Sugar Doesn’t Cause DiabetesJun 28, 2014 Slideshares 33 commentsShare post on ...Enjoy today’s lovely 180DegreeHealth slideshare from the izzle of diabizzle Matt Stone… Sugar does not cause diabetes from Matt Stone33 Comments Gregg Sheehan on June 28, 2014 at 6:58 pm If the eating of sugar and other highly refined carbohydrates doesn’t cause type 2 diabetes, then how is it that taking those ingestibles out of your diet tends to reverse the symptoms of the disease? Reply Matt Stone on June 28, 2014 at 8:01 pm Don’t see that too often, other than perhaps a transient and temporary improvement due to decreased blood sugar in the short-term before an eventual worsening. There are lots of faux ways to “cure diabetes” in the short-term, but they are short-lived and more like parlor tricks. Only interventions that result in superior glucose clearance offer true improvement in the condition. Having said that, I have nothing against eating primarily, or even exclusively unrefined food as long as people are eating enough calories to keep metabolism up and not suffering from digestive problems or a psychological compulsion to eat what they’ve forbid themselves from eating. Reply Phil Thompson on June 29, 2014 at 5:31 am Reduced carbohydrate intake has been shown to be beneficial to people with diabetes in long term studies like http://www.nutritionandmetabolism.com/content/5/1/14 for example.That is beyond ” a transient and temporary improvement”. It ays nothing about the *cause* of diabetes but if you can’t regulate blood sugar then creating less of it has to have some merit, given that chronic elevated blood sugar has well defined bad consequences. Reply Phil Thompson on June 29, 2014 at 5:34 am Long terms studies like http://www.nutritionandmetabolism.com/content/5/1/14 show benefit of reduced carbohydrate intake to people with diabetes well beyond any “transient and temporary improvement”If you have a problem regulating blood sugar, and chronic high blood sugar has well known bad outcomes, then does it not make sense to reduce the amount of blood sugar created by ingesting carbs ? Reply Rufio on June 29, 2014 at 7:48 am Possibly, but that kind of assumes that ingesting carbs is a significant contributor to chronic high blood sugar, whereas research has found that relative insulin deficiency and hepatic insulin resistance appear to be the main culprits. More on this here.To play devils advocate for a second, it would be possible for a low fat proponent could construct a similar argument. People with diabetes have elevated levels of free fatty acids (FFA) and reduced clearence. Elevated FFA are a major cause of insulin resistance in skeletal muscle and liver and cause impaired glucose tolerance. So wouldn’t it make sense to reduce the amount of FFA in the bloodstream by reducing fat intake? Reply Matt Stone on June 29, 2014 at 12:39 pm If you don’t know a solution to fixing the blood sugar regulation problem, then yes. It could very well be better to avoid carbs if you can’t fix the problem, which is exactly what I wrote in 180 Diabetes (currently unpublished until updated).But what makes more sense is to fix the blood sugar regulation problem. Reply Gina on July 1, 2014 at 9:04 am When will 180 Diabetes be released? I try to apply Eat for Heat and Food Ninjas to family meals, but hubs is sick and tired of me screwing with his diet. He wants a succinct answer to eating/exercising with diabetes. And so do I.The doctor and dietician want him to exercise regularly (I get that but do we rest and refeed first), avoid fat (really?), and eat a 2:1 carb to protein diet (ok, they like a few carbs).I feel like I’ve read all the hip diet dogma over the last year (yup, that includes cross fit, Paleo and WAPF). I feel I can trust you, and really just want your answer to helping hubs lose fat and treat his diabetes without drugs. John Kozinski on March 5, 2015 at 6:46 pm Hi Matt, Will the update to the Diabetes book be out soon? In the version that I have you suggest eating unrefined carbs. Look forward to the revised edition. John marcus volke on July 1, 2014 at 11:32 pm Low carb diets don’t necessarily just improve diabetes ‘markers’, they may also improve the underlying condition (loss of insulin sensitivity). as stephan guyenet noted about this study – http://www.ncbi.nlm.nih.gov/pubmed/15331548 in his article here – http://wholehealthsource.blogspot.com.au/2009/09/diabetics-on-low-carbohydrate-diet.html“It’s interesting to note in the graph above that fasting blood glucose (18-24 hours) also fell dramatically. This could reflect improved insulin sensitivity in the liver. The liver pumps glucose into the bloodstream when it’s necessary, and insulin suppresses this. When the liver is insulin resistant, it doesn’t respond to the normal signal that there’s already sufficient glucose, so it releases more and increases fasting blood glucose. When other tissues are insulin resistant, they don’t take up the extra glucose, also contributing to the problem.” Reply Matt Stone on July 2, 2014 at 1:03 am Firstly, I think Guyenet’s views have probably matured tremendously since 2009 when that was written. I concede that if one cannot fix their diabetes, eating a low-carb diet is usually a better option than just continuing on with out-of-control blood sugar issues. The whole “if glucose is poison, it’s better to eat fat” idea. However, I’ve seen countless times that fasting and postprandial glucose levels can be improved without resorting to a low-carb diet, and that they can be brought even lower on a higher-carb diet than a low-carb diet.This study is completely irrelevant however (as 99% of studies are), as it is only 5 weeks long and doesn’t take into account the study subjects’ response to a normal meal (what 95% of people will gravitate towards eventually no matter what any study on earth claims) after the test period (a better test of how a diet affects glucose control/clearance/the root of the problem).Okay, too many parentheses, sorry.There is also no mention of how satisfied the subjects were, how they felt, what other problems they might have developed, whether or not they experienced carbohydrate cravings or whether they will in the future if they are to continue, on so on ad infinitum.It’s just an isolated look at blood glucose in a very crude, shallow, and superficial way. From experience, I can tell you that what sends many people’s blood sugar down in the short-term induces all kinds of problems such as insomnia, reduced metabolic rate, mood disorders, constipation, sexual dysfunction, and on and on.Ultimately, this study shows that reducing carbohydrate intake can lower blood glucose in diabetics over a 5-week period. Tell me something I don’t know. That’s obvious. Everyone knows this.But an intervention that makes people increasingly crave carbohydrates and tolerate them more poorly over time is not a solution, it’s a recipe for disaster, which is exactly why people shouldn’t settle for these kinds of temporary band-aids for their problems, but should really address the root cause and see if they can get to the bottom of it. Reply marcus volke on July 2, 2014 at 4:27 am I basically agree with you and i dont think that very low carbohydrate diets are healthy or sustainable by any means. However it seems like you are saying that low carb diets only lower glucose levels by reducing glucose intake. The point i was making is that they also appeared to improve hepatic insulin sensitivity and stopped the liver pumping out more glucose. Donna on October 8, 2014 at 7:25 pm Matt, you are really off the mark here. I am a diabetes nurse and I can tell you that sugar plays a major role in the development of diabetes. I know that goes against what you’ve heard from some “experts”, but “experts” are often wrong I find. Check out the research conducted by a team of researchers at UCSF. A study conducted over 10 years and in 160 countries showed, beyond a doubt that sugar is the major factor in increasing diabetes rates (even after controlling for obesity). Mark Hyman of the NY Times did a very good editorial on this. Check it out. And I agree that once diabetes has developed, just stopping sugar isn’t enough. But, yes, it can be reversed by avoiding processed foods, sugar, limiting starches and increasing vegetable intake dramatically. I’ve seen blood sugar levels come down to low normal in newly diagnosed diabetics using this method. Of course exercise and stress management helps too… Reply Matt Stone on October 9, 2014 at 2:24 am I’m not off the mark. And I have helped several diabetics lower postprandial readings from 300 to 150 and below in a week or less by doubling and even tripling their carbohydrate consumption–both