Paleo vs. Type 1 Diabetes
I received the following email today, pretty cool stuff:
Robb,
I emailed you about a month or so ago. I just want to give you an update on my situation: I’ve lost about 15-20lbs. I’ve taken no insulin for 5 weeks and I’m type 1 Diabetic!. Because of my strict paleo diet(gluten and dairy free) my a1c is not going to be much higher than when I was taking crap load of insulin. My glucose has really stabilized in the low 100s (100-125) and I haven’t had a low at all during this time nor have I had extreme highs like when I was taking so much insulin. My blood pressure has dropped tremendously and my Internist thinks that my pancreas has jumped started again, because even when I have had a cheat meal my blood is responding in a completely different manner. We are going to do a c-peptide test again. I’ve also started to incorporate better sleeping patterns (trying to get 9-10 hours) and my fasting glucose is even better (lower) than before.
All that to say, I really appreciate your help and your blog. It’s been incredibly resourceful and much more helpful than even my endocrinologist. Best of luck in the future! I’ll try to keep you posted when the end results come.
It is well understood that Type 1 Diabetes is a failure of the beta cells of the pancreas to produce insulin. This is generally acknowledged to be the result of an autoimmune response, usually attributed to a viral infection or some kind of trauma. What is less known is the role of grain lectins in this process. Many people benefit not only from reducing the recommended American Diabetes Association 60% carb diet (higher even than the diet that causes most of the type 2 diabetes we see) because of a more fat fueled metabolism but also, occasionally, we see a return of normal pancreatic function with the removal of the neo-lithic foods. The inflammation and immune response that has been beating down the beta cells cease, some repair occurs and things come back to normal. This is not the norm unfortunately, but it does happen. Even without the full return of pancreatic function, the reduced carb, higher fat paleo diet greatly mitigates the accelerated aging and systemic inflammation inherent in both type 1 and type 2 diabetes.
That this is not the standard of care baffles me. As much as I hate spurious litigation the AMA should face a class action suit for it’s role in obscuring the facts in this situation.
This example is also why I’m a hard-ass on the whole paleo thing. For many people the Zone simply does not cut it. Precise ratios are fantastic but potentially worthless if the food being consumed is in some way toxic to the individual.
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21 Comments
Rob
Thanks for this post. My fiance is Type I and I have been trying to help her make better food choices (it helps when I’m the chef).
Just to ask, but is your advice for Type I individuals to do paleo the same as someone w/o diabetes? Are there any out of the ordinary things you have run into concerning Type I and paleo? thanks.
Peter-
I’d check out dr. bernstein’s book. It recommends a nearly ketogenic diet for a type 1 diabetic. If I were type 1 this si the way i’d go. You have to work at finding the right dosage of insulin while the individual transitions to a fat based metabolism.
The person who wrote the message above is my husband and I would just like to say , “thank you.” It broke my heart when he was diagnosed type 1 and I didn’t know what to do to help except, be there for him. In hind sight, I still think that’s the best answer as a spouse. There is nothing harder for some one going through that transition than to watch other people enjoy all of the tasty cupcakes, ice cream, and mashed potatoes that you’ve indulged your entire life and have to stand in the corner and check you blood levels all by yourself. It feels so shameful and so many people know so little about diabetes that they want to give you all kinds of solutions that usually come accross as something that you’ve brought on yourself, whilst they go on muching their cheetos. However, there is nothing more wonderful than to watch your spouse find an answer to both your prayers and theirs. I am truly grateful for the friendly help that you have given us. I have been passing this information along to any and everyone that I think it might benefit!
Shannon-
I’m stunned. I wanted to go into medicine to help people and I realized that for me at least, that was not a good fit. I really feel like I’m able to help folks affect some positive change via this blog, the nutrition certs, CrossFit Journal and when finally done, my book. Thanks to both you and your husband for sharing this experience and just giving this approach a shot. I often feel like the “crazy guy in the warehouse”…it’s nice to know the work I do matters.
Hey Rob,
First post here, thanks so much for what you do. Truly inspiring.
You’ve really got me thinking about food quality with regard to weight-loss.
I subsribed to http://www.formulazone.com, which makes it incredibly easy for a family with really young kiddos to create zone-meals quickly.
HOWEVER, if you take a moment to look around there, you will be amazed at how the people submitting highly zone-specific meals (technically) work so hard to create zone foods that taste just like they used to eat.
IOW, sure, they’re balanced, but there are all sorts of grains all through this site. This led to several weeks of eating supposedly zone meals with no change in body-comp. Very frustrating.
