Contents:

• Executive summary
• What is diabetes?
• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes
• Metabolic syndrome
• Pre-diabetes
• Common health complications
• Why do people become diabetic?
• Genetics
• Lifestyle and environmental factors
• Life with diabetes
• Classical approach to treatment
• Medication
• Type 1 diabetes
• Type 2 diabetes
• Diet
• How well does it work?
• The D-Diet
• Basic principles of the D-Diet
• Why and how it works
• The D-Diet nutrition basics
• Conclusion
• References

Why and how it works

What we eat has an enormous effect on our metabolism. As we have shown, the accumulation of fat in body cells can seriously damage our health and trigger a whole range of other problems. The D-Diet – a plant-based, wholesome and low-fat diet – works on many levels and for both types of diabetes.

This is why:

1) It eliminates intramyocellular lipids and thus improves cell metabolism, enabling mitochondria to work properly by removing the fatty obstacles which stand in the way of
insulin sensitivity.

A study comparing intramyocellular lipids in muscle cells of vegans and non-vegans, matched for age and body weight, revealed that vegans had 31 per cent less fat in their muscles (Goff et al., 2005). Another study of morbidly obese people who had to undergo gastric bypass
surgery (Greco et al., 2002) – which reduced the size of their stomach and shortened the length of intestine available for the absorption of nutrients – showed that the drastic weight-loss that followed had a striking effect on their cells. After the first six months, their intramyocellular lipid levels dropped by 87 per cent and their insulin resistance had largely disappeared.

Obviously, we do not recommend taking such extreme measures but these findings
illustrate an important point: insulin resistance is reversible.

As a part of the same study, researchers tested whether a low-calorie diet can also deplete intramyocellular lipids. They found that although weight loss was slower, the effects were equally significant. Nevertheless, the diet focused only on restriction of calories, not on types of food eaten. As other studies have shown, plant-based, low-fat and low GI diets can produce better results in terms of intracellular fat elimination (Barnard, 2007) and improved insulin sensitivity (Lovejoy et al., 1998).

2) When refined carbohydrates and fats are avoided and animal products are eliminated from the diet, the risk of heart and circulation-related problems (high blood pressure, raised
cholesterol and triglycerides and atherosclerosis) plummets. There is no cholesterol in plant foods. A recent review of studies (Ferdowsian and Barnard, 2009) on vegetarian and vegan diets concluded that a plant-based diet, including nuts, soya and soluble fibre, can reduce LDL (bad) cholesterol by 25-30 per cent – a figure comparable to the effects of statin drugs.

3) The kidneys can cope with plant protein much more easily than animal protein. By  switching to a vegan diet, the kidneys are less stressed. Research has shown that among people with any degree of kidney damage, consumption of animal protein increases the risk of further kidney deterioration (Knight et al., 2003), while a vegan diet has a protective effect
(Kontessis et al., 1990; Soroka et al., 1998). Anderson et al. (2004) also suggested that
substituting soya protein for animal protein significantly reduces renal hyperfiltration, a
condition that may develop into diabetic nephropathy (kidney disease).

4) Many diabetes-associated complications are caused by damage to blood vessels of all sizes by poor blood sugar control (resulting in high glucose levels) and by raised cholesterol levels, which can harm artery walls. A diet based on starchy, high-fibre foods can protect blood vessels by reducing excess cholesterol, and enables the body to digest carbohydrates
gradually, therefore preventing peaks in blood glucose levels (Chandalia et al., 2000). This is
extremely important especially for the eyes, kidneys and the heart itself because these organs tend to suffer most as the result of diabetes. An investigation into the links between nutrition and retinopathy in diabetics (Roy et al., 1989) found that patients without retinopathy had a significantly higher daily intake of carbohydrates and fibre, and a lower intake of protein, than diabetics with retinopathy.

5) The D-Diet also induces the desired effect of weight loss without portion restriction, ensuring that those who follow it need never feel hungry. This is of particular importance as
too many dietary restrictions, limitations and a lack of positive results have the potential to
induce depression in many diabetics (Diabetes UK, 2010b). An increased intake of fibre
slightly decreases the intake of calories. It was suggested that every 14 grams of fibre reduce
the calorie intake by approximately 10 per cent (Howarth et al., 2001).