I reversed my Pre diabetes condition by doing the following changes. 1- Quit all barcoded and packaged foods and consumed mostly natural and unprocessed foods. 2- I removed lunch and eat only two meals a day. 3- Walking 1-2 hours a day. Results: Lost 52 pounds within 9 months, blood pressure is 113/72 and Hba1c is 5.3 I still follow my dietary changes and didn’t get any weight in the past 2 years.
Wow, that's amazing. Thank you for sharing. I agree that ultra-processed foods are likely one of the major culprits of overeating, obesity, and cardiometabolic disease. If you haven't seen it yet, I made a video about this as well: czcams.com/video/ZACaF8pD6JI/video.html Warm wishes, Mario
@@nourishedbyscience I live in America and I see people here more than six times a day and they eat junk. Human bodies are not designed to handle chemically made products for many years. Thanks for your time spent on providing such videos. Every word is precious and listen to it.
One of the things I like most about these videos is being reminded not to just swallow every CZcamsr health guru's claims, but ask the right questions about their conclusions.
@@mirzamanmirzaman1482 And medical doctors generally know almost nothing about nutrition. It's not part of their education, as unbelievable as that is.
Must remember: what works is the truth. Incomplete details of the patient, diet, exercise, and environment are unfortunately common. @@mirzamanmirzaman1482
Like my retiring doctor said, exercise, lose weight, eat whole food. That cures most problems, it's free, and I can do it now. No processed food. No chemicals.
A good number of people who are not obese or over weight, vegetarian, have diabetes. They have heart issues. Diabetes dictates LCHF but heart condition tells them to minimize fat. One episode on thin diabetics would be interesting. Fatty liver is cited but not much info on how to test for it and address it is missing.
I was put on a strict low carb diet 15 years ago. It’s not fun to give up all the foods you love (I do indulge a little from time to time). However my health is great and I watched a friend who refused to do low carb progress to worse and worse diabetes and all the complications and finally death. So I don’t think my diet is so bad when I can enjoy my life and my grandchildren.
When you say you were “put on a low-carb diet” who recommended that diet? I have always had the opposite problem. Once I discovered that I had pre-diabetes (my doctor never mentioned the significance of my fasting blood glucose being over 100), I went on a ketogenic/Low-carb diet with intermittent fasting against her advice despite my weight loss and better numbers. She retired and every doctor since then strongly recommends a low-fat, higher carb diet (grains, fruits and vegetables) which is def better than a SAD way of eating, but despite epidemiological evidence I just can’t believe is better for someone who has had a carb addiction. I’m not necessarily high fat, just low carb. I’ve always included my own fat as part of my energy source an am maintaining an 80-lb weight loss. But! I DO have FH and I did have a stroke last January. I do worry about whether I’m doing the right thing, but feel most comfortable keeping to my No sugar, No grains, No seed oils kind of diet.
I was able to get off cholesterol medication by reducing my meat and eggs by a third. I was able to lower my A1C from 7.5 to 5.7 with Whole Food Plant Based no sugar no oil no salt lifestyle. Before changing diets Metformin got me down to 6.5, so I am really happy with 5.7 with no Metformin through diet, walking and an occasional intermittent fast. I lost 50 in 10 months. My cognition improved too. The following year I experimented with bread, dates and potatoes and my A1C went up to 6.3, gained some weight and memory got worse. I am back to no flour products and no potatoes or white rice. I favor berries and limes for fruit.
If you want to enjoy potato you can put them peeled in water for few hours and this way they do not contain so much starch, then cooked them as you like.
@@katkalucky4060 Cooking the potatoes and then cooling them overnight in the refrigerator will convert some of the digestible starch to resistant starch. This can be repeated through subsequent heating and cooling cycles, but the amount of starch being converted falls off quite a bit each time.
@murraybrockway6540 - Congratulations on such an amazing success! If you happen to see this comment, I'd enjoy hearing about the amount of meat and eggs you were eating at the time of your last comment. Also, have you ever been diagnosed with familial hypercholesterolemia? That stinks that you weren't able to successfully incorporate foods like bread, dates, and potatoes without your A1c increasing. Personally, I have a weakness for Medjool dates. I still eat them, but not very often. I used to think that eating dates was like a great secret that few others knew -- that I could eat a whole food that was also like a dessert. Eventually, I started reading nutrition labels and realized I had been blissfully unaware. I was really dismayed to realize the amount of calories and sugar they contained. Sadly, there's always a catch. Anyway, you got me thinking again about the two guys on the Mastering Diabetes channel. They're both Type 1 Diabetics and eat several hundred grams of unprocessed, whole food carbohydrates per day (one of them, Cyrus, has reported that he sometimes eats upwards of 800 grams of unprocessed, whole food carbohydrates per day) and they both inject only minimal amounts of insulin. Both are very lean, too. I believe both have always been lean, if I recall correctly, including before they were symptomatic and diagnosed. It makes me wonder: If folks like you and me are unable to eat even moderate amounts of unprocessed, whole food carbohydrates, does that mean we still have ectopic fat that is preventing us from being able to metabolize unprocessed, whole food carbohydrates like a healthy person? Or, I wonder if it means we have permanent damage and we'll never be able to return to a normal, healthy baseline metabolism? I guess it would take an abdominal MRI to gather more data to help reach a conclusion. Final question: After your remarkable 50 pound weight loss, were you quite lean? Do you know what your BMI was at the time? I realize BMI is imperfect, as it doesn't account for body composition. Still, I'd be curious to know what your BMI was after your weight loss, if you care to share. If not, no worries. I hope you're continuing to do well.
Thank you so much for sharing your knowledge. I feel let down by the Canadian medical system. When I talk to my doctor about diabetes it feels kind of pointless. Thank God for people like you.
Low carb or low fat, why do we have to choose? Take the best of the two diets: lots of whole carbs and some healthy whole food fats like nuts and seeds. Then everything has fiber and optimal nutrients. This is how I keep my weight steady, and if I have gone off the diet at times with too many oatmeal cookies and dark chocolate, I just get back on it and adjust the calories for a while. Usually it's effortless to stay at a good weight, and easy to lose if at rare times I've strayed. Because I never feel depraved of either fats, proteins or carbs.
A “balanced” diet with whole, healthy carbs just doesn’t work for a section of the population. At the core of it is the chemical signaling concerning satiety. Genetics and damage would be the contributors I would think. I’ve heard it from learned sources that roughly 2/3 of the general population can eat what ever macro mix they want, but not so for the other 1/3. Particularly as they age and have abused their systems.
One of the best 30 mins I have spent. Your presentation is like high nutrition dense foods, packed with so many facts and useful information. 😊 Thank you so much!
If someone is determined to stay healthy and avoid diabetes, the LCHF in the keto realm (because not every study made have the same parameters of what low carb is)is the way to go. I was diagnosed with pre diabetes in 2021 till today, I follow the keto
In my n=1 self-experimentation study, if you have very advanced insulin resistance any carbs will raise your glucose and keep it high for quite a long time (presumably also keeping insulin high and making insulin resistance worse - unfortunately, I can't measure my insulin). Therefore, I have switched to a very low carb + 4-5 hour TRE and after a month my glucose is in a range where my estimated A1c is 4.8% (if I continued the current daily trends for the next 4 months). Admittedly, I still use metformin and a very small dose of a slow release sulfonylurea, but I'm slowly reducing the dosage on those. I believe by the time 4 months are up, I will be off all meds (or on minimal dose of metformin) and will record an A1c < 5%. I started with 13.3% a month ago. Great content and very nuanced analyses (much appreciated)!
Nice! One important point: insulin resistance does not automatically trigger high blood sugar levels, because in many cases, the pancreas can simply produce more insulin. That in and of itself may not be good in the long term, but it's important to understand the relationship between dietary carbs, insulin resistance, and glucose intolerance, as there is a lot of wrong information and confusion around these topics. To understand the relationship between insulin resistance, the amount of insulin produced by the pancreatic beta-cell (i.e., beta-cell function), and a third factor called glucose effectiveness, feel free to check out this video here: czcams.com/video/Yg9AS2sfY9Y/video.html Warm wishes, Mario
A1c < 5% is very low. Keto-Gurus say < 5,4% Doctors say < 5,8% (below prediabetes) or at least < 6,6% (below diabetes) Fruits, vegetables and legumes have (often) other health benefits When you reduced your A1c down the (pre-)diabetic level the real risk is cardiovascular, not glucose alone. For example: bacon, eggs and grilled tomatoes are glucose friendly but not for cardiovascular risk, the gut microbiome, vascular function or your blood pressure. There is a lot more to say. So do not focus solely on one number!
I am T2 and do N=1 a lot. One morning took Dogs for a short walk(warmup) and checked Blood Sugar, 7.1. I then had Porridge at 1200hrs, checked BS at 1400hrs 7.1. Big surprise, I expected BS of 8-9.
I would love to see a video dedicated to saturated fats in meat, dairy etc. There are so many confusing data going around in the Internet... I just dont know if plant based diet is really the only healthy option, as some say, or if meat and other animal sources of fat are also safe. Thank you for your hard work and dedication to this channel!
