Carbs, Fruit and Diabetes | The Exam Room

time to master diabetes here on the exam room brought to you by the physicians committee with the weight loss champion chuck carroll so thrilled now to be joined by an old friend of the program you know him cyrus kombata dr cyrus cambada i should say he is one half of the team over at mastering diabetes here now to answer your questions all about this disease cyrus how you doing today my man uh i am all i'm doing great and it's always fun to be here with you so thanks for inviting me back oh the pleasure is all mine my friend and we have a lot of great questions coming in today a lot of these are kind of like it seems like these are people who may be new to the idea of eating a plant-based diet but they've had diabetes and so now they're they've heard some good things and now it's time to answer those questions and fill in those gaps so you ready my man let's do it let's have some fun all right well the first question comes to us from sheena she wants to know because you and i previously have talked about fat being a real culprit here as opposed to sugar a lot of fat and coconut meat so she's wondering when you eat coconut meat or drink coconut juice do you also get saturated fat or does that only apply when it's uh processed oil so coconut oil ooh very very very good question okay so let's talk about saturated fat in particular because it's uh you know fat is a it's a complex topic to be perfectly honest and i think a lot of it is uh is poorly communicated in the world of health so in order to talk about carbohydrates and fat and protein we have to be like very very specific in our language and if if you're not then you run into problems where you started get confused and you say well this person said this about sugar and this person said this about carbohydrates and then it becomes confusing so uh first things first um in the world of let's say in the world of natural health there's this sort of common misconception that diabetes and insulin resistance is caused by eating too much sugar and so you'll hear this over and over again that people say oh you know like don't eat sugar because it raises your risk for pre-diabetes and type 2 diabetes and it raises your risk for uh obesity and it raises your risk for fatty liver disease and alzheimer's disease right and the truth is that uh all that information is correct as long as you're referring to refined sugar okay so you cannot use the word sugar by itself you got to put the modifier in front of it you got to say refined sugar which is white table sugar high fructose corn syrup nat i'm sorry um processed sugars that you get from the grocery store that are inside of the package products that you're eating and may not even know okay but when you're referring to another thing that people say all the time is they say oh don't eat fruit because fruit contains sugar and that right there as soon as i hear that i say nope that stop stop can't say that can't say that because fruit contains carbohydrates that are whole so fruit contains whole carbohydrates and the whole carbohydrates are broken down into molecules of glucose and fructose primarily so those molecules the glucose and fructose are actually fuels for your brain for your liver for your muscle tissue and using the word sugar to describe those foods is technically technically accurate but it's also very misleading so instead of using the word sugar what i like to tell people is no fruit contains whole sugar or whole carbohydrates and when you use the words refined sugar and whole carbohydrates then all of a sudden it starts to become much easier to understand same thing is true when it comes to fat okay people say oh you know fat causes obesity fat causes diabetes and the truth is that no no no no the consumption of excess fat beyond your physiological requirements uh is what increases your risk for many chronic diseases uh whether it's diabetes whether it's heart disease whether it's obesity whether it's fatty liver disease chronic kidney disease alzheimer's disease you name it okay so it's not just fat it's the excess consumption of fat in particular saturated fat so the question really here is well what is saturated fat is it only in coconut oil or do i get it from the coconut meat as well and saturated fat as a uh as a as a species of fat if you will um comes mainly from the animal world so you get it from red meat white meat chicken fish uh eggs dairy products that's where most those products are very high in saturated fat and then saturated fat is also found in the plant world it's found in a i'm sorry it's found in avocados nuts and seeds it's found in olives it's found in coconuts and it's found in vegetable oils okay truth be told is factoid saturated fat is everywhere saturated fat is in lettuce it's in this banana contains saturated fat believe it or not it's just in such a small quantity that it's not really worth talking about but the foods that do contain you know a significant quantity of saturated fat from the plant-based world are like i said avocados nuts and seeds olives coconuts and vegetable oils okay so if you're taking a coconut and you press the coconut and you turn it into an oil that's one way that you can consume the coconut or you can take the coconut you can scoop out the meat and then you can have the coconut meat okay so both of the uh the ways that you consume this are going to contain the same saturated fat content or very similar saturated fat content okay the reason why people gravitate towards coconuts is because you hear this all the time they say oh um coconuts contain a medium chain triglyceride and it functions different differently than a long chain triglyceride and this launched this whole product line called mct oil medium chain triglyceride oil and truth be told a lot of this is just pure marketing pure marketing hype but what i want you guys to understand here is that coconuts absolutely contain saturated fat it just happens to be a shorter chain length than you would find in chicken or red meat or dairy products but just because it's a shorter chain length does not give you the green light to go consume large quantities of