In this episode, I am with Cyrus Khambatta and Robby Barbaro – co-founders of Mastering Diabetes, which is a coaching program that teaches people how to reverse insulin resistance through a low-fat, plant-based lifestyle.
Cyrus has an undergraduate degree from Stanford University and a PhD in nutritional biochemistry from UC Berkeley, and Robby has worked at Forks Over Knives for six years and has a Master’s degree in public health. Both are diagnosed with Type 1 diabetes and have managed to take control of their own health by adopting a specific whole-foods lifestyle, which is something we will talk about in this episode.
They have since taken their vast knowledge, expertise, and the latest evidence-based research, and co-founded Mastering Diabetes, which is a coaching program that teaches people how to treat – and beat – diabetes by consuming a low-fat, plant-based diet. You can sign up for FREE here!
In this podcast, Cyrus and Robby will cover:
- Type 1 vs Type 2 diabetes. What you need to know about each.
- How reversing insulin resistance IS possible…with this type of diet.
- Why millions of people are dying from diabetes each year and how to stop the pandemic.
- Why other diabetes lifestyle programs might be wasting your time and money.
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Reversing Insulin Resistance With Low-Fat Vegan Diets? With Robby and Cyrus - Transcript
Ari Whitten: Hey there. This is Ari Whitten. Welcome back to The Energy Blueprint podcast. Today I have with me Cyrus Khambatta and Robby Barbaro, which are cool names by the way guys, who are the cofounders of Mastering Diabetes, a coaching program that teaches people how to reverse insulin resistance via low fat, plant-based whole food nutrition. Cyrus has been living with type 1 diabetes since 2002 and has an undergraduate degree from Stanford University and a PhD in nutritional biochemistry from UC Berkeley. Robby was diagnosed with type 1 diabetes in 2000 and has been living a plant-based lifestyle since 2006 he worked at Forks Over Knives for six years and earned a master’s in public health in 2019. Welcome guys. Nice to see you again after you interviewed me the last time we chatted a few weeks ago.
Robby Barbaro: The interview was mind-blowing, people are going to want to check one out.
Ari Whitten: Thank you. Appreciate it.
Cyrus Khambatta: I also just became like an instant super fan of you. I was like, we got off the conversation. I was like can we be best friends with Ari? Is that possible?
Ari Whitten: Totally, yes it is but, but Cyrus, as we were chatting about before this, since you live in Costa Rica, you’ll have to start surfing. That’s the one condition I’m going to have.
Cyrus Khambatta: That’s the condition. Okay, I’m in.
Ari Whitten: Think about it.
Cyrus Khambatta: I know that’s a hard sell. Let me tell you.
Ari Whitten: That’s a no brainer. Cyrus. You can do it.
Cyrus Khambatta: All right, fine.
Ari Whitten: Guys, I know you have a very personal history of why you got into doing this thing, this mastering diabetes thing. What is the personal story/stories behind Mastering Diabetes?
Robby Barbaro: I was personally diagnosed with type 1 just like you said, in 2000, so closing in on 30 or 20 years now, living with type 1 diabetes. The difference between type 1 and type 2 diabetes is that my pancreas does not secrete sufficient quantities of insulin. My beta cells have been damaged and I now need to inject insulin in order to eat food to stay alive. That’s insulin-dependent diabetes. Whereas type 2 is mainly characterized by people who produce too much insulin. Insulin resistance is the cause of that condition and we’ll go into that in more detail today, but I’m living with type 1 diabetes. Of course, you start googling and reading books and learning how can you take the best care of yourself?
How can you reduce the longterm complications? How to get your best A1C, how do you make your blood glucose not a roller coaster because quite frankly, managing your blood glucose is quite difficult? I mean, Ari, your pancreas is working perfectly. All-day long it’s producing a little bit of insulin, keeping you in check. You eat meals, it’s got phase one insulin ready to fire, you need more insulin, your body produces it and keeps your blood glucose under fantastic control.
Ari Whitten: That’s the sweetest compliment anyone has ever made. My pancreas is just beautiful.
Robby Barbaro: Trying to do that manually, it’s not actually the easiest thing ever, but there’s things you can do to make that a much more fluid and graceful process. Anybody living with type 1 you start learning. I tried many different diets over the years and I suffered with a lot of regular issues that many people struggle with. I had chronic allergies. I’d take Nasonex, Claritin-D year-round and still get sick all the time. I had terrible acne as a teenager. Took all the drugs you could take, eventually taking Accutane, which is one of the most serious drugs you can possibly take and has a lot of side effects.
I have plantar fasciitis, I had warts on my feet. I just had these typical problems. I’ve continued to do more research and learn and eventually, I tried low carbohydrate nutrition. I try the Weston A. Price Foundation style thing and none of those diets really improved my diabetes control. Eventually, I ended up trying low carb, like a plant-based ketogenic diet. I noticed that I’m eating lots of olive oil, lots of nuts and seeds, lots of greens. Very, very simple diet and my carbohydrate to insulin ratio was three to one.
For every single gram of carbohydrate, I would eat, I would inject for every three grams, I would inject one unit of insulin. This is a good indicator of insulin sensitivity, a great way to measure how insulin sensitive somebody is. All right, as I did that, the major problem I had, other than being, that’s not a good ratio. That’s very poor. All right. Trust me, Ari, you’re much more insulin sensitive. Second compliment for you. Your pancreas is working fine and you’re more insulin sensitive than that.
Ari Whitten: Tell me more about my internal organs.
Robby Barbaro: I will. Basically, at that point, I was doing this diet, I’m a student at the University of Florida freshmen and I basically ran out of– I just had no energy. I was really struggling. I needed the energy blueprint at that point in my life and I didn’t have access to it. So I continued to search for more answers and eventually I came across the idea of low-fat plant-based whole food nutrition. That is when I started eating lots of fruit, lots of greens, lots of vegetables. In a short period of time, my insulin sensitivity went up and up and up to a point where I can now eat 22 grams of carbohydrate for every one unit of insulin.
This is a 600% change in insulin sensitivity. I’ve actually recently seen it go even higher than that, but the point is people living with type 1 diabetes, myself, Cyrus and millions of others. We are excellent test subjects of what lifestyle behaviors result in insulin sensitivity or leading towards insulin resistance because we know exactly how much insulin our body requires. We count the carbohydrates that we consume and we measure our blood glucose levels all day long.
Many of us wear continuous glucose monitors where we can see our blood glucose every five minutes ping to our phone. I know my blood glucose profile all throughout the day and that can give you your time and range and it can give you your predicted A1C. It’s just a lot of data. This is one thing you don’t know, Ari, I know I’m trying not to keep a tie here by–
Ari Whitten: Oh, man, you’re going to say a negative thing about my brain.
Robby Barbaro: You don’t know how much insulin you produce on a meal by meal basis.
Ari Whitten: Fair enough.
Robby Barbaro: You can’t quantify, did I become more insulin sensitive or insulin resistant in the past couple of days based on my lifestyle. You just didn’t know for sure, you’d have to go into a laboratory. You’d have to do some serious testing. Cyrus and I, we know meal by meal by meal by meal. That was a fascinating insight when I saw this transformation, then my plantar fasciitis went away. The warts on my feet went away. I do not get sick. I don’t take any Nasonex or Claritin-D anymore. My skin cleared up. All these amazing transformations occurred and I started looking to more of the research.
