Warning: Long rant coming (Hope you are used to these by now)
I just got back from filming an episode of The Doctors, and it was a nightmare. Basically felt like a hit job on me and the producer of the documentary What The Health, Kip Andersen.
It was actually kind of sad, and not unexpected. The movie challenges some very basic assumptions we have, like sugar causes diabetes. People hold fast to their preconceived notions and beliefs. Change is difficult. The problem is, without change, we stay the same, and the same is not good.
We spend more money per capita, and as a percentage of GDP, on healthcare than any other country in the world, including those that have socialized healthcare. We also take about 75% of the meds that are taken worldwide. So when people ask me whether we should keep Obamacare, or switch to single payer, or go straight insurance, I tell them it doesn’t matter. NONE of them will work because we keep getting sicker and sicker. They will all fail. And the crazy thing is we keep doing the same things over and over again and expecting different results. I was laughing at Chris Rock who was questioning what good are doctors anyway, we haven’t cured anything, not even toe fungus. He has a point.
So it is so frustrating to me to have these doctors on this TV show ignoring the evidence and trying to argue that we should be eating these foods that the International Agency for Research of Cancer and World Health Organization have labeled as Class I and Class 2a carcinogens: https://www.ncbi.nlm.nih.gov/pubmed/28450127.
How absurd to argue that we should eat a carcinogen.
The saddest thing is how little these TV doctors know about the research. They had huge criticism of the fact that the movie says that one egg has the same risk as smoking 5 cigarettes. They acted like we got this from an industry funded study, or simply made it up. Exactly what industry would fund this I have no idea. The study was from Harvard in what is called a comparative risks analysis looking at the very well respected Nurses Health Study https://academic.oup.com/aje/article/173/3/319/129763.
The results were echoed by two very famous researchers who examined the plaque in the carotid arteries of their patients and compared cholesterol intake to smoking, https://www.ncbi.nlm.nih.gov/pubmed/22882905.
They then tried to counter us by presenting a study showing that eggs are good for you, and guess who funded that study????? THE EGG INDUSTRY! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586539/. I pointed this out but I bet that hits the cutting room floor.
They basically wanted to make the movie look like vegan propaganda with no science to back it, and that is what really gets me.
They asked me if I was vegan, as if this somehow clouded my judgement. I am vegan BECAUSE of this research. As you probably can tell, I really don’t care what people think of me, or what they call me, but I cannot stand people saying that there is no science to back my statements.
Just because you don’t read the science does NOT mean that the science does not exist! Saying we don’t have the science, and not giving us the time to present the science, is intellectually dishonest. There is so much astounding science I could write a book about it; oh wait, I did. A book that has hundreds of peer reviewed studies from top journals and top researchers, and includes huge epidemiologic studies, lab based mechanism of action research, and randomized control trials.
What really gets me is that here is a show that has the opportunity to affect the health of their viewers, and we are there to present the evidence about a diet that has been proven to reverse our greatest killer (heart disease) https://www.ncbi.nlm.nih.gov/pubmed/9863851, https://www.ncbi.nlm.nih.gov/pubmed/10496449, and can help reduce the incidence of our second greatest killer (cancer), and all this while helping to save our environment. Yet they want to talk about moderation, and what moderation leads to is no change at all.
Their main issue had to do with the idea that I state in the movie that sugar does not cause diabetes. This just blows their mind, and so they therefore they don’t believe this is possible. BUT, this is not a belief, it is science. So brace yourself. I will show you the science here if you want to see it, since the doctors didn’t. This is the kind of evidence that compelled me to change my views, but is far too complex for a TV show. It is also an example of how closed-minded it is to dismiss an argument by stating there is no evidence.
There is a very common misconception that we have been eating more sugar and that is why we have more diabetes. This would be a convenient explanation, except, according to the Department of Agriculture we are eating less sugar since 1999, and more oil and fat. In fact, if you look at the highest carbohydrate consuming countries in the world, they have the lowest diabetes rates, until they start eating meat and fat.
