Site Navigation

Rochester, NY

© 2018, Ian M. Cramer, MS, ATC.

Let's Get Healthier, and Stay Healthier, Together. 

Robby and Cyrus THUMBNAIL.png

ICP 52: Robby Barbaro and Dr. Cyrus Khambatta, PhD.

Reversing Type 2 Diabetes with Fruit

If you or someone you know if living with pre-diabetes, Full blown Type 2 diabetes or is a Type 1 diabetic, this is the episode for you.

Robby and Cyrus are experts at treating and reversing pre-diabetes and Type 2 Diabetes, a scourge to over 100 million people in the US, according to a new CDC report.

In our discussion, we get into the details of what is truly causing Type 2 Diabetes, the enormous role our diet plays in causing this and the role our diet can play in reversing it. We also juxtapose their method of treating diabetes with other methods touted in the interwebs and talk about which one is better and why.

And as you could tell in the intro, Robby and Cyrus treat it very differently than you would think. They are able to reverse a disease of too much blood sugar with foods that contain lots of carbohydrates, or sugars. It seems wildly counterintuitive and it seems like they’re nuts, but Trust me, by the end of this hour, you will understand why, you’ll understand the root cause of why people have Type 2 Diabetes and be able to take control of your health and learn more about this completely 100% preventable disease.

So, Let’s get right into it, on Episode 52, with Robby Barbaro and Dr. Cyrus Khambatta, PhD. of Mastering Diabetes.

Check out the Mastering Diabetes Website

Special thank you to Adam Sud who gave me a nudge and recommended I speak with Robby and Cyrus. I really enjoyed that conversation. And more thank you’s to 2 new patrons, Fellow plant-based Cyclist Stephen Collins and Bilberry Elf, thank you for your kindness and support.

Do you pay for a Netflix subscription? Or Perhaps Sports Illustrated, National Geographic or The New York Times? If so, you do this because you get value and enjoyment out of those publications, magazines or newspapers. In this case, my publication is free and always will be because I feel in the bottom of my heart that this information is too important to withhold from the public. So my business model is slightly different and the barriers to obtain this information are essentially zero, but the ‘value aspect’ still remains. And so I will end this episode with asking you, how much do you value these conversations? You might say “Not enough to pay for them”. And that’s fine, no judgment. Enjoy them and I hope you learn and get healthier. But you want to help my cause and my work and help this message of plant-based nutrition and lifestyle medicine, join the 34 other Listeners and Patrons who feel the same way. Per Month, Sports Illustrated is around $1, The New York times and Netflix is $8, and National Geographic is $12. We have Patrons donating 1, 2, 5, 10 or as much as $40 per month for these thoughtful and well researched conversations. And I really appreciate your support. To find out more about how this works, you can visit Patreon.com/IanCramerPodcast to read about the donation levels, the perks or what you can do to help if donating isn’t your cup of tea.

The bottom line is I hope you get something out of these conversations, I do this because I love it and it’s a labor of love. I want to change the world with this message, and would love for you to join me.

           

Until next time, keep eating more plants, keep asking questions and stay curious, remain responsible and compassionate ambassadors to this movement, and stay healthy.

Intro Music Credit: http://birocratic.bandcamp.com

Insulin Resistant? Who cares? 

What is Insulin Resistance? 

Encouraging Fruit for Type 2

Diabetics

Ketogenic adaptation stop.

Type 2 Diabetics die from Heart Disease

Ian Cramer:                  00:00:10          Can I just say, can I just say before you get into this, I was envisioning myself saying this, so I want to get this in here, is if people hear, I'm sure if people hear the way you and Cyrus treat type two diabetes with a high carbohydrate, again, coming from not refined sugars and refined flours, carbohydrates, but from whole plant foods, which I'm sure you're going to get to tell us about, if they hear that they probably. They probably think you're nuts. You're absolutely nuts!

Robbie Barbaro:           00:00:43          They think we're absolutely not and then it gets even worse when we tell them that we eat majority of our calories from fruit. I mean personally, that's our personal stories.

Ian Cramer:                  00:00:52          That's Robby Barbaro, along with his partner in diabetes prevention and reversal Dr Cyrus Khambatta on the podcast that's dedicated to making you healthier by interviewing medical doctors and scholars of lifestyle medicine and plant based nutrition. This is episode number 52 of the Ian Cramer podcast. If you or someone you know is living with prediabetes full blown type two diabetes or is a type one diabetic, this is the episode for you.

Ian Cramer:                  00:01:42          Robby and Cyrus are experts at treating and reversing pre-diabetes and type two diabetes, a scourge to over 100 million people in the US, according to a new CDC report. In our discussion, we get into the details of what is truly causing type two diabetes. The enormous role diet plays in causing this and the role our diet can play in reversing it. We also juxtapose their method of treating diabetes with other methods touted in the interwebs and talk about which one is better and why. As you could tell in the intro, Robby and Cyrus treat it very differently than you would think. They are able to reverse a disease of too much blood sugar with foods that contain lots of carbohydrates or sugars. It seems wildly counterintuitive and it seems like they're nuts, but trust me, by the end of this hour, you will understand why, you'll understand the root cause of why people have type two diabetes and be able to take control of your health and learn more about this completely, One hundred percent preventable disease. So let's get right into it. On episode number 52 with Robby Barbaro. And Dr Cyrus Khambatta of mastering diabetes,

Ian Cramer:                  00:03:26          Robby Barbaro, Cyrus Khambatta. Did I pronounce that correctly? That's exactly right. All right. It's great to be speaking with you guys. Let's start this off. I, I, I try to gather as much background knowledge as I could about you two, and interesting. Something I didn't realize is that you, you are both currently type one diabetics and that kind of brings us into my first question of pick any chronic disease or malady that people are suffering from these days. Why get focused? Why get really nichey with diabetes?

Cyrus Khambatta:         00:04:03          That's it. That's a great question. First of all, thank you so much for having us on the podcast. We really appreciate it when it comes to diabetes, The reason that Robby and I decided early on in this process that we wanted to, you know, really focused on talking with people with diabetes is because we recognized that diabetes is very confusing. It's extremely confusing to the outside world. So if you're living with any form of diabetes, whether it's type one, type, one point five prediabetes, type two diabetes or gestational diabetes, a lot of people end up going to youtube and typing in things like how to reverse diabetes, you know, foods for diabetes, weight loss for diabetes, and they do the same thing in google. If you do this, if you perform this exercise, you get hit with a bunch of different philosophies. The American Diabetes Association is saying one thing the Ketogenic community is saying another thing, the low carbohydrate community is saying something similar. And then the low fat community like us is saying something completely opposite. So your average person goes onto any of these channels and starts reading for 10, 15 minutes and then they just turn off their computer and they say, I'm confused. Right? How is it that there's so much evidence in support of things that seem to be completely opposite to each other. And so having lived with type one diabetes, both Robby and I now for a combined total of 30 years and having transitioned to plant based low fat plant based whole food diets, you know, for a combined total of 25 of those years, we felt like we had a lot of personal experience. And then also I went back to school and got a phd in nutritional biochemistry so that I could understand the science of it. So we have a personal experience and then also a lot of scientific experience which can, we can use that information to communicate with the diabetes audience and talk the language that people with diabetes want to need to have to hear in order to have the confidence that low fat plant based nutrition could be something that actually is beneficial for them.

Robby Barbaro:             00:06:03          And I'll just add to that, um, uh, when Cyrus and I created mastering diabetes, you know, we really wanted to fill a niche that was really not truly being served. So I was working in forks over knives for six years, publishing all kinds of great content articles. I remember publishing plenty of diabetes testimonials, but they weren't really detailed, they weren't in the, into the nuance details that of another person that maybe diabetes would really want to see us. You can look at our testimonials on our site. They're very, very specific to all the diabetes numbers, all diabetes information that you would really need to know. So if you're living with diabetes and you hear about plant based nutrition and you want to go somewhere, you're like, hey, I really want to learn this. I want to know what to do. I want some tips, I want some advice. So really wasn't one place to go. I mean, those. Dr Neal Barnard has a great book, antacid resource that's out there, but there wasn't really a website. Just focus the diabetes, you know, by people living with diabetes. So we're like, hey, we need to create this and that's why we have a coaching program and all the information out there to help people.

Ian Cramer:                  00:07:06          Cool. Cool. Um, I liked, I liked the fact that I think it's remarkable that, you know, where Cyrus was saying how, uh, it was a very confusing in a very complex topic, so it's, you guys chose like one of the most complex topics and one of the most difficult topics to, to explain into research as your niche, which I think just makes it all the more powerful. Um, so let's talk about then let's talk. Let's start talking a little bit about diabetes is, you know, absorbing information over the last seven years of being plant based myself. Um, and certainly in the last couple I'm, I'm very curious and I want to learn more about the other side, which I'm sure you guys do to, to Kinda help with your message. One of the messages from the other side and then sort of more of the quote low carb way of treating diabetes is this vilification of both sugar and also insulin. So my question is regarding insulin. Talk to us about the role of insulin. What is insulin resistance and how that fits into our normal physiology and also type two diabetes.

 

Cyrus Khambatta:         00:08:26          The question that you're asking is you just hit it on the head is literally like the most important question and probably the biggest controversy in this world of diabetes. Let's start at the top. Uh, insulin is a hormone that your, the Beta cells in your pancreas secrete when you eat food. So you eat some food. That food travels down your Esophagus, into your stomach. It gets into your small intestine and then eventually gets into your blood. Beta cells in your pancreas have these little antenna on these, uh, these receptors that are kind of sticking out into the, uh, into the blood at all times, and as soon as they sense that the glucose level in your blood has gone up just a little bit as a result of having eaten food, then their responses to manufacture insulin and put that insulin into your blood. The reason for that is because glucose cannot get into tissues for free. Okay? Glucose has to be escorted by insulin in order to gain access to your muscles and your liver and your gallbladder and your kidney and your thyroid gland, et cetera. So in order to get into these tissues, insulin is basically the, the escort that comes to the door of these tissues and it says, Hey, knock knock, I got some glucose, do you want to take this glucose up? And then tissues can either respond by saying, yes, I'll take it up, or no, I don't want to take it up. Right, okay. Now the ketogenic and low carbohydrate community has recognized something that's very important, which is that when you eat foods that don't contain very much carbohydrate energy like meats and cheeses and fish and dairy products and oils, that because those foods are so low in their carbohydrate content that they don't raise your blood glucose. So you can eat meat, you can eat dairy products, you can eat all these low carbohydrate foods and your blood glucose is not going to get elevated very much. And as a result of that, your pancreas is not going to have to manufacturer very much insulin. So it seems like a good thing because the, uh, the less insulin that you're forcing your, the Beta cells in your pancreas to manufacturer the better. Okay. And and and eating low carbohydrate foods will help you control your blood glucose. Okay? So all of this is a true statement. The problem is that number one, the low carbohydrate and ketogenic communities unnecessarily vilify or make insulin the enemy. And they put a finger on insulin and they say insulin is bad. Insulin is your fat storage hormone. Insulin will make you fat. Insulin will increase your cholesterol levels and insulin will will increase your risk of death. Okay? That is not a true statement. That is an exaggeration of the truth. The truth is that insulin is a required biological hormone that every mammal requires for life. You need it. You're nondiabetic A. I need it. Robby needs it. Cats need it. Dogs need it. Monkeys needed pigs needed sheet needed. You name it. If you're a mammal, you secrete insulin because it's a required biological hormone to allow glucose to enter tissues. Like we talked about. The problem is not insulin, but problem is excess insulin. So Ian, you, you are nondiabetic. If we had a, a way of measuring how much insulin your Beta cells are secreting as you eat food, we would come up with some number. Let's just say for the sake of argument that that number is 20 to 25 units per day. Okay? That's what a quote unquote healthy individual would be secreted. So let's just say that you're secreting 25 units of insulin per day. Okay? Um, the 25 units of insulin that your pancreas was manufacturing is, is safe. It keeps your metabolism functioning properly, it keeps your blood glucose in the normal range. And to be perfectly honest, it keeps you alive. If you went down to zero units of insulin or if you had a, an impaired insulin production, uh, your blood glucose, what yellow elevated and your risk for death would go up, period. End of story. So that insulin is required and that 25 units is a, is considered safe because it's within the range of what's considered a normal quote. Normal quote unquote healthy metabolism. Okay? The problem is that if you adopted some type of lifestyle that made it so that your pancreas now had to secrete 30, 35, 40, 50, 70, 80 units of insulin per day, now you're running into a situation where you're secreting excess amounts of insulin and that excess insulin is actually what's increasing your risk for death. So what the Ketogenic and Low Carbohydrate community, um, unfortunately they misinterpret is they say all insulin is bad. Let's try and minimize your insulin to use. And the only way to do that is to get you to eat the least carbohydrate rich foods on the planet. The more meat, more cheese, more fish, more oil, more dairy products. And by doing that you can take that 25 units of insulin and you can bring it down to 20 or 15 or 10 or even five units of insulin per day. Okay? The problem is that when you eat a low carbohydrate slash high fat slash high protein diet, you end up developing this thing called insulin resistance. And what insulin resistance is, is basically the storage of fat in tissues that are not designed to store excess quantities of fat. So when you consume that rich foods, the, uh, those fat molecules travel in your blood and they get into your adipose tissue primarily. So your adipose is, look at it everywhere. It's in your neck, it's in your abdomen and your shoulders. It's in there, but it's in your, uh, you know, it's in your legs, you name it. Um, so some of that fatty acid gets stored in that adipose tissue, but some of those fatty acids ended up in your muscle and some of those fatty acids ended up in your liver and some of them end up in your pancreas and some of them end up in your kidney. So if you were starting just tiny, tiny, tiny amounts of those fatty acids inside of those, uh, you know, non adipose tissues, there would be no problem. But when you eat more and more high fat, high protein foods as the Paleo and a ketogenic community will tell you that the amount of fat that's stored inside of your muscle and liver in particular starts to grow over time. So it starts out a small amount and then it becomes more and more and more and more and more, and then at that point when you're storing excess fat inside of those tissues, those tissues stop responding to insulin and when those tissues stop responding to insulin, the next time you go eat a banana or a bowl of quinoa or something that's carbohydrate rich then the glucose molecules that are in circulation that would normally be accompanied by insulin can no longer get into tissues because insulin comes knocking and says, Hey, do you want to take this glucose up? And the tissue say, are you kidding me? There's no way on taking that glucose up. Look at all this fatty acid that I've accumulated over time. I got to first get rid of this stuff and then and only then will I be able to take up glucose. So it's affected like the low carbohydrate foods are effectively blocking the carbohydrate rich foods from entering tissues.

