The Rich Roll Podcast - Cyrus Khambatta, PhD & Robby Barbaro, MPH Are Mastering Diabetes

Episode Date: February 17, 2020

A full blown epidemic in the developed world, diabetes currently afflicts an astonishing 30 million people in the US alone, despite the fact that 1 out of 4 don’t even know they have it. Even more bewildering, over one-third of all U.S. adults have prediabetes. That's more than 84 million people, 90% of whom are unaware of their condition. Not enough? Over the last 20 years, the number of adults diagnosed has more than doubled, with no end in sight. For purposes of clarity, 90-95% of all diagnosed cases of diabetes are the Type 2 form. The good news is that Type 2 isn’t just treatable, it’s actually reversible -- often to the point of undetectability. And for those suffering from Type 1, certain diet and lifestyle changes render the illness more manageable than ever. To learn more about the nature of diabetes, how to avoid it and the many things you can do if you have it, I sat down with Cyrus Khambatta, PhD and Robby Barbaro MPH -- the team behind Mastering Diabetes, an online coaching platform for people living with all forms of diabetes that focuses on low-fat, plant-based, whole-food nutrition.  Living with Type 1 diabetes since 2002, Cyrus received a degree in mechanical engineering from Stanford University and a PhD in nutritional biochemistry from UC Berkeley. In addition, he has co-authored many peer-reviewed scientific publications. Robbie has a master's degree in public health from American Public University, spent six years helping build Forks Over Knives, and has been living with type 1 diabetes since 2000.  Experts in the science of insulin resistance, together they have successfully helped thousands prevent, navigate and reverse diabetes not by way of medication, but rather through simple changes in diet and lifestyle -- all principles beautifully chronicled in their new book, aptly titled Mastering Diabetes -- hitting bookstores February 18. Current medical dogma urges a very low-carbohydrate, high-fat diet for anyone suffering from diabetes or prediabetes. But is this actually true? Today Cyrus & Robby put this paradigm to the test. While it is true that a low carb approach may improve short-term blood glucose control, such a diet also increases the long-term risk for an array of chronic diseases. Although it may sound counter-intuitive, perhaps even radical, the hard science is ironically quite clear: eating a high carbohydrate, low fat, plant-based whole-food diet rich in fruit (yes, fruit) and vegetables is actually the most powerful way to reverse insulin resistance in all types of diabetes -- while also simultaneously preventing a litany of chronic disorders typically linked to today's popular low-carb approach. Whether or not you have diabetes, chances are you care for someone who does. For those who fall into this category, I truly believe that this conversation is potentially life-saving. The visually inclined can watch it all go down on YouTube. And as always, the audio version streams wild and free on Apple Podcasts and Spotify. I appreciate the work these two young men are doing to positively impact a disease that unnecessarily debilitates millions. It's an honor to share their message. And . I sincerely hope you take it to heart. Peace + Plants, Rich

I think part of the problem here is that doctors are not trained in nutrition, first of all. So they go through medical school. They go through four years of medical school plus a residency plus a fellowship. Sometimes that can be almost a decade worth of schooling. And you ask your average doctor, hey, how much nutrition do you learn? And they're like, eh, I don't know. I learned one class, one day, maybe six hours. And there's studies that actually show that your average doctor learns nutrition for a maximum of 20 to 25 hours while they're in med school. So they're just not given the training to talk about food. And it's

not their fault because doctors are phenomenal human beings and they go into it with altruistic tendencies, but they're just not given the right tool set. So they leave medical school, they go into their practice. And then when they, when somebody with diabetes or high cholesterol or hypertension presents to them, their solution is like, well, I have this pill that I can prescribe for you because that's the system that I know how to do. And that's part of the confusion around diabetes. It's one of the few chronic conditions

you can monitor on a meal-by-meal basis. You can look at your own- Yeah, you're constantly getting feedback all day long. You're getting data. And like you said, we're gonna get into the weeds on the cause and what's going on here. But yes, there is particular confusion in diabetes that is very nuanced. And that is part of the reason I think this approach has not caught on yet because people don't understand the confusion of the headlines and

the studies that are being cited. Just a lot of misinformation. The disconnect between the research and what the public believes and understands is mind-boggling. It's massive. Absolutely mind-boggling. That's Dr. Cyrus Kambada and Robby Barbaro. And this is The Rich Roll Podcast. The Rich Roll Podcast.

Greetings, good people of planet Earth. My name is Rich Roll. I am your host, and this is my podcast. Welcome to it. Today, we're going to talk about diabetes, an affliction that impacts an astonishing 30 million people in the U.S. alone, despite the fact that one out of every four who has it doesn't even know that they have it. Even more bewildering, in excess of 84 million U.S. adults,

over a third have prediabetes, and 90% of these people are unaware they have it. And over the last 20 years, the number of adults diagnosed has more than doubled. One thing to point out, 90 to 95% of all diagnosed cases are the type 2 form. And the good news and what we're going to talk about today is that type 2 isn't just treatable, it's actually reversible, often to the point of undetectability. To learn more about the nature of this illness, what is fueling what I would characterize

as a full-blown epidemic, how to avoid it, and what you can do if you have it, I sat down with Cyrus Kambada, PhD, and Robby Barbaro, MPH, the team behind Mastering Diabetes, which is a wonderful online coaching platform for people living with all forms of diabetes that focuses on low-fat, plant-based, whole food nutrition. Cyrus has a degree in mechanical engineering from Stanford University as well as a PhD in nutritional biochemistry from UC Berkeley. The co-author of many peer-reviewed scientific publications, Cyrus himself has been living with type 1 diabetes since 2002.

Robby has a master's degree in public health from American Public University. He spent six years helping build and manage forks over knives and himself has been living with type 1 diabetes since the year 2000. Both experts in the science of insulin resistance, together, Cyrus and Robbie, have successfully helped thousands of people prevent, navigate, and actually reverse diabetes, not by way of medication, but rather through some pretty simple and basic changes in diet and lifestyle, all of which is beautifully chronicled in their new book, aptly titled Mastering Diabetes, that hits bookstores everywhere February 18th.

I got a couple more things I would very much like to mention before we dig into this one, but first. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment, an experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care.

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Life in recovery is wonderful, and recovery.com is your partner in starting that journey. is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, so here's the thing. Current conventional medical wisdom basically advises that anyone suffering from diabetes or pre-diabetes should eat a very low-carbohydrate, high-fat diet. Get rid of all the sugar. But is this actually true? So today, Cyrus and Robbie put this paradigm to the test, and what we're going to discover is just how misguided it is. While it is true that a low-carb approach may improve short-term blood glucose control, such a diet also increases the long-term risk for an array of chronic diseases.

this all sounds very counterintuitive, perhaps even radical, but as you will soon discover, science actually supports eating a low-fat, plant-based, whole food diet as the most powerful way to reverse insulin resistance in all types of diabetes. Whether or not you have diabetes, chances are you care for somebody who does. And for those people, I truly, truly believe that, and I say this without any hyperbole, this conversation is potentially life-saving. So without further ado, I give you Cyrus Kambada and Robby Barbaro. Great to see you guys. Thank you for doing this. It's good to be here. Appreciate both you and the work that you're doing.

Very exciting. You've got the book coming out soon, so you're making the rounds. Yes, sir. I appreciate you taking time out to talk to me about all the stuff that you guys are up to. It's cool. And Cyrus, you live in Costa Rica. That's right. Yeah, I've been in Costa Rica now for two years.

What is the deal with that? So my wife and I went to Costa Rica for That's right. Yeah. I've been in Costa Rica now for two years. What is the deal with that? So my wife and I went to Costa Rica for our honeymoon. And while we were there, we had just had like this idea that like maybe it would be fun to live outside the United States one day. And then when we started talking with people, we got introduced to this whole network of expats that live there. And the overwhelming feeling from the expats that we had talked to were like, if you don't move here, you're making a big mistake.

And we were like, wait, why are people so like such strong conviction about this, right? And we met a real estate agent and he said, oh, you could live over here on the beach and here's a condo, here's a house, here's up on the hill, you name it. And it was very affordable. So we kind of looked at each other. We were like, should we do this?

Went back to San Francisco where we were living at the time, about a month set in or so. And we had like, you know, the desire to move there was like very strong. And then it kind of started waning over time. Of course. So, you know, it's June, we wake up one morning and it's cold, it's windy, it's foggy.

And I think it's raining. And everywhere else on the planet is warm, except the little like seven by seven city of San Francisco. Those great summers in San Francisco. So my wife wakes up and she looks at me, she's like, can I ask you a question? I was like, what? She goes, what are we doing here? And I was like, I don't know, let's go.

So within a couple of weeks, we had bought two one-way plane tickets. She had resigned from her job working as a nurse manager at Kaiser. And then we basically just like packed up our bags, sold all our stuff and moved out to Costa Rica. That's a bold move. Very bold move. Yeah. And after two years, I mean, do you feel, do you, I mean, do you come back here frequently or do you feel like I would, my sense is that I would start to feel kind of detached, like, you know, a little bit isolated, but maybe that's not, I mean, if you're surrounded by an amazing community, I mean, living and doing what you do

kind of online and all that kind of stuff, you can do what you do anywhere, I suppose, right? Yeah, for sure, yeah. So because we can do video conferencing and we can do podcasts and you name it, and I can interact with Robbie and the team every single day, all day long, it's great. You know, the internet is like more powerful today

than it's ever been. And so as a result of that, you don't really feel isolated. But then, you know, aside from being on the computer all day long, there's a whole collection of people that are from the United States that moved down there. Plus there's a whole bunch of Ticos that I've become friends with. I'm on a soccer team there. I go to the CrossFit gym, you name it. So we're like integrated into the community, which is great. What part of Costa Rica? We're in, do you know where Tamarindo is by any chance?

Yeah. That's like the big surf beach. It's a big surf beach, right? Yeah. I've been there. So it's like West coast on the North. Yeah. And then we're like another 20 minutes North of there. Oh, cool. Yeah, I know that area.

Have you actually been there before? I've been there, yeah, one time, one time. Yeah, did you like it? I did, yeah. I wasn't there as long as I would have liked to have like sort of explored the area, but I did go to that one beach, yeah. Yeah, the whole area is really nice.

And the town that we live in has, on a good day, 1,000 people. And there's something that's actually, what we like about it so much is that it's real simple. And that's the main reason why we moved out there. We were just looking for simplicity. And I think there's many people, probably yourself included, where you're sort of like, at a certain point, you're just sort of like, I don't really want things. And I don't want all this stuff around me. I just want to live in a

nice place that's just close to the beach. I want to hear the monkeys in the morning. And I want to hang out with my cats. I'm like, is that okay? You know what I mean? You're like a 65-year-old man. We've hosted several retreats down there. It's beautiful. I can confirm it's beautiful. For retreats, yeah. That's great. Do you go down there? Yeah. For the run retreats and visit. And I told him, the internet connection's got to be good. If the internet

connection is good, we can make this work. That's key, yeah. That was the condition. And Robbie, I was trying to remember when we first met. I mean, I think it was almost 10 years ago. I remember going over to Brian Wendell's for lunch and having lunch with you. It must have been like 2009 or something like that.

Yeah. And we even met, I believe it was before that, at one of the VegFests. Oh, probably, yeah. Before you even launched the podcast and everything. Yeah, yeah, yeah. I remember people, hey, that guy, he's an incredible athlete. Like, check him out. Yeah.

I mean, you cut your teeth at Forks Over Knives before going out on your own. So it's cool, man. And this is a holy alliance between the two of you guys. You guys are doing powerful stuff. So let's get into it. I mean, I think the best place to kind of launch into this is for both of you guys to share your own personal story with diabetes, type one diabetes,

because you're both T1, and you both have pretty fascinating kind of histories around that. That's right. I don't know who wants to start. Who wants to start with that? Rush Hambo? Ready?

Yeah. Two. Scissors. Oh, there you go. All right. Okay. So I grew up in Palo Alto, California. You went to Palo Alto High, right?

I went to Palo Alto High, and then went to to Palo Alto High and then went to Stanford as well, just like you. You're like half my age, but go ahead. What year did you graduate? 89. I don't think you were even in high school yet.

I was, you're right, I was in fifth grade. Right. Yeah. All right. So I'm just a few years younger. So went to Palo Alto High

and then, you know, when I was at Stanford, senior year in college, trying to graduate, move on with my life. And then, you know, when I was at Stanford, senior year in college, trying to graduate, move on with my life. And all of a sudden I get diagnosed with type one diabetes. And I didn't know anything about diabetes at that time. So all I remember feeling before I even knew

what diabetes was, was I was trying to study for finals and I was extremely low energy. My thirst was unbelievable. And I just couldn't concentrate very well. And as a result of drinking, you know, one gallon, one and a half, two gallons of water a day, just kind of out of the blue, I was urinating all the time. So I would go to the bathroom, light clockwork every 30 minutes. So I picked up the phone and call my sister after like 48 hours of going through this.

And she's a doctor of osteopathy. And I said, hey, Shanaz, here's my symptoms. What is happening to me? And she's normally pretty calm under pressure. And she just lost it. She just started crying right away. And she was like, please just drop everything you're doing. Go to the hospital right now or go to the health center.

And I was like, why, what's happening? And she's like, you have type one diabetes and that's what you're explaining to me. And I was like, Shanaz, come on. I don't have diabetes. Don't be silly. Don't be, you know, how could that be possible? I'm like, I'm normal weight.

I exercise. I think I eat well. And she's like, you don't understand. At that time, I literally thought that diabetes had something to do with old people and cake. That's literally all I thought about. And so I was like, all right, let me go to the health center. Show up at the health center half an hour later,

test my blood glucose. And it's 600, a little higher than 600. So for context. And normal range, we were just talking about this because you just tested and you were at 77. Normal range is between 70 and 130? 70, 130, exactly. That's what's considered. So sort of like, you know, normal range. So if we tested your blood glucose at any moment in time, either before a meal or after a meal, you would likely be within that 70 to 130 range. And that's good because you're sort of your pancreas and liver are making sure that you stay

in that physiologically normal range. I was six times higher than that. And so at that point, I was like, wow, I don't really understand what's happening. They took me to the hospital. They started giving me an IV of saline in one arm, IV of insulin in the other arm. And over a 24 hour period,

they monitored my blood glucose by giving me insulin and they dropped my blood glucose to a safe level. And then they discharged me. So while I was in the hospital, they pieced together my health history that I wasn't able to do before that. And they said, hey, by the way, you have not one, not two, but three autoimmune conditions.

