Mastering Diabetes

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Mastering Diabetes

If you’re pre-diabetic or diabetic, this episode is a must-listen. It shatters some of the myths and misinformation about diabetes and carbs. Robby Barbaro, MPH and Cyrus Khambatta, PhD are the authors of Mastering Diabetes.

They’re both Type 1 diabetics who are thriving while eating a ton of carbs (in the form of whole, unprocessed fruit and vegetables). They have helped thousands of diabetics and pre-diabetics improve their quality of life and reverse insulin resistance through diet. In this episode, they share how a low-fat, plant-based, whole food diet (including fruit and starchy vegetable) is the most powerful way to reverse insulin resistance in all types of diabetes: Type 1, Type 1.5, Type 2, pre-diabetes, and gestational diabetes.

Robby Barbaro, MPH

Robby Barbaro, MPH

CO-AUTHOR OF MASTERING DIABETES

Robby Barbaro, MPH, is a co-founder of Mastering Diabetes, a coaching program that teaches people how to reverse insulin resistance via low-fat, plant-based, whole-food nutrition. Robby was diagnosed with Type 1 diabetes in 2000, and has been living a plant-based lifestyle since 2006.

Transcript

Maria Marlowe: [00:00:33] Welcome back to the Happier and Healthier Podcast. Today, we’re talking all things diabetes and insulin resistance with Robby Barbaro, the co-founder of Mastering Diabetes. Robby has his Master’s of public health and started mastering diabetes as a coaching program that teaches people how to reverse insulin resistance with a low fat, plant based whole food diet. He was diagnosed with Type 1 diabetes in 2000 and has been living a whole food plant based diet since 2006. His co-founder, Cyrus Khambatta, is also living with Type 1 diabetes and he has his Phd in nutritional biochemistry. Together, they have created mastering diabetes to help show the world that you can thrive with diabetes, and you can even in certain cases, reverse it. Their book, Mastering Diabetes, just launched this week. So Robby is here to share some tips from that on how to master diabetes through your diet and lifestyle. If you or someone you love is pre-diabetic, has type 1 or type 2 diabetes, I highly recommend checking out this book. I won’t even be giving away a free copy of it to one lucky listener. Just head over to my Instagram @mariamarlowe and there are details on how you can win a free copy of this excellent book.

Maria Marlowe: [00:02:00] Before we get started. Check out these brands that make the happier and healthier podcasts possible. If you’re looking for better health and especially better digestion, then you have to check out my favorite probiotic brand, Hyperbiotics. Digestive health is the root of our overall health. And it’s so important to get it under control and get it healthy. Not just so you’re not embarrassed with gas and bloating or constantly running to the bathroom or maybe never running to the bathroom because you’re constipated. It is so important that we nourish our gut and take care of our gut, because when it’s not healthy and it’s not working properly, it’s only a matter of time before we start seeing other health problems, whether that skin problems, autoimmune problems and lower immunity, because our digestive system is so intricately linked with our immune system and so much more. So if you’re having digestive issues currently, gas, bloating, diarrhea, constipation, of course, definitely check with your doctor. But you probably also want to look into a probiotic.

Maria Marlowe: [00:03:10] Robby, thanks so much for being here.

Robby Barbaro, MPH: [00:03:12] I am so excited to be talking with you. I know we have a lot of fun stuff to cover.

Maria Marlowe: [00:03:16] Yes. So first, before we dive into the book and diabetes, I have to comment on the wall behind you, which is covered with an amazing array of tropical fruit. How much fruit are you eating a day? Can you tell us a little bit about your fruit collection here?

Robby Barbaro, MPH: [00:03:33] I love that you’re asking this question because a lot of people, you know, if you look at Instagram or they see a picture of me and my my fruit rack, they’re like, that is a ton of food. Like, how can you possibly eat all of that? And I like to educate people that it is it’s misleading. It looks like a lot of food. Really, it’s a lot of water. So the food that I’m eating here is very high in water content. So a lot of water and a lot of fiber. It’s tons of fruits. And also, I have a ripening cycle. So all the food that you might see behind behind me or on a rack picture is food and different cycles. So bananas need to ripen. So I’m a lot of green bananas behind me. I have a jackfruit behind. That’s going to take three or four days to ripen. There’s mangoes that are different stages of ripeness. So it’s really a cycle. And when you choose to eat a lot of fruit based meals, you do have to, you know, put some effort into planting that and making sure you always have enough. And I like to also share with friends and neighbors. I shop at the wholesale market so I can get things for quite cheap. And this morning, I just bought a 40 pound box of ripe bananas for eight.

Maria Marlowe: [00:04:43] I got a box that’s like the same for a set of health food store for one one bunch of bananas.

Robby Barbaro, MPH: [00:04:52] Absolutely. And I got eleven pounds of organic bell peppers for $4. I mean, you pay that much for one bell pepper. So I get it a lot. And I put stuff in fridge, I put stuff in the freezer. And of course I eat a lot. So I’m a big fan of abundance is a big thing. We talk about a lot of masking diabetes. You get to eat more and weigh less when you’re eating calorie dilute foods.

Maria Marlowe: [00:05:16] So let’s talk a little bit about diabetes, because you have type 1 diabetes and you seem to be thriving. So first, can you tell us what is life look like for most type 1 diabetics? And then secondly, why do you think you’re you’re doing so well and you seem to be so healthy and you’re mastering diabetes?

Robby Barbaro, MPH: [00:05:38] Absolutely. So the distinction between type 1 and type 2 diabetes is that people living with type 2 have impaired insulin production. OK. So something has happened. We don’t know the exact cause of Type 1 diabetes, but something has happened where the beta cells inside the pancreas have been disrupted and do not produce sufficient quantities of insulin. So people living with Type 1 diabetes, we inject insulin to eat food. So anytime we want to have a meal, we’re going to inject a little bit of insulin to match the glucose of the carbohydrate content that is in the food we’re eating. And we also inject basal insulin that works as sort of like a drip feed all throughout the day to give our cells the energy it needs. So insulin is responsible for taking glucose out your bloodstream into your cells, and that needs to happen on a 24 hour basis. So people living with type 2 diabetes and pre-diabetes, that’s initially characterized by producing too much insulin. So they’re living with insulin resistance and their pancreas is to keep on spitting out more and more and more insulin to compensate for insulin resistance. And so resistance is when your cells have basically the diminished ability of glucose to get into your cells. And that’s basically in some resistance. So the body has to work harder and harder and harder to sort of force the glucose into cells. And eventually people living with type 2 diabetes can get essentially become insulin dependent because their pancreas gets exhausted. They’re not producing enough insulin any longer. So life with Type 1 diabetes, it can be very difficult. It absolutely can be very difficult. But the mastering diabetes method, which recover in our book here, really teaches people how to gain full control of life with all forms of diabetes. But there is definitely a big focus here on people living with insulin dependent diabetes, because both Cyrus and I are living with Type 1 diabetes.

Robby Barbaro, MPH: [00:07:36] So the key factor that makes it so I can feel healthy, have an active life, have a high level of insulin sensitivity is the fact that the foods we are eating are low fat plant based Whole Foods. So each of those phrases is really key here. So the main I’m jumping around here because a lot of covered answer that question, but I want these are all important topics. So insulin resistance. OK. We discovered that briefly. OK. That that’s the title of the book. The. A method to reverse insulin resistance permanently in type 1, type 0.5, type 2, pre-diabetes and gestational diabetes. So insulin resistance is the main topic that we are talking about here. It’s also quite relevant for PCOS, which I’m sure many of your listeners are familiar with. So what we’re doing here with the master diabetes, we are addressing insulin resistance and the causes of it at every single level. OK.

Maria Marlowe: [00:08:35] Let me just stop you. I’m curious. So before you get into the whole food plant based, low fat diet, can you just share what is the common dietary guidelines or what are the common dietary guidelines for people living with type 1 or type 2 diabetes?

Robby Barbaro, MPH: [00:08:52] So the American Diabetes Association is pretty pretty much in the middle. They’re not going to be like, hey, go super low carb or go super high carb. They’re going to be in the middle. They’re gonna just have a general maybe 30 percent of calories and fat, you know, and roughly around there for the main focus of fat percentages. Now, in general, when it comes to people who look in, hey, I want to I want to control my diabetes, I want do an alternative solution. The main thing that pops up is people like to do a low carbohydrate diet because I have high blood glucose levels. So in order to not see my glucose meter meter have a high number, I should stop eating carbohydrates. I should stop eating glucose. So the really the general consensus is just eat a low carbohydrate diet, you’ll lower your A1C, you’ll see better. You’ll see better glucose readings and what we’re presenting in this book is really the exact opposite.

Maria Marlowe: [00:09:43] Ok. So, yes, explain that a little bit more.

Robby Barbaro, MPH: [00:09:46] So and I know I know it’s it’s very counterintuitive, but it really is. So it’s like, wait a minute, you’re living with diabetes, you’re living with Type 1 diabetes and you’re eating pounds in pounds of fruit every day. And that’s a lot of sugar that that should cause you to inject a lot of insulin that should cause your blood because to be variable and go up and down and just be a disaster. So let’s go back to the focus on on type 1 diabetes here. So people when I first got diagnosed with type 1 diabetes, I was twelve just about to turn thirteen. So I’ve had it for almost 20 years now. And so at that point, I was doing a standard American diet. Nothing really special. And I injected probably, you know, just a normal average amount of insulin, a healthy human pancreas you’re going to secrete somewhere between maybe twenty five-ish to 50 units of total insulin per day. So over the years, I tried many different diets and one of the key diets I tried was a plant based ketogenic diet. So I eat a very small amount of of carbohydrate. So about 30 grams of total carbohydrate per day. All right.

Robby Barbaro, MPH: [00:10:52] And at that point, I was injecting quite a small amount of insulin. So it was about 10 minutes a day. So you’d calculate that as a 3 to 1, twenty four hour carbohydrate insane ratio. OK. So for every three grams of glucose I consume, I would inject one unit of insulin. All right. Then as I transition to a low fat plant based diet, I now consume over 700 grams of carbohydrate on many days. I can see it on my Instagram story highlights if you want to see everything I’m eating and documenting all the numbers and I’m injecting to twenty five and thirty-ish units of insulin. So the twenty four hour carbohydrate ratio becomes like twenty five ish to one. We’re talking about a 600 percent change in insulin sensitivity, doing the exact opposite of what people have been taught to do. Again, getting into the Type 1 diabetes nuances here.

Robby Barbaro, MPH: [00:12:04] What’s really powerful is that people living with type 1 diabetes often wear continuous glucose monitors. So these are devices that we test to our stomach or our arm or leg. The Bluetooth technology, it communicates with our cell phone and tells us our blood glucose number every five minutes. So people having the time when they have these, we get to see the curve. Hour after hour meals go, hey, you just a you know, some mangoes, some some 70, some raspberries. What happened? What was that curve? And we get to see that repeatedly. And so. What we’ve also established in type one community is this idea of called time in range.

Robby Barbaro, MPH: [00:12:35] Ok. So time and range is how much of a 24 hour period you spend with your buggy goes between 70 and 180. So that’s the consensus for type 1 diabetes. That’s a good range that we want to stay in. Now, people who are have a pancreas that’s functioning properly. You’ll have a tighter range. You’re never seeing above because of 1, because your pancreas is working perfectly. So. But in general, that’s the range. So people living with type 1 diabetes following, you know, standard diets and whatnot. They’re roughly in range, about 50 to 70 percent. That’s what that’s what’s going on. I’m showing every day on Instagram what’s happening with my time and range in my 90 day average is eighty nine percent. So, again, these are gritty details that might not apply on us, really understand type 1 diabetes. But the point is I’m trying nitty to make here is that I’m showing it’s not just me. It’s we have hundreds of hundreds of clients, thousands of people, if you include pre-diabetes, type 2 diabetes, who are having the same results. And the I’m saying is we have the data to show that these foods are not causing the glucose spikes. They are not requiring me to use more insulin. The manufacturers require me to use less than that anybody would ever imagine how much carbohydrates I’m consuming.

Robby Barbaro, MPH: [00:13:50] And the standard deviation, like the volatility of my blood glucose is absolutely excellent. It’s just as good as people who are doing a low carbohydrate diet. And for a lot of people, it’s just mind-blowing. It doesn’t make sense until you start to understand the science and the research and all the components which address insulin resistance. So a low fat diet is part of it. That’s one components. The biggest component.

Robby Barbaro, MPH: [00:14:16] But there’s also the idea of what happens when you reduce your iron consumption. What happens when you reduce your sodium consumption? What happens when you’re increasing your fiber intake? What happens? Are you moving your body more? What happens when you’re incorporating insulin in intermittent fasting? So these are all lot of the variables that are important for addressing insulin sensitivity. And the mastering diabetes method addresses each and every single one.

Maria Marlowe: [00:14:44] Yeah. That’s a great reminder. I think very often when we think of illness or an issue, we think there is or we hope there’s one key key issue. It’s just diet or it’s just the fruit or it’s just one food group. But often it’s really there’s a number of different factors that come into play.  So then let’s just start before we go into the details of the science behind it. I’d love to get a better idea of what you’re eating day to day. Like what does a normal day look like for you food-wise?

Robby Barbaro, MPH: [00:15:15] Yeah. So I’ll answer that for me personally so people can know. And then also does one explain what we teach at large. So I personally, I love fruit. I just absolutely love fruit. I live in Santa Monica, California. I can access amazing local fruit and I can get a lot of great imports at the Los Angeles wholesale market.

Robby Barbaro, MPH: [00:15:34] So I eat from basically four food groups. I eat fruits, I leafy greens, I eat non starchy vegetables and a nascent seeds. So I keep it very simple. But the real guideline here is the focus that all those foods are in our green light category. So at Mastering Diabetes, we put fruit into a green light, yellow light, red light category and green light foods include fruits, starchy vegetables, beans, intact whole grains, leafy greens, non starchy vegetables, urban spices and mushrooms. I also do eat mushrooms such include that. But those are the foods that we’re teaching people to eat, albumin to eat as much as them when they’re hungry, until they’re satisfied. Focus on those whole foods and their intact form and that will help people maximize the sensitivity. So I will typically eat like for breakfast. Morning. I had mango at SPDM, I had raspberries and I had a rule for lunch today. I’ll probably have some persimmons, I’ll probably have some mangoes, have some white chipotle here and then I have a snack before dinner. Usually wild blueberries, mangoes, bell peppers, arugula, stuff like that. And then dinner is a big salad where I have romaine lettuce, tomatoes, onions, papaya, mangos, stuff like that. So it’s pretty simple. Each meal is. We have that many ingredients. But the key thing is that everything is whole intact. So people living with insulin resistance. These are important nuances to address. So things like smoothies, they’re good. They’re they’re full of healthy ingredients. But if you’re living in some resistance and you’re trying to manage that blood glucose elevation that’s happening, eating whole food and chewing it is going to be important. Same thing when it comes to foods being little more processed if you’re going to eat. Rice or something? It’s better to have brown rice than brown rice pasta. Brown passes. Great. But we have this huge emphasis on the green light category being nothing but truly whole intact, unprocessed foods.

