This presentation by Dr. John McDougall MD was about the relationship between fat and type 2 diabetes (T2D). He discusses both the dangers of conventional western treatments for T2D, and how a low-fat plant-based diet can be both preventative and a cure for those with the T2D condition. A video of this presentation is embedded at the bottom of this article, which contains the notes I took during the Advanced Study Weekend earlier this year. These notes contain links to the resources referenced during the presentation.
Notes from a presentation by Dr. John McDougall
You can watch the entire presentation on video embedded at the end of this article.
These are notes taken during a presentation given at the McDougall Program's Advanced Study Weekend.
What does that mean?
- Because these notes were typed during a presentation by the noted doctor, and are being written by a "lay person". While I did my best to make notes about what they said, these notes may not be entirely accurate. However, I will link resources (such as the peer-reviewed studies referenced within the presentation) whenever possible within the text.
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Type 2 Diabetes (T2D): it isn't a disease
Dr. McDougall states that T2D is not a disease, it's instead a normal adaptation to being overweight. For example, if you gain 60lbs over normal weight, the body says "60 lbs gained is enough" and makes changes in the form of insulin resistance.
Some people do not develop insulin resistance, and they keep gaining yet their levels are normal. This is the same way one person in 500 or so do not get high cholesterol despite what they eat, insulin resistance, and so on.
Surgery and medication
Bariatric surgery (often used in these cases) is big business, but can lead to surgically-induced malabsorption, malnutrition, and sickness. But by definition, type 2 diabetes is 100% curable (without this kind of surgery). Loose weight.
Over half of all medicare claims are for metformin.
However, Metformin is not safe and may risk cardiovascular health. (Please see note below)
(Editor: I believe Dr. McDougall referenced this study on PLOS in this presentation. The conclusions are cautious and indicate more study required, as most studies do.) Dr. McDougall references his January 2017 newsletter article about diabetes, which links this article that discusses the flaws of studies regarding the cardiovascular benefits of Metformin. Please refer to his newsletter from Jan 2017 for more in-depth information on this topic.
The body and diabetes
When you have diabetes, you have more hemoglobin A1c (Glycosylated hemoglobin). This refers to how many have extra sugar attached to the protein. When this happens, it distorts the protein.
A normal amount is 6% or less. When you have diabetes, this is elevated. 6/2% or so is pre-diabetes, and standard diabetes is around 8%.
Aggressive and intensive treatment of diabetes increases problems:
- Increased number of heart-related deaths
- Higher cholesterol, triglycerides, etc.
- Microvascular disease (as opposed to macro-vascular), which is related to nerve damage and retina problems. It does not improve microvascular health or reduce risk.
Studies and Type 2 diabetes
Two day healthy med student study was run regarding diabetes. It's important to note that because medical students were studied, this was a fairly well-controlled study (as opposed to recall related studies in the wild).
- The students were fed sugars, and when this happened they did not become diabetic.
- When they were fed lean meat and egg whites, they became pre-diabetic.
- When they were fed fats, they became diabetic.
This study supports the above idea that people can be fed carbs and be fine, but fed meat and fats and resulted in diabetes.
(Editor: May be referencing this study.)
These data suggest the high carb diet increased the sensitivity of peripheral tissues to insulin, and that sugar makes insulin work more efficiently.
(Editor: It may be referring to this study.
Pritikin Longevity Center / Anderson
This study changed the kind of calories received. Fat calories were found to be the ones that paralyze insulin, and these calories were changed to ones that make them work more efficiently (carbs).
(Editor: I could not the 1979 Anderson / Pritikin studies referenced, however I did find possibly related ones by these colleages and others: "Response of Non-insulin-dependent Diabetic Patients to an Intensive Program of Diet and Exercise" and "Long-Term Use of a High-Complex-Carbohydrate, High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM Patients")
Neal Barnard MD, and related 2013 study
Dr. McDougall also mentions Dr. Neal Barnard, and how he has found improvements in response after following a vegan diet. He also mentioned the following study "Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes" from 2013 which concludes:
This study suggests that adults with type 1 diabetes require more insulin coverage for higher-fat meals than for lower-fat meals with identical carbohydrate content.
Chinese adult diabetes study
Dr. McDougall also references a type 2 diabetes study from China in 2013. This study, Prevalence and Control of Diabetes in Chinese Adults (PDF) notes the incredible prevalence of diabetes in the Chinese population (and how important of an issue this is):
The estimated prevalence of diabetes among a representative sample of Chinese adults was 11.6% and the prevalence of prediabetes was 50.1%.
Editors Summary and take away
The takeaway I had is how important dietary interventions are with Type 2 diabetes, and trying to reduce and cease the use of medicine used to treat the condition. A strong case was made for a low-fat plant based diet and healthy weight to both prevent type 2 diabetes or reverse it. A strong case with supporting evidence was also made that dietary fat is a leading cause of the condition, and whole, complex carbs are not "evil" for those with T2D.
As always, use this evidence to speak with a health professional if you are dealing with T2D. Do not use it in lieu of speaking with a doctor. For questions regarding the ideas and data made in the presentation Dr. McDougall, please contact him or his team.
The video for this presentation on diabetes by Dr. John McDougall
The notes for this article came from the following presentation: