was enough.

            I can’t do fats almost at all.

              1. And my green tea soy latte. I drank water for dinner and tea without any milk during the day.

                It has been a useful experiment.

    2. Isn’t this just another low carb apologia that confuses refined carbs with healthy complex carbs?

      Yes processed foods like refined carbs increase the risk of heart disease, stroke and diabetes. It’s a mighty leap of logic to say that this shows that compkex carbs also increase risk …… especially when people eating healthy high carb diets are observed to have significantly lower risk of heart disease etc., eg this 2017 systematic review and meta analysis

      ‘Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.’
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837313/

      1. Yes, let’s do be precise.

        So maybe the slogan from the Happy Healthy Vegan channel should be “Keep It Complex-Carbed, Baby,” not “Keep it Carbed, Baby.” :-)

  14. This video comes at an opportune time for me, I just got in a discussion with someone advocating a low carb high fat diet for diabetes. I know all the usual whole food plant based arguments, but my friend said that a low carb high fat diet could reduce a hemaglobin A1c from 10 to 5 when he claims vegan diets give you a reductiong from 8 to 6.5. Ok I think his numbers are junk, but is their any studies that fairly compare these virtually opposite macro nutrient diets in terms of A1c levels in diabetes? can anyone weigh in?

    1. I think your friend needs to provide a source for those numbers he is bandying about. Even the most committed (keto) researchers promoting low carb diets aren’t reporting these sorts of figures. Eric Westman for example reports a reduction 1.5 ……. not 5 ……. even though he controlled and conducted the study himself
      https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-5-36

      I suppose that you might possibly stack the decks further and combine weight loss with a keto diiet and compare it to a low fibre ‘vegan’ diet eaten ny onese diabetics who did not lose weight, to generate such startling figures but at forst sight they seem like bunk.

      More to the point. low carb diets seem tio increase the risk of early death eg

      “Low carbohydrate diets are unsafe and should be avoided, according to a large study presented today at ESC Congress 2018.
      Study author Professor Maciej Banach, of the Medical University of Lodz, Poland, said: “We found that people who consumed a low carbohydrate diet were at greater risk of premature death. Risks were also increased for individual causes of death including coronary heart disease, stroke, and cancer. These diets should be avoided.”
      https://www.sciencedaily.com/releases/2018/08/180828085922.htm

      And if people insist on adopting such diets, the prudent course might be a ‘vegan’ low carb diet

      “To shake that down into numbers, a moderate-carb diet results in an estimated life expectancy of 83 years, per the study. For a high-carb diet, it’s 82 years. For a low-carb diet where less than 30 percent of energy is from carbs, it’s only 79 years. It may not seem like a huge gap, but that’s four full years less than it could be.
      Here’s the twist: According to the researchers, low-carb diets where carbs are replaced with animal meat, full of animal protein and fat, lead to early death. That’s not great news for keto believers. However, low-carb diets packed with protein and fat from plant-based sources like veggies, whole grains, and nuts do not.
      “Our data suggests that animal-based low carbohydrate diets, which are prevalent in North America and Europe, might be associated with shorter overall life span and should be discouraged,” lead researcher Dr. Sara Seidelmann said, per BBC. ”
      https://www.esquire.com/lifestyle/health/a22786840/low-carb-diet-negative-effect-is-earlier-death/

      And those are studies that don’t even appear to differentate between healthy complex carbs and the white bread, pastries etc high carb diets common in Western countries!

  15. Went WFPB a year and a half ago and A1C went to 4.8 from prediabetic 5.7. Also lost 20lbs. This has been the easiest weight loss ever, all I do is eat real food, and carbs are my friend!
    I agree with Deb’s comment, fat for me is an instant weight gain, as are any animal products, especially animal protein. I do fall of the wagon once in a while, especially while traveling, but it is easy to go back when the results are so wonderful.
    Interestingly enough, my niece is in medical school and How Not To Die is on her required reading list. Yay Dr. Greger, making progress! I had heard it was going to be, but to see it actually implemented is fabulous.

    1. That is SO cool, Marti! That’s really exciting to hear. Hopeful news for the future.

      I didn’t read all the comments but I do really well on what’s probably considered a high fat whole foods plant based diet, personally. To each their own and for their own reasons so long as it’s whole plant foods!

