the ultrasimple diet



cyrus:there is story after story. vijay is another example. he was living with type 2 diabetes for 9 years. neglecting his diet, not really paying attentionto it. he came to use and basically said hey, i needsome

help, and we showed him this approach. over the course of 6 months, he dropped 30pounds. hestopped using metformin diabetes medication. how many of you guys use metformin?

he stoppedusing metformin. he also stopped using a statin medicationand also stopped using a blood pressure medication. now, he exercises 6 days a week, and he isa happy guy as you can tell. cyrus:thank you guys so much (i have a couple of microphones, is this too loud. ok, great)thanks for the opportunity to present here erin today, appreciate it. just like erin said there is a lot of confusionin the world of diabetes, and our goal here

today is to tryand help clear up some of that confusion. because unfortunately diabetes can be oneof these really grim diagnoses where the doctor says thatyou have it, and then from that point onwards it can lead tocomplex emotions and a confusion about what to put into your body. our goal here today is to try tosimplify that a little bit so that you can understand a little bit about what is trulycausing the problem for type 1 diabetes and type 2 diabetes and howthat can be handled. so, i will tell you first a little bit aboutmyself.

i was diagnosed with type 1 diabetes at theage of 22. i was a senior in college. i was going tostanford university. out of nowhere, i started to feel incrediblythirsty. i felt very thirsty, and i lost allmy energy. in a very short period of time, i found myselfgoing to the bathroom every half an hour like clockwork; 17, 18, 19 times a day. i knew that something was terribly wrong withme, but i did not have the confidence to say anything to anyone.

i lived like that for a couple of days. after a couple of days, iwent straight to the health center at school, and i said "here is my symptoms", and theytook a look at me, and they knew immediately what the problemwas. they said you have type 1 diabetes. they tooka finger stick of blood glucose, went into another room, checked it on the meter, andcame back. in the3 minutes that it took for them to check it on the blood glucose meter and come back,i had fallen

asleep. i woke up, and i did not know where i was. so, i looked up at the ceiling and was likewhere am i , how did i get here. ok, i am in a doctor's office. who brought me here? what did i get here for? so,they took me to the er. they admitted me, and i was there for 24 hours.

over that 24 hour period, theyexplained to me that my pancreas, the insulin producing cells in my pancreas failed. as a result of that,i now have type 1 diabetes which means that i have to inject insulin every day for therest of my life. you can imagine as a 22-year-old, you knowi am in the middle of college, i am just a happy-go-lucky guyand all of a sudden i get this really grim diagnosis, and it scared me. so if you rewind the clock maybe 6months backwards, i had been diagnosed with 2 other autoimmune conditions.

the first one washypothyroidism which is a decrease in thyroid production from my thyroid gland. the second wasalopecia universalis which is why i have no hair. i have no hair. no eyebrows. no armpit hair. no nosehair. nothing.

first, hashimoto's thyroiditis set in. then alopecia. then the icing on the cake was type1 diabetes. at that point, i was very scared. i did not know what to do. my doctor's basically told me tofollow a low carbohydrate diet because that is the one size fits all prescription forpeople with diabetes. i was told to eat foods like you see picturedhere; cheese, eggs, meat, and under no circumstances was ito eat carbohydrates because the more carbohydrate

i ate, the more insulin i would need. so, itsounded like a pretty reasonable strategy, so i said "ok, fine". i did my best to try and keep mycarbohydrate intake low and then to gravitate towards more fatty and high protein foods. so, i did thatfor the first year. within 365 days, i recognized that thingswere going even further south than they had already gotten to. i suffered from incredibly low energy.

i became depressed because i did not haveenough energy to go and play sports. i grew up as an athlete. i love playing soccer. i love playingvolleyball, baseball, basketball. you name it, and i could not do it anymore. on top of that, my bloodglucose was a rollercoaster. eating this way was supposed to make my bloodglucose much more manageable, but it did the exact opposite. it made it so when i checked my blood glucoseat any given

moment of time i would see these giant numberslike 284. sometimes i would see a 55. sometimes iwould see a 400. i had absolutely no idea what was causingthis. so after a year of living this way, idecided i had to make a change. i had to make a big change because this clearlywas not working. so, idid all this research, and i started reading books and watching movies and attending scientificlectures. one thing led to another, and i got open tothe ideas that maybe if i adopted a plant-based

diet thatmaybe that would change things for the better. i was hesitant at first because i grew upas an athlete, you know, a guy athlete, and we are told froma young age that if you do not eat meat, if you do notdrink milk, you do not eat cheese that you are going to become scrawny, and you are notgoing to become strong, and girls are not going tolike you. so, as a result of that, i said "ok, fine". i eat like aman. that is how men eat.

but then all of a sudden, this ideas of becominga plant-based eater came into my mind, and i struggled with it fora little while. i finally decided that i am willing to tryanything at this point because clearly i do not feel good. so, i adopted a plant-based diet. a low-fat, plant-based,whole foods diet which i will talk in detail about today. in so doing, it was the single greatest decisioni ever made in my whole adult life.

