http://naivenutrition.blogspot.ca/2008/11/httpwww.html

This is an old blog post I did. I have an old pet theory about vegan diets vs diabetes.

A lot of the specifics of the blog post I would have a problem with now. But the essentials might still stand.

Basically, in mice fed a diabetes-inducing diet, if you make them choline and methionine deficient, they won't get diabetes, their metabolism increases, and they get nice fatty livers.

Not hard to imagine a choline, methionine deficient vegan diet, as I said back then.

Where's the choline or methionine in the Rice diet? Not even green veggies are allowed. Fruit, rice, sugar? Not much there.

A fatty liver/pancreas can cause insulin resistance and diabetes. But it's not the triglycerides themselves that do the damage--it's the presence of certain metabolites of free fatty acid metabolism, in conjunction with elevated glucose, that causes damage to beta cells and liver cells. This has been shown ad-puke-um in various studies. There's a study on beta cell damage from glucolipotoxicity where oleic acid is shown to be protective. What's it do? It facilitates triglyceride synthesis--lowering the free fatty acid levels in the cells (more specifically, the palmitic acid levels). So I wonder if choline/methionine deficiency in the mice might have not only increased triglycerides and decreased ceramide etc. synthesis in the liver, but also done so in the pancreas. Triglyceride accumulation without glucose/lipotoxicity, to hammer a point on the head again.

Who knows? Maybe the diabetics who didn't respond to the Rice diet were just better at synthesizing choline.

Does lowering fat, causing a reversal of diabetes when people go on the Rice Diet make sense? Because after all, if they weren't digging deep into those fat stores, they wouldn't be losing weight. They might be on a zero fat diet, nearly, but they're certainly not on a zero fat metabolism.

Of course this would make the Rice Diet a "cure" for diabetes and a bit of a lobster trap, also--making people less protein tolerant (since protein equals methionine equals substrate for choline production).

A ketogenic diet/fasting plus supplementing every nutrient known to fight fatty liver, looking real good to me right now. Choline, betaine, the various b vitamins, maybe creatine because it's shown to lower homocysteine, homocysteine is formed when either choline or creatine is synthesized--so creatine might spare substrate for methionine. (Careful with creatine if bipolar, one study on depression, only two subjects were bipolar, both went manic. And I had my own problems with that a few years back, although I was taking a number of supplements relative to mania at the time.) Eggs, liver, spinach. A ketogenic diet without care for getting enough choline could be problematic, restricting protein means restricting methionine. It's not impossible for a ketogenic diet to make your liver fattier while giving you better blood glucose by reducing substrate for glucose production.

Perhaps shutting down fat handling would create a situation where the pancreas can handle the sugar load from the Rice/fruit regimen? Because it is not doing other, previously unknown, kinds of things as well as squirting out insulin? Perhaps that is not all the pancreas does?

That's true, they tend to focus on the beta cells. Are alpha cells subject to glucose/lipid toxicity? Or the cells responsible for producing digestive enzymes? All sorts of complexity there. And how the pancreas handles enzyme production is sort of rate limiting, you could imagine the pancreas managing blood glucose not only through insulin and glucagon, but by controlling the rate of glucose/fructose absorption through rate of enzyme production.

We've seen studies showing weight loss for those in HCLF and those in LCHF. The ones to which I'm referring used Atkins as the diet for the LC group. While both groups showed a weight loss over time, the most successful was the Atkins group. The LF group also lost weight, and while successful, did not lose as much as the Atkins group. However, the Atkins group had more positive numbers with higher HDL and lower TGs. So, while insulin resistance may have decreased in both groups, the LC group had better numbers.

That's why I'm intrigued with the rice diet, and I'm amazed that anyone could ever follow it (without being whipped) and am extremely curious about how one fares in two scenarious: a) after a successful period on the rice diet with weight lost and BP controlled, attempting to go back to a SAD (it was mentioned that people could resume normal eating without any reoccurrences of previous conditions), and b) whether anyone could make the rice diet a long-term WOE??? I think not, but then some of my assumptions have changed after reading about Kempner's program.

The rice diet as written doesn't sound too appealing. A little help from the fine people who brought us Snackwells could probably fix that.

I think the SAD would be a disaster sooner rather than later. It would be nice if something would reverse things to the point where if a person took several decades to develop type II, it would take a similar amount of time for them to develop the disease again, if they went back to the SAD.

I did Eat to Win, an Ornish-like program when I was a teenager. I felt good on it, lost fat. Did awful things to my teeth though, I think probably down to a diet high in phytic acid and low in fat soluble vitamins during a critical growth period.

So in order to maintain the benefits of a super-low-fat diet, you have to stay on a choline and methionine-free diet? which means you basically must remain a vegan and never consume animal products or nuts. I don't trust follow-up that consists of calling former patients and quizzing them on the phone, let's drag them in for a good look and get some blood samples at least.

An interesting new study on vegetarians--just quoting the junk I hear on the radio mind you---one out of 3 vegetarians will eat meat if they are intoxicated. There are 5 times as many former vegetarians (me! also) as there are vegetarians. It is a difficult diet to keep--I quit because I was obviously unhealthy (like covered in bruises). True vegan would be infinitely harder. Hey if someone has the willpower and willing to do the effort to eat a healthy, balanced vegan diet, good for them, but I suspect few of the general public are up for that for a long term diet.

So the super-low-fat diet fails in the area of long-term sustainability. A radical short-term diet is interesting if you want to do lab studies and publish interesting graphs, it's great for losing a few pounds before the reunion, but it fails miserably in changing peoples lives for the better and keeping them from dietary-related diseases (a category which seems to grow by the day).

Telling us that a diabetic can lower bs levels by eating more carbs is downright delusional. Next thing she will tell us is that you can keep more $$ by spending more.

I have a friend who has been eating a "plant based whole food" diet for about a year now. In other words a vegan without the junk. She was diagnosed diabetic before starting this way of eating and says that her A1C is down to 5.3 now. She tends to go into things whole hog (or whole tofu) so she is very passionate about this way of eating and believes that it is the healthiest way to eat. She has also lost a lot of weight. About two months ago she had a small stroke and is still suffering residual after affects from it. Of course it is impossible to say that the diet had anything to do with the stroke and it does seem likely that it was the result of past habits rather than a year of vegan eating. Who knows? I'm sticking with my low carb whole food diet, no junk. She and I simply don't discuss the particulars of the way we eat. I go with the very pragmatic what works for me approach, which is what she believes she is doing too. Mostly we don't discuss it. I am hoping we are both right.

Jean

Cotonpal, Markers for diabetes look good but how low is her cholesterol? Low cholesterol is a risk factor for hemorrhagic stoke.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299064/

Just throwing this out as a wild thought with no science behind it - Is a low fat diet really low fat if you are losing weight (fat) on it? Using the CICO theory (I know, pretty suspect but I think it's illustrative), if you go on a 1,200 calorie per day zero fat diet and need 2,000 calories to maintain weight, then aren't you really on a 40% fat diet? You would be "eating" 800 fat calories every day.

That much dietary fat eaten along with the carbohydrate would increase considerably the amount of insulin needed to handle a given glucose/fructose load. The consequence of getting the fat from body stores vs. diet is very different. Or it should be. Normally, insulin reduces blood free fatty acids, so there's less competition for uptake with glucose during glucose absorption. Fat digested at the same time as carbs sort of interferes with that, and some people aren't that good at getting free fatty acids down, even if they didn't eat any fat with the carbs.

I guess the big question is--does the 1200 calorie, fat-free diet leave you hungry? I know it would leave me hungry, but I've seen people write about doing the potato hack and having a similar decrease in appetite to what some experience on low carb. All the potato hack did for me is make me want to stop eating potatoes.

http://www.ncbi.nlm.nih.gov/pmc/art...a00273-0059.pdf

Kempner might have "cured" diabetes in adults. Meanwhile, in parts of the world where people had little choice but to eat diets similar to the Rice Diet, at least in macronutrient content, there's something sometimes called "J" diabetes. Sort of like type II, but patients generally aren't obese. Protein deficiency seems to be involved in the development. Cyanide can cause a kind of diabetes in rodents, protein deficiency makes it worse--because various amino acids are involved in the detoxification process. That's one theory, anyways. I could see the kind of high carb, very low fat diet being eaten during the post-weaning years of development just plain causing inappropriate development, and poor adaptation to a more varied diet, should it become available.

I don't know what her cholesterol numbers are. I prefer to not discuss issues of heath and diet with her. She is a very strong minded person and truly believes that she has done the research and that a vegan whole food diet is the healthiest diet there is. A decade ago she was very active on this site and equally passionate about lchf. This change of mind on her part leaves me puzzled but I know enough not to try to convince her to change. I am trying to keep an open mind about her new way of eating but in my heart of hearts I find it hard to believe that she has made a wise choice.

Jean

Dr. Fung's Thoughts on the Kempner Rice Diet:
(also long, more graphs )
https://intensivedietarymanagement....pner-rice-diet/