And I was like, wait, what? And they said, yeah, you have Hashimoto's hypothyroidism, which had set in six months prior. You also have alopecia universalis, which is why I have no hair, no eyebrows. Did you have no hair at that time? I was losing my hair at that time. That had to be confusing. Oh, extremely confusing. I mean, I remember I- I've seen pictures. It was weird. You must've known something was up.

For sure. When you called your sister, like something's not right. My hair It was weird. So you must've known something was up. For sure. When you called your sister, like something's not right. My hair's falling out. Exactly right. My eyebrows are. Yeah. Like I was getting these little bald patches in the back of my head and then it kind of like spread to the front of my head and a little bit on my like chest hair as well.

But the doctors at that time, before they arrived at the conclusion that it was alopecia, were treating me for ringworm. And so they were giving me steroid injections directly into my head, thinking that if they did that, it would stimulate hair growth. And I went for some of those injections and my God, was it painful.

So they said, okay, you have Hashimoto's, hypothyroidism, alopecia universalis, and then number three, type one diabetes. By the way, we've never seen anybody with this combination of autoimmune conditions ever before. You have what's called a polyglandular autoimmune syndrome. Can we talk about you at our next huddle? And I was like, okay. So they didn't really instill me with much confidence and they were being honest with me and that's all I could ask, right?

And what have you learned? Sorry to interject, but like what have you learned in the years since about the relationship between those three things? Like what kind of confluence of events or what was happening biomechanically inside of you that led to all three of those manifesting at the same time? Yeah, it's a great question actually. So as far as alopecia universalis is concerned, I haven't found too strong of a sort

of like dietary connection or like what could actually trigger that. But there is a strong axis between Hashimoto's hypothyroidism, type 1 diabetes, and celiac disease. So patients that present with one often can present with another in that group. And so there's a lot of people that we know who are living with type one diabetes, as well as Hashimoto's hypothyroidism. And that seems to be a really common occurrence. Some of it could be diet induced.

Some of it can be induced by a virus. Some of it can be induced by potential pathogens inside of food. And so there's, there's a whole collection, like the, the, the type one diabetes research base is constantly searching for us an answer. It's like, what causes type one diabetes?

And there's some strong evidence that there's multiple environmental triggers, but there's really no smoking gun at this point. And I don't necessarily know there ever will be. Point being, they gave me this diagnosis of three. They discharged me from the hospital blood glucose meter two types of insulin test strips uh carbohydrate counting guide a life alert bracelet and a box of syringes and they're like see you later and as far as the hair is concerned

just forget about it yeah they had no answers luckily i did have a friend who uh i was eating dinner with him at some point around that time and he was like hey cyrus no offense but uh your hair looks weird and i was like i got you i got you ari and he's like um here's what we're gonna do we're gonna finish dinner we're gonna drive to the store i'm gonna get a bick razor that's what i was gonna ask did you just decide to shave it yeah and he was like i'm just gonna get rid of your hair tonight and i was like game let's do it so there's few people that can wear it as well you definitely rock it well i appreciate it but see at the time i didn't know right because i had hair and i was like if i get rid of this this is a gamble right so uh get discharged and you know

like i had all those physical you know know, medical electronic devices, plus insulin, syringes, test strips, you name it. And then what I didn't expect was that I was going to also be discharged with a bunch of fear. So I go return to my normal life. You know, I have like six months left to school and I'm like, I don't know what to do. I literally don't know what to do. I don't know what to eat. I don't know when to exercise. I don't know how much insulin to give myself.

This is literally just like a guess and check game, I guess. They didn't give you any sort of counseling or somebody who could help kind of, you know, mentor you through that aspect of it? They gave me some light recommendations and they have this sort of, you know, inject this much insulin if your blood glucose is doing this. It's called a sliding scale, you know, and it's insulin if your blood glucose is doing this. It's called a sliding scale,

you know, and it's like, it's like a generalized set of recommendations that are all based off of, you know, what is your glucose right now? And it's just like, it's just, it's just not that helpful. Let's put it that way. And so I got that. Plus I also got this idea of like, you should eat a low carbohydrate diet. And I was like, why would I do that? They said, well, when you eat more carbohydrates, your blood glucose will go up and your insulin use will go up. So a simple way to not have that happen is to reduce your carbohydrate intake and then you can keep your glucose controlled

and you can keep your insulin controlled. And I said, cool, sounds good. So I started eating a lower carbohydrate diet, more turkey burgers for breakfast, eggs, black forest ham sandwiches for lunch with small amount of bread. I'd have some fish for dinner, small amounts of rice. And I was just really trying to focus on like

eating more fat and protein rich foods and eating less carbohydrate because that's what my doctor told me. So for the first year of my life with diabetes, it's supposed to make my glucose more controllable. It didn't, not at all. My blood glucose meter, which you had saw me using just before this, right? What it does is you choose, you use it every day, multiple times a day. And it's, it's an indicator of whether where your glucose is. So you can use that to make decisions. And so what was supposed to happen is my glucose is supposed to you can use that to make decisions. And so what was supposed to happen

is my glucose was supposed to stay within that 80 to 130 range for majority of the day. And if it goes higher, it comes low, I can do something about it. But on a given day, my glucose was 40, 210, 120, 280, 64, just bouncing up, down, up, down, up, down. A random number generator. Literally a random number generator literally a random number generator and when you're dealing with if you i don't know if you've ever you've probably never

experienced a glucose higher than like 140 or 160 is my guess because you're non-diabetic and that's a good thing but when your blood glucose goes high it feels terrible it feels really terrible what is that experience so for me i feels, it feels like my head is a balloon. Like it's kind of expanded and it's very large. I get a taste of metal inside my mouth and my nose starts to feel like it's larger than it really is. And it just kind of feels like my head is swelling. It's got a lot of pressure inside of it.

And I get really thirsty. When your glucose is low or when my glucose is low, you get the opposite, which is sort of like, basically your brain is sort of being starved for glucose temporarily. And so it leads to shaky hands, some flirty speech. Sometimes you see little like black spots in your vision. You can get this diaphoretic sweating. And it's just kind of this like panic mode.

And then all of a sudden your appetite increases and you want to eat everything that you can see. So, you know, bouncing between hyperglycemia and hypoglycemia on a daily basis, just like it sucks all the mental energy out of you. It just takes it away. And you must've been thinking that, well, I just need to perfect how I'm doing this, right?

Like clearly, like I'm just, I'm an amateur. And if I can just figure out, you know, if I can read the signals of my body and regulate my insulin intake and pay more attention to when I'm eating and what I'm eating that I can get this like dialed in. Exactly right. And like, I was trained as an engineer, as a mechanical engineer in college. And, you know, that training basically teaches you how to control very complex systems that have multiple moving parts, you know, into something that's very controllable. So you got spreadsheets out.

Totally, yeah. I'm trying to figure this out. And I'm like, come on, there's not that many variables. Let's control this. And this is literally the one system I could not control. Again, I didn't have a degree in biology. I didn't really know that much. But I figured I could try and control the system.

And why was I wrong? So it all kind of came to a tipping point. One day I had gone to work in the morning. I had played a game of soccer at lunch for an hour. I had worked out in the morning before work. I had eaten a low carbohydrate diet. And then I got home at like five o'clock PM to go to eat dinner.

So I checked my blood glucose in preparation for eating dinner, and I was hoping that it would be in range. Give me a 120, a 130, then that I can inject a normal amount of insulin, go eat my dinner and go to sleep. I checked my glucose and it was like 288. And I got so frustrated because again, I was doing everything that I was supposed to do. And so I just got filled with this just anxious rage. And I just picked up my glucose meter and I just threw it across the room

and it just hit the wall and shattered. And then I just sunk into the couch and I just started crying. And I was just like, I was so frustrated that I couldn't figure this out. And it was in that moment where I literally heard a voice inside of my head and the voice said,

Cyrus, just learn how to eat. You don't know anything about nutrition. Learn how to eat and your life will fundamentally change for the better. And I was like, okay, this is my calling. This is me. This is your message from God. Literally, yeah.

And you're like, and I probably should get a new glucose meter. That's right. Yeah, exactly. So the next day, I basically started looking for more information. I started getting recipe books. I started viewing videos online and talking to people. One thing led to another. And I got introduced to this guy named Doug Graham.

So Doug Graham, when I met him, he basically was the only person I knew that was confident in talking to a person with type one diabetes. Because type one diabetes is considered like a dangerous enough condition or like a nuanced enough condition that most health practitioners are sort of like, I don't really know how to handle insulin. It's kind of dangerous. But Doug was like, listen, come under my wing. I'll show you exactly what to do. So I go to a retreat that he's hosting. And under his guidance, he basically says, listen, I'm going to transition you to a diet that's basically lots of fruit, lots of vegetables. And we're going to temporarily while you're here, we're going to give up meat, cheese,

chicken, fish, and high fat foods in general. I said, okay, great. Let's do this. And he said, your glucose is going to become a lot more controllable, but I want you to feel it. So over the course of that seven days, what happened to my blood glucose was mind blowing, absolutely mind blowing. I went into it with, again, really highly variable blood glucose, a lot of insulin use. In the first 24 hours of being there, my blood glucose fell so dramatically that I hit six hypoglycemias, five to six hypoglycemias, back to back to back to back. And I was like, I hadn't felt that in a long time. As a result of that, I had to start backing off on the amount of insulin I was dosing

myself. And then that got better by day two, by day three, by day four, by the time day seven had rolled around, I had cut my insulin use by 35 to 40%. And the kicker in this whole thing was that it wasn't, I wasn't calorie restricting. I wasn't, I wasn't not eating food in order to reduce my insulin use. On the contrary, I was eating more food than I'd ever eaten before. And I was eating more carbohydrate rich food than I'd ever eaten before. More fruits, more vegetables. I mean, I kid you not, I was eating plates with like six to eight bananas on them

with persimmons and grapes and papayas and mangoes. And I was like, how is it that I'm eating all this food, but I'm using less insulin? That doesn't make sense. And to kind of put this in context, first of all, Doug Graham, widely known for being a proponent of what he calls an 80-10-10 diet.

Exactly right. Ratio of macros, 80% carbohydrates, 10% fat, 10% protein. And this, in terms of type one diabetes, this is anathema. And this, in terms of type one diabetes, this is anathema. Like this contravenes the medical establishment or the point of view that somebody with your condition should be eating a low carbohydrate diet.

Instead, he's putting you on this very high carbohydrate regimen, which basically flies in the face of everything that you've been told. Exactly right. So the conventional wisdom would be that if you're eating this much fruit, that this is gonna make your blood glucose skyrocket

and make this more difficult to control. Exactly. And require more insulin. Yes. Yeah. So my insulin use had been creeping up. And so, yeah, just to put a pin in it, that the experience that you had was diametrically opposed to that. It was the opposite. Exactly right.

So yeah, my insulin use had been increasing over the course of time. From the time I was first diagnosed, I was using like mid-20s. And then it became 32, 36, 37, 41, 43. There were times where I was injecting 45 to 50 units of insulin per day on this low-carbohydrate diet. And now i'm faced with the prospect of eating boatloads of fruit and i'm doing some mental math and i'm like oh 50 is going to turn into 70 is going to turn into 120 that seems like a lot of insulin but instead 50 turned into 26 27 32 units of insulin per day yeah and we're going to talk about why that is. We're gonna get into the weeds on that in a minute.

Yeah, we can geek out there. But I also think it's worth mentioning, like Doug Graham, he's not without controversy himself. 100%. This guy is like, he's gotten into trouble with these fasting retreats and people going a little bit too far with this stuff, right? Yeah.

And to be clear, we're not advocating that exact approach in what we've written in the book and the science we're citing. It's a little different. He kind of like sparked our journey. Right. Yeah. I got it. I got it. Yeah. To give Doug the credit that he's due. Doug fundamentally changed my life. No questions asked. And like, you know, if it wasn't for Doug, I wouldn't have been introduced to this at that point in my life. And it wouldn't have like allowed me to start changing my life for the better and then going on to learn more about it. So I got to give him the credit that he's due. And as an engineer, this must have blown your mind a little bit.

A hundred percent. It was fascinating to me. So I leave this retreat. I was so fascinated by what I learned that I just went straight to the books and I just started reading everything I possibly could, started accessing the literature, reading textbooks, you name it. Then I enrolled in school to go learn organic chemistry, biochemistry, nutritional biochemistry. And then at a certain point I said, you know what? I think I want to actually get a PhD degree in this. So I applied to schools.

I got into UC Berkeley and then I was there for five years to learn nutritional biochemistry so that I could talk science about my own personal experience. But the motivation to get your PhD was fueled entirely by your own experience. Fueled entirely by my own experience,

but it was to ask a bigger question. And the question was, am I a freak of nature? That's literally what I wanted to learn. Because if this was something that only applied to me and I was just some really interesting end of one experiment, okay, fine, I get it. But if what I was experiencing could also be applied to other people living with type one or prediabetes

or type two, now you have a much bigger story. And so while I was at school, I started to understand the science of blood glucose control and diabetes and insulin resistance. And while I was there, I started to understand the science of blood glucose control and diabetes and insulin resistance. And while I was there, I started to realize that there is almost a hundred years of science that clearly describes the phenomenon that I was experiencing. And that hundred years of science is actually one of the most powerful solutions that we've ever found for treating this thing called diabetes in all forms

and can really be applied to large numbers of people with phenomenal results. That being the case, then why is this not the conventional dogma today in terms of treating diabetes? I mean, this is the big question, right? This is why you do what you do and why you write your book. Absolutely. Yeah. I wish we had the exact answer to that.

There's a lot of guesses. I think part of the problem here is that doctors are not trained. They're not trained in nutrition, first of all. So they go through medical school. They go through four years of medical school plus a residency plus a fellowship. Sometimes that can be almost a decade worth of schooling. And you ask your average doctor, hey, how much nutrition do you learn?

And they're like, eh, I don't know. I learned one class one day, maybe six hours, right? And there's studies that actually show that your average doctor learns nutrition for a maximum of 20 to 25 hours while they're in med school. So they're just not given the training to talk about food. And it's not their fault because doctors are phenomenal human beings

and they go into it with altruistic tendencies, but they're just not given the right tool set. So they leave medical school, they go into their practice. And then when somebody with diabetes or high cholesterol or hypertension presents to them, their solution is like, well, I have this pill that I can prescribe for you because that's the system that I know how to do. And so I think that's a huge problem. And then it sort of makes it so that people living with diabetes don't really have dietary options. When they go talk to a dietician who's been trained in a much more traditional setting, their answer is low carbohydrate.

So you're getting, sorry, go ahead. Yeah, I mean, that's part of the confusion around diabetes. It's one of the few chronic conditions you can monitor on a meal by meal basis. You can look at your own constantly getting feedback all day long. You're getting data. And like you said, we're going to get into the weeds on, you know, the cause and what's going on here. But yes, it's true. If you do a low carbohydrate diet, you will see better numbers. You'll see flatline blood glucose on your CGM. So there is particular confusion in diabetes that is very nuanced.

And that is part of the reason I think this approach has not caught on yet because people don't understand the confusion of the headlines and the studies that are being cited. Just a lot of misinformation. So Cyrus, when you're getting your PhD and you're digging deep into this stuff and you're uncovering these studies

that date back decades and decades, was this and and when you would kind of present this to your colleagues or you know whoever you were working with at the time were they on board with what you were finding and kind of the path that you were blazing or are they were they more on the conventional path of like hey this isn't really the way we do this no no they no, they, they were very supportive actually, because, you know, whether it was talking to other graduate students or whether it was talking to my advisor or even some of the other professors, you know, I would be explaining the results of the research. So it was like, you know, my story was one thing. Okay, fine. It's an anecdotal experience. It makes sense.

But then when you translate that and you start to get the same results in laboratory animals, because that's the, the, what you're supposed to be doing in graduate school, we were running a whole collection of experiments to induce insulin resistance in mice using dietary methods and then reverse that using either intermittent fasting or diet or exercise. And the way that you induce a diabetic response in an animal is to put them on a pretty high-fat diet, right? So that was another epiphany for me, right? I'm sitting here tasked with the objective of trying to make animals insulin-resistant so that we can use them as a testing ground. And when I started looking in the literature, I was like, how do I make an animal insulin-resistant?

Okay, I probably got to give them a high fructose diet or a high sucrose diet. And so I was looking in the literature with that preconceived notion. And then I would read, you know, we induced insulin resistance in laboratory animals by feeding them a diet containing 70% saturated fat for eight weeks. We induced insulin resistance. We induced type two diabetes in laboratory animals, you know, by feeding them a high fat diet, high fat diet, high fat diet. And I was like, this is unreal. You feed animals a high fat diet and they develop diabetes. Why is it that when, when in the, in the public,

when you say the word diabetes, the first association with the people makers is sugar, right? Yeah. I had Neil Bernard on the podcast. I just put an episode up with him last night, but I had did a previous episode with him where we talked a lot about this and people went crazy. They're like, that can't be true. Because he was talking about the real cause of this condition is people eat too much fat. 100%.

And that it's just, yeah, that flies in the face of everything that you thought that you knew. The disconnect between the research and what the public believes and understands is mind boggling. It's massive. Absolutely mind boggling. All right, so you have this epiphany.

So I have this epiphany and then I start to realize, okay, wait a minute. The high fat diet that leads to insulin resistance, insulin resistance being the underlying cause of prediabetes, predi resistance being the underlying cause of prediabetes, prediabetes being the underlying cause of type two diabetes, right? The stepwise progression is person develops insulin resistance. They then progress to prediabetes. They then progress to type two diabetes that affects 90% of the diabetes population, right? Type ones like Robbie and I

are like eight to 10% of the population. So that story, I was like, wait a minute. Okay, so does this mean that it could be that people who are eating high fat diets in the real world are actually developing a state of insulin resistance that can then progress to type two diabetes themselves? And the answer is absolutely, because these studies have also been done in humans

and the way to induce insulin resistance in a human being, which we'll get into a thousand times more detail, is by feeding them a high-fat diet. Right. In terms of the statistics, obviously there's been an explosion in the incidence of type two. Is it similar with type one or has that remained kind of a stable data point? That's a phenomenal question, actually. It's growing.

It's growing, yeah. Over the past 10 years, there's been a 23% increase in type 1 diabetes. And this is the first time in human history that we've ever seen that. And so scientists are really shrugging their shoulders and throwing up their hands and they're saying, we don't know why.

Because type 1 diabetes has historically only affected the same proportion of the population. So as the population grows, the proportion of the population stays flat. But now we're actually seeing an increase in the proportion of the population. So as the population grows, the proportion of the population stays flat. But now we're actually seeing an increase in the proportion of the population that's diagnosed with autoimmune conditions in general, type one diabetes for sure.

And who knows why that's happening? So type one is essentially, they're still trying to figure out what the kind of initial cause of this is. But essentially, your pancreas just stops functioning properly and it's not secreting insulin. Yeah, so for clarity, your pancreas basically has many, many, many functions.

So there's what's called an exocrine function and an endocrine function. So the exocrine function is what 99% plus of your pancreas is occupied doing. And that exocrine function is to make digestive hormones, I'm sorry, digestive enzymes, such that when you eat food, you can digest that food. These are like amylases, these are hydrases,

these are proteases, these are lipases, right? The other 1% of your pancreas is endocrine. Endocrine meaning it's these cells secrete hormones into your blood and then those travel to various tissues to elicit their biological effect. So the beta cells are part of these things called islets clusters, and the beta cells are responsible for making insulin. And so those guys secrete

insulin into your blood. And when you develop type one diabetes, the autoimmune reaction is effectively your own immune system that has been sort of tricked or hijacked into believing and targeting beta cells for destruction. So your own immune system is manufacturing antibodies that basically go and they target proteins on the cell surface of beta cells and they end up disabling those beta cells. So you end up losing insulin production. And as a result of that,

99 plus percent of your pancreas is functioning just fine. It's that 1% that's not functioning and all of a sudden that's non-recoverable. Right, got it. Okay, before we get too far into this, Robbie, we got to hear your version of this. So when I was 12 years old, I had the same symptoms Cyrus had.

I was thirsty all the time, going to the bathroom all the time. What's with the thirst thing? What is that about? Yeah. So when your glucose level goes really high, then the concentration of glucose inside of your blood increases. Your brain basically says, oh, wait a minute, let's drink more water so that we can flush that glucose out.

So it's a way that you will take on more fluid to decrease the concentration of glucose and then eventually pee it out. So it's a way of just basically getting rid of glucose. All right. Keep going. So I was quite familiar with these symptoms because my older brother was diagnosed with type 1 diabetes nine years prior. So I said to my mom, I think I have type 1 diabetes. She said, no, no, don't be silly. You don't have type 1 diabetes. So she leaves town for a weekend to go check out some places with my dad in Florida because we were going to move to Florida. We're living in St. Cloud, Minnesota. So my mom calls a check-in

and she says, how are things going? I said, mom, I couldn't sleep last night. I was cramping. She said, okay, go upstairs, test your blood glucose and let's see what's going on. So I test myself on my brother's meter. I'm over 400. So four times higher than I'm supposed to be. And my brother says right then and there, yep, you have type one diabetes, pack your bag. You're going to be in the hospital for a few nights. So we go to the regular doctor. They make the diagnosis. I see my brother cry for the first time. He's like, oh, I'm just so sorry. You have to deal regular doctor. They make the diagnosis. I see my brother cry for the first time. He's like, oh, I'm just so sorry you have to deal with this. And my parents fly back the next night.

And my dad just said in the hospital, it's an inconvenience. Don't worry about it. You're still going to get to do whatever you want in life. And that was sort of the way I was brought up. I had standard medical care. I went to the Mayo Clinic, had an endocrinologist, a psychologist, a dietician. the Mayo Clinic had an endocrinologist, a psychologist, a dietician. And looking back, it's really a missed opportunity, I think, to really turn somebody onto a better state of health. Whereas at that point, all they were saying is just eat normal, follow the standard

American diet, just make sure you get every single food group. We want you to feel normal. You're a teenager. Don't let this make you feel weird. That was the focus. And you're at the Mayo Clinic. Yeah, exactly. We think the best care And you were at the Mayo Clinic. Yeah, exactly. You'd think the best care. They could do a little better. But that's what happened. So life with type 1 begins.

I was a competitive tennis player, type A personality. I took pretty good care of it. I was on top of it. I'd count my carbohydrates. I'd dose my insulin properly. I'd fill out the logbook very diligently to figure out what to do. Sort of that guidance that you had suggested that, hey, that they probably would give, right?

So the Mayo Clinic did give that guidance. And I had, you know, pretty good control, but I had lots of other just unfortunate symptoms like chronic allergies. I would take Nasonex and Claritin D and still get sick all the time. I had plantar fasciitis, which was very frustrating as a tennis player. I wore these big blue boots at night to try and do passive stretching. I had warts on my feet.

And in high school, I developed cystic acne. It was really frustrating. I did all the treatments, the creams, the pills, the laser treatments, microdermabrasion. Eventually they put me on Accutane. It's like the most serious drug you can possibly take when you have acne. So your parents have to sign a waiver because some people have committed suicide on that drug. So I had these frustrating symptoms, but I was starting to get into learning about how

can I take better care of myself just through some of my dad selling supplements. And just, it kind of resonated with me. I just kept on learning a little more, a little more, hey, try and avoid the MSG, try and avoid the additives. It just, it kind of resonated with me. I just kept on learning a little more, a little more. Hey, try and avoid the MSG. Try and avoid the additives. It just kind of made sense. What was your dad slinging? He was his Herbalife at first. He's been through many different ones.

USANA eventually. A lot of different network marketing. That was pretty funny. So in high school, I'm living in Florida at this point. And I stumbled across a book called natural cures they don't want you to know about okay this is by kevin trudeau we are not recommending this book this guy got put in jail for fraud do you remember seeing those commercials i don't know it's like a purple book it's got a big smiling face on the front it was it was crazy what was

what was his pitch so this book planted a seed in my mind that it would be possible to reverse type 1 diabetes. And that changed the course of my life. And I said, okay, I'm going to do anything and everything to get my beta cells to work again. That was the mindset. What was his protocol to do that? Honestly, it was just, it was like one sentence. It was one sentence in the book that planted the seed. Okay, wait a minute. It wasn't a particular protocol. He didn't actually tell you how to do it? No, no.

There was all kinds of crazy things, like colonics and supplements and crazy stuff. But it was just the idea that that could be possible. Yes, that was transformative. Kind of like opened a door for you. Yes, absolutely. And my mindset was, hey, people told Roger Bannister, you can't run a four-minute mile.

The smartest people in the world said that's not possible. And then he did it. And now other people can run four minute miles. So somebody's got to do it first. So I will do anything and everything. So this leads me to try the Western A Price Foundation, which is a diet where you're eating lots of grass fed beef. You're having raw milk.

I would go to the local farmer's market and buy milk for a cat because you couldn't sell raw milk to a human. So I was willing to do anything farmer's market and buy milk for a cat because you couldn't sell raw milk to a human. So I was willing to do anything. It was crazy stuff. And learning the information, like each step along the path, like it made sense. It's like, okay, that's interesting. That's interesting.

I'll try this. I'll try that. Grass-fed beef, yeah, probably better than the beef from the factory farms and stuff like that. So I did the Weston A. Price Foundation diet. I didn't see any big difference in my diabetes health. So I continue to learn. Eventually, I come across a plant-based ketogenic diet. So this guy, Gabriel Cousins, had a movie called Raw for 30 Days. And this is a diet where you eat lots of

greens, lots of vegetables, but you're getting your calories from nuts and seeds and oil. So I started trying that. And of course, now I'm removing carbohydrates from my diet. My total insulin use is coming down. And I'm saying, wow, this is working. That's my goal. I want to take less and less insulin. But in hindsight, that only makes sense if you know the beta cells in your pancreas are simultaneously starting to make their own insulin. But that clearly wasn't the case in hindsight. So I'm following that diet and I'm at the University of Florida this time. I'm a freshman and I'm on campus and I black out several times. It's just really scary that moment. Like you just kind of need to pause and be like,

wait a minute, what's going on? You'd like regroup, get home, rest. Hypoglycemic. I mean, I don't know exactly. I mean, yeah, probably it was a little bit, but I think I was just low energy. So I go back to my naturopath. I'm like, what's going on here? Like, what can we do? And she's like, okay, you know what? Maybe you should do some chelation therapy. Maybe that'll help you get rid of some heavy metals and stuff like that.

I'm like, okay, you know what? I'll drive from Gainesville. I'll go all the way to Tampa and I'll try this therapy. I'll do any modality. I'll do anything. I mean, I also, I flew to San Jose, California and met with a Chinese medicine man. He made me this herbal tea. I was drinking that in college.

It smelled so bad that I would brew it outside on the sidewalk with like a portable. I'm not a stranger to that kind of thing. Been there, done that. The guy had worked magic for my father and some injuries he had, like put some like peanut butter stuff on his arm and like, it was crazy.

But I didn't really see again any specific results with my diabetes health. So I'm considering all my options, trying all this stuff. But before I commit to the chelation therapy, I hear Doug Graham on a podcast. And this is in September of 2006. And he's talking about this fruit-based diet also being able to help you get rid of heavy metals and cleanse your body. Like this is a healthy thing to do. I'm like, you know what? I'm missing fruit. I would love to eat some fruit again.

