Tackling diabetes with a bold new dietary approach: Neal Barnard at TEDxFremont

Tackling diabetes with a bold new dietary approach: Neal Barnard at TEDxFremont

November 15, 2019 100 By Bertrand Dibbert


Translator: Giedrė Kasparaitytė
Reviewer: Denise RQ Today, I’d like to talk about
turning around an epidemic. One hundred million Americans right now
do have either diabetes or pre-diabetes, and that puts them
at risk for amputations, for heart disease, for blindness. and we’re exporting
this epidemic overseas. The word “epidemic” comes from Old Greek: ‘epi’ means ‘on’, ‘demos’ means ‘people’, so an epidemic is something we study with
sterile statistics, and maps, and graphs, but the truth is, it’s something that impinges directly on people,
on living, breathing human-beings. But my story actually starts
in the basement of a Minneapolis hospital. The year before I went to medical school,
I was the morgue attendant, or as I’d like to say,
“the autopsy assistant”. What that meant was, whenever anybody died,
I would bring the body out of the cooler, and put the body on
an examination table, and the pathologist
would come into the room. And one day, a person died
in a hospital of a massive heart attack. Probably from eating hospital food,
but that’s another story. (Laughter) To examine the heart,
you have to remove a section of ribs, and this is not done with great delicacy: you take what looks like a garden clipper, and you go crunch, crunch, crunch,
through the ribs on this side, and crunch, crunch, crunch,
through the ribs on this side. And the pathologist pulled
this big high wedge of ribs off the chest, set it on the table. And he knew I was going to be
going to medical school, so he wanted to make sure
that I saw everything. And he would say, “Neal, look at this.
These are the coronary arteries,” – we call them coronary
because they crown the heart – and he sliced one open,
and he said, “Look inside.” With my gloved finger, I poked around,
and it wasn’t a wide open artery, it had what was sort
of like chewing gum inside, except that it was hard
like a rock, and he said, “That’s your bacon and eggs,
Neal, that’s atherosclerosis.” And we looked at the carotid arteries
going to the brain, the arteries going to the legs,
the arteries going to the kidneys. They all had this hardening
of the arteries, that’s atherosclerosis. He said, “We see the beginnings of this
in two thirds of people by age 23, which happened to be the exact age
that I was at the time. (Laughter) So, anyway, he writes up his findings, “massive atherosclerosis,
acute myocardial infarction,” and he leaves the room. So, I picked up the ribs
and put them back in the chest, tried to make them fit
right with the other ribs, and I sewed up the skin, and cleaned up, and then I went out
and went up to the cafeteria, where turned out
they were serving ribs for lunch. (Laughter) Now, let me tell you something,
I knew about ribs. I grew up in Fargo, North Dakota,
I come from a long line of cattle ranchers and I remember the smell
of the cows out in the field, I remember the smell of the cows
in my grandpa’s barn and driving a load of cattle
with my uncle to East Saint Louis, to the National Stockyards, and I remember the National
Stockyards hotel, two dollars a night, and the smell of that room. (Laughter) And I have to say, everyday in my life, it was roast beef,
baked potatoes, and corn. Except for special occasions, when it was
roast beef, baked potatoes, and peas. (Laughter) And that’s the sort of the way we ate, but my father did not like
the cattle business, so he left, left the family farm,
and he went to medical school. And he spent his life at the Fargo clinic
treating diabetes, he became a diabetes expert
for the whole region. And I have to say
my father really was frustrated because patients were given diets
that they did not like. What we would say is,
or what they would say, is diabetes is a condition
where it’s too much sugar in your blood, so don’t eat anything that turns to sugar,
so don’t eat bread, don’t eat fruit, don’t eat pasta, rice, sweet potatoes, don’t eat regular potatoes,
beans, don’t eat carrots; all these things had to be limited
and while you are at it, cut calories, and that’s what people had to adhere to,
that’s gets old by Wednesday. Patients were also given medicines,
and they were given needles, and instructions on how to stick
their fingers and how to inject insulin. And despite all of this,
diabetes never got better, it always progressed, and it then became something
that we’re exporting overseas. And when I got out of medical school,
we had more medicines, and I think we had sharper needles,
but to tell you the truth, it was the same sort of result,
we had unhappy patients, and we’ve never ever cured
this disease, it never turned around, it was always considered
