Do Carbs Cause Diabetes?


There’s so much misinformation about carbohydrates causing diabetes, that I feel it’s necessary to write this entry and share some truth about this non-existent correlation. I also want to say that while carbohydrates are blamed for everything from a spike in blood sugar levels to obesity, those of us who know the truth about healthy high carbohydrate diets need to provide people with information, sources, studies, and more. There are too many people who will subscribe to a high fat diet because it closely resembles their diet anyway. Of course if you tell people to eat butter, eggs, and bacon they’re going to get on board (especially in this country). But they’ll be signing up for constipation, diabetes, heart disease – including heart attacks, and more. And that’s not safe, responsible, or morally acceptable.

Dr. Garth Davis is a phenomenal physician who is doing an excellent job of taking care of his patients and providing them (and the public) with lots of helpful health information. He recently posted a long status on Facebook, which probably seems like a funny thing for me to share here, but it was packed with such amazing information that I feel it’s necessary for everyone to read this. I will include his many sources as well. Take some time to read through everything he included in his post and then enjoy a video from Dr. Michael Greger. For more information, take a look at the myriad of sources that Dr. Garth Davis provides at the end of his post, visit, Physicians Committee for Responsible Medicine, read through Dr. Dean Ornish’s studies on reversing heart disease, join me for a free 1-hour health consultation, and if you want to lose weight, and/or have prediabetes, ask me about the YMCA’s Diabetes Prevention Program.

Here is what Dr. Garth has to say about carbs, diabetes, and fat: “So, this is going to be a long rant with lots of scientific references, reader beware. The cliff notes: carbs do not cause Type 2 diabetes, meat does! I will provide references at the end of the post.

“But wait a second” you may say. “My sugar goes up when I eat carbs, so carbs must be to blame”. You are not alone in this thought. Even the President of  The American Society of Bariatric Medicine thinks this way. He believes that if your sugars are low you are cured of diabetes. So he puts people on low carb diets, and in fact the studies show low carb diets will lowers blood sugar, go figure. But has diabetes been cured? Are they healthier? Low carb studies are very short term and use lab results as their end points, not end organ disease. They don’t prove that low carb diets reduce heart disease, they show that it raises HDL and since high HDL is associated with less heart disease they assume that heart disease is lower. Likewise, they assume diabetes is cured when blood sugar is low, but has diabetes been cured? Not at all. As soon as the patient eats a carb the blood sugar will rise. Why? Because they still have insulin resistance. So many people make the mistake of thinking diabetes is a disease of high blood sugar. High blood sugar is just a symptom, the disease is insulin resistance. This is why I see so many failed Atkins and protein fast patients.

So what causes insulin resistance. This is the big question. Treating the symptom and not the cause is the typical western medicine paradigm. We need to look beyond. The fact is the biggest consumer of sugar, the organ most affected by insulin, are your muscles. I find it ridiculous that people, like Robert Lustig and Gary Taubes, talk about insulin as some kind of awful hormone. Why would we evolve to have an evil hormone that is in every single person. Insulin is only a problem when the body is resistant to insulin. Insulin serves a vital purpose, which is to get the fuel into the cells, and muscle needs glucose to generate fuel.

Our bodies are built to live off sugar. Insulin is supposed to join to an insulin receptor on the surface of the muscle cell which allows the sugar to enter the body and then be utilized to produce energy in the mitochondria. In fact, the healthiest people in the world eat tons of carbs. The Sardinians and the Okinawans eat 80% of their calories from starches and yet their insulin levels are not sky high, and their blood sugars are normal.

So what causes the muscle to become insulin resistant. Well this is a little more complex but it appears that it is fat build up in the muscle cell. Excess fat entering the cells interferes with the muscle cells ability to produce insulin receptors. If the muscle cannot make insulin receptors then sugar cannot get into the cell and then the sugar starts to build up in the system. Then the pancreas has to produce even more insulin to try and force sugar into the cells, and now you start getting high insulin levels. Moderate insulin is good but high insulin inhibits an enzyme called hormone sensitive lipase causing even more fat accumulation, and a vicious cycle begins.

This then begs the question, “what causes fat to accumulate in the muscle cell”? Well, there are many theories. One is that insulin combined with lipids in the blood stream after eating causes intramyocellular fat. This makes sense. So if you eat steak believe it or not your insulin rises. It is also filled with fat. The insulin will cause fat to be accumulated in the cell. The same thing would happen if you ate a donut or a pizza. These are not carbs. They have carbs but they actually have more fat than carbs.