What’s going on here? Why is insulin sensitivity a big deal? The key insight I had, this is in college, is I realized that what I was experiencing in my own body was this solution to prediabetes and type 2 diabetes, which is affecting over 115 million people in the US alone right now. By demonstrating the concept of reversing insulin resistance to my own body, we can extrapolate that and say, wait a minute, this same thing, this same behavior, the same lifestyle decisions is literally the solution reversing prediabetes and type 2 diabetes.
This has been documented in the research dating back to the 1920s. That’s my story of how I got into this and how we became– okay, wait a minute. It’s mastering diabetes. It’s not just typed 1 diabetes. It’s this whole picture of how insulin resistance is affecting all forms of diabetes.
Ari Whitten: Yes, very cool. I definitely want to dig into that last bit there but Cyrus, do you want to talk your background and how you got into this, your personal story first?
Cyrus Khambatta: Yes, for sure. I was diagnosed with type 1 diabetes similar to Robby, except I got it at the age of 22. That’s pretty late for a type one diagnosis. Normally you get diagnosed when you’re like 6 or 10 or 12., but there’s a growing number of people now in today’s world that are getting it in their 20s, their 30s their 50s, their 60s. I just happened to be one of those people. I’m a happy-go-lucky senior in college.
I’m trying to graduate, move on with my life and all of a sudden I find myself really thirsty, very low energy and cramping every single time I would try to go to sleep. That type of cramping where you go to sleep and all a sudden your hamstring cramps and it’s really intense. You try and like to manipulate your body so that that hamstring cramp goes away. Imagine doing that and then by trying to relieve that, now you get a cramp on the other side. Now all of a sudden your quad cramps on that side and then your AB cramps and then your shoulder cramps.
Before I knew it, there were days where I was literally lying in bed and it’s like full-body rigor mortise because I was like, “Oh my God, what is happening to me right now?” I picked up the phone, I called my sister and I explained my symptomology to her because she’s a doctor of osteopathy and she’s very smart. She started crying immediately. She said, “Cyrus, everything you’re telling me is type 1 diabetes, go straight to the health center.” I remember talking to her at the time, I was like, “Shut up. I don’t have diabetes. Are you kidding me?”
Look, I’m normal weight. I’m an active guy. I eat well. How do I have diabetes? She’s like, I don’t have time to explain but trust me, you have diabetes. At that time, all I thought was diabetes had something to do with old people and cake. That’s it. Here I am being like, this is ridiculous. My sister doesn’t know what she’s talking about. Go to the health center. They measured my blood glucose. I’m at 600 just a little bit over 600 which is six times higher than your blood glucose is supposed to be. It’s supposed to be somewhere between 80 and 130 all day long. I’m six times off of that.
They take me to the hospital. They start injecting insulin. They started giving me saline. I become hydrated. My blood glucose starts to come down using insulin. 24 hours later I get discharged from the hospital with a prescription for two types of insulin, a blood glucose meter, test strips, a carbohydrate counting guide and a bracelet that I have to wear that basically says, “Hey, I’m a life alert patient. I have a chronic disease if something happens to me call this phone number.”
That took a toll on me mentally and physically. For the first year of my life I didn’t understand why it was happening to me, what did I do wrong, can I fix this, can I reverse it? All these questions were going through my head. I listened to the advice of the doctors and the doctors basically said, “Listen, the only way to do this is to eat a low carbohydrate diet because your blood glucose is going to fluctuate depending on how many grams of carbohydrate you eat per day. Think about it this way, think about as though you’re almost allergic to carbohydrate-rich foods now.”
That goes for bread, cereals, pasta, cookies, crackers, waffles things like that. Also for fruits and potatoes and starchy vegetables and whole grains.” They’re like, “Try to minimize all those foods and try to eat more meat, cheese, chicken, fish, oil, you name it.” I was like, “Great. I can do that, that doesn’t sound hard.” I tried doing that for the first year and it was supposed to make my glucose more controllable, it did the opposite. My glucose was all over the place. On any given day my blood glucose would fluctuate between 40 and 340, it’s just like back and forth, back and forth.
After about a year, I decided that there’s got to be a better way. I started doing some research and I just happened to come across this idea of eating a plant-based diet. I didn’t ask for it, I didn’t want to eat a plant-based diet, it was just like the universe presented it for me. I said okay, great let me learning something about this. Under the supervision of the same guy that taught Robby, his name is Dr. Doug Graham. He taught how to transition to a high carbohydrate, low-fat diet.
In the process of doing that, my glucose instantly, I kid you not, within 24 hours of starting to eat this way, my blood glucose became much more controllable, it was much more stable, my insulin use fell by 10% then 15% then 30%. By one week I had cut my insulin use by 40%. I had more energy, I was not cramping anymore, I was able to return playing sports and playing sports hard just like the way I liked to do it. I was like, “What is going on here? This is fascinating, I want to learn more.”
I put myself back to graduate school, I went and got a PhD in nutrition biochemistry so that I could understand the nitty-gritty details of what’s actually happening inside of my liver, my pancreas, my muscle, my brain because I wanted to understand–
Ari Whitten: You started the degree in nutrition biochemistry after you had already gone vegan and started fixing your diabetes?
Cyrus Khambatta: That’s exactly right. I decide to do it that way because I was so fascinated by what was happening to me that I wanted to basically understand, I literally went there with one question, which was I’m a freak of nature? I’ve never heard of anybody that’s gone through this transition before. If it was applicable to the general population, then how come nobody’s told me about it before. This seems weird that I would just be learning because I had to, right?
In this process, as I started learning more just like Robby was saying, I started to uncover this whole body of research about diabetes, insulin resistance, insulin sensitivity. This whole body of research is unbelievably expansive. It goes back to the 1920s, almost 100 hundred years at this point. As I read more and more and more, it was literally like I was reading the science of what I had personally experienced. That was very exciting to me. In the same way that you get lost in research and you sit there and you read and read to get to the truth, I was doing the same thing.
Over the course of five years, I got to a point where I started to understand the research basis of insulin sensitivity and how to actually manipulate your glucose to your advantage using a very specific dietary pattern. Here we are now trying to take that complex scientific information and translate it for people that don’t know how to read science or don’t care. We’re trying to bring it to the masses to teach people that, yes if you live with type 1 diabetes sure you can experience what Robby and I have experienced.
It’s also applicable to you if you’re living with prediabetes or type 2 diabetes. Oh, and by the way, it’s also applicable to you if you don’t even have diabetes. That’s where I think the true magic of this message really lies.
Ari Whitten: Got you. First of all very intense personal stories guys, I want to segue into the last bit that you mentioned there which is type 1 versus type 2 diabetes. These are obviously totally different conditions with different sets of causal factors.
Cyrus Khambatta: Correct.
Ari Whitten: Yet in your approach, you’re using this particular approach for both type 1 and type 2 diabetes.
Cyrus Khambatta: That’s right.
The differences between type 1 and type 2 diabetes and the most common causes
Ari Whitten: Maybe you can first explain for people who don’t really understand all the nuances, what’s the difference between type 1 and type 2 diabetes are in terms of the mechanism as well as the causal factors. Then why it is that you feel your approach works equally well for both?
Cyrus Khambatta: For sure. The simplest way to think about it is that type 1 diabetes is usually referred to as juvenile-onset diabetes, that’s the classical way that people refer to it. That’s no longer necessarily true because people are now getting type 1 diabetes over the course of time 30s, 40s, 50s and beyond. Type 1 diabetes at its root is an auto-immune condition. What that means is that your own immune system has been coaxed and tricked into believing that specific proteins on the outside of your beta cells in your pancreas are a threat to you.