from sugars and starches. Saying I should check out Mark Hyman and that an epidemiological study proved something (epidemiology is meaningless), are not going to change my mind.My article Starch Lowers Insulin will be a particularly enlightening read for you.Dropping someone’s blood sugar readings by feeding them tons of vegetables, removing palatable foods, removing carbohydrates, exercising them, or feeding them a raw foods diet or putting them on a juice fast or other gimmicks, only lowers blood sugar because they are starving these people of calories. That’s not a solution, and the effects from doing this wear off over time as the metabolic rate downregulates.The focus in diabetes treatment, if a true improvement in the condition is what you seek, should be on improving glucose clearance. That’s the future of treatment for the condition.Take a typical mixed meal, eat it, and monitor blood glucose at 1 and 2 hours postprandial. Work on lowering the 1 and 2 hour postprandials in response to the exact same meal with the exact same glycemic index and glycemic load. That which yields improvements you can be sure are actually helping to resolve the root issue. Everything else is just a cruel Band-Aid.And please don’t insult me by saying I just listen to “experts” and regurgitate what I read elsewhere here. I’m the expert. Reply franz on June 30, 2014 at 5:57 am I think I noticed some benefits in glucose clearance from supplementing B3 because I think that ever since I have an even greater sweet tooth :P. Reply marcus volke on July 1, 2014 at 9:13 am No offence but your slide show was pretty much meaningless since all you really did was make a series of rudimentary assertions without providing any evidence or offering an alternative explanation. Im not saying you’re wrong but maybe you should have written a convincing article and left the slides to dr.oz and play-school Reply David199 on July 1, 2014 at 10:11 am One issue with the study Phil linked was that they appear to be reducing the calories for the test subjects and adding exercise. It’s not exactly clear if that was done for the control or not (there was a slight mention of being “advised on a diet of similar calories” but nothing about exercise). Either way, i don’t know why studies change 3 variables and then attribute the results to only one of them. Granted, i’m at work and only skimmed the study so i may have missed something.Second, to Matt’s point, diabeties is a program with sugar metabolism. Too much blood sugar is a symptom. Restricting carbohydrates doesn’t cure a Type 2 anymore than an eye doctor cured my eyesight by giving me glasses. With that said, there does seem to be evidence that carb restriction helps the obese in some cases. Reply Bob Dean Metal Dude on July 1, 2014 at 7:59 pm Whats up everybody. Just to let you know Matt, you’re awesome, but I just typed out a decent sized comment and forgot the captcha and all my shit was gone. Might wanna make it so people don’t lose their content if they forget that OR get it wrong accidentally. I’m not going to type what I typed again right now…It’s irritating..Crap it was good too =\ Reply marcus volke on July 2, 2014 at 1:08 am I think this post is a bit misleading. It’s important to distinguish between sugar consumption and carbohydrate consumption in general. For one thing, sugar (unlike starch) is 50% fructose. Even moderate consumption of fructose can cause hepatic insulin resistance in humans and has been shown to increase circulating free fatty acids – http://www.ncbi.nlm.nih.gov/pubmed/22933433 Increasing circulating free fatty acids in humans appears to induce insulin resistance – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC370462/ http://www.ncbi.nlm.nih.gov/pubmed/1885781 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC293539/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC407880/ http://www.ncbi.nlm.nih.gov/pubmed/15919784 while reducing circulating free fatty acids restores insulin sensitivity in obese and diabetic subjects – http://www.ncbi.nlm.nih.gov/pubmed/10480616Insulin resistance has also been associated with fructose consumption in adolscents – http://www.ncbi.nlm.nih.gov/pubmed/22190023Fructose overfeeding (but not glucose overfeeding) can induce insulin resistance in humans in as little as a week, albeit that is an unnaturally high intake