Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU
I have the best job in the world. I’m a doctor. But believe me, that’s not why. I’m an obesitologist. I have the honor to work with a group of people who are victims of the most widespread accepted prejudice: that they are fat.
Before I meet them, these people will suffer a lot: They are ashamed, guilty, remorse and discriminated against. The approach of many people, including health professionals, is that these people are to blame for their problem.
If they only managed better, they wouldn’t be overweight, and they don’t even want to change. Believe me, it’s not like that. They’re to blame if I divorce it a little, our own advice. And it’s time to change that. Obesity is a disease, not something caused by a lack of character. It is a hormonal disease, and there are a lot of hormones in the role.
One of the main ones is a hormone called insulin. Most obese people are insulin resistant. So what does it actually mean to be insulin resistant? Well, insulin resistance is actually a condition that precedes type 2 diabetes. Insulin is used to deliver glucose, blood sugar, into those cells where it can be used.
In a nutshell, when someone is resistant to insulin, it’s a problem for him to get blood sugar where he needs it, into those cells. And yet he can’t just stay in the blood after every meal, otherwise we would find ourselves in a diabetic crisis after every meal! So when someone has insulin resistance, the body responds with even more insulin production.
And insulin levels will rise more and more, and for a while, even for a few years, it will continue, and blood sugar can easily remain normal. Usually, however, this condition does not last forever, nor did the elevated insulin level it cannot keep the sugar level in the normal range. So it starts to rise. It’s diabetes. You probably won’t be surprised that most of my patients suffer from insulin resistance or diabetes.
And if you’re sitting there thinking, “Ugh, not me yet,” maybe think again Because almost 50% of Americans now have diabetes, or prediabetes. That’s almost 120 million of us. But it’s hard for anyone with insulin problems.
Because like I said, people have elevated levels due to insulin resistance years, or decades, than are diagnosed even for prediabetes. In addition, it turned out that 16-25% of adults of normal weight It is also resistant to insulin. So if you’re still counting, it’s a hell of a lot of us. The problem with insulin resistance is this: When it rises, we are at risk of type 2 diabetes.
But also, because of insulin, we’re hungry, and it is more likely that the food we eat will be stored in fat stores. Insulin is our fat storage hormone. So we’re starting to see why this will be a problem, for diseases such as obesity and for metabolic disorders such as diabetes. But what if we followed the problem to its beginning, and we didn’t have that much glucose to have to compete with insulin?
Let’s see how to achieve this. In everything you dream of is either a carbohydrate, a protein or a fat, and each has a different effect on glucose and insulin levels, as you can see on the chart. So when we eat carbs, both glucose and insulin levels shoot up. It looks better with protein. But see what it looks like when we eat fat. Basically nothing, no ripples.
And this is definitely very important. I’ll explain the graph to you now with the help of a real situation. I want you to come back and remember how you last ate an American version of Chinese food. It is clear to us that there are things that happen regularly.
The first is the fact that you desire. Because no STOP signal was sent, until you literally cracked at the seams. The second rule is: you will be hungry in an hour. Why? Well, because rice causes both glucose and insulin peaks in food, which triggered hunger, fat storage and sweet cravings. So if you suffer from insulin resistance, and insulin levels are already high, you’re really still hungry.
And we work on this setting: Eat carbohydrates, glucose will rise, insulin will rise, and you are hungry and store fat. So what kind of food do we recommend to these people? This seems to be very important. Let’s now focus on type 2 diabetics, because the usual recommendations for all type 2 diabetics They eat 40-60 g of carbohydrates in one meal, and other carbohydrates during snacks.
Believe me, that’s a lot of carbs. And remember what happens to glucose and insulin, with blood sugar and insulin, when we eat them? Yes. Basically, we recommend to eat exactly what is causing their problem. Doesn’t that sound crazy? It’s really crazy. Because basically diabetes is a state of toxicity from an excess of carbohydrates. We can’t get blood sugar into the cells, and this causes a problem very soon.