As a result of that, your immune system then goes and it attacks those cells and it kills those cells thus crippling your ability to manufacture insulin.
The reason that your immune system got tricked in the first place, nobody really knows the answer to that. There’s many different things that could be tricking your immune system. It has to deal with very specific types of protein and the foods that you’re eating, the quality of the food that you eat, whether you’re susceptible to certain types of viruses and the list goes on.
The idea here is that type 1 diabetes at its root is an auto-immune condition where your immune system is actually the one that’s crippling your ability to secrete insulin. When it comes to type 2 diabetes, type 2 diabetes is the type of diabetes that is generally thought of as what happens later in life in your 40s, 50s, and 60s and usually happens to people who are overweight.
Now, type 2 diabetes is a lifestyle condition. It’s a condition that you literally eat and live your weight into. Some people have a very strong genetic predisposition towards type 2 diabetes but the overwhelming majority of people are eating a diet that is actually high in fat, with excess calories especially high unsaturated fat and they likely don’t exercise and they may be slightly overweight.
As a result of living with that lifestyle that then leads to a whole collection of metabolic issues, this thing called insulin resistance begins to develop. Insulin resistance is basically the precursor condition that then progresses to pre-diabetes and then progresses to type 2 diabetes. Insulin resistance, you can think of it as being a condition that’s caused by a diet that is high in saturated fat. Those saturated fat molecules, what they end up doing is they end up going into your adipose tissue, your fat tissue which is stored of where your body but it also goes directly into your muscle and directly into your liver.
Over the cause of time as your muscle and liver accumulate saturated fat beyond their storage capabilities, then they institute this process known as insulin resistance to try and block more energy from coming into the tissue. It’s almost like you’ve eaten yourself into a state of very high energy over nutrition and the tissues are now basically saying, “Hold on, let’s try and block more energy from coming in.” The easiest way to block energy from coming into a tissue is to tell insulin to go away.
They create the state of insulin resistance which basically means that when you eat anything that’s carbohydrate-rich like a banana or a bowl of Quinoa after you’ve developed insulin resistance, then the glucose from that food tries to get inside of the muscles and tries to get inside of the liver. Insulin knocks on the door and says, “Hey, knock-knock I got this glucose molecule, would you like to take it up?” Those of those tissues respond by saying, “No, I don’t have the space for this right now. There’s all this saturated fat that has accumulated inside of me. I’ve got to get rid of this stuff first.”
As a result of that, people who develop insulin resistance end up with a large amount of lipid inside of their blood. They end up with high circulating triglycerides, sometimes higher cholesterol values and then they also end up with insulin and glucose that’s trapped inside of their blood. As a result of this, their blood glucose begins to rise over the cause of time and that happens over months to years, they end developing this thing called type 2 diabetes. Which can get to a point where your glucose is so elevated that you have to make some severe lifestyle changes in order to reverse yourself back to a non-diabetic state.
Ari Whitten: Got you. This presentation that you just gave as far as the causal factors and mechanism behind type 2 diabetes is very different than what most people would expect to hear from a lot of the low carb and keto diet authors and advocates that are out there right now. Their narrative very much focuses on diabetes being a disease of high blood sugar caused by carbohydrate. Your narrative or your presentation here is about focusing on this intracellular triglyceride, intracellular fat that’s there-
Cyrus Khambatta: Exactly, right.
Why the Mastering Diabetes is different from other programs
Ari Whitten: -as the causal factor. How do we square these two things? These are two, I would say, pretty diametrically opposed narratives on what the causal factor of type 2 diabetes is, or the main primary causal factor and thus the main way of treating it obviously, from that paradigm differs dramatically between your approach and their approach. Why do you think you are right and they are wrong?
Cyrus Khambatta: Somebody’s done their homework, this is a phenomenal question. This is the thing that’s the most confusing in our world today.
Robby Barbaro: First off, before Cyrus goes into this, I just want to say, we don’t think this– it’s not right or wrong, okay? It’s like, we have a lot of respect for all these people you’re talking about. We have a lot of friends who do a complete opposite approach to us, that’s their choice. That’s what they want, that’s their lifestyle. It’s not really like, “Hey, we’re right, you’re wrong.” It’s just “Here’s the information, here is science.”
Ari Whitten: Those are my words, right and wrong. I’m just trying to start trouble and drama.
Robby Barbaro: Yes, yes, for sure, for sure. I just want to let you know where we’re coming from.
Cyrus Khambatta: Robby’s wrong, I’m right.
In order to fully really wrap your head around, how is it that these two guys are telling me that a low-fat diet is actually the solution to insulin resistance versus the other side which is telling me that a diet that’s low in sugar or low in carbohydrates is actually the solution. The first question that I would ask would be this if we’re going to talk about reversing diabetes and reversing insulin resistance, we got to ask ourselves, what does that mean?
How would you know that you have reversed diabetes, type 2 diabetes or reversed insulin resistance complete? It’s a tough question to answer because if I were to go ask people on a low carbohydrate side of things, they might give me one answer. If I would ask you on the low-fat side of things that might give me a slightly different answer.
Ari Whitten: What answer would you get from just a run-of-the-mill endocrinologist who treats diabetes who is not an advocate of any particular diet?
Cyrus Khambatta: That’s a great question. I think what they would say is they would say, “In order to reverse type 2 diabetes, you have to drop your A1C value, your A1C is just a blood test that you can get that gives you a general indicator of your average blood glucose. They would say, “We got to get your A1C value to less than 5.7%.” If your A1C value is less than 5.7% then that means that you’re living free of any form of diabetes. You don’t have pre-diabetes, you don’t have type 2 diabetes, and you’re in the safe zone, problem solved. In addition to that, they would likely say, “We got to get your fasting blood glucose to under 100.”
If you do the two of those things and you’re able to maintain that over time then technically, you have “reversed type 2 diabetes.” Now, if you ask people on the low carbohydrate side of things, what does it mean to reverse prediabetes insulin resistance? They might tell you something very similar. They would say, “Get your A1C value to less than 5.7%. Get your fasting blood glucose to less than a hundred. They might also tell you to get your fasting insulin to something less than five.” There’s a different set of units associated with that. Okay?
Ari Whitten: What’s wrong with that? I assume that you prefer a different definition so what’s wrong with that way of defining reversing diabetes?
Cyrus Khambatta: The thing that’s missing in this equation is that both of those indicators are a very good metrics of what’s happening to your overall health but they don’t take into consideration what is happening when you eat a meal. If I’m going to do anything, if I’m going to measure anything about you in the fasted state, effectively, what I’m measuring is what’s happening to your body as a result of not eating food for something like 8 to 12 hours.
I can measure anything in the fasted state and I would get a good indicator of, let’s say, “What’s your testosterone level after 8 to 12 hours of fasting? What’s your insulin level? What’s your hemoglobin level, you name it? There’s a certain utility to understanding what’s happening in the fasting state. There’s also a certain utility to understanding what’s happening in the post-meal state, or the postprandial state.
The post-meal state is something that’s not captured by an A1C value, it’s not captured by fasting insulin value. It’s not captured by a fasting blood glucose value. What I would say if you’re going to say, “Hey, how do you reverse type 2 diabetes?” I would say, “Yes, I want your A1C value to be less than 5.7, just like everyone else. I want your fasting blood glucose to be less than 100 but I also want you to be able to eat a carbohydrate-rich meal and have your blood glucose not deviate beyond about 130 or 140 and then come right back down within a two-hour window.”
