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Eating for Diabetes Reversal: Part 4
Dating the Diets
Reversing diabetes is all about backpedaling away from modern human diet and getting enough exercise. There is a whole spectrum of options for backing away from the modern human diet, and the scientific evidence that has accumulated over the past 5 years demonstrates that dietary adherence level, rather than diet type, is the key predictor of the amount of weight loss and improvements in heart disease and diabetes risk factors.
All the diets we compared in the Tufts Popular Diet Trial (see Eating for Diabetes Reversal Part 3) reduced caloric intake, and that appears to be the main determinant of weight loss. The Atkins diet is not all about eating low calorie food however. Butter, mayonnaise, cheese, fatty meats, and many other high-calorie foods are allowed and were eaten by study participants, with no direct focus on reducing food amounts or daily caloric intake. How did they lose weight? Food records indicated they lost weigh by eating fewer calories (indirect calorie reduction). Our study was not designed to verify or exclude the possibility of a "metabolic advantage" (increased metabolism) caused by eliminating carbohydrates, however as best as I can tell, the Atkins diet results in a reduced caloric intake by reducing hunger and appetite. Fat and protein reduce hunger, while starch and sugar increase hunger, due to the effects of these foods on hormones and other signals to the appetite center of the brain. Furthermore, the foods are high in saturated fat and cholesterol, yet the expected worsening of cholesterol levels in the blood is offset by the weight loss that occurs. In fact, the Atkins diet improved cholesterol ratios as well as any other eating strategy, mainly by increasing good (HDL) cholesterol without increasing bad (LDL) cholesterol. In people with high blood pressure, prediabetes, or diabetes, the Atkins diet did a nice job improving those problems too. Unfortunately, we were unable to assess the effect of any of the diets on heart attack rates, so it is possible that the Atkins diet worsens the risk of heart attacks, even though all the blood tests and other measurements suggest otherwise.
On the other hand, the Ornish low-fat vegetarian diet reduced caloric intake directly because the food people were eating was low in calories. They ate plenty of food, but the daily caloric intake was low. Again, the more closely someone followed the Ornish diet, the lower the daily calorie intake, and the greater the weight loss. The greater the weight loss, the greater the reduction in heart disease and diabetes risk factors. Even though the Ornish diet is high in whole grains and therefore starch, the weight loss offsets any rise in blood sugar or insulin that might have been expected. The cholesterol ratios improved, mainly by decreasing the bad (LDL) cholesterol without increasing the good (HDL) cholesterol. Dr. Ornish has demonstrated that high adherence to his diet can reduce blockages in the heart arteries, and reduce heart attack rates. This does not prove that his diet would reduce heart attacks better than other diets in a fair head-to-head trial in which all participants were highly adherent to the diets.
The other diets, like Zone and Weight Watchers appear to benefit from both the direct, and indirect approach to calorie reduction. They reduce starch and sugar, resulting in less hunger, and they reduce the caloric density of the food, thus resulting in direct caloric reduction. Similarly, they improve body weight and risk factors for diabetes and heart disease in parallel to dietary adherence level.
To those who say one diet is best for everyone, I say that is like saying one color of the rainbow is best, or one type of music is best. Individuals may have favorites, but that is different from saying one is best for everyone. Similarly, those who say a particular diet is bad (or worst) for people, are not being open-minded or basing their opinions on the scientific evidence we have to date. Sadly, the Atkins diet was unfairly dismissed many decades ago, and had the authorities been open to testing this diet in the 1970’s, we could have known then what we know now.
I welcomed the news that there are many options available. Some might say this adds confusion and "too many choices" but I reject that concern. I know many people who have failed the classical mainstream approach to weight loss, but found long-term success on less mainstream approaches.
"How do I find the right eating strategy for me?" My answer is "Dating the Diets". There are hundreds of diet books out there, each a little different from the others. Many fish in the sea. A cover for every pot. Go find yours! I have often said looking for the right eating strategy is like looking for a life partner. You might have to kiss a few frogs along the way, but that is a small price to pay for finding your soul mate – your long-term match. Your true love to which you can remain faithful forever. Some may prefer to play the field and just switch from plan to plan, which also works. They all cut calories, so as long as you switch plans without any significant time spent "off plan" you can maintain or extend your weight loss or health goals.
In an attempt to take advantage of these new insights (about 6 years ago), I directed a medical program devoted to offering about a dozen different eating strategies to my patients. After getting to know each patient’s medical situation, lifestyle, and food preferences, I would help them choose from a "menu" of eating plan options ranging from very low carb to very low fat, and everything in between. We had small groups available for each eating plan, and it was a lot of fun for me to lead so many kinds of groups. Some patients did switch between groups sometimes, although most preferred to remain devoted to their one particular favorite.
So to sum up so far, there are many eating strategies that work, but only if you can find one you can stick to. For too may people, that challenge remains unmet.
I wish there was some kind of pill I could prescribe that caused high adherence levels – because that pill would produce diabetes reversal!
Talk with others about Taking Your Diet on a Date on Dr Dansinger's message board.