But the long-term consequences are even worse. And insulin resistance is basically carbohydrate intolerance. So why do we still recommend people to eat them? Nutritional recommendations of the American Diabetes Association they state precisely that there is inconclusive evidence on recommending carbohydrate restrictions.
But these recommendations agree on what we already know: Our carbohydrate intake is the single biggest factor affecting glucose, and also the need for medication. These recommendations then say: Look, look when you’re taking certain medication, in fact, you have to eat carbohydrates, otherwise your glucose levels would drop too much. Good.
So let’s see to the vicious circle caused by this advice. Eat carbs so you have to take medication, then you have to eat more carbohydrates, to avoid the side effects of these medicines, and still around. Even worse, you won’t find it anywhere in the ADA recommendations a goal that would reverse the course of type 2 diabetes. That must change, because type 2 diabetes can be reversed, in many, in most cases, especially if we start soon. Not only do we have to tell people about it, but we must begin to give them practical advice to be able to do so.
Think about carbohydrates. First, it will be a shock to you: we don’t need them. Seriously! The minimum daily carbohydrate requirement is zero. We have essential amino acids, those are proteins, essential fatty acids, but no, no essential carbohydrate. Nutrients are essential if we need them to work and we can’t make them out of nothing else.
We make glucose, in fact all the time and quite a lot, this is called gluconeogenesis. So we don’t need them, we are sick due to their excessive consumption, and yet we recommend to patients to eat almost, or maybe more than half of the daily energy intake in the form of carbohydrates.
It makes no sense. Let’s say what makes sense. Significant carbohydrate reduction. Yes, we teach patients in my department, to eat carbohydrates to a minimum, not at the maximum. And how does it work? Well, when our patients reduce their carbohydrate intake, their glucose will drop so they don’t need as much insulin.
So the insulin level drops rapidly. And that’s very important, because the study which examined data from the National Health and Diet Research, better known as NHANES, has shown that the single biggest risk factor coronary heart disease is insulin resistance. He is responsible for as much as 42% of heart attacks. The effects of a low-carb diet will be so rapid that that we can reduce human insulin doses by hundreds of units within days or weeks.
One of my favorite stories happened recently. A young girl who has had type 2 diabetes for almost 20 years she came to us after a doctor told her from elsewhere that she was simply ill, and she should get used to it. Her diabetes was completely out of control. Even though she was taking several drugs, including almost 300 units of insulin, which the pump injected into her body. And all this, remember when glucose was out of control.
So we recommended a low-carb diet to her and let’s go 4 months forward. She lost weight, yes, but it’s even better that she’s not sick anymore. Her blood sugars were normal all the time. What’s more, she wasn’t taking any diabetes medication. Gone with 300 units of insulin, no more insulin pump, no finger prick several times a day, gone, no more diabetes. One of the greatest joys of my job is just telling such a patient that he no longer has diabetes, and we will solemnly remove her from the list of their troubles.
So are they cured? Is this a miracle? We’ll leave this play to the Wizard of Oz. “Cured” would indicate that he could not return. And if they start eating too much carbohydrates again, they’ll come back.
So not “cured”, but they no longer have diabetes. It is solved, and it can remain so until we get rid of the cause. So what does it look like? What does the diet actually look like? Well, first I’ll tell you what it doesn’t look like. Low carbohydrate does not mean carbohydrate free and is not high in protein.
These are common criticisms, and they’re so frustrating, because they are not true. Next, if we reduce carbohydrate intake, how do we replace it? Because, we know that there are only three macronutrients: When we reduce one, we must increase the other. My patients eat fat. And they eat him a lot.
“What?” You say to yourself. What happens when you eat fat? Well, let me tell you, you’ll be happy because fats taste great, and are incredibly satisfying. But, remember that fat is the only macronutrient which keeps glucose and insulin levels low, and this is very important. So here are my simple rules on how you should eat. These rules, remember, will be even more important to you, if you are one of the tens of millions of Americans, who have problems with insulin levels.
Rule # 1: If it’s low-fat, light, or fat-free, leave it in the store. Because when they cut fat, they replaced it with carbohydrates and chemistry.
