https://www.youtube.com/embed/35hCCFrL9X0
- My name is Dr. Michelle McMacken and I'm super excited and
honored to be partnering with plant-based news on this course. I'm gonna be covering
what is type 2 diabetes, what are some of the
causes of type 2 diabetes? And what should I be aware
of as far as my medications, my blood sugar and other
aspects of medical care if I have type 2 diabetes, and finally, what should
I talk to my doctor about, what kind of blood tests should I get, and what exactly should I be eating if I have type 2 diabetes? - Hi everyone, welcome
to this diabetes course. My name is Dr. Chan and I'm a UK physician with 14 years of experience. I've looked after many
patients with type 2 diabetes, and I used to tell my patients that they had a chronic
progressive lifelong condition. That's why I'm so excited to
be bringing you this course because much of what we
understand about diabetes has been turned on its
head in the last few years, we're here to present
you with evidenced based information that is going
to help you make changes to your life and bring back your health.
I hope you enjoy . - Diabetes is one of the most
common chronic conditions in the world and in fact it's
becoming more and more common, we know that now more
than 380,000,000 people in the world are living with diabetes. Some of the most common
complications of this illness are heart disease, stroke,
chronic kidney disease, which can lead to the need for dialysis and eye disease, blindness as
well as damage to the nerves, particularly in the feet.
I think a lot of people
think that when they are told they have type 2 diabetes,
that they're committed to a lifetime of pills or even injections. And that's a really hard thing to hear, what I have experienced and
what I love to tell my patients and what the science shows
is that when you receive a diagnosis of type 2 diabetes, that's actually an opportunity. That's an opportunity
to start to work towards a healthier lifestyle and
ideally a plant-based diet, and that can actually not just reduce the need for medication, but in many cases it can put diabetes into remission.
I have seen that myself in
my patients, and it's one of the most rewarding things
about treating patients with type 2 diabetes, is
that you can almost predict that if they change their
lifestyle and start eating a more plant-based diet that
their diabetes will improve and in some cases completely reverse. So type 2 diabetes is a
condition in which our body cells don't respond properly to the
insulin that our body makes and this is a phenomenon
called insulin resistance. So when our body cells don't
respond properly to insulin particularly our body's
muscle cells what can happen is that glucose or sugar can
build up in the bloodstream.
And when this happens,
this can lead over time to type 2 diabetes. Because we're talking about
elevated sugar in the blood a lot of people think that
sugar itself in our diets is the only cause of type 2 diabetes. And while sugar is
associated with the risk of type 2 diabetes, many
people forget about other foods and nutrients that can also
contribute to diabetes. And in fact, we know
that probably the number one contributor in terms of
foods to type 2 diabetes risk is actually processed meat. Foods like ham, bacon,
cold cuts, these are foods for which one serving a
day has been associated with between 37 and 51%
higher risk of developing type 2 diabetes so there's a very, very strong relationship. And also foods like red
meat, beef, lamb, goat, pork, all of these foods are
also very strongly tied to the risk of type 2 diabetes
because they can affect the way that our body's
cells respond to insulin. And so while it's very important
to avoid unhealthy foods that contain added sugar, it's
also really good to consider other foods that actually
are just as associated with the risk of type 2 diabetes.
A lot of people think that
because type 2 diabetes runs in their family, that they're
automatically gonna get type 2 diabetes themselves,
but the reality is that although it does increase the
risk to have a family history of type 2 diabetes, there's
a lot that we can do as far as lifestyle choices to reduce that risk. So very large studies have
shown that when people adopt a plant-based diet, that's
rich in whole grains, fruits, vegetables,
and legumes like beans, they can actually reduce their risk of getting type 2 diabetes
by up to between 34 and 60%. So that is a really dramatic
risk reduction that you can get from just adopting a healthier diet. A keto diet drastically
cuts carbohydrates, and so it can definitely
temporarily lower blood sugar in people who have type 2 diabetes. It also happens to be lower in calories than a lot of typical Western style diets so it can also result in some weight loss at least in the short run. But what we know from large
long-term studies on keto diets is that actually the weight does not tend to stay off over time, it
tends to come back and people with type 2 diabetes
following keto style diets do not achieve better blood
glucose control in the long run.
