Participants:
Series Code: MH
Program Code: MH240002S
|
00:01 I find the Rubik's Cube such a complicated puzzle.
00:05 The goal is you're supposed to align the blocks so that 00:09 each side is one color. 00:11 But as soon as you feel like you start getting one side 00:13 pretty good, you realize the other sides are a mess. 00:17 It's just so frustrating. 00:18 And you know why? Because I can't solve it. 00:21 I think we do that with our health a lot of times. 00:24 We get a diagnosis like diabetes and it becomes this 00:27 challenging problem that we don't always know how to tackle. 00:30 So we give it to the doctor to solve for us. 00:33 But what if it was possible to learn how to align 00:35 the different moving parts of our health? 00:57 In our last episode, we learned that insulin resistance 01:00 plays a profound role in the development of type 2 diabetes. 01:04 Today we're going to try to look at what is 01:05 causing the insulin resistance. 01:09 What a great question about diabetes and insulin resistance. 01:15 Many people, when we talk about diabetes, 01:18 think about sugar. 01:20 It's all about sugar. 01:21 Maybe people who develop diabetes 01:23 were eating too much sugar. 01:25 You know, that's what many people think. 01:27 But when we look at the evidence, it's amazing. 01:31 We've come to think often times, erroneously, 01:33 that diabetes is a disease of carbohydrate ingestion. 01:38 It is a disease of carbohydrate intolerance, 01:41 which is another way of saying it's a disease 01:43 of insulin resistance. 01:44 Now how do we break the cycle? 01:47 There's two ways how to think about it. 01:49 Most frequently people think, "Well, if your blood sugar is 01:53 too high, I just need to limit the carbohydrate intake. 01:56 I need to cut down on potatoes and rice 02:00 so that my blood sugar stays within limits." 02:04 And that's like thinking if you have a fireplace at home, 02:10 you got it to burn wood in the first place. 02:13 And that's like thinking, you know, if the fireplace 02:16 is smoking and there's too much smoke around it, 02:19 it's like thinking, "Well if I don't burn too much wood, 02:23 there will not be so much smoke." 02:25 Well, so that's about how it works with 02:29 the carbohydrates restriction. 02:32 Yeah, it's true, it works some. 02:34 But at the same time, you're missing the main point. 02:37 Your body was made to burn carbohydrates as your main fuel. 02:42 And so as with the fireplace, what's the solution 02:45 if your fireplace, there's too much smoke around the fireplace? 02:49 You just need to clean the chimney and the fireplace, 02:54 and then you will be able to burn as much wood as you like. 02:57 And similarly, instead of restricting carbohydrates, 03:02 we just need to get rid of the extra fat that's being stored 03:06 in the liver, and in the muscle, and in all the organs. 03:09 Dr. Kahleova's wood burning illustration makes sense to me, 03:12 because we've burn wood to heat our home for years. 03:15 Now if you start a fire and your house fills up with smoke, 03:18 you're coughing, opening up the windows, it's bad. 03:21 But it's not the woods fault. 03:22 The chimney needs to be cleaned. 03:24 So if you clean the chimney, the smokestack, 03:26 then the wood will burn clean. 03:28 Going on a super low carb diet is like saying, 03:30 "I'm not going to use wood for heat." 03:33 Right. 03:34 And so, you're eluding to the fact that very often people are 03:38 encouraged to eliminate the carbohydrates in their diet. 03:43 And so when they do that, they might find their 03:45 blood sugar drops, and goes down to normal even. 03:49 A low carbohydrate diet is really a diet which 03:52 is necessarily high in fats and proteins. 03:55 If you eliminate carbohydrates, 03:57 you're left with fats and proteins. 03:59 And for most Americans, or for most people in the 04:01 western world, they're getting their protein 04:03 from animal sources. 04:05 So necessarily they're eating more saturated fat. 04:08 And even if their blood sugar is lower as a result of 04:11 starving themselves of carbohydrates, 04:14 which is to say, starving oneself of the 04:16 preferred energy source, 04:19 those who have eliminated carbohydrates from their diet, 04:22 they might find their blood sugar lower, 04:23 all the while their insulin resistance within their cells 04:27 is only getting worse. 