Great article by Dr. Greger yesterday:

How to Reverse Type 2 Diabetes
Michael Greger M.D. FACLM on September 20th, 2018

All of the things he says here are true, including the title of his article, which, I know, many will ridicule. But he backs it all up. Here are the studies he referenced:

Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol, Diabetologia, 2011

Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake.

Effects of the High Carbohydrate-Low Calorie Diet Upon Carbohydrate Tolerance in Diabetes Mellitus, Canadian Medical Association, Journal, 1935

Effect of rice diet on diabetes mellitus associated with vascular disease, Postgraduate Medicine, 1958

Here are some photos from Dr. Kempner’s rice diet, and some background. It was astonishing at the time. Still is.

High-carbohydrate, high-fiber diets for insulin-treated men with diabetes mellitus, American Journal of Clinical Nutrition, 1979

These studies suggest that [high carbohydrate, high-fiber] diets may be the dietary therapy of choice for certain patients with the maturity-onset type of diabetes.

Usefulness of vegetarian and vegan diets for treating type 2 diabetes, Current Diabetes Reports, 2010

Significant benefits for diabetes prevention and management have been observed with vegetarian and especially vegan diets. This article reviews observational studies and intervention trials on such diets, and discusses their efficacy, nutritional adequacy, acceptability, and sustainability. Research to date has demonstrated that a low-fat, plant-based nutritional approach improves control of weight, glycemia, and cardiovascular risk. These studies have also shown that carefully planned vegan diets can be more nutritious than diets based on more conventional diet guidelines, with an acceptability that is comparable with that of other therapeutic regimens. Current intervention guidelines from professional organizations offer support for this approach. Vegetarian and vegan diets present potential advantages in managing type 2 diabetes that merit the attention of individuals with diabetes and their caregivers.

There you have it. Read his article if you’re concerned about diabetes, especially this part:

To be clear, we’re talking about diabetics who had had diabetes as long as 20 years, injecting 20 units of insulin a day, getting off insulin altogether in as few as 13 days, thanks to less than two weeks on a plant-based diet. Patient 15, for example, had injected 32 units of insulin while on the control diet, and then, 18 days later, none. Lower blood sugars on 32 units less insulin.

A diagnosis of type 2 diabetes is not a forever proposition. One thing Dr. Greger doesn’t mention though is that the diet he prescribes, one of mostly whole plant foods, is accessible primarily to upper classes, not so much to the elderly, the poor and low-income, the sick and disabled. Unfortunately, those groups suffer the highest prevalence burden for diabetes. It’s not that a head of broccoli or a bag of beans will put someone out, it’s the external costs to eating this way which I’ve spoken about fairly often on my blog.

Here’s a video of Dr. Greger in 2016 saying the same thing as his article:

I like what he says about moderation:

Moderate changes in diet can leave one with moderate blindness, moderate kidney failure, moderate amputations. Moderation in all things is not necessarily a good thing.

Several good examples here.

This one always gets me:

“This McDonald’s, somewhere on the east coast of the US, is sure to leave you shaking your head. Admitting that the 2017 solar eclipse was a ‘once in a lifetime’ spectacle, the note says that employees will only be given three minutes to enjoy it.”

In a similar vein:

More at the source.

It’s about capitalism. Right?

It’s that time of year, time to revist this sage advice:

H. Gilbert Welch (MD, MPH, Professor of Medicine at Dartmouth University, author of Less Medicine, More Health, and Overdiagnosed: Making People Sick In The Pursuit Of Health) says we’re testing too much … blood tests, colonoscopies, endoscopies, mammograms, ultrasounds, MRIs, CT scans, biopsies, gene tests. He says all this testing isn’t making us any healthier. To the contrary, by digging incessantly for some tiny abnormality – abnormalities that may never harm us, abnormalities that BigPharma and BigHospital and BigMedicalEstablishment can treat – it leaves consumers with unnecessary stress and undesirable side effects, not least of which is the pain in their wallet.

Mark Cuban, owner of the Dallas Mavericks, started a firestorm with this tweet:

1)If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health

— Mark Cuban (@mcuban) April 1, 2015

Comprehensive blood tests every 3 months. In a healthy person. Wow.

