The high incidence of type 2 diabetes (T2D) has taken the world by storm. In Australia, T2D is the biggest challenge confronting our healthcare system and the fastest growing chronic condition, surpassing heart disease and cancer. In fact, almost 2 million Australians are estimated to have T2D right now. This is inclusive of diagnosed and silent, undiagnosed patients.
With 280 Australians developing T2D every day, this should be evidence enough that what we are doing to combat this disease is ineffective. Currently, Australia's medical efforts are focused primarily on managing the symptoms, rather than working with patients to implement comprehensive lifestyle changes that, in many cases, are effective at actually reversing the disease process.
It's time to equip ourselves with the knowledge of what T2D is and what we can do to prevent and even reverse this disease.
What is Type 2 Diabetes?
T2D is characterised by a disease process that we call insulin resistance. In order to understand why insulin resistance is so harmful, we need to start with some basic nutritional biochemistry first.
When we eat carbohydrates, those carbs are broken down into glucose which is then absorbed into our bloodstream. The presence of glucose in our bloodstream triggers our pancreas to release insulin. The insulin travels with glucose to our liver and skeletal muscle cells, facilitating the uptake of glucose into those cells. Insulin does this by binding to little receptors on these cells and opening the cells up to receive the glucose. You can think of this process like a lock and key; the receptors are locks and insulin is the key.
Once glucose enters our cells, it is no longer roaming our bloodstream and, as a result, insulin dissolves. The glucose is then used by our cells in a series of important pathways for energy production.
However, this lock and key process does not work effectively in a patient with T2D. As the term insulin resistance suggests, in T2D our liver and skeletal muscle cells become resistant to the effects of insulin.
So… Why does this happen?
Insulin resistance
Insulin resistance is the result of an excess of microscopic fat particles within our skeletal muscle and liver cells, otherwise known as intramyocellular lipids. But how does this cause insulin resistance?
Let's expand on the lock and key analogy from before. Remember, the cell receptor is the lock and insulin is your key. Now, think of the cell itself as your house and your glucose.
You've just finished a long day of work and you've pulled up to your house, key in hand, ready to go inside and have a relaxing night. You walk up to the front door, put your key in your lock but when you try to turn your key the lock won't budge. You keep trying but still no luck. How odd! You crouch down to look inside the lock and notice that someone has shoved a piece of gum inside of it, which is getting in the way of your key unlocking the door.
So, what do you do? You spend some time scraping the gum out but eventually you're able to get inside your house! You're happy that the key worked and you go on with your evening.
Now, let's bring this all into context. The excess microscopic fat particles in your cells is the pesky gum in the above scenario. These excess particles are what is stopping insulin from binding to our cell receptors and preventing glucose from getting in, thereby causing insulin resistance. It is this disease process that results in high blood sugar levels in patients with T2D. When left unchecked, it can lead to a slew of complications, including coronary heart disease, nerve damage and a variety of chronic diseases.
The cause of insulin resistance is predominantly lifestyle. Hereditary factors play a small role in the onset of this disease process. This is why T2D has been labelled as a lifestyle disease. But that's actually fantastic news because in the same way poor dietary/lifestyle choices can cause T2D, switching to a healthy diet and clean-living have the power to reverse it!
Right, so how do we get the gum out of the lock?
Plant-based Diets for Insulin Resistance
Raise your hand if you think sugar is the cause of T2D! If you raised your hand, you're certainly not alone. For years, doctors have been blaming sugar for T2D. However, this is truly one of the greatest misconceptions about the disease and one that is now widely refuted by scientists around the world.
Although consuming too much sugary drinks and foods can cause weight gain due to a calorie surplus, it is not directly responsible for insulin resistance. According to research, the real driver of insulin resistance is the fat that we eat.
Remember the gum in your lock - those pesky microscopic fat particles? Yep! Those actually come from the surplus of fatty foods we eat, particularly saturated and trans fatty foods.
Traditionally, doctors have advised patients with T2D to restrict their intake of carbohydrates to prevent high blood glucose levels. However, this medical advice is a band-aid solution that not only fails to address the cause of insulin resistance but is unsustainable and detrimental in the long-term.