this is what happened. my carbohydrate intake went from about 100maybe 150 grams per day all the way up to 600 grams per day within the first month. now, in thediabetes world, if you tell someone you are eating 600 grams of carbohydrates, they lookat you like you have 4 eyes, right? that is more carbohydrate than most peoplewith diabetes will eat in a full week. iwas doing that on a daily basis. i was expecting that by increasing my carbohydrateintake that much

that my insulin use would also go up becauselike we said earlier, the more carbohydrates you eat themore insulin you are going to need, right? well, this is what happened to my insulinuse. it went down. so, i started out using between 40 and 45units per day and over the course of the first month, itdropped all the way down to 25, 24 and hovered in that range. so, for 3 weeks, i cut my insulin use by40%. that is a big deal when you are living withtype 1 diabetes because if you are supposed

to injectinsulin every single time you eat a meal, if you are using less and less insulin andyou are pouring in more and more carbohydrates, clearly somethingvery interesting is happening. so, at this point, irecognized that this traditional model of carbohydrate metabolism is totally not right. that somethingwas at play here that i could not explain using words. so, at that point, i decided that i wantedto investigate this sort of linear carbohydratemodel a little bit more, right?

again, the model goes like this. eat less carbohydrate, have less blood glucose,therefore you use less insulin. pretty straight forward. so, what i did is i went to, i enrolled inphd programs all around the country, and i decided that i wantedto turn this into my intellectual passion because i wanted to explain this experiment. i wanted to beable to describe what was happening inside of mine brain, inside of my thyroid, insideof my pancreas, inside of my muscles, but i could not do itusing the words that i wanted to describe

it with. so, in thisprocess, i went to uc berkeley. i studied nutritional biochemistry for 5 yearsand really got to the point of understanding the molecular level of detailsof what is happening inside the human body. i went witha real simple question which is "am i a freak of nature?". that is all i wanted to know. just a simplequestion, right? "so, what do you want to study for your phd?"

"i want to understand if i am a freak". that is what i want to understand, right? am i a freak of nature in the sense that whatis happening inside of my body just a one off scenarioor is it something i can actually apply to other people. does itapply to other people with type 1, with type 2, people who do not have diabetes? so, i was able tostudy insulin resistance which we are going to talk about in detail today.

insulin resistance is the rootcause of type 2 diabetes, but is also an underlying factor in many health conditions includingtype 1. inthis process, i was able to investigate, do a bunch of studies, and write a thesis specificallyon the effects of insulin resistance. so, here i am today 15 years later from thatinitial diagnosis of 2002. i havereduced my insulin use by 40%. i eat more than 700 grams of carbohydrateson a daily basis. my a1cvalue, which is a 3 month marker of your average

blood glucose, is between 5.6% and 6.0%. that is inthe target range where i want to keep it. so, i am going to introduce you to my co-founder,robby. robby also has a very interesting story. he has been diagnosed with type 1 diabetesas well, and he has got a great story. robby:how are you guys doing, can you hear me? maybe it is better if i do not use this microphonecause i think this one still is on, but i think itis ok.

guys, thank you erin for putting this togetherand getting all these people here. this is really wonderful. these people are interested in this information. my nameis robby barbaro. on social media, some people know me as "mindfuldiabetic robby". i love to postpictures of what i am eating and videos on youtube and just sharing this with as manypeople as possible.

so, it is funny, cyrus and i were actuallydiagnosed with type 1 diabetes in the same year. itwas 2002 that i was diagnosed. my older brother actually has type 1 diabetesas well. my family is sortof familiar with it. i was complaining to my mom, "mom, like iam thirsty all the time, i have to go to the bathroom all the time. i think i have diabetes just like steve". she was like, "no, don't be silly".

so, iwas like, "ok". we were living in minnesota at the time, andmy parents were in florida looking at a house because we were going to move there. my mom called me to check in and say hey howare things going. i said, "mom, i couldn't sleep last night,i was cramping, felt terrible". she was like, ok, goupstairs use your brother's blood sugar meter and see what is going on. so, i measure, and i am likeover 450, and my brother right there was like

yup you have type 1 diabetes. pack your bags. you aregoing to have to go to the hospital for a few days. so, we went to the regular doctor, and theyrun some tests. then they send you to the hospital. so, i stayed in the hospital, i think, itwas only 1 or 2 nights because my family knew what to do.

my parents came back, and they told me don'tworry about. it isjust going to be an inconvenience. my parents were really great about helpingme work through it. so,in the beginning, i was following the standard american diet. nothing was off limits. we would eatmcdonald's, twinkies, just normal food. when you are in the honeymoon phase of type1, you usually are under control.

so, i never really was out of whack as faras my diabetes numbers, but i did have other health problems. so, i took allergy medication. i have claritin-d all the time. i still got sick everyyear. i had terrible acne as a teenager. you did everything. you go and do microdermabrasion. you diddifferent pills and all this stuff, and eventually

they gave me accutane which is one of themost serious drugs you can give for acne, and it stilldidn't really work that well. then i also suffer from plantarfasciitis. so, i was a competitive tennis player, andit would just hurt, so i had to where these blue bootsat night which was really uncomfortable. i started to read and learn more about howcan i take care of myself, how can i prevent complications, andeventually i stumbled across the western a. pricefoundation at some point. i started eating grass fed beef and raw milkand all that stuff, and i still was

limited in sugar and fruits because that wasnot good for you. it had too much carbs. after that, istarted learning more and more information. eventually, i came across a plant-based versionof a low- carb diet. i started learning from gabriel cousins. he had like a phase 1 program where you basicallyeat only nuts and seeds and oil and lots of greens, so i could have like celery and almondbutter. basically, i was living off of that stuff.

