Cyrus Khambatta and Kylie Buckner: Reversing Insulin Resistance Using Food As Medicine
16th April 2020
Cyrus Khambatta, PhD earned a Bachelor of Science in Mechanical Engineering from Stanford University in 2003, then earned a PhD in Nutritional Biochemistry from the University of California at Berkeley in 2012. He is the co-author of many peer-reviewed scientific publications.
He is the co-founder of Mastering Diabetes and Amla Green, and is an internationally recognized nutrition and fitness coach who has been living with type 1 diabetes since 2002. He co-created the Mastering Diabetes Method to reverse insulin resistance in all forms of diabetes, and has helped more than 10,000 people improve their metabolic health using low-fat, plant-based, whole-food nutrition, intermittent fasting, and exercise.
He is the co-host of the annual Mastering Diabetes Online Summit, a featured speaker at the Plant-Based Nutrition and Healthcare Conference (PBNHC), the American College of Lifestyle Medicine Conference (ACLM), Plant Stock, the Torrance Memorial Medical Center, and has been featured on NPR, KQED, Forks Over Knives, Healthline, Fast Company, Diet Fiction, and the wildly popular podcasts Plant Proof and Nutrition Rounds. He is a co-author of the upcoming book Mastering Diabetes with Robby Barbaro, MPH.
Kylie Buckner, RN is a registered nurse and has a master’s degree in nursing education. She has more than 18 years of experience working as a nurse in the neonatal intensive care unit, labor and delivery, OB-GYN, and in pediatrics.
Currently, Kylie has been working as a coach and the Director of Lifestyle Change for Mastering Diabetes and uses her background in women’s health and within the healthcare system to help our members learn more about how to achieve their maximum insulin sensitivity.
In episode 47 of the podcast, we discuss how you can reverse insulin resistance using food as medicine.
- Cyrus and Kylie's story/journey [00:07:31]
- What diabetes is and the different types [00:17:15]
- What insulin resistance is and the cause [00:20:19]
- How does someone know if they have insulin resistance? What are the tests? [00:28:50]
- The Keto diet vs the Plant-Based diet [00:34:34]
- How does someone get started following a plant based diet [00:40:34]
- How long it takes to see improvements in your insulin resistance after following a plant based diet [00:49:6]
You can find the transcript of this episode below.
Cyrus Khambatta and Kylie Buckner: Reversing Insulin Resistance Using Food As Medicine
Despina Hello and welcome to the podcast Cyrus and Kylie.
I've been following your work for some time now, so it's an honor to have you on the podcast and to be speaking with you today. I'm certain this episode will be an eye opener for many people. And we'll have our listeners questioning what they thought they knew about diabetes and insulin resistance.
A lot of us out there, you know, have this misinformation and so many myths.
So I'm excited to delve in, to discuss our topic and a lot of the stuff that we'll be discussing, breaking those misconceptions that you also discuss in the book Mastering Diabetes, which was released February 18th. So just over a month ago from recording this podcast episode, and it's a New York bestseller, which is amazing. Congratulations on that.
So obviously the book and what we're going to be talking about goes against the grain of what people have been told by their doctors and what they've read online and this conflicting information which I am excited to, you know, break some of those myths and misconception.
I remember when I first started looking into insulin resistance to understand it better for my PCOS clients, because around 70 percent of women with PCOS suffer from this condition. Your website, mangomannutrition was one of the first ones I discovered. And since then, I've been learning a lot from you. So I'm excited to have you on. And it's an honor to be speaking with you both.
Cyrus Thank you so much Despina we really appreciate it.
And PCOS is a condition that is growing in today's world. There's a lot more women that are being diagnosed with it. There's a lot more women that are, you know, that are discovering that they now have symptoms of PCOS. And so being able to, you know, help women understand exactly what they can do is near and dear to our hearts. Thanks for having us.
So I guess before we delve into a topic of discussion for today. Can you both start by sharing your stories and like your journey and tell us tell our listeners why you decided to write the mastering diabetes book?
So so my name is Cyrus Khambatta and I was diagnosed with Type 1 diabetes at the age of 22.
So I was a senior at Stanford University, in the year 2002 and I I just noticed that I felt very low energy. I was urinating all the time and I was cramping when I went to go to sleep.
So I showed up at the health center and I presented with all these symptoms. They checked my blood sugar levels they found out it was six hundred, six times higher than it was supposed to be. And then they took me straight to the to the emergency room where I was monitored over the course of 24 hours, given insulin and then I was told that I have Type 1 diabetes.
In fact, I was told that I had not only type 1 diabetes, but alopecia universalis, which why as you can see, I have no hair, I have no ear hair, nose hair, eyebrows. And then I was also diagnosed with Hashimoto's hypothyroidism.
So three autoimmune conditions within a six month period.
So the doctors told me to eat a low carbohydrate diet because that's the one size fits all prescription for people living with any form of diabetes.
So I did that and it was supposed to keep my blood glucose control. And it was supposed to keep my insulin controlled.
But in reality, my blood glucose was an absolute disaster and my insulin started creeping up over time.
So it started out in the mid 20's and then it became twenty seven, thirty to thirty six, thirty nine, forty to forty five mmo/l a day.
And it was on an upward trajectory and like my carbohydrate intake wasn't changing. And in addition to that, I felt low energy, I couldn't exercise properly and I said, you know what? It's time for a change.