Ian Cramer: 00:15:26 Okay. So I want to break this down. There's a couple things I want to talk to about in more detail. And, and, and Robby, I'll try to get you in on this too, is maybe this continual can go to Robby. First is Cyrus was talking about normal insulin response. Uh, if I eat a whole foods plant based meal, there's some sugar and my insulin is going to secrete or my, my pancreas is going to secrete some insulin. Normal ranges are about, let's say 25 units. In what situation, I'm assuming it's like standard American diet would be the situation where someone might naturally secrete 50, 60, 70, 80 units of insulin. Is that correct? Cyrus can answer that.

Cyrus Khambatta: 00:16:09 Yeah. So, so really think of it as like a spectrum, right? So imagine you have, um, you know, a line in front of you a horizontal line, and on the left hand side of the spectrum you have the low carbohydrate diet, which is basically a very small amount of carbohydrate and then lots of fat and lots of protein. On the right hand side of the spectrum you have the exact opposite, which is high carbohydrate, low fat, low protein, and then right in the middle is the standard American diet, which is medium carbohydrate, medium fat, medium protein. All right, so if you go onto either side of the spectrum, whether you go into the left hand side or the right hand side, you can actually bring your insulin, the amount of insulin in circulation down dramatically. So that's why people in the Paleo and Ketogenic community will show you these flat line blood glucose values because it works and it keeps your blood glucose low, and then people in the low fat community like us, we'll do the exact same thing so we can control your blood glucose with precision as well. The problem, like you just said, is that when you're in the middle, when you're in this no man's land where your fat intake is sufficiently high enough, which is anything over 15 percent of your total calories and your carbohydrate intake is also, you know, relatively high, call it 40, 50 percent. Then you're in a situation where there's a sufficient amount of fat that has entered tissues and then that fat blocks the glucose from being utilized went from the other carbohydrate rich foods. Does that make sense?

Ian Cramer: 00:17:40 Yeah, it does. So this is something else I want to parse out is I find that in some situations, especially with people who are your nutritionally literate, we can kind of, we kind of understand, I understand what you're talking about when it comes to high carb versus low carb, but when you bring up fats and Intramyocellular lipids, I know as a term that you've used it kind of Dr Barnard, I first heard from Dr Barnard, what fats are we talking about that, that effectively infiltrate the muscle cell and from the description that he says kind of clog or clogged the lock on the muscle. So what fats are we talking about?

Cyrus Khambatta: 00:18:22 That's a great question. So you'll see a lot on the Internet where people are saying, oh, okay, well don't eat the bad fats, eat the good fats, eat the healthy fast, right? And they'll say the bad fats are the ones that are coming from chicken and beef and olive oil or sorry, chicken and beef and dairy products. And the good fats are the ones that come from nuts and seeds and Avocados. I really, really, really don't like to use the word good fat and bad fat because these are words that these are a descriptors that human beings place on, on these fatty acid molecules, and they're not technically relevant, they're not physiologically relevant. In reality, there's three types of fat. There's trans fat and trans fat predominantly in our diet comes from a hydrogenation process that food manufacturers use to create these things called partially hydrogenated oils that go into our foods and give it a good flavor, And then also change the texture. That's number one. Then number two is saturated fat. Saturated fat comes mainly from animal based products. And then number three is unsaturated fat. And that comes mainly from plant based products. Okay? So they induce insulin resistance in the order that I described. Number one, the worst perpetrators are the trans fats. When you consume even small amounts of trans fats on a daily basis, uh, those trans fats can cause all types of cellular inflammation. They can increase your risk for insulin resistance, for heart disease. They can increase your LDL cholesterol, they can increase arterial plaque, and they set you up for a metabolic disaster. So Trans Fats, if you can, try and just completely eliminate them from your diet. There's small amounts of trans fats that are naturally occurring in animal products. Very small and beef, chicken, lamb, fish, you name it. Okay. But, um, the, the problem comes from the partially hydrogenated oils that we talked about. That's number one. Number two, saturated fat. Saturated fat is really the, uh, the type of fat that again, is found predominantly in animal products and it's the easiest type of fat to consume because when you're eating chicken, when you're eating fish, when you're eating a beef, when you're eating dairy products, saturated fat is all over the place, even in these quote unquote low fat milk and low fat cheeses. They're not actually that low fat or low fat by weight, but not low fat by calories.

Ian Cramer: 00:20:46 Do lean meats fit into that category too?

Cyrus Khambatta: 00:20:49 Lean meats also fit into that category as well, so even though they should be called leaner meats because they're leaner, then you know they're, they're fattier counterparts. But the idea here is that the saturated, the type of fat that you predominately find inside of those foods are saturated and what saturated means is effectively think of like a chain in front of you. So there's like a chain that basically says carbon carbon, carbon, carbon, carbon, carbon carbon, and there's like 16 carbons in a row that are all linked to each other. And then the term saturated basically means that there's hydrogens parked all around these carbon molecules and there's no more available parking spaces for any other hydrogens. Okay? So it's basically, it's an organic chemistry definition for a type of fat that is predominant inside of these animal products. And the point is that when you consume saturated fats, a lot of these saturated fats end up getting inside of your muscle and it's of your liver, like we talked about earlier. And these guys, once they get inside of your muscles and liver, they plug up these, you know, insulin receptors as Dr Barnard likes to say, or they prevent glucose from preventing insulin from signaling to the tissue. And these are the ones that are actually, um, the most common cause of insulin resistance in our world today. And then number three is unsaturated fat and unsaturated fat is found predominantly in nuts and seeds and Avocados and coconuts. I'm actually sorry, not coconut oil, nuts, seeds, avocados. I'm plant based fats and, and these types of foods have a slightly different chemical structure to their fatty acids. And these fatty acids, if they're eaten in excess, can also cause insulin resistance. So I don't want to say that, you know, eating, all types of unsaturated fatty acids are safe. It's just that if you keep your unsaturated fatty acid intake to between 10 and 15 percent of your total diet, then you're protected against insulin resistance. It's when you consume an excess quantity of any type of fat, unsaturated fat included that your level of insulin resistance goes up. And then again, your Beta cells starts to creating a too much insulin.

