Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU

Translator: Anders BjrkReviewer: Ivan Stamenkovi I have the best job in the world. I’m a doctor. No! Believe me that’s not why. I’m an obesity physician. I have the honor of workingwith the group of people subject to the last widelyaccepted preconception: being overweight. These people have suffered a lotby the time they envision me: reproach, regret, blameand outright discrimination. The position that many give, including those in healthcare, is that these peopleare to blame for their situation. If they could just control themselves, they wouldn’t be overweight, and they are not motivated to change.Please let me tell youthis is not the case. The denounce, if we’ve gotto extend some now, has been with our opinion. And it’s time we convert that. Obesity is a disease, it’s not somethingcreated by lack of attribute. It’s a hormonal cancer, and there are many hormones involved. And one of the main onesis a hormone called insulin. Most obese individualsare resistant to this hormone, insulin.So, what does that aim accurately, to be resistant to insulin? Well, insulin resist is essentiallya state of pre-pre-type 2 diabetes. Insulin’s chore is to drive glucose, or blood sugar, into the cells where it can be used. In a nutshell, when someoneis insulin resistant, they are having troublegetting blood sugar where it needs to go, into those cadres. And it simply can’t hang outin the blood after we eat or we would all have a diabetic crisisafter every snack! So, when someone is resistant to insulin, the body’s response to thisis to really form more of it. And insulin tiers will rise and rise, and for a while, years even, this is going to keep up, and blood sugar positions can remain normal. However, often it can’t keep up forever, and even those elevated levels of insulin are not enough to keep blood sugarin the normal range. So it starts to rise. That’s diabetes. It probably won’t surprise you to hear that most of my patientshave insulin resistance or diabetes.And if you are sitting there thinking, “Phew, that’s not me, ” you actually might want to think again, because approximately 50% of adult Americansnow have diabetes or prediabetes. That is almost 120 million of us. But that’s hardly everyonewho has issues with insulin. Because as I was saying, people have hoisted insulin levelsdue to insulin resistance for years, even decades, before the diagnosisof even prediabetes is uttered. Plus it’s been shown that 16 -2 5% of normal-weight adults are also insulin resistant. So, in case you’re keeping track, this is a heck of a good deal of us. So, the troublewith insulin defiance is: If it goes up, we are at great riskfor developing type 2 diabetes. But too, insulin spawns us hungry, and the menu we eatmuch more likely to be collected as fatty. Insulin is our fat storage hormone. So we can start to seehow it’s going to be a problem for ailments like obesityand metabolic issues like diabetes.But what if we traced this problemback at the very beginning, and we just didn’t haveso much glucose around that insulin needed to deal with? Let’s take a look at how who is able to. Everything you eat is either a carbohydrate, a protein or a solid, and they all have very different effecton glucose and therefore insulin status, as you can see on the graph. So when we eat carbohydrates, our insulin and glucoseare going to spike up fast. And with proteins it appears a little better. But take a look at what happenswhen we eat solid. Essentially nothing, a flat boundary. And, this is going to wind upbeing very important. So , now I just wanted to translatethat graph for you into a real-world situation. I want you to go back and think about the last time you atean American edition of Chinese food.We all know there’s rulesassociated with this, right? And the first convention is: You’re going to overeat. Because the stop signal doesn’t get direct until you are literallybusting at the seams. Rule number two is: In an hour you’re starving. Why? Well, because the rice in that mealcaused glucose and insulin to skyrocket, which triggered hunger, solid storage and itches. So, if you are insulinresistant to begin with, and your insulin levelsare already higher, “youve been” are hungrier all the time. And we have this setup: Eat carbs, your glucose goes up, your insulin goes up, and you have hunger and fat storage. So, how do we recommendto these parties to eat, because it seems like that would bereally important, and it is. Let’s focus precisely on character 2 diabetes, because the general recommendationsare to tell cases with category 2 diabetes to destroy 40 to 65 gramsof carbohydrates per meal, plus more at snacks. Trust me on this, that’s a great deal of carbs.And remember what’s going to happento glucose and insulin, blood sugar and insulin, when we eat them? Yes, we are essentially recommending that they chew exactlywhat’s causing their problem. Sound crazy? It genuinely, really is. Because, at its root, diabetesis a state of carbohydrate toxicity. We can’t get the blood sugarinto the cadres, and that effects a problemin the short term. But the long-term consequencesare even greater. And insulin defiance is essentiallya state of carbohydrate antipathy. So