In this episode, Dr. Scott and Tommy dive into the history of the last 100 years since the discovery of insulin. Medical and technological breakthroughs are oftentimes significant inflection points for society, but not always in the positive ways they're expected to be. They discuss where we came from, the state of the union of society's health, where we're headed, as well as how to accelerate positive change.
Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom. Belinda S. Lennerz,1,2,3 Andrew P. Koutnik,4,5 Svetlana Azova,1,2,3 Joseph I. Wolfsdorf,2,3 and David S. Ludwig1,2,3. J Clin Invest. 2021;131(1):e142246.https://doi.org/10.1172/JCI142246.
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Show Transcript: www.thefastingforlife.com/blog
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Fasting For Life Ep. 58
[00:00:01] Hello, I'm Dr. Scott Watier, and I'm Tommy Welling, and you're listening to the Fasting for Life podcast, and this podcast is about using fasting as a tool to regain your health, achieve ultimate wellness and live the life you truly deserve.
[00:00:15] Each episode is a short conversation on a single topic with immediate, actionable steps. We cover everything from fat loss on health and wellness to the science of lifestyle design.
[00:00:25] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned along the way.
[00:00:40] Hey, everyone, welcome to the Fasting for Life podcast. My name is Dr. Scott Watier and I am here, as always, am a good friend and colleague, Tommy Welling. Good afternoon to you, sir. Hey, Scott. How are you doing? Fantastic. I think today is going to be a monumental episode. Wow. So now that I've put that out there, we have to deliver. So no pressure. And this might be a multiple episode article that we've kind of stumbled across, but I think it probably has. That much potential for impact and maybe uncovering some of the inadequacy of the understanding of what it is that we're dealing with when we talk about blood sugar and health related conditions related to blood sugar. So with that, that was a mouthful. I'm excited to kind of start uncovering this and unpacking it so people can kind of peek behind the curtain, so to speak.
[00:01:31] Yeah, me too. And I love the history behind this.
[00:01:33] So what we're going to be diving into and how long this question has been around and what what we've already discovered and what we're quote unquote rediscovering and how it's applicable to today and how the problems keep getting worse. But even though the solutions have been discovered a long time ago.
[00:01:52] Yeah, I know when I was growing up and this is probably a weird analogy, but neon was a big thing, right? So in the 80s, late 80s, early 90s, neon checkerboard slip on shoes like. Yeah, all that stuff. Well, Neon's come back around, so everything seems to be cyclic. And some of the stuff we're going to talk about today was once very widely accepted. And then we'll talk about how the potential that big food, big pharma in the in the agricultural boom, the industrial, all that kind of stuff that happened over the years, that's kind of led us to a point where we're not really treating the cause of the problem, but we're really kind of keeping the agreed upon metrics, so to speak, between the field goal posts. If if we end up in between this range for this individual, then we've achieved a health metric, you know, that would be good for the individual. And that's just not true. The outcome and we'll get into the details here. I don't want to be too abstract, but the outcome is not a better health metric or a better outcome for the patient. It's actually a worsening and increasing of the comorbidities and other things that can happen. And it's incredible that in the age of information that we have and the access that we have to it, there's still this kind of almost blindness to it where I don't really understand other than maybe going down a rabbit hole of done on purpose, almost like how can people not realize that this is the way that should be used, yet the opposite mechanisms have been being used. So I want to lay it out kind of linearly if we can. But I think it's going to be hopefully encouraging to people that have been struggling and not understanding why you can't get the results when you have blood sugar related issues.
[00:03:54] Yeah, I think that'll be good because we get to peel back the layers of the onion a little bit and start getting to the crux of the matter. And, you know, because we've talked about in the past in a bit of a State of the Union kind of way, the the problems with obesity and blood sugar and diabetes and all the comorbidities and but but getting to where it's almost like how did we get to this spot, like where we are today? Where did the recommendations come from? How are the treatments designed and what what's the end goal of them? And why do some people feel like they've been struggling for four decades and can't seem to to gain any sort of control or traction? Right.