coconut and put in large quantities of saturated fat into your body on a daily basis because when you do that you increase your overall chronic disease risk and that sets you up for long-term you know problems in the future all right now here's the ultimate follow-up question from meg wondering if sugar isn't the problem are you really saying that a fatty hamburger is healthier than a candy bar oh this is a tough question i've got this before it's like it's like what's the lesser of two evils right so i guess we have a hamburger that's like a fatty oily hamburger on one side and then we have a candy bar on the other side um truth be told i don't know i don't know which one's worse for you um i could i could argue that you know the candy bar is worse for you i could argue the hamburger is worse for you what i will tell you is that the hamburger does present multiple problems number one the hamburger contains a significant amount of saturated fat number two the hamburger contains a significant amount of cholesterol number three the bun on the hamburger is a refined carbohydrate okay and so the only you know nutrients the only foods of value inside of a hamburger in my opinion are the lettuce and onions and tomatoes that go between the bun and the patty okay the rest of the you know the patty itself plus the the bun plus you know the ketchup and mustard and relish which are all processed foods none of those have any valuable nutrient uh you know value um so the hamburger presents multiple problems we got the saturated fat we got the refined carbohydrates plus we also have cholesterol the candy bar presents multiple problems as well because candy bars often contain chocolate as an example so milk chocolate so boom now you got yourself saturated fat uh now you got yourself synthetic white sugar without question and then in addition to that candy bars often have other sugar you know versions of sugar like nougat or caramel or high fructose corn syrup and these are the things that make them taste really good so the candy bar just tends to be like more refined from like the sugar area but it also does contain saturated fat and then the hamburger presents saturated fat plus cholesterol plus refined carbohydrates so slice it however you want you come up with the answer you know which one's worse for you i say they both kind of are not awesome so if i were in your position i would eat neither one of them and i would just opt for whole foods from the plant-based world as much as humanly possible but a a plant-based burger i mean you kind of you can't go wrong some burgers right so then let's say the healthier ones the ones made from beans as opposed to say maybe the impossible burger or something like that bingo okay so when it comes to plant-based burgers just like you're saying you can go to the store and you can buy a packaged and and or processed burger that's either an impossible burger or it's a beyond meat burger those are sort of like two name brands that you find these days and those burgers if you actually read the the the packaging you'll find that there's a whole bunch of synthetic ingredients in them they're effectively made in a laboratory or you know contain a lot of like synthetic laboratory made ingredients and they just happen to taste incredibly good and they taste like a normal burger would and then you have the other type of burger which is like a homemade burger that you could make by yourself which contains just like you were saying black beans chickpeas sun-dried tomatoes zucchini sometimes i've seen oatmeal put inside of burger patties so you put together some combination of again whole foods you you process them in a way that they turn into a patty you stick it in your oven you cook them and then you take that and you put it onto a burger or even better you take a portobello mushroom you put a little bit of vinegar on that thing you put it in the oven you take it out you stick it inside of you know two pieces of whole grain bread now you have yourself a burger right so i would always opt for just like you're hinting at here i would always offer the whole food version uh over the synthetic version any day of the week and if you do that then you're going to consistently be improving your health meal by meal that portobello burger sounds like that would hit the spot right about now i'm not even going to lie to you man my stomach is rumbling jack uh charlie he wants to know what are your thoughts on sugar-free candy that is marketed to people with diabetes is that a healthier option no absolutely not absolutely not there's a number of reasons why i say absolutely not because even though you know a lot of this like uh this like sugar-free or low-fat these words that you read on the the outside of a package sometimes they say like you know protein rich or like 15 grams of protein right it says this is marketing this is pure marketing and food manufacturers know that if they put certain keywords and certain phrases on the front of a bottle or the front of a package that people will buy them and people will buy them in large quantities so they do this over and over and over again and they figure out what are the exact words what color should the words be in how big should the words be where should they be printed how does someone's eye look at the package and what are they reading and they this is a science and so they know exactly what to put on the package to to sort of trick you into thinking they're like oh hey this candy this candy says it's sugar-free that's awesome i'm gonna buy this and then you go buy it and you're like well i'm a diabetic and i'm doing the right healthy thing okay but what they're not telling you is they're not telling you that maybe it's you know sugar-free like how do they define sugar first of all because there's no actual definition for sugar are they saying that it's white sugar-free does it contain high fructose corn syrup because some manufacturers don't consider high fructose corn syrup to be a sugar does it contain sugar alcohol alcohols like sorbitol or mannitol or erythritol okay these are all questions that you've got to ask yourself because there's like many different