The dutch paradox

Is Diabetes an Infection? A New Perspective on the Cause of Weight Gain and Type 2 Diabetes

by Rita Wilhelm

Have you ever felt that no matter what you do, you keep putting on weight?   Or, you temporarily lose the weight, only to gain it right back?

I’m a nutritionist, and I feel your pain.  I have tried most diets, which is saying a lot.  In my twenties, I was a vegetarian and actually managed a NutriSystem Center at one point, though I didn’t lose weight on their program.  I spent about a decade following the American Heart Association low-fat type of diet.  For the last 4 years, I’ve kept to a low-carb and sometimes ketogenic diet.   I should mention that I also tried intermittent fasting and intense exercise programs.

Despite all this varied effort and years of commitment to improve my health, not once did I experience weight loss.  And I’m a nutritionist for heaven’s sake!  Things were not making sense!

Finally, I shared my frustration with some of my fellow nutritionists.  One of them suggested that I take a fasting insulin test, which I took.  The result shocked me.  I was insulin resistant, which is a precursor to diabetes.  I was shocked that I, a nutritionist, eating a low-carb organic diet, was well on my way to having diabetes!

In the holistic world, a diet typically offered for weight loss is the low-carb or, ketogenic diet.  For many, this diet improves a variety of symptoms and significantly helps weight loss.  This is mainly because glucose (sugar) metabolism has become so screwed up, that we use our body’s back-up system.  This back-up system operates within a different pathway using fat to fuel the body.  But this does not fix our compromised glucose metabolism, and as I learned later, it can even make things worse!

Everyone says diabetes is a sugar disease… right?  Yet, I wasn’t eating sugar and very few carbs. I was consuming roughly 1200 calories per day with moderate exercise.  When I tried talking to my doctor about it, she told me that I might just be one of those people who can only eat 700 calories per day. Seriously?

That’s when I realized that I had to throw my belief systems about food out the window, and start from scratch.

That’s exactly what I did.

For 8 months, I was obsessed.   In that 8-month period, I spent over 1000 hours poring over study after study after study. I logged more than 400 pages of notes. I used myself as a science experiment, and took regular blood tests to measure the impact of my diet changes.

One of the things I did was to look at the diets of people who lived the longest, to find correlations.   I also looked at the diabetes rates of different countries around the world, and analyzed their diets.

I was surprised to see how high the diabetes rate was in Saudi Arabia.  Their rate of diabetes is 17.2 percent!  That means that almost 1 out of 6 people has diabetes, which makes the U.S. rate look good by comparison at 10.79% of the population having diabetes.  That still means 1 out of about every 9 people has diabetes!

Yet, amid the array of statistics, something really jumped out at me. In the Netherlands (Holland), the diabetes rate was much lower, at 5.29%, where 1 out of about every 19 people has diabetes.  How could the Dutch have such a low diabetes rate, with their high-carb diet?

This is what I like to call The Dutch Paradox.

My heritage is 100% Dutch. My parents were both immigrants from Holland, so we grew up eating the traditional Dutch diet.  I spent a lot of my youth in Holland staying with different relatives, so I’m very familiar with what that diet is like.

If you ever have the pleasures of visiting Holland, you will immediately be struck by how tall and thin the population is. In fact, the Dutch are the tallest people in the world.

Interestingly, the Dutch didn’t used to be tall. This is only something that happened in the last 200 years.  They used to be short.  And you might say that it’s genetics, but the offspring of people who have immigrated to Holland from other countries increased in height as well.  Isn’t that crazy?

But here’s the other crazy thing.  The Dutch people eat a lot of food.  You really would be shocked at how much food a Dutch person can eat.  I’ve read several articles online where they say the average Dutch person eats over 3,000 calories per day.   Although they eat a lot of dairy along with common healthy foods like cabbage, their diet is loaded with bread, sugary foods, chocolates, pastries and potatoes. They also enjoy regular tea and coffee times between meals, which always include some kind of little sweet delectable.  Their diet is full of carbs, and includes plenty of the sugary kind, that our society says causes diabetes. Yet, their diabetes rate is low.