Maria Marlowe: [00:17:42] Right. So I’m curious about the Arugula. Are you literally just eating the Arugula or are you putting some dressing on there?

Robby Barbaro, MPH: [00:17:52] It’s so good. And there’s I mean, again, I’m super lucky that I have access to all this stuff, but I get Bloomsdale, spinach at the farmer’s market. I mean, there’s a green called soro, which is really sweet. There’s a sort lettuce I get Simpson lettuce, Vulcan lettuce. I mean, there’s at least 10 different varieties. Let us get the farmer’s market. And I wish and hope for a world where these produce varieties are available everywhere because people are demanding them and they want these things in their grocery store, you know, versus demanding more processed food.

Maria Marlowe: [00:18:29] So I’m curious, your diet seems like it’s primarily fruit. And you mentioned that you eat for mainly for food. Grapes are fine with the mushrooms, but yet you do recommend it as part of the green light category, a wider range of food. So why the difference?

Robby Barbaro, MPH: [00:18:45] So, you know, for me, it’s just become a habit. I’ve been doing this now, eating nothing with fruits & vegetables, naturally simple foods for 13 years. And the reason I got into this whole thing, the reason I pursued this is because I went on a mission to do anything and everything I possibly could to reverse Type 1 diabetes, which is a station we do not have. There is no repeatable, reliable solution for how to for somebody to get their beta cells to start producing insulin once again. So that was my mission. I came into this saying, hey, look, this somebody has to be the first to do anything. I mean, Roger Bannister was the first person to run the four minute mile before that happened. The smartest people in the world says that’s not possible. And now many people run forming a model. He showed what’s possible and now that human beings are doing it. So I do believe at some point we are going to figure out a natural solution for people living with in some dependent diabetes to get their pancreas to produce insulin once again, to get those beta cells regenerated, rejuvenated and operating again, but haven’t figured that out yet. So the reason I got to this very, very clean, specific diet is I was initially trying to just do anything I possibly could to lessen the load on my digestive system. So when we go to bed at night, we’re basically we everybody does a fast every day. It’s when you go to bed and then you eat breakfast. You break your fats. And we all know that healing and regeneration happens when your body is given that break. So digestion is one of the most energy intensive activities in the body.

Robby Barbaro, MPH: [00:20:23] So the mentality is like, hey, if I can just eat foods that are much easier on my digestive system than my body can use that energy to do, some humans, it is more parent. So that was the mentality. And I was just laser focused. I mean, just like, I’m going to do this. I’ma do this. I started a Facebook group for my friends is like was–we reverse type 1 diabetes. Things were going so well in the beginning as I was improving my insulin sensitivity and eating all these, you know, fruits and then eating less and less insulin. I’m like, man, this is exciting. This is going to happen. I’m going to keep on going. I’m gonna go down. And so, you know, it hit a plateau and I require insulin just like everybody else living with diabetes. So to your question, it’s just become a habit. It’s the way of life. I I like it. I enjoy it. And I do one thing I’m a big advocate of is each person looking themselves in the mirror, deciding what are my bright lines? Where am I going to draw a line? What, what, what do I do? I not eat and try and stick to it consistently, whatever that is. Some people may want to add in, you know, a little bit of these treats here. They’re like, oh, that’s okay. I’m happy to have that. You know, once a week or whatever, twice a week. Just be clear with yourself. Set those those boundaries and stick with it to get your goals to achieve the goals that you’re looking to achieve.

Maria Marlowe: [00:21:47] Right. So let’s talk a little bit more about the specifics of the food. I’m curious. You mentioned treats. So what are your thoughts on some of these sweeteners like coconut sugar or stevia among fruit or those things that or dates? Well, obviously, dates are fruit, but are those things that people can include with diabetes or.

Robby Barbaro, MPH: [00:22:06] So ideally, we want to encourage people to steer away from those those. But dates would be a great sweetener. So taking dates, you know, blending them up, that can be a great sweetener. But in general, yeah. We want people to reactivate their tastebuds. So Stevia is cool. It’s good. It’s not really bad. It’s not really a problem. But the one downside. Is that it’s so concentrated that it sort of inhibits your ability to enjoy the natural sugars in fruits. So you kind of expect that that big hit. So it’s just something to be cognizant of. But, you know, it’s a great question and there are a lot of nuances around this and that is why we created a coaching program. So that’s why Cyrus and I launched this whole thing, because we knew that people were going to have very nuanced questions are specific to them and their taste and their flavors. And, you know, what does it take to stick to an overall healthy diet? If some people are feeling too restrictive, you’re telling me I can’t stevia like screw you. I’m not doing this. I mean, like there’s there’s going to be a different level of what’s going to be included, not included for each individual. But in general, again, we’re just going to try and steer people towards maximizing their green light consumption.

Maria Marlowe: [00:23:24] And can you talk a little bit about fat? So what is it about fat that causes issues in the diet? Well, with insulin resistance.

Robby Barbaro, MPH: [00:23:32] Ok. So particularly saturated fat is the biggest culprit here. But what’s happening is when people are living with instant resistance, the primary issue is that fat, too much fat has accumulated in cells that are not designed to store fat. Adipose tissue is designed to store fat. Your muscle and liver cells are designed to store only a small amount of fat. But when you consume too much, it ends up getting stored in there. And fat has an easy entry. So fat can get into muscle liver cells very easily, whereas glucose, it needs insulin, it has a more challenging pathway to get in there. So what happens is when people consume too much fat in general, they end up gaining weight and they start storing this fad tissues that are not designed. So fat insulin receptors do not work properly. So that is what prevents in some from being able to open the door. So you then are you know, you go in living with diabetes, you eat a banana and your body’s trying to take the glucose from the banana into the cells. But it’s the cell says, no, I’m full, I’m overloaded. I can’t I can’t accept the glucose right now. So it ends up floating around the bloodstream and people say, hey, the banana led to me having a high bug glucose reading like, how can you argue that I just had a banana. I had two bananas. I tested myself. And my number three hundred is supposed to be between, you know, 80 and 120. What’s going on? How can you tell me it wasn’t the banana? And the problem is, it’s the bananas, the innocent bystander. The real issue here is that your insulin is not being able to open the door, and that’s why the glucose is stuck inside your bloodstream.

Maria Marlowe: [00:25:21] So what are your thoughts on this whole keto diet trend?

Robby Barbaro, MPH: [00:25:25] Yes. So that’s very fascinating and a lot of levels. And there’s also, you know, I want to acknowledge there’s like a plant based Keto world and then there’s, you know, an animal based Keto world. So I primarily want to talk about animal based ketogenic diet first. So the issue here is that, number one, they’re very high in saturated fat. So that’s problematic. They’re very low in fiber and low base ketogenic diet. So those are big problems.

Robby Barbaro, MPH: [00:25:50] But when it comes to diabetes, here’s the here’s the issue. People are getting fantastic results. You can live with the results. Go look on the Internet. You see the before and after pictures. You see, though, the blood test results. You see that people are getting off diabetes medications. They’re lowering their A1C into a non-diabetic range. These are their fantastic results. But the concern that we have is that they are eating themselves into a state of higher levels of insulin resistance. They are making themselves glucose intolerance. So if they try and eat a banana or two, if they try and eat a carton of blueberries, they see their blood glucose skyrocket. People doing a true, true keto diet really are keeping it to about 30 grams or less of carbohydrate per day, maybe 50, so people can have a little bit of a higher tolerance. But what’s happening is you are now limiting what has been shown to be some of the healthiest foods that we know. You’re limiting your consumption of fruits, limiting your consumption of, in fact, whole grains. Lemon consumption of beans, lentils, peas, starchy foods like potatoes. These are foods all being limited now. And you are now glucose intolerant, which there is no society which has ever live that has shown that that is going to result in Monstermon. We don’t know. There aren’t any long term signs like the long study I’m aware of is five years. There isn’t epidemiological research to look at what happens to large groups of people to do this for an extended period of time. So the short term numbers are good. Nobody’s going to deny that. But the short term number that’s not good is insulin sensitivity.

Robby Barbaro, MPH: [00:27:38] And as a person living with Type 1 diabetes, I can confirm that through my own experience and through hundreds and hundreds of people we’ve worked with, we are amazing test subjects for this very important topic. And the reason why great tests of this is because we know how much insulin were injecting. We count our carbohydrate consumption and we measure our blood glucose consistently. Many of us having 24 hour data. So those three pieces of data mean that we can truly assess our insulin sensitivity meal by meal. Unfortunately, you can’t do that. You don’t know how much insulin your pancreas secreted based on the meal you just eat. You’re not sure and you’re likely not testing your body because levels. So people living with Type 1 diabetes, we have this data and I have never seen not a single exception. There are few things in the world of health that you can just say absolutely 100 percent. And insulin sensitivity in people with type 1 diabetes is absolutely one of these things where I can say one hundred percent as people increase their carbohydrate consumption, eat more whole carbohydrate foods while simultaneously reducing their fat intake. They will need less insulin for more total grams of carbohydrate. And I look, I’ve been deep down this path. Any of the skeptics can say, oh, well, you’re increasing your fiber consumption or you’re increasing your fructose consumption, which may or may not require insulin. OK, fine, no problem. Take those numbers out. I do this every day on Instagram account and I will I use chronometer to tell people how much glucose I’m consuming, just straight glucose.

Robby Barbaro, MPH: [00:29:14] So you calculate that by you look at how much sucrose did you consume. You divide it by two because that’s half glucose, half fructose. Then you take the glucose number and you take the starch number. Take those three numbers in any nutrition, analytic software and you know exactly how much glucose you consume. And we can do this for any single type, whether those millions of us out there and anybody can test it within days, within days. They will see that what we’re saying is absolutely true. And it’s mind-blowing. And we do this at our four day retreats. I’ve never had a type one come to a retreat. I have well over 100 people under our tree at this point. I do not see them. There is some sensitivity improve. A lot of time based helps with that.

Maria Marlowe: [00:30:00] So this I mean, it sounds incredible, you obviously have hundreds, if not more testimonials for for eating this way for type 1 thing, because I’m always thinking of what what are people listening thinking? And I’m sure a question that’s popping up is, oh, well, what about a little bit of animal products? What’s so wrong with the animal products? Why do we need to cut those out? What if we’re a 90 percent plant based and 10 percent animal?

Robby Barbaro, MPH: [00:30:26] So, I mean, what I would say to that person if I was like working with them personally and how we work with clients is I would say, look, it’s up to you and your goals and what you want to achieve. And for people living with Type 1 diabetes, I can let them fill out this thing called the Decision Tree, which is one of the four components of the massive diabetes method. And that will give them the data to see what’s going on with their sensitivity and their blood glucose management. So we tell people, look, go ahead and experiment. And if you are OK with the results that happened, then that’s your choice. That’s your choice. There’s no doubt that a predominantly plant based diet is what we’re looking for people to achieve. So I am a bigger picture person. I studied public health, got my master’s in public health trying to help a lot of people. So I would just I would not stress about it. I’m like, look, if that’s what works for you, you think that’s important to you? I’m not going to get in the nuances. I’m not going to argue like you can find research that shows there are some concerns with some small amounts in our products. But if that’s important to you, things are working for you. Your gut microbiome is in good shape. I’m not going. I’m not going to argue. I’m not going to like getting in the weeds about this small thing. I just want people to achieve their goals. I want people living with all forms of diabetes to reduce or eliminate unnecessary medications. And if a 90 percent plant based diet is helping them achieve that goal, then go for it.

Maria Marlowe: [00:31:53] Right. Yeah. I think it’s always great to emphasize the fact that each of us is different and our bodies are different. Our goals are different. And so we need to find the right diet that works for us. And the best way to do that is to experiment. Experiment. See how you feel. See if you’re living with Type 1 diabetes. You have some real hard data as well. And then you make those decisions.

Robby Barbaro, MPH: [00:32:14] No question. No question. And I guess I guess I can’t emphasize enough. Don’t get lost in little weeds. Little nuances. Focus on the bigger picture. I mean, let’s look at what’s happening in our culture, the amount of money we’re spending on people who are struggling with diabetes when it’s just not necessary. They got to a 90 percent whole food plant based diet like we would solve so many problems. It’s incredible.

Maria Marlowe: [00:32:40] Right. So we talked a lot about Type 1. Let’s talk a little bit about type 2, because that’s generally something that develops later on at some point in your life. What are some of the warning signs for Type 2 diabetes? And is there any connection between age and diabetes or genetics and type 2 diabetes, or is it all primarily diet lifestyle based?

Robby Barbaro, MPH: [00:33:02] So unfortunately, young children are starting to get diagnosed with type 2 diabetes. So initially Type 1 was called juvenile onset diabetes and then type 2 was adult onset diabetes or juvenile diabetes and adult onset. And they have now changed that. So you have type 1 because unfortunately also older people are getting diagnosed with type 1 diabetes. But really, the really sad part is to see young children. I mean, we’re talking my grade school, third grade, fourth grade, fifth grade. People living with type 2 diabetes. It’s very sad. So there is a a small genetic component. But I think the bigger component is the fact that what’s passed down from generation to generation is lifestyle habits, is eating habits. That’s really the biggest component here. And so it’s really what’s happening is for most people, it’s it’s excess weight, excess visceral fat is leading to insulin resistance. Fat storing tissues that are not thymus or fat has basically made the mechanism of insulin opening the doors, not work. And it truly is that simple. So you definitely can find research where as long as people just lose weight, even if they lose weight on a low carbohydrate diet, you will see improvements in insulin sensitivity. You will see improvements in diabetes metrics, A1C fasting, blood glucose, even glucose tolerance a little bit just by losing weight. So that is a huge component.