i was in college at the university of floridaat this point. i followedit perfectly, and you are going to see later on in this lecture we are going to talk about,cyrus is going to talk about insulin use and all that stuff. i was doing that diet, and i was taking theleast amount of insulin that i ever have taken, but the problemwas is i did not have any energy. i was on campus, and iwas like blacking out. i was eating very little amounts of carbsand of course, injecting a very small amount of insulin.

it was not working. at this point, i was getting scared. i tried a lot of things. i reallydo not know what to do. i am doing everything i can. so, i went back to a naturopath that i hadseen for many years throughout high school andcollege, and she said maybe you should try a chelationtherapy. maybe it is heavy metals that are causingsome of these problems.

i said, "ok". it was going tobe expensive, but i am willing to do anything. i was considering it, and between making thedecision to do that i heard a podcast and found this guruthat started talking about eating fruits and vegetables andthey were great and that fat was actually a big problem for diabetics. i was like this sounds amazing. iwould love to eat some fruit. so, i gave it a try.

i signed up for his coaching program. i emailed this guyevery single day for 90 days straight. every single day. we got to know each other well. i started eatingthis diet, and it was the best decision i had ever made. so, i started eating persimmons, mangos,bananas, papaya. my insulin sensitivity, the amount of carbsi was eating for the insulin i was injecting was through the roof.

it had never been that good before; although,my total intake went more towards what my pancreas would have been secretingif i was not a type 1 diabetic. so, things were goingamazingly well. i was absolutely loving it. now, it is 10 years later. i have been doing this diet for over10 years. i started december 2006, and in that timeframei have never had an a1c above 6.4% with my current a1c which was a couple weeks ago at5.9%. i am super active every day.

i feel amazing. my skinhas cleared up. i do not take any other medication other thaninsulin. i am just really passionate aboutsharing this message with as many people as so, it is really fun to be working with cyrus. i amgoing to hand it over to him, and he has got a great lecture for you guys. we will talk to you in the q&a. cyrus:ok, so question, i want to understand who

is in the audience today. how many of you guys are currentlyliving with diabetes? anyone? raise them high. we have got a lot of people. raise your hand if youhave type 2 diabetes. raise your hand if you have been diagnosedwith prediabetes. wow, a lot ofpeople. raise your hand if you have been diagnosedwith type 1 diabetes.

fantastic. raise your hand ifdo not have diabetes at all. ok. some of you raised your hand twice. ok, great. so, you guys haveprobably heard of the term insulin resistance before. maybe, yes? ok, i want to know what you guysthink.

if you could define insulin resistance in1 or 2 sentences , what would you say? raise your hand,go ahead and shout it out. anyone know? ok, so when your pancreas is broken? ok! fantastic! youwant to give the lecture? you clearly understand what is happening. what was yours?

it was the samedefinition? when the insulin you make is not effective. good. can you say your definition one moretime back there? you guys nailed it. what i really want to hit on the head is insulinresistance, and that is sort of the major focus of the talk today because insulin resistanceis the underlying factor present across all formsof diabetes. a lot of out doctors, the medical communitydoes

not understand this. they were not trained properly to get theknowledge and the tools and as a result of this, they are giving improper information. doctors are great people. they are not to blame, but thefact of the matter is if you really understand what insulin resistance is then you yourselfcan treat insulin resistance and reverse it. that is what we are looking for today. so just like you guys said, insulinresistance is caused by the storage of fat

in tissues that are not designed to storefat. so, rememberthat. insulin resistance is caused by the storageof fat in tissues that are not designed to store fat. fromnow on, you guys are world's experts in insulin resistance. if anybody asks you what is it, you repeatthat sentence right there. so, now we have to understand well how doesthat happen in the first place. if you cannot read this it is my fault.

insulin resistance is a very prominent healthcondition in our work today, and it influences a lot of other chronicdiseases. so, we talk about insulin resistance in thecontext of diabetes and only diabetes, but it actually influences many other health conditionsincluding cancer, coronary artery disease, hypertension,atherosclerosis, obesity, high cholesterol, fatty liver,polycystic ovarian syndrome, alzheimer's disease, neuropathy, blindness, kidney failure, retinopathy,and erectile dysfunction. insulin resistance is a central controllinghealth condition that talks to every single one of those and increases your riskfor every single one of those conditions.

that is why it is soimportant. now, heart disease is the most important ofall of those conditions that i just mentioned because heart disease is the number 1 killerof people with diabetes. there is a statistic that scared mewhen i first read it. it says that 33% of all people living withtype 1 diabetes, the same diabetes that robby and i have and 2 other people in thisroom, 33% of them will die before the age of 50 due toheart disease. that is a scary statistic. heart disease is also very prevalent in thetype 2 diabetes and

the prediabetes world as well. you see if you read the literature like ido in my spare time because i am a nerd you will find that insulin resistanceis very strongly correlated with heart disease. it is stronglycorrelated with hypertension, with high cholesterol, with coronary artery disease, ischemia. this is veryscary because if you don't control insulin resistance then ultimately heart disease isone of the things that can get you. now, most physicians have been trained tobelieve that insulin resistance is only

associated with predicates and type 2 diabetes. the model goes like this. first, you develop insulinresistance. then you develop predicates. then you develop full-blown type 2 diabetes. that is it. theproblem, though, is that insulin resistance like i mentioned earlier is actually influencingall forms of diabetes.

