about a health problem you've been trying to reverse?

Maybe high blood pressure, diabetes, or heart disease.

Well, there's nothing I like better than bringing you the information

that will help you do just that.

Welcome to the Nutrition Facts Podcast.

I'm your host, Dr. Michael Greger.

Today we discover the mighty power of oatmeal.

Did you know that before there was insulin,

there was the 'oatmeal cure'?

The life of many diabetics was saved

or prolonged by Carl von Noorden's oatmeal diet,

which he apparently stumbled upon accidentally.

Some of his diabetic patients had gastrointestinal issues;

so, he put them on oatmeal,

and instead of the sugars spilling over into their urine

getting worse, they started getting better.

He published his findings in 1903, which was received

with a great deal of skepticism.

But the skeptics were overcome, however, in the following years

by the weight of the evidence.

A turning point came when a doctor

as notable as James B. Herrick gave it a try.

Dr. Herrick is acclaimed for his description of sickle cell anemia,

which was originally known as Herrick's syndrome.

When Dr. Herrick began to try out the oatmeal diet on his patients,

he was very skeptical, but was astonished by the results.

Intense skepticism was how Herrick put it.

His first experience in prescribing it

was far from encouraging.

After taking one or two meals, the patient said,

“Doctor, I will die before I taste another spoonful of that oatmeal mush.”

And indeed, tragically, she did.

Other doctors echoed patient reticence

to tolerate so monotonous an equine diet.

But in general, Herrick said,

he went on to experience little difficulty

in putting patients on the oatmeal diet

and in keeping them there for a few weeks.

And nothing, he reported, was more surprising

or more gratifying than the salutary effects he witnessed

of the oatmeal diet in diabetes of the young,

leading to the 1909 proclamation that no case of juvenile

or adolescent diabetes should be deprived

of the benefits of the oatmeal cure.

The great Elliott Joslin, founder of the oldest

and largest diabetes clinic in the world,

described the effects of the oatmeal as sometimes magical,

describing the oatmeal cure as an unsolved mystery,

referred to back then as one

of the greatest puzzles in diabetes.

They did have some clues though.

They found that animal protein had to be strictly excluded,

as it annihilates the favorable action of oatmeal-type diets.

They used to use eggs with the oatmeal diet,

but they got better results without them.

And now we know, over a century later that indeed,

animal protein intake intensifies insulin resistance,

which is the cause of prediabetes and type 2 diabetes,

whereas plant-based foods enhance insulin sensitivity,

which is the opposite.

Animal-protein intake is not just associated

with insulin resistance and a clear association

with an increased risk of type 2 diabetes

(and this included animal protein from meat, dairy, and fish—

higher insulin resistance and risk of prediabetes and type 2 diabetes).

But not just an association; you can put it to the test.

Swapping in beans for beef improves cardiometabolic risk factors.

And it doesn't take much.

Replace just two servings of red meat with lentils, chickpeas,

split peas, or beans a few days a week,

and you can significantly improve fasting blood sugars and insulin levels,

along with the improvements you'd expect,

like lowering of cholesterol and triglycerides.

Based on over a dozen randomized controlled trials,

even just swapping like a third of protein

from animal to plant sources

can significantly improve blood sugar control.

What's the difference

between animal protein and plant protein?

We think it's the branched-chain amino acids

concentrated in animal protein.

How do we know branched-chain amino acids are playing a role?

Because if you give vegans branched-chain amino acid supplements,

you can make them as insulin resistant as meat eaters.

Their insulin sensitivity dropped to the level resembling omnivores

and only improved again after stopping the supplements.

But wait a second.

I thought insulin resistance stems from excess accumulation of fat

inside your muscle cells, particularly saturated fat.

Insulin resistance directly correlates

with increased saturated fat inside your muscles.

I've got tons of videos on this,

but basically you can show a substantial

and consistent impairment of insulin action,

substantial and consistent insulin resistance

after just a single day

consuming a diet high in saturated fat.

In fact, even a single meal rich in saturated fat

reduces insulin sensitivity.

A single dose of butter, for example,

impairs insulin sensitivity even in healthy subjects.

And over time, reducing cholesterol

and fat intake may even enhance the ability of your pancreas

to pump out insulin in the first place.

Now, the saturated fat getting lodged in your muscles

may come from the foods going into your mouth,

or if you have excess abdominal fat,

from previous meals spilling over into your blood stream.

But either way, what does animal protein have to do with it?

It turns out a branched-chain amino acid breakdown product

appears to stimulate fat uptake

and accumulation inside the muscle cells.

But oatmeal doesn't have any saturated animal fat or animal protein.

Okay, but neither does any plant food.

Why might oatmeal work particularly well?

That's the question I explore next.

It is now widely accepted that diets high in animal fat

and processed foods are an important risk factor

for development of type 2 diabetes.

And it's not just animal fat, but animal protein intake

intensifies insulin resistance,

which predisposes people to type 2 diabetes.