So I started reading everything under the sun, attending scientific lectures, just opening my mind to the idea that maybe there was a different way. And along came this idea of eating a plant based diet.
And I used to be the kind of guy that would make fun of vegetarians, because when I was growing up, I would be like, oh, that sucks that you have to be a vegetarian. I'm sorry that your life is so bad. Right. And then all of a sudden I got open to this idea of being a plant based eater because many people that I've spoken with told me that they felt dramatically different and better.
So I said, you know what? Let me try this out.
So under the guidance of a guy named Dr. Doug Graham, who actually lives in the UK as well.
He taught me how to start eating lots of fruits and lots of vegetable. Just that simple. And also to eliminate meat, cheese, fish, chicken, dairy products and oils.
And in so doing, I was expecting when my glucose would go through the roof because I was eating a lot more carbohydrate rich foods.
But in reality, my blood glucose came down quickly and my insulin use came from forty five units down to twenty five units in one week.
I was eating almost six times the amount of carbohydrate people might eat, but my insulin use had fallen by 40 percent.
So I said, wait a minute. Something interesting is happening here.
So long story short, I took myself back to graduate school. I went to go get a PHD in nutritional biochemistry so that I could understand the actual science of what was happening inside of my body.
I just wanted to explain this machine. And while I was there at UC Berkeley, I learned that there's actually a whole collection of scientific information that explains not only what happened to me, but also what happens in people living with all forms of diabetes, not just type 1, but 3 diabetes, type 2, gestational and beyond.
So I took that information and me and Robbie Barbaro created Mastering Diabetes and Mastering Diabetes is basically a coaching program that teaches people living with all forms of diabetes how to transition to a plant based diet so that they can also get exceptional help.
So we've been at this now for, you know, just the better over four years. And we're absolute loving it.
We're seeing, I mean, thousands and thousands of success stories from people all around the world living with all forms of diabetes. And we now have a growing base of women who are diagnosed with PCOS and gestational diabetes, because insulin resistance is at the foundation for both of those conditions.
Here we are today. You know, I'm a happy camper and trying to spread as much good information as possible.
Hearing your story is incredible to think how this demonization of carbohydrates that people are being told to follow, they are not really as bad as we actually thought.
And people kind of in a way making themselves sicker by following low carb diets and restricting this key macronutrient, which has so many nutrients in.
And to see that you focus so much on just eating these carbohydrates that your insulin sensitivity improved and your diabetes improved. It's just like it kind of it it goes against the grain of what you what we hear or what we've been told.
So it's just it's fascinating to just break those myths and for people to not fear carbohydrates anymore. Because when I was diagnosed, I was told, you know, lose weight for my PCOS. I didn't have a insulin resistance. But the standardized information is always cut carbs, lose weight, exercise more and all this stuff.
And I went down that route of cutting carbs and feeling like absolute rubbish and over-exercising and doing all this stuff. When you don't have to cut the carbs, I could just eat better carbohydrates and just nourish my body better.
So it is just simple and obviously there is no one size fits all diet firstly and carbohydrates are not the devil like we all think.
Cyrus Not even close.
Kylie Really briefly. So my name's Kylie Buckner.
I'm a nurse and you know, as a nurse, like I sort of grew up with that same mindset like I I learned as a nurse how to help people with diabetes and to teach them how to eat a low carbohydrate diet.
And so, you know, I kind of came up in that medical system that's very standard approach for all forms of diabetes. And it was in 2011 that I read the China study and basically my sort of shift happened in terms of how I wanted to eat at that point.
So and, you know, I had some some underlying inflammatory issues that I knew were happening and I didn't really understand them. But making that change really helped me a lot with improving some of the inflammation that was in my body.
Now, when I met Cyrus. And you know, I was already sort of following the plant based diet. I was trying to put it all together, figure it out. Cyrus and I met.
He was living with Type 1 diabetes and already following this method and eating all this fruit. I was like, what is happening? Again, the nurse and me was like, you have diabetes.
You can't eat all that fruit like, what's happening? And you know the way that he managed his own diet, diabetes, how he took charge of that through his nutrition, through food was just so fascinating to me.
And so you know, it definitely opened up a path for me to maybe pull my world together a little bit more.
So I've been working with Mastering Diabetes as a coach since basically it started.
But I mean, you know, we're married, we work together, we do this work together. And it's so amazing to see so many stories of people who are taking their health in their own hands. They're using this method, they're using these tools, eating a whole food plant based diet and feeling great and also getting results that are improving their health.
You know, we see women, we work with women. They may come to us because of their Type 2 diabetes or pre-diabetes, but they also have a diagnosis of PCOS. Someone who come to us because they have PCOS and to see the results that they get in terms of the weight loss or, you know, being able to reduce their A1C, it's just it's so exciting because it really gives people so much hope in their own health condition in understanding how their body is working and it's just a really exciting process to be a part of.
Despina Yeah, it really is.
It's just amazing when you really uncover the causes of, you know, PCOS, which is like it could. one of the biggest causes is insulin resistance.
So uncovering the root cause and figuring out that there's a way to reverse the symptoms of PCOS and live symptom free is incredible.
Because when you're diagnosed, you often feel like a victim that you are stuck and you can't really get out of your symptoms, whether it's like infertility or the symptoms of insulin resistance and irregular periods.
It's just amazing that there's there is a way out and to live symptom free and, you know, have a, you know, successfully become pregnant and conceive.
And all this stuff is just amazing that, you know, put all this information out there raising awareness about insulin resistance and PCOS as well.
