Diabetes causes and refined carbohydrates- The vegan argument

Most people have a belief that refined carbs like white rice are terrible and that refined carbohydrates are associated with insulin spikes and are one of the diabetes causes. They are right.

However, they are wrong at the same time. We will have to look at the entire picture of refined carbohydrates and diabetes.

When rice or grain is refined, the bran is removed. Consumers like nice and soft bread or rice without fiber that can stick between our teeth and taste bad. However, because fiber slows down digestion and absorbs water the carbs in rice without it gets absorbed more rapidly and create an unnatural insulin spike causing an unnatural reaction in our body which by compensation adapts by downregulation of insulin receptors. That is causing insulin resistance and is one of many factors that people with diabetes have to cut out of their diet.

Another factor is intercellular fat which blocks insulin receptor signaling. So refined carbs and sugars cause fast digestion of large and unnatural quantities of calories. Because we have absorption of sugar at a fast rate, we do not burn all of the calories because there are too many in the bloodstream, and some will end up stored as fat. What is worse, as soon as digestion is over, and all the sugars are out of the blood we will start to feel hungry again. Thus lack of fiber is correlated with constant binge eating which then causes obesity and insulin receptors downregulation. Then obesity independently causes all the bad stuff I already wrote about before, and the loop is finished. One small intervention like I do not like sticking bran in my teeth can cause a cascade of effects. A big chunk of the medical community finds that carbs are the cause of all evil and all diseases that we have today. This is the basis of reasoning for diets like the Paleo and Atkins diet. There is no bad logic here. So far.

The industry can sell protein powders and supplements and all the meat they can, especially if the meat is lean. Good old chicken breast and maybe some with healthy fats like tuna. Many people with diabetes that start to adopt this kind of diet may worsen their condition. For example, the modern diabetes epidemic in China and Japan has been linked to white rice consumption which is another half-truth. Consequently, that is why The China Study irritates people.

Rice currently feeds almost half of the world population but how can we settle much lower diabetes rates than just a few decades ago when they ate even more rice? In this study for example (Hu et al., 2012) higher consumption of white rice was correlated with a  significantly heightened chance of type 2 diabetes, particularly in Asian (Chinese and Japanese) populations. Also, this is not a small study, with 352,384 participants with follow-up periods ranging from 4 to 22 years. If we analyze this statistically by total population numbers, the dose-response meta-analysis showed that for every meal per day addition of white rice intake, the relative risk of type 2 diabetes was 1.11 meaning an 11% increase in risk. Today China has the same diabetes rate of around 10% as the US which has around 11% despite the seven times less obesity. White rice does not appear to be correlated with obesity and heart attacks and strokes, just diabetes.

However, again if we look at The China Study rural plant-based diets centered around rice were associated with a low risk of diabetes and cancer, and heart disease. This 10% of diabetes prevalence just happened. In the year 2000, China had one of the lowest diabetes rates in the world. This is a dramatic shift that happened in just 20 years.

So what happened?

Well, the same thing happens in every country when the standard of living goes up. Meat consumption went up by an astonishing 40 percent, and rice consumption went down by 30 percent. And now we have a problem.  If meat consumption goes up, rice consumption goes down, and diabetes risk goes up, and at the same time, rice consumption independently is correlated with diabetes risk, what is going on? Is it just rice?

Should we eat a more paleo type of diet and cut all the rice? That is what they tell us. Refined carbohydrates are correlated with diabetes and obesity. The answer is simple. What happens is that animal protein is making the rice much worse. This is one study you should go and read (Gulliford et al., 1989). The date of publication was Oct 1989.

Real “new” medical breakthrough. Six noninsulin-dependent diabetic subjects had received meals containing 25 g carbohydrates either as potato or as spaghetti. That is the same meal as white rice. Pure white flour pasta and starch-rich low fiber potato. Then insulin response was measured, and the meals were duplicated including the bonus of 25 g of protein and another one including 25 g of fat. The level of sugar in the blood and insulin responses were measured for 4h after the test meal. The addition of protein increased insulin responses dramatically. This is a “cutting-edge” science to give someone sugar and protein and measure the insulin response.