species of sugar and until you really like get to the fine print and read the packaging you're never gonna know if there's synthetic you know artificial sweeteners inside of your food or not okay so that's the first thing i would say and then the second thing is that oftentimes even though something might be sugar-free okay let's say it's a candy bar and it's sugar-free again we talked about the fact that it you know saturated fat as a problem right so they might actually reduce the artificial sugar content of that food but in the process they might add more chocolate okay and the chocolate might be made with like cocoa butter and or real butter and or margarine right and or hydrogenated vegetable oils and now you're talking about either trans fats or saturated fats which are known evidence-based research demonstrates clearly that trans fats can cause significant cardiovascular problems and that saturated fat can be a cardiovascular and diabetes nightmare so if you're reducing your sugar content but you're putting more of these other trans and saturated fats inside of the food are you actually getting healthier i don't think so all right everybody loves the smoothie it seems like we can never do one of these q a shows without a smoothie coming up one time or another linda wants to know whether your blood sugar will rise more if you're drinking a smoothie rather than eating the whole fruit yes so i'm looking down here at this bowl that doesn't look very appetizing at all right now no it doesn't i'm not gonna lie to you yeah sorry maybe i should have shown this used to be a smoothie okay this used to be a smoothie bowl and um the question is if you consume a smoothie or a smoothie bowl uh does that get sort of like processed quicker than if you're eating the whole fruit the answer is yes it absolutely does okay so here's a simple way to think about it when you're consuming a whole fruit like let's say you take this banana and you decide to put this banana inside of your mouth it's going to take time for this banana to get broken down by the enzymes in your digestive system and then it's going to take more time for those nutrients to be absorbed through the walls of your your small intestine to get inside of your blood okay so i want you to think about whole foods and fruits in this context because we're talking about smoothies as being three dimensional matrices of nutrients okay people a lot of the time they think oh the banana it's just it's just a ball of potassium right not even close not even close whole foods are three-dimensional objects that have vitamins minerals fiber water antioxidants phytochemicals carbohydrate fat and protein that is nine classes of nutrients that you find inside of a simple whole food like that but we don't talk about it that way people look at an apple and they're like oh that apples you know it's high in sugar right they take a look at a carrot and they go oh that carrot's got you know vitamin c in it right or they take a look at an orange oh that's vitamin c right but the truth is that all whole foods whether you're talking about a bean or a whole grain or a fruit or a starchy vegetable every single one of them has all nine of those classes okay and it's important to understand that because the carbohydrate the fat and the protein are the macronutrients these are the ones that actually give you energy so you will your body can actually turn the carbohydrate the fat in the protein into atp and atp is what sells it's a cellular form of of energy it's their currency that they use to you know oxidize i'm sorry they used to sort of um they use that for all of their sort of internal housekeeping and to stay alive right now um in addition to the carbohydrate the fat and the protein there's all these other micronutrients the vitamins the minerals the fiber the water the antioxidants and the phytochemicals okay the fiber is think of it like rebar okay it's literally like the rebar that you would find inside of like a concrete structure okay it's this it's this very complicated mesh that holds the nutrients together and the nutrients are again the carbohydrate fat and the protein plus all the micro nutrients the vitamins the mineral the water plus the phytochemicals and the antioxidants okay so all of these eight classes of nutrients are locked up inside of this fiber matrix and that's important because as long as the fiber is present when you put it in your mouth and it goes into your digestive system it takes time for your digestive system to get access to those nutrients okay you can't break down the fiber and completely degrade it because humans don't have the enzyme called cellulase that's required to break down the cellulose the the bacteria inside of your large intestine do and those are the ones that actually eat the fiber but what your digestive system can do is it can basically start to what's called denature or like open the the the three-dimensional object so that the other nutrients can can be degraded and can get chopped up into little pieces and then absorbed into your blood okay so i want you to think always about whole foods as literally being three dimensional objects and when these three-dimensional objects go inside your digestive system it requires time for them to be able to uh for for the the carbohydrate the fat and the protein to be able to enter your blood and then get circulated to tissues and time is your friend you want things to take a while because when they do it leads to a slow rise in blood glucose and a slow rise in amino acids and a slow rise in fatty acids inside of your blood and that is fine now when you process something say i took this banana and i took a banana and i ran it through a blender and i turned it into a smoothie and i added some spinach and maybe i added some acai berries and maybe i added some cocoa powder and i turned it into this beautiful tasty smoothie because i've processed it and i've run it through a blade and the blade has chopped up the components and turned them into like a slurry from the moment it hits my tongue and goes into my digestive system my digestive system has to do less work to get access to those nutrients because