So, for now we’ve scrapped the weigh/measure method for a more loosely defined paleo diet. As a result we’ve started seeing progress again.
(Question: can you make 3 book suggestions for an aspiring (read: weak) crossfitter who rarely gets enough sleep b/c of toddlers? I need to continue to make better food choices, but also need my diet to not consume whatever daylight remains after work!)
Thanks!
Scott
Scott-
thanks for the validation on this…the composition DOES matter. Many put forward this notion that beer, peanuts and jerky will sub-in for blocks the same as salmon, broccoli and olive oil. As much as I love beer and jerky, it just ain’t so! Many people never stay with the program unless they remove most of the grains, and in the case of this very blog post, there are a host of medical conditions that WILL NOT improve without the removal of grains, particularly the gluten containing varieties, from the line-up.
Robb,
Unfortunately one would have to tackle more than the AMA..try adding the ADA, AHA and the millions of ‘outdated’ physicians who promulgate unproven dietary recommendations.
As a physician who promotes dietary ‘cleanliness’ ala paleo/Zone principals, I receive frequent sideways stares from colleagues, despite the fact that my post-surgical diabetics are enjoying much improved glucose control at least while under my direct dietary control.
DocMo
Doc!
Good to know we have at least 1 doctor on the paleo/zone band-wagon!
I am going paleo/hyperlipid as well and have cut out all dairy except for some high-fat choice such as brie, goat cheese and heavy cream for my coffee.
Do you think I should cut out ALL dairy?
Patrick-
All you can do is tinker. Your choices sound pretty solid to me however but it’s never a bad thing to switch things up.
Rob,
I am a military physician, crossfit trainer, and regular reader of your blog. I have all of my patients (the one’s who will listen) on paleo/zone with fantastic results. Like DocMo above, there are a couple of us out there who think outside the medical party line on nutrition and exercise. Just wanted to echo those above and thank you for making a difference. You certainly have with me, and through me, my patients.
Chris
thanks Cris! Just need to get that FAQ done and I think that will both help people and streamline my efforts.
Hi Robb, This is very interesting, so I’ve asked Bastos about it and here’s his answer:
In rats, type 1 diabetes progresses more rapidly when gluten is incorporated into their diet, early in life. (1,2)
Also, and quoting Schmid and colleagues: “Diabetes onset was delayed and diabetes incidence was significantly reduced in female mice that received the wheat and barley protein-free diet throughout life”. (3)
In humans, exposure to gluten before 3 months of age increases the risk for Type 1 Diabetes. (4)
And a gluten-free diet in subjects with high risk for type 1 diabetes led to significant improvements in their insulin response during a glucose tolerance test. (5)
Moreover, there is a very interesting report in the medical literature, where an adolescent, who had abnormal blood glucose and insulin levels and was tested positive for islet cell auto-antibodies and celiac disease (diagnosed through small bowel biopsy), after following a gluten-free diet for 6 months, became islet cell autoantibody negative and presented normal glycemia and insulinemia. (6)
Finally, multiple studies also implicate bovine milk in Type 1 Diabetes (7) and a higher intake of Omega 3 fatty acids (and also vitamin D) (8,9)may reduce the risk for this terrible disease.
To sum up, my first line approach for Type 1 Diabetes would be a very low glycemic load Paleo type diet along with regular exercise (including Weight Training, which is sometimes sadly neglected)
References:
1) Hoorfar J, Buschard K, Dagnaes-Hansen F. Prophylactic nutritional modification of the incidence of diabetes in autoimmune non-obese diabetic (NOD) mice. Br J Nutr. 1993 Mar;69(2):597-607.
2) Scott FW. Food-induced type 1 diabetes in the BB rat. Diabetes Metab Rev 1996;12:341–59.
3) Schmid S, Koczwara K, Schwinghammer S, Lampasona V, Ziegler AG, Bonifacio E. Delayed exposure to wheat and barley proteins reduces diabetes incidence in non-obese diabetic mice. Clin Immunol. 2004 Apr;111(1):108-18.~
4) Ziegler A-G, Schmid S, Huber D, Hummel M, Bonifacio E. Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA 2003;290:1721–8.
5) Pastore M-R, Bazzigaluppi E, Belloni C, Arcovio C, Bonifacio E, Bosi E. Six months of gluten-free diet do not influence antibody titers, but improve insulin secretion in subjects at high risk for type 1 diabetes. J Clin Endocrinol Metab 2003;88:162–5.
6) Banin P, Perretta R, Ravaioli E, De Sanctis V. Regression of autoimmunity and abnormal glucose homeostasis in an adolescent boy with silent coeliac disease. Acta Paediatr 2002;91:1141–3.
7) Knip M, Veijola R, Virtanen SM, Hyöty H, Vaarala O, Akerblom HK. Environmental triggers and determinants of type 1 diabetes. Diabetes. 2005 Dec;54 Suppl 2:S125-36.
9) Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov 3;358(9292):1500-3.
Miguel-
Thanks for the awesome info and the refrences…I need to get to Portugal so I can meet Pedro in person!
Shannon – CONGRATULATIONS TO YOU AND YOUR HUSBAND!!!
Robb, as always – spot on.
Get that FAQ done! Hang in there!!
Great post Miguel. Thank you so much for those references.
I’m type 1 diabetic.. going low carb has been vital for my blood sugar control, but taking no insulin at all is incredible. That must take a lot of hard work.
For most type 1 diabetics, enough of the pancreas has been destroyed so that they must take insulin regardless of diet and exercise, and of course this can’t be reversed. At the very minimum, people usually require 2 or 3 units of insulin a day; I take 6.
The American Diabetes Association won’t even admit that low carbing can help blood sugar control.
Sam-
What we are seeing in these folks is recovery of otherwise damaged pancreatic tissue. Unfortunately it does not work this way for everyone, nut there is no doubt it helps with blood sugar maintenance. The American Diabetic Association is absolutely criminal. They recommend both a diet and a medication protocol that worsens an already tough situation.
Robb-
How about for the teens with Type1? I have started to adopt Zone and Paleo guidelines in my eating. But how do you adequately feed a 15 year old O-Line guard who is a carbo-holic? I have had great results with my body comp by using the principles, but this kid is already super lean, but needs to gain weight.
The thing that is so frustrating is how screwed up all of the nutritional resources are for diabetics. It is as if they are conspiring to keep the disease going. Could money be the motivation (duh, no need to guess there!).
I would like to start to integrate what I can so that when my boy is older and on his own, I have at least instilled these correct principles into his brain.
Advice?
Anne-
Fish oil is critical for normalizing insulin sensitivity (10-15g/day). Carbs post WO is likely a smart idea. I think I will do an e-book or small specialty book on this once the main book is done as there is obviously a need here. What are his post exercise numbers? are they sky high? Low? Important stuff to know before we make a plan.
I have a trick one; my daughter is a newly diagnosed Type 1, I have Crohn’s and my mother just died in horrible health with long term SJogren’s and RA. My daugter has celiac too and is currently due to intestinal inflammation of unknown origin which has been diagnosed as Eosinophilic Esophagitis, is on a diet restricted from Soy, dairy, eggs, nuts and fish and shellfish. She is back on soy, having some abdominal symptoms, but she always seems to. I wonder if you could suggest alternate good fat foods than nuts right now? I’m thinking avocadoes and coconuts, we do a lot of coconut for dairy replacement. Any suggestions? This has been a devastating year for her health, and now we are high on carbs, rice and corn, but I’m considering going paleo very soon. She is starting to have trouble concentrating in school which was not the case before, and b. glucose levels are out of control. I just finished Bernstein and think with my own Crohn’s issues, that there may be something to the diet issue. My dad will fight me on the ketosis versus DKA issue, but I’m willing to try it.
Do YOU< as a type 1, have any advice to offer. Should we put the eggs and nuts back in (she is severely allergic to peanuts and I suspect that allergy may make her intolerant to soy as well, as a legume)…?
Erika, Tucson (daugther aged 10, diagnosed Type 1 last year)
Erika-
What I’d do.
1-I’d go straight paleo. Remove the soy, rice etc. Minimal to no fruit…if she is celiac she will have a hell of a time with fructose. Carbs are from well cooked yams, sweet potatoes and squash. Well cooked being easily mashed with a fork, baking or pressure cooking works great for this. Keep eggs, nuts and common allergens out for a while (month or longer). Use grassfed meat if you can get it. Coconut is great if it’s well tolerated.
2-Supplement with fish oil (this is a time for some kind of ultra pure variety like Nordic Naturals…they have some flavored versions she will likely handle well. 4-8g/day, again as tolerated.
3-Supplement with ox bile. Try to get 1-2 caps with each meal, make each meal have some coconut oil and fish oil if possible. Her GI tract will not absorb fats efficiently for while and this will help.
4-Make sure sleep is as good as it can be.
I’m going to drop this in on the front page so folks can see this more prominently. If you give this ashot please do keep in touch and let me know how it goes.
hey funny think is i stopped taking insulin 6 weeks ago , have not lost any weight and feel much better and my doc just keeps saying i have type 1 diabetes , maybe you can give me your docs name ??? my email is amg66645@yahoo.com
I am a 22 year old collegiate rower with type 1 diabetes, I have been a diabetic for about 7 years now and was just shown this article and several others by my teammate who is using cross fit. I have been to serveral doctors and endrocronologists( excuse the spelling) and this is the first time I have heard of such information. usually when informed about bringing my A1c down my doctors would recomend changing my insulin to carb ratio rather than a severe reduction in carbohydrates. The information presented in this article and others like it is truely revolutionary and needs to be made more readily availiable to performance atheletes and children alike. Thank you for this information and please continue to publish more.
Robb–
Thank you for the research you have done into this topic. It gives hope to those of us who are plagued with autoimmune diseases that consume our lives. However, I think it is irresponsible of you to mislead people into thinking that through a strict diet it is possible to reverse the damages that have been done through type 1 diabetes. I am not a doctor, but I know that it is impossible through diet for the beta cells in my pancreas to begin producing insulin again. Perhaps there is more to the story above that should be mentioned. It is possible to prolong the damage to beta cells when you are newly diagnosed and still have some function of the pancreas. Also, readers, please do not be misled into thinking that if you adapt a gluten-free and dairy-free diet that you can abandon your insulin. Do not forget about the glucose your liver produces at fasting blood sugar levels. Type 1’s, do not forget your glucose tabs on long runs and strenuous workouts. Even with this diet, there will be times your blood sugar drops and Dr Robb’s plan will not pull you out of an emergency.
I know the importance of diet and exercise to maintain normal blood sugar levels and reduce the risk of complications. I am glad to see my fellow diabetics leading healthy lifestyles. But please do not foster false hope that you have the magic cure to diabetes. Please consider our feelings before you make such claims.
Brooke-
You need to read all 5 of the posts on this topic, use the search function. About 20 people HAVE REVERSED their Type 1 because they still had some functioning beta-cells. You are familiar with the “honeymoon” phase common in children in which they alternately get then lose function? This is a time when they could recover pancreatic function. Unfortunately, the vast majority of people will not see this effect.
Also, the people who have adopted this way of eating UNIVERSALLY report vastly improved blood sugar control. Not trying to be mean, but please take some time to fully educate yourself about this site and what resources are here.
Blake-
Keep us up to date on your training and progress. Read all the other posts on type 1, there is some good info in there.
I’ve been reading your blog. And I am so excited.
I’ve been type 1 diabetic on insulin injections for 38 years looking for a natural healing, for many years. I did the zone in 1994-94. Then switched to Dr Bernstein’s low carb, high protein in 1996, did that for 7 years. My health improved but still taking 24 units for insulin. Started raw foods in 2003 and got insulin down to 6 units but in the last year or two insulin requirements gradually increased to 14-16 units. I’ve been looking for a more truly healing diet, looking into local meat, maybe raw meat. But the idea of raw meat —I just couldn’t get it to my lips. I haven’t touched grains or high carbs in 14 years. On a very low carb, raw diet.
I’ve been reading your blog and realize that all type 1’s may not be able to discontinue their injections but I am willing to try and the CrossFit intrigues me as well. Where is the best place to start, I want to get going right away!
Please answer, thank you so much for your work!
It is so exciting that some diabetics are getting off insulin. I have known for a long time that the AMA and the ADA are wrong, wrong, wrong!
Aimee
Aimee-
Read all the comments from the folks in the type 1 threads. You need to ease into things and keep good notes on what is doing what.
I think I need to do a book specifically on this topic.
My daughter is 4 years old. She was diagnosed 6 months ago with type 1. We instantly took her off of dairy. We then took her off of grain a month later. We now took her off of legumes. We have been on a roller coaster. She gets down to 1/2 unit of lantus, then she spikes for a few days. We start all over. We are very frustrated and EXHAUSTED. We started this knowing it may not reverse her diabetes, but we knew it would make us all healthier. Any suggestions?
Stephanie-
We just had another client whose son went Type 1. We are guessing that this “honeymoon” phase offers an opportunity to halt the autoimmune progression. AT this point it is nothing more than that, but it IS a more effective way to manage the problem even if we do not see a recovery of pancreatic function. We are looking at starting a support group out of NorCal, perhaps we can do this as a webinar so folks can listen in on this? I am pretty sure I will also do a specific book on diabetes (both type 1 & 2) once this primary book is finished. I think the recipe is still the same:
1-Gluten free, dairy free paleo diet.
2-Keep carbs on the LOW side ala-Benrsteins Diabetes solution (but better food quality).
3-Map blood sugar responses to activity, sleep and food.
This works, but it takes effort and time
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