Some of you may have read my previous blog post about how I came to embrace a whole-food, plant-based diet and the effects it had on my personal health and my approach to the prevention and treatment of chronic disease in my practice. As I have incorporated plant-based eating as the cornerstone of my therapeutic arsenal, many of my patients have experienced the same near-miraculous results. Take for example “Bob.”
Bob was a longstanding patient of mine who was overweight. In February of this year, he presented with blurry vision, increased thirst, and frequent urination, all classic signs of diabetes. His initial bloodwork showed a fasting blood sugar (FBS) of 442 and a hemoglobin A1c (a measure of the average blood sugar over the last 3 months) of 9.8%.
|American Diabetes Association
Reference Ranges for fasting blood sugar (FBS) and hemoglobin A1c1
|FBS: Normal = < 100; pre-diabetes = 100 to 125; diabetes = >125.|
|A1c: Normal = < 5.7%; pre-diabetes = 5.7 to 6.4%; diabetes = > 6.4%.|
|The ADA defines control of diabetes as an A1c < 7%.|
Bob and I had a long discussion about the fundamental importance of a whole-food, plant-based diet and exercise in the reversal of diabetes. I then had him watch Forks Over Knives and read Neal Barnard’s book Reversing Diabetes.
When Bob returned just three months later, I was frankly shocked at his results! His weight had dropped from 275 to 205 pounds, his FBS had plummeted from 440 to 80, and most astounding, his A1c went from 9.9 to 5.3!
To put the significance of that change into perspective, standard lifestyle changes (restricting calories but still including animal foods2) has been shown to reduce A1c by only one to two percentage points. Metformin (a standard medication used as initial therapy) can reduce A1c by another one to two percentage points. And adding other medications can gain another drop of 0.5 to 3.5 percentage points (insulin providing the greatest reduction, at 1.5 to 3.5 percentage points3). Bob had attained better blood sugar results with a plant-based diet and exercise than he would have with a combination of two or three medications (including insulin!) And he not only “controlled” his diabetes ― he had outright cured it! To top it all off, he had significantly reduced his blood pressure and cholesterol readings, as well.
I think this is a perfect example of why the standard of care for treatment of diabetes and most other chronic diseases is fundamentally flawed. By taking a reductionist approach, we expose patients to the cost and side effects of drugs and oftentimes leave them with residual risk. We pat ourselves on the back when a patient’s diabetes is “controlled” (i.e., their A1c reads < 7%), even though they are on two or three medications, they still have diabetes, and they are still at risk for the complications of diabetes, such as heart disease, stroke, and nerve damage.
This treatment approach is what I was taught in med school and what my patients learn from the media, particularly TV ads. But the most powerful medication we have available to us to prevent, treat, and sometimes reverse many chronic diseases is NOT the medication from your doctor; it is the food you put in your mouth.
1 “Diagnosis and Classification of Diabetes Mellitus.” Diabetes Care (American Diabetes Association). 33 Suppl 1 (Supplement_1): S62–9. January 2010.
3 Nathan DM, Buse JB, Davidson MB, et al. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32:193-203.