The Rich Roll Podcast - Physiologist Drew Harrisberg On Everything Blood Glucose, Understanding Diabetes & Plant-Based Nutrition Fundamentals
Episode Date: October 9, 2023A full-blown epidemic in the developed world, diabetes currently afflicts an astonishing 37 million people in the U.S. alone, and 1 in 5 Americans don’t even know they have it. An astonishing 96 mil...lion US adults (over one-third) have pre-diabetes, with the rate of Type 2 diagnoses among adults more than doubling in the last 20 years. To better understand this epidemic of metabolic dysfunction, I sat down with exercise physiologist, sports scientist, and Type 1 diabetic Drew Harrisberg. Diagnosed at 22, Drew shares his story, along with the diet and lifestyle changes he relies upon to thrive with his condition—changes he details and recommends not just for Type 1 diabetics but for anyone and everyone concerned about metabolic health and how to improve it. We go deep into the physiology of diabetes, the differences between Type 1, Type 2, and pre-diabetes, and what can be prevented or reversed versus managed through lifestyle, movement, mindset, and nutrition. We also discuss how diet and lifestyle impact blood glucose management generally, along with Drew’s take on the usefulness (or lack thereof) of continuous glucose monitors for non-diabetics. But perhaps what is most fascinating about this conversation is Drew’s experience searching for the optimal diet to manage his own condition, a journey that took him from Paleo, to Keto, to you guessed it, finally settling on a whole food plant-based approach to his nutrition—and all the why’s and how’s behind this decision. This episode isn’t just a must-listen for those that suffer from diabetes—because improved metabolic health is relevant to all. Enjoy! Show notes + MORE Watch on YouTube Newsletter Sign-Up Today’s Sponsors: Seed: Seed.com/RICHROLL On: On.com Indeed: Indeed.com/RICHROLL Birch: BirchLiving.com/RICHROLL Momentous: LiveMomentous.com/RICHROLL Plant Power Meal Planner: https://meals.richroll.com Peace + Plants, Rich
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You might even have diabetes unknowingly.
A lot of the people who are undiagnosed aren't visiting their doctor.
They're not tracking any data whatsoever.
So they're walking around with diabetes, not knowing it,
which is a silent killer, increasing your risk of cardiovascular disease
and all these other metabolic issues.
I'm educated. I'm an exercise physiologist. I'm a diabetes educator.
I'm living with diabetes.
How could I not share this information?
My guest today is Drew Harrisburg, an exercise physiologist, a sports scientist, and also a type 1 diabetic, which is a diagnosis that Drew
received when he was 22 years old that sent him on this journey to understand this particular
disease and how to thrive along with it as both an athlete as well as an educator
through his online platform, Drew's Daily Dose, and his many appearances on our mutual friend
Simon Hill's podcast, The Proof. In this conversation, we go deep on Drew's personal
story as well as the physiology of diabetes. We discuss the differences between type 1,
type 2, and pre-diabetes, and also the
differences between what can be prevented or reversed versus, on the other hand, managed
through lifestyle, movement, mindset, and of course, nutrition, which leads us into how diet
impacts blood glucose management, what is important to Understand About This and What Isn't.
We also talk about Drew's take on the usefulness of continuous glucose monitors,
as well as Drew's search for the optimal diet to manage his own condition
and improve the lives of those he coaches,
which is a journey that took him from paleo to keto to, wait for it, whole food, plant-based.
And it's coming right up after a quick word from the sponsors who make this show possible.
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super nice to finally meet you thank you for doing this uh we are sitting in our mutual
friend simon hill's uh studio um So shout out to Simon.
Thank you for opening up your space
to let us record today.
And you're somebody, Drew,
who came on my radar
because of our mutual friend, Simon.
I think you've been a guest on his show
something like 12 times
or something like that.
I stopped counting,
but it might be around.
Quite a few, right?
So clearly a trusted source on a show
that's literally called The Proof. So you've
been vetted and I've been looking forward to talking to you for a long time. I think your
personal story is really compelling. And in your own words, talk a little bit, like introduce
yourself and tell us a little bit about like who you are and what you do. Well, firstly,
thank you for having me on the show. I mean, it feels so weird doing it in my hometown.
I would not have expected us to be doing it in Bondi, but it's awesome that you're here.
And I'm excited to share my story with your audience.
I've shared my story with Simon's audience a number of times, but I haven't spoken about it for a long time.
Because you know what happens when you tell your story over and over.
It becomes like a story you tell rather than something that you really feel in the moment. So I'm excited to go through it with you today. So, I mean, I guess the best way to
introduce myself would be to go back to, I guess, life before diabetes, as I like to say.
When I was 21 or about 22, I was diagnosed with type 1 diabetes, which was something that I actually, I knew a
little bit about it because I'd studied to become an exercise physiologist. And we learned a lot
about diabetes and how to treat and manage it. But until I actually was diagnosed with type 1
diabetes, you really, you don't understand the depth of a condition or a disease until you're living it. So before being
diagnosed, I grew up in Bondi. I had the best upbringing you could have. I finished school and
I decided I want to pursue a career in music. So I was playing gigs around Bondi and all over Sydney
and I was actually making money playing music, which I never thought would happen.
And I was actually making money playing music, which I never thought would happen.
I was traveling the world.
I was carefree, cruising on autopilot.
Life was honestly just too good to be true.
And I was aware of it.
I didn't take it for granted at all.
But there was this sort of transition period, which lasted for about six to 12 months,
where I noticed that my health was, I just knew that something was wrong. It was hard to explain what, it was just this feeling, this innate feeling that there was something wrong.
And at that time, I'd already finished university. I graduated as an exercise physiologist or sports
scientist. And I was in the process of getting my accreditation to become an exercise physiologist.
And as part of the accreditation, you have to do a certain number of clinical hours at a hospital or physiotherapist.
So I remember this one day, I was doing my accreditation at this physiotherapist and
I caught a glimpse of myself in the mirror. This sounds so vain, but I saw myself in the mirror and
I had this moment where I was like, I'm really skinny. I never used to be this
skinny. What the hell is going on? I've lost all my muscle. And I sort of talked myself out of it,
but I was like, this is weird. I'm going to start eating more food and try to bulk up.
I was playing rugby as well at the time. And obviously it's a very physical sport.
You need to be strong and you need your body weight to be up. So I jumped on the scale at the physio and I was around 70 kilos whilst my pre-season weight or my normal healthy body weight was 83 kilos.
So I was like 10 to 12 kilos under where I should be.
Without any change in your diet?
No change in my diet.
Training hard, focused on maintaining a strong body so I could play this sport.
So I started to eat more food and really started just anything and everything was coming in.
And I then finished that placement at the physiotherapist and I had to start another one at a hospital just down south.
And I was working at a cardiac rehab ward. But to get into that position as the,
I guess the trainee student to get the accreditation, you sit through an interview
sort of like at a desk, just like we are now face to face with the head of the cardiac rehab
facility. And I'm sitting there across from this guy and all of a sudden I'm like dozing off. My
eyes are shutting. It feels like my eyelids are just heavy.
And I'm like, I cannot believe I'm falling asleep face to face right now with the guy
who's trying to get me this position so that I can follow my dreams of becoming an exercise
physiologist.
Like, what is going on here?
I've got my pen under the table, like jamming it into my leg, doing anything I could to
stay awake.
And I'm just, I'm gone. Like I can
feel that I'm going to fall asleep. Somehow I get the position. After that interview, the guy
probably felt so sorry for me. He's like, let's just give this kid a shot. Anyway, I get the role
and I start working as this trainee student at this cardiac rehab facility in the hospital.
A few weeks go by and every time I drive home, it's probably like a
40-minute drive or more, maybe a 60-minute drive in traffic, I'm falling asleep at the wheel.
And I'm thinking to myself, why am I so tired? How is this possible that my eyes can shut,
not only face-to-face in an interview, but while I'm driving my car? Surely I'd have this safety
mechanism in my brain that would just go, hey, you could die right now.
Stay awake.
Anyway, I fell asleep a few times driving home over the next few weeks.
And then there was this one day where I was driving through the cross city tunnel, this tunnel that brings me back to the eastern suburbs.
And I wake up inches from the side of the tunnel wall.
I've drifted across a lane and I've had this like micro sleep. I slam back into my lane, windows down, screaming, music up, doing anything that
I could do to stay awake. I finally make it through the tunnel. I pull over at Rushcutters
Bay, this little area outside of the tunnel and I fall asleep in my car intentionally. I put my
seat down, I shut my eyes and I wake up like two
and a half hours later or something. As soon as I wake up, I call my parents, they're doctors,
and I say, there's something seriously wrong. I need to go for a blood test immediately. I just
fell asleep driving. I fell asleep multiple times over the last few months, it's time to get checked out. So my mom sends me
for this long list of blood tests. She just stacks everything in. I mean, we were concerned.
What kind of doctors are your parents?
My mom's a general practitioner and my dad is an eye surgeon or ophthalmologist.
So my mom had been sending people blood tests for years and she knew what to look for.
But for me, she just said, look, let's just test everything. Let's just rule out sinister stuff. We didn't know what it could be at this
stage. No idea. So I go to get my bloods done. They take vial upon vial of blood. Like I am dry
by the end of it. And we get these results back, you know, just a few days later, because we slapped
an urgent sticker on it and it came back really quick. And most of my results looked
relatively normal, but there was this one marker, this one biomarker that came back out of range,
which was very strange for somebody of my sort of age and health status, so to speak, right?
And interestingly, this biomarker is not something that most GPs would test for,
but my mom just threw it in there as just another Hail Mary. Let's see what happens.
It's called your HbA1c. It's a three-monthly average blood glucose. So it's this marker
that tells you what your blood glucose control has been like over the last three months.
And this number came back, not just a little bit high, but in the diabetes territory,
not just a little bit high, but in the diabetes territory, right? I think it was 6.6% and you want it to be below 5.5%. So we were, that was the first red flag. We were like, why
has this number come back so high? We better look into this a little bit further.
Now, the irony is my dad, who's an ophthalmologist, was at the time working alongside RPA Hospital, the diabetes clinic there, one of
the best diabetes centers in the world. And he spoke to the professor there and said, listen,
my son just got this blood result back. His HbA1c is a little bit elevated. What should we do?
Should we be concerned about diabetes? So they said, listen, go get another blood test and test for autoimmune antibodies, which are these immune antibodies that essentially show up if your body is attacking itself.
And there were the two main ones for diabetes that we tested were GAD, G-A-D, and I-A-2, which were markers of this autoimmune attack.
And they're meant to be below 10.
Mine came back in the thousands.
So when you get this result back of these two positive tests for these two autoimmune antibodies,
but you don't have a family history of type 1 diabetes, your chances of getting type 1 diabetes
are 25%. So I get this result back, we see these numbers and we go in for a meeting with the
professor, the endocrinologist, the diabetes educator, and we sit down and they say to me,
look, there's a chance that you're going to get diabetes one day. It's one in four. It could be
in five days, five years, or maybe not at all. But what we're going to do is we're going to give
you this blood glucose meter, and you're going to take this with you for the next two weeks. And you're going to measure your
blood sugar before bed, when you wake up, before and after every meal, at random times throughout
the day, just collect some data. Let's see what's happening. And we'll keep an eye on this thing.
Come back in six weeks, we'll reassess, we'll make a plan. So, you know.
come back in six weeks, we'll reassess, we'll make a plan.
So, you know.
But that's not exactly comforting in light of your HbA1c results and the fact that you're falling asleep behind the wheel.
Like that, you know, you're in a sort of acute situation
in which you need to figure things out pretty quickly.
Right.
So at this stage, there was no treatment protocol.
There was no solution or plan forward.
It was just collect data, look for trends and patterns, and we'll figure it out soon.
Like you said, I still felt like shit.
I was still underweight.
I was exhausted.
I mean, the other signs, by the way, of type 1 diabetes or undiagnosed diabetes, they're
called the four Ts.
Thirst, excessive thirst.
So waking up in the night to drink, you're drinking all day long.