Charles Ornstein (CO), a senior editor for ProPublica, interviewed Dr. Welch about that tweet:

Mark Cuban’s Advice A ‘Recipe For Making All Of Us Sick,’ Expert Says, ProPublica, 6 April 2015

Some excerpts:

(CO) Is quarterly blood work for healthy people a good thing?

No. It’s not. This is potentially a recipe for making all of us sick.

(CO) Explain.

I guess the first thing to say is that we all harbor abnormalities, and increasingly our technologies are able to detect them–be they biochemical, be they structural. We can see things down to millimeters in size; we can measure things down to parts per billion; and we can sequence the whole genome. That’s 3 billion data points.

So there’s no shortage of biometric data that people could be collecting on themselves regularly, and by the way, there’s a huge financial interest in having people do that. The market of the well is a huge, huge market.

The problem is you’ll always be catching things out of what we would say is normal. This is anticipatory medicine at its worst, where you’re really focused on what could be going wrong in the future and you’re trying to pick up [a] signal.

The problem is there’s so much noise, because the human body is a living organism. Variation is the very essence of life. People will start reacting to this data. I also think it’s really important to label it what it is: data. To me it only becomes information to the extent that it accurately predicts something will happen in the future, and it only becomes useful knowledge – a higher level piece of information – if we can do something about it.

(CO) Cuban argues that any misdiagnoses and unnecessary treatment rests with the doctors, and not with patients owning their data. Do you agree?

I think there’s a misunderstanding that diagnosis is some super clear black-white kind of distinction, when in fact there are 1,000 shades of gray in between. The time you get into that gray is when you’re dealing with people who feel fine and have some detectable abnormality. That’s how we get into it in cancer screening. We’re looking for very early signs of disease. There’s going to be great pressure to react to those abnormalities.

It’s not fair to say the pathologists have misdiagnosed. Undoubtedly there is some misdiagnosis, but their standard for what constitutes cancer is the appearance of individual cells, and how they relate to one another – the architecture of the cells. That was a perfectly good standard when you were sending them cancers that you could feel, things the size of golf balls. But when you start sending them microscopic collections of cells, expecting them to make some prediction about the dynamics of that process and how that will interact with the host – that’s you – it’s understandably going to be fraught with uncertainly. It’s all going to be probabilistic.

(CO) Cuban makes a distinction between making a diagnosis, and collecting a series of data points to benchmark yourself.

The more tests you do, and this is only the statistical process, the more likely one of them will be falsely abnormal. And the more times you do it, the more chance that something will be falsely abnormal.

There will be great pressure to take actions and that’s how people will get hurt. It’s going to distract them from the more positive things that they can do now.

It gets down to what health is. What I’m worried about is allowing health to be defined as some set of biometric measurements. … Health is about more than a bunch of physical measurements. It’s about a state of mind and we have to be careful not to undermine that state of mind. Ironically, part of health is not being too focused on it. … Much better for people to develop good relationships, have good friends, be outside, eat well, find things that produce meaning in their lives.

I agree with Dr. Welch:

1. The more tests you do, the more likely one of them will be falsely abnormal.
2. Treating people who are well has become a huge market.
3. Health is about more than biometric measurements.

From what I can tell, not a lot of people agree with Welch. People like to test themselves. As Paul Roberts writes in Impulse Society, we have become so inside ourselves, so self-focused and narcissistic that meticulous analysis of our every cell and secretion, every bit of bile, phlegm, feces, and blood, is all that matters.

But test-chasers are playing into the hands of businesses that are more interested in making money than in making sure people live to a ripe old age with all their faculties. How do they make money? The tests may be free (covered by insurance), but the treatments aren’t. Employers have been a key player in getting people onto the testing treadmill by requiring workers to have annual screenings, penalizing them if they don’t. It’s not because they care about their employees’ health, or at least not only. It’s because insurance companies offer employers plan discounts for getting people into the system. I mean, the more people you can test for cholesterol, the more statins you can sell.

Here’s a clip from The Lady In Number 6: Music Saved My Life, a 2013 Oscar-winning documentary about Alice Herz Sommer (1903-2014) who, in 2013 was thought to be the world’s oldest pianist. She was also a Holocaust survivor. Here she describes her relationship with music, its beauty, it’s ability to give hope.

