1 00:00:09,560 --> 00:00:13,080 Speaker 1: Hey, everyone, welcome to another edition of Wisdom Wednesdays. Today 2 00:00:13,119 --> 00:00:16,720 Speaker 1: we're going to dive into the debate that has gone 3 00:00:16,720 --> 00:00:19,720 Speaker 1: on for far too long in the world of nutrition 4 00:00:20,000 --> 00:00:24,240 Speaker 1: and chronic disease, and that is what diet is best 5 00:00:24,280 --> 00:00:27,320 Speaker 1: for type two diabetes. Is it a low carb diet 6 00:00:27,640 --> 00:00:30,320 Speaker 1: or is it, as health professionals have told us for 7 00:00:30,400 --> 00:00:35,199 Speaker 1: thirty years, a low fat diet. Because more evidence is 8 00:00:35,240 --> 00:00:38,879 Speaker 1: in in the form of a systematic review, and it's 9 00:00:38,880 --> 00:00:43,360 Speaker 1: pretty clear we have to stop promoting low fat diets 10 00:00:43,400 --> 00:00:47,120 Speaker 1: as the gold standard for managing type two diabetes. So, 11 00:00:47,240 --> 00:00:51,080 Speaker 1: as I said, there's a major new systematic review that's 12 00:00:51,240 --> 00:00:55,720 Speaker 1: just been published comparing low carbohydrate diets with low fat diets, 13 00:00:56,240 --> 00:00:58,880 Speaker 1: which for decades have been targeted as the go to 14 00:00:59,080 --> 00:01:03,160 Speaker 1: for diabetes and heart health. And I know this because 15 00:01:03,240 --> 00:01:06,800 Speaker 1: my mum and my aunt had suffered from tatoo diabetes. 16 00:01:07,520 --> 00:01:09,960 Speaker 1: It's rampant in our family. We know that our genes 17 00:01:10,000 --> 00:01:12,520 Speaker 1: are pretty shiitthu surround it. And my mum has been 18 00:01:12,560 --> 00:01:14,759 Speaker 1: told and my aunt has been told for. 19 00:01:14,880 --> 00:01:18,080 Speaker 2: Decades to be on a low fat diet with. 20 00:01:18,160 --> 00:01:23,679 Speaker 1: Relatively high carbohydrate but from more complex carbohydrates. Now does 21 00:01:23,800 --> 00:01:27,520 Speaker 1: that stack up to the research. Well, this looked at 22 00:01:27,680 --> 00:01:31,759 Speaker 1: seven randomized control trials, so the best form of evidence, 23 00:01:32,240 --> 00:01:35,480 Speaker 1: and these trials are all involved having adults with tatoo 24 00:01:35,560 --> 00:01:39,560 Speaker 1: diabetes or pre diabetes, and they were all put on 25 00:01:39,600 --> 00:01:43,080 Speaker 1: a diet, or half of them in each of these 26 00:01:43,120 --> 00:01:45,520 Speaker 1: were put on a low carb diet and half were 27 00:01:45,520 --> 00:01:48,800 Speaker 1: put on the low fat diet. And across the board, 28 00:01:49,240 --> 00:01:54,800 Speaker 1: low carb diets outperformed low fat diets in every meaningful way. 29 00:01:55,200 --> 00:01:56,920 Speaker 2: Better blood sugar control. 30 00:01:56,800 --> 00:02:02,160 Speaker 1: More weight loss, improved lipid profile, a less reliance on 31 00:02:02,280 --> 00:02:07,120 Speaker 1: diabetes medications, which is really the key outcome here, So 32 00:02:07,240 --> 00:02:10,480 Speaker 1: let's dive into it a little bit. What the researchers 33 00:02:10,480 --> 00:02:15,480 Speaker 1: did was they reviewed dietary interventions ranging from very low 34 00:02:15,520 --> 00:02:19,720 Speaker 1: carb ketogenic diets, which generally have less than ten percent 35 00:02:19,760 --> 00:02:22,560 Speaker 1: of your total calories coming from carbs, all the way 36 00:02:22,639 --> 00:02:26,919 Speaker 1: up to a moderate low carb diet where carbs make 37 00:02:27,000 --> 00:02:29,840 Speaker 1: up thirty to even as as forty five percent of 38 00:02:29,840 --> 00:02:34,320 Speaker 1: your total intake, and these that typically emphasize higher fat 39 00:02:34,400 --> 00:02:38,400 Speaker 1: and moderate protein. Then on the flip side, the traditional 40 00:02:38,440 --> 00:02:43,520 Speaker 1: low fat diets, they prioritize carbohydrate intake, often suggesting fifty 41 00:02:43,560 --> 00:02:47,560 Speaker 1: to sixty percent of total calories with fat restricted to 42 00:02:47,720 --> 00:02:48,560 Speaker 1: under ten percent. 43 00:02:49,160 --> 00:02:50,160 Speaker 2: And here's the key. 44 00:02:50,280 --> 00:02:54,240 Speaker 1: Many of these low fat diets are still consistent with 45 00:02:54,360 --> 00:02:58,440 Speaker 1: mainstream dietary guidelines other than the US ones which have 46 00:02:58,560 --> 00:03:01,160 Speaker 1: just been revised, which are going to do a podcast on. 47 00:03:01,320 --> 00:03:05,440 Speaker 1: But this is exactly what this review calls into question. 48 00:03:06,080 --> 00:03:09,359 Speaker 1: Across all the studies, the low carb dats, and that's 49 00:03:09,480 --> 00:03:13,200 Speaker 1: all of them, the low carb dats consistently achieved greater 50 00:03:13,320 --> 00:03:18,080 Speaker 1: reductions in HbA one C, which is is that more 51 00:03:18,120 --> 00:03:23,480 Speaker 1: stable three months snapshot of your glucose. They also had 52 00:03:23,560 --> 00:03:29,160 Speaker 1: lower fasting glucose levels, They had significantly improved triglyceride and 53 00:03:29,720 --> 00:03:34,360 Speaker 1: HHDL or the good cholesterol levels. But even more interesting 54 00:03:34,560 --> 00:03:37,960 Speaker 1: was that several of these studies reported that participants on 55 00:03:38,040 --> 00:03:42,800 Speaker 1: the low carb diets were able to reduce and in 56 00:03:42,800 --> 00:03:47,680 Speaker 1: some cases eliminate diabetes medications. And for me, that is 57 00:03:47,720 --> 00:03:52,040 Speaker 1: the game changer. And this is so important because diabetes 58 00:03:52,360 --> 00:03:58,280 Speaker 1: is rampant in Western societies, and the research shows that 59 00:03:58,600 --> 00:04:01,760 Speaker 1: for everybody who knows that they've got diabetes, there's somebody 60 00:04:01,760 --> 00:04:05,000 Speaker 1: else out there who has diabetes that doesn't actually know it, 61 00:04:05,400 --> 00:04:10,160 Speaker 1: And having diabetes increases your risk of cardiovascular disease. It 62 00:04:10,320 --> 00:04:15,000 Speaker 1: also very significantly increases your risk of Alzheimer's disease and 63 00:04:15,080 --> 00:04:19,880 Speaker 1: other forms of dementia and other metabolic complications like chronic 64 00:04:19,960 --> 00:04:23,840 Speaker 1: kidney disease and things like that. But let's think about this. 65 00:04:23,839 --> 00:04:26,840 Speaker 1: This is a diet that not only improves blood sugar, 66 00:04:27,320 --> 00:04:31,200 Speaker 1: but can reverse the course of diabetes enough to reduce 67 00:04:31,279 --> 00:04:35,360 Speaker 1: medication or to get off it completely. That is a 68 00:04:35,440 --> 00:04:38,800 Speaker 1: massive shift in the way that we approach chronic disease. 69 00:04:39,800 --> 00:04:42,080 Speaker 1: So let's dive into a couple of these studies because 70 00:04:42,080 --> 00:04:44,520 Speaker 1: it's quite interesting to look at them. One of the 71 00:04:44,600 --> 00:04:49,240 Speaker 1: large trial was by researcher called Doran's and colleagues, and 72 00:04:49,320 --> 00:04:53,320 Speaker 1: they had people following a low carb diet. They found 73 00:04:53,360 --> 00:04:57,560 Speaker 1: that they had significant reductions in HbA once and lost 74 00:04:57,600 --> 00:05:01,520 Speaker 1: about six kilograms in six months. The fasting glucose levels 75 00:05:01,600 --> 00:05:06,000 Speaker 1: dropped by over ten milligrams per desci liter and that's 76 00:05:06,040 --> 00:05:10,000 Speaker 1: the American values. That's not a small shift. It is cleaningly, 77 00:05:10,200 --> 00:05:14,960 Speaker 1: clinically sorry, meaningful. And then another study and the researchers 78 00:05:15,000 --> 00:05:18,520 Speaker 1: were salslow at all participants on. 79 00:05:18,200 --> 00:05:19,560 Speaker 2: A very low carb diet. 80 00:05:19,640 --> 00:05:22,400 Speaker 1: Here they saw and that was a very low carb 81 00:05:22,520 --> 00:05:27,240 Speaker 1: ketogenic diet. Not only did they have greater reductions in 82 00:05:27,480 --> 00:05:30,479 Speaker 1: HbA one C than those on a moderate carb diet, 83 00:05:30,920 --> 00:05:35,120 Speaker 1: but they also lost nearly eight kilograms more of weight 84 00:05:35,640 --> 00:05:38,359 Speaker 1: and had a significant reduction in medication use. So it 85 00:05:38,360 --> 00:05:45,120 Speaker 1: seems that lower carbs were even better. In Teatal's study, 86 00:05:45,400 --> 00:05:48,640 Speaker 1: both low carb and high carb groups lost a similar 87 00:05:48,640 --> 00:05:52,680 Speaker 1: amount of weight, but only the low carb group showed 88 00:05:52,760 --> 00:05:58,800 Speaker 1: better glucose control, had better triglyceride levels, and reduced medication use. 89 00:05:58,880 --> 00:06:02,800 Speaker 1: So even though the low fat diet lost weight, they 90 00:06:02,839 --> 00:06:07,960 Speaker 1: didn't have any metabolic benefits. So it's the metabolic benefits 91 00:06:07,960 --> 00:06:10,480 Speaker 1: that are really key, and that comes from changing the 92 00:06:10,520 --> 00:06:15,320 Speaker 1: macronutrient composition of your diet. Now, low corp dits don't 93 00:06:15,400 --> 00:06:18,480 Speaker 1: just help you to lose fat. They help your body 94 00:06:18,520 --> 00:06:21,720 Speaker 1: to work better. They stabilize your blood sugar, They reduce 95 00:06:21,800 --> 00:06:25,480 Speaker 1: inflammation because we know that high blood sugar is a 96 00:06:25,760 --> 00:06:30,640 Speaker 1: massive driver of systemic inflammation. These lower corp dits even 97 00:06:30,720 --> 00:06:35,159 Speaker 1: improve your cholesterol profile, which people have criticized, you know, 98 00:06:35,200 --> 00:06:37,880 Speaker 1: saying that that's one of the problems with them, right, 99 00:06:38,200 --> 00:06:41,960 Speaker 1: and they give people, many people the chance to get 100 00:06:42,040 --> 00:06:43,760 Speaker 1: off the blood sugar roller coaster. 101 00:06:44,680 --> 00:06:47,720 Speaker 2: But this is where things get really important. 102 00:06:48,360 --> 00:06:53,560 Speaker 1: Despite these outcomes, low fat diets are still being widely recommended, 103 00:06:54,200 --> 00:06:58,679 Speaker 1: both in clinical settings and in public health campaigns, which 104 00:06:58,800 --> 00:07:02,840 Speaker 1: for me is complete, delately bonkers. We have been told 105 00:07:02,839 --> 00:07:05,760 Speaker 1: for decades that decay to heart health and diabetes is 106 00:07:05,800 --> 00:07:08,480 Speaker 1: cutting fat, and its horseshit. 107 00:07:09,200 --> 00:07:10,320 Speaker 2: It was based on. 108 00:07:10,480 --> 00:07:16,680 Speaker 1: Outdated, very poor quality epidemiological studies where they just follow 109 00:07:16,720 --> 00:07:18,600 Speaker 1: people for a number of years, and we know that 110 00:07:18,600 --> 00:07:22,080 Speaker 1: that's really poor way to design studies. 111 00:07:22,960 --> 00:07:24,280 Speaker 2: And what we now know. 112 00:07:24,440 --> 00:07:27,680 Speaker 1: Is that when you cut fat and replace it with carbohydrates, 113 00:07:27,720 --> 00:07:31,560 Speaker 1: you actually make metabolic health worse. It's like trying to 114 00:07:31,640 --> 00:07:33,880 Speaker 1: fix a fire by throwing petrol on it. 115 00:07:35,040 --> 00:07:38,800 Speaker 2: So we also know that this is a bigger picture, right. 116 00:07:39,200 --> 00:07:42,440 Speaker 1: A diet high and refined carbohydrates is one of the 117 00:07:42,760 --> 00:07:47,040 Speaker 1: core drivers of metabolic disease. And this systematic review gives 118 00:07:47,160 --> 00:07:52,280 Speaker 1: us really solid, high quality, randomized control evidence to support 119 00:07:52,320 --> 00:07:56,280 Speaker 1: the idea that carbohydrate restriction is more effective than low 120 00:07:56,320 --> 00:08:01,680 Speaker 1: fat eating and in managing and even reversing type two diabetes. 121 00:08:02,200 --> 00:08:05,960 Speaker 1: So why hasn't the world caught up with this yet? Well, 122 00:08:06,040 --> 00:08:10,080 Speaker 1: part of it is just inertia. Public health guidelines are 123 00:08:10,360 --> 00:08:13,160 Speaker 1: very slow to change, and a big part of This 124 00:08:13,240 --> 00:08:17,840 Speaker 1: is bias. Many dieticians and doctors were trained under the 125 00:08:17,880 --> 00:08:21,520 Speaker 1: low fat paradigm, and it's very hard to unlearn what 126 00:08:21,560 --> 00:08:24,200 Speaker 1: you've been taught for years, particularly if you've been telling 127 00:08:24,240 --> 00:08:25,920 Speaker 1: people to do stuff for years. 128 00:08:26,280 --> 00:08:30,080 Speaker 2: We have that confirmation bias, and you tend. 129 00:08:29,920 --> 00:08:32,640 Speaker 1: To then seek out the studies that support your view 130 00:08:32,800 --> 00:08:34,840 Speaker 1: and ignore or minimize the studies. 131 00:08:34,520 --> 00:08:35,800 Speaker 2: That don't support the review. 132 00:08:36,240 --> 00:08:40,800 Speaker 1: But the science has clearly moved in a different direction, 133 00:08:41,400 --> 00:08:45,080 Speaker 1: and that's why it's definitely time for health professionals to 134 00:08:45,280 --> 00:08:50,680 Speaker 1: shift to the new narrative where low carbohydrates shouldn't be 135 00:08:50,840 --> 00:08:54,080 Speaker 1: tided as an alternative. So some of the diabetes sites 136 00:08:54,120 --> 00:08:57,520 Speaker 1: will say how you can do this? They should be 137 00:08:57,760 --> 00:09:00,960 Speaker 1: this is the thing that you should do. This is 138 00:09:00,960 --> 00:09:04,800 Speaker 1: the thing that is most proven to actually get you 139 00:09:04,880 --> 00:09:09,480 Speaker 1: off the diabetes medication and fix your metabolism. Now, there's 140 00:09:09,559 --> 00:09:12,880 Speaker 1: a little nuance behind this, right, and it. 141 00:09:12,880 --> 00:09:13,800 Speaker 2: Is a small nuance. 142 00:09:14,200 --> 00:09:15,959 Speaker 1: So we know, and I've known this for years, that 143 00:09:16,320 --> 00:09:20,400 Speaker 1: there are some people about one in eight to one 144 00:09:20,480 --> 00:09:24,960 Speaker 1: in ten of the population that have a variant of 145 00:09:25,000 --> 00:09:28,079 Speaker 1: a particular gene, and this is called the apo A 146 00:09:28,440 --> 00:09:32,199 Speaker 1: two gene. The apple lipperprotein A two gene. So you 147 00:09:32,320 --> 00:09:37,680 Speaker 1: probably heard me talk about before the apoe E four gene, 148 00:09:38,120 --> 00:09:41,400 Speaker 1: and that's linked to Alzheimer's disease, and this is a 149 00:09:41,440 --> 00:09:45,960 Speaker 1: slightly different gene. It's involved in a part of its 150 00:09:46,040 --> 00:09:49,040 Speaker 1: role is in fat metabolism, and we know that people 151 00:09:49,080 --> 00:09:53,600 Speaker 1: with a certain variants called this c C genotype, they 152 00:09:54,280 --> 00:09:57,920 Speaker 1: have a higher risk when they consume high amounts of 153 00:09:58,000 --> 00:09:59,040 Speaker 1: saturated fat. 154 00:10:00,000 --> 00:10:01,400 Speaker 2: They have a higher risk. 155 00:10:01,280 --> 00:10:04,719 Speaker 1: Of insulin resistance and glucose metabolism in response to that 156 00:10:04,800 --> 00:10:10,600 Speaker 1: saturated fat. But this is only in finding about ten 157 00:10:10,720 --> 00:10:14,720 Speaker 1: to twelve percent of the population, and this is why 158 00:10:14,840 --> 00:10:18,200 Speaker 1: some people might go on a high fat diet, So 159 00:10:18,240 --> 00:10:20,520 Speaker 1: this isn't particularly low carb. If they're eating lots of 160 00:10:20,600 --> 00:10:24,840 Speaker 1: saturated fat, they may find that their blood glucose and 161 00:10:24,880 --> 00:10:29,880 Speaker 1: their insulin levels get worse. But the vast majority of 162 00:10:29,880 --> 00:10:33,200 Speaker 1: people eighty five to ninety percent don't have that variant, 163 00:10:33,679 --> 00:10:38,319 Speaker 1: and even with reasonably high amounts of saturated fat, which 164 00:10:38,320 --> 00:10:41,040 Speaker 1: by the way, is not the thing that's promoted in 165 00:10:41,040 --> 00:10:44,400 Speaker 1: a low carb diet. It's saying, you know, just just 166 00:10:44,520 --> 00:10:47,880 Speaker 1: eat more fat and have adequate amount of protein. That 167 00:10:47,920 --> 00:10:50,440 Speaker 1: fat doesn't have to be particularly saturated fat. So if 168 00:10:50,480 --> 00:10:53,520 Speaker 1: you're concerned about that, or if you've had your genes 169 00:10:53,559 --> 00:10:57,839 Speaker 1: tested and you know you've got this cc alletal of 170 00:10:57,880 --> 00:11:02,439 Speaker 1: the ApoA two, then just keeping your saturated fat to 171 00:11:02,520 --> 00:11:04,720 Speaker 1: about ten percent will soarch you out. 172 00:11:05,400 --> 00:11:07,240 Speaker 2: But other than that, for the rest of. 173 00:11:07,240 --> 00:11:09,960 Speaker 1: The people, in the vast majority of the people, it's 174 00:11:10,120 --> 00:11:13,240 Speaker 1: clear that if you have glucose problems or type two 175 00:11:13,240 --> 00:11:16,640 Speaker 1: diabetes or pre diabetes, the best thing that you can 176 00:11:16,679 --> 00:11:20,480 Speaker 1: possibly do is shift on to a low carbohydrate diet, 177 00:11:20,520 --> 00:11:23,600 Speaker 1: and if you can tolerate a very low carbohydrate diet, 178 00:11:23,640 --> 00:11:27,160 Speaker 1: because that will be a quicker fix for your metabolism. 179 00:11:27,200 --> 00:11:31,160 Speaker 1: And remember, it's not just about diabetes. It's about all 180 00:11:31,280 --> 00:11:36,280 Speaker 1: of the complications that go along with the diabetes, such 181 00:11:36,280 --> 00:11:39,760 Speaker 1: as caronic kidney disease, increased risk of heart disease, increase 182 00:11:39,840 --> 00:11:43,640 Speaker 1: risk of Alzheimer's disease and other forms of dementia, and 183 00:11:43,679 --> 00:11:47,240 Speaker 1: a number of other different health conditions. So this is 184 00:11:47,320 --> 00:11:53,800 Speaker 1: really about cutting back on the ultra process carbs, especially sugar, bread, pasta, rice, 185 00:11:53,880 --> 00:11:57,360 Speaker 1: breakfast cereals, fruit juice, all of that, and swap those 186 00:11:57,400 --> 00:12:02,120 Speaker 1: out for whole unprocessed mood for sorry and meat, fish, eggs, 187 00:12:02,200 --> 00:12:05,920 Speaker 1: not seeds, vegetables, and then healthy fats are good fats 188 00:12:05,960 --> 00:12:07,439 Speaker 1: like olive oil and avocado. 189 00:12:08,440 --> 00:12:10,360 Speaker 2: But again, unless you know you've. 190 00:12:10,160 --> 00:12:13,800 Speaker 1: Got that variant of that particular gene, you don't need 191 00:12:13,840 --> 00:12:16,400 Speaker 1: to be scarred of a little bit of saturated fat. 192 00:12:17,360 --> 00:12:20,480 Speaker 1: And the other thing here is this can also act 193 00:12:20,480 --> 00:12:21,440 Speaker 1: as primary prevention. 194 00:12:22,920 --> 00:12:24,440 Speaker 2: And it's good to see. 195 00:12:24,640 --> 00:12:26,720 Speaker 1: And I'm just giving a teaser for my next one 196 00:12:27,120 --> 00:12:32,959 Speaker 1: that the American Dietary Guidelines have eventually started talking about 197 00:12:32,960 --> 00:12:37,120 Speaker 1: eating real food and not promoting all of this ultra 198 00:12:37,200 --> 00:12:40,679 Speaker 1: process shit that they have been for many, many decades. 199 00:12:41,120 --> 00:12:44,120 Speaker 2: But that's for another week down the track. 200 00:12:44,559 --> 00:12:47,600 Speaker 1: In the interim, low carbohydrate is the way to go 201 00:12:48,000 --> 00:12:51,199 Speaker 1: if you have blood sugar issues or you're concerned about 202 00:12:51,200 --> 00:12:55,760 Speaker 1: blood sugar issues and all of the other associated health issues. 203 00:12:56,120 --> 00:12:56,920 Speaker 2: Catch you next time.