The Secret of Apple Pie
How It Serves Blood Sugar Health
Who could have guessed that America's favorite dessert harbors a health-giving secret?
ype 2 diabetes mellitus (also called adult-onset, or non-insulin dependent, diabetes mellitus) is becoming more prevalent, not only in the United States, but worldwide. Is this disease a modern "invention," i.e., is our modern diet responsible because it has strayed so far from the kinds of foods our hunter-gatherer ancestors ate for countless millennia? Could these dietary changes have altered the way in which some of our genes are expressed?
In the following interview conducted by Life Enhancement's Will Block, the prominent natural medicine physician Jonathan V. Wright, M.D., gives us some insight into the problems of type 2 diabetes and reveals an unexpected new factor with a surprising health benefit: apple pie! Dr. Wright describes the exciting possibilities of a new supplement, methylhydroxychalcone polymer (MHCP), a compound found in cinnamon. If you want to avoid falling prey to type 2 diabetes, read on.
LE: How prevalent is type 2 diabetes?
DR. WRIGHT: In the United States alone, approximately 15 million adults have type 2 diabetes (that's about 90% of all diabetes), which mainly affects people over 40. The primary cause is obesity, brought on by lack of exercise and our Western diet, which is high in carbohydrates and fats, but low in many essential nutrients, including omega-3 fatty acids. Although there is certainly a genetic link to type 2 diabetes, it would not express itself strongly were it not for our physical inactivity and unhealthy diet, and the disease would be rare. The disease is thus largely preventable.
By contrast, type 1 diabetes mellitus (also called juvenile-onset, or insulin dependent, diabetes mellitus) is an autoimmune disease believed to be caused by a combination of genetics and viruses, or exposure to certain toxins. It is even possible that an infant's exposure to the proteins in cow's milk can trigger type 1 diabetes.
LE: Epidemiologists estimate that as many as one-third of all Americans are potential diabetics.
DR. WRIGHT: Certainly as we grow older, our bodies' ability to regulate blood sugar declines, and that sets the stage for diabetes. And when the disease does take hold, it accelerates the aging process. One way in which this occurs is through a process called glycation, in which carbohydrate molecules react with protein molecules to form complex structures called advanced glycation end products (AGEs). The accumulation of AGEs in our tissues causes them to stiffen somewhat, resulting in a gradual immobilization of body functions. One example of glycation occurs in the blood, when glucose reacts with hemoglobin. The resulting complex, called hemoglobin A1c, is actually used as a diagnostic test for diabetes.
LE: What is the conventional wisdom about preventing and treating type 2 diabetes?
DR. WRIGHT: Prevention is relatively easy: avoid obesity (OK, that's easier said than done, and there's more to it than that, but that is the major factor). Conventional medical practice, unfortunately, is not big on prevention, and when diabetes does occur, the usual treatment is to prescribe drugs that regulate blood sugar levels by, in effect, flogging your pancreas to produce more insulin. The paradox here is that, in type 2 diabetes, the pancreas is already overproducing insulin, in an increasingly futile effort to keep blood sugar levels in check. So the main problem is not a deficiency of insulin (remember that it's called "non-insulin-dependent" diabetes), but rather insulin resistance - the inability of the body's cells to utilize insulin efficiently. Prescribing drugs that force the pancreas to make still more insulin incurs the risk of accelerating a breakdown of the entire insulin regulatory system.
MHCP has effects similar to those
of insulin, and it works almost as
well as insulin. When the two act
together, the effect is synergistic:
the total effect is greater than
the sum of its parts.
Another type of treatment uses prescription drugs - some of them derived from the herbal medicine tradition - that overcome insulin resistance by increasing the cells' sensitivity to insulin, thus helping to control blood sugar. Many of these drugs, however, are effective only for a limited time, and many are synthetic compounds not found in nature. Such compounds almost invariably cause unwanted side effects, which can range from merely annoying to downright dangerous. Problems of this kind are much less likely to occur, however, if we use compounds that are at home in the human body because they are naturally found there, or elsewhere in nature.
Now, it must be said that conventional medical practice does emphasize the crucial importance of diet. All the big clinics I know of offer classes on how to eat properly, but unfortunately they tend to get it wrong, because they usually focus on what are called "carbohydrate exchanges." These rely heavily on grains, legumes, and so forth that, although they are much healthier than refined foods, do not match the diets that humans have eaten for over 99% of the history of our species. To be fair, however, there are a few modern diet doctors who advocate a high-protein, low-carbohydrate diet similar to that of many of our primitive ancestors.
