To be clear, onset of type2 diabetes is tied in with weight and health.
My wife (who studied dietetics/food & nutrition) while at university volunteered for a pre-diabetes program whose sole purpose was to stress to people who were at high risk for developing type2 diabetes that they could stave off the effects of the disease by eating more healthily, and explaining how they could accomplish it.
The vastly important thing to stress here is that a reduction of the level of fat is the important part, not starving themselves. Presumably other forms of weight loss (as a means to better overall health) would have the same sorts of effects.
Starving one's self should not be taken as the first step that people should reach for, and even if people were to do so, they should make absolutely sure that they're still getting proper nutrition so that they are losing weight safely.
tl;dr: it's unhealthy to be morbidly obese. Your health improves if you stop being morbidly obese. That can include the effects of type 2 diabetes.
I did my surgical internship at a hospital with a substantial bariatrics service. Yes. Starvation will cure type 2 diabetes. Overnight. Roux-en-Y patients often have normal blood sugars by the time they're out of the OR. We would watch them for 48 hours and their blood sugar didn't go back up. When they came in for follow-up, still down. It works. Like a champ.
I would like to reply to more comments here, but it's past midnight and my battery is dying. Maybe more tomorrow.
But, yeah, in general, type 2 diabetes is almost universally a consequence of over-eating.
I came here to say the same thing. While on my bariatric surgery rotation, the attending surgeons all said much what you said above with regards to normalizing blood sugars. One of them felt that the majority of her patients normalized their blood sugars pre-op thanks to their preoperative fast...
> After the baseline measurements, individuals with type 2 diabetes started the diet, which consisted of a liquid diet formula (46.4% carbohydrate, 32.5% protein and 20.1% fat; vitamins, minerals and trace elements; 2.1 MJ/day [510 kcal/day]; Optifast; Nestlé Nutrition, Croydon, UK). This was supplemented with three portions of non-starchy vegetables such that total energy intake was about 2.5 MJ (600 kcal)/day. Participants were provided with sugges- tions of vegetable recipes to enhance compliance by varying daily eating. They were also encouraged to drink at least 2 l of water or other energy-free beverages each day, and asked to maintain their habitual level of physical activity. Ongoing support and encouragement was provided by means of regular telephone contact. At the end of the 8 week intervention participants returned to normal eating but were provided with information about portion size and healthy eating.
I suspect the word cure is used capriciously here. Remission would probably be a better term. I know this study made a splash on Drudge the other day, but the response over on diabetesforums.com was much more measured:
Right, well the whole point to a "cure" is to not have to make lifestyle adjustments. Anyone who's looking to be rid of their diabetes without having to adjust their lifestyle is going to be disappointed by this research and it's conclusions. In fact, I imagine that some sufferers will be outright livid once they realize the full implications of the research results.
Basically, we're getting more conclusive research showing that type 2 diabetes (runs in my family) is a lifestyle disease. In other words: if you are diagnosed with type 2, it's your own fault.
Specifically, insulin resistance is caused by higher-than-normal levels of fat in the liver and pancreas. Belly fat doesn't matter much. Arm fat doesn't matter much. It's the fat in your organs that's gumming up the works. People are more or less prone to developing fatty organs, so diabetes rates vary between genetic/family backgrounds.
To me, this is all fantastic news. I imagine that many of us are prepared to make a few comfort sacrifices in order to avoid these types of diseases. There is still a very persistent mindset, though, that all body issues (even obesity) are caused by external factors and that the sufferers are just helpless victims. I wouldn't expect that anyone trapped in the "my type 2 is out of my control, but the cure is just around the corner" mindset is going to be welcoming of the crash diet research.
So much argument here with extreme positions and blanket absolute statements, I am a little surprised.
What you eat is inextricably linked to your body's proper functioning and, yes, risk for a variety of diseases.
Thinking just about calories is meaningless. A single calorie of glucose / fructose / fat / alcohol / gasoline are simply not at all the same. Even the same ingredients (those useless nutritional composition labels) affect the body totally differently depending on how they are structured.