why, oh why, do we want to continueto recommend to parties to eat them? The American DiabetesAssociation guidelines solely state that there isinconclusive evidence to recommenda specific carbohydrate limit. But those guidelines go right onto say what we all know: Our carbohydrate intake is the single, biggest factor in blood sugar ranks, and therefore need for medication. These guidelines then go on to say: Hey look, if you are takingcertain diabetic prescriptions, you actually have to eat carbs, otherwise your blood sugar can go too low. Okay, so let’s take a look at the vicious cyclethat that opinion precisely set up.So it’s: Eat carbs so you haveto take medicine, then you have to eat more carbs so you avoid the side-effectof those medications, and around and around we go. Even worse is that nowherein the ADA guidelines is the goal of overturning character 2 diabetes. This needs to be changed, because character 2 diabetes can be overruled, in numerous, if not most, places, specially if “were starting to” early. Not only do we needto let people know this, but we have to start giving themthe practical advice so they can do this.Consider carbs. First, here’s a shocker for you: We don’t need them. Earnestly! Our minimum daily requirementfor carbohydrates is zero. We have indispensable amino battery-acids, those are proteins, essential fatty acids, but , nope , no indispensable carb. A nutrient is essential if we have to have it to role, and we can’t make it from something else. We fix glucose, plenty of it, all the time, it’s called gluconeogenesis. So, we don’t need them, the overconsumption of themis performing us very sick, yet we are continuingto recommend to cases to eat close to, if not more than, half of their total energy intakeevery day from them. It doesn’t make sense. Let’s talk about what does. Cutting carbs, a good deal. Yes, in my clinic we teach patients to eat with carbsas the minority of their intake , not the majority of members. So, how does “whos working”? Well, when our patientsdecrease their carbs their glucose goes down, and they don’t need as much insulin.So those insulin heights descend, and fast. And this is very important, because a study looking at our National Healthand Nutrition Examination Survey data, better known as NHANES, showed that the single, biggest risk factor for coronary artery disease is insulin resistance. It is responsiblefor a whopping 42% of heart attacks. Low-carb intervention efforts so fast that we are able to literally pull people offof hundreds of parts of insulin in daylights to weeks. One of my favorite storiesis a very recent one. A young gallon, but who had an almost2 0-year biography of nature 2 diabetes, came in when a doctor from anotherclinic told her she was just sick, and she’d probably get used to it. Her diabetes was way out of control. This despite the fact that shewas on multiple drugs, including almost 300 cells of insulin, that was being injected into hercontinuously every day via a pump. All of this, recollect, blood sugar still out of control. So we positioned her on a low-carb diet, and now let’s fast-forward four months.She lost load, yes, but, better than good, sick no more. Her blood sugar levelswere now regular all of the time. This on, get this , no diabetes prescription. Gone was the 300 measurements of insulin , no more insulin shoot , no more pricking her fingermultiple times each day, become, all of it , no more diabetes. One of the greatest euphoriums of my jobis to be able to tell a patient like this that they no longer have diabetes, and we ceremoniously take it offtheir problem list together. So, are they antidote, is this a miracle? We’ll leave that grandstandingto Doctor Oz. Cured would imply that it can’t come back. And if they start eatingexcessive carbs again, it will.So no not healed, but they don’t havediabetes any longer. It’s resolved, and it can stay that wayas long as we deter apart the case. So, what does this look like then? How does somebody eat this highway? Well, first, let me tell youwhat it’s not. Low-carb is not zero carb, and it is not high protein. These are common criticismthat are so frustrating because they are not true. Next, if we take the carbs out, what are we going to put in? Because, remember, there’s only three macronutrients: if one goes down, one has to go up.My cases eat fatty, and a lot of it. “What !? ” you say. What’s goingto happen when you snack fat? Well, let me tell you, you’regoing to be happy, because fatty smacks immense, and it is incredibly satisfying.