Hi I have a question about Dr Greger author of, How not to die. And exponent of the plant-based diet, he says fat causes diabetes not carbs.

My current thinking on dietary fat follows from soaking up Jason Fung's books, articles and you tube vids - fat doesn't trigger an insulin response, and without an insulin response your body doesn't try to store incoming nutrients as fat. I am as greedy as they come and I can say with complete honesty that I can only eat so much fat (with non starchy vegetables and protein - if you give me fat with carbs I will eat until I pass out) before a genuine satiety state hits.

Carbs trigger an insulin response, which tells your body to store any excess incoming nutrients as body fat - first in the liver, then when there's no more room there, in other parts of the body (such as visceral fat). I personally (and I know many others are like me) lack the off switch for carby, sugary, salty, fatty combinations. Carbs vary in their GI and therefore insulin response, sure, but they do all trigger a response while fat does not.

Finally on carbs, particularly grains - it's in the interests of the world's biggest investors for us to consume them in the forms they are offered to us. Those are the forms that make us want to eat them up yum and bypass satiety. I struggle to resist them every day, and for most of my life have failed. I know I'm not alone!

And finally on fats, animal fats are historically not associated with cardiovascular disease as we have been told (plenty of reliable science on that now) - while most of the processed seed oils we're told are healthy are loaded with inflammatory Omega 6, and likely rancid before they're even packaged. Plenty of disease potential there.

KennyA said:

My response would be simply that while (as a population) we ate high levels of saturated fat and meat, we had lower levels of heart disease, obesity, and T2 diabetes. When the official advice changed in the the 1980s to recommend high carb rather than a traditional diet of sat fat and meat, we have seen increases in heart disease, obesity and T2 diabetes.

There is usually some sleight of hand going on when dietary fat is mentioned, usually to obscure the difference between dietary fat and body fat. I don't think anyone suggests that body fat, particularly round the organs, is a good thing. However, that body fat is a product of glucose (digested carb) storage, and not storage of dietary fat.

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I've been watching some good videos featuring Chris Van Tulleken, who has a lot to say about that official advice - he and others point out that the advice to switch to carbs and ultra processed foods had nothing to do with our health and everything to do with the pockets of the world's most powerful investors. The most astonishing example is that mountains of cotton seed waste product were turned into margarine and touted as super healthy. The byproduct was worthless but the margarine was a gold mine, until the reality of trans fats was no longer deniable. It amazes me that the UK still hasn't banned trans fats outright!

The ultra processed foods featuring carbs haven't been properly called out yet, but it's starting. Again, investors aren't interested in our health, but in which breakfast cereal (or whatever ultra processed carbs) best bypasses our satiety response.

Having a plant based diet doesn't prevent it cure diabetes because diabetes is about csrbs & sugars. I have been eating plant based for decades & I was diagnosed diabetic last year. I was educated on low carb diet ,(, I'm still plant based) but it's the pastries, flour, porridge, bread, pizza base, cakes, pasta, sugar, all of which is vegan that encouraged diabetes with me.
Cutting these and taking exercise has put me in remission.

Good for you @socks55 - excellent work !!

We were all taught the same, looking at the history; it's actually a masterclass in delivering a message - there are very few examples of a story taking hold so pervasively. Saturated fat, red meat and salt is bad, m'kay... I spent 3 years on an aggressive "healthy diet" before being diagnosed ... and actually mis-diagnosed as T1 because it didn't seem possible that I could be T2.. but it was grapes and honey that did it for me. At the time I had this notion that "natural sugars are kind of like a free pass" - I shudder at my own ignorance.

Interestingly, if you go back prior to the seventies, the advice was pretty consistent for 150 years prior, that "sugars and starches are fattening".

There are - like all facets of life - ways to turn the extremes into conflict; but nearly all nutritional advice which isn't trying to justify old dogma can agree that reducing sugars and starches is common ground...

James9000 said:

I know it makes no logical sense and goes against almost everyone's experience here on this forum. But is there anything in his hypothesis. Dr Greger, is a big proponent of the plant-based diet. He's always using research to back up his argument however i've noticed that he is very selective about the research that he chooses to analyse. He only explains and talks on research that supports a plant-based diet.