So this is not really a
great long-term approach. The really important thing to
recognize about a keto diet is that it's not without risks. So, we know from keto diet
research that a keto diet has been associated with kidney stones, vitamin and mineral deficiencies, poor bone health, cardiac arrhythmias, and it's also been
shown to raise the level of the unhealthy type of
blood cholesterol called the LDL cholesterol which
is really a key risk factor for cardiovascular disease. And since people with type
2 diabetes are already at higher risk of cardiovascular disease, this is not looking at the big picture.
So the big picture for
people with type 2 diabetes is you wanna do everything
you can to improve not just your blood sugar
control, but your longterm risks and a keto diet is not
going to help address that. We don't have long-term data showing that a keto diet lowers
the risk of heart disease. Whereas we have astounding
overwhelming evidence that a plant-based diet not
just prevents heart disease, but it actually treats
and it can completely reverse heart disease. So looking at the big
picture, a plant-based diet is actually a fantastic choice for people with type 2 diabetes
because it helps treat not just the type 2 diabetes but also the long-term risks of diabetes. - Not many people truly
understand the underlying cause of type 2 diabetes because
the blood sugar is high. They understandably
assume that carbohydrates and sugars are causing type 2 diabetes. That's a very limited view of what type 2 diabetes diabetes is about.
At the root cause of type 2 diabetes is insulin receptors
that don't work properly and therefore sugar in the
blood cannot get inside of the cells starts to accumulate and cause damage in the organs. Simply avoiding carbohydrates
and taking medications are actually great ways
to manage your diabetes but it actually doesn't
get to the root cause of your type 2 diabetes.
To get to the root cause
of type 2 diabetes, we have to make the insulin
receptors work again. And once the insulin
receptors work properly again, you can eat carbohydrates without your blood sugar going high. That's our main goal in the
treatment of type 2 diabetes. We want you to be able
to enjoy foods that you used to enjoy without worrying. Many scientific studies dating
back to 1920s have shown that sugar is not the
cause of type 2 diabetes or insulin resistance. One of the most shocking
studies that I came across when I first began researching and reading about the underlying
cause of type 2 diabetes was a study done by Dr.
Kempner in the 1950s.
Dr. Kempner now was a
physician at Duke University and he invented what was
known as the rice diet. Initially, he invented this
diet to treat his patients with hypertension, but this
diet proved to be useful in the reversal of
end-stage kidney disease end stage heart disease,
and also diabetes. In one of the studies he
put 100 diabetic patients on his rice diet. These patients ate only
rice, fruits, fruit juice and refined sugar. Now, if the myth that sugar
causes diabetes was true, then these patients should
have worsening diabetes at the end of the study. But what was shocking was
that out of the 68 patients who needed insulin at the
beginning of the study for their diabetes, 14
was able to come off their insulin altogether and 41 patients were able to reduce their
insulin requirements.
So if you believe the
paradigm that carbohydrates and sugar causes type 2
diabetes then this study makes no sense at all. Since then other studies
have also backed up what Dr. Kempner found and we now know that the true root
cause of type 2 diabetes is insulin receptors
that don't work properly. First, let's look at
what happens when we eat. When we eat food, our digestive
tract breaks down the food into amino acids, simple
sugars and fatty acids. The simple sugars are
absorbed into our bloodstream and travel to the cells where
they're taken up with the help of insulin and the insulin
receptors into the cells and inside the cell sugar
is then turned into ATP which is energy.
Here's a great video
showing how insulin works at the molecular level. Here's a muscle cell. The yellow layer is the cell membrane and the purple structure
is the insulin receptor. As you can see, the white
molecules are the sugar in the blood trying to get inside a cell. When insulin binds the receptor, a series of enzyme
activation occurs allowing a channel to appear in the cell membrane. And this is the door which
lets sugar into our cells.