  16. I was just Diagnosed with SIBO. After testing I was told I have Congenital Sucrase-Isomaltase Deficiency which they feel is the underlying cause. I’ve had stomach issues my whole life but thought it was bc of my struggles with bulimia/bulimarexia. I don’t digest animal flesh (I have disliked it since I was a kid) and was basically an on/off again vegetarian until 3 years ago. I decided to stick to being vegetarian full time. I had surgery to remove excess abdominal skin (I used to be 300lbs and then yo-yo’d for 20+ years) and cut out all processed sugars/gluten. Unfortunately bc of that surgery and knee surgery I had 5 rounds of antibiotics over the last 3 years. 2 years – after a lot of research and to be honest – watching Dr Greger videos – I became vegan. It has been wonderful except for the bloating/constipation which has followed each round of antibiotic – progressively getting worse (I can look 5 months preggo’s on a bad day).
    I need serious help. The diet they want me to follow for CSID is basically paleo. They also prescribed Sucraid – a yeast derived enzyme supplement. Not sure how to deal with it all as a vegan. I am NOT going to go back to animal products.
    I am to start on herbal antibiotics and do the low starch/low sugar protocol next week. So I’m trying to get info on low carb vegan meal plans. I need to cut out a lot for 2-8 weeks.
    I know this is long but Wondering if Dr Gregor has any info on this. I trust his medical opinions.
    Ps Normally my weight is stable @ 130-135lbs. But with these issues I fluctuate 10-15lbs!

  17. Hi, Anne! You have been through a lot, but it seems like you are getting healthier, and I congratulate you on that! You did not say who diagnosed you with SIBO and suggested the paleo-style diet. Repeated and prolonged antibiotic use and eating disorders can lead to gut dysbiosis. You might be interested in this video, if you have not already seen it: https://nutritionfacts.org/video/gut-dysbiosis-starving-microbial-self/ Check out these resources, as well: https://nutritionfacts.org/2013/01/10/boosting-gut-flora-without-probiotics/
    https://nutritionfacts.org/2019/03/26/what-to-feed-your-gut-bacteria/
    https://nutritionfacts.org/video/how-to-change-your-enterotype/
    You can find everything on this site related to gut flora here: https://nutritionfacts.org/topics/microbiome/
    I hope that helps!

  18. I am not exclusively vegan but eat a 90% WFPB diet. We do eat wild game once a week that we process ourselves, eggs from our chickens, and enjoy cultured organic dairy occasionally. Mostly just to compromise with my husband who is very supportive of these choices and was raised on a VERY different diet.

    I am 23 weeks pregnant with our first baby. I have not been diagnosed with Gestational Diabetes (GD) but I will be taking a glucose test next month. Ever since hearing about this test I have been a bit obsessive about researching GD. Unfortunately I have not been able to find very much information on the causes or prevention, just treatment.

    I fear the recommendations of my midwife and other online sources are skewed by the SAD diet and I am unsure what kind of diet to follow, should I develop GD. I have watched and listened to a lot of your videos and posts about the ideal diet for pregnant women which I have been following pretty closely except for the addition of the foods listed above. But what about GD? Do I have to follow a low carb diet?

  19. Hi, Karlie! You do not need a low-carb diet, but cutting the animal products may help. This video may interest you, if you have not already seen it: https://nutritionfacts.org/video/bacon-eggs-and-gestational-diabetes-during-pregnancy-2/ I suggest following Dr. Greger’s Daily Dozen, found here: https://nutritionfacts.org/app/themes/sage/dist/images/book/daily-dozen_6c40d3eb.jpg and explained in detail here: https://nutritionfacts.org/healthkit/
    Make sure you are eating enough calories from whole plant foods to sustain your needs during pregnancy. For additional information, you can find everything on this site related to pregnancy here: https://nutritionfacts.org/topics/pregnancy/ I hope that helps!

  20. “I take Metformin for the diabetes caused by the Hydrochlorothiazide I take for high blood pressure, which I got from the Ambien I take for insomnia caused by the Xanax I take for the anxiety that I got from the Wellbutrin I take for chronic fatigue, which I got from the Lipitor I take because I have high cholesterol because a plant-based diet and exercise are just too much trouble!”