04:28 And we can show that clearly and easily 04:31 by giving them a glucose tolerance test. 04:33 So sometimes people think, "I've cured my diabetes. 04:36 My blood sugars are back to normal." 04:37 "What are you eating?" "Oh, eggs and bacon." 04:41 Give them a carbohydrate tolerance test 04:43 and their blood sugar will skyrocket, and we'll see it. 04:45 No, you still have diabetes. 04:47 You've masked it by lowering your 04:49 blood sugar sort of artificially. 04:50 But this damage that's going on in your cells, 04:54 and in your arteries, and in your organs 04:55 is carrying on and gaining speed due to a low carbohydrate diet. 05:01 And so we know that people on low carbohydrate diets 05:03 tend to die younger. 05:05 They tend to have more strokes, at higher risk for cancers, 05:09 higher risk for heart disease. 05:10 Now, whenever the conversation about diabetes 05:14 or insulin resistance comes up, people always try to 05:17 blame carbohydrates as the inciting agents. 05:22 But it's not the carbohydrates. 05:24 Because carbohydrate in itself is a huge group. 05:28 There are complex carbohydrates that are absolutely necessary 05:31 for our health. 05:32 And when people are in an insulin resistance state, 05:36 it basically means that they do not have the capacity to 05:39 metabolize glucose properly. 05:41 So yes, introduction of any type of carbohydrates at that stage 05:44 could raise their glucose levels and could create a situation 05:47 where they face some problems. 05:49 But over time when they start healing themselves, 05:53 when they reverse their insulin resistance, 05:56 the body actually can metabolize glucose properly. 05:59 At the stage it's important for people to know that 06:01 things like processed foods, saturated fats which have a 06:05 very important role in insulin resistance, 06:07 refined carbohydrates should be, you know, eliminated 06:11 or at least reduced. 06:13 And introduction of unprocessed plant-based foods 06:17 with the right kind of fats, which is 06:18 poly and monounsaturated fats derived from plants, 06:22 make a huge difference. 06:24 If it's not the sugar, what is it? 06:27 It turns out that the most important factor 06:30 in the risk of developing type 2 diabetes is fat. 06:34 Especially in the form of meat. 06:36 If we had to pinpoint just one single food 06:40 that would be most risky for development of type 2 diabetes 06:44 down the road, it would be meat. 06:46 We talked about food earlier, about the importance of eating 06:49 unprocessed foods and lowering our processed sugar intake, 06:53 And that definitely affects insulin resistance. 06:56 Saturated fat intake also affects insulin resistance. 07:00 The predominance of saturated fats in our diet actually 07:04 prevents cells to be able to 07:06 metabolize glucose appropriately. 07:10 And so, with this in mind, how does fat and meat 07:15 come into play? 07:16 How does it raise your blood sugar when it's all about fat? 07:20 Well, when we consume meat or other fatty foods, 07:27 when we are on a typical western diet, which is super high 07:31 in fat, the extra fat will be deposited in places 07:37 where it doesn't belong to. 07:39 Our adipose tissue has only a certain capacity 07:42 where to store fat. 07:44 Once we exceed the capacity, the fat starts overflowing 07:49 to the inner organs. 07:50 It starts being deposited in the liver, in the muscle, 07:53 in the heart, in the pancreas. 07:56 And it just compromises the metabolic function of the organ. 08:00 Why is meat the biggest driver in type 2 diabetes risk? 08:06 These are the results from many prospective studies. 08:11 The Adventist Health Study too. 08:13 But also from the Nurses' Health Study. 08:18 Red meat, and especially processed meat, are the 08:21 biggest risk factors for developing type 2 diabetes. 08:25 Now why is that? 08:26 Meat is rich in fat, and especially saturated fat. 08:33 It's not only about the quantity of fat we're consuming, 08:38 it's also about the quality. 08:40 And we know that saturated fat is the biggest driver 08:44 of the fat being deposited in other organs. 08:48 For example, in one randomized clinical trial 08:51 in Sweden, they gave the study participants muffins 08:56 for a couple of weeks. 08:58 And the muffins were consumed as extra energy. 09:01 So it was like an over feeding study, if you will. 09:04 People were eating their usual diet, plus the muffin 09:09 they were getting from the research group. 