Nutritional disease

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TYPE II ADULT-ONSET DIABETES IS A Nutritional Disease

TYPE II DIABETES, ALSO KNOWN AS "adult-onset diabetes," is one of many chronic diseases that are mainly caused by straying from our Paleolithic diet. What is this diet? Lean meat (including game, reptiles, amphibians, and insects), fish, shellfish, raw fruits and vegetables, occasional nuts and seeds. No cereal grains, refined sugar, soybeans, dairy products, alcohol, hydrogenated fats or large amounts of animal fat and dried legumes. Nothing processed, preserved or artificial.

The most important concept in nutrition, which is usually glazed over if even considered by scientists and non-scientists alike, is that we still have the bodies, metabolisms, and physiology of Paleolithic hunter-gatherers.

Before we go too far, we need to understand the difference between structural fat and storage fat. Structural fat is a major component of cell membranes, internal organs, brain and nervous tissue; the myelin that sheathes our nerves is 79 percent fat. Structural fat contains the essential fatty acids (EFAs), polyunsaturated fats which must be supplied from our diet. Storage fat is largely saturated fat; our ancestors needed to carry around excess food for emergencies. We have kitchens and supermarkets to store food now, so we don't need much storage fat-but we continue to accumulate it. We are straying from our evolutionary diet into foods loaded with sugar, refined grains, alcohol and excess fat, including animal storage fat.

An excess of storage fat is known as obesity. Ninety-five percent of all diabetics are Type II, and obesity is the leading cause of Type II diabetes. Type I diabetes, also known as "insulin-dependent diabetes," is a very different condition where the pancreas does not produce insulin. Type I diabetics need to inject insulin daily to remain alive. However, Type II diabetics typically have adequate or even too much insulin, but this insulin is not utilized effectively. Insulin receptors on the cells may not "accept" insulin as they should.

TYPE II DIABETES IS CAUSED BY MODERN DIETS
I have found that the major causes of Type II diabetes can all be related to a processed-food, agriculture-based diet:

Obesity, or too much body fat with respect to the weight of lean tissue.
Too many calories, especially from refined and processed carbohydrates, fats and alcohol.
Lack of certain EFAs, and unbalanced fat intakes.
Chromium deficiency
Lack of certain phytochemicals.
Pre-agricultural diets were dependent on lean animal protein, which contains mainly structural fat as opposed to storage fat. The calories from fat were usually below 30 percent. With the rare exception of honey, these diets never contained concentrated carbohydrate sources such as sugar, corn syrup, flour, rice and pasta. Hunter-gatherers also consumed a seasonal variety of vegetables, fruits, seeds and nuts. These foods contain plenty of fiber and beneficial phytochemicals.

The Agricultural Revolution changed this dramatically. Cereal grains became the basis for both human and livestock nutrition. Modern agriculture and food processing have led to over 30 percent of calories from fat in our diets-with a lot more saturated and hydrogenated fats and unbalanced and/or reduced intakes of EFAs. Fats and carbohydrates are now separated from whole foods, refined, processed and added again. This addition usually increases the amount of fat and sugar in foods, while decreasing the amount of fiber and vitamins, minerals, and phytochemicals (and often protein) which were obligatory for our ancestors. Cereal grains are unnatural foods for livestock too, and cause excessive storage fat accumulation.

CAN TYPE II DIABETES BE PREVENTED OR CURED?
If you understand the evolutionary perspective, then you understand that controlling Type II diabetes involves a commitment to addressing points 1) and 2) by losing fat, exercising and rnot eating junk food. These life style improvements follow conventional medical wisdom. However, I believe we also need to address items 3), 4) and 5) aggressively, and with supplements. As we age, we metabolize glucose less efficiently, so all five of the items above become more problematic. Although it's better to improve your nutrition before you become diabetic, it's never too late to change. The following sections explain 3), 4) and 5) in more detail so you can understand what might be lacking in your modern diet, and how to supplement for diabetes prevention.

ESSENTIAL FATTY ACIDS
Generally, cell membranes that are flexible have more and better insulin receptors and allow for better glucose metabolism. EFAs (polyunsaturated fats) help make cell membranes flexible, whereas saturated fats make them stiffer. This means that a diet high in saturated fats and/or hydrogenated fats can directly cause Type II diabetes. Conversely, a diet low in overall fat but with a relatively high ratio of EFAs to saturated fats helps prevent diabetes. Most important are omega-3 EFAs. Studies on rats have shown dramatic reversal of diabetic symptoms with fish oil (and to a lesser degree flax oil) supplementation.

A good rule of thumb is to supplement EFAs in a 1:1 omega-6 to omega-3 ratio, since our modern diets are typically "front-loaded" with omega-6 EFAs. This is due to the prevalence of agricultural seed oils (i.e. corn, soybean, peanut and cottonseed) and land animal fats which are rich sources of omega-6 EFAs, but poor sources of omega-3 EFAs. I recommend 1-2 tablespoons of flax seed oil or Essential Balance Registered Trademark oil, and 2,000 to 4,000 mg fish oil per day. Also substitute fish or shellfish for meat whenever possible, and cut way back on saturated fats.

CHROMIUM
Chromium (Cr) is an essential trace element required for normal insulin functioning. Cr deficiency produces diabetic symptoms including high blood sugar, impaired glucose metabolism, decreased insulin binding and receptor number, decreased HDL cholesterol, and increased total cholesterol and triglycerides. A diet high in refined grains and sugars exacerbates Cr depletion. First, these foods contain low amounts of Cr, yet Cr is necessary to metabolize them. Secondly, a high consumption of sugars and refined starches foods increases Cr excreted in the urine by 10 to 300 percent. Typical North American and European diets require more Cr than they provide, thus leading to long-term depletion of Cr from our bodies. The majority of the U.S. population does not obtain the recommended intake of 50 to 200 micrograms per day.

Brewer's yeast, beer, whole grains, cheese, liver and meat can be good dietary sources of Cr; however, Cr contents of foods vary widely. Much of the Cr in foods may be unabsorbable metal contamination from stainless steel food processing equipment. Refining of grains and sugars and processing of foods removes most of the absorbable Cr. Unlike most essential minerals, Cr isn't needed by plants, so they don't make an effort to concentrate it.

Geologically speaking, Cr-rich rocks are rare, found only at tectonic plate margins where one plate is thrust beneath another, or where plates have rifted and new oceanic crust is being created.

Appropriate dietary choices and chromium supplementation of 200-400 micrograms per day may help prevent Type II diabetes but may not be sufficient to reverse existing diabetes. A recent double-blind study on three groups of 60 Chinese Type II diabetics found that 500 micrograms of chromium picolinate given twice per day for four months was greatly superior to placebo. Total cholesterol and insulin levels also dropped. A third group given 100 micrograms twice per day showed lesser but significant improvements in glycated hemoglobin and insulin levels, but not blood glucose.

The Cr requirements of our Paleolithic ancestors were almost certainly lower than ours since they consumed no cereal grains or refined sugars but did consume lean protein, balanced EFAs, and plenty of soluble fiber. They also lived in the geologically active East African Rift Valley for over four million years. During this time volcanoes erupted often, covering the area with trace-element rich lava and ash. Further, traditional hunting societies made a point to consume the internal organs of game, which are rich sources of absorbable trace elements, Cr included. We have no reason to think this behavior differed in the past.

MEDICINAL PLANTS
Regarding 5), many biochemically-active plant phytochemicals are flavonoids, saponins, alkaloids, lignans and tannins. These compounds are usually bitter or astringent, therefore horticulturists have practiced "negative selection" for these compounds over the years. Bitter and astringent phytochemicals are bred down to low levels, or concentrated in peelings, which are not consumed. Produce is consistently bred to be larger, sweeter and milder. The fruits and vegetables our Paleolithic ancestors ate were akin to chickweed, chokecherries, and kumquats rather than to iceberg lettuce, bing cherries or navel oranges. Consequently we have lost a good deal of phytochemical protection from many diseases, Type II diabetes included. The more bland and processed the diet, the greater the loss.

While most of us could improve our diets, even a hard-core evolutionary diet fan like me is loathe to return to bitter, fibrous edible weeds when I can have coleslaw or peas. However, many of these bitter and astringent compounds are with us today in the form of herbal products. The use of medicinal plants for diabetes is not just a search for safer alternatives to pharmaceutical drugs. Here are a few examples of traditional tonic herbs which have been proven effective in controlled human studies:

Bitter melon: Unripe bitter melon is used traditionally in India, Africa and Asia as a diabetic remedy and "bitter tonic food." The effects of bitter melon are gradual and cumulative, and a juice or decoction is more effective than the powdered, dried preparation. In a 1991 study, six Type II diabetics were given 100 milliliters of a bitter melon decoction once each day. After three weeks their fasting blood glucose dropped by 54 percent. After seven weeks, all six were at or near the normal glucose limit and sugar was no longer detectable in their urine.

