The China Study (23 page)

146                          THE CHINA STUDY
In both types, the disease begins with dysfunctional glucose metabo-
lism. Normal metabolism goes like this:
• We eat food.
• The food is digested and the carbohydrate part is broken down
into simple sugars, much of which is glucose.
• Glucose (blood sugar) enters the blood, and insulin is produced by
the pancreas to manage its transport and distribution around the
body.
• Insulin, acting like an usher, opens doors for glucose into different
cells for a variety of purposes. Some of the glucose is converted to
short-term energy for immediate cell use, and some is stored as
long-term energy (fat) for later use.
As a person develops diabetes, this metabolic process collapses. Type
1 diabetics cannot produce adequate insulin because the insulin-pro-
d u c i n g cells of their pancreas have been destroyed. This is the result
of the body attacking itself, making Type 1 diabetes an autoimmune
disease. (Type 1 diabetes and other autoimmune diseases are discussed
in chapter nine.) Type 2 diabetics can produce insulin, but the insulin
doesn't do its job. This is called insulin resistance, which means that
once the insulin starts "giving orders" to dispatch the blood sugar, the
body doesn't pay attention. The insulin is rendered ineffective, and the
blood sugar is not metabolized properly.
Imagine your body as an airport, complete with vast parking areas.
Each unit of your blood sugar is an individual traveler. After you eat,
your blood sugar rises. In our analogy, then, that means lots of travel-
ers would start to arrive at the airport. The people would drive in, park
in a lot and walk to the stop where the shuttle bus is supposed to pick
them up. As your blood sugar continues to rise, all the airport parking
lots would fill to capacity, and all the people would congregate at the
shuttle bus stops. The shuttle buses, of course, represent insulin. In the
diabetic airport, unfortunately, there are all sorts of problems with the
buses. In the Type 1 diabetic airport, the shuttle buses simply don't ex-
ist. The only shuttle bus manufacturer in the known universe, Pancreas
Company, was shut down. In the Type 2 diabetic airport, there are some
shuttle buses, but they don't work very well.
In both cases, travelers never get to where they want to go. The
airport system breaks down, and chaos ensues. In real life, this corre-
s p o n d s with a rise in blood sugar to dangerous levels. In fact, diabetes

DlAB ETES                           147
is diagnosed by the observation of elevated blood sugar levels, or its
"spillage" into urine.
What are the long-term health risks of glucose metabolism being
disrupted? Here's a summary, taken from a report from the Centers for
Disease ControF:
Diabetes Complications
Heart Disease
• 2-4 times the risk of death from heart disease.
Stroke
• 2-4 times the risk of stroke.
High Blood Pressure
• Over 70% of people with diabetes have high blood pressure.
Blindness
• Diabetes is the leading cause of blindness in adults.
Kidney Disease
• Diabetes is the leading cause of end-stage kidney disease.
• Over 100,000 diabetics underwent dialysis or kidney trans-
p l a n t a t i o n in 1999.
Nervous System Disease
• 60% to 70% of diabetics suffer mild to severe nervous system
damage.
Amputation
• Over 60% of all lower limb amputations occur with diabet-
ics.
Dental Disease
• Increased frequency and severity of gum disease that can lead
to tooth loss.
Pregnancy Complications
Increased Susceptibility to Other Illnesses
Death

148                                  THE CHINA STUDY
Modern drugs and surgery offer no cure for diabetics . At best, current
drugs allow diabetics to maintain a reasonably functional lifestyle, but
these drugs will never treat the cause of the disease. As a consequence,
diabetics face a lifetime of drugs and medications, making diabetes an
enormously costly disease. The economic toll of diabetes in the u.s.:
over $130 billion a year.2
But there is hope. In fact, there is much more than hope. The food
we eat has enormous influence over this disease. The right diet not only
prevents but also treats diabetes. What, then, is the "right" diet? You
can probably guess what I'm going to say, but let the research speak for
itself.
NOW YOU SEE IT, NOW YOU DON'T
Like most chronic diseases , diabetes shows up more often in some parts
of the world than in others. This has been known for a hundred years.
It has also been well documented that those populations with low rates
of diabetes eat different diets than those populations with high rates
of diabetes. But is that just a coincidence, or is there something else at
work?
CHART 7.1: DIETS AND DIABETES RATES, CIRCA 19254 , 5
25
90
g
75                                            20
o
6
En                                                       o
60
15   ~
% Fat
Qj                                                        Qj
c
_   % Carbohydrates
0..
w      45                                                 Q)
'+-
~Diabetes
0                                                   10 0::
-:u
-;,R
30
0
£
+-'
ro
Q)
o
15
0
«                                  c
V1
"D          "D
ro
c
J!!
C
Vl
ro    ro            0..
~
:::::>
~
S     'P
(5           0
:r:         u
"D    Vl
C
ro
"D
c
~
CJ)
c
w