The Chinese have had a huge rise in their rate of diabetes, from 2.6% to 9.7% in just a decade. During that time they have had considerable rise in the amount of pork and chicken and oil consumed. The Japanese have likewise seen a huge rise in diabetes, leading their ministry of health to release a report that this is due to the increase in meat consumption and decreased fruit consumption.
The crazy thing is that a huge 7-year study of 500, 000 Chinese showed that regular consumption of fruit reduced the incidence of diabetes by 12% and reduced diabetics from developing complications by 28%. The ridiculous world wide fear of carbs has inextricably lead to a worldwide fear of fruit, and is seriously affecting our health. My patients cannot be convinced that an apple is better for their health than a protein bar. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002279.
To give you an idea how ridiculous this carb fear is, a 2017 meta-analysis looking at 9 different studies with 251,261 people showed that not only did sugar NOT correlate with diabetes, the more sugar the less diabetes (likely because the sugar came in fruit), https://www.ncbi.nlm.nih.gov/pubmed/28536126. The very large Women’s Health Initiative also found no correlation between sugar and diabetes, https://www.ncbi.nlm.nih.gov/pubmed/12663565.
And the famous EPIC study, which followed 500,000 Europeans over 12 years showed that replacing just 5% of saturated fatty acid with fructose decreased the risk of diabetes https://www.ncbi.nlm.nih.gov/pubmed/23880355. And there are many other prospective studies that just don’t show the correlation of sugar and diabetes https://www.ncbi.nlm.nih.gov/pubmed/12663565.
Now, to be fair, there are studies showing consumption of soft drinks can be correlated with diabetes https://www.ncbi.nlm.nih.gov/pubmed/15328324. How can sugar not be related with diabetes but sugar beverages are? Well, partly because they are associated with increase calorie intake and therefore increased weight, but one of the main reasons is people drink their coke while eating their hamburger, and meat and fat correlate strongly with diabetes. The EPIC study showed strong correlation between meat, especially processed meat, and diabetes:
https://www.ncbi.nlm.nih.gov/pubmed/22983636
https://www.ncbi.nlm.nih.gov/pubmed/24196190.
I think one of the greatest studies is the Adventist Health Study because they had the opportunity to follow thousands of people living similar lives in a similar environment, most dedicated to healthy living, but with varying genetics. Perfect audience to follow, especially because they had people who ate meat, though infrequently, and could compare them to lacto-ovo vegetarians and to vegans. What they found is that increasing consumption of protein led to increasing diabetes. In fact, they stated that weekly consumption of meat lead to a whopping 74% increase in the risk of developing diabetes:
https://www.ncbi.nlm.nih.gov/pubmed/19351712
https://www.ncbi.nlm.nih.gov/pubmed/21411506
https://www.ncbi.nlm.nih.gov/pubmed/3985239
https://www.ncbi.nlm.nih.gov/pubmed/18349528
And the associations don’t stop there. The Nurses Health Study, The Health Professionals Study, The Women’s Health Initiative, and many more have shown this same correlation of meat and diabetes.
https://www.ncbi.nlm.nih.gov/pubmed/15534160
https://www.ncbi.nlm.nih.gov/pubmed/23779232
https://www.ncbi.nlm.nih.gov/pubmed/24284436
https://www.ncbi.nlm.nih.gov/pubmed/11874924
https://www.ncbi.nlm.nih.gov/pubmed/15333470
https://www.ncbi.nlm.nih.gov/pubmed/25832335
If anybody calls this cherry picking they are just crazy! So now you may ask HOW??? How can meat/fat cause diabetes and sugar not cause it. Well, this is a much more in depth discussion.
Evidence that Fat, Not Sugar, Causes Diabetes
We are perfectly designed to consume carbs and burn sugar. Every cell in our body is built to burn sugar. The issue comes in the fact that the sugar needs to be able to get into the cell for the cell to utilize the sugar or store it as glycogen. There have been many studies showing that turning sugar to fat is very rare and in over feeding studies, where people are fed large amounts of carbs, only about 3% are turned to fat:
https://www.ncbi.nlm.nih.gov/pubmed/10365981
http://ajcn.nutrition.org/content/74/6/707.full.
