Every minute, three people in the U.S. are diagnosed with diabetes. Unknown in traditional cultures but an increasingly serious epidemic in the modern world, diabetes affects more than 25 million people in the U.S. alone, with 79 million more who are pre-diabetic or have other diabetes-related metabolic conditions. Unsurprisingly, behind the barrage of dire statistics lurk the usual culprits for “diseases of civilization:” the poor diet, environmental toxins, and sedentary habits of the modern world – and a mainstream medical establishment too tied up in conventional wisdom to face the problem effectively. Diabetes is a disease caused by a modern lifestyle that your body simply wasn’t designed for. Paleo offers an alternative: a lifestyle that supports your body, rather than poisoning it, allowing you avoid the triggers of diabetes, or effectively control the symptoms if you already have it.
Diabetes: The Basics
Diabetes is essentially an inability of the body to regulate insulin, a hormone produced by the pancreas to metabolize glucose. The disease has three forms: Type 1Diabetes (T1D), Type 2 Diabetes (T2D), and Gestational Diabetes. Type 1 diabetics simply cannot produce insulin, due to an autoimmune response in the pancreas. Type 2 diabetics have a different problem: their pancreas produces too much insulin, causing an inflammatory condition known as insulin resistance. Gestational diabetes is a temporary condition similar to T2D in a pregnant woman, usually triggered around the 24th week.
All three types of diabetes do have some basis in genetics, but genes can’t account for the whole story. Even if you carry a gene linked to diabetes, certain environmental factors have to be present to trigger the expression of the gene. Similarly, pregnancy can naturally cause a temporary state of insulin resistance in the mother, but this brief insulin resistance doesn’t inevitably develop into full-blown diabetes. This is where the modern diet and lifestyle come in. The dietary toxins, environmental pollutants, and sedentary lifestyle of the modern world trigger the expression of the diabetes genes, causing the disease to rear its ugly head.
Diabetes and the Modern Lifestyle
The most obvious culprit for diabetes is the modern diet. Insulin regulation is one of the physiological processes most deranged by a modern diet based heavily on sugar and carbohydrates. When you eat any kind of carbohydrate, your body converts it into glucose. Your bloodstream can’t handle too much glucose at once, so beta cells in your pancreas respond by producing the hormone insulin, which lets the glucose into your muscles. Your muscles store the glucose as glycogen, which they can then use as fuel. This saves your bloodstream from an overload of glucose, and gives your muscles a ready supply of fuel – or at least, that’s what’s supposed to happen. The modern diet and lifestyle derail this system with a one-two punch: too many carbs and not enough exercise.
When you don’t exercise, but continue to eat carbohydrates without burning the fuel already in your muscles, the muscle cells get full The insulin receptors in your muscles become fewer and less efficient, fighting back against the insulin that’s trying to force more glucose into them. In response, your pancreas increases production of insulin, trying to signal the muscles to let the glucose in. Your muscles have locked the door, plugged their headphones in, and cranked up the volume, but your pancreas just keeps knocking louder and louder. This creates a positive feedback loop, where your muscles react to the increase in insulin by becoming even more insulin resistant, which triggers the pancreas to produce even more. Meanwhile, the extra glucose is stored as fat instead. Eventually, the cycle creates full-blown insulin resistance: you can no longer metabolize carbohydrates effectively, and you’re on the verge of developing Type 2 Diabetes.
Insulin resistance brought on by too many carbohydrates is just one way that the modern world contributes to diabetes. Exposure to dietary and environmental toxins also triggers another aspect of diabetes: the autoimmune response. Gluten, seed oils, and industrially processed sugar don’t just present your body with more carbs than it can handle; they’re harmful in and of themselves because they provide these toxins with an avenue into your body. These elements in your diet produce inflammation in your gut, and increase the permeability of your intestinal walls, causing a condition known as “leaky gut.” A leaky gut allows all the toxins in your environment a pathway out to the rest of your body, where they cause autoimmune responses, including the autoimmune response in the pancreas that contributes to Type 1 Diabetes. The environmental toxins in our air and water contribute to the same problems – and a leaky gut allows them to range free in your body.
A third characteristic of diabetes is inflammation. As well as the inflammation leading to a leaky gut, diabetes is tied to systemic inflammation at every point in the disease. When insulin resistance forces your body to store glucose in your fat cells instead of your muscles, your fat cells become inflamed from the glucose overload. Meanwhile, the glucose floating around in your bloodstream is causing systemic inflammation. Inflammation itself contributes to insulin resistance, so the cycle of inflammation becomes a positive feedback loop driving your body into an increasingly disordered state.
The modern lifestyle thus contributes to all three types of diabetes: the combination of insulin resistance, autoimmunity, and systemic inflammation can develop into full-blown Type 2 or Gestational Diabetes, or trigger the autoimmune response of Type 1. Diabetes first causes symptoms like frequent urination, extreme hunger or thirst, inexplicable weight loss, tingling or numbness in your hands and feet, intense fatigue, dry skin, and vision changes. Left untreated, it can lead to complications like heart disease, hypertension, kidney disease, blindness, nervous system damage, and dental disease.