( Applause)( Laughter) But, remember, fatis the only macronutrient that’s going to keep our glucose -blood sugar – and insulin positions low-pitched, and that is so important. So, I want you to now hearmy simple rules for eating. These rules, you have to remember, are even going to be more important if you are one of the tensof millions of Americans who have trouble with insulin heights. Rule number one: If it says light, low fator fat-free, stays in grocery store.Because they took the fat out, they settled carbs and chemicals in. Rule number two: Eat food. The most important rulein low-carb nutrition: Real food does not come in a container, and no-one should have to tell youreal food is natural. You should be aware that when you look at it. Don’t eat anything you don’t like. And dine when you’re hungry ;d on’t dine when you’re not , no matter what the clock says.And numeral five is a simple wayto remember what we want to avoid. No GPS: no particles, no potatoes and no carbohydrate. That last one is a biggie, right , no grains? Na , no specks. But we have to have them. Nope, they’re a carb. But entire specks are so good for us. Well, first of all, there are actuallyvery few foods out there that are truly whole graineven when they say they are. Most menus that purport themselvesto be wholegrain are highly processedand the fiber benefit broke. Or they’re comingwith highly refined flour, frequently both sets of things. So if you are one of the trulyinsulin-sensitive parties, you can eat real, entire particle. But if you’re in the enormous sliceof our population with insulin issues, it’s obliging things worse. So what if you are oneof the real insulin-sensitive beings? Can you still eat this way? Yes! I am a great example.Over a year ago I decidedI would cut my carbs as low-pitched as I recommendto my diabetic patients. Now, it’s not mandatory for my healthlike it is a matter of theirs; I’m not insulin resistant, so would this be a problem? No! That’s just the thing. Unless you havean exceedingly rare ailment, then cutting carbsis going to be good for you, even if it’s not necessary. I want to show you a couple of picturesof my radical food.So, this is a common breakfastin my house. So does it look likeI time ended my own settle? I didn’t because this muffinis procreated with coconut flour. I broil all the time still. I merely use non-grain-based flours: coconut, almond, hazelnut, flax. They stimulate savory things. And this is a conventional dinner in my housewith a usual starch. That would be the sauted mushrooms. No, my patients and I feed happy foodall of the time and loved it. But what about the research on this? I entail is this just anecdotalevidence now from my clinic? No! There was still dozens ofrandomized ascertained visitations looking at low-carb intervention for things like diabetes, cardiovascular risk factors, obesity. They’re consistent. It operates! There are even a large numberof studies showing that low-carb nutritiondecreases inflammatory markers, which is realizing it really excitingfor diseases like cancer. We just finished research studies in our clinic. And what we did is, we took 50 sort 2 diabetic patients that were treated withour low-carb-high-fat-based program, and we equated them to 50 patients who were treated with the ADA guidelines.And after six months , not only did we finda significant metabolic advantage for the low-carb group, but, and let’s face it, this is important, a huge cost savings. Our analysis showed that our patientscould save over $2,000 a year just on the diabetes medsthey were no longer making. Really mull how quickly that supplements up. We are currently in diabetes epidemic now that we are spending $250 billion a year on in this country. So, I want to show you a slither now that substantiates wherethose savings are coming from. So this is lookingjust at the insulin gap in the two groups after six months. And what we can see is that the low-carb groupwas able to decrease their insulin by nearly 500 legions a daytime. Whereas in the ADA considered group, they had to increase their insulinby almost 350 cells a period. Two important things. Number one: Insulin is expensive. And number two: Not all the peoplein this study were even on insulin, which draws these resultseven more impressive. But what I would say isthat this graph actually represents two different approachesto treating this disease.The first, our group, with the goal of changing illnes, meaning they need little remedy. And the second group, which very clearlyaligns with the ADA guidelines, which state that diabetesis a progressive malady, expecting more drug over epoch. Progressive unless we take out the crusade. So, what’s the problem then? Why is this not everywhere? Why isn’t low-pitched carb standards and norms? There’s two big-hearted rationalizations. Number one: status quo.It is hard to break. There are many agendas involved. We get this notion that low fatwas the way to go decades ago.But a recent study just came out showing that there waszero randomized verify prove to recommend to Americansto remove the fatty from our diet. And that’s how the carbs got added in. It was basically a huge experimenton millions of people, and it disappointed miserably. The second reason we don’tsee it everywhere is money. Don’t be moron, there’s a lot of moneyto be made from keeping you sick. And what we see is, with these specialty guideline bodies, they are stackedwith conflict in the best interests. So, the solution to the diabetes epidemicin my clinic is exceedingly clear: Stop using medicine to treat food. And for a diseasewhose root cause is carbohydrates, take away the carbohydrates, or at least chipped them, so we can rememberwhat we used to know. We knew it a long time ago, this was said thousands of years ago, and the work requires, in this day and age, to get back to that notion.Thank you.( Applause ).

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