a progressive disease. But there are two scientific discoveries
that really turned all this around. And the first one was taking
the widest possible lens. If you look around the world, at those countries that have the least
diabetes, like Japan, for example, they weren’t following anything like the diet we were given
to diabetic patients. They weren’t saying, “I’m not going
to eat rice, I won’t eat noodles,” they eat this kind of food all the time,
it’s front and center on their plate. And the second discovery
came from looking inside the cell, especially the muscle cell. And the reason we look
at muscle cells in particular is that’s where glucose is going,
that’s where blood sugar is going, that’s the fuel that powers your movement. Do you know about a person
who’s running a marathon? What are they doing in the weeks leading
up for it? They’re carbo-loading. So they’re eating pasta,
they’re eating bread to try to get that glucose
into the cell for energy. And that is the problem in diabetes, because glucose, glucose is there,
outside the cell, trying get inside. In order to get in, it needs a key.
And that key is insulin. Now, what if I get home,
and I’m getting up to my front door and take my key out of the pocket,
I put it in the front door– Wait a minute, it’s not working. And there’s nothing wrong
with my key, but I look in the lock, and while I was gone,
somebody put chewing gum in my lock. So what am I going to do?
Crawling in and out the window? No. I’m going to clean out the lock. Well, when a person has diabetes,
their insulin key is not working. Why would that be?
Why could insulin not signal? What supposed to happen is the glucose
is supposed to enter into the cell. And [insulin] is the key
that makes that happen. But the reason it doesn’t happen it’s not that there’s
chewing gum inside the cell. What there is, is fat.
Fat, little globules of fat. I have to say, doctors hate
words like “fat”,it has one syllable. (Laughter) So we want to call it
intramyocellular lipid. (Laughter) ‘Intra’ means’ inside’, ‘myo’ means
‘muscle’, ‘cellular’ means ‘cellular’ (Laughter) ‘lipid’ means ‘fat’. Intramyocellular lipid is fat
inside your muscle cells, and that is what interferes with insulin’s ability to work
like a key to signal glucose coming in. In 2003, The National Institute of Health
gave my research team a grant and said, “Let’s test something
completely different. Instead of limiting breads
and all these kinds of things, if fat is the issue, what if we have
a diet that has effectively no fat in it?” Well, where does fat come from? It comes from two sources: animal products, animal fat,
and vegetable oils. So we brought in 99 people,
and we asked them to do two things: to really eat a bounty of food
and not worrying about quantity, we’re not counting calories here, we’re not counting carb grams
or anything like that. What we’re doing instead, is we’re setting the animal products aside
keeping the vegetable oils low. Very simple. One of our participants
was a man named Vance, and Vance’s father was dead by age 30. Vance was 31 when he was
diagnosed with diabetes, he was in his late 30s
when he came to see us. And he said, “This is not hard!” Unlike every other diet he’d been on,
we didn’t care how many carbs he ate, or how many calories,
or how many portions. If he was having chilli,
not a meat chilli, would be a bean chilli,
chunky vegetable chilli. If he was having spaghetti,
instead of a meat topping, it would be topped
with artichoke hearts and wild mushrooms,
and chunky tomato sauce. So that kind of thing; very, very easy. Over the course
of about a year, he lost 60 pounds, his blood sugar came down
and down, and down, and one day his doctor
sat him down and said, “Vance, I know you’ve had
family members die of this disease.” But he said, “I look at your blood tests;
you don’t have it anymore.” And can you imagine what that feels like
to have family members who felt there’s this absolutely one way street
and have this disease just turn around? And when I asked Vance’s permission
to tell you about his story, he said, “Make sure you tell everybody that
my erectile dysfunction went away too.” (Laughter) Write that down. (Laughter) So, we published our findings
in peer-reviewed journals, the American Diabetes Association cites it
and accepts this as an effective approach. And people around the world
started using this and I heard from a man in England, who wanted to let me know
about his experience. He had had diabetes, tried all kinds of diets
without a lot of success. And then he heard about our approach,
tried it for several weeks, went to the doctor,
the doctor drew a number of blood tests. And he got home. The phone rang,
“This is the doctor’s office. Could you come back right now? So he [goes], “Good heavens!
What’s in my blood test? He races into his car,
he’s driving to doctor’s office thinking what disease did they discover
on my blood test, what did they find …” And he runs into. They say,”We need you to sit down.
Explain exactly what you’ve been doing.” All traces of his diabetes were gone. The doctor said,
“Your blood tests are better than mine, and I don’t have diabetes,
how is this possible?” The doctor explained to him, “We can never
say a person has been cured of diabetes because we all know that’s not possible,
but technically, it’s not there. And the doctor was skeptical, he said, “Come back in two months,
I want to test you again.” Never came back. Now, wait a minute. Diabetes is genetic, right? It runs in families. And there, in fact,
are genes for diabetes, but this is an important thing
to remember, genes are in two categories. Certain genes are dictators, I’m talking about the genes that say,
‘blue eyes’ or ‘brown hair’. They are dictators,
they give orders, you can’t argue. But the genes for diabetes are committees. They’re making suggestions. And you can say, “Wait a minute, I don’t really think
I want to have diabetes.” And, in fact, most disease genes,
whether it’s for heart disease, or diabetes, or hypertension,
certain forms of cancer, even Alzheimer’s disease, they’re not dictators, they’re committees. And their activity depends on
what we put into our bodies. So, what I’m saying is that we’re putting into our bodies
foods that we’re really not designed for. Which raises the question:
what foods are we really designed for? There are different ways
of looking at this. And one is called the dental test.
Do you know the dental test? What you do is you wait
for your cat to yawn, and you look in your cat’s mouth
and what you notice is in its mouth are these very, very long
protruding canine teeth, and on each side of its mouth,
it’s just like a pitchfork that’s really good for capturing pray,
killing small animals, and ripping the hide off the flesh
and eating meat. So now look at your own mouth. What you discover is that your canine teeth
are no longer than your incisors. And that change occurred
at least 3,5 million years ago. So our molars are really good
for crunching on an apple, they’re not so hot for handling roadkill. There’s the bunny test.
Do you know the bunny test? (Laughter) You take a bunny, and you put the bunny
in front of your cat (Laughter) what you discover, no matter how young your cat is,
the cat has this irrepressible desire to capture, attack, kill,
and swallow that bunny. Now, you put the very same bunny
in front of a toddler or baby. (Laughter) And what you discover is
the toddler say, “Bunny, bunny!” They want to play and the baby
is just absolutely delighted, the idea of killing and eating him
would never occur to him in a million years. We’re learning something here. Do you know the box test?
(Laughter) You take a box that it was used
to carry electronic equipment, and you look around at the bottom
and what you find is silica gel. And silica gel is there
to take moisture out of the box. And apparently, the manufacturers
of silica gel have realized that human-beings are so indiscriminate
in their eating habits, that they have to put
these words on it, “Do not eat”. (Laughter) So, here’s how I put this together: human-beings are naturally herbivores,
but we’re really easily thrown off track. (Laughter) The fact of the matter is,
before the Stone Age, people would have been
just terrible hunters, really. You know this is true
because we’re not very quick. A lion, a lion is quick, in the forest,
a lion can easily catch a gazelle. A hawk or a falcon
can easily catch a mouse. Humans, we sort of catch cold.
That’s like it. (Laughter) We don’t really detect pray very well,
we don’t have sensitive noses. If you look at the dog, a dog has a very highly
developed sense of smell, they can detect pray at long distances, which is why they are used in airports to detect bombs, and drugs,
and that kind of things. And their sense of hearing
far outstrips ours, they are outfitted
to be able to detect pray. Now, human-beings, we have
cute noses and we have cute ears, but we really are pathetic as hunters. And if you’re going to succeed
as a carnivore, you need good sharp claws,
good sharp teeth, you need to be very, very quick, and you need to have sensitive hearing,
sensitive smell, sensitive vision. Which actually raises the question: what is the most sensitive part
of the human body? What do you think? Well, I actually learned the answer. As I was coming here,
I was at the airport. And the TSA agent pulled me aside
and said, “I got to do a pat down, and when I get to a sensitive part
of your body, I’ll use the back of my hand.” And I realized that apparently, the most sensitive part of the human body
must be our back side, I guess. So, anyway, what I take from this
is that meat eating began somehow. How did it begin? I put that question to Richard Leakey. – Richard Leakey,
the famous paleoanthropologist – and what he said was, “You know, human-beings as herbivores,
you don’t have to be quick, you don’t have to be
particularly sharp or sensitive because you don’t really have
to sneak up on a strawberry, it’s just sitting, not doing anything. But to become carnivores
really took some work. And it probably started as scavenging.” In other words,
a lion doesn’t eat everything. When they walk away
from the little pile of bones they’ve left there’s a little meat there, and humans could
relatively easily sneak in and cut some of that off and take it back. Now, that requires having
some tools to do that with. So once the Stone Age arrived, then we had the possibility
of actually doing that. And once we had arrowheads,
and axes, and that sort of thing, then we were really on to something. Meat eating really became a big thing.
But, we have pre-stone age bodies. To this day, when a person puts
into their body plant foods, their arteries open up again,
their diabetes starts to get better, their weight starts to come off,
their bodies start to recover. Americans, unfortunately, are
really not on a diabetes reversal diet. Americans today eat more
than a million animals per hour. And the Centers for Disease Control
and Prevention say that one of three kids born
in the year 2000 and in the years since is going to get diabetes
at some point in their life. And you see the truth of it,
turn on the television: half the commercials are for burgers,
chicken wings, snack foods, the other half of the commercials
are for medicines to undue the effects
of all the foods that we’re eating. So, that’s where we are. And what if it happened that instead
of a hundred million Americans having diabetes or pre-diabetes, what if all hundred million
had diabetes itself? Or more people than that? All of them need medicines, and testing,
and hospital care, and so forth. Financially, it’s a disaster. But, personally,
the personal cost is just incalculable. I think we’re starting
to turn the corner: my family has promoted me for generation
after generation, after generation. However, in 2004, we reached the peak
at 201,5 pounds of meat. That’s what the average person
consumed in that year. And in the subsequent years,
it’s dropped and dropped, and we’re now under 190, and hopefully,
that downward trend will continue. But to this day, doctors,
dieticians, nurses will say, “Diabetes is a one way street,
it never goes away.” But that was before
we looked around the world and saw, you know, there are
dietary patterns that are more helpful. And that was before we realized
that looking inside the cell, we can understand how this occurs, and we can understand
how to reverse this process. And it was before we realized that patients will make bigger changes
than we gave them credit for. So, families like mine, that have been selling meat
for generations, instead, maybe could sell carrots,
asparagus, sweet potatoes, and beans, and hopefully, the autopsy room
will more neglected than ever, because people are going to live longer,
and look better, and maybe the hospital cafeteria,
instead of serving ribs, could serve a bounty of helpful foods, and instead of studying epidemics, maybe we could celebrate
a resurgence of health. Thank you very much. (Applause)