Day 033 - 10 Oct 94 - Page 40
1 the break, increase the likelihood -- well, they increase
2 body weight, in general, and increase the likelihood of
3 frank obesity.
4
5 So, the causal link between a high fat diet and adult
6 onset or non-insulin-dependent or type 2 diabetes can be
7 mediated by the chain of a high fat diet causing obesity
8 which, in turn, greatly increases the risk of diabetes.
9 However, that is probably not the only causal chain
10 because it is known that when fat is removed from the
11 diet, even when calories are kept in a research setting,
12 kept absolutely equal, the diabetes tends to get under
13 better control.
14
15 In other words, the diabetic who is injecting insulin
16 every day to make up for the failure of their own insulin
17 to act fully, when fat is reduced from their diet, their
18 control improves, suggesting that it may not be obesity
19 alone that mediates between a high fat diet and the cause
20 of diabetes. In addition, a substantial amount of
21 evidence comes from vegetarians who have a very low
22 exposure to animal fat and a typically lower exposure to
23 fat in general.
24
25 7th day Adventists have provided a useful research
26 population for this because Adventists are an homogenous
27 population with regards to tobacco use, alcohol use and
28 other lifestyle factors. However, only about half of
29 Adventists are vegetarian and the other half of Adventists
30 tend to have a low meat, rather low fat diet, but are not
31 vegetarians.
32
33 If one looks at the rates of diabetes amongst the
34 vegetarian Adventists, they are substantially lower than
35 those of the Adventists who are not vegetarian.
36
37 If one then excludes in research studies (as has been
38 done) all of those who have diabetes at the outset and
39 simply tracks all the rest of them, all the rest of the
40 individuals who are non-diabetic at the outset of a study,
41 those who have adopted a vegetarian diet and stick to it
42 are less likely to develop diabetes later in life. So,
43 there is something about the non-vegetarian diet that is
44 linked to the risk of diabetes later and certainly to the
45 risk of dying of diabetes.
46
47 Now, the figures that I presented in my paper are actually
48 more modest than the true associations, because the
49 figures are adjusted for body weight when, in fact, body
50 weight actually encourages diabetes. So, when the figures
51 are adjusted for body weight, it appears that the links
52 are absolutely less than they are; nonetheless, they are
53 significant.
54
55 When the researchers have taken groups of subjects with
56 adult on-set diabetes and have reduced their fat intake,
57 this is usually done in concert with exercise. So, it is
58 not a pure dietary trial, and I think both are important.
59 However, their requirements for either oral medications or
60 for insulin tend to reduce, and also in a number of
