Participants: N. David Emerson
Series Code: WM
Program Code: WM000427
00:36 Hello, I'm Dr. Emerson,
00:38 Medical Director at Eden Valley Lifestyle Center 00:41 Today, I want to talk to you about diabetes, 00:44 and the insulin resistance syndrome. 00:47 We start with a story about Toni. 00:49 She was a patient who came in our practice... 00:52 She actually wheeled into our practice in a wheelchair. 00:56 Now, you wonder why a wheelchair? 00:58 Well, she didn't have multiple sclerosis, or polio 01:01 BUT, at 5 feet 3 inches, she weighed 325 pounds. 01:05 She weighed more than she could lift. 01:08 This is one of the effects of diabetes type 2 which she had. 01:12 She was on large doses of insulin, 01:15 about 44 units of insulin per day. 01:18 A normal pancreas only produces about 30 units per day 01:22 in a normal person, but she was requiring even more 01:25 than in a normal person would require. 01:27 We're going to find out why shortly. 01:30 She also had high blood pressure. 01:32 She was on 2 blood pressure medications, 01:33 and her blood pressure was still poorly controlled. 01:36 She had high cholesterol, and was on a 01:38 medication for that as well. 01:41 She was tragically blind from her diabetes. 01:46 This is one of the complications from diabetes... 01:48 diabetic retinopathy, and was not reversible at this point. 01:53 So, she was coming there for help, and the question is... 01:59 "What should I tell her?" 02:02 Well, I could tell her the diabetes is genetic 02:05 and there's really nothing you can do about it, except 02:07 continue to take medications the rest of your life 02:09 and wait for further complications such as... 02:12 heart attacks, stroke, kidney failure necessitating dialysis 02:16 or an amputation from poor vasculature to her 02:19 lower extremities... and I could tell her that she was doomed 02:25 to carry the weight for the rest of her life... 02:27 that she'd need to take medications for her cholesterol 02:29 and her high blood pressure for the rest of her life... 02:31 Or, I could tell her about God's Plan for a healthy body. 02:35 A plan that many times can eliminate the need 02:38 for medications and improve and reverse the disease process 02:46 So, what exactly did I tell her? 02:49 Well, first the question is... "Is diabetes genetic?" 02:53 Well genetics can increase your predisposition for diabetes. 02:57 BUT, if you make the right choices, 02:59 you can avoid getting diabetes. 03:02 Now, we look at the Pima Indians, in America, 03:05 as well as the Pacific Islanders 03:07 They both have a very HIGH rate of diabetes today... 03:09 However, this was NOT always true. 03:12 At the turn of the century, a German endocrinologist 03:15 went to the Pima Indians and screened them for diabetes. 03:21 This was in 1901, and out of the whole tribe, 03:24 he could only find 1 diabetic. 03:27 Today, in the Pima Indians, diabetes is rampant. 03:32 Back in the turn of the century, they were on a plant-based diet 03:39 and they didn't get the diabetes that they're getting today 03:43 on the western diet. 03:44 Dr. Murdoch, an endocrinologist at Loma Linda, says 03:47 "Genetics can load the gun, but the environment... 03:51 that is the choices WE MAKE is what pulls the trigger. " 03:54 So, if you make the right choices, 03:56 even though you have a predisposition for diabetes, 03:59 you may not get it. 04:01 Now, diabetes has increased dramatically recently. 04:06 I remember in medical school, studying about diabetes type 2 04:10 wondering if I'd ever SEE it. 04:11 NOW, just about everybody I know either has diabetes 04:15 or knows someone that has diabetes. 04:18 Between 1958, and 1994, a span of 36 years, 04:23 the prevalence of diagnosed cases of diabetes 04:27 has increased, not just 5 or 10% ... it's increased 500% 04:32 and recent surveys show no sign of it decreasing or slowing down 04:40 Well, have our genetics changed in the last 50 years? No 04:43 Have our eating habits changed? Yes 04:46 Can what we eat cause diabetes? 04:49 That's an important question. 04:52 Can what we eat actually cause type 2 diabetes? 04:55 Well in 1927, Dr. Sweeney asked a similar question 05:00 and he did tests to investigate. 