so, it influences type 1 diabetes. it influences type 1.5 diabetes which is ahighly misunderstood form of diabetes. it is an adult onset slow progressing versionof type 1 diabetes. it alsoinfluences prediabetes, type 2 diabetes, gestational diabetes, what pregnant women get which istemporary, and alzheimer's disease which is now being classified as type 3 diabetes. that is insulinresistance of your brain. so, we can't really talk about any versionof diabetes unless we talk about

insulin resistance because we are just missinga very large puzzle piece. in order to understand this, let'sunderstand a little bit about how your pancreas functions. your pancreas has 2 functions. there is anexocrine function and am endocrine function. 99% of your pancreas is related to exocrinefunction. that is what it performs. exocrine means it secretes digestive enzymesthat are required for breaking down the food that you eat, so every singletime you open your mouth and you eat food,

that foodtravels down through your digestive system, your pancreas makes digestive enzymes. 99% of yourpancreas is devoted to that task. the other 1% of your pancreas contains thesethings called islet cells. islet cells are the endocrine function ofyour pancreas. endocrine is a fancy way of saying secretedinto the blood. so, it makes very specific hormones and veryspecific proteins that are put into the blood. so, if we look a little bit closer at that1% and try to understand what islets look

like. islet cells areactually clusters of cells. so, instead of calling them islet cells, wewill refer to them islet clusters because they are collections of anywhere from1,000 to 4,000 cells that have a very special function. those cells have 3 different types. there are alpha cells. there are beta cells. there are delta cells.

don't worry about that. all we need to worry about are the cells ingreen, the beta cells because those are the cells that actually secrete the insulin. so, when you eat foods that contain carbohydrate,those cells sense it. again, a small population of cells but whenthose cells fail, you have a system-wide problem that if left untreated can cause death. it is a very important collection of cellseven though there is not very many of them.

so, in the case of type 1 and type 1.5 diabetes,we have the picture shown here. a normal islet cell function on the left iswhen beta cells sense how much glucose is in theblood stream, and then they can secrete insulin as you see in the red. in the case of type 1 diabetes,where it is an autoimmune condition, it is when your own immune system is actually attackingthose cells, your immune system creates antibodies. these antibodies then go with a specific taskto just kill

beta cells and only beta cells. as a result of that, those cells can no longersecrete insulin because most of them are dead. type 2 diabetes on the other hand is a separateissue. type 2 diabetes before itbecomes a pancreas problems starts in your muscle and starts in your liver. when we think of type 2diabetes, we are always thinking about what is happening with my pancreas. what is wrong with mypancreas.

clearly, my pancreas is not working, right? but your pancreas is a consequence of whatis happening in your muscle and what is happeningin your liver. if we could just focus on treating yourmuscle and tour liver properly, then your pancreas can get room to breathe and regainits normal so, this dysfunction that happens to yourmuscle and liver is called insulin resistance. alright,here is where we are going to have some fun. i need 15 volunteers. we are going to do a little role playhere.

don't all raise your hand at once. one, two, come on up, three, four, five, justcome on up. overon that side, anyone? six, you want to come?, seven, eight, good,fantastic. so this is the fun part. dowe have 15? one, two, three, four, five.....we got a lot. alright, so, i am going to need 3 volunteersto go stand at the door over there.

so the 3 of you here, you guys are all glucosemolecules. so, the 3 ofyou are going to go to the door. alright, great, now i need 3 more people. how about the 3 of you. youguys are going to be insulin receptors. so, you guys are going to go to the door butin front of them. ok? alright, then we have, 1, 2, 3, 4, 5. perfect!

can you guys just shift this way a littlebit. "we are notgoing to get killed off are we?" "i hope not". presentation gone wrong, ok, lol. so, you guys are fattyacid molecules. ok? don't read into that statement. ok, so we are in a cell inside the muscletissue and inside of the cell we have the nucleus whichis the super computer over there that has

got all the dna,and it is constantly processing things and telling the cell what to do. then we have mitochondria whichare littered all over the place, and they are making energy for us. then we have energy depos. we havewhat is called the glycogen molecule where you store carbohydrate or glycose, and thenyou have a lipid depo or a lipid droplet where you store fattyacids. so, in this cell, we are operating in a personwho has

insulin resistance who has developed insulinresistance through their diet. so what happen is they areeating a low carbohydrate diet which is a high fat, high protein diet. as a result of that, fatty acidsmarch their way into the cell. so, you guys all got here because you werepresent in the blood stream to begin with and then you just marched yourway right into the cell. unfortunately, muscle cells have avery difficult time preventing fatty acids from coming in. so, as soon as you eat fatty acids and itis in

your blood stream, it just goes straight intoyour tissues. there is very little you can do about that. soyou guys all got in here because of that process. you guys all congregate together on one sideof the cell. you get to hold hands with each other, andyou form what is called a lipid droplet. so this lipiddroplet is now present inside of the cell. it is a slight problem for the cell becausethe cell is not designed to store very much of this.

under normal circumstances, the cell wantsto keep maybe 1 or maybe 2 of these here. over the course of time a you eat more andmore fat, and you eat more and more protein, this stuff starts to accumulateso you get more and more. so this lipid droplet is nowcausing a problem. the problem is that this lipid droplet candirectly communicate with those insulin receptors. so, raise your hand if you are an insulinreceptor. beautiful.