I don't want to do this expensive chelation therapy. Let me try this. So I started dabbling a little bit. The book finally comes out in December of 2006. I read it straight through. And Cyrus is one of the testimonials in the back. I'm like, wow, this is interesting. The 80-10-10. Yes, he's one of the testimonials in there. So I start Googling a little more about Cyrus. I find some pictures of him online. He was talking to me earlier. He's like

looking fit. I'm like, oh, this is cool. This is encouraging. I'm going to try this. So I started working with Doug Graham. I email him every single day for 90 days straight. He emails me back every day for 90 days straight. And I learned how to do this fruit-based living. And this is again around Christmas time. I remember going down to eat Christmas dinner. I have a pyramid of bananas, you know, like five on the bottom and four and three. My family just looking and laughing like this is going to be another phase. They'd seen me go through so many things. And now we're 13 years later. It's not a phase. I mean,

if you, if you follow Robbie on Instagram, I'm like, wow. Like that is so like this, this is like, first of all, like the,

the amount of attention and like diligence that you put into like preparing all of this, you create like these sort of performance art installations out of the food that you... It's like all raw fruit. It's fun. It looks like a lot of food, but I always tell people it's a lot of water and it's a lot of fiber. It's a little deceptive in terms of volume. Yeah. I start doing this diet and just like Cyrus, you would expect you need to use

way more insulin. Your blood glucose should be way more difficult to control. And that's not what happened. My insulin sensitivity improved by over 600%. So you can calculate that by taking a 24 hour insulin sensitivity ratio. You take your total carbohydrate consumption, divide that by your total insulin use, and you get a ratio there. So when i was doing the plant-based ketogenic diet it was three to one 30 grams of carbohydrate per day one unit of insulin now it's well over 30 grams of carbohydrate per day one unit of insulin no no sorry 10 units of insulin sorry 10 units of insulin which gets you a three to one ratio that's what i was using 10 units of insulin sorry so then now i'm the ratio is 22 to. I'm eating over 750 grams of carbohydrate per day and injecting roughly 27 units. So it's over 22 to one. That's over 600% improvement in insulin

sensitivity. And this just gets me really excited. So I'm in college. I decided to start looking up some research, looking into this. Neil Barnard's information's out there. Dr. McDougall's information. research looking into this. Neil Barnard's information's out there, Dr. McDougall's information. That leads me to the original studies. And just like Cyrus, I find this information has been out there for almost a hundred years, that if you eat more carbohydrate-rich food and limit the fat consumption, you improve the function of insulin. Insulin resistance is caused by a high-fat diet. So it was really transformative. All my symptoms went away. Plantar fasciitis, gone. My skin starts to clear up. I'm not using any more medications, no more creams. I don't take any allergy medications. I don't get sick, no more warts on

my feet. And I'm feeling energetic again, really excited about life at this point. And I'm like, you know what? I'm going to, the why was really strong. Again, I'm doing all this stuff because I'm trying to get my beta cells to work again. So I'm like, okay know what? The why was really strong. Again, I'm doing all this stuff because I'm trying to get my beta cells to work again. So I'm like, okay, this is going to help my body rest and rejuvenate and heal the cells. Maybe my stem cells can make some new beta cells. I wish it was that simple. It's a little more complicated, but that was the mindset. So I was just really stoked about life. Okay, let's just keep doing this. Let's keep doing this. Let's keep optimizing the insulin sensitivity, eating really well, getting a nutrient-dense diet, and let's see if we can get the beta cells working again.

So that was the mindset. And you've essentially just built on that ever since, right? I mean, are you eating any vegetables at all at this point? I eat lots of non-starchy vegetables and lots of greens. Yeah, true. Right. Big time. So it's not entirely a fruitarian diet.

Correct. It's not a Michael Arnstein. Yeah, we're not advocating a fruitarian diet. A fruitarian pure diet. And have you found, like, do you do, we're kind of skipping ahead here a little bit, but like, are you supplementing at all? Like, are you worried about your omega-3s

and your DHA and like all that other kind of stuff? So- Like, how does that all work? As far as omega-3s and your DHA and all that other kind of stuff? How does that all work? As far as omega-3s, essential fatty acids, I do not supplement. And we actually covered this thoroughly in the book. There's a lot of confusion when it comes to essential fatty acids. So the two essential fatty acids are LA on the omega-6 side and ALA on the omega-3 side. And getting enough ALA is not that difficult. I mean, you can get it just by eating enough calories. But if you want an insurance policy... Get some nuts and seeds.

Well, if you have one tablespoon of flax seed or one tablespoon of chia seeds, ideally ground up, you already meet your requirements for ALA. Right then and there. To your point, if you have some nuts and seeds, that's going to increase your ALA intake, no question. But the issue is the conversion process. So people are

consuming too many omega-6 fats, which is inhibiting the conversion. The same enzyme, delta-60 saturase, starts the conversion process on both sides. So if you're eating too much omega-6 fats, it's going to prefer that pathway. And it's going to focus

on doing the conversion on that side. And there's not enough enzymes left over to do the conversion on the ALA side to take the omega-3s and make EPA and DHA. So in the book, we talk about an N of 2 study, which is our own personal results. And you can get this quantified through an omega quant test. And you can see what is your essential fatty acid status inside the membranes of your cells. And our numbers are extraordinary. I mean, mine was over 8%. Cyrus is over 7%.

And people who are supplementing, people who are eating excess nuts and seeds, they're roughly around 4% and they're happy with that. Interesting. All right, so both of you guys have this epiphany and it flies in the face of all this conventional wisdom that you gotta go low carb. You're eating this unbelievably high carbohydrate diet.

How are you, like when you go to the doctor, like what are your doctors saying at this point early on? My endocrinologists have never even asked. They don't look in the details. They say, you know what, your A1C is great. Your have never even asked. They don't look in the details. They say, you know what? Your A1C is great. Your insulin use is fine. You don't have any complications.

Just 10 minutes. I mean, in and out, write my prescriptions and that's it. So they're not even really diving into what it is that you're doing. Three different endocrinologists over the past 13 years are following a low-fat plant-based whole food diet. Not a single one of them knows exactly what I eat. They've never asked. Because they don't ask.

So I don't need to tell them. Right. What about you, Cyrus? Yeah. When you go to an endocrinologist's office, the currency that they ask you for is your blood glucose meter or your CGM. So they take a device from you. They then download the information from that device, and they look at numbers.

And they say, OK, your time and range was this. Highs, lows. Okay. Your A1C is doing this. Okay, great. Here's my prescription for you. Change your insulin dosing strategy. Don't change something like that. Nowhere in that conversation does food enter into the picture. I had the opportunity to bring it up once with one of my endocrinologists and the response that I got was like, oh, that's really interesting. Yeah, I guess a plant-based diet works for some people. And I was like, okay, fair enough. You know, like I didn't want to get into it, but I was like, all right, I understand, you know.

But for the most part, just like Robbie's saying, 90 plus percent of all people's, you know, doctors, again, they're not trained in diet. That's just not part of their tool set. And therefore it doesn't even come up. But again, I think if there was a problem, they would take the time to look into it. There just hasn't been a problem. Gotcha. All right. So we talked about what type one is. Maybe we can talk a little bit more about what type two is. Let's kind of define our terms. of define our terms um distinguishing type 2 from pre-diabetic from insulin resistant and also type 1.5 which i'd never heard about until i was listening to you guys talk about it

researchers believe there's more people living with type 1.5 diabetes than type 1 what is that it's a slow onset version of type one. Okay. So, so let's start, let's, it's going to be very confusing. So let's just think of like diabetes as being like a general umbrella term for like, what could have the thing that you get when your blood glucose becomes variable, right? Within that umbrella, you have many different things, many different flavors we'll call them, right? So you have the type one, which is Robbie and me. So it's an autoimmune condition, like we described earlier. And generally it's considered a strong autoimmune condition, which means that you express at least one, sometimes most of the time, multiple antibodies to the beta cells. And as a result

of that, it's a rapid destruction, happens within 12 to 18 months, and then you go to full insulin dependence. And that can affect kids as low, you know, from the age of, from birth all the way up to the age of about 30. There's another type of autoimmune diabetes, which affects adults greater than the age of 30 who also get an autoimmune reaction, but it's a weaker autoimmune reaction.

So rather than having multiple antibodies to the beta cells or to insulin, they usually only express one. It's not a hard and fast rule, but generally only one. So as a result of that, type 1.5 diabetes is considered adult onset, slow progressing type 1 diabetes. And again, over the age of 30, there's people who are now in their 60s that are diagnosed with autoimmune diabetes it's type 1.5 okay the third type of diabetes is called pre-diabetes think of pre-diabetes as like baby type 2 diabetes so it's the thing that you get on the way to type 2 and uh like we were talking about earlier insulin

resistance is the underlying condition that first sets in and then insulin resistance progresses to prediabetes. You know that you have prediabetes because you go to the doctor, you get your A1C value measured and or your fasting glucose and or your fasting insulin. And those numbers usually are showing a slight elevation. So as a result of that, you get this diagnosis of prediabetes, but usually people are given the warning like, hey, if you make some lifestyle changes right now, you can go back to being non-diabetic. Right. It's your choice. If pre-diabetes progresses and continues to get worse and the amount of

insulin resistance that you're experiencing grows, then it turns into type two diabetes. Type two diabetes occurs when, again, you are quite insulin resistant. Glucose levels are quite high. Fasting glucose, postprandial or post-meal blood glucose is high. And the amount of insulin that your pancreas is secreting in this progression goes from being normal to high in the pre-diabetic state. So your, your pancreas is like trying to, to control your blood glucose. Like I can secrete more, I can secrete more. So pre-diabetics usually have a high fat insulin level. And then by the time you get to type two diabetes, the ability of those beta cells to continue to manufacture insulin has been compromised.

So now instead of having a high insulin production, you go back to having a compromised insulin production. Okay. So it's like you started out at normal, you went into overdrive and then boom, now you fell. You didn't fall to zero usually, but you fell to like suboptimal, 50%, 60% normal insulin production. That's when type two sets in. And at that point, the question really becomes,

is it possible to go from type two back to prediabetes, back to non-diabetic? And if so, how would you do it? And the answer is absolutely. It can happen in more than 80%, sometimes even 90% of all cases. The question is, what are the lifestyle choices that you put into play to make that happen?

And that's a complex question because there's so many different types of, there's so many different worlds saying, I know the answer, I know the answer, I know the answer. But the idea is, generality speaking, yes, you can move from type two back to non-diabetic and it happens for the majority of people. And I wanna get into that solution.

But before we do that, maybe we should talk a little bit about cause. I mean, when I was a kid, it wasn't even type one and type two. It was like adult onset diabetes and juvenile diabetes. And I didn't know anybody that had what we now commonly refer to as type two, but we're in a situation at the moment

where I think the statistics are something, I mean, you would know much better than me, but we're verging on like 30% of Americans being, of adult Americans being diabetic or pre-diabetic. That's right. And the childhood rates are insane as well. I mean, where are we at the moment? Yeah. Okay. So the statistics say by 2030, that one in three people in the United States will be living with some form of diabetes. It's insane.

Okay. Let's do the math on that. How many people- Well, I mean, we already have one third with the pre-diabetes 85 million people just don't know it correct correct so so what the statistics are saying is that by 2030 so let's fast forward 10 years from now there's going to be a massive diabetes problem with one out of every three people walking around saying i have diabetes i have type 2 diabetes mainly right but what robbie is saying which is absolutely right, which is that today, in 2020, there are 30 million people approximately in the United States that have been diagnosed with some form of diabetes. So about one to 3 million of those have type one, and then the other 27 to 33 million have type two. In addition to those people, there are now 85 million other people

who are living with prediabetes, but don't even know it, right? So the total number is somewhere about 110 million people who are living with some form of blood glucose instability, blood glucose variation problem. And majority of them don't even know it. And those are the people that over the course of the next 10 years

are going to likely progress to type 2 diabetes, causing a huge, you know, an even larger epidemic than we're facing now. And the cause is standard American diet and not enough exercise and living stressful lives, essentially. Excess calories, excess saturated fat in the diet, not enough exercise, high stress. No questions. And the solution. With the diet being the biggest problem of all.

Yes, exactly right. Yeah. All right, well, let's talk about the solution. So we already kind of, you know, waded into it a little bit here, but you guys are coaching people. You've got this book, Mastering Diabetes, and it's essentially you've created this protocol to say,

look, we're N of two, but here's what the research says. Here's what the science says. Here's how we can hold your hand and walk you through this process and get you from your type two diabetic state or your pre-diabetic state and walk it back. Yeah, NF2 and also 3,000 plus people who've been through our coaching program.

And like you said, a lot of research, there's over 800 plus citations in that book. And the research goes back. It goes back all the way to the 1920s, showcasing that the more carbohydrate food you eat, the lower your insulin resistance goes. So, I mean, insulin was first discovered in 1921. Then it was first used in humans in 1922. So around this time, that's when the whole conversation starts to emerge about, okay, insulin sensitivity. So in 1926, Dr. Sansom publishes a paper in the Journal of the American Medical Association called The Use of High Carbohydrate Diets in Treating Diabetes. And this is the first time that he said, I used a radical experiment in 150 patients adding bread, potatoes, fruit, and low-fat milk.

All right. That's what he adds. And he finds that his patients don't need to use more insulin. So prior to the discovery of insulin, they were fed a very, very low carb diet, very high in fat, very high in protein, just to keep people alive. So that's what was going on. They were having like 400 calories a day. It was miserable. Nobody liked the food. They couldn't think clearly. They had no energy. So Dr. Sansom feeds them this higher carbohydrate diet, and all of a sudden, they return to physical activity. They return to their normal mental capacity. The diet actually tastes good. And this is just the beginning. Then in the 1930s, Dr. Rabinowicz in Canada starts practicing a higher carbohydrate diet with his patients. Publishes several papers. In 1935,

he publishes a paper, which is a five-year randomized controlled trial in 100 people. 50 people try the old low carbohydrate diet. 50 people try the new higher-carbohydrate diet, okay? He sees a 1% reduction in insulin use on the old diet and a 57% reduction in insulin use on the higher-carbohydrate diet. Okay? I mean, he actually brought a few statements here to read. He concludes, Carbohydrates increase whereas fats decrease the sensitivity of the individual,

animal, and man to insulin. This is 1935. Just researchers clearly stating fat consumption impairs insulin sensitivity. Then at the same time, you have Dr. Hemsworth in the United Kingdom. He's publishing very fancy studies in people who do not have diabetes. So he wants to test in normal human subjects what's going on with insulin use depending on what type of diet I feed them. So he wants to test in normal human subjects what's going on with insulin use depending on what type of diet I feed them. So he gets a bunch of healthy young male medical students. He feeds them seven different diets for the minimum of seven days. All right, the high fat diets, 80% of calories come from fat. Low fat diet is 16% of calories

coming from fat. Okay, and he sees there's a step wise improvement in insulin sensitivity as he decreases the fat in the diet. You get seven different diets over seven different, it's very, very thorough experiment. He concludes that study saying the greater the amount of carbohydrate in the diet, the greater the sensitivity of the organism to insulin. Again, this is 1935. People are saying this. And then you skip to like the work of Walter Kempner, 1958. You remember his work? I mean, fruit juice. Okay. He's feeding people white rice, fruit juice, fruit, and white sugar. This is a diet of less than 5% of calories come from fat, a very highly processed. It was

originally designed to treat hypertension okay so he publishes a paper he's like he got great results he was reversing heart disease kidney disease all kinds of stuff he was even skeptical what's going to happen if i feed this diet to people living with diabetes so he publishes a paper on 100 consecutive patients no cherry picking and they're eating all these processed foods, their fasting blood glucose drops, their insulin levels drop, their cholesterol drops, and their weight drops

eating processed, high-carbohydrate-rich foods. And what's amazing is that the four foods that he fed people, fruit, fruit juice, white rice, white table sugar. These are literally four of the foods or food groups, I would say, that modern diabetes- Well, everybody's telling you to avoid all of those.