Diabetes is also, of course, tied to obesity – so much so that one doctor coined the term “diabesity” to refer to the whole array of metabolic dysfunction and blood sugar imbalances characterizing the modern lifestyle. The insulin resistance in your muscles keeps you in fat storage mode, so you continue to gain weight. Even worse, the same insulin resistance that keeps sugar out of your muscles also blocks amino acids from entering, so you start to loose muscle mass on top of gaining fat. Obesity in turn can contribute to diabetes: if you’re already overweight, you’re less likely to exercise, exacerbating the oversupply of glucose in your bloodstream. But diabetes isn’t restricted to the obese: even lean and healthy-looking individuals can have a damaged metabolism and poor sugar regulation. In fact, diabetes can be even more dangerous for these people, since it might never occur to them as a possible cause of their symptoms.
Diabetes and a Paleo Diet
Diabetes is clearly a pressing health problem. But mainstream medical advice is worse than inadequate: it actually contributes to the problem. Diabetics are commonly obese because excess carbohydrates get stored as fat, not because they eat too much fat, but official guidelines still stuck in a “low-fat” model of healthy diet recommend a “diabetes food pyramid” with carbs at the base – about 60-70% of daily calories. If you want to get diabetes, the diabetes food pyramid is a great way to start.
Rather than adding even more carbs as fuel for the fire of insulin resistance, Paleo nutrition fights diabetes by addressing the heart of the problem: a diet and lifestyle that simply aren’t adapted to your body’s needs. A diet based in fat and protein instead of carbohydrates doesn’t trigger the huge glucose spikes that lead to insulin resistance. A diet without processed frankenfoods and unpronounceable ingredients doesn’t contain the seed oils and other toxins that can set off an autoimmune response. A diet that emphasizes grass-fed meat and organic produce cuts down your exposure to various other toxins in the modern food supply. A diet without gluten and lectins to irritate your system doesn’t cause systemic inflammation or leaky gut. And contrary to popular opinion, red meat doesn’t cause diabetes; neither does a high fat diet. Paleo does look drastically different from the mainstream nutritional guidelines, but considering how badly mainstream nutritional science has failed generations of diabetics, that should be more reassuring than worrying.
As well as eating the right food, the Paleo lifestyle also emphasizes regular physical activity and adequate sleep, both important factors in controlling diabetes. Your body is an integrated system, with every aspect of your life affecting every other one: even if you eat the most optimal diet, sleep deprivation or lack of exercise will still have negative effects.
By encouraging a lifestyle in line with your body’s natural processes, Paleo removes the environmental triggers that bring on and exacerbate diabetes. And it works. On top of countless individual stories, clinical studies have proven Paleo to be very effective at controlling diabetes – even more so than the famous Mediterranean diet. It’s been so successful, in fact, that even mainstream media outlets have taken notice.
Although any variation of Paleo is healthier for a diabetic than following the guidelines in the standard food pyramid, various tweaks to the basic diet can make it even more specifically adapted to controlling diabetes. Some people on Paleo use artificial sweeteners in place of sugar, but while they may not trigger insulin spikes, zero-calorie sweeteners like aspartame can damage your pancreas in other ways and trigger sugar cravings, so diabetics should avoid them anyway. (And for everyone trying to steer clear of sweeteners but confused by tongue-twisting ingredient labels, the Whole9 provides a useful list of all the different names for sugar and artificial sweeteners.)
Diabetics may also find it helpful to limit consumption of fruit, especially dried fruit – it is technically Paleo, but the high amounts of sugar make it less than ideal for anyone with carbohydrate metabolism problems. Dairy triggers a large release of insulin, so you may want to avoid dairy products. Taking a probiotic can help repair the damage to your gut flora. If you suffer from a leaky gut, avoiding nuts, nightshades, and eggs can also help. Since every person’s body has slightly different reactions, the best way to tailor a Paleo diet to your specific needs is to experiment – and if you’re confused by your results or want a second opinion, PaleoHacks is always a good place to ask.
All the dietary tweaking in the world can’t do much good if you don’t have a solid idea of how different foods affect your blood sugar levels. Investing in a glucometer can be helpful whether or not you think you have a blood sugar problem: if you catch unhealthy insulin levels early, treatment is easier and more effective.
Tests administered by your doctor can also be helpful – but with two caveats. First, a “normal” reading doesn’t necessarily mean that you’re home free: even blood sugar levels on the high end of “normal” can predict problems in the future. Double-check your “normal” results to make sure you aren’t heading for trouble down the line. Second, on a low-carb Paleo diet, don’t worry too much about a high result from an oral glucose tolerance test. In an OGTT, you ingest 100 grams of pure glucose, and your doctor measures your insulin response. But 100 grams at once is a lot of glucose even for someone on a carb-heavy modern diet (you’d have to chug an entire liter of coke to get that much sugar). If you’re eating low-carb Paleo, your body is completely unused to handling huge rushes of glucose, so you might react poorly to the test despite having healthy blood sugar levels overall.
Paleo isn’t a magical diabetes cure-all that can take 20 pounds off your stomach and eliminate your insulin resistance overnight. Type 1 is especially difficult to treat, since after a certain point the autoimmune response can permanently damage the pancreas. While some patients do completely eliminate their symptoms, more often a Paleo diet helps control the symptoms of diabetes, reduce your dependence on insulin, and delay or prevent serious side effects. But even when you struggle, you won’t struggle alone – the Paleo community is full of welcoming, knowledgeable people at least one of whom has probably been in your shoes. Diabetes has no quick fix, but you are worth the effort it takes to eliminate modern toxins and eat and move the way your body was designed to.