05:03 He took several medical students, 05:05 and he was able to induce a diabetic state with a 05:09 high fat diet in just 2 days. How did he do this? 05:13 How did he accomplish this? 05:15 Well, first he tested them for diabetes, 05:17 with a glucose tolerance test. 05:19 He gave them 75 grams of sugar 05:22 and he watched how high the sugar went. 05:24 The sugar rose from below, say 100, which was normal. 05:27 It rose, stayed below 150, and then it slowly came back 05:31 to normal... down below 100. 05:33 This was a normal response, they did not have diabetes. 05:37 Now, what was happening in this process, 05:41 when they took the sugar into the body. 05:42 How did the body regulate sugar? 05:44 As the sugar goes into the intestines, 05:47 it dissolves and goes into the bloodstream, 05:49 and the blood sugar rises. 05:51 The pancreas senses that, releases insulin, 05:54 and insulin acts like a little key. 05:56 It goes to all the cells in your body, 05:58 and it unlocks the doors to the cells. 06:01 The sugar then leaves the blood, 06:02 goes into the cells, and gets burned 06:04 and that brings your blood sugars down. 06:06 And that's the way it's supposed to work... 06:08 And that's the way it was working with these 06:10 medical students. 06:11 Then he tried his experiment. 06:13 He gave them 2 days of a high fat diet, 06:15 that's olive oil, butter, mayonnaise made with egg yolks 06:18 and 20% cream... then he re-tested them. 06:22 He gave them the 75 grams of glucose, 06:26 and in 4 out of 6 of the patients, 06:29 the blood sugars rose, and they ran between 150 and 200 06:34 before coming back down... 06:35 That's called insulin resistance. 06:37 The blood sugars were going higher than normal. 06:40 It's a prediabetic state. 06:42 In the other 2, at 2 hours, the blood sugars 06:45 were still above 200, and that's a diabetic state 06:48 ...That's the criteria we use to diagnose diabetes. 06:51 What actually had happened? 06:54 What was causing them to be in this state? 06:56 Well what happened was, the fats that they were taking 06:59 from these foods, these animal products was going into 07:02 the bloodstream, and plugging up the keyholes- 07:06 those insulin receptors. 07:08 So NOW when they took a sugar or starch, 07:10 their blood sugar went UP, insulin was released, 07:12 and couldn't get in the keyholes. 07:14 The door stayed shut, and the blood sugars rose 07:16 because they had nowhere to go... 07:18 and this is insulin resistance... 07:20 and it eventually leads to diabetes. 07:24 Well, at the time of Dr. Sweeney many people surmised that 07:29 because the blood sugars are elevated, 07:32 maybe the real problem is too much sugar or starches 07:37 which break down into sugar... 07:38 Maybe too much sugar and starch in the diet. 07:41 Was this what was the problem? 07:45 Well, he decided to do a preliminary test to check for it 07:48 He took some more medical students who were usually 07:52 eager subjects, and he gave them 2 days of a very high 07:56 sugary diet... lots of high simple sugars, 08:00 and complex carbohydrates such as sugar, candy, pastries, 08:03 white bread, baked potatoes, syrup, bananas, rice, oatmeal, 08:08 and then he re-tested them. 08:10 When he re-tested them, 08:12 he gave them 75 grams of glucose. 08:13 He watched how high the blood sugar rose... 08:15 started below 100 which was normal... 08:17 It rose, and stayed below 150 and came back to normal. 08:20 This was a normal response... 08:22 They did not have insulin resistance. 08:24 So, simply put, the sugars, and the starches 08:29 were not able to induce this insulin resistance state. 08:35 So, up to this point, the simple message is 08:38 "You can make someone diabetic with lots of fats and oils, 08:41 particularly the animal products, 08:43 and you can cure, or reverse this process in early diabetics 08:47 by eliminating those fats and oils. " 08:50 And also, sugar doesn't seem to be the primary 08:54 cause of the primary problem in diabetics. 08:57 Well, in 1973, Dr. Anderson wanted to confirm these tests. 09:03 He is a world authority on diabetes, 09:06 and he essentially repeated Dr. Sweeney's experiments 09:09 and he was able to turn lean, healthy individuals, 09:11 into mild diabetics in less than 2 weeks... 