So let's delve into the main topic here.
Let's kind of backtrack, what is diabetes and insulin resistance. What are the different types of diabetes that you mentioned in the intro just that our listeners who don't really know, they may have heard of it, but actually don't know what it is and how to find out if you do have insulin resistance. What do they need to do?
The Types of Diabetes
So diabetes can become pretty confusing in today's world because there's so many different types. So let's just be straightforward and understand exactly what they are.
So the first two types are called type 1 and type 1.5 diabetes.
Both of these are considered auto immune condition.
Type 1 diabetes affects people generally under the age of 30 years old.
Type 1.5 diabetes affects generally people over the age of 30 years old.
Both of them are auto immune. Which means that your immune system has been coerced or tricked into believing that the insulin producing cells in your pancreas are a danger and a threat to you.
Therefore, your own immune system goes and destroys those cells and that cripples your ability to secrete your own insulin.
So type 1 diabetes affects younger people.
It's a fast acting condition and people can get diagnosed with type 1 diabetes and then within 12 to 18 months they can have effectively zero insulin levels.
People with type 1.5 diabetes are diagnosed over the age of 30 in general. They test positive for only one antibody as opposed to multiple. It's a slower progressing autoimmune. So you can think of it as adult onset, slow progressing type 1 diabetes, a phrase used.
Now you also have type 2 diabetes and pre-diabetes. Now, both of those are considered lifestyle conditions, they're not autoimmune.
The underlying condition that causes pre-diabetes is called insulin resistance. And then so what happens is that insulin resistance sets in first and then pre-diabetes happens next, and then after pre-diabetes, if you don't treat that properly and then it expands, it can then turn into type 2 diabetes.
So the nice thing is that when you started with some insulin resistance and then go to pre-diabetes, type 2 diabetes. In like 80 to 90 percent of all cases, you can move backwards and you can go from type 2 back to pre-diabetes, back to insulin resistance, back to healthy slash non-diabetic, and most people are unaware of the fact that you can actually do that. So that's the first sort of like light bulb that goes off in the head.
And then finally you have gestational diabetes.
Gestational diabetes is what happens to women when they're pregnant.
They usually get diagnosed at the end of their first trimester or maybe the middle of the second trimester. And the underlying cause of gestational diabetes is also insulin resistance. And so many women living with gestational diabetes are told that they are to either go on a low carbohydrate diet or modify their lifestyle so that they can control their blood glucose with precision so that they can maximize their own health as well as with their baby.
But what most women don't realize is that you can actually reverse gestational diabetes during pregnancy, and it's smart to try and do that because women who have been diagnosed with gestational diabetes are a greater risk for the development of Type 2 diabetes years after they develop or after they deliver. So the two of them are sort of like very closely connected to each other.
You can actually reverse gestational diabetes during pregnancy, and it's smart to try and do that because women who have been diagnosed with gestational diabetes are a greater risk for the development of Type 2 diabetes.
So the next question is sort of, well, what the heck is insulin resistance because we keep on referring to it, but what is it? Right.
What is Insulin Resistance
So the simplest way to think about insulin resistance is insulin resistance is caused by the consumption of a diet that is high in fat. Period. End of story.
And there's plenty of scientific evidence based literature to sort of back up everything that I'm saying.
So when you consume a diet that is either medium or high in fat and medium or high in fat, it's usually somewhere greater than about 20 percent of all calories that you consume when you either eat immediately or a high fat diet.
What is happening to the fat that you eat ends up travelling down your oesophagus and to your stomach and into your small intestine and these fatty acid molecules actually getting inside your blood.
Once they're inside of your blood, these fatty acid molecules, travel and other particles known as chylomicron.
So these chylomicron's have a job to sort of distribute fatty acids to tissues all throughout your body.
So their job is to distribute fatty acids to your adipose tissue, your fat tissue, as well as your liver as well as your muscle as well as your pancreas as well as your kidneys.
Now, if a majority of those fatty acids went into your adipose tissue, let's say all of those tissue, all of those fatty acids went into your adipose tissue. There wouldn't really be much of a problem. Diabetes would not really exist. That would be kind of a very, very small condition that nobody really cared about.
The problem is that there are plenty of fatty acids that are going to adipose tissue. But in addition to that, fatty acids also end up going inside of your muscle and inside of your liver. And that's OK as long as the fatty acid content is very small.
But what ends up happening is when you're eat a high fat diet for breakfast, lunch or dinner, you're having nuts, seeds, avocados, olive oil, red meat, white chicken, fish, eggs, bacon, you name it. And you're eating a lot of these foods. It's very common in the low carbohydrate world. Then the amount of fatty acids that gets inside of your muscle and liver starts to accumulate and gets more and more and more and more.
It is a true statement that both your liver and and muscle basically say, oh, wait a minute, there's more fatty acids coming in. I'm going to try and burn those fatty acids because it's an available fuel supply.
But in these low carbohydrate scenarios, what ends up happening is that the amount that comes in is in excess of the amount that can be burned. And as a result of that, your liver and muscle is accumulating fatty acids over the course of time.
So when they accumulate fatty acids over the course of time, they then go into a self-protective mechanism and they block insulin from working.
And the reason they want to do that in the first place is because they want to block more fat from coming into the tissue.
They want to block more energy in general coming into the tissue, but they don't have a good mechanism to do that.
There's really no solid you know, there's no solid form of a hormone that you can block that's going to basically block fatty acids from coming in.