You can't stop drinking. Needing to urinate and go to the toilet multiple times throughout the
day and the night. And all of these things are happening to me, excessive hunger, weight loss,
and exhaustion. So I was experiencing all of these things and I go home with this blood glucose
meter and I start to test, prick my finger and I would do it at all the times that
they told me I should do it. And there was this one morning where I woke up and they said to me,
if you ever see a number above, I think it was 11, a random blood glucose above 11 or a fasting
blood glucose above seven, call us immediately, come back into the clinic. So I woke up one morning and I saw a 7.7.
And I was in complete denial.
I convinced myself that it was a mistake.
There's no chance.
So I did log it down in this book they gave me
and I carried on with my day.
I went to the gym.
I ate the meals that I would eat.
I was checking.
The rest of the day was normal.
I continued for weeks and weeks. And then eventually it was time to go back into the clinic. So I'm sitting down with a diabetes educator and I show her my numbers and I say,
look, this is the numbers that I've got. And I was, I kind of like prompted her. I was like,
I'm going to be fine. Right. You know, I've got mostly normal numbers here. She saw the seven.
She said, that is an interesting number there. Why don't we
give you a new meter that we've just got? The accuracy is a bit better. It's a bit smaller.
Keep tracking for another two weeks. So she goes out to the back room.
She brings in this new blood glucose meter. And I'm sitting next to my dad and I'm across from her
and she opens the box and she's like, let's test your blood glucose now
to show you how to use this meter.
It's a little bit different.
So she pricks my finger, squeezes out a little drop of blood,
takes the sample, and then she's holding the device,
and she's waiting for it to show up with a number,
and I just see her face just changes.
And she looks at me, and she says,
when was the last time you ate a meal? And I said,
I had a piece of toast just before I came here on the way over. She said, I'm afraid to tell you,
you've got type 1 diabetes. And that was the moment right there that I was diagnosed
face to face with this diabetes educator, with my dad next to me, who'd spent his career
treating and diagnosing eye conditions for people that had type 1 diabetes or type 2 diabetes
uncontrolled for years. And he was in complete denial. He said, there's no way. That's got to
be a mistake. Why don't you get a new meter? So she went out the back. She obliged.
She came back in with a new meter.
We went through the same process.
Pricked the finger.
Same result.
My blood sugar was 16 at the time, which is about maybe 350 or something in milligrams per deciliter.
So four times the normal range.
So I got diagnosed with type 1 diabetes in the most bizarre circumstances,
sitting in this clinic that my dad had pretty much worked at for decades with the team that
knew him and knew me. And it was just such a surreal experience. You know the phrase,
the world caved in. Yeah. It's just not something you expect as a young, vibrant, athletic guy at the beginning of his life and his career who's used to doing whatever he wants, that sort of youthful sense of being unstoppable, right?
And so you suddenly, this unstoppable energy that you have comes up against an immovable force. So your world changes overnight, but I think it would be good to talk a little bit about what diabetes is,
the differences between type 1 and type 2.
I think there's a lot of confusion out there, misconceptions certainly with respect to T1,
being incident lifestyle decisions, very different from type 2.
So diabetes is basically your body's dysregulation of your ability to metabolize glucose in a healthy way.
But it's so much more than that as well.
So what is the clinical kind of way to describe this condition?
Yeah. I mean, diabetes is an umbrella term for these multiple types that manifest in completely
different ways, but the symptoms are the same. So they all share a common symptom, which is high
blood glucose or hyperglycemia. But the way in which that hyperglycemia comes to fruition is through different pathways.
So in type 1 diabetes, it's an autoimmune condition.
So the immune system attacks and destroys the cells of the pancreas that produce insulin, the beta cells.
Once those beta cells are destroyed, you cannot produce insulin.
So you have to administer it exogenously.
So through a pen
or through a pump. So every day for the rest of your life, you have to give insulin through
either device with your meals. You have to give a basal dose before bed that sort of sits,
or some people take it in the morning. But essentially the basal dose is this background
insulin that's floating around for like 24 hours.
And then you've got a mealtime insulin, which is like a rapid acting.
You know, if I wanted to say eat a bowl of fruit like I've got on this table, I would have to look at this bowl of fruit, calculate how many grams of carbohydrates are in it, understand what my carbohydrate to insulin ratio is, do the math, wind up the pen and give that dose. Right.
wind up the pen and give that dose, right?
Right.
So what's interesting is that there are different types of insulin and different ways in which you can administer that.
You're not wearing a pump.
Like I know other people that have T1, they're wearing a pump.
Like you do this differently.
So I'm interested in why.
Right.
The pump is delivering insulin,
either drip feeding it on a basal dose,
so all day just dripping it out. Or if you want to eat a meal, the same thing.
You just plug it into the little computer, you hit the button, and it sends that insulin.
That sends a signal, and then the insulin is administered into your body.
So it's a different system to administer it, but the problem of going low is the same with both.
I see.
So it can still happen to anyone.
It does.
It's
extremely common. And that's the one thing you want to try avoid is these terrible lows because
acutely that is the biggest danger of type 1 diabetes. The chronic high blood glucose is more
of a long-term danger. That's something that causes the retinopathy, the blindness, kidney
disease, nerve disease. But it takes time, takes years to develop
that. But in an instant, if you go too low, you can completely lose consciousness and end up in a
coma. So going back to the definitions though, so type 1 diabetes, your body stops producing
insulin because the beta cells aren't working. Now, most people get diagnosed in a way that was
very different to my experience. Most people are rushed to hospital in ambulance, conscious or unconscious, and likely in a coma with ketoacidosis.
So the blood glucose gets so high for so many months unknowingly, and kids will feel this immense thirst, and then they'll start drinking soft drinks to try to quench their thirst, which sends their blood glucose.
So they go to hospital with ketoacidosis, whilst my experience was very different. And when I think about it,
I may have been dealing with this pathogenesis unfolding for six to 12 months, but I think my
lifestyle was holding me from getting diagnosed sooner. So type two, on the other hand, is not a problem
with insulin production initially. It can be later, but initially it's an issue with
insulin resistance. So the action of insulin doesn't work properly. So the role of insulin is
to attach to the cells of your body. It's like a key that unlocks this gateway. So glucose from
the bloodstream can enter the cells of your body because that's where key that unlocks this gateway so glucose from the bloodstream can enter
the cells of your body because that's where we need that energy to go so when you have type 2
diabetes you develop insulin resistance so the insulin isn't working properly but your pancreas
is still producing insulin but eventually over time they can also experience pancreatic beta
cell destruction or burnout where they stop producing enough insulin so you can be
you can become an insulin dependent type 2 diabetic and in pretty much all cases of type
one you're insulin dependent right so being insulin dependent as a type 2 diabetic is the
result of uh long-term you know chronic uh living with that condition
that leads to that result.
But it just feels like they should have separate names.
So that people are not confused about this.
And then when I, like often now,
because type two diabetes is on the rise
and I don't have the statistics with me right now but
it's quite staggering that's huge i've got some numbers to which yeah people are are falling prey
uh you know to this disorder and the number of people that are becoming pre-diabetic it's really
a metabolic disease which distinguishes it from a pancreatic disorder that is type 1. Right, exactly.
The numbers are staggering.
I think globally, and these numbers are from 2021,
the International Diabetes Federation,
one of those organizations put out some numbers.
I think it's 537 million people globally have diabetes.
50% are undiagnosed.
50%.
So you've got this silent, insidious condition that's present amongst 50% of undiagnosed. 50%. So you've got this silent insidious condition
that's present amongst 50% of those numbers.
They don't even know it,
which is where I think the CGM could play a role.
We'll get into that.
We'll get into that.
There's a lot of controversy around that.
A lot, a lot.
I'm looking for some clarity
and I know you've thought a lot about that,
but let's put a pin in that for the moment
and just return to kind of the timeline here,
which is you get diagnosed as a young person.
I'm interested in what you were told the prognosis is.
Now we see all kinds of people being athletic
and running marathons.
And there's a whole type one, you know,
professional cycling team where everybody, you know,
it's like there's a permissiveness or a sort of understanding
that you can live an active lifestyle with this condition.
Was that communicated to you at the time?
Or did you think suddenly your life is over as you know it?
Right.
Yeah, I'd say the latter.
It felt like a life sentence initially.
I'm sitting in that room and the world caves in. It's just, I can't explain the feeling of life's over. I'm done. Like I have no, the future was just so grim.
of the world changed. The saturation was pulled out of the environment. It was gray.
So they told me that you can still live a great life, but your life expectancy is going to go down. You probably won't live as long. Your risk of cardiovascular disease is significantly
increased. The long-term complications are very frightening. And showed me this like caricature of a person who is poorly
managed for multiple decades and they are blind they've got their their own kidney dialysis and
they're missing a limb i mean like like that's what i needed to see in that moment i mean what
a ridiculous thing to to attach your future to they said that you can exercise, but it's very dangerous and you need to learn how to do it safely.
And then they said, one of the most dangerous things about type 1 diabetes is the administering the insulin and getting the dose wrong.
If you overdose, it can be a life sentence for real.
You can die, seizure, coma, the list goes on.
So they actually sent me home without insulin.
They said, said look keep monitoring
for a few days let's see these trends and patterns and then we'll figure out a therapy
an insulin therapy to match your lifestyle because everyone's a bit different so they sent me home
and i mean that night was that was dark i mean i cried myself to sleep my family were an absolute
mess especially being doctors and having an insight into this condition. They just, they knew what the potential complications were. And we all just were
hoping that I wouldn't be another statistic, you know? So I had a rough night, wake up the next
day and I'm like, okay, I'm going to do what the doctors told me. I'm going to track the next
movements of my day and get some data of blood glucose and log of my book. And, you know,
I was begging for insulin therapy because I knew that it would make me feel better, that my blood
glucose would come back into the normal range, that I would probably start to gain my weight
back. And I just want, I was like, please give me insulin. Like, I really want this. They're like,
just be patient. We'll get it to you. So the next day after being diagnosed this was the crossroads in my life this
was the game changer so i remember eating breakfast i ate you know a meal that i would eat back then
it was probably like oats and yogurt and banana or something and i checked my blood glucose and it
spiked up to 25 which is 450 milligrams per deciliter, huge, five times normal range.
And I remember seeing that number and just feeling so deflated.
Like I felt terrible in my own skin already,
but then just seeing that number was just another reason
to sort of hate this position I was in.
Anyway, I went to the gym, which is what I would usually do,
and I put my glucose meter away, smashed out of workout, and for those 60 minutes, I was just in my happy space.
I felt amazing.
I still managed to do a good workout, full body workout, got a good sweat on for 60 minutes or so.
I got out of the gym, and I checked my blood glucose again, expecting to see the same number.
gym and I checked my blood glucose again, expecting to see the same number because at that stage that I didn't know that anything in your life, in the day-to-day activities of your life could
influence your blood glucose, right? So I checked my blood sugar and I see that the number's back
into the normal range. So it dropped from 25 down to about five and I was blown away. I could not
believe it.
That was the first time that I felt this,
like a little bit of hope.
All of a sudden the color was coming back
into the world around me.
And I felt like,
hey, actually this is pretty powerful stuff.
I can manage my condition potentially just by exercising.
This is incredible.
Right, like a little spark of agency that you could exert.
What's interesting is without insulin,
without insulin being the molecule that opens the gate
that allows glucose access to the cells,
how does exercise provide that role
in the absence of insulin?
Well, this is what is so fascinating
about the human body is there is another mechanism
by which glucose can enter the cells of the body.
I will say the caveat here is that because I was in my, they call it the honeymoon phase,
which is such a ridiculous term for this phase.
But when you're newly diagnosed, you may still have like three or 4%
pancreatic function at that point.
So I may have been producing just a little bit of insulin, right?
So small amounts,
but just enough. But the other mechanism is really where the magic is. So, I mean, it's such a great
question. Like how did my blood glucose go from 25 down to five? Like how did that even happen?
So as we said before, insulin acts like this key that opens the gateway to the cell.
