Can a Holistic Approach to Diabetes Reduce Risk?

Written by Dr. Steve Chaney on . Posted in Holistic Approach to Diabetes

The Role of Supplementation In Reducing Diabetes Risk

Author: Dr. Stephen Chaney

 

holistic approach diabetes doctors recommendDoctors usually discuss a holistic approach to diabetes with their patients.  But, that often isn’t the case for other diseases. Why do doctors recommend drugs rather than natural approaches for controlling and treating other diseases? In part, it’s because so many Americans would rather take a pill than change their diet or lifestyle. Many of our doctors have become so conditioned to that expectation from their patients they don’t even suggest diet and lifestyle changes.

That is our fault. We need to take responsibility for our health. Rather than just accepting whatever treatment our doctors suggest, we should partner with our doctors in designing the best treatment plan for us.

The other reason doctors often recommend drugs is that they are trained to base their decisions on evidence-based medicine. The Gold Standard for evidence-based medicine is, of course, a double blind, placebo controlled clinical trial. In those studies, a single component is compared to the placebo. That is easy to do when you are comparing a drug to a placebo. The drug either works better than the placebo, or it doesn’t.

 

Do Natural Remedies for Diabetes Work?

 

Of course, many of you are more interested in knowing whether holistic, natural approaches also work. That is a much more difficult question to answer.

Double blind, placebo controlled clinical studies are much more difficult to perform when you are looking at foods or nutrients. That’s because foods and nutrients are seldom effective by themselves. They interact with each other. It is the whole, rather than the individual components, that reduce the risk of diabetes and other diseases. Even worse, when you want to test the effectiveness of a holistic change in diet and lifestyle, how do you design a placebo?

holistic approach diabetes talkIt reminds me of an international cancer symposium I attended over 30 years ago as a young Assistant Professor. A world-renowned cancer expert gave a talk from main stage and concluded by saying “I can show you, unequivocally, that colon cancer risk is significantly decreased by a lifestyle that includes a high-fiber diet, a low-fat diet, adequate calcium, adequate B vitamins, omega-3 fatty acids, exercise, and weight control. But, I can’t show you that any one of them, by themselves, is effective.”

The question that came to me as I heard him speak was: “What’s the message that a responsible scientist or responsible health professional should be giving to their patients or the people that they are advising?” You’ve heard experts saying: “Don’t worry about the fat.” “Don’t worry about calcium.” “Don’t worry about B vitamins.” “Don’t worry about fiber.” “None of them can be shown to decrease the risk of colon cancer.”

Is that the message we should be giving people? Or should we really be saying what that doctor said many years ago – that a lifestyle that includes all those things significantly decreases the risk of colon cancer?

The problem is the negative studies you hear about, and your doctor hears about, are usually studies done with individual foods or individual nutrients. Those studies leave the impression that natural approaches don’t work. However, when you look at a holistic approach to diabetes, the answers are often much different.

 

Can a Holistic Approach to Diabetes Reduce Risk?

holistic approach diabetes reduceI created the diagram on the left for my book “Slaying the Food Myths” to represent holistic approaches to health. Simply put, diet, weight control, exercise, and supplementation all play a role in improving our health. It is that sweet spot in the middle of the diagram where we receive the optimal benefit. Finally, both diet and supplementation should also be holistic. No one food or nutrient will be effective by itself.

This is perfectly illustrated by a recent study (S.M. Kimball et al, Journal of Clinical & Translational Endocrinology, doi: 10.1016/j.jcte.2017.11.002 eCollection Dec 2017 ). If you just read the headlines, you would conclude the study was just about the effect of supplementation on the risk of developing diabetes. However, when you read the publication, you realized the study involves a lot more than supplementation.

The study was conducted by a non-profit wellness organization called Pure North S’Energy Foundation located in Calgary, Canada. They enrolled 188 middle-aged adults (ages 25-54 years) in the studies. Based on BMI measurements the participants were overweight, but not obese. They were followed for a two-year period.

Each of the participants met regularly with a health care professional who provided them with lifestyle advice. Specifically:

  • They were advised to increase fruit and vegetable intake and reduce processed foods.
  • If they had cardiovascular risk factors such as hypertension or hyperlipidemia, they were advised to go on the DASH diet.
  • They were advised to follow an exercise routine that was appropriate for their health status.

