Optimizing Metabolism

by Ingrid Kohlstadt, MD, MPH

Reversing Diabetes with The Fat Factor

Introduction

I distinctly remember the lecture in medical school in which the professor emphasized that good observation skills are central to being a good doctor. Doctors used to diagnose diabetes, for example, based on the odor and, yes, taste, of urine, he explained. The professor pretended to demonstrate. He placed his finger in a urine sample (or whatever liquid it was) and then licked his finger. Yuck – then I don’t want to be a “good” doctor! What the astute observers noticed was that the finger dipped in the urine was not the same finger that he licked. Be a good observer, he underscored.

Diabetes mellitus was so named because those who suffer from it urinated frequently and their urine had a sweet odor and taste. For decades, sugar was thought the key to managing type 2 and pregnancy-related diabetes. The story does not stop with sugar. Now astute clinicians are observing many roles for dietary fats in diabetes pathology. Fat plays a role in causing diabetes: This column focuses on the roles of fat in “fixing” diabetes.

Avoid Medications That Promote Excess Body Fat

Type 2 diabetes improves with weight (fat) loss. However, several medications reduce satiety and physical energy, thereby challenging patients’ efforts at weight reduction.

Often overlooked are antihistamines, taken for allergy or sleep. Antihistamines increase appetite and are dehydrating. Various nutritional protocols exist to control allergy and sleep disturbance, thereby reducing the need for symptom-control with antihistamines.

Sulfonylureas and insulin, two medications taken to manage diabetes, also promote weight gain, often putting patients in a vicious cycle of weight gain and worsening diabetes. Nutritional protocols, exercise and weight reduction surgery (preferably the less invasive forms) can reduce medication requirements.

Beta blockers, generally taken for managing cardiovascular disease, promote fat gain. They tend to make patients tired, often too tired to exercise. And when patients do exercise their heart doesn’t beat as quickly, reducing the metabolic benefits of exercise.

Eat Lots of Fat-Soluble Vitamins

Often overlooked are that resveratrol in grapes, lutein in green leafy vegetables, zeaxanthin in coffee and tea, carotene in various yellow and orange vegetables, and lycopene in tomatoes are all fat-soluble vitamins shown to improve diabetes-damaged metabolism, but multivitamins are not a likely source – food is. Eat these foods with a little fat which helps the body absorb them. Don’t misunderstand the advice associated with warfarin (Coumadin) to eat vitamin K containing foods such as green leafy vegetables in consistent amounts. Don’t avoid them.

Alpha-Lipoic Acid

This fat-soluble and water-soluble sulfur-containing vitamin is available as a supplement that has been shown to reduce the peripheral nerve damage associated with diabetes.

Do Not Eat Trans, Overheated, or Rancid Fats or Charbroiled Meats

Cooking meat over an open flame causes many fats to spoil because of the high heat. There is also a second problem: the fat from the meat drips onto the coals, creating smoke that contains chemicals strongly associated with increased colon cancer risk and also correlated with diabetes.

Supplement with the Fat-Soluble Vitamin D and Use Laboratory Testing As a Guide

Type 2 diabetes is strongly associated with excess body fat, and excess body fat is associated with low vitamin D levels. Vitamin D is associated with fewer falls, not only with fewer fractures, because it strengthens the connection between muscles and nerves often damaged by diabetes.

Supplement with Both Omega-3 and Omega-6 Fats

Since our diet tends to be disproportionately high in omega-6 fats, which are pro-inflammatory, the need for the very long-chain omega-6 gamma-linolenic acid (GLA) is sometimes overlooked. Elevated blood sugar, supplementing omega-3 fats, low zinc, and B vitamin deficiencies all impair the body’s ability to make GLA. GLA, even though it is an omega-6 fat, is a precursor to important brain chemicals, including some that reduce inflammation.

Measure the Fats in the Bloodstream Called Triglycerides

Even mild elevations in triglycerides merit aggressive treatment and can improve the course of diabetes. Diet and nutrients to reduce the associated liver inflammation are well described elsewhere, including recent issues of Townsend Letter.

Apply Oils to Skin

Coconut butter, rosemary oil, lemongrass oil, sandalwood oil, and so on, contain fat-soluble nutrients which can be absorbed into the skin. This is the basic concept behind A & D Ointment, which contains the vitamins A and D extracted from fish oil. Also organic plant pesticides consist of these oils. Keeping scale off plants is not unlike treating athlete’s foot. Women with gestational diabetes who are more susceptible to stretch marks, those at high risk for diabetic food ulcers, and people with fungal toes are especially likely to benefit from applying oils.¹

Don’t Use Plastic When Preparing Foods with Fat

The chemicals in plastic are fat-soluble, which means that foods containing fat absorb the plastic chemicals, especially when exposed to heat. These chemicals which are endocrine disrupters further disturb metabolism.

‘Chew the fat’

This colloquialism has its roots in tough times when it was a luxury to have a piece of lard in your mouth when gathered around the knitting circle. Today the luxury is not the fat but the time. How few of us take the time to chew our food and enjoy it fully? How many times do we have to grab a bite to eat and inhale our food? Studies from various scientific disciplines show that taking the time to sit down and eat meals leads to more healthful food intake. The various antacids used to manage the symptoms of a stressed lifestyle further impair digestion and are thought to worsen diabetes. That is, the converse, adding vinegar to meals, has demonstrated benefit in diabetes.

Conclusion

There are benefits to focusing on dietary fat in treating sugar diabetes. The ten suggestions in this column are fairly easy to implement and can augment conventional lifestyle and medical interventions in the successful management of type 2 diabetes.

Ingrid Kohlstadt, MD, MPH, is an FDA Commissioner’s Fellow, using diet to improve drug safety. She has been elected a Fellow of the American College of Nutrition and is an associate at the Johns Hopkins School of Public Health.  She is the founder and chief medical officer of INGRIDients Inc., editing Food and Nutrients in Disease Management (CRC Press, 2009) and Scientific Evidence for Musculoskeletal, Bariatric and Sports Nutrition (CRC Press, 2006).

Disclaimer:

The views expressed in this article are her own and do not necessarily reflect the views of the FDA.  

Notes

1. Further information can be found on www.OilMD.com.