But if they were to block insulin, then what they can do is they can block a lot of glucose from coming in and they can also reduce the amount of fatty acids that come into the tissue.
So to sort of put on a break, they basically say, OK, we're going to stop paying attention to this insulin thing.
So what that means is that the next time you go eat a banana or a bowl of quinoa or a potato or anything that has carbohydrate value to it. You eat that food, the glucose from those carbohydrates wants to get inside of your liver, wants to get inside of your muscle. And when insulin comes and says, hey, knock, knock, liver, knock, knock muscle, there's some glucose in the blood you want to take it up. Both of those tissues say, no, no, no, I don't have the time to listen to you right now. I've got to burn this fatty acids up first. Let me get rid of this. And then once I do, I will then allow myself to communicate with you.
So as a result of that, people will eat carbohydrate rich foods and they'll check their blood glucose two hours later and they will see a high number on their blood glucose meter because glucose got trapped in your blood and insulin both got trap in your blood.
And then they look at their diet and they say, look, every time I eat fruits, my glucose goes high. Therefore, fruits are bad for me. Fruits equals sugar. Sugar is gonna make me more diabetic. It's going to make me gain weight. Therefore, I shouldn't eat fruit. Right.
So that it sort of reinforces this anti carbohydrate propaganda.
But it turns out that it's not the banana's fault. It's not the quinoa's fault. It's everything that you eat before that that actually caused the traffic jam that prevented the glucose from being utilized properly.
So the way to reverse it is to adopt to sort of flip everything on its head and reduce your total fat intake. And we do it in the Mastering Diabetes book, we teach people how to do it by reducing their fat intake.
Eating a whole bunch more plant material and eating as many whole foods as you possibly can.
So when you eat a low fat plant based whole foods diet, then you end up quickly reversing this situation, relieving stress from your liver and from your muscle, allowing both of those tissues to communicate with insulin more effectively.
And that makes it so that when you go and eat carbohydrate rich food now, your glucose is very stable and you don't run into excess glucose or excess insulin in your blood, which limits your risk for chronic diseases. That makes sense.
Despina As you can see it is not the carbohydrates. It's another macronutrient, fat.
Well, you know, not like fats bad. But the over consumption of the fat and certain types to fat, that can cause the problem that we believe to be carbohydrates and fruit.
The whole demonization of fruit as well. Where everyone is always saying fruits bad all the time. It's just like, why would fruit be bad? Just because it's that thing, like you said, because it's got sugar everyone thinks anything that has sugar in it is automatically put in this group where just avoid, avoid, avoid it. In reality, it really isn't the case.
But it also bothers me when people use the word sugar to describe the material that's in fruit, because in reality, technically speaking, yes, glucose and fructose, which are the two predominant.
What do you call them? The two predominant.
They're they're both sugars. They're the monosacharides. They are the two predominant monsacharide molecules that are present in fruit. They get over exaggerated.
So they're both sweet and they both have they can be both used as fuels except people like those two into a thing called sugar. And then they refer to that fuel from a fruit as having the same metabolic effect as high fructose corn syrup or as a tablespoon of white sugar, which is a fundamentally incorrect argument.
But yet when you use the word sugar to describe both types of fuel, then it's confusing. And also you say, OK, well, anything that contains this stuff for quote unquote, sugar is bad for me, including potatoes and quinoa and rice. Right. And that's where people go get a little bit.
And it's like this misinformation that really makes just us laymen people get so confused. And then you end up restricting everything, every kind of food. You just get stuck what do you actually to eat?
People say fats bad, carbs are bad, don't drink this, don't eat that.
People are just so confused and feel so overwhelmed with this, just conflicting information. So I'm just glad that you're able to provide the evidence and the actual biology and the biological process of what actually causes insulin resistance. And so we really know that this evidence out is not just like people just randomly just making it up, just just to go against the grain. It's like a debate.
So how can someone go about what test do people need to do to find out if they have insulin resistance?
How To Find Out If You Are Insulin Resistant
So there's many tests that they can do that they can take, actually.
Kylie developed a really simple collection. She built a mnemonic called PILAF like rice pilaf and PILAF is what you can use to actually determine whether or not you are likely to be insulin resistant.
So I'll turn it over to her and she can explain all about that.
So basically think there are bio metric numbers that you can use based on your health assessment that you get using your doctor.
You get to check out lab work and the primary sort of bio metrics that we use for understanding insulin resistance is in terms of PILAF.
What that stands for is, the P stands for blood pressure.
So if you have elevated blood pressure, that's one indicator of insulin resistance, because insulin resistance, influences not only a diabetes diagnosis, but also influences cardiovascular functioning.
So it's multi systemic and it will impact so many parts of your body's functioning.
So blood pressure is one of once you're living with hypertension or high blood pressure. That's one indication that you are living with some degree, of insulin resistance.
The I in PILAF stands for ideal body weight.
That's basically what you're aiming for. It's to be at your ideal body weight.
If you're carrying excess weight, or excess energy in your body, that is another indicator of insulin resistance.
The L stands for lipids and that refers to your cholesterol panel.
So LDL cholesterol, HDL, triglycerides and your total cholesterol numbers. If any of those are elevated or out of range, that is one another kind of like adding to the layer of your level of insulin resistance.
The A stands for A1C, which is the measurement for people living with insulin resistance and diabetes. Usually that's the diagnostic criteria for pre-diabetes or type 2 diabetes.