[00:04:38] Yeah, and it really came from just the basis of one of the things that we teach in our lives have been transformed by which is this concept of insulin, insulin resistance and the insulin friendly lifestyle. So I was coming across a tweet the other day by an his name is Dr. Drew Droog. I don't know if I'm pronouncing that correctly, but he had a post where it was like just really linearly linear. Thinking in too much insulin equals obesity, too much insulin for too long results in insulin resistance, which then is pretty much diabetes type two diabetes. Too much insulin can also result in salt retention, which can result in high blood pressure. Too much insulin can result in high triglyceride levels and high cholesterol. And too much insulin can even put your body into a grow and divide pathway, which can increase your certain cancer risk, et cetera. So we're looking at that. And then the article we're actually going to be kind of reviewing and pulling from is out of the Journal of Clinical Investigation. And this was part of a review series where it's the 100th anniversary of insulin's discovery. So when someone was discovered a hundred years ago and this panel went back and looked at the titles, Carbohydrate Restriction for Diabetes, rediscovering centuries old wisdom. And it's interesting the timeline of what used to be accepted to where we are now and how far away from that concept that the discovery of insulin in the application of the use of insulin has really fueled the problem and put gasoline on the fire, so to speak, rather than actually like getting to the cause of blood sugar related issues and insulin resistance?
[00:06:24] Yeah, almost like like whenever technology or discovery kind of almost becomes an enabling kind of situation where where we found a. A solution to an issue or we found a way to somehow control it, which was a huge technological and medical breakthrough at the time, and it still is, but at the same time, it allowed for an enabling lifestyle, things and and diets and and habits that were known to actually help with the issue, like the article leads off with low carbohydrate lifestyles have been used for the for the last three hundred years to prolong the lives of diabetic patients. But with the discovery of insulin, those same diets kind of fell out of out of favor. They became less popular because they didn't feel like they were they were as needed anymore.
[00:07:29] Yeah. And that was one of the most Eye-Opening things, you know, when looking at kind of the the timeline, so to speak, the ADA guidelines and how they've changed over the years and how in the seventies they went to that more low fat, high carb. But what they've realized, one of the things that's in here is the high carbohydrate diet is how they how they refer to it. And that's the prevailing dietary pattern in the US, consistent with the recent recommendations for people with diabetes and the USDA recommendations for the general public. And that's greater than forty five percent of your carbohydrate daily intake coming from carbohydrates, meaning greater than two hundred and twenty five grams per deciliter of carbs in any given day. And it never used to be that way. Back before the advent of insulin, there was a a high dependent or a high success rate, and it was the accepted treatment protocol for people that had blood sugar related issues or diabetes to be on a low carbohydrate diet, which was, you know, a medically medical nutritional therapy, where then as we've progressed through the decades and we're not going to hit all of the exit ramps right. On this timeline. But as things progressed, the creation of insulin, the the acceptance of insulin then led to this idea that, you know, especially when it became commercial that diabetes patients didn't have a lifestyle induced issue and they could live more normally air quotes. Right. So I know you can see me air quotes normally and it relaxed the food monitoring. Right. And then twenty five years later, combine that with a flood of processed convenient snacks and cereals and juices and mainstream marketing. You know, the ninety in the nineteen fifties, the grocery stores just exploded in the nineteen seventies. Those those FDA guidelines, you know where it's low carb, high fat. I mean, excuse me, low fat. High carb is going to be heart healthy, your heart protective and you've got the you know the the heart healthy label checkmark. Yeah exactly. That's where I was going which by the way they just pay for.
[00:09:49] You can buy them, you can get like a group discount if you have a bunch of products.