DIABETES                              149
Almost seventy years ago, H.P. Himsworth compiled all the existing
research in a report comparing diets and diabetes rates in six countries.
What he found was that some cultures were consuming high-fat diets,
while others had diets high in carbohydrates. These fat vs. carbohydrate
consumption patterns were the result of animal vs. plant food consump-
tion. Chart 7.1 documents the diet and disease conditions for these
countries in the early part of the twentieth century. 5
As carbohydrate intake goes up and fat intake goes down, the num-
b e r of deaths from diabetes plummets from 20.4 to 2.9 per 100,000
people. The verdict? A high-carbohydrate, low-fat diet-a plant-based
diet-may help to prevent diabetes.
Thirty years later, the question was reexamined. After examining four
countries from Southeast Asia and South America, researchers again
found that high-carbohydrate diets were linked to low rates of diabetes.
Researchers noted that the country with the highest rate of diabetes,
Uruguay, had a diet that was "typically 'Western' in character, being
high in calories, animal protein, [total) fat and animal fat. " Countries
with low rates of diabetes used a diet that was "relatively lower in pro-
tein (particularly animal protein), fat and animal fat. A high proportion
of calories is derived from carbohydrates, particularly from rice."6
These same researchers enlarged their study to eleven countries
through Central and South America and Asia. The strongest associa-
t i o n they found with diabetes was excess weight.? Populations eating
the most "Western" type of diet also had the highest cholesterol levels,
which in turn was strongly associated with the rate of diabetes. ? Is this
starting to sound familiar?
WITHIN ONE POPULATION
These old, cross-cultural studies can be crude, resulting in conclusions
that are not entirely reliable. Perhaps the difference in diabetes rates in
the above studies were not due to diet, but to genetics. Perhaps other
unmeasured cultural factors, like phYSical activity, were more relevant.
A better test would be a study of diabetes rates in a single population.
The Seventh-day Adventists population is a good example. They are
an interesting group of people to study because of their dietary habits:
their religion encourages them to stay away from meat, fish, eggs, cof-
fee, alcohol and tobacco . As a result, half of them are vegetarian. But
90% of these vegetarians still consume dairy and/or egg products, thus
deriving a Significant amount of their calories from animal sources. It

150                           THE CHINA STUDY
should also be noted that the meat-eating Adventists are not the meati-
est of eaters. They consume about three servings of beef a week, and less
than one serving a week of fish and poultry.8 I know plenty of people
who consume this amount of meat (including fish and poultry) every
two days.
In dietary studies involving the Adventists, scientists compare "mod-
erate" vegetarians to "moderate" meat eaters. This is not a big differ-
ence. Even so, the Adventist vegetarians are much healthier than their meat
eating counterparts. 8 Those Adventists that "deprived" themselves of meat
also "deprived" themselves of the ravages of diabetes. Compared to the meat
eaters, the vegetarians had about one-half the rate of diabetes. 8,9 They also
had almost half the rate of obesity.8
In another study, scientists measured diets and diabetes in a popula-
t i o n of japanese American men in Washington State. 1O These men were
the sons ofjapanese immigrants to the u.s. Remarkably, they had more
than four times the prevalence of diabetes than the average rate found in
similar-aged men who stayed in japan. So what happened?
For japanese Americans, the ones who developed diabetes also ate
the most animal protein, animal fat and dietary cholesterol, each of
which is only found in animal-based foods.1O Total fat intake also was
higher among the diabetics. These same dietary characteristics also re-
s u l t e d in excess weight. These second-generation japanese Americans
ate a meatier diet with less plant-based food than men born in japan.
The researchers wrote, "Apparently, the eating habits of japanese men
living in the United States resemble more the American eating style
than the japanese." The consequence: four times as much incidence of
diabetes, 10
Some other studies:
• Researchers found that increased fat intake was associated with an
increased rate of Type 2 diabetes among 1,300 people in the San
Luis valley in Colorado, They said, "The findings support the hy-
p o t h e s i s that high-fat, low-carbohydrate diets are associated with
the onset of non-insulin-dependent [Type 2] diabetes mellitus in
humans." 11
• In the past twenty-five years, the rate at which children in japan
contract Type 2 diabetes has more than tripled, Researchers note
that consumption of animal protein and animal fat has drastically
increased in the past fifty years. Researchers say that this dietary

