Defeating diabetes - diet therapy

Nutrition Health Review, Spring, 2003 by Brenda Davis, Tom Barnard

The ultimate goal in treating type 2 diabetes is to restore insulin function by overcoming insulin resistance. This is accomplished by major diet and lifestyle changes--primarily, increased physical activity and weight loss. There are three primary goals of diet therapy:

* to protect against heart disease

* to promote a healthy body weight

* to achieve and maintain good blood sugar (glucose) control

The purpose is to reduce both long-term and short-term complications of diabetes. This includes diseases of the eye, kidney, nerves, heart, and blood vessels and the improvement of quality of life and overall health. We will examine the evidence and determine what type of diet best accomplishes each of these goals.

Goal No. 1: Heart Disease Prevention

Which diet best supports heart health? The diet most commonly recommended for the prevention and treatment of heart disease is the American Heart Association (AHA) "heart-healthy" or "prudent" diet (less than 30 percent of calories from fat, 10 percent from saturated fat, and 300 mg. cholesterol daily). Although this goes along way toward reducing the risk of heart disease, its effectiveness as a treatment has been less than impressive, with cholesterol reductions averaging a modest 5 to 6 percent. More profound results have come from two seemingly opposite eating patterns: very-low-fat vegetarian diets and relatively high-fat Mediterranean diets.

Very-Low-Fat Vegetarian Diets

Very-low-fat vegetarian diets and vegan diets have been shown to be powerful allies in preventing and treating heart disease. Several researchers have demonstrated that these diets not only surpass the usual cholesterol reduction seen in the AHA diets but also can often reverse the course of the disease.

The most well recognized of these studies is the groundbreaking Lifestyle Heart Trial conducted by Dr. Dean Ornish. Patients with serious heart disease followed a program that include a low-fat vegetarian diet. stress management, aerobic exercise, and group therapy. The Ornish group was compared with a control group who followed the AHA diet and exercise program.

After one year, the Ornish experimental group experienced a decline of almost 38 percent in low-density lipoprotein-cholesterol (LDL-C); the control group achieved a drop of only 6 percent. Angina (chest pain) fell by 91 percent in the experimental group but increased by 165 percent in the control group. An impressive 82 percent of the experimental group experienced some reversal of disease; the control group experienced progression of disease.

In another study conducted by Dr. Caldwell Esselstyn of the Cleveland Clinic, 11 patients followed a very-low-fat vegetarian diet along with cholesterol-lowering medication. Seventy percent of the participants experienced a reversal of disease. In the eight years before the study, these patients experienced a total of 48 cardiac events (such as heart attacks). During the 12 years of the study, only one person had an event.

These and other studies have made very-low-fat, plant-based diets extremely attractive to those seeking to prevent or treat coronary artery disease.

Adapted with permission. Defeating Diabetes c2003 by Brenda Davis, R.D., Tom Bernard, M.D., Published by Healthy Living Publications. $14.95.