Puzzled by study results for diabetes

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Puzzled by study results for diabetes

Postby Birdy » Sat Nov 15, 2014 2:18 pm

On the PCRM website here: http://www.pcrm.org/health/medNews/plan ... -treatment the results of a large study on the effects of plant-based diets on diabetes showed that, "Earlier studies had shown that plant-based diets could improve a key indicator of blood sugar control, called hemoglobin A1c, as much as 1.2 points, which is far greater than the effect of typical oral diabetes medicines. The new study is a meta-analysis, widely considered the highest level of scientific evidence. Focusing on longer-term effects and combining the results of all available studies, the benefit of leaving out meat, cheese, and eggs was as much as 0.7 points in some studies, and averaged about 0.4 points overall."

So someone with an A1C of say 7.5 could expect to lower that to between 7.1 - 6.8 by eating plant-based. While any decrease in A1C is good, I've gotten the impression from reading Dr. Barnard's book titled REVERSING Diabetes that it can actually be reversed, not just slightly improved as in the results published for the meta-analysis. I've also gotten the distinct impression that people following Dr. McDougall's plan can reverse T2D. I'm surprised by the results of this meta-analysis. There's a lot of information about improving both T1 and T2 diabetes with diets: both high protein/low carb a la Dr. Bernstein and high carb plant-based a la McDougall and Barnard.

Any thoughts on the science?
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Re: Puzzled by study results for diabetes

Postby GeoffreyLevens » Sat Nov 15, 2014 2:30 pm

Can't find the actual science i.e. the article via google so no way to tell what diets and for how long they are looking at in the studies. Reversing diabetes can take different amounts of time or not happen at all depending on the diet being followed and the overall health of the subjects.
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Re: Puzzled by study results for diabetes

Postby colonyofcells » Sat Nov 15, 2014 2:48 pm

The main help for diabetes seems to be avoiding refined foods and exercise. Both high starch diets and high fat diets tend to promote unrefined foods too. I don't get confused by studies bec. most diets around the planet are starch based and these give me lots of confidence. I don't have any desire to follow a high fat inuit diet or high fat Greenland diet since I don't like to hunt fat whales. For type 1 diabetics like Dr Richard Bernstein, high fat diets can lead to lower insulin requirements altho I don't know if this high fat diet can lead to longevity. Take vitamin b12 daily and buy all your natural food from the farmers markets and it is that simple, and I don't have to waste my time reading reductionist studies.
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Re: Puzzled by study results for diabetes

Postby dteresa » Sat Nov 15, 2014 3:08 pm

The reference at the PCRM website says --results of a plant based diet and also says vegetarian diet not vegan. I do not think the title of the article used the word vegan, but used vegetarian. I could not find the article but plant based could mean anything as could the term vegetarian. From the studies of Seventh Day Adventists you can see that some identify themselves as vegetarians if they eat plants and fish. Some identify themselves as vegetarians if they eat dairy and eggs. And oddly some people even identify themselves as vegetarian if they occasionally eat meat. I cannot remember where I read it but the number of real, low fat vegans is so small that researchers include them in with the dairy or fish and/or fat consuming group who identify themselves as vegetarians.

Some vegetarians do as dr. Barnard says to do in his book and use fake foods like commercial vegie burgers, sausages, hot dogs and high fat vegie cheeses. I would not expect the best results with these foods and do not think he was helping people by including them among his recipes and giving the ok to use them as "transitional" foods.

Pick up almost any vegetarian or vegan cook book and you will find either dairy and eggs or fat used in recipes. A couple of vegan and vegetarian cooks on PBS shoes, one of which has Dr. Pam Popper as a guest, use oil to cook with. Some might use lots of nuts--vegan but lots of fat. Read the thread on diabetes in India and you will see the number of diabetic vegetarians (who are most likely vegetarian for religious reasons) is climbing thanks to use of lots of dairy and butter and oil.

My own A1c twenty years ago at diagnosis was 9 and a random test of blood sugar was 345 and a fasting test was 245. After a short while on glyburide and a couple of months without any meds my A1c lowered to 5.3 and I was not even eating totally plants.

My own fasting blood sugars are in the low eighties and two and a half years ago, after an MI, I tested at 5.6 but was still not totally eating plants.

