Turning the Tide on Lifestyle Diseases: The most ancient of all diets

So far in our discussion about the “plague” of diabetes threatening the health of our world population, we have discussed how serious and common it is (insulin resistance and diabetes affects already up to half the population in the USA); we discussed the patho-physiology of diabetes type 2 (the underlying mechanisms); then we discussed the popular ketogenic dietary approach.

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In our previous article we looked at the current dietary recommendations of an expert committee in South Africa, and how this has changed over the years towards a more positive attitude towards complex carbohydrates in whole foods and against a high fat-content diet.

In this article we will explore the most ancient of all diets and the support of numerous experts in the field of lifestyle medicine of a whole-food, plant-based diet.

He was educated in the most sophisticated university in Egypt, and being groomed to become a Pharaoh he certainly was exposed to all the ancient knowledge of the time.

But it was his understanding of the origins of the world and the original diet presented to our first parents that draws our attention to Moses and his writings.

In Genesis 1:29,30 he reports that both humans and animals were given fruits, vegetables, seeds and nuts for nutrition.  It was only many, many years later that they were permitted to eat animal flesh.

Another highly educated statesman, who amazingly served as prime minister in two world empires (Babylon and Medo-Persia) presents the first ever recorded scientific controlled trial (experiment) in nutrition. 

When still a young captive, recently abducted from Jerusalem by the great Babylonian army under King Nebuchadnezzar, Daniel and his three young friends requested that they be given the option of a vegetarian diet instead of the lavish and rich fare offered to them from no less than the king’s table.  A 10-day case-controlled scientific experiment ensued which showed the vast superiority of the simple whole-food, plant-based diet compared to a sumptuous royal feast in terms of both physical as well as mental outcomes.  This is recorded in Daniel 1:8-16.

What other more recent evidence supports the concept of a whole-food, plant based diet in the management and reversal of insulin resistance and even type 2 diabetes, as well as improving outcomes in type 1 diabetes?  There is a great deal of literature, and we will only touch on some of the most significant.  The most convincing evidence is to be found not from small, short term studies, but rather from long term studies involving thousands of participants, or even large population studies.  There are some limitations, though, because many of these studies rely on personal recall of diet, and that is subject to bias and memory lapses.  Another limitation is the effect of confounding variables, which can affect the outcomes through too many other influences than those being studied.  Scientists are aware of these and try to limit their effect on the statistical outcomes.

Take for instance the China Study, a collaboration between Cornell University, Oxford University and the Chinese Academy of Preventive Medicine.  The study took 20 years to complete and involved detailed analysis of 367 variables in 65 counties in China in 6500 adults. At the end of the study they had more than 8000 statistically significant associations between lifestyle, diet and disease variables.  “People who ate the most animal-based foods got the most chronic disease. People who ate the most plant-based foods were the healthiest,” the authors state.

Another rich source of longterm population studies has been the Adventist Health Study 1 and 2 conducted by Loma Linda University in the USA.  Various aspects of this study have involved up to 96,000 individuals over a period of 40 years. In one aspect of this complex study, various chronic diseases (diabetes, heart disease, cancer, etc.) have been elucidated in their relationship to diet and lifestyle.  Participants were 15,200 Adventist men and 26,187 women across the U.S. and Canada who were free of diabetes and who provided demographic, anthropometric, lifestyle and dietary data.

After 2 years in this particular study, the incidence of the development of diabetes showed statistical differences depending on whether the participants were vegan, ovo-lacto-vegetarian, pisco-vegetarian, or non-vegetarian. 

The lowest incidence of development of diabetes was found amongst the vegan, 4 times lower than amongst non-vegetarians.  Similar differences were found with other chronic diseases as well.

The epidemiological evidence collected from three large US cohorts (Nurses’ Health Study, Nurses’ Health Study 2, and Health Professionals’ Follow-up Study) (involving well over 150,000 individuals over a period of 40 years) has yielded important information regarding the roles of overall diet, individual foods and nutrients, physical activity and other lifestyle factors in the development of type 2 diabetes. Independent of body weight, the quality or type of dietary fat and carbohydrate is more crucial than the quantity in determining diabetes risk.

Higher consumption of coffee, whole grains, fruits, and nuts is associated with lower risk of diabetes, whereas regular consumption of refined grains, red and processed meats, and sugar-sweetened beverages including fruits juices is associated with increased risk. Dietary patterns rich in fruits and vegetables, whole grains, and nuts and legumes but lower in red and processed meats, refined grains, and sugar-sweetened beverages are consistently associated with diabetes risk, even after adjustment for body mass index.

Taken together, these ongoing large cohort studies have provided convincing epidemiologic evidence that a healthy diet, together with regular physical activity, maintenance of a healthy weight, moderate alcohol consumption, and avoidance of sedentary behaviours and smoking would prevent the majority of type 2 diabetes cases.  https://www.ncbi.nlm.nih.gov/pubmed/25599007

What about large population studies in countries?  In Japan there was a sharp 30-fold increase in the incidence of diabetes during the 30 years from 1959 to 1991. Studies are ongoing by the Epidemiology Study Group sponsored by the Ministry of Health and Welfare in Japan.  Of interest is during this same period of time there has been a dramatic increase in the intake of dietary fats, as well as a dramatic drop in the intake of carbohydrates away from the traditional rice three times per day to a more Western diet.  The consumption of meat has also dramatically increased.  Could there be a connection???  https://www.ncbi.nlm.nih.gov/pubmed/7859598

Resources to help

There are a number of resources available which can help with reversal or significant improvement of outcomes of diabetes – both in terms of prevention as well as management.

A prolific writer and speaker on the subject is Dr Neal Barnard, Adjunct Associate Professor of Medicine,The George Washington University School of Medicine, and president of the Physicians Committee for Responsible Medicine (pcrm.org).  You will find numerous resources on their website for both doctors and patients.  He has also been actively involved in research on the subject, sponsored by the US National Institute of Health.

A very practical resource is masteringdiabetes.org .  This is a mentorship team who have helped close on 10,000 diabetics to significantly improve their lives and control of diabetes through ongoing and supportive interaction, as well as wonderful educational resources.  Their aim is to help one million diabetics.  Dr Cyrus Khambatta did his PhD on the subject of insulin resistance so speaks with a wealth of authority and experience.  Here is an article that covers practical aspects of the diabetic diet that will reverse most type 2 diabetes, reverse many of the complications of diabetes (even early neuropathy and macular degeneration, heart disease and early kidney dysfunction and help you to lose weight).  On top of that it will help control auto-immune diseases, high blood pressure and obesity as well as give you energy and vitality.  https://www.masteringdiabetes.org/diabetes-nutrition-guidelines/

For those who want the science behind all this, one of the most impressive resources is found on this website: https://nutritionfacts.org/2018/04/12/plant-based-diets-put-to-the-test-for-diabetes/ Dr Michael Greger and his team of assistants trawl through all the latest scientific nutrition literature gathering information to pass on to us “lesser mortals” in a summarised format and make it available free of charge.

If you want recipes for plant-based foods, you can look up forksoverknives.com and check the hundreds of recipes available there.  You may need to make adjustments because that is an American resource and some of the ingredients either have different names or are not available in this country.  But what is more important is that you don’t have to go fancy or expensive to have a healthy plant-based diet.  We will share some recipes in our next blog of simple but delicious foods that can help you in your quest to improve your life.

To good eating and a healthier life,

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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