Animal Protein and Diabetes

People in my practice are often diagnosed with adult-onset diabetes and they are usually curious as to how and why they developed it. My answer has been that it is some combination of their genetic heritage and their environment, but that the environment is playing a big role because we have seen a huge increase in the number of cases of diabetes over the last decade.

A recent study showed that people who ate no animal protein were only 25% as likely to develop adult-onset diabetes as those who ate a regular American diet. A close analysis of the data seems to suggest that the finding is robust.

The number of patients in the study was quite high, over 40,000 people. This increases the power of a study to detect small differences, but also makes it much less likely that a given finding of a study is due to chance differences, rather than real differences.

In addition, there are other studies that seem to show the same things. A study in Japanese schoolchildren was particularly interesting. It showed that increased consumption of animal proteins was associated with increased diabetes. This was only correlation and not cause, since the study was retrospective, but it seems to confirm the Loma Linda study's findings.

Also, a study done in Europe, called EPIC showed animal protein consumption was also an independent risk factor for the development of diabetes.

The takeaway message from these three studies on three continents in three very different populations is that we should all try to avoid animal protein to the degree our histories and personalities will allow, unless we want to become diabetic. In addition, it seems to suggest that even people with diabetes stand a good chance of returning their body to normal functioning if they avoid food that tends to cause the disease.

If you have a strong genetic heritage of diabetes, this information should be even more important to you. Feel free to make an appointment at Total Care Family Practice to review your current eating habits and see if we can make significant changes to protect your health.

Chickpeas and Sugar

Sounds like a sort of odd Mediterranean recipe, I know, but it isn't. It's the topic of a new study that tried to figure out what the role of legume consumption was on diabetes.

The study is small, only 121 patients, and thus the results can't be fully generalized, but the addition of a cup of legumes or chickpeas to the diabetic patient's diets dropped hemoglobin A1c, a measure of average blood sugar over 3 months, by 0.5%, which is comparable to many drugs used to treat diabetes.

Interestingly, the comparative group were given a cup of whole grain per day, and they also saw a drop in Hgba1c of 0.3%. Possibly due to the Hawthorne effect.

What we learn is that adding legumes like chickpeas and lentils may help blood sugar control as much as several medications. So have at them!

The Little Decisions

When it comes to your health, sometimes the biggest decisions are the smallest ones. Everyone has had the experience of walking past a box of cookies or a bowl full of candy. The decisions that you make during such a daily task have a gigantic cumulative effect on your overall health. American sugar consumption is now over 107 pounds of sugar per person per year.

So that you can understand what this means, in 1822, which is certainly not the lowest the refined sugar concentration has ever been in the human diet, the average American ate as much sugar as is found in a regular twelve ounce Coca-Cola every five days. The staggering increase in sugar consumption hasn't happened simply by having people gorge on Twinkies and M&Ms however. Sugars are added to many foods that are not thought of as sweets to increase their palatability. Thousand Island dressing, for example, has over four grams of sugar per ounce.

So one small decision that I strongly recommend is to read food labels when shopping. Avoid purchasing foods with high levels of any sugar, be it cane juice, agave, sugar, high-fructose corn syrup, brown sugar or honey. In addition, avoid sugary condiments like thousand island dressing and ketchup as anything other than a rare treat (every week or less).

Can't I Do This Naturally?

"Is there a natural way to get my cholesterol down?"

"Is there a way to get my diabetes under control without all these pills?"

"Can I control my blood pressure naturally?"

Usually, the answer is, "Yes, you can." I recommend eating a healthy diet, exercising regularly and avoiding the extremes of psychological stressors. Yet most of my patients have trouble making the adjustments to diet and lifestyle that are necessary to control their metabolism without medications.

So it is gratifying when occasionally I have patients who do exactly what I recommend and harvest the results. Over the last month, I've seen three patients, all of whom were diagnosed with diabetes. Each one had changed their diet to a primarily whole foods, plant-based diet and all of them had been able, in consultation with me to drop all diabetes medications. All but one had been (again, on my advice) able to discontinue their cholesterol pills, and we stopped the one who was still on them. One patient was only on a single blood pressure pill with a goal of stopping that as well, down from seven different medications previously.

The lesson is that the people who can and do make modifications to their eating and lifestyle do get great results.

Locos Win!

Gary Manley and I were happy to serve as medical personnel at the most recent Las Vegas Locos game! The game was a lot of fun to attend and it was great to meet and talk to the players and coaching staff. The trainers really put in a lot of effort to help the players get ready and stay ready to play.

The Locos did end up winning the game 19-6. They have won their league two out of three seasons and started the year with a defeat of the defending champs. We'll be rooting for them as they take on Omaha this Wednesday night!

Five Great Pieces of News About Fruit!

William Tell once shot one off his son's head in an old Swiss Legend that appears to have been based on an older Norse legend about a marksman. Modern iconography seems to always depict the fruit eaten by Eve in the Garden of Eden as one. One a day, so the saying goes, keeps the doctor away.