Definitely will have some dedicated videos about these topics. Even if we look at just one endpoint, such as the serum lipid profile, the complexities come into play because there are a lot of different saturated fatty acids, it matters what we are comparing these saturated fats to (mono- or polyunsaturated fatty acids, complex or refined carbs etc.), and the health effects differ depending on the food in which the saturated fatty acids are eaten (dairy fat from butter vs. cheese, for example). I am looking forward to talking about this, because there is a lot of confusing and also misleading or incorrect information about this online. Cheers Mario
I recommend time restricted eating. Work your way up to OMAD. To me it's the best way to stop constantly eating and maintaining a healthy BMI. Best way to become metabolically healthy. Definitely need to switch to healthy fats.
I have been binge watching all your videos. They are not only informative but the approach that you take shows very well how we need to take these kind of problems with a critical and complex look. I really appreciate it! I was wondering if you have seen the blueprint project. It is about a millionaire who is expending 2 million dollars each year to reverse his age. He has put all the information for free on his website. His lifestyle is a bit extreme, but I was wondering what would be the opinion of a researcher such as yourself. Specially taking into account that most coverage about the project has been done in a kind of spectacular/mediatic fashion. Thanks again for your effort on putting these videos! Greetings from Peru.
Thank you for your feedback. I am not overly familiar with the Blueprint Project, but will look into it and may share thoughts at some point. Thanks for the suggestion. Cheers Mario
I have recently been diagnosed with T2 diabetes and am keen to reverse it naturally. I watched your videos with great interest, they provide excellent explanations and valuable information about important factors when considering reversal of diabetes.Thank you very much for making these videos available, greatly appreciated👍
Went on the carnivore diet and went from mild diabetes, 120-150 everyday numbers, to pre diabetes, 100- 130 in 2 weeks and lost 10 lbs, only meat products w/ hi fat, Dr Berry, CZcams. Now on ketovore with higher numbers, have to quit cheating too. Age 74, gym rat, organic eater.
Carnivore diet, zero sugar, zero carbs, zero plants, high protein, high saturated fat, cures t2 diabetes in short order in virtually everyone who eats this way. Also, statin meds cause diabetes and other neurological issues. You can reverse diabetes in a few weeks by going Carnivore diet. Ive done it, and seen it done. Diabetes is a choice, not a lifelong sentence.
Is it also possible, if not probable, that just as we all suffer from different maladies, our individual make-up, age, gender and of course lifestyle factors all influence how we tolerate certain foods? I think it is clear that we should eat whole food and avoid ultra-processed food as much as possible. I also think our psyches are not meant to avoid everything that may not be completely nutritious. I think limiting those significantly is the answer.
Thank you Mario, for your reply. I would be very interested in your analysis of a couple of studies, that I have seen, because I value your point of view as balanced and well informed. I will post the links once I find them. Cheers!
I have successfully and satisfactorily made effort for 3 years to reverse T2D with Keto diet, whole foods, moderate exercise and most importantly intermittent fasting. I stopped all medications for T2d and also statins for cholesterol and steroid inhalers for asthma. I gave up all processed sugary carb-rich foods and sodas, and have no cravings now. I lost 60 pounds weight and have sustained it. I do not eat out anymore. I did not smoke or drink alcohol, but got obese and very sick because of overeating sugary carb junk and killer sodas. It is shocking how medics got it so wrong, and food-drug industries have destroyed human health and trashed the environment. Rows upon rows of slickly packaged stuff in grocery stores is actually poison. Living simply now, my time and money shopping grocery and cooking etc has been cut in half.
Thanks for sharing. Couldn't agree more. All over the internet, people are fighting whether low-carb or low-fat is better, where in reality the most important thing by far is low-ultra-processed. I think the scientific evidence is such that people can be pretty healthy eating most whole foods, as long as they are meeting their micronutrient requirements and stay away from the packaged stuff in the center or the supermarket as much as possible. Cheers Mario
@@nourishedbyscienceI don’t understand why my sugar goes up when I eat complex carbs with no processed food. I are brown rice w steamed veggies. Protein and fats were from lentils and almonds. All home cooked. My post prandial was 285. Dr wants me to go on Metformin but I worry if it will stop my liver from functioning completely. My a1c is 6.5 now. I exercise and am very thin. I ate the protein first then veggies and carbs.
You mentioned a test for insulin resistance on one of your videos. I don't remember the name of that lab test and I might like to test myself. I am a "pre-pre" diabetic- My daughter rolls her eyes at me when I say that. I have been using a CGM for several months now and have gotten my A1C down from 5.7 to 5.2. I am mostly plant based and am liberal with nuts and avocado. No weight changes because I am slip but I have a strong family hx of T2DM.
Thanks! Can you show a healthy meals that are as delicious as a lot of the processed meals. I would love to eat more vegetarian if it tasted as good as a pepperoni pizza, or In-N-Out Burger.
Thanks for your comment, and your support, Steve! You hit the nail on the head with that comment. By far, the biggest obstacle to eating well is the convenience, availability, and highly-rewarding quality of ultra-processed and fast foods. I find that an approach similar to acceptance and commitment therapy works well for me. I have long accepted that I crave certain unhealthy foods, such as potato chips and ice cream, but I have made a commitment to eat these foods only very rarely (as an occasional treat, and only in the context of social events) so that I can be healthy and functional for as long as possible, enjoy time with my friends and family, and be there for them when they need me. I guess everyone needs to find their own why, but in the end, no one likes being sick and ailing ....! So for me, many of the options out there don't effectively exist. I never visit fast food places, and I stay out of the middle sections of grocery stores entirely. I may invite a colleague at some point to talk more about this approach to actively choosing a healthy lifestyle, rather than being at the whim of the obesogenic environment again and again. Warm wishes, Mario
Please give more information on the difference between eating a slice of regular store bread and, for example, a slice of Ezekiel 4:9 sesame bread. Or steel cut oats with added nuts and berries and a cup of brown sugar flavored instant Oatmeal! Or a serving of barley and a slice of store bought bread, even if labeled "wholegrain "! The average person does NOT know the difference. Most people watching your videos probably do recognize the importance of the seemingly slight differences.
Being 80 years old I have to balance between risk of cardiovascular disease and diabetes. High fat (low carbon) reduce the risk of diabetes, whereas low fat (high carbs) reduce the risk of CVD. However, concerning blood sugar, could it be that the glucose peaks matters? Is hpa1c an expression of the mean sugar level or more related to the peaks? If so, and the peaks could be avoided by having proteins, fiber, cider and "some fats" in the gut (according to your podcasts), reasonable amounts of starch could be accepted - avoiding both CVD and diabetes?
The first thing I would say is that we should challenge your assumption that high-fat low-carb reduces the risk of diabetes while low-fat reduces the risk of CVD. A low-carb diet is an excellent way of eating for people who already are glucose intolerant and insulin resistant. However, if you watch my recent video on 'Do Carbs Cause Insulin Resistance' (link below), you'll see that the totality of the evidence does not support the idea that eating carbohydrates per se causes insulin resistance and diabetes. As long as the carbs we do eat are whole-food-based sources of carbs and not mostly refined grains and added sugars, of course. Lastly, a low-carb diet does not necessarily have to increase the risk of CVD, and I'll talk about that in detail in a future video. I'd say that in most people, a well-designed low-carb diet lowers the risk of CVD. czcams.com/video/ZcVenUbqsYY/video.htmlsi=vqrKmzu2YSlizpFE Similarly, you do not need to limit fat intake to lower your risk of CVD. That's partly why I mention the trial in this video in which participants substantially lowered their CVD risk by adopting a whole-foods diet rich in legumes, vegetables, fruit, and MORE olive oil and nuts. As to your other question, blood sugar spikes do likely increase the risk of CVD, if we define a spike as an increase to 180 mg/dL (10 mmol/L) or higher. As long as someone is reasonably glucose tolerant, I'd say that complex carbs with ideally a low glycemic index are fine, ideally still combined within a meal that also contains some fiber and some protein. Here are a few more videos that may be of interest to you: The Regulation of Blood Sugar: czcams.com/video/Yg9AS2sfY9Y/video.htmlsi=TV2it2G0XzsOzAz3 How to avoid blood sugar spikes: czcams.com/video/yg0Y3eNSANg/video.htmlsi=jXGplM5bCPkewgTy Q&A Video about that: czcams.com/video/LVw60RIhbzg/video.htmlsi=Vwp1gRUX1XErcEss Best wishes, Mario
@@nourishedbyscience. Thank you for taking the time to answer this person about their question. You are truly a wonderful person and I also appreciate you so much!❤
I avoided diabetese with diet only for 10 years. With the covid, I could not keep up with my life style, and was less careful about my diet, and developed diabetese unfortunatly. Now I am on metformin (1000 mg twice a day) with a healthy diet, maintaining a controled blood sugar. (AC1 of 6.5) Only thing that still can't control best is my fasting blood sugar which fluctuates from 7. to 8.3.
I think there is an error in your summary of Dr. Caldwell Esselstyn's studies. In his past lecture, i recall he stated that his study was done BEFORE statins were available as a standard of care.
No, the participants were all on lipid-lowering medication. Here, for example, is the official abstract: Abstract Coronary artery disease is essentially nonexistent in cultures whose nutrition assures cholesterol levels
Good to know that though. If you haven't, try eating the fruit as a desert after a meal that contains some protein. It may raise your blood sugar much less then.
Well, gotta eat something, so low-carb low-fat would mean very high protein. It's not really an option to eat most of your calories in the form of protein, mostly because there are almost no foods available that come only as protein and little fat and carbs. Also, google 'Rabbit starvation' if you'd like to know more about why eating only protein without much fat and carbs is not a good idea. Aside from very high protein, I do think eating a diet with modestly elevated protein is an interesting option, for a number of reasons, and I'll cover that in separate videos soon. Cheers Mario
Food can be as addictive as drugs, but when you are facing a dangerous health problem, you should be able to switch diets after a moment's reflection. But, there is evidence that removing carbs completely can be dangerous. So is the Keto diet fad.
Thank you for your comment. Which evidence do you see that removing carbs completely can be dangeous? I am not aware of that. I also don't see the keto diet, or low-carb in general, as fad diets. I do see plenty of evidence that low-carb diets and keto can have major benefits in certain health conditions, and to me, a well-designed keto diet is clearly a better choice than the diet most people eat. At the same time, and that was one point of the video, I also see evidence that very high-carb diets can be beneficial, and hold the view that it would be beneficial to keep an open mind as to why that may be possible. Best wishes, Mario
@@nourishedbyscience Hi Mario. Well, I could only track down one source: czcams.com/video/nEjuZsP8o7g/video.html. The other one basically said that there's evidence that if you remove all carbs, the body shuts down its ability to break down carbs, which could be dangerous. Any thoughts?
@@TheTwangKings Oh my, that is not a video I would recommend to anyone. But, I don't 'debunk' people here, and like to focus on the claims made, so let's do that (briefly): - The video claims that the ketogenic diet is likely deficient in essential micronutrients, and specifically mentions vitamin C and selenium. That doesn't make any sense to me, as I could get enough vitamin C from bell peppers and selenium from Brazil nuts alone, neither of which are off limits on a ketogenic diet. It may be true that there could be micronutrient deficiencies on keto diets, but that is really the case on any diet. A vegan diet that consists mostly of decadent chocolate cake would probably not provide all micronutrients either. Eating a mix of different whole foods will make it a lot easier actually to meet requirements for all micronutrients on a keto diet than on a vegan diet (and I am not for or against either of these). - The video mentions that keto diets are likely low in fiber because key fiber-rich foods such as whole grains and legumes cannot be eaten. I also disagree there. It's quite easy to meet requirements for fiber from non-starchy vegetables, nuts and seeds, and maybe some berries. I have yet to see any good evidence that we 'need' fiber from whole grains and legumes. - The video mentions that studies show an association between ketogenic diets and poor health outcomes in observational studies, such as an increased risk of CVD. That's not true. The presented papers are all based on observational studies that have grouped participants by a 'low-carb score'. However, we must consider several things when interpreting these data. First, those eating a diet with the highest low-carb score (i.e., the lowest carb content) were not eating keto diets or even low-carb diets. They were just eating a little bit fewer carbs and a little bit more fat. But they were still eating quite a bit of carbs, and in most studies, mostly refined carbs and added sugars. That's because at the time these studies were conducted, the percentage of thepopulation that was following an actual keto diet was tiny. Second, when these studies were initiated, the dietary guidelines recommended low-fat diets. As a result, all of these observational studies see strong associations between fat consumption and unhealthier lifestyles, simply because those who chose a healthier lifestyle chose to follow the guidelines and ate less fat. So who were those in the group eating the lowest-carb diet? Not health-conscious people eating an actual keto diet, but people who didn't care about their health, who smoked more, who drank more, and who ate a diet consisting mostly of fast foods and convenient foods. That creates a huge problem with potential confounding (any of those associated factors could cause the health problems, not the higher fat or lower carb intake). In any case, these types of studies cannot tell us anything about the long-term health effects of a whole foods ketogenic diet. Almost no one in these studies ate this way. Further, it's important to keep in mind that a keto diet doesn't have to be super high in saturated fats, and it doesn't have to raise LDL-cholesterol and apo B concentrations. - My greatest dislike is that the video is so lopsided. There are clear benefits to a ketogenic diet (blood sugar effects for example, or a much smaller amount of antinutrients) that are not mentioned at all. Lastly, your question: yes, glucose tolerance is lower on a low-carb or keto diet, due to a diminished first phase insulin response. But that is temporary, and I have not seen any evidence that the body's ability to deal with carbs is chronically diminished in someone who has been on a low carb diet. I would say it's not a problem as long as someone on a keto or low-carb diets eats low-carb meals at all times. The glucose intolerance would only become a problem (cause a spike) if the person ate a high-carb meal once in a while. Check out this video here if you'd like to know more about the first-phase insulin response and how it's affected by a low-carb diet: czcams.com/video/LVw60RIhbzg/video.html Hope this helps. I will cover all of this ion more detail in future videos. Cheers Mario
That question is impossible to answer, I am sorry to say, as it entirely depends on many personal factors I know nothing about. I suggest you discuss this with a dietitian/nutritionist personally. Best, Mario
Are you not making unfounded assumption(s) for the reasons why 33 participants dropped out of the low carb diet study? Without surveying them for the reasons why they left the study, you can't eliminate the possibility that some (perhaps many) of them grew weary or unmotivated despite losing weight and feeling better. There are myriad reasons why someone would choose to exit the study that don't relate to the progress of their weight loss or their metabolic health.
Because we cannot know why people dropped out (unless this information was collected, which was not the case here), we should try to account for all participants that were enrolled into the study by conducting the analyses on all participants (i.e., conducting an intent-to-treat analysis), not just those who finished the study. I was merely giving examples to illustrate why it is possible that the high drop-out rate could have distorted the results from this clinical study, and why we should be at least a bit skeptical of the data presented. You are correct that there were likely numerous reasons why people dropped out, including some who just moved away or who couldn't keep the time commitment up, but it's similarly possible that several developed diabetes, or gained weight, or developed other health conditions, and therefore dropped out. In a proper clinical trial, it would be critical to account for all of these. Don't get me wrong, the study still provides some valuable insight and helps us develop hypotheses. The methodological limitations (no control group, no intent-to-treat analysis) simply mean that the results are not conclusive in any way. Cheers Mario
As someone who's been inducted into the low-fat, WFPB cult, this video was eye-opening for me. Thank you for the clear, calm, and factual presentation.
They are talking well below 50g a day. Most at 25g. An actual keto diet that produces a fair amount of keytones (ketosis). Some seem to adapt quite naturally, many don’t. I’ve eaten a variety of ways in my 62 years, and do best at what I’d call a lower carb diet: around 150g a day. When I was younger I was slamming down way over 600g a day. Truth is, it all comes down to satiety. Higher carbs for me, higher hunger, bigger belly. When I was younger, didn’t matter what I ate, or drank😂
HbA1c doesn't say much about insulin resistance in low carb diets, since there's no real carb/glucose challenge. So you are talking about control, not true reversal..
Hi Carina, Yes, true. At the same time, remission and reversal of type 2 diabetes is not always clearly defined. In most cases, people talk about remission when someone with type 2 diabetes achieves a normal HbA1c off diabetes medications. Some investigators have also called this reversal. I don't care too much what we call it. What I am mostly worried about is that HbA1c can get reduced on low-carb diets even though the pathophysiological changes that led to the glucose intolerance (ectopic fat deposition, low-grade inflammation, insulin resistance) have not necessarily been addressed. Usually, these get better, particularly if people lose weight. However, in some cases, they don't, and that may still keep diabetes-associated risks such as CVD or kidney disease elevated despite the lowered HbA1c. Good comment. Cheers Mario
@@nourishedbyscience Thanks! So it comes down to semantics, but I think it gets less confusing if "reversal" is referred to when insulin resistance is actually improved rather than covered up by keeping spikes low while not being able to eat foods that humans should be able to eat like normally healthy carbs 🙂.
@@carinaekstrom1 Yes! I feel like the goal should be to reverse all of the pathologies that led to the diabetes, not just the elevated blood sugar levels. That's a much more ambitious goal, and you would need to monitor body fat distribution, ectopic fat deposition, insulin resistance and a few other things, so this is never done in clinical care or even in most research studies. But personally think this should be the goal. Cheers Mario
@@nourishedbyscience Or just lose weight and do a glucose tolerance test. Some people can handle more fat in their organs than others. Of course you know all this, so I feel we are in agreement 🙂.
while this is using 'reviewed science' little if any indicate anything. For example 'Mediterranean Diet represent nowhere in the geographical region, noone eats this way all the time and in some degree is based off the ideas put forward by king charlatan Ancel Keys. When vegans push the blue zones they point to Sardinia and Ikaria in the Mediterranean. Sardinia as a region of Italy is actually quite low in longevity in Italy, so where do they get the idea that Sardinians live longer? They get it from 2 remote mountain villages that are home to pastoral people (pastoral is something that keeps popping up). Ikaria, again the pastoral people that farm goat for the fatty dairy, eat plenty of pigs, chickens, goats but not fatty fish much like the mountain villagers in Sardinia do. So what about other regions, when you look into the areas you notice again the Puerto Ricans were the pastoral people living up in the hills and not the coastal people, the village of Okimi in Okinawa, where the most centenarians live in that area (and often not looked at in their studies) eats more of pretty much everything especially meat. What about the vegetarians of Loma Linda? Dr Gundry (a cardiologist and plant based who was in that very community as a cardiologist during the time of these studies) freely admits that the long lived people of that time ate over 50% of their energy from eggs and dairy. All groups did not avoid fat, it was in large volumes, especially saturated and monosaturated, in their diet. They did have virtually no oils though. Some olive oil can be used in Sardinia but again a small plate of salad covered in olive oil is an appetizer, not a main to them. So what about Esselstyn? He was a fraudster, he had success with 1 patient in a similar study, eating much like the Loma Linda population did and then posted that result in the second study even though that study did not have any results like that. So why would oil be bad but fat not? To point to some actual studies we see the Sydney and Minnesota heart studies of the late 60s into the early 70s for this. Both were intervention RCTs with one group given polyunsaturated oils to replace saturated fat and the control remain on the same diet. The Sydney one did not control what was eaten but the final results showed in this study of thousands of men who already had heart attacks previously that over the 6 years there was a 60-61% increase in heart attacks and all cause mortality in the intervention (oil) group. In the Minnesota trial that Ancel Keys himself was in charge of then fled when the numbers started coming in also tracked Total Cholesterol etc and used only patients where they could control the diet of. The intervention again came out as contra to the logic pushed for even many decades after. The end results were for each 0.76mmol/L total cholesterol dropped All cause and heart attacks increased by 22%. So say someone total was 9 before and dropped to 6 during the experiment their incidence would be about 88% higher than the group that did not change. Now some, especially vegans, may point to trans fats as being the issue. Even back then the Sydney researchers were a little iffy on trans fats and instructed the intervention to not consume goods manufactured with high levels of trans fats such as baked goods. The intervention 'spread' was made from safflower oil which is one of the lower trans fat oils around at that time. The Randle Cycle is the reason why processed foods that contain both carbs and fats (or oils when looking at the fried foods) were worse for weight gain. essentially mixing two energy sources increases the rate of fat storage etc
Hi Scott, Thank you for watching the video, and for your comment. You touch on many issues, so I hope you will forgive me that I am unable to respond to every point you make. Your main point seems to be that there are many healthy populations that have traditionally eaten diets rich in pasture-raised animal foods. I don't disagree with you. Was it your impression that I am suggesting that only a vegetarian or vegan diet can be healthy? My apologies if that was the impression. Take a look again at my conclusions, highlighting why I made the video (time point 25:36): 1. Diet can have a very substantial impact on health. 2. There is no one 'healthy' diet. Taken together, the research discussed in the video and other studies suggest strongly that people can be healthy eating a wide variety of diets. 3. All studies are informative about what we should NOT be eating: ultra-processed foods and empty-calorie foods. Do we have any disagreement on any of these main points? Cheers Mario
@@nourishedbyscience sorry for tor the delayed response. much of the grief is with the fake med diet. the longest lived groups in that area don't eat much fish and consistent with the 5 meta analysis on saturated fat they also had a diet rich in saturated fat and low in fruits etc. Unfortunately these days I see these same long lived groups giving their children potato chips most presumably cooked in seed oils. So to answer the 3 points you made: 1. Yes, diet can even create a six pack with limited exercise required. 2. Not really. 'Balance', 'Variety' etc are more essential to sell products rather than improve health. You feed most 1 single food, like beef or eggs etc and people would survive, from what we can tell, a long life with minimal issues. In a 1930s study of the Massai found the only health issues they seem to have which we unsual was associated to the very high consumption of milk (constipation and R arthritis). Apart from that they were healthier in essentially every metric of their genetically identical vegetairian neighbors. 3.Studies can muddy the water as with the Esselstyn one. Rather than inform many of these are designed to point the light elsewhere. In scientific studies we see an increase in refusing to release the data, algorithm and conflicts of interest. An example of conflict of interest is pretty much any study Walter Willet produces. He usually cites no conflict of interest whereas the work of Belinda Fetkke showed he had 23 pages of conflicts with several on each page. Thanks for your response.
The low fat, high carb diet and movement intervention includes calorie restriction, doesn't it? This usually results in weight gain long term. You under play that aspect.
Hm. Do you mean the Diabetes Prevention Program? What do you call long-term? The follow-up was 4 years, and the lifestyle group was still weight reduced compared to the two other study arms. And actually, even 22 years later, people who had been randomized to the lifestyle arm still had much lower risk of diabetes: diabetes.org/newsroom/press-releases/2020/new-data-from-diabetes-prevention-program-outcomes-study-shows-persistent-reduction-of-t2d-development-over-22-year-average-follow-up
@@nourishedbyscience People who died were removed from the study, so the claims of outcome are radically biased to healthy subjects. Total garbage, IMHO.
@@nourishedbyscience As far as long term, there are a number of studies showing that people who do calorie diets regain the weight and more after they stop the diet. Anecdotally, I know lots of people who were able to control their weight somewhat early in life by dieting but ended up very overweight as they got older. Opra Winfrey is the queen of this. It seems it works a few times but stops working later.
I am afraid it's a German accent. The region in the US where I have lived and spoken English for most of the last 20 years is the Pacific Northwest/Seattle. Cheers Mario
I think you didnt have type2 diabetes ever. High carb = Fatigue and sleepy mood so even scienties says low and high carb very close it doesnt matter for a patient cos quality of life is terrible especially with high carbs such as bread pasta rice patato etc.
The whole diabetes explosion was triggered by fatfobia. We tried to avoid fat for half a century (replacing it with sugary ultra processed crap) and things got worse.As Einstein said something like: "Insanity is doing the same thing over and over again and expecting different results". Contrary to what the food and pharmaceutical industrie wants you to believe: Saturated fat is not bad. Meat is superfood (you need nothing else if the soil has no dificiencies). Seedoils are ultra processed unstable rancid crap. Grains and legumes are not your friend. Eat real food. Keto won't kill you! Keto (or carnivore) reduces cravings so the food industry hates it.
As you will see in future videos on this channel, I agree with you on some points and disagree on others, but I certainly don't have nearly as strong opinions as you on most of these points simply because the science is too inconclusive or nuanced to allow such strong statements IMO. For one, you may want to watch my two videos about ultra-processed foods and the obesity epidemic. IMO, the existing data much more strongly suggest that the emergence of industry-designed and factory-produced ultra-processed foods are a major cause of the twin epidemic of obesity and type 2 diabetes than the fat-phobia driven reduction in fat intake and concurrent increase in carb intake, as you contend. For example, countries such as Italy and Japan consume diets rich in carbs, but they have stayed largely stayed away from ultra-processed foods and so far have very low rates of obesity and type 2 diabetes. Cheers Mario
@@nourishedbyscience Thanks for the nice reply. Looking forward.. As long as you are metabolically healthy you can tolerate a lot of carbs and some fake food. Important triggers for hyperinsulinaemia are constant stress and lack of sleep, at least for me. Keto(vore) helped me a lot to lose more than 33 pounds (on more calories) and dropped my A1c without excessive cravings. Cutting calories is the best recipe for hunger imo. I learned a lot from Nina Teicholz, Robert Lustig, Benjamin Bikman (why we get sick) and Paul Mason. Cheers Henk
Why no discussion of SJ Hallberg et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther. 2018 Apr;9(2):583-612. doi: 10.1007/s13300-018-0373-9. Epub 2018 Feb 7? Best study I've seen showing a dietary change (low carb ketogenic) that can drastically improve T2D (i.e., 94% of participants were able to reduce or eliminate insulin use at 1 year). Tro Kalayjian also has had impressive results though on smaller numbers of participants.
Could have included that as well, but the low-carb type 2 diabetes prevention study I talked about was already from that same group (Virta Health), and the type 2 diabetes treatment study I covered had a better design, with control group, than the Hallberg et al.-paper you mention. It's fair to say though that it wasn't the point of that video to review the entirety of the evidence on this topic. I will do this in much more detail in later videos. My main objective was to pick some examples from the literature, imperfect as some of them may be, and show that a variety of diets has substantial potential to prevent - or even reverse - major chronic diseases such as type 2 diabetes and heart disease. Cheers Mario
I reversed my Pre diabetes condition by doing the following changes.
1- Quit all barcoded and packaged foods and consumed mostly natural and unprocessed foods.
2- I removed lunch and eat only two meals a day.
3- Walking 1-2 hours a day.
Results: Lost 52 pounds within 9 months, blood pressure is 113/72 and Hba1c is 5.3
I still follow my dietary changes and didn’t get any weight in the past 2 years.
Wow, that's amazing. Thank you for sharing. I agree that ultra-processed foods are likely one of the major culprits of overeating, obesity, and cardiometabolic disease. If you haven't seen it yet, I made a video about this as well:
czcams.com/video/ZACaF8pD6JI/video.html
Warm wishes,
Mario
@@nourishedbyscience I live in America and I see people here more than six times a day and they eat junk. Human bodies are not designed to handle chemically made products for many years. Thanks for your time spent on providing such videos. Every word is precious and listen to it.
Congratulations!
We all need a change, that is sure.
Thank you for your advice. I need this advice. Thanks.
@@mirzamanmirzaman1482❤ nice feedback
One of the things I like most about these videos is being reminded not to just swallow every CZcamsr health guru's claims, but ask the right questions about their conclusions.
Yes. You are right. Some of them are not even doctors and upload videos for making money. We need to find the real knowledgeable people.
@@mirzamanmirzaman1482 And medical doctors generally know almost nothing about nutrition. It's not part of their education, as unbelievable as that is.
Must remember: what works is the truth. Incomplete details of the patient, diet, exercise, and environment are unfortunately common. @@mirzamanmirzaman1482
Like my retiring doctor said, exercise, lose weight, eat whole food. That cures most problems, it's free, and I can do it now. No processed food. No chemicals.