How could the Dutch have such a low rate of diabetes, with such a high intake of sugar?

Insulin resistance starts before diabetes does, and Western medicine has no cure for insulin resistance.  They say that the only way to reverse insulin resistance is to lose weight.   Uhh… Hello?

In my research, I found that insulin resistance, non-alcoholic fatty liver disease (NAFLD), polycystic ovarian syndrome (PCOS), metabolic syndrome and diabetes were all part of the same disorder, with the same underlying conditions.  Those same underlying conditions are likely behind many other diseases, such as Alzheimer’s, Parkinson’s, cardiovascular disease and cancer, as well as many digestive and autoimmune issues.

I’ve finally come to an ‘ah-ha’, which is what I want to share with you.  Part of me thought that I should charge for sharing all my hours of research with everyone, but I think that this information is too important not to share.  People need to know this. So be prepared for a long post, because I really do want to explain this to you. You really have to understand the situation the body is in when it comes to a metabolic disease, if you want to be able to do something about it.

I should probably mention disclaimers here.   I am a nutritionist, and not a doctor.   I’m not diagnosing or curing any diseases.   I’m simply sharing what I learned, and this is my take on the situation.

What is the Cause of Weight Gain and Type 2 Diabetes?

The Nutshell – Iron and Bacteria, oh my!

I’ve referenced a bunch of studies at the bottom of this post to credibly support my viewpoint.

  1.  It’s been shown that iron plays a “significant” role in diabetes. In the 1960’s researchers observed a strong correlation between iron and obesity.
  2. Iron is a volatile metal that is vital for survival. But it can also kill a cell, so it has to be handled with kid gloves.

    It’s very dangerous when there is too much iron, especially in the presence of certain bacteria.

  3. When we think of too much iron, I believe we need to look not only at what is being absorbed by the body, but also at all the non-absorbed iron that goes to the bacteria in our gut.

  4. Most bacteria live in surroundings where there is not enough iron to satisfy their requirements for survival. They go dormant when nutrients are not available.   Antibiotics cannot kill bacteria when bacteria are in their dormant states.

  5. Pathogenic (bad) bacteria are forced out of their dormant states in the presence of available iron, and are able to reproduce, growing their populations. This makes it next to impossible for our good bacteria to keep the bad bacteria in check.

  6. A high-iron environment can be caused by eating iron-fortified cereal, pasta and bread. In China they now fortify soy sauce with iron.The United States mandated that white flour be fortified with iron after World War II, because of a universal iron deficiency. Over fifty nations now fortify their foods with iron. (The Dutch by the way do not fortify their foods.) These nations probably didn’t realize at the time that an iron deficiency was likely due to an infection, not necessarily due to a lack of iron in food.

    In my opinion, many of the ketogenic and Paleo folks are getting too much iron if they are eating a lot of red meat, venison, lamb and turkey sausage.

    Iron-containing supplements can, in my opinion, can be quite dangerous, especially if it contains vitamin C. Vitamin C can increase the absorption of non-heme iron by 4 times. (I’ll talk more about iron deficiencies in just a moment.)

    One study found that supplemental iron with fruit increases iron stores by as much as three times!  It makes me worry about kids getting way too much iron just from a fruity supplement.

    Cooking in a cast iron pan can also add lots of iron to food, especially if acidic foods like tomatoes are cooked in the skillet.

    Hemochromatosis and other genetic conditions can cause the body to store too much iron.

    Well water can also be a significant source of iron.  I know that many people who suffer from small intestinal bacteria overgrowth (SIBO) can get a flair-up just by drinking water.

    Even iron welders should think about the iron they inhale.

    There are many other reasons and conditions that contribute to high iron.

  7. The adult body will typically only absorb the amount of iron that was lost in sweat and urine in a day, which is normally about 1 to 2 mg. So an adult will typically just absorb 1 to 2 mg per day.

    It might surprise you to know that mother’s milk has no iron in it.  Yet, baby formula is fortified with 1.8 mg of iron PER SERVING!   I think this presents a BIG problem!