While low-carbohydrate diets can help manage blood glucose levels in individuals with type 2 diabetes, it may also lead to many side effects such as hypoglycemia and reduced energy intake. Following this type of diet for the management of T2D should be strictly done under the supervision of a doctor, especially for patients with cardiovascular diseases, such as coronary artery disease and peripheral vascular disease, or who are on blood pressure medications.
Given that the typical Australian diet is marked by shockingly high intakes of saturated fat-rich animal products, it is not surprising that the rates of T2D have skyrocketed. As more research has emerged, what we've seen is that a low-fat, whole-food, plant-based diet is the most powerful tool we have to successfully reverse insulin resistance, and therefore T2D.
Not only does this diet contain almost negligible amounts of saturated fat and zero cholesterol, it's also high in fibre, antioxidants and magnesium, all of which have been proven to promote insulin sensitivity – which is what we want!
One study placed 20 men with T2D on either a low-fat, whole-food, plant-based diet or a conventional low-carb diet, while also ensuring that none of the men lost weight. The results? After just two weeks, half the men in the plant-based group were able to stop taking insulin completely, while the other half reduced their need for insulin by an average of 60% - and this was WITHOUT weight loss. The conventional group saw some improvements, but they were negligible in comparison to the plant-based group.
The importance of this study, and many others that have shown very similar results, should not be overlooked. There are people all over the world who have been living with T2D for years who have been able to reverse their disease or substantially improve their condition within WEEKS of following a low-fat, whole-food, plant-based diet. They got the gum out of their locks!
And when this diet is paired with regular exercise and weight loss, the results are even more incredible.
If we had a pharmaceutical drug that was capable of this, there is NO doubt that it would be making headlines and certainly a lot of money. Fortunately, the research that has been done is slowly starting to be recognised by the broader medical community. The future is starting to look brighter!
What Does a Low-fat, Whole-food, Plant-based Diet Look Like?
The macronutrient breakdown of this diet looks something along the lines of 70-75% carbohydrates, 15% protein and 10-15% unsaturated fat. However, this is not a free pass to binge on refined carbohydrates like white breads, cookies and pastas. You want to focus on complex carbohydrate intake, which means the carbohydrates you want to eat actually come from fruits, vegetables and unrefined grains, such as brown rice, rye, oats and quinoa (to name a few). Beans and legumes also make up fantastic protein and carbohydrate diets – double whammy!
Your fat intake should be limited to small amounts of plant sources only, such as avocados, nuts and seeds. Avoid oils and other processed fats.
One of the best things about a low-fat plant-based diet is that you have the freedom to eat until you're satisfied, without the pressure or need to count calories.
Safety first
Remember that this type of diet is powerful! If followed religiously, it can lead to the remission of type 2 diabetes. Before transitioning to a plant-based nutrition program, though, be sure to consult with your healthcare team first so that safe modifications to your medications can be made along the way.
Healthy eating involves getting the recommended dietary intake (RDI) of macronutrients and micronutrients to meet your body's nutrient needs. However, the blood glucose levels of people with T2D are not stable, so they need to seek dietary advice before shifting their dietary pattern.
Let's Summarise
I shared a lot of information with you today, so let's summarise! My top tips for combatting or reducing your risk of type T2D are:
- Maintain a healthy weight.
- Exercise regularly to lower blood glucose levels.
- Adopt a low-fat, whole-food, plant-based diet. Low-fat means only 10-15% of your calories come from fat.
- Consume at least 30g of fibre per day from fresh fruits and vegetables. Note that starchy vegetables are safe as long as they're eaten in moderation.
- Eat a wide range of whole grains, legumes, vegetables and whole fruits (avoid juice).
- Cook without vegetable oils or use a very (VERY) small amount.
- Stick to whole-food fat sources, such as avocados or nuts and seeds. This should be in moderation. Avoid animal protein as they contain high levels of saturated fat.
- Minimise or avoid packaged, processed foods. These foods usually contain high amounts of saturated fats, trans fats, refined sugar and calories with very little micronutrients (vitamins, minerals, etc.).
Want to learn more?
If you're looking for a diabetes educator to learn more information about this topic, or if you require assistance in developing plant-based eating patterns for type 2 diabetes management, please feel free to reach out to me directly. I can be reached via email or phone: hello@mvnutrition.com.au, 0411 324 046.
