I have been listening to the Food Matters Total Wellness Summit online and one of the interviews was with the two authors of the New York Times bestselling book Mastering Diabetes. Cyrus Khambatta and Robby Barbaro have degrees in nutritional biochemistry and public health (respectively) and are both Type 1 diabetics with firsthand experience on the nutrition protocol they researched and found to be optimal for reversing insulin resistance.
Based on their research, the authors promote a primarily plant-based diet with emphasis on whole foods with nominal good fats.
Here are the highlights:
- Key contributing factors for diabetes in the western world, especially for Type 2 diabetes:
- There is a lot of misinformation and also too much information that is conflicting which breeds apathy for the consumer and lack of motivation to make changes. It’s important to note that both forms of diabetes (Type 1 or 2) are unified by insulin resistance.
- The American living environment is not set up for success – we have too many options at restaurants and easy access to unhealthy fast food. The bulk of grocery stores are dominated by packaged and processed foods and this has become the norm for the American public. That is why heart disease, diabetes and cancer are growing exponentially. Also, healthy food requires HARD work and it’s much easier for us to grab fast, processed junk food.
- Food matters and is the biggest problem as we are so far away from the norm of what a healthy diet should be.
- The authors found, when conducting research on how to create and reverse insulin resistance in rats, they needed to be fed a high saturated diet. It was not sugar (glucose, fructose, sucrose) but fat, particularly saturated fat. This really surprised me as I’ve always thought that sugar was the culprit in diabetes. And here’s why…
- When dietary fat gets eaten, the triglycerides (the fat molecule) is broken down by enzymes secreted by the liver or pancreas to liberate fatty acids. These fatty acids get absorbed by the small intestine and then go into the blood into particles called chylomicrons. These chylomicron particles deliver dietary lipids to adipose tissues which is the enzymatically and mechanically safe place to store the fat where it can be used after days, weeks, or months. However, with higher and more regular amounts of fat eaten in the standard western diet, there is no more room in the adipose tissue to store the fat so it pushes it to the liver and muscle for storage. The muscle and liver are designed only to store small amounts of fat and oxidize the fat when needed. Eating too much saturated fat overwhelms the cells in the liver and muscle tissue so as a protective mechanism, they respond by blocking the fat, glucose and amino acids that are coming in. And this is where insulin resistance starts.
- Insulin is the master anabolic hormone which means it assists in the body’s building process. When insulin is present, it sends the signal to replicate and take up energy from the blood. If you slow down the effectiveness of insulin, you will also slow down the rate at which the fuel gets into the tissues. This slowdown or blocking of insulin is a self-protective mechanism set up by the liver and muscle to deal with the excess fat that is in the body. So, as soon as the insulin resistance mechanism is initiated inside the liver and muscle, it makes it hard for carbohydrates to be utilized as a fuel. For example, if you eat a ketogenic, high fat, low carb diet and then have a banana, the muscle and liver will reject the glucose from the banana as it is still working on oxidizing the fats it has stored. As a result of this, glucose from the banana cannot exit the blood easily and accumulates in higher concentrations. So, for an insulin resistance person on a classic high fat diet (Atkins, keto, Paleo), it’s not abnormal for their glucose reading to shoot up past 200 upon eating a banana. The banana is labeled as the culprit but really it’s the fat that the body cannot process.
- Insulin resistance is caused by the accumulation of excess saturated fat in tissues that are not mechanically or enzymatically designed to store large quantities of fat.
- Overweight people have a high propensity for insulin resistance and diabetes because they have a lot of stored fat.
- Fat has gotten a bad rap in some dietary circles and it’s important to note that not all fats are created equal. Fat is essential for regulating hormones, for brain health and satiety but certain fats are better than others.
- There are 3 main classes of fat:
- Trans fats come from partially hydrogenated oils and are created from a chemical hydrogenation process to turn the oil into a more shelf-stable solid. There is ample evidence now that trans fats increase atherosclerosis and risk of diabetes. Products that contain trans fats include cakes, pies, cookies, biscuits, breakfast sandwiches, crackers, microwave popcorn, cream filled candies, doughnuts, ready-to-use dough, dairy and non-dairy creamers and vegetable shortening. It’s best to avoid any type of trans fat but it’s in so many products so read the label carefully.
- Saturated fat is known to be the biggest culprit in insulin resistance because it is very abundant in the western diet; mainly in red meat, white meat, dairy, cheese, coconut oil, medium chain triglycerides oil (from coconuts) and plant-based foods like avocados, nuts and seeds, and olives. It’s safer than trans fat but we eat way too much of it. In the old days, it was hard work to get nuts from trees and out of their shells. Now you can buy giant packages of shelled, roasted nuts for easy snacking from your recliner. The same goes for meat – the mechanization of the industry has made it way too easy for us to buy and consume it. And factory farmed meat has a high omega-9 to omega-3 fatty acids ratio so the balance is way off compared to grass fed meat.
- Unsaturated fats – Mono-Unsaturated Fatty Acids (MUFA) and Poly-Unsaturated Fatty Acids (PUFA) – have missing hydrogens in their structure due to one or more carbon-carbon double bonds and have a different biological function than saturated fats. These fats are signaling molecules and not used for energy. They regulate the fluidity of the membrane and as a result, MUFAs and PUFAs can actually improve insulin sensitivity. A meta-analysis study showed that substituting 10% of calories of saturated fat with MUFA/PUFA can drop cholesterol by 25 points. Still, it’s not recommended to consume these fats in high quantities either.
The quantity of fat in your diet has a big influence on promoting insulin resistance. When you become insulin resistant, you increase the overall chronic disease risk including diabetes, non-alcoholic fatty liver, kidney disease, Alzheimer’s and heart disease.
- There’s been a lot of good press and research about the Mediterranean diet; but that doesn’t give you the license to eat tons of olive oil. Remember that olive oil is still ‘mechanically processed through extraction’ so it is ideal to eat the olives and less of the oil.
- One recommendation is to lower overall oil/fat intake no matter what type it is. The authors claim that less oil/fat over time will make you more metabolically flexible. Biomarkers like post-meal glucose, triglycerides, blood pressure and HbA1c can be lowered just by limiting oil/fat consumption.
- Aim to eat less animal fat and more fat from a natural source in its whole form. There are only so many olives, avocados or coconuts you can eat but it’s easy to drench olive oil, avocado oil and coconut cream into drinks and dishes.
- If you take out the fat, can you add more carbs and fruit? Yes, because fat inhibits glucose uptake so lowering it will enable carbs to be metabolized more readily. But remember that the type of carbs you eat are also important.
- There are four classes of food that contain carbs and can be eaten in a low fat environment: fruits, starchy veggies (potatoes, yams, squashes), legumes (beans, peas, lentils), and whole grains (quinoa, oat, millet, sorghum, faroe, buckwheat). In general, eat whole carbohydrates NOT refined foods.
- As for juicing, stick to greens and herbs so you can get the nutrients without eating excess fiber. Fruit should be eaten in whole form.
- There is ample research on lowering the risk of diabetes with fruit consumption but it must be eaten in its whole form.
So, in summary, “eat the rainbow”, stick to whole foods with minimal processing, and reduce saturated fat intake. Sounds simple right? If you have insulin resistance or bordering on it, this could be the right strategy for you.
For more details, check out their book, Mastering Diabetes.