09:14 by giving them a diet in which 09:16 65% of the calories came from fats. 09:20 He then wanted to confirm the sugar question, 09:25 or find an answer to the sugar question, 09:27 so he decided to give them not just a LITTLE bit of sugar 09:29 but he gave them a pound of sugar a day... 09:33 That was, you know, 5 pounds of sugar is about that much... 09:36 A pound would be about that much sugar... 09:38 a huge amount of sugar on a daily basis. 09:41 He tried this for 1 week, 2 weeks... 09:43 He went actually 11 weeks, and at the end of 11 weeks, 09:48 he was not able to produce even 1 mildly diabetic individual. 09:52 All the glucose tolerance tests were still in the normal range 09:55 And he concluded that, again, sugar doesn't appear to be the 09:58 primary problem in diabetes. 10:01 Dr. Bronzo asked a similar question about sugar. 10:05 He took subjects with mild diabetes, 10:09 and he changed them from a diet containing 45% 10:13 simple sugars to one containing 85% sugars. 10:17 He was unable to produce diabetes in those, 10:23 and actually, with those mild diabetics, the blood sugars 10:26 actually dropped... the fasting sugars dropped. 10:29 So, again, we can induce the diabetic state with the 10:34 fats and the oils, and we can help to eliminate that state 10:37 by eliminating the fats and the oils. 10:41 Sugar is NOT the primary problem in diabetes. 10:45 Well, let's move out of the laboratory into real life. 10:50 Let's try Dr. Sweeney's experiment on NOT just 10:53 a few subjects in the laboratory 10:56 but let's go to a whole island! 10:59 Prior to World War II, the natives of the 11:03 small Micronesian island of Nauru 11:06 had a very low incidence of diabetes. 11:09 They had excellent health. 11:12 Their diet consisted mainly of bananas, taro which is a root, 11:16 breadfruit, coconuts, some fresh fish, vegetables. 11:20 Consumption of canned foods and frozen meats was 11:26 essentially nonexistent... They didn't have it then. 11:28 After World War II, however, they found phosphorus 11:34 in the bird dung... that had been deposited over 11:36 hundreds of years there. 11:38 This was a product that was in demand in the world 11:42 and they came and they mined it... 11:45 And they became the richest per capita nation in the world 11:49 just after World War II. 11:52 What do you do when you have money? 11:53 Many people will buy the western diet, 12:00 and start importing the foods... and this is just what they did 12:02 The consumption of canned and frozen meats 12:04 fish, sodas and oils increased dramatically. 12:07 Fat intake increased, fiber intake decreased... 12:10 Many meals would include 2 or 3 meat dishes per meal. 12:17 Eventually in the 80s, those over age 15, 12:23 1 out of 3 was diagnosed with diabetes. 12:26 Obesity, atherosclerotic complications 12:29 became very common. 12:31 The other islands in Micronesia were also affected 12:36 After World War II, the U.S. Navy, 12:40 toured the Micronesian Islands, 12:42 they felt an obligation to address the medical needs 12:46 of those islands after freeing them from the occupation 12:49 during World War II... 12:51 so they wanted to find out what the problems were. 12:53 The USS Whidbey toured those islands and surveyed them, 12:58 and they found that, yes, they had bacterial diseases... 13:00 They had venereal diseases, parasitic diseases, 13:04 but they had no diabetes, high blood pressure, 13:07 obesity, hypertension... these were not issues for them. 13:12 When I went to Guam in the 90s, 13:15 we served at a little Seventh-day Adventist clinic 13:18 on the island there... 13:19 By that time, in 1992, diabetes was rampant. 13:24 It was their #1 problem. 13:26 Heart disease was their #2 problem, 13:28 and we were frequently flying patients to Hawaii 13:30 for their cardiac catheterizations, 13:33 and further examinations. 13:35 We went to the "Nutcracker Suite" at one point 13:39 at the gym there, and when we went in the gym, 13:42 we got a sense of the preferences in Guam. 13:46 Food preferences... we saw a huge banner on the side 13:48 of the gym saying, "SPAM THE FLAVOR OF GUAM" 13:53 So their dietary changes had changed dramatically 13:56 in 50 years, and so had their medical problems. 14:01 Countries that have maintained a low fat, high fiber diet 14:05 such as the Africans, some of the Asians, 14:07 some of the Polynesians, still have a very low incidence of 14:12 diabetes, hypertension, and heart disease. 