I do not like the term plant based. To me it implies that plants are the base but animal foods might be included. While I have not seen the study I would be very surprised if many of the subjects in the studies ate only whole plant foods with zero fats.

didi

Now that I am 100% compliant and have lost even more weight, I suspect the A1c will be low but have not been to a doc for testing.
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Re: Puzzled by study results for diabetes

Postby f1jim » Sat Nov 15, 2014 3:39 pm

This is an issue about studies. How many people in these studies follow what we would call a McDougall type diet. Honestly? Very few. So where is the data going to come from to support this type of diet? Dr. Barnard has done some. Dr. McDougall has lot's of patients he has treated with T2 diabetes. The other studies in meta-analysis will have vegetarians in the most loose use of the word but few seriously healthy eaters. Expect much better results than seen in the studies using the generic vegetarian model in this country.
You have been a member since 2006. Surely you have seen the same parade of successful people treating this condition I have here on the forum.
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Re: Puzzled by study results for diabetes

Postby AlwaysAgnes » Sat Nov 15, 2014 3:54 pm

This has a bit of info: http://kanker-actueel.nl/NL/plantaardig ... udies.html

Six (of 477) studies met inclusion criteria. One requirement was that the study was equal to or greater than 4 weeks. As far as I can tell, these vegetarian diets weren't necessarily low or very low fat. I imagine that would be an important factor. Eliminating animal products does reduce fat from animal sources, but it says nothing about the amount of oils or fatty vegetarian foods that might have been consumed if "vegetarian" is the only thing we're going by. It's possible that there were both vegetarian and vegan diets included.
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Re: Puzzled by study results for diabetes

Postby dteresa » Sat Nov 15, 2014 4:25 pm

the study could have lasted only four weeks? That is not a bad drop in A1c in only a month.

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Re: Puzzled by study results for diabetes

Postby Birdy » Sat Nov 15, 2014 7:44 pm

Very helpful responses. Thanks to you all. It seems clear that the definition of plant-based is vague and, as several of you point out, the meta-analysis likely included a variety of "vegetarians".

I was interested mostly in the science, not personal anecdotal stories Jim. And although I first signed into this website in 2006, I've actually visited and participated on Dr. McDougall's boards since he first started them in the 1990s. Before that, in about 1993, a student of mine who was vegan gave me two large grocery bags of printed materials and two books that launched me on a long and winding road of reading about nutrition. The two books were Diet for a New America and The McDougall Plan. When she gave me these books, I ate a mixed diet with a little chicken, turkey, fish and dairy, not very many carbs, very little sugar and lots of vegetables and fruit. I weighed 125 pounds and had weighed the same since about the age of 13. After receiving that information on veganism from my student, I started trying to be a vegan and gained 20 pounds in the next two years. Mind you, I was not following Dr. McDougall's plan. I've never followed it successfully for more than a few weeks. My desire to do so has not been strong enough to result in success. That and I live with a family who are not about to eat an oil free, avocado/nut/seed/coconut/olive/chocolate free vegan diet. Also, I can honestly say that I've never fully bought the idea of eating such an extremely restrictive diet. That is certainly the root cause of my failure to McDougall. So, after I gained that 20 pounds as a wanna-be vegan, I had my third child and gained another 20 pounds. I've only managed to lose about 10 out of the total 40 pounds. And I now have high blood pressure, high lipids and T2 diabetes. All anyone here can say (and rightfully so) is that I haven't followed the plan so I can't expect to experience its benefits.

Often I feel that I absolutely should stop coming to this board and stop posting. However, it's a wonderful forum unlike anything that exists elsewhere on the Internet that I know about. I have great respect for Dr. McD and for the many people who've been successful eating this way. If it were possible to wave a magic wand over me and turn me into a bonafide McDougaller, that would be so great. But of course it's silly. I suspect there are a LOT of people around like me who do or have visited here.
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Re: Puzzled by study results for diabetes

Postby f1jim » Sat Nov 15, 2014 9:59 pm

You are not alone. Most people evaluating this way of eating will NOT adopt it. It will only be a small number of people that will embrace this way of eating in a world where it has become so foreign given our culture. Yes, people ate this way and in some places still do. But usually because they didn't have a choice. Given a choice most will choose the diet of Kings and Queens.
But hopefully you will pull out enough bits of nutritional help to make your health respond. It's why we are all here no matter our level of adherence.
This won't be news to you....You have been around this too long....Some only adopt this way of eating because their health deteriorates to their point of desperation. I only made changes when facing my own mortality over heart disease. If not for that I would probably not be eating this way today. In fact, my best guess is I would not be alive. Some simply get fed up with their weight or appearance and are willing to do ANYTHING to correct this. All of us knew going in this is a diet that appears extreme to those on the "outside" But to those on the "inside" we have a real secret we keep hidden most of the time. This way of eating is really simple, terribly satisfying, and highly addictive once you jump in with both feet. I get the honor of meeting up with many that have been following this program adherently for many years and we love to share with each other just how easy it is to eat this way on a daily basis. We bask in the simplicity and economy of a starch based diet. We marvel that more people haven't caught on to this. Yet, we do see more and more people joining the club. The movement to eating like a peasant is catching on out there.
Seeing this program as extremely rigid and limiting is but a mind game with yourself. It can also be seen as a door to the freedom good health brings. Not much is more limiting than the results of chronic disease. This way of eating can free us from those shackles.
But to assume this diet will be attractive to everyone is naive. It won't be. Some will only see what they can't have and not see what they can have. It can be a monumental head game with yourself if you let it. Where the real struggle is when you know it's the healthiest way to eat but you fight with yourself over adopting it. Sometimes the inner struggle can be too much for some. If it is maybe it isn't worth the benefits. We all have that choice. Life can be pretty special to allow us that choice.

