As we age, our bodies begin to show evidence of the ravages of time. Faced with symptoms like increasing blood pressure or increasing blood sugar a person can start to feel overwhelmed and to dread the next blow to their health. Many people begin to amass a collection of medications, one to decrease their cholesterol, another one or two to control their blood pressure, a couple more to keep their blood sugar in check. Sometimes taking a pill seems like a fairly easy way to cope with health changes….but is it the best way?
When it comes to prevention of type-2 diabetes, lifestyle changes are proving to be a better way to go. The drug metformin is usually the first medication prescribed to a person with increasing levels of blood sugar (prediabetes). Metformin is successful at lowering the rate of development of full-blown diabetes by about 17%. However, a landmark study revealed that diet and exercise works even better. The Diabetes Prevention Program Outcomes Study has now passed the fifteen year mark and its results are very encouraging. Participants were randomized into one of three groups. Those in an intensive lifestyle change group ate a low-fat diet (less than 25% of calories from fat) and maintained at least 150 minutes a week of moderate exercise (walking, cycling). A second group received standard advice for diet and exercise along with treatment with the drug, metformin. The third group received standard advice on diet and exercise and a placebo pill instead of metformin. After ten years, participants in the intensive lifestyle change group showed modest weight loss, increased their physical activity and had a 34% lower rate of developing diabetes compared to placebo. Additionally, those that did develop diabetes delayed its onset for about four years. Those taking the drug metformin reduced the rate of developing diabetes by 18% compared to placebo and delayed the onset of diabetes by only two years. The benefits of lifestyle change were especially pronounced in people aged 60 and over who cut their rate of developing type-2 diabetes over the next ten years in half. These benefits are continuing into the fifteenth year and show no signs of abating. As a bonus, participants who made the lifestyle changes also reduced their cardiovascular risk factors by lowering their blood pressure and triglyceride levels. (1,2)
How about dealing with diabetes itself? A type of legume known as a pulse shows remarkable results at controlling diabetes and the regular consumption of pulses is recommended by the Canadian Diabetes Association, the American Diabetes Association and the European Association for the Study of Diabetes. Pulses are dried peas and beans. They do not include green beans or fresh green peas, soybeans or peanuts. Pulses, especially chickpeas, black beans and pinto beans, lower fasting blood sugar and insulin levels which is exactly what drug therapy for diabetes aims to accomplish. One reason for this is the low glycemic index of pulses. But an even stronger mechanism is the ability of pulses to partially block the action of amylases, starch-digesting enzymes, which allows some of the starchy carbohydrate from the legume to make it all the way down to the colon where it can feed the beneficial gut bacteria (3,4). The carb-blocking drug, acarbose, works exactly the same way. However pulses exert their beneficial effect without any of the side effects that acarbose can produce such as diarrhea and gas, liver problems and serious intestinal conditions.
Is it possible to reverse diabetes? Researchers have known for decades that diets high in fats decrease insulin sensitivity and that low-fat and low-calorie diets can greatly improve diabetes symptoms as well as the nerve and organ damage that can result from diabetes (6,7). It was once thought that these health improvements were simply a result of the weight loss that accompanies such a diet. This idea was refuted by a study designed to maintain weight in the diabetics taking part. In fact, the researchers practically had to force-feed their participants to prevent them from losing weight. Maintain weight they did however and the results were conclusive. Even with no loss of weight, insulin requirements dropped by an average of 58% in the group eating a low-fat diet. Conversely, insulin requirements did not change in those eating a conventional diabetes diet. Half of the subjects eating low-fat discontinued their insulin altogether and the remainder decreased their insulin dosages by between 7% and 98%. Remarkably, these results happened quickly, with diabetics who had been taking insulin for many years stopping it altogether after only sixteen days on a low-fat diet. Accompanying the excellent improvement in diabetes was a decrease in cholesterol levels of an average of 29%. (5)
Here is the simple truth. One transforming step, changing your lifestyle, is all it takes to prevent diabetes, to treat diabetes and to reverse diabetes. Simply eat more plants. Stop eating foods high in animal fat and protein. Move your body more. Try to lose weight. Your health will start to improve and, if you throw moderation to the winds and are diligent in these changes, you can leave diabetes with all its debilitating consequences behind.
Lifestyle changes have far reaching benefits for the health of the rest of your body too, decreasing cardiovascular and cancer risks as well as the risk of many other diseases and conditions encountered frequently in modern life. Perhaps the biggest bonus from following the plant-based path is wrenching the reins of your future from the hands of chance and halting your headlong race into hopeless and helpless infirmity.
1 Knowler, W.C., Fowler, S.R., Hamman, R.F., et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14; 374(9702):1677-86.
2 Nathan, D.M., Barrett-Connor, E., Crandall, J.P., Edelstein, S.L, Goldberg, R.B., Horton, E.S., Knowler, W.C. et al. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. Lancet November 2015; 3(11):p866–875.
3 Sievenpiper, J.L., Kendall, C.W.C., Esfahani, A., Wong, J.M.W, Carleton et al. Effect of non-oil-seed pulses on glycaemic control: A systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia 2009 52(8):1479 – 1495.
4 Thompson, S.V., Winham, D.M., Hutchins, A.M. Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study. Nutr J. 2012 Apr 11; 11:23.
5 Anderson, J.W., Ward, K. High-carbohydrate, high-fiber diets for insulin-treated men with diabetes mellitus.
Am J Clin Nutr. 1979 Nov; 32(11):2312-21.
6 Rabinowitch, I.M. Effects of the High Carbohydrate-Low Calorie Diet Upon Carbohydrate Tolerance in Diabetes Mellitus. Can Med Assoc J. 1935 Aug; (2):136-144.
7 Kempner, W., Peschel, R.L., Schlayer, C. Effect of rice diet on diabetes mellitus associated with vascular disease. Postgrad Med. 1958 Oct; 24(4):359–371.