A1C is an important measurement for the last three month period of your blood glucose average gives you an average number of your blood glucose.
So if your A1C is elevated, it indicates a higher degree of insulin resistance.
And then the F in PILAF stands for your fasting blood glucose.
Again if you go to the lab and have your fasted blood glucose tested or if you're checking your own blood glucose and you see an elevated fasting blood glucose value. Fasting blood glucose is actually one of the best indicators of insulin resistance or improving insulin sensitivity as your fasting blood glucose goes down.
That's a really good indicator that your insulin resistance is actually improving.
So we kind of use that in both directions. But we've actually created a little checklist that's the insulin resistance checklist because those bio markers are things that you can measure over time.
And so if you're somebody who's looking to understand your level of insulin resistance, you can hang it up on your refrigerator.
And, you know, every time you go to your doctor and you're getting your blood or your blood pressure checked, you can kind of keep track of things over the course of time to see how you're progressing or even to see how things are maybe even you made that becoming more insulin resistant over time as well.
Cyrus And another test that you can do that's like the most direct measurement that's easily accessible is you can go to the doctor and you can order what's called a glucose tolerance tests or a OGTT, Oral Glucose Tolerance Test or GTT, Glucose Tolerance Test.
So the way that this works is you go to the doctor, they measure your fasting blood glucose before you get to show up in the fasted state. They measure your fasting blood glucose, then they give you a solution that contains water with about 75 grams worth of just pure glucose.
So you drink that and then they monitor your blood glucose and insulin levels over the course of the next two hours and they should monitor every 30 minutes. So they should matter at zero, 30, 60, 90, 120.
Now, if your blood glucose goes high during that time period, as high as anything, overbuy 160. That's one indicator that your basal metabolism is unable to process and metabolize glucose from that beverage.
But more importantly, if your insulin levels go high, regardless of whether your glucose goes up, that is the best indicator as the strongest indicator that you are insulin resistant, because anytime you are forcing your pancreas to secrete large amounts of insulin, you are basically forcing your pancreas to work hard. And that right there is a classic, classic insulin resistance response that we're trying to limit by consuming a whole foods plant based diet.
Despina Awesome, thanks for sharing that.
And I'll try and include the PILAF in the show notes so people can refer back to it.
So I want to ask you something, because I feel like people going to this always this huge debate here where people are like Keto and plant based.
So people follow the keto diet for their insulin resistance and they notice an improvement. And then there's always this whole evidence for the plant based diet that it helps insulin resistance.
So what would you say to someone who has been diagnosed with insulin resistance or diabetes and they have been scrolling through the internet and they found Keto or they are on social media and some influencer said keto is the best diet for insulin resistance.
What would you say to this person to give them that extra information to why Keto might not be the best kind of diet for this situation?
The Keto Diet vs the Plant-Based Diet
So the reason why both people who eat a plant based diet and people who get a ketogenic diet experience improvements in their diabetes. And I would also love PCOS in this exact same category. You know, women with PCOS also experience health for both sides.
The reason that that happens is actually quite simple. Both approaches are likely to lower your fasting insulin and your fasting glucose.
A plant based diet can absolutely lower your fasting insulin and fasting glucose. We see that over and over again. A ketogenic diet also lowers your fasting glucose and also lowers your fasting insulin level.
So what people what people do is they eat a ketogenic diet. Oftentimes they lose weight. They drop their fasting insulin, the fasting glucose, their A1C improves, their blood pressure improve, their cholesterol goes down, the triglyceride goes down. And they say, hey, looks like things are moving in the right direction. And I give them a giant high five, as I say, hey, look, things are definitely moving in the right direction.
But here's the problem. Only taking a look at your fasting insulin and your fasting glucose and or your A1C value does not definitively measure insulin resistance.
OK. Again, those are those are important indicators. But like we just said, if you are going to measure your level of insulin resistance, there is really only one way to do it. That will give you a definitive answer, and that is to get a glucose tolerance test.
So if you take a ketogenic dieter and you say, OK, great, your fasting insulin is low. You're fasting glucose is low and your A1C is low. High five.
You give them a glucose tolerance test within that two hour period, their blood glucose and or their insulin requirements are going to skyrocket. And when I say skyrocket, I really mean skyrocket. I mean, likely their blood glucose is going to go way in excess of 160, likely in the 200 to maybe low to two hundreds to 50.
And there are insulin requirements are also going to be dramatically high. And the reason for that is because there are a ketogenic diet has actually increased the amount of insulin resistance in their body, even though in the fasting state they get a low fasting blood glucose and a low fasting.
So what they're doing is they're looking at two bio markers and making it and making a conclusion that is incorrect.
Now, if you look at the plant based eater especially, it's a low fat plant based eater. What you will find is that they also have low fasting glucose and insulin. But if you give a plant based eater a glucose tolerance test in most situations, because they have gained insulin sensitivity when they consume that beverage that contains 75 grams of glucose. Their blood glucose is not likely to budge in their insulin levels are not likely to budge.
Again, that's a strong indicator that they are insulin sensitive as opposed to something else.
So it's just a classic example of of not using the right test to determine whether you are insulin resistant or not. Looking at the incorrect bio markers and then making conclusions that actually don't stand the test.
Despina Awesome, I am glad you touched on that because this is like a huge debate in the PCOS community.
So it's good to be like raising this information on the podcast because I get I get this question all time. So I like to have people like yourselves say your stance and provide the evidence.