1 gram of pureed corn for instance will burn very differently from 1 gram of steamed corn kernels, versus that same 1 gram, popped.
It is a massive failure of education that people are surprised to hear that eating poorly leads to increased risk of disease.
Arguing that diet has no effect on disease is like suggesting that you could just live on glucose, a multivitamin, and water. Try that for a week and your body will be in full-on war against you. Actually, please don't.
The benefits from fasting and/or eliminating sugar and starches from your diet comports with Robert Lustig's research on sugar toxicity (http://news.ycombinator.com/item?id=2472019).
It would be interesting to see if a fat- and protein-sparing fast (i.e. Atkins diet) would work as well. Apparently it's much easier to eat a semi-starvation diet by eliminating nearly all carbohydrates than by simply cutting back calories in general.
Good point. Reversing type 2 diabetes comes when insulin sensitivity is gained back. For this to happen I believe a low carb diet should be enough, not a caloric restriction, but merely the elimination of foods that spike blood sugar. Would like to see clinical results of a strict Atkins / Paleo type diet for this group.
Did you actually read the article? The hypothesis has nothing to do with insulin itself, and everything to do with reducing fat deposits in the pancreas.
As the article says, that was just a hypothesis. There's no mention of tracking insulin levels, only blood sugar. And what's more, type diabetes is described in the article as resistance to insulin.
I can think of at least one further hypothesis, which is that cutting out indigestible sugars, per Lustig, frees up the liver from the task of metabolizing fructose/sucrose etc., to respond correctly to insulin, allowing blood sugar to be regulated.
I'd guess that just about any diet would work. Type 2 diabetes is often triggered by bad genes, and excess body fat. I'm not exactly sure why. I'm guessing that if you have lots of fat, your body starts ignoring the "make more fat" message from insulin.
Body fat an diabetes type two are just correlated. Type 2 is caused by stressing how your body deals with massive sugar. Now, the life style that enables you to stress your insulin production will make you fat.
There is a significant cultural difference in the matter of treating diseases between West and East.
In the West people first use a drug (rather tons of them), then, if no progress was made, a medical assistance, then, changes in behavior as an inevitable consequence and a restricted diet as a last resort.
In the East (Tibet, for example) people at fist use shifting to an appropriate diet and behavioral changes, then, medical assistance and a drug (which is in most cases a placebo) as a last resort.
The differences between these two almost opposite approaches could be easily seen in the life expectation statistics between poor (common) people in Tibet/China/Mongolia/Japan and, say, Russia (where they use vodka, in many cases along with antibiotics, as the first aid) or US where the medicare is the way to make money, not to heal people, could be easily found in the net. ^_^
Of course there is. Good high quality healthy food costs way more than deep fried potatoes and low quality burger meat, and is out of price range of a good portion of Americans.
It's a reversal. Cure implies that a disease cannot, under most circumstances, come back due to the treatment regimen (whether that be diet, drugs, radiation, etc...). The reason it's a reversal and not a cure is that if a patient were to "stop treatment," which in this case means revert to a diet far above daily caloric needs, it is likely insulin resistance will return.
Or you could eat natural healthy food with exception of flour and sugar products (and reduction in lentils and dairy) instead of starving yourself: http://www.marksdailyapple.com/diabetes/
Since you claim Max Gerson was "a complete quack", does that mean that people who were helped by following the advice of eating fresh fruits and vegetables to the exclusion of other foods (which almost nobody does) were just coincindentally made healthier? And we should dismiss that advice because you don't like Gerson?
What would you recommend their diet consist of if they want to prevent ill health or gain health?
Ignore diet because Gerson was a quack? And just hope they don't get sick? And if they do, come to you for you to select what drugs you deem to have the least conflict of interest at the time?
Do healthy and sick people a favor, and keep your "intellectual" clown bullying from encouraging them to ignore the daily factors that accumulate to become their health or ill health over years.
No, it means that he invented treatment regiments that weren't supported by any scientific evidence, and did so while failing to document or properly control any of his "studies," some of which were repeated and found to be not only no better than placebo, but actually harmful to patients.
