Diabetes: The Real Cause and the Right Cure
The book Brigade talks to physician John Poothullil.
Posted September 6, 2018
The number of people with diabetes has more than tripled since 1980. The condition is closely associated with the rise in obesity worldwide. But there are still important unknowns about the disorder.
What is the real cause of diabetes?
First, let us be clear about the two types of diabetes. Type 1 is the result of a dysfunctional pancreas, which produces minimal or no insulin and usually occurs in childhood. Type 2 used to be called adult-onset but it is now occurring in children and teenagers.
My view is that Type 2 diabetes is not a hormonal disease but a nutritional condition, caused by the excessive consumption of cultivated grains and grain-based foods. This is why the incidence of Type 2 diabetes is increasing in every nation where grains provide 50 percent or more of the daily energy intake.
How does your view differ from the conventional view?
The conventional view of Type 2 diabetes is based on “insulin resistance,” and has four key points: 1) reduced glucose entry into muscles, 2) increased glucose production by the liver, 3) increased fatty acid release by fat tissue, and 4) reduced insulin secretion by the pancreas. The first three are considered evidence of insulin resistance because they occur in the presence of insulin. However, despite being heavily investigated for decades, the reason for each is incompletely understood.
My view is that when muscles are using fatty acids for energy production, as they commonly do in the fasting state, they do not need glucose as fuel. When muscles use fatty acids continuously, the liver interprets this as secondary to non-availability of glucose and starts glucose production, as it is programmed to do. The inability of fatty acids to enter fat cells, due to them being already full, steers them back into the circulation, creating the impression of fatty acid release by fat tissue. Meanwhile, the pancreas reduces its insulin secretion, even in the presence of elevated blood glucose, to preserve pancreatic function and to prevent cancer growth, as insulin is a growth stimulator. My view thus provides the biological explanation for all four points above.
If insulin resistance doesn’t explain diabetes, what does?
The most logical explanation for Type 2 diabetes is that the constant consumption of grains and grain-flour products fills up a person’s natural allotment of fat cells. When fat cells become full, fatty acids flow through the bloodstream. When freely available fatty acids are burned constantly, glucose, absorbed from the food as well as created by the liver, is left in the bloodstream. In other words, “insulin resistance” is not necessary to explain elevation of blood sugar to the level of Type 2 diabetes.
How does insulin resistance fail to explain diabetes?
Traditionally, a scientific concept is not printed in medical textbooks before it is validated through logic, mechanism, and measurement. However, insulin resistance theory was exempted from this tradition when it was hypothesized about 90 years ago.
These are many illogical facts about insulin resistance. First, what is the reason for the body to start resisting insulin, and why by only three types of cells out of 200 types? It also makes no sense that while resisting insulin, cells respond normally to three other hormones—glucagon, adrenaline, and cortisol–involved in blood sugar regulation. The theory fails to explain why thin people develop diabetes as it often blames weight gain and obesity as causing insulin resistance. The theory cannot explain why some women, but not all, get diabetes within weeks of pregnancy and then lose it within days after giving birth. Finally, no one has explained the intracellular mechanism of insulin resistance, and there is no test to directly measure the degree of insulin resistance at any one of the sites of resistance.
What are the practical implications of your view vs. the conventional view?
The conventional view of Type 2 diabetes is linked to weight gain and obesity. Although doctors talk about eating healthy and exercising more, their main emphasis is on medications including insulin injections (which is illogical if patients are presumably resistant to it).
I believe that, rather than medications, Type 2 diabetes can be prevented or reversed by reducing the availability of fatty acids to muscles, forcing them to use glucose again. This can be accomplished by reducing to almost zero one’s consumption of grains -- breads, wraps, tacos, tortillas, pizza, pastas, rice, corn, cakes and pies, and snack foods.
What research supports your view?
Clinical observations of American Pima Indians in Arizona support my hypothesis. Type 2 diabetes was unheard of in this tribe when it was moved to reservations. However, between 1965 and 1969, nearly 50 percent of the tribe’s adults over age 35 had diabetes. Researchers speculated that this was due to the change of diet from their native foods on the plains to foods consumed on reservations. While they had no cultivated grains in their natural habitat, the majority of food energy in the reservation diet came from grain-based items.
In another experiment in the 1970s, 10 aboriginal Australians with diabetes living in urban areas and eating western style diets were asked to live in their ancestral region, eating natural foods grown in the wild or that they hunted or fished as their ancestors did. Within eight weeks, all subjects lowered their blood sugar to normal levels. In this case, switching their high carbohydrate, high-fat diet for one with no cultivated grains made the difference.
A recent study of mice also shows a correlation between liver glucose production and muscle fatty acid use in a dose-response manner when shifting from a normal to a high-fat to a ketogenic diet.
What does fat have to do with diabetes?
Weight gain and obesity are closely associated with Type 2 diabetes, and fat is often blamed for these. However, there are many inconsistencies. For example, why do some obese people maintain normal blood sugar, and some lean people develop Type 2 diabetes?
In my theory, it is not the total amount of fat consumed or stored in the body but the amount in excess of your body’s natural fat-storage capacity that determines your potential to develop Type 2 diabetes. This is because excess glucose not stored as fat - because fat cells are full - is converted into the fatty acids that muscles begin continuously utilizing, leaving glucose in the blood.
What are the important dietary implications for diabetics?
The key to prevent or reverse diabetes is to limit food energy intake to avoid filling up your fat storage capacity. Eat most meals without any grains or grain-flour products. If you must, eat grains only in the morning. Otherwise, avoid the everyday consumption of sandwiches, pizza, rice, pastas, and snack foods. If you do this for eight weeks, you will see your blood sugar levels decrease.
When someone inherits a family tendency to diabetes, exactly what genetic fault(s) are they inheriting?
The genetic fault that you inherit is not a gene for Type 2 diabetes (which has never been found) but rather your fat-storage capacity. Each of us inherits from our ancestors a certain amount of fat stem cells that can become fat cells. As I said, filling your fat cells causes excess glucose that is converted to fatty acids, and your muscles use them as fuel, leaving additional glucose in your bloodstream.
If you had to pick one thing to tell anyone about diabetes prevention, what would it be?
From the earliest age possible, become conscious of your eating habits by emulating what toddlers do. For example, eat only when you are hungry and sense how much food you need to feel satisfied based on taste and flavor. Eat only food items that require chewing and try to avoid eating grains at every meal. Form new habits and tastes that emphasize fresh vegetables, fruits, meats, fish, and dairy.
If you could tell only one thing to someone with Type 2 diabetes, what would it be?
Spend eight weeks eating almost no grains and you will see your blood sugar levels decrease as well as lose weight.
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