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How exercise and diet can reverse type 2 diabetes

By Aimee McNew, Lifestyle writer
September 10, 2020
Africa Studio/
Africa Studio/

Type 2 diabetes is a pervasive health problem in the U.S. As of 2018, more than 10 percent of the American population had this metabolic disease. That’s more than 32 million people with type 2 diabetes, in contrast to 1.6 million who have type 1 diabetes, an autoimmune disorder.

Contrary to popular belief, this disease is not simply a matter of high blood glucose alone. Over time, type 2 diabetes erodes the health of the entire body and can have negative effects on the cardiovascular system, nervous system, circulation, weight, endocrine health, mental health, gut health, and beyond. [1]

Tens of thousands of studies and reviews have been published on type 2 diabetes in recent years. While the medical community traditionally states that it is a life-long condition, new research has made it increasingly clear that this condition may be reversible with the right combination of diet and exercise.

Type 2 diabetes and your heart

When you restore your body’s ability to properly process glucose and its sensitivity to insulin, the potential for damaging effects fades away.

One of the most important benefits of controlling type 2 diabetes is heart health; the disease is one of the biggest triggers for heart disease. [2] And one of the most effective ways to do this is with exercise. A new study in Diabetes Care examined how exercise is vital for improving heart function in people who have type 2 diabetes. [3]

This study focused on 87 patients between the ages of 18 and 65, all of whom had been diagnosed with type 2 diabetes. Patients in the exercise group experienced significant improvement in heart function as measured by echocardiogram and MRI compared to a control group. They also built better tolerance for exercise and physical activity. Diet alone did not have that dramatic an effect on heart function or health.

Why diet and exercise together are essential

While a low-energy diet did not improve heart health or physical activity tolerance, no one would expect only diet or exercise to reverse type 2 diabetes. Paleo ancestors were fit and free from disease because both movement and nutrient-rich foods were normal parts of daily existence.

The study in Diabetes Care revealed another important factor: While diet didn’t optimize heart capacity in the way that exercise could, it did effectively reverse diabetes in 83 percent of the diet study participants.

A therapeutic program for type 2 diabetes and for heart health cannot ignore either wing of physical health: diet and exercise. Both are crucial for proper metabolic function.

While the specifics of either (What kind of exercise? Which diet is best?) could be argued and are the subject of ongoing research, a Paleo Diet® that focuses on simple, whole foods and which avoids processed foods, high salt, grains, dairy, and legumes results in better and faster metabolic improvement than typical diabetes diet guidelines. [4]

If you’ve been following the Paleo Diet for any amount of time, this is not a surprise, but it continues to be a good reminder that we in the modern world benefit from taking a page from the ancestral playbook. Our bodies need to move and they need to be fed to support metabolic function.


[1] Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. (2017). Type 2 diabetes and quality of life. World journal of diabetes, 8(4), 120–129.

[2] De Rosa, S., Arcidiacono, B., Chiefari, E., Brunetti, A., Indolfi, C., & Foti, D. P. (2018). Type 2 Diabetes Mellitus and Cardiovascular Disease: Genetic and Epigenetic Links. Frontiers in endocrinology, 9, 2.

[3] Gulsin, G. S., Swarbrick, D. J., Athithan, L., Brady, E. M., Henson, J., Baldry, E., Argyridou, S., Jaicim, N. B., Squire, G., Walters, Y., Marsh, A. M., McAdam, J., Parke, K. S., Biglands, J. D., Yates, T., Khunti, K., Davies, M. J., & McCann, G. P. (2020). Effects of Low-Energy Diet or Exercise on Cardiovascular Function in Working-Age Adults With Type 2 Diabetes: A Prospective, Randomized, Open-Label, Blinded End Point Trial. Diabetes care, 43(6), 1300–1310.

[4] Manheimer, E. W., van Zuuren, E. J., Fedorowicz, Z., & Pijl, H. (2015). Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. The American journal of clinical nutrition, 102(4), 922–932.

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