The magical, flavorful, crunchy apple is today's topic.

Is it really as good as they say it is? Actually, it may be even better.

Apples have been shown to contain several contents that are unique and carry significant health benefits.

First, they contain phlorizin, which has been shown to lower blood sugar and improve insulin sensitivity in a rat model.

Secondly, they are very high in pectins, which have been shown to lower LDL cholesterol in both rat, guinea pig and human models.

Thirdly, the pectins found in apples and other fruits actually cause colon cancer cells to undergo apoptosis, a type of suicide.

In addition, they also contain quercetin, a flavonoid compound that actually protects against lung cancer.

Finally, as if you needed more reasons to up your intake of apples, they actually appear to help with weight loss! Three apples or pears a day seemed to make it easier for women in one study to lose weight.

So go get yourself a pocket knife, or an apple corer or just eat them as they come off the tree, but eat some apples! I'm going to have one right now.

Is the Atkins Diet Actually Good for You?

A new article was published in the Journal of Obesity regarding the Atkins diet or low-carbohydrate diet. This article was an analysis of numerous studies (mostly short-term studies) and tried to quantify the effect of the diet on weight. The authors verified that the Atkins diet led to weight loss and did not elevate cholesterol or creatinine in short-term studies. What they couldn't show was the long-term effect of this diet on the overall health of the patients who tried it.

Weight loss can be accomplished by any number of means including surgery, jaw-wiring, eating only one food (I've seen bananas, hot dogs, Twinkies and ice cream all used as single-food diets that resulted in short term weight loss), or significant calorie-restriction. The goal of most people who are trying to lose weight isn't solely to weigh less, but to get a normal physiology and recapture lost health and vitality that became worse with increased weight. So any study that establishes simply that a strategy creates weight loss is interesting but not compelling unless one can establish in addition that 1) the weight loss is sustained, 2) the patients health improves by some objective measures related to outcomes and not just lab test results (for example, fewer heart attacks, strokes, cancers, cases of diabetes or osteoporosis) 3) the diet is nutritionally replete and doesn't cause unwanted side effects.

While the Atkins diet does seem to cause a weight loss of ten to fifteen pounds in most patients, it hasn't been shown in long-term studies to be superior to other calorie-restricted diets. 

The American Heart Association is pretty clear cut:

The American Heart Association doesn't recommend high-protein diets for weight loss. Some of these diets restrict healthful foods that provide essential nutrients and don't provide the variety of foods needed to adequately meet nutritional needs. People who stay on these diets very long may not get enough vitamins and minerals and face other potential health risks. ...

A healthy diet that includes a variety of foods and is rich in fresh fruits and vegetables along with regular physical activity can help most people manage and maintain weight loss for both cardiovascular health and appearance. The American Heart Association urges people to take a safe and proven route to losing and maintaining weight. By paying attention to portion size and calories and following our guidelines, you can enjoy healthy, nutritionally balanced weight loss for a lifetime of good health.

So is the American Cancer Society, their web page emphasizes limiting red meat and eating at least 2 1/2 cups of fruit and vegetables daily.

A healthy diet will increase energy and vitality. This alone is a very good reason to adopt it, that it can help you lose weight is simply a by-product of the quality of the food.

Dangers of Processed Meats

A recent meta-analysis (study of studies) out of Stockholm, Sweden has suggested that increased consumption of processed meats like pepperoni, sausage and bacon increases the risk of cancer of the pancreas in people who consume them daily. Reviewing the study, I find the data intriguing and a large study designed to answer this question seems imperative, given the large amounts of consumption of these products in the US and throughout the world.

What did they find specifically?

Eating more than 50 gm (1.8 oz) of processed meat per day was associated with an increase of almost 1 in 5 in the risk of developing cancer of the pancreas. Pancreatic cancer is a very serious cancer, with a survival rate five years after diagnosis of about 5.5%. Prior studies have already established an association between consumption of processed meat and stomach and colorectal cancers.

It is important to understand that all this and previous studies have shown is correlation or association between the two things. They do not show that the consumption of the processed meat is proven to cause the cancer, they simply show that the risk of the cancer is increased in those people who consume more processed meat. It is possible (maybe even probable) that part of any association between the consumption of processed meat and any cancer will be due to the loss from the diet in the individual consuming the meat of an equivalent amount of fresh fruits and vegetables or other foods higher in fiber. Many studies have established the importance of dietary fiber load in the likelihood of developing colorectal cancer.

This evidence also cannot prove that there is some other component of processed meat that is the primary carcinogen rather than the meat itself. Indeed, the idea that nitrites used to preserve the meats that are the primary cause of the association is mentioned in the article. This article is not a conclusive study, since it is a meta-analysis and not a prospective study. However, other lines of evidence do seem to warrant the conclusion at this point that the healthiest practice would be to avoid daily consumption of processed meats and limit their consumption to very rare occasions. Most importantly, consume lots of fresh vegetables, fruits and other foods high in dietary fiber, both soluble and insoluble.