Wednesday, July 17, 2024

The Reverse Diabetes Diet by Dr. Neal Barnard

James O’Donovan summarises the main points from the book by the well-known author and founder of the Physicians Committee for Resonsible Medicine.

This article should obviously not be taken as medical advice and you should undertake any changes in your diet in consultation with your doctor.  But if you are interested in educating yourself in order to take responsibility for living a healthy life then read on.

Information from Diabetes Ireland:

There are two main categories of diabetes: Type 1 diabetes tends to occur in childhood or early adult life, and always requires treatment with insulin injections. It is caused by the body’s own immune system destroying the insulin-making cells (beta-cells) of the pancreas.  Type 2 diabetes usually develops slowly in adulthood. It can be progressive but can be treated with diet and exercise, but typically it is treated with medications and/or insulin injections along with diet and lifestyle advice.  About 40% of people diagnosed with diabetes end up being treated with insulin injections.

You are more at risk of getting Type 2 diabetes if you are:

  • Over 40 years of age
  • Have a parent or brother/sister with diabetes
  • Had diabetes during a pregnancy
  • Are overweight for your height
  • Do not take 30 minutes of physical activity daily
  • Have high blood pressure
  • Have high cholesterol

And/or recognise any of these symptoms:

  • Blurred vision
  • Fatigue, lack of energy
  • Extreme thirst
  • Frequent trips to the bathroom (urination) especially at night
  • Rapid and unexplained weight gain or loss
  • Frequent infections
  • Numbness, pain or tingling in your hands or feet

The more risk factors or symptoms that you have the more likely you are to have diabetes or pre-diabetes.  Diabetes causes damage to small and large blood vessels that can lead to retinopathy, blindness, heart disease, kidney disease, amputation, and early death.

225,840 people are estimated to be living with diabetes in Ireland. People with type 1 diabetes account for approximately 14,000 – 16,000.  A further 350,000 people are estimated to be pre-diabetic.  The cost of treating diabetes in Ireland is about 10% of the national health budget, which is a very substantial economic burden.

The Diabetes Ireland website provide the following dietary recommendations:

  • Eat regular meals.
  • Include a starchy carbohydrate food such as bread, cereal, potato, rice or pasta at each meal.
  • Limit your intake of sweet and sugary foods.
  • Reduce your total fat intake and choose more mono-unsaturated fats.
  • Eat fruit and vegetables regularly, aim for a minimum of 5 portions of a mix of fruit and vegetables every day.
  • Eat oily fish twice a week.
  • Avoid adding salt to food and cut down on processed foods.
  • Don’t exceed the recommended alcohol consumption levels.

For a long time diabetes was considered a progressive disease but recent studies have shown that the condition can be reversed.  The Diabetes Prevention Program Outcomes Study showed that Type 2 diabetes in the group with lifestyle changes was reduced by 34% compared with the control group.  The Finnish Diabetes Study was more intensive with participants offered intensive lifestyle support (dietary intake, physical activity, smoking and alcohol intake) and showed that they could reduce Type 2 diabetes by 80%.

‘The Reverse Diabetes Diet’ by Dr Neal Barnard

This book provides a thorough scientific explanation of the causes, symptoms, and treatment of diabetes.  The book recommends a Whole Food Plant Based (WFPB) diet, which has been shown to cut blood sugar levels, increase insulin sensitivity, and reduce or eliminate medications.


The book highlights dozens of different research studies clarifying how a WFPB diet reverses diabetes and its symptoms including heart disease.  A 2003 research trial at the George Washington University and the University of Toronto compared a WFPB diet with the diet recommended by the American Diabetic Association (similar to the diet recommended by Diabetes Ireland).   In a careful analysis that kept exercise and medication use constant, it was found that a WFPB diet controls blood sugar three times more effectively than the above best practice diet.  It also accelerates weight loss, controls cholesterol, and leads to a drop in blood pressure.

What Causes Diabetes

Glucose is the basic fuel that drives our cells and our body’s activity and it is essential for life.  The fundamental problem of diabetes is that the glucose is not able to pass from your bloodstream into your cells.  Since your cells are not getting the fuel they need you experience fatigue.  There is also increased urination as the body tries to get rid of the excess sugar in the blood.  High levels of glucose in the blood can damage the heart, and the delicate blood vessels of the eyes, kidneys, and extremities.

Insulin is a hormone produced in the pancreas.  It acts like a key opening a door in the cell wall that allows the glucose to enter the cell and fuel the cell’s activities.  If your pancreas is not producing insulin or if when the key goes in the lock the door does not open that results in high blood glucose levels.

Insulin functions by attaching to a receptor on the cell’s surface, which signals the cell membrane to allow glucose to enter.  However, if muscle cell fat, called intramyocellular lipid, accumulates inside the cell it interferes with insulin’s signalling process.  It’s like if the lock on a door became gummed up with chewing gum then the door can’t open.  Fortunately, a number of studies have shown that diet can clean out our biological cellular locks so that the insulin keys can start working again.

Usually, tiny organelles called mitochondria are supposed to burn the fat stored in our cells.  When people are on a high fat diet, fat builds up in the muscle cells but also it seems the number of mitochondria that burn up fat are reduced.  Historically, this could have been advantageous in environments where fatty foods are hard to come by but in our current environment it is problematic.  It has been shown that when people adopt a low fat diet the fat in their cells drops and their insulin resistance disappears.  In a study at the Imperial College School of Medicine in London they measured the intramyocellular fat in people following a WFPB diet and an omnivore diet.  The vegans were found to have 31% lower intracellular fat than the omnivores.  A WFPB diet prevents fat building up in our cells.

Most dietary recommendations focus on limiting the sugary foods that you take in and regulating the times and quantities of the carbohydrates that you do eat.  They also tend to cut calories to get you to lose weight and to limit certain fats to reduce the risk of cardio-vascular disease.  However, since chicken, fish, eggs and dairy products are all high in fat then when people follow this diet the improvements are often not substantial.  Consequently most Irish people end up taking medications and 40% of people end up requiring insulin injections.

The WFPB diet works on two levels.  First, the goal is to remove the gum out of the locks enabling the insulin key to fulfil its signalling function.  The second goal is to help protect your body from the disease process allowing the heart and blood vessels the best chance of recovering (explained in the final three chapters).


The reverse diabetes diet therefore recommends:

  • Choose food from plant sources – this reduces fat intake, increases plant protein, increases fibre, and increases thousands of health enhancing phytonutrients; grains (8 servings per day(s/d)), pulses (3 s/d), vegetables (4 or more s/d), and fruits (3 or more s/d).
  • Set aside all animal products – this reduces fats (particularly trans and saturated fats) and eliminates intake of cholesterol and animal protein, which can reduce kidney functioning and cause bone calcium losses.
  • Keep vegetable oils to a minimum – reduce fats to approx. 10% of calorific intake.
  • Choose whole grain products (low glycaemic index ) – avoid sugar and white flour.
  • Avoid added salt, instead flavouring with health enhancing spices.
  • A daily multi vitamin is a convenient source of vitamins B12 and D.

There are no limits on portions, calories, or carbohydrates.  The diet should be supported by a healthy lifestyle which includes no smoking, exercise that you enjoy (aerobic, strengthening, and stretching), stress management (yoga, meditation, or even simple breathing exercises), and psycho-social support (a group of friends that you are close to physically and not virtually).

The book also provides detailed information on starting a WFPB diet, weight loss, an enjoyable exercise routine and healthy plant based recipes for seven days and is highly recommended.  The book is available at good bookstores and online.  You can also try the PCRM 21 day Vegan Kick Start program for free on the website.


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