ok, so what you guys are goingto tell those insulin receptors is you are going to say, hey stop working. so, the cell is basically sayingalright i have all of this lipid i have to deal with. i have to burn this stuff somehow, but wehave all that glucose over there trying to get into thecell. it is kind of a problem because now thereis more energy and more energy trying to walk inside thiscell. so what you guys do is tell those insulinreceptors to

stop working. so now when you go eat a banana or eat potatoor eat a piece of bread, that carbohydrate breaks down into glucose. that glucose circulates in the blood stream,and that glucose now has an opportunity to come out of thecell. in order to get inside the cell, that glucosehas to talk to those insulin receptors. i need 2 more people to act as insulin. do i have 2 more volunteers?

anyone,anyone, anyone? one, one more? two, ok. so, you guys are going to go out in the bloodstream as well with the glucose. let say you eat a potato, and there is glucosefloating around in the blood stream, that glucose went to your pancreas and toldyour pancreas hey let's make some insulin. your pancreasmade a little insulin. now, that insulin is floating around in theblood stream.

so, the insulins jobs is tocome into the door of the cell and knock on the door and say hey by the way i have someglucose. doyou guys want to take that glucose up? so that is what the insulin molecules do. raise your hand if youare insulin. so you guys repeat after me, hey by the wayi have some glucose. you are going to talk tothose insulin receptors and you are going to say hey by the way, i have some glucose. do you want totake up that glucose?

so the insulin says hey i have some glucose,do you want to take it up? theinsulin receptors are going to say what? the insulin receptors are going to say what,they are going to say yes or no? no. why are they going to say no? because you told them to say no. therefore, you sayno, and now the insulin is like great, now i am just going to stand here and do nothing.

so now whathappens to the glucose? the glucose can't go anywhere. the glucose stays in the blood stream. so,now as a result of this lipid droplet, we have a lot of glucose and a lot of insulininside the blood. problem! so you ate that potato. you go check your blood glucose 2 hours later. what do you see?

you see a high number. the high number is because that glucose istrapped. it cannot get inside of thecell where it wants to be. so, if you guys had the opportunity to reversethis whole process, what would you do? you got to get rid of these guys first, right? no one likes you guys, lol. you guys are dead. sohow are we going to get rid of these guys?

are we going to just magically hope they disappear. wehave to do something, right? throw it out there. what could we possibly do to get rid of theseguys? we could exercise, #1. what else could we do? change our diet. be more specific. go more wholeplants.

more whole plants. not so much fat, cut out the fat. ooh, not so much fat. very good, howdid these guys get here in the first place?, because we were eating a lot of fat. because you invitedthem in, lol. so they got here in the first place becausewe were eating a lot of fat in the first place. soif we either exercise or get rid of the fat or some combination of both, then these guyswill go away.

soover the course of time, you do that, and you start to eat less fat, so as a resultof eating less fat, now this fat gets burned. ok, there is mitochondria in here. these mitochondria are basically picking youguys off one by one and saying ha, ha, sorry, i am going to burn you and get rid of you. so, you just gotburned. thank you. question...

is the fat from animal fat or vegetables. these are saturated fatmolecules. saturated fat comes predominantly from theanimal world, but you can also find it from plants. so, this is predominantly animal fat. however, it is present in the plant worldas well. that is agood question. sorry, you are done too. so this fat is getting burned.

you are also done. thank you for your participation. so now we have a reasonable amount of fatinside this cell, and that is ok because the cell can incorporate just asmall amount, not a large amount. so as a result of this, whatare those insulin receptors going to do now? right, the insulin receptors are going tosay come on in, go for it. so what happens is that the glucose moleculesnow can come on in. ok, the insulin stays at thedoor.

the insulin says hey i got some glucose, buti am not going to go inside the cell. then the glucosegoes flooding in. so, glucose molecules come in. round of applause. come in, all the wayin. so, the glucose molecules come in the door,and now you guys are going to come in and stand inthat part of the cell, and you are going to go into what is called the glycogen molecule. glycogen isbasically stored glucose.

so, you guys go build up that glycogen molecule,and then the mitochondria can start top burn you guys if it wants andalso starts to burn some of that. over the course of time yousee that we are shifting away from fatty acids and more towards glucose and towards the glycogen. that is how you reverse insulin resistance. how do we do this, one more time? so, if we reduce ourintake of fat we can start to selectively burn these guys. that is one thing that happens.

if we go andexercise, what does that do? it burns this, and it burns that. it burns both of them which is ok becauseeven if we get rid of those guys we can always refill it. so, the goal is to burn and burn and refillonly. we don't have to go into a fat free diet. no such thing exists. we are just going to go into a low-fat diet,and that is going to solve this problem all together.

thank you, guys. appreciate it. so, if we go back towhat we said earlier, insulin resistance is what? very good, the storage of fat in the tissuesthat are not designed to store fat. there are 2 main tissues that we need to worryabout. your muscle which is whatwe just went through. this same exact situation happens in yourliver.

when your muscle and your liverbecome insulin resistant, glucose becomes trapped in the blood, and that is a problem. so, again, if yougo into the part of the research and you start to really investigate what is happening here,you will see this all over the place. they have all these fancy pictures with thesetransport proteins and insulin molecules and insulin receptors, and you endup with a picture that looks like this. so, let's walkthrough this right here. first step called fatty acid flux or basicallyincrease in fatty acids in your diet.

