In fact we have a lot of evidence linking high-fat diets to diabetes:
https://nutritionfacts.org/2016/11/17/fat-is-the-cause-of-ty...
High fat diets also do a lot of bad things to your cardiovascular system. Proceed with caution.
https://www.nytimes.com/2018/01/01/science/food-fiber-microb...
Consuming fiber along with carbs dramatically changes their glycemic profile. Asians get away with eating so much white rice, for example, because they almost eat it along with a bunch of vegetables.
https://nutritionfacts.org/video/if-white-rice-is-linked-to-...
The slender Asians you see aren't the ones stuffing on huge amounts of rice, with or without veggies.
A huge plate of rice might be 1000 calories, but if all a person eats otherwise are some veggies and some tea, there is nothing unsustainable about that
I'm in Asia now (Japan). The predominant eating pattern is: tiny portions, by American standards. (Stuffing with large servings of rice is a Chinese or SE Asian thing. I have seen it too.)
It sounds to me as if it's the refined carbs/sugars that are the primary enemy.
* By cured, I mean they were able to get off of all medication. But if / when they revert their diets, the symptoms come back, and the meds are again required.
In general minimizing starchy carbs alone, along with refined sugars and grains goes a long way. If you eat vegan or keto/lchf. I've done both... with vegan, I still had to take a large amount of insulin and gained weight, even at 1500-1800 calories a day... on keto, I eat a little more but managed to lose 63# last year and come off insulin (mostly).
IIRC a study showed low carb diets worked in a similar way, people just ate less as they found it harder to find enough calories.
Calories are inescapable. The body's output changes in compensation for incoming calories, but only within a certain range.
Also, there is all sorts of processed crap that's bad for you that qualifies as vegan because no animal products are involved. Hydrogenated vegetable oil, anyone?
You could be a potato chip and cookie vegan.
https://www.vegkitchen.com/nutrition/do-vegans-have-a-weight...
Sure, let's get our data from "vegikitchen.com", quoting from some vegan book by nutritionist quacks.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/
Yeah pedantically you can nothing but Oreos and be "vegan". But FTA:
"In a cohort of 4384 Taiwanese Buddhists, vegetarian men had approximately half of the rate of diabetes (OR: 0.49, 95% CI: 0.28–0.89), and vegetarian post-menopausal women had one-quarter the rate of diabetes (OR: 0.25, 95% CI: 0.15–0.42), compared with their omnivorous counterparts, despite statistical adjustment for body mass index and other factors. Interestingly, the omnivores in this study consumed a predominantly plant-based diet with little meat or fish, again implying that small amounts of meat contribute significantly to the development of insulin resistance"
And the idea that fat = calories in - calories burned is a simplistic view that no serious nutritionist on either side of the debate believes.
I want to preface this comment by saying I am not attempting to be rude or combative, I am genuinely curious.
If a calorie is a measure of energy contained in food, and food is the only source of energy for a body, and one mechanism by which the body uses that energy is to store fat, then a positive change in fat matter stored can maximally be the value of calorie intake converted to mass (in some discrete time).
Or, a positive change in fat stored (mass) <= calories in (again, in some discrete time).
Is this still too simplistic?
[Edit: I hope it's clear that I don't advocate eating 1000 calories of any one food. :)]
Again, no. The reason obese people are so obese is because they are never satiated. You can eat potato chips and drink soda all day, without ever feeling full. Secondly, it's an addiction to refined sugars and super simple carbs. I'm not arguing that calories aren't calories, but your body reacts differently to a Snickers bar than it does broccoli.
The most likely theory I've seen is:
1. We have a certain amount of genetic propensity for higher-than-necessary insulin secretion
2. How we develop that propensity is still unknown (!).
Gary Taubes likes the sugar hypothesis (i.e. something about fructose metabolism in the liver causes the system's self-regulation to fail) but thats mostly supported by observational studies - the mechanics aren't clear at all.
Michael Greger likes the lipid hypothesis (fat inhibits muscle ability to absorb carbohydrates i.e. causes insulin resistance) but that doesn't explain why the liver continues to produce tons of fat despite its insulin receptors being clogged.
Jason Fung likes the overflow hypotheis (as the muscles get fuller of glycogen, they're less able to store blood glucose, which means more insulin is needed to do it - however the liver isn't resistant and insulin upregulates its fat production) - but that doesn't fully explain how there are people who do lots of heavy physical activity yet remain obese and insulin resistant.
Its possible that any subset of the above could be a cause if excessive enough - high GI carbs to raise the blood sugar, fat to slow sugar absorption and lack of exercise to keep your muscle cells overfilled with glycogen all contribute to high insulin secretion, together.
3. Insulin definitely regulates fat accumulation in fat cells. No doubt about it - more insulin means less fat released by fat cells and more carbs converted to fats by the liver and stored in fat cells. Insulin also blocks leptin which signals our brain that we're full, so we feel hungrier.
4. Keto and fasting definitely work in that they remove the primary reason for insulin to secrete. You can't have raised insulin secretion if you don't have a lot of sugars in your blood to start with.
5. Its possible that vegans (on average) also remove the secondary reason for insulin to over-secrete, whatever that is. Keep in mind that vegans on average are more mindful about having a healthy lifestyle, so it could be any number of things (correlation is not causation). But if veganism itself was the definite fix, we would expect to see no long-term vegans that are obese. Good averages to compare would be long-term vegans with long-term "ketoers"
Keep in mind, the mechanisms to prevent weight gain are very different from those needed to actually lose weight. The first one is about maintaining a stable homeostatic state while the second one is about deliberately causing a different non-homeostatic state.
"Replacing carbohydrates (mainly refined starches and simple sugars) and saturated fats with monounsaturated and polyunsaturated fats lowered hemoglobin A1c and improved insulin resistance; polyunsaturated fats were also noted to improve insulin secretion. The authors concluded that in comparison to carbohydrates and saturated fats, monounsaturated and polyunsaturated fats had the most favorable effect on glycemia, insulin resistance, and secretion. In terms of foods, these findings support consumption of vegetable fats (e.g., nuts, avocados, olives) in place of animal fats and refined grains."
One thing it seems to assume is that effects of carbohydrate reduction are linear, which might not be the case. The study analysed the effect of "replacing 5% energy from carbohydrate with SFA" and found it had no significant effect on fasting glucose - this might be true even if ketosis works perfectly, since on average the trials listed there are medium-to-high carb. It would be very useful if they also had listed a table with the individual study outcome data.
Another thing that seems weird is that they deem an increase in insulin secretion capacity as good. Increasing insulin secretion capacity and insulin sensitivity will lower blood glucose, but at the expense of increased obesity - the blood sugar is going somewhere and its either the muscles or fat. So it seems to me that in T2D the increase of secretion capacity only postpones the problem. Ideally what you want is the (fasting) insulin levels to drop while maintaining the same or somewhat lower blood glucose.
I like Jason Fung's theory best too, but there still are some problems. Its true that I've mischaracterised it somewhat, but he seems to hold several theories at once, for example:
* The overflow theory: https://www.dietdoctor.com/new-paradigm-insulin-resistance
* The insulin desensitisation theory: https://www.dietdoctor.com/insulin-causes-insulin-resistance
The desensitisation theory (eating too many carbs too often without pause we desensitise our insulin receptors, causing increased insulin secretion) has the same problem as the lock-and-key/fat model - how come the liver receptors are still just as sensitive to insulin when it comes to producing fat? There is some inconsistency there, for sure - its either my lack of familiarity with the topic, or a problem with the theory.