A good physician!
A good number of people who are not obese or over weight, vegetarian, have diabetes. They have heart issues. Diabetes dictates LCHF but heart condition tells them to minimize fat. One episode on thin diabetics would be interesting. Fatty liver is cited but not much info on how to test for it and address it is missing.
I would love to know the proper diet for skinny diabetic patients.
I was put on a strict low carb diet 15 years ago. It’s not fun to give up all the foods you love (I do indulge a little from time to time). However my health is great and I watched a friend who refused to do low carb progress to worse and worse diabetes and all the complications and finally death. So I don’t think my diet is so bad when I can enjoy my life and my grandchildren.
I agree wholeheartedly. In 9 months on a very low carb diet (
Not bad, but probably could be better.
When you say you were “put on a low-carb diet” who recommended that diet? I have always had the opposite problem. Once I discovered that I had pre-diabetes (my doctor never mentioned the significance of my fasting blood glucose being over 100), I went on a ketogenic/Low-carb diet with intermittent fasting against her advice despite my weight loss and better numbers. She retired and every doctor since then strongly recommends a low-fat, higher carb diet (grains, fruits and vegetables) which is def better than a SAD way of eating, but despite epidemiological evidence I just can’t believe is better for someone who has had a carb addiction. I’m not necessarily high fat, just low carb. I’ve always included my own fat as part of my energy source an am maintaining an 80-lb weight loss. But! I DO have FH and I did have a stroke last January. I do worry about whether I’m doing the right thing, but feel most comfortable keeping to my No sugar, No grains, No seed oils kind of diet.
Sir , Your comment inspired me and scared me too
I was able to get off cholesterol medication by reducing my meat and eggs by a third.
I was able to lower my A1C from 7.5 to 5.7 with Whole Food Plant Based no sugar no oil no salt lifestyle. Before changing diets Metformin got me down to 6.5, so I am really happy with 5.7 with no Metformin through diet, walking and an occasional intermittent fast. I lost 50 in 10 months. My cognition improved too.
The following year I experimented with bread, dates and potatoes and my A1C went up to 6.3, gained some weight and memory got worse. I am back to no flour products and no potatoes or white rice. I favor berries and limes for fruit.
If you want to enjoy potato you can put them peeled in water for few hours and this way they do not contain so much starch, then cooked them as you like.
@@katkalucky4060 Cooking the potatoes and then cooling them overnight in the refrigerator will convert some of the digestible starch to resistant starch. This can be repeated through subsequent heating and cooling cycles, but the amount of starch being converted falls off quite a bit each time.
@murraybrockway6540 - Congratulations on such an amazing success! If you happen to see this comment, I'd enjoy hearing about the amount of meat and eggs you were eating at the time of your last comment. Also, have you ever been diagnosed with familial hypercholesterolemia?
That stinks that you weren't able to successfully incorporate foods like bread, dates, and potatoes without your A1c increasing. Personally, I have a weakness for Medjool dates. I still eat them, but not very often. I used to think that eating dates was like a great secret that few others knew -- that I could eat a whole food that was also like a dessert. Eventually, I started reading nutrition labels and realized I had been blissfully unaware. I was really dismayed to realize the amount of calories and sugar they contained. Sadly, there's always a catch.
Anyway, you got me thinking again about the two guys on the Mastering Diabetes channel. They're both Type 1 Diabetics and eat several hundred grams of unprocessed, whole food carbohydrates per day (one of them, Cyrus, has reported that he sometimes eats upwards of 800 grams of unprocessed, whole food carbohydrates per day) and they both inject only minimal amounts of insulin. Both are very lean, too. I believe both have always been lean, if I recall correctly, including before they were symptomatic and diagnosed.
It makes me wonder: If folks like you and me are unable to eat even moderate amounts of unprocessed, whole food carbohydrates, does that mean we still have ectopic fat that is preventing us from being able to metabolize unprocessed, whole food carbohydrates like a healthy person? Or, I wonder if it means we have permanent damage and we'll never be able to return to a normal, healthy baseline metabolism? I guess it would take an abdominal MRI to gather more data to help reach a conclusion.
Final question: After your remarkable 50 pound weight loss, were you quite lean? Do you know what your BMI was at the time? I realize BMI is imperfect, as it doesn't account for body composition. Still, I'd be curious to know what your BMI was after your weight loss, if you care to share. If not, no worries. I hope you're continuing to do well.
Thank you so much for sharing your knowledge. I feel let down by the Canadian medical system. When I talk to my doctor about diabetes it feels kind of pointless. Thank God for people like you.
You Tube needs more people and channels like yours. Many thanks for sharing
Low carb or low fat, why do we have to choose? Take the best of the two diets: lots of whole carbs and some healthy whole food fats like nuts and seeds. Then everything has fiber and optimal nutrients. This is how I keep my weight steady, and if I have gone off the diet at times with too many oatmeal cookies and dark chocolate, I just get back on it and adjust the calories for a while. Usually it's effortless to stay at a good weight, and easy to lose if at rare times I've strayed. Because I never feel depraved of either fats, proteins or carbs.
A “balanced” diet with whole, healthy carbs just doesn’t work for a section of the population. At the core of it is the chemical signaling concerning satiety. Genetics and damage would be the contributors I would think. I’ve heard it from learned sources that roughly 2/3 of the general population can eat what ever macro mix they want, but not so for the other 1/3. Particularly as they age and have abused their systems.
I also wonder why it has to be one or the other. I'm sure there is a balanced approach, which can incorporate both.
Your due diligence is much appreciated…
Thank you.
One of the best 30 mins I have spent. Your presentation is like high nutrition dense foods, packed with so many facts and useful information. 😊 Thank you so much!
One of the best minutes I have spent reading your comment ...:-)...! Thanks so much for the kind feedback.
Best,
Mario
If someone is determined to stay healthy and avoid diabetes, the LCHF in the keto realm (because not every study made have the same parameters of what low carb is)is the way to go. I was diagnosed with pre diabetes in 2021 till today, I follow the keto
In my n=1 self-experimentation study, if you have very advanced insulin resistance any carbs will raise your glucose and keep it high for quite a long time (presumably also keeping insulin high and making insulin resistance worse - unfortunately, I can't measure my insulin). Therefore, I have switched to a very low carb + 4-5 hour TRE and after a month my glucose is in a range where my estimated A1c is 4.8% (if I continued the current daily trends for the next 4 months). Admittedly, I still use metformin and a very small dose of a slow release sulfonylurea, but I'm slowly reducing the dosage on those. I believe by the time 4 months are up, I will be off all meds (or on minimal dose of metformin) and will record an A1c < 5%. I started with 13.3% a month ago. Great content and very nuanced analyses (much appreciated)!
Nice!
One important point: insulin resistance does not automatically trigger high blood sugar levels, because in many cases, the pancreas can simply produce more insulin. That in and of itself may not be good in the long term, but it's important to understand the relationship between dietary carbs, insulin resistance, and glucose intolerance, as there is a lot of wrong information and confusion around these topics. To understand the relationship between insulin resistance, the amount of insulin produced by the pancreatic beta-cell (i.e., beta-cell function), and a third factor called glucose effectiveness, feel free to check out this video here:
czcams.com/video/Yg9AS2sfY9Y/video.html
Warm wishes,
Mario
A1c < 5% is very low.
Keto-Gurus say < 5,4%
Doctors say < 5,8% (below prediabetes) or at least < 6,6% (below diabetes)
Fruits, vegetables and legumes have (often) other health benefits
When you reduced your A1c down the (pre-)diabetic level the real risk is cardiovascular, not glucose alone.
For example: bacon, eggs and grilled tomatoes are glucose friendly but not for cardiovascular risk, the gut microbiome, vascular function or your blood pressure.
There is a lot more to say. So do not focus solely on one number!
I am T2 and do N=1 a lot. One morning took Dogs for a short walk(warmup) and checked Blood Sugar, 7.1. I then had Porridge at 1200hrs, checked BS at 1400hrs 7.1. Big surprise, I expected BS of 8-9.
I would love to see a video dedicated to saturated fats in meat, dairy etc. There are so many confusing data going around in the Internet... I just dont know if plant based diet is really the only healthy option, as some say, or if meat and other animal sources of fat are also safe. Thank you for your hard work and dedication to this channel!
Definitely will have some dedicated videos about these topics. Even if we look at just one endpoint, such as the serum lipid profile, the complexities come into play because there are a lot of different saturated fatty acids, it matters what we are comparing these saturated fats to (mono- or polyunsaturated fatty acids, complex or refined carbs etc.), and the health effects differ depending on the food in which the saturated fatty acids are eaten (dairy fat from butter vs. cheese, for example). I am looking forward to talking about this, because there is a lot of confusing and also misleading or incorrect information about this online.
Cheers
Mario
I would also love to see a video on this topic. I'd also love to understand if chicken /fish is an acceptable protein vs red meat.
I recommend time restricted eating. Work your way up to OMAD. To me it's the best way to stop constantly eating and maintaining a healthy BMI. Best way to become metabolically healthy. Definitely need to switch to healthy fats.
This man speaks great sense…
There's no "it make sense " in nature . Either you know how it works, or you don't
I have been binge watching all your videos. They are not only informative but the approach that you take shows very well how we need to take these kind of problems with a critical and complex look. I really appreciate it!
