Type 2 Diabetes Can Be Reversed with Low Carb Diet

Type 2 Diabetes Can Be Reversed with Low Carb Diet

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Hello but then it raises some other  questions too for example   well what is a low carb diet how did they  define it in here and I think you'll see   that they defined it fairly loosely  and once you start getting into that   I mean what's a diet is it a change in lifestyle  permanent change or is it a six-month thing   that comes up in in this article as well another  thing that comes up is very low-carb diet   because one of the things they found was the   "very low-carb diet" didn't seem to work as well now   what does that mean and why would a low carb diet  but not a very low carb diet work was the very   low carb keto and is this saying that keto doesn't  work a lot of questions on this article and I'm   very excited to cover it today I think it uh  again deals with some very critical uh indicators   some drivers of our health that people are just  either they're ignoring or they're confused about   uh we're gonna go through a few things before we  do that as usual we'll cover a few things in terms   of uh other content that we offer as usual since  uh COVID-19 is one of our major determinants of   health right now especially for our population the  baby boomers the folks that are starting to get   insulin resistant and therefore starting to become  at risk for heart attack and stroke and guess what   COVID-19 cytokine storm so we can't be  focused on baby boomer health and not   cover some coveted stuff so we've got a lot  of stuff on that but we get into things like   we're talking about today as well diet you  know the USDA just made a big failure on   the USDA guidelines yet again and why did  they do that was it because they were too   friendly with their uh the folks that were the  the industry that was uh funding them big food   big pharma okay so before we do uh get into the  uh the program again a couple of other uh comments   as before we've each new year new year is a  big time for us in terms of actual patient   care because people say new year's resolution  I'm going to finally get my health in order   and more than anything else that ends up  involving I'm going to change the way I eat   that's a big deal both in terms of  managing your health in terms of   uh new year's and we always try to help people  out calcium score now James you said that you   you joined us you came sliding in home  right at the last minute you and I were   talking about the show before it came on did  you want to make a comment about calcium score   well good morning Dr. Brewer um good show yes  you know the calcium score the reason that you   offer this help for those who are listening that  may have had a calcium score or in those that   have not and don't really understand the  funnel of sales that happens in healthcare as   listeners may know you and I have run healthcare  systems before the calcium score is a legitimate   test and it tells you of course whether you  know the condition of your arteries but it often   not always but often it's the top of a funnel  cell cycle that the health care system is getting   you in it can disturb you with the calcium score  and suggest the follow-up might be a stress test   you can speak to how often stress  tests are actually false positives   it's a significant amount of time so because  of that we need to probe a little bit deeper   and do an angioplasty and then of course  with an angioplasty it's an expensive and    somewhat risky um a procedure to go through and  then based on what they find there you may have   a sin uh put in when in fact maybe there was  a lifestyle change that that calcium score   should trigger some just a disturbing event in  your life to make some changes but would you   not say Dr. Brewer that instead of getting on that  financial cycle that funds the world of cardiology   always put your phones on sign up  before you start a YouTube channel   that's a good idea instead of funding that uh  system you might find a lifestyle change is   uh may accomplish everything that you need and so  that's the reason we're emphasizing if you have a   positive calcium score and you're disturbed good  you should be disturbed not good that you had a   it is what it was but there is an alternative that  is proven in studies is healthy alternative to   address most conditions once you have a positive  calcium score you can tell more about how we   treat that what we do for individuals to you know  once they've identified that they may be at risk   so you bring up several good points um I don't  have the statistics and I can't say for sure but   it's just an impression I think more patients come  to see us because they've had a positive calcium   score than anything else another one yesterday  and this individual was a gentleman 75 years old   and he had a positive calcium score as you began  to dig deeper he was like so many of our patients   over half he had weighed 20 30 pounds more just  about three or four years ago back in his early   70s uh at this point in time he had no he had no  um he had significant calcium but uh and obviously   some old plaque but it was all uh stable which  you're not going to see on a calcium score a lot   of people have compared my channel to um to Ivor  Cummins um until the COVID thing came up and then   Ivor and I took two different directions he became  more of the he went a different direction but   I think both of us would agree that calcium score  is very a very appropriate test I tended to use   a lot more CIMT but simply because I had a couple  of good sources I've really only found three good   sources for a reliable CIMT uh in the country  the reason I used CIMT is that it was able to   tell me like in this gentleman yesterday he didn't  have any soft plaque now here's the big issue and   and you may have thought I was about to ignore  it the big issue is going down the rest of that   wrong path if you look at what most people do  where most cardiologists take people it's okay you   got a positive calcium score most cardiologists  are still not using calcium score but when they do   let's do a stress test and guess  what uh just google it uh what 1.5   million out of the 8 million stress tests that  were done prior to the prior to COVID per year   we knew the NIH said we knew was going to  be either a false positive or false negative   well guess what whether it's a false if it's a  even if it's a false positive and we knew that   about 25 of them would be false positive you're  still going into the cath lab and guess what if   you've had those two things what's the probability  of seeing plaque and guess what if you're a hammer   everything looks like a nail if you see  plaque in there you make an assumption that   I'm going to put a stent in there and the stents  going to stop that prevent a heart attack now   10% of stents do something good they're  treating actually treating a heart attack   the other 90% of stents are put there to   "prevent a heart attack" and if you look at   uh the the studies that have been done over  the past three to five years it's really clear   stents don't prevent a heart attack over  the past year so it's also become clear   with the ISCHEMIA trial that even bypasses don't  prevent heart attack so you get into a situation   similar to what I'm sure happened  with Tim Russert he goes in he gets a   a stress test now he was on the other  side he had a "negative" stress test   so he goes home thinking you know what I know  I've gained a little bit of weight I'm up over   40 inches on my waistline now but my stress test  says I'm okay so I'm good I can breathe a sigh of   relief and continue those business breakfasts  those business lunches continue to pack it on   but I'm running so I'm go and my stress test is  okay so I'm good and we all know what happened to   Tim and if you don't know what happened three  months later he had a heart attack and died   in at his place of work so stress tests are  not a great way to go they just take you down that   path uh anything else before I uh move on James no  that's great in our newsletter for those who are   signed up for our newsletter uh you will see that  we mentioned this week uh how to use how to do a   brachial test so you may talk so you talked about  CIMTs carotid internal medial thickness test   uh but you also uh in this month's newsletter  discuss how you can uh take a blood pressure cuff   so if you want to pitch that a little  bit it's very similar to look and   see what what may be occurring using uh something  you may already have at home to run an ad hoc test   it is I have to tell you James uh oh in some  ways I've had mixed emotions about putting   that video up there because one of the things that  that's done it's been a very popular video for us   uh do-it-yourself plaque detection using um  using ABI uh ankle brachial index looking at the   the blood pressure in your  uh arm versus your ankle   with the assumption that plaque at a significant  level is going to change the the ratio there   here's the problem and I don't think I was strong  enough on talking about the problem with that a)   it doesn't rule out plaque b) uh you can  have plaque which doesn't impact this at all   and still it'd be enough plaque that  cause a heart attack or stroke and so   it was really more of a question is this  a do-it-yourself plaque detection and   again I don't think I made that case well enough  I think that's one of the things we need to   keep our eye on in terms of our own content to  get back and make that case stronger that   uh a negative you can't use it to rule  out plaque you just cannot well let me   ask you something well I know we're down  a bunny hole pardon me I'll tell you this   even though I apologize for going down bunny holes  a lot a whole lot of folks then come back and say   the bunny holes are the best part so far well  Steve Mitchum in the questions ask and this is a   good time to answer it while we're on the subject  is a cat scan with contrast as good as a CIMT so actually if you go I don't know if Gilbert is  still showing my screen there's a reason I went   to my screen prevention myths it's the book  the upcoming book that I keep promising and   uh my co-author the three of us my  co-author and my publisher and I   can't seem to get our act together the last this  past week there were problems with one of them   being in Mexico with uh being ill and the other  waiting on each other anyhow bottom line is that   this book if you have an interest in the topics  that we've just covered this book goes into detail   it starts off with that Tim Russert's story but  it goes way deep into plaque plaque is what's   uh you know it's causing the problem now there are  several different ways and it's like James started   out your typical progression is Framingham  from Framingham if you've got risk go to   statins and to the stress test well the Framingham  is based on old data and it results in way too   many people going on statins uh stress tests  we've already talked about major problem   um getting us a needle stuck into your groin in a  in a tube catheter up to your heart that's not fun   and that's got its own set of problems and then  that leads in almost inevitably to a stent which   doesn't prevent a heart attack so that's what this  book talks about it goes into the details on how   these things were developed but more importantly  and back to your question on this bunny hole what   are the ways of evaluating plaque and how should  we do it and we talk in depth about three ways   one of them is the CIMT which we just discussed  for a minute the second one is calcium score   which you just brought up and the third is what  the the question that just came up CT angiogram   a CT angiogram is um it is the up and comer  even the the a lot of the guys in the standard   medical community have already begun to embrace  CT angiogram one of the key things that the CT   angiogram does if you go back and you look at the  COURAGE studies and a couple of the studies that   compared this what they did was they said look  we're going to have the cardiologist do whatever   he or she would normally do that's usually going  to be a strip Framingham stress test all that   other stuff but in this in the study arm we're  going to have them add a CT angiogram SCOT-HEART   study was the other one the two big ones COURAGE  trial and SCOT-HEART I think uh here's what they   found that they there were actually a  few more procedures early on in the uh   the study group the CT angiogram group overall  the procedures done were the same so it wasn't   the procedures but here's what did happen and  here's why you saw more procedures early on   the CT angiogram is better than any of these  other technologies it's showing you where you've   got plaque we had a fellow that worked with us  for about a year or two about a year his name is   Gerry Kurth and he said Ford you got to look at  my CT angiogram he said I mean it was ugly but   that was perfect here's what I did with it I took  the image and I taped it to my refrigerator door   so what what that does I mean as you see  James it continues to go back to this theme   small amounts of plaque can cause this problem   uh the typical ways of looking at it  Framingham stress tests angiogram really   are not working the simpler ways are working  but they're still not leading to procedures so   much as they're leading to recognition that I have  plaque and changing the lifestyle so that's where   uh I've given you uh uh what a three three  to five minute summary of the book well uh   just remember they're all saying things that may  not prevent a heart attack do pay for Cadillacs in any other comments before we move to uh   on to the next phase we're going to try  to script skip through some of these just   to let you let make you aware though we've got  we're continuing to get uh content out on our uh   uh on on our website it's continuing to work  it's continuing to become a destination website   where people actually go and learn right and  um and I would I would emphasize right now   again another good time is we're giving away the  CVI course so you can sign up and take the CVI   course for free which will cover a lot of this so  I recommend everyone that's listening go take the   CVI course for free learn learn the baseline  of uh what we're doing at PrevMed what Ford's   model is and it's reversing it's reversing uh  disease reversing chronic disease you can reverse   this stuff you can you can you make a 180 degree  turn in your life most people can make tremendous   uh improvements and that's a great course to start  with and it's free you're making it available free   good point I pulled up the courses while you  were talking there's a reason why these are the   courses that we have they're the core curriculum  you don't need to know a whole lot more than the   plaque evaluation course the insulin resistance  course in terms of what's the root cause   and cardiovascular inflammation you know am I  in danger now or if you if you want to get all   three of them and get more of a a comprehensive  course we have the the conference proceedings   all of which are available so let me move on  and if you're one of those guys that rather   that prefers to hear on podcasts we've got plenty  of information on the podcast as well but let's   uh let's get a water ball uh Gilbert  and then we'll go into a transition actually I messed up I did have one more slide  it's our uh totally unrelated science issue   slide a quick one slide bunny hole I got  to put I got to make a comment about it   and here's my take on it uh I  have volunteered to become a   uh I'm a physician uh trained in prevention I  taught prevention I know how to give actually   when I was at Kroger in the little clinics I ended  up testifying to the FDA on methods of mass   vaccination I volunteered here at Lexington  Fayette several times to help them   give vaccines I haven't heard back I volunteered  uh for over uh at Louisville Louisville Kentucky   about an hour away what I got was I ended  up one of the calls I made was to the state   COVID line and they said yeah we really need help  we really need help but here's the number to call   got nowhere so here's my perspective state and  local governments uh and and local hospitals   tend to have huge bureaucracies and they're  you know they approach things bureaucratically   unfortunately bureaucracies are not built  for efficiency tens of millions of lives   are currently depending on their ability  to efficiently get that vaccine out there   and just one there was an article I read  recently is about Southern California   their vaccine lines aren't moving either there  are many barriers there's no part-time shift   available so the only available shift is ten  and a half hours for a doctor to volunteer   or a health care person it's really going to  be more nurses than anybody else there's a lot   more nurses available to do this than there  are docs but they only take uh 10 and a half   hour shifts so they get plenty of volunteers on  Saturday but not on Monday through Friday   there's just a huge number of bureaucratic  processes that's jamming this thing up   in LA the health website requires seven  to ten clicks before clinicians can sign up   I found the same thing here in Lexington Fayette  I had to look and look and look and I went to   multiple websites I finally found a tiny little  statement at the bottom of one of the back pages   are you a health care person  you want to volunteer to give   vaccines I did I clicked on it I filled all that  out over a week ago haven't heard from anybody   the frustration isn't only in LA two former  San Diego county medical association presidents   have been trying to volunteer as well but  they've been thwarted by a confusing array   of steps and processes too many forms county  officials failing to take them up on their offer   and some look just like Lexington Fayette failed  to take me up on my offer in some locations   doctors are to go through training and a quiz to  verify they know how to give a vaccine injection   this is keeping the vaccine from  being from getting into arms   so James I'm go unless you have any other comments  about that space I'm going to move on to the   uh to the program for today about low carb uh one  quick comment and that is uh how good last week uh   I was joining I was watching I was ill  and um and I appreciate your the good doctor   got me back healthy uh after last week's  event but last week's vaccine show with Dr.   Vigerust was extraordinarily good so anyone that  hasn't seen that show it's archived they should   go back and watch it you and Dr. Vigerust had  fantastic chemistry together great knowledge  

uh it was it was my favorite show maybe that  should tell me something about being on here maybe   more but it's a great show we covered a lot about  vaccines on that show um and a lot about the virus   so I highly recommend if you're interested in this  subject go back find that show and watch it with   Dr. Vigerust and Dr. Brewer I highly recommend it  it's a good point uh thank you very much James and   uh thanks for your humility as well glad to have  you back glad you're glad you're feeling better   one of the things that we didn't cover and we uh I  just sent uh one of the articles to Chris to talk   about uh the projections for the mutant uh one of  the mutant variations one of the new variations to   to be dominating in the US and right now the  CDC's uh projecting that that'll be by March   and I think they're referring to the UK variant  which now has a new name sort of like the   artist that was formerly known as Prince it's the  variant that was formerly known as the UK variant   so anything else before we get to  the content for today the program okay type 2 diabetes reversed with low carb  diet you know whenever you see stuff like this   it's helpful to start saying okay well how do they  define each of these things how did they define   type 2 diabetes how did they define reversed and  then how did they define low carb and how did   they define diet so these are all questions to  be thinking about as we go through the details   so uh people with type 2 diabetes have a low  tolerance to carbohydrates well you would think   but again you get into some of the folks that are  just uber plant-based they say it's really all fat   that causes the problem I don't agree with that  but we'll get to that a little bit later we'll   that's one of our discussion points eating excess  carbs increases blood pressure levels I mean blood   sugar levels it eventually requires people to take  insulin or diabetes medication according to Mark   Cucuzzella a professor at the West Virginia  University School of Medicine has published   several studies on dietary changes and diabetes  their bodies do not metabolize and respond well   to carbohydrates well that's the truth and the end  result is high insulin levels and hyperglycemia   or high blood sugar levels yes that's true as well  and either of those things high insulin levels or   high glucose levels can cause inflammation  which in turn causes the inflammation of the   causes a burn of the lining of the artery wall  that burn of the lining of the artery wall causes   cholesterol at whatever level your cholesterol  happens to be to seep through that lining it won't   go through the next layer the media or muscle  layer so it gets stuck it gets stuck between   the intima layer the lining and the muscle  layer the media layer that's why we look at CIMT   the carotid intima-media thickness test you're  measuring the amount of plaque in those two layers   however restricting carb intake to management  type 2 diabetes is a controversial topic believe   it or not largely because trial results have  so far been pretty inconclusive now that's an   interesting question which we can discuss again  later if there's an appetite to do so so here's   a couple of the articles one is BMJ again one  of the the major medical journals in the world   you can criticize it just like you can  criticize any of them but here are the   two topics efficacy and safety of low and very low  carbohydrate diets for type 2 diabetes remission   systematic review meta-analysis now one thing I'll  stop and say remember meta-analysis is not just   one clinical trial it's a study of all the  other clinical trials and studies that have been   done and published meta-analysis of published  and unpublished randomized clinical trials   the other one is nutrition therapy for adults  with diabetes or prediabetes a consensus   report from Diabetes Journal to better understand  the impact of a low-carb diet researchers   that published in this BMJ article analyzed the  data from 23 trials that involved 1,357 patients   with type 2 diabetes the new meta-analysis was  published in BMJ researchers found that type 2   diabetics who followed a low-carb diet for at  least 6 months experienced greater rates of   remission than those who did not I'm going to  stop and make a editorial comment if you read   Jenny Ruhl r-u-h-l runs an award-winning site for  diabetics it's called Blood Sugar 101 she wrote a   book called Blood Sugar 101 you can learn an  immense amount just reading the first 60 pages   depending on how quickly you read spend about  an hour with that book you learn a lot about   prediabetes she wrote another book it was called  Diet 101 and in that book she had a couple of key   things to say one of them is eat to the glucometer  and if you're eating to the glucometer which James   has become a passionate uh supporter of if  you're eating to the glucometer there you're   not going to have many arguments about  eating a low carb versus high carb diet   the other thing that she brings up which is a  critical point in Diet 101 is it's not a diet   it's not six months if and that's  the problem with randomized clinical   trials with a randomized clinical trial  you've got to get someone who's agreeing   to eat a certain way and they're only going to  do it for a certain time period it has to be a   permanent change in a lifestyle the way you eat  so it's almost if you begin to understand that   it's not a diet it's a changed lifestyle  you begin to understand the problems   in saying we're gonna do a randomized clinical  trial for diet who's going to stay there for   for over six for even six months that's  the problem when you start looking at   randomized clinical trials so the BMJ findings  are consistent with the ADA's 2019 recommendation   on carbs reducing overall carbohydrate intake  for individuals with diabetes has demonstrated   the most evident or the most evidence for  improving glycemia and may be applied in a   variety of eating patterns that meet individual  needs and preferences now that may sound like a   little bit of weasel wording uh to you it does to  me especially there at the end and may be applied   but that's actually a huge improvement  over where they were 2018 and before at   2018 and before ADA folks were saying uh carb it  up yeah a whole different set of battles which   I'm not going to get into because you  know we've only got like an hour so   previously the the ADA warned against diets under  130 grams of carbs a day because people would be   deprived of "essential nutrients"  so not going to make more comments in that space   so researchers first so let's go back to this  this uh excuse me BMJ study low carb diet how   did they define it I've asked that question a  couple of times they defined it as 26% of daily   calories coming from carbs well James you know  maybe you can be doing some of the math on a   16 to 1700 calorie diet and you know  how many carbs would you have to do   how many grams of carbs so I'm going to give  you a few minutes to do that while I finish this   this uh this part of the presentation and then  they had the very low carb diet 10% of daily   calories coming from carbs and is that really like  a more of a keto kind of diet and again I can't   help you know when I'm asking questions and  trying to sift out fact versus misunderstanding   there's really no definition of carbs here here  or here and it reminds me of the conversation   that I had with David Meinz who is in this  same space cardiovascular prevention but for   and he was a public speaker for like over  20 years and he talked about he was one   of those as well he talked about carbs  carb it up you know the the typical old   old style until about a couple years ago  he and I were sitting in his car prior to   a meeting and he said Ford I just I have to  tell you it's so frustrating and embarrassing   I'm a professional in dietetics and for so  many years I've been telling people to eat carbs   so part of the confusion there was just  about six months ago he and I were or six   to 12 months prior to that conversation he and  I were in a debate at one of our meetings I was   I was on the low carb side he was on the ADA  side at that point this was about three years ago   and it and I was said something about decreasing  carbs and he said are you telling me to decrease   uh broccoli to decrease cauliflower  to decrease asparagus because   these are all high carb foods they're  made of nothing but carbs so again pardon   me for the bunny hole but we've got to be  careful about what we're defining no wonder   we have so much argument as humans  we can't define things very well so   um at the end of the day uh I think we have to  be more careful about saying low carb or glycemic   so participants were evaluated at two intervals  at six and 12 months the primary outcomes were   type 2 diabetes remission well speaking of  definitions what did that mean uh if for their   study it meant as a person who has previously  been diagnosed with type 2 diabetes now has a   hemoglobin A1c of less than 6.5 well those of you  who followed our channel know that it's there's   a significant challenge in terms of comparing  A1c's between people it's impacted by hemoglobin   fasting glucose less than seven   millimoles or 126 milligrams per deciliter or with   or without uh diabetes medication so that's not  the way I would define uh full-blown diabetes well that's one of several ways I wouldn't use  the A1c I would use the fasting glucose   but most often I use the peak glucose  on an OGTT oral glucose tolerance test they also talked about weight loss A1c fasting  glucose and adverse events in terms of trying to   define someone as quote in remission for type 2  diabetes they also looked at secondary outcomes   too health-related quality of life biochemical  laboratory data but as you see they really   where's the stuff about heart attack and stroke  which is one of the key things that we want to   look at six months the low-carb diets achieved  a 32% diabetes remission which is higher than the   other diets remission was defined as we said A1c  less than 6.5 fasting glucose less than 7 or 126   smaller non-significant effect  occurred without a diabetes medication   additional benefits for the low carb diet  include large improvements in weight loss   significant weight loss and I can  tell you from doing this for a living   there is nothing like losing body fat to  improve this situation prediabetes diabetes   insulin resistance you're usually going to  get a significant decrease in triglycerides   and again those are the three things that they're  talking about large improvements in weight loss   triglycerides and insulin sensitivity so  they may have been using some slightly   different definitions but they're still we're all  focusing on the same issue researchers acknowledge   weight loss as the primary driver of remission  I do too again I do this all day every day and   weight loss is king however while  low-carb groups lost more weight   compared to the control groups around  7.4 kilograms so what is that 15 pounds   or more 20 pounds the weight difference as well  as remission disappeared by 12 months remember   what we talked about these are clinical  trials in other words you're randomized to   okay for six months I'm going to agree to this  diet they're not committed to making a change on   their lifestyle the decrease in benefits may  have occurred because patients stop sticking to   the diet over time well that's what we just said  more research as most of these things do they   they end up calling for more research to be done  in exploring long-term adherence and effects   I will say this in my own experience I have  a few folks who do very well on a ketogenic   diet more folks more often do better on a kinder  gentler low carb diet because it's just easier to   to stick to this is not a sprint sprint lasts  what eight or nine seconds this is not even a   marathon marathons last between two and six  hours depending on how fast or slow you are   this is month after month decade uh year  after year decade after decade so this   is a permanent change that we have to look for  also very low-carb diets were less effective in   than low-carb diets for weight loss however  this may have been explained by diet adherence   people on the very low carb diets had more  difficulty adhering to the very low carb diet   the idea of diabetes remission is somewhat a new  idea I wouldn't say quite new somewhat new we   don't have enough evidence yet that remission  is permanent so a lot of research is needed   I will say this it's really clear that it's not  permanent you don't sign with the weight loss will   decrease there are a couple of things that impact  the receptor the insulin receptor one is your age   another is your body fat so if you lose body  fat you will improve your insulin resistance   um I can't go further without mentioning one  other little bunny hole once we get past age 65 we   have to be very careful that it's not just losing  weight that it's losing body fat because uh you're   65 and older is notorious for maintaining the  same uh circumference the same size of your leg   but muscle being replaced with fat that is  very dangerous and that's one of the biggest   causes of cardiovascular inflammation and  insulin resistance the amount of carbs people   consumed on a low carb diet varied ranging from  less than 26% to 45% of daily calories from carbs   that's not a low-carb diet to me unless my math  is wrong that's a very very gentle very easy diet   unless it's including all of those um  broccoli you know all of those fiber   related carbs this could impact whether some low  carb diets work better than others none of the   studies control for protein intake many of the  low carb diets doubled the calories from protein   which could also have impacted the chance  of remission none of the studies controlled   for medication use making it difficult to  really see the impact of low carb diets alone   when beginning a low-carb diet it's important  to monitor blood sugar levels and to have the   assistance of a doctor or registered dietitian who specializes in diabetes and nutrition   I would also say when you talk to the doc when you  talk to the dietitian find out first if they're   if they're open and amenable to a low-carb  diet uh more and more are especially over   the past couple of excuse me the past couple of  years dietitians like David many of them have   made that transition even the ADA has made that  transition so you're not seeing it so much anymore   but you still see it dietitians who  say and doctors who say low carb is bad   so we're going to go and talk about we're going  to get a quick minute or two on this video and   then we'll go into Q&A meet Jim Jim's got type  2 diabetes and wants to put it into remission meet Jim Jjim's got type 2 diabetes and wants  to put it into remission what's remission   to explain let's take a look inside his body the  pancreas is a really important organ that makes   the hormone insulin insulin travels around the  body and helps our cells to use glucose as fuel   but in people with type 2 diabetes like Jim  insulin stops working properly and there might   not be enough a bit at the right times this means  glucose builds up in Jim's blood damaging his body   Jim used to manage his diabetes with diet but now  he needs medication to stop his blood sugar levels   rising but our scientists thought there could be  another way they wanted to see if type 2 diabetes   could be put into remission they believe a  buildup of fat inside the liver and pancreas   could be the root of the problem they're running  our DIRECT trial testing a new remission program   and Jim is a trial volunteer with support from a  dietitian he swaps his usual food for low calorie   soups and shakes which helps them to lose weight  quickly after a few months the dietitian helps Jim   to keep the weight off by eating the right amounts  of healthy foods our scientists looked at what   was happening inside Jim's body over time the fats  inside his liver and pancreas started to disappear   his pancreas is now making the right amount of  insulin at the right time and his insulin is   starting to work properly this means that Jim's  blood sugar levels are healthy without needing   any diabetes medications he's in remission  Jim still has an annual review with his doctor   but he's now much healthier back out on his bike  and running after the family he's likely to have   a lower risk of diabetes complications  like heart disease it's life-changing   remission isn't possible for everyone but  losing extra weight has lots of benefits   better sleep you can move more easily and you can  feel better emotionally and physically it can also   help to reduce your risk of diabetes complications  and you might need fewer diabetes medications   the weight management program tested by our  scientists is amongst the strongest evidence we   have for remission so far but there are different  ways to lose extra weight find something that   works for you there's still a lot we don't know  about remission we want to help people keep their   weight healthy and stay in remission we also want  a treatment that works for people of different   ethnicities or who are a healthy weight already  that's why our scientists are working hard to   build our knowledge so that together we can make  remission a reality for as many people as possible so we've been beating up on the topic and getting  uh questioning a whole lot of things again   I think as I said before you get a  lot of questions in terms of just what is   how are they defining prediabetes how would  you define prediabetes how do you define   insulin resistance how do you define  quote remission having said all of that the question still is i think is this significant  evidence for a low-carb diet and there's no   question in my mind it is it's very significant  evidence that low-carb diet is is very helpful   and I didn't need it I mean I work with it all day  every day James comments uh absolutely agree I've   I've done some math for you as well one quick  comment for just to get you frustrated because   we're still having a delay feed for the people  who are watching if they're seeing the same delay   feed in the video versus the voice uh we  either having a delay feed or you are the   world's greatest ventriloquist uh because at times  that you're you're talking it'll go silent so   we ask our audience bear with us that's it's a  streaming issue that we've we've struggled with so   can I make a comment about that yes we uh  uh Gilbert and I noticed this and I can see   it right now according to now I'm uh my video  looks like it's about a minute behind my voice   um we turned my computer off looked like it  had and turned it back on looked like it had   cured it again last week we were having the  same problem and a little bit the week before   it turned out last week that one of my patients  that afternoon actually manages home call centers   for a large hospital system he said yeah  I saw it and yes I do this for a living   and you may think it's your RAM you can go  back and try to clean that out like we had done   and we see this all the time I don't think it's  your RAM I think it's local bandwidth issues and I   just I just don't think you're going to be able to  fix that I don't think you're going to be able to   problem solve that so thank you for bringing  it up just for the audience and uh I know   it frustrates you a little bit you're doing the  best you can um a couple of things on that diet   to the point that you mentioned so I think if my  conversion ratio is right with carbs it's about a   four to one ratio so four calories for every  one gram of carbs now I know it certain foods can   maybe shift that a little bit but I think that's  a good rule in fat is about a nine to one ratio   so if you have a 1,600 calorie diet and about 400  of those calories according to that recommendation   of 25 being carbs that's going to be 25 simply 100  grams of carbs and I think you and I both agree   more importantly you would say that's probably  not a low carb diet 100 grams of carbs is   probably not a low carb diet when when you  look at a nine to one ratio you could do 50   fat and we'll talk about the kinds of fat that  would be in my own personal experience and   changing but it's about a nine to one ratio so  that's the math and we can talk about specific   foods in that broccoli for instance that  the one doctor brought up broccoli is about   9 to 10 grams of carbohydrates but you might  address what are called net carbs you're talking   about definition but it's ensured carbs not all  carbs are created equal either not all fats are   created so as a rule we're saying higher fat lower  carbs which got me excited I went out ate Kentucky   fried chicken for a week didn't seem to work out  so well for me but that was tongue and cheek but   talk about net carbs net fats different kinds  of fats different kind of carbs and maybe   that'll help clarify for some of our listeners and  we'll talk about some of those foods if you want   that I use and what their fat what their calorie  content is well to your point about fried chicken   I will uh I'll just tell you as I told you  last week I have discovered I've gotten back   to my roots and I have discovered a low-carb  version of fried chicken I used a pork panko I'm making large masses of  pork panko fried chicken now   zero carbs because you got the pork cracklin  crumbs the uh the avocado oil and the chicken   right so actually I'm glad you did the math I  don't think I did the math that well earlier   I don't really think a hundred grams of carbs  uh per day is that bad but again I'm assuming   we're talking about total carbs and not just  net carbs right um what I would suggest Gilbert   is maybe you could find pictures or stills of  me and James and when we're lagging like this uh   just put a still picture up so it's not quite  as distracting well um I'm not lagging but if   you're gonna put a picture up Gilbert find Tom  Selleck or Brad Pitt or something like that   let's stop a picture if they're going to look  at us and it's live I get it if you're going to   put pictures off make a slightly better looking  that's my only suggestion for it I'm not sure I   could tell the difference between you and Tom  Selleck I didn't want to be ugly to you Ford so   if you're going to be make us all uncomfortable  yes just put one over Ford's picture uh that would   work anyhow we've gone down a bunny hole that  I'm not sure is that uh productive for folks um   but uh so I'm again I was a little bit  surprised when you did that math uh   I do actually tell people that one good way  of dealing with this is not overdoing it   not saying uh I'm going to restrict myself to 25%  to 50% carbs total because that's too hard now to   get back to your point well total carbs versus  net carbs so the FDA and their infinite wisdom   has and I'm being sarcastic in case now  so in their infinite wisdom has said look   we have to present if you look at the organic  chemistry um fiber plant fiber is a carbohydrate   it doesn't matter that it doesn't impact your  blood sugar at all in fact if anything it tends   to help control it by slowing the dumping of  of sugars from your GI system from your stomach   into your bloodstream so uh when you look at a  at a uh food label you'll often see uh things   like cauliflower and broccoli listed as a carb  now though now that we're getting more health   conscious more glycemia conscious you'll start to  see net carbs you'll see carbs you'll see sugars   you'll see total carbs and sometimes even net  carbs so what they're doing is they're taking that   fiber out of the total carbs and that's really  much more realistic any comments about that James   no other than so if you do the math you and I  often talk about you talk about stealth cards and   that's usually what catches people uh for instance  if you if you need to limit to 100 net carbs and   and maybe lower a diet excuse me a regular Coke  from McDonald's is 65 grams of that so you're   you're gonna get most of your carbs just in one  Coke a day uh a Starbucks with a frappuccino mocha   wafferino is gonna throw you out of your carbs  so it's those one or two little things an apple   is 21 grams of carbs and getting that out maybe  the fiber a little bit but it certainly affects   your blood sugar great certainly do so um that's  the math it's four to one and then you've got to   determine whether it's fiber or not I think that  is how we get our definitions aligned correctly   very good I see your Aunt Martha's aunt yes Daryl  is that her husband Daryl is my uncle started   using the Freestyle Libre uh we've had a couple  of other people comment about the Freestyle Libre   uh we actually have a program for it you might  mention that we have a program they can reach   out to us for subscription to the Libre from  PrevMed so you might want to address that because   people ask that question uh you know where can we  get the subscription prescription excuse me for   a Freestyle uh so do you want to comment on  that quickly sure sure uh the big question   most people ask is how much does it cost I don't  know you may know but here's my view on it that um   again I used to think I wasn't that political  but I'm hearing myself being sarcastic about more   and more government agencies I was always  anti-big government but anyway the FDA in   its continued infinite wisdom has decided  that a Freestyle Libre needs a prescription   why they decided that I have no clue um I think  what they may you know they're always you know   how bureaucrats tend to look for potential  danger and I think the potential danger that   some bureaucrat on the FDA committee may have said  was well look people are going to try to adjust   their insulin based on this and that's dangerous  well you know it's dangerous to drive a car at 90   miles an hour with your eyes close too I mean  that people do a lot of dangerous things but   what they've done is they've made continuous  glucose monitoring uh unavailable for the masses   unless you can convince a doctor to write you  a script and that's just flat wrong and so   I've got licenses in over 40 states I'm totally  comfortable writing Freestyle Libre for folks   if you have an interest in getting a script  for Freestyle Libre give us a call 859-721-1414 that's 859-721-1414 and the bottom line  is knowing what your blood sugar value is   is critical on a day-to-day basis  how does it respond when you go for   a walk how does it respond when you eat  lentils how does it respond when you eat you get up and you have that "healthy"  breakfast of orange juice and oatmeal   versus that really bad breakfast of bacon and  eggs well I can tell you you'll be surprised   if you think that the first is healthy and the  latter is unhealthy um major major surprises   people get when they actually start using  it in fact to go back to the car analogy   uh the FDA decision to make this a prescription  is analogous to taking away a dashboard   a speedometer on car for health you know you it's  like having a speedometer there and you really   need it you need to understand what how your blood  sugar responds to what you eat and what you do   and by the way to your point Ford that I agree  with you because sometimes I see common sense   you don't have to have a script you can  you can get your hands on all types of   measuring meters you know the finger stick kind  so if someone wanted to play that game they   could do that they would just have to they just  have to take their fingers more often you know   create more pain but if someone wanted to say  I'm gonna I'm gonna manage this myself and   not work with my health care provider well that  that option is already available that abuse is   already there you're not changing the ability  of someone who abuses it you're simply   you know making their life more unconquered I'd  be careful there's a couple of things if you're   going to do that one is you still don't figure  out what's going on you should get a decrease   in your blood sugar about three four in the  morning right before that cortisol dump happens   um and you're not going to find that just by  doing repeated finger sticks the other thing is   be careful which finger stick device you  get the cheapest ones are often so wrong   as to be worse than worthless um none of them  are perfect but I think Contour for example is   sold by either CVS or Walgreens I think  it's CVS and Contour is really really bad um   on the other hand there are some that are  really good um the uh Abbott Freestyle now I'm   not talking about the Libre just the Abott Freestyle  devices there's a Neo there's a couple of others   and no I do not have any financial uh link to  Abbott or the makers of any of these things I'm   not the ultimate expert in this area either  that would be Richard Bernstein he's a physician   living about 10 miles from where I used to live  in New York the father of diabetes self-care a lot of the comments and questions uh we're gonna  get into relate to this we're getting a lot of   great comments and one of them is we'll jump ahead  around oatmeal and since we're talking about the   meters you know the debate around whether  oatmeal should be netted out for the fiber   well the Libre the continuous glucose monitor  helps you determine that so if you get a   continuous glucose monitor and you really  want to find that answer out for yourself you can   you can eat oatmeal now I can tell you in my own  personal history years ago when i worked with a   personal um exercise assistant I had a trainer and  she recommended that I eat oatmeal in the morning   eat oatmeal in the morning and I needed to lose  weight I wanted to exercise well I was exercising   like a madman because I was paying somebody to  help me and I was eating that oatmeal eating   that oatmeal and it really wasn't losing a lot  of weight you'd think I'd know better this is   10 12 15 years ago she said well what kind of  oatmeal are you eating well sometimes I have   the brown maple sugar oatmeal sometimes  have the strawberry and cream oatmeal   I should pour that sugar down me you know with all  the sweeteners that were in the paper oatmeal so   of course you know I'm just spiking my blood sugar  in the morning and just burning when I'd exercise   I just burn the carbs out of my blood bloodstream  not really affecting uh any weight loss so   using the Freestyle Libre and then eating the  right kind of oatmeal you know not pouring sugar   or sweets or honey or anything that increases  that glycemic index you'll be able to see very   quickly I've done it I still do it you'll be  able to see very quickly the impact that food   has one hour two hours three hours after   eating and you will find a lot of surprises   yes you will uh some of the some  of the worst oatmeal to eat is the   instant oatmeal the rolled oatmeals the  things that have been powdered uh because   it just grinds up those uh those carbohydrates  where they can hit your bloodstream all at once   I'm looking at my picture it looks like I'm  looking at my foot or something well there you go   pick the most opportune time to freeze  didn't it you know Gilbert if you if   in the future if you can find a picture  of Doogie Houser or Doogie Houser   and just whenever he freezes just put that  picture up there and everyone will think   it's all the same so that's how we'll solve  that question what a headache you know it   it's we've talked many times it's like spouses  can't live with them can't live without them   uh technology is just can't can't live without it  anymore but it can be a headache too or on to the   questions we ran a lot of bunny holes we burned up  the hour already today um but we covered a lot of   the questions as well some of this conversation  was both of us checking this and seeing   some of these issues so you can scroll  through them and maybe hit some of   these questions about the diet if you want uh  since we've used up a lot of our time already   I did see one question from My Bjj uh I  think that was the again my system has   gone wonky again I think it was My Bjj that asked  the question about uh atorvastatin he saw I think   he said he saw a study where atorvastatin was  banging on the beta cells uh it may actually   do that it is um it's well known that the um that  all of the statins except one push you down that   insulin resistance highway that diabetes highway  so why would you give any statins at all because   I give statins for example I give them for  another reason for cardiovascular inflammation   the other thing is I don't use atorvastatin at all  atorvastatin doesn't do as much positive work for   inflammation as some of the others there's one one  a couple of other comments about statins when I   use them I tend I almost always use a very low  dose statin because low doses will impact that   cardiovascular inflammation that immune system  storm against the against plaque but they don't   have nearly as much impact on the beta cells  or the insulin receptors there is one statin uh   we're using more and more now that it's becoming  affordable and that is pitavastatin or Livalo   that among the statins it's the only one  that does not increase insulin resistance   there was another comment from one of the uh again  I can't find it now it was question about the uh   the COVID vaccines and here's just  a real quick question Doc what's your   what's your perspective on the vaccines uh  I would take any of the vaccines I could get   and I would almost even take  the Chinese Sinovac vaccine   and I expect to get a lot of haters on that  comment but here's the thing every vaccine no   matter which one you're talking about even the  absolute best one can cause problems uh one of   the reasons I wanted to go ahead and respond to  that question about about vaccines is that we're   starting to get a little bit more clarity on uh  those problems they tend to be associated uh   when significant problems happen they  tend to be more of an anaphylactic type of   of um reaction and it's people  that have this rare anaphylaxis   to lipid layers you know these are put out in  a lipid pocket and there's a simple um there's   a simple old product that's got lipid in it or  fat in it James you are fat or wax my wife was   telling me about it yesterday we have a family  member who's got nut allergies and was talking   with an allergist immunologist and she said no  I don't have any concerns with you she said it's   if you have an allergy to blank and it was  the old household product you don't happen to   remember what it was do you no no I have not  seen that I'll have to look that up I meant to   to do that for this channel but uh again the the  major underlying response is number one there's no   question that um if you're gonna get exposed  to that spike protein sooner or later if it's   not within the next sick for most of us it's  going to be within the next six months uh for   very few of us it may be more than six months  before we get exposed to that spike protein   so if you're going to get exposed to the spike  protein you got to ask yourself the question which poison do I want to take do  I want that spike protein to be   associated with a whole virus or do I want  it to be something that's been cleaved off   and got all the problems with vaccine production  and vaccines etc and all the politics etc   or do I want to do I want to go head-to-head  against the whole virus I think once you start   looking at it that way uh you begin to get  a slightly different perspective regarding   the politics and the all the other junk that  can go and the big pharma money all the other   junk that can go with the vaccine James I know  you've got a slightly different perspective on   vaccines I've sarcastically called  you an anti-vaxxer you corrected me   and you may want to restate your position and uh  maybe give give your reaction to the comment that   I just made no we agree my own wife brought  that up this just last night she's because   someone called and asked me if I'd which one I was  recognized I'm not I'm in level two    I'm over 50 but under 60 and I don't have any  underlying health conditions but other than mental   health incapacities so I'm still at  two in our county is still in one a   they haven't completed all the vaccinations but  when the time comes I'd be vaccinated I'm   more comfortable to have waited in the scene I  was doing a lot of preventive things around not   getting the virus if possible you and I both you  know we can say the reason I was out last week is   I was sick and we thought for a while I probably  did have the virus if I tested negative twice   but I had come to find out people still get colds  flus and sinuses and allergies and sicknesses   but when the time comes I'll get the  virus I think I'm more concerned about   children under 16 getting the virus and I was more  concerned and I am still concerned with why the   you know they passed the virus out to healthy  people who were politicians like Congress people   giving them the shots when there were  nursing homes that hadn't been tested yet so   I think I'm just more measured in watching than  I am anti um this particular vaccine um and I am   I am one of those I think studied concerned about  children under two getting a lot of vaccinations   piling it on prior to age two I'm more of  those the Japanese approach you know to you   know stretch it out over the first four years  of their life and don't bunch them all up we'll   bunch them all up don't don't yeah um because  it's not the vaccines I'm not one of those   that think that they're assault or the other  things are I just think there's something   and it goes back to a lot of research we did at  MyGenetics and a lot of the studies we read that   it's something to do with the same mechanism we  studied a couple of weeks ago on this channel   about what may be occurring in the immune response  that some people seem to have a system that   once that switch is fully up it's hard to turn  that off and so you get some respond adversely   uh more severely and if you over challenge the  system I think uh that may be where some of these   anecdotal stories are coming from because  I believe in that there are some stories   we know there are some stories because there's a  uh there is a fund that pays people who are harmed   you know from bad vaccines Guillain-Barre is a real  result as to what happens sometimes it's rare   you know and but I'm not certain that it's a shot  as much as my response to that shot just like the   anaphylactic response is uh to these vaccines it  doesn't mean the vaccine is bad but I may not be   you know I may be my response may be the  issue so I'll certainly be vaccinated when   when the time comes I'm not going to jump in line  in front of someone else but when my time comes I   haven't had the virus yet I'll be vaccinated  you bring up a good point and I want to uh to   emphasize Guillain-Barre it's you know that sounds  kind of dry and clinical uh if you if you look it   up you can get a really gut level picture of this  look up iron lung and vaccine when I was in when I   was at Hopkins and uh studying uh public health  as a student that's one of the things we talked   about is that that fiasco that problem and there's  no question that a lot of people have been damaged   permanently and a life-threatening damage from  vaccines there's absolutely no question about that   and I um but millions and millions and millions  of lives have been saved and so that's the balance   that we have to go through there is no denying  that polio the world has changed because of polio   vaccines the world is different because of the  measles vaccine I mean there are just absolutely   tremendous good that's done you know we banter  and joke I take the adversarial approach just for   simple conversation most of the time but there's  great and good that's done we don't deny that it's   just you've got to be aware and just like with  your own prevention everyone's responsible for   their own health and becoming as informed as they  can to the choices they make with their own body   you brought up you took the words right out of my  mouth that's exactly right it's when these   physicians and public health people study the iron  lung problems that happened with uh the vaccine   what 50 years ago 40 years ago it's similar to  pilots looking at and uh they do you know looking   at airplane crashes when you look at the aftermath  of an airplane crash and the bodies laying   on the ground it's ugly but people still  get back in the airplane and we know why uh   and it's the same analogy we have we have  risks with every decision that we make   I want to do a quick shout out to Type One Talks  he's made several comments very helpful comments   let me just read one I use Freestyle   Libre as well it's been a game changer for me   showed me so many things about how my blood  sugar reacts real time to all kinds of food   that I had no idea about he goes on  uh to say he's not just a he's not just a   prediabetes patient he's not a type 2 diabetes  patient he's had type 1 diabetes for what 30 years   plus so it's really helpful uh Type One Talks when  somebody like you comes on you make a few comments   you share with others because it's one thing  for people you know like James and me who have   the maybe the temerity or maybe the lack of  good sense to get up and talk about things uh   as a self-appointed expert in an area as a guide  but it's very different for people to hear from   someone else who's on that same journey at the  end of the day when you look at what we're doing   it's you guys it's your journey it's your  life we are trying to help the goal for   this show is to to help you in your journey your  comments help us immensely in terms of doing that   and we appreciate your views we appreciate  uh more than anything else your feedback   absolutely and Dr. Brewer is temerity  over the counter o

2021-01-27 09:28

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