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

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