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Long term diabetes lifestyle intervention trial fails

Posted: Tuesday, Nov 20th, 2012

Dr. Joel Fuhrman
Recently, the National Institutes of Health (NIH) stopped their Look AHEAD trial, which was investigating an “intensive lifestyle intervention program” to reduce the considerable cardiovascular risk associated with type 2 diabetes, compared to traditional diabetes support and education. After 11 years, there was no difference in incidence of cardiovascular events (e.g. heart attack and stroke) between the two groups, prompting the NIH to end the trial.

The major flaw in this study was that the intensive lifestyle intervention was not “intensive” at all. The program encouraged subjects to follow a conventional low-fat diet and exercise three hours per week, with the goal of losing 7 percent of their body weight and maintaining that weight loss. However, the suboptimal 7 percent goal was not even met.

The average weight loss was less than 5 percent. Of course there was no reduction in cardiovascular risk! For a diabetic starting at 200 pounds, that is a weight loss of less than 10 pounds. Why would anyone expect this tiny amount of weight loss to significantly improve someone’s health; especially someone with diabetes – a disease whose primary risk factor is excess weight?2

To meaningfully reduce the serious cardiovascular risks associated with diabetes, diabetics must achieve a healthy weight; losing a few pounds is not enough. Conventional recommendations to reduce fat intake or portion sizes do not bring about meaningful weight loss. Even the study’s authors acknowledged that subjects who lost more weight had greater reductions in cardiovascular risk factors.

If the subjects were coached to reach a healthy weight with a nutritarian diet, rather than just to lose a few pounds, the researchers probably would have seen a dramatic reduction in cardiovascular events.

The goal must be set high – the goal is to reverse diabetes. Now that obesity and diabetes have become epidemic, we cannot set suboptimal goals. The watered-down advice that losing 5-10 percent of one’s body weight will significantly improve health is misleading and dangerous. Cardiovascular disease is the most common cause of death among diabetics – having diabetes more than doubles the risk of heart attack and stroke. More than 11 percent of American adults have type 2 diabetes, and it is the 7th leading cause of death in the U.S.

A slightly lower fat version of the standard American diet cannot complete the demanding task of reversing diabetes. Only radical changes will produce radical results – a radical lifestyle change, to a natural, high-nutrient, vegetable-based (nutritarian) eating style, plus frequent exercise. In a recently published study, my colleagues and I investigated a nutritarian diet-style for treating patients with type 2 diabetes. Within just 7 months, 62 percent of the participants reached normal (nondiabetic) HbA1c levels, triglycerides dropped and the average number of medications dropped from four to one. A nutritarian eating style has tremendous potential to reverse diabetes and ameliorate the associated cardiovascular risk.My results are unequaled in this field. Most of the type 2 diabetics who follow my nutritarian program become non-diabetic.

The choice to make is this: do you want to lose a few pounds, or do you want to get rid of your diabetes? Hundreds of my patients and readers have reversed their diabetes, many losing 100 pounds or more. They now live healthy active lives, and the cardiovascular risk that loomed over them has diminished with the disappearance of their diabetes.

Learn more about reversing diabetes in my new book "The End of Diabetes," available Dec. 20.

Dr. Fuhrman is the #1 New York Times bestselling author of Eat to Live, and a board certified family physician specializing in lifestyle and nutritional medicine. His newest book Super Immunity discusses how to naturally strengthen the immune system against everything from the common cold to cancer. Visit his informative website at DrFuhrman.com. Submit your questions and comments about this column directly to newsquestions@drfuhrman.com.

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