REVERSING DIABETES
Neal Barnard interviewed by David Horton

It’s a chronic degenerative problem in the West for over 200 million people suffering from diabetes. The eminent Dr Neal Barnard is travelling around Australia currently promoting his latest research into a vegan diet as a new approach to this old problem.  Dr Barnard suggests not only overcoming the drudgery of medications and blood tests that serve to slow the inevitable damage diabetes inflicts but he suggests targeting and eradicating the condition altogether with a vegan diet, using minimum oil and foods of low glycemic index. David Horton goes along to one of his lectures in Sydney to find out what he has to say.

DH:  You suggest that a vegan diet, using minimum oil and foods of low glycemic index, can reverse diabetes. Why hasn’t this regime been promoted before?
 
Some researchers have used near-vegetarian diets, with very little meat and very vigorous exercise. Our goal was to use a more powerful dietary approach, and to test its effect in the absence of exercise, in order to understand what diet alone will do.
 
DH:  Your approach to diabetes is not to slow the inevitable damage of the disease but to deal with the causes, and to dispel the importance of genetic predisposition to the disease.
 
Yes, diabetes is clearly not caused by a deficiency of medications! It appears to be caused by Western dietary habits, which pack fat into the cells of the body, interfering with insulin action. 
 
DH:  Is there a problem, that people don’t know the extent to which diabetes might affect them? You mention heart conditions, nerve damage and eye damage. Will fear of all this be enough to encourage a radical diet change or should the positives be emphasised – good diet leading to lack of tiredness, better concentration, digestion and sleep – prevention being more urgent than cure? 
 
Many people with diabetes are well-informed about these risks and are anxious to prevent them. However, they often feel let down by more conventional diets; these approaches rarely save them from needing more and more medications. I hear from thousands of people who are looking for a better way, and a great many are now trying the vegan approach with great success. 
 
DH:  Even with a diabetic condition, cravings for certain foods can dominate food choices and exacerbate diabetes. In your earlier book Breaking the Food Seduction you emphasise the addictive qualities of certain foods and how they prevent diabetes sufferers from taking up your suggestions. How can diabetics, or anyone else come to that, overcome the power of these foods?

It is important to first recognise that some foods have properties that cause them to get us “hooked”. Sugar and chocolate, for example, trigger the release of opiate chemicals within the brain. The effect is subtle, but just enough to make people want these foods again and again, especially when they are stressed—exactly the pattern seen with alcohol and drugs. Cheese and meat seem to have much the same effect. Cheese contains highly concentrated casein protein, which digests to produce opiates, called casomorphins (casein-derive morphine-like compounds), and it seems to be one of the foods people really have trouble breaking away from, despite the fact that it smells a bit like old socks.
 
If we are indeed “hooked” on certain foods, then we should use the techniques that are known to help conquer drug or alcohol habits: group support, the complete elimination of temptation (the first taste leads us astray), remaining well rested, involving the family, etc. 
 
DH:  If you are healthy your suggestions still need a great deal of self discipline to adopt, but if you are unwell even though wanting to be healthy, your suggestions seem like climbing Mount Everest. Just a vegan diet is difficult to contemplate but an almost fat/oil free diet, it’s like food is all discipline and no longer pleasure. How to convince the sceptic that this regime is doable and pleasurable?
 
It is important to allow people to simply try it for a brief period—say three weeks—without feeling a need to make a life-long commitment. Once people see the results it can bring, they are in a better position to commit to it for a longer period.
 
Also, oily foods are pleasurable to some people, but after people have broken the habit of oily foods, they find them quite unpalatable. As time goes on, people come to prefer simpler, cleaner foods, although no one would imagine that to be the case at the start.
 
DH: You say that the “traditional” diabetes diet, advocating cutting calories, limiting certain fats, lowering sugar intake and starch foods (which break down to release sugars), is not enough to bring blood sugar under control.  Do you suggest the a person with diabetes, by understanding the logic behind the disease, will be better able to accept your approach?
 
Yes. Many people have tried a more traditional approach and found it difficult and not as helpful as it might be. A low-fat vegan diet is not only easier (it does not require calorie counting or tracking carbohydrate), but all its “side effects” are good ones—lower cholesterol, lower blood pressure, better energy, etc.
 
DH: How important is weight control in the reversal of diabetes?  You explain how your researchers set out to show weight loss is best achieved through a vegan diet, and not so much affected by calories, carbohydrates or exercise.
 
For people with weight problems, weight loss is important. A vegan diet is very high in fiber, which triggers satiety—so people feel full and satisfied with fewer calories. It is also low in fat, which means it tends to be lower in calories. The result is easy weight loss. However, I should add that people who are already at a good weight still benefit from the diet. We found that people with diabetes who did not need to lose weight, still benefited enormously from the diet change.
 
CV: I'd like to ask Neal what he considers to be the external forces playing upon the individual re: diabetes.  What are they and does he make a link between diabetes, cancer and external toxins in the environment. If so, what are they, where are they ushering from and what is his prevention strategy. Also, does he distinguish between juvenile diabetes and late onset?

The external forces, so far as I can see, are dietary. Genetic factors make diabetes possible—some people simply will not get it no matter what their diets are like. But diets make it manifest and flourish. The westernization of the diet has brought diabetes to areas that were largely immune to it. And the western dietary pattern continues to become more and more pronounced in North America, Europe, and Australia, with ever more consumption of meat, dairy products, and sugar. There may be a role for toxins, as well, but I have not yet seen strong evidence of that.
 
Type 1 diabetes, which used to be called juvenile-onset diabetes, occurs when the insulin-producing cells of the pancreas have been destroyed. This occurs as the result of an autoantibody attack—that is, the body makes antibodies—microscopic torpedoes, if you will, which end up destroying the body’s own insulin-producing cells. It is believed that the antibodies are produced in response to cow’s milk proteins, viruses, or both, and there may be a genetic predisposition, as well.
 
Dietary steps for type 1 diabetes are designed with two goals in mind. First, it may be possible to prevent the disease by breast-feeding and avoiding exposure to cow’s milk, at least early in life. This is still controversial, and studies are now underway to assess its effectiveness. The second role for diet changes in is to reduce the risk of complications. By avoiding animal products and minimizing oils, one can reduce the cardiovascular risks. It is not currently possible to eliminate the need for insulin injections in this type of diabetes.
 
In type 2 diabetes, insulin is still produced, and the dietary goals can be more far-reaching: It is possible, in some cases, to eliminate medication use, and, of course, to greatly reduce the risk of complications.