DIABETES                              151
shift, along with low exercise levels, might be to blame for this
explosion of diabetes. 12
• In England and Wales the rate of diabetes markedly dropped from
1940 to 1950, largely during World War II when food consump-
t i o n patterns changed markedly. During the war and its aftermath,
fiber and grain intake went up and fat intake went down. People
ate "lower" on the food chain because of national necessity. Around
1950, though, people gave up the grain-based diets and returned
to eating more fat , more sugar and less fiber. Sure enough, diabetes
rates started going Up.13
• Researchers studied 36,000 women in Iowa for six years. All were
free of diabetes at the start of the study, but more than 1,100 cases
of diabetes developed after six years. The women who were least
likely to get diabetes were those that ate the most whole grains and
fiber14-those whose diets contained the most carbohydrates (the
complex kind found in whole foods).
All of these findings support the idea that both across and within
populations, high-fiber, whole, plant-based foods protect against diabe-
tes, and high-fat, high-protein, animal-based foods promote diabetes.
CURING THE INCURABLE
All of the research cited above was observational and an observed as-
sociation, even if frequently seen, may only be an incidental association
that masks the real cause-effect relationship of environment (including
diet) and disease. There is, however, also research of the "controlled"
or intervention variety. This involves changing the diets of people who
already have either full-blown Type 1 or Type 2 diabetes or mild diabetic
symptoms (impaired glucose tolerance) .
James Anderson, M.D., is one of the most prominent scientists study-
i n g diet and diabetes today, garnering dramatic results using dietary
means alone. One of his studies examined the effects of a high-fiber,
high-carbohydrate, low-fat diet on twenty-five Type 1 diabetics and
twenty-five Type 2 diabetics in a hospital settingY None of his fifty
patients were overweight and all of them were taking insulin shots to
control their blood sugar levels.
His experimental diet consisted mostly of whole plant foods and the
equivalent of only a cold cut or two of meat a day. He put his patients on
the conservative, American-style diet recommended by the American

THE CHINA STUDY
152
Diabetes Association for one week and then switched them over to the
experimental "veggie" diet for three weeks. He measured their blood
sugar levels, cholesterol levels, weight and medication requirements.
The results were impressive.
Type 1 diabetics cannot produce insulin. It is difficult to imagine
any dietary change that might aid their predicament. But after just
three weeks, the Type 1 diabetic patients were able to lower their insulin
medication by an average of 40%1 Their blood sugar profiles improved
dramatically. Just as importantly, their cholesterol levels dropped by 30%PS
Remember, one of the dangers of being diabetic is the secondary out-
comes , heart disease and stroke. Lowering risk factors for those second-
ary outcomes by improving the cholesterol profile is almost as impor-
t a n t as treating high blood sugar.
Type 2 diabetics, unlike Type 1, are more "treatable" because they
haven't incurred such extensive damage to their pancreas. So when An-
derson 's Type 2 patients ate the high-fiber, low-fat diet, the results were
even more impressive. Of the twenty-five Type 2 patients, twenty-four
were able to discontinue their insulin medication! Let me say that again.
All but one person were able to discontinue their insulin medication in a mat-
ter of weeksPS
One man had a twenty-one-year history of diabetes and was taking
thirty-five units of insulin a day. After three weeks of intensive dietary
treatment, his insulin dosage dropped to eight units a day. After eight
weeks at home, his need for insulin shots vanished.15 Chart 7.2 shows
a sample of patients and how eating a plant-based diet lowered their
insulin medications. This is a huge effect.
In another study of fourteen lean diabetic patients, Anderson found
that diet alone could lower total cholesterol levels by 32% in just over
two weeks.16 Some of the results are shown in Chart 7.3.
These benefits, representing a decrease in blood cholesterol from 206
mgldL to 141 mgldL, are astounding-especially considering the speed
with which they appear. Dr. Anderson also found no evidence that this
cholesterol decrease was temporary as long as people continued on the
diet; it remained low for four years Y
Another group of scientists at the Pritikin Center achieved equally
spectacular results by prescribing a low-fat, plant-based diet and exer-
cise to a group of diabetic patients. Of forty patients on medication at the
start of the program, thirty-four were able to discontinue all medication
after only twenty-six days .IS This research group also demonstrated that