If I call Dr. X a fraud because he claims coffee enemas are a great way to clear the body of cancer (Such as, say... Max Gerson did), yet Dr. X also believes that drinking water is necessary to sustain life, it doesn't follow that I don't believe drinking water is a great way to stay alive.
Haven't seen this movie, but your question is more online group think pessimism and reluctance to take responsibility for our actions and lifestyles.
What about the movie, apparently covering diet and nutrition, makes you think it has anything to do with a belief system based on stronger dilutions of chemicals having a greater effect than a weaker dilution?
Seriously, some of the questions asked by geeks online leave the ordinary reader wondering if there's a herd of you in a room high-fiving each other after your asinine remarks. Carry on with your groupthink if you must, but it's getting old.
Most people tend to discredit diet therapy because it's "not mainstream" or against the norm.
Of course you don't see nearly as many "studies" on diet therapy as you do a typical medicine or pill, most scientists and doctors that practice alternative therapy are considered heretics (cooks, crazy people, etc) and banished from the "mainstream" portion of the medical world (the one with all the cash flow).
Look up Dr. Max Gerson and all of the amazing things he's done with the use of a simple diet therapy consisting mainly of juices and fruits and vegetables. I would highly recommend his biography - http://www.amazon.com/Dr-Max-Gerson-Healing-Hopeless/dp/0976...
It's a fascinating read and really challenges you to think against the mainstream medical world.
Max Gerson believed that cancer was a result of an individual lacking production of "cancer digesting" pancreatic enzymes - aka he was a complete quack.
As a medical student dedicating the overwhelming majority of my spare time fighting conflict of interest infringement in the Pharma/Device-physician relationship, and in addition attempting to permanently establish evidence-based standards for patient care, its advice like yours that take the whole fucking thing two steps back.
Do sick people a favor, and keep your ignorant statements to yourself.
" Research has shown that people with severe coronary heart disease are able to halt disease progression or reverse it without drugs or surgery by making comprehensive lifestyle changes such as managing stress through yoga and meditation, switching to a low-fat vegetarian diet, stopping smoking, exercising moderately, and finding social support.
http://www.pmri.org/publications/1761.pdf
• The June 2008 Proceedings of the National Academy of Sciences published a prostate cancer study demonstrating that lifestyle change can affect gene expression. The researchers found that improved nutrition, stress management, walking, and psychosocial support changed the expression of over 500 genes in men with early-stage prostate cancer.
http://www.pnas.org/content/105/24/8369
• A long-term randomized controlled trial of patients with coronary heart disease showed that Transcendental Meditation practice was associated with a 47 percent reduction in mortality, nonfatal myocardial infarction, and stroke compared with controls during a five-year follow-up
http://161.58.228.161/TM_and_mortality.pdf
"
"What if you were given that choice? For real. What if it weren't just the hyperbolic rhetoric that conflates corporate performance with life and death? Not the overblown exhortations of a rabid boss, or a slick motivational speaker, or a self-dramatizing CEO. We're talking actual life or death now. Your own life or death. What if a well-informed, trusted authority figure said you had to make difficult and enduring changes in the way you think and act? If you didn't, your time would end soon -- a lot sooner than it had to. Could you change when change really mattered? When it mattered most?
This is a tin-foil-hat conspiracy theory reaction.
Define "use it more often". Doctors recommend diet and exercise all the time. It's the first thing to recommend to patients. It's simply very hard for people to accomplish it, and the vast majority of people either can't or won't lose weight.
I'm 42, I've been involved with two major medical systems for 30+ years, both in Canada and the United States (Kaiser) - for one reason or another, I've been to a doctor maybe a dozen times. For about 15-20 years I was either on the cusp of obesity, was always overweight - and certainly was never in the slightest bit of good physical shape.
In that 30+ years, I solemnly swear no medical official has ever made any recommendations about diet and/or exercise, with one exception of a emergency room intake doctor giving me some guidance on drinking more water after I was checked in for dehydration and the second time, when I contacted Kaiser Intake (half dead from a case of pneumonia ) - and they recommended I drink tea with a bit of honey. Sum total of diet advice.
