According to the US Centers for Disease Control and Prevention (CDC), the rates of type 2 diabetes have tripled in the last 30 years.^[1] This is due largely to the global epidemic of obesity, a major risk factor for developing the disease. The association between obesity and diabetes is so strong that former Surgeon General C. Everett Koop coined the term “Diabesity.”^[2] It is no longer just an epidemic, it is pandemic. Despite significant changes in treatment standards for diabetes, waistlines and diabetic medication usage are up.^[3]

The main reason our current approach to treating diabesity fails is because it focuses on treating the symptoms or risk factors of the disease rather than the causes. All of our attention is focused on treatments that:

• Lower blood sugar (diabetes drugs and insulin)
• Lower high blood pressure (anti-hypertensive drugs)
• Lower cholesterol (statins)
• Thin the blood (aspirin)

But we never ask the most important questions: Why is your blood sugar, blood pressure, or blood cholesterol too high and why is your blood too sticky and likely to clot in the first place? What are the causes of diabesity?

In truth, type 2 diabetes, elevated blood sugar, blood pressure, and cholesterol are simply downstream symptoms that result from problems with our diet and lifestyle interacting with our unique genetic susceptibilities. While there are some predisposing genes, type 2 diabetes is almost entirely induced by environmental and lifestyle factors.^[4] Therefore, a search for the diabetes gene and the magic-bullet drug or gene therapy to treat it will lead us nowhere. While understanding our genes can help us personalize our approach to weight loss, it can also shift our focus away from the most important target: the modifiable lifestyle that drives this epidemic.

Understanding the role of diet and lifestyle has a profound impact on the whole way we think about diabesity. It’s not simply a matter of trying one type of medication or another. We need to address the underlying problems in diet and lifestyle that are leading to and perpetuating this problem. Otherwise, we will only be masking the problem with treatments, instead of addressing the root causes.

Studies indicate that low-fat, plant-based diets are ideal for diabetes and the conditions associated with it, such as heart disease, weight gain, high cholesterol, and high blood pressure.^[5] New information suggests that fat in animal products and oils interferes with insulin’s ability to move glucose into the cells. Eating less fat reduces body fat. Less body fat allows insulin to do its job.^[6] A recent study showed that a low-fat, vegan diet led to greater weight loss and blood glucose control, compared to a diet following American Diabetes Association guidelines.^[6]

If we want to effectively treat this epidemic of diabesity, we must start focusing on the underlying causes that are driving these problems in the first place. The main driving factor of our diabesity epidemic is our nutrient-poor, calorie-rich diet, which has led to a nation of overfed but undernourished people.

References

1. http://www.cdc.gov
2. http://www.shapeup.org/about/about_sua.html
3. Drugs are not enough: the metabolic syndrome–a call for intensive therapeutic lifestyle change. J Cardiometab Syndr. 2009 Winter;4(1):20-5
4. Achievement of heart health characteristics through participation in an intensive lifestyle change program (Coronary Artery Disease Reversal Study). J Cardiopulm Rehabil Prev. 2009 Mar-Apr;29(2):84-94
5. Barnard ND, Scialli AR, Turner-McGrievy,G, Lanou AJ, Glass J: The effects of a lowfat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity. Am J Med 118:991–997, 2005
6. Barnard ND, Cohen, J, Jenkins DJ, Turner-McGrievy G, Gloede L, Green A, Ferdowsian H. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. AM J Clin Nutr. 2009 May; 89(5):1588S-1596S. Epub 2009 Apr 1.