Chasing diabetes around the world: using ancient foods and medicines to treat a 21st century disease

0 Comments | Saturday Evening Post, March-April, 2008 | by Ted Kreiter

They say history repeats itself, and it may be doing just that at the University of Toronto, where a group of medical researchers are looking for new ways to treat the growing epidemic of type 2 diabetes. Toronto's medical school emerged as the epicenter of diabetes treatment in 1920 when researchers Frederick Banting and Charles Best isolated the pancreatic hormone insulin there, for which Banting later received the Nobel Prize in medicine. Some 17 million people with juvenile onset diabetes are alive today because of that discovery. But insulin is not the whole answer for 90 percent of diabetic patients who suffer from the lifestyle form of the disease that is linked to bad diet and lack of exercise. Diabetes has become the sixth largest cause of death in North America in spite of medications and lifestyle therapies.

The major sticking point in controlling type 2 diabetes is diet, says Dr. Vladimir Vuksan, associate director of the Risk Factor Modification Centre at the university's St. Michael's Hospital. In laboratories not far from where insulin was first discovered, he and his colleagues are investigating natural food supplements that are effective beyond modern treatment strategies.

"For many years I have been advising diabetic patients to eat less of this, more of that; to remove fat; avoid refined carbohydrates; and so on," explains Dr. Vuksan, who holds a dual professorship in the departments of Medicine and Nutritional Sciences at the University of Toronto's Faculty of Medicine. "But most of the people will do well for a few months or so, and then even the much-disciplined ones will go back to their usual, often less-than-optimal diet. This is why we decided to provide them with food that could easily be incorporated into their dally diet that was not noticeable by either taste or aroma."

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Working for over two decades, the researchers have developed an arsenal of novel dietary therapies based on medicinal herbs, viscous dietary fiber, and ancient whole grains.

"These supplements represent a new advancement in the way we approach prevention and treatment of diabetes," Dr. Vuksan explains. "Now, in addition to conventional medication and diet, patients may be better able to control the disease by simply adding supplements that not only help them reach their target treatment goal, but also give them the ability to take their health into their own hands. It's really a lifestyle therapy that is turning bad dietary choices into good ones and propelling old medicine into forms of new treatment for diabetes, obesity, and heart disease."

A SUPER FIBER. When Dr. Vuksan came to Toronto from Croatia 20 years ago, he brought a little bottle of a natural fiber blend packed in his suitcase. After ten years of experimenting on various combinations, his research team came up with perhaps the ultimate dietary fiber. This highly viscous fiber blend is mainly a combination of konjac mannan from the Japanese medicinal root and xanthum gum developed by bacteria in a laboratory. Although konjac mannan by itself was already known as an excellent fiber source, the Toronto groups' blend was a stellar improvement. "It is one of the most viscous substances in nature, making it physiologically very active," Dr. Vuksan explains.

When the researchers added their colorless and tasteless two-fiber blend to the meals of diabetic patients already on a healthy diet, the patients' glucose, blood pressure, and cholesterol profiles improved further, even though they already were taking medications for all three conditions. People with the prediabetic condition called metabolic syndrome, or Syndrome-X, a condition present in more than 50 million Americans, showed similar results to diabetics after taking Vuksan's fiber blend.

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An advantage of this blend is that smaller amounts of fiber can be used to achieve the same beneficial effects seen with much larger amounts of other fibers such as oat bran and psyllium, or even with a medium dose of leading cholesterol-lowering medications. Large doses of these dietary fibers often lead to very unpleasant gastrointestinal side effects.

"We found that our fiber blend is much stronger than most other fibers which reduce cholesterol, typically by four or five percent," Dr. Vuksan says. "Here, we are talking over 15 percent cholesterol reduction, even in those already taking cholesterol-lowering medications. Recently the idea was taken up by a company in Calgary, InovoBiologic Inc., which now produces a three-fiber blend marketed under the name PGX (Polyglycoplex). The various fibers in PGX are uniquely formulated into tiny compacted granules to delay the development of viscosity, making it much more palatable and easy to use than our fiber blend but, at the same time, retaining its health benefits."

In their most recent study, the group compared the dietary effects of the fiber blend to considerably higher amounts of psyllium given to individuals with normal serum cholesterol who were consuming a typical North American diet high in fat and refined carbohydrates. Even at an approximately 50 percent higher dose, the psyllium had no effect on cholesterol levels, but the fiber blend reduced blood lipid levels significantly. "This is appealing to people who are less disciplined in following restrictive dietary recommendations and/or prefer eating high-fat diet and refined foods," Dr. Vuksan says. "They can still benefit with the addition of this fiber."