If you’re in a low carbohydrate setting or you’re in a ketogenic setting, what a lot of these individuals and what all these health professionals have experienced is that as soon as they adopt a low carbohydrate or ketogenic diet, then all of a sudden, their blood glucose flatlines, their A1C falls and they get the most stable blood glucose they’ve ever had in their entire life. They started with an A1C of let’s say, 7.4%, then it drops to 6.6 to 6.2 and then before they know it, now they have an A1C of 5.1%.
They say to themselves, “Look at that I solved diabetes, I don’t have diabetes anymore.” The problem is that if they were to eat a carbohydrate-rich meal, I’m not talking cookies and crackers and chips, I’m talking a banana, a bowl of rice, some beans or lentils. They have one single meal that’s carbohydrate-rich and then they measured their blood glucose and monitored what happened over the course of the next two hours, they would likely find that their blood glucose goes up and it goes up real high, it goes of 160, 180, 200, 220, 240 and then it might come back down within a three to four-hour window.
Again, what they’ve done is they’ve optimized their blood glucose control in the fasting state and they’ve optimized their blood glucose control when carbohydrates are not present but they have not optimized their blood glucose control in the fed state when carbohydrates are present. The real crux of this matter really boils down to what we like to educate people to do is to eat a diet and live a lifestyle that turns your liver and your muscle tissue into carbohydrate processing machines.
That’s a simple way to think about it. If you live a certain lifestyle with a combination of diet, with exercise, maybe with some intermittent fasting that enables you to be able to eat large quantities of carbohydrate energy without a significant blood glucose elevation, then what that means is that your muscle and liver are sensitive to insulin and are able to dispose off large quantities of carbohydrate and use that for energy. If you’re only able to do that in the fasting state but you’re not able to do it in the fed state, then you’re solving half of the problem but missing the other half of the problem.
Ari Whitten: What if they are able to do it in the fed state by sticking to let’s say a low carb ketogenic diet? They say I am able to maintain my postprandial, post-meal blood sugar levels if I just keep on avoiding carbohydrates, why do you think that’s not a good way of thinking about it?
Cyrus Khambatta: Again, that’s exactly what they do say and the answer again is if you vilify all carbohydrate energy and say anything that contains carbohydrate is bad for me, it’s going to trigger a high blood glucose value. It’s going to make me fat, it’s going to make me overweight, it’s going to increase my risk for chronic disease, then that’s one philosophy. The truth is that we know from over a hundred years of scientific research and maybe even more than that, that carbohydrate as a type of energy, a specific compound of molecules or a class of compounds is not dangerous for your brain, your liver, your kidney, you name it.
Carbohydrates are required for energy. They’re a type of compound that actually metabolize to glucose and the glucose is transported all throughout your body to be used for energy by your brain, by your muscles, by your liver. It is important to be able to metabolize carbohydrates when they are present in your food. There goes [unintelligible] It’s very important to be able to metabolize carbohydrates when they are present in your food. If you eat a diet where you’re avoiding carbohydrate energy, sure, just like you said, you can control your blood glucose with precision. Again, you’re doing it in the fed state but you’re doing it where carbohydrates are minimized and or you eliminate it altogether.
Again, actually, when you eat a low carbohydrate diet, you actually eat yourself into increasing insulin resistance and this is the key here. You may be able to maintain a low A1C and a flatline blood glucose and you may be excited about that result but in the long term, as you eat yourself into more insulin resistance, your risk for other chronic diseases begins to increase over the course of time.
There’s plenty of research to show that people who live with more insulin resistance are at a higher risk for hypertension. They’re the higher risk for cognitive decline. Alzheimer’s disease and dementia. They’re at a higher risk for autoimmune diseases. They’re at a higher risk for cardiovascular disease, coronary artery disease, kidney failure, liver disease- [crosstalk]
Ari Whitten: Aren’t those metrics based largely on fasting blood sugar and hemoglobin A1c as far as how they’re assessing and defining insulin resistance. They’re not doing it based on your metric that you presented as far as postprandial, basically carb tolerance and how somebody processes carbs after a meal, they’re doing it mainly based on fasting blood glucose, and hemoglobin A1c. I’m just saying from the perspective of Keto advocates, of which I’m not one to be clear, I’ve had people who are low carb Keto advocates on this show that I’ve challenged a lot and given a lot of guff to.
I tend to be somewhere in the middle on the dietary spectrum, so now I’m interviewing you guys who are vegan low-fat advocates. I’m trying to bring in the best arguments from that other side for the sake of discussion and debate, but I think they would argue that basically they are– Their study is showing, for example, that if you adopt a keto diet, you can effectively lower fasting blood glucose and hemoglobin A1c, as you mentioned. I think they would argue, “Well, we are effectively lowering those risk factors for those diseases that you mentioned.” Correct me if I’m wrong, but I don’t think that there’s a lot of literature specifically showing that post-meal carb tolerance is a good predictor of disease risk.
Cyrus Khambatta: You bring up a good point. I see where you’re coming with this. The question is, just like you’re saying, is there research that shows that a post-meal decrease in glucose tolerance is associated with increased chronic disease risk, and I believe the answer is yes. I’m not just saying that to toot my own horn here or anything, I can go and dig up the actual papers, but there’s a whole body of research that actually classifies what happens– Sorry, go ahead.
Why carbohydrate rich meals may help reversing insulin resistance
Ari Whitten: No, I just want to jump in. When you frame it like that, I agree with you, there probably is research like that, but I guess I’m trying to draw a distinction between assessing insulin resistance that way versus hemoglobin A1c and fasting blood glucose. I think in the majority of people with post-meal carb intolerance who have very, very elevated blood sugar after a carb-rich meal, in general, I think the vast majority of those people also have very high fasting blood glucose and hemoglobin A1c. I guess what I’m saying is post-meal carbon intolerance in the absence of elevated hemoglobin A1c and fasting blood glucose, a good predictor of long term disease risk.
Cyrus Khambatta: My response to that would be, I don’t think there’s a sufficient amount of long term data to answer that question. There’s a certain amount of inference which has to happen in this thought process. Because, like we said earlier we know that insulin resistance is correlated with increasing chronic disease risk, but yet on the other side, we know that lowering your A1c value and lowering your fasting blood glucose is correlated with improved chronic disease risk or decrease chronic disease risk. The ketogenic diet or this low carbohydrate diet is just somewhere in the middle because they’re elevating insulin resistance, but they’re decreasing A1c and fasting glucose, so you’re like, “Well, what would happen to those people?”
The truth is that when it comes to ketogenic diets and low carbohydrate diets, very low carbohydrate diets, there’s a strong paucity of research of what happens to people over the course of two, three, four, five years and beyond. Until that body of research starts to surface, we’re not going to be able to answer the question about what happens to somebody who’s just strictly avoiding carbohydrate energy and maintaining a good A1c and fasting blood glucose.
From a whole collection of research that we do know about what happens to people who accumulate excess fatty acids and triglyceride inside of their liver and inside of their muscle over the course of time, that are classically insulin resistant, there’s a body of research that actually shows that form of insulin resistance, that it’s associated with or correlated with increasing intramuscular triglyceride and increasing liver triglyceride values, those people are at risk for many chronic diseases including fatty liver disease, including chronic kidney disease, and including coronary artery disease.