they're already is partially broken down and so as a result of that my glucose and or amino acids and or fatty acids are likely to get inside of my blood faster so if you're does that mean that you can't ever eat a smoothie and the answer is no absolutely i am a huge fan of smoothies no question but one of the things i tell people to do is when you're consuming a smoothie you do two things number one eat it slowly okay drink it slowly rather than just taking the whole thing down and wolfing it in like 10 minutes make it take half an hour okay and by doing that you're slowing down the rate at which these nutrients get inside of your blood number two if you can drink a smoothie and have some some solid material to come along with it like some greens maybe some spinach maybe some type of celery to go along with it that will also add fibrous material into your digestive system that'll slow down the rate at which your those nutrients get inside of your blood and that's a good thing okay so anything you can do to like keep that rate nice and slow is good and as a result of that smoothies are a go but try and balance it with either eating it slower or having actual real food to come along with it and i feel like after that answer i need one of those graduation caps and i need to flip the tassel to the other side because school is in session holy cow man that was complex i love it that was that was like one of the best answers anybody's given to any question ever on the exam room man thanks perfect all right i'm out i'll see you guys later total mic drop moment too bad we still have at least four questions to go and we should have saved that one for last oh my gosh uh god leek uh good luck topping that um all right so we've and seriously where do you go from this oh my gosh uh all right question from ian we've talked a lot about fruit let's switch over to potatoes interesting one here ian writes that he's heard sweet potatoes don't raise blood sugar as much as white potatoes how could that be when we're talking about a sweet potato ah okay so there is something that very interesting that happens from food to food to food so you read on the internet says sweet potatoes are are better for people with diabetes than white potatoes because again what they're trying to communicate is that the speed at which the glucose molecules get inside of your blood is slower for a sweet potato than it is for a white potato and then you will also hear people say things like you know a sweet potato is a better option for you than is a banana because a banana is gonna get inside of your blood quicker okay and the truth is that these uh the speed at which foods get like a sweet potato versus a white potato the speed at which those glucose molecules get inside of your blood actually varies from person to person okay so the reason that i'm confident in making that statement is because we have a coaching program in our coaching program we are coaching thousands of people uh through the process of integrating a plant-based diet so that they can become more insulin sensitive aka they can lower the fat content of their diet lower the amount of fat that's stored inside of their liver and muscle and make it so that the insulin that their pancreas is producing or the insulin that they inject becomes significantly more powerful and significantly more effective and that's a good thing because when insulin is powerful in your body your chronic disease risk drops significantly so the goal here is target insulin resistance on the head make yourself insulin sensitive and as a result of doing that diabetes tends to fade away and chronic disease tends to fade away okay now let's go back to the potato okay if you have heard that a sweet potato is better than a white potato that might be helpful information but the truth is that in our coaching program when we teach people how to start integrating potatoes into their diet some people come back to us myself included and they say you know what if i have as little as two bites of a sweet potato good luck glucose through the root okay if i have as much as two bites of a white potato totally fine glucose is very controllable right other people are the exact opposite they go oh yeah i eat a white potato glucose through the root i ate a sweet potato i eat a purple potato glucose very controllable right so i would love to have a magic wand where i could just take this wand and i could like put it up against someone and i could be like oh okay cool you should eat white potatoes and you know lower your intake of sweet potatoes because that's what this magic wand tells me but the truth is that there's a biological individuality from person to person that makes it very hard to predict whether or not this like general advice that sweet is better than white very hard to interpret okay the same type of thing happens from fruit to fruit some people find that when they consume bananas their blood glucose is very controllable it's not a big deal and some people find that when they have watermelon as an example their glucose goes through the roof and there's nothing they can do to stop it okay other people find the exact opposite they they're like yeah i can eat a watermelon all day long and everything's fine but the minute i have an orange boom glucose through the room right and i can be the first i'll be one of the first people to tell you that that individuality from food to food and then the individuality from person to person is a real phenomenon and as a result of that what i you know unfortunately what what i recommend people to do is they have to sort of like start simply and then expand their diet over the course of time in a systematic manner and we have you know many products and services and mastering diabetes that are designed to help people go through this process and we just created this thing called a weekly meal plan which delivers you 21 recipes in your inbox every single week and that's exactly what we do is we teach people how to start with a sort of basic collection of foods and then expand the diversity over the course of time and in that process you're going to have to be the detective and you're going to