LE: What specifically constitutes an appropriate diet?
DR. WRIGHT: First let me say that a low-fat, high-complex-carbohydrate diet is entirely unsuitable for both the prevention and treatment of type 2 diabetes. To prevent this disease, we need a diet with relatively high amounts of protein, lots of vegetables, and a few fruits, while keeping grains, beans, and other starches way down and, of course, eliminating most sugar. Note, however, that this is not "universal diet advice" for everyone! It's best for the approximately one in three of us who have a family history of type 2 diabetes. And whatever our diet may be, we can't forget the importance of regular exercise, which helps to regulate blood sugar throughout our lives, whether we have diabetes or not.
In addition, there are valuable dietary supplements, which are most helpful when the basic diet has already been established. Years ago, pioneering nutritionist Adele Davis told us that brewer's yeast could improve our blood sugar levels and even help prevent type 2 diabetes. Researchers looking further found that brewer's yeast was a rich source of the element chromium and that chromium by itself can improve blood sugar regulation in type 2 diabetes. If you already have the disease, however, the amount of chromium that may be preventive (200-500 micrograms/day) may be only marginally effective in improving blood sugar regulation and insulin sensitivity. But at 1000 micrograms (1 milligram) of chromium per day, it appears that there is a statistically significant improvement in these factors.
Fortunately, chromium is a very safe trace element in what is called the trivalent chemical state, the state in which it is usually found in food (albeit in lesser amounts). Dr. Richard Anderson, a leading chromium and diabetes researcher, believes that 1000 micrograms per day is a safe amount to meet the greater need for chromium of people with type 2 diabetes.
LE: We've heard that Dr. Anderson has been working on something new for the last few years that may be as beneficial for type 2 diabetes, if not more so, than chromium. What can you tell us about that?
DR. WRIGHT: Dr. Anderson and his research team examined foods that had a positive impact on blood sugar, and their attention was drawn to - believe it or not - apple pie! Because apple pie improved blood sugar regulation and insulin sensitivity so much, they started examining its components to find out what produced these effects, and how they did it. They found that apple pie spices (these are typically cinnamon and nutmeg, but various other spices are sometimes also used) were responsible for the beneficial effects. Looking further, they found that it was in fact cinnamon that had far and way the greatest effect, and looking further still, they found a particular component of cinnamon, with the catchy name methylhydroxychalcone polymer (MHCP), that was primarily responsible.*
*A polymer is a long, chainlike molecule in which the links are repeating units of a relatively small molecule - in this case, MHC. Galega helps restore insulin sensitivity, regulate blood sugar, regenerate pancreatic cells, and prevent the formation of AGEs.
What Dr. Anderson and his research team have discovered is that MHCP can stimulate glucose uptake by our cells. It can even help in the synthesis of glycogen, a polymer of glucose that our bodies produce as a means of storing energy for later use, when it is depolymerized back to glucose (see Figure 1). Most of our glycogen is found in the liver, but some is found in our muscles - a handy place to be when we start exercising and need it for quick energy. Producing adequate amounts of glycogen is a principal function of blood sugar metabolism, and MHCP can help with this.
Figure 1. When blood sugar (glucose) is low, the pancreatic hormone glucagon causes the liver to release glucose from its stores of glycogen. When blood sugar is high, insulin causes some of it to be taken in by fat cells. This keeps blood sugar in check, but you may get fat.
Dr. Anderson has stated that MHCP has effects similar to those of insulin, and this has created quite a stir because MHCP works almost as well as insulin. Both of these substances work by chemically modifying our cells' insulin receptors in such a way as to activate them to do their job, which is to allow glucose molecules to pass through the cell wall into the interior of the cell, where the glucose is used for energy production. What's really interesting here is that the insulin cascade - the series of molecular events triggered by insulin's interaction with its receptor - is also triggered by MHCP.
Galega helps restore insulin
sensitivity, regulate blood sugar,
regenerate pancreatic cells, and
prevent the formation of AGEs.