I was wondering if you have seen the blueprint project. It is about a millionaire who is expending 2 million dollars each year to reverse his age. He has put all the information for free on his website. His lifestyle is a bit extreme, but I was wondering what would be the opinion of a researcher such as yourself. Specially taking into account that most coverage about the project has been done in a kind of spectacular/mediatic fashion.
Thanks again for your effort on putting these videos!
Greetings from Peru.
Thank you for your feedback.
I am not overly familiar with the Blueprint Project, but will look into it and may share thoughts at some point. Thanks for the suggestion.
Cheers
Mario
Thank you for putting this information about diabetes in laymen’s terms. My family has learned so much since we found your videos.
This is what you call knowledge is power! This info can save people's lives. Thanks for the great info again.
Love your clear, direct presentation, in 30 min or less! Thank you!
Mario please make a video about protein powder 🙏
Great video Mario! I appreciated the discussion of the "intent to treat" method and how that influences our interpretation of results. 👍
Thanks so much Dan!
I am enjoying your presentations you are an analysis of many studies is most impressive. I look forward to watching many more.
I have recently been diagnosed with T2 diabetes and am keen to reverse it naturally. I watched your videos with great interest, they provide excellent explanations and valuable information about important factors when considering reversal of diabetes.Thank you very much for making these videos available, greatly appreciated👍
Went on the carnivore diet and went from mild diabetes, 120-150 everyday numbers, to pre diabetes, 100- 130 in 2 weeks and lost 10 lbs, only meat products w/ hi fat, Dr Berry, CZcams. Now on ketovore with higher numbers, have to quit cheating too. Age 74, gym rat, organic eater.
Carnivore diet, zero sugar, zero carbs, zero plants, high protein, high saturated fat, cures t2 diabetes in short order in virtually everyone who eats this way. Also, statin meds cause diabetes and other neurological issues. You can reverse diabetes in a few weeks by going Carnivore diet. Ive done it, and seen it done. Diabetes is a choice, not a lifelong sentence.
Is it also possible, if not probable, that just as we all suffer from different maladies, our individual make-up, age, gender and of course lifestyle factors all influence how we tolerate certain foods? I think it is clear that we should eat whole food and avoid ultra-processed food as much as possible. I also think our psyches are not meant to avoid everything that may not be completely nutritious. I think limiting those significantly is the answer.
Thank you Mario, for your reply. I would be very interested in your analysis of a couple of studies, that I have seen, because I value your point of view as balanced and well informed. I will post the links once I find them. Cheers!
I have successfully and satisfactorily made effort for 3 years to reverse T2D with Keto diet, whole foods, moderate exercise and most importantly intermittent fasting. I stopped all medications for T2d and also statins for cholesterol and steroid inhalers for asthma. I gave up all processed sugary carb-rich foods and sodas, and have no cravings now. I lost 60 pounds weight and have sustained it. I do not eat out anymore. I did not smoke or drink alcohol, but got obese and very sick because of overeating sugary carb junk and killer sodas. It is shocking how medics got it so wrong, and food-drug industries have destroyed human health and trashed the environment. Rows upon rows of slickly packaged stuff in grocery stores is actually poison. Living simply now, my time and money shopping grocery and cooking etc has been cut in half.
Thanks for sharing. Couldn't agree more. All over the internet, people are fighting whether low-carb or low-fat is better, where in reality the most important thing by far is low-ultra-processed. I think the scientific evidence is such that people can be pretty healthy eating most whole foods, as long as they are meeting their micronutrient requirements and stay away from the packaged stuff in the center or the supermarket as much as possible.
Cheers
Mario
@@nourishedbyscienceI don’t understand why my sugar goes up when I eat complex carbs with no processed food. I are brown rice w steamed veggies. Protein and fats were from lentils and almonds. All home cooked. My post prandial was 285. Dr wants me to go on Metformin but I worry if it will stop my liver from functioning completely. My a1c is 6.5 now. I exercise and am very thin. I ate the protein first then veggies and carbs.
You mentioned a test for insulin resistance on one of your videos. I don't remember the name of that lab test and I might like to test myself. I am a "pre-pre" diabetic- My daughter rolls her eyes at me when I say that. I have been using a CGM for several months now and have gotten my A1C down from 5.7 to 5.2. I am mostly plant based and am liberal with nuts and avocado. No weight changes because I am slip but I have a strong family hx of T2DM.
Laura, next video, to be published on Wednesday, will cover the measurement of insulin resistance.
Cheers
Mario
Thanks so much!
thank you for making these videos.
Great information provided - thank you very much
lot of thanks giving knowledge in very simple way
Thanks! Can you show a healthy meals that are as delicious as a lot of the processed meals. I would love to eat more vegetarian if it tasted as good as a pepperoni pizza, or In-N-Out Burger.
Thanks for your comment, and your support, Steve!
You hit the nail on the head with that comment. By far, the biggest obstacle to eating well is the convenience, availability, and highly-rewarding quality of ultra-processed and fast foods.
I find that an approach similar to acceptance and commitment therapy works well for me. I have long accepted that I crave certain unhealthy foods, such as potato chips and ice cream, but I have made a commitment to eat these foods only very rarely (as an occasional treat, and only in the context of social events) so that I can be healthy and functional for as long as possible, enjoy time with my friends and family, and be there for them when they need me. I guess everyone needs to find their own why, but in the end, no one likes being sick and ailing ....! So for me, many of the options out there don't effectively exist. I never visit fast food places, and I stay out of the middle sections of grocery stores entirely.
I may invite a colleague at some point to talk more about this approach to actively choosing a healthy lifestyle, rather than being at the whim of the obesogenic environment again and again.
Warm wishes,
Mario
Please give more information on the difference between eating a slice of regular store bread and, for example, a slice of Ezekiel 4:9 sesame bread. Or steel cut oats with added nuts and berries and a cup of brown sugar flavored instant Oatmeal! Or a serving of barley and a slice of store bought bread, even if labeled "wholegrain "!
The average person does NOT know the difference. Most people watching your videos probably do recognize the importance of the seemingly slight differences.
Being 80 years old I have to balance between risk of cardiovascular disease and diabetes. High fat (low carbon) reduce the risk of diabetes, whereas low fat (high carbs) reduce the risk of CVD. However, concerning blood sugar, could it be that the glucose peaks matters? Is hpa1c an expression of the mean sugar level or more related to the peaks? If so, and the peaks could be avoided by having proteins, fiber, cider and "some fats" in the gut (according to your podcasts), reasonable amounts of starch could be accepted - avoiding both CVD and diabetes?
The first thing I would say is that we should challenge your assumption that high-fat low-carb reduces the risk of diabetes while low-fat reduces the risk of CVD.
A low-carb diet is an excellent way of eating for people who already are glucose intolerant and insulin resistant. However, if you watch my recent video on 'Do Carbs Cause Insulin Resistance' (link below), you'll see that the totality of the evidence does not support the idea that eating carbohydrates per se causes insulin resistance and diabetes. As long as the carbs we do eat are whole-food-based sources of carbs and not mostly refined grains and added sugars, of course. Lastly, a low-carb diet does not necessarily have to increase the risk of CVD, and I'll talk about that in detail in a future video. I'd say that in most people, a well-designed low-carb diet lowers the risk of CVD.
czcams.com/video/ZcVenUbqsYY/video.htmlsi=vqrKmzu2YSlizpFE
Similarly, you do not need to limit fat intake to lower your risk of CVD. That's partly why I mention the trial in this video in which participants substantially lowered their CVD risk by adopting a whole-foods diet rich in legumes, vegetables, fruit, and MORE olive oil and nuts.
As to your other question, blood sugar spikes do likely increase the risk of CVD, if we define a spike as an increase to 180 mg/dL (10 mmol/L) or higher. As long as someone is reasonably glucose tolerant, I'd say that complex carbs with ideally a low glycemic index are fine, ideally still combined within a meal that also contains some fiber and some protein.
Here are a few more videos that may be of interest to you:
The Regulation of Blood Sugar:
czcams.com/video/Yg9AS2sfY9Y/video.htmlsi=TV2it2G0XzsOzAz3
How to avoid blood sugar spikes:
czcams.com/video/yg0Y3eNSANg/video.htmlsi=jXGplM5bCPkewgTy
Q&A Video about that:
czcams.com/video/LVw60RIhbzg/video.htmlsi=Vwp1gRUX1XErcEss
Best wishes,
Mario
@@nourishedbyscience. Thank you for taking the time to answer this person about their question. You are truly a wonderful person and I also appreciate you so much!❤
I avoided diabetese with diet only for 10 years. With the covid, I could not keep up with my life style, and was less careful about my diet, and developed diabetese unfortunatly. Now I am on metformin (1000 mg twice a day) with a healthy diet, maintaining a controled blood sugar. (AC1 of 6.5) Only thing that still can't control best is my fasting blood sugar which fluctuates from 7. to 8.3.
make your meal portions smaller
Do what the doc said. Low carb/hi fat. Carnivore diet is the best.
I think there is an error in your summary of Dr. Caldwell Esselstyn's studies. In his past lecture, i recall he stated that his study was done BEFORE statins were available as a standard of care.
No, the participants were all on lipid-lowering medication. Here, for example, is the official abstract:
Abstract
Coronary artery disease is essentially nonexistent in cultures whose nutrition assures cholesterol levels
Fruits spike my blood sugar massively
Good to know that though.