The problem begins when our cells become resistant to insulin. Insulin is the key that unlocks the door that allows sugar into the cell. If the key all of a sudden doesn’t fit, then sugar backs up. When sugar backs up then the pancreas has to churn out even more insulin. Eventually the pancreas begins to fail, and then you have steeply rising sugars and a diagnosis of diabetes.
Basically, there are a combination of reasons that the insulin receptors stop working. Part of it is that saturated fat directly affects the cells themselves. The muscle is the main burner of sugar. As fat gets taken up in the muscle cells it interferes with the cells ability to make insulin receptors. There is also evidence that fat in the cell competes with the cells ability to utilize sugar, called the Randle effect. To get even more scientific, there is evidence that leucine, an amino acid heavy in meat, activates a pathway called mTOR which affects the receptor. There is also evidence that inflammation and the formation of advanced glycalated end products all affect the insulin receptor.
Bottom line is this: I can make anybody insulin resistant by hooking them up to an IV and infusing them with fats, or just feeding them lots of fats, and specifically saturated fat. https://www.ncbi.nlm.nih.gov/pubmed/24550191.
If you then do a muscle biopsy or a special MRI, you will see that the muscle cell is full of fat, and when it is full of fat, it cannot take in the sugar. Add to this the fact that saturated fat and heme iron found in meat damage the Beta cells of the pancreas, and you get diabetes.
https://www.ncbi.nlm.nih.gov/pubmed/22360800,
https://www.ncbi.nlm.nih.gov/pubmed/23509418,
https://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+26615402
https://www.ncbi.nlm.nih.gov/pubmed/27903520
https://www.ncbi.nlm.nih.gov/pubmed/25353663
https://www.ncbi.nlm.nih.gov/pubmed/?term=PMID%3A+27732859
https://www.ncbi.nlm.nih.gov/pubmed/21862724
https://www.ncbi.nlm.nih.gov/pubmed/15836891
https://www.ncbi.nlm.nih.gov/pubmed/23046549
https://www.ncbi.nlm.nih.gov/pubmed/14871914
https://www.ncbi.nlm.nih.gov/pubmed/1317328
https://www.ncbi.nlm.nih.gov/pubmed/23866833
https://www.ncbi.nlm.nih.gov/pubmed/11591239
https://www.ncbi.nlm.nih.gov/pubmed/14668275
https://www.ncbi.nlm.nih.gov/pubmed/19026935
https://www.ncbi.nlm.nih.gov/pubmed/15356006
https://www.ncbi.nlm.nih.gov/pubmed/22185843
https://www.ncbi.nlm.nih.gov/pubmed/25820254
So if I can induce insulin resistance simply by giving someone fats, what happens if I give them very little fat but lots of carbs? Well in one study they compared 21 vegetarians vs 21 omnivores matching them calorie by calorie for 1 week. They then did muscle biopsies and the vegetarians had less fat in their muscle and, you guessed it, less insulin resistance. https://www.ncbi.nlm.nih.gov/pubmed/15523486.
Dr. Neal Barnard took 100 diabetic people and put half on the ADA a diet, which is the typically recommended lower carb diet. The other half where put on a high carb vegan diet that was unrestricted in the amounts of carbs and calories. After 72 weeks, the vegan group had better measured sugars. https://www.ncbi.nlm.nih.gov/pubmed/19339401
Another study put people on the Daniel Fast, high in carbs and low in fat. Their insulin resistance improved significantly, and these were not people that were diabetic https://www.ncbi.nlm.nih.gov/pubmed/20815907.
I’m Not Telling You to Eat Sugar
This long-winded diatribe is not done to encourage eating sugar! Sugar is nutrient poor, high calorie food, and certainly not part of a whole foods plant based diet. The point is that we live in fear of sugar and therefore avoid starches and fruits, which are the exact foods that people should be eating to avoid diabetes. And the whole point of the movie was to demonstrate that the national organizations that are supposed to tell us what to eat display diets that have the exact foods that cause the diseases they are trying to protect us from developing!
Meanwhile, the nationally syndicated TV show says we are propagandists with no science to back up our claims.
You be the judge.