I mean, we vilified fruit, but you know, the other ones seem even more like, yeah, of course you're not supposed to do that. Yeah. I mean, has anybody ever studied what would happen if you put a diabetic on like, just, they just drink Coca-Cola and eat candy, like just like pure table sugar. Okay, I'm going to answer that question right now.

No fruit, no fiber, just like. I can't believe you just asked that question. You just lined it up as if we talked to him beforehand. 1971, Dr. Brunzel publishes a paper in the New England Journal of Medicine. He feeds people a sugar water diet, literally dextrose and a little bit of protein powder. 85% of calories coming from carbohydrate, 15% from protein, 0% from fat

because it's a processed diet. When you eat a whole food diet, you can't eat 0% fat. There's fat in lettuce, there's fat in bananas, there's fat in apples, there's fat in everything you eat. You just need enough whole foods, you're going to get like 6-70% of calories coming from fat. So he feeds people this highly processed diet. So he had them on a controlled diet. There were 22 subjects. 13 of them had pre-diabetes. The rest did not have diabetes. Okay. Puts them on a controlled diet for 7-10 days and then he feeds them the sugar water diet. Their fasting blood glucose levels drop. 8% in the non-diabetics, 9.6% in the people having the pre-diabetes. But more importantly, he does a paired oral glucose tolerance test. So this is where subjects are given a glucose challenge, like 75 grams of

carbohydrate and like a liquid solution. And they're going to measure the blood glucose levels at every 30 minutes and insulin levels every 30 minutes for the next two to three hours. And he finds that on this sugar water diet, the blood glucose values went down and their insulin levels went down. So they're eating liquid sugar water requiring less insulin with low... So New England... But what would happen if you... So how come you're not just like eating candy all the time? Well...

I mean, we do. The point is, this is just the biology of what's happening. But as far as long-term health, overall health, your gut microbiome, of course you want to have nutrient-dense foods that also happen to be low in fat. Okay, but there's still one,

there's a couple more studies that I think are worth noting, but the 1979. Yeah. Tell them about this. 1979. Mind-blowing. James W. Anderson, he conducts a study at the University of Kentucky with Kyleen Ward.

They take 20 subjects who are all living with type 2 diabetes for a minimum of two years. He puts them on a controlled diet, you know, the standard diet. I think it was like 40% of calories and fat or so. And then they put them on a weight-maintaining, high-carbohydrate diet. So this is not weight loss can be attributed to any success here. And in 16 days, 50% of the subjects require zero insulin.

So these are individuals that have been using insulin for two years. Yes, they all had high fasting blood glucose levels. They were straight up type two diabetics. And then he just switches them to a diet and he forces them to eat enough food so they don't lose a single pound. And within 16 days, call it two weeks,

they're off insulin altogether. And what were they eating specifically? It was a lot of starch, high carbohydrate starch. Potatoes, rice, things like that. Bread, stuff like that. Wow. Percent of calories was 9% of calories coming from fat on that diet

as we go into the biochemistry which i know we're going to have cyrus talk about you'll understand why the low fat component is so important so let's talk about what happens conversely on a low carb high fat diet which is kind of the reigning protocol for people that have this condition. It is. Either ketogenic or very low carbohydrate. You can't talk about diabetes and not talk about the ketogenic diet. A hundred percent.

No question about it. Okay, so let's suppose that you're eating a low carbohydrate diet. So what that means is that you're gonna be eating a diet that contains somewhere between, call it 70 to 85% fat in your diet. And then the remainder is going to be fat, protein and carbohydrate. So a low carbohydrate diet has been sort of talked about, you know,

for 30, 40, 50 years at this point. At this point, we're now in the ketogenic diet and the ketogenic diet is basically considered a very low carbohydrate diet. So what that means is that the total number of carbohydrates that they were to suggest per day is 30 grams per day, maximum, divided between breakfast and lunch and dinner. So you're eating 30 grams of carbohydrate plus more than 150 to 170 grams of fat per day. So again, we're looking at like an 80% fat intake,

then a small amount of carbohydrate and the remainder in protein. Okay. So in that situation, when you eat a low carbohydrate diet, you're effectively eating foods that are high in fat, medium and protein. And the fat molecules that are, that are coming inside of your mouth, they're actually locked up as triglyceride in the food that you're eating. So triglyceride literally means glycerol backbone with three fatty acids attached to it. So you're eating a lot of that triglyceride. It comes down your esophagus,

it gets into your small intestine. In your small intestine, the glycerol backbone is removed from those fatty acids. Those fatty acids then go through the wall of your small intestine. They get into your lymph system. Your lymph circulates it into your blood. And then from your blood, they circulate in these particles called chylomicrons. Chylomicrons are particles that can basically deliver these fatty

acids to tissues. So you eat it, they get inside of your blood. Now these chylomicrons are basically trying to give fatty acids to tissue. So if 100% of those fatty acid molecules ended up inside of your fat tissue or your adipose tissue, then diabetes probably wouldn't exist today. The problem is that those fatty acid molecules, a lot of them do get into your adipose tissue, which is where they belong. It's a perfectly designed storage warehouse to absorb fatty acids from the blood when they're available. But in addition to getting inside of the fat tissue, they also get inside of your muscle. They also get inside of your liver. And that's okay if the total quantity of fat in your diet is maintained at a low level, like Robbie was saying,

10%, 15%, maybe as high as 20%, okay? But when you're eating a ketogenic diet, again, you're eating 70, 80% fat in your diet. And as a result of that, the amount of fat that gets partitioned inside of your muscle and inside of your liver starts to grow over the course of time. So today you store a little bit,

tomorrow you store a little bit more, the next day you store a little bit more. And over the course of time, now your muscle and liver have become effectively fatty acid storage depots in addition to your adipose tissue. So your muscle and liver are designed to store small amounts of fatty acids. And inside of each cell, they have this thing called a lipid droplet. The lipid droplet is effectively where the fatty acids or lipid soluble compounds congregate together. lipid soluble compounds congregate together.

So this lipid droplet starts to grow over the course of time within each liver cell, within each muscle cell. And effectively that cell gets into a high energy state where what it's trying to communicate is like, wow, I have too much stuff inside of me. This lipid droplet has grown. Each one of these fatty acid molecules is worth, is nine calories per gram.

And it's a very energy dense molecule. And so the cell effectively says, okay, wait a minute, we need to go into self-defense mode here. And we need to prevent more stuff from coming inside. So if it were able to block more fatty acids from coming inside, it would do so. The problem is that fatty acids

can easily get inside of tissues. They can easily get inside of tissues. They can easily get inside of your fat. I'm sorry, your liver and your muscle, because the mechanisms to get fat inside of there are not very highly regulated. So because these tissues can't really block too much more fat from coming inside, what they can do is they can block the ability to communicate with insulin. Because the insulin is a molecule that's mainly designed to allow glucose to enter tissues. In addition to that,

glucose can also signal fatty acids and amino acids to come into tissues, albeit just a little bit less powerful than glucose. Yes. So what the cells do is they basically say, all right, listen, what if we were to just shut down this insulin signaling pathway? Because if we did that, then when insulin comes knocking at the door,

we can basically block pretty much all of glucose from coming in. And we can also block a small amount of fatty acids and a small amount of amino acids from coming inside. So intracellularly, this lipid droplet starts to create a traffic jam. And this traffic jam, you know, basically goes into the, the inside surface of these insulin receptor and starts to alter some of the proteins that start the insulin signaling cascade. On the surface of that cell? On the inside of that cell. Okay. Yeah. So the insulin receptor is kind of like out into the surface and, you know, in the extracellular environment, interacting with insulin. But then when you cross the cellular membrane

on the inside, there's a whole bunch of, there's another motif in that protein. And if you alter the way that that protein functions or alter any of its downstream signaling molecules, then you can basically shut down or strongly inhibit the action of everything underneath it. So it's basically just a game of dominoes.

Let's just like alter the first couple so that nothing else beneath it functions properly. So this lipid droplet ends up causing a problem and impairing insulin signaling. So as a result of that, the next time that you go and eat a banana or you have a bowl of quinoa or some wild rice as an example, that's carbohydrate rich food.

Those carbohydrates enter your digestive system. Those carbohydrate chains get broken down into glucose. Glucose is now in circulation inside of your blood. Glucose has to be accompanied by insulin in order to get inside of tissues. So insulin comes knocking at the door, says, hey, knock, knock. I got this glucose. Do you want to take it up?' And the cells respond by saying,

"'We can't take it up right now, sorry. "'We got all this lipid that we got to take care of first.'" Or some of the cells can't even hear insulin because they've shut down the entire signaling pathway. So as a result of that, insulin's knocking, it's knocking, it's knocking, it's knocking, saying there's no response, knocking, no response. So as a result of that,

the glucose gets trapped inside of your blood. So you have literally one banana. And then you go check your blood glucose two hours later and you look at the number and you're like, huh, 245? I only had one banana. I guess bananas are bad for me. See, every time I try and eat fruit, my blood glucose goes high.

Every time I eat potatoes, my blood glucose goes high. I guess those foods are bad for me. See, every time I try and eat fruit, my blood glucose goes high. Every time I eat potatoes, my blood glucose goes high. I guess those foods are bad for me. I should eat less carbohydrate rich food. So when that glucose is trapped in your bloodstream with the insulin and the cells are sort of refusing to uptake it, does that then prompt additional insulin secretion? So the insulin then continues to build in the bloodstream? Like what is the downstream impact of that? And how does that relate to insulin resistance? Yeah. Someone knows his biochemistry. I like this. I like this. Trust me. I'm winging it here. No, this is great. So yes, in that situation, what we just described, that is classic insulin resistance, right?

So like we talked about earlier, insulin resistance can progress into prediabetes and then eventually to type two. So in that state, if you've developed this level of insulin resistance, a small amount of insulin resistance, then the beta cells inside of your pancreas are saying, you know what?

The insulin that we just manufactured and secreted into the blood, it didn't really do much. Let's make more. So then they go into sort of overproduction mode. And instead of making, call it five units for a given meal, they're going to make seven units. And that happens today. And maybe those extra two units, they go and they get the job done

and it brings your blood glucose down. Then tomorrow, the same thing happens. And then the next day, the same thing happens. And then months and years down the road, before you know it, normally your pancreas was secreting, call it 25 to 30 units of insulin per day. And now that 25 to 30 has grown to 40, 50, 60. Sometimes it can be four to five times as much as you were secreting in a non-diabetic state. So this domino effect, this cascading series of events can all be tracked back to excess lipid intake, which then causes your liver and muscle cells

to over accumulate these lipids and shut this whole thing down. Exactly right. Wow. Yeah, so you can think of it as like excess accumulation of liver, I'm sorry, excess accumulation of saturated fatty acids in tissues that are not designed

to store large amounts of fatty acids that then causes a traffic jam of glucose inside of your blood. Right. And in turn, eating a low carb or a ketogenic diet that's high in fat is basically a masking technique.

Because you're not taking in any carbohydrates, you're not prompting your pancreas to secrete any insulin. So you're under the illusion that you're dealing in the solution, but actually you're just basically exacerbating a situation that will manifest the minute you put any carbohydrates into your body whatsoever. So you're actually exacerbating insulin resistance.

By doing that, you're just not seeing the impact of that until or unless you eat some carbohydrates. Is that accurate? So you live in an insulin resistant state by eating a ketogenic diet. And you're making it worse. And you're making it worse over the course of time. And you're playing the carbohydrate avoidance game, which allows you to never challenge your liver or muscle to uptake glucose, large amounts of it. And as a result of that, you literally cannot see that you are living with insulin resistance. And as a result of that, you literally cannot see

that you are living with insulin resistance. And to be fair, I don't want us to get ridiculed on Twitter, okay? So that'll happen no matter what. If you do a low carbohydrate diet and you lose weight- You get results, but you also can see some studies

showing improvements in insulin sensitivity if they lose weight. So there is a small improvement, but it's not the same magnitude of improvement that we're talking about here. But once you lose the weight and your weight stabilizes and you perpetuate like a low carb diet, you'll be able to kind of maintain that state, right? And your blood work will be stable. You're going to hit a plateau. Yes and no. Yeah. So, I mean, it is possible, sure. So let's say you lost 40 pounds on a ketogenic diet because weight loss is an inevitable consequence and it's one of the main things that happens. And it's one of the main reasons why people adopt a ketogenic diet.

So they lose weight. And as a result of losing weight, total cholesterol drops. HDL cholesterol sometimes goes up. Triglycerides drop. A1C goes down losing weight, total cholesterol drops. HDL cholesterol sometimes goes up. Triglycerides drop. A1C goes down. Fasting insulin goes down. Fasting glucose goes down. Blood pressure goes down. So all these markers, these biomarkers start to move in the right direction. And you're like, huh, I've done this only for a year. This is fantastic. Now I'm at my normal weight. That's great. Those are short-term results and those are phenomenal. And I'm not going to take that away from anybody who's experienced that. That's great. Those are short-term results and those are phenomenal. And I'm not going to take that away from anybody who's experienced that.

That's great. But what a lot of people who come to us, relay to us is that they say, hey, look, I've been doing this ketogenic thing. I've been doing this low carbohydrate thing for a while, but I can tell that I'm just not functioning. I'm not firing on all cylinders, right? And what that means is that they've either developed or are in the process of developing other chronic conditions

like hypertension. Okay. Once they've plateaued, now things can move in the wrong direction. Sometimes they get high LDL cholesterol. Okay. Sometimes they become hypertensive. Sometimes they end up developing really complex digestive problems. They get gas, bloating, constipation, and that's frequent, and it prevents them from being able to eat frequently. A lot of people say, oh, you know, I have this brain fog. Like I just cannot think clearly, and I don't know what's happening. A lot of people can't exercise frequently. And so there's all these sort of like ancillary conditions that begin to accumulate

over the course of time. Some of them are diagnosable conditions. Some of them are non-diagnosable conditions. And it generally makes people over the course of a year to two years to three years, depending on the individual, a lot of them are like, ha, I don't know if I can continue or want to continue to do this anymore. It's very difficult to maintain. And the one thing that's happening that you cannot argue or disagree on is that they have eaten themselves into a state of glucose intolerance. They'll say, oh, well, I don't care. Like I'm not going to eat a banana. I'm just never going to eat a carbohydrate ever again. So they can say if they want to, that's fine. But the fact is they've

eaten themselves into a state of glucose intolerance. And the only way to get out of it is to lower their fat intake and eat more carbohydrate-rich food, which they will do. And they say, oh, yeah, if I want to become more insulin sensitive and perform well on oral glucose tolerance test, I just have to carb adapt. Okay, yeah. So you have to start adopting features of the Mastering Diabetes Method to become more insulin sensitive.

In fairness to that individual, that's got to be a scary prospect. Like if they've been told their whole life or ever since they've been diagnosed that they got to eat low carb and they've been doing it and they've gotten to a place of stability with that, for you to then say, actually, you got to switch gears and do the exact opposite. I would imagine that that provokes a little bit of fear in most people. For sure. I mean, there's no question. No doubt. I mean, I think you're bringing up a really important topic here, which is that- The psychology of this is just as important as the, you know, biochemistry of it. I would say the psychology is even more important than the biochemistry. Like we can nerd out on biochemistry all day long, but at the end of the day, there's a certain amount of emotional anxiety that it creates in people when all of a sudden you say to them a couple of things.

Number one, you can eat potatoes, as an example. You can eat fruits. And I think what people do is they translate that message into, oh, so you're saying what I've been doing is wrong, right? And then it can create a sort of like negative mindset. Right, a defensiveness. Exactly. And in reality, we never want to point a finger at someone and be like,

yo, you're doing something wrong. You know, again, even in this conversation of low carbohydrate diets, we want to be very clear. We're not pointing a finger at any individual. We're just sort of saying the science could use some refinement. The conversation about the science could use some refinement. And to be clear, we also have a lot of respect for people who choose to adopt a low carbohydrate diet. All the experts, people who choose to say, you know what? I'm going to do something different. I'm not just going to go to McDonald's, eat standard American diet.

We have a lot more in common than we don't have in common as far as lifestyle change. There's a lot to celebrate. Yeah, everyone's, they're all trying to do the right thing. Agreed. Putting a lot of effort towards it. Right. So, all right, you guys have gotten together and you've taken 3,000 people? Over 3,000.

together and you've taken 3,000 people like over 3,000. So walk me through like, you know, the experience of onboarding somebody into this and like how long it takes before you start to see results and what that looks like specifically. Okay. So Cyrus and I initially, you know, you were working in like a biochemistry lab to work. You didn't really enjoy. I was loving life at Forks Over Knives, having a lot of fun. We were changing a lot of lives. But the one thing that I realized is that if you were a person living with diabetes and you wanted some guidance, some coaching, some support, a go-to place to adopt a plant-based diet and manage your diabetes or reverse type 2 diabetes and prediabetes,

there wasn't one place to go to. Neil Barnard, he wrote the foreword to this book. We're good friends with him. He had a great book, but he didn't have a website, a destination. Joel Fuhrman's written some good books. There's some good information out there, but there wasn't one place to actually get coaching and support and the nuanced details of diabetes in general, and especially type 1, type 1.5, insulin dependent type 2, how to manage all that. So we joined forces. 2017, we created an online group coaching program.

That's our passion. It's really working directly with people. And so you join the coaching program. There's three different tools that we have to help people really transition and understand what to do. We have an online course which teaches people step-by-step what to do. And we help people transition slowly. A lot of people, if you jump in, make too many changes, you bite off more than you can chew, it can become challenging.

So we're teaching people just change breakfast. Just start there, one step at a time. And then people start doing that, and they work through the program all the way down to lunch, to dinner, one step at a time. And then people start doing that and they work through the program all the way down to lunch, to dinner, to cleaning out your pantry, to going to restaurants, all the details. Okay, so that's really step one of onboarding with the Mastering Diabetes Coaching Program. Then you have an online community. And this is where we have coaches who have a lot of experience with diabetes. Several of them have reversed type 2 diabetes themselves. Adam Sud was on your show in the past. These people are going to help you answer questions every step of the way. We literally promise you post a question,

we're going to have a team member answer it within 24 hours. In addition to a coach helping you out, you are also going to get support from the community, from a bunch of other people living with diabetes going through the same thing you're going through. And that is priceless. you are also going to get support from the community, from a bunch of other people living with diabetes, going through the same thing you're going through. And that is priceless, especially when somebody's struggling. And those are actually the posts that get the most interaction. Somebody said, hey, I fell off the wagon. I feel really bad. You have all these people, hey, it's okay. I've been there. I've dealt with that. I had this challenging family interaction. I have a challenging situation with my doctor. They're telling me I shouldn't do this. I'm going to

get my health worse. Like all these really scary moments to have a place to go to and get that support from other people has been really valuable. So that's another part of our program. Then we also do live coaching calls. So the first and third Sunday of every month, we do a Zoom call so you can actually interact with the coach, interact with the community. But it's this really supportive, comprehensive program that has helped us get amazing results in a lot of people. And we are publishing testimonials all the time, getting a new story almost every day on our Slack thread and just hearing it through Instagram and Facebook. And are you able to scale this or are you maxed out on the number of people that you can deal with? I mean, when people listening,

there's gonna be people listening to this that are dealing with these very conditions. So we do actually have a wait list. So that is true. But the goal of, we initially did coaching, it was just Cyrus and I. We're just helping people, that's it. And we realized that we can't clone ourselves.

So we have to get other coaches involved. And that has definitely helped us to scale this. And that is our plan. We can help a lot of people for sure. Yeah, it's cool. And once somebody begins this process, I'm sure it varies depending upon the extent of their condition, but how quickly do people start to see results?

Days. Yeah. Absolutely Days. Yeah. Absolutely days. Wow. Especially if you're living with insulin-dependent diabetes, type 1, type 1.5, insulin-dependent type 2, you're injecting insulin and you start eating more carbohydrate-rich food.

It is not unexpected to see your insulin use change within 24, 48 hours. That's literally how quickly it can work, depending on how much of a change you make. So we have four-day retreats. People come down. We ran some in LA. We've done some in Costa Rica now.

In four days, people are adjusting their insulin use dramatically. And they're literally eating unlimited amounts of carbohydrate-rich foods. You come there, there's butternut squash, there mangoes there's papaya there's beans just in individual bowls a buffet go and take what you want we have lots of vegetables lots of greens and there's no calorie restriction at all we're actually encouraging them to eat more because that's one of the biggest mistakes when people adopt this diet is they don't eat enough yeah i know one of the things that you that you do and you lay this out in the book is you divide these foods into kind of three buckets,

like the green light, the yellow light, and the red light. And for foods that are in this green light category, it's like eat as much as you want. There's like, just eat until you literally can't eat anymore. Absolutely. And because they're so full of water and fiber, it's difficult to eat too much of them. And in the green light category, we have specifically listed the carbohydrate rich foods first, fruits, starchy vegetables, intact whole grains, legumes, and then intact whole

grains. So you have those four categories listed first because we want you to emphasize them. And I know people, they're scared. They're absolutely scared in the beginning. And part of the book, I think, is understanding the science and what's actually happening in that for people living with prediabetes, type 2 diabetes, the high blood glucose reading is a symptom of insulin resistance. Don't get too lost in worrying about higher readings in the beginning. And we go through a lot of tips and nuances that you can apply to really handle that depending on how insulin resistant you are. So there are certain foods you can add lots more non-starchy vegetables, lots more greens. You add foods like that to any given meal, you're going to slow down the rate of glucose absorption. And that's going to help you avoid

spikes. So there's lots of tweaks we can make. Small amount, even walking after a meal can make a big difference. Just walking in general, any time of day is a huge, huge difference for people living with all forms of diabetes. So the foods that find themselves in the green light category are fruits, starchy vegetables, legumes, intact whole grains, and then non-starchy vegetables, leafy greens, herbs and spices, and mushrooms. Yellow light are things like nuts and seeds, avocados, things that are higher in fat. So these are healthy plant foods. They're whole plant foods.

They're nutrient dense. But you're exactly right. They're a little bit higher in fat, actually a lot higher in fat. And you can easily eat way too much of them, which is not going to help your insulin sensitivity and definitely not going to help weight loss as well, which a lot of people are looking for who are living with insulin resistance. Now, we also have higher processed foods in that category. So brown rice pasta, Ezekiel bread, foods like that.

It's a little bit more processed than the original intact food it was made from. So I'd rather have you have brown rice than brown rice pasta. But still, it's in the yellow light category and it can be part of your diet. Right. And red light. Red light. It's basically everything else, right? It's basically everything else.

You have animal products in there. It means oils in there because it's a highly processed food. You've taken virtually all the vitamins, all the minerals, all the antioxidants, all the carbohydrate, all the protein. You've stripped it out. You have basically nothing but fat left. Very, very calorie dense. It's easy to eat too much. Also, a lot of oils are going to mess up your omega-6 to omega-3 ratio. So it's best to just limit or avoid them to the best of your ability. And then we also have processed foods. I mean, the basics. But I think it's worth pointing out, there's a lot of vegan processed foods coming out now.

Now more than ever. They're not health foods. Yeah. So if you want to enjoy them for other reasons, go ahead. But if you're trying to reverse insulin resistance, it's not going to help you. Right. What about beans?

Beans? Double green light. Triple green light. Highly encouraged. Yeah. Highly encouraged. Yeah. Did you ask that question because you enjoy eating beans yourself?

I eat a ridiculous amount of beans. Tell them about the second meal effect. Oh, yeah. One second here. In Finding Ultra, you talk about the fact that when you finally transitioned to a plant-based diet and you actually gave it a good shot, that you had to go through some personalization as well.

You were sort of manipulating your diet to, to determine what's going to give you the best performance, the best recovery, and what's going to make you feel best. Were you also at that time, did you also get excited about the, the prospect of eating lots of carbohydrate rich food? Like what was the emotional under,

under feeling? I mean, yeah, I would say yes. I wasn't, I mean, I don't, I didn't approach it with an engineer's mindset in the way that you might. And I wasn't avoiding carbohydrates prior to that. I was just trying to find a way to eat that would keep my energy levels super high, like all the time. And then as, as the training began to ramp up, I mean, my,

my diet is much higher in fat than what you guys are recommending. And, and, and even this conversation, having it with you guys right now is, is, and, and other conversations that I've had with lots of other people, interesting people on this podcast that do things similar to you as me rethinking that and reducing my fat intake considerably based on, you know, in, in comparison to what I have been doing. But when I was training 25, 30 hours a week, yeah, like lots of avocados and some higher fat stuff that, you know, I probably wouldn't do now. Fair enough. Well, there is this thing called the athlete's paradox,

which I think is actually phenomenal. It's very interesting, which is that some research actually shows that the lipid droplet also grows inside of muscle tissue of athletes who are eating a slightly higher fat intake, but it's not problematic because that lipid depot is basically, it grows and shrinks and grows and shrinks rapidly. So as a result of doing endurance sports, a result of being a frequent athlete, that becomes a fuel depot rather than a pathological storage of fatty acids.

Until you stop training. Yeah, exactly. And then you got a problem. That's great. Well, let's talk about what you mean when you say reversal, like reversal, remission. Like, is it possible to cure type two diabetes? Like, what do you actually mean? Okay. Great question. I think this is actually,

it can be kind of controversial to even talk about this because it means different things to different people. So when we refer to reversing, we, we talk about reversing insulin resistance because it's the underlying cause of prediabetes and type 2 diabetes. And it's the thing that makes your blood glucose wonky. And when it comes to reversing type 2 diabetes as an example, what you want to do is drop your A1C value. Your A1C is basically like a three month, an indicator that tells you what your blood glucose stability has been over the course of three months. And so the standard is to get your blood, your A1C to less than a 5.7%. Okay. So between 5.7 and 6.4 is considered pre-diabetes and then 6.5 and beyond is considered

type two. So let's say you start out at a 7.0 and then you drop that from a seven to a six, from a six to a 5.5, boom, you're at a 5.5. Technically you're in the green zone. You're in the non-diabetic range. Cool. Let's stay there. In addition to that, we also want to see a low fasting blood glucose and a low fasting insulin. So low fasting blood glucose means less than a hundred milligrams per deciliter and low fasting insulin means less than five. Okay. So if you can achieve all three of those, then technically speaking, you're in the safe zone. But what we want to see is that you maintain that not only you just get it today, I want you to maintain that for a year, right? I want you to prove to me that your lifestyle is dialed in enough that you can maintain all of those biomarkers for a year. Now,

those are the, those two markers, the fasting insulin and fasting glucose are indicators of what your fasting metabolism is doing. And that's important, no question. But it's also important to make sure that your glucose challenged metabolism is also functioning well. And the glucose challenged metabolism effectively refers to what happens after you eat a carbohydrate rich meal, right? So if you were to go eat a carbohydrate rich meal, I also want to make sure that your post-meal insulin is not high and that your post-meal blood glucose is also not high, right? Now in the world of ketogenic diets, what we're talking about earlier, a lot of the research focuses on what's happening in the fasting state, because again, you lose

weight, you drop your fasting glucose, you drop your fasting insulin, you drop your A1C, everything looks good. But they're using that as a collection of information to say, good job, you've reversed type two diabetes, but they're not testing the glucose challenge state. And if you're not testing the glucose challenge state, then you're missing an entire component. That's the real marker of just how insulin resistant you are or not. Exactly. So that's why what we like to say is let's get the biomarkers set in the fasting state and let's get them set in the glucose challenge state. And if you can do both of those and you can maintain that over the course of time, give me a full year, then we can say that you've reversed type 2 diabetes

altogether. So, I mean, I don't think the exact words matter. Is it reversal? Is it cure? Is it remission? It's what's happening in real people's lives. People who come to us with a high A1c, they're taking diabetes medications. They have fatty liver disease. They have no energy. Okay, so we get them. They don't need medication anymore. I mean, I just pulled up this story, Tammy, because she's one of my favorite testimonials.

She actually lives here in Los Angeles. I got to meet her at the farmer's market. When she joined our program, her A1C was 7.2% and she was using metformin. So that's a common diabetes medication. That's a high A1C medicated. Now she follows our program. She gets to eat all the carbohydrate-rich food she wants, unlimited amounts.