If you haven't, try eating the fruit as a desert after a meal that contains some protein. It may raise your blood sugar much less then.
Add some nuts (Walnuts, Almonds, Pistachios, Brazilnuts)
Try different fruits.
Everyone is different but there are a number of different kinds of berries that are relatively easy on your blood glucose. Try some strawberry
By whole beans potatoes and sweet potatoes and fruits are high carb
Dang
How abt low carb low fat diet? Is it better than the other two? Is vegan diet better than meat?
Well, gotta eat something, so low-carb low-fat would mean very high protein. It's not really an option to eat most of your calories in the form of protein, mostly because there are almost no foods available that come only as protein and little fat and carbs. Also, google 'Rabbit starvation' if you'd like to know more about why eating only protein without much fat and carbs is not a good idea.
Aside from very high protein, I do think eating a diet with modestly elevated protein is an interesting option, for a number of reasons, and I'll cover that in separate videos soon.
Cheers
Mario
Food can be as addictive as drugs, but when you are facing a dangerous health problem, you should be able to switch diets after a moment's reflection. But, there is evidence that removing carbs completely can be dangerous. So is the Keto diet fad.
Thank you for your comment. Which evidence do you see that removing carbs completely can be dangeous? I am not aware of that. I also don't see the keto diet, or low-carb in general, as fad diets. I do see plenty of evidence that low-carb diets and keto can have major benefits in certain health conditions, and to me, a well-designed keto diet is clearly a better choice than the diet most people eat. At the same time, and that was one point of the video, I also see evidence that very high-carb diets can be beneficial, and hold the view that it would be beneficial to keep an open mind as to why that may be possible.
Best wishes,
Mario
@@nourishedbyscience Hi Mario. Well, I could only track down one source: czcams.com/video/nEjuZsP8o7g/video.html. The other one basically said that there's evidence that if you remove all carbs, the body shuts down its ability to break down carbs, which could be dangerous. Any thoughts?
@@TheTwangKings Oh my, that is not a video I would recommend to anyone. But, I don't 'debunk' people here, and like to focus on the claims made, so let's do that (briefly):
- The video claims that the ketogenic diet is likely deficient in essential micronutrients, and specifically mentions vitamin C and selenium. That doesn't make any sense to me, as I could get enough vitamin C from bell peppers and selenium from Brazil nuts alone, neither of which are off limits on a ketogenic diet. It may be true that there could be micronutrient deficiencies on keto diets, but that is really the case on any diet. A vegan diet that consists mostly of decadent chocolate cake would probably not provide all micronutrients either. Eating a mix of different whole foods will make it a lot easier actually to meet requirements for all micronutrients on a keto diet than on a vegan diet (and I am not for or against either of these).
- The video mentions that keto diets are likely low in fiber because key fiber-rich foods such as whole grains and legumes cannot be eaten. I also disagree there. It's quite easy to meet requirements for fiber from non-starchy vegetables, nuts and seeds, and maybe some berries. I have yet to see any good evidence that we 'need' fiber from whole grains and legumes.
- The video mentions that studies show an association between ketogenic diets and poor health outcomes in observational studies, such as an increased risk of CVD. That's not true. The presented papers are all based on observational studies that have grouped participants by a 'low-carb score'. However, we must consider several things when interpreting these data. First, those eating a diet with the highest low-carb score (i.e., the lowest carb content) were not eating keto diets or even low-carb diets. They were just eating a little bit fewer carbs and a little bit more fat. But they were still eating quite a bit of carbs, and in most studies, mostly refined carbs and added sugars. That's because at the time these studies were conducted, the percentage of thepopulation that was following an actual keto diet was tiny. Second, when these studies were initiated, the dietary guidelines recommended low-fat diets. As a result, all of these observational studies see strong associations between fat consumption and unhealthier lifestyles, simply because those who chose a healthier lifestyle chose to follow the guidelines and ate less fat. So who were those in the group eating the lowest-carb diet? Not health-conscious people eating an actual keto diet, but people who didn't care about their health, who smoked more, who drank more, and who ate a diet consisting mostly of fast foods and convenient foods. That creates a huge problem with potential confounding (any of those associated factors could cause the health problems, not the higher fat or lower carb intake). In any case, these types of studies cannot tell us anything about the long-term health effects of a whole foods ketogenic diet. Almost no one in these studies ate this way. Further, it's important to keep in mind that a keto diet doesn't have to be super high in saturated fats, and it doesn't have to raise LDL-cholesterol and apo B concentrations.
- My greatest dislike is that the video is so lopsided. There are clear benefits to a ketogenic diet (blood sugar effects for example, or a much smaller amount of antinutrients) that are not mentioned at all.
Lastly, your question: yes, glucose tolerance is lower on a low-carb or keto diet, due to a diminished first phase insulin response. But that is temporary, and I have not seen any evidence that the body's ability to deal with carbs is chronically diminished in someone who has been on a low carb diet. I would say it's not a problem as long as someone on a keto or low-carb diets eats low-carb meals at all times. The glucose intolerance would only become a problem (cause a spike) if the person ate a high-carb meal once in a while.
Check out this video here if you'd like to know more about the first-phase insulin response and how it's affected by a low-carb diet:
czcams.com/video/LVw60RIhbzg/video.html
Hope this helps. I will cover all of this ion more detail in future videos.
Cheers
Mario
@@nourishedbyscience Thank you so much, Mario. I appreciate the time you took to clarify this for me. I'll keep these points in mind.👍👍👍
What about butter? Can I have 2 tablespoons every day?
That question is impossible to answer, I am sorry to say, as it entirely depends on many personal factors I know nothing about. I suggest you discuss this with a dietitian/nutritionist personally.
Best,
Mario
I eat Irish butter every day. Some days, I just eat half a stick. My blood numbers are all optimal. Cheers.
Are you not making unfounded assumption(s) for the reasons why 33 participants dropped out of the low carb diet study? Without surveying them for the reasons why they left the study, you can't eliminate the possibility that some (perhaps many) of them grew weary or unmotivated despite losing weight and feeling better. There are myriad reasons why someone would choose to exit the study that don't relate to the progress of their weight loss or their metabolic health.
Because we cannot know why people dropped out (unless this information was collected, which was not the case here), we should try to account for all participants that were enrolled into the study by conducting the analyses on all participants (i.e., conducting an intent-to-treat analysis), not just those who finished the study. I was merely giving examples to illustrate why it is possible that the high drop-out rate could have distorted the results from this clinical study, and why we should be at least a bit skeptical of the data presented. You are correct that there were likely numerous reasons why people dropped out, including some who just moved away or who couldn't keep the time commitment up, but it's similarly possible that several developed diabetes, or gained weight, or developed other health conditions, and therefore dropped out. In a proper clinical trial, it would be critical to account for all of these.
Don't get me wrong, the study still provides some valuable insight and helps us develop hypotheses. The methodological limitations (no control group, no intent-to-treat analysis) simply mean that the results are not conclusive in any way.
Cheers
Mario
❤❤❤❤
As someone who's been inducted into the low-fat, WFPB cult, this video was eye-opening for me.
Thank you for the clear, calm, and factual presentation.
Thank you, Eric.
Many comments here said they use a low-crab diet for reversing diabetes and losing weight. I wonder how low is low and is sustainable and healthy?
Complex question that I cannot answer here. I will make several dedicated videos about low-carb diets, later this year.
Cheers
Mario
They are talking well below 50g a day. Most at 25g. An actual keto diet that produces a fair amount of keytones (ketosis). Some seem to adapt quite naturally, many don’t. I’ve eaten a variety of ways in my 62 years, and do best at what I’d call a lower carb diet: around 150g a day. When I was younger I was slamming down way over 600g a day. Truth is, it all comes down to satiety. Higher carbs for me, higher hunger, bigger belly. When I was younger, didn’t matter what I ate, or drank😂
HbA1c doesn't say much about insulin resistance in low carb diets, since there's no real carb/glucose challenge. So you are talking about control, not true reversal..
Hi Carina,
Yes, true. At the same time, remission and reversal of type 2 diabetes is not always clearly defined. In most cases, people talk about remission when someone with type 2 diabetes achieves a normal HbA1c off diabetes medications. Some investigators have also called this reversal.
I don't care too much what we call it. What I am mostly worried about is that HbA1c can get reduced on low-carb diets even though the pathophysiological changes that led to the glucose intolerance (ectopic fat deposition, low-grade inflammation, insulin resistance) have not necessarily been addressed. Usually, these get better, particularly if people lose weight. However, in some cases, they don't, and that may still keep diabetes-associated risks such as CVD or kidney disease elevated despite the lowered HbA1c.
Good comment.
Cheers
Mario
@@nourishedbyscience Thanks! So it comes down to semantics, but I think it gets less confusing if "reversal" is referred to when insulin resistance is actually improved rather than covered up by keeping spikes low while not being able to eat foods that humans should be able to eat like normally healthy carbs 🙂.
@@carinaekstrom1 Yes! I feel like the goal should be to reverse all of the pathologies that led to the diabetes, not just the elevated blood sugar levels. That's a much more ambitious goal, and you would need to monitor body fat distribution, ectopic fat deposition, insulin resistance and a few other things, so this is never done in clinical care or even in most research studies. But personally think this should be the goal.
