Refined grains and sugars are the main sources of carbohydrates, and any low-carbohydrate diet should restrict these.
Yet we need to make a further distinction between unrefined carbohydrates, such as potatoes and fruit, and refined carbohydrates, such as added sugars and flour, because the higher the intake of refined carbohydrates, the higher the risk of diabetes.25 The reason is that refined carbohydrates increase blood glucose higher and faster than unrefined ones.
This effect becomes obvious when looking at glycemic load.
Unrefined foods score low on the scale despite having similar amounts of dietary carbohydrates.
Figure 14.4.
Glycemic load of various carbohydrates26
This distinction explains how many traditional societies can eat carbohydrate-based diets without evidence of disease.
For example, the Tukisenta, a highland tribe of New Guinea, derive 94.6 percent of their energy intake as whole, unprocessed carbohydrates; and the Okinawans, a group living on a small island in southern Japan, eat a traditional diet that is almost 85 percent starch.
Both groups eat mostly sweet potatoes.
With virtually no sugar or refined grains such as flour,27 type 2 diabetes is almost non-existent.
The native diet of Kitava, a small island off New Guinea, consists of 69 percent carbohydrates, mostly tubers (sweet potato, cassava, and yam), coconut, and fruit, but their average insulin level is lower than 90 percent of Swedes.28 In other words, higher carbohydrate intake alone does not necessarily lead to higher insulin levels.
Refining and processing plays a leading role in enhancing the insulin effect.
Removing the natural fiber, fat, and proteins in foods leaves pure concentrated carbohydrates, a form not found naturally.
Further grinding of these carbohydrates into a fine powder (such as flour) increases the speed of digestion, which results in higher blood glucose spikes.
At the same time, we tend to eat more refined carbohydrates because the satiating effect of the protein, fiber, and fat have been lost.
Fructose plays a dominant role in the development of fatty liver, insulin resistance, and hyperinsulinemia, and
traditional societies eat little or no added sugar.
The essential defect of type 2 diabetes is hyperinsulinemia, which may or may not be the result of too many carbohydrates.
Reversing or preventing type 2 diabetes means lowering insulin, and even diets high in carbohydrates may do that.
However, avoiding sugar and refined carbohydrates remains the cornerstone of success.
Studies prove that a reduced-carbohydrate, higher-fat Mediterranean diet using olive oil reduces the need for medication by a stunning 59 percent.29 By recognizing the potential benefits of eating natural fats and reducing the amount of added sugars and processed, refined carbohydrates, we are on our way to reducing and reversing type 2 diabetes.
GET RID OF SUGAR, GET RID OF DIABETES
WE KNOW THAT the very essence of type 2 diabetes is too much sugar in the body, not just in the blood. Once we understand this basic paradigm, the solution is immediately obvious. If the problem is too much sugar (glucose and fructose), two treatments will work. And luckily, neither involves surgery or medications: