Insulin Resistance Diet — What To Eat & Why - Real Doctor Reacts

Hello Health Champions. Today we're going to talk about the insulin resistance

diet. What to eat and why. Coming right up.

Hey I'm Dr. Ekberg. I'm a holistic doctor and a former

Olympic decathlete and if you want to truly master health by understanding how

the body really works make sure you subscribe and hit that notification bell

so you don't miss anything. So obviously when we're gonna talk about the insulin

resistance diet we're going to talk about the diet that helps reverse

insulin resistance not the diet that helps promote it insulin resistance is

reaching epidemic proportions so more people than ever are looking for

solutions but there's so much conflicting information out there

people wonder should I eat a low-carb diet should I eat a low-fat diet should

I eat a high carb diet should I eat a high fat diet is saturated fat the cause

of insulin resistance a lot of people claim that and by now hundreds of

thousands of people have had great results in reversing insulin resistance

and losing weight and reversing diabetes with low carb high fat diets and

ketogenic diets and intermittent fasting but at the same time there's a large

number of videos where people claiming the same benefits from a plant-based

low-fat high-carb diet a lot of you out there have seen examples of such

seemingly conflicting information and a lot of you have asked for me to comment

on it so today we're gonna take a look at a video and try to clear up some of

the issues he was living with type 2 diabetes for nine years neglecting his

diet not really paying attention to it he came to us he basically said hey I

need some help and we showed him this approach and over the course of six

months he dropped 30 pounds he stopped using metformin diabetes medication how

many of you guys use metformin yep okay he stopped using metformin he also

stopped using a statin medication he also stopped using blood pressure

medication now he actually says exercise six days per week and he's a happy guy as

you can tell. That clip was from a video promoting a plant-based very low-fat

high-carb diet and Vijay here got amazing results but if you notice how he said he

had been neglecting his diet and type-2 diabetes for nine years he had been

neglecting his diet so anytime that you start eating real food instead of junk

you're gonna get healthier alright so we're talking about a lot of different

variables but the first thing to remember is if you go from eating junk

to eating actual food you will get healthier now in my office we use kind

of an opposite approach we use a low carb high fat diet and we have results

very very similar to that we have people get off their statins their blood

pressure medication their metformin their insulin no matter how long they've

been diabetics and how long no matter how long they've had metabolic syndrome

it goes away when you stop pushing in the wrong things in the body but how is

it possible that you can get similar results with seemingly opposite

approaches so in order to answer and clarify that dichotomy we're going to

try to answer three questions first of all are the approaches really that

opposite or do they have some similarities secondly we're gonna ask

what are the results that we're getting are they actually getting the same

results that we are and thirdly we're gonna get in detail and understand the

mechanisms by which you can get this kind of change so that you understand

why one approach might work better than another or why both might

work so this is one of those videos you really want to look at it the whole way

through and stick till the end because if you don't get all the components and

you don't see how they all fit together you're not gonna get the full value so

the speaker in the video is a guy named Cyrus and he's the one who together with

a partner of his Bobby they came up with this particular approach and the reason

was that he was diagnosed with type 1 diabetes

when he was 22 years old and then he followed what they told him was a

low-carb diet where he was eating a hundred to 150 grams of carbs per day and

he was taking his insulin but he didn't feel well he felt like he had no energy

and he didn't get better the way he wanted to so he looked into different

approaches and because of how he felt he was pretty desperate and he said I'm

gonna change totally I'm gonna go plant-based high carb low

fat my carbohydrate intake went from about a hundred maybe 150 grams per day

all the way up to 600 grams per day within the first month so I started out

using between 40 and 45 units per day and over the course of four the first

month it dropped all the way down to 25 24 and hovered in that range so here I

am today 15 years later from that initial diagnosis of 2002 I've reduced

my insulin used by 40% I eat more than 700 grams of carbohydrate on a daily

basis and my a1c values which is a 3-month marker of blood glucose your

average blood glucose is between five point six and 6.0. So I'm genuinely happy

for Cyrus that he has found a way that he feels works for him and I have seen

too many examples in too many different circumstances to say that there's only

one way to make something work for you but we do have to ask some questions

though and one of those is he's getting pretty good results but are they optimal

the results are going to be influenced by things such as age activity and level

of degeneration so he was very young and he did something about this at a very

young age he got it when he was 22 and now he is 15 years later at 37 that's

still a very young age that's much much younger than most people who are talking

about type 2 diabetes and because he was still very young he had a very low level

of degeneration most of his metabolic pathways are still working really well

he never had a chance to develop a fatty liver or anything like

that then he is very very active you can tell from the picture he were going to

show in a second that he is in very very good shape and he says he gives several

examples of how people exercise every day and that's a great thing now I don't

think that you should have to exercise to control your insulin resistance you

need to exercise for the reasons but if you're young and you're active that's

going to help tremendously in keeping these values in range and if you are

already in your 50s or 60s and you've have degenerated then there might be

much harder to get the same results so I'm not saying that I'm not trying to

discount anything I'm just saying that we have to be aware of these variables

so the question then is are these good values to a1 C that's a three month

average of blood glucose and in the medical diabetes world your insulin

resistance you're heading toward diabetes if your a1c is over five point

seven or anything five six or over which would be five point seven he had

reported five point six to 6.0 which is actually pre-diabetic and his partner

Bobby said that he was currently at five point nine and he had his highest value

had been six point four so that's great they're not diabetic values but they are

pre-diabetic values okay and I think even for a type one diabetic you have to

inject insulin to control blood sugar if you cut your carbs then you can keep

that a one C at a much lower level and you can create much more stable blood

sugar which we'll talk a lot more about so there are many many reasons to keep

the a1c low but I want to show you a graph here and as you see on that graph

the higher your a1c the faster your brain shrinks and the best level to keep

your a1c is four point four to five point two so I believe the best range

would be somewhere right around five okay you don't really want to get

/ 5.2 because now you're moving into insulin resistance and you're

accelerating brain shrinkage the brain is going to shrink no matter what it's

inevitable with age that the brain shrinks

however with high glucose and high a1c it shrinks faster and then he goes on to

explain a lot important things about insulin resistance that it's not just

about diabetes whether it's type 1 or type 2

but it's the driving factor in all degenerative disease so high blood

pressure and metabolic syndrome and cardiovascular disease and stroke

insulin resistance is the driving factor in all those conditions and I couldn't

agree more this is really important stuff to understand in something that's

really important to understand is that even though type 1 and type 2 diabetes

are opposites in the sense that one is caused by the total lack of insulin

while the other is caused by excess insulin if they are mismanaged if you

just keep controlling the blood sugar in a type one with insulin then you will

still create insulin resistance and the end result in many many cases is

cardiovascular disease which is the leading cause of death in diabetes and

especially in type 1 diabetes because it is more sensitive it has to be managed

more closely because you're completely dependent on injecting that insulin and

that's why it's so important to truly understand these underlying mechanisms

so that whether it's type 1 or type 2 or pre-diabetes or whatever that we

understand how to manage it properly but then we get to the big question if

insulin resistance is that big a deal then what causes it insulin resistance

is the underlying factor present across all forms of diabetes but a lot of our

doctors the medical community doesn't understand this they they weren't

trained properly to to get the knowledge and the tools and as a result of that a

lot of us are given improper information doctors are great people they're not to

blame but the fact of the matter is if you really understand what insulin

resistance is then you yourself can treat insulin resistance and reverse it

that's what we're looking for today so just like you guys said insulin

resistance is caused by the storage of fat in tissues that are not designed to

store fat so I by that definition that fat in the tissues makes that's tissues

resistant to insulin that's what insulin resistance is and he's primarily talking

about liver and muscles and when the liver and muscles are full of fat

then insulin doesn't work and the glucose gets stuck in the bloodstream

resulting in even higher blood sugar so I'm totally on board with that but now

we want to try to figure out how does the fat get into the cell if the fat in

the cell is the problem how did it get there and then we have energy depots we

have what's called a glycogen molecule where you store carbohydrate or glucose

and then you have a lipid Depot or a lipid droplet where you store fatty

acids so in this cell we're operating in a person who has insulin resistance

who's developed insulin resistance through their diet so what happens is

that they're eating a low carbohydrate diet which is a high-fat high-protein

diet and as a result of that fatty acids marched their way into the cell so you

guys all got here because you were present in the bloodstream to begin with

and then you just marched your way right into the cell so up to this point I

agreed with him about 99% of everything he said in the video but when he said

that the fat in the cell is caused by a low-carb high-fat diet that it's because

you eat fat that you get fat in the blood and that fat goes into the cell

then he is actually plain wrong he is ignoring hormone mechanisms he's

ignoring physiological principles right so let's look at this a little bit more

in detail he says that the cell is over stuff that it has too much fat in it

because you ate too much fat but the truth of the matter is that anything

that you eat in excess gets converted to fat it's not the fat excess it's the

excess period because that's what the body has to do that's the mechanism of

storing the excess from a feast and saving it for a famine that's just what

the body does so we want to think of it as excess anything leads to storage

that's the survival mechanism and it's insulin that does that insulin is a good

thing it helps us create fat for future use and if you open up any physiology

textbook you can read that insulin is a fat storing hormone that insulin

promotes the conversion of glucose to fat and it prevents the conversion from

fat to glucose it promotes lipogenesis and it prevents lipolysis lipolysis so

this is as basic as it yet this is not disputable this is not negotiable it's

the way it is any excess will create an insulin response and if we continuously

create excess because insulin stores things away and as long as there's

plenty of food we're going to eat more then we have the opportunity to overload

and we want to think of this as overloading as clogging the cell as

congesting the cell and if one more factor is frequent meal this results in

a bloated overloaded clogged cell this cell is instantly resistant it has a lot

of fat in it it has a lot of saturated fat in it so here's where they go wrong

there's thousands of research papers that say we observed this cell it was

full of saturated fats and this cell was insulin resistant it resisted the action

of insulin it blocked the entry of glucose they're absolutely right there's

thousands of papers saying that but there's no paper that

as the fat ended up there we have proven the MEK that the mechanism by which the

fat ended up in that cell was that the person ate saturated fat and that's the

same saturated fat that's in that cell there is no paper that says that it's an

assumption it's a correlation so think about it this way

this cell is gonna have mostly saturated fats gonna be how about 50% saturated

fat and most of the rest of the fat is going to be mono unsaturated and this is

the exact same proportions or very very close to beef fat to pure beef tallow

now I can see where it's not too far-fetched to think that well if that

fat in there has this component and beef tallow has the same component then it

must be because we ate the saturated fat from the beef but that's kind of like

saying well then the cow must have eaten that fat as well right no the cow ate

the grass which is pure carbohydrate it converted that carbohydrate into fat

because that is what mammals do we store excess as saturated fat that is the only