so, that happens in the blood first. the second step, tell the insulin receptorsto reject insulin. step 3,don't allow glucose to enter the cell using these things called glucose transporters. as a result of that,last glucose comes in to build a glycogen molecule and as a result you end up with lessglycogen. seethe problem? too much fat to begin with. now, we can't store carbohydrate or glucose.

so, again iwant to reiterate this and hit this on the head, the accumulation of fat in muscle andliver traps glucose in the blood. that is the problem. that is insulin resistance. that is predicates. that is what happens intype 2 diabetes as well. now, it turns out that dietary protein alsohas a very similar effect independent of fat.

so, in some studies that were performed totry and understand exactly how protein effects yourblood glucose values, what some researchers found was very eye opening. you see this complicatedgraph here on the left. let's walk through it really slowly. on the very bottom, we have a curve thatshows what happens to your blood glucose after you eat a low fat, low protein meal. so, you see howyour blood glucose rises and then comes right back down?

that is what is called a normal glucoseresponse or a normal glycemic response to a meal. if you simply increase the amount of proteinin that meal, you go from 5 grams of protein to 40grams of protein, look what happens. your blood glucoseresponse goes up. we did not touch fat. we only added protein. if you add fat and you take away theprotein, you get a similar response. what happens if you add fat and protein together?

if you add fatand protein together, you get that response. so, what this shows you here is that by simplyadding either fat or protein, and i am talking considerablequantities of either one, you end up elevating yourblood glucose even more and more. if you have a meal that contains both fattyacids and protein together, your glucose is highest. it is a problem. so, now what happens is that when you havebeen diagnosed with diabetes, how many of you guyshave been told to restrict your carbohydrate

intake? raise your hand high, raise your hand high. i want to see it. a lot of you. so, again, doctors are notbad people. i have 5 doctors in my family, absolutelywonderful people. the tools they have been given,the education they have been given is insufficient. as a result of that, they say, oh you havebeen diagnosed with diabetes, carbohydrates areyour enemy.

let's put you on a low carbohydrate diet. so,that is what happens, you shift away from the blue, the carbohydrates, and you startto eat more red and more green, more fat and more protein. this complicates the problem. so, whether you have type1, type 2, gestational diabetes, prediabetes, that is what happens. they push you towards this high fat,high protein diet, and you become more and more insulin resistant.

so, low carbohydrate diets havebeen given a ton of different names over the course of time. we first started with the atkins diet backin the 1970s. then that became the defacto low carb diet. from that point in the 1990s came thesouth beach diet, the zone diet, the paleo diet, you have the ketogenic diet, and thenyou have things like dr. bernstein who is the ultra-low carbohydratesolution. have you guys seen these types of dietsmarketed on tv commercials? they are all just different carnations ofa low carbohydrate diet.

they all have the same effect which is thatthey increase the level of insulin resistance. now, here isanother thing that kind of complicates the fact. if you look in the literature, you will seethese types of studies that get reported in the new yorktimes and washington post where they basically say, look, wedirectly compared a low-fat diet vs a low carb diet, and here is what we found. the title of this paperbasically says the comparison of low and high carbohydrate diets for type 2 diabetes.

the conclusionshown here in red is, i will read it to you, "both diets achieve substantial weight lossand reduced hemoglobin a1c (again that is your averageblood glucose marker) and fasting glucose. the lowcarbohydrate diet which was high in unsaturated fat and low in saturated fat achieved greaterimprovements in the lipid profile (so that means that your cholesterol level came down). blood glucosestability and reductions in diabetes medication requirements suggesting that low carbohydratediets are an effective strategy for the optimizationof type 2 diabetes management."

so, the conclusion that theauthors came to is that a low carbohydrate diet, what? it is better than a low-fat diet but if youdo a little bit of digging and you actually readwhat happened in the study, what you will find is this. that inthe low carb diet, ok, the high fat diet, they are eating 60% of their calories fromfat. that is exactlyright, that is what happens in a low carb diet.

in the low-fat diet, they are actually eating30% of their calories from fat. so, they call it a low-fat diet, but theyfeed people 30% calories from fat. it is not alow-fat diet. it is not even close to a low-fat diet. so, these types of studies are flawed at theircore. they are all over the place. they drive people, and they drive policy changestowards more low carbohydrate diet, more low carbohydrate diet.

so, you guys are now educated. when you see thistype of information, dig deep and find out what is actually happening here. robby and i like to say thisall the time there is not a single low fat study that shows that a truly low fat dietwhich is less than 10 or 15% of your diet does worse than a low carbohydratediet. there is not a single study that we can find. when we are talking about a low-fat diet,we are talking about a diet that contains at most 15% ofcalories from fat.

that is very important. so, low carbohydrate diets promote short-termimprovements in a lot of things. how many of you guys know somebody that haseaten a low carbohydrate diet? howmany of you guys are on low carbohydrate diets right now? raise your hand. howmany of you guys have interacted with somebody who said, oh ya, i went on this low carbohydratediet

and i lost a ton of weight? i lost weight. my glucose improved. my cholesterol dropped. right? youhave heard this before, right? that is because low carb diets work. they absolutely work, but they workin the short-term. they are not an effective long-term strategy.