    An experiment in Kenya with formula-fed babies provided formula either with, or without iron. Researchers found that the iron-fortified formula caused these babies to have lots of disease-causing microbes.Iron supplement with 65 mg of iron

    What really surprises me is how much iron there is in an iron supplement. I came across a supplement at Costco with 65 mg of iron in it. YIKES!!  That’s more than 32 times more iron than a healthy body would absorb!  That leaves plenty of extra iron for the bad bacteria!

    Studies have found that iron supplementation can cause a leaky gut, making it easy for bad bacteria to pass through the gut wall and into the bloodstream.

    Here’s another shocker.

    One of the most popular whole grain cereals in America has 18 mg of iron!   That’s 9 times more than our body would absorb.

    And speaking of cereal, did you know that manufactures fortify cereal with raw iron metal shavings?  You can pull out some of these shavings with a magnet.  There are many videos you can find on YouTube showing this experiment.   Here’s just one of them:

  1. A bacterial infection can cause an iron deficiency. As bacteria try to access iron from our body stores, the iron is sequestered to keep it away from bacteria. Our body removes iron from our blood and tucks it away somewhere else for safekeeping.

    Studies have also shown that an iron deficiency can be reversed after getting rid of the infection.

    My concern is that many people are supplementing iron for the problem of iron deficiency, when iron supplementation is fueling the problem.

  2. If one’s ancestry is from Northern Europe or Ireland (Viking ancestry), they may be carriers of a gene (C282Y and/or H63D) causing the body to absorb up to 4 times more iron than the regular person. This is called hereditary hemochromatosis.

    Sweden and Denmark stopped fortifying their foods because pregnant women and babies were experiencing iron overload, probably due to this gene.  With pregnant women typically supplementing with iron, I’m sure it magnified the whole iron-overload issue.

    In other studies, it was found that pregnant women who supplement with iron have higher blood sugars, blood pressure and pregnancy BMI (body mass index) than women not being supplemented with iron.

    It’s also interesting to note that once Sweden and Denmark stopped fortifying, it did not change the rates of iron deficiency in their countries. This may be because iron deficiency is due to a bacterial infection and not because food needs more iron.

    It’s easy to get genetic testing done. You can buy a DNA test here.

  3. Okay… now we’re going to shift gears just a bit, and you’ll see just how these bad bacteria operate.The problem with saturated fats like coconut oil

    When we eat certain saturated fats (and yes… this includes butter and coconut oil), we inadvertently absorb a toxic molecule into our blood stream that hangs along for the ride. This toxic molecule is found on the backs of bad bacteria, and when these bacteria die, they release this toxin. These toxic molecules from dead bacteria are called endotoxins, lipopolysaccharides, or LPS for short.

    There are only 2 ways that these toxins can get into our bloodstream. That is via saturated fat absorption (during chylomicron formation) or a leaky gut. And iron by the way, causes the gut to become leaky.

    The life expectancy of a single bacteria is around 12 hours. So there can be a lot of toxins that make it through to the bloodstream, especially considering the fact that we have 10 times more bacteria cells than human cells. Kind of freaky … right?  Makes you wonder who’s really in control.

    So although coconut oil might have beneficial antibacterial effects that kill bacteria, it also means that we absorb the toxins of these dead bacteria when we eat saturated fats such as coconut oil. Those toxins get absorbed into the bloodstream, which in turn, causes systematic inflammation.

    People who have an overgrowth of bad bacteria will have more of an inflammatory response, than a healthy person would.

    Studies confirm that there is a large after-meal increase of endotoxins in the blood stream after consuming coconut oil, palm oil, butter, cream and other saturated fats.

  4. Bad bacteria use these toxins to cause us physical and/or mental and emotional stress.

    These toxins induce depression and anxiety, and can cause physical ailments, depending on the body tissue that is attacked.

    Stress will cause the body to release a molecule called epinephrine.

    Epinephrine makes it so that these bacteria can access our body’s iron transporters, and steal iron from us.

    Bad bacteria are even known to turn on certain viruses to cause stress.

  5. These endotoxins begin to change our metabolism, to where we have trouble regulating blood sugar and producing certain hormones. Insulin resistance, diabetes, PCOS, metabolic syndrome, and even Alzheimer’s, all have ‘metabolic endotoxemia’ in common.

    These toxins cause an increase in waist circumference, waist-to-hip ratio, total cholesterol, triglycerides and insulin.

    Bad bacteria cause insulin resistance, which can turn into metabolic syndrome, PCOS and diabetes.

    Yes… you heard that right.

    I believe diabetes is a bacterial infection!

    You might be surprised to know that they’ve been able to treat diabetes in different parts of the world by getting rid of the bacterial infection.

    In Holland for instance, they found that if they removed the mucus layer in the small intestine where certain microbes live, the patients no longer needed insulin.

    In Nigeria, they kill the bacteria with Senna leaves. Nigeria has one of the lowest rates of diabetes.

    Brewer’s yeast has been used traditionally to treat diabetes, probably due to an antibiotic-type of effect.

    In mice they’ve been able to reduce ‘metabolic endotoxemia’ with antibiotics.

  6. But killing bacteria isn’t going to make someone thin. In fact, many people gain weight after killing off infections. Again, this is probably because killing bacteria releases endotoxins, which get absorbed into the bloodstream and cause inflammation. This alone puts on weight.  (Consider how we swell up after a wasp sting.)

    But we haven’t even dealt with iron stores as a cause of weight gain and obesity yet, which I’ll explain next.

  7. Because of these endotoxins, the body begins to respond to the infection. Certain white blood cells (macrophages) from our immune system work to not only get rid of the infection, but to also keep iron away from the bacteria. They surround the iron, and hold onto it. The more iron there is, the more macrophages there are doing their best to keep iron away from these bacteria.

    These macrophages are holding onto and storing iron in belly fat, and in liver fat, among many other places.

  8. Research shows excess iron in the body is a major cause of obesity.
  9. The body has no natural pathway to get rid of excess iron, so it stays stored.
  10. Let me repeat that. The body has no known pathway to get rid of excess iron.

    This is why we really need to look at our lifetime absorption of iron.

    A study found that limiting the body’s lifetime exposure to iron can limit the risk of neurodegenerative brain disorders.

    Other studies found that a near iron deficiency improved markers of liver inflammation, blood sugar regulation, and gouty arthritis.

    And just a side note about gout, researchers found that a person’s gout risk is linked to iron their intake. In fact, they believe that gout could be used to screen for iron overload.

    Studies have also found that a damaged or inflamed liver can be nearly normalized in a near iron deficiency.

    Stored iron is also a major predictor for breast cancer.   In a double blind randomized clinical trial among cancer patients over a 4-year period, researchers found that cancer patients had significantly better outcomes if they reduced their body’s iron stores through phlebotomies (blood draws).

  11. In the meantime, this excess iron is causing free radical damage, especially if the diet is heavy in polyunsaturated fats, such as canola oil, seed oils and vegetable oils.

  12. And this entire situation is made worse if the current diet is short on certain protective nutrients.

So you see how complicated the issue is, especially when the body has no known pathway to get rid of excess iron.  It’s no wonder that modern medicine hasn’t found a way to reverse insulin resistance.

So what can you do?

Blood donation is a great option to get rid of excess iron.  It’s a win-win situation, as you not only get rid of iron, but you help someone in need of blood.  Interestingly, they have found that blood donors have improved insulin sensitivity and type 2 diabetes symptoms.

Supplements that might help

Keep in mind that supplements (and even positive diet changes), can affect medicines. This can be due to the body becoming healthier to where the dosage of medicine may be too much. Talk to your doctor.


Many women already drink cranberry juice to keep urinary tract infections at bay.   This is because certain plant chemicals found in the cranberry make it difficult for bacteria to attach themselves to our cells.  Cranberries don’t kill bacteria, but they do help to eventually flush the bacteria out of the body.

Additionally, cranberries are a potent iron chelator, meaning that compounds in cranberries can bind to iron and deprive bacteria of this iron.