What our message is to people is that, yes, you might be able to get a good A1c value, you might be able to get a really good fasting blood glucose value and post-meal blood glucose value in the absence of carbohydrate-rich foods, but that’s a very tunnel vision approach. Because what you’re doing is you’re basically saying, “Okay, as long as I can keep my blood glucose within this very narrow band, then everything’s okay.”
The question really becomes, if you’re eating a very high-fat diet, especially if it’s high saturated fat from a significant amount of animal products over the course of time, even if your blood glucose is controlled very well, does that mean that you’re at low risk for all chronic disease? We would argue, “The answer is no”, and the opposite side would probably argue that, “Yes, the answer is yes. Likely to be yes.” Even though neither side necessarily has a large body of research to go off of. Does that make sense?
Ari Whitten: Yes, it does. There’s not a…
Robby Barbaro: The one thing that I would really like to add here is this key distinction between the results that can be achieved on the low carbohydrate approach, which Cyrus just went over, and then this belief and just unknown fact that the exact same results, if not better, can be achieved by eating large amounts of carbohydrate-rich foods, including fruits, starchy vegetables, beans, and intact whole grains, those four categories. There’s this large group of people who genuinely believe, “If you eat more fruit, you eat more quinoa, my insulin levels are going to go up and my blood glucose levels are going to go up.”
Our message to the world and what we’re talking about in our summit, which you are a part of sharing and raising information is to just let people know, no, that’s actually not true.
There’s research, again this goes back to the 1920s, but there’s just this massive library of research showing people eating very high carbohydrate diets and seeing the insulin levels drop and their fasting glucose levels drop in journals. New England Journal of Medicine 1971, Dr. Brunsell fed people a liquid sugar diet, literally sugar water with protein powder, 85% carbohydrate, 15% protein powder, and he saw that their fasting blood glucose and fasting insulin levels dropped compared with a controlled diet.
Again, that’s processed food. When you actually do whole food you get better results. Like Cyrus was saying, the concern we have is that people are eating themselves into a state of insulin resistance. There’s really no question about that. The only question is physiological insulin resistance, and if the low carb or ketogenic people stopped doing a low-fat diet, started adding in some carbohydrate, then they could go and show that they’re actually decently insulin sensitive, but there’s no questions asked. Nobody’s going to argue with this if you look at the research. Which of the two approaches is going to result in maximum insulin sensitivity? It’s going to be the low-fat plant-based wholefood approach? No questions asked.
Ari Whitten: There are a lot of people out there in the general public who are certainly not under that impression. I think the low carb movement that has been going on for, I don’t know, probably 15 years at this point, something like that has successfully basically promoted the idea to the general public that it wasn’t fat that made us fat. The whole low-fat movement got it all wrong, and in fact, it’s carbs that caused the obesity epidemic or the problem with diabetes. Really, we need to be just avoiding carbohydrate.
I know you just alluded to it there but can you speak to– basically the narrative that you guys are presenting is diametrically opposed to the commonly held belief in the general public right now. Why do you think this whole thing is just a bunch of misinformation and they’ve gotten it wrong?
Robby Barbaro: Let me start with that first claim there. Then this is repeated over and over and over again in the low carbohydrate community, and we’re just trying to share facts just talk about the facts here. They say America tried a low-fat diet in the ’70s and ’80s. In the 1970s, Americans ate an average of 147 grams of fat per day. In 1980, it was 162 grams. In 1990, it was 167 grams. In 2000, it was 191 grams. In 2010, it was 190 grams. America never went on a low-fat diet, so yes, by percentage of calories, there was a very small drop, a couple of percentage points, but in total fat, no, it’s because we ate more calories, more garbage.
The diet that we’re advocating, the Master Diabetes method, we’re telling people to have no more than 30 grams of total fat per day. It’s a dramatic difference.
Ari Whitten: I just want to emphasize something you said there for people who maybe didn’t quite get it. The narrative in the low-carb community is that everybody went low-fat, the whole nation adopted a low-fat diet. Then the trend in obesity still went up and up and up. We just kept getting fatter despite the low-fat trend. The distinction is yes, there were experts calling for people to adopt a lower-fat diet. As you noted the data there and I’m familiar with that data as well, the general public, there was no actual nationwide decrease in fat intake that happened.
There was no actual test of people adopting low-fat diets. As you guys have mentioned, there are a number of controlled studies where they have effectively lowered people’s dietary fat intake, they put them on low-fat diets and achieve successfully big reductions in weight and reversal of diabetes and so on.
Robby Barbaro: That’s exactly right. The same mistake is still continued to be made when it comes to comparing low-fat diets to low-carbohydrate diets in recent research, but the diet they’re defining as low-fat is not low-fat.
Cyrus Khambatta: This is a big deal. Go into it Robby. This is very important.
Robby Barbaro: Roughly, they’re citing research where people are fed a diet somewhere between the low 20s and high 30s, maybe 35% to 23% of calories from fat and saying that that is a low-fat diet and saying, “Well, the low-carbohydrate diet performed better.” Well, it’s because you didn’t actually look at a truly low-fat diet. It’s really that simple.
Ari Whitten: I know you’ve alluded to it a bit, but what do you see as the best research that has proven the idea that low-fat diets and I don’t know to what extent you want to say low-fat, vegan diets or just low-fat diets, effective in reversing insulin resistance and diabetes and what evidence has led you guys to the conclusion that those diets are superior to low-carb and keto diets?
Cyrus Khambatta: One of Robby’s and I’s favorite studies actually happened in 1979. This is a study that happened at Montreal University by a guy named James W. Anderson. What James W. Anderson and his colleagues decided to do was, over the course of time, there had been previous researchers who had shown that they could improve insulin sensitivity by transitioning people to a lower-fat diet. In those studies that started in the 1920s and ’30s and ’50s, the individuals in those studies also lost weight.
The critics, they said, “Okay, cool. This is interesting, but not that interesting because there’s a couple of things that are changing. We’re changing their diet, and they’re losing weight. We don’t really know if they’re increasing insulin sensitivity due to weight loss or due to a reduced-fat diet.” James W. Anderson came around. He said, “Okay, cool. Me and my colleague, Colleen Ward, we’re going to figure this out.”
The two of them created a study in which they took 30 people living with insulin-dependent diabetes regardless of whether they were type 1 or type 2, they basically took– I say, correct me if I’m wrong, Robby, these were people with type 2 insulin-dependent diabetes.
Robby Barbaro: It’s correct.
Cyrus Khambatta: They were living with type 2 diabetes, but they had begun injecting insulin in order to keep their blood glucose control. What they did in the study was they said, “Listen, we’re going to feed you a low-fat plant-based whole food diet, but we’re going to do it whereby you’re not allowed to lose a single pound of weight. If you lose weight, we’re just going to feed you more and keep you very weight-stable. Now, I want to see what’s happening to your insulin sensitivity and your insulin requirements independent of weight loss.”
Robby Barbaro: Just to add to that, their fasting blood glucose was all above 200 for every single one of them, and they were on a weight-maintaining control diet for seven days, 37% of calories from fat and then they put them on this low-fat diet which was 9% of calories from fat for 16 days.
Ari Whitten: I just want to add one thing that’s just been alluded to a couple of times through the interview, but I want to point out that there are a number of people who argue, a number of experts in the field who would argue that the primary cause of type 2 diabetes is actually excess body fat gain. The actual excess fat mass itself is the primary cause of the insulin resistance in type 2 diabetes.
