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by exelius 3711 days ago
Given that Type 2 diabetes is generally believed to be caused by diet, it makes sense that diet could fix it as well.

My personal hypothesis is that some people have intestinal bacteria that are really, really good at breaking down sugar very quickly. So when you eat high GI foods, your gut turns them into glucose very quickly releases them into your blood, and your body has to deal accordingly. IMO that would help explain why people who are very obese get type 2 with some regularity, but how otherwise healthy adults who are simply moderately overweight can also develop it.

A corollary to this hypothesis is that the ability of your (personal) intestinal bacteria to break down different types of foods at different rates means that there is no such thing as a "universal diet". Some people will be healthiest eating large amounts of red meat, some will be healthiest on a high-carb diet, while others may need something more fiber-rich (assuming appropriate calorie control, of course). This appears to be borne out anecdotally, with diet plans having different efficacy on different people.

Intestinal flora is something the medical community is just now beginning to research and understand. There's something unique that happens in our intestines, and while there's obviously a genetic component to it, the genes your intestinal flora carry may be just as important. We don't understand the system or the feedback loops (maybe eating too much sugar causes these bacteria to over-populate the intestines in some people and crowd out other bacteria?) The point is, there's a whole lot we don't know about how our bodies process the nutrients we take in. There are a lot of studies underway, but holistic medicine is pretty obviously a real thing -- we just don't understand the science behind it yet.

6 comments

The standard human digestion system is really really good at breaking down sugar very quickly. Enzymes dominate the process, not microorganisms.
But the word "dominates" should really be emphasized there because there is growing evidence that gut microbiota can help with breaking down lactose even when you lack the ability to produce lactase.

http://www.ncbi.nlm.nih.gov/pubmed/17927751 http://www.ncbi.nlm.nih.gov/pubmed/11157352

It isn't that nuanced; lactose intolerance is uncomfortable because there are microorganisms breaking down the lactose and releasing gas (and what not). Those studies are looking at whether bacteria that do not produce as much gas can colonize our digestive systems.

If the lactose passed through intact, it wouldn't be a problem. If enzymes weren't responsible for breaking down sucrose and there were bacteria doing it, HFCS would probably be even more popular.

Interesting, thanks for the correction that does change my mental model slightly and I appreciate it!
> Intestinal flora is something the medical community is just now beginning to research and understand.

What's interesting is that intestinal flora can take time to adjust in response to dietary changes (wish I could find some good figures on precisely how long, but the whole field of research on the subject is so new). This means that those on a seemingly unhealthy diet can initially do far worse switching over to 'unfamiliar' healthy food as their gut flora are presented with something they have little 'experience' digesting.

In my own experience, cutting out grains and milk from my diet resulted in a good few months of problems before things settled down again which seemed very counter intuitive until I read up on the significant role gut bacteria play in digestion.

I know when I started eating paleo, I had really painful gas (to me and everyone else) for a few months. Then, after a while, I could eat all the broccoli I could stand and it was fine.
> My personal hypothesis is that some people have intestinal bacteria that are really, really good at breaking down sugar very quickly. So when you eat high GI foods, your gut turns them into glucose very quickly releases them into your blood

Are there such bacteria? I only know about intestinal bacteria breaking down indigestable carbohydrate (also called soluble "fiber") into short-chain fatty acids. Other carbs except fructose (handled by liver) should be broken down into glucose via digestive enzymes prior to colon throughout the digestive tract starting in your mouth.

> IMO that would help explain why people who are very obese get type 2 with some regularity, but how otherwise healthy adults who are simply moderately overweight can also develop it.

Well many obese also never develop T2DM either. The non-fat people who become T2 might have been on a high-carb-low-fat regimen rather than a high-carb-high-fat regimen.

> A corollary to this hypothesis is that the ability of your (personal) intestinal bacteria to break down different types of foods at different rates means that there is no such thing as a "universal diet". Some people will be healthiest eating large amounts of red meat, some will be healthiest on a high-carb diet, while others may need something more fiber-rich (assuming appropriate calorie control, of course).

This seems to assume an unduly large role for intestinal bacteria in digestion. Stomach acid and digestive enzymes do the bulk of the work prior, and colon bacteria get leftovers that our bodies don't handle "natively" AFAIK. Exception is some cause or other flushing stuff down the tract prematurely prior to absorption, perhaps something dangerous that stomach acid didn't neutralize, enzyme problems, overstuffing or what not..

> Intestinal flora is something the medical community is just now beginning to research and understand. There's something unique that happens in our intestines

I agree but people shouldn't forget bacteria only get the leftovers and if bacteria are found to be the cause of weight or health issues, maybe one should first evaluate whether enzymes are broken or too much (improperly preprocessed) cellulose is being consumed?

> Exception is some cause or other flushing stuff down the tract prematurely prior to absorption, perhaps something dangerous that stomach acid didn't neutralize, enzyme problems, overstuffing or what not..

I've read some advice about not drinking water with meals for this reason. The idea is that it will dilute your stomach acid making it more basic and less effective.

> There are a lot of studies underway, but holistic medicine is pretty obviously a real thing -- we just don't understand the science behind it yet.

"[W]e just don't understand the science behind it yet" because there is none. Holistic medicine is quackery that has failed scientific tests if efficacy time and time again.

I don't mean that the current "practice" of holistic medicine is quackery -- but that the principles behind it (what you eat can cause/treat certain diseases), when proven with proper scientific methodology, aren't entirely crazy.
Times article (from 5 years ago) describing an emerging awareness of gut-bacteria types much like blood types: http://www.nytimes.com/2011/04/21/science/21gut.html?_r=0
Are there any particular probiotics you'd recommend? I've heard many good things about General Biotics.