of fructose – http://www.ncbi.nlm.nih.gov/pubmed/6986758Fructose (but not glucose) exacerbates insulin sensitivity in overweight/obese humans – http://www.ncbi.nlm.nih.gov/pubmed/19381015 http://www.ncbi.nlm.nih.gov/pubmed/20029377It’s also important to note that added sugars increase caloric intake via their effects on food reward / palatability. Cellular calorie overload induces cellular insulin resistance – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2764908/ and excess calorie consumption contributes to obesity and type 2 diabetes – http://www.ncbi.nlm.nih.gov/pubmed/20547978 – http://www.ncbi.nlm.nih.gov/pubmed/4881681 – http://www.ncbi.nlm.nih.gov/pubmed/4750591Since added sugars promote overeating, and since both overeating and fructose overfeeding can induce metabolic syndrome, I think it’s quite likely that the huge intake of sugar in the standard western diet is contributing to the pathogenesis of type 2 diabetes. Reply Andy on July 11, 2014 at 7:09 pm Matt, I admire you for being willing to spend this much time fielding questions on a simple blog. If I were you I’d disable comments. Of course, maybe you enjoy it. It’s still a lot of work. Hey, here’s a comment ….. THANK YOU. I’m going to go get some ice cream with my daughter. Guilt free. Reply Matt Stone on July 11, 2014 at 7:51 pm I wouldn’t do it if it was “work.” Work is against my religion, lol. I do this because it is fun and interesting. Reply claire on July 11, 2014 at 7:59 pm Hi Matt, my dad just got diagnosed with diabetes… How do I help him ??? Reply Matt Stone on July 11, 2014 at 8:17 pm What were his sugar readings? You can start by getting a glucose meter and some test strips and establishing a baseline for where he’s at right now. What is his 1, 2, and 3-hour postprandial readings after a mixed meal with 100 grams of carbohydrates? What is his typical morning fasting level?When you get to know that kind of thing, then you can begin working on improving his glucose clearance.Let’s say his fasting right now is 130, and after a mixed meal his 1, 2, and 3 hour readings are 210, 180, and 120.An improvement would be to see his fasting go to 110, and 1, 2, and 3 hour readings go to maybe 150, 120, and 100… And to be able to achieve this WITHOUT reducing calorie or carbohydrate intake. Anyone can temporarily starve their blood sugar down, but it’s not a solution, and that doesn’t address the root problem.Hopefully that can provide you with a good start and a good framework in your attempts to actually improve the condition instead of just “treat” it.If all else fails, you can always take the “treatment” approach (low-carb), but that shouldn’t be a first course of action in my opinion unless his condition is quite severe. Reply Lisa V in BC on July 17, 2014 at 7:52 pm So I’m in Canada and we have a different system from the states as far as I can tell. My glucose meter tells me my fasting blood sugar was 7.4 this morning then 8.9 after breakfast, 7.0 an hour later and 5.6 an hour after that. Seems pretty good to me except for the fasting glucose which is high according to my doctor who tells me I am in the pre-diabetes range. Do you know how these readings compare to the ones you gave above and any ideas how to improve my fasting levels? Reply Matt Stone on July 18, 2014 at 1:32 am This sounds like stress-induced high blood sugar, which is greatly improved by ingesting food. As you can see, you have no problem clearing glucose, it just seems your nervous system is hyperactive in the morning hours. Do you have bad sleep with an adrenaline surge in the middle of the night? Feel really funky in the morning? If you give me a few more details, I’m happy to continue trying to get to the bottom of this. How old are you? How long has this elevated fasting sugar thing been going on? Reply Lisa V in BC on July 18, 2014 at 10:50 am Thanks Matt!I’m 40 and switched from the GAPS diet to RRARF in February after being low carb (as well as orthorexic) on and off for many years. I gained 30 in the first two months of RRARFing but my weight has now been stable for the last twoish months. I really struggled with sleep the first few months, but it seems to finally be settling down – I’m not lying awake anymore for 1.5 – 2 hours per night. At first I would make sure I had a snack right before bed as well as something beside my bed for when I