Have you ever thought that giving up certain foods to reverse type 2 diabetes is hard? If so, this episode is for you!
In this last episode of the 3-part series on undoing type 2 diabetes, join Dr. George Cho as he interviews Dr. Wes Youngberg, the creator of the Diabetes Undone program, and Dr. John Kelly, founding president of the American College of Lifestyle Medicine. Dr. Youngberg and Dr. Kelly will encourage and educate you on the benefits of a whole-food, plant-based diet.
They’ll explore the following questions:
I’ve heard that nuts make you gain weight. Are nuts and seeds okay for a diabetic to eat?
Are there certain times of day that I should be eating?
What specific vegetables should I be eating?
Can I eat animal products in moderation?
Is juicing good?
What’s your response to patients who say, “I know I have to give up meat and dairy. I know I have to eat a whole-foods, plant-based diet. This just seems very hard!” ?
Let’s learn and be encouraged on the steps to take to reverse type 2 diabetes!
The recording is from Lifestyle MED LIVE, a series of free online events on today’s most important health and lifestyle medicine topics.
Links
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, 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
Music credits
Positive
Akashic Records
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Episode Transcript
Dr. George Cho: Hello everyone! Welcome to the Lifestyle is Medicine podcast brought to you by Lifestyle is Medicine. Today we bring you to the final part of our 3 part series about type 2 diabetes. This was during a webinar that we did not too long ago where we had Dr. Wes Youngberg and Dr. John Kelly speak to us regarding the lifestyle medicine approach to addressing type 2 diabetes. We hope that you are blessed by this discussion!
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Dr. Cho: Dr. Kelly, this one’s for you. So, you talked about excess calories and weight gain and so forth. So a lot of people say, you know, nuts and seeds. They have a lot of calories. Nuts make you fat. So forth. Are nuts okay? What are your guidelines, what are your thoughts on nuts and seeds?
Dr. John Kelly: Well when it comes to type 2 diabetes, I do not find whole nuts to be a problem. I do know of course and respect Dr. Caldwell Esselstyn who is one of the more prominent clinicians that restricts nut intake for very severe heart disease patients. But in my own experience and studies that I’m aware of, the fact is that whole nuts, especially whole raw nuts, are helpful not harmful. And so I do not encourage people to avoid nuts at all, but to take them in moderation.
Dr. Wes Youngberg: I agree.
Dr. Cho: Dr. Wes [Youngberg], there’s a lot of… it’s kind of a fad now but you know intermittent fasting, time-restricted fasting, meal timing and all of this. When someone has type 2 diabetes-- Is there certain times of the day they should be eating or does it matter? What are your thoughts on intermittent fasting and time-restricted fasting?
Dr. Youngberg: Yeah, great question! I’m actually a big fan of this. And I tell my patients that the challenge has to do with what medicines they’re currently taking. Our goal is to get to the point where we’re adjusting the medicines to the lifestyle not adjusting the lifestyle to the medicine which--
Dr. Kelly: Yes.
Dr. Youngberg: --could get you into all kinds of trouble. But as you initiate that approach where you are adjusting your medicines to your new healthier lifestyle, you have to work with your prescribing physician and let them know what you’re doing so that they can start adjusting your medicines immediately!
Because if you’re on insulin or you’re on the medications that increase the production of insulin and you’re produced by your pancreas, and you start exercising after meals and you start doing other forms of exercise to get fitter and you start eating a healthier diet and getting a lot of nutrients. All of a sudden, your body’s ability to control blood sugars improves dramatically and now you’re overmedicated!
And so one of the worse things that can happen is that you end up in the emergency room because your blood sugars have crashed because you’re on a healthy lifestyle program. But the reality is that happened because you did not adjust your medicines accordingly.
So that’s the very important caveat that we always say at the beginning of any diabetic management program.
You have to be checking your blood sugars regularly: before and preferably 2 hours after meals. The first week or two, I would do it 2 hours before and 2 hours after every meal so that you get a feeling for what’s going on and you can quickly then adjust your medications according to a schedule that your doctor has given you knowing that you’re going to be doing it.
Basically tell your doctor, “If I were to go on an intermittent fast or any form of fast, how would you restrict my medicine intake?” And then follow that. We would rather your blood sugar run too high for a period of time then run too low. Too low is far more dangerous than too high, especially in the short-term.
Dr. Cho: Can you describe intermittent fasting? Like the timeframes of intermittent fasting.
Dr. Youngberg: So basically, eating a good breakfast and then 5 hours later or so a good lunch, and then if you want to have a more rapid weight loss or reversal of insulin resistance which is the main underlying driver of diabetes, then you just skip the meal. Now that’s too dramatic for you, you eat a very light evening meal and then you have nothing to eat later than that early evening meal so that you have at least 12-14 hours of no calories between a early evening meal and your next breakfast.
If you’re doing a 12+ hour intermittent fast, that gives your body a chance to get used to burning its own fat stores as Dr. Kelly pointed out. That’s when you can get rid of some of that lipotoxicity associated with unnaturally high levels of fat built up in parts of your organs that damage the ability of the body to do what it’s designed to do.
Dr. Kelly: Yeah, I would just add to that. Intermittent fasting can be done by fasting 1 day a week. Clears throat. Excuse me. But I do like the plan that Dr. Youngberg just mentioned which is actually… If you look in the research it’s called “early time-restricted feeding.” This idea of intermittent fasting each day is called “time-restricted feeding.” Anyway, I know we’re short on time and there’s so much--
Dr. Youngberg: Yeah, for diabetics you wouldn’t want to do a full day of fasting because then that really messes up. Unless they’re not on any meds.
Dr. Kelly: Correct.
Dr. Youngberg: If you’re on medicines, you’re better off with setting a time-restricted eating option of that, which mostly you can refer to as intermittent fasting which…
Dr. Kelly: Yeah, thank you for explaining that! That’s true. I should definitely… It can be harmful if you’re on insulin or whatever and you have nothing to eat all day. That’s a problem.
Dr. Cho: Alright, last few questions here. Dr. John [Kelly], there’s a lot of questions about: Are there specific plant foods that people should be eating or not? Because you both talked about generally whole foods plant-based. We know that that means plant foods that are generally less processed.
But even amongst fruits and vegetables, do you recommend a lower glycemic index? Are bananas okay? People ask these types of questions. What are your thoughts?
Dr. Kelly: Sure, no those are good questions. Actually, I don’t think we’re going to be… I mean there’s individualized aspects to this so I want to say that right off. If I were a physician, I would certainly want to talk to the patient before answering this specific question for them. But overall, in general, diabetics have been taught to be way too afraid of food.
You know, it’s not the food! But, what I have had diabetics that are the most difficult to control like Dr. Youngberg was saying: Maybe their pancreas has gotten weak and they can’t produce as much endogenous insulin, etc. But I’ve had patients all the time that say, “But I’ll do whatever it takes to get off of medicine.” If they’re really honest with that, I put them on the intermittent fasting that he was talking about. So we’re skipping suppers. And what I use for meals is what I’ve come to call leaf, stem and flower.
So we’re going to give them veggies instead of fruits for the majority of their diet. We’re going to give it to them like cruciferous vegetables. The leaf, stem and fruit.
We’re going to have the broccoli. We’re going to have the cauliflower. We’re going to have greens like kale and other kinds of things. Cooked or raw is fine. And with some flavoring.
But where I’m headed is.. Um this is only during this period of time where we’re getting their metabolism back to more normal. You do not have to eat like that for the rest of your life. It’s a therapeutic diet. And once… I have all the time people that start this way. They get their sugars under control, they get off their medicines, and then they start to eat a more normal whole food plant diet.
Dr. Cho: Okay, great great. You know, Dr. Wes Youngberg, I want to show you something here. This is the Canadian Food Guide that was just released. As you can see, it’s pretty good but they still recommend moderate use of animal foods. What if someone says to you, “You know, everything in moderation.” Just very quickly, could you comment on that? Everything in moderation. Why do I need to go “extreme”?
Dr. Youngberg: Well, you know, remember: food is politics. It’s been said that it’s easier to change someone’s religion than it is to change their diet. In any organization, whether it’s a nonprofit organization or a government organization or government itself, there’s always politics, and you’re never going to get a recommendation that is not watered down in terms of the science. There’s always going to be compromise from any recommendation or any consensus development statement. So that’s why I choose to listen to the experts that I trust more so than organizations. Because you’re always going to get a watered down, mediocre approach when you listen to organizations.
But, speaking to your question directly: Dr. Walter Willett, who’s one of the most respected nutritional epidemiologists ever from Harvard University, said it best when he says: “There’s definitely some foods we should avoid completely! There’s definitely some foods that we should take in on a regular basis. There’s many other foods that are maybe what we call 'yellow light’ foods or secondary, second class foods.”
In our programs and in the book “Goodbye Diabetes ” we outline the green light foods which means, “Have it and enjoy it! Eat as much as you want of those!” And then the yellow light foods are, “Okay you have to be a little more cautious! Those are okay to incorporate, but those are the foods that you eat in moderation.” And then the red light foods are the ones that, “No!” You stop, you just completely avoid those. Also known as 1st, 2nd and 3rd class foods.
Do you want to have 1st class health or 3rd class health?
These are really our choices. I never force anything on anybody, because I believe that each person is a chairman or chairwoman of their own health. Nobody else should have control over what we do for our health! No one, okay? That’s our decision, but we need to accept the consequences of our choices. That forces other people to pay for those consequences, right? Because it’s on us!
So when people say it’s too hard, like we see on the screen: “It’s too hard to change my diet!”
Well yeah nothing is easy, but is that harder than going through the complications of COVID-19?
Is that harder than having a heart attack or a stroke?
Is that harder than having your leg amputated?
Is it harder than going blind or having all the complications associated with diabetes?
Absolutely not!
It’s relatively easy to do this. Where there’s a will, there’s a way. So I just encourage everybody listening to say, “No, it’s not too hard!” Okay? It’s a willingness to put ourselves out there and make choices and learn about how to do this and so I applaud you, Dr. Cho, and your organization there in Toronto and for fellow Canadians and people all over the world watching that this information is doable.
It’s not too hard! Okay? Especially if you decide it’s not going to get you down!
Dr. Cho: Great and for those who wondered why he brought up COVID-19, at the start [see podcast Episode 58] we talked about how they’re finding that those who have diabetes, hypertension or other chronic diseases have a greater risk of getting more severe forms or severe illness from COVID-19.
Just to comment, I guess everyone draws a line somewhere, right? No one actually believes in everything in moderation.
Dr. Kelly, just one last question before we close off here. There’s a question about juicing. Do you think that juicing is good? How much? When? What are your thoughts? Very quickly.
Dr. Kelly: Yes, that’s a really great question. Bottom line is, keep in mind that juicing usually refers to a refined product. You take a whole food and you put it through a juicer and you end up with pulp. [Pulp] comes out one place and juice comes out of another place. We call it a smoothie if it’s got everything. The whole thing!
So I don’t actually recommend juicing or juices. I recommend the entire foods, so smoothie would be a more appropriate way to do this. I have definitely found that you can make green smoothies and they can be very effective ways to help you change your diet! So if that’s something that someone likes and they make them in such a way that it’s a whole food, then yes: I think it works well! It can work well.
Dr. Cho: Great thank you! Just to close off, Dr. Wes [Youngberg] already addressed the question on the screen. Dr. Kelly, you’re also a clinician. You’re not just a researcher. You see many, many patients. Someone’s listening to this saying, “Whole foods, plantbased, cutting out meat and dairy. This all sounds really too hard!” I’m pretty sure you’ve had patients who’ve had concerns. What would you say to that? Someone’s listening to this and saying, “This sounds really hard!”
Dr. Kelly: Well, Wes let me be brief. Let me go first and then you can finish.
Dr. Youngberg: I already did it, go for it.
Dr. Kelly: But anyway, I just want to say that I had… of course we have this all the time. There are people that say, “Dr. John, I’ve tried this before. I’ve tried many times and it just won’t work.”
And so I spend time with them trying to encourage them. “Will you give this a trial? Will you give me 2 weeks? If you give me 2 weeks, then evaluate is this going to work for me or not?”
Then, what I do is I help them to see that number 1: What they are doing with their lifestyle change is changing the switches on their genes.
We can literally change one cell into another cell as I’m sure you know, Dr. Cho and Dr. Youngberg. Maybe not all of our audience, but we now are able to take a fibroblast and change the gene switches and turn it into a functioning heart cell. It’s been done in mice! That’s how powerful… I’m telling you this because that’s how powerful changing switches is! And the most powerful modulator or change agent for gene switches is diet!
I can change more gene switches more rapidly by changing my diet than anything!
So why am I talking about this? The person that’s saying this is hard. Because when you understand the power of lifestyle, it becomes a lot less of a problem.
If you think of it, “Oh I’m going to have to fast. I’m going to have to give up this…” No, it’s not about giving up. It’s about actually turning on the switches that will give you good health. It’s a very different way of looking at it.
The other thing I say about sounding too hard is I tell them about this study that was published in Diabetologia 2 or 3 years ago. Or maybe it’s 4 or 5… but anyway the Taylor group from the United Kingdom published a study showing that they reversed the triacylglycerols in the liver and in the pancreas within just a matter of about a week or 2. The insulin response of the pancreas is normalized in 4 weeks!
They then started getting people calling and asking them, “Can I put myself on this diet?” They published this study showing that almost 100 people who had put themselves on a very low energy diet to reverse their diabetes. The interesting thing was. They asked them about working with their doctor. About ⅓ of them, their doctor worked with them to change their medicines and whatever. ⅓ didn’t tell their doctor that they were doing it and the other ⅓ the doctor told them, “Oh my goodness don’t do that!”
So my point is, it may sound too hard. I’m glad that word is in there. Sound. It sounds hard, but it’s actually really easy. Studies show that when you see results, when you see the reversal of your disease and you feel better than you ever have, it seems easy to you.
Dr. Youngberg: Let me just add to that. If you’re checking your blood sugars both before each meal and 2 hours after the beginning of that meal, and you’re looking at the impact of the change of diets, start with the first 2 days of not changing your diet. See what happens! Most people never know how high their blood sugar goes.
Dr. Kelly: Sure. True.
Dr. Youngberg: They say, “Oh my goodness my blood sugar is over 300 or 2-3 times higher than it should be!” Then they start checking it after they implement the meal changes, the exercise after the meal changes, and all of a sudden now they are convinced because they see the power associated with these relatively simple strategies.
Dr. Cho: Thank you so much. So thank you, Dr. Wes [Youngberg] and Dr. Kelly for your input, your insight on nutrition! I know due to time we couldn’t address other aspects of diabetes care like exercise and so forth. We’ll probably adjust those in future lectures. Just to remind everyone that you can also follow Dr. Wes [Youngberg] and Dr. Kelly on different platforms.
We talked about Dr. Wes’s [Youngberg] book, “Goodbye Diabetes.” He also has a program that’s online called Diabetes Undone. I highly recommend it!
Also there’s a website called Audioverse.org where you can listen to Dr. Wes [Youngberg] and Dr. Kelly’s talks if you search on there. I’m pretty sure you’re also on YouTube as well.
Also, I just want to thank the organizations that put this on. Pathways to Wholeness Lifestyle Medicine Clinics, Lifestyle is Medicine and of course the Downsview Seventh-Day Adventist Church. We want to thank the church so much for sponsoring and supporting this program!