09:12 And one muffin contained sunflower oil as the main source 09:17 of polyunsaturated fatty acids, versus another muffin containing 09:22 palm oil as a source of saturated fat. 09:27 And people were depositing the saturated fat in the liver 09:33 compared with the sunflower oil. 09:35 So it's definitely about the quality of the fat 09:38 that we're consuming as well. 09:40 In addition to the high-fat content 09:44 and high saturated fat content, meat also contains 09:48 a lot of animal protein which is an independent risk factor 09:51 for developing type 2 diabetes. 09:54 Also heme iron is another independent risk factor. 09:59 And it doesn't have any fiber, doesn't have any antioxidants, 10:03 so it's lacking all the protective factors. 10:06 And when there's too much fat stored inside the cells, 10:11 the door lock is jammed 10:14 and insulin is not able to open the door. 10:18 The glucose, after a meal, is just building up in the 10:21 bloodstream and is not able to get into the cells. 10:25 So the cells are starving for energy, 10:28 and we have too much blood sugar. 10:31 So this is called insulin resistance. 10:34 Well, it was kind of a mystery. 10:35 What happened to the insulin receptor? 10:36 Why did the signal not properly transmit 10:41 in this state called insulin resistance? 10:43 With some very well-done carefully designed studies, 10:47 it actually used MRI to look and see 10:49 what's happening inside cells. 10:51 They figured out that it's the presence inside a cell 10:55 of fatty acids, saturated fats as a matter of fact. 11:00 Saturated fatty acids that have accumulated over time 11:03 within the muscle cells. 11:04 This is where it happens first, in the skeletal muscle. 11:07 Our skeletal muscle will absorb and accumulate, 11:10 or build-up, store saturated fats. 11:14 Saturated fatty acids, the chemists call them. 11:16 These fats, they don't belong inside our muscle cells. 11:18 The cells of our muscles are not designed to store fat. 11:21 But they'll do it if there's enough saturated fat 11:24 flowing past them in the bloodstream day in and day out. 11:27 The muscle cells will absorb saturated fat; 11:30 those fatty acids interfere with the insulin receptor, 11:33 prevent it from working properly, 11:35 and ultimately lead to diabetes, type 2 diabetes. 11:38 Yes, exactly. 11:39 The cell membrane is composed of phospholipid bilayer, 11:44 and fats are an integral part of the cell membrane. 11:49 And so, we are what we eat. 11:52 And that's literal for the composition 11:54 of the cell membranes. 11:56 The fat we eat will be deposited in the cell membranes. 12:00 If we eat a lot of fat from the animal products, 12:04 these become the bricks from which the cell membrane 12:08 will be composed. 12:09 And the saturated fat from animal products 12:12 will make the cell membranes more rigid 12:15 and is the ultimate cause for insulin resistance. 12:20 That's the jammed door lock where insulin is not able to 12:23 open the door. 12:25 In contrast, when we eat a lot of plant foods, 12:29 those are rich in polyunsaturated 12:31 and monounsaturated fatty acids. 12:33 And those will make the cell membrane more flexible 12:37 and more fluid, 12:39 and the metabolic processes will be easier. 12:42 The insulin will be working properly, 12:44 it will be able to open the door, 12:46 and glucose will be able to come in. 12:48 So it makes a huge difference what kind of fat we're using. 12:52 Fat is an important part of this process. 12:55 And it also affects the cells of the pancreas 12:57 that produces insulin. 12:59 You're asking about beta cells in the pancreas 13:02 and how saturated fats affect the production of insulin. 13:05 So our beta cells are highly specialized. 13:09 They are busy 24/7 in producing and storing insulin molecules. 13:16 It turns out that saturated fat, when absorbed by beta cells, 13:21 those beta cells want to be busy making insulin. 13:23 When they are dealing with saturated fatty acids, 13:26 that saturated fatty acid actually interferes directly 13:29 with the ability of the endoplasmic reticulum 13:32 to form insulin. 13:34 And so what gets made as a result is misshapen insulin 13:37 or incomplete insulin molecules. 13:40 In effect, molecules that were supposed to be insulin, 13:43 but came out so badly formed that they don't do their job 13:47 when they get out of the cell and go to the muscle. 