Robby Barbaro, MPH: [00:34:34] And again, the reason the masking diabetes is effective is a lot of reasons, but including people living with type 2 diabetes can lose weight quite easily and maintain that weight loss because it’s a diet of abundance rather than restriction. So that’s a key thing that we focus on. A massive diabetes is long term health. Anybody can do something in the short term with willpower. But you’ve got to have a program, a way of living that really works with your life for the long term. It’s easy, it’s graceful, it’s enjoyable, it’s affordable. These are really important things for people to stick to it. So basically type 2 diabetes in the vast majority of cases can be reversed. Now, there are people, like I said earlier, they have had type 2 diabetes for a long time. Their pancreas has been secreting excess insulin to compensate for insulin resistance for 10, 20, 30 years. And eventually the beta cells get exhausted and they just can’t do it anymore. And they essentially die off. And you can get a test to measure how well your pancreas is secreting insulin or how much insulin your pancreas is secreting. So, I mean, fasting and so on. Tests can help with that. But also a C peptide test.

Robby Barbaro, MPH: [00:36:05] So C peptide is produced in a 1 to 1 ratio when insulin is produced. Then they break off in some does its job and C peptide kind of floats around, does nothing. But it’s in the bloodstream for an extended period time which makes it easier to test. So you can get to that point where you’re living with insulin dependent type 2 diabetes and that’s OK. It’s not. It’s no big deal. You just have to start using a small amount of insulin to try and compensate for what your pancreas is no longer secreting. So people living with type 1 diabetes and inter-dependent type 2 and also type 1 point. Our goal is to inject the same amount of insulin. Our pancreas would have normally secreted before the beta cells stopped working properly. That’s the goal. And there’s a lot of fear in the health world about insulin being the enemy. And if I inject insulin, I’m going to gain weight. And that’s absolutely not true. Excess insulin will lead to gain, but a appropriate amount of insulin is not going to lead to weight gain. It’s an essential, necessary hormone. Every single human, your dog, your cat produces insulin in order for you to survive.

Robby Barbaro, MPH: [00:37:14] So pre-diabetes, I would say, is reversible and pretty much 100 percent of cases. So this is where you have not gotten to full blown type 2. All right. So your  A1C level, your fasting glucose level has not gone into that 6.5 percent or above. It’s going to put you into type 2 category. Pre-diabetes is your 5.7 to 6.4. That’s your A1C range. It’s going to put you in the pre-diabetes category. 5.6 percent or below means you’re non diabetic. So, again, pre-diabetes. It has not gotten to the point where your your A1C is too high and you’re basically producing a good amount of and some of that point, if you live in the pre-diabetes, your pancreas is not completely exhausted yet. So the point at that at that point, you got to ask yourself. My body’s producing plenty of insulin. My pancreas, my beta cells are still functioning properly. What do I have to do to make that insulin work efficiently? What do I have to do to stop taxing my pancreas, to prevent it from getting to that point where it’s just absolutely exhausted and I could eventually become its own dependent or I could need more diabetes medications? That’s the question you can ask yourself. And that’s the fun part that Cyrus and myself and all of us type ones are experiencing, is that we get to our living example. We get to show people living with pre-diabetes and type 2 diabetes every single day, every single meal, how to make insulin work more efficiently. It’s undeniable, unarguable, there is no question. You can look at any type 1. You can watch him inject the insulin. You can swatch of eat the food. How I’m sure you there glucose profile. You can watch it on my Instagram and plenty of other Instagrams. And there is no denying that this approach, this way of living is going to maximize insulin’s ability to take glucose out your bloodstream into your cells.

Robby Barbaro, MPH: [00:38:53] So you have pre-diabetes, you have elevated fasting by glucose, trying to ask yourself, OK, how do I reduce that elevated glucose? How do I make it so the glucose is not sitting in my bloodstream and it goes into my cells where it belongs to my cells can get fuel and function properly and I can feel amazing with my best life. The answer to that question is to adopt the mastering diabetes method, get a low fat cloud based off diet. You got to move your body. You can incorporate intermittent fasting. You can use decision trees to document what you are doing.

Maria Marlowe: [00:39:53] Yeah, that’s pretty incredible. And I know from your Instagram and your site and everything. It is just really incredible to watch so many people actually thriving with diabetes, because I think most of us think of diabetes. We don’t necessarily thriving. It’s not usually the thought that comes to mind.

Robby Barbaro, MPH: [00:40:12] Absolutely. And I mean, I just want to add real quick, because I’m so passionate about this topic, that this idea of reducing your consumption of fat in order to improve your insulin sensitivity. This dates back to the 1920s. So Dr. Sansom published an article in JAMA in 1926 showing that as his patients eat more carbohydrate rich food than anyone, they didn’t need more insulin. So that was number one. And number two, a lot of the struggles that they were having at a low carbohydrate diet disappeared. So they returned to normal physical activity. So you can take a step back. Your insulin was discovered in the 1920s. OK. So prior to that, people who were living with insulin of diabetes or even diabetes in general were advised to follow a low carbohydrate diet. That’s the only thing they could do because it didn’t have enough insulin production that you really are at a loss at that point. So once they discovered insulin, they could help people who had impaired insulin production. And they went in. OK. What can we do here to try and give them a higher quality of life and help them measure both those levels? So Dr. Sansom was one of the first to experiment with people eating more carbohydrates, fruity added fruit to their diet. He added potatoes and he added bread, which were foods that were just not allowed prior to the use of insulin. You living with any form of diabetes? It just wouldn’t work.