This kind of experiment that you’re talking about where they’re intentionally preventing you from losing body fat, so that they can control for that confounding variable, which we know basically, essentially every type of diet that causes weight loss from any, just pure fasting interventions to the entire spectrum of different dietary interventions. If you cause a significant amount of weight loss, basically, you can reverse insulin resistance in type 2 diabetes. The study, I just want to point out to listeners, the study that you’re citing, they’re controlling for that confounding variable, keeping them weight stable and then assessing how much effect can we have on insulin sensitivity in the absence of weight loss.
Cyrus Khambatta: That is exactly right. Robby, you read the results of the study because you have the slides pulled up in front of you. I think this is one of the most fascinating results I’ve ever seen before.
Robby Barbaro: In 16 days, 10 of 20 people stopped using insulin, every single person reduced their insulin requirements, no exception, fasting and post-meal blood glucose levels decreased and there was also a 29% drop in cholesterol, and this was in 16 days.
Cyrus Khambatta: Here’s the crux of the argument. You take people living with type 2 diabetes, who are injecting insulin to control their blood glucose. You transition them to a diet you prevent against weight loss. Now, these individuals have been injecting insulin for, I believe, at least a year, in order to get into the study. Some had been injecting insulin for many years. They’re injecting insulin to control their blood glucose. You transition them to a diet that’s low in fat and their insulin requirements fall and some of them get off of insulin entirely in just over two weeks.
Ari Whitten: Wow.
Cyrus Khambatta: That’s a big deal.
Ari Whitten: Yes.
Robby Barbaro: This is just scratching the surface. It’s study after study after study where we want to look at Walter Kempner’s work, feeding people white rice, fruit, fruit juice, and sugar and seeing people’s fasting blood glucose go down, insulin levels drop, cholesterol drop, weight drop. This is even with refined carbohydrate. The point the research drives home is that what is being said in the low-carbohydrate community that, “No, no, no. These foods, they make your fasting blood glucose higher, they make you secrete more insulin,” is factually false, just patently false.
Also, our passion for this topic just gets so much more juice [unintelligible] the fact that every single day, every meal, we’re injecting insulin in our own body and observing how much insulin is required to process hundreds and hundreds of grams of carbohydrate. What we’re experiencing in our own body should be absolutely impossible according to what’s being taught in mainstream media.
It’s not just us, it’s thousands of clients, hundreds of type 1’s by this point. We have people come to our in-person retreats. I am not exaggerating when I say I have never seen a single exception of a person living with type 1 diabetes, who begins to increase their carbohydrate content and simultaneously decrease their fat intake and not see a dramatic improvement in insulin sensitivity, hands down, every single time.
Even if you want to get technical and argue, “Well, you’ve increased their fiber consumption and you increased their fructose consumption.” Even if you just calculate glucose. You use software like Chronometer and you can figure out exactly how many grams of glucose are in your diet. You will objectively see as a person living with insulin- dependent diabetes, more carbohydrate, less fat, all this glucose, your insulin sensitivity improves, your glucose tolerance improves. Going back to some of your earlier points. There is no long-lived group of people.
There’s no long-term society that has ever chosen to live in a glucose-intolerant state where they actually specifically had to avoid carbohydrate-rich food to maintain their blood glucose levels. That does not exist, but the long-term societies do exist. They ate predominantly plants, plenty of glucose was in their diet, and they were glucose tolerant. There was different percentage of calories from fat, but none of them were completely trying to avoid this food group.
What Robby and Cyrus typically eat to balance insulin levels
Ari Whitten: One other question I have, you need to get really practical is, what exactly is it as far as the specific dietary pattern that you guys recommend? Actually to get even more practical, maybe you guys can talk about what you’ve eaten so far today or yesterday.
Cyrus Khambatta: For sure. We put these into a pretty simple green light, yellow light, red light traffic light system. In the green light category, we advocate eating fruits of any shape, color, size, starchy vegetables that come from the ground like potatoes, yams, corn, sweet potatoes, we put corn in that category even though it’s technically a grain. Then we’re also talking about– Sorry, fruits, starchy vegetables, whole grains, and then legumes like beans, peas, and lentils.
Then in addition to that, we have non-starchy vegetables and green leafy vegetables as well, as well as mushrooms. The idea is that those are carbohydrate-rich foods that are minimally processed or requires zero processing, they’re in the green light category. The yellow light category tends to have things like nuts, seeds, avocados, coconuts. These are higher fat plant-based foods that we absolutely say, “You can eat these foods, no question,” but we’re just trying to educate people that a little bit goes a long way.
“If you’re going to put them into your diet, it’s totally fine, but just try not to overeat on them because if you do, then you can trigger your blood glucose to start increasing over time.” Then in the red-light category, we have, mainly animal-based products because again, the research shows that people who eat more animal-based foods are at a higher risk for developing insulin resistance in type 2 diabetes and they tend to be slightly higher in fat, which actually causes blood glucose elevations in the postprandial state.
Red meat, white meat, fish, chicken, we put olive oil into this category, coconut oil as well because these are pure fats. Then we put eggs and dairy products in that category as well. To answer the question, Robby, what did you eat today, [unintelligible]?
Robby Barbaro: Yes, absolutely. I love this game. I’m very diligent about entering my food intake into an app called Chronometer. I can calculate the carbohydrate content very diligently. I can figure out how much insulin to dose. That’s why I put food into a nutrition app. I wouldn’t encourage people to do that if they don’t have to use insulin. Just eat food and enjoy. This morning, I had papayas, bananas, lettuce and arugula. That was my breakfast. This meal was 123 grams of carbohydrate, which is actually a lower amount. Usually, it’s a little bit higher. That’s breakfast. Lunch, I had cherimoya, I had white sapote, and I had arugula, that was my lunch.
Ari Whitten: What was the last thing?
Robby Barbaro: Arugula.
Ari Whitten: Arugula, okay. I thought you said Uruvu. I was like–
Ari Whitten: Some kind of exotic fruit I’ve never heard of.
Robby Barbaro: If anybody is curious to see this stuff and really look into the data, on my Instagram story, every day, I’m taking pictures of what I eat. I’ve saved several days in my highlight, so people can see exactly what I’m eating, exactly how much insulin I’m injecting, and my blood glucose levels. I have the CGM data. You can see the average blood glucose throughout the day. You can see my time in range. It is a specific metric for people living with type 1 diabetes. My numbers are far better than what people could ever imagine possible.
The average type 1, their time in range is maybe somewhere between 50% and 70%. I spend 90% of my time in range, and I use a physiologically normal amount of insulin. Somewhere between 25 and 50 units of insulin is what my pancreas would secrete if I did not have damaged beta cells. As a person living with type 1 diabetes, you want to find a way to live a lifestyle to eat a diet and move your body in a way where you’re only injecting what your pancreas would have normally physiologically produced. I’m doing that eating 600 g to 700 g to 800 g of total carbohydrate per day. It shouldn’t work out, it shouldn’t make sense, but when you go and look at the research, you understand why it actually works out.
Ari Whitten: Did you say what you had for dinner as well?
Robby Barbaro: I haven’t eaten dinner yet.
Ari Whitten: Yesterday.
Robby Barbaro: Oh yesterday. Let’s see. Yesterday, dinner was lettuce, pomegranate, mangoes, carrots, and red bell pepper.
Ari Whitten: It’s basically pure fruits and vegetables. No even nuts and seeds. Obviously, you guys have thought a lot about diet, but I’m wondering to what extent you’re worried about a protein deficiency. What extent you’re worried about B12 deficiency which I’m under the impression something like 90% of vegans are deficient in B12. Zinc deficiency, DHA, EPA, things like that. To what extent are you worried about those issues? I assume you’re not worried about them, but what’s the rationale for why you’re not worried about them?