What happens if there's no insulin? The sugar in the bloodstream
cannot get inside the cell and the sugar level rises and rises and this is what happens
in type 1 diabetes. The pancreatic cells that produce insulin have been destroyed and
there's no insulin around. In this course we will
focus on a second type of diabetes called type 2 diabetes where there is initially
plenty of insulin around, but the insulin doesn't work. The key is there, but a lock is gummed up. So sugar cannot get inside the cells. What causes the lock to gum though? Fat, also known as intramyocellular
lipid in our muscle cells or intrahepatic cellular
lipid in our liver cells. The fat build up in these cells mean that the insulin receptor is
gummed up and that channel which allows sugar to get
in simply do not open. Therefore, it doesn't
matter how much insulin there is in our blood,
the sugar cannot get in. Initially your body responds
by producing more insulin and that may work temporarily,
but over time the pancreas can get tired of making so much insulin and also the insulin receptors
get more and more jammed up and sugar starts to build
up outside of the cell and you may be diagnosed with diabetes.
So as you can see, the key
to treating type 2 diabetes is not just to reduce the amount of sugar in your bloodstream, the key is to make those insulin receptors
work again by getting rid of the fat inside of the cells. I like to use this
analogy with my patients. Remember back to when
you last went on vacation and you're packing your suitcase. The suitcase is already full of clothes but you still have three pairs of shoes that you need to get in. No matter how much you
shove and jam those shoes they just won't get in or the
suitcase simply won't close. So what do you need to do? You need to remove some of those clothes to make room for the shoes and that's exactly what's
going on inside of our cells. The fat is the clothes and it's jamming up the insulin receptors,
so in order to get sugar into the cells, i.e the shoes, we need to remove some clothes first.
Some of the more popular
diets will tell you to reduce carbohydrates in your diet and that's like telling you to go on vacation without your shoes. We can function, but it's
not the ideal scenario. Nobody wants to be on
vacation without their shoes. And it's the same with our bodies. The body can react to
diets in a short term, but it's not a preferred option. So the better option is to
remove some of those clothes and make room for the shoes. And the equivalent in
terms of type 2 diabetes, is that the preferred option is to get rid of some of the fat buildup
in ourselves and make room so that the sugar molecules can
start to get in efficiently. - If you think about
foods in three categories for type 2 diabetes and you use a sort of a traffic light
system so green light, yellow light, and red light
foods for type 2 diabetes.
The green light foods are
foods such as whole grains, foods like oats, brown rice, barley, any type of whole grain. Legumes, beans, lentils,
chickpeas, veggies of all types, diverse amount of vegetables
and whole fruits so fruits in their whole form rather
than turned into juices. Those are really the green
light foods for type 2 diabetes and we should all be
eating those in abundance. The yellow light foods for
type 2 diabetes I would say are the fatty or plant foods
so nuts, seeds, avocados, and to some degree the vegetable oils, these are things that
really should be limited.
And the red light foods
are foods such as red meat, processed meat, refined
grains, or white flour foods, the added sugars in the diet,
as well as really any type of very ultra processed or
highly processed plant foods. - When you first make the transition to a whole food plant based
diet, you may feel more hungry. And this is because whole
plant foods tend to be lower in calorie density which is
an important consideration when you're trying to lose weight, or improve your insulin sensitivity. Calorie density is basically
the amount of calories per pound of food. Whole plant foods which are
lower in calorie density can therefore make us
feel fuller for longer and therefore aid in weight loss and reversal of insulin resistance. Research has shown that
people can eat freely of foods that are 300 calories per pound
or less and not gain weight. People can consume relatively
large portions of foods that are between 300 and
800 calories per pound and still lose or maintain
their weight depending on the individual activity
levels and metabolism. The intake of foods with
a calorie density of 800 to 1,800 calories per
pound, should be limited as these can contribute to weight gain and therefore interfere
with efforts to lose weight.
- I would say the ideal amount
of fruits and vegetables to eat per day is really
actually unlimited. We should probably all be
eating at least five servings of fruits and vegetables a day
and really powerful research shows that we can get benefits
from eating up to 10 servings a day when it comes to preventing and treating type 2
diabetes as well as lowering the risk of heart disease and cancer. So really the more the merrier
when it comes to fruits and vegetables, just eating them primarily in their whole form Most Studies of using plant-based diets to treat type 2 diabetes
involve using very little if any oil in the diet.
