Until insulin’s discovery in 1921, the only effective therapy for diabetes was dietary. The standard of care for over a century had been the “animal diet” — fatty meat and green vegetables, boiled three times to remove the carbohydrates. “Patients were always urged to take more fat,” in the words of Elliott Joslin, the most influential diabetes authority of the era. Those with the chronic form of the disease (type 2 diabetes, in today’s terminology) could seemingly put their disease in remission on such a diet. Those with the acute illness (type 1) could at least improve their prospects.
In 1971, after half a century of insulin therapy, the American Diabetes Association would flip this dietary prescription on its head. The ADA would now advise all patients with diabetes to religiously avoid dietary fat and so consume more than half their calories from carbohydrates, the one macronutrient that they cannot metabolize safely without pharmaceutical help.
The ADA authorities would take this step with no meaningful clinical trials to support the recommendation. When those trials were finally done — in the 2000s — they consistently suggested that carbohydrate-rich diets for diabetes do more harm than good. And yet dietary recommendations for diabetes have changed little, if at all.
Does this sound like a good idea to you?
How did this happen?
What should have happened?
How do we fix it?
My latest book, Rethinking Diabetes: What Science Reveals About Diet, Insulin and Successful Treatments, is available for preorder. And for those who want to skip straight to Amazon, here it is.