have to figure out if quinoa makes your blood glucose do weird things but brown rice doesn't then maybe you should eat more brown rice and a little bit less quinoa right so if there's sort of like some experimentation which is required but um it's a very valuable process to go through because when you really figure it out then you have a whole menu of foods which you know control your blood glucose well and a menu of foods which tend to be problematic and i wish i could explain the actual scientific mechanism that explains the bio individuality from one person or another but i can't right now and maybe that'll that'll be in a future episode let's do some real talk here for a second uh what you just said is critically important and people do get so frustrated i've heard this from viewers and listeners of the exam room who say well i'm doing everything you guys are talking about and still my cholesterol is high still my blood sugar is high and my heart goes out to them and one of the things that i always talk to people specific to weight loss is that there is not a one-size-fits-all program here and it sounds like the same thing applies for diabetes and a lot of other chronic conditions as well it it's about finding what works for you but don't give up if the first thing doesn't click right into place i love the way that you turn that as far as you need to be your own detective like that is huge to me don't give up just keep digging absolutely and you know and the truth is that when it comes to diet and understanding what foods might have what positive or negative effects like you and i were never taught this in school right nobody goes through a nutrition detective class and walks away understanding how they can test specific foods for their response either in the short term or the long term okay there are things like a blood glucose meter which can help out for sure because it gives you like a real time feedback there's a there's you know a continuous glucose monitor will do that an insulin pump can help you understand that information but if you're not using any of those devices and you're just sort of an average individual who's you know medication and device free and you're trying to lose weight or you're trying to lower your cholesterol it can be challenging because again we're not equipped with the right tools and you don't know what information to gather in order to determine whether or not you're doing something right you're doing something incorrect but the general idea here is start simply okay when i say start simply i mean find seven maybe ten foods in the plant-based world that you really enjoy eating okay so some of those could be fruits some of those could be beans some of those could be whole grains some of those could be starchy vegetables some of those could be non-starchy vegetables doesn't really matter let's just say for the sake of argument my foods were mangoes papayas and plantains i love those foods i'll eat those all day long that's one two three i'm gonna add to that chickpeas i'm gonna add to that quinoa i'm gonna add to that broccoli and then i'm gonna add to that um let's do brown lentils and then that's it those are my eight foods right there okay so what i would do is i would start constructing foods using some combination of those or start constructing meals using some combination of those foods and then what i'm looking to learn is how do i feel how is my energy level how is my sleep how is my digestive process this is a big one okay if every time i eat a meal that contains lentils i discovered that the next morning i have stomach pain and maybe i felt gassy while i was sleeping then you're gonna have to be a detective and be like wait a minute let me go backwards in time and figure out what did i do and what am i doing consistently that's giving me that same process oh okay it's probably the lentils so then the next thing you do you pull the lentils out and then you have that same meal without the lentils in them and also you're like oh okay the problem went away so that's a good indicator that the lentils might be causing a problem if that's the case take the lentils out and substitute them with something else put black beans there instead right so there's a little bit of like a a detective process which is required but the idea here is if you start with a small number of variables and then you increase the diversity over the course of time if you add foods in one by one that enables you to better understand and better identify things that could be causing you problems i'll be the first person to tell you that i've gone through this process for the last 18 years and there are certain foods that i just literally cannot eat because they'll either cause my blood glucose to go extremely high or i just can't digest them properly and you know what that's okay it's not a big deal so what i do is i don't worry about those foods and instead i focus on the foods that i can eat and i eat those foods in abundance and i'm a happy camper you don't feel restricted at all like i i really wish i could eat that slice of vegan pizza right now but i know that it's just not going to be any good for me the way that i kind of look at that is that well yeah that's one food that you can't eat but there are 18 bazillion others that you can readily enjoy totally i i flip it around every single time i mean don't get me wrong i'm human when somebody's sitting down and they're eating a vegan pizza and it tastes really good and it's got barbecue sauce all over it like there there definitely there's a part of my brain which is like oh my god i don't want to eat that i want to eat that right but there's a funny thing that happens inside of you know your brain and your digestive system because the two of them are talking all at all times let's say you're sitting down and you see this vegan pizza and it looks really good and it smells really good it just came out of the oven and your friends and family are about to eat it and you're just like wow god i want to eat that thing so badly okay so let's just suppose that you went and you ate that food and you were like all right i'm just gonna have a slice or i'm