13:50 They might not even be secreted from the cell. 13:52 The point is, saturated fat in the beta cells 13:55 impair and inhibit and destroy the ability of the beta cell 13:59 to make insulin. 14:00 So now we've got type 2 diabetes really ramping up. 14:04 We have insulin resistance in the periphery or the muscles. 14:06 We have the inability to make insulin 14:08 in the first place in the beta cell. 14:10 Our blood sugar is skyrocketing. 14:12 All as a result of saturated fats and the damage they do 14:16 inside these various cells. 14:17 I find again and again that when individuals that I'm seeing 14:21 for type 2 diabetes change their diet in such a way that 14:25 they get rid of saturated fat, we'll talk about 14:28 the sources of that, we can if you'd like, 14:31 when they reduce their saturated fat intake 14:34 and started eating more of complex carbohydrates, 14:37 their diabetes gets easier and easier to treat 14:39 because their insulin resistance is going away. 14:42 Melting back towards insulin sensitivity. 14:45 Which can happen if we can get those saturated fats 14:47 out of the cell, the insulin receptor comes back and says, 14:51 "Oh, I'm so glad to be working properly again. Thank you." 14:54 Even though we can't spend a lot of time on the different 14:56 factors that can potentially contribute to type 2 diabetes, 15:00 I want you just to see that ROS wreaks havoc here as well. 15:04 Remember ROS? 15:07 Oxidative stress is the underlying mechanism 15:11 behind the development of insulin resistance 15:14 and type 2 diabetes, but also of other chronic conditions 15:18 such as cardiovascular disease and cancer. 15:21 So what can we do to protect ourselves? 15:24 The oxidative stress is caused by the free radicals that 15:29 are missing an electron and are highly reactive. 15:32 If they're highly reactive, they will be damaging 15:36 our proteins and our other molecules in our body. 15:42 In an ideal scenario, the antioxidant production 15:47 will counterbalance the free radical formation in our body. 15:51 Unfortunately in type 2 diabetes the free radical formation 15:58 outweighs the antioxidants in your body. 16:01 Now we conducted a study where we put people with 16:06 type 2 diabetes on a plant-based diet for 12 weeks 16:10 and we looked at their oxidative stress markers. 16:15 And what we found out was really fascinating. 16:17 After only 12 weeks the vitamin C levels were 16:21 much higher than in the controlled group 16:24 that were counting their calories and carbohydrates. 16:27 But of course, this is what we would expect, 16:30 because vitamin C is in all the plant foods. 16:33 So we would think, well they were consuming more fruits 16:36 and vegetables, so of course, their vitamin C 16:39 levels were increased. 16:41 But not only vitamin C levels, but also the levels of enzymes 16:46 that are being produced in response to oxidative stress. 16:50 Such as superoxide dismutase and reduced glutathione. 16:54 They increased dramatically on the plant-based diet. 16:58 Which means that it was not only about the foods 17:01 that people were consuming that helped them with antioxidants, 17:06 but the plant-based diet also helped them produce 17:10 the protective antioxidants in their body. 17:14 Now oxidative stress is not only involved in the 17:18 development of type 2 diabetes, it's directly involved in the 17:22 development of insulin resistance and also the failure 17:26 of the beta cells to produce enough insulin. 17:29 And it's also directly involved in the development 17:32 of diabetic complications. 17:34 So it's never too late to change our diet 17:37 and just break the cycle. 17:39 Please don't get turned off or tuned out 17:42 because of the fancy names, superoxide dismutase 17:46 and glutathione. 17:47 It's just referring to the defenders of your health. 17:50 They function as ROS's steady woman that calms him down, 17:54 neutralizing the stress. 17:56 And when we eat a plant-based diet, we are ensuring that 17:59 there's enough of her to go around. 18:01 Do you remember the program on securing the border? 18:04 That was another previous program about gut health, 18:06 which can also be an important place to address 18:09 the root cause of diabetes. 