- Michael Dansinger, MD
Read the entire series:
Related Topics:
Reversing diabetes is all about backpedaling away from modern human diet and getting enough exercise. There is a whole spectrum of options for backing away from the modern human diet, and the scientific evidence that has accumulated over the past 5 years demonstrates that dietary adherence level, rather than diet type, is the key predictor of the amount of weight loss and improvements in heart disease and diabetes risk factors.
All the diets we compared in the Tufts Popular Diet Trial (see Eating for Diabetes Reversal Part 3) reduced caloric intake, and that appears to be the main determinant of weight loss. The Atkins diet is not all about eating low calorie food however. Butter, mayonnaise, cheese, fatty meats, and many other high-calorie foods are allowed and were eaten by study participants, with no direct focus on reducing food amounts or daily caloric intake. How did they lose weight? Food records indicated they lost weigh by eating fewer calories (indirect calorie reduction). Our study was not designed to verify or exclude the possibility of a "metabolic advantage" (increased metabolism) caused by eliminating carbohydrates, however as best as I can tell, the Atkins diet results in a reduced caloric intake by reducing hunger and appetite. Fat and protein reduce hunger, while starch and sugar increase hunger, due to the effects of these foods on hormones and other signals to the appetite center of the brain. Furthermore, the foods are high in saturated fat and cholesterol, yet the expected worsening of cholesterol levels in the blood is offset by the weight loss that occurs. In fact, the Atkins diet improved cholesterol ratios as well as any other eating strategy, mainly by increasing good (HDL) cholesterol without increasing bad (LDL) cholesterol. In people with high blood pressure, prediabetes, or diabetes, the Atkins diet did a nice job improving those problems too. Unfortunately, we were unable to assess the effect of any of the diets on heart attack rates, so it is possible that the Atkins diet worsens the risk of heart attacks, even though all the blood tests and other measurements suggest otherwise.
On the other hand, the Ornish low-fat vegetarian diet reduced caloric intake directly because the food people were eating was low in calories. They ate plenty of food, but the daily caloric intake was low. Again, the more closely someone followed the Ornish diet, the lower the daily calorie intake, and the greater the weight loss. The greater the weight loss, the greater the reduction in heart disease and diabetes risk factors. Even though the Ornish diet is high in whole grains and therefore starch, the weight loss offsets any rise in blood sugar or insulin that might have been expected. The cholesterol ratios improved, mainly by decreasing the bad (LDL) cholesterol without increasing the good (HDL) cholesterol. Dr. Ornish has demonstrated that high adherence to his diet can reduce blockages in the heart arteries, and reduce heart attack rates. This does not prove that his diet would reduce heart attacks better than other diets in a fair head-to-head trial in which all participants were highly adherent to the diets.
The other diets, like Zone and Weight Watchers appear to benefit from both the direct, and indirect approach to calorie reduction. They reduce starch and sugar, resulting in less hunger, and they reduce the caloric density of the food, thus resulting in direct caloric reduction. Similarly, they improve body weight and risk factors for diabetes and heart disease in parallel to dietary adherence level.
To those who say one diet is best for everyone, I say that is like saying one color of the rainbow is best, or one type of music is best. Individuals may have favorites, but that is different from saying one is best for everyone. Similarly, those who say a particular diet is bad (or worst) for people, are not being open-minded or basing their opinions on the scientific evidence we have to date. Sadly, the Atkins diet was unfairly dismissed many decades ago, and had the authorities been open to testing this diet in the 1970’s, we could have known then what we know now.
I welcomed the news that there are many options available. Some might say this adds confusion and "too many choices" but I reject that concern. I know many people who have failed the classical mainstream approach to weight loss, but found long-term success on less mainstream approaches.
"How do I find the right eating strategy for me?" My answer is "Dating the Diets". There are hundreds of diet books out there, each a little different from the others. Many fish in the sea. A cover for every pot. Go find yours! I have often said looking for the right eating strategy is like looking for a life partner. You might have to kiss a few frogs along the way, but that is a small price to pay for finding your soul mate – your long-term match. Your true love to which you can remain faithful forever. Some may prefer to play the field and just switch from plan to plan, which also works. They all cut calories, so as long as you switch plans without any significant time spent "off plan" you can maintain or extend your weight loss or health goals.
In an attempt to take advantage of these new insights (about 6 years ago), I directed a medical program devoted to offering about a dozen different eating strategies to my patients. After getting to know each patient’s medical situation, lifestyle, and food preferences, I would help them choose from a "menu" of eating plan options ranging from very low carb to very low fat, and everything in between. We had small groups available for each eating plan, and it was a lot of fun for me to lead so many kinds of groups. Some patients did switch between groups sometimes, although most preferred to remain devoted to their one particular favorite.
So to sum up so far, there are many eating strategies that work, but only if you can find one you can stick to. For too may people, that challenge remains unmet.
I wish there was some kind of pill I could prescribe that caused high adherence levels – because that pill would produce diabetes reversal!
Talk with others about Taking Your Diet on a Date on Dr Dansinger's message board.
- Michael Dansinger, MD
Read the entire series:
- "Natural Food" versus "Modern Food"
- A Spectrum Of Options
- The Tufts Popular Diet Trial
- Dating the Diets
- Caloric Density, Glycemic Load, and Saturated Fat: Key Players In Diabetes Reversal
- Dr. Dansinger's Eating Strategy for Diabetes Reversal
- Sample Meals
Related Topics:
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