long-term storage mechanism that we have and because humans are mammals we're

gonna store our excess fat as the same saturated and monounsaturated fat that a

cow does that's just the most efficient way of storing excess energy the cow

stores excess grass we store excess anything so then the next thing to

understand is any mechanism any way that we can reduce this that we can undo the

excess and the stories in the clogging if we can reduce the inflow if we can

start burning off if we can unload and unclogged and decongest it doesn't

matter which way we do that then we are gonna create

a cleaner cell a thinner cell with less fat that is less insulin resistant

because once it has a healthy flow of energy and it burned through its doors

it's open to receiving more energy so then the next question is and the only

remaining question is how does that happen for you

some people can do it with calorie restriction but it's usually doesn't

work very long because they go hungry and eventually they start eating again

you can do it with low carb high fat because you get very satiated so you

start eating fewer meals and fewer calories a smaller amount of food and

that works or if you reduce the fat extremely now you have a less

nutrient-dense food like what they're promoting in this video so either way

that you eat less you can create this benefit the question is which one is

going to work best for you and which one is going to be the most sustainable for

you on the very bottom we have a curve which shows what happens to your blood

glucose after you eat a low-fat low protein meal so you see how your blood

glucose Rises and then comes right back down okay

that's what's called a normal glucose response or a normal glycemic response

to a meal actually that's about as far from a normal glycemic response as you

can get alright let me explain so I've just

copied that graph what he has on the left side here on the x-axis is the

excursion of blood glucose the changes in blood glucose measured in milli molar

give you the absolute numbers they just give you how much it changes they put

the baseline at zero and they put all the different diets at the same starting

point just so you could see how much they changed so I don't know where they

started but I'm going to assume that they were somewhere around a hundred

maybe they were a hundred 10 maybe there were 90 maybe they were

120 then you would just have to add those numbers to to get into that range

but it's all relatively the same now millimoles of blood-glucose 1 milli

mole is 18 milligrams of blood sugar change so if you look at the graph he

goes from zero and all the diet's quickly increase by an amount of 4

millimoles that means their blood glucose increases by 72 grams right and

that's what he calls a normal blossom Achra sponsz so the red line here is a

copy of what he is referencing that in 90 minutes your blood glucose increases

by 72 points in milligrams but then as soon as it hit the peak it starts going

down and within 3 hours you're basically down to where you started and this is

the problem that it keeps going down because this these carbohydrates because

like he says in the graph it's a very low amount of protein and a very low

amount of fat so this food is processed very quickly it raises blood sugar and

when it's reached the top it just crashes and when it starts going down it

keeps going down and what he calls a normal glycemic response is ends up

somewhere around 3 millimoles lower than where they started this poor guy is

going to be in the 50s right or if they started at 120 which would be close to

diabetic he's still gonna be hypoglycemic relatively speaking because

he is used to 120 and now he's going to be in the 70s and this is a huge problem

this is an extreme form of reactive hypoglycemia that you get an excess

insulin response and then it drives the glucose down very quickly and these

people have to eat very very frequently so this was

probably a fairly big meal if it's a smaller meal and here they have to

refuel after about three hours every three hours throughout if they don't

fill up again then they're gonna crash and burn in our four so what he is

calling a normal blasts emic response is that from the highest point to the

lowest in just a few hours it drops about 120 points okay that's the kind of

unstable blood sugar that creates unstable moods unstable energy and

disease so what he's calling normal blood sugar responses is that it goes

from the highest point to the lowest point it changes over a hundred and

twenty milligrams per deciliter in just a few hours now that's the kind of blood

sugar swings that results in unstable energy in unstable mood and inconstant

hunger and I'm not necessarily saying that he with his diet and lifestyle is

this bad off but I'm saying that the statistics the data that he's

referencing someone with these values would have that kind of response if you

simply increase the amount of protein in that meal okay you go from five grams of

protein to 40 grams of protein look what happens your blood glucose response goes

up we didn't touch fat we only added protein if you add fat and you take away

the protein you get a similar response what happens if you add fat and protein

together if you add fat and protein together you get that response now I

think it's fascinating how you can look at the same graph and interpret it so

completely differently so he says that because the low fat low protein blood

sugar goes down the fastest because it crashes he's saying that the combination

of high fat high protein provides the highest blood sugar they were all up at

the same point but the blood-sugar didn't crash when you ate

fat and protein right so first of all I don't know what they fed these people on

a high-fat high-protein diet to get the blood sugar to rise by 72 points all

right my blood sugar I eat high fat high protein and my blood sugar might go up

10 15 20 maybe 25 points if I have a large meal right my my line would be

kind of just hovering right here in the middle I probably would just barely

break the hundred point line so again they probably fed them high sugar high

protein high fat to get this kind of response but even so what this creates

is satiety and your blood sugar is stable this is a good thing

stable blood sugar is stable energy stable mood and if you hadn't fed them

so much sugar then you would have that stability at a much lower level and then

I kind of combined the other curves so if you had both protein and fats you end

up with a blue line if you had either protein or fat then you ended up

somewhere in the middle so either one is provides satiety both provide more

satiety more stability so it's kind of like you have a fire do you want to fuel

that fire with gasoline or do you want to put a log on the fire if you put a

gasoline on it it creates a short burst of heat and energy and then it crashes

whereas if you put a slow burning fuel on you create long term stability so

what he calls the highest blood sugar is just the most stable blood sugar and all

