Can lifestyle practices really prevent, treat and potentially reverse type 2 diabetes? In this part 1 of a 3-part series of episodes, join Dr. George Cho and leading diabetes experts Dr. Wes Youngberg, creator of the Diabetes Undone program, and Dr. John Kelly, the founding president of the American College of Lifestyle Medicine, as they explore this question. They will also be answering these common questions about diabetes:
What is type 2 diabetes?
Does sugar cause type 2 diabetes or is that a myth?
Why does someone's blood sugar go up when they have type 2 diabetes?
Is type 2 diabetes genetic?
Is there a link between type 2 diabetes and COVID-19?
The number of people diagnosed with type 2 diabetes is increasing every year. Let’s implement changes to our lifestyles from what we learn in this podcast episode and series!
The recording is from Lifestyle MED LIVE, a series of free online events on today’s most important health and lifestyle medicine topics.
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The Lifestyle Is Medicine podcast is produced by Pathways to Wholeness Lifestyle Medicine in Toronto, Canada and Lifestyle Is Medicine.
Pathways is a group of clinics in Toronto that prevents, treats and reverses disease using evidence-based lifestyle medicine. Pathways provides compassionate, evidence-based care at three locations in Toronto: North York, Junction Lifestyle, and Scarborough Learn more at: www.pathwaystowholeness.ca
Lifestyle Is Medicine is a not for profit that shares the principles of lifestyle medicine to help individuals and families prevent and reverse today’s leading chronic conditions. Learn more at: www.lifestylemed.org
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Akashic Records
Episode Transcript
Pathways Lifestyle Medicine Clinics / Lifestyle Is Medicine
Time: 16:01
Dr. George Cho: Hello everyone, welcome to the Lifestyle is Medicine podcast brought to you by Lifestyle is Medicine. For the next 3 episodes, we take you to the webinar we recently did on diabetes.
We had Dr. Wes Youngberg and Dr. John Kelly speak for the audience on how to use lifestyle medicine to prevent, treat, and potentially reverse type 2 diabetes. We hope that you are blessed by this talk. Here is Part 1.
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Dr.George Cho: Today our topic is going to be type 2 diabetes. A very important discussion! We all know that diabetes is going up and up, but we believe that through lifestyle practices this disease can be addressed effectively. Today we have 2 speakers who are well-qualified to speak on this topic. I am going to introduce them to you at this time.
First, we have Dr. John Kelly. Dr. John Kelly is a physician and founding president of the American College of Lifestyle Medicine. He is also an Assistant Research Professor in the Nutrition Department at Loma Linda University. He was a principal investigator for a multi-million dollar diabetes research project in the Marshall Islands and continues to do research in lifestyle interventions for diabetes. He is also the director of Oak Haven Lifestyle Center in Michigan.
The other presenter today is Dr. Wes Youngberg. He has a doctorate degree in public health. He is a clinical professor for both the Department of Preventive Medicine at Loma Linda University School of Medicine and also Loma Linda University Department of Public Health. He is also the founding director of the American College of Lifestyle Medicine. Dr. Youngberg spent 14 years in Guam researching diabetes and has written a book on diabetes titled, “Goodbye Diabetes.” He has developed an online diabetes program called Diabetes Undone.
Dr. Kelly and Dr. Youngberg, welcome to Lifestyle Medicine live!
Dr. Kelly: Thank you. Dr. Cho. It’s good to be with you, and this is indeed a very important topic. I’m really pleased to be with Wes, my friend, Dr. Youngberg.
Dr. Youngberg: Likewise! Dr. Kelly and I go way back. Back in Loma Linda days but as well as the Marshall Islands. We’re looking forward to being on this webinar with you today, Dr. Cho.
Dr. Cho: Great! You know, Dr. Youngberg, just to break the ice a little bit: You don’t know this but when I was an intern in naturopathic college, I used your book to help guide me and treat my patients with type 2 diabetes. It’s great to speak with you!
Dr. Youngberg: I’m honored.
Dr. Cho: Before we get to the main discussion on diabetes, I just want both of you to comment right now. Just bring it a little closer to home. Right now we know that COVID-19 is happening, SARS-CoV-2 virus. But diabetes has a big role to play in that, right? We don’t want to get too deep into the weeds of that, but can you comment on that? People may not be aware of the research coming up linking diabetes and COVID-19.