But it turns out there's another mechanism,
which is called non-insulin mediated glucose uptake. It's got a few names,
contraction mediated glucose uptake, exercise induced glucose uptake. But essentially,
the act of contracting your muscles sends this message inside of the cell to send,
it's called a glucose transporter that sort of resides inside of the cell to send, it's called glute for a trans, a transporter, a glucose
transporter that sort of resides inside of the cell. When you contract your muscles, it sends
this cascade down into that cell and this little transporter translocates to the cell wall and acts
as this gateway. So if anyone has prediabetes, insulin resistance, or, you know, type one,
or has high blood glucose, or I mean, in everybody, in healthy people too, it's the same mechanism.
So you contract your muscles and you get these glucose gateways opening up, which allows this free access for glucose to enter the cells, completely independent of insulin.
So there's no insulin cost at all in that case.
of insulin so you don't have there's no insulin cost at all in that case it makes sense uh from a survival and evolutionary perspective to have this kind of backup generator right like hey these
muscles are contracting they need glucose like i don't know what's going on with the insulin over
here but like we're gonna have to you know get the supply going yeah exactly so you know in a
fight or flight situation or anything like that where the muscles can't be dependent on wherever the insulin happens to be or not be in order to function.
Exactly. And, you know, the unique thing about this mechanism is that it's site-specific. So,
depending on which muscle you contract is where that glute four or glucose transporter will do
its work. So, if you only go to the gym and do calf raises and bicep curls,
compared to the person who does a full body workout or training all the major muscle groups,
the glute floor translocation will be very different between the two.
So if you have diabetes and you want to get your blood glucose under control,
a full body workout is going to be a way better way to open those gateways than just isolation
work, doing a bro workout. So
that workout that I did was just so powerful for me because it gave me this sense of responsibility
or agency, as you said, but also a tool. This is my first tool that I figured out was like,
I can do this. I can control my diabetes as long as I exercise every day, which became a-
Right, that might be overstating the case.
Very much so, which I didn't realize at the time,
but I made some big errors.
All I need to do is to do this, right?
I made some big errors after.
At some point, obviously,
you get on the insulin program and all of that,
and you learn how to administer it responsibly and safely.
I'm sure there was a whole learning curve.
Walk me through kind of the evolution
of developing greater and greater agency
through lifestyle choices.
Yes, with exercise, but even beyond that,
that have kind of informed how you live with this day to day and sustain a healthy, active lifestyle.
So life became a big experiment, you know, and I was already trained and accredited as an exercise
physiologist. So I had this understanding of the science and I knew about how the body worked,
but I'd never walked the walk as someone, you know, living with diabetes. So I began to just test everything.
And at this stage as well, I was still using the glucose meter.
I didn't have a CGM.
I've only had this for a couple of years
and I've been living with diabetes for like 12 years now.
So I was doing 15 to 20 finger pricks per day,
but I became obsessed with collecting the data.
So I was just pricking my finger all the time.
I didn't want an hour to go by without knowing what my blood glucose was, right?
And they'd offered me this technology, but I just, I wasn't ready to wear my condition on my body.
You know, I was in hiding.
For the first, I want to say even a year, I did not want anyone to know that I had diabetes.
I would go to the bathroom to give my insulin if I was out at a restaurant.
I would never prick my finger in public.
I'd go to the bathroom to do that too or go to my car.
I didn't want anyone to know what I was dealing with.
I hadn't identified with my new being and my new condition
that I was going to be carrying with me for the rest of my life.
I don't want to say I felt ashamed, but I definitely felt icky about it, you know,
and I know it was not my fault at all for getting it, but I wasn't ready to wear it confidently and
proudly. So the first year was hard, a lot of hiding it, but a lot of self-experimentation.
And I would check, you know, my blood glucose before and after certain workouts. And I would
notice that depending on the type of workout, the blood glucose response was completely different.
And that was the mistake I made early.
I mean, it was a blessing and a curse.
But that pivotal moment where I did that great workout and brought me back into range, in a way, set me up for some failures.
Because I saw exercise as a hammer, know, as a hammer basically. And
everything, everything was a nail. Every time the blood glucose was up, got to hammer it, right?
But what I didn't realize was certain cases required a different tool and the hammer was
not going to do it. Like I was trying to tighten screws with them. Like it just, you need to find
other tools. So, I mean, a couple of learnings that were that depending on the intensity of the exercise, your blood glucose can actually go up. So, for the first week or two
after doing that great workout, I would wake up in the morning and go for a fasted sprint session
at Bondi on the soft sand. And I'd finish the session and my sugar would be up to like 20,
which is the same blood glucose that it was
when I ate that carbohydrate-rich meal.
And I was just so confused.
I was like, hold on a second.
I just used exercise in that case and it worked perfectly,
but today it's made my sugar go up.
And then I realized that caffeine from drinking coffee
can stimulate adrenaline, which also you get this glucose output. So the high intensity sprint
training, the caffeine in a fasted state early in the morning, I was layering these two things on
top of each other and causing my blood glucose to go even higher as the body has this ability to put
endogenous glucose or glucose that's stored in the body into the bloodstream through the liver.
endogenous glucose or glucose that's stored in the body into the bloodstream through the liver.
So I was turning this liver tap on unknowingly in the mornings and I would wake up with a blood glucose that was normal. And after my workout, I'd be in the twenties again. So, I mean, just so
many little failures and learnings along the way, of course, nutrition. I mean, that was the next
thing that I had to try to tackle. And the way I sort of fell into the nutrition side of things was I just did a simple Google search.
Just being diagnosed with type 1 diabetes, what diet should I eat or something?
Or like how to treat or cure type 1 diabetes with diet, which obviously you can't treat or cure it.
But the first thing I landed on was a paleo way of eating,
I landed, the first thing I landed on was a paleo way of eating, which, you know, when you compare it to a standard Australian diet or standard American diet, it's a step in the right direction.
Certainly. And your diet leading up to that point was typical.
Right. I mean, of course, health conscious, but by no means, you know, whole food focused. Like I would kind of eat a bit of everything so i fell into this
paleo way of eating and instantly some great results you know my carbohydrates per day were
roughly say 150 grams per day so not too too low but you know just right in that sort of sweet spot
um i focus on whole foods i eliminated whole grains and legumes and dairy but i was eating
fruit and vegetables and lots of meat and eggs and chicken.
Right, lean meats, fruit, veg.
Right.
No grains and no legumes.
Right.
And no processed foods, obviously, and no dairy.
Exactly.
Yeah.
So in comparison to just a typical person's way of just mindlessly eating whatever,
obviously, you're going to have amazing improvements from that.
Right.
Yeah.
And what I noticed was in the first maybe,
I mean, the timeline's a little bit blurry now,
but within say four weeks or so,
my insulin requirements had come down quite a lot.
So in the beginning, you know, I was given this,
I was told by the educator to give a basal dose of insulin, which is every day you're going to give this sort of large dose that's going to sit in your bloodstream for 24 hours.
That dose came down by about 50% to 60% after a month or so on this paleo diet.
So the basal had come down and then my other insulin, the short-acting one with meals, had also come down. So per unit of
insulin, I could now metabolize more glucose, which was really interesting. So again, another
great tool. So I discovered exercise as this wonderful tool. Now I've got nutrition. And at
this point, I felt very comfortable with where I was. I was super happy with my diabetes management.
My HbA1c was great,
close to normal. Not quite there yet, but very close. You were able to put weight back on and go out and live your active life in a pretty normal way? Yes. The weight came on rapidly and
to the point where it came on a little bit too quick. I got very fluffy, very fast, which makes
sense because I was essentially starving for those months because although I was eating a lot of food, it wasn't getting into the cells
of my body. It was sitting in my bloodstream and I was either excreting it through the kidneys,
urinating the glucose out, or it just wasn't getting, it was just building up in the bloodstream.
So, you know, once you start taking insulin, which is a very anabolic hormone,
you're going to gain weight extremely quickly. And I got fluffy and I was doing a lot of modeling in my early twenties. And all of a sudden this,
I mean, this was a hard thing to deal with because I was getting no work now because my body had
completely changed. The modeling industry loved the skinny, you know, fashion-y, editorial-looking
body. And now I was really out of shape. And in fact, there's a huge overlap
with type 1 diabetes and eating disorders,
especially in women.
The stats are crazy.
Like 30 to 40% of women with type 1 diabetes
develop an eating disorder.
And I'm not surprised why.
Well, the disease, the condition itself
makes you like sort of hypervigilant
about what you're eating.
And then you're taking this on anabolic
and it's creating weight gain.
So it's not surprising.
It's not surprising.
It's gonna have that impact.
A lot of women intentionally don't take their insulin
so that they can lose the weight.
And then you can imagine what happens there
to their blood glucose.
It's a slippery slope.
And I've known many girls who have gone through this.
It's really, it's horrible.
And guys, and guys.
I certainly, there was a period where I also developed some disordered eating.
Right, well, you're getting fluffy, to use your word.
And you're like, well, I know how to fix that.
All I have to do is cut back on this other thing.
It's a lot easier than trying to regulate your dietary choices.
And to add to it, if my blood glucose was in range, I would just skip meals. I would go,
you know what? I'm in range. I don't want to go high. I'm so scared of these long-term
complications of going high. I'm just not going to eat for like 10 hours and just stay in range
longer. Then by the end of the day, I'm in a huge calorie deficit. I'm not nourishing my body with anywhere near the number of nutrients
and macronutrients that I need. And then I'm going the other way. So that I dealt with that for a
long time. And you know what? I did some damage for sure to my health in many ways. And again,
just these little failures, I kept tripping over and figuring things out and dusting myself off. And I
found my way back to a path that was really good for my health. But the first year or two was
extremely difficult. So you cottoned on to this paleo diet and lifestyle, and that seems to be
working. Why not stick with that for the long haul? What happened? Well, I sort of immersed myself in
the diabetes community online and I became somewhat of an advocate for healthy living
with type 1 diabetes. And I was talking to people on Facebook groups and Instagram and all these
things. And people would ask me all the time for my opinion on certain ways of eating for diabetes.
And one of the questions I kept getting asked was, what about keto?
What do you think of the keto diet for type 1 diabetes?
And being someone who loves the self-experimentation,
I found it hard to give an answer having not tried it myself.
So I thought, you know what?
I'm not going to give my opinion on the keto diet until I've tried it.
So I sort of dived into that.
I started a keto diet and I was documenting it in real time on social media. I was posting about it on Instagram and I was waving the flag. I was an
advocate. I was raving about it because the first two months, again, my insulin requirements came
down even further. My insulin to carb ratio, even though it was a very low, low carb diet,
but I was taking hardly any insulin and i was
keeping this beautiful just flat line in range everything looked amazing and what exactly were
you eating like what was the breakdown what did that look like so i mean 75 of the calories were
from fat um i definitely did a paleo-y kind of keto diet in terms of I kept a lot of whole foods,
a lot of leafy greens, non-starchy vegetables,
broccoli, cauliflower.
I try to keep it vegetable heavy.
I wanted to keep fiber in there.
Right, but like completely non-glycemic vegetables.
Right.
Right, and when you say 70, I mean 75% fat.
So what is that?
Like you're putting coconut oil in your coffee and-
I didn't go to that extent.
Saturated fat.
How did you consume 75% of your calories in fat?
So a lot of olive oil on salads with half an avocado,
a piece of salmon, nuts and seeds on top, and an egg.
And then a big base of leafy greens, broccoli, cauliflower, those kinds of things.
A big salad bowls with lots of fat sources and some protein.
I was consuming a lot of coconut oil, fatty meats, chicken, beef.
I was eating a fair amount of saturated fat,
but I would say I was doing a healthier keto diet
than what you do see other people.
Right, that sounds, that doesn't sound so bad.
I mean that in comparison to videos you'll see online
of people just literally taking a bite
out of a stick of butter.
There's some wild stuff out there, right? literally taking a bite out of a stick of butter. I wasn't that guy.
There's some wild stuff out there, right?
But that's still a lot of fat, a lot of saturated fat,
but had this amazing impact on your ability
to really flatten that curve
and manage your diabetic condition.
And this is something that a lot of people with type two
or any kind of metabolic disorder or just in general, people are experiencing success with in terms of how they feel.