Ian Cramer: 00:23:00 Alright, so Robby, I see, uh, I see lots of food behind you there, including including some Avocados. Let's talk about what kind of advice you know, what's some of the language and the verbiage you provide to your patients and give us a typical day in the life of one of your patients who has type two diabetes.

Robby Barbaro: 00:23:25 Okay. So I'm so glad you asked that question. I do have a lot of produce behind me and I don't think people are gonna be able to see it because I think it's just audio here, but those are actually Keitt mangoes, there are no Avocados on this shelf. Our program is very particularly very low in fat. So, uh, there's lot of Keitt Mangos behind me.

Ian Cramer: 00:23:46 Well, can I just say, can I just say before you get into this, I, I was envisioning myself saying this, so I, I want to get this in here, is if people hear, I'm sure if people hear the way you and Cyrus treat type two diabetes with a high carbohydrate, again, coming from not refined sugars and refined flours, carbohydrates, but from whole plant foods, which I'm sure you're going to tell us about, if they hear that they're, they probably, they probably think you're nuts. Yeah, you're absolutely nuts.

Robby Barbaro: 00:24:19 They think we're absolutely nuts, Then it gets even worse when we tell them that we eat majority of our calories from fruit. I mean personally, that's our personal stories. Not necessarily do all our clients do that, but we are a very, very fruit friendly diabetes coaching program because it works and we see over and over and over again. The more fruit people eat, the better blood glucose management they have, the better their weight is, the better their A1c becomes. It's just that helpful over and over and over again and peer reviewed research shows the same that you know, I always tell people, show me the studies where you see the headline saying you no more bananas leads to x problem as somebody increases mango, like it's just doesn't happen. But you see over and over and over again, fish meat dairy just in the headlines of research papers being questioned. Right? It's amazing.

Ian Cramer: 00:25:12 So give us kind of an example, piggyback on what Cyrus just told us about sort of the physiology of type two diabetes. And tell us again how eating a lot of fruit, a lot of carbohydrates is going to help me and my type two diabetes,

Robby Barbaro: 00:25:29 Absolutely. So again, it's mindbogglingly simple. It's so simple. All people have to do is they reduce their fat consumption to we teach no more than 30 grams per day, which roughly ends up putting about 10 percent of total calories from fat. If you limit your fat consumption and then the foods you're eating are whole foods, full of water, fiber, vitamins, minerals, antioxidants, that insulin resistance is reversed. You begin to process of reversing insulin resistance. Depending on how bad your situation is, is going to depend on how long it takes you to really see that you've optimized insulin sensitivity. So for a person living with type two diabetes, when they come into our program, we teach people to change one meal at a time. We know that lifestyle change can be overwhelming and we're in this for the long haul. They've had diabetes, they had this problem for many, many years, even years before they were officially diagnosed, they were living with this problem, so it doesn't necessarily have a sense of urgency to fix it overnight. Okay? We have to understand this is a process. We take it one day at a time, one meal at a time, so they start changing breakfast and when we tell people to do is primarily four of your favorite fruits. That's our ideal breakfast in our coaching program and you get to eat as much of those foods as you want and even just changing breakfast, people start to see improvements. Alright, and then once they've changed the breakfast and then move on to changing lunch and lunch for most people usually starts to become more of a starch based meal. We teach people that that should be their most calorie rich meal of the day. That's when your your need most of your energy and you're going to be able to digest that so they start eating things like a bean stew or chili or potatoes with vegetables or butternut squash with vegetables, so that's lunch and then people we suggest an afternoon snack of whatever they want mostly fruit and then move into dinner and dinner again is going to be usually a starch based meal. A lot of people are again, same foods, whether it's intact whole grains, beans, starchy vegetables, we want them to get their calories from those whole plant foods and then add plenty of Greens and vegetables, so lots of non starchy vegetables like Eggplant, cauliflower, Zucchini, stuff like that, and Greens, Swiss Chard, Kale, all that stuff is great stuff to add.

Ian Cramer: 00:27:57 And so you mentioned that fruit is your. Is it more of a personal favorite but you don't necessarily mandate to your patients? Hey, stick to only fruit.

Robby Barbaro: 00:28:08 That's right. We don't, we don't mandate everything anyway. Don't mandate anything. We like to say that we're not the food police and now we're here providing guidance and really helping people understand the consequences of their decisions and we truly understand over working with thousands of people what is realistic for people and what they actually desire. So they see me and Cyrus, you know, eating tons of tons of fruit, eating lots of fruits sometimes at every single meal, breakfast, lunch and dinner and you know, they see that example, but not necessarily. People don't choose to do that. They want to have these other specialty. When it comes to the winter months, which coming up here, people want to have these other foods, so that's what we teach them what to do.

Ian Cramer: 00:28:50 Right. Are you speaking to me from Southern California?

Robby Barbaro: 00:28:53 I am the Santa Monica.

Ian Cramer: 00:28:55 Well, so yeah, when you live in the Arctic Tundra like me in Rochester, New York, it's a little harder to. Cyrus is laughing at me. It's, it's harder to get quality fruit, so in that case, I mean some of them, some of my staples are, and correct me if I'm wrong, like I love me a yukon gold potato. I love sweet potatoes. I love brown rice beans and lentils, Yay or Nay Robby.

Robby Barbaro: 00:29:21 Absolutely. Yeah, so we have. We've put our food into a green light, yellow light and red light system. The greenlight category is listed in a very specific order. We have fruits, starchy vegetables, beans, peas and lentils. Then we have intact whole grains, non starchy vegetables and then leafy Greens and then we have the four categories there in the, in the beginning, our calorie dense green light foods. Because people go on this diet, they start eating tons of vegetables, they get hungry, and then they go and have a cheeseburger and they feel better because they finally got the calories, they need it. So people, and again we emphasize this in the world of diabetes nutrition because people are so afraid of carbohydrates when it actually is the solution. It's what's going to keep you sustained on this lifestyle and do it for the longterm. So many people doing these quick fixes and you get results real quickly, but you're not going to stay on it, so you have to learn how to eat calorie dense green light foods at every single meal.

Ian Cramer: 00:30:24 That's Something I hear all the time, both, In populations who don't have diabetes, want to get healthier, they hear about a whole foods plant based diet and they do it or especially in a, in a population of who is going plant based and also our athletic is a major problem. It sounds like you're having to is people just don't eat enough calories. They think of having salads all day and they wonder why they're hungry

New Speaker: 00:30:46 100 percent. One hundred percent, this is the number one reason people fail when they try to adopt a low fat plant based whole food diet is that they're scared of carbohydrates. They focus too much on vegetables and they don't eat enough of the starchy vegetables, whole grains, beans and fruits.

Ian Cramer: 00:31:03 Because they're not used to eating the volume.

Robby Barbaro: 00:31:05 Yes, that's exactly right.