Dr. Youngberg: Yeah, there’s a tremendous amount of research. In fact, the big concern has been that people having problems with COVID-19 (if they’re infected) are the ones that have underlying medical complications like diabetes in particular. That’s one of the first ones that you hear about. It can be asthma; it can be hypertension. It can be heart disease or diabetes. In fact, many emergency room physicians are reporting that their patients respond very well to many of the strategies that are introduced there in the ICU unit, but if they’re diabetic they’re the ones that are amongst the highest risk to go on to develop serious complications requiring ventilator support. Between 50-80% of people who go on a ventilator don’t come out of the hospital alive.
My passion has been, over the last 3 months, to educate diabetic individuals that if there was ever a time to really focus on the natural and lifestyle medicine strategies to help reverse the underlying triggers or causes of diabetes, this is the time because you have the most to gain and the most to lose if you do not follow this protocol.
What Dr. Kelly and I will be sharing with you all is the good news that diabetes can be undone! That we literally can say goodbye to diabetes much of the time! And even if we don’t--even if we do all the strategies that are well documented in medical literature that help many people reverse their diabetes. Just by simply following those strategies, even if you may remain a diabetic, you are dramatically lowering your risk of complications because of COVID-19. Because treating the underlying causes of diabetes are also treating the underlying factors that drive somebody’s immune system to depression that then allows the body to succumb to the virus. Otherwise, the vast majority of people have an immune system that is capable of being victorious over this virus. So we want everybody to be victorious including our diabetic population!
Dr. Kelly: And Dr. Cho, just to cite one statistic. Just 2 or 3 days ago, there was an article in the Journal of the American Medical Association looking at the results in 5,700 patients from New York City and the risk. Those who needed to go on the ventilator had almost twice the likelihood of having diabetes than the ones that did not. That completely verifies what Dr. Youngberg was just saying.
Dr. Cho: It’s amazing how one chronic disease can affect an acute disease. Well, let’s go right into diabetes. Dr. Kelly, I’ll direct the first question to you.
Many people know that type 2 diabetes is when your blood sugar is high, but many people do not know why it’s high. They’re not told the underlying pathogenesis, pathology. Can you explain exactly what type 2 diabetes, and what is the root cause? Why is blood sugar going up?
Dr. Kelly: This is a fantastic question! It is true. A lot of people do not understand. Even people that have diabetes sometimes do not understand. So, I would have to say first off that I cannot explain exactly because I don’t think that we know exactly yet. What we do know is this:
We know that the problem is not sugar. We call it diabetes, or sugar diabetes in my part of the country, but it’s not sugar that causes diabetes. It’s actually excess calories. The chronic excess calories lead to storage of energy in the form of adipose tissue. When these excess calories build up, then it leads to lipotoxicity throughout the body causing insulin resistance, causing problems in the liver and gluconeogenesis in the pancreas. And so, this is becoming more and more widely known.
Right now Dr. Youngberg, myself, and others are working on a course for the American College of Lifestyle Medicine: Reversing insulin resistance and diabetes with lifestyle. We’ve been doing a lot of recent research in the literature. I can tell you that I can see studies, and over the last 10 years there’s more and more recognition on what I’m saying. 10 years ago or 20 years ago, it was thought that the cause was genetic, that it was strictly senior genes and you couldn’t do anything about it. All you could do is thank God for insulin. Well it turns out that insulin may be great for type 1 diabetes, but many ways it’s a curse for type 2.
So to answer the question about what is diabetes? What is going on? Chronically excess caloric intake leads to hyperstorage of adipose which then invades other tissues.
Normally you want to store your calories in adipose cells, but when they start being stored in the liver cells and in the pancreatic cells and in the muscle cells, things start to go awry and the body produces more and more insulin to try and keep the blood sugars down into the normal range. Eventually, that cannot happen and the blood sugar starts to rise. That’s when we say we have pre-diabetes or diabetes. But in reality, as you’re going to learn through the rest of this seminar, this is a process that started way before your blood sugar went up. The solution is not managing your carbohydrates or managing your sugar intake. That only controls the symptoms. If you really want to fix this disease, you have to go to the chronic excess caloric intake. That’s my short answer.