Kylie You know one more thing to add on to that, too, is the fact that when you're looking at long term health outcomes as well, you know, we know from the research and from years of evidence that people who follow a high fat diet are much higher risk for cardiovascular disease, much higher risk for hypertension, much higher risk for high cholesterol that causes things like strokes and heart attacks.
And I think that that's something that also doesn't really fit into the equation when you're comparing ketogenic versus the plant based diet, because the ketogenic diet being a high fat diet, we know the long term effects of that. And you put it up against my best diet, looking at long term health outcomes. You're going to see a very significant reduction in your risk for these long term health issues when you're following a plant based diet.
So, you know, I feel like, you know, again, as a nurse, as a wellness promoter, a health promoter, I can't overlook that in terms of long term health outcomes and life expectancy. And that's a really important part that I think there's just not enough information. I mean, if you're looking at strictly the ketogenic diet, such a new term for the new term for a new version of other high fat diet.
And when you look at the research and look at the evidence on the high fat diet, you will see time and again that it just has detrimental effects for your long term health.
Despina That's that's the thing I like to tell my clients.
So you got to be looking long term whenever you're thinking of following some kind of diet.
Always look long term. See, has there been any long term studies looking into the ketogenic diet and seeing what the effects will be on your body?
Just short term, yeah I may lose weight, I'm going to see some improvements in certain markers. But long term, is there evidence that this is actually going to help, ten years from now, not just from one month to the next.
I want to ask you. Someone who's just been diagnosed now and they've heard about the plant based diet and they want to give it go. How how does your approach how would they get started following a plant based diet if they've been, you know, a meat eater and just a normal kind of person who follows a balanced diet. How would they start following your approach?
How Someone Can Get Started Following A Plant-Based Diet
Kylie Yeah, I mean, this is something this is like what I do every day, you know, I help people make this transition to. I love this question. And one of the things to keep in mind was that's the way to do it is it is slow and steady approach. That's how we approach it.
It's a very methodical your meal by meal approach. And, you know, there's so many influences on the decisions that make every day. And I know, it's hard to make changes in your life. Very challenging to me, too.
Our brains don't like it when we make changes. Our brains, like the path of least resistance and doing the things that we've done for years and years and years and familiar smells and familiar flavors.
So when you're making these changes, it can be very disruptive inside your brain. And so we start with one meal and that meal we tend to start with is breakfast. And it's a great way to start your day with a new choice, a fresh start.
And the way that we recommend is to start by eating fruit for breakfast because it's highly nutrient rich, has tons of fiber, tons of carbohydrate energy to give throughout the day.
Making these changes, it can be very disruptive inside your brain. And so we start with one meal and that meal we tend to start with is breakfast. And it's a great way to start your day with a new choice, a fresh start.
And, you know, some of our clients will take a little while longer on that first meal. So it's sort of like kind of get a gage for yourself when you're ready to start making that move to the next meal.
Cyrus And we usually recommend making one change per week.
So if somebody were to start changing their breakfast, just like you describe, we don't literally change your breakfast and nothing else. I don't want you to change anything else and just understand how your body reacts to that meal. What is your appetite like? What is your digestive process? How's your glucose? What does your mental process is like? And then once you feel comfortable, you understand what's happening.
Then you move on to the next one.
Kylie Yeah, kind of allowing your body and your brain to catch up with the choice that you make. Right. The decision that you need to make to try something new.
But the slow and steady method works really well that week by week approach you by the end of a month or so, you're looking at a whole new maybe dietary experience, which is way less overwhelming for your brain to have to deal with that like going from zero to 60. Right.
Like all of a sudden and just today and just going to diet and not really know how to such a self up here, how to grocery shop, you know, preparing to eat differently also takes time to get used to. So if you're only having to shop for a new one, new meal a time, it just makes that transition way more fun and a little bit easier. Yeah.
And you've got all this broken down in the book as well. I've seen, you know, the chapter where you kind of break everything down, which is really useful.
But I think, like you said, slow and steady, changing one meal compared to just one day waking up and being like all right, plant based diet.
It's just you get it gets overwhelming.
You don't where to start and you just kind of guess I should be doing this. And it's good that when you change one meal, you assess how you feel after that one meal. So it's not just, you know, just going making a change and not assessing how your body's reacting. How you mentally feeling?
I mean, it's good to take a step back and assess the changes you'll making before completely diving straight in and hoping everything works out without planning.
Planning is really important. And in the book, you really help people understand how to plan something and make it enjoyable.
The recipes you provide in the book are just awesome and it makes it exciting. So it's it's just great awesome.
So is there anything else you kind of want to touch on about the plant based diet? Your book, the Mastering Diabetes book, Mastering Diabetes The Method. Your approaches to get people, you know, to inform them a little bit more about the whole process.
Cyrus So what the take home message here that I think is important not only for people living with any form of diabetes, but, you know, for people living with any health condition that is influenced by insulin resistance or health conditions that are influenced by insulin resistance are increasing in number over the course of time.
We have all the versions of diabetes, type 1, type of 1.5, they are not caused by insulin resistance but they are influenced by it.
In other words, if you become insulin resistant, then your glucose becomes harder to manage.
Again, pre-diabetes, type 2 diabetes, they're caused by insulin resistance. Gestational diabetes is caused by insulin resistance.
Then in addition to that, you have hypertension, high cholesterol, coronary artery disease, atherosclerosis, many forms of cancer. Erectile dysfunction is a vascular problem that is also affected by insulin resistance, peripheral neuropathy, nervous nerve tingling in your extremities, that's also influenced by insulin resistance, as is PCOS as well.
So women who are living with Polycystic Ovarian Syndrome, just like you said, 70 percent of them are living with insulin resistance and they're trying to find ways to relieve that insulin resistance because when they do, their symptomology improves.
So the real question becomes, OK, well, how do you deal with this insulin resistance? Because if you can, then the symptomology of many other conditions either goes down or disappears. And that's the beauty of really addressing these these conditions at the root, at the core of the problem.
So carbohydrate phobia is is is a very dangerous game to play. It may get you good biomarkers in the short term.
But just like Kylie said, it's not going to improve your long term health effects. It's going to decrease your long term health.
There is plenty of studies that demonstrate that eating a low carbohydrate diet where you are limiting your carbohydrate intake leads to increased chronic disease, whether that's hypertension, atherosclerosis, high cholesterol, type 2 diabetes and beyond.
So what I would really, really, really strongly encourage your listeners to understand is that insulin resistance is a central condition that controls so many other chronic diseases. And if you can really, really address it, using a plant focused diet or a plant strong diet, it doesn't have to be a fully plant based diet, but as plants strong as you can get, then you dramatically you like relieve the pressure.
It's like a pressure release valve that many tissues in your body benefit from your brain, your thyroid gland, your vasculature, your heart, your liver, your kidneys, your sexual organs, all your nerves.
All of these tissues become more functional or less dysfunctional. And over the course of time, if you're improving your total body health, then that's going to promote longevity.
And remember that you're just going to feel better, period. End of story.
So let's try and move in that direction rather than being coerced into this concept that a low carbohydrate/ketogenic diet is the solution because it's a short term solution that doesn't translate well in the long term.
I think people just group all carbohydrates like processed and the natural carbohydrates can't go into like the one big basket rather than like, you know, like completely different things.
These processed are not the same as eating quinoa or a sweet potato for fruit and vegetables.
I think people need to, you know, I know people will say don't label food, but there is clear differences between these carbohydrates that they're not the same and they act differently in the body.
So just assuming every carbohydrate is bad, it's we have to just change our perception that our mindset mindset towards them.
But, I wanted to ask one thing that I always get asked. And it's a really common question. I think there is not really like an answer. Like a certain answer. But I'm going to ask anyway.
The question is, how long does it take to start seeing improvements or fully reverse insulin resistance or diabetes. Is it a time frame that people can, you know, because obviously it gets a bit, you know, you're kind of make these changes but you don't really see stuff.
What's that time frame where people can expect to start to see some improvement?
How Long it Takes to see Improvements in your Insulin Resistance after Following a Plant-Based Diet
So the beauty here is that it's it's pretty darn fast. OK. But it's not a one size fits all approach because all human beings are graded differently.
So if you go back to the PILAF checklist that Kylie talked about earlier, we are talking about blood pressure, ideal body weight, lipid panel, A1C and fasting glucose.
So if those markers are elevated, then it's going to take time to move them back into range.
Now, if those markers are significantly elevated, that is likely going to take even an even longer time to get the written. Right. Right. So let me say this worst case scenario. You take somebody who is 60 pounds overweight, who has an A1C value of 9.0 where it's supposed to be closer to 5.6. Maybe their blood pressure is one hundred and fifty over one hundred and twenty. Their lipid panels elevated, their LDL cholesterol is elevated and their fasting blood glucose is two hundred.
So in that scenario, you take somebody, you put them through the mastering diabetes protocol and mastering diabetes method. Worst case scenario, their blood glucose and insulin levels or their blood glucose is not going to change for, I don't know, 10 days, maybe two weeks max, at which point if they stick with the protocol, they're going to start to see some improvements. That's like that's an absolute worst case scenario.
More appropriately, what we see usually is that people who adopt the Mastering Diabetes method start to see changes in their blood glucose and their energy levels and their digestive processes and their mental clarity within literally three to four days. I mean, it is fast.
When I transition to a low fat plant based diet whole food diet, I saw changes in my blood with those within 24 hours and my blood glucose fell like a rock and I had to start decreasing how much insulin I was giving myself to do that quickly. Right.
But in addition to that, I'm also at my normal body weight. I have a normal lipid panel. I'm not hypertensive. My A1c is slightly elevated and I exercise for 60 minutes every single day.
So as a result of that, I already had a number of you know, I had I was not that far away from, you know, having an ideal insulin sensitivity. And as a result of that, I saw changes pretty quickly.
So point being is that it's a very fast improvement. And most people think, oh, well, you know, if I'm going to reverse insulin resistance, reversing insulin resistance is going to take me two years. And the answer is yes, fully reversing insulin resistance can take six months to a year to two years depending on the severity. No questions asked.
But to start seeing the improvements and to be positively encouraged by what you're experiencing. That usually happens within days to one or two weeks the most.
Kylie Yes, it is really encouraging for people to see the changes in their blood glucose readings because that is a daily reminder.
And you know, with weight you maybe do a weekly weigh in or maybe less frequently than that. Even so, it's harder to see the changes there.
But when you start seeing changes in your blood glucose right away, it's very, very motivating. And we have a one member of our program who came to us in January after having their last A1c be 7.5.
Somebody living with Type 1 diabetes have never, ever been below 7.5. And after six weeks in our program happened to be getting their A1C rechecked. And the follow up A1C from six weeks in this program was down to 6.5.