I'm generally quite clued up, my degree was in experimental psychology but I'm genuinely confused. Is it some mixture , Perhaps saturated fat may contribute to developing diabetes but if you have the condition and it is more sensible to follow a low-carb keto diet. Or is it saturated fat and junk food that is the problem?

This question is of particular interest to me because I suffer from ulcerative colitis and I'm in remission because of eating a mostly plant-based diet. But although I try to be careful even after a small meal, of completely healthy food with the carbs quite diluted, my blood sugar hangs around about 8.0.

Very confused, YouTube is a nightmare for this topic, they seem to be two viewpoints, plant-based and keto diet which seem to be at war with each other, each one totally convinced their right. How is a person supposed to make sense of it all?

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All my research points to carbs and not saturated fats. The disease we have is insulin resistance. What will help is Insulin IQ, the metabolic classroom by Dr Ben Bikman. He covers in over 60 videos everything to do with insulin and metabolic disease on YouTube. It is very easy to understand. Covers fat cell and insulin resistance, how insulin causes weight gain. Everything you ever wanted to know about our disease and the root cause which is elevated insulin levels causing us to be insulin resistant, and how insulin levels are elevated for 15 years before the blood sugars rise. Absolutely amazing series.

Fenn said:

As it is suggested above, I am 100% convinced that Fat people don’t get T2, T2 people are far far more likely to get fat, due to the insulin resistance, try being hungry your entire life due to not being able to utilize your natural energy reserves and not get fat.

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It all comes to the type of fat cell and where it is in or on the body. Small fat cells are insulin sensitive and large fat cells are not. The large fat cells are found in the belly where's the small fat cells are the outside of the body.

KennyA said:

You might be interested in what the Journal of American Cardiology is printing in terms of research - here's the highlights:

Highlights

The U.S. Dietary Guidelines recommend the restriction of SFA intake to <10% of calories to reduce CVD.

Different SFAs have different biologic effects, which are further modified by the food matrix and the carbohydrate content of the diet.

Several foods relatively rich in SFAs, such as whole-fat dairy, dark chocolate, and unprocessed meat, are not associated with increased CVD or diabetes risk.

There is no robust evidence that current population-wide arbitrary upper limits on saturated fat consumption in the United States will prevent CVD or reduce mortality.


link to paper here:

https://www.sciencedirect.com/science/article/pii/S0735109720356874?via%3Dihub=&utm_source=arrow.proteinpower.com&utm_medium=referral&utm_campaign=the-arrow-188

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The elephant in the room is seed oils like sunflower oil, rapeseed oil and all vegetables oils. Our bodies can process and use saturated fat as fuel. When it comes to seed oils our bodies can't process and burn them as fuel and the high levels of omega 6 causes inflammation in the blood vessels and throughout the body. The seed oils have have 25 times the amount omega 6 than we need as an essential fatty acid. Plenty of research out there. The elephant in the room fructose. Our bodies can't burn fructose and it has to be processed by the liver which breaks it down the same way it breaks down alcohol. It will store the broken down fructose as fat in the liver. The breakdown of fructose leads to NAFLD it raises uric acid levels that causes more damage.

Just watched a lecture from Ben Bikman, totally agree @potshot - he is a rare resource, insulin resistance is so **** complicated that I find I learn something every time I listen or read him. I had to clip this from the video, his simple list of the things that are connected to insulin resistance..

(forgive the play controls, this was really just me clipping out for my own notes and learning)

@Melgar - you have mentioned the 85% statistic a couple of times, I'm not questioning, but do you have any links I could dig into on that? I'm sure you are correct, but unless you say that 15% of type 2s are exclusively LADA - ie, an unconnected failing of the beta cells that mimics the progression of insulin resistance, I'm just not sure how anyone gets to T2 without exhibiting some level of insulin resistance.

Ie, I see this more as - T2DM is one of the possible outcomes of insulin resistance, per the image above.