it means is that you're not going to need to eat as soon again so let's just

try to tie it together a little bit and compare these different diets and try to

understand these variables so the standard American diet is high in sugar

it's high in carbohydrate and it's high in fat especially processed low quality

fats tying processed food overall it is very

low in nutrients because the food processing destroys most of the live

elements it is a calorie dense diet and you eat frequently it is high in

inflammatory omega-6s and it is high in the most common allergens such as wheat

and processed low-fat dairy this is like a long list of problems because if it's

calorie dense but it's still deficient in nutrients it makes you eat frequently

and this is why you overeat and that's why you get all this junk you get the

congestion but you're constantly undernourished it's like the worst of

all the components then we look at the diet that's promoted in this video which

is a plant-based diet but it's very very high quality food all right it is it

completely eliminates sugar and sugar is the primary cause of insulin resistance

because sugar is 50% glucose 50% fructose fructose can only be processed

by the liver it can gests the liver it does all these

things to the liver and the standard diet has a lot of it their diet does

away with processed sugar entirely so that's like a huge huge step forward

already it is high in carbs but it's also high in water and fiber which makes

the absorption slower it is extremely low in fat it is pretty much zero

processed food it's all good quality Whole Foods because of that it is

nutrient-dense whole food has nutrients but it is very low in calories all right

it has a lot of fiber and water it has a lot of bulk so it's difficult to eat

even if you eat a lot of meals throughout the day you don't get all

that many calories not as many as you would get from a standard American diet

but you they're gonna have to eat frequently

because you're not getting the log on the fire

you're not getting the satiety from just the carbs so your blood sugar is gonna

go up and down its gonna fluctuate a whole lot more and you're gonna have to

fill up more frequently they've also eliminated all processed

oils because they eliminate all oils period so they're gonna eliminate the

plant oils the inflammatory omega-6s and they also avoid most of the common

allergens because they don't do any dairy or any bread or any pastries or

any desserts or anything like that any no processed foods so the biggest thing

that they've done and in that sense they're not so different from a good

quality low-carb diet is they've reduced all the junk from a standard diet that's

a huge step forward but then if we contrast it to the low carb high fat now

these have in common that they're zero sugar basically this one's high carb but

this is a very low carb this is low fat this is very high fat those are the main

differences if you do it properly if you learn to eat real food which is what you

want to do to get healthy in the long run now I do agree with some of the

critics that if you just eat junk fat you can still reduce insulin resistance

but you're not providing the body healthy nutrients and your chances of

being healthy decades down the road are not that great so you want to reduce

processed foods that way you increase nutrients you eat whole food now here's

the difference also because it's very calorie dense you're eating tons of fat

you are eating a lot of density the potential for clogging the cell is great

but it is so satisfying and you're not eating any carbs to drive your cravings

so you can reduce the frequency it's very very easy on a low carb high fat

diet to go down to two meals or even one meal at

and you're reducing the omega sixes and you're reducing a lot of the allergens

because you're not eating bread you're not eating processed food and

you're not eating low-fat dairy you're not eating nonfat dairy typically so

whether you have type 1 type 2 gestational diabetes pre-diabetes that's

what happens they push you towards this you know high-fat high-protein diet and

you become more and more insulin resistant and that's because low-carb

diets work they absolutely work but they work in the short term they're not

effective long term strategies they're not effective long term solutions

because they actually increase your risk for chronic disease but you can't see

that in the short term because all you're focused on in the short term is

that you get a better a 1 C value you reduce your blood glucose availability

meaning you get less swings and you get a much more stable blood glucose which

is a good thing you can reduce your total insulin use you can reduce your

LDL cholesterol the bad cholesterol and you can lose a ton of weight alright so

now I think he's really losing his footing a bit because he says that all

these diabetics are being pushed into a low carb diet and it's a high-fat

high-protein diet that is causing insulin resistance but then he turns

around and says that Oh low-carb high-fat diets they absolutely work and

he lists all these benefits and you can't have it both ways

alright so he says that in the short term a 1 C goes down your blood glucose

variability go down and that's a good thing he says that you can decrease your

total insulin use and that your LDL cholesterol goes down plus you can lose

a bunch of weight now this is the inconsistency ok insulin resistance is

caused by insulin it's caused by a high level of insulin not allowing the

glucose entry because of the fat in the cells right he's got most of the model

right he's just totally stuck on the fact that it's the fat

inside the cell that's causing the problem but the fat in the cell is

causing the blood sugar to go up causing the insulin to go up and creating a

vicious cycle but if you can have a diet where you get these results if you can

lower your a1c if you can lower your total insulin you are reversing your

insulin resistance there is no way that you can lower your insulin need and

become more insulin resistant at the same time that you lower your blood

sugar it is impossible you can't have it both ways either low carb works and you

get these benefits or low carb does not do what he says then the fat is not the

cause of the insulin resistance because if you can eat a high fat diet and get

these benefits then high fat does not cause insulin resistance okay it's

completely inconsistent but then he goes on and this is the main concern this is

why a lot of people asked me and they get these results they're so happy but

there's always someone that has to throw out that scare tactic and say that well

you don't know what happens in the long term and here's what they mean by that

he says that short term it works great it's fantastic but in the long term you

get the opposite and it doesn't explain why you get the opposite he just says

that you get these benefits for a short term but in the long term you get higher

a1c you get more insulin resistance you get more fatty liver you get more weight

gain and on and on and on and here's where they are stuck they look at all

these research papers and they see the fat inside the cell they see the insulin