Dr. Cho: Dr. John [Kelly], you mentioned a word, “lipotoxicity.” Can you distill this down in easy language for us?
Dr. Kelly: Yes, thank you. So what we’re talking about is when our cells in the body are forced by this high insulin level to take up glucose that they’re not using. They don’t need that glucose for their normal level of function. Then they actually store this in the form of lipid or fat in the cell. So we call this lipotoxicity because lipo meaning “fat”. This is harmful to that cell’s functioning. So that’s what we mean by lipotoxicity.
Dr. Cho: Dr. Wes [Youngberg], fat and cells and diabetes. Not too many people make that connection. They always think it’s sugar and insulin.
Dr. Youngberg: Well, it’s a combination as Dr. Kelly just said. It’s excess calories. And so the number 1 cause of excess calories is too much refined carbohydrates. This number 2, or close to it, would be excess fat especially of the animal fat variety or the free oil variety that is just unnecessary in our diet and simply adds excessively to our caloric load which the body metabolically can’t handle. So that’s why when I’m working for the first time with a new diabetic or someone who struggled with their diabetes over years and decades, I simply say 2 things.
Number 1: The reason why your blood sugars are high is because your metabolism is depressed. We need to figure out what all the triggers are that are contributing to that depressed metabolism. In medicine, we call it metabolic syndrome or insulin resistance syndrome. So we help educate them about how to reverse insulin resistance because the cells of the muscles are throughout the body. The cells of the liver [are] specifically not wanting to let sugar into the cells, so the blood sugar goes high and that can be quickly remedied within days and sometimes within meals if we’re eating the right foods. And then, on a practical note, if we can get individuals to balance their meals and eat the right foods, right? The whole plant-based diet is the goal.
[Number 2]: The second goal is to get them exercising lightly after every meal because that clearly brings down the after meal blood sugars which is by far the most important blood sugar for the diabetic. That has the biggest impact on the caramelization effect, the glazing effect that proteins throughout their whole body and bloodstream. And so, if we can get them exercising a little bit (not get sweaty, just go walking or do some light activity immediately after eating), that’ll lower the after meal blood sugar by anywhere from 1-3 points for every minute that they do light exercise. That can have a powerful shift on their blood sugar!
Most people never check their blood sugars after meals. They always check before the meal. But how are you going to know the impact of your meal if you don’t check your blood sugar after the meal? That’s what gets people focusing on how my body responds to the choices that I make. We see great success when people start doing that.
Dr. Cho: Dr. Wes [Youngberg], Dr. Kelly talked about excess calories and building up of fat. So the next question is--Is type 2 diabetes mainly genetic? A lot of people say, “My mom and dad had diabetes. Therefore, here I am with diabetes.” Your comment? How much does genetics play into this?
Dr. Youngberg: Well, genetics always plays a role. If it wasn’t genetic, it wouldn’t happen. Genes have a lot to do with our help, but they’re not the primary reason we develop the problem. Genes open the window, but we can choose if we jump out the window or not. So, researchers have been clear over decades. We’ve known that easily 70% of the world population have at least some major gene mutations associated with diabetes. But that should never be an excuse (as Dr. Kelly pointed out) to say, “Well mom had it. Dad had it. My aunt had her leg amputated. My uncle went blind. It’s just in the cards for me! It’s just something that’s going to happen eventually. Que sera, sera. Whatever will be, will be.” That’s precisely a fatalistic viewpoint that will get us into trouble.
The reality is that we can change the expression of those genes favorably. We call that epigenetics. The influence of things outside of genetics-- on how those genes operate. How we turn those on or off is dictated by the choices that we make with our diet, with exercise, with sleep habits, with our environmental exposures. So that’s why lifestyle is medicine! It’s the most important medicine of all.
Dr. Kelly: I always like to tell folks that we don’t only inherit our genes from our parents. We inherit cookbooks! It’s a fact that actually we’re now realizing that type 2 diabetes is more epigenetic than it is genetic. It’s really more about our lifestyle affecting the gene switches than it is about the genes themselves.