Right. And it makes sense as to why it works.
You've got this condition where glucose is something that's hard to metabolize and you're eliminating glucose from entering your bloodstream.
So you're going to stay in range for longer, which also means your requirement for insulin is lower right so it just makes sense and for about
two months it was great and i was telling everyone about it and i was recommending it
until i hit a brick wall where i noticed that every morning my fasting blood glucose was a
little bit higher and it would happen day after day week after week for a couple months and i And I was very persistent. I was like, I'm going to ride this storm. I'm
going to see what happens. How long were you into it when that began?
So two months into the diet, I started to see my fasting blood glucose
elevate. And then I stayed with it for about two months. So what was happening was my liver
overnight was pushing glucose into my bloodstream. So what was happening was my liver overnight was pushing
glucose into my bloodstream. So remember I mentioned that glucose tap. That tap was on
all night. And when the glucose was in my bloodstream, there was no way out. It wasn't
getting into the cells of my muscles or anywhere else that it could bring my blood glucose back
into the normal range. So I would increase that basal insulin, which is that background insulin.
I would just give a little bit more each night until I'd find the dose that would stabilize me.
But I just couldn't get it under control.
So my basal was going up, my insulin, but my blood glucose wasn't coming down.
So I was at this position where I felt like I was getting resistant to the insulin.
It wasn't even working anymore, which is pretty frightening because that is the one tool that I need to keep me alive. I'll literally die without it. So during the day
as well, my short acting insulin doses were going up and it just wasn't working. And there was this
one day where I was actually on a photo shoot and the photographer was like, are you okay?
Like you just don't look vibrant. And it's because I was dealing with a high blood glucose that I
couldn't get under control. So before the shoot, i gave a large dose of insulin checked my blood glucose two hours
later hadn't moved so i gave another big dose of insulin checked again it was not moving so
i got to this place where i was like i think i'm actually resistant to the exogenous insulin that
i'm administering which is a pretty scary reality, right? And then that was where I
kind of knew I had to shift gears. It was time to look into this, like what is going on? And this is
where Simon Hill enters the conversation. Right. And what's interesting is that you are doing
everything that you think is right. The conventional wisdom out there
for people that are contending with this condition
is that carbs are the enemy.
And the best, most effective way
to manage a diabetic condition
is to eat a low to no carb diet
to focus on fats and proteins.
And this will allow you to kind of manage your blood glucose
levels, which is effective until it's not, right? And I think what's pernicious and kind of beneath
the surface here that we're going to get to is this idea that that's the curative path. But in
reality, it's quite pernicious because all it's doing is masking your body's inability to metabolize
glucose because you're not exposing your body to glucose. So you're not actually dealing with
the problem. You're removing kind of the external symptomology because the minute that you do expose
your body to glucose, you quickly realize like it's completely incapable
of doing it.
So basically you're in this persistent state
or you're kind of pursuing this path blind to,
kind of the reality of what's going on.
And this journey that you've been on,
we've talked about this on my show before with other people
like Robbie and Cyrus, et cetera.
There's a whole other way of looking at this
that you're soon to discover by dint of our friend Simon.
Right.
Yeah, that's exactly right.
When you can achieve normal blood glucose levels
and normal insulin requirements
in the absence of carbohydrates in your diet, you're essentially
just, it's a band-aid solution to a degree. It can still be a solution for some people,
because if you can maintain that long enough and you don't run into the same hurdle that I did,
which it happens to a lot of people, I've gotten dozens of messages over the years, but
some people can keep that up for a long time. But that is just, like you say, you're just
masking these symptoms, right? Because as soon as you reintroduce the carbohydrate or that trigger,
you're going to see the real identity of what's going on. So whilst on the other hand, if you
could achieve blood glucose control, that's normal with good insulin sensitivity and normal insulin requirements in the presence of carbohydrates.
That is the true insulin sensitivity.
That is true diabetes management.
Resilience and robustness, right.
Exactly, exactly.
So, you know, I was posting online
about the keto diet and type 1 diabetes
and how to manage it and all this stuff.
And, you know, Simon,
he flicked me Instagram stories of a doctor who had been at
a conference and delivered a talk with these lecture slides. Was it Michelle McMacken?
Yes, it was. It was, yeah.
Yes. So she had been talking about a plant-based, high carbohydrate approach to managing diabetes.
And I'd never heard of whole food plant-based at that point.
I didn't actually understand
there was a whole movement there.
To me, it was just paleo, keto or just-
That's interesting in and of itself.
How would you not have even known?
Didn't even know.
Yeah, because there's like a whole world there.
I guess that's a larger conversation
about how our information silos can work at cross purposes
with exposing us to different ideas. I guess if you're in the paleo or keto kind of wormhole,
you're not hearing a lot about other options or alternatives.
I literally had never heard of it. He sent me a message with these lecture slides and he wrote,
have you considered,
and he wrote WFPB.
And I was like, what is that?
I had to Google the acronym to even see what it meant.
Did you know Simon?
I knew him from around Bondi.
We had mutual friends.
You see him down at the beach or whatever.
I was just picturing you guys, like, you know.
We'd cross down, like working out, you know.
Oh, that guy looks fit.
Yeah, like we, obviously we knew of each other and I knew him as the nutrition guy.
And I knew, I didn't know really what his message was.
Somebody, I thought he was a chef, to be honest.
Because a friend of mine was working with him and taking some photos.
And I saw photos of him with food and I thought he was a chef.
Anyway, he introduces me to these lecture slides and I had a look at them and I read through it and I was like, wow, so there's another way.
And this way has all the carbohydrates in the diet and they're claiming that the control is as good if not better than these other approaches.
I guess being the self-experimenter that I love to be, I'm going to have to give this a crack.
self-experimenter that I love to be, I'm going to have to give this a crack.
That contravenes everything that we kind of hear around how to manage this condition.
Carbs are the enemy. The solution can't reside in eating a bunch of carbs to manage this.
That doesn't make any sense at all. It does feel like mixed messaging, doesn't it?
Right. And people get really agitated and activated when you propose that as an idea.
Right.
I mean, look, carbohydrates, depending on the context in which you have them,
can be a trigger of high blood glucose excursions.
That is a fact.
That is true.
But what they're not telling you is that the degree of insulin sensitivity that you have will dictate whether or not you can
tolerate carbohydrates, right? So you need to be insulin sensitive. You need your insulin to work
properly. And the way to achieve good insulin sensitivity is, number one, you've got to be a
healthy body weight. Body composition matters. You need a fair amount of muscle on your body
because that's the glucose sink. Those are the glucose sponges that soak up the glucose.
The types of fat that you eat will impact your insulin sensitivity. So if you have a very high saturated fat diet
and you're eating carbohydrates, which is the standard Western diet essentially,
that is a recipe for disaster. Sure. So if you add carbohydrates into that system,
in that context, you will see these glucose spikes and you'll blame the carbohydrate immediately
because you'll just say, I ate the banana or I ate the whatever it is, the candy and my blood glucose went up.
But what you're failing to see in that context is if you swap those fats and replace them with
unsaturated fats, lots of fiber, whole foods, that you can now tolerate those carbohydrates
a lot better than in the context of high saturated fat intake.
So it's really, really important to understand
the different macronutrients
and how they mix together and how they play.
So you have a receptivity to trying this,
to experimenting.
And I think it's worth noting
that that is not unrelated
to the grace with which Simon approached you.
He didn't ping you and like shame you
or say you're getting it wrong or browbeat you.
He just said, hey, maybe check this out.
Like, I think that there's something about that
that is worth noting because the way that we communicate
in our various dietary circles
with the silos and the judgments
and the owning of the other side
and all that kind of stuff
is not really productive at all.
And I think Simon's just kind of very gentle,
like, hey man, check this out.
You're a scientist, here's the paper.
I'm not telling you what to do.
Like, hey, maybe read this. Yeah, that's exactly it. So the way he did it was gentle. He sort of just
gave me this nice little gentle nudge in the direction of now you take responsibility,
you do the reading and see where you end up. Yeah. And I'm not attached to whether you change
or do anything differently, even if you read this paper. And he didn't oversell it either.
He didn't say, trust me, if you follow this diet, he didn't oversell it either he didn't say
trust me if you follow this diet you'll have the best insulin sensitivity and you can manage your
diabetes way better than this he just let me do the work and i'm glad i did the work because
where i've ended up is a great place but you know essentially i decide just decided
that day that i was going to dive into becoming fully plant-based.
And I was going to let go of the keto, which was the other end of the spectrum.
It was quite a contrast.
You decided that, but after experimenting though, you must have said, well, let me check it out and see if this is even effective.
After reading a little bit about it, I mean, how else can you go plant-based without going fully?
Because I was already pretty much there
cause I was eating a paleo diet that was, you know,
80% plants.
Like I was eating a lot of plants already.
But you didn't have a, like a bowl of fruit like that.
Oh no, no, no, no, no, no, no, no.
That would not be even in the house, no chance.
And just remember being paleo,
you're not eating whole grains or legumes.
So, you know, carbs were, I was, I wouldn't say I was fearful of them, but I was certainly not embracing them. And I had victimized them in certain ways myself because I'd seen sometimes I'd have these spikes and it's very easy to blame the carbohydrate.
The decision to go plant-based, I was like, I'm just going to do it 100%. I could have edged their show.
I could have just slowly taken out the salmon off that plate and then swapped it with whatever, beans, and then kept the eggs in and kept a bit of it.
But I just wanted to go full in to see the impact on my blood glucose management.
Because I just remember at that time, I was again in a place of turmoil where my blood glucose control wasn't great.
At the end of that keto diet, my blood glucose control was not good.
I wanted to fix it as quickly as possible.
And the exposure from high saturated fat keto diet to a low saturated fat, more unsaturated fats, high carb diet, I'm going to see straight away the difference.
Yeah, your numbers are going to see straight away the difference. Yeah. Your numbers are going to
reflect the reality pretty quickly. Right. And I was petrified of eating
carbohydrates at first. I thought I was going to spike immediately. I hadn't eaten whole grains
or legumes in like seven years, seven years with no whole grains. Because that's how long I was on
the paleo diet for about seven years. And fruit. I mean, I started to add in a lot of fruit.
And I accepted a couple of things.
There were these two realities that I accepted.
And I surrendered to.
Number one, I'm going to lose all my muscle because I'm not going to be eating any protein.
And number two, my blood glucose is going to be very high for a number of weeks probably.
That's what I thought was going to happen. And for a number of weeks probably that's that's what i
thought was going to happen and what did happen blew my mind so within a few weeks my insulin
requirements and my insulin sensitivity was the best it had been in a long time so i all of a
sudden my my muscles were able to soak up the glucose again that was in my bloodstream my
insulin requirements went down and down and down. The insulin to carbohydrate ratio, which is an indication of your sensitivity to insulin,
improved beyond actually the best that it had ever been. So it was pretty good on a paleo diet,
but when I removed the saturated fat and got it down to roughly 10% of total calories,
up the unsaturated fats, I could tolerate a fair amount of glucose.
So that ratio was improving along.
I can almost hear the outrage of the person who's listening to this
who is experiencing positive results on a keto diet.
So explain how you account for that. Why is this happening? Because it contravenes everything that I thought was true and false
when it comes to diabetes. And when I say that, we're talking about type 2 here as well. The experience that you're having would not be dissimilar for somebody suffering from type 2.
Is that correct?
Correct.
Yeah, very similar.
The truth is you can have good diabetes management on a keto diet.
That is the truth.
You can also do a keto diet that is healthier
than the one that you see, like you say,
on social media of a guy eating a stick of butter,
pouring coconut oil and butter into his coffee
and eating bacon and eggs all day.
And, you know, a carnivore style keto diet.
You can eat a high fiber, whole food based ketogenic diet
and you can achieve good
diabetes management for a long time. But some people don't as well, right? So different
individuals are going to react differently to certain diets. And even in the case of those
people that can keep that keto diet up for a long time, when they decide to reintroduce carbohydrates,
even if it's just on a cheeky weekend or every now and then, the ability to tolerate glucose goes down.
And it happens in healthy people.
