The truth about diabetes – and why you’re not hearing it

The German philosopher Arthur Schopenhauer famously wrote that

“All truth passes through three stages: First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident.”

As the Diet Wars rage on, with proponents of diets across the spectrum from carnivore and ketogenic, through Mediterranean to vegan, all duking it out across social media platforms, it’s increasingly apparent to me that while in the public sphere the truth about healthy eating is still mired in Schopenhauer’s first and second stages, in the research community it is edging toward the third stage.

Type 2 diabetes (formerly known as maturity onset diabetes, but now afflicting teenagers and even children) is a case in point. Most members of the public – and even a considerable number of health and medical professionals, who should know better but apparently don’t – still view the most common form of diabetes as a disorder caused by excessive intake of carbohydrates.

It’s an understandable mistake at least for lay people, since diabetes is characterised by an elevated blood sugar level, and the source of that sugar is the digestion and absorption of dietary carbohydrates.

However, contrary to the carbophobia peddled by keto and carnivore advocates, it’s been known for decades that the carbohydrate intolerance of diabetes is not caused by excessive intake of ‘carbs’, and in fact a diet high in unrefined carbohydrates can effectively reverse insulin resistance, in a matter of days.

Instead, other dietary factors such as high intake of saturated fat, animal protein, nitrites and haem iron have all been linked to diabetes, with clear mechanisms of action identified.

Red meat intake in particular is strongly associated with a heightened risk of developing diabetes.

On the other hand, multiple studies have demonstrated that eating a more plant-based diet – which is inherently richer in carbohydrates – is protective against diabetes.

A meta-analysis (a method of combining data from multiple studies) published in JAMA Internal Medicine in July 2019 is the most recent addition to the growing pile of evidence contradicting low-carbist dogma.

A total of 9 studies were included in the meta-analysis, involving over 300 000 participants. The researchers found a significant inverse association between higher adherence to a plant-based dietary pattern and risk of type 2 diabetes, especially when the plant-based diet fruits, vegetables, whole grains, legumes, and nuts (rather than processed vegan foods).

Moreover,

“a significant inverse linear dose-response association was identified between plant-based dietary indices and risk of type 2 diabetes”

Or in plain English, the more plant foods and the less animal foods participants ate, the lower their risk of becoming diabetic.

So, if researchers are increasingly accepting as self-evident the truth that plant-based eating patterns protect against chronic diseases such as diabetes, why isn’t this message reaching more health practitioners, and the general public?

Over 2000 years before Schopenhauer, the Greek dramatist Aeschylus presciently observed that

“In war, truth is the first casualty.”

It’s no exaggeration to characterise the backlash against the plant-based movement as a war. The forces arraigned against it range from the industries which produce and sell animal products, which have an obvious vested interest in maintaining public confusion about nutrition in order to maximise sales of their wares, to far more subtle psychosocial factors such as cultural and religious traditions, the deeply entrenched association of meat-eating with masculinity, and the cognitive dissonance that occurs when people’s lifelong eating habits are challenged by new information.

In the Diet Wars, truth has well and truly become a casualty, sacrificed on the altar of corporate greed and individual and societal biases.

Thanks to the interconnectivity of social media networks, unfounded claims about the healthfulness or unhealthfulness of entire food groups, such as red meat, or macronutrients, such as fat, can be propagated at lightning speed.

Traditional media outlets, which mine trending stories on social media to produce their own content, amplify these messages; gone are the days when newspaper editors felt much responsibility to establish the veracity of a story before publishing it.

In addition, when newspapers do print articles drawn from the medical literature (rather than Joe Blow’s YouTube channel or blog), they have repeatedly been shown to give more coverage to low quality studies with weak methodology than to more reliable studies.

And specialist medical journalists don’t perform much better than those employed by general news outlets. For example, an analysis of medical news reports published in a German medical journal  found exaggerations in 45% of the headlines compared to the conclusions of the related journal article, and misstatement of a causal relationship rather than a correlation in 65 of 137 news headlines.

But how can there be such a disconnect between what careful application of the scientific method has demonstrated, and what most people believe?

In Mein Kampf, Adolf Hitler laid out his theory of the ‘Big Lie’:

“In the big lie there is always a certain force of credibility; because the broad masses of a nation are always more easily corrupted in the deeper strata of their emotional nature than consciously or voluntarily; and thus in the primitive simplicity of their minds they more readily fall victims to the big lie than the small lie, since they themselves often tell small lies in little matters but would be ashamed to resort to large-scale falsehoods.
It would never come into their heads to fabricate colossal untruths, and they would not believe that others could have the impudence to distort the truth so infamously. Even though the facts which prove this to be so may be brought clearly to their minds, they will still doubt and waver and will continue to think that there may be some other explanation. For the grossly impudent lie always leaves traces behind it, even after it has been nailed down, a fact which is known to all expert liars in this world and to all who conspire together in the art of lying.”

So how can you survive the Diet Wars, and the War on Truth more generally? My best advice is to leave the battlefield. Participating in online slanging matches is a waste of your precious time and energy. Allowing yourself to become deluged by multiple email lists and social media feeds is a recipe for creating doubt and confusion, and getting ‘lost in the weeds’ of minor details rather than concentrating on the fundamental practices that promote good health:

  1. Eat more plants
  2. Move your body ever day, preferably outdoors, in nature
  3. Prioritise sleep and rest
  4. Manage your stress proactively
  5. Deepen your loving connections with those around you, and with your own sense of life purpose.

My EmpowerEd health and nutrition education program is expressly designed to equip you with the skills to navigate the ocean of conflicting information on health and nutrition. Learn about the benefits of membership and register for your 1 month free trial here.

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