The Diabetes Cure

Forget counting carbs. Here's the new way to reverse this disease.
By William Gottlieb

Rosa Gonzalez knew firsthand about the disasters of type-2 diabetes—a condition that results when your body stops responding normally to insulin, a hormone that pulls sugar from the bloodstream into cells, where it’s used for energy. Her uncle lost a leg to the disease; he’s one of the 61,000 people a year with diabetes who have a limb amputated because of nerve damage to legs and feet. Her aunt was on dialysis—a four-hour mechanical cleansing of the blood that took place three times a week—because type-2 diabetes had destroyed her kidneys. And every day her mother had to inject herself with the glucose-lowering hormone insulin to control advanced diabetes.

Then, at age 45, it seemed like it was Gonzalez’s turn for metabolic misery when she got the results from a routine blood test. Her A1C—a measure of long-term blood-sugar levels—was 14 percent (5 percent or lower is normal); her “bad,” artery-clogging LDL cholesterol was 153 (less than 100 is optimal); and at 5-foot-5 and 225 pounds, Rosa was officially obese. A follow-up test showed her fasting blood-sugar level (a standard measurement taken about 10 hours after not eating or drinking anything) was nearing 400 mg/dl (less than 100 is normal). The obvious diagnosis: type-2 diabetes. The prescribed solution: a three-drug cocktail of Glumetza (metformin), an oral drug to lower blood sugar; a statin to lower LDL cholesterol; and a diuretic to lower blood pressure.

However, Gonzalez refused these drugs—and her most recent blood test revealed a healthy A1C of 5 percent and an LDL of 78. She also dropped 80 pounds and went from a size 18 to a size 6. How did these seemingly miraculous changes happen without her taking these three medications faithfully? Gonzalez went on a low-fat, vegan diet—one that cured her diabetes and regenerated her health.

“About a year after starting the vegan diet, I had a routine appointment with my doctor, and he was floored,” says the Fredericksburg, Virginia, mom, now 47. “He told me that I no longer had diabetes. Of course, he wanted to know how I had reversed my diabetes—and I told him I owed my health to Dr. Barnard and his vegan diet, which gave me my life back.”

Diet’s role in diabetes
Neal Barnard, MD, is an adjunct associate professor of medicine at George Washington University School of Medicine and author of several books, including Dr. Neal Barnard’s Program for Reversing Diabetes (Rodale, 2007), which presents a low-fat, vegan diet as a unique and groundbreaking solution to the problem of diabetes.

Why doesn’t Barnard recommend the traditional diabetes diet advocated by the American Diabetes Association (ADA)—one that limits sugary, starchy, glucose-spiking carbohydrates?

Well, he says, studies show the ADA diet isn’t particularly effective in controlling type-2 diabetes, and most people who follow it eventually need medication to manage the disease. In fact, a 22-week scientific study published in the medical journal Diabetes Care compared a low-fat, vegan diet with the ADA diet. People eating the low-fat, vegan diet reduced their diabetes medication by 43 percent, compared to 26 percent on the ADA diet. The meatless eaters also lost twice as much weight—14.3 pounds compared to 6.8—and lowered their LDL cholesterol by 21 percent, compared to 11 percent for the ADA dieters.

What’s more, research from around the world shows that type-2 diabetes isn’t common in countries in which carbohydrates are dietary staples, such as Japan, China, and Thailand, where people eat a lot of rice and other grains, starchy vegetables, bean dishes, and noodles. The latest scientific thinking? A low-carbohydrate diet may not be the best way to manage diabetes.

But there is a diet that may play a role in causing the disease, says Barnard. It’s the diet eaten by most Americans—one that’s high in fat and loaded with meat, dairy products, fried foods, and oils. According to Barnard, here’s what happens when you eat too much fat: Blood-sugar levels are controlled by “locks” in muscle cells that are turned by insulin, the hormonal “key” that allows blood sugar into those cells. Diabetes develops when the locks are clogged with fat and the key can’t work—a condition called insulin resistance. If you can lower dietary fat, unclog the locks, and reverse insulin resistance, you can reverse diabetes. And Gonzalez—along with the thousands of others following Barnard’s plan—is proof that a low-fat, vegan diet can do just that.

The new four food groups
Barnard’s diet has no animal products (meat, poultry, fish, dairy, or eggs). It contains a smidgen of fat from high-fat, vegan foods such as avocados, nuts, and seeds. And it has no carbohydrates high on the glycemic index (GI), a scale of 1 to 100 that measures how fast a certain food releases sugar into the bloodstream (100 being fastest). That means no sugar, white bread, or other products with white flour; no cold cereals (except for bran cereals); and no white potatoes.