Cheers
Mario
@@nourishedbyscience Or just lose weight and do a glucose tolerance test. Some people can handle more fat in their organs than others. Of course you know all this, so I feel we are in agreement 🙂.
while this is using 'reviewed science' little if any indicate anything. For example 'Mediterranean Diet represent nowhere in the geographical region, noone eats this way all the time and in some degree is based off the ideas put forward by king charlatan Ancel Keys. When vegans push the blue zones they point to Sardinia and Ikaria in the Mediterranean. Sardinia as a region of Italy is actually quite low in longevity in Italy, so where do they get the idea that Sardinians live longer? They get it from 2 remote mountain villages that are home to pastoral people (pastoral is something that keeps popping up). Ikaria, again the pastoral people that farm goat for the fatty dairy, eat plenty of pigs, chickens, goats but not fatty fish much like the mountain villagers in Sardinia do.
So what about other regions, when you look into the areas you notice again the Puerto Ricans were the pastoral people living up in the hills and not the coastal people, the village of Okimi in Okinawa, where the most centenarians live in that area (and often not looked at in their studies) eats more of pretty much everything especially meat. What about the vegetarians of Loma Linda? Dr Gundry (a cardiologist and plant based who was in that very community as a cardiologist during the time of these studies) freely admits that the long lived people of that time ate over 50% of their energy from eggs and dairy.
All groups did not avoid fat, it was in large volumes, especially saturated and monosaturated, in their diet. They did have virtually no oils though. Some olive oil can be used in Sardinia but again a small plate of salad covered in olive oil is an appetizer, not a main to them.
So what about Esselstyn? He was a fraudster, he had success with 1 patient in a similar study, eating much like the Loma Linda population did and then posted that result in the second study even though that study did not have any results like that.
So why would oil be bad but fat not? To point to some actual studies we see the Sydney and Minnesota heart studies of the late 60s into the early 70s for this. Both were intervention RCTs with one group given polyunsaturated oils to replace saturated fat and the control remain on the same diet. The Sydney one did not control what was eaten but the final results showed in this study of thousands of men who already had heart attacks previously that over the 6 years there was a 60-61% increase in heart attacks and all cause mortality in the intervention (oil) group. In the Minnesota trial that Ancel Keys himself was in charge of then fled when the numbers started coming in also tracked Total Cholesterol etc and used only patients where they could control the diet of. The intervention again came out as contra to the logic pushed for even many decades after. The end results were for each 0.76mmol/L total cholesterol dropped All cause and heart attacks increased by 22%. So say someone total was 9 before and dropped to 6 during the experiment their incidence would be about 88% higher than the group that did not change.
Now some, especially vegans, may point to trans fats as being the issue. Even back then the Sydney researchers were a little iffy on trans fats and instructed the intervention to not consume goods manufactured with high levels of trans fats such as baked goods. The intervention 'spread' was made from safflower oil which is one of the lower trans fat oils around at that time.
The Randle Cycle is the reason why processed foods that contain both carbs and fats (or oils when looking at the fried foods) were worse for weight gain. essentially mixing two energy sources increases the rate of fat storage etc
Hi Scott,
Thank you for watching the video, and for your comment. You touch on many issues, so I hope you will forgive me that I am unable to respond to every point you make.
Your main point seems to be that there are many healthy populations that have traditionally eaten diets rich in pasture-raised animal foods. I don't disagree with you. Was it your impression that I am suggesting that only a vegetarian or vegan diet can be healthy? My apologies if that was the impression. Take a look again at my conclusions, highlighting why I made the video (time point 25:36):
1. Diet can have a very substantial impact on health.
2. There is no one 'healthy' diet. Taken together, the research discussed in the video and other studies suggest strongly that people can be healthy eating a wide variety of diets.
3. All studies are informative about what we should NOT be eating: ultra-processed foods and empty-calorie foods.
Do we have any disagreement on any of these main points?
Cheers
Mario
@@nourishedbyscience sorry for tor the delayed response.
much of the grief is with the fake med diet. the longest lived groups in that area don't eat much fish and consistent with the 5 meta analysis on saturated fat they also had a diet rich in saturated fat and low in fruits etc. Unfortunately these days I see these same long lived groups giving their children potato chips most presumably cooked in seed oils.
So to answer the 3 points you made:
1. Yes, diet can even create a six pack with limited exercise required.
2. Not really. 'Balance', 'Variety' etc are more essential to sell products rather than improve health. You feed most 1 single food, like beef or eggs etc and people would survive, from what we can tell, a long life with minimal issues. In a 1930s study of the Massai found the only health issues they seem to have which we unsual was associated to the very high consumption of milk (constipation and R arthritis). Apart from that they were healthier in essentially every metric of their genetically identical vegetairian neighbors.
3.Studies can muddy the water as with the Esselstyn one. Rather than inform many of these are designed to point the light elsewhere. In scientific studies we see an increase in refusing to release the data, algorithm and conflicts of interest. An example of conflict of interest is pretty much any study Walter Willet produces. He usually cites no conflict of interest whereas the work of Belinda Fetkke showed he had 23 pages of conflicts with several on each page.
Thanks for your response.
The low fat, high carb diet and movement intervention includes calorie restriction, doesn't it? This usually results in weight gain long term. You under play that aspect.
Hm. Do you mean the Diabetes Prevention Program? What do you call long-term? The follow-up was 4 years, and the lifestyle group was still weight reduced compared to the two other study arms. And actually, even 22 years later, people who had been randomized to the lifestyle arm still had much lower risk of diabetes:
diabetes.org/newsroom/press-releases/2020/new-data-from-diabetes-prevention-program-outcomes-study-shows-persistent-reduction-of-t2d-development-over-22-year-average-follow-up
For it to have been equally comparative, the exercise either should not have been included or it should have been promoted in all groups.
@@nourishedbyscience People who died were removed from the study, so the claims of outcome are radically biased to healthy subjects. Total garbage, IMHO.
@@nourishedbyscience Do you just read the title headlines?
@@nourishedbyscience As far as long term, there are a number of studies showing that people who do calorie diets regain the weight and more after they stop the diet. Anecdotally, I know lots of people who were able to control their weight somewhat early in life by dieting but ended up very overweight as they got older. Opra Winfrey is the queen of this. It seems it works a few times but stops working later.
What American accent do you have?
I am afraid it's a German accent. The region in the US where I have lived and spoken English for most of the last 20 years is the Pacific Northwest/Seattle.
Cheers
Mario
I think you didnt have type2 diabetes ever. High carb = Fatigue and sleepy mood so even scienties says low and high carb very close it doesnt matter for a patient cos quality of life is terrible especially with high carbs such as bread pasta rice patato etc.
The whole diabetes explosion was triggered by fatfobia. We tried to avoid fat for half a century (replacing it with sugary ultra processed crap) and things got worse.As Einstein said something like: "Insanity is doing the same thing over and over again and expecting different results".
Contrary to what the food and pharmaceutical industrie wants you to believe:
Saturated fat is not bad.
Meat is superfood (you need nothing else if the soil has no dificiencies).
Seedoils are ultra processed unstable rancid crap.
Grains and legumes are not your friend.
Eat real food.
Keto won't kill you!
Keto (or carnivore) reduces cravings so the food industry hates it.
As you will see in future videos on this channel, I agree with you on some points and disagree on others, but I certainly don't have nearly as strong opinions as you on most of these points simply because the science is too inconclusive or nuanced to allow such strong statements IMO.
For one, you may want to watch my two videos about ultra-processed foods and the obesity epidemic. IMO, the existing data much more strongly suggest that the emergence of industry-designed and factory-produced ultra-processed foods are a major cause of the twin epidemic of obesity and type 2 diabetes than the fat-phobia driven reduction in fat intake and concurrent increase in carb intake, as you contend. For example, countries such as Italy and Japan consume diets rich in carbs, but they have stayed largely stayed away from ultra-processed foods and so far have very low rates of obesity and type 2 diabetes.
Cheers
Mario
@@nourishedbyscience Thanks for the nice reply. Looking forward.. As long as you are metabolically healthy you can tolerate a lot of carbs and some fake food. Important triggers for hyperinsulinaemia are constant stress and lack of sleep, at least for me. Keto(vore) helped me a lot to lose more than 33 pounds (on more calories) and dropped my A1c without excessive cravings. Cutting calories is the best recipe for hunger imo. I learned a lot from Nina Teicholz, Robert Lustig, Benjamin Bikman (why we get sick) and Paul Mason.
Cheers
Henk
Why no discussion of SJ Hallberg et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther. 2018 Apr;9(2):583-612. doi: 10.1007/s13300-018-0373-9. Epub 2018 Feb 7? Best study I've seen showing a dietary change (low carb ketogenic) that can drastically improve T2D (i.e., 94% of participants were able to reduce or eliminate insulin use at 1 year). Tro Kalayjian also has had impressive results though on smaller numbers of participants.
Could have included that as well, but the low-carb type 2 diabetes prevention study I talked about was already from that same group (Virta Health), and the type 2 diabetes treatment study I covered had a better design, with control group, than the Hallberg et al.-paper you mention.
It's fair to say though that it wasn't the point of that video to review the entirety of the evidence on this topic. I will do this in much more detail in later videos. My main objective was to pick some examples from the literature, imperfect as some of them may be, and show that a variety of diets has substantial potential to prevent - or even reverse - major chronic diseases such as type 2 diabetes and heart disease.
Cheers
Mario
@@nourishedbyscienceso basiclsly any Calorie reduced diet can control diabetes?