Robby Barbaro, MPH: [00:41:41] And so he add those foods and now they make their blood glucose measure. It was just fine. Their cardiovascular health improved. The diet was more palatable. It was cheaper. They had reduced cravings. And it was it was a real eye opener. OK. And then in the nineteen 1930s, Dr. Hemsworth, he’s conducting elegant studies where they would do what’s called. But it was basically a test where they would they can’t do it anymore because it’s not that safe. But they would inject insulin and they would see how far down with some results would go like that. Where would we drive it to. And he found out that when people eat a low fat diet, insulin worked faster and it drove their blood glucose down lower into this consistently. This is the 1930s. And he would he would conclude one study, he says, whilst on the high carbohydrate diet, the glucose tolerance was raised. And so he also said, this is my favorite quotes. It is demonstrated that the efficiency with which standard dose of crystal insulin acts on the blood sugar is determined by the carbohydrate content of the diet, so that the greater the amount of carbohydrate in the diet, the greater the sensitivity of the organism to insulin. So this is research dating back to the 1930s and they continued to be finding the same thing over and over and over again. And we cover all this in the book. But upon trying to make is we’re not basing everything. We’re saying our personal stories and all. That’s what I’ve talked about a lot today. Everything we are experiencing is coming from is basically corroborating with evidence based research, almost 100 years of evidence based research with nothing to the contrary.

Robby Barbaro, MPH: [00:43:22] So in this book, we have over eight hundred citations. We dug through the research looking at all sides where a whole chapter comparing the ketogenic diet, a low fat diet, looking at the details of the scientific research. And when you dig deep into the studies, you will, if any study where people were fed a plant based diet where there was no more than 15 percent of calories coming from fat. The result was improvements in sensitivity, lower blood glucose levels, lower A1C across the board. I’ve yet to see an exception. So we cover a lot of those studies in the book. But the point is that there’s confusion in the research about what is a low fat diet. So you’ll hear a lot of people saying, oh, ham, you know, the low fat diet, low carbohydrate diet, low carbohydrate diet performed better. And in those studies, invariably they were doing a low fat diet. Twenty six percent of calories from fat, 30 thirty five. So you really have to dig into the research and understand what type of low fat diet was study. And so the massive Diabetes method, we’re teaching people no more than 15 percent of calories from fat, again, because that’s what the research shows is effective. And we’re also saying, you know, another guideline is no more than 30 grams of fat per day. And in the book, we also go into mad detail about fat soluble vitamins. How much fat do you need per meal to absorb those those vitamins and what does the research show? So, in short, the answer is not that much. And you get more than enough when you’re eating. 80 percent of calories come from fat or 30 grams.

Maria Marlowe: [00:45:02] It’s really, really fascinating. So the book Mastering Diabetes is out this week. Congratulations on that. If anyone listening is living with diabetes, has pre-diabetes or has a family member that has any of these issues, definitely pick up a copy. I’m sure you’ll find it very, very informative and beneficial. One last question I like to ask all my guests. If there is just one tip or piece of advice, you can leave our listeners to live a happier and healthier life. What would that be?

Robby Barbaro, MPH: [00:45:32] Ok. So my one tip is, again, just going along with what you’ve been talking about today. What we’re so passionate about doing with helping people is just become aware of how much total fat you consume per day. Use a nutrition software. It’s not about judging yourself or having to make change you, whatever. Never. Just start with one question. How many grams of fat do I eat on a daily basis and start there? And I think people are going to be very intrigued and surprised to find that it’s a lot more than they think they’re having.

Maria Marlowe: [00:46:06] That’s a really interesting tip. I’m curious since you said this, for someone who is not living with diabetes, is your recommendation for fat different?

Robby Barbaro, MPH: [00:46:18] No, it’s going to be about the same. I really believe that this is what like the ideal way is essentially Whole Natural Foods. I think that that’s the way to go. But again, yeah, it’s a good question. And I think at that point you don’t really have as much motivation and it might not matter as much. So I think there would be more room for flexibility. But again, it really depends on what somebody’s goals are. But the answer the short answer is the short answer is yes, I really do. I didn’t have diabetes. I would be doing the same thing.

Maria Marlowe: [00:46:54] Got it. Well, thank you so much, Robby. This has been really insightful and. Yeah. I look forward to talking to you soon. Thank you.

Maria Marlowe: [00:47:02] As mentioned earlier, we’re giving one lucky listener a copy of Mastering Diabetes for free in order to enter, simply head over to Instagram, @mariamarlowe and Marlowe is m a r l o w e with details on how to win.

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