Raw emotionalism

I happened upon an interesting website yesterday called rawfor30days.com. According to the site:

Raw For 30 Days is a documentary film that chronicles six McDonald’s-munching Americans with diabetes who switch to a diet consisting entirely of organic, living, vegan foods.

The website contains the 9+ – minute trailer below, renamed Simply Raw: Reversing Diabetes in 30 Days. It’s definitely worth a peek. Apparently the film was first screened at the Newport, RI Film Festival only last week, so don’t feel bad if you’ve missed it.

Still here? Good.

I was personally intrigued by the site and the documentary because I have a family history of type 2 diabetes. And quite frankly, while I’m not (yet) obese, I can certainly stand to lose a few pounds. Like a double-digit number 😕 . I’ve never been very fond of meat, and most of my weekday meals these days would come under the category of ovo-lacto vegetarian (meaning they contain no meat or fish, but do contain eggs and milk products). I’ve been pondering the idea of going vegetarian or even mostly vegan for a while now, because I rather like many cooked dishes from that type of cuisine – tofu stir-fries, brown rice pilafs, quinoa, etc. Unfortunately, I hate making salads (though eating them is cool) and I’m also a big sugar addict – but hey, sugar is vegan, too! 😉 . Raw food veganism seemed a bit faddish and nutrient-deficient for my tastes, but I’d looked into it as well.

The problem with this documentary (at least based upon the trailer – I admit the documentary would probably be fascinating to see in full – well, skipping the interviews with Woody Harrelson, please. The man is seriously creepy) is that some rather unsubstantiated claims are made about the efficacy of this diet in “reversing” diabetes of both types, and that this is somehow unknown to all doctors but themselves. Also, the “vegan, organic, live rawness” of the diet is what’s credited with bringing about the improvement in the 6 men and women who participated in this experiment. Let’s examine those claims and see if they hold water.

The participants in this raw-food experiment were six adults, four of whom are older, overweight/obese people suffer from type 2 diabetes, two are younger men who have type 1 diabetes (one of which was apparently misdiagnosed as type 2 until recently). There are already signs on this webpage that whoever wrote it doesn’t deal with diabetes on a regular basis: the proper nomenclature is type 1 and 2 diabetes, in Arabic, not Roman numerals. Also, type 1 diabetes is catagorized as “genetically inherited”; in fact, though there are certain genetic markers associated with type 1 diabetes, in both types, heredity and environment both play a role. However, type 2 diabetes is far more heritable than type 1: in studies done in identical twins, nearly 100% of twin siblings of those affected by type 2 diabetes developed the disease, whereas fewer than 50% of siblings of type 1 sufferers were similarly affected – suggesting a far greater genetic component to type 2 than type 1. The Pima Indian tribe, to which the participant Henry belongs, is a well-known example of how heredity and environment both predispose certain people to develop type 2 diabetes; the disease was all but unknown among them until they started eating the standard high-fat, high-carb and high-calorie Western diet. Now, fully half of adult Pimas are overweight and have type 2 diabetes.

The distinction between type 1 and 2 diabetes is not merely a semantic one; they are, essentially, 2 different diseases with a similar expression – consistently high blood sugar and its ensuing symptoms and complications (though there are people with components of both types).

Type 1 diabetes is caused by an inflammatory process that gradually destroys the beta-type islet cells in the pancreas. These cells produce the hormone insulin, whose job it is to facilitate the entry of glucose from the blood into the body’s cells to use it for energy. When not enough insulin is produced, blood glucose starts to rise, and the body’s cells go into starvation mode, using up proteins from muscle tissue and then fatty tissue; this results in the patient going into diabetic ketoacidosis, usually following a stressful event such as a viral illness. This type of diabetes is insulin dependent; without giving insulin shots, patients with type 1 diabetes will die. While in the very early stages there may be some vestigial insulin production by the still-alive beta cells, the inflammatory process will almost always destroy all the beta cells eventually.

Type 2 diabetes, conversely, is mainly a problem of insulin resistance: insulin is produced, but the body’s cells aren’t capable of responding normally to it – so even more insulin is put out. The vicious cycle is exacerbated by the fact that the insulin secreted helps build even more fatty tissue, thus increasing the insulin resistance. The treatment is initally by diet. The next step is usually oral medicines that either help the pancreatic cells work harder (sulfonylureas) or help reduce insulin resistance (medicines such as Metformin or Avandia). In advanced cases of type 2 diabetes, beta-cell exhaustion (or even destruction) ensues and insulin therapy, as in type 1, is necessary.

It’s long been known that when type 2 diabetics adhere to a diet and lose weight – even as little as 5-10% of their total body weight – their diabetes control improves enormously. The most effective type of diet is relatively low in fat, calories and carbohydrates with low glycemic indices. So the claim that “doctors don’t know about this” is pretty bogus, as we recommend this all the time.

Getting back to the documentary, we have 6 people, 4 of whom are either overweight or obese, all of whom previously apparently had atrocious eating habits. They were put on a raw food diet – which just happens to be very low in fat and low glycemic index (being that most high-glycemic index carbohydrates are unpalatable when not cooked – think potatoes, grains and rice. While melons are high glycemic index, if the participants only had seasonal fruits and veggies, they probably didn’t have too many of those around – the way they’re clothed makes it clear this experiment took place in the winter). I can’t comment about the caloric value of the foods they consumed, but it’s probably much less than what the particiapnts previously ate. Regardless, this diet is far, far healthier than their previous McDonalds-like diet, and not because of the raw enzymes or the organic qualities of the foods.

As I said before, dietary modification is the cornerstone of diabetes treatment, regardless of type, but in practice, many people find it very, very hard to stick to these type of diets (much less a raw-food one) for very long. When I was less experienced, I would really hate upping my patients’ medications for cholesterol, diabetes or high blood pressure, especially if they were overweight. I’d tell them, “if you just tried to lose just a few more kilos, we might be able to control your disease without another pill”, and test them in 3-6 months. Experience has taught me, however, that very few are able to do further restrict their diet and do this, and in the meantime they’re sustaining irreparable damage to their internal organs. So I grit my teeth, give them the extra pill, and send them yet again to the dietician.

I wonder what’s happened to these people since their return to their regular lives. It’s relatively easy (though as the documentary shows, not very easy at all) to eat a raw-food diet when someone else is making the meals, the nearest McDonalds is miles away, you have support groups twice a day and none of the stresses of your usual way of life. What happens once you need to shop for your own foods (and if the stress is on organic, it can be very expensive), go back to work, be exposed to your Dunkin’ Donuts-eating family once again? There doesn’t seem to be much follow-up in the documentary, though it may be in a part not shown in the trailer.

Also, while I can certainly believe the type 2 diabetics may have completely kicked their need for insulin or oral meds, I am skeptical, given the mechanism of the disease, that the type 1 diabetics did. Lowered their insulin requirements drastically? Absolutely. But they’d still need a minimum amount of insulin to utilize what food they eat. I suspect that if this were truly a novel way to “cure” type 1 diabetics of their illness, they wouldn’t be doing a documentary film about it – it’d be the subject of a major scientific paper, with a Nobel prize on its way. (You can cure type 1 diabetes by transplanting islet beta cells or a new pancreas; however, replacing insulin with anti-rejection drugs for the rest of your life isn’t a very attractive proposition for many people).

Mind you, it’s not like vegan raw food diets, even if one can stick to them, are without problems of their own. You can lose too much weight, develop vitamin deficiencies (especially vitamin B12); interestingly, vegans are slightly more likely to die of heart disease than vegetarians, though both fare better than meat-eaters; with women in particular, there is the issue of getting enough calcium on this diet to prevent osteoporosis in the future. There have been very few studies on long-term raw-foodist vegans (or raw-foodists in general) to really know.

All in all, it seems this documentary isn’t telling us anything we don’t already know: Get people to eat low-fat, low glycemic index carbs, the weight will come off and diabetic control will be much improved. The real problem is getting people to stick to it.

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4 Responses

  1. I strongly support minimizing meat intake for health and/or ethics, and I support cruelty-free eggs and milk. That said, in order to be a healthy vegan you either have to have a degree in nutrition, follow a day-by-day plan someone else prepared for you, or take dietary supplements. Usually the dietary supplements are needed anyway. Full-out veganism is a ridiculous and, for certain people, dangerous idea.

    Raw food interests me, though. Personally the diet I prefer is small amounts of lean meats, fish and eggs, and ostrich meat if I am having anemia issues and can afford it, accompanied by raw fruits and vegetables and whole grain carbs. Fruit and veggies are best raw in my opinion and I think it’s healthier, too.

  2. This is a bit off-topic, but I’ve often wondered whether it’s possible to have a truly vegan diet in the long-term. I’ve read that B12 can only be found in animal sources, so if that’s the case, doesn’t that mean B12 supplements aren’t vegan? I’ve tried to find out how B12 supplements are manufactured but haven’t found anything through Google, which makes me think that a lot of vegans may be ingesting animal products without realizing it.

  3. Basiorana – oddly enough, some fruits and veggies are actually more nutritious processed or cooked. I was going to add this link to the above post, but the comments will do as well.

    Li – I think that the B12 in the pills is synthetic, as it’s in a slightly different form than naturally-produced B12. However, some raw foodies/vegans recommend not completely washing earth off the food eaten in order to get vitamin B12 from soil bacteria adhering to the food. JMO, but…yuck!

  4. In response to Basiorana and Li, b12 is not only found in animal products, but is not found in high doses in plant based products. Yes it can be found in mushrooms, but you have to eat 40 a day, and it is in soil and everywhere, but our modern lifestyle washes this off.

    The b12 supplements can come from people cultivating the bacteria that produce b12, so you just have to check if the supplement says suitable for vegans.

    Also, you dont need to take supplements, if you eat a few fortified products each day, such as soy milk and cereals (make sure they say they are supplimented with b12), you can get enough b12.

    As a vegan, I am not a nutritionist, dont follow a plan, and dont take suppliments and I am fine – have been perfectly healthy for 12 years, in fact, amazingly healthy.

    However, when I eat raw food for any amount of time, and cant eat soymilk or cereals, then I do take b12 tablets.

    Basiorana – if someone eats a variety of vegetables and fruit they should be ok, your comment about needing a nutrionist is perhaps valid if they are transitioning from an unhealthy diet where meat was covering what they lacked from healthy sources, but if someone already was eating healthily they will probably be ok. OK… you are right, answers like that only work most of the time – some peoples diets might be lacking some things, so people do need to think about their nutrition, the basics that we need, and make sure they eat a few things to cover all different types of nutrition.

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