18:12 If the border is not secure, this can be a cause of 18:17 increased inflammation in our body 18:20 and the development of insulin resistance down the road. 18:27 The rise in the prevalence of type 2 diabetes 18:30 is mainly due to a high fat western diet 18:34 and also a lack of physical exercise, 18:36 but also other factors such as lack of sleep 18:40 and disruption of circadian rhythms. 18:44 And I need to tell you about one of the cellular mechanisms 18:50 that develops in type 2 diabetes. 18:53 Each cell has a signature on their cell membrane. 18:58 If someone has diabetes, there is a diabetes signature 19:03 on each cell membrane, which is based on the fatty acid 19:09 composition of the cell membrane. 19:11 There is a high-level of palmitic acid 19:14 which is one of the saturated fats 19:17 mainly coming from dairy, meat, and eggs. 19:22 And the low levels of linoleic acid, which is one of the 19:26 polyunsaturated fatty acids coming from vegetables 19:29 and vegetable sources. 19:31 And this combination is a clear diabetic signature. 19:36 That's just written on each cell membrane. 19:40 Once people go on a plant-based diet, 19:43 we were looking at this specific signature on the cell membranes, 19:47 and in only 12 weeks 19:49 the diabetic signature just disappeared. 19:53 So it's not only about your blood sugar levels, 19:56 it's actually what happens in each cell of the body. 20:00 The plant-based diet is super powerful 20:03 in just erasing the diabetes signature 20:07 from the cell membranes. 20:08 How do we do that? 20:10 The most effective way is first of all, a plant-based diet, 20:16 which is naturally low in fat and also 20:20 rich in fiber and antioxidants. 20:23 And that helps get rid of the extra fat stored inside 20:28 the muscle and liver cells. 20:30 We did a 16 week randomized clinical trial 20:34 where we measured the amount of liver fat. 20:38 And we found out that on a low-fat vegan diet 20:42 the liver fat content decreased by 34% in 16 weeks. 20:48 It's just amazing what a healthy plant-based diet can do. 20:52 So that's number one. 20:54 Begin, you know, a transition towards a plant-based diet. 20:59 The second recommendation would be intermittent fasting. 21:04 In another study, I took people with type 2 diabetes; 21:08 and usually people with type 2 diabetes are recommended 21:13 to eat many small meals during the day. 21:16 So we gave them for 12 weeks they were on six meals a day, 21:21 which is like the usually recommended regiment. 21:25 And for another 12 weeks they were only on two meals a day; 21:30 big breakfast and big lunch. 21:31 The diet composition was the same, 21:33 the energy content was the same. 21:36 And they began in a random order either with 21:39 six meals or with two meals. 21:41 And after 12 weeks they tried the opposite intervention. 21:47 So it was a crossover design which means each participant 21:51 tried both of these regiments. 21:53 So they found out what works for them specifically, 21:57 and also it gave us a wonderful power to detect 22:02 the differences between the interventions. 22:05 What we found out was really fascinating. 22:07 With the same amount of energy and with the same 22:10 diet composition, people lost more weight on two meals a day. 22:15 They lost more liver fat on two meals a day. 22:19 Their insulin sensitivity increased 22:22 more on two meals a day. 22:24 That means improved. 22:26 And also what was fascinating, the depressive symptoms 22:30 decreased more on two meals a day. 22:32 And also feelings of hunger decreased more 22:35 on two meals a day, which was amazing. 22:37 In the beginning of the study, the study participants were 22:41 like, "I'd like to join the study, but I'm afraid I will be 22:44 starving with two meals a day. 22:46 I may not be able to follow it." 22:48 And it took only a couple of days for people to adjust. 22:54 And at the end of the study, most people were like, 22:57 "Oh, two meals a day are just amazing. 22:59 I'm sticking to it for life." 23:01 So that's how powerful intermittent fasting is. 23:04 So when we talk about diabetes, plant-based nutrition 23:08 and intermittent fasting are the most powerful 23:11 game changers in terms of diabetes. 23:14 We teach that you want to exercise 23:18 immediately after eating. 23:20 And you want to do it within 23:22 5 or 10 minutes of finishing eating. 23:23 The minute you put that fork down, 23:25 you go out and walk around the block. 23:27 It doesn't have to be hard exercise. 23:30 People think they have to go out there and run. 23:31 You don't. 23:33 Just get out and start moving. 