Other theories are that inflammation causes the muscle cell to dysfunction and not oxidate fat, causing fat accumulation. There is definitely evidence that acid accumulation cause insulin resistance likely from muscle cell dysfunction. Type II diabetes has been rising at astounding rates. How does our diet differ? We are eating a very acidic diet with too little of the bicarbonate producing plants as our ancestors did! Meat based diets are very acidic and cause inflammation which results in intramyocellular fat. There are even models that show certain amino acids will cause direct deposit of fat in the muscle cells.

There is some fascinating research looking at MRI’s of people’s muscles which show that athletes are able to mobilize fat easily from their muscle but overweight people cannot. This raises the additional question as to whether exercise has an affect on intramyocellular fat.

There is also a good body of studies showing high iron stores can affect insulin resistance. As you may know, meat is high in a particularly toxic form of iron which can further attribute to insulin resistance.

Interestingly, carbs are readily burned in our body or stored as glycogen. It is actually very difficult to turn carbs to fat. The only time carbs become fat is when glycogen stores are full and calorie intake has exceeded expenditure. A nutrition professor proved this by eating a high sugar diet but keeping calories less than 1800 calories. Despite eating almost purely sugar, he lost weight and his insulin resistance improved.

So if what I tell you is true then it should work in a randomized control trial and in epidemiologic studies of populations of people. In fact, it does. Dr. Turner-Mcgrievy and Dr. Barnard have put it to the test. They took diabetics and randomized to either vegan diet or the typical ADA, high protein diet recommended by doctors. Despite eating high carbs and lots of fruit, the vegan group had significantly greater drop in A1C.

We can see this in action in many different epidemiological studies too. The EPIC/Panacea study, which is the largest epidemiological study ever done on food and disease, found no correlation between carb consumption and development of diabetes, but meat had strong correlation to diabetes. In fact, fructose consumption was associated with less diabetes. This becomes more understandable when you know that meat causes inflammation, acidosis, stimulates insulin, and has fat.

People tend to think Type II diabetes is genetic, but diabetes is affecting all races at this point. In fact, Japanese had low rates of diabetes but if they migrated to Brazil, which is having a crisis of diabetes, they get very high rates of diabetes. In fact, the Brazil government has made recs to decrease meat. The same recs are being given by the Japanese government which has noted an increasing rate of diabetes with the increasing meat consumption.

One of the best long term studies is the Adventist Healthy study as they followed a large population for many years. The population was healthier in general due to lack of smoking and drinking and moderate exercise, making them an excellent study given less confounding factors. The vegans had considerably lower diabetes than the meat eaters.

Even Harvard’s Nurses Health Study, which is the largest and longest epidemiologic study in America, shows a significant relationship between animal protein consumption and Type II DM formation.

Let me also add that the randomized control trials and epidemiological studies, unlike the low carb studies, show improvement in end organ function. Less heart disease, less kidney dysfunction, less neuropathy, and longer life.

Most of all. Let me tell you that it is absolutely ridiculous to eat less fruit, as the president of the American Society of Bariatric Medicine claimed at our meeting. Studies show that fruit consumption does NOT increase A1C and is actually associated with weight loss and diabetes control. Studies show increasing carbs actually controls diabetes if they are whole grains, fruits and veggies!” There are so many studies that prove this point. I have included just a sample below.

(I put Dr. Garth Davis’ references at the end of this post.)

As Dr. Garth points out, “The Sardinians and the Okinawans eat 80% of their calories from starches and yet their insulin levels are not sky high, and their blood sugars are normal.” This isn’t a fluke. This is consistent with centuries of research and has helped people get healthier: high-carb low-fat diets are the key to optimal health. Eat your fruits. Eat your vegetables. Eat your whole grains. Eat your legumes. Whenever people adopt a healthy plant-based diet, they reap many healthful benefits such as weight loss, a drop in A1c levels, lower cholesterol levels (plants do not have any cholesterol – only animals and their by-products do!), lower blood pressure, less rates of prediabetes, diabetes, and several cancers.

You may have noticed that Dr. Garth Davis states, “There is some fascinating research looking at MRI’s of people’s muscles which show that athletes are able to mobilize fat easily from their muscle but overweight people cannot. This raises the additional question as to whether exercise has an affect on intramyocellular fat.” You may have also noticed that believers in a Paleo diet (or their warped version of a Paleo diet) are also cross-fitters. How much exercise does it take to ward off the effects of a terrible diet? It’s hard to say, if it’s even possible, as we see athletes who exercise frequently and with high intensity, but eat unhealthy diets, and then have heart attacks. Certainly staying active is good for you – but why not also have a healthful diet? Why flood your arteries with the very things that have contributed to this country’s gigantic obesity, heart disease, and diabetes problem? I’ll never know.

While a diet that’s high in some of your favorite foods (bacon, eggs, butter, beef, etc.) may be appealing, do not gamble with your health. The research has been done. We will continue to see the same results again and again: a high-carb low-fat diet is the way to go – do not believe the hype about high-fat low-carb diets. They’re just that: hype.

Enjoy this video from Dr. Michael Greger, one of my favorite physicians, as he discusses Diabetes and the many dangers of high-fat, low-carb diets.

Dr. Davis’ list of references:

Gimeno, S. G., et al. (2002). “Prevalence and 7-year incidence of Type II diabetes mellitus in a Japanese-Brazilian population: an alarming public health problem.” Diabetologia 45(12): 1635-1638.

de Carvalho, A. M., et al. (2013). “Excessive meat consumption in Brazil: diet quality and environmental impacts.” Public Health Nutr 16(10): 1893-1899.

Morimoto, A. (2010). Trends in the Epidemiology of Patients with Diabetes in Japan. JMAJ. 53: 36-40.

Adeva, M. M. and G. Souto (2011). “Diet-induced metabolic acidosis.” Clin Nutr 30(4): 416-421.

Souto, G., et al. (2011). “Metabolic acidosis-induced insulin resistance and cardiovascular risk.” Metab Syndr Relat Disord 9(4): 247-253.

Sebastian, A., et al. (2002). “Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors.” Am J Clin Nutr 76(6): 1308-1316.

Dawson-Hughes, B., et al. (2008). “Alkaline diets favor lean tissue mass in older adults.” Am J Clin Nutr 87(3): 662-665.

Jenkins, D. J., et al. (2003). “Type 2 diabetes and the vegetarian diet.” Am J Clin Nutr 78(3 Suppl): 610S-616S.

Holt, S. H., et al. (1997). “An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods.” Am J Clin Nutr 66(5): 1264-1276.

Barnard, N. D., et al. (2009). “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 89(5): 1588S-1596S.

Barnard, N. D., et al. (2006). “A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes.” Diabetes Care 29(8): 1777-1783.

Barnard, R. J., et al. (1998). “Diet-induced insulin resistance precedes other aspects of the metabolic syndrome.” J Appl Physiol (1985) 84(4): 1311-1315.

Stubbs, R. J., et al. (1997). “Carbohydrates and energy balance.” Ann N Y Acad Sci 819: 44-69.

Bloomer, R. J., et al. (2010). “Effect of a 21 day Daniel Fast on metabolic and cardiovascular disease risk factors in men and women.” Lipids Health Dis 9: 94.

Snowdon, D. A. and R. L. Phillips (1985). “Does a vegetarian diet reduce the occurrence of diabetes?” Am J Public Health 75(5): 507-512

Tonstad, S., et al. (2009). “Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.” Diabetes Care 32(5): 791-796.

Fung, T. T., et al. (2004). “Dietary patterns, meat intake, and the risk of type 2 diabetes in women.” Arch Intern Med 164(20): 2235-2240.

Jornayvaz, F. R., et al. (2010). “A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain.” Am J Physiol Endocrinol Metab 299(5): E808-815.

Valachovicová, M., et al. (2006). “No evidence of insulin resistance in normal weight vegetarians. A case control study.” Eur J Nutr 45(1): 52-54.

Frassetto, L., et al. (2001). “Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet.” Eur J Nutr 40(5): 200-213.

Flanagan, A. M., et al. (2008). “High-fat diets promote insulin resistance through cytokine gene expression in growing female rats.” J Nutr Biochem 19(8): 505-513.

Cai, H., et al. (2007). “A prospective study of dietary patterns and mortality in Chinese women.” Epidemiology 18(3): 393-401.

Schulze, M. B., et al. (2003). “Processed meat intake and incidence of Type 2 diabetes in younger and middle-aged women.” Diabetologia 46(11): 1465-1473.

Song, Y., et al. (2004). “A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women’s health study.” Diabetes Care 27(9): 2108-2115.

Vang, A., et al. (2008). “Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies.” Ann Nutr Metab 52(2): 96-104.

Pan, A., et al. (2013). “Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes Mellitus: Three Cohorts of US Men and Women.” JAMA Intern Med: 1-8.

Ahmadi-Abhari, S., et al. (2014). “Dietary intake of carbohydrates and risk of type 2 diabetes: the European Prospective Investigation into Cancer-Norfolk study.” Br J Nutr 111(2): 342-352.

