Simply Raw: Can you reverse diabetes in 30 days by eating raw food?

Question

The documentary "Simply Raw: Reversing diabetes in 30 days" claims that you can cure diabetes by following a diet of raw food, avoiding any processed "junk" food:

Simply Raw: Reversing Diabetes in 30 Days is an independent documentary film that chronicles six Americans with 'incurable' diabetes switching their diet and getting off insulin.

The program seems to be mostly targeted towards type II diabetes patients, but they claim in the fineprint on their site that it can also be somewhat effective for type I diabetes:

The program featured in the film at the Tree of Life Rejuvination Center is most effective with diabetes type 2 but is also very effective at increasing quality of life and reducing insulin levels for diabetes type 1.

Is it possible to cure diabetes by switching to a raw diet, curing meaning to remove the need for insulin injection and other diabetes medication? And if it is possible to achieve this by changing your diet, is there anything specific to raw food as opposed to just cutting the amount of sugar and calories?

Related Question: Can a 600-calorie diet cure Type 2 diabetes?

Answer 1

The Cochrane Collaboration are my heroes. I quote from their meta-studies (where they group together a number of smaller studies and carefully scrutinise the protocols to ensure that they are statistically valid) so often, I should really sit down and write a standard paragraph of introduction to their work - and what a meta-study is - to re-use each time.

The Cochrane Collaboration have a number of meta-studies looking a diet and the treatment of Type II Diabetes (and prevention too).

• One looked at consumption of Sweet Potato of all things! Conclusion: The studies were poor quality, but there was an effect! The benefits were too small to be of any clinical use though, especially as some of the patients reported pain (!) - they don't recommend it.

• Reducing salt was found by Cochrane to have a positive effect in reducing the progression of diabetic kidney disease. The recommendations aren't aggressive - just to follow the normal recommended daily allowances for salt:

Public health guidelines recommend reducing dietary salt intake to less than 5-6 g/day and people with diabetes would benefit from reducing salt in their diet to at least this level.

• Reducing protein helped some people with (Type I & II) diabetic kidney disease a bit:

restricted protein intake appeared to slow progression of diabetic kidney disease, but not by much on average. However, individual variation existed, therefore a low-protein diet may benefit some individuals. A low-protein diet can be difficult to adhere to, especially over the long term. Reducing the amount of animal protein is the usual method but some evidence suggests that a shift from red meat to white meat and fish or vegetables may give similar results. We found no data on the effects of low-protein diet on health-related quality of life and costs.

• Low GI foods, such as legumes, (may?) allow better glycaemic control for all kinds of diabetes (a.k.a. diabetes mellitus)

Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary strategy for diabetes. Different carbohydrate foods have different effects on blood glucose and can be ranked by the overall effect on the blood glucose levels using the so-called glycaemic index. By contributing a gradual supply of glucose to the bloodstream and hence stimulating lower insulin release, low glycaemic index foods, such as lentils, beans and oats, may contribute to improved glycaemic control, compared to high glycaemic index foods, such as white bread. The so-called glycaemic load represents the overall glycaemic effect of the diet and is calculated by multiplying the glycaemic index by the grammes of carbohydrates.

We identified eleven relevant randomised controlled trials, lasting 1 to 12 months, involving 402 participants. Metabolic control (measured by glycated haemoglobin A1c (HbA1c), a long-term measure of blood glucose levels) decreased by 0.5% HbA1c with low glycaemic index diet, which is both statistically and clinically significant. Hypoglycaemic episodes significantly decreased with low glycaemic index diet compared to high glycaemic index diet. No study reported on mortality, morbidity or costs.

Despite these small measures, the overall effect of diets on Type II diabetes remains unclear:

No high quality data on the efficacy of diet alone exists for treatment of type 2 diabetes mellitus. This systematic review assesses the effects of studies that examined dietary advice with or without the addition of exercise or behavioural approaches. Eighteen studies were included. No data were found on micro- or macrovascular diabetic complications, mortality or quality of life. It is difficult to draw reliable conclusions from the limited data that are presented in this review, however, the addition of exercise to dietary advice showed improvement of metabolic control after six- and twelve-month follow-up.

...

Dietary approaches assessed in this review were low-fat/high-carbohydrate diets, high-fat/low-carbohydrate diets, low-calorie (1000 kcal per day) and very-low-calorie (500 kcal per day) diets and modified fat diets. Two trials compared the American Diabetes Association exchange diet with a standard reduced fat diet and five studies assessed low-fat diets versus moderate fat or low-carbohydrate diets. Two studies assessed the effect of a very-low-calorie diet versus a low-calorie diet. Six studies compared dietary advice with dietary advice plus exercise and three other studies assessed dietary advice versus dietary advice plus behavioural approaches. The studies all measured weight and measures of glycaemic control although not all studies reported these in the articles published. Other outcomes which were measured in these studies included mortality, blood pressure, serum cholesterol (including LDL and HDL cholesterol), serum triglycerides, maximal exercise capacity and compliance. The results suggest that adoption of regular exercise is a good way to promote better glycaemic control in type 2 diabetic patients, however all of these studies were at high risk of bias.

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In conclusion, a raw food (or any balanced) diet that included moderate salt intake, low-protein, and low-GI foods (and maybe a sweet potato or two, for taste) would have some evidence for helping with the treatment of Type II diabetes. However, the effect would be likely small and variable and not reliably reproduced. Adding exercise to the mix would help. Allowing white meat and fish may make it more easy to follow.

Claiming it as a cure, claiming it has the ability to control the glycaemic episodes or even that it reliably slows the progression of the disease would be overstating the evidence here.

Answer 2

Dr. Atkins in chapter 24 of his "new diet revolution, revised edition", notes that

Type II diabetes is caused by a genetic predisposition to the disease and/or a diet filled with refined carbohydrates combined with an overall decrease in physical activity.

He goes on to mention "Saccharine Disease: The Master Disease of Our Time", by Surgeon Captain T. L. Cleave, MD, a bok that found

almost a dozen cultures in which diabetes (and coronary heart disease as well) simply never occurred until 20 years after the people in that culture began to consume significant amounts of refined carbohydrates

Later he mentions

The simple fact is that the earliest diagnosable state of Type II diabetes is associates with the production of excessive amounts of insulin.

In such a condition, the body does not allow insulin to do its job

He continues to conclude that:

The primary cause is eating too much of the wrong kind of carbohydrates. To a lesser degree eating excessive amounts of protein can affect blood sugar levels; however, when protein is used for its primary function of building muscle mass, insulin is not produced.

After which he states his clinical experience working with diabetics:

In my clinical experience - reading food diaries kept by patients - I have seen time and again that a diabetic following a high-carbohydrate, low-calorie diet with the emphasis on fat reduction will usually find that a meal raises his or her blood-sugar levels an average of 100 points..... The same person will not that a steak or ... plus a tosses green salad ... will raise the blood sugar level no more than 20 points, if at all.

He does go on to mention that he could find no independent research confirming his own clinical experience, which to me indicates none was performed or published. Other reading I've done on the topic (will try to find references, don't have them here) confirms that.

On the question of whether diabetes can be reversed he writes (again, based on his personal clinical experience with diabetic patients):

If you want to know why I am so certain that the comparison testing will prove Atkins to be so effective, it is because in our clinical experience we have treated over five thousand (emphasis mine) Type II diabetics. Of those taking insulin-stimulating drugs (sulfonylurea) we were able to get the majority off those drugs. And the Type II diabetics taking insulin, more than half were able to cease their injections.

Now this is one source of course, but one who has done his own clinical research and concludes that Type II diabetes can indeed, at least in some patients, be reversed or controlled through a "raw" diet (meaning here a diet low in processed carbohydrates).
Quotes from the Kindle edition of "Dr. Atkins' New Diet Revolution, Revised Edition", Robert C. Atkins MD, ISBN 978-1-59077-002-3, 2002

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http://www.diabetesdaily.com/edelman/2010/03/interview-dr-bernstein-on-low-carb-diets-treatments-politics/ here's another link I found which says much the same thing in other words, by another physician.

Answer 3

There are no published trials of raw food diets in the treatment of type 2 diabetes (T2DM). The best we have are trials using vegan diets where there is some evidence of efficacy in promoting weight loss, lowering cholesterol levels and HbA1c levels. This 74 week trial by Neal Barnard et al showed that vegan diet was superior to the traditional diabetes diet [2]

Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established.

You will note that nothing is said about curing T2DM.

As for the very expensive DVD being promoted by the rawfor30days, then I think you're getting a raw deal. In the 5 minute video I watched, they used a Dr Gabriel Cousins who had his licence taken away in California ( but since reinstated ) and remains censured in New York. The documentary is filmed at his Tree of Life Rejuventation Center in Arizona. Note that he is ineligible for an Arizona medical license so has been practicing as a homeopath. [1] So, when at 0.29 in the trailer they say he's an MD, in some states this a misdemeanor when you haven't been granted a license to practice in that state.

The more interesting question though is how T2DM can be reversed. We now have 3 year trial data from the STAMPEDE study [3] from last month's (May 2014) NEJM.

We assessed outcomes 3 years after the randomization of 150 obese patients with uncontrolled type 2 diabetes to receive either intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary end point was a glycated hemoglobin level of 6.0% or less.

and it was found that gastric-bypass was better than gastric-sleeve which was better again than intensive medical treatment. Some of these subjects were able to achieve normal blood gluose levels off medication ( ie. reversal ).

Among obese patients with uncontrolled type 2 diabetes, 3 years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone. Analyses of secondary end points, including body weight, use of glucose-lowering medications, and quality of life, also showed favorable results at 3 years in the surgical groups, as compared with the group receiving medical therapy alone.

The point of this is that T2DM is more likely to reverse with greater weight loss no matter how you achieve it. If you sequester 6 people onto a remote ranch and put them onto a calorie restricted raw food diet, or, you put them onto a Newcastle 600 kcalorie ( 500 kcals from Optifast sachets, 110 cals from non-starchy vegs ~ 600 cals ) diet for 8 weeks, then some of these people will greatly improve their diabetes. What is important is how sustainable these temporary dietary changes are as without intensive lifestyle modification that can be sustained in the future their T2DM is likely to relapse.

So, the point of all this is, yes, it's feasible a raw food diet for 30 days could potentially reverse T2DM, but only through the mechanism of severe caloric restriction.

[1] http://www.phoenixnewtimes.com/2008-04-10/news/arizona-s-homeopathic-board-is-the-second-chance-for-doctors-who-ve-lost-their-conventional-medical-licenses-in-other-states/3/

[2] Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Green A, Ferdowsian H. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am. J. Clin. Nutr. 2009 May;89(5):1588S-1596S. doi: 10.3945/ajcn.2009.26736H. PubMed PMID: 19339401.

[3] Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR, . Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N. Engl. J. Med. 2014 May;370(21):2002-13. doi: 10.1056/NEJMoa1401329. PubMed PMID: 24679060.

[4] http://www.diabetes.co.uk/diet/newcastle-study-600-calorie-diet.html

Answer 4

This (very compelling) lecture by Robert H. Lustig (MD, UCSF Professor of Pediatrics in the Division of Endocrinology) backs up the idea that Type 2 diabetes can be reversed by changes in diet, but the focus is on increase roughage (and exercise) and reducing refined sugar. I believe he makes reference to several studies.

http://www.youtube.com/watch?v=dBnniua6-oM

You'll note it has nothing to do with the magical power of raw vegetables, just the vast increase in fibre intake which helps the body deal with sugar better (and other simple health changes).

This BBC news article, also backs up the same understanding:

http://www.bbc.co.uk/news/health-13887909