How to Reverse Type 2 Diabetes

 

Diabetes reversal, not just treatment, should be a goal in the management of type 2 diabetes. Type 2 diabetes can be reversed not only with an extremely low calorie diet, but it can  also be reversed with an extremely healthy diet. Could it be because an extremely healthy diet is also low in calories? This is the topic of my video Diabetes Reversal: Is It the Calories or the Food 

Study subjects lost as much weight on a green, leafy vegetable-packed plant-based diet as those who were on a semi-starvation diet based on liquid meal replacements. So, does it matter what we’re eating as long as we’re eating few enough calories to lose 15 pounds a month?

Even if diabetes reversal is just about calorie restriction, instead of subsisting off largely sugar, powdered milk, corn syrup, and oil (common ingredients in some liquid diet drinks) on the plant-based diet at least one can real food—in fact, as many low-cal veggies as desired. So, even if it only works because it’s just another type of calorie-restricted diet, it’s certainly a healthier version. But, even participants in the study who did not lose weight—or even gained weight eating enormous quantities of whole healthy plant foods—appeared to improve their diabetes. Thus, the beneficial effects of this kind of diet appear to extend beyond weight loss.

The successful treatment of type 2 diabetes with a plant-based diet goes back to the 1930s, providing “incontestable evidence” that a diet centered around vegetables, fruits, grains, and beans was more effective in controlling diabetes than any other dietary treatment. In a randomized controlled trial, insulin needs were cut in half and a quarter of the subjects ended up off insulin altogether. But, again, this was a low-calorie diet. Walter Kempner at Duke University School of Medicine reported similar results 20 years later with his rice and fruit diet studies, showing for the first time documented reversal of diabetic retinopathy in a quarter of his patients, something never even thought possible. One patient, for example, was a 60-year-old diabetic woman already blind in one eye and who could only see contours of large objects with the other. Five years later, while on the diet, instead of her vision getting worse, it got better. She “could make out faces and read signs and large newspaper print,” and got off insulin, had normal blood sugars, and had a 100-point drop in her cholesterol. Another patient went from only being able to read big headlines to being able to read newsprint four months later. What was behind these remarkable reversals? Was it because the diet was extremely low-fat or because there was no animal protein or animal fat? Or, was it because the diet was so restrictive and monotonous that the patients lost weight and improved their diabetes that way?

To tease this out, we needed a study where researchers switched people to a healthy diet, but forced them to eat so much they didn’t lose any weight. Then, we could see if a plant-based diet has unique benefits independent of all the weight loss. For that, we had to wait another 20 years until a study in the 1970s. In it, diets were designed to be weight-maintaining. Participants were weighed every day, and, if they started losing weight, the researchers made them eat more food—in fact, so much food that some of the participants had trouble eating it all, but they eventually adapted. Thus, there were no significant alterations in body weight despite restrictions of meat, dairy, eggs and processed junk, and there were enough whole plant foods—whole grains, beans, vegetables, and fruit—to provide 65 grams of fiber a day, four times what the Standard American Diet provides.

The control diet they used was the conventional diabetic diet, which actually had nearly twice the fiber content of the Standard American Diet, so it was probably healthier than what they had been used to eating. So, how did the even healthier diet group do? With zero weight loss, did the dietary intervention still help? The study compared the number of units of insulin with which subjects had to inject themselves daily before and after going on the plant-based diet. Overall, despite no change in weight, insulin requirements were cut about 60 percent, and half of the diabetics  were able to get off insulin altogether. Was this after five years, or after seven months, as had been the case in the other studies discussed above? No.

It was after 16 days.

To be clear, we’re talking about diabetics who had had diabetes as long as 20 years, injecting 20 units of insulin a day, getting off insulin altogether in as few as 13 days, thanks to less than two weeks on a plant-based diet. Patient 15, for example, had injected 32 units of insulin while on the control diet, and then, 18 days later, none. Lower blood sugars on 32 units less insulin.

That’s the power of plants.

As a bonus, their cholesterol dropped like a rock to under 150 on average in 16 days, making them nearly heart attack proof as well. Just as “moderate changes in diet usually result in only modest reductions” in cholesterol, asking people with diabetes to make moderate changes often achieves equally moderate results, which is one possible reason why most end up on oral drugs, injections, or both. Everything in moderation may be a truer statement than people realize. Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, moderate amputations. Moderation in all things is not necessarily a good thing.