No wonder studies have shown that elevated consumption

of animal products and low intake of unprocessed plant foods

increases the risk of not only cardiovascular disease but diabetes.

But of all the whole plant foods to pick, why choose oatmeal

to treat diabetes, which, as I discussed in my last video,

was used for the treatment of diabetes before insulin was discovered.

We've long known that higher consumption of whole grains, including oats,

is associated with a lower risk of diabetes, but you don't know...

until you put it to the test.

There have been over a dozen randomized controlled trials

looking at the metabolic effects

of oats intake in patients with type 2 diabetes,

and oats were found to significantly improve

both short-term blood sugar control and long-term blood sugar control

in addition to lowering cholesterol levels.

We think the benefits arise from a fermentable fiber in oats

called beta glucan, because you can get cholesterol-lowering

even if you just give the oat fiber straight,

as well as an improvement in blood sugar control

and insulin sensitivity in both type 2 diabetics,

as well as type 1 diabetics.

How exactly does the fiber do that?

Well, we know one of the underlying cholesterol-lowering mechanisms

of oatmeal consumption might be its microbiome-manipulating ability,

in other words, having a beneficial effect

on our intestinal bacteria.

The anti-inflammatory effects of the short-chain fatty acids

that our good gut flora make from fiber.

There are dozens of randomized controlled trials

showing the types of fiber found in oats

and beans can improve long-term blood sugar control in diabetics—

in fact, nearly double the FDA threshold

required for new blood sugar- lowering drugs. Why?

Because the gut bacteria selectively promoted by dietary fiber intake

can help alleviate type 2 diabetes.

In fact, on the basis of 50 distinct bacterial markers of the feces,

you can tell who does and does not have diabetes.

But change your diet, and you can change

your gut flora within one day.

We feed them with fiber, and in return,

they feed us right back with these short-chain fatty acids

like butyrate that have all these wonderful effects.

Put people on a diet packed with oats, beans, fruits, vegetables, and nuts,

and the number of fiber-feeders

churning out the beneficial short- chain fatty acids shoots up,

and fasting diabetic blood sugars drop about 25 percent within one month.

And the more fiber- feeders they fostered,

the better their blood sugar control.

When the fiber-promoted short-chain fatty acid producers

were present in greater diversity and abundance,

participants had better improvement in their hemoglobin A1c levels

(which is a measure of longer-term blood sugar control).

Then, before and after fecal transplant studies

helped nail down cause and effect.

The oat fiber itself has been shown to act as a prebiotic,

boosting the growth of beneficial bacteria

like lactobacillus and bifidobacteria.

So, between the lack of animal protein,

lack of animal fat,

and bursting at the seams with prebiotic fiber,

it's no wonder that oatmeal diets grew to become

part of the clinical routine in the treatment of diabetics.

However, over time, this practice

has later become increasingly forgotten,

a disappearance that's been compared to the fate

of unpopular theories in successive editions

of Soviet encyclopedias.

Despite advances in therapy, we still have many people

with poorly controlled diabetes.

Thankfully this forgotten tool is back.

I'll review all the new oatmeal diet studies next.

Thousands of years ago in ancient Egypt, diabetes was described

as a “too great emptying of urine” or, more poetically,

as being “like the River Nile between the thighs.”

The recommended remedy, ironically, was a diet

consisting of wheat grains, grapes, honey, and berries.

The guy who coined the term “diabetes” about 500 years later

also prescribed a high-carbohydrate diet.

Then, right up until we had insulin,

doctors were saving the lives of diabetics with an oatmeal diet.

This wouldn't make any sense until Sir Harold Himsworth arrived

on the scene, the first to separate out type 1 diabetes

from type 2 diabetes and define this concept of insulin resistance.

After just a few days on a high-fat diet,

you can get twice the blood sugar spike in response

to drinking sugar water,

compared to after eating a high-carb diet.

Now that type 2 diabetes is like the Black Death of the 21st century

in terms of devastating health impacts,

what about revisiting the almost forgotten,

short-term dietary oatmeal intervention as an economical,

yet—spoiler alert— highly effective tool to achieve

better blood sugar control in patients with type 2 diabetes?

Basically, patients are offered up to about

two and a half cups of oatmeal three times a day

as their meals with nothing but some herbs

and maybe small amounts of raw vegetables just to mix things up.

For how long? Just a couple of days.

Note that's only like a thousand calories;

so, the result is a hypocaloric, plant-based dietary intervention

that is low in fat—in fact, no added fat—no salt,

and excludes animal protein.

Is a few days of oatmeal really going

to make much of a difference?

Check out this case report of an oatmeal intervention

for severe insulin resistance in the ICU.

Within 48 hours of admission, the patient developed

such severe insulin resistance she required

more than 200 units of insulin per day.

Up until then, the patient received standard diabetic tube feeds,

which obviously were not working.

So instead, they dropped oatmeal and vegetables down the tube instead,

presumably using a really good blender.

And lo and behold, it worked.

But you've got to see the numbers.

Yeah, her first blood sugars of the day dropped

from up around 250 down to about 100 five days later.