[00:09:52] Yeah. Right. So we're not going to go down that rabbit hole. But yeah. I don't want to be in the show. No. To a conspiracy. No, I mean it's a real thing. You just go look it up. So but the problem is, is that, you know, again, you weren't addressing the underlying issue. You started. It's almost like having the answers to the test. So you had this this complex problem that was was then turned into a bigger problem when insulin became the standard bearer or standard treatment protocol, when other forms of lifestyle management or other medications didn't get the result. You ended up in this place where you were cheating the system because you were using insulin to drive the blood sugars down, which is a natural process. But when you have resistance, that process doesn't work as efficiently as it should. So we have, you know, the the the problem of the misguided recommendations with the commercially available insulin, which allow people to kind of I don't know if I mean, I'm sure I assume it wasn't intentional, but just kind of sit back and be like, no, it's OK. I don't really need to make these changes because we have this stopgap that's going to save my life. And that's the complete actual opposite of what what happens, because we know that when you have diabetes, that you have a higher risk of heart issues, which is like one of the number one comorbidities when you when you're when you're not correcting the disease, but merely managing it.
[00:11:23] Correct? Right. And, you know, I thought it was it was really interesting in the article. It said in nineteen seventy nine that the ADA guidelines were revised. They revised the goal of dietary management from a.
[00:11:37] Avoiding deleterious metabolic derangements, so they were trying to avoid issues with actual metabolism and they switched it to maintaining plasma glucose as near to the normal physiologic range as possible. So so they changed the endpoint. They changed where the goalpost was. And insulin is exactly what allows a patient or a provider to be looking towards that particular goal post because the insulin is generally administered to actually control what the plasma glucose levels read. But the problem is then that takes the complete focus on what the insulin levels are and also what's what's causing the issue being the lifestyle changes that were so readily accepted beforehand and then almost were allowed to kind of go by the wayside and become much less popular after insulin became readily available.
[00:12:40] And one of the things that was really interesting is that some of the the investigation in this article over the last 100 years nutritionally ruined from carb restriction to just like you just mentioned, carb overload. Right. Fiber was a savior at one point. And then we've got also the insulin therapy and how that so-called improved over the years, because now we have rapid acting insulin and long acting insulin and different ways to kind of split the baby, so to speak. We're like, well, if this isn't working, we can use this this modality and try to stabilize those blood sugar numbers. And the point I'm getting at here is over the years, the focus has gone from medical nutritional therapy. So pure like lifestyle, medical nutrition, like here is what you need to do to reverse this process or not let it progress or actually literally like increase your lifespan and increase your quality of life. Right. To an emphasis on pharmacotherapy and technology. And there's been some benefit with the technology, meaning, for instance, insulin is extremely important for type one diabetics, like it is a requirement or else that person will not survive benefit, not a benefit for type two diabetics. And on top of that, insulin pumps Type one diabetics. Hugely important because you can get real time data in real time insulin release to keep that person within a safe blood sugar range. Constant glucose monitors, those have been hugely impactful because now you have real time data. Every 15 minutes throughout the day, you can get a blood sugar reading. There's a benefit for the technology part of how we've gone from emphasis on nutrition therapy, medical nutritional therapy, and in the nineteen twenties to where we are now, which is on pharmacotherapy, which really isn't isn't beneficial for the long term health of the patient.
[00:14:43] Yeah. And you know, it wasn't very long ago that that people didn't have access to a glucose test. They couldn't walk around like I couldn't pull my keto module out of my pocket and and get a blood sugar and a ketone reading you it within two minutes. Right. But if if I was needing to take insulin and I was told to keep my blood sugar below one hundred or one hundred and ten, whatever, I'm being told, that's that's my that's my goal post. That's what I'm aiming for. And with that feedback from the technology, if I see that within that range because I'm administering the insulin, then I'm getting positive feedback on on the complete wrong thing because I could be maintaining the poor lifestyle choices to further the problem, to further the disease and to shorten my lifespan while being told that I'm hitting the right marks and that I'm hitting the numbers I need to be. That's the problem, right? Yeah.