She reduces her A1C to 5.3% unmedicated. So- Totally off metformin. Yeah, so at that point, I don't care what you want to call that. Right. Reversal, it doesn't matter. She's non-diabetic.

She's removed the cause of the problem and now she's able to metabolize glucose. But most importantly, she also had insulin data. So when she was living with type 2 diabetes, had the elevated A1c, still using metformin, her fasting insulin was 17.4. This is very high. Now she starts eating our diet, doesn't need the medication anymore, has lost weight. Her fasting insulin is 5.2. That's healthy. That's where it's supposed to be. Yeah, it's crazy.

Is there ever a situation where somebody's type 2 diabetes is so, like extreme examples of this being unchecked for a very long time, somebody who's very overweight, like the person who's gonna get their foot amputated or whatever, where it's just even to put them on this program like it's too late, or do you always see improvement?

It's never too late to improve your overall health. But this is a really important topic. We're actually quite passionate about it, and we wrote about this in the book. There is a situation where you can become an insulin dependent type two. That's actually real. So if you have gone through that situation where Cyrus was talking about all the insulin being produced and knocking on the door, it's possible that your beta cells have become exhausted and you literally aren't able to produce enough insulin to manage your blood glucose level without exogenous insulin so you're more like a

type one without the autoimmunity without the antibodies and that's okay so we talk about c peptide testing you can go and get a test done you can figure out and establish how well are your beta cells working how much insulin are you producing and then we can gauge your goals yeah it's cool and so yeah you you at that point, okay, of course, they're more like Cyrus and I. They're more like a type one. There's still no reason not to gain some more energy to reduce your risk of heart disease,

which is the number one killer of people living with all forms of diabetes. To reduce your risk of fatty liver disease, chronic kidney disease, high cholesterol, high blood pressure, erectile dysfunction, depression, you name it. You want to maximize your insulin sensitivity. Where do you guys come down on intermittent fasting? Oh, huge fans, huge fans. When I was in graduate school, I got to study intermittent fasting and

many different permutations of it and how it affected animals in the insulin resistant state. And the results that we were getting were just phenomenal. So we were learning about different techniques that other research labs had used to improve the health of either animals or humans. And there's a whole laundry list of different intermittent fasting strategies and permutations. So we were testing out what happens

in a 25% calorie restricted state, which basically means you eat 25% less food than you normally would. And you hold that constant every single day. Then there's what's called an alternate day fasting strategy where you eat today, then nothing tomorrow, then eat today, then nothing tomorrow. Then there's 25% alternate day fasting, eat today, and then you only have 25% of your normal food, and on and off, on and off. So in the Mastering Diabetes program, we basically teach people how to implement one of two different strategies.

The sort of beginner strategy and where we recommend starting would be a once per week, 24-hour intermittent fast. And when you do a once per week, 24-hour intermittent fast, I think it solves many problems. a week, 24 hour intermittent fast, I think it solves many problems. Number one is it's an opportunity to recognize the difference between true physiological hunger and mental hunger or emotional hunger, right? I'm sure you've probably felt that before. You know, most people think that they're truly hungry, but in reality, they're not necessarily. It's just, you know, it's timed, it's programmed. Oh, it's six o'clock PM, it's dinnertime. Or I smell that pizza, so therefore I want food.

So this is an opportunity to sort of really recognize what is true physiological hunger and what is not. But that's a psychological experiment. That is an absolute psychological experiment, no question. And then in addition to that, people who are living with insulin dependent type, you know, either type one diabetes or insulin dependent type two diabetes,

are able to use it as an opportunity to check whether their basal or their background insulin is set properly. Are they injecting the right amount? And if so, then their blood glucose stays stable. If they're injecting either too much or too little, their blood glucose will do some funny things. Because in that period without food, you get some kind of baseline reading that you can set your parameters on? Exactly. So if you're using an insulin pump as an example, the insulin pump is literally just drip irrigating insulin into your bloodstream or into the subcutaneous tissue that gets into your blood. Rich's healthy pancreas is doing that right now. That's exactly right.

Yeah. So that's the thing. Like my friend Robin Arzon has a thing on her tricep, you know, like a little box thing there. You guys don't have that though, right? We're going to be working out with Robin in a couple days in New York. Oh, cool. That's what that's doing. Yeah, she has an Omnipod.

But you guys don't have that. So we do not personally use pumps, but she also has a continuous glucose monitor, a CGM. She wears a Dexcom. I don't know what that means, but don't yeah blank stare continuous glucose monitor it's new technology and what it's doing is it is actually measuring subcutaneous fluid right they have a like she's got like a little doodad like that's not her phone

that she's like looking at all the time looks like a pager yeah yeah now Yeah. Yeah. Now she's probably doing it on her phone because they can communicate with the phone now. But yeah. So anyways, it's giving you 24 seven data on your blood glucose values. Every five minutes you get a new number from these continuous glucose monitors and it's fascinating data. And now for people living with type one and type 1.5, this concept of time in range has become a very big deal. So we can now see what percent of any given period of time are you spending in any range. So the type 1 community has established between 70 and 180 milligrams per deciliter that is in range. You want to try and be there as much as possible. A minimum of 70%.

That's the goal. And then to be low, that would be 69 or lower. You want to be there 4%, okay? No more than 4% max. And then less than 55, no more than 1%. So below 1% in a very urgent low. And then you want to minimize the highs. So above 180, you want to try and be there as little as possible. So they have done some studies, some New England Journal of Medicine,

some high quality journals have looked into this. What's actually happening with people with type one diabetes right now? How good is their time in range? And people who are using a pump, they see a little bit of an improvement. They're getting, you know, maybe somewhere around like 65% of their time spent in range. But then this new technology called a closed loop system, also known as an artificial pancreas, is getting people on average closer to the 70% threshold that we're looking for here, 75%. Okay, now this is where the pump and the CGM are talking to each other. So the CGM says, oh, hey, you're going up, you're 150 and going up. So that talks to the pump and the CGM are talking to each other. So the CGM says, oh, hey, you're going up. You're 150 and going up.

So that talks to the pump and the pump says, okay, you know what? You need one unit of insulin. Let's bring you back down. And where it's really helpful is when people are sleeping. So it makes these small micro adjustments overnight, helps them keep a steady blood glucose profile. But even then, I want to make a point here. They're still getting somewhere around like 70-75% on average.

I have become personally very passionate about this topic. I'm like, hey, if I'm going to be an educator in this field, I should have some good numbers here. So let me look into this. Let me start looking at this data. And I've started to pay close attention to it. And over the past 90 days, my time and range is 91%. Which is, again, people with the closed loop system are, they're getting, some people are getting close to that. I mean, it's not that often. So without a system, without antiquated technology, I'm at 91%. My low is 3%, less than, well, less than 55 is less than 1%. And then the high is 6%. So in addition to the time and range data, we now also can have an average blood glucose value throughout the entire day.

And it's not based on just finger pricks. You can't hide from this data. And so we can see, okay, what's your average over a 24-hour period? And that number, you can also figure out, okay, what's the standard deviation? What's the fluctuation from your average? And you want that to be,

you want your standard deviation to be less than- Less than one-third third. Okay. Of the value. Yeah. And mine is about one fourth. So you're basically flattening that sine curve. Exactly. And so what I'm trying to demonstrate here and what we're doing here with the master diabetes method is like, I'm not special. I'm just telling you, I promise you, if you apply these principles, it doesn't matter what form of diabetes you're living with, you can get your blood glucose under excellent control. You are not going to see these peaks and valleys of what you would expect with carbohydrate-rich food. And so I have the data to show that, hey, I'm doing that myself, and I'm not even having the best technology doing it. Yeah, but Robbie, bacon.

Hey, you have a bacon avocado to eat today. You know, people like their high fatty foods, man. Yeah. You know? And you know, we teach that in our program, in the book. We say, we're not the food police. It's your choice. We're just here to teach you the consequences

and you can get whatever result you want. We're just giving you the information and the support if you want it. Robin is one of the most active, energetic people I've ever met. And you guys seem like you have a lot of energy. Like, are there things that you can't do? Like, as people who are athletic, like, do you find that you can go out there and be all you can be and do all the stuff that you want to do without running into problems? Okay, so.

And how does that work with someone who has a progressed state of type two? All right. So the number of stories that are popping into my head right now is just like, ding, ding, ding, ding, ding. Okay. When I first transitioned to a low fat plant-based whole food diet, one of the first things I felt not only was my glucose more controllable and my insulin uses down, but I literally felt like I took a, like a wall charger and stuck it into the wall. And I just got like electrified. So I felt the energy boost immediately. And as a result of that, I went out and bought a bike and I started cycling all over the place. And I think I wrote, brother, you know, it is, I think I wrote something like 6,000 miles in the first year because I was literally just excited. And I told people at that time, I was, they would see that. Why are you up at six o'clock in the morning? And I'm like,

I feel like a puppy. I like, I wake up and I just have all this energy and I don't know what to do with it. Right. So I've experienced that. Robin is a perfect example. We taught her this method, right. And we sort of were like, Hey, you know, how do you feel about this? And so she's like, great, let's do it. When I was talking with her not too long ago, she said, hey, one of the things that, one of the best benefits of this is I thought I had a lot of energy beforehand, but now my boyfriend makes fun of me all the time because he says that I don't stop.

Yeah. Right? She doesn't. She literally does not. Yeah. And her now husband, I mean, he's, you know, he's one of the most fit dudes ever. Yeah.

So take the Robin that you know, and then add another 20, 30, 40% on top of that. We love you, Robin. Okay. Then in addition to that, one of the best stories that we've been able to influence is there was a woman named Marilyn who came into our program and she was literally house ridden, couch ridden. She'd

been living with type one diabetes for, I want to say 60 plus years. And she had so little energy that on a given daily basis, she could not even leave her house. She was hardcore ketogenic, hardcore. So she was very ketogenic leading up to that. Her glucose was under exceptional control while eating a ketogenic diet. But she was like, I think I'm missing something. So she was very ketogenic leading up to that. Her glucose was under exceptional control while eating a ketogenic diet. But she was like, I think I'm missing something. So she comes over to starts learning from us. Her glucose is under great control following this approach as well.

And over the course of, I wanna say it took her in her particular situation about one and a half to two years to get to a point where she started to really feel it. So there was a lot of work that had to be done underneath, but she eventually became a little bit more active inside of her house. And then she eventually started going outside of her house

to go get things. And then she now gets on a bicycle and goes and rides her bike for 10 miles a day. And then she's like, you have fundamentally changed my body and my life and i'm like i didn't do anything marilyn you did all the work here it's the classic example she had a1c's in the fours consistently and you think oh this is great but what was the long-term consequence she became house ridden so yeah exactly is there what's the deal i mean basically you guys are eating a raw diet

right it's it's it's predominantly raw like where where do you come down on like cooked foods and i mean you like beans so you gotta cook those right so we're definitely we're not teaching a raw food diet that's not definitely not like a focus at all i mean i know you've stayed clear like you're not labeling this, you know, you, you guys avoid words like vegan and raw and all that kind of stuff. I get that, you know, but I just want to kind of drill down. For sure.

So we get into the nuances of both of our personal stories here. Yes, it is true. I still, still do follow a raw food diet. I eat lots of non-sourcy vegetables, lots of greens. You've been doing this for a long time.

It's been over 13 years now. And I eat prime, my calories come. Teeth haven doing this for a long time. It's been over 13 years now. And I eat, my calories come. Teeth haven't fallen out. Teeth are still working just fine. Barely. And Cyrus, he's added some foods. Yeah, so I was raw for, I don't know, 14 years or so. And I just decided that I wanted to start eating potatoes.

So I started eating potatoes, quinoa, garbanzo beans, black beans, steamed vegetables. And those are all on my diet right now. And how did that impact your blood work? Like what was the, any changes that you saw when you did that? Or why did you decide to start doing that? Yeah, I decided to start doing that because when I would go to like, you know,

go to restaurants and go out to dinner with people, I would always kind of like be eyeing the food. And I was sort of like, oh, I kind of want to eat some of that, right? And then I said, you know what? What if I were to just try incorporating it? So the first time I tried incorporating cooked foods, it did not do good things to my blood glucose. My blood glucose went high.

And as a result of that, I had to use more insulin. And I was like, man, this is frustrating. But what I've learned in this process is that there are certain cooked foods, which are very non-problematic. You know, I can eat quinoa as much as I want. I can eat garbanzo beans as much as I want, steamed vegetables as much as I want, and it's not going to budge my blood glucose. But there are certain types of beans for some reason that I cannot explain that make my blood glucose go crazy. And just to be clear, these are nuances of living with insulin-dependent diabetes. Correct.

For people coming into our program, pre-diabetic, type 2, there is no restriction on any of these healthy cooked foods that we're talking about in the book. We have like 30 recipes in here. I'm pretty sure like 26 of them are probably cooked. A couple raw food ones in there. So let's blow a few minds and you guys can walk me through what you eat. Let's like get down to brass tacks on what this actually is.

Or just go to either of your Instagram. For sure. Your Instagram has the word mango in it. Yeah, right. People call me the mango man. I mean, personally, I will eat for breakfast. I mean, right now,

persimmons are in season. I should say, you gifted me with this beautiful fruit basket. That's some high quality fruit there, Rich. Thank you for that. Those are local grown Valencia Pride mangoes.

Very special. Hachia persimmons, which are, you gotta eat them when they're like a balloon. He won't even give me some of those fruits yeah it's a great fruit so anyways you know every meal is essentially fruits and greens like pretty and i eat four times a day i have breakfast i have lunch i have a pre-dinner and i have dinner so breakfast it's going to be whatever see whatever fruits are in season but a particularly calorie dense fruit. So persimmons are much more calorie

dense than something like melons. And we list all the foods in the book in order of calorie density. So people can use that as a tool to make sure they're staying satisfied and sticking to the program long-term. And then lunch is again going to be another fruit-based meal. And again, if you want to blow some people's minds, I will commonly eat well over 210 grams of total carbohydrate at a lunch meal. That's my biggest meal of the day. And if you're following a ketogenic diet and you're staying to 30 grams of carbohydrate or less per day, you're eating 210 per week. So I'm eating more carbohydrate energy in one meal than a low-carb person is eating in one week. But here's the kicker, Rich. There's published research. People living with type 1 diabetes following a ketogenic diet will use on average 30 units of insulin per day. 30 grams of carbohydrate, 30 units of total insulin.