Gymnema: An ancient Ayurvedic treatment for diabetes, gymnema stimulates insulin secretion and lowers cholesterol and triglycerides. In a 1990 study, 22 patients (non-insulin dependent but taking oral antidiabetic medications) were given 400 mg standardized gymnema extract per day for 18 to 20 months. They were all able to reduce their medication dosages and five were able to discontinue it. Gymnema was superior to the medications for long-term blood sugar control, lowering triglycerides and the overall well-being of the patients. Note: Since gymnema acts primarily to increase insulin secretion, It may not be appropriate for individuals with chronically high levels of circulating insulin.

Korean ginseng: Traditional Chinese medicine recognized that ginseng helped diabetes centuries ago. On the Western front, a 1995 Finnish study found that 200 mg ginseng per day for eight weeks improved mood and physical activity and lowered fasting blood glucose and body weight, compared to a placebo.

BEYOND FIBER
High-fiber diets are uniformly recommended for diabetics. Particularly important is soluble fiber, found mainly in fruits, vegetables and some seeds. (Insoluble fiber is more characteristic of brans and husks of whole grains, i.e. bran cereal, brown rice.) Soluble fibers include pectins, gums and mucilages, which act to slow or reduce the absorption of glucose in the intestines. In this respect, any diet featuring large quantities of raw or lightly-cooked vegetables is beneficial. Not surprisingly, our evolutionary diet was high in soluble fiber; however people today often shun vegetables rich in soluble fiber such as okra, turnips and parsnips. Many herbs and foods with a good deal of pectin or mucilage have been used successfully for diabetes, and the soluble fiber is effective. However, some herbs provide synergistic benefits beyond just inhibiting glucose absorption. Here are a few examples:

Flaxseed: Flaxseed meal is one of the richest sources of fiber. In a 1991 study, a glucose solution was given along with plain water, or water containing mucilage extracted from flaxseed. The mucilage dose improved glucose metabolism by 27 percent, compared to water. Two other groups were given either white bread or bread made with flaxseed meal. The flaxseed bread improved glucose metabolism by 28 percent, compared to white bread. Since the mucilage content of flaxseed meal is only a few percent, there must be more going on than simple inhibition of glucose absorption. Flaxseed is the world's richest source of lignans and also has protein, omega-3 EFAs, and trace minerals, all of which are evidently beneficial.

Fenugreek: Whole fenugreek seeds are about 50 percent fiber, with 20 percent of that mucilage. In a 1990 study, 10 Type I diabetics were given meals with 100 grams of fenugreek powder per day or regular meals. After 10 days, fasting blood glucose decreased by 30 percent in those that ate fenugreek. The amount of sugar excreted in urine dropped an astonishing 54 percent, yet there was no increase in insulin levels. Since fasting glucose was strongly affected, simple inhibition can't be the only explanation. In addition to mucilage, fenugreek also contains protein, saponins, and the hypoglycemic phytochemicals coumarin, fenugreekine, nicotinic acid, physic acid scopoletin, and trigonelline. In other studies, 15 to 25 grams of fenugreek powder were similarly effective for Type II diabetics. In all studies, fenugreek lowered LDL cholesterol and triglycerides.

Nopal (prickly pear) cactus: Widely used throughout Latin America, nopal is rich in pectin. In a 1990 study, eight diabetics were given 500 grams of nopal on an empty stomach. Five tests were performed on each subject, four with different cooked or raw cactus preparations and one with water. After 180 minutes, fasting glucose was lowered by 22 to 25 percent by nopal preparations, as compared to six percent for water. In rabbits, nopal improved metabolism of injected glucose by 33 percent (180-minute value for comparison) as compared to water. In both these cases there was no glucose in the intestines, so nopal has "soluble fiber synergy," too. Note: dried nopal is not effective.

The good news is that Type 11 adult-onset diabetes is a nutritional disease that can be a chronic condition if the cause is not addressed, or it can be treated and prevented by sound nutritional regimens, for a drug-free solution.

ILLUSTRATION

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By LEIGH BROADHURST, Ph. D.

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