So there it is. The answer. It is the holy grail of nutrition.

The Protein.

If we look at the chart, we would see that the addition of protein makes potatoes exactly two times worse. From 150 to 300.

We can do it with sugar water too. From 50 to 100. The more meat we add, the worse it gets. When we get to 50 g of protein, we will elicit a surge of insulin that is seriously unnatural and disease-causing. Animal protein significantly potentiates insulin secretion triggered by carbohydrate ingestion. And all along we had been told that diabetes causes are white rice and white flour and sugar. And that is correct partially. The real truth is more complicated. Diabetes causes prime factor is maladaptation to our new diet.

Fiber will lower insulin response like whole wheat pasta but not at the level of 100 percent. Adding meat to any starch is problematic. This combination is unnatural. It is much worse, almost two times worse for insulin response to eat roasted chicken breast with whole wheat bread than the same portion of regular white flour-like Pomodoro pasta with or without oil.

Think about it this way. Does any other animal have regular lunch that consists of different food items?

Carnivores eat only meat. Plant eaters eat only plants. What about omnivores? Do we think that bear is going to catch a fish and then don’t eat it for some period until there is lunchtime so that he can bring that fish to the beehive in order to have dessert afterward?

Even combining different food items at the same meal is 100% unnatural and a modern human invention. And this surge of insulin is maladaptation.

I would ask this. Can we eat just meat without bread? Would we enjoy greasy sausages just by themselves? Would we enjoy just meat from burgers without the buns? It is a mixture of fat and carbohydrates (sugar) that abnormally triggers dopamine signaling in our brains and many other things like in this case abnormal insulin reaction. Combining this with low fiber intake is a recipe for disaster. Combining different food items is not a natural form of eating, but it is pleasurable so we will have to deal with it in the best way we can.

Type 2 diabetes is treatable to some extent. It is actually pretty simple. If we count out the exercise and losing weight number one would be no animal protein. Number two would be fiber. Meaning a lot of it in every meal. If you have to eat meat and have no other choice, then go ahead and eat meat. Just meat. No bread, rice, or any sugar with it. Sugar means regular sugar or fructose or carbs in any form. No salads no nothing. Maybe some cheese. No milk. Milk has sugar or lactose in it.

If you have to eat a combination of sugars and proteins, then it would be a good idea to add some psyllium husk or regular wheat bran and eat spoons of it after a meal. That will slow down digestion to some degree. Psyllium husk has no calories; it is 100 percent fiber. We can use it for diets if we want to bulk up meals in the stomach to give us more saturation but it tastes like cardboard that is liquid.

Number three would be resistant starch meaning beans. If we eat sausages with lots of bread and lots of alcohol we are probably done deal if we have diabetes in the family. When we see the numbers that 1 in 10 people have diabetes, it is an understatement. The actual number is 1 in 3 people in developed countries; just they might not know it because they do not have visible symptoms and insulin resistance is in the range that is known as pre-diabetes. Pre-diabetes is a disease just by itself and would also cause in the long run some adverse effects. It escalates to full-blown diabetes in 1 in 10 cases. CDC estimates that these numbers will still grow primarily on a global scale as the industrialization of the undeveloped regions of the world is taking place. If you have pre-diabetes, the long-term damage, especially to your heart, blood vessels, and kidneys, may already be starting.

References:

1. Hu, E. A., Pan, A., Malik, V., & Sun, Q. (2012). White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ (Clinical research ed.), 344, e1454. https://doi.org/10.1136/bmj.e1454
2. Gulliford, M. C., Bicknell, E. J., & Scarpello, J. H. (1989). Differential effect of protein and fat ingestion on blood glucose responses to high- and low-glycemic-index carbohydrates in noninsulin-dependent diabetic subjects. The American journal of clinical nutrition, 50(4), 773–777. https://doi.org/10.1093/ajcn/50.4.773