In general, the medical system is much more interested in "Fix it when it's broken" then they are "Prevent it from breaking in the first place."
And they really tend to reach towards surgery/and drugs any time there is a problem. Some are offended when you suggest that perhaps an affliction might be diet recommended.
It's not a tin-foil-hat theory reaction. The American Journal of Clinical Nutrition has any number of peer reviewed observational studies on what happens to indigenous populations when they encountered western (refined) diets.
Taubes has an endless number of references in "Good Calories, Bad Calories" for those who are even moderately interested in how unbelievably important diet turns out to be when it comes to modern health.
But, where's the money in getting people to lead a healthy lifestyle?
People will need to figure this stuff out for themselves, it certainly won't be marketed to them the way HFCS laden beverages will be.
"I'm 42, I've been involved with two major medical systems for 30+ years, both in Canada and the United States (Kaiser) - for one reason or another, I've been to a doctor maybe a dozen times. For about 15-20 years I was either on the cusp of obesity, was always overweight - and certainly was never in the slightest bit of good physical shape. In that 30+ years, I solemnly swear no medical official has ever made any recommendations about diet and/or exercise"
I'm 36, I was a physician for 8 years (no longer practicing). I recommended diet and exercise to many many patients for general prevention and certainly for anyone with type 2 diabetes. And this was considered standard of care. I was not the exception.
This is lame-brain hand-waving dismissal in order to continue being lazy and essentially helpless in our personal health.
Doctors make standardized dietary recommendations that are not enough to protect and heal against lifestyle diseases. Compare the 30% fat American Heart Association diet to the Dr. Dean Ornish, Dr. McDougall, or Dr. Esselstyn diets that recommend 10% fat and whole foods, not products marketed as 'low fat' snacks and meals. The latter diets are clinically shown to reverse heart disease, essentially heal Type II diabetes, rheumatoid arthritis, and many other diseases. There is ongoing research by McDougall into multiple sclerosis, based on past great success with the low fat Swank diet.
The standard dietary advice is given largely because people can't make enough changes to even follow that, much less make the effort to have every single meal conform to something as seemingly 'radical' as a 10% fat diet.
So yes, arn, "doctors recommend diet and exercise all the time", but it's not to the extent necessary to bring about meaningful results.
But carry on with your dismissal of anything that doesn't make you feel good (mentally, physically, or morally) as "tin foil conspiracies". And follow the herd and make sure others can take care of you (and pay for you) when you get sick.
"The standard dietary advice is given largely because people can't make enough changes to even follow that, much less make the effort to have every single meal conform to something as seemingly 'radical' as a 10% fat diet."
So you agree with me. People won't follow even a "moderate" diet. So why do you think they will follow a more stringent diet?
But (as the OP does) blaming it on a lack of financial motives does put it squarely in the conspiracy theory realm for me, as it ignores any individual responsibility and blames it on the "bad system" instead.
While there's no denying that nutrition is an important determinant of overall health, I think "can be used as a form of cure for nearly every disease" is going a little overboard. The vast majority of diseases of all kinds cannot be cured by diet alone. Eating an apple a day, for example, is not going to kill HIV.
And, just imagine, if people stuck to a simple diet (Zone, Atkins, Paleo, South Beach, Mayo - hell, even Weight Watchers/Jenny Craig - it doesn't really matter, just chose _something_ and stick to it, they'll all get the job done eventually) + a couple hours of walking a day + some progressive resistive strength training.
Can you imagine what kind of condition the average citizen would be in?
The only problems with this are:
o Who will buy all the refined foods?
o None of the above exercises cost anything. The resistive strength training
can be done very effectively as bodyweight in
your bedroom. (Pushups FTW!)
o Social Security costs would skyrocket as people start living longer.
I hate to rain on your parade, I do... But, you simply couldn't be further from the truth. Diet can only be considered a "cure" in an extremely small subset of all disease; and, furthermore, the word "cure" is practically never used to describe the effects of diet in any treatment scenario.