23:35 Because the only thing that puts glucose, 23:38 take it out of the blood and puts it into a cell 23:41 is either insulin, which you're having a problem with, 23:44 or exercise. 23:46 So if you have not enough insulin, 23:48 you've got that insulin resistance, 23:49 instead, you exercise, and you'll bring those 23:52 blood sugars under control. 23:53 Exercise will help increase the capacity of the muscles 23:58 to take in all the glucose after the meals. 24:01 We know that exercise is good in general. 24:05 For example, for people with type 2 diabetes 24:08 who struggle with blood sugar control after the meals, 24:12 it has been shown that going for a walk after each meal 24:17 is more beneficial than exercising in general. 24:20 So if you can go, and the walk can be short, 24:24 10 to 15 minutes, but it will help all the glucose from the 24:29 meal gets into the muscles 24:31 instead of being stored in our fat. 24:34 When we exercise, our muscles are more ready 24:36 to absorb glucose. 24:38 Exercise increases and improves insulin sensitivity, 24:41 it tends to reverse insulin resistance. 24:43 So we often like to encourage patients with type 2 diabetes 24:46 to take a good 10 to 15 minute walk after every meal. 24:49 It makes a big difference in the after-meal blood sugar levels. 24:52 As much a difference as some drugs that are prescribed. 24:57 A gentleman in our health class, I think his fasting 25:01 blood sugar was 350. 25:03 And at one of our classes we talked about this. 25:06 And within five days, he used to work in an operating room, 25:11 so it was tough to do, but within five days 25:14 of starting to walk around the hospital up and down the aisles, 25:19 his blood sugar was down to 175. 25:21 Which still wasn't great, but huge change. 25:24 It makes a huge difference. 25:26 Exercise is not just about losing weight. 25:29 The average person, even if lean, 25:31 can have toxic levels of fat. 25:33 In fact, we call it the skinny obese. 25:37 Like in the 70's there was this model called, Twiggy. 25:43 And she was so, just you know, board thin. 25:46 And yet she was officially obese by looking at the percentage 25:50 of fat versus lean muscle on her body. 25:53 She didn't look obese, she looked skinny, skinny, 25:56 but she wasn't healthy at all. 25:58 I'm curious, how long would it take to see improvements 26:01 in insulin sensitivity. 26:02 To develop type 2 diabetes usually takes at least a decade 26:07 or maybe even several decades. 26:10 When people start transitioning toward a healthy lifestyle, 26:14 they decide to change their diet, I'm always amazed 26:18 at how quickly the changes happen. 26:21 The first changes usually happen in a few days. 26:24 People start, you know, their blood sugars 26:27 starts getting lower and lower, and we need to cut down on 26:30 their diabetes medication. 26:33 And in a few months sometimes they can 26:38 get rid of all their medications. 26:40 Sometimes not. 26:41 Sometimes they're just cutting back on their medications 26:44 as the time goes. 26:46 But the first changes happen in a few days. 26:49 I'm always amazed. 26:51 I'm like, it took a decade, or even two or three, 26:55 to develop diabetes, and now we're seeing 26:58 all these rapid changes. 27:00 If we want to protect our brain cognitive function, 27:04 if we want to protect our immune system, 27:06 if we want to protect our cardiovascular system, 27:10 it's imperative that we have the right diet, 27:12 but also take advantage of exercise 27:15 so that we're burning off the excess, 27:18 and therefore preventing that glucose toxicity 27:23 and the lipotoxicity of the fat. 27:26 The lipid fats actually can cause toxicity. 27:30 So that's why, when we exercise appropriately 27:33 and we eat appropriately, the body is able to 27:36 burn off the excess fat and bring us down to a 27:40 healthier weight. 27:42 And we know that when we burn excess fat centrally, 27:47 we're also burning off the excess fat inside the pancreas 27:52 that is damaging the pancreas, that is promoting the diabetes. 27:56 We're burning off the excess fat in the liver 27:59 which is creating toxicity issues that is creating 28:05 problems, preventing all kinds of diseases. 28:10 Amen and praise God for that. 28:13 Today's episode may give us some homework to do, 28:15 but it also gave us ground for hope. 28:18 Remember, you were made for health. |
Revised 2025-03-17