gonna have two slices so you eat that it's got it's got the crust right which is a refined carbohydrate most likely and then it's got a bunch of vegetables on top of it it's got a barbecue sauce which who knows what's in that barbecue sauce you eat that food and temporarily you're like man that hit the spot that was great i really i really enjoyed that process right but then two hours later you recognize you're like uh hold on a second i gotta go to the bathroom you go to the bathroom not a fun experience right next morning you wake up and all of a sudden you're just like man i feel sluggish that didn't really feel that good right if you go through that process once twice three times four times five times who knows how many times it'll take you but there comes a point at which when you repeat that behavior the next time and you have that pizza again or something similar and then you get that frustrating digestive process there will come a point where your brain flips and basically says you know what it's tasty but it doesn't do good things to me and as a result of that you are likely to not want to eat that food the third time it shows up or the fifth time it shows up and so there's this feedback mechanism that happens with your peripheral tissues and your central nervous system and if you can get in tune with that feedback mechanism then you start to make decisions that are actually subconscious where you don't even have to think about it and every time that pizza appears it's not like you're having a fight with it being like oh my god i really want to eat that thing i really want to eat that thing and you just you see the pizza and you're just sort of like all right that's not cyrus food that's not cyrus food i'm gonna focus on this plate of mangoes and garbanzo beans with passion fruit on top of it and i'm gonna enjoy the heck out of this thing and i could care less about that pizza because this thing is going to work for me digestively it's going to help me control my glucose it's going to keep my cholesterol low it's going to give me a lot of energy i'm going to be able to sleep like a million bucks i'm going to be able to exercise as much as i want i'm a happy camper it took me 27 years to learn that lesson 27 years man but eventually you're right the brain just it flips and that is a glorious day um question from kiana this is a really good one a lot of people can probably use this one diabetes runs in my family my mom my grandma my dad and my brothers all have it and i feel like i'm just biting time until i too have diabetes how big of a role does genetics actually play in terms of a person's risk of developing it seems right there it's that big it's that important literally that important okay it i don't wanna i don't wanna um make things uh hard to understand here i don't i don't wanna mislead and misrepresent the actual biology there is such a thing as a genetic predisposition towards autoimmune diabetes which is what i have type 1 and then autoimmune type 1.5 diabetes meaning if you have a family member that is living with an autoimmune version of diabetes your chances of developing it are increased versus the general population no questions asked it could be a brother a sister a mom a dad an uncle a grandfather a grandmother you name it okay there's also people who are worried just like kiana is saying that you know oh you know type 2 diabetes that runs in my family my mom had it my dad had it my grandfather had it my sister has it my brother has it so therefore i'm a ticking time bomb right the truth is that when it comes to pre-diabetes and type 2 diabetes and gestational diabetes the the genetic predisposition that you may have is about this important because you can control your level of insulin resistance which is the underlying condition that increases your risk for all three of those conditions you can control insulin resistance every single time you open your mouth you can fuel insulin resistance by eating the foods i was describing earlier the saturated fat the cholesterol and the refined carbohydrates go for it you eat those foods insulin resistance will get high it'll stay high and as a result of that your risk for all of these lifestyle versions of diabetes whether it's pre-diabetes type 2 or gestational goes up no questions asked but if you choose to do the opposite which is eat lower amounts of cholesterol or none lower amounts of saturated fat and lower refined carbohydrates or none if you choose to do that then what you're doing is you're taking an insulin resistant state and you're lowering it so that you can become you can either reverse insulin resistance altogether or you can become extremely insulin sensitive there's sort of two different ways of explaining it when you do that when you reverse insulin resistance you're literally dramatically lowering your risk for pre-diabetes type 2 diabetes and gestational diabetes we see this in our coaching program literally every single day of the week this is the system that robbie my co-founder and i have developed over the course of the last 15 years it's grounded in a hundred years of evidence-based science and we have practiced it with almost 10 000 people at this point and i can be the first person to tell you that when you eat to maximize your insulin sensitivity your genetics are literally this important and it doesn't matter anymore it literally doesn't matter so we've had people who have come through our coaching program and they are like oh cyrus like the odds are against me you're like i'm 120 pounds overweight and diabetes is in seven of my family members and i say to them i don't really care i mean i'm not trying to be insensitive here but that doesn't really matter okay the cards are not stacked against you all you have to do is learn how to eat and learn how to be consistent and integrate tools such as low-fat plant-based whole food nutrition intermittent fasting when necessary and daily movement and you do those three things and you just watch as your risk for diabetes or your pre-existing diabetes vaporizes and just is gone right we see that in 80 to 90 of all cases and i really want people to understand that like your genetics