The more we, as physicians, ask from our patients, the more we—and they—get. The old adage, “shoot for the moon,” seems to apply. It “may be more effective than limiting patients to small steps that may sound more manageable but are not sufficient to actually prevent disease progression.”


Although I have dozens of videos about diabetes, I think Diabetes Reversal: Is It the Calories or the Food may be the single most powerful one I‘ve made. Please share this life-changing, life-saving video with anyone you know who has type 2 diabetes or is at risk for the dreaded disease. As far as I’m concerned, it should be required viewing for every healthcare practitioner. I wish I had seen it when I was a medical student!

If these kinds of videos have benefited you or your loved ones, please consider becoming a monthly supporter.

This is the final installment of a three-part series. If you missed the first two, check out Reversing Diabetes with Surgery and Reversing Diabetes with Food.

For more on the remarkable work of Dr. Kempner, see:

For more related videos, give one of these a try!

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Don’t Let Their Divide and Conquer Strategy Work

Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of calorie-dense foods, including corn syrup, sugar, animal products, and oils. This is all thanks to global agricultural policies that have built in a long-term focus on creating things like cheap corn. “Consumption of foods high in saturated and industrially produced trans fats, salt, and sugar is the cause of at least 14 million deaths every year.”

“Few governments prioritize health over big business. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything,” said Dr. Margaret Chan, Director-General of the World Health Organization. “This is not a failure of individual will-power. This is a failure of political will to take on big business.”

This is difficult terrain for many public health scientists. As discussed in my video The Healthy Food Movement: Strength in Unity, “It took five decades after the initial studies linking tobacco and cancer for effective public health policies to be put in place, with enormous cost to human health. Must we wait another five decades to respond to the similar effects of Big Food?”

They do have money on their side. The chemical, tobacco, and food industries have the luxury to share similar tactics with the drug companies because they have the resources to do so. By contrast, powerful and inexpensive health-promoting activities, such as eating a healthy diet, are actually “too cheap and not patented.”

Preventing cardiovascular disease “is not an easy task because it means engaging in a battle against strong industrial sectors; but it is possible with sufficient political courage and citizen support.”

In fact, it’s not only possible—it’s been done before. The move back to breastfeeding is a great example of action in public health nutrition that is still succeeding. Breastmilk doesn’t make anyone any money, so companies like Nestle pushed infant formulas and millions of babies may have died as a result. A global movement rose up and resulted in the passage of a code regulating the marketing of breastmilk substitutes. As the Director-General of the World Health Organization (WHO) at the time said, “Without their constant lobbying, reminding us of our duty as public health officers…WHO simply would not have had the courage to get on with it.”

“What has this got to do with nutrition and food policy [now]? Everything, if we want to improve public health. We must seek out the food and nutrition equivalents of Greenpeace…we should be prepared to stand up and be counted…Might this put our jobs and careers on the line? You had better believe that it will.”

To do this, the healthy food movement needs to stay united.

Tobacco industry giant Philip Morris is still fighting into the 21st century. Their latest campaign, dubbed ‘‘Project Sunrise,’’ was launched to lead to the ‘‘dawn of a new day.’’ Their own internal Public Policy Plan Draft calls Project Sunrise “an explicit divide-and-conquer strategy against the tobacco control movement.” Indeed, according to Philip Morris, the number-one vulnerability of the anti-smoking movement is that their success “may blind organizations to carefully orchestrated efforts by the tobacco industry and its allies to accelerate turf wars and exacerbate philosophical schisms.” So, their main objectives were to attack the credibility of the anti-smoking movement, create schisms, and force them to fight amongst themselves. Think of how much of that we already do in the healthy food movement, and it just distracts us from the bigger picture.

One of Philip Morris’ primary strategies was to drive a wedge between various anti-smoking groups. Another was to weaken the their credibility, in part by developing communication strategies to “demonstrate the extremism of the health prevention movement. First tobacco, then alcohol, then meet (sic), then other products.” Not only are the tobacco lawyers a bit spelling challenged, but public health groups are part of a health promotion movement. Health prevention is more the purview of Big Ag.