It happens in people with type 2, type 1.
That is just how the human body works is your tolerance for glucose goes down when you are fully eliminated from the diet and you increase your saturated fat.
So it's just nice for people to know that there is another solution.
And you increase your saturated fat.
So it's just nice for people to know that there is another solution.
You don't have to.
Like some people stick to this keto diet for years or decades, but they feel like a slave to their diet.
And they feel like they have to follow that way of eating because it is treating their
condition without even knowing about this other solution.
So I don't want to tell anyone what to eat, but I just want to say there is another way
that you can do this.
And if you do remove saturated fat or at least limit it to about 10% of total calories, you can regain that insulin
sensitivity, your carbohydrate tolerance will go up and you can eat the fruit, you can eat the
banana, you can eat the grains, and you're not always going to see this spike in your blood
glucose. But you also seem to be achieving the goal which is to uh you know be
in a situation where your body can tolerate the carbohydrates that you have that um you know
robustness that is lacking on a keto diet because you're just avoiding that exposure yeah i think a
lot of people with type 2 diabetes in particular they go on a low-carb diet, remove carbohydrates from the system,
and they say that they have achieved remission or even reversal. They think they've reversed it
because they come off the medication, their blood glucose goes back to normal. They wake up in the
morning, their fasting glucose is normal. Their postprandial or post-meal glucose is normal.
The A1C goes down.
They may come off insulin if they were dependent on it for a while because they might still have some pancreatic beta cells that are working.
And then they think, I've done it.
And then all of a sudden, they add back the carbohydrates
and it shows up again.
So you've got to understand that, again,
the absence of carbs from the diet are going to show you a blood glucose and insulin picture that may not represent the true robustness of the system, like you mentioned.
Whilst in the presence of glucose, if you can handle glucose, you can handle carbohydrates and achieve the same numbers as the people who are completely eliminating the carbohydrates, to me, that is the true step. Yeah, yeah. Then you're in not just
remission, you're in a journey of reversal. I mean, is that overstating the case? It's not.
It can absolutely happen. If you have type 2 diabetes, you can't reverse type 1. I'll just
say that now. Once you've got type 1, at this stage, there's no cure. You cannot reverse it.
But if you have type 2 diabetes and you can tolerate carbohydrates,
you have completely normal blood glucose, your pancreas is still working, you've got the beta
cells, that would be reversal. So you can reverse type 2 in certain cases. If your beta cell function
is burnt out and you don't produce insulin, that's a different story. Now you can't really
reverse it. That's where staying on a low carb diet longterm
can work for people because they don't produce insulin.
So keeping glucose out of the system,
you can keep them in range for longer.
Right, so you adopt this plant-based,
whole food plant-based approach.
Like how quickly before you started to,
you know, perceive these results
and realize that you were onto something pretty
powerful? Maybe two weeks in, my numbers were back to normal. I mean, two, that sounds like,
even when I think about it now, that's very fast. I couldn't believe how quickly it happened.
And then it just slowly sort of, you know, plateaued in terms of the gains. It wasn't
just linear and, you know, it sort of plateaued a little bit and I was able to maintain it. I'm five years in now and I'm maintaining the
same insulin sensitivity. I'm eating, you know, hundreds of grams of carbohydrates.
I didn't wither away and lose all my muscle, you know, I was very happy with my gym performance
and my sporting performance and how I feel and just the whole list. I was very, very nervous about a few things there
and thankfully I was wrong.
Right, your ability to build lean muscle mass
and be the fit kind of exercising fiend that you are.
Right, to maintain my strength and still,
you have this vision of you're gonna be frail
and your bones are gonna turn to dust
and you're not gonna be, it's just not the case.
It's so wild.
I mean, I had Robbie Bavaro and Cyrus,
the Mastering Diabetes guys on the podcast.
Robbie is basically a fruitarian.
Like he just eats fruit all day long
and he's managing his type one diabetes
and he was very transparent about all his numbers
and that just blows people's minds.
Like the comments on the YouTube of that are like bananas.
Like people just can't believe it.
They think he's lying, because it's like what fruit
is the thing you're supposed to avoid?
You're supposed to avoid all these sugars. And here he is like doing the exact opposite. Like,
how can this possibly be true? And the guy has like more energy than anybody I've ever met.
It's incredible. He literally eats upwards of a thousand grams of carbohydrate in a day.
Some of his meals have like 300 grams of carbs just in a bowl of fruit. And again, if people are wondering how is this even possible because so-and-so told me that fruit is terrible for diabetes and spikes your blood glucose, he's so sensitive to insulin.
The insulin is working so well because his saturated fat intake is extremely low and he's a healthy body weight.
That's a huge part of it and that's something we haven't really spoken about.
he's a healthy body weight. That's a huge part of it. And that's something we haven't really spoken about. But people with type 2 diabetes, if you're trying to reverse your type 2 diabetes,
the number one thing is weight loss. And a lot of the studies show that there's sort of this
key number of about 15 kilograms of weight loss can achieve a reversal or a mission of this type 2 diabetes. So that's why, again,
if you start a keto diet and you lose all this weight, and all of a sudden your type 2 diabetes
seem to be going away, a lot of it may be attributed to the weight loss, right? So that's,
again, I'm not completely excluding these other dietary patterns if they can help people achieve
weight loss. Let's call it fat loss to be be a bit more specific because you don't want to lose muscle
we want to hold on muscle is very precious muscle is the sink or the sponge that soaks up the
glucose so we want to hold on to as much of that as possible it's not just an aesthetics thing it's
quite important for many aspects of health but then losing body fat that 15 kilograms for some
reason is a number that people can achieve some really good results if they hit that. And in addition to just this fear around carbohydrates is a whole ideology
around grains that you had to sort of deprogram yourself from. So talk a little bit about
introducing grains back, whole grains, we should say, back into your diet and the impact of that.
Yeah, I definitely demonized grains for many, many years.
I thought that they caused inflammation, ruined your gut health, you know, would elevate your blood glucose levels.
And it's because I was reading a lot of these paleo blogosphere style of, you know, the rhetoric there is that whole grains are, you know, they have lectins and poisons that they're trying to kill you and you know all this stuff and i
definitely fell for it in the beginning because it's a compelling story it's a lot sexier than the
the current story of the whole food plant-based one it just you know as you mentioned before it
seems to not get the same limelight as these really appealing you know carnivore grains are
trying to kill you plants are trying to kill you,
plants are trying to kill you, that sort of storytelling?
Well, those stories are very reductive and they're often delivered in a package that comes with a,
you know, like a developed torso and a lot of sort of conviction, right? Like, you know,
we can get into that. Like, it is interesting that the plant-based message
doesn't track in the same way
because it's missing that kind of,
you know, it's not all tied up in an alpha bow
that is appealing to a young male, I guess I should say.
I mean, there are many developed torsos in the plant-based world that are promoting the message, is appealing to a young male, I guess I should say.
I mean, there are many developed torsos in the plant-based world that are promoting the message.
But as you say, even in spite of that,
it still doesn't quite get the spotlight that I think it deserves.
And I think a lot of it is to do with that alpha male,
you know, rise of the liver king,
that carnival craze of like the hunter, right?
Right.
looking the carnival craze of like the hunter, right? Right, there's a whole story around masculinity
and a search for identity
and the connection between that hunter kind of paleo primal,
what does it mean to be a man
that connects with a certain dietary affiliation
that involves a lot of animal protein.
And when you strip that away
and you're talking about whole food plant-based,
it just sounds beta, soy boy.
It's just a harder narrative.
How does that?
It's just not gonna track in an Instagram reel
or in a TikTok in the same way,
which is problematic and is a longer conversation around like how you storytell
and how you communicate.
But you as, you know, like you're an incredibly fit dude,
you came to this after your exploration in good faith
in the paleo community and the keto community
and discovered this plant-based way of eating.
And not only has it helped you manage your diabetes,
it's fueled your active lifestyle
and you've become this sort of proponent,
sort of an unlikely proponent of a way of living
that is more sustainable, healthier long-term
without the compromises that some would have you believe
are part and parcel of eliminating animal products from your diet.
And when I made the transition to the plant-based diet,
I've got to be honest,
the animal ethics side of it was not my focus
because I was very, very determined to manage my diabetes, get those
numbers under control, try to maintain my physique the best way I could. I wasn't thinking about the
planet or the animals. I've got to be honest. But as you dive into research and reading and
documentaries and just the community, you get exposed to those other two pillars that now anchor me potentially more than
the health side of this diet because i think a diet attached to values and ethics is much easier
to maintain long term whilst a diet attached to a little bit more vanity and you know vanity and uh weight loss and aesthetics yeah it's harder
to maintain long term so the animal side of things for me is absolutely huge i mean i always
considered myself an animal lover and i remember i got a i was when i was paleo i was like making
a chicken broth and i had like the chicken carcass i cooked a bowl of meat and i had all the bones
left over and i was boiling it down and, you know,
videoing and put on social media.
And someone slipped into my DMs and said,
you know, you're an abuser.
You want to know where that chicken came from?
Watch this.
And then I got into this dialogue with this person.
I'm saying, no, no, trust me.
I love animals.
I really, I love animals.
You're wrong about me.
You don't know me.
I didn't know me.
I was so, I love animals. You're wrong about me. You don't know me. I didn't know me. I was so, I was contradicting, I was a hypocrite
because I told myself I loved animals and I did,
but I was eating some of them.
And I loved my dog,
but I was eating the other animals
who feel the same pain as my dog,
suffer in the same way as my dog
and arguably are as intelligent as my dog.
So, you know, I just didn't,
I didn't see it until I started eating a
plant-based diet for health, got exposed to these other two pillars. And then before I knew it,
I saw some things that you just can't unsee. And yeah, I mean, that holds me now, holds me together.
Yeah. My journey was not dissimilar. It started from a kind of vanity and health perspective.
I didn't feel good.
I didn't like the way that I looked.
And the ethics and the kind of environmental considerations came much later,
but now are much more, they're on a parody with the, you know,
it's like, it's a lifestyle that checks all the boxes, right?
You can be more gentle on the planet.
It's more compassionate towards our animal friends.
It's actually in the best interest of our health.
It's almost as if nature designed it that way.
You know what I mean?
And it's interesting to kind of be on the receiving end
of all the mental gymnastics that go into rationalizing and these other choices like,
oh, actually, if you eat meat, you're part of the solution.
And the way to save the planet is more pasture,
more cattle pastures, et cetera,
that really don't hold up under close scrutiny,
which is a whole other podcast.
I don't wanna go too far down that rabbit hole,
but I think it gets confusing in the influencer space
for people who are in a position
to be easily kind of massaged or manipulated away from the truth.
Oh, yeah. Absolutely. You see it now more than ever. I think that narrative has grown a lot.
And I think people use it as an excuse. I know a lot of, like, let's be honest, most alpha men who
are eating meat today aren't hunting it themselves. They are paying somebody to kill the animal for
them. In what world does that make you a man to pay for this industry to exist so that you can
eat meat? I just don't see that as a masculine characteristic. I mean, I feel more of a man now
choosing not to partake in something that goes against my values. To me, that is a stronger move
than to go,
hey, I'm only gonna eat meat,
but I'm gonna make sure that that person grows the animal,
feeds the animal and kills the animal for me.
I just, you know.
It's more masculine and takes more courage
to take a hard ethical stand
that contravenes a socially acceptable behavior
and to do it out of compassion for the souls
that can't speak for themselves, like to be a caretaker,
to be a protector, but that is a harder, once again,
like a harder narrative to spin.
But I think it's people like yourself
who hold themselves out as an example.
That's how you kind of create change in this narrative.
And I think the era of,
activism is a tricky thing.
Like you need all kinds,
you need people who are on the far edge
and uncompromising and speaking truth to power.
And then you have people like Simon who are a little bit more gentle.
And all those different voices have different ways of connecting with people.
but I found much like Simon that a lot of the sort of tools used by the animal rights
and vegan community not to work for me
and I think are failing in general
and it's much better to be an example
like a healthy vibrant living example of this lifestyle
to attract people who are curious about that
and to allow them in without judgment
to have a dialogue about what that might look like for them.