The science? Yes the science is what brought me to this way of eating. Looking for that alternative to a bypass made me look at the literature about heart disease and the more I dug into it the more it became apparent that the real source of good health was a diet like this. For over 7 years the medical science and data has only reinforced this position. Not just the anecdotal evidence but the peer reviewed data in the most respected journals. The data that drove Nathan Pritikin, Dr. McDougall, Dr. Esselstyn, Dr. Ornish, Dr. Campbell, and many many more use this diet therapeutically.
I do hope you find peace and contentment with whatever diet you follow and hope your health responds favorably.
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Re: Puzzled by study results for diabetes

Postby Birdy » Sat Nov 15, 2014 10:32 pm

What a thoughtful and well written response you posted Jim. I truly appreciate it. Your description of what's it's like to be on the other side of eating this way is something I haven't heard expressed in quite that way before, "This way of eating is really simple, terribly satisfying, and highly addictive once you jump in with both feet....We bask in the simplicity and economy of a starch based diet." And I like your phrase, "eating like a peasant" which I know is the flip side of Dr. McD's references to "eating like Kings and Queens."

It's super helpful to be able to be honest about the struggle, and to still receive encouragement such as you offer.
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Re: Puzzled by study results for diabetes

Postby Birdy » Sun Nov 16, 2014 9:56 am

On the subject of my original post about the results from the meta-analysis posted on the PCRM site, I looked up what Dr. Barnard wrote in his book Reversing Diabetes about changes among his subjects. He wrote, "The biggest changes we have seen in short-term research studies are on the order of 3 or 4 points in approximately 6 months. These are seen in people whose A1cs were high (say 9 or 10) to begin with. People whose A1cs are in the 7 to 8 range are likely to have a drop averaging between 1 and 2 points. People who continue to lose weight beyond this time could have an even greater drop, assuming they were not already in the normal range," (page 103).

So that is the science as reported for very low fat plant-based vegan diets. Since this information is based on averages, I wonder what the range of responses was. That information isn't provided. Does anyone here know about that?

The other point Dr. Barnard makes (and Dr. McD, Esselstyn, etc.) is that the LFPBD lowers cholesterol, blood pressure and weight thereby reducing risk from heart and circulatory disease that is so problematic for diabetics.

Jim, another thing you said that really captured my struggle is, "It can be a monumental head game with yourself if you let it. Where the real struggle is when you know it's the healthiest way to eat but you fight with yourself over adopting it." You nailed it for me with those words.
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Re: Puzzled by study results for diabetes

Postby Bix » Mon Nov 17, 2014 7:10 am

I liked what you said here, Jim. I second Birdy's comments.
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Re: Puzzled by study results for diabetes

Postby GeoffreyLevens » Mon Nov 17, 2014 8:22 am

And I like your phrase, "eating like a peasant" which I know is the flip side of Dr. McD's references to "eating like Kings and Queens."
Funny side bar: Few years ago I saw a Naturopath for a sports injury I had. He asked me about my diet and then started to extol the virtues of Paleo/low carb eating. He said, "Would you rather be a peasant or a warrior?!?" Without a split seconds thought or hesitation I replied, "A peasant of course!" I thought his jaw was going to fall off; I think that is actually the only time I have ever seen someone literally have the "jaw dropping" reaction.
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Re: Puzzled by study results for diabetes

Postby dteresa » Mon Nov 17, 2014 9:55 am

No reason you can't eat like a peasant and be a warrior. According to doctor McD the roman soldiers would complain if they were fed too much meat especially before a battle and were known as the Barley men. And they conquered the world.

There are many vegan "warriors" whom you can find out about on the internet. I am talking about all kinds of athletes. To be honest, I have never seen a video of members of present day marauding armies whose warriors claim their excellence at slaughtering the innocent is due to their vegan diet but, heck, they could be out there.

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Re: Puzzled by study results for diabetes

Postby colonyofcells » Mon Nov 17, 2014 12:03 pm

Both peasant and warrior probably ate mostly agriculture unrefined starch foods and there is no puzzle. High fat diet is just the newer unhealthy fad even though it has been a curse on american culture for several decades now ever since Dr Atkins.
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