  21. Dear NutritionFacts Team,

    I am a Dietitian from South Africa. I live and breathe the philosophy of your organisation. Thank you so much to Dr. Greger and the team for the work that you are doing. I wish that “How not to Die” was our main text book at university.

    The below link is to the Isreali Study regarding post prandial blood sugar spikes that vary highly between individuals consuming the same meal. The theory is that the key to weight loss and chronic disease reversal is in the percentage sugar spike after a meal. So they recommend that patients try all sorts of foods and test their blood sugar 1 hour after eating. Any spike more than 20% is bad news. One person would spike for brown rice and not a chocolate milkshake, and vice versa. The also theorise that it is the difference in the microbiome of individuals that may account for these differences.

    I do not agree with this. The recommendation that non-diabetics test their blood sugar 3-5 times per day until they run out of meals to try is absurd to me. The level at which your blood sugar spikes depend on your degree of insulin sensitivity which is influenced for example by your saturated fat intake among many other factors. Also, if you have an unfavourable microbiome, why not alter it to favourable with a WFPB diet?

    Some of my family members are completely excluding legumes form their diets, because it caused a 1-hour blood sugar spike of more than 20%.

    I would really appreciate your comments on this study.

    https://www.cell.com/cell/fulltext/S0092-8674(15)01481-6

  22. Hi Rudé van Wyk , thanks for your question, Our bodies are fascinating and I do see in some individuals their tolerance of bean consumption is quite different. It could be due to how their body break down the sugar or the Lectin. Also microbiom is a huge factor in the health of an individuals as you know since the past several years of research. In the below study they indicate, early-life disease, type 1 diabetes, that has been associated with the pediatric micro biome. In addition to genetic predisposition and other factors, researchers have found significant differences in microbial ecology between children who develop type 1 diabetes and children who do not (Brown et al., 2011; Vaarala et al., 2008). Butyrate-producing bacteria appear to be especially important for maintaining a healthy gut and preventing type 1 diabetes. Health of an individual has so many factors associated with it and diet is one factor. I assume the researchers in the study you are referring to are aiming for a product to sell that would involve tests such as blood and stool sample to figure out what can work for an individual person. However, personalize diet plan can be planned by a dietitian and a medical team that work with Functional medicine to find the root cause of a disease. Dr Greger has a good pod cast on life style medicine that I shall refer you to it.

    https://nutritionfacts.org/audio/lifestyle-medicine/
    https://www.ncbi.nlm.nih.gov/books/NBK154093/

  23. Hello Dr. Greger
    I have been following your advises through YouTube and I have bought your book how not to die that was translated into Hebrew. Thank you for excellent work.
    I was wondering if I could ask some questions regarding diabetes type 2.
    I am 53 years old, over weight, been diagnosed with type 2 15 years ago.
    At the moment I am 9 month vegan, have lost approx. 10 kg, and reduced Insulin intake from 54 units to 24 units.
    I take 4 medications for the sugar and statin 20 mg.
    I have made some attempts to stop the medications, on and off, but it seems I can’t manage the sugar levels and the blood fats without the medications.
    That really bothers me. I thought going on plant based diet will be more effective to manage it with less or no medications at all. Yesterday I met with a dietician who is vegan friendly that said that this can not happen and it is a lie that anyone can loss the medications and the diabetes all together while being vegan. what do you think? thank you

    1. Hello Iris,

      First off, congratulations on reducing your medications! That’s a great accomplishment. I understand that you want to eventually get off your medications, which in most cases of diabetes is possible. It is important to note that a full remission can take time. This will not be a quick process, even though in some cases it can turn out that way. So far you have done a great job with improving your insulin needs, so I would encourage you to stick with it and eat a whole foods, plant-based diet, eliminating oils and processed foods. That will give you the best shot at getting off your medications.
      As for your dietician’s comments, I believe the science will disagree with them on that topic, but it is understandable that they believe it’s impossible since dieticians, doctors, etc. are never taught about disease reversal in school. Stick to the program and continue to follow up with your doctor so they can best manage your medications.