That seems it's a slower change, I think,
but I think more effective.
I think the sort of more aggressive advocacy,
like the example is the guy who sent me the message saying,
you tortured that chicken, blah, blah, blah.
Right.
That doesn't make you-
Didn't work for me.
That's not gonna make you feel
like you wanna make that change.
Right, it wasn't productive.
It's gonna make you defensive.
Correct.
And it's gonna entrench you in that, yeah.
Yeah, I decided not to be that guy going forward,
even though I want to say that to so many people.
And I know it's true,
what's true is not as important as what is productive
if you wanna move the needle.
Talk a little bit about overcoming your fear
of suddenly sort of dying on the vine.
Like if you're gonna eat only plant-based protein,
well, that protein is inferior
and it's certainly gonna be substandard
compared to the way that I was
eating before. How has your fitness changed or your gains, have they been compromised?
What does that look like? The first couple of weeks and months,
I did feel a bit different. I think I lost a little bit of weight though, because naturally,
when you adopt a whole food plant-based diet, because the calorie density of the diet is so
low, you are probably going to lose some weight, which is pretty awesome if you're somebody who's
overweight and wants to lose weight in a way that's kind of effortless in that you can eat
large volumes of food and not have to count your calories and worry too much about it.
So I lost a little bit of weight and I did feel count your calories and worry too much about it. So I lost
a little bit of weight and I did feel a little bit weaker in the beginning. And that's when I
started messaging Simon. I'm like, mate, I need your help here. The muscle's going, I feel a bit
weak. And I wasn't pretending everything was perfect straight away. And he said, look, you
need to eat more calories. What are your protein, what are you eating at the moment? And I'd never,
ever had tofu or tempeh, ever in my life. So he introduced me to those two foods, which are now a staple of my diet.
I eat soy foods every single day.
Another myth that we can bust another time.
But I had to learn what were the protein replacements to make in my diet.
If I was taking out fatty cuts of meat and steak and chicken, eggs, fish.
What am I going to add back in?
And Simon helped me to develop sort of not a meal plan,
but understand how to manufacture that bowl.
Every time I sat down to eat, like what are you going to put in that bowl
that's going to give you all the nutrients and the protein
and the macronutrients that you need to still perform, play sport, build muscle.
And I've gained probably a few kilos.
So of what I like to think is lean muscle, I definitely didn't just blow up.
Tofu, tempeh, beans, lentils, and the like.
And protein supplements.
What about all the lectins?
They're everywhere.
Are they destroying everything?
Are you toxic from all the lectins? They're everywhere. Are they destroying?
Are you toxic from all the lentil, from all the lectins?
Well, it turns out it's easier to destroy lectins
than it is for lectins to destroy you.
And all you gotta do is cook them or soak them or both.
And you're gonna pretty much remove most of them.
Right, nobody's eating raw beans.
Well, I don't know many people know.
So, you know, the idea, this whole lectin,
I mean, whatever, that's a whole other,
like, you know, but it is,
it's worth spending a minute to bust that myth.
I know.
Because there are a lot of people
who are afraid of lectins.
Yeah, I mean, the way Simon put it to me-
There's one person who's responsible for that.
Isn't that incredible though?
Like, hats off to that marketing team.
That one person just completely changed the diet
of tens of millions of people with one book.
I don't even want to name him.
We don't need to get airtime.
But Simon explained to me, he goes,
look, lectins are destroyed when you cook them.
If you look at epidemiological studies
of the longest living populations
with the least amount of chronic disease, they eat arguably the most lectins.
Beans are a staple of their diet.
And just to tie it back into diabetes, those same populations, who Dan Bittner calls the blue zones, right?
Yep.
Not only do they eat a lot of beans and lectins, they have quite a high carbohydrate diet and they have the lowest amount of type 2 diabetes
because their body weight, their healthy body weight,
they're active, they move a lot,
they've got wonderful bonds and connections with family and community,
they enjoy their life, enjoy what they eat
and the last thing on their mind is,
are those carbohydrates going to make me fat or are going to cause diabetes?
It's just we invented this problem because people want to point the finger at something to blame
for the way they feel today and it's always very reductive it's like this is the one thing that you
need to remove or whatever and you know i appreciate the nuance and the complexity with
which you describe your condition like saying it's not just any one of these things.
And if you do that, yes, this will happen,
but then you have to worry about this.
Like our physiology is complicated.
Diabetes is complicated.
Nutrition is super complicated.
And anybody who tells you this is the solution that fits all
and you just have to do this one thing
or remove this one thing right i would be
very wary of yeah that that's the red flag if somebody has the solution to a problem that you
didn't even know was a problem so they probably probably invented the problem and then sell you
the solution you know to probably look for other people to bounce some ideas off that's a problem
which leads us to cgms so let's spend a few minutes talking about this.
Obviously, CGM, a continuous glucose monitor,
is a life or death, very important piece of technology
that's instrumental to any diabetic's life
in order to simply survive, right?
You have to be monitoring your levels all the time.
It's crucial.
But we're in a very interesting moment
in which we're seeing the pioneering,
the innovation of all kinds of technology
that's connecting the everyday person
with what's happening in their body in real time,
whether it's your whoop strap or your aura ring. And now
these companies where you could do blood work and they give you in-depth analysis around that.
And of course, an added piece here is the CGM for the first time ever being available to everyday people through various companies.
And this allows anyone to wear one and to monitor their own blood glucose in real time.
There's an argument that this is a good thing
because anything that connects a person
to what their body is doing is knowledge
and knowledge is power.
But there are also many people in the diabetes community
who are upset about this
and are concerned about what this means, right?
So talk me through like your philosophy on this
because I'm actually trying to figure out
where I stand on all of it.
I am too, to be honest. I've given this a lot of thought, obviously.
As somebody who wears a CGM, as you mentioned, for purposes that relate to keeping me alive,
it is a little bit funny seeing people wearing them on the streets who essentially don't need it.
It's more of a want. It's more of a
fashion accessory or a badge of honor to show how much they care about investing in their health,
which is something to commend in some ways. If you care about your health that much,
that you're willing to wear a device that was invented for people with diabetes,
you've got to sort of take your hat off and say, okay, well, you obviously care about your health,
good on you. But whilst knowledge is power, if you don't understand or know how to interpret the data that you're
collecting, I believe it's kind of useless. And I think that people are falling into the trap of
wearing a CGM to collect data without knowing exactly what it means or what caused certain
fluctuations in their blood glucose levels. And then again, pointing the finger at something
that may not be the actual cause of that issue.
And I'm seeing CGMs as a way for people to justify low-carb diets or keto diets.
Again, it's not giving you that whole picture.
It's only telling you what the symptoms are,
which are those little fluctuations in blood glucose,
but it's not telling you about your insulin sensitivity.
It doesn't tell you about,
do you have fat building up in cells that it shouldn't be, which means that insulin isn't working properly. It doesn't tell you that stuff. So the problem is people are demonizing foods off
the back of CGM use. It's happening. They're eating a carbohydrate and saying, see, look at
that. There's my blood glucose spike. It was because of X.
Yeah, it gamifies the whole thing
where the goal is to flatten that thing as much as possible,
which is gonna lead you to making dietary choices
that might not have the best long-term results, right?
Right.
Without that education piece.
I think the education piece is super important,
and I'm not sure that it's quite in place. The contrary opinion would be like, listen,
I wore one for two weeks and I learned a lot. Like I had no idea that this food did this, or
when I don't sleep well, for example, that was something that I learned after playing around
with it for a little bit. Like, holy shit. when I'm not rested, it's all over the place.
That was something I didn't realize or fully appreciate.
Or certain foods are acting in a way that I wouldn't have expected.
Like when I eat a banana, it does spike higher than I would have thought.
Like, okay, I can file that away.
I'm not going to make a big deal about it.
But it's a data point.
But the importance of that data point is only in correlation to a whole other world of understanding and nuance that really isn't part and parcel of what that whole thing is about right now.
And is that data point clinically meaningful right that's the thing that
cares like and there's a there's a kind of a weird shaming oh i have this spike that's bad right is
it bad we don't know but what we do know is there's studies looking at hba1c you know which is that
average three month glucose level um in normal healthy people over thousands and thousands of people, big epidemiological studies and even randomized studies.
But there's a clear inflection point.
It's like a hockey stick.
So the idea that the flatter the better means you're going to have less health complications,
less chronic disease, you're going to live longer.
I'm not convinced that is true right now today,
especially looking at this inflection point at
around, I think it's about 5.5%, the HbA1c. Whether your A1c is 4.1 or 5.5, your risk for
chronic disease is pretty much the same. But when it starts to go outside of that normal range,
then you're going to see some complications and your risk might increase. So if you're wearing
CGM because you're gamifying and you want to be the flatter the better,
I'm not convinced that that is an evidence-based approach.
And I'm not convinced that those spikes,
quote unquote spikes, that you're seeing
are clinically meaningful
or even relevant in your overall health.
Right.
Well, I think one of the problems is that
the people that are signing up to wear a CGM are not the people who actually would benefit from having one.
Because we're in, as we mentioned earlier, like there's a massive rise in metabolic disease right now. people who are either pre-diabetic or inching ever so closely towards that who would benefit
from understanding how haywire their glucose regulation is. But those are not the biohackers.
The biohackers are probably fine, right? They don't have to worry about it. But to the extent
that there could be a better way to deploy these CGMs as a tool in the toolbox of stemming the rise of type 2 diabetes and prediabetes.
Because by 2030, something like 50% of Americans are expected to suffer from this.
Like this is a massive problem, right?
And here's something that could kind of help people earlier as they're nearing
that to understand that they're at risk. I think there's a benefit there. Definitely.
Secondarily, you have on the far other end of the spectrum, elite athletes who are using super
sapiens and really understanding how nutrition impacts performance. And they're able to extract
really valuable data,
especially in the endurance space.
How do you get through an Ironman in high humidity
and hydrates and keep your glucose stable?
All that kind of stuff I think is interesting
at the cutting edge of athletics.
But that's a whole other world, right?
That's different from what we're talking about.
So I see your point. I think
it's very valid. The other question I had is, because I've heard this, because I've talked
about CGMs on the podcast before and people from the diabetes community who get sort of agitated
about that have led me to believe, like, is there like a shortage of these? Certainly, like, if there's only so many CGMs
and there are people for whom wearing one of these
is life or death, I would rather those people have them
than the biohackers out there
who are just noodling around with it.
Right.
And there's an expense thing too.
Like, how does that work in,
if more people are using them,
do we reach a certain scale where they become cheaper and more affordable to the people that work in? If more people are using them, do we reach a certain scale where
they become cheaper and more affordable to the people that need them? Or is there a scarcity
of these devices altogether that make it important that we be conscious of that if we're going to
try to play around with one? Rich, I don't know the answer to that. I understand that some people
who have diabetes may not be able to get their hands on them because, like you say, they're attached to the arm of somebody who's a gym goer who just wants to use it as a fat loss tool, which I don't believe it is.
I haven't seen – I don't know anyone who doesn't have a CGM because there's a shortage of them.
In Australia, it's subsidized.
So the government pays the bulk majority of that fee. It only came into
use, I think it was maybe a year ago now or less, actually just a few months,
where it used to be like $5,000 a year to have one. And now it costs maybe 10 bucks a sensor.
So it's much, much cheaper. So it's affordable now for people with diabetes in Australia. I
don't know about in the US. I have heard that that though that people can't get their hands on them but then the other argument as you mentioned is the supply
demand and if you can increase the scale does it become cheaper for everybody but i just don't know
that these companies producing them are there yet to create well if we look at the price of insulin
we can we can we can predict right you know how that might play
but you know just going back to one other utility that i can see a cgm working is imagine if we put
a cgm on the people who are high risk right so you go to your doctor your doctor sees that you're
high risk maybe it's for family history or it's to do with your bmi or waist circumference or
whatever other metabolic conditions you have you might even have diabetes unknowingly. And we could
diagnose a large amount of people with diabetes just by using the CGMs, right? Because a lot of
the people who are undiagnosed aren't visiting their doctor. They're not tracking any data
whatsoever. So they're walking around with diabetes, not knowing it, which is a silent
killer, essentially, increasing your risk of cardiovascular disease and all these other metabolic issues.
