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In 1982 when a group of middle-aged Aboriginal people with type 2 diabetes reverted to their traditional hunter-gatherer lifestyle for just 7 weeks, all of the metabolic abnormalities of diabetes were greatly ameliorated or reversed, as were the major risk factors for cardiovascular disease. Three factors were likely responsible for these striking improvements: low energy intake; high protein, low fat diet; and elevated physical activity. Low energy intake (estimated 1200 kcal/day) was probably the most important.
The most important lesson that can be drawn from this study is that metabolic control in type 2 diabetes can be greatly improved with healthy lifestyle interventions. The diet in the 1982 study was rich in very lean meat from wild animals: its high protein content aided satiety despite low energy intake. The carbohydrate was mostly high fibre and slowly digested. The fat content was low, but relatively rich in long chain highly polyunsaturated fats (omega-3 and omega-6). Recent research has demonstrated that ectopic fat is a driver of both defects of type 2 diabetes: insulin resistance when in the liver, and impaired insulin secretion when in the pancreas. Both are potentially reversible by healthy diets instituted early in the disease process. However, current population trends to increased obesity are driven by the powerful transnational food industry. Preventive interventions will therefore be very challenging.