Dr. Anderson has also discovered that when MHCP and insulin act together, the effect is synergistic, i.e., the total effect is greater than the sum of its parts. Thus, because the activity of insulin is compromised by insulin resistance in type 2 diabetes, using MHCP could make a real difference, not only through its own positive effect but also through its ability to enhance that of insulin.
What's more, I think MHCP may also have some use in type 1 (insulin-dependent) diabetes. If MHCP is synergistic with insulin in triggering the insulin cascade, one could imagine that MHCP might reduce the amount of insulin that must be injected to control the type 1 disease. But this is hypothetical.
In any case, I'm really excited and grateful that Dr. Anderson and his team have apparently found a safe, natural substance that can benefit so many people!
LE: That's good news. And doesn't MHCP also tend to reduce blood pressure?
DR. WRIGHT: Yes - in experimental animals, anyway. Even before the animal studies that demonstrated MHCP's ability to improve insulin sensitivity, researchers discovered that it reduced blood pressure. Now, are these two effects connected? At present we don't know. Blood pressure reduction may be a separate effect of MHCP, or it may be part of the insulin effect.
One more thing: a blood platelet assay showed that MHCP prevented the formation of damaging oxygen radicals. According to Dr. Anderson, that could be an important additional benefit, because other studies have shown that antioxidant supplements can reduce or slow the progression of various complications of diabetes.
LE: MHCP is a polyphenol, and red wine polyphenols have been in the news lately because of their cardiovascular benefit in inhibiting the constriction of blood vessels. Could MHCP work by a similar mechanism?
DR. WRIGHT: We don't know yet. But many polyphenols have substantial health benefits. For example, certain polyphenols found in green tea may help prevent prostate cancer. It could be that the best things about MHCP haven't even been discovered yet. In any case, it has been reported that some people with type 2 diabetes, after hearing about Dr. Anderson's research, started eating cinnamon right out of the spice rack, a quarter to half a teaspoon per day. Many of these folks have apparently called Dr. Anderson's lab and said, "Hey, that helped my blood sugar." This may not be a good idea, however, because cinnamon contains hundreds of compounds, not just MHCP, and one of these compounds is the anticoagulant drug coumarin, which you do not want to get too much of.
LE: So it could be a mistake to take cinnamon in huge amounts?
DR. WRIGHT: Yes. It's unlikely that men and women have ever eaten very large amounts of this delightful spice (which, by the way, has useful antibacterial properties), because too much of a good thing just isn't that good anymore, and it could even be harmful. MHCP, by the way, is a very safe compound.
LE: The compounds in cinnamon that could be harmful in large amounts are soluble in oil, whereas I understand that MHCP is water-soluble, so it's not found in cinnamon oils.
DR. WRIGHT: What's more, I recommend three vitamins: C, E, and B6. Vitamin C is known to inhibit the accumulation of sorbitol, a sweet-tasting alcohol derived from glucose. Excess sorbitol is implicated in the formation of cataracts in diabetic individuals, and it is thought to lead to diabetic neuropathy, a catchall term that means a functional disturbance or pathological change in the peripheral nervous system. Diabetic neuropathy is common in the early stages of type 1 diabetes and also in the later stages of type 2 diabetes.
Here are a couple of paradoxes for you. Sorbitol, which is found in various fruits and berries, is used as a food sweetener, instead of sugar, for diabetics! It's also used in the manufacture of vitamin C as well as various cosmetics, foodstuffs, and medicines. It just goes to show you that a chemical compound can be a blessing or a curse, depending on where and when it's found, and at what levels. Anyway, vitamin C also inhibits the process of glycation to some degree, thus helping to prevent the tissue-stiffening effect of those AGEs that I mentioned earlier. It also improves lipid metabolism. By the way, it should be good to take both fat-soluble and water-soluble forms of vitamin C, for maximum benefit.
I included vitamin E because it has been noticed that people who supplement with this vitamin have a lower incidence of diabetes. And since both vitamin E and vitamin C are potent antioxidants, they work together to reduce oxidative stress, thus improving glucose sensitivity and transport. These two vitamins also help to improve glucose sensitivity in cooperation with the highly beneficial omega-3 fatty acids, which are found highly concentrated in cell membranes.
Vitamin B6 has been shown to help protect against diabetic neuropathy, and it is another nutrient that contributes to the inhibition of glycation and those destructive AGEs.
