I have often declared that there are many good eating strategies for diabetes reversal. All eating strategies have strengths and weaknesses. In this blog entry, I’ll share my thoughts about Dr. Neal Barnard’s program for reversing diabetes.
I like Dr. Barnard’s approach. He is a physician who cares deeply about fighting diabetes and getting at the root causes. He recognizes the power of lifestyle change for reversing and preventing health problems, and he has been a leader in framing type 2 diabetes as a potentially “reversible” condition. He has published several books, including the Program for Reversing Diabetes (Rodale, 2007).
Dr. Barnard points out that people with type 2 diabetes or those at risk for diabetes accumulate abnormal fat droplets inside the muscle cells, and this leads to insulin resistance. Eating a high-fat American diet can worsen the problem. He also points out that weight loss can reduce insulin resistance and reduce or eliminate the abnormal fat droplets. This reduction of insulin resistance (or increase in sensitivity to insulin) results in improvement in blood glucose and A1c levels because the available insulin can now work more effectively to usher glucose from the blood into the muscles and organs that use glucose.
He reasons that minimizing dietary fat, especially animal fat (found in meat, eggs and dairy) can directly reduce or eliminate the fat deposits in the muscles. He has repeatedly demonstrated in published research studies (as have other researchers) that a low-fat vegan diet can reduce insulin resistance, improve insulin sensitivity and reduce elevated glucose and A1c levels. Part of the improvement is a result of the weight loss, and part of the improvement is driven by the diet itself. Add exercise to the diet and weight loss and you have a great prescription for type 2 diabetes reversal or prevention.
He frames the vegan diet according to 4 main food groups – whole grains, legumes, vegetables and fruits. He recommends steering away from refined grains and foods made from refined grains (such as white bread) as well as significant amounts of nuts, vegetable oil or high-fat vegetables and fruits. All animal products, including egg whites and non-fat dairy are out. Soy foods, if low in fat, are in.
His book provides a plethora of breakfast, lunch, dinner, and snack ideas and recipes, and a strategy for adapting to this way of eating. A one-day menu might include:
- Veggie sausage, rye toast, oatmeal with raisins and cantaloupe for breakfast
- Green salad, split-pea soup and hummus-cucumber-tomato sandwich on rye for lunch
- Spinach salad, pasta with tomato mushroom sauce and broccoli for dinner
- Fruit for snacks
In my view, this is a solid eating plan that consistently produces good results when the plan is followed carefully. Whole grains help reverse diabetes in the context of a low-fat eating strategy. Fruits, vegetables and legumes do the same. Most people like these foods and find them filling and satisfying. Unfortunately, most people with type 2 diabetes find the vegan diet challenging to start and continue without exceptional coaching.
The vegan diet is a huge leap from the typical Western diet consumed by many with type 2 diabetes. Meat, cheese and animal products are hard for people to avoid after eating such foods daily for decades. Ditto for refined starches and foods high in sugar and fat. All eating strategies require dietary sacrifices (food types and/or portions), and going vegan low-fat may be one of the most ambitious changes one can make.
The payoff is high, but the dietary change is just too extreme for most folks. This is unfortunate, and I believe well-trained lifestyle coaches can help patients/clients overcome the barriers in many cases. If we in the medical profession tried harder, we could help a lot of people go vegan and reap the health benefits.
I’m grateful for Dr. Barnard’s leadership on this issue and see him as a great role model who personally practices what he prescribes. The low-fat vegan diet is not the only way to reverse diabetes, but it is an excellent option that is seriously underrated by patients and health experts.