In addition, the subjects were divided into two groups:

  • Group 1 received a liquid vitamin D3 supplement consisting of 1,000 IU of vitamin D/drop. The dosage they received was individualized so that each subject received enough vitamin D to bring their blood levels of 25-hydroxy-vitamin D to an optimal level of >100 nmole/L.
  • Group 2 received the vitamin D plus 600 mg of EPA and EPA, plus a very comprehensive multivitamin. In addition to the nutrients found in most multivitamins, their formulation contained carotenoids such as lutein and lycopene, polyphenols from wine grapes, N-acetyl cysteine, coenzyme Q10 and a host of other phytonutrients.

[Note: This supplement is not commercially available. However, I would not recommend it if it were. There appears to be little scientific rationale for the amounts of some ingredients.]

In short, all the subjects were put on a holistic diet and lifestyle program ( a holistic approach to diabetes ). Groupe 2 also received what I would consider a holistic supplement. Here were the results of the study.

  • Neither group had significant weight loss or weight gain.
  • Serum 25-hydroxyvitamin D increased significantly in both groups (the vitamin D supplementation was effective).
  • HbA1c levels (a measure of blood sugar control) worsened slightly in Group 1 and improved slightly in Group 2.

However, those were average values. Individual subjects had much more significant changes in HbA1c. In fact, based on changes in HbA1c levels:

  • 16% of Group 1 participants and only 8% of Group 2 participants progressed from normal blood sugar control to either prediabetes or diabetes.
  • 8% of Group1 participants and 44% of Group 2 participants improved from prediabetes or diabetes to normal blood sugar control.

The authors of the study concluded: “The results suggest that nutrient supplementation may provide a safe, economical, and effective means for lowering diabetes risk. Further examination of this potential via randomized controlled trials is warranted.”

 

The Role of Supplementation In Reducing Diabetes Risk

holistic approach to diabetes supplementationThis is a single study and needs to be confirmed by future studies. However, if this study is confirmed, it has some interesting implications:

  • It suggests a holistic approach to supplementation may be effective at decreasing diabetes risk.
  • The holistic approach to supplementation was coupled with a holistic diet and lifestyle change in this study. We cannot assume that supplementation alone would have been effective in reducing diabetes risk.
  • Since both Groups 1 and Group 2 included diet and lifestyle changes, we can conclude that the holistic diet and lifestyle changes in this study were not sufficient to reduce diabetes risk. Holistic supplementation was also required.
  • The reason that diet and lifestyle changes did not affect diabetes risk in this study was most likely the failure to include a weight loss component. Multiple studies have shown that weight loss reduces diabetes risk.

 

The Bottom Line:

 

A recent study looked at the effect of a holistic diet, lifestyle and supplementation intervention on diabetes risk.

All participants in the study met regularly with a health care professional who provided them with lifestyle advice. Specifically:

  • They were advised to increase fruit and vegetable intake and reduce processed foods.
  • If they had cardiovascular risk factors such as hypertension or hyperlipidemia, they were advised to go on the DASH diet.
  • They were advised to follow an exercise routine that was appropriate for their health status.

The subjects were divided into two groups:

  • Group 1 received a liquid vitamin D3 supplement consisting of 1,000 IU of vitamin D.
  • Group 2 received the vitamin D plus 600 mg of EPA and EPA, plus a very comprehensive multivitamin containing carotenoids such as lutein and lycopene, polyphenols from wine grapes, N-acetyl cysteine, coenzyme Q10 and a host of other phytonutrients.

Over a two-year period:

  • 16% of Group 1 participants and only 8% of Group 2 progressed from normal blood sugar control to either prediabetes or diabetes.
  • 8% of Group1 participants and 44% of Group 2 participants improved from prediabetes or diabetes to normal blood sugar control.

This is a single study and needs to be confirmed by future studies. However, if this study is confirmed, it has some interesting implications:

  • It suggests a holistic approach to supplementation may be effective at decreasing diabetes risk.
  • The holistic approach to supplementation was coupled with a holistic diet and lifestyle change in this study. We cannot assume that supplementation alone would have been effective in reducing diabetes risk.
  • Since both Groups 1 and Group 2 included diet and lifestyle changes, we know that the holistic diet and lifestyle changes in this study were not sufficient to reduce diabetes risk. Holistic supplementation was also required.
  • The reason that diet and lifestyle change did not affect diabetes risk was most likely the failure to include a weight loss component. Multiple studies have shown that weight loss reduces diabetes risk.

