What Causes Type 2 — Genes or Food?

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There’s a major split in the Type 2 diabetes world. Some believe Type 2 is all about diet (and maybe exercise.) Others say it’s mostly a genetic illness and that diet doesn’t make much difference. Who’s right?

This disagreement came to the forefront in the controversy over TV chef Paula Deen. When Deen told the world she had Type 2 diabetes, some people blamed the high-sugar and high-fat food she cooks on her shows. (One signature dish is deep-fried cheesecake.)

But Deen denied her diet had much to do with it. She pointed out that many people eat like her and don’t get diabetes. She said her genes were at fault, even though no one else in her family has diabetes.

Bloggers jumped in; some to attack Deen, some to defend her. On Diabetes Self-Management, Jan Chait wrote, “Psst! Food does NOT give you diabetes!”

Some doctors agreed. Dr. Terry Simpson wrote, “It is more a matter of genetics than anything else. For those who are unlucky enough to have the genetic code that predisposes them to diabetes, the odds are they will become its victim… Even the most “in shape” individual, who eats “right” who has the genetics for diabetes can no more avoid that than you can avoid a car accident if someone misses a stop sign because they are texting.”

I beg to differ. Blaming genes without referencing diet makes no sense at all. There has been an increase in diabetes worldwide of 100% to 400% (depending on location) in the last 20 years. Genes don’t change that fast. The environment has changed. People are more sedentary and more stressed now. But the number one change has been the mass consumption of sugars and refined carbs.

Dr. Robert Lustig at University of California San Francisco blames sugars for most of the diabetes increase. Our bodies just weren’t made to eat these highly concentrated carbs, he believes. His research on how different foods like corn syrup (or “corn sugar” as the growers prefer to call it) break down in our bodies seems to show that many sugars cause insulin resistance and liver damage. They’re “poison,” he says.

Why is this important? It matters because, if foods are a main cause of Type 2, diabetes treatment should focus on eating healthier food. Genes clearly play a role, but it’s not true that “genes give you diabetes.” Genes can make you vulnerable to the foods that cause Type 2. But if you avoid those foods, you won’t get it.
Paula Deen isn’t going to change. Her Web site Diabetes in a New Light says she doesn’t plan to make major changes in her lifestyle, although she has started walking with her husband.

Dr. Simpson agrees that diet changes won’t help much. “Food can kill you,” he says, “but it cannot cure you.” But Dr. Simpson is a weight-loss surgeon. He has a vested interest in believing that diet changes don’t work.

The reality, as most of our readers know and many have written in comments, is that diet makes a huge difference in diabetes. Many doctors have found that Type 2 diabetes can be improved and sometimes reversed by stopping sugars and refined carbs, eating more fiber, getting more exercise, and reducing stress.

Dr. Mark Hyman, author of the Blood Sugar Solution, says hundreds of his patients and thousands of readers have gotten off all diabetes medicines just by changing diets and taking some dietary supplements if needed.

In his book The 30-Day Diabetes Cure, cowritten with Jim Healthy, naturopath Dr. Stefan Ripich says he has never had a person with Type 2 who couldn’t get off medicines by changing to a high-fiber, very-low-sugar diet.

And it’s not just doctors with programs to sell who have demonstrated that diet can make all the difference in Type 2. Studies show that a vegan diet (no animal products at all) often enables people to reduce or stop their medicines, possibly because of the high fiber content. You can see some of their success stories at the Physicians Committee for Responsible Medicine Web site.

Very-low-carb diets also seem to greatly improve diabetes, as has been shown in several studies. Dr. Lustig notes that people on the Atkins (low-carb) diet and Japanese people both have very low rates of diabetes. One group eats lots of animal protein, the other very little. The one thing they have in common, says Lustig, is that they eat little or no sugar.

In my view, the evidence for a dietary cause of Type 2 diabetes is overwhelming. Stress, genetic background, and lack of physical activity are also very important. But you can’t change genes, and stress reduction is a lifelong effort. The dramatic results many people achieve by coming off refined carbohydrates and sugars certainly make one of the approaches I mentioned worth trying. What do you think?

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