are important but your diet is way more important every single time big shout out to dick who's checking us out from toronto today he wants to know oh boy this is a not a 101 question this is at least 201 maybe even 301 here we go we haven't talked about intro myocellular lipid here yet uh how can fat get trapped in a muscle i thought it hung out just below the skin all right let's get nerdy boom here we go nerdy intramuscular lipid imcl okay um this is not a shameless plug we wrote a book it's called mastering diabetes right here you can see this right here okay this book came out a year ago this book has 800 scientific references in it and it tells you the ins and outs of how you can become the most insulin sensitive you've ever become a very large portion of that story is all about intra-myocellular fat intra-myocellular lipid otherwise known as imcl okay let me tell you a quick story when you put fat into your mouth saturated fat in particular okay you're eating chicken you're eating fish you're eating uh bacon okay or you're eating you know significant amount of nuts and seeds and avocados and coconuts okay if you're eating a large quantity of those foods the fat ends up traveling down your esophagus it gets inside of your stomach it gets to your small intestine inside of your small intestine it's acted upon by a whole collection of enzymes and these enzymes are designed to take the triglyceride molecule because that's how it exists in nature and break it apart such that you have the glycerol backbone and the three fatty acids again the triglyceride the triglycerol and break it apart and when it does that now these three fatty acids can become absorbed into your blood so these three fatty acids are absorbed into your blood they're put into these little spaceships called chylomicrons these chylomicrons circulate they go all throughout your your circulatory system now these chylomicrons have one objective and their objective is to deliver cholesterol and fatty acids into tissues that's what they're that's what they're designed to do the question becomes where where are they going to put them are they going to put the cholesterol and fatty acids in your brain they're going to put in your thyroid they're going to put in your fat your muscle your liver your kidney your heart your sexual organs where the where's it gonna go and the truth is that all of these tissues with the exception of your brain are capable of taking up fatty acids and cholesterol from these chylomicron particles now fun fact if these chylomicron particles were to deliver fatty acids to your adipose tissue and only your adipose tissue then diabetes would not be a very important pro condition in today's world okay diabetes would be a chronic disease but it would be very very small and it wouldn't really impact a significant portion of the population but what ends up happening is that these chylomicron particles they deliver fatty acids into your adipose tissue and then in addition to that they also deliver fatty acids inside into your liver and into your muscle now the problem is that your liver and muscle are two tissues which are designed to operate primarily off of glucose when i say primarily off of glucose i mean their enzymatic machinery in the entire cellular architecture is built upon the foundation of glucose as a fuel and there is a small section of the cellular architecture that is mechanically and enzymatically designed to be able to take in fatty acids and either store those fatty acids or take them in and then oxidize them and turn them into atp okay it's just that the majority of the cellular architecture is designed for glucose and a small amount is designed for fatty acids so what that means is that if you're if you're eating a saturated fat rich diet for breakfast and lunch and dinner today and tomorrow and the next day and so on and so forth within a short period of time you end up overwhelming your liver and muscle with too much saturated fat and in that situation your liver and muscle go into a self-defense mechanism because they're like whoa whoa whoa whoa hold on we can't handle all the saturated fat so what they do is they try and find a way to block more saturated fat from coming in so they they they initiate what's called insulin resistance they stop communicating with insulin as effectively so what that means is that the next time you eat something that contains carbohydrate you pick up this banana and you eat it what happens is that the carbohydrate the the carbohydrate molecules are broken down into glucose that glucose is now in your circulatory system the glucose is trying to get inside of your liver and trying to get inside of your muscle because that's where it belongs and insulin comes and goes knock knock hey liver hey muscle there's some glucose inside of the tissue inside the blood do you want it and your liver and muscle go nah nah nah remember i'm doing insulin resistance right now i'm in doing insulin rejection i'm not paying attention to you insulin i am in self-defense mode see you later so insulin literally becomes so ineffective that insulin cannot get glucose inside of the tissues and as a result of that glucose and insulin accumulate inside of your blood so what that means is that people who are eating low carbohydrate diets or saturated fat rich diets eat one fruit one fruit and their glucose goes through the roof and their conclusion is i told it's the fruit the fruit's bad for me i shouldn't eat that fruit but in reality the answer is no no it's not the fruit it's the metabolic traffic jam that occurred before you consumed that fruit that made it so that you your your tissue your your liver and muscle we're not responsive to insulin that's the problem so to answer the pre the question is you know what about these imcl imcl intra myocellular lipid is just a fancy scientific word for excess fat excess saturated fat inside of your muscle that's all it is and now that you know the story of insulin resistance you know exactly how this cascade unfolds and if you can lower your incl content by lowering your fat intake all of a sudden you become insulin responsive and the world is your oyster there