Cyrus Khambatta: 00:31:07 Right. And one thing that I think is, uh, you know, at play here is that back in the early two thousands when plant based diets weren't really that big of a deal. And being a vegetarian or Vegan was considered weird. Um, you know, at that time, there just weren't that many resources available. There weren't that many cookbooks. There weren't that many movies. There weren't that many, uh, websites like forks over knives that just had like an unbelievable collection of recipes. So at that time, I think a lot of people were eating lots of salads and tomatoes and carrots and thinking, oh, that's how you eat a plant based diet. But no, no, no, no, no. Just like you guys are saying, eating those calorie that staples is really the moneymaker now.

Ian Cramer: 00:31:45 Yeah, I mean it's a good start. Like I always, whoever says like, Hey, I've incorporated more carrots into my diet. Good for you. Like I've incorporated more. Plants is always should always be seen as a victory, but if again, if, if maybe you dig a little deeper and say, well, how you feeling? Man, I feel so tired. I feel so hungry. Well, maybe part of your problem is you're not eating enough starchy complex carbohydrates and starchy carbohydrates. Yup. Cyrus, I want to touch on. I had here at markers of success within diabetes, Blood Glucose. We talked about insulin. We talked about. You haven't mentioned A1c yet, but hopefully you can touch on that. Is there, you know, because those are the common markers that we hear about and are those the markers that you encourage people out in the real world to and even medical professionals because they listen to this podcast to. Are those the markers that people should be looking at and, and to document how the, how their blood sugar control is or are there other markers?

Cyrus Khambatta: 00:32:49 A 100 percent. Okay. So we came up with this thing called the insulin resistance checklist, and the insulin resistance checklist is basically a collection of biomarkers which we believe to be the most important biomarkers to measure in order to get a full picture of your diabetes health. Uh, and the acronym for the instruments resistance checklist is PILAF, like rice PILAF, p I l a f. okay. So p stands for pressure pressure basically as a reference to your blood pressure. Okay? Um, believe it or not, the more insulin resistant you become insulin resistance as an independent risk. Sorry, hypertension is an independent risk factor for insulin resistance. So the two of them are linked to each other. So it's important to get your blood pressure down below. Uh, I believe it's 130 over 80 is the new guidelines, if I'm not mistaken. Um, and when you're in that safe range, then that's, you know, you can check that box off. So that's what P is high stands for, ideal body weight. Okay. There's a simple formula that we use to calculate your ideal body weight. And um, you know, without going into too much detail here, if you use that calculator, you can basically figure out what your ideal body weight is and we recommend that you be within a few percent of that ideal body weight. And if you are, then you're sort of relieving a lot of the metabolic stress that, that your liver and pancreas and muscles will experience when you are overweight. So that's, that's P a l, L, L stands for lipids, so lipid, is a reference to your lipid profile. So it's very important to make sure that your lipid profile is monitored closely, which is your total cholesterol, your LCL cholesterol, your HDL cholesterol, and your triglycerides. Okay? Now there's reference ranges for all of those. We recommended our program to get your total cholesterol under 150 to get your ldl cholesterol under 100 to get your triglycerides under 150 and to get your hdl cholesterol, it actually doesn't technically matter if the other three things are in line. Okay, so that's, that's what L is PiL. Now we get to a and a stands for A1c, and A1c is a marker of your three months average blood glucose. We just did a Webinar on this the other night, but you know, people in the world of diabetes are just fixated on the idea of getting an awesome A1c value and yeah, and A1c value is important for sure. Ideally, what you want to do is get your A1c value to a, If you're living with type two diabetes, you want to drop your A1c value to less than five point seven, and if you're in the five point seven percent or below that, that means you're technically nondiabetic. And that's a good thing if you're living with type one diabetes, we recommend it's okay to keep your blog. I'm sorry, your A1c just a little bit higher, somewhere between a six and six point five percent. Um, and then that's a safe way to maintain a good blood glucose control without developing hypoglycemia frequently. Okay. And then, uh, f what is f stand for? I'm hitting a blank on this one. Fasting Blood Glucose. Thank you. I just had a brain fart here. Okay. So F stands for fasting blood glucose and that basically means that we're trying to get your, your fasting blood glucose to below a hundred milligrams per deciliter. And again, we're trying to do that without medication, without exogenous medication, whether it's oral medication or whether it's insulin. So again, if you're living with type two diabetes and you're taking any form of medication, the goal is to try and hit all these metrics without the use of any medication. And if you're living with type one diabetes then it's to try and get your, your total insulin use down to it's physiologically normal amount and then try and hit those numbers at the same time. Does that make sense?

Ian Cramer: 00:36:50 Yes it does. Yup. Okay. So let's talk about, maybe Rob , you can chime in a little bit on this one is a success rates and adherence and I'm just thinking about, you know, if, if people are going hungry, people are super hungry, they're not going to adhere to this. Uh, and we talked about the, you know, eating enough calories. So what are, you know, if you take a cohort of 100 or a thousand people, depending on how many people you treated over the years, give us an idea. Paint us a picture of the success you guys have had over time.

Robby Barbaro: 00:37:28 Okay. This is a great question. I wish I had, you know, some good hard data if you be like, okay, yeah, I know exactly the answer. It's coming, right? I'm sure that's coming out. Will say that. I mean the success rate of somebody who comes into our coaching program and does one thing, the one thing we have to do is communicate with us. If all they do is just reach out, no matter what's going on, they write to us in the facebook group or in our teachable community, that success rate is 100 percent. I kid you not. Every single person, they will see improvements. They will see progress. We can objectively to say your insulin sensitivity has improved. That's very obvious. Or people living with type one diabetes or any form of insulin dependent diabetes because we're injecting insulin, measuring our carbohydrate intake and testing our blood glucose. So you can easily see how those things interplay and that you're insulin you're injecting is much is taking glucose into your bloodstream, into your cells much more efficiently. That's easy for insulin dependent. Now people living with noninsulin dependent, they're taking oral glucose medication. As that medication is reduced and they're eating more total carbohydrates and their fasting blood glucose is dropping. That is an obvious way to say they have improved their insulin sensitivity. It's very easy. You can take less medication, they're eating more carbohydrates and they're blood glucose is better their bodies taking glucose out of the bloodstream into the cells and a much more efficient rate. So that's why I say this a lot on social media. I'm telling you, if you do it, it's a hundred percent. Now can't. I can't say that every single person that signs up for a coaching program does take action. So what that number is, it's hard to tell. There's a lot of people that will sign up. They will not say anything in a facebook group or are teachable community and they will then just pop up three months later and say, Hey, I just. I went to my doctor, I've been reading all your guys posts. It's been very inspirational and I am now officially nondiabetic. That's happened many times in our program.

Ian Cramer: 00:39:33 Okay. Okay, cool. Um, so I want to spend a little bit of time on. We spoke at the beginning a little bit about the other side and I don't, I don't want to demonize the other side, you know, they're, the other side is, well, you know, there's, there's even, there's a lot of doctors out there in the, you know, I'm getting a little more familiar with the twitter sphere and uh, most of the time being a bystander, just observing from the sidelines, reading some threads and watched a couple movies online. Um, have a, uh, of a. let me see if I can look up the name real quick of a Sarah. There's a youtube movie called by Sarah Hallberg. Yes, she was in the blue outfit that people might recognize her and her talk about how do we reverse diabetes. There's also another one out there, their TED talks. There's also another one up there by Peter Attia. He's, I know a physician as well who's big with a low carbohydrate. So my question is this, they are proporting success with reversing type two diabetes and so are you so being, you know, being the moderator here, like is it possible that both sides are seeing success and just sort of like a hey, whatever works for you. Great.

Robby Barbaro: 00:41:04 Okay. So I just want to say one thing real quick and I'm gonna let Cyrus talk about some of the science here. What's going on? So the first thing I want to say is that there are several, I mean look on Instagram, outside of instagram, email, there are several people in diabetes community, particularly type ones that we know on a personal level and we're friends with. And I got to say we absolutely respect that group of people at 100 percent if you are truly doing the ketogenic diet. But people like Sarah Hallberg and Peter Attia and these people are recommending if you are doing that, we have a lot more in common with you than we don't have in common. And you're a person who's taken the effort to really clean up your diet. You're not eating any of this junk processed food. You're consciously choosing, this is what I want to do. You're making those decisions, you're sticking with it. You're trying to do what you believe is the best you can for your diabetes health. Like Kudos to you. You know, I, I respect that we're on the same page, but when it comes to why it's working and the science, I'll that cyrus talk about that.

Cyrus Khambatta: 00:42:07 Okay. Yeah, I think that's actually a really good preface because, you know, in this world of diet and it's like there's, there's a few things in this world that are very contentious. There's a religion and politics, politics and nutrition. But somehow when you talk about any of these subjects, it's like, you know, how dare you tell me what to do. You don't know what you're talking about. And it becomes this fight all the time. And Robby and I did. We don't, we're not bread from that cloth. We W, what we're really trying to do is, uh, is, is shed evidence based information. And, and not fight with anybody because it doesn't make any sense, right? So that being said, the people in the Paleo and low carbohydrate community, they have a lot of validity and so they are not lying by any stretch of the imagination when somebody adopts a ketogenic diet. And what they will generally see in the short term is that they will get rapid weight loss. Okay? And for many people living with type two diabetes, that's very important. So rapid weight loss was the first thing that starts happening. And then as a result of that rapid weight loss, Dr Greger has some videos about this as well. It says that, you know, when you're losing weight, everything moves in the right direction. Everything moves in the right direction. So, uh, as a result of rapid weight loss, you end up dropping your ldl cholesterol. You end up dropping your blood pressure, you end up, uh, dropping the amount of insulin that your pancreas is being forced to produce in order to metabolize your food. Your, A1c value will come down. You will probably start to feel more energy in your skin condition can improve, etc. Etc. Etc. So all of these things unfold in the short term. And now I want to be very clear when I say that the people in the low carbohydrate community, they're not bad people. They're not lying by any stretch of imagination because what they see is true. It happens and it's real. What we are saying is that by adopting a low fat plant based whole food diet, we can get the exact same results. You can get reduced cholesterol, reduce blood pressure, reduce insulin resistance, reduce value, reduced blood glucose, reduced fasting blood glucose. You fill in the blank. The where things get different is that if you fast forward over the course of time, it takes somebody living on a ketogenic diet and they've been following the ketogenic approach for call it six months or a year or maybe two years. Over the course of time, these metabolic adaptations, all these favorable things that have happened to them in the beginning, they stop and then a lot of times they reverse. And so over the course of time, what ends up happening is that people who eat low carbohydrate dIets end up with increasing blood pressure, increasing ldl cholesterol, uh, they develop a significant amount of insulin resistance, like we talked about earlier because they're eating fat rich in protein rich foods, which ends up storing a bunch of fat inside of their muscles and side of their liver. And that's shown in the literature. Oh yeah, yeah, yeah. This is very well documented in the literature, no question about it. And I'm happy to share any of that literature with you or any of your listeners If they're interested in looking at it. Um, but in the longterm, so people eating a low a low carbohydrate diet are likely to increase their risk for all of these chronic metabolic diseases that I just talked about. And what's also very prevalent in the literature is that people who eat low carbohydrate diets increase their risk for all cause mortality, which is a fancy super nerd way of saying premature death from any cause. So what that means is that if you eat a low carbohydrate diet, you're increasing your risk for hypertension, high cholesterol, alzheimer's disease, kidney failure, fatty liver, uh, and uh, all cause mortality. But that happens in the future. It doesn't happen right now, right? When you eat a low fat plant based whole food diet, you still get those benefits, those short term benefits, but they extend over time, they work for the first six months and then the nugget get better over 12. And then over two years, five years, 10 years, 20 years. So over the course of time, people who eat low fat plant based whole foods ended up with a reduced risk for these chronic diseases. And that's the true differentiator between the low carbohydrate and fat communities.

Robby Barbaro: 00:46:22 The respect these people. I love Them, but sometimes the logic is just mind boggling. The biggest thing that happens here, in addition to everything Cyrus, just said is that you can see in the short term that there's just no question about, there's no debating, you know, research questions is nothing is the fact that they have made themselves more insulin resistant. They've eaten themselves into a state of insulin resistance and they can easily objectively see this because they can't eat blueberries like you go reading their blog posts that you read in. Again, respect all these people. We've read their books. They literally, I mean Dr. Bernstein, one of the key guys in the world of type one diabetes writes in his book, no fruit. If it's in the book, it says no fruit like you to think that you are at a healthy state and you can't eat something like blueberry is just. It's mind boggling. It's absolutely crazy.

Ian Cramer: 00:47:25 So I just want to connect the dots here. So what cyrus was saying it and you both were saying, is that there's no doubt that people in the low carb community, physicians, medical professionals, and people who adopt this who adopt a low carb diet, there's no doubt that the amount of insulin they're secreting is going to go down, that the amount of glucose that's circulating in their blood is going to go down because they're not consuming carbohydrates. But one of, one of the things you just brought up, my question was, is going to be, how can people figure out if they're still insulin resistant?

Cyrus Khambatta: 00:48:05 That's a great question. That's a great question. So there's many ways to measure insulin resistance there. There's a whole slew of them. There's a really complIcated and expensive ways to do it, and then there's somewhat ineffective. I'm sorry, effective but cheap ways to do it. The easiest way to do it is to take what's called an oral glucose tolerance test an OGGT, and the way that you do this is if you were to go to your doctor, your doctor would give you a solution that's basically water with a dissolved glucose inside of it, so it's got 75 grams of glucose and you take a shot of that, and then you measure your blood glucose and insulin over the course of the next two hours. You measure at time equals zero. Then you take the shot, then you measure it at time equals 60 time equals 90 and time equals 120. Uh, if you do that, um, what, what will end up happening is you can graph your change in your blood glucose and the change in your insulin secretion. And based off of the shape of those curves, whether they went very high or whether they're nice and small, you can then determine how insulin resistant you are. Okay?