So, I mean, that's a really big change, the 1 percent reduction in A1C over six week period. And that's a huge improvement for somebody who's been living with any form diabetes, struggling with your A1C.
If that's you know what that struggles like, then to go to your doctor every time you feel that we have that test.
Oh my gosh, how's this one going to go this time. Because it's a real concern for a lot of people living with diabetes and you know to finally get some like really positive feedback that, wow, I can actually make these changes in my health.
I can influence my A1c. I can see reductions in my daily blood glucose readings or improvements in those readings.
It's just such a wonderful feeling to be able to see those changes. It's very motivating, very empowering.
It keeps people recommitted to that lifestyle.
Because obviously living with a condition that can be, you know, it's hard.
So being able to see those improvements while making the changes to, you know, of the diet that, you know, used to like you are completely changing your eating habits they want to see those quick improvements even within a few weeks, a few months is is really motivating and encouraging to keep sticking to that whole way of eating and continue your lifestyle.
The final thing I want to ask is, is it possible for someone who's following the plant based diet to just do that alone or do they have to couple it with exercise? Can you just be just changing the way you eat?
So in in the mastering diabetes book, we explain the mastering diabetes method and the method is specifically designed just like Kylie said earlier, to do it step by step format so we actually don't recommend making changes to your exercise habits right off the bat we really don't.
Because when you make changes to just your diet by itself and you transition to more plant based diet, there's so many changes that are happening right off the bat that adding exercise in, especially if it's like long duration high intensity exercise can actually become problematic.
So what we recommend is literally change your diet in isolation first. Do that for at least a month.
Change your breakfast for a week. Change your lunch for a week. Change a dinner for a week. Change your desserts for a week and get really comfortable with it. If you need another month, go for it. Take it. It's fine.
Once you've gotten there, then we recommend starting with with intermittent fasting and then we teach you how to use intermittent fasting as another tool in your insulin sensitivity toolkit, and then we teach you how to use exercise as the third insulin sensitizes.
So most people in our program, they don't even touch exercise for like two months. Three months. Right. The super ambitious people do. And we teach them how to do it in a safe manner.
But the idea is, if you if you only wanted to make changes to your diet, didn't want to make changes to exercise pattern, by all means, go for it. It's going to work. It's going to work well.
And, you know, we're here to support in any way possible. We have people in our coaching program that are, you know, working with us on a daily basis to make sure that they are safe as they make this transition. And when you do it in a controlled manner, the sky's the limit. No questions aksed.
Despina Amazing. Amazing.
So where can listeners find the book Mastering Diabetes? But where is it available?
Cyrus Well, there's one on our counter right now.
So what you do is you go to our website, masteringdiabetes.org/book.
You go there and then you can read all about the book. You'll see that it's been endorsed by its practically every single plant based doctor under the sun. And then on that page you can you can buy it from Amazon or Barnes and Noble, Books a Million, IndieBound.
If you live internationally, meaning outside of the United States, you can absolutely get your hands on a copy. You know, whether you're in the U.K., whether you're in Australia, whether you're in China, you know, you can you can find a way to get it to you. No problem. That's the easiest thing to do.
And then, you know, for people who are interested in participating in a coaching program, they want guidance, help, assistance, expert coaching, Q&A, video conferencing on a weekly basis. They can also see that on our website, masteringdiabetes.org/coaching or it's like coaching, masteringdiabetes.org/plans, whatever you want. And it works like a charm.
Kylie The book is also available on audible.
Cyrus The book is also available on Audible.
If you want to listen to the audio book, which Robbie and I actually recorded. That's fine as well. And then there's also the Kindle version or the Nook version, if you like to look at it digitally.
So all those are available and we appreciate the opportunity to talk about it here today Despina, super cool of you.
I really enjoyed reading the book, you did a great job of breaking down a really complex information and explaining through evidence why the popular way of thinking that we've been told and we see on Google about insulin resistance and diabetes and carbs is false. And by breaking those myths and misconceptions.
I will link the book in the show notes and where you can buy it.
Do you have any social media channels you want our listeners to follow you on?
Cyrus Of course. Of course.
Social media is fun for us. So if you're on Instagram, find us at @masteringdiabetes.
If you're on Facebook, follow us at @masteringdiabetes. If you're on YouTube, following us at mastering diabetes. Pretty, pretty straightforward. So just type in those two words to any social media platform. And we should pull up.
Instagram is usually is the the best place to find us. Because we're very active there. And, you know, for those grammars out there, come hang out with us and we can have some fun.
Despina Awesome, thank you so much for coming on the podcast.
Highly recommend buying the book, follow you on Instagram and other social media platforms. Its been an honour speaking to you both.
I'm sure our listeners have learnt a lot about insulin resistance, diabetes, carbohydrates, fats. Everything. So thank you so much for taking the time out of your day to share the knowledge, raise awareness and its been great speaking with you. So thank you.
Cyrus Thank you Despina.
We really appreciate it. You know, we really appreciate the opportunity to talk about this and get the word out because you doing a great job of spreading information that's evidence based for people who are really looking for solutions, so thank you one more time and we appreciate it.
Despina Thank you so much.
Purchase Cyrus's and Robby's Mastering Diabetes book masteringdiabetes.org/book
Interested in the Mastering Diabetes approach, check out their coaching plans https://www.masteringdiabetes.org/plans/
Connect with Cyrus Khambatta and Kylie Buckner
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