Having oil in the diet can
actually for some people make it harder to achieve
a healthy body weight which is really critical if you're trying to treat type 2 diabetes. So it's really a better
idea to get your plant fats from whole plant foods, such
as small quantities of nuts or seeds or avocados, rather
than from vegetable oils which are really extracted
from the original plant. - An important distinction I want to make is that not all carbohydrates
are created equal. Compact carbohydrates are full of fiber and phytonutrients that our bodies need. However, refined carbohydrates
for example, refined sugar and white flour can spike
our blood sugar very rapidly and therefore cause our insulin to go up. A whole food plant based
diet focuses on whole, unrefined carbohydrates
which all healthful foods that our bodies need for
nutrients and can actually help to regulate our blood sugar control. However, it's a good idea to
avoid refined carbohydrates like refined sugar and white flour which may spike your blood sugar.
- There are three supplements
that anyone following a whole food plant-based
diet but particularly for type 2 diabetes, should consider. The first is B12 and this one's
really the most important. Everyone who's eating a
exclusively plant-based diet should really ensure that
they're getting adequate B12, and this is ideally done
through taking a supplement. The second is finding a plant
source or algae-based source of DHA and EPA and these you can think of as sort of the
active forms of omega 3s. Researchers mounting that people
following plant-based diets should consider taking a
direct source of DHA and EPA from a plant source like algae, because it might help long-term
with overall cognitive health and other functions,
but particularly if you have type 2 diabetes or
other chronic conditions.
So that's the second supplement
that would be recommended and the third supplement
to consider is vitamin D because many of us,
including omnivores don't get enough vitamin D from
being exposed to sunlight, depending on where we
live, and many people need to supplement with vitamin D. The average person needs about
0.8 grams for every kilogram of body weight when it comes to protein. But the reality is that
most of us are getting a lot more protein than we
need whether we're eating an omnivore diet or a
more plant-based diets so there's not really a
need to focus too much on the amount of protein
that you're getting.
If you're eating a wide
range of plant foods particularly if you include
legumes in your diet, then you're most likely
meeting your protein targets. The most important thing
when it comes to protein is really the source of your protein so if you're getting your
protein from plant sources that's associated with a huge
amount of health benefits in terms of lowering your risk of cancer, as well as heart disease
and in general longevity and vitality as opposed
to getting your protein from animal sources which tends
to be very pro-inflammatory, increases the risk of cancer
as well as increases the risk of heart disease and other
long-term complications. The wonderful thing
about a plant-based diet is that it is so rich in
fiber and phytonutrients and antioxidants that it
actually can start to reverse a lot of the inflammation
and insulin resistance that may have built up over
time, and it certainly goes a long way for preventing type 2 diabetes.
So we know that when people
eat diets rich in fiber, what we see is a few different things. First, the fiber in the
foods tends to reduce the calorie density of those foods. So overall you tend to be
eating fewer calories over time which is fantastic for most
people especially people who are at risk of type 2 diabetes. The fiber also helps curate a
really healthy gut microbiota, gut bacterial pattern,
and that in turn leads to incredible downstream
effects, it actually leads to us making more healthy
nutrients from those gut bacteria, they like to feed on
fiber and make nutrients like short chain fatty
acids which then help decrease insulin resistance. It also helps our insulin
directly function better and helps our cells burn fat
so that the fat doesn't tend to build up as much in the
muscle and liver cells.
Phytonutrients and antioxidants
in plant foods also tend to reduce inflammation in our cells, and this is simply a diet that
helps most people maintain a healthier body weight over
time, which really, really drives down the risk of type 2 diabetes. So everything put together,
it's really pretty simple the more whole or minimally
processed plant foods in your diet like veggies,
whole fruits, beans and whole grains, the
lower your risk of diabetes and the lower your risk of
having insulin resistance and it will help actually
reverse insulin resistance in most cases. And the more animal-based
or highly processed foods in your diet, the more that will actually drive insulin resistance. - I was trained at medical school to treat type 2 diabetes with medications.
