Day 033 - 10 Oct 94 - Page 41


     
     1        studies neuropathy, meaning the nerve side effects,
     2        painful nerves and numbness in the nerves, tend to remit
     3        in most subjects.  In a number of subjects the diabetes,
     4        frankly, disappears when the diet is changed.
     5
     6        So, to summarise, there does seem to be an indisputable
     7        link between a high fat diet and diabetes.  The link is of
     8        a causal nature because the high fat diet clearly
     9        encourages obesity.  It is not a controversial point and
    10        well-supported in literature.  Obesity in turn increases
    11        the risk of diabetes.  Again not a controversial point and
    12        it is well-supported.
    13
    14        However, there is a also a body of evidence suggesting
    15        that fat intake alone can also aggravate diabetes and
    16        probably make its onset more likely.  The reputed
    17        mechanism for this is that fat impairs the action of
    18        insulin.  What we call insulin resistance.  The tissues of
    19        the body need insulin to escort glucose from the
    20        bloodstream into the cells.  Insulin is the doorman, if
    21        you will, allowing the sugar glucose to pass from the
    22        bloodstream through the membrane into the cell.  Without
    23        glucose (sic) certain tissues of the body cannot get --
    24        glucose cannot enter.
    25
    26        A high fat diet appears to aggravate insulin resistance
    27        meaning that in the face of a high fat diet insulin simply
    28        cannot do its job effectively.
    29
    30   Q.   On page 15 you refer to the international comparisons?
    31        A.  Yes.
    32
    33   Q.   Do you want to say something about that?
    34        A.  As I say in my statement, rather like the research
    35        done on cancer, researchers have looked at the prevalence
    36        of diabetes across different populations.  There are many
    37        more studies than I have done there, than I have mentioned
    38        here, but a high intake of fat, particularly animal fat
    39        but total fat, correlates with a high prevalence of
    40        diabetes.
    41
    42        This has also been demonstrated in cultures of native
    43        Americans.  American Indians who, historically, had a
    44        very, very low incidence of diabetes, when their diet,
    45        dietary fat as well as a diet of high in sugar, when that
    46        sort of diet became prevalent, their incidence of diabetes
    47        or, I should say, prevalence of diabetes, rather,
    48        increased quite dramatically.
    49
    50        There is also a role for fibre separate from the role of 
    51        fat but also, quite important.  Many studies, and I have 
    52        only cited a few, perhaps one of them here, but there are 
    53        many, many, many of these, showing that high fibre diets
    54        can improve glucose metabolism making diabetes more
    55        manageable, such that even a person with a genetic
    56        predisposition towards developing diabetes, if their diet
    57        is low in fat and is high in fibre, it maybe that that
    58        diabetes will never manifest itself.  This is, by the way,
    59        true whether it is fibre actually used in foods such as
    60        beans or in fibre as an additive in either case.

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