It’s also been found that cranberries help prevent diet-induced obesity.

Milk Thistle

Milk Thistle reduces liver injury caused by iron overload   It binds to iron and helps reduce iron stores.  It’s been shown to reduce insulin resistance.


Fenugreek has a protective effect on the liver and has been shown to improve liver function.  It can bind endotoxins.  Additionally, fenugreek makes it more difficult for these bad bacteria to form colonies (biofilms).  When bacteria form biofilms, it’s harder to deal with infections.

Fenugreek is also good for other microbial issues such as SIBO, candida, leaky gut, irritable bowel syndrome (IBS), colon ulcers and acid reflux.

Note:  Pregnant women should not take fenugreek, because it can induce labor.  But, after the baby is born, fenugreek can be taken to increase milk supply.


Turmeric can also bind and remove iron from the body.   I would love to take turmeric more often, but it’s pretty high in oxalates (which is a different topic for a different post).   It causes pain in my big toe (a gout signal), which tells me that I’ve got to lay low on the turmeric for a while.  But if you can handle turmeric, great!

Apple Cider Vinegar

Apple cider vinegar creates an environment where bad bacteria don’t want to live.   In fact, some of our own good bacteria produce acetic acid (which is basically what vinegar is).  This makes living conditions very hard for the competing bad bacteria.

You can add vinegar to a salad or beverage.  If you hate the taste, apple cider vinegar can now be taken in a supplement form.

Coffee and Tea

low prevalence of type 2 diabetes with black tea drinkersCoffee and tea are not exactly supplements, but they are very helpful in reducing iron absorption from a meal in both humans and bacteria.   This only works for non-heme iron, which means it doesn’t reduce absorption of heme iron from meat.

Interestingly, there is a low prevalence of type 2 diabetes in black tea drinkers.

To get this benefit of coffee or tea, I would drink it within the hour, or during your meal.

Diet Changes

Ultimately, we need to make diet changes as well.

I believe the diet needs to be low in iron, and if there is a high iron meal, one needs to think about the other foods in the meal.  There are many food pairings that increase or decrease iron absorption, for both the human and the microbe.

The diet also has to deal with fats.  Saturated fats can be helpful in the diet, but they can also cause systematic inflammation when the body is dealing with toxins from bad microbes.   There are however, things you can do to reduce the absorption of these toxins when eating a high fat meal.  Again, it comes down to pairing your foods.

We also need to reduce the amount of circulating toxins, which means we need to change our microbial makeup, to where we have a lot more of the good bacteria in our gut, that help to create an environment that keep the bad bacteria in check.

Update 8/23/2019
I believe the copper is part of the solution.
Please read my research on copper.

I personally have made some very radical changes in my diet.   I know that many from the low-carb community would be shocked at some of the things I’m including in my diet.   Yet, with these radical diet changes, I’ve managed to reduce my fasting insulin by 30%!   So much for not being able to reverse insulin resistance right?!  I’ve also managed to significantly improve both liver function and kidney function.

I’d like to be able to share this diet with you, but I’m still experimenting, tweaking and taking more tests.  I’m getting close though!  If you would like to be notified of this diet when I’m ready, please sign up in the green box below.   I’d also love to hear your comments.  Please share this information with other people who might benefit from knowing this.

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  1. Really interesting article Rita – lots of facts involved. I look forward to hearing more from you in the future. I know you put in A LOT of hours into this study, and you wouldn’t publish anything you haven’t thoroughly investigated.

  2. Nice work Rita! Thank you for sharing your research. I’ve been following your self-studies because my husband has similar weight challenges. Interestingly, he has high iron levels and is of northern European descent. Ah-ha! Let me know if you need a male (guinea pig) to test your diet theories on. He is highly motivated!

  3. Great article, interesting facts and easy to read. I too have wondered about the role of both bacterial and viral infections in obesity and type 2 diabetes (not to mention all the other possibly related conditions), will be interested to follow your dietary findings. What are your thoughts or research (if any) on Olive Leaf Extract and the role it might have in reducing bacterial/viral load. I have been taking it on and off for years yet not really knowing if it’s the right thing. Thanks for your hard work and sharing. ?