For more details, read the article above:

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Kathy Brauer

    |

    Group 2 received the vitamin D plus 600 mg of EPA and EPA, plus a very comprehensive multivitamin.

    Should that be EPA and DHA? Not too pick, but checking my assumption.

    Reply

    • Dr. Steve Chaney

      |

      Yes. Thanks for spotting the typo

      Reply

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Latest Article

What Is The Planetary Diet?

Posted May 21, 2019 by Dr. Steve Chaney

Is Your Diet Destroying The Planet?

Author: Dr. Stephen Chaney

 

Earth Day has come and gone, but you are still committed to saving the planet. You save energy. You recycle. You drive an electric car. But is your diet destroying the planet?

This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) serves as a dire warning of what will happen if we don’t change our ways. I touched on this report briefly in a previous issue of “Health Tips From The Professor,” What Is The Flexitarian Diet , but this topic is important enough that it deserves an issue all its own.

The commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The commission described the typical American diet as a “lose-lose diet.” It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

How Was The Study Done?

The study (W. Willet et al, The Lancet, 393, issue 10170, 447-492, 2019 ) was the report of the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems. This Commission convened 30 of the top experts from across the globe to prepare a science-based evaluation of the effect of diet on both health and sustainable food production through the year 2050. The Commission included world class experts on healthy diets, agricultural methods, climate change, and earth sciences. The Commission reviewed 356 published studies in preparing their report.

 

Is Your Diet Destroying The Planet?

When they looked at the effect of food production on the environment, the Commission concluded:

  • “Strong evidence indicates that food production is among the largest drivers of global environmental change.” Specifically, the commission reported:
  • Agriculture occupies 40% of global land (58% of that is for pasture use).
  • Food production is responsible for 30% of global greenhouse gas emissions and 70% of freshwater use.
  • Conversion of natural ecosystems to croplands and pastures is the largest factor causing species to be threatened with extinction. Specifically, 80% of extinction threats to mammals and bird species are due to agricultural practices.
  • Overuse and misuse of nitrogen and phosphorous in fertilizers causes eutrophication. In case you are wondering, eutrophication is defined as the process by which a body of water becomes enriched in dissolved nutrients (such as phosphates from commercial fertilizer) that stimulate the growth of algae and other aquatic plant life, usually resulting in the depletion of dissolved oxygen. This creates dead zones in lakes and coastal regions where fish and other marine organisms cannot survive.
  • About 60% of world fish stocks are fully fished and more than 30% are overfished. Because of this, catch by global marine fisheries has been declining since 1996.
  • “Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”
  • The world’s population is expected to increase to 10 billion by 2050. The current system of food production is unsustainable.

When they looked at the effect of the foods we eat on the environment, the Commission concluded:

  • Beef and lamb are the biggest contributors to greenhouse gas emissions and land use.
  • The concern about land use is obvious because of the large amount of pasture land required to raise cattle and sheep.
  • The concern about greenhouse gas emissions is because cattle and sheep are ruminants. They not only breathe out CO2, but they also release methane into the atmosphere from fermentation in their rumens of the food they eat. Methane is a potent greenhouse gas, and it persists in the atmosphere 25 times longer than CO2. The single most important thing we can do as individuals to reduce greenhouse gas emissions is to eat less beef and lamb. [Note: grass fed cattle produce more greenhouse gas emissions than cattle raised on corn because they require 3 years to bring to market rather than 2 years.]
  • In terms of energy use beef, lamb, pork, chicken, dairy and eggs all require much more energy to produce than any of the plant foods.
  • In terms of eutrophication, beef, lamb, and pork, all cause much more eutrophication than any plant food. Dairy and eggs cause more eutrophication than any plant food except fruits.
  • In contrast, plant crops reduce greenhouse gas emissions by removing CO2 from the atmosphere.

 

What Is The Planetary Diet?

In the words of the Commission: “[The Planetary Diet] largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, poultry, and eggs. It includes no or a very low amount of red meat, processed meat, sugar, refined grains, and starchy vegetables.”