Ian Cramer: 00:49:08 So someone in the other. So being devil's advocate, I might say, well, cyrus, who cares? Who cares about being insulin resistant, I'm never going to eat carbohydrates ever again. So What does it matter?

Cyrus Khambatta: 00:49:19 Great. Um, if you look into literature, insulin resistance is a what I believe to be a central node and a central node means that it is a, it is the most important condition which influences your risk for other chronic diseases. So as you increase your risk for a as far as you increase your level of insulin resistance, your risk for hypertension, high cholesterol, alzheimer's disease, neuropathy, retinopathy, poor circulation, peripheral arterial disease, fill in the blank, yada, yada, yada. All of these conditions increases and so it's, if you're avoiding carbohydrates and keeping your blood glucose steady, good job. You've done a great job. But this tunnel vision, the, the diabetes world operates with tunnel vision and the tunnel vision basically says, if I can just keep, keep my A1c under control and I can keep my blood glucose nice and low, then everything is going well. And what we're trying to say is your A1c is important. Your blood glucose is important, but it's not the big picture.

Ian Cramer: 00:50:26 So the blood sugar, again, what I want to emphasize and see if I can uh, interpret this is the blood sugar is sort of more of a symptom whereas you are trying to address the root cause of the insulin resistance. Robby, what were you going to say?

Robby Barbaro: 00:50:43 And I just want to add to remind the audience that people living with diabetes do not die of high blood glucose readings. That's not the number one killer of all people living with diabetes is heart disease. So fixing your blood glucose fixing your A1c, but then being in a metabolic state that increases your chance of heart disease doesn't seem like a logical decision to us.

Ian Cramer: 00:51:07 Robby has a low, has a low carbohydrate diet, been shown to reverse heart disease. I have not seen that. No. cyrus, what do you think?

Cyrus Khambatta: 00:51:16 Absolutely not. There's only one diet that's actually been shown that technically reverse heart disease. Right? And that is a low fat plant based whole food diet. And that was Dr. Caldwell Esselstyn and Dr. Dean Ornish to understand if the two of them both published on that.

Ian Cramer: 00:51:31 What were you, you were saying something before that I wanted to touch on about how when we look at the results and longterm results of someone who's eating a low carbohydrate hydrate diet, so you said in the short term you see results losing weight and these markers are getting better longterm. We start to see this reversing it is it, it's, it's basically, it sounds to me like another way of saying it's not the diet that we evolved eating because I like to look back historically not only to the days of T. Colin Campbell and ancient, uh, you know, in Asia, but also way before that, like thousands of years ago, hundreds of thousands of years ago is that no one's saying that we were vegan 100,000 years ago. But what we're saying is that our diets definitely varied, but we were nowhere near low carbohydrate. We were eating significant portions of carbohydrates and so that's what our bodies evolved to run best off of him. Am I along this? Is that right?

Cyrus Khambatta: 00:52:39 One hundred percent. You know, it's funny, when I first started going to grad school back in 2007 and I started reading all the evidence about it for, I started learning human physiology first of all, and then I started reading a lot of the evidence about diet and how it affects human disease and the first question that I had was, okay, wait a minute. When you look in the physiology textbook and you start to understand how organ systems work, how your heart works, how blood vessels work, how your liver works, your kidney works, your muscles, you name it. One of the things that you'll find is that every single tissue in your body, including your brain, runs off of a process called glycolysis and glycolysis is basically a very complex pathway that starts with glucose and ends up with ATP. Right? And I would just kept on looking at, you know, different tissues and saying, wait a minute. Cells in your liver, use glycolysis cells in your kidney. Use glycolysis cells in your muscle, use glycolosis, how is it that every single tissue in your body is designed to run off of like glycolosis, But yet the low carbohydrate community says anything that turns into glucose is bad for you. It's just phYsiologically it's a, it's a bogus argument. And so if you take a look at that sort of basic physiology and then backup and say, well, what are we designed to eat? We're designed to eat exactly what our physiology is designed to metabolize, which is foods that metabolize glucose in a low fat environment.

Ian Cramer: 00:54:13 Right? So maybe we'll, maybe we'll, uh, we'll save that conversation of ketosis and, and uh, and the glycolysis for another conversation, but I'm sure. So I wanted to just kind of end this with a question with regards to type one diabetes. I had, I reached out to my patrons of the podcast and, uh, they had a question about basically the management of type one diabetes. So just again to review. So type one diabetes, unlike type two, type one, you got it for life. But I'm, I'm assuming there are things that you can do to mitigate symptoms and to help with your blood glucose regulation. Can you give us some tips on regulating type one diabetes?

Robby Barbaro: 00:55:03 Yeah, absolutely. So there's no question about it. You can throw your lifestyle, make your life with type one diabetes a heck of a lot better, and really just live honestly, whatever life you want to live, I shouldn't set you back. That's kind of one thing that means Cyrus really passionate about. So that we talked about this a lot, how we just type one diabetes has never stopped us from doing anything we've ever wanted to do. And I think a lot of it has to do with the fact that we are in full control of it and we're eating while our overall health is excellent. So the point is you, it's this, it's truly is the same thing that we would do for people living with type two diabetes because the overall goal is to reverse insulin resistance. You want to optimize your insulin sensitivity. So obviously with type one, we're injecting, um, long acting and short acting insulin. Or if you're on a pump, you're using a fast acting insulin, a drip rate, but you want to optimize your insulin sensitivity. And one of the key tips is to be aware of your carbohydrates to insulin ratio. Okay? So that is how you're going to make sure that when you eat a meal, two hours, three hours after you're in range, that happens when you know how much insulin you need to inject for a given amount of carbohydrate consumption. So we do this through a tool called the decision tree, which people can get for free on our website. Just type in mastering diabetes decision tree and to google and living with type one diabetes. The number one thing we suggest is to fill out that decision tree. If you do that seven days in a row and fill in every single box, you're going to learn so much. You're going to really understand how the food you're eating, the exercise you're doing is affecting your blood glucose, and you'll see also how certain processed foods affect your blood glucose or when you're eating whole foods that include all the fiber, how that affects your blood glucose throughout the day. So the decision tree is the number one tip of the ultimate suggestion we can give people. and if they want to ask us questions about it, we have a free facebook group where they can interact with us as well.

Ian Cramer: 00:57:06 Excellent. Excellent. And cyrus, you'd want to just touch on that too and talked, you know, I know you mentioned you guys have a podcast as well.