It's true that there is no money to be made by Pharma, and that's why they aren't funding this study. My words may be harsh, but it's people like you, spreading pseudoscience, that lead to desperate patients being taken advantage of.
He goes over the top but so do you. Diet is a word usually reserved for a temporary alteration in the type and amount of food we eat. But of course it also refers to a permanent change in what we eat. The evidence that an evidence-supported diet in the latter sense (eating 'properly') can protect us to varying degrees from the onset of much disease is overwhelmingly supported by countless peer-reviewed studies.
Right because desperate cancer patients that could clearly seek an alternative are being told that their only hope is Chemo therapy or death aren't being taken advantage of...
God forbid someone suggest an alternative as simple as gasp diet.
Well, to be fair, I don't believe there are a lot of peer-reviewed, doubly blinded, placebo controlled studies that provide evidence that diet helps in most cancers. Lots of evidence that suggests you can avoid them in the first place, but once you have Cancer, you usually have to turn to modern medicine, in much the same way you do when you have something like HIV. Diet just won't cut it.
It's also important to differentiate diseases resulting from pathogens, versus basic body health.
Type-2 Diabetes is almost 100% a function of nutrition - it almost doesn't exist in many populations of the world that haven't been exposed to a western diet, and, quickly develops in those populations as they adopt a western diet.
There are instances in which chemotherapy is the only option, as advised by sound evidence-based medical research, just as there are instances in which diet is a completely acceptable treatment, and those instances must abide by the same strict evidence-based guidelines.
However, when people go around claiming that diet can cure the majority of disease it plants a seed in the minds of patients that have no option, patients that should be discussing palliative care with their physician, that all they need is a pot of "herbs" and a low-fat, vegan diet to cure their terminal illness. Then the physician has to spend an exponentially larger amount of time than it took to plant that seed to dig it up and move on, time s/he could be spending discussing palliative treatment or even working with other sick patients.
Let me know if you disagree, however I think the problem so many people have in this thread (and an increasing number in today's world), and one reason a good number seek and believe in alternative treatments, is because the medical community (as viewed by individuals from the outside anyway) is viewed to be full of self-righteous elitists who believe they always know what is best when dealing with the human body, while a. People like to believe in miracles, and b. Successful outlier cases that are contrary to common medical understanding keep cropping up -- the media loves them and people notice them. One more reason could be that many have experienced alternative treatments be fiercely dismissed by their physician, even when it can be surmised that the dismiss-er is probably fairly ignorant on the particular topic -- it turns people off. Naturally physicians don't have to have an answer or even an opinion, so why does it seem like they often feel they have to? Can it be boiled down to personal insecurities and fears? Trying to live up to the stigmas around what a doctor should be and know?
I would agree that people like miracles and notice them. However miracles are by their very nature the exception, not the norm. Science works by quantifying what is the norm through carefully controlled studies. The reason that alternative treatments are fiercely dismissed by many physicians is because they know, on account of said science, that they should not be the first course of action. Empirically, they work far too infrequently. Until an alternative treatment can demonstrate that it works for a statistically significant sample size it should not be recommended as the first course of action. However, if it does prove to be a viable treatment in a statistically significant study, it becomes part of mainstream medicine, not an "alternative" therapy.
My wife (who studied dietetics/food & nutrition) while at university volunteered for a pre-diabetes program whose sole purpose was to stress to people who were at high risk for developing type2 diabetes that they could stave off the effects of the disease by eating more healthily, and explaining how they could accomplish it.
The vastly important thing to stress here is that a reduction of the level of fat is the important part, not starving themselves. Presumably other forms of weight loss (as a means to better overall health) would have the same sorts of effects.
Starving one's self should not be taken as the first step that people should reach for, and even if people were to do so, they should make absolutely sure that they're still getting proper nutrition so that they are losing weight safely.
tl;dr: it's unhealthy to be morbidly obese. Your health improves if you stop being morbidly obese. That can include the effects of type 2 diabetes.