woke up in the middle of the night, but haven’t had to do that for the past week and have been sleeping much better. Still waking up around 1:30/2:00 but going right back to sleep without any problems.I’m not sure how long the fasting sugar thing has been going on as I had my first blood test in 4 years done after I started RRARFing, but my first test came back 6.4, second test 3 months later (at end of June) was 6.5 and then I just started taking my own tests yesterday which showed the 7.4 and this morning it was 8.8 – doesn’t make sense since it’s getting worse as my sleep improves…I actually feel pretty good in the morning – having had Gestational Diabetes 5 years ago, I don’t have that yucky feeling that I associated with high blood sugar at that time. But I’ve been crashing in the early afternoon all this week – have had to take naps every day, which could be the result of being much busier than usual in the mornings or the heat, but regardless, it’s a pain.I haven’t been tracking calories for a long time, just eating to appetite and not purposely avoiding grains, but not eating much of them – more salads & fruit, smoothies etc. as I’ve started following Jon Gabriel’s stuff and adding in nutrients as well as starting to walk more and a little bit of time on my elliptical (less than 5 min so far) I’m never feeling hungry and although I haven’t tracked my temp since my thermometer broke, I’m usually feeling quite hot after eating anything.Thanks for any suggestions you can give! Lisa Reply Matt Stone on July 18, 2014 at 9:05 pm That is definitely odd that it’s worsening as your sleep improves, but it is promising at the same time that you don’t seem to have much of a glucose clearance problem at all. 8.8 is quite high for a fasting level. It’s also quite abnormal to see it jump up and down between 6.4 and 8.8. Perhaps we can shift this conversation over to my email address. Email me at: [email protected] and we can keep an eye on it a little bit. But this sounds peculiar enough, as well as serious enough, that you should consider working with Dr. Garrett Smith. Reply Lisa V in BC on July 19, 2014 at 7:29 pm Thanks Matt, will do! Reply dolphin005 on December 22, 2014 at 5:32 pm I developed blood sugar issues from trying RRARF that I now can’t seem to fix. I did reach out to Dr. Smith, but I can’t afford a consultation. Even more so now since I just lost my job. My levels were fine for years before I tried to fix my metabolism. I’m frustrated. I seemed to have made myself worse by RRARFing. Any ideas? Reply Matt Stone on December 27, 2014 at 7:19 pm Can you elaborate on what you mean by “blood sugar issues?” I’m happy to try to help you out a little and see if we can get to the bottom of it. Reply dolphin005 on December 29, 2014 at 12:05 pm Hi Matt – Meaning they are high now. Higher fasting and higher post meals since I started trying to do RRARF. Reply Julia on March 16, 2015 at 1:46 pm Hi Matt. I know this is an older article/comments but I’m hoping that you can still help! My husband was just told that he is pre-diabetic with higher than normal cholesterol. I have PCOS (even though my blood sugar is fine) so we are both in the insulin resistant category. My husband is wanting to make big changes in our diet, including no sugar or starches and I know that that’s not the way to go for long term results. We have 3 months until my husband is retested and I really would love to make some serious progress and avoid him needing insulin or me wanting to punch someone for a cupcake! Reply Matt Stone on March 23, 2015 at 2:49 pm I would decrease fat intake, not carbohydrate intake, and focus on eating an abundance of root vegetables, fruits, beans, vegetables, and rice. Basing your diet around these staples, keeping stress levels down, sleeping a lot (going to bed early), and getting lots of physical activity (lot of easy, a little bit of hard stuff), actually stands a chance to FIX the problem, not just temporarily improve blood markers without really fixing the glucose clearance/insulin sensitivity issue. Reply Matt Stone on March 23, 2015 at 2:50 pm You can also try supplementing with things known to help with glucose metabolism, such as magnesium and glycine for starters. Reply Submit a Comment Cancel replyYour email address will not be published. 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