 

Cyrus Khambatta: 00:57:13 A hundred percent. Yeah. So we have a podcast called the mastering diabetes audio experience. And just like your podcast, what we try and do is not give, not interview people just for their opinion, their opinion is important. but what we really care about is the science because that's ultimately what's going to change people's lives. So in the same way that you're interviewing the best of the best and you're getting all the, you know, the top flight based doctors, we try and do the exact same thing so that people have a good understanding about what does the actual scientific evidence say about, uh, you know, eating for diabetes. Um, but Robby hit it on the head when it comes to type one diabetes. It's all about understanding your carbohydrate to insulin ratio at breakfast and at lunch and at dinner because they're slightly different than each other, and then putting all the lifestyle factors in the play. Are you exercising? If so, how much, um, are you a high stress individual? If so, that's gonna make your blood glucose a little bit higher. Uh, You know, are you getting enough sleep? Are you suffering from a virus or a bacterial infection because that's going to cause your blood glucose to go higher. And once you kinda figure out what all the puzzle pieces are, then you can start to put together this puzzle and be like, oh, now I get it. My glucose is under control because I have these things in place and now my life is much simpler.

Ian Cramer: 00:58:29 So put very. Let me just summarize very generally, and I guess I'm looking for like a yes or no basically is even for type one diabetics, you still advocate whole plant foods. You still advocate carbohydrates from whole plant foods. You still discourage a refined oils, refined flours, uh, basically the standard american crap. Am I correct?

Cyrus Khambatta: 00:58:59 No question.

Ian Cramer: 00:59:00 Is there anything, is there anything that differs between the advice you offer a type two diabetic trying to reverse their diabetes versus a type one diabetic who comes to visit you who says, hey, I want to better manage my type one diabetes?

Robby Barbaro: 00:59:18 so particular suggestions for people living with type one diabetes we should mention in addition to the carbohydrates insulin ratio is optimizing the basal rate, so that's something we teach people with type one diabetes, how to do by using intermittent fasting and making sure that that is on point, but in addition to as far as dietary suggestions, one thing that I have learned personally through using a continuous glucose monitor over the past few years, which is a device that shows me my blood glucose every five minutes so I can see the curve after a meal. one thing I've learned is the importance for people living with type one to add greens or non starchy vegetables to a meal. If you want to really sort of shorten, you know, lower the curve a little bit, you want to reduce the spike so it's normal. You're blog is supposed to go up, but again, we've got to understand here where people living with type one, we the pancreas is not producing insulin and to try and manually do that, it is a difficult process. it's not a perfect science. You know the curve is not going to be as perfect as it is in somebody like you where your pancreas is working just fine. There's different phases of insulin. Your body's just ready to fire when you eat right away and it keeps everything in check for us, you know, manually injecting all that stuff. It's a little more problematic, so that's why we would have these extra suggestions for how to manipulate that curve if you want to. Another thing there is insulin timing, so when we inject insulin as a person living with type one diabetes, you got to make sure it's working before you eat a high carbohydrate meal because a high carbohydrate meal is going to raise your blood glucose quicker than a super high fat meal. So you've got to make sure that the insulin is working. This is a very common mistake we'll see people make they'll inject insulin and they'll eat right away and that is literally as if they were eating food without injecting insulin. So if you told the type one, hey, if you go and eat a bunch a bunch of mangoes and you inject an insulin, but I'd be like, oh yeah, of course my blood glucose is going to go super high, 300, 400. It's going to be way up there. They get that, but they also need to understand that if you inject insulin and eat right away, it's as if that's exactly what you just did. You just ate food and didn't inject because it's not working. Even the, the medication pamphlet will tell you that it takes 10, 15 minutes or so for it to work and if your blood glucose is high and you have to wait even longer to eat food if you want to optimize your blood glucose curve.

Ian Cramer: 01:01:52 Gotcha, gotcha. So I mean we could, we could go another two hours, but I think we'll have to leave it for another time here. Let's bring this back into the, into, into the finishing line. I, in my research, I looked into your youtube channel where you had to have a lot of really informational movies, inspirational and informational. You've got a podcast. I'm sure people can learn a lot more about you on your website as well, but if someone listening in Alaska wanted to reach out to you and want it to get some guidance on how they can, uh, uh, treat or reverse their type two diabetes, I'm sure they can do that on, on reach out on there on your website?

Cyrus Khambatta: 01:02:33 Yeah. Actually, a very good question. We have designed our coaching program to be accessible by anybody who can get access to the internet. So if you have an internet connection then great. You can be part of the Mastering Diabetes program. And even if you don't want to be a member of the Mastering DIabetes program, it's fine. Just come to our website and you can read other people's success stories. We have a, every couple of weeks we come out with a new article about something very important to the world of diabetes and it's 100 percent research based. Uh, we also have a ton of recipes that you can find on our website and um, then you can also get information about the podcast as well. So thank you for allowing us to talk about that and for having us on the show. I really appreciate it.

Ian Cramer: 01:03:18 Awesome. Well, thank you guys both very much for your time. Um, and you know, what I say with every guest is I hope that someday I saw, was it Robby, I mean, were you just at the, uh, the recent event in Anaheim?

Robbie Barbaro: 01:03:31 So Cyrus and I were both at the plant based nutrition healthcare conference in San Diego having a blast.

Ian Cramer: 01:03:37 Yeah. Well I hope that we can see each other at a veggie fest or a conference like that in the future. So Robby Barbaro, Cyrus Khambatta, I'll just have you stuck on for one second as I sign off. Thank you so much for your time. I feel so much better about communicating, uh, the, the, um, you know, the information on how we can reverse and prevent type two diabetes after this conversation. Thank you guys so much. Thank you.

Ian Cramer: 01:04:10 A special thank you to Adam Sud, a special thank you. What a shout out to adam sud, who gave me a nudge and recommended that I speak with Robby and cyrus. I really enjoyed this conversation and more thank you's to two new patrons in the last several weeks. Fellow plant based cyclist, Steven Collins and Bilberry elf. Thank you very much for your kindness and financial support. Do you pay for a netflix subscription or perhaps sports illustrated, national geographic or the New York times? If so, you do this because you get value and enjoyment out of those publications, magazines or newspapers. In this case, my publication is free and always will be because I feel in the bottom of my heart that this information is too important to withhold from the public. So my business model is slightly different and the barriers to obtain this information are essentially zero, but the value aspect still remains. And so I will end this episode with asking you how much do you value these conversations? You might say not enough to pay for them and that's fine. NO judgment, enjoy them and I hope you learn and get healthier, but if you want to help my cause and my work and help this message of plant based nutrition and lifestyle medicine, join the 34 other listeners and patrons who feel the same way. Per month. Sports illustrated is around a buck. The New York times and netflix are around eight bucks and national geographic is around 12. We have patrons donating at one, two, five, 10, or even as much as 40 bucks a month for these thoughtful and well researched conversations and I really appreciate your support. To find out more about how this works, you can visit Patreon.com/IanCrameerPodcast to read about the donation levels, the perks or what you could do to help if donating is in your cup of tea. The bottom line is, I hope you get something out of these conversations. I do this because I love it and it's a labor of love. I want to change the world with this message and would love for you to join me. Until next time, keep eating more plants. Keep asking questions, and stay curious. Remain responsible and compassionate ambassadors to this movement and stay healthy.