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Vegan Diabetes Summit — Day 3 Part 1

Published 2.7.2017
This is the third in a series in which I will be commenting on the Mastering Diabetes Online Summit, otherwise known as the Vegan Diabetes Summit. The two hosts are vegans, as are most of the presenters. Videos and audio recordings of the event expire at the end of the last day (Thursday, February 9th at 9:00 PM Pacific time). I will not have published the entire series before that time, so if you want to hear it from the "horse's mouth" so to speak, click on the link above and register.

The good news is, that the presentations get more interesting further into the week. The first few days have essentially been vegan doctor after vegan doctor touting the amazing benefits of eating only plants. And to be clear, eating a wide variety of fruits, vegetables, legumes and intact whole grains, is a wonderful part of a healthy diet. The healthiness of avoiding all animal products is less clear. Type two diabetes and heart disease (because cardiovascular disease (CVD) gets mention a lot too) can be reversed using the Pritikin protocol. I keep pointing to Pritikin, the same way I point to successful vegan interventions when low carb proponents try to insist theirs is the only or healthiest way.

If you're going to assert that the healthiest way to eat, then you have to explain why Pritikin works. For that matter, you have to explain away why the longest lived people on the planet, those living in the so-called Blue Zones, are not vegan. However, I'm getting ahead of myself. The author of the Blue Zones study is a guest on Day 6 of the summit— for the record, possibly the most interesting day of the entire summit, at least for me.

The conceit of the summit organizers, Cyrus Khambatta and Robby Barbaro, is that both type one (T1D) and type 2 (T2D) diabetes are being covered. However, in most of the early talks, mostly the emphasis is T2D, which can be reversed by lifestyle. T1D means the pancreas no longer functions. there is no proven cure for T1D, though a couple of speakers have now suggested that early treated with a low fat whole food plant based diet (aka a vegan diet) can reverse T1D. Extraordinary claims (and that IS one) require extraordinary evidence. With that tease as to future content, let's get started.

What follows is not a recap, but rather selected notes and commentary I make while listening to the recordings. And I'm dividing into two parts… because it's late and I'm not going to get through all my notes from this day's speakers. I've wound up listening to almost everything so far, except for the "medical medium" dude on Day 2. Note: I am not a nutritionist or medical professional. I am stating what these presenters claimed, mostly without any fact checking. When I know a statement is false, I say so. However, no endorsement is implied for statements presented without additional commentary or fact checking. [added 2.8.2017]

Michelle McMacken MD

McMacken is associated with both Forks over Knives (FoK), which was a 2010 movie pushing plant based diet and is now an entire network of like-minded doctors and media. There is a magazine in addition to the essential website. McMacken is also part of the Plantrician Project, which is a group of plant based doctors. I think the idea is similar to what physicians who push the “Paleo” diet, in that it’s a clearing house where interested patients can locate doctors near them who are plant based (vegan).

  • Is there a best macro ratio for diabetics? She says high carb— of course she does, she wouldn't be here if she didn't.
  • The carbs shouldn’t be refined carbs. Refined carbs cause metabolic damage.
  • Refined means fiber removed. Added sugars are refined carbs.
  • Pritikin, folks, you have to explain Pritikin's results. His plan was not/is not vegan, though it is heavily "plant based," as I would define the term. Meaning most calories ingested are plants. Pritikin is also very low fat. Eschewing animal products is not a requirement to eat a low fat diet.
  • Can you reverse diabetic neuropathy? She says that a low fat WFPBD* works better than drugs.
  • In the case of insulin resistance (IR), how do you know it’s going down? Look at the HbA1c (the three month test) result, plus if sugars after meals don’t spike as high, you know good things are happening.
  • A bit of honesty: starting a high carb low fat (HCLF) regime does spike the BG at first. You have to stick with it for the sugars to come down. They don’t say how long you have to wait though. This fits with reports I’ve seen on blogs. Low carbers who want to find a better way, give HCLF a go and find their sugars shooting through the roof. This point is not emphasized enough here.
  • Khambatta says within 96 hours, blood glucose (BG) and insulin levels normalized.
  • T1Ds might see it sooner because they test their BG levels more often.
  • At least she realizes that not everybody is going to jump onboard at once. She’s emphasizing grains though. Then beans, then vegetables. And fruit— but NOT smoothies— “grind with your teeth” Food in the least processed form. But if you’re T2D, can’t eat plant fats with abandon. No oils.
  • Her elevator pitch is similar to everyone else’s Eat a variety of whole plant foods. At least 90% of your diet.