But if CGMs were accessible and cheap and everyone wore one, then we're probably going to diagnose millions and millions of people.
And there is something about seeing it on your screen right after you eat something like, wait, you mean when I do that, this happens?
Like,
I didn't know that. That creates a connection with your body and also provides that sense of agency.
Like, oh, but when I do this, then this happens. Like, oh, cool. Like, you become much more
engaged with yourself. And that can then lead you down a path of being more engaged in other areas. Like
once you experience a certain positive result, then you're encouraged and motivated to explore
further. Yeah. It's a kind of wearing like a step tracker. I mean, that simple data input of
how many steps did I do today may make you go to the gym and might make you choose a healthier meal.
There's so it It snowballs.
So, yeah, I mean, there are cases where I can see it being very beneficial.
I just worry that we might be misusing it at the moment.
I'm not sure that. I'm not going to stamp.
Yeah, no, I understand that.
And like I said, I do think that there is a lot of room for improvement in the education piece because it isn't as simple as like keep it
flat no definitely not it's not that simple it's very complicated but the other thing is like if
you're only doing finger pricks like i was for many many years before i had the courage to wear
wear a device um and i say courage because i didn't want to have this physical device attached
to me 24 77 that represented my
condition. So I was doing these finger pricks every single day, but you're only getting a
little snapshot of this very dynamic system that's in flux all the time. So if I did a finger prick
at 10 a.m. and the next one I did was at 3 p.m., I have no idea what happened in between those hours.
Did my blood glucose rise very high and come down? Did it stay flat? Did it go low and come back? You just don't know. So the data that you get from
the CGM, as you say, you pick up your phone and you can see in real time, these little dots,
you know, in graph form, you can see the trends and patterns. You can learn, you know, at this
time of day, naturally my blood glucose goes up, you know, because in the morning you've got
cortisol flowing and your blood glucose will kind of rise and at this time of day it naturally goes down
and you just you learn so much in real time so that that is the beauty of the technology it's
amazing technology one of the other things i learned using it is how my body responds to
different uh versions of time restricted eating and intermittent fasting.
And I went through a period where I was kind of doing
this one meal a day and I would eat it too late.
I would eat like a big dinner,
but I would do it late at night.
And then watching what would happen to my blood glucose
over the period of when I was sleeping
was like very surprising.
What did it do?
Well, it would just, it would like drop
and then it would like spike at like two in the morning.
And that was typically when I would like wake up,
you know, it was, and I was like, wow,
this is like wreaking havoc on me.
Like I wouldn't have thought that.
And I since have realized like, oh,
actually when I eat smaller meals throughout the day,
I have better results.
I have more restful sleep.
I don't have this, you know, strange looking graph
that happens in the middle of the night.
And I could feel it,
but being able to match what I was experiencing
with those data points helped convince me
that I needed to do things a little bit differently.
That's very interesting.
I mean, that's a phenomenon
that happens to people with type one a lot
is if you have a very large dinner close to bed,
especially if it's packed with a lot of fat because that slows down gastric emptying. So the rate at which the food leaves your digestive system enters the bloodstream
and carbohydrates, right? So you basically, you're slamming your foot on the brakes.
You've got all this food in your stomach waiting to digest. And then like six hours later,
it starts to enter your bloodstream and you can have these massive spikes like six hours later the classic example here with
type 1 is a pizza it's just the one food that i don't know anyone who's figured it out because
it's got a lot of cheese saturated fat refined carbohydrates big serve you eat that six hours
later your blood glucose spikes and by that time the insulin that
you gave for the meal is long gone out of the system so it's this mismatch between the rate
of glucose entering the system and the rate of which your insulin is working well now it's gone
so i never thought about that though in people without diabetes and i'm actually really
surprised that that's the case i would not have predicted that i would have thought that your
pancreas would handle that naturally.
Now you're scaring me.
No, no, no, no.
I'm not saying anything.
I'm not diagnosing anything right here.
But yeah, it's very interesting.
Well, I don't do that anymore.
But I'm interested in whether you've played around with,
as an experimenter, with intermittent fasting or time-restricted eating
and how that kind of operates
as a type one. Yeah, absolutely. I've played around with everything at this point, I think.
The fasting is a really good tool. I find it makes it a lot easier. If you're in range,
if your blood glucose is in range and then you aren't adding these inputs to the system,
it can be easy to stay in range. The problem that I was running
into was similar to you. I was eating meals that were too big. I was so hungry by the time it was
time to break the fast that I was overeating the volume of the meal, which delays the gastric
emptying. And then there was that mismatch, as I mentioned, between the insulin and the glucose.
But I think I just need to learn to sort of scale back the size of the meals.
And it's definitely a good tool.
It can absolutely work.
And some people just like, you know, some people just aren't hungry in the morning.
I like to train fasted.
I don't want to eat a big meal before I train.
So, it works practically for lots of people to fast until you're hungry.
It makes sense.
But you haven't found like a specific protocol that works for you?
I haven't.
I mean, I haven't played around with it that much.
But for me, when I do the fast, I backload my calorie intake.
So I'll fast in the morning and eat more from sort of noon onwards.
But I know people who do the opposite and they front load their calories and they get some pretty good results with that.
So I think that it definitely does matter the protocol that you choose
and what time you decide to do your fast versus your eating window.
I haven't tried the front loading yet.
So maybe you're enticing me to do another experiment.
The front loading, yeah, it's like I don't want to wake up in the morning
and eat a bunch of food.
Same.
I want to go out and train right away.
Right.
If I'm training really hard, I can't
always do a fasted workout session in the morning. Right. Because that will impair my ability to do
it the next day and the next day and the next day. You're always like, you're eating not for that
session, but you're kind of eating for the following day. Right. In order to recover and
repair. But in general, if I'm not training super hard, yeah, like just get out and get it done first thing.
Is that including-
Rather than eating a huge meal
right when I wake up in the morning,
like I just never want to do it.
But you don't have to do it that way.
What you could do is do your fasted workout.
So what time would you do that workout?
Is it early?
Seven, eight in the morning.
So seven or eight in the morning,
you do your workout,
you're home by nine, 10.
That's when your eating window can begin.
So it's like a post-meal breakfast. You can that sort of maybe it's 10 till 4 i don't know
10 till whatever that could be your eating window but again if you love food and you don't have
metabolic issues and you don't need to be adding all these tools into your life then perhaps you
don't have to do it yeah it's it's it's just it's a it's what's in vogue right now.
Like what is your protocol?
Right, right.
You know what I mean?
Like my protocol is enjoying my life.
Yes.
Which kind of brings us to,
I wanna spend the last part of our conversation
talking about good practices for just eating
a healthy whole food plant-based diet.
Like we talked a little bit about the protein,
but common misconceptions or confusions
around things like omega-3s and vitamin D and B12,
like how are you making sure that you're not deficient?
Like how do you think about these things
in terms of not only how you function
as a fit, active person, but also long-term, like how are you eating to sidestep,
to not only manage your diabetes,
but also sidestep heart disease,
which is a risk factor for your condition
and to prevent cognitive decline
and all the other kind of downstream things
that we need to be thinking about
sooner rather than later. The way that I've constructed my dietary pattern is
the front of mind for me, the most important thing, the most important principle is diversity,
plant diversity. I need to try and get as many different unique plants in there as possible
because they all come with unique nutrients.
Some have protein, some have carbs, some have fat.
I just need diversity there and also for gut health, right? If you're just sticking to three or four vegetables,
I would argue that your microbiome health
is probably not as robust.
The Tim Spector 30 plants a week,
which should be really easy actually.
Like if you're actually eating a robust, diverse,
whole food, plant-based diet, you're probably getting 30 different plants a day.
I would say so. Yeah, I think I could do that in a meal sometimes even.
So plant diversity is key. When I'm making that plate or bowl, I'm thinking of the three
macronutrients, but I will say that I have to think about those because I'm living with diabetes.
So every time I make a meal, I have to eye off that plate and understand how many grams of carbohydrate are in the meal, how many grams of protein, how many grams of fat, because the
interplay between those three macros will influence the dose of insulin that I have to give.
And it took me years of learning how to understand what's in the foods and counting the carbohydrates,
because in the beginning, I would have a food scale.
I would weigh every single ingredient that went in.
I'd plug it into an app.
It would spit out the information regarding the macros and the calories, and then I would give my insulin dose.
Thankfully, now I'm at the point where I can just look at it and understand what to do.
I want to try to get 30 grams of protein per main meal. And I get that from tofu, tempeh,
legumes, beans, chickpeas, lentils, some nuts and seeds. I'm trying to eat carbohydrates at
all my meals as well. And I'd like to get it from whole grains. And then a big, big base.
This is where the volume comes. I can get my volume
that fills me up from the lower calorie density, nutrient dense, leafy greens, cruciferous,
non-starchy vegetables. If you stick to that and you eat three meals a day,
you're pretty much going to be good. But if you really want to bulletproof it,
three meals a day, you're pretty much going to be good. But if you really want to bulletproof it,
you know, I'll take a protein supplement after workouts just because I enjoy it. I actually like the flavors and I can make a smoothie or, you know, like a sort of like protein ice cream
or something. And that's the enjoyment. That's the enjoying life factor that you just mentioned.
For me, people say, oh, it's processed and I don't care. I like the taste. It's not bad for you.
And it helps me hit my protein targets.
So you're getting maybe an extra 30 grams.
So you're looking at, I don't know, 100, 120 grams a day?
120 to 150 sometimes.
It depends.
Sometimes I'll have two scoops over a day or I'll have an extra serve of tempeh.
So I'm not counting and I'm not being granular, but
roughly 30 per main meal, maybe a snack and maybe that protein shake gets me approximately 1.5
grams of protein per kilo of body weight, roughly. And how do you think about omega-3s, DHA, DHEA?
There's a lot of discussion around that and whether you can adequately meet your body's requirements
on a plant-based diet.
Look, I try to get it from food as much as I can.
I eat a lot of whole flax meal, hemp seeds, chia seeds.
But I also take a supplement to, again,
bulletproof those nutrients.
And I'm not afraid to take an essential,
it's called Essential A,
it's one that I like to take.
It's called, you know, Simon's help formulate a meal.
Yeah, so I take that every day.
It's called B12, vitamin D, algae oil.
So for those, instead of fish oil,
you take the algae oil, same thing.
And yeah, that's my daily dose.
I just take that and I bulletproof my diet
and I do blood work very frequently
and I have no issues, I'm healthy.
And when people come to you and say,
"'Tell me about your diet'
or, how are you doing what you're doing?
What are some of the misconceptions around not only
eating plant-based as a type one diabetic,
but just life as a T1 diabetic in general
and also being this kind of like fit person who likes to train.
Like what are some of the things you would like to,
not necessarily correct the record,
but sort of misconceptions out there around how you're eating and how you're living?
Well, I mean, the main misconceptions are,
and most people have seen these floating around on the internet,
is that you need to eat animals to get your protein, which you don't.
So people's major concern is, where am I going to get my protein?
Is there enough protein in plants?
Yes, there is. Spoiler alert.
What about all those carbohydrates? Isn't it too high in carbs?
And this is a fair point that people make is what if they want to do a low carb version of
a plant-based diet? That's getting a little tricky now. And I think that if you're going
to do a plant-based diet, you've got to be willing to surrender in certain aspects of your life and
say, you know what, perhaps I need to amend my relationship with carbohydrates and adopt this
dietary pattern instead of trying to make my relationship with carbohydrates and adopt this dietary pattern
instead of trying to make my dietary pattern meet my carbohydrate goals.
You mean like a keto plant-based?
Right. It can be done.
But a lot of the protein sources that you get from plants come with carbohydrates.
So I think it's tricky.
I haven't tried it and that's one experiment I don't really want to try right now.
But some people want to try to do that version and it's possible.
But I really think that, I think we need to like zoom out a little bit and look long term.