Robby Barbaro: It’s a fantastic question. First off, I choose to eat a much more simpler diet than we’re actually recommending as the mastering diabetes method. It’s a lot broader. Let’s start there. Number two, B12 deficiency is a problem no matter what diet people are following. We do recommend that everybody takes a B12 supplement. Zinc, iodine, some of those, those are nutrients of concern. We would definitely tell people to pay attention to them. Pay attention. Again, no matter what your diet is, there could be some issues there. Especially if you take out salt, you don’t have any algae anymore, there’s things to pay attention there.
A key thing here, when it comes to EPA and DHA, this is something we covered really in detail in our book. The biggest problem there is people say, “You follow a vegan diet, you can’t do the conversion.” The biggest issue is that people are eating too many Omega-6 fats. It’s the same enzyme, delta-6 desaturase that’s doing the conversion of both the Omega-3 side and the Omega-6 side. When you have too many Omega-6’s, the pathway prefers to handle that path and then the Omega-3 path is left just basically not getting the conversion that needs to happen.
Cyrus and I, again, experiment [unintelligible 00:55:06], we both have had our EPA and DHA levels tested. We are way above the norm. Cyrus, maybe you can explain the results better than I can, but we do better than people who supplement, people who eat nuts and seeds. Again, [unintelligible] we encourage people to get tested. There’s tests you can use from OmegaQuant. You can see what is your EPA and DHA level inside your cell membranes. You can decide are you going to make lifestyle changes or are you going to supplement.
Most people, their Omega-6 to Omega-3 ratio is 20:1. Certainly high. It should be 4:1 to 1:1, somewhere in that range. That’s the biggest reason why people are struggling on that front. Then they do, maybe they do add in some animal products. Maybe they do add in a supplement and symptoms go away. It’s because they did fix that nutrient deficiency. It wasn’t the diet that was the problem, that wasn’t the source of the issue. They didn’t try it another way. Again, it’s such an important issue. If you are out of whack, it might be smarter to supplement and fix your diet simultaneously. That’s a personal decision for you to make with your doctor.
Ari Whitten: How do you guys explain and I assume you’re not supplementing with Omega-3, how do you explain your personal results in terms of your own Omega-3 levels, especially given that you’re not consuming– Cyrus, I don’t know about your diet, but certainly, Robby is not consuming lots of sources of ALA, of plant-based Omega-3’s, that can be potentially converted into DHA and EPA. How do you explain those results?
Robby Barbaro: In short, when you eat the foods that I eat, I absolutely do consume enough ALA to do the conversion. I’m just looking it up in our book right now. My result was 8.28% and Cyrus’ was 7.11%. This is after–
Cyrus Khambatta: Just for context. In a general population, if you go get this OmegaQuant test, anything over 4% is considered very good. You want your Omega-3 results to be 4% or beyond. When we got these tests taken, we had no idea what we’re going to get. I was actually expecting that I was going to be low. Then Robby came in at 8.28. I came in at 7.11.
When we showed this to some of our colleagues, they were blown away because they said, “You guys don’t even eat nuts and seeds, you’re not taking an algae supplement, you’re not taking Omega-3, a fish oil supplement, you’re not taking anything that is canonically considered to be high in Omega-3’s, but yet, your Omega-3 essential fatty acid status is quite high. That’s impressive.”
Robby Barbaro: To be clear, what do we attribute that to? We wrote this explicitly in the book. We attributed to our consistent healthy ratio of Omega-6 to Omega-3 fats.
Ari Whitten: Got you.
Robby Barbaro: As simple as that.
Ari Whitten: What about proteins? Robby, I think based on this description of meals that you had, I’m guessing maybe somewhere in the neighborhood of maybe 30 grams of protein per day is what you’re getting?
Robby Barbaro: Well, it’s roughly 6% to 8% of calories coming from protein in my particular diet. Again, more than enough to meet your essential needs.
Ari Whitten: I think I’m under the impression that I don’t know the exact numbers offhand, but I’m remembering somewhere in the neighborhood of at least 45 is considered bare minimum, 45 grams and then I think it goes up to around 90. I’m sure that the specifics of the numbers are I’m getting wrong, but it’s somewhere in that neighborhood is considered bare minimum to meet nutritional sufficiency. I’m just guessing based on the description of the meals you had that you’re not hitting those numbers.
Robby Barbaro: Based on a Chronometer, I am hitting the essential requirements. It’s 40 grams. The other day, it was 41. Let’s see, we have another day with 77, I ate way more calories. Another day, it was 69.7.
Ari Whitten: What is the rationale for protein restriction? You gave some rationale for avoidance of animal foods, but why not consume some more plant foods that are richer in protein, even things like let’s say Spirulina or lentils or nuts and seeds or even plant-based protein powders, what would be the rationale for avoidance of those?
Cyrus Khambatta: Like Robby was saying in his particular situation, he chooses to eat a diet that’s literally strictly fruits and vegetables and that’s it. Fruits, vegetables, leafy greens, maybe some mushrooms, that’s it. That’s a personal choice on his end. What we advocate is not actually to become that narrow in your dietary habits. We recommend people eating fruits, vegetables, starchy vegetables, legumes just like you said, beans, peas, lentils and then whole grains as well.
I used to eat similar to Robby, but over the course of time, I’ve diversified my food intake. Now, I eat on a daily basis. I eat legumes. I eat chickpeas. I eat black beans. I’m also eating things like quinoa. I’m eating rice. As a result of that, it’s easier for me now to intake more protein than it is for Robby. Robby is hovering around 6%, 7%. If you do the calculation, he’s actually getting about 0.6 grams per kilogram body weight, which is actually not in a protein deficient state by any stretch of the imagination.
Again, when you’re eating things that are a little bit more protein-rich, even if you have nuts and seeds you throw in there with legumes especially, your protein intake can go up and it can go up dramatically.
On a daily basis, my protein intake tends to be a little bit higher than Robby’s just because I choose to eat those foods. I’m hovering somewhere between 75 and 100 grams per day. We have people that we know of, people in our coaching program who are eating excess of 100 grams of protein per day, but just like you said, they’re coming mainly from a plant-based world. Full disclosure, I also take a Hemp protein powder supplement. I’m fully open with the fact that I use this. Do we recommend everybody–
Ari Whitten: You say it like it’s such a horrible thing to consume it.
Cyrus Khambatta: No, the reason I say it that way actually is because in the plant-based world, I’ll be totally honest with you, there’s a stigma about using protein powders.
Ari Whitten: Yes, I’m aware of that. I personally find it to be extremely irrational and not very grounded in evidence.
Cyrus Khambatta: Sure, okay. There’s some people who advocate that getting concentrated forms of protein, even if they come from plant-based sources, can become inflammatory, which again, unlike you, I haven’t seen the data to back that up. Then also there’s other people that are saying that the protein powders tend to actually have heavy metals inside of them and they’re not disclosed on the labels and it’s hard to know but if you actually test them in a laboratory, then a lot of them test positive for heavy metals.
Regardless of whether either one of those is true, the fact of the matter is I use a protein powder supplement, it works, it keeps me feeling fantastic, it keeps me recovering really quickly from exercise [crosstalk]
Ari Whitten: For clarity, because I personally have no problem with protein powder supplements, provided you’re using a good quality supplement, I don’t sell protein powder myself, so I don’t really have any vested interest here, but just to point out the heavy metals issue, a number of them have been tested and we have an idea of which ones are higher or lower. Also, I think people don’t realize a lot of times in those discussions that many sources of plain produce, you can find traces of heavy metals there as well.