you go man that's we're going to move that tassel to the other side again you're on a roll today you are on a roll today professor kombata uh time for one final question and i love this one more than any other that we've had on the show today because it offers both inspiration and hope to people who think that they're in a hopeless situation shelby wrote in wants to know how much improvement can somebody see if they've had diabetes for 25 years or longer phenomenal question uh the answer is um in order to fully understand uh in order to definitively answer your question i would recommend you get one test done first and that one test is called a c peptide test a c peptide test is a test that will tell us how effective or how much insulin your beta cells in your pancreas are capable of producing okay so if you went and got a c-peptide test it's a very easy test that you can get you can call your doctor say hey can i get a cpap that test they can order it and you can get it done it's just a simple blood test uh if you get that c-peptide test and it comes back as a low right meaning your c-peptide is low what that means is that the ability of your beta cells to secrete insulin is low and that right there is an indicator that diabetes is going to be hard to fully reverse inside of you without the use of insulin if you go get your c-peptide tested and your answer is medium what that means is that you can definitely reverse uh diabetes and insulin resistance using your diet but that you're going to have to be pretty darn diligent about it okay and when i say diligent i mean consistent and uh no wavering no cheat days no no messing around okay if you go get your c-peptide measurement and you come back with a high result what that means is that you you can easily reverse insulin resistance and diabetes using a low-fat plant-based whole food diet because your pancreas is secreting a sufficient amount of insulin now statistically speaking i don't know the actual number but if i had to hazard a guess what i would say is that about 20 percent of the diabetes population the type 2 diabetes population has a low c-peptide level and therefore is going to require insulin over the course of time the other 80 okay the the majority of people living with type 2 diabetes have either a medium or high c peptide value and as a result of that diet is sufficient so get that test figure out what your level is and then based off of that level you can use that as a compass to try and figure out do i need diet plus insulin or can i just do diet alone and if again this the odds are in your favor that you can do it for your diet alone but the cpap diet test just tends to be very helpful in understanding that process all right a little bit earlier in the show you mentioned that you had just developed a weekly meal plan and i need to know my man before i let you go what kind of food is on there give me an idea of what's on this menu make my mouth water here is your opportunity to go thank you sir okay so we have received an overwhelming number of messages from people who are living with diabetes around the world who have been telling us like hey guys your information is awesome but here's the thing i just need to know what to eat tell literally tell me what to make tell me what to buy at the grocery store tell me what to make and i'll do it so what we did was we developed a weekly meal plan which is literally a a collection of recipes you get 21 recipes per week delivered directly to your email inbox and every week you get a whole new collection of recipes and these recipes are delicious if i don't mind saying so myself okay we put a lot of work into these recipes these recipes are made primarily of every single fruit you can possibly think of and buy in the grocery store we are very fruit friendly starchy vegetables like potatoes and sweet potatoes and purple potatoes and squash and i will put corn into that category because it tends to be starchy also uh you can do whole grains like quinoa and brown rice and millet and farro and the like and then we also have legumes like beans lentils and peas okay so we focus on those four food groups fruits starchy vegetables whole grains and legumes and practically every meal is built around that and then there's a whole bunch of other things that come in for fun you know green leafy vegetables non-starchy vegetables a little bit of nuts and seeds here and there some avocados here and there and we put together these very very tasty meals so that all you have to do literally is look at the grocery shopping list and be like all right i'm just going to go buy this stuff you go to the grocery store you buy it you bring it home you follow the instructions and now you have yourself something that's extremely delicious something that's very nutritious and something that is designed to keep your blood glucose very controllable as you reverse insulin resistance and become the most insulin sensitive you've ever become so if you're if anybody's interested in this you can just go to the masterydiabetes.org website and go mastering diabetes.org slash meal plan take a look at it if you're interested go for it if you're not interested no problem dude that is fantastic i'm going to go take a look at that i want to get my hands on some of those recipes for sure cyrus kambata phd you are the man to me thank you so very much for joining us my man chuck i totally appreciate you allowing me to be here today and uh i hope we answered a lot of really good questions here about diabetes i hope people are uh you know enjoyed this content oh my man you definitely raised some nutrition iqs today very well done my friend thank you [Music] if you feel like you've raised your health iq by a couple of points go ahead and subscribe to this channel and leave a nice comment below and to hear the entire interview head over to apple podcast or wherever you get your shows from and subscribe to the exam room by the physicians committee and please leave a five star rating

Channel: Physicians Committee

Views: 393,074

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Id: fORPzup-Hrw

Length: 49min 53sec (2993 seconds)

Published: Fri Mar 05 2021