Rule No. 2: Eat food. The most important rule of a low-carbohydrate diet: real food is not out of the box, and no one needs to remind you that it is natural. You should know this at a glance. Don’t eat anything you don’t like. And eat when you are hungry, do not eat when you are not, and it doesn’t matter what time it is. Number five is an easy way to remember what to avoid. No BOC: potatoes. cereals and sugar. That’s quite a charge, isn’t it? No cereals? No, none. But we need them. No, they’re carbohydrates.
But wholegrain is good for us. So first, there are very few foods which are truly whole grain, even if they claim it. Most foods that claim to be whole grain they are highly processed and the fiber in them is destroyed. Or they are made with highly refined flour, but usually it’s both. So if you don’t really have insulin resistance, you can eat real whole grain foods. But if you’re in the majority of the population with insulin problems, things only make it worse. So what if you don’t have insulin problems? Can you eat like this? Yes! I’m a great example.
More than a year ago, I decided to cut carbs, as much as I recommend to my patients. It’s not as necessary for my health as it is for theirs, I’m not insulin resistant, so, would that be a problem? No! And that’s what it’s about. If you do not have a very rare syndrome, then reducing carbohydrates in your diet will benefit you, although it is not necessary.
I want to show you a few photos of my radical diet. This is a regular breakfast at home. Didn’t I just break my own rules? No, because this muffin is made from coconut flour. I’m still baking. I only use flour without cereals: coconut, almond, flax, hazelnut. They are great things. And this is what a typical dinner with the usual “starches” looks like.
These are roasted mushrooms. No, my patients and I always eat great food all the time and enjoy it. And what about some research? Isn’t that just my unsubstantiated evidence from my office? No! There are dozens of randomized controlled trials on a low-carbohydrate diet, due to risk factors such as obesity, cardiovascular risks, diabetes.
They are consistent. It works! There are even many more studies that show that a low-carbohydrate diet reduces inflammatory markers, which are very exciting prospects for diseases such as cancer. We have just completed one study at our clinic. We took 50 type 2 diabetics, which we treated with a low-carbohydrate diet, and compared them with 50 patients, who followed the ADA recommendations.
After six months not only have we noticed a significant metabolic improvement in the low-carbohydrate group, But also, and this is important, huge cost savings. Our analysis has shown that patients can save up to $2,000 a year only on medications for diabetes that he no longer has to take.
Just think of how it adds up. We are now going through an epidemic of diabetes, for which we give $ 250 billion a year in this country. Now I’ll show you the page which proves where the savings come from. Just look at the difference in insulin needed in both groups for 6 months. We see here that the low-carbohydrate group was able to reduce its doses about 500 units a day.
While in the ADA group they had to increase their insulin by 350 units a day. Two important things. One: insulin is expensive. And two: not all people in this study needed insulin at all, thanks to that, the results are much more impressive. But I would say that this graph rather shows two different approaches to treating this disease.
This first, our group, in order to reverse the disease, so that people no longer need medication. And the other group, which sticks to the ADA’s recommendations, and which claims that diabetes is a progressive disease, which over time requires higher and higher doses of drugs.
It is progressive until we eliminate the cause. So where is the problem? Why isn’t this talked about? Why is a low-carb diet not the norm? There are two big reasons. One: the status quo. It’s hard to break. There is too much politics in that. We have had this low-fat idea here for decades. But a recent study released which shows that there is no randomized controlled evidence that to help Americans remove fat from their diets.
And that’s how carbohydrates started to be added. It was actually a huge experiment of millions of people and failed immensely. The second reason why we don’t see it written anywhere is money. Don’t let anything be persuaded, a lot of money is invested to make us sick. And we see on those specialized boards with recommendations, that they crack at the seams due to a conflict of interest.
So the solution to this diabetic epidemic in my clinic is clear: stop taking medication and treat yourself with food. And for a disease whose roots are carbohydrate consumption: stop eating or reduce carbohydrates, it will only return you to what we knew before. We knew it a long time ago, it was said thousands of years ago, and today we must return to this idea. Thanks.