      I hope this helps,
      Dr. Matt

      1. Thank you!!
        That is most helpful.
        I will surely keep it up.
        Going back to the old nutrition is not an option any more and I enjoy been vegan so much.
        My doctor is very pleased with my recent result of Hba1c that is 7.1!! and so am I :)

  24. I have an urgent question. Why is my wife’s blood sugar increasing significantly since switching to a plant-based diet? Here’s the background:

    My wife, Lynn and I have been eating whole foods, mostly organic for about 10 years. I want to emphasize, we DON’T eat the typical American diet, and haven’t for several years. We prepare almost all of our meals at home.

    Around three years ago, Lynn went to the doctor’s office for a routine physical and found that her morning fasting blood sugar was around 140. This was quite alarming. She bought a home blood sugar testing kit and began to monitor her blood sugar and adjusted our diet. She found that her blood sugar was less than 100 most hours of the day, except for the dawn effect, where she would go up to about 120, 130, or so.

    We had been eating rice and potatoes often, along with a moderate serving of meat. She switched us to a low-carb diet, which meant we ate a lot of healthy fats (olive oil, for example) and protein, but was low in carbohydrates. We ate tons of whole, unprocessed vegetables. We ate moderate amounts of meat, fish, cheese, creams, etc. We avoided legumes, rice, potatoes, pasta, and bread.

    For several years, I have been wanting to switch to a plant-based diet. I had my own motivations, but I had also read that a plant-based diet decreases diabetes. Less than two weeks ago, we switched to a plant-based diet. Now, every morning Lynn’s blood sugar is climbing. Today, she hit 142, which is alarming. We are cooking whole foods, and not using processes foods. We don’t eat meat. We eat lots of whole vegetables. We have also added legumes, whole grains, sprouted bread, whole grain tortillas, nuts, and seeds. Therefore, our carbohydrate intake has flipped from less than 20% of our diet to closer to 80%. These are complex carbohydrates, not simple.

    So, any idea what’s going on? Why is Lynn’s morning blood sugar now surging since switching to a plant-based diet?

  25. Without a diet log, it’s very hard to tell what might be going on. I am concerned about your comment: “healthy fats” as there is no such thing as healthy fats other than eating whole raw nuts or avocados. Olive oil decreases flow mediated dilation which correlates highly with premature death. Please keep in mind that “plant based” is usually not enough to return to health. It often requires 100% unprocessed plant based. I.e no blenders or machinery of any kind. Also, other factors are often involved such as metabolic syndrome and or medication. Best to find a medical doctor that ascribes to the WFPB lifestyle to do a workup and find out what is happening.

  26. Thanks for the great resources and videos, and for taking time to put them together.

    I have a question for the community: “Should I be taking insulin/other medication while on a PBWF diet?”

    Some context: I am a 53YO male, with a starting weight of 365lb, type II diabetes, but none of the complications that often accompany T2D. I have lost about 60lb (current weight 304.2lb) and my target is to lose a further 98lb. I fell off the WFPB wagon for a few months until one of my fee started to swell up. I took my blood sugar and it was 390mg/DL (not good, I know). That was about 3 weeks ago, so I got strict about being on the WFPB diet, drinking hibiscus tea, eating about 1tbspn ground flax seeds daily, and having the requisite cruciferous vegetables. Based on some recent videos from Dr. Gregor, have bought vitamins B12 and Omega 3 supplements. I have also tried to limit fat intake to less than 15% of calories for daily intake, and while I don’t always achieve that, most of the fat comes from the flax seeds and green lentils.

    What prompted the question is that my I take my blood sugar readings, they seem to be higher than I expected: fasting is about 145-165mg/dL and during the day ranging from 158-219mg/dL. I do recognize that while these numbers are *much* better than my starting 390mg/DL fiasco, it is still not at the less-than-100mg/dL fast blood sugar that I am told I should have.

    I would appreciate any insights from the community. Thanks in anticipation.

  27. Hello Mark, and thank you for your question,
    I am a family doctor with a private practice in lifestyle medicine, and also a volunteer for Dr. Greger on this website. I’ll start by saying that trying to give advice to a patient on the internet, without knowing your full history, is difficult, and could lead to my giving you poor advice.

