"Plant-Based Diets Recognized by Diabetes Associations"
Dr. Kim Williams, immediate past president
of the American College of Cardiology,
started out an editorial on plant-based diets
with the classic Schopenhauer quote
that “All truth passes through three stages.
First, it is ridiculed.
Second, it is violently opposed.
Third, it is accepted as…” like duh, of course.
In 2013, plant-based diets for diabetes were in the ridiculed stage
in the official endocrinology practice guidelines,
placed in the “fad diets” section.
They acknowledge strictly plant-based diets have been shown to reduce the risk
for type 2 diabetes and improve management of diabetes
better than the American Diabetes Association recommendations,
but then inexplicably go on to say that the evidence
“does not support the use of one type of diet over another,”
with respect to diabetes or in general.
The best approach for a healthy lifestyle is simply
the “amelioration of unhealthy choices,”
whatever the heck that means.
But by 2015, the clinical practice guidelines
from the same professional associations explicitly endorsed
as their general recommendation for diabetic patients:
a plant-based diet.
Times they are a-changin’.
The American Diabetes Association itself is also now on board,
listing it as one of the dietary patterns acceptable
for the management of the condition,
but the Canadian Diabetes Association has really taken the lead.
“Type 2 diabetes…is considered one of the fastest growing
diseases in Canada, representing a serious public health concern;”
so, they’re not messin’ around, recommending plant-based diets
for disease management because of their potential
to improve body weight and blood sugar control,
as well as heart disease risk, in addition to reducing
the need for diabetes medications.
They use the Kaiser Permanente definition:
a regimen that encourages whole, plant-based foods
and discourages meats, dairy…,
and eggs, as well as all refined and processed junk.
They recommend diabetes education centers in Canada
improve patients’ perceptions of plant-based diets by developing
educational materials and providing individualized counseling sessions
to address what barriers people have to eating plant-based.
The biggest barrier identified was ignorance.
Nearly 9 out of 10 patients interviewed had never even heard
of using a plant-based diet to treat diabetes.
Why is that?
Maybe patient awareness of the benefits are being
“influenced by the perception of the diabetes educators and clinicians.”
See, most of the staff were aware,
yet only about 1 in 3 were currently recommending it.
Why not?
One of the common reasons given
was that they didn’t think their patients would do it,
so they didn’t even bring it up.
But “this notion is contrary to the patient survey results”
they cite in which most patients said
they would be willing to at least give it a try.
The researchers cite the PCRM Geico studies I did videos about,
in which strictly plant-based diets were well accepted
with an over 95% adherence rate, presumably because they just felt
so much better—increased energy, better digestion, better sleep, and satisfaction.
A number of staff members also expressed their second reason
for not recommending this diet:
not being clear about the supportive scientific evidence.
But it’s been shown to be more effective
than an American Diabetes Association-recommended diet
at reducing the use of diabetes medication,
long-term blood sugar control, and cholesterol.
It’s therefore possible that the diabetes educators
were simply behind the times, as there’s a lag-time in dissemination
of new scientific findings from the literature,
to the clinician, and finally to the patient.
That’s one of the reasons I started NutritionFacts.org—
to speed up the process!
As Dr. Williams put it, the evidence for the benefits
of plant-based nutrition continues to mount.
This now includes lower rates of stroke, hypertension, diabetes,
obesity, heart attacks, and cardiac death, as well as many non-cardiac issues
that affect our patients in cardiology,
ranging from cancer to a variety of inflammatory conditions.
The science we got.
The bigger challenge is overcoming the “inertia, culture, habit,
and widespread marketing of unhealthy foods.”
He concludes: “Reading the existing [scientific] literature
and evaluating the impact of plant-based nutrition,
it clearly represents the single most important yet underutilized opportunity
to reverse the pending obesity and diabetes-induced
epidemic of disease and [death].”