Lara-Castro, C. and W. T. Garvey (2008). “Intracellular lipid accumulation in liver and muscle and the insulin resistance syndrome.” Endocrinol Metab Clin North Am 37(4): 841-856.

Cozma, A. I., et al. (2012). “Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials.” Diabetes Care 35(7): 1611-1620.

Azadbakht, L. and A. Esmaillzadeh (2009). “Soy-protein consumption and kidney-related biomarkers among type 2 diabetics: a crossover, randomized clinical trial.” J Ren Nutr 19(6): 479-486.

Sørensen, L. B., et al. (2005). “Effect of sucrose on inflammatory markers in overweight humans.” Am J Clin Nutr 82(2): 421-427.

Montonen, J., et al. (2013). “Consumption of red meat and whole-grain bread in relation to biomarkers of obesity, inflammation, glucose metabolism and oxidative stress.” Eur J Nutr 52(1): 337-345.

Barbaresko, J., et al. (2013). “Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review.” Nutr Rev 71(8): 511-527.

Muraki, I., et al. (2013). “Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies.” BMJ 347: f5001.

Ye, E. Q., et al. (2012). “Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain.” J Nutr 142(7): 1304-1313.

Chiu, T. H., et al. (2014). “Taiwanese Vegetarians and Omnivores: Dietary Composition, Prevalence of Diabetes and IFG.” PLoS One 9(2): e88547.

Goff, L. M., et al. (2005). “Veganism and its relationship with insulin resistance and intramyocellular lipid.” Eur J Clin Nutr 59(2): 291-298.

Esposito, K., et al. (2003). “Effect of dietary antioxidants on postprandial endothelial dysfunction induced by a high-fat meal in healthy subjects.” Am J Clin Nutr 77(1): 139-143.

Jiang, R., et al. (2004). “Body iron stores in relation to risk of type 2 diabetes in apparently healthy women.” JAMA 291(6): 711-717.

Hua, N. W., et al. (2001). “Low iron status and enhanced insulin sensitivity in lacto-ovo vegetarians.” Br J Nutr 86(4): 515-519.

Watzl, B. (2008). “Anti-inflammatory effects of plant-based foods and of their constituents.” Int J Vitam Nutr Res 78(6): 293-298.

Chandalia, M., et al. (2000). “Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus.” N Engl J Med 342(19): 1392-1398.

Pickup, J. C. (2004). “Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes.” Diabetes Care 27(3): 813-823.

Deopurkar, R., et al. (2010). “Differential effects of cream, glucose, and orange juice on inflammation, endotoxin, and the expression of Toll-like receptor-4 and suppressor of cytokine signaling-3.” Diabetes Care 33(5): 991-997.

Ghanim, H., et al. (2009). “Increase in plasma endotoxin concentrations and the expression of Toll-like receptors and suppressor of cytokine signaling-3 in mononuclear cells after a high-fat, high-carbohydrate meal: implications for insulin resistance.” Diabetes Care 32(12): 2281-2287.

Bao, W., et al. (2012). “Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis.” BMC Med 10: 119.

Romeu, M., et al. (2013). “Diet, iron biomarkers and oxidative stress in a representative sample of Mediterranean population.” Nutr J 12(1): 102.

Cooper, A. J., et al. (2012). “A prospective study of the association between quantity and variety of fruit and vegetable intake and incident type 2 diabetes.” Diabetes Care 35(6): 1293-1300.

Rizzo, N. S., et al. (2011). “Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2.” Diabetes Care 34(5): 1225-1227.

Consortium, I. (2013). “Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study.” Diabetologia 56(1): 47-59.

Watt, M. J. and A. J. Hoy (2012). “Lipid metabolism in skeletal muscle: generation of adaptive and maladaptive intracellular signals for cellular function.” Am J Physiol Endocrinol Metab 302(11): E1315-1328.

Coletta, D. K. and L. J. Mandarino (2011). “Mitochondrial dysfunction and insulin resistance from the outside in: extracellular matrix, the cytoskeleton, and mitochondria.” Am J Physiol Endocrinol Metab 301(5): E749-755.

Eckel, R. H., et al. (2005). “The metabolic syndrome.” Lancet 365(9468): 1415-1428.

Brunzell, J. D., et al. (1971). “Improved glucose tolerance with high carbohydrate feeding in mild diabetes.” N Engl J Med 284(10): 521-524.

Christensen, A. S., et al. (2013). “Effect of fruit restriction on glycemic control in patients with type 2 diabetes–a randomized trial.” Nutr J 12: 29.”


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