14:15 But, as their diet becomes westernized, 14:17 they develop our problems as well. 14:21 Well, remember Dr. Sweeney's experiment 14:23 with the 6 medical students... 14:24 A high fat diet was able to turn them into early diabetics 14:29 in just 2 days. 14:30 What if you took a whole nation and gave them the same 14:33 high fat diet... What would you expect to produce? 14:36 You think diabetes would become rampant? 14:38 Yes, you would expect that, 14:41 and that is what we're finding in America today... 14:43 And that's why the large increase in diabetes 14:47 that we see is occurring. 14:49 Well, up to this point, we've seen that fat causes 14:56 insulin resistance by plugging up the insulin receptors. 14:59 We've seen that insulin resistance leads eventually 15:01 to diabetes. 15:02 Is insulin resistance a NEW concept... 15:05 or is this something we've known about for a while? 15:08 Actually, it was first discovered in 1935 15:10 by Sir Harold Himsworth, physician at the 15:14 University Hospital in London. 15:17 What he found was that the insulin requirements of 15:22 the diabetics changed based on how much fat they were getting 15:25 If they had a high fat diet, 15:27 he would have to increase their insulin doses to cover it 15:29 If they were on a low fat diet, he could reduce the insulin 15:33 doses that were needed to control their blood sugars. 15:37 In 1964, Dr. Felber again demonstrated the effects of 15:42 high fat on insulin resistance. 15:45 He found that on a high fat diet, 15:47 nondiabetics' insulin levels raised by 35%. 15:52 Now why would this occur? 15:54 Well, what happened was, when you're on a high fat diet, 15:57 the insulin receptors become plugged up with insulin, 16:00 the pancreas says, "You know the normal 30 units of insulin 16:03 a day that I'm normally secreting is not working... 16:06 I've got this insulin resistance what am I going to do?" 16:10 "I'll do the only thing I can do, I can release more insulin" 16:14 So the pancreas would release more insulin, 16:16 overcome the insulin resistance bring the sugars down, 16:19 but at the cost of higher insulin levels... 16:21 And that's why the insulin levels on a high fat diet 16:24 increase, and in this test they increased by 35%. 16:28 When subjects on the high fat diet were tested by Dr. Felber, 16:36 they also fell into the diabetic range. 16:38 Later, studies done on animals confirmed... 16:43 in over 34 animal studies that 16:46 "Yes, a high fat diet does induce insulin resistance" 16:50 The drug companies that make medication pills for diabetes 16:57 they have to test their drugs on diabetic rats 17:01 Do you think the drug companies are aware of 17:03 this insulin resistance problem? 17:05 Well actually, they are because 17:08 to test the drug on diabetic rats, they have to 17:10 get diabetic rats... 17:12 Now, last I checked Wal-Mart does not sell diabetic rats! 17:16 ...So where do they get their diabetic rats? 17:18 They have to make them diabetic. 17:20 And they know how to make them diabetic. 17:22 Very efficiently, they take a normal rat, and they feed it 17:25 a diet 60% lard, and in several weeks they've got diabetic rats. 17:31 This is a reproducible effect, 17:34 and it's a very dependable effect and can 17:36 guarantee them their supply of test animals. 17:39 Since then, also 15 recent human studies have also confirmed 17:45 that a high fat diet causes insulin resistance. 17:49 So, up to this point in time, insulin resistance had been 17:54 reported basically with high fat diets. 17:57 Major fat sources were either high saturated fats, 18:00 or hydrogenated fats, or polyunsaturated fats. 18:03 Work after 1986, started to look more specifically at 18:06 what fats were more harmful than others, 18:09 and they've also found that the prediabetic state, 18:18 the state just before diabetes, 18:20 caused problems as well as diabetes itself. 18:26 People may say, "Well, the doctor says I'm not diabetic, 18:30 but I just have some insulin resistance, 18:33 or I have an impaired fasting glucose. " 18:36 "Am I at risk?" 18:38 What they found was that, yes, you ARE at risk. 18:41 Individuals with insulin resistance, or syndrome X 18:43 had a markedly increased risk of heart disease... 18:46 and this was found in a 18:48 prospective epidemiological study of 970 men with 18:52 no heart disease who were followed for 22 years 18:55 in the presence of hyperinsulinemia. 18:58 Now, again, higher insulin levels mean that the pancreas 19:02 is working harder to overcome insulin resistance... 19:03 So it's in evidence that there is insulin resistance present. 19:06 In those people, they had higher risks of heart disease 19:11 and death from heart disease. 19:13 This was illustrated in a prospective epidemiological 19:17 study of 970 men with no known heart disease 19:21 who were followed for 22 years. 19:23 The presence of hyperinsulinemia was associated with 19:27 increased risk of a major coronary event, 19:29 either death, or nonfatal heart attack. 19:31 Now, they measured the insulin levels... 19:34 That's the most sensitive test to determine 19:36 if you have insulin resistance. 19:38 What happens is... The first thing that happens is 19:40 the insulin levels rise, and keep the blood sugars controlled 19:44 Only when the pancreas can no longer compensate 19:46 adequately, do the blood sugars rise. 19:48 So they had evidence of insulin resistance by the fact that 19:51 the insulin levels were higher, 19:53 and those higher insulin levels showed insulin resistance 19:56 indeed was present, and increased their risk 19:58 of heart attacks, and death from heart attacks. 20:01 Studies showing the prevalence of diabetes with age 20:05 showed that by age 65, 45% of Americans had 20:10 either diabetes, prediabetes, or undiagnosed diabetes. 20:14 That's almost half! 20:17 So, if a patient says, "You know I'm at risk for diabetes 20:22 because one of my parents has diabetes, 20:24 actually statically, one of your parents probably should have 20:29 diabetes if they're over 65... 20:32 As almost half of the population has diabetes or prediabetes. 20:38 In 1988, Dr. Raven coined a term called "syndrome X" 20:45 What he found was that diabetes doesn't come alone... 20:50 It doesn't come by itself... 20:51 that this insulin resistance not only causes high blood sugars, 20:54 but ALSO causes high blood pressure, 20:58 causes an elevation of triglycerides, 21:00 it lowers the good cholesterol, the HDLs 21:05 and it can cause obesity. 21:08 This addition of obesity was added somewhat later. 21:13 If you have 3 of any of the following parts of the package, 21:18 you have the insulin resistance syndrome... 21:22 And this includes either a fasting blood sugar above 100, 21:26 abdominal obesity... 21:29 For men, that's the waistline above 40... 21:32 or for women, above 35. 21:34 If you have hypertension, that is a blood pressure 21:38 above 130 or diastolic above 85, that's another factor. 21:43 Or if you have high triglycerides... 21:45 that the fat in the blood. 21:46 If it's above or equal to 150, or if you have a low HDL 21:52 below 40... any 3 of those puts you in the syndrome X 21:58 category and puts you at increased risk for heart disease 22:03 How common is syndrome X? 22:06 Well, the young from ages 20 to 29, 22:09 have a very low prevalence, 6.7% but middle-aged 22:14 people from ages 60-69, the prevalence is 22:17 very high, about 43.5% 22:21 Just like the previous study on insulin resistance 22:23 prevalence of syndrome X generally increases 22:26 with the amount of time on the American diet. 22:28 The prevalence of the syndrome X in 4,000 Scandinavians 22:32 varied based on their glucose tolerance tests. 22:35 If they had a normal glucose tolerance test, 22:37 the risk of having any 3 of those 5 symptoms 22:40 was less than 10%. 22:42 If they had an ABNORMAL glucose tolerance, 22:44 a prediabetic state, it rose to 50%. 22:47 If they had diabetes, they had an 80% chance of having 22:51 3 of those 5 symptoms. 22:54 In subjects with the metabolic syndrome, 22:57 the risk of heart disease and stroke was increased 3-fold. 23:01 Heart disease mortality was was markedly increased 23:04 up to 12% versus 2.2%, compared with subjects that 23:08 did not have syndrome X. 23:11 Well, can I give syndrome X to rats? 23:15 Now, we know that we can give insulin resistance to rats, 23:18 but can I give them this whole syndrome X metabolic picture? 23:21 Yes, we can... 23:23 They did this on a test with rats. 23:26 They fed them a HIGH fat diet, 32% lard, 18% corn oil, 23:32 27% sucrose, with 23% casein which is a milk protein 23:38 and in 4 weeks, they had 35% DECREASE in insulin sensitivity. 