  4. Thanks Susan. And good to know. 🙂 At least he can get started with some of the suggestions in the article.

  5. Thank you. I haven’t looked into olive leaf extract, but I am enjoying olives and olive oil. 🙂

  6. SO it looks like this was first posted in 2014. Has anything come of this or has the author abandoned her research?

  7. Hi Rita, I was sent this arrival by a client of mine who is a nutritionist. I’ve been dealing a with a few health issues recently and she is belong with research. After reading I am more interested in trying to flush out whatever bacteriaI may have. I must also say that Hemacromatosis is genetic in my family. My father passed away from this 8 years ago and his dad (My grandpa) 9 months later. My grandpa had a liver transplant in 2000 after going through horrible liver failure. My most recent blood work and Cat scan results show that my Hemagloben is extremely low and that I have an enlarged Liver. My older sister has an enlarged lug ever as well. It sounds to me like we got in to this realm of diet/ health plan. But we need an overhaul. I have tried every diet and exercise and no matter what I do I can’t lose more than 10lbs, but only ever gain weight when something significant is going on in life. I have 3 kids, most weight was put on while pregnant. I am also anemic and cannot donate blood as you suggested.

    Thanks for a great read!

  8. Hi Cassie,

    Sorry that you have to go through all that and that you recently lost family members from hemochromatosis. I too have hemochromatosis, have low blood iron and have an enlarged liver. I’m still doing blood donations, as I believe there is still plenty of iron in the body, particularly in the liver and belly fat. I doing the supplements mentioned above and am also working on the diet. I’d remove fortified foods and vitamins from the diet. I hope you signed up for the diet notification list. In that case I can inform you when I’m ready to report on my diet findings.

  9. Thank you Rita for this article and list of helpful supplements. I am looking forward to your diet findings. I need to lose weight and improve my health and get off medicines with all the horrible side affect to them!

  10. When will the diet portion of this be available? I have many of the issues you discuss.

  11. Interesting article! I was told to take iron supplements (at least 36 mg of it per day) by an MD and a naturopath because I was feeling tired and dizzy a lot and had shortness of breath (my blood results showed low ferritin). The low iron is caused by an H. pylori infection and heavy periods. My hormones are also low thanks to the H. pylori infection.

    I’m really not sure what to do anymore. I have been skipping the iron supplements most days because I’ve been wondering whether it’s just been feeding the H. pylori. I’m on my second natural treatment for H. pylori and I’m hoping this one will work better than the last one.

    I’m also trying to figure out what’s going on with my belly. I lost a lot of weight (at least 80 lbs) over the last 3 years, but I didn’t lose more than 2 inches off my waist. I’m wondering whether it’s an insulin resistance problem (even though my blood sugar tests are always good) or maybe inflammation. I still need to lose another 60 lbs, but I seem to be stuck.

  12. Brilliant research and I def think ur on tge right path to answering they “Why”…American diet is killing us!! I hope ur research is shared, published and notably noticed on the medical community….I think u have the key to unlocking major health issues. Please keep researching and sharing ur valuable info.

  13. Great article! I’m trying to keep up and like you I don’t lose weight, I’ve done every diet also. Currently I’m doing keto/low carb and stopped losing any weight after a few months. I have multiple illnesses (including pcos) and 4 autoimmune diseases. I feel lost on this and desperately need help as I’m disabled and in constant pain. My a1c was 5.5 last time we tested.
    Low on ferritin.
    Hashimoto’s also…
    I’m not sure what I can do 1st. I have a hard time getting blood draws even so I’m not sure about giving blood but I’m up for it.
    How are you feeling on your new diet?
    Thank you again!
    Arvada, Co

  14. What kind if bacterial infection do u suspect? I have a similar history as you and am unable to lose weight. I am trying desperately to get healthy. I am inching towards 100 kg and am dangerously close. I too realized that IF and low carb don’t help me. I cant shed at all

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