When described in that fashion it sounds very much like other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable. Here is a more detailed description of the diet:

  • It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.
  • It allows the option of adding one serving of dairy a day (It turns out that cows produce much less greenhouse emissions per serving of dairy than per serving of beef. That’s because cows take several years to mature before they can be converted to meat, and they are emitting greenhouse gases the entire time).
  • It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.
  • It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

This is obviously very different from the way most Americans currently eat. According to the Commission:

  • “This would require greater than 50% reduction in consumption of unhealthy foods, such as red meat and sugar, and greater than 100% increase in the consumption of healthy foods, such as nuts, fruits, vegetables, and legumes.”
  • “In addition to the benefits for the environment, “dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10.8-11.6 million deaths per year globally.”

What Else Did The Commission Recommend?

In addition to changes in our diets, the Commission also recommended several changes in the way food is produced. Here are a few of them.

  • Reduce greenhouse gas emissions from the fuel used to transport food to market.
  • Reduce food losses and waste by at least 50%.
  • Make radical improvements in the efficiency of fertilizer and water use. In terms of fertilizer, the change would be two-fold:
    • In developed countries, reduce fertilizer use and put in place systems to capture runoff and recycle the phosphorous.
    • In third world countries, make fertilizer more available so that crop yields can be increased, something the Commission refer to as eliminating the “yield gap” between third world and developed countries.
  • Stop the expansion of new agricultural land use into natural ecosystems and put in place policies aimed at restoring and re-foresting degraded land.
  • Manage the world’s oceans effectively to ensure that fish stocks are used responsibly and global aquaculture (fish farm) production is expanded sustainability.

What we can do: While most of these are government level policies, we can contribute to the first three by reducing personal food waste and purchasing organic produce locally whenever possible.

What Does This Mean For You?

If you are a vegan, you are probably asking why the Commission did not recommend a completely plant-based diet. The answer is that a vegan diet is perfect for the health of our planet. However, the Commission wanted to make a diet that was as consumer-friendly as possible and still meet their goals of a healthy, environmentally friendly, and sustainable diet.

If you are eating a typical American diet or one of the fad diets that encourage meat consumption, you are probably wondering how you can ever make such drastic changes to your diet. The answer is “one step at a time.”  If you have read my books “Slaying The Food Myths” or “Slaying the Supplement Myths,”  you know that my wife and I did not change our diet overnight. Our diet evolved to something very close to the Planetary Diet over a period of years.

The Commission also purposely designed the Planetary Diet so that you “never have to say never” to your favorite foods. Three ounces of red meat a week does not sound like much, but it allows you a juicy steak once a month.

Sometimes you just need to develop a new mindset. As I shared in my books, my father prided himself on grilling the perfect steak. I love steaks, but I decided to set a few parameters. I don’t waste my red meat calories on anything besides filet mignon at a fine restaurant. It must be a special occasion, and someone else must be buying. That limits it to 2-3 times a year. I still get to enjoy good steak, and I stay well within the parameters of the Planetary diet.

Develop your strategy for enjoying some of your favorite foods within the parameters of the Planetary Diet and have fun with it.

The Bottom Line

 

Is your diet destroying the planet? This is not a new question, but a recent commission of international scientists has conducted a comprehensive study into our diet and its effect on our health and our environment. Their report serves as a dire warning of what will happen to us and our planet if we don’t change our ways.

The Commission carefully evaluated diet and food production methods and asked three questions:

  • Are they good for us?
  • Are they good for the planet?
  • Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

The Commission described the typical American diet as a “lose-lose diet.”  It is bad for our health. It is bad for the planet. And it is not sustainable.

In its place they carefully designed their version of a primarily plant-based diet they called a “win-win diet.”  It is good for our health. It is good for the planet. And, it is sustainable.

In their publication they refer to their diet as the “universal healthy reference diet” (What else would you expect from a committee?). However, it has become popularly known as the “Planetary Diet.”

The Planetary Diet is similar to other healthy diets such as semi-vegetarian, Mediterranean, DASH, and Flexitarian. However, what truly distinguishes it from the other diets is the restrictions placed on the non-plant portion of the diet to make it both environmentally friendly and sustainable (for details, read the article above).

I have spoken before about the importance of a primarily plant-based diet for our health. In that context it is a personal choice. It is optional.

However, this report is a wake-up call. It puts a primarily plant-based diet in an entirely different context. It is essential for the survival of our planet. It is no longer optional.

If you care about global warming…If you care about saving our planet, there is no other choice.

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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