And it wasn't until much later
when I did my own reading and research that I
realized the true cause of type 2 diabetes and the
evidence out there showing that type 2 diabetes can be reversed. That was extremely exciting
for me as a physician, because nothing is more rewarding than getting your
patients off medications. However, not every doctor has
seen the evidence out there and truly understand the
cause of type 2 diabetes. And therefore your doctor
may not yet be subscribed to the idea of using a
whole food plant-based diet to help you with your diabetes.
That doesn't mean that they can't help and support you in your transition. And in fact, your blood sugar
and blood pressure can drop so rapidly when you change your diet. That it's important you
engage your physician's help in monitoring you and making sure that that transition is safe especially
if you're on medications. The best way to engage
your doctor is to show them that you're committed to your health. For example, you may go to
them with specific goals of how much weight do you want to lose, or how much you want to reduce your HbA1c. If they don't sound keen
or supportive of your wish to transition to a whole
food plant based diet, you could ask them questions like, I've heard that when I
changed my diet my blood sugar or blood pressure can drop very rapidly.
Can you give me some suggestions on how to monitor myself
so that I stay safe? Maybe your doctor is not
yet aware of the research showing that the true underlying
cause of type 2 diabetes is the buildup of fat inside cells. And some doctors may be
telling their patients with type 2 diabetes to
eat a low carbohydrate high protein, or high fat diet. A whole food plant based
diet has just been endorsed by the American Association
of Clinical Endocrinologists as a first line dietary change in the treatment of type 2 diabetes. The truth is there have
been so many studies showing the benefits of a whole
food plant-based diet, and we will provide you with
five of the most important and landmark studies that
you could perhaps share with your doctor to help them understand. If you're switching to a
whole food plant based diet, it may also be important
to ask your doctor to monitor your B12,
vitamin D and iron levels. Some useful markers to
ask from your doctor on your regular blood work
include HbA1c, serum lipids, C-peptide, vitamin D, vitamin
B12, iron, and folate. I hope by now you have
heard enough of the benefits of a whole food plant based
diet and want to give it a try.
You may be feeling overwhelmed and that's completely understandable. You may be thinking that you will miss some of your favorite foods, but the truth is that our taste buds have been hijacked by these hyper palatable
foods that have been designed by the food industry to make us eat more. We are hardwired to enjoy
high fat, high sugar foods, because it's an evolutionary
mechanism that allowed us to survive when there were
times of lack of food. However, we now have such
an abundance of food.
This mechanism is now obsolete. With time your taste buds will change and you will start to
enjoy the deliciousness of whole foods that have
been put on the earth by mother nature and
intended for us to eat. - My name is Adam Sud and
I reversed type 2 diabetes with a low fat whole
food plant-based diet. My story starts on August 21st of 2012, I had just survived a
suicide attempt as a result of the end of a long struggle
with substance abuse. And I found myself in
rehab where I was diagnosed with type 2 diabetes, high blood pressure, high cholesterol and a whole host of psychological conditions.
My A1C was nearly 12 and my
fasting blood glucose was 390. And I knew that I needed
to radically change the way that I fed myself and moved my body. So I transitioned to a low fat,
whole food plant-based diet. It wasn't easy in the beginning, but I found reasons to
want to get up and do it. I found reasons to want
to practice self-care and self-love through food,
and as a result of doing so within three months my blood
glucose dropped from 390 to 80.
And at month four I went to
go see my endocrinologist and we had done blood
work and my A1C had fallen from nearly 12 to five. So within four months, I
had completely reversed my type 2 diabetes, completely reversed my high blood pressure,
my high cholesterol. Within 10 months, I had
lost over 100 pounds and within a year I was off
of every single medication I was prescribed when I got into rehab, including all my psych meds. I've lost 200 pounds as of now, and I absolutely have fallen in love with the process of owning
my health and well being with the low fat, whole
food plant-based diet.