We can’t be irrational about how we assess heavy metals, hold on to the narrative where only seafood or only protein powder are contaminated with heavy metals but nothing else is contaminated with heavy metals. It’s like, yes, there’s traces of heavy metals in pretty much everything.
Robby Barbaro: To be clear, our coaching program, we specifically created it to make sure that people’s personal preferences and personal needs are accommodated and met. Any nutritional question, “Hey, I’m concerned. I’m not getting enough protein.” “Okay, let’s help you tweak it, let’s look at the data in Chronometer, let’s see what you’re eating, let’s make sure you’re feeling really happy and that you’re getting what you think you need or what you’re looking for. Let’s make it happen.”
There’s actually a lot of flexibility within our program to make sure people are getting the results that they want and that they’re mentally really confident and happy with everything they’re putting in their body.
Ari Whitten: Yes, got it. I want to make sure that we explicitly talk about type 1 and type 2 diabetes. We’ve alluded to this a number of times, throughout the interview you guys have. Specifically, why is it that the dietary intervention that you guys are talking about is something that works equally well for type 1 diabetes which is, as you guys said, an autoimmune condition where the body is attacking the pancreas and preventing it from producing enough insulin or insulin at all.
Type 2 diabetes which is primarily lifestyle-induced insulin resistance which is some combination of lifestyle factors, accumulation of excess body fat and intracellular triglyceride and some of the other factors you’ve mentioned. Why is it that this dietary intervention applies to both of those things with two radically different sets of causes?
Cyrus Khambatta: That’s a great question actually because the reason why it’s so effective for both types of diabetes, and I’m also going to throw in gestational diabetes into the same category, is because in all situations, what a low-fat plant-based whole food diet does is it optimizes the effectiveness of insulin. Effectively what is happening is that by eating a diet that is low in fat, that is high in carbohydrate, high in micronutrients, high in fiber, by eating that particular diet, what ends up happening is that insulin becomes more effective at every site that it elicits an action.
Insulin becomes more effective inside of your muscle tissue, it becomes more effective inside of your liver, it becomes more effective inside of your brain, becomes more effective inside of your kidney, your heart, your vasculature, you name it. Because insulin becomes more effective, it is now applicable to any form of diabetes, and it is applicable to the general population at large. You, in your particular situation, like we said earlier, you’re not measuring how much insulin your pancreas is secreting on a daily basis.
To a certain extent, your insulin output is a black box to you. If we were to measure it and we were to transition you to a low-fat plant-based whole food diet, what we would likely find is that your pancreas would have to secrete less insulin. Less insulin from your current baseline and your insulin requirements would go down, even though your carbohydrate intake is going up. To a certain extent, you would be reducing your risk for the development of insulin resistance in diabetes because you’re allowing your pancreas to perform less work to metabolize carbohydrate-rich food.
You’re right in the sense that for people with pre-diabetes and type 2 diabetes, we’re addressing their lifestyle-related issues. They’ve already developed insulin resistance like we covered and now this is a good solution for them because they’re allowing their muscle and liver to become very insulin sensitive. For people with type 1 diabetes, people with type 1 diabetes don’t necessarily have insulin resistance.
What ends up happening is that they get diagnosed with type 1 diabetes first and then they start eating a low-carbohydrate diet second because that’s the canonical wisdom and that’s what the general recommendations are. They develop type 1 diabetes. Then they eat a low-carbohydrate diet which then induces an insulin-resistant state.
As a result of that, by transitioning to a low-fat plant-based whole food diet, they can then recover their insulin sensitivity and watch as their insulin requirements fall as their carbohydrate tolerance increases dramatically. Does that make sense?
Ari Whitten: It does, yes. Guys, thank you so much for this interview. Thank you for hanging around for about 15 minutes extra beyond the allotted time window, I appreciate it. This has been a blast, I’ve really enjoyed it. Thank you for playing so nice as I’ve stirred up drama between you and the low-carb community.
Cyrus Khambatta: Good, I’m glad you did.
Ari Whitten: You guys have a summit, Mastering Diabetes Summit that is coming up. Everybody can opt in for that summit. It is 100% free, you can get access to a bunch of great talks. As I mentioned, I’m one of the speakers there as well. It’s theenergyblueprint.com/masteringdiabetes. You can opt in for that. There’s a bunch of great bonuses that they have for you as well. Guys, tell us about the quick and dirty on what this summit is all about.
Cyrus Khambatta: This is the fourth year that we’re hosting this summit. We do this annually. What we do is we basically interview between 20 and 30 of what we consider to be some of the smartest people on the planet when it comes to understanding the nuances of insulin resistance in diabetes. We put together an interview series.
If you register for the summit, then every day for a nine-day period, you will be given access to three new speakers and you can watch these interviews as Robby and I conduct interviews with prominent speakers, New York Times, bestselling authors, prominent researchers. We ask them some pretty darn challenging questions about their knowledge and their experience in working with people with diabetes and in understanding the science of insulin resistance and diabetes at large.
What we’ve heard from people who have participated in these events is that it completely transforms the way that they think because it’s human nature to be presented with a new idea and that new idea becomes challenging at first in the same way that I’m sure a lot of you listeners right now are listening to this podcast and they’re thinking to themselves, “Well, if what Robby and Cyrus are saying is true, how come I haven’t heard about it before? It sounds like some made-up thing that these two guys just happen to experience, but there’s not a good solid research basis behind it.”
Then you hear it a second time and you hear it a third time and you hear it a fourth time and you hear from a different angle, you hear multiple people talking about it and they each give you access to more subtle nuanced information about this thing that we refer to as low-fat plant-based whole food nutrition.
Before you know, all of a sudden, you’re like, “Wow, there is actually much more information here than I had ever anticipated.” That’s what the whole summit is about. It’s to try and teach people using not just one source of information but multiple sources of information, multiple experts to talk about various aspects of how a plant-based diet and how achieving an optimal lifestyle can actually dramatically reduce your risk for the development of pre-diabetes and type 2 diabetes and make you living with type 1 or 1.5 diabetes feel like a million bucks.
It’s a really fun event. It’s online. It’s starting in January. It’s going to be going live on January 15th this year of 2020. We really hope that people would get an opportunity to participate and really learn a lot from these phenomenal speakers.
Ari Whitten: Awesome. Guys, really this has been a blast. Thank you so much for coming on the show. To everybody listening, again, you can go to theenergyblueprint.com/masteringdiabetes. There will be a link there to sign up for the summit for free.
Guys, thank you so much for your time, and I hope to chat with you again in the near future. The last couple of chats we’ve had have been awesome, so hopefully, we can keep doing this year after year.
Cyrus Khambatta: We appreciate it. It’s been super fun for us and thanks for having us on the show.
Robby Barbaro: Thank you so much.
Ari Whitten: My pleasure. Take care, guys.
Reversing Insulin Resistance With Low-Fat Vegan Diets? With Robby and Cyrus - Show Notes
The differences between type 1 and type 2 diabetes and the most common causes (15:00)
Why the Mastering Diabetes is different from other programs (19:55)
Why carbohydrate rich meals may help reversing insulin resistance (32:16)
What Robby and Cyrus typically eat to balance insulin levels (48:38)