Marc Hellerstein MD, PhD This will not be the only time I mention Marc Hellerstein's presentation, because there was so much "meat" (pun intended) presented. Hellerstein is one of those people who knows so much about his topic that he has a hard time simplifying the presentation. As a result this presentation was clearly edited to abridge his comments when he went too far into the weeds on a few topics. The title was "How to give your pancreas the rest that it needs."

  • Hllerstein was the first speaker to be careful as to whether he was talking about T1D and T2D, because there's a huge difference.
  • Said not a single word about diet composition during the entire talk!
  • A common thread among T2Ds is that they want to get off of or avoid going on insulin. Even T1Ds want to get off insulin. And they simply can’t. T1D can make insulin work better, but you must have it.
  • In a healthy person, the pancreas always makes at least a little bit of insulin in response to liver glucose. In a healthy person, a bit of insulin is produced even before eating commences.
  • Insulin deficiency in T1Ds creates IR. In fact, he made that point about the entire endocrine system. Deficiencies in hormones lead to resistance.
  • Healthy people put out 30 units per day that’s the TOTAL includes meal response and basal. The body is smarter than the pump.
  • The body uses less than the pump because it keeps just a small amount around (the basal) that keeps the cells primed to take glucose.
  • Beta cells after stressed for a long time results in beta cell exhaustion. Starts putting out pro-insulin, which is a precursor and can’t be used by cells. Chronic stress of beta cells causes death in time. So if they have to work too hard for too long, they will die. Some can grow back, but not always. He's talking T1D here.
  • The honeymoon effect is when this might work (the regrowth upon treatment with insulin) of beta cells. But it hasn’t been proven.
  • In his research they've tried to get beta cells to grow, with little success, maybe no success. (his words)
  • The pancreas is the opposite of muscles, which get stronger with use.
  • Improving sensitivity to insulin can improve beta cell function in T2D. So taking Metformin rests the beta cell, in T2D and can improve pancreas function.
  • Small changes in exercise increase sensitivity and rests the pancreas. Small amounts of exercise are all that's needed.
  • Weight loss for T2D: if you don’t respond in the first five pounds, then you’re not going to. What if you don’t respond?
  • Studies with a very low calories (VLC) diet for 10 days, resulted in all the biomarkers improving. Then they stopped the diet for another 10 days, and subjects were better. The pancreas was rested and began to function. This is akin to what Roy Taylor at Newcastle did, though he said liver function improved first, and pancreatic function took longer. This is why Khambatta can claim results in 96 hours. Because inevitably switching to a WFPBD means eating fewer calories. More volume, but lower calorie density food means lower calories.
  • Pregnancy is a test for a woman's pancreas. If you get gestational diabetes, your odds of "real" diabetes increase dramatically.

Anne Bingham MD

Dr. Anne Bingham is a practitioner in obstetrics and gynecology who studied at Yale. She practices in Middletown, CT, which isn't surprising because in my experience many medical students practice not far from where they study. The topic is gestational diabetes. Of course she's all about plant based (vegan) eating.

  • She has midwives in her practice. It’s an all women practice.
  • She explains how the OGTT in pregnancy works. I don’t remember my blood being drawn four times, just once after downing the drink (in Albuquerque, NM I got to eat a pancake breakfast instead) But maybe because I passed the test.
  • Of course there are complications if you’re diabetic. A big baby is one of the risks.
  • Having to have a C-section is also a risk, which affects the gut biome. Apparently some doctors take a rag and take vaginal fluids then wipe it on the baby’s face. Khambatta asks about it and she doesn’t seem onboard with vaginal seeding (that’s what is called).
  • Not common or sanctioned yet. Goes against the sterile trend. And not all vaginal bugs are good bugs, they are already testing and treating for a bad one. She don’t do it is my bet (the seeding).
  • Yes, she's all about plant base. Pregnant plant based women eat the same thing that non-pregnant women do.
  • She can’t push too hard, so she takes progress she can get.
  • Only few women can make the change that they are pushing because they don’t have confidence that plants only will be the healthy choice. Every message says drink milk and eat dairy.
  • Does what the mother eat affect a kid’s taste buds? Basically she says we don’t know, any info is observational and associations.
  • Polactin — hormone that produces milk, is lower in diabetic moms so they don’t breastfeed as well. Would switching to plant based reverse this? The doctor doesn’t know. Breast milk production is field all by itself, so there’s no way to know. It’s also the case the more you nurse, the more you make.
  • Didn’t quite make it to the end. Basically, they are looking for definitive answers, and she can’t give them. Treating patients isn’t as simple as here’s a recipe, let’s measure the results.
  • I think the most interesting comments were that sure, she can tell them to go plant based, but the reality is that pregnancy is already a stressful time of changes, and radically upending your diet would be a significant additional stress. Pretending otherwise is propaganda.
*WFPBD = whole foods plant based diet
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