    But you pose an important question in general, which is whether or not there is a place for taking medication in addition to following a whole foods plant-based diet — for ANY disease. The answer to that, in my opinion, is clearly YES. You didn’t mention your height, but assuming you’re about 6 feet tall, that means your current body mass index (BMI) would be 41.2, which puts you in the “morbidly obese” category — anything above 40 is morbidly obese. (I know that this term can be insulting, so sorry for that).

    You also did not mention what is your “hemoglobin A1c” level. This is a more helpful number to know than your glucose level(s), because the “A1c” level shows what your AVERAGE blood glucose levels have been, over about the past month or so. For your reference, a normal A1c level is less than 5.7; “pre-diabetes” levels are 5.7-6.4, diabetes is 6.5 and above; people with diabetes should aim to get their A1c below 7.0; “poorly controlled” diabetes is 8.0 or above (there may be some disagreement about this last number).

    My own procedure with patients is that EVERY diabetic, no matter how high their A1c level is, should get on a whole food plant-based diet, for the reasons that Dr. Greger outlines in the above video. For those whose A1c is above 8.0, I would give them 3 months or so to see how much improvement they can make with diet alone. If they haven’t made much progress, I would probably advise them to start on metformin (or if they’re already taking it, to keep taking it).

    I tend to avoid starting patients on insulin, unless they’re very sick and in the hospital. This is because the problem with Type 2 diabetics is not a lack of insulin — indeed insulin levels of T2 diabetics are higher than normal — it’s that you have “insulin resistance” — i.e. your body does not respond properly to insulin. Giving T2 diabetics more insulin does work to lower blood glucose (if the dose is high enough), but it’s kind of like throwing more fuel on the fire, and does not address the underlying problem. Insulin therapy also almost always leads to weight GAIN. Metformin, on the other hand, at least helps somewhat with the underlying problem, by lowering insulin resistance, and usually results in some loss of weight.

    So, my advice to you is to get your A1c level checked every 3 months, and definitely to stick closely to a WFPB diet. If your A1c is still 8.0 or above, after being on a good diet for over 3 months, I would probably advise you to start metformin — depending on your other medical problems. For example, if your kidney function has declined, metformin might not be a good idea. So, you need to get a “chem-14” panel drawn as well, plus cholesterol levels.

    I assume you know that uncontrolled diabetes can lead to kidney failure, blindness, loss of sensation in your feet and hands, erectile dysfunction, coronary artery disease and heart attacks, and death. Morbid obesity is also a clear risk factor for early death, and various other illnesses.

    I hope this has helped.
    Dr. Jon
    PhysicianAssistedWellness.com
    Health Support Volunteer for NutritionFacts.org

    1. To minimize insulin resistance you need to get the fat out of your diet and fat off your body. Working in the McDougall Corporate programs for over 5 years it is easy to get the fat out of your diet in a residential 8 day program. Yes that means no olive or canola or coconut or palm oils. Getting the fat off your body is a lengthier proposition as Dr. Jon can attest to. The best NF.org video’s that drive home these concepts in my opinion are:
      1. https://nutritionfacts.org/video/the-spillover-effect-links-obesity-to-diabetes/

      2. https://nutritionfacts.org/video/what-causes-insulin-resistance/

      Dr. McDougall and myself never prescribe oral medications. You and see his reasoning in his December 2009 newsletter article, Simple Care for Diabetes, available free on his website. I must admit it took me some time and experience to feel comfortable not pushing pills and tests after 30 years in standard practice. I recommend the use home glucose testing in conjunction with your provider and avoid requiring trips to the lab for testing. You have to remember that the medical industry sets “normal” which is not necessarily “healthy”. Dr. Greger’s up coming book, How Not to Diet, will support folks who are getting the fat off their body. I have also found Jeff Novick’s free You Tube video, Calorie Density: Eat More, Weigh Less and Live Longer, useful in understanding what I believe is the most important concept in achieving and/or maintaining a healthy body weight. Good luck and keep tuned as the science keeps coming. Dr. Greger with the support of many volunteers review the science… so you don’t have to.

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This