“Only when we are so old. Only! We are aware of the beauty of life.”
– Alice Herz Sommer

Beethoven Moonlight Sonata, Valentina Lisitsa:

Beethoven’s Pathetique, Daniel Barenboim:

All whole grains. No fat or oil. Since the ratio of cornmeal-to-flour is high, 2-to-1, it has a crumbly texture. Deliciously corn-y. Makes about 30 servings.

Ingredients:

4 cups medium-grind whole grain cornmeal
2 cups whole wheat pastry flour
1 1/4 teaspoons salt
2 level teaspoons baking soda
1 rounded teaspoon baking powder
1 1/2 teaspoons cinnamon

1/2 cups rolled oats (not instant)
1/2 cup water

1 1/4 cups pumpkin (a 15 ounce can of pumpkin is about 1.5 cups)
1/3 cup maple syrup
3 teaspoons vinegar (I use apple cider vinegar)
2 cups low-fat unsweetened almond milk (or other non-dairy milk)
1 cup water

Directions:

Preheat oven to 350 degrees F. Mold a large piece of parchment paper to fit a Pyrex baking dish. I used a 12×8 inch dish (11 3/4 x 7 1/2 x 1 3/4 is what it says on the bottom). Place the dish with the molded paper into the oven to preheat. The paper won’t burn. At least mine didn’t.

Mix the rolled oats with the water. Set aside.

Mix the dry ingredients: cornmeal, flour, salt, baking soda, baking powder, cinnamon.

Mix the wet ingredients: pumpkin, maple syrup, vinegar, almond milk, water. Add the oat mixture to this. Mix thoroughly.

Take the baking dish out of the oven and place on a trivet. Working quickly, combine the wet and dry ingredients and stir just until you see no more flour. Don’t over-blend. Pour into hot parchment-lined dish and return to oven.

Bake for 70 minutes or until toothpick comes out clean. Lift out of the glass dish by holding the parchment corners after 10-15 minutes and set on a cooling rack. Cool for at least 3 hours before slicing.

A better way to recolonize the colon after taking antibiotics is to consume foods that enhance growth of good bacteria, such as this fat-free potato salad which is high in resistance starch.

The lesson from this recent study is that we’re not only wasting our money taking probiotics after we’ve been on a course of amoxicillin, ciprofloxacin, or other antibiotics, but we’re probably doing harm. Probiotics won’t reestablish microbial populations in the large intestine. In fact, they may hinder natural recolonization.

Human Gut Study Questions Probiotic Health Benefits, Science Daily, September 2018

Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics And Improved By Autologous FMT*, Cell August 2018

Importantly, in both mice and humans, we demonstrate that enhanced post-antibiotic probiotic colonization comes at a tradeoff of delayed indigenous microbiome and host mucosal transcriptome reconstitution to a homeostatic configuration as compared to either watchful waiting or aFMT.

… prolonged dysbiosis that lasted at least 5 months following the cessation of probiotic exposure

5 months! So, if we’re taking probiotics to reestablish our microbiome, it may take 5 months or more to restore it – after we stop taking the probiotics! Doing nothing or “watchful waiting” was better.

The mechanism: Probiotics are acting as a “place holder,” blocking the recolonization of normal resident bacteria.

This may also apply to fermented foods people consume for their bacteria … yogurt, kefir, sauerkraut, pickles, miso, tempeh. Not saying these aren’t beneficial foods in other respects, but their bacteria probably won’t help reestablish our microbiome, and may in fact hinder it.

The best thing to do (apart from inserting some of our pre-sick bacterial colonies back into our colon – autologous FMT – which this study did find useful) is to eat starches, all kind of beans, pastas, oatmeal and other cooked cereals, rices, breads, potatoes, yams, squashes, bananas. Any undigested carbohydrates in those will end up feeding what’s left of the good bacteria in our colon. (This is what PREbiotics do.) Even if you didn’t take antibiotics, it’s a good idea to regularly feed these good bacteria. It will ensure a healthy microbiome, which helps stave off future infections as well as lowering the risk of many chronic diseases.

* FMT: Fecal microbiome transplantation

The article says “traces.” Remember, it doesn’t take much for glyphosate to act as an endocrine disruptor.

Here’s the lawsuit (pdf).