23:43 By 8 weeks, they had a 60% drop in insulin sensitivity 23:47 on the same diet... 23:49 Which shows that if the diet is poor, 23:51 and if it's continued, insulin resistance continues 23:55 to increase with time. 23:59 The high fat diet produced 24:02 the insulin resistance as WELL as abdominal obesity, 24:06 with a significant increase in abdominal fat occurring 24:09 as soon as 4 weeks, and continuing to rise. 24:12 Note again that abdominal obesity continued to increase 24:15 with time on that same diet. 24:18 This is the second component of the insulin resistance syndrome. 24:24 So they had higher blood sugars... 24:26 they had abdominal obesity, 24:28 and they also had a rise in total cholesterol 24:32 in the bad cholesterol which is the LDL 24:34 and the triglycerides which is the third part 24:36 of the insulin resistance syndrome 24:39 So, the insulin resistance syndrome CAN be reproduced 24:42 in rats fairly simply with the high fat diet. 24:45 Well, is insulin resistance syndrome reversible? 24:49 And the good news is... YES, it is reversible. 24:52 Can a low fat diet reverse this insulin resistance? 24:55 At the University of Montreal, Dr. Ravinowitz did a 24:58 5- year control trial with 100 diabetics on a 20% fat diet 25:03 He treated the patients with a high carbohydrate low fat diet 25:07 What were the results? 25:08 24% were able to stop using the insulin and returned to normal 25:12 The others reduced their dosage dramatically. 25:16 The patients, of course, preferred the diet 25:18 rather than taking insulin which was pretty much 25:21 the only thing available at the time. 25:23 In 1955, Dr. Singh put 80 insulin-taking diabetics 25:27 an 11% fat diet of natural foods. 25:31 What were his results? 25:32 Well in less than 6 weeks, 50% were off their insulin entirely 25:36 At 18 weeks, all but 12 were off of insulin injections. 25:40 That is 85% were off their insulin. 25:43 In 1981, Dr. Anderson, a world authority on diabetes 25:47 took 13 diabetic patients who were on the ADA diet 25:50 at the time which consisted of 34% fat and 23% protein 25:55 The ADA diet was stopped. 25:57 They started a 9% fat diet with high fiber, 26:01 and a very starchy diet. 26:02 Fifty percent of those taking insulin could stop. 26:05 All those taking pills could stop. 26:09 Currently he finds that 95% of those taking pills 26:12 can be off all pills in about less than 8 weeks. 26:15 And 50 to 75% of those taking insulin can be off in weeks. 26:20 After 1986, not only were some of the fats found 26:24 to NOT cause insulin resistance, 26:25 but some of the fats, in low amounts, 26:28 were actually found to be helpful in lowering 26:30 insulin resistance. 26:31 Saturated fats in the animal products, 26:33 and the trans fats were the worst in terms of 26:36 insulin resistance. 26:37 The polyunsaturated fats in the plants 26:39 actually appear to be helpful in terms of lowering 26:42 insulin resistance if taken in their native state. 26:44 Food components that decrease insulin resistance 26:47 include the Monosaturated fats 26:49 These are the fats found in the olive oil, in the olives. 26:54 Plants containing polyunsaturated fats 26:58 included the safflower, the sunflower, 27:00 and corn and the soybean... 27:02 These were shown to decrease insulin resistance. 27:04 However, one study done by "Vesby" showed that 27:08 even if these good fats are used from the plants 27:12 if the total fat exceeds 37% of the total calories, 27:15 it can become a problem and cause insulin resistance. 27:21 Fiber was found to decrease insulin resistance. 27:24 Whole grains from plants were also found to 27:27 decrease insulin resistance. 27:28 Foods that INCREASE insulin resistance include 27:32 the saturated fats from the flesh and the dairy, 27:35 trans fats from margarines, and shortenings, 27:38 hydrogenated vegetable fats can also cause problems 27:43 and cause insulin resistance. 27:44 Remember 5% of milk, butter, and beef are trans fats. 27:48 Cholesterol was also associated with high insulin resistance. 27:52 So, in summary, we encourage you to work with your doctor 27:56 If you're changing your diet, work with him... 27:59 Let him know what your blood sugars are, 28:01 so that he can reduce your insulin levels 28:03 as your blood sugars drop. 28:05 I wish you God's blessings as you embark on a new diet. 28:09 Thank you. |
Revised 2014-12-17