Not only do public health nutrition groups fight amongst themselves—they sometimes even bed down with Big Food. See my videos Collaboration with the New Vectors of Disease and American Medical Association Complicity with Big Tobacco.

The True Health Initiative, spearheaded by Dr. David Katz, is a great example of the strength in unity concept I’m trying to get across. Please consider joining.

For more on unbelievable tobacco tactics, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The post Don’t Let Their Divide and Conquer Strategy Work appeared first on NutritionFacts.org.

Follow the 5-to-1 Rule for Packaged Foods

When people think fiber, they think constipation. And it’s true: If we could get Americans to eat just the minimum recommended daily intake of fiber-containing foods, we could save our country $80 billion—and that’s just from the effects on constipation alone. But that’s not all. “Accumulating evidence indicates that greater dietary fiber intakes reduce risk for type 2 diabetes, cardiovascular disease, certain cancers, weight gain, obesity, and diverticular disease, as well as functional constipation.” So, we need to eat more fiber-rich foods, which means eating more whole grains, vegetables, fruits, and legumes (beans, split peas, chickpeas, and lentils).

As fiber intake goes up, the risk of metabolic syndrome appears to go down, with less inflammation and an apparent step-wise drop in obesity risk. It’s therefore no surprise that greater dietary fiber intake is associated with a lower risk of heart disease: There is a 9 percent lower risk for every additional 7 grams a day of total fiber consumed, which is just some rice and beans or a few servings of fruits and veggies.

How does fiber do its magic? What are the mechanisms by which dietary fiber may extend our lifespan? It helps get rid of excess bile, feeds our good bacteria, and changes our gut hormones, which collectively helps control our cholesterol, body weight, blood sugar, and blood pressure, thereby reducing the risk for cardiovascular disease. Reducing inflammation is a whole other mechanism by which fiber may help prevent chronic disease.

An accompanying editorial to a fiber and heart disease meta-analysis implored doctors to “enthusiastically and skil[l]fully recommend that patients consume more dietary fibre”––which means a lot of whole plant foods. If we do buy something packaged, however, the first word in the ingredients list should be “whole.” But, even if it is, the rest of the ingredients could be junk. A second strategy is to look at the ratio of grams of carbohydrates to grams of dietary fiber. We’re looking for about 5 to 1 or less. For example, whole-wheat Wonder Bread passes the first test: The first word in its ingredients list is “whole.” However, it then includes corn syrup and the contents of a chemistry set. So, let’s see if it passes the 5-to-1 rule.

In my video The 5-to-1 Fiber Rule. I show examples of some Nutrition Facts labels. The whole-wheat Wonder Bread lists 20 grams of carbs and 2.7 grams of dietary fiber per serving. Dividing the carbohydrates by the dietary fiber, 20 divided by 2.7, is about 7, which is obviously more than 5, so back it goes onto the shelf. It’s better than white Wonder Bread, though, which comes in at over 18. Ezekiel sprouted grain bread, however, makes the cut: 15 divided by 3 equals 5.

You can do the same thing with breakfast cereal. Multi-Grain Cheerios sounds healthy but has a ratio over 7. Uncle Sam original cereal is an example of one that makes the cut, sliding in under 4.

The editorial concluded that the “recommendation to consume diets with adequate amounts of dietary fibre may turn out to be the most important nutritional recommendation of all.”


I love producing videos about practical, day-to-day decision-making. Next time you go to the grocery store, look for products that fit the 5-to-1 ratio rule. They aren’t easy to find!

Eating fiber-rich foods is more than just a way to avoid constipation. For example, watch my videos Fiber vs. Breast Cancer and How to Prevent a Stroke.

There’s a misconception that we can’t digest fiber. We can’t do it alone, but we can with a little help from our gut flora friends. See Prebiotics: Tending Our Inner Garden and Gut Microbiome: Strike It Rich with Whole Grains.

This isn’t to downplay all the suffering caused by constipation. Check out How Many Bowel Movements Should You Have Every Day? and Should You Sit, Squat, or Lean During a Bowel Movement? to learn more.

Isn’t this talk of fiber reductionist? Good question! So good, in fact, that I created an entire video about it. See Is the Fiber Theory Wrong?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: