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Your Good Health: Plant-based diet good for diabetes

There is good evidence that people with diabetes have excellent results with this kind of diet
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Dr. Keith Roach

Dear Dr. Roach: Your recent column about treating diabetes left me wondering. Diabetes, as I understand it, is usually a result of too much sugar being consumed. But consuming carbohydrates is not that much different because they are quickly converted to sugar through the human chemical processes. So, why are you promoting a plant-based diet that is high in carbohydrates?

Consuming protein, which is easily obtained by eating meat, seems to be the answer to reducing the consumption of simple and complex carbohydrates that are quickly converted to sugar in our body. I’ve switched to a high-protein diet (both plant and animal protein), and my blood sugar has been very well-controlled for a couple of years.

F.B.

Diabetes is not a result of consuming too much sugar. Type 1 diabetes is an autoimmune disorder where the cells that make insulin are destroyed by the body. Type 2 diabetes is a disease of insulin resistance and a relative inability to secrete insulin in response to a sugar load.

In a person with Type 2 diabetes, consuming too much sugar in a short time overloads the body’s ability to respond, so their blood sugar level goes up. It is persistent high blood sugar that is responsible for most of the damage to the kidneys, eyes, blood vessels and nerves.

I am careful about what I mean by a plant-based diet. While it’s true that a diet consisting entirely of maple syrup and orange juice would be extremely bad for a person with diabetes because of the concerns about blood sugar that you raised, a plant-based diet that is mostly vegetables, whole grains, legumes, fatty fish and nuts/seeds with moderate amounts of whole fruits does not raise blood sugar more than a standard Western diet.

The high fibre content of the legumes, whole grains and vegetables prevents rapid absorption, and the protein and healthy fat in nuts and fatty fish likewise slows stomach-emptying. Finally, there is good evidence that people with diabetes have excellent results with this kind of diet.

You are right that protein is an important part of the diet for a person with diabetes, but many high-protein diets based on meat also have high amounts of saturated fat, which increase the risk for heart blockages — and is a major cause of disease and death in people with diabetes. However, it is possible to have a healthy, high-protein diet with care.

Dear Dr. Roach: The supplemental facts on the One A Day Men’s 50+ and Women’s 50+ vitamins are similar — only the men’s had vitamin K, and the women’s didn’t. Other than this, the sole differences were variations in some of the daily values.

Is there any potential downside to a man taking a Women’s 50+ vitamin or vice versa?

J.M.

I don’t recommend daily multivitamins for healthy people, besides a few exceptions:

Women of reproductive age who are considering pregnancy should be on a folate-containing regimen. People with known deficiencies (such as vitamin D) should be getting replacement supplements. Vitamin E may increase prostate cancer risk and should be avoided in those with a prostate.

Also, women who are menstruating need more iron than men do, and sex-specific vitamin formulations keep these issues in mind. Iron generally isn’t dangerous for people who aren’t menstruating, unless they have hemochromatosis.

So, while I don’t recommend them, and although they are very similar, there are subtle reasons to choose a sex-appropriate vitamin.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu