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TEDx Talks
Published: 2015-05-04
Source: https://www.youtube.com/watch?v=da1vvigy5tQ
job in the world I'm a doctor now believe me that's not why I'm an obesity doctor I have the honor of working with a group of people subject the last widely accepted prejudice being fat these people have suffered a lot by the time they see me shame guilt blame an outright discrimination the attitude that many take including those in health care is that these people are
to blame for their situation if they could just control themselves they wouldn't be overweight and they're not motivated to change please let me tell you this is not the case the blame if we've got to extend some here has been with our advice and it's time we change that obesity is a disease it's not something created by lack of character it's a hormonal disease and there
are many hormones involved in one of the main ones is a hormone called insulin most obese individuals are resistant to this hormone insulin so what does that mean exactly to be resistant to insulin what if one resistance is essentially a state of pre pre type two diabetes yes job is to drive glucose or blood sugar into the cells where it can be used in a nutshell
when someone is insulin resistant they're having trouble getting blood sugar where it needs to go into those south and it just can't hang out in the blood after we eat or we would all have a diabetic crisis after every meal so when someone is resistant to insulin the body's response to this is to just make more of it and insulin levels will rise and rise and
for awhile years even this is going to keep up and blood sugar levels can remain normal however usually it can't keep up forever and even at those elevated levels of insulin are not enough the blood sugar in the normal range so it starts to rise that's diabetes it probably won't surprise you to hear that most of my patients have insulin resistance or diabetes and if you're
sitting there thinking that's not me yeah actually might want to think again because almost fifty percent of adult Americans now have diabetes or prediabetes it is almost a hundred and twenty million of us that's hardly everyone who has issues with excellent because as I was saying people have elevated insulin levels due to insulin resistance for years even decades before the diagnosis of even pre diabetes is
made plus it's been shown that sixteen to twenty five percent of normal weight adults are also insulin resistant so in case you're keeping track this is a heck of a lot of us so the trouble with insulin resistance it if it goes up we are at great risk for developing type two diabetes but also insulin makes us hungry and the food we eat much more likely
to be stored as fat insulin is our fact storage hormone so we can start to see how it's going to be a problem for diseases like obesity and metabolic issues like diabetes but what if we trace this problem back to the beginning and we just didn't have so much glucose around that insulin needed to deal with let's take a look at how that could be everything
you eat is either a carbohydrate a protein or fat and they all have a very different fact on glucose and therefore insulin levels as you can see on the graph so when we eat carbohydrates are insulin and glucose organised by got facts and with proteins it looks a lot better look at what happens when we eat fat essentially nothing a flat line and this is going
to wind up being very important so now I want to translate back grass for you into a real world situation I want you to go back and think about the last time you ate an American version of Chinese food we all know there's rules associated with that's right and the first rule is you're gonna overeat because the stop signal doesn't get sent until you are literally
busting at the seams rule number two is in an hour you're starving why well because the ricin that meal because glucose and insulin to skyrocket triggered hunger fat storage and cravings so if your insulin resistant to begin with and your insulin levels are already higher you really are hungrier all the time and we have this set up the cards you're good cost goes up your insulin
goes up and you have hunger and fat storage so do we recommend to these people to eat because it's like that would be really important ended it let's focus just on type two diabetes because the general recommendations are to tell patients with type two diabetes to consume forty to sixty five grams of carbohydrates her meal plus more it's snacks trust me on this that's a lot
of carbs and remember what's gonna happen to glucose and insulin blood sugar and insulin when we eat them yes we are essentially recommending that they eat exactly what's causing their problem sound crazy it really really because at its root diabetes is a state of carbohydrate talks we can't get the blood sugar into the cells and that causes a problem in the short term but the long
term consequences are even greater and insulin resistance is essentially a state of carbohydrate intolerance the H1N1 I do we want to continue to recommend it to people that the American diabetes association guidelines typically state that there is inconclusive evidence to recommend a specific carbohydrate limit but those guidelines go right on to say what we all know a carbohydrate intake is the single biggest factor in blood
sugar levels and therefore need for medication these guidelines then go on to say Hey look if you're taking certain diabetic medications you actually hostage carps brother you're otherwise your blood sugar can go to level okay so let's take a look at the vicious cycle that that advice just so it's E. cards so you have to take medicine then you eat more carbs you avoid the side
effect of those medications and around and around we go even worse is that nowhere in the eighty eight guidelines is the goal of reversing type two diabetes this needs to be changed because type two diabetes Lauren be reversed in many if not most situations especially if we start early not only do we need to let people know this but we have to start giving them practical
advice so they can do that consider car first here's a shocker for you we don't need that seriously our minimum daily requirement for carbohydrates is zero we have essential amino acids those proteins essential fatty acids but nope no essential carp a new trick is essential if I have to have it to function and we can't make it from something else we make glucose plenty of it
all the time it's called gluconeogenesis so we don't need them the over consumption of them is making us very sick yet we are continuing to recommend to patients to consume close to if not more than half of their total energy intake every day from them it doesn't make sense let's talk about what does cutting cards a lot yes in my clinic we teach patients to eat
with cards as the minority of their intake not the majority so how does that work well when our patients decrease their cards their glucose goes down and they don't need as much insulin so does it when levels drop and fax and this is very important because eight study looking at our national health and nutrition examination survey data better known as an Haynes showed that the single
biggest risk factor for coronary artery disease is insulin resistance it is responsible for a whopping forty two percent of heart attack low carb intervention work so fast that we can literally pull people off of hundreds of units of insulin in days to weeks one of my favorite stories is a very recent one a young gal but who had an almost twenty year history of type two
diabetes came in when a physician from another clinic told her she was just say and should probably get used to it her diabetes was way out of control this despite the fact that she was on multiple medications including almost three hundred units of insulin that was being injected into her continuously every day via a pop all of this remember blood sugar still out of control so
we put her on a low carb diet and now let's fast forward four months she lost weight yes but better than that sick no more her blood sugar levels were now normal all of the time this on get this no diabetes medication gone was the three hundred units of insulin no more insulin pump no more tricking her finger multiple times each day gone all of it
no more diabetes one of the greatest joys of my job is to be able to tell a patient like this that they no longer have diabetes and we ceremoniously taken off their problem list together so are they cured is this a miracle we'll leave that grandstanding to doctor oz cured would imply that he can't come back and if they start eating excessive carbs again it will
no not cured but they don't have diabetes any longer it's resolved any kids that way as long as we keep away the cost so what does this look like that how does the body eat does first let me tell you what it's not low card is not zero car and it is not high protein these are common criticisms that are so frustrating because they're not true
next if we take the carbs out what we gonna put it because remember there's only three macronutrients if one goes down one has to go up my patience eat back and a lot of that what you say the what's gonna happen when you eat fat well let me tell you you're gonna be happy because it's a great and it is incredibly satisfying but remember that is
the only macronutrient that's going to keep our glucose blood sugar and insulin levels low and that is so important so I watch it now here my simple rules for eating these rules you have to remember Eric even gonna be more important if you are one of the tens of millions of Americans who have trouble with insulin levels will never one if it's as light low fat
or fat free stays in the grocery store because if they took the fat out they put cards in chemicals then rule number two eat food the most important rule in low carb nutrition real food does not come in a box and no one should have to tell you real food is natural you should know that when you look at it don't eat anything you don't like
and even you're hungry don't eat when you're not no matter what the clock says and number five is a simple way to remember what we want to avoid no G. P. S. no grains no potatoes and no sugar that last one is a Biggie right no grains yeah no grains but I have them no their car whole grains are so good for us hope first of
all there are actually very few foods out there that are truly whole grain even when they say they are most foods that purport themselves to be whole grain are highly processed in the fiber benefit ruined or they're coming with highly refined flour usually both of these things so if you are one of the truly insulin sensitive people you can eat real whole grain but if you're
in the enormous slice of our population with insulin issues it's making things worse so what if you are one of the real influence sensitive people can you still eat this white yes I'm a great example over year ago I decided I would cut my cards as low as I recommend to my diabetic patients now it's not mandatory for my health like it is for their I'm
not insulin resistance so would this be a problem no that's just the thing unless you have an exceedingly rare syndrome that cutting carbs is going to be good for you even if it's not necessary I want to show you a couple pictures of my radical food so this is a common breakfast in my house so does it look like I just broke my own rule I
didn't because this muffin is made with coconut flour I bake all the time still I just use non green beast flowers coconut almond hazel not flax they make delicious things and this is a typical dinner in my house with the typical starch that would be the sauteed mushrooms nope my patients and I eat delightful food all of the time and enjoy it but what about the
research on this I mean is this just anecdotal evidence now from my clinic no there are dozens of randomized controlled trials looking at low carb intervention for things like diabetes cardiovascular risk factors obesity they're consistent it works they're even a large numbers but number of study showing that low carb nutrition decreases inflammatory markers which is making it really exciting for diseases like cancer we just finished
a study in our clinic and what we did is we took fifty type two diabetic patients that were treated with our Lokar high fat based program and we compared them to fifty patients who were treated the eighty a guideline and after six months not only did we find a significant metabolic advantage for the low carb group but and let's face it this is important a huge
cost savings our analysis showed that our patients could save over two thousand dollars a year just on the diabetes meds they were no longer taking just think how fast that adds up winner diabetes epidemic now that we are spending two hundred fifty billion dollars a year on in this kind so I want to show you a slide now that demonstrate weight demonstrates where that savings is
coming from still this looking just at the insulin difference in the two groups after six months and what we can see is that the low carb group was able to decrease their insulin by almost five hundred units a day where is in the eighty eight treated group they increase their insulin by almost three hundred and fifty that's it I two important things number one insolence expensive
number two not all the people in this study were even on insulin which makes these results even more impressive but what I would say is that this graph really represent two different approaches to treating this disease first our group with the goal of reversing disease meaning they need less medicine and the second group which very clearly alliance with the ADA guidelines which states that diabetes is
a progressive disease requiring more medicine over time aggressive unless we take away the costs so what's the problem then why is this not everywhere why isn't low carb the nor there's two big reasons number one status quo it is hard to break there are many agendas involved we got this notion that low fat was the way to go decades ago but a recent study just came
out showing that there was zero randomized control evidence to recommend to Americans to remove the fact from our diet and that's how the cards got added in it was essentially a huge experiment on millions of people and it failed miserably the second reason we don't see it everywhere is money don't be fooled there's a lot of money to be made from keeping you sick and what
we see is what the special the guideline panels they are stacked conflict of interest so the solution to the diabetes epidemic in my clinic is exceedingly clear stop using medicine treat food and for a disease whose root causes carbohydrates take away the carbohydrates or at least cut them so we can remember what we use to now we knew it a long time ago this was said