What do you want to achieve long term?
If you want to achieve a diet that is attached to values and ethics, a diet that makes you
feel satiated and full, that contains all the nutrients you need, that you can build
muscle and you can
still reduce your risk of chronic disease, reduce your risk of developing cardiovascular disease,
our biggest killer, then the plant-based diet is ticking all of those boxes.
And some people might find that they can't stick to it, that they have digestive discomfort or
it's just not for them. Well, then you can do an 85% plant-based diet
and get a lot of the,
probably all of the benefits, to be honest,
other than the ethical side and environmental, perhaps.
But most of the health benefits
come from going 85% plant-based, I would say.
And I think that there is research to support that.
So yeah, you don't have to go 100%,
but maybe you start at 80, 85,
and you nudge your way to 100.
And some people will be surprised
at how kind of easy it is to do once you're in the groove.
What are some ways of getting people started with that?
I mean, there are certain people,
it sounds like you just were like,
okay, I'm in and you just snap your fingers
and you're all in overnight.
I had a similar kind of way of getting into it.
Most people are not like that.
You know, like, how do I dip my toe in this?
How do I, you know, break up with some of my favorite foods that I feel powerless to put behind?
Like, how do you embark upon this journey
in a way that you're focused on creating
new sustainable habits that will last you the test of time
and not just get you through a 30 day experiment.
Well, I think going back to what we spoke about before
is if you can attach your dietary change
to something a lot deeper than just vanity or aesthetics,
and you think about ethics or environment
or something a little bit stronger,
if you have a pull towards that,
it's gonna be easier to do it. But I think understanding the swaps you've got to make.
So maybe it starts with reducing the portion size of the animal product on your plate. You don't
have to eliminate it entirely, but just reduce it. And then maybe the 50% reduction that you've
taken away, you put in with beans or tofu or tempeh or something plant-based. So you're still getting the protein dose you need. Half of it may be coming from plant protein,
the other half from animal protein. And then slowly you can just nudge towards the plant
protein over time, adding new vegetables and fruits and trying new things. I hadn't eaten
fruit, like a diversity of fruit in many, many, many years. And you forget how bloody good fruit
is. It's really delicious.
And there are so many different types.
It's not just apples and oranges.
Like take a leaf out of Robbie's book,
go to a market and fall in love with the variety.
And that guy has, you know, a weird like romantic obsession.
Yeah, yeah.
Like durian, you know, like it's like,
what is the fetishization that certain people have with durian?
Like Doug Evans is the same way. It's so funny. I'm like, it's like, what is the fetishization that certain people have with durian? Like Doug Evans is the same way.
It's so funny.
I'm like, you guys should just get married or get a room.
Like, it's weird.
It is bizarre.
I mean, I don't understand it.
I'm not that way inclined.
But yeah, they have romanticized that relationship for sure.
I mean, Robbie knows the names of fruits that I've never heard of.
You know, he shows us on Instagram like this strange looking thing.
Where people, normal people have bookshelves.
He has like shelves and he puts all his fruit on there.
I mean, it's like, yeah.
Yeah.
But I guess, look, you got to fall in love with the food you're eating.
You got to enjoy it.
That's sustainable, you know.
And if it's healthy food, that's even better.
I mean, a lot of people fall in love with foods that aren't so good for them.
So I think if you're going to move the needle, you've got to be willing to experiment.
You've got to be willing to try new foods, make it taste good. This is the thing. If it tastes
shit, you're not going to eat it. And a lot of people tend to say, oh, tofu, yuck, it's so bland.
Yeah, marinate it, make it. Whatever you do to your chicken, you can use the same thing for your tofu or use the tofu as the canvas and, you know, make it tasty. Find recipes online. You know, there's
so many great plant-based recipes and homemade dressings and sauces and you've got to find a
way to actually make it taste good. I think that's an important one because it's really easy
to eat some boring meals and go, no, it wasn't for me.
Yeah, because you had boring meals.
Make them enjoyable.
Yeah, I think you have to make it fun and not make it so pressurized and adhere to some kind of perfectionist ideal.
Such that when you have a weak moment or you lapse into some old, you know, kind of habit that doesn't serve you,
it's like, okay, that's fine.
Just get back to what's the next best choice.
Totally.
You know, how can I like find new recipes and turn it into, you know, something that's just,
that ignites your curiosity
and doesn't feel like heavy and burdensome.
Yeah, I agree.
And I think that it's easier now than it ever has been. If you go on social media and you follow a few people who have,
you know, amazing recipes and they teach you how to do it from scratch. I mean, there is definitely
the side of it that people don't talk about enough is sort of like culinary skills, like actually
learning how to cook is quite important because I mean even in Bondi there's
a shortage of plant-based restaurants I mean there's a handful of them but not all restaurants
are going to have a plant-based option so a lot of your eating is probably going to be done at home
which is probably healthier for you anyway because you know what you're putting in the food
so you got to get those skills and learn how to cook that's probably another good good place to
do all your cooking I do a lot of it yeah so. Yeah, so what happens when you go out to eat
and like how do you manage like the social aspect
of the whole thing?
Because I feel like that's really the Achilles heel.
People don't wanna be problematic in social settings.
They don't wanna be in situations
where like they are making other people uncomfortable because they have a certain way of eating and it just becomes tricky and complicated.
Yeah.
The social aspect is very interesting because, I mean, for me, it's actually double-edged because on one hand-
Your life depends on it.
This is your job, right?
Right.
It's different. You have an excuse that everyone job, right? Right, right. But also-
It's different.
You have an excuse that everyone is gonna be like, cool.
And I hate that.
I hate leaning on diabetes as the excuse,
which is easy to do when I go out.
It's like, oh guys, I have to eat this
because my diabetes, it's an easy thing to do,
but I try my best not to do it.
And I told myself from day one,
I will, I know it's not my fault I have it,
but it's my responsibility to manage it. And I'm never going to use it as an excuse because I want
to empower myself to do whatever the hell I want to do in this world. And if I'm leaning on it,
even once as a crutch, it's just going to trickle into other things in my life. And I don't want
that to be an excuse. So you know what? You just got to own it. So when I go out with friends and
we finished rugby season once, we went to a pub here in Bondi
and all the boys ordered burgers and chips and steak and stuff. And I really quietly pulled the
waitress aside and I said, hey, actually, I don't eat meat. Have you got anything on the menu that's
vegan or plant-based? And she's like, yeah, we'll whip something up for you. Anyway, all the food
comes out, all these burgers line up the table
and then I get this like rainbow bowl, like this Buddha bowl,
most beautiful looking thing and the boys all look at me and they go,
hey, that looks really good.
I didn't see that on the menu.
And I'm like, yeah, I just asked for the way.
They said, I wonder if we can get some.
So, I mean, look, if you can just own it and be willing to,
I was willing for them to say the comments, whatever, soy boy, whatever they wanted to say. I owned it. I held my ground.
I enjoyed my meal and it turns out that they wanted to taste it too. Yeah, I love that. That's
cool. Well, I just think that you're a really powerful example of this lifestyle, young, vibrant, living with type one diabetes,
but not in a way that it's inhibiting you
in any meaningful way.
And the fact that you have, in good faith,
lived these other lifestyles and have kind of arrived here,
and this is a sustainable solution
that's working for you is amazing.
And I think that that gives you a certain resonance,
you know, when you talk about it, that that's really powerful.
I appreciate that.
Yeah, man. So I appreciate you coming to talk to me today. You have this website, Drew's Daily Dose.
You've got all kinds of resources there for anybody who's curious about how you do what you do. You've
got these five pillars. We talked about nutrition and exercise,
but there's mindfulness.
And we talked about managing blood glucose and all of that.
But you have lots of tools and resources
and kind of a whole protocol.
Yeah, I mean, one part of the story that I didn't mention
was after being diagnosed,
I went back to uni and got a degree as a diabetes educator.
Because I thought, you know, I'm in to uni and got a degree as a diabetes educator because I thought,
you know, I'm in the perfect position to educate people. You know, I've got this family of doctors,
I'm educated, I'm an exercise physiologist, I'm a diabetes educator, I'm living with diabetes.
How could I not share this information? So Drew's Daily Dose was my way of sort of figuring out a
protocol, that five pillar protocol to help people.
And I was consulting a lot online and doing coaching and one-on-ones.
But, you know, now I'm at the point where I really want to reach
way more people at once.
And Simon and I have got some really fun ideas for some online courses
that we want to start generating around certain niche groups
and diabetes obviously being a huge part of it.
And I just released, you know, after 12 years of doing all this
social media stuff or whatever it is, I just released you know after 12 years of doing all this social media stuff or
whatever it is um i just released my first like training program like an online training program
you know resistance training for strength and hypertrophy cardio zone two i know you love your
zone two zone five all like evidence-based protocols and an e-book with you know it's like
16 000 words 50 pages you know explaining the's like 16,000 words, 50 pages, you know, explaining the state
of the evidence in terms of you want to gain muscle and build muscle, build strength and
improve your cardiovascular fitness for health and longevity. This was my way of distilling all
of that into this e-book with like videos of every exercise and eight week programs. And
so I just, I actually just only released that a couple weeks ago so yeah that's
pretty cool exciting um and uh and uh really interesting i mean we could have done a whole
podcast on you know endurance training strength training hit high intensity all of that like i
know that you and simon have spoken at length about that on various podcasts. So you have plenty more to share.
Oh, so much.
Again, if you find yourself in Los Angeles.
Yeah, so if you're digging on Drew and his message,
like I said, there's at least 12 conversations
between you and Simon on the proof and your website,
lots of stuff out there for you to kind of learn more
and dig a little bit deeper.
Is there anywhere else that you want to direct people?
You know, I'm active on Instagram.
That's the only social media account I've got,
Drew's Daily Dose.
And Simon and I are running some retreats now, actually.
Oh, yeah.
Did you just do the Bali one?
It's in October.
It's coming up.
Yeah, coming up in October.
Is it sold out?
We might be opening a second week.
So there's definitely space.
And we plan to make that the best week ever.
And I know you just did one, right?
Yeah, yeah, yeah, in Italy.
A little bit different than the one that you're doing.
But it looked cool.
I was checking it out and the location looks insane.
Beautiful location.
World-class surfing wave right out the front of the resort.
We're going to make it very education heavy,
as Simon and I love our science and education.
Yeah, everyone's getting blood work. Yeah, everyone's getting blood work.
Right, everyone's getting blood work.
Probably going to get DEXA scans as well.
And we want to make it not just a week,
but like an ongoing protocol.
And we'll still check in with people
and stay on top of their blood work
and all of their goals
and build the community in person and online
and just keep it going.
I mean, look, this is Simon's,
he's done all the hard work.
I'm definitely, I came on as the exercise physiologist,
but he's so generous that he's, you know,
taking me along for the rides.
I'm just so grateful in so many ways for him.
I mean, we're here in his studio, Waves Bondi.
He got me on this plant-based diet.
We're doing these retreats together.
So, you know, we're in his studio.
Yeah, I mean, he's an unbelievable person.
Like when I was here in January,
I mean,
he just hooked me up
and is so,
you know,
open and,
and like you said,
generous with,
with what he has.
He's a,
he's a really extraordinary person.
Great.
I'm very grateful to have in my life.
Me too.
And he brought us together.
Right.
In his home.
So that's right.
Shout out to Simon, of course.
I don't know when this podcast is going to go up,
but it'll probably be sold out by that time.
But if not, go to theproof.com.
There's a whole kind of landing page there
with more information on that.
And this was cool, man.
Thank you.
Thank you so much.
I can't believe we did this here in Bondi.
It's quite surreal for me.
I'm a little jet lagged.
I hope I didn't come off too incoherent, but I just let you talk the whole time. You seemed
very awake. Excellent. Thank you, Drew. Thank you so much. Peace.
That's it for today. Thank you for listening. I truly hope you enjoyed the conversation.
To learn more about today's guest, including links and resources related to everything
discussed today, visit the episode page at richroll.com, where you can find the entire
podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change in the Plant Power Way, as well as the
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See you back here soon.
Peace.
Plants.
Namaste.