It's a one-to-one ratio. I am eating over 700 grams of carbohydrate per day and using 27 total units. That's mind-blowing. The people really let that sink in. And that's the conversation of this whole book about maximizing insulin sensitivity or reversing insulin sensitivity. And the size of your lunch meal is like the size of your physical body. Pretty darn close. I used to think that I could eat and then I hung out with Robby and I was like, wow, this dude can eat. There's no question about it. My pre-dinner is going to have like some blueberries, some bell peppers, some mangoes, some greens. I love arugula. I love spinach. I like

specific varieties. I gifted you some Bloomsdale spinach, special stuff. And then dinner is a very high, you know, vegetable based meal. You know, lots of greens. Again, I'm lucky I live in LA. I get to have different varieties of lettuce. I can have sword lettuce, you know, uh, green Obla, Sierra. It's fun. Green peas, sugar snap peas, um, stuff like that. And then of course, there's some fruit in my dinner. So I have some mangoes there, some berries, stuff like that. Cyrus. Yes, sir. What do I eat? Yeah. Okay. so because i live in costa rica i get to eat lots of plantains lots of papaya lots of mangoes i just have this vision of you sitting on the beach just eating fruit wearing board shorts just like two more hours until i have to go do a do a webinar webinar it's so accurate it's unbelievable it's unbelievable okay so for breakfast i will wake up

and i will eat maybe one plantain raw plantain which people find weird but it's very tasty so i'll eat like one giant raw plantain and then maybe like half of a maradol papaya you know those like big mexican papaya yeah okay then i'll go and i'll do a workout i'll go to crossfit for an hour and then i'll come back and my wife kylie will put together some type of like giant fruit bowl slash smoothie bowl for me so i'll eat that and that usually contains maybe another three plantains plus two mangoes and some berries and maybe um you know another half of a papaya. So fruit-heavy breakfast, fruit-heavy second breakfast. Lunch rolls around. I still eat some more fruit. Why?

Because I really like it, just like Robbie. This whole fruit thing. Here's the thing. I've got to just say this. The people that I know, and I know you don't characterize what you do as a fruitarian diet, but the people that I know that are like fruitarians, quote unquote, I've never seen people more in love with what they eat.

They just want to talk about it and romanticize it. I'm like, what is that about? I don't understand. I like fruit. I'm not going to write poetry about it. I wish I could explain because I seriously, I have the same issue. And Cyrus actually makes fun of me. He cares way less about like this particular variety and the ripeness.

And I go to all these farmer's markets. I don't know what to say, Rich. I just love it. It's like a Saturday Night Live skit. It really is. All right. Okay. No, but when it comes to mangoes i am i'm mildly obsessed with

them and so like this fascination with like different types and different shapes and different colors and whatnot uh i'm well well into that when i was living in hawaii back in 2005 and 2006 i wanted to set the world record for eating mangoes so i mapped out all the mango trees on the south a part of Oahu and I would drive by them every single day and I would go mango hunting. And then I would had a bucket in the back of my truck and I would just go to people's houses and then I would pick up the fallen mangoes and I would just eat those. Is this like a series on YouTube? Yeah. Mango hunter. Right. So during that time I was eating 23 mangoes a day on average over a three and a half month

period. Oh my God. And I was eating 1,750 mangoes. Oh my God. All right. And again, I was trying to set the world record, applied to the Guinness book, and they said no. There is a world record?

Does somebody hold this? Nope. Well, I tried to set the world. Sorry. I applied for the Guinness book, and they basically said, we don't do food eating records. It promotes too much competitivism. You're going to have to go to this other organization to do it. So I said, we don't do food eating records. It promotes too much competitivism. You're going to have to go to this other organization to do it. So I said, fine.

I hold the unofficial world record. We'll just state it here. Which is how many again? So 1,750 mangoes in three and a half months. But really what I wanted to do was set the world record for a 24-hour period. And eat something like 50 mangoes in a 24-hour period or more. Point being. You could still do that. you could still do that i could still do that point being so you know it's like fruit heavy up until lunch

and then uh when you know middle of the afternoon and dinner rolls around that's when i go into more vegetables so that's when i eat things like chickpeas i'll have some steamed vegetables i might have a giant salad i might have um some beans. I might add a little bit of rice in as well. So, you know, I used to be 100% raw, but now I'm, you know, I don't know, whatever, 70% raw. And your wife, she eats the same way? She does. She's a little bit less fruit obsessed than we are.

She tends to eat a little bit more cooked food, but she's, you know, whole food, plant-based, low fat, loving it. One of the things that I can imagine, somebody listening to this right now might be thinking is, wow, maybe I need to take a look at this, but it's intimidating. For the social aspect of it, like, oh, I guess I can just never go

to a friend's house again, or I can never go to a restaurant. Like I could see people panicking over how they could actually make this function. Yeah. Well, again, when you look at the list of foods that can be eaten, you actually can eat this way very well and enjoy it at just about any restaurant. You really can. I mean, I've been 13 years now, a lot of business meetings, a lot of restaurants, a lot of traveling. You can make it work. And I also want to remind people, it's not about being perfect. You know, maybe you're a little intimidated.

Maybe you say, I don't want to give this up. Like, small changes make a big difference. And I can tell you, like like almost every success story we publish, like they'll say, I'm not perfect. We'll get consistently regular posts in our Facebook group of like, I have been like kind of struggling. I haven't really been doing it. I just got back from my doctor.

I couldn't believe how good my A1C was. I couldn't believe how much weight I'm still losing. My blood pressure went down. Like all these amazing things are happening, even if you don't go all the way. So I don't want people to think like, oh, you have to be perfect and eat this amazing clean diet that we just described. You don't have to do that in general. But even when it comes to social situations, there's a lot of nuanced things you can do. You can prepare a dish before you go. You can learn how to communicate with them.

And if you're living with diabetes and you use that as sort of like a clear communication of why you're doing this, a lot of people will get behind you. Same thing with using, communicating with a waiter. You know, we have strategies for that. You can sort of pull them aside and let them know, hey, I have these specific goals and you can add some humor in there and make it sort of funny. Like Cyrus will tell a waiter, I'm trying to set the world record for insulin sensitivity.

Can you help me out? And if you put a little oil in there, you're going to crush my hopes and dreams. So there's ways to make it fun. And I really think it comes down to your desire, your goals, figuring out what your why is, figuring out what's important. And if you can communicate that to the people you love, they're going to support you and you can get through any

situation. Yeah, I think that's good advice. And I think if you are dealing with diabetes, you have a perfect thing to hang your hat on and say, this is why I'm doing it. As opposed to like, oh, this is just the freaky new thing that I stumbled across and it's the new year. And making sure that you're focusing on, hey, this is me. Thisaky new thing that I stumbled across and it's the new year. And making sure that you're focusing on, hey, this is me, this is what I'm doing for my health. You're not saying what you're doing is wrong or the way you eat is bad. If you can really establish that level of comfort

and support, hey, I'm just doing this for me. Like, I'm just trying, I'm just testing it out. Are you supposed to avoid those things though? Like that's the conversation that I would imagine inevitably ensue. All right, I gotta land inevitably ensue. All right. I got to land this plane in a few minutes, but the last thing I want to talk to you about really out of just my own personal curiosity is about YouTube culture. Like you're, you know, you're not like a vlogger, but like I consider you as somebody

who's kind of part of that ecosystem of like the vegan YouTube community at large. And it's been fascinating to me to kind of observe at arm's length, the evolution of that whole dynamic over the last several years. And for the most part, I think it's been an absolute shit show. You know what I mean? Time to disagree with that. Yeah. And I'm just, I'm interested in kind of your relationship

to that world and your perspective on it. I think it's evolved. Like there's a lot of really cool stuff that's happening there now. Exactly. And I think the content that you guys are putting out, like super high quality, but I've sort of watched, you know, it start out as this kind of cultish thing and then became kind of a vlogger thing.

And then it kind of devolved into a lot of mudslinging and gossip and very unproductive, dysfunctional behavior. Exactly. We do not participate in that. And I think the evolution- Maybe we should. No. The evolution of YouTube, and I think in general, I think this movement on a lot of levels is the focus on evidence-based information. And there are channels popping up

that are putting that at the center of what they're communicating versus- Like Mike the Vegan, I think is doing amazing work. Absolutely. I love that guy. Plant-based news. Like there's some really cool channels that are doing really solid work.

Exactly. And so I think we've graduated from that kind of gestation phase. Taking away the emphasis on N of one examples and being like, oh, I'm going to listen to this blogger

because that's what they said. Oh, and then when they said it didn't work for them, then oh, I'll just listen to why it didn't work for them. It's too small of a sample size. You can't make decisions based on bloggers.

Yeah. You really got to look at the evidence. It could be inspiring. It could be interesting, but go and look at the research. What about all these people making, I mean, we're kind of past this now, but there was that whole sort of season of like why I'm no longer vegan. It was very unfortunate. I mean, it's probably not going to disappear, unfortunately,

but, but again, it's just, you got to remember to look at the research and not get lost in the details of individual stories. And I think if you look at some of the nuances of a lot of those stories, you'll realize that we don't know a fraction of what's really going on in people's lives. For how long are people showing they're looking amazing, they're feeling amazing, they're doing this, they're selling programs or whatever. And then behind the scenes, we find out, no, that's not what was going on. So you just have to take it all with a grain of salt.

And I think there's also a huge growth in evidence-based doctors and being able to access them. I think that the Instagram culture is sort of like taken over. And now instead of vlogging, it's Instagram stories. And the amount of doctors who are participating in that game and giving really solid information is very encouraging for the future. So who are the go-to people in your guys' estimation?

Dr. Will? Dr. Will B. Dr. B, Will Buskiewicz, gastroenterologist, unbelievably smart. Dr. Danielle Bellardo, Dr. Michelle McMacken, Dr. Rob Osvelt. Who am I missing? Dr. Joel Kahn. Yep. Dr. Michael Greger.

All participating in the Instagram culture. It really has shifted to see doctors. You know, these really well-respected people making Instagram stories. It's kind of funny. Like when I saw this happen, you know, you and I, we've been around a long, long time, this Instagram thing, when it was just, you know, the homepage was one homepage for everybody. Okay. Everybody saw the one homepage.

I know. Remember, like if you got your picture on that homepage, that was the page that everybody all over the world saw the same thing. Absolutely. And all it was, was pretty food photos. That was it. And now Instagram posts, they're kind of like replacing blog posts. that everybody all over the world saw the same thing. Absolutely. And all it was was pretty food photos. That was it. And now Instagram posts,

they're kind of like replacing blog posts. People are posting really solid educational content in an Instagram post and also illustrating it with great pictures. You're sliding through, you're seeing the pictures, you're seeing the videos. We're doing a lot of that on our Instagram account. So it's been fun to see the evolution. Cool.

All right, you guys guys thank you so much uh i really appreciate everything that you guys are doing you're you're you're truly changing lives and uh you're to be applauded for that appreciate it so thank you thank you my man appreciate it um i i'm super excited for the book to come out it comes out on february 18th right feing Diabetes. Here it is. This is what it looks like on camera. Pick it up wherever you purchase books. I would assume that you guys are going to be

out and about talking about this quite a bit. We are. We're going to be doing our best. We'll stay in touch and come back and talk to me again sometime. Thank you. I'm looking forward to it. Thank you so much for everything you do. You are one of the most inspirational human beings literally on the planet.

Thank you. And I hope you know that at this point. That's a very difficult thing. I mean, the number of people that I know. But I love the affirmation and the validation and I live for that. So I will feed out on that for a while. 100%.

The number of people I know that have told me that your podcast has truly fundamentally changed their life is like, it's countless at this point. So, I mean, for us to say, we appreciate what you do would be an understatement. You're a force for good and we totally appreciate it. Thanks you guys. All right. So beyond the book, the best place to get in touch with you guys, masteringdiabetes.org and your Instagram accounts. At masteringdiabetes. And then That's it. And your Instagram accounts. At Mastering Diabetes.

And then mine is at MindfulDiabeticRobbie. Right. And yours is a mango-oriented one. At Mango Man Nutrition. At Mango Man Nutrition. All right, you guys. Peace out. Peace.

Plants. On a scale of one to 10, how much did that blow your mind? Pretty fascinating, right? Please do me a favor. Hit up Cyrus and Robbie on the social channels and let them know what you thought of today's conversation. You can find Robbie at Mastering Diabetes and or at Mindful Diabetic Robbie on Instagram.

Cyrus is at Mango Man Nutrition on Instagram and Cyrus KPHD on Twitter. Also, please make sure to check out the show notes on the episode page where you will find a litany of resources to learn more about the things that we talked about today. If you are sold on the plant-based diet thing after hearing Cyrus and Robbie today, but you feel like you need a little extra guidance in the kitchen, I know for a fact our Plant Powered Meal Planner can help. It is truly an extraordinary product.

We work very hard to solve a very basic problem, making nutritious eating convenient, delicious, and affordable. When you sign up at meals.richroll.com, you'll get access not only to thousands of delicious and easy-to-prepare plant-based recipes, they're all thoroughly customized based upon all these preferences that you input when you sign up. We also offer unlimited grocery lists. It integrates with grocery delivery in most metropolitan areas. And we have an incredible team of expert nutrition coaches at the ready to guide you to answer all your questions seven days a week. And you get all of this, wait for it, for just $1.90 a week when

you sign up for a year, literally the price of a cup of coffee. So to learn more and to sign up, go to meals.richroll.com or click on Meal Planner on the top menu on my website. If you'd like to support the work we do here on the show, subscribe, rate, and comment on it on Apple Podcasts, Spotify for you Android people, and YouTube for the visually inclined. Share the show or your favorite episode with your friends or on social media. I love seeing all that stuff. And you can support us financially on Patreon at richroll.com forward slash donate. I appreciate my incredible team who works very hard to put on this show every week. Jason Camiello for audio engineering, production, show notes, and interstitial music. Blake Curtis and Margo Lubin for videoing the podcast and editing it and creating all the short clips, et cetera. Jessica

Miranda for graphics, Allie Rogers for her beautiful portraits, DK for advertiser relationships to keep this train running and theme music as always by Annalima. Thanks for the love you guys. See you back here in a couple of days with a very, very special episode, 500. 500 episodes. This one is good. I'm not going to spoil it. You're just going to have to wait. Until then, peace, plants, namaste. Take care of yourselves, guys. Thank you.