they are not an effective long-termsolution because they actually increase your risk for chronic disease, but you can't seethat in the short- term because all you are focused on in theshort-term is that you get a better a1c value, you reduceyour blood glucose variability meaning you get less swings and you get a much more stableblood glucose which is a good thing, you can reduceyour total insulin use, you can reduce your ldl cholesterol(the bad cholesterol), and you can lose a ton of weight. the problem, though, is if you look at theliterature and really try and understand what

is the effect of a low carbohydrate diet inthe long-term, i am talking 6 months, 9 months, 12 months,2 years, 5 years, 10 years of a low carbohydrate diet, whatyou will find is that low carbohydrate diets that are high in fat and high in protein endof developing a lot of the problems that you see here. so as far as heart disease is concerned, wehave increased risk for heart disease, for hypertension, increasedldl cholesterol, increased triglycerides, and increased risk foratherosclerosis which is the hardening of blood vessels all around your body.

you also see in the glucoseside of things you get an increased level does that make sense why insulinresistance is what starts to predominate? think of the picture we painted earlier. more fatcauses less glucose, glucose has to stay out, it gets trapped in the blood so you get moreinsulin resistance and as a result of that your liverbuilds up fatty acids, and you can develop a condition knownas fatty liver which can eventually lead to liver cirrhosis and eventually liver failure. you can alsosignificantly increase your risk for cancer.

this is now being shown. you can significantly increase yourrisk for kidney failure because your protein intake is very high. you get increased total bodyinflammation which is measured by a protein called c-reactive protein. then in the long-term we seepeople end up actually either gaining weight or preventing the loss of further weight. low energy,impaired digestion, food cravings. the list goes on.

so, that is why we have to understand thatlow carb diets even though they work in the short-termare not effective strategies for the long-term becausethey will actually increase your risk for the development of other health complications. so, the questionreally becomes well what are we going to do about that. how do you actually reverse it through diet? your brought that up earlier. what was your name?

lynn, so tell everybody, how do you reverseit through diet? wow, that is great. cut out the oil and get lots of exercise. what else are you going to doon your diet? whole foods, plant based. i love it. she is not a plant. i did not put her there.

ok, youare living proof this works? (audience telling story.....applause). that is great. that is how you do it. alow-fat, plant-based, whole food diet. that is how you reverse insulin resistanceand gain insulin sensitivity. that is exactly how robby decreased his insulinuse. that is how i decreased my insulin useby 40% even though my carbohydrate intake

went through the roof. that is insulin sensitivity. morecarbohydrate for less insulin. that is what it means. so, people who adopt a low-fat plant basedapproach, we recommend eating 15% of your calories from fat at the max and 15% of yourcalories from protein as the max. so, if you max out both of those at 15%, thenthe balance becomes carbohydrate. so, you can call it a high carb diet.

you can call is a low-fat diet. a low fat, low protein diet. call itwhatever you want. the fact of the matter is you are eating alot more carbohydrate and a lot less fat and protein. so, on this approach you might be wonderingwell what the heck can i possibly eat, right? is there anybody else in this room that isalso a plant based eater? raise your hand and raise them high. i am preaching to the choir.

look at that. i didn't even know. ok, we have got a lot of people. this isgreat. ok, so we like to separate foods into thered light, yellow light, green light categories. so, let'sstart with the green light category. fruits, all fruits, non-starchy vegetableslike tomatoes, cucumbers, okra, zucchini, cauliflower, broccoli, starchyvegetable like potatoes, squash, rutabaga, things that growin the grounds, beans, lentils, and peas,

green leafy vegetables like lettuce, arugula,intact whole grain, herbs and spices which have significant documentedantioxidant activity. so, if you focus your diet onthese green light foods and stay away from the red foods over on the right, just watchwhat happens. the red foods we have on the right - dairyproducts like milk, cheese, ice cream, yogurt, eggs, processmeats, red meat, white meat, poultry, fish, and shellfish, oils of any kind. this is a very important thingto understand even though oils come from plants. oils are not food.

oil is the most refined product inthe supermarket. oil is the fat equivalent of sugar. you take a red beat as an example and youprocess it to death, and you end up with a white crystal. you take olives and you process them and youend up with a liquid called oil. it is a pure fat, and even small amounts ofthat fat can damage your endothelium which is the lining of your blood vessels,and it can increase this fatty acid deposit that happens inside oftissues causing insulin resistance, so all

oils are out. eat the olive, don't have the olive oil. eat thecoconut, don't have the coconut oil. then we also have in this category refinedsugars and pastries and bread which are refined carbohydrates. foods that are in the center category arethe foods that you don't have to avoid, just have to have themin a very moderate amount. nuts and seeds documentedanticancer effects, documented antidiabetic activity but again when you eat nuts and seedsit is very

easy to overeat on these foods. it is very easy to overeat on them, so youjust have to be a little bit moderate in that. avocados, coconuts, olives - these are higherfat foods which have a definite place in a plant based diet, but again we just haveto exe4rcise moderation. then we have pastas and pastaalternatives. these are more refined products that can definitelycause blood glucose spikes in a lot of people. so, if you know that is the case for you,you have to limit those in your diet or eliminate

thementirely. sprouted bread would be the last one. question from audience... - fish and shellfish are in thered category for a number of reasons. 1) they contain high amounts of saturatedfat so we have been told over and over that fish is really goodfor us because why? omega 3 fatty acids. right. omega 3fatty acids are found in the plant world.

