According to the International Diabetes Federation, the number of people with diabetes in India is projected to total 101 million by 2030. The corresponding number in the US in 2030 is 29 million.
Experts in India explain that lifestyle factors causing the development of insulin resistance are responsible. Diabetes experts in the United States repeat the same explanation.
I agree that lifestyle factors underlie the increasing incidence of type 2 diabetes. But I disagree that insulin resistance is the cause. So what lifestyle factors could possibly lead to diabetes in two cultures that are so different?
Different lifestyles but one commonality
Almost 80% of the population of India practices Hinduism—a way of life with a wide range of philosophies, concepts and rituals, and with emphasis on local deities considered to be manifestations of a single impersonal ultimate reality of God. The ancient grouping of people into four classes – the Brahmins (priestly people), the Kshatriyas (administrators and warriors), the Vaishyas (artisans, merchants and farmers), and Shudras (laboring class) form the basis of many customs in the Indian society. The cuisine of India is an amalgam of a wide variety of regional traditions using locally available spices, herbs, vegetables and fruits. Lentils are staple ingredients in Indian cuisine, often prepared using different vegetable oils.
In contrast, the culture of the United States is based on the Abrahamic religions—Judaism and Christianity—that worship the God of Abraham. Each has core fundamental beliefs and crucial differences in practices. Meanwhile, the societal customs in the United States are based on the beliefs of the colonists with their Protestant work ethic and frontier spirit. However, the importation of slaves from Africa and the immigration of millions of people from Europe, Asia, and other parts of the world have made the nation a melting pot of races and ethnicities. The cuisine of the US evolved from the colonial days in which hunted game, salted and smoked meats, seafood, cherries, berries, potatoes and other vegetables formed the diet of most. Elements of the cuisine evolved over time owing to local history, landscape and immigrants. Fats and oils made from animals were used extensively, and alcoholic drinks were often consumed.
Even though these two cultures are vastly different, both are experiencing an epidemic of diabetes. Why?
The reason is that one thing is nearly identical: the heavy consumption of grains and grain-flour products in both cultures. On average, Indians get 70% food energy from carbohydrate and Americans are at about 50% because of more protein and fat intake. Both percentages are high compared to the amount of carbohydrate energy consumed before large-scale cultivation of grains started, about 60 years ago. I suggest this over-consumption of grains is the true cause of high blood sugar and diabetes. Here’s how it happens.
An incorrect theory
After a meal, the presence of insulin, a hormone released by the pancreas, is needed to enable glucose to enter inside cells. (There are a few exceptions, such as intestinal and nerve cells that do not need help from insulin to let glucose in.) Experts say that diabetes is caused by “insulin resistance,” but it occurs in only three out of 200 groups of cells: 1) muscle cells; 2) liver cells; and 3) fat cells.
The primary evidence presented is as follows. When both glucose and insulin are administered simultaneously through a vein, excess glucose stays in the blood instead of going into cells as it should, despite there being plenty of insulin. The explanation given for how this happens is that fat molecules outside cells create resistance to insulin inside. However, no mechanism has ever been delineated to show exactly how this occurs.
This theory ignores the fact that there are four hormones that keep the blood glucose level normal – insulin, glucagon, epinephrine, and cortisol. Why is only insulin is resisted? Even more mindboggling is the assertion that billions of liver and fat cells become resistant during some women’s pregnancies and then return to insulin sensitivity within days after delivery, as if they downloaded a flip-flop program from the cloud. How? Why?
So the question is, how can grain consumption possibly cause high blood sugar and diabetes? Read the answer in the online edition of India West over the next weeks in this 3-part series.
Dr. John Poothullil is a retired physician who practiced for 30 years in Lake Jackson, Texas. He is the author of two books on diabetes. The first, Eat, Chew Live is intended to teach how to prevent diabetes and the other book, Diabetes: The Real Cause and the Right Cure teaches people how to reverse diabetes if they already have been diagnosed. The first book is available in India from The Book People (www.olivepublication.com) and in the US at bookstores and Amazon. The second book will be available in July in both countries. He is also working on a new book about diabetes and cancer, to be published in October 2017.
(This is Part 1 in a 3-part series.This information is provided by Dr. Poothullil in his individual capacity and does not represent the views of India-West.))