The best news? There’s no calorie counting or specifically timed meals, which are common in diabetes diets. Barnard’s diet also allows unlimited portions of the following foods, which Barnard calls the new four food groups:
• The whole-grain group. Whole grains are filling but have very little fat and no cholesterol. Reach for whole-grain pasta, brown rice, bran cereal, oatmeal, pumpernickel or rye bread, couscous, bulgur wheat, millet, and barley. Suggested servings: eight per day. One serving is 1/2 cup of cooked grain (oatmeal or pasta), 1 ounce of dry cereal, or one slice of bread.
• The legume group. Legumes are hearty, high-protein foods low on the GI scale and rich in calcium, iron, cholesterol-lowering soluble fiber, and even traces of “good” fats—omega-3 fatty acids. This food group includes beans (black, pinto, or kidney beans; chickpeas; baked beans; soybeans, etc.), as well as peas, split peas, lentils, and fat-free soy products (unsweetened soy milk, veggie burgers, textured vegetable protein; and tofu). Suggested servings: three per day. One serving is 1/2 cup of cooked beans, 4 ounces of tofu, or 8 ounces of soy milk.
• The vegetable group. Not surprisingly, you can’t go wrong with most of the veggies you find at the supermarket. “Each member of the vegetable group is loaded with vitamins and minerals, is very low in fat, and has no cholesterol,” says Barnard. Opt for sweet potatoes, broccoli, cauliflower, spinach, kale, collards, squash, green beans, bok choy, and artichokes. Suggested servings: four or more per day. One serving is 1 cup of raw or 1/2 cup of cooked vegetables.
• The fruit group. Like veggies, fruits are loaded with vitamins and have no fat or cholesterol. “Many people with diabetes imagine that because fruits are sweet, they will raise blood sugar,” says Barnard. The fact is, though, nearly all fruits—apples, bananas, blueberries, cherries, clementines, oranges, peaches, pears, and most others—are low on the GI scale. The exceptions are watermelon and cantaloupe, so eat those sparingly. Suggested servings: three or more per day. One serving is one piece of raw fruit, 1/2 cup of chopped fruit, or 1/2 cup of cooked fruit or juice.

This diet also permits fat-free salad dressings and condiments; fat-free, sugar-free beverages, such as coffee or tea (with a nonfat dairy creamer, if desired) and alcoholic beverages (occasionally); and, when eaten sparingly, nuts, seeds, and dark chocolate (made without milk). Soy products such as tofu, tempeh, and soy cheese are fine as long as they have no more than 2 to 3 grams of fat per serving. Barnard also recommends a daily multivitamin that includes at least 5 micrograms (mcg) of B12, which is often in short supply in a vegan diet.

You probably noticed that olive oil—often touted as a “healthy fat”—isn’t on the diet. Its 13 percent saturated fat content can raise cholesterol, says Barnard, and it’s an extremely concentrated form of calories. What’s more, including it in your diet may actually stimulate your craving for other unhealthy fats, such as those found in beef, chicken, and dairy products. Dark chocolate and nuts also stimulate those cravings, which is why they, too, aren’t a regular part of the diet.

How to go vegan
It may seem like a vegan diet is just too difficult to start and sustain. “Diabetes is difficult,” says Barnard. “Yes, people may think eating a vegan diet sounds hard—but ending up on dialysis and going blind is what is hard.”

Barnard suggests that you go vegan in two easy steps: First, he recommends identifying healthy breakfasts, lunches, and dinners that you really like. For breakfast, for example, you might try old-fashioned oats (not instant or one-minute varieties, which rank high on the glycemic index) topped with cinnamon, raisins, or berries. The next day, opt for veggie sausage or bacon, which is tasty and high in protein, with scrambled tofu (a great substitute for scrambled eggs) topped with salsa or combined with tasty spices such as onion powder, curry powder, salt, turmeric, or cumin. “All you need to do is find eight or nine healthy breakfast, lunch, and dinner meals that suit your tastes, and you’re set,” he says. And get creative in the kitchen. Don’t ditch your family meatloaf and sloppy joe recipes altogether; just find a non-meat alternative (see “Meet the Fakers” on page 48 for ideas) and experiment.

That’s what Gonzalez did. “Even mainstream supermarkets carry healthier alternatives to high-fat foods and animal products, and it’s amazing how tasty the foods on this diet can be when you’re open-minded and give them a try,” she says.

The next step is to mark a three-week period on your calendar, and commit yourself completely to the diet for those 21 days. “This isn’t the time to stick your toe in the water—it’s the time to jump in,” says Barnard. Why three weeks? Fat and sugar cravings last about three weeks, he says. “After that period, you’ll be surprised how little you miss the unhealthy foods you’ve left behind. Instead, you’ll begin to appreciate the natural sweetness of an apple, and the fat in a typical restaurant’s stir-fry will taste greasy and unpleasant.”

This was true for Gonzalez.

“Initially, it was hard to give up some of these foods,” she says. “But when I was tempted to have a slice of cake or a chocolate chip cookie, I visualized my diabetic mother—and it was easier to resist temptation.” Dropping six dress sizes also helped Gonzalez stay on track.

“I’m living proof this diet works to cure diabetes,” she says. “I will be a vegan for life.

Bill Gottlieb is a freelance writer in northern California.

Quick tip! Not sure you can commit to a vegan diet? Give it three weeks. That’s how long fat and sugar cravings last. After that, you’ll be surprised how little you miss the high-fat foods you’ve left behind (odds are they’ll even start to taste bad) and begin to appreciate the natural sweetness of whole foods.

Should You Use Sugar Substitutes?
While you may be tempted to use sugar substitutes for a shot of sweet without the blood-sugar spike, Neal Barnard, MD, recommends steering clear of them. “These substitutes can keep you craving sweets, and that can undermine your ability to say no to them,” he says. Even a natural substitute such as agave nectar—which is much lower on the glycemic index than sugar—should be used sparingly, he says. “After forgoing sweet foods for two or three weeks, you’ll lose your desire for foods that contain added artificial or natural sweeteners.”

Brussels Sprouts With Lemon and Vegetarian Bacon
Serves 8
3 pounds brussels sprouts, trimmed and halved vertically
1 cup chopped vegetarian bacon (about 8 slices)
4 scallions, chopped
1/4 cup low-sodium vegetarian broth
Salt and freshly ground black pepper to taste
2 tablespoons lemon juice

1. Add the brussels sprouts to a saucepan of boiling water, and cook 3 minutes. Drain immediately, and plunge sprouts into ice-cold water to stop the cooking process. When they are cold, drain well.
2. Heat a large wok over high heat, and add bacon and scallions. Steam-fry until scallions are soft, adding water as needed to prevent sticking and burning.
3. Add sprouts and broth, and stir-fry for 3 minutes.
4. Season with salt and pepper, and drizzle with lemon juice. Toss and serve.
nutrition info per serving: 71 calories, 0.5 g total fat, 0 mg cholesterol, 12 g protein, 5 g carbohydrates, 1 g sugar, 2 g fiber, 331 mg sodium

Red Cabbage Slaw With Cranberries and Apples
Serves 8

Fat-free oil substitute
1 cup cold water
1 tablespoon low-sodium vegetarian broth powder
2 teaspoons cornstarch
Cranberry-Orange Vinaigrette
3/4 cup fat-free oil substitute
1/2 cup orange juice
1/3 cup chopped fresh or frozen
unsweetened cranberries
2 tablespoons red-wine vinegar
1?1/2 tablespoons chopped chives or scallions
1 tablespoon balsamic vinegar
1 tablespoon lemon juice
1 tablespoon sugar
1 large clove garlic, crushed
1 teaspoon salt
Freshly ground pepper to taste
1?1/2 pounds red cabbage, thinly sliced
3/4 cup fresh or frozen unsweetened cranberries
2 crisp sweet apples, sliced

For the fat-free oil substitute
1. Combine all ingredients; makes 2 cups, which can be refrigerated for up to 3 days.
For the vinaigrette
1. Blend all ingredients. If making ahead of time, transfer vinaigrette to a covered container and refrigerate.
For the salad
1. Combine the cabbage, cranberries, and vinaigrette in a medium salad bowl, and toss gently. Cover and refrigerate for at least 2 hours to allow the flavors to blend.
2. When ready to serve, slice the apples (with peel), add to the salad, and toss well.
nutrition info per serving: 70 calories, 0.5 g total fat, 0 mg cholesterol, 1 g protein, 18 g carbohydrates, 11 g sugar, 3 g fiber, 251 mg sodium

Pineapple Sherbert Pops
Serves 18
1 package reduced-fat firm or extra-firm silken tofu
3 tablespoons agave nectar
4 teaspoons lemon juice
3/4 teaspoon vanilla extract
1 can (19-ounce) juice-packed, unsweetened crushed pineapple
1/4 teaspoon coconut extract

1. Place tofu, agave nectar, lemon juice, vanilla, pineapple (with juice), and coconut extract in a blender, and process until smooth.
2. Pour into 18 small ice-pop molds, insert sticks, and freeze until solid.
3. To serve, dip the bottoms of the molds in hot water for a few seconds so the pops slide out easily.
nutrition info per serving: 30 calories, 0.5 g total fat, 0 mg cholesterol, 2 g protein, 6 g carbohydrates, 6 g sugar, 0.5 g fiber, 19 mg sodium