[00:15:39] And one of the crazy I mean, Dr. Funt, Dr Jason Fong, who one of the books that we both read early on in our fasting journey, had mentioned, like he realized that when he was treating and obviously it's not a direct quote from him, but I remember him talking about in his stories he was telling in his book he'd be treating these patients and when he was a nephrologist and patients on dialysis, etc., and he'd be treating these patients, realizing it like they're not getting any better, like they're actually getting worse. So that was one of the reasons why he pivoted and now has been doing the intensive diabetes management system and all this other stuff that he's created over the years. But, you know, the crazy take home for me was when I'm thinking through this is like high carb diets became popular, but not because of the superiority of the evidence. That's why I was talking about early on in the vague nature that I said it was like, OK, we have to look in the mirror here and be like, OK, what are the results, you know, of the practices that we've been doing and why in the first place were they ever changed?
[00:16:39] Yeah, that's that's a good point, and if if we can kind of zoom out, especially, you know, if if I'm currently suffering from from any of insulin related issues, if I'm zooming out and take a look at the history of where where we are and where we kind of came from, that can give me a bit of perspective on on why why I might be kind of aiming towards the wrong goal post, so to speak.
[00:17:07] Some of this stuff came from the misunderstanding of Type one Type two diabetes over the years and the misunderstanding of what nutritional ketosis versus ketoacidosis is. So I know some of this stuff was insulated around, like trying to obviously make the right decision for the health in the life, literally the life of the patient and type one diabetes situations. But now we have a much better understanding of those effects. Right. So one of the outcomes of this for me is like, OK, well, the economic burden of diabetes in the US right now in twenty seventeen was three hundred and twenty seven billion dollars and fifteen billion of that was specifically for insulin and that can be up to eight hundred dollars a month for someone to be requiring insulin. And if you've known anyone that's on insulin and the type two diabetes world, they're typically very health compromised. You know, for my personal experience, we've had runs in the family, the heart of the heart attacks, the cardiovascular disease, obesity. Obviously, you know, excess weight has issues, the high blood pressure, the high cholesterol. But one of the easiest things we could do then is, you know, go back to the old tried and true nutritional recommendations of decreasing the carbohydrate intake, increasing your insulin sensitivity, which is how well your insulin works that you have in your in your bloodstream and how how how well your body is producing it, how much it's producing and then how how well it's acting actually to remove the sugar. But if you have less sugar in your body or less carbohydrate intake, then you have less need for the insulin, which gives that body an opportunity to repair.
[00:18:52] And it's just crazy to me that, you know, it. There was no superior superiority in the use of insulin for long term outcomes. And we know that insulin could reduce that risk that I referred to when there wasn't a good understanding of the actual disease processes or the Qaeda versus ketoacidosis. Right. So it could it could reduce those acute effects of the carbohydrate consumption so that high in that low, that can be like life threatening. But now, like the majority of the time, when I when we when we talk to clients or we have people send us messages, they're not told any of this. They're just told you have to make sure you stick to your diet plan because you have to worry about low blood sugar. Right, hypoglycemia is only or or ketoacidosis on the other end of the spectrum is only a concern when you're overmedicating or in the case of Type one diabetes. So the encouragement here is that if you are on the spectrum of pre diabetes, weight loss, retention and weight loss resistance excuse me, Irun, you see your family and friends and co-workers around you. For me, it was my, my, my, my dads, uncles, my family, my grandparents where I could just see the effects of this. It's like, OK, well, yeah, it's great. We have an agency now to track these over the next over the last 90 days. But having an HBO and see in a normal range taking insulin and a bunch of other medications for things that could simply be fixed by removing the source makes no sense to me.
[00:20:33] Yeah, absolutely. It's it's just serving to further the further the problem without getting to the to the crux of the matter. But, you know, with with all of these historical points and kind of seeing the timeline, being able to zoom out like this, I think that I think it really sheds some light on kind of where we came from and and why we could be aiming at the at the wrong goal still today, even though despite more information than ever, despite better technology than ever.
[00:21:01] And yet still we find ourselves getting sicker and then asking ourselves, well, why and what can we do about it?
[00:21:09] Yeah, and I think maybe one of the points of clarification, too, is that you and I