they are found in flax seeds, chia seeds. the omega 3s that youget from fish and shellfish are slightly different than the omega 3s that you get from the planworld. i donot want to go into the detail of that, but the fact of the matter is that when you eatfish you are getting omega 3s but you are also getting a lot ofsaturated fat, you are getting a lot of environmental contaminants, and you are getting mercury. i don't care where that fish came from. it could come fromthe deepest ocean in the pacific 3,000 under

the surface. it still has mercury inside of it, and thatis a problem. pasta alternatives are made either out ofquinoa, lentils, brown rice, beans, corn. it looks likepasta. it tastes like pasta. it is shaped like pasta. it just does not use whole wheat as its base. so, this iswhat low fat, plant based, whole food nutrition

looks like. as you can see, it is super colorful. peoplewho become plant eaters take a lot of pictures of their food, right? how could you not. i mean look atit, it is tasty. i am getting hungry just looking at this. very colorful food. foods that are extremelycolorful are rich in compounds known as antioxidants.

you guys have probably heard of that before,right? antioxidants are pigments. the more colored your food is the higher antioxidantvalue, the more antiinflammation it will promote insideof your body so that is why when your mother told you toeat the rainbow, she was right, even though she did not know why she was right, she was. we aretalking about dishes that look like this. we have got beans. we have got fruit.

we have got rootvegetable soups. we got corn, fruits, salads, all types offood. if you don't think that this food is tasty,i challenge you. this stuff is incredibly tasty and very addicting. again, we take a lot of pictures of ourfood for good reason because it is tasty. how could you not? so, let me show you a couple of examples. this is patricia.

she has type 1 diabetes. she came to us because she was diagnosed withtype 1 diabetes at the age of 63. type 1 diabetes at the age of 63. she did not know what to do. she wasfollowing this low carbohydrate bernstein style approach which basically says limityour carbohydrate intake to 30 grams per day. that is it maximum.

so, she was doing that for a long period oftime. as aresult, she ended up getting very low energy, her blood glucose was all over the place,and she was injecting more and more insulin over time. so, she came to us and said hey guys i needsome help, so we told her about the low fat, plant based,whole foods approach. she adopted this approach, and hereis what happened. she started out with an a1c value of 7.1%elevated. she dropped it from 7.1 to 5.6%in less than 8 months.

she lost 42 pounds without even trying. she reduced her insulin use by 25%. shealmost ten-tupled her insulin sensitivity. now, she has so much energy she does not knowwhat to do. ihave been encouraging her to exercise, and she still refuses, but she now claims thatshe has enough energy to do it if she wanted to. question from audience.... great question.

so, insulin sensitivity isdefined as the total number of grams of carbohydrate that you eat in a 24-hour period divided bythe total number of units of insulin you use ina 24-hour period. so, when she first came to us, hercarbohydrate intake was low. it was somewhere in the 30s, and her insulinusage was somewhere close to i believe it was 30-40, so she had an insulinsensitivity of 30 divided by 30 which is 1. over the courseof time, that 30 grams of carbohydrate has now gone up to 350 grams of carbohydrate perday. sheuses something like 31 units of insulin.

so, it is 350 divided by 31. she is now operating at a 10:1 ratio,an 11:1 ratio. the point being that is how she has increasedher insulin sensitivity. the morecarbohydrates for less insulin. in her case, more carbohydrate for the sameamount of insulin. there isstory after story. neglectinghis diet, not really paying attention to it. he came to use and basically said hey, i needsome help, and we showed him this approach.

he stopped usingmetformin diabetes medication. he stopped using metformin. he also stopped using a statin medicationand also stopped using a blood pressure medication. now, heexercises 6 days a week, and he is a happy guy as you can tell. it is also important to understand statinmedication increases your risk for type 2 so even though you are taking a statin medicationto keep your cholesterol low, what it is doingis actually increasing your risk for the development of type 2diabetes.

so, if you don't have type 2, now you areat a higher risk. if you have type 2, now it is going tobecome more complicated. so, what that means is either you are goingto need more medication if you continue the same habits or you have to completelychange your lifestyle from the ground up. so, wegot sharon another prefect example, lost 25 pounds in 4 months. she is studying nutrition at berkeley. she is 2 years behind me in school. she is living with type 1 diabetes.

she didn't even know. she had noidea that she had 25 pounds to lose. she didn't know. it just felt normal to her. she adopted thisapproach, and the weigh flew off of her, and now look at her. twenty-five pounds less. she hasreduced her insulin use by 40%. now, she is active.

she is a happy girl. so, these stories you see theseover and over and over again. the same story that happened to robby. the same story that happenedto me. the same story that happened to, what's yourname? lynn. the same story that happened tolynn. if any of you guys want more information,the business we run is called mastering diabetes.org. go to that website.

there is a lot of information on there. there are a lot of cool things that you canlearn about, about diabetes. if coaching is something you need, then gofor it. no worries. if you arelooking for more information, do that. also, nutritionfacts.org. like i said earlier, if you are not on dr.mcgregor's newsletter, please do it.

the ultrasimple diet,he is a personal friend of ours. he is brilliant.

his information willchange your life. so, please do that.