By Andrew Nicholson, M. D. -- PCRM's "Good Medicine" -- Winter, 1997
Diabetes is not necessarily a one-way street. Early studies suggest that persons with diabetes can improve and, in some cases, even cure themselves of the disease by switching to an unrefined, vegan diet. Unfortunately, none of these studies included a comparison group. So the Diabetes Action and Research Education Foundation provided a grant to PCRM to perform a carefully controlled test.
Working with Georgetown University, we compared two different diets: a high-fiber, low-fat, vegan diet and the more commonly used American Diabetes Association (ADA) diet. We invited persons with non-insulin-dependent diabetes and their spouses or partners to follow one of the two diets for three months. Caterers prepared take-home lunches and dinners so participants could simply heat up the food at home.
The vegan meals were made from unrefined vegetables, grains, beans, and fruits, with no refined ingredients, such as vegetable oil, white flour, or white pasta. These meals averaged just 10 percent fat (as a percentage of calories) and 80 percent complex carbohydrate. They also offered 60-70 grams of fiber per day and had no cholesterol at all.
The comparison (ADA) diet contained somewhat more plant-based ingredients than the average American diet, but still relied on the conventional chicken and fish recipes. That diet was 30 percent fat and 50 percent carbohydrate. It provided about 30 grams of fiber and 200 milligrams of cholesterol per day.
Participants in both groups came to the University two evenings per week for group sessions covering nutrition, cooking, and support.
There were several challenges in planning the study. Would persons with diabetes -- and their partners -- volunteer for the study? Would they change their eating habits and maintain the study program for the full three months? Could we find caterers who would dependably prepare and deliver attractive vegan and ADA meals?
The first of these worries was quickly dispelled. On the very first day that our advertisement appeared in the newspaper, more than 100 people responded. The participants who were accepted for the study threw themselves into it with enthusiasm. One said, "I was amazed at how powerful the vegan diet was right from the beginning. The blood sugars and weight just started falling off."
Some subjects were pleasantly surprised at how well they adapted to the experimental diet. One said, "If anyone had told me 12 weeks ago that I would be satisfied with a totally vegetarian diet, I would not have believed it." Another participant needed more time to adjust: "In the beginning, it's not an easy diet. But I managed to lose, at last count, 17 pounds. I am no longer on medication for diabetes, and I am no longer on medication for blood pressure. So, actually, it's been a very, very positive result for me."
Some found unexpected benefits: "My asthma has really improved. I'm not taking as much asthma medicine because I can breathe better. The overall mental outlook on how I feel about myself as a diabetic is much more hopeful now, as I am self-sufficient with a diet that makes sense for me."
Both groups did an overall great job in adhering to their prescribed diets. However, the vegan group clearly had the edge in many of the results. Fasting blood sugars decreased 59 percent more in the vegan group than in the ADA group. And, while the vegans needed less medication to control their blood sugars, the ADA group needed just as much medicine as before. The vegans were taking less medicine, but were in better control.
While the ADA group lost an impressive 8 pounds, on average, the vegans lost nearly 16 pounds. Cholesterol levels also dropped more substantially in the vegan group compared to the ADA group.
Diabetes can cause serious damage to the kidneys, resulting in protein loss in the urine. Several of our subjects already had significant protein loss at the beginning of the study, and the ADA group did not improve in this respect. In fact, their protein losses actually worsened somewhat over the 12 weeks of the study. The vegan group, on the other hand, had a large reduction in protein losses.
Encouraged by the strong results of this pilot study, we are planning a much larger study for next year. We also owe a great debt to these volunteers who generously gave their time to help us learn how to improve our treatments for diabetes.
THE LATEST IN DIABETES
More Evidence Against Milk
A new research report adds more evidence linking cow's milk to diabetes in children. A milk protein causes an immune reaction in diabetic children, according to a study in The Lancet. It is believed that this reaction can result in the destruction of the body's insulin-producing cells.
The protein culprit, beta-casein, also exists in human milk, but in a different molecular configuration and in much lower amounts than that in cow's milk. Breast-fed infants have a measure of protection against diabetes.
In 1993, PCRM held a press conference to alert parents to potential risks to their children from milk consumption. Benjamin Spock, M.D.; Frank Oski, M.D., of Johns Hopkins University; and others pointed to evidence that cow's milk could increase the risk of diabetes, iron deficiency anemia, and other serious problems.
While the dairy industry dismissed these concerns, the American Academy of Pediatrics concluded that exposure to cow's milk protein may indeed be an important factor in the development of diabetes. Based on the more than 90 studies that have addressed the issue, an Academy panel reported that avoiding cow's milk exposure may delay or prevent the disease in susceptible individuals.
An editorial in The Lancet stated that the new findings were particularly telling because they involved T-cells, "the key players" in the cause of diabetes.