LE: What about lipoic acid? There has been a lot of excitement about that recently.
DR. WRIGHT: Indeed there has. Lipoic acid is a crucially important antioxidant, particularly for many of the processes that occur in our liver, where the metabolism of a wide variety of compounds takes place. Equally important is that lipoic acid can enhance our microcirculation, which helps prevent diabetic neuropathy. And perhaps more important still, lipoic acid increases insulin sensitivity in type 2 diabetics (remember that their insulin sensitivity is impaired). This means that the pancreas does not have to work so hard at making insulin, and the insulin level goes down, while blood sugar regulation is actually improved. Research shows that we need up to 600 mg of lipoic acid per day.
Chromium, as I mentioned earlier, also improves insulin sensitivity - which is one of the benefits that MHCP provides in a major way. In cell cultures, MHCP has been found to increase glucose metabolism by 20 times over baseline, which is really fantastic.With lipoic acid, chromium, and MHCP all combined, there may be a synergistic effect rather than merely an additive one.
LE: Can the mineral vanadium be of help?
DR. WRIGHT: Yes. Two decades ago, researchers were showing that vanadium, in the form of vanadyl sulfate, would help blood sugar regulation even when the experimental animal's pancreas was destroyed. To this day we do not know exactly how vanadium does that, but it definitely can improve blood sugar regulation. This trace mineral can be harmful in excess, however, so we must be careful not to use too much - 1 to 2 mg per day is about right.
LE: What else should we know?
DR. WRIGHT: Well, Galega officinalis, the botanical name for an herbal called goat's rue, has been used in Europe since medieval times for the treatment of diabetes. (This Eurasian plant should not be confused with the North American goat's rue, an entirely different plant.) The active ingredients in Galega that are responsible for its antidiabetic benefits are compounds called guanides, but because these are natural substances that can't be patented, pharmaceutical chemists synthesized derivatives called biguanides, which could be, and have been, patented for use as antidiabetic agents. One of these drugs, metformin, is still sold as a glucose inhibitor and insulin sensitizer (Glucophage®), but the closely related drug phenformin was withdrawn from the market because it caused too many deaths from lactic acidosis.
It is interesting to note that metformin, a synthetic drug, has come to represent a minor trend in so-called "antiaging medicine" - which is not always the same as natural medicine. In my opinion, this is counterproductive, because the metformin molecule is not part of the original human blueprint, nor is it found in nature.
LE: Why not look at Galega itself, the original natural herbal?
DR. WRIGHT: Precisely. I believe we are better off with Galega, which has been used for centuries. The modern rediscovery of this plant is an exciting development, because the natural guanides it contains help restore insulin sensitivity, regulate blood sugar, and regenerate pancreatic cells, all without the side effects of the drug. Galega has also been observed to help prevent and reverse the formation of those damaging AGEs; it may thus help "destiffen" our tissues.
The flavonoid quercetin has been found to inhibit an enzyme involved in the conversion of glucose to sorbitol, that good molecule that can turn very bad - unless you're eating it - in diabetes. (Recall that vitamin C also inhibits sorbitol.) Quercetin is also an antioxidant and thus helps to protect the cells of the pancreas, which when inflamed can succumb to damage from free radicals.
Furthermore, N-acetylcysteine is an amino acid derivative that is converted into glutathione, the body's "master antioxidant," the most vital of all such molecules. The roles of glutathione are too numerous to list, but it's worth noting that it can help prevent some of the complications of diabetes.
Then there is vitamin K, in the form of phylloquinone, the form found in plants, particularly leafy green vegetables. Although deficiencies of this vitamin are rare, it is included for good measure because Japanese researchers have found that it can help improve insulin sensitivity and blood sugar regulation.
LE: Speaking of veggies, let's get back to the question of diet and the pivotal role it plays as a cause of diabetes.
DR. WRIGHT: Our apparent addiction to the Western diet is truly unfortunate, because it skews our blood sugar in the wrong direction, dooming millions of us to type 2 diabetes and all that it entails, including an acceleration of the aging process due to AGEs and the stiffening of our tissues that they cause.
LE: All of which makes me want to shout: Praise be to apple pie, cinnamon, and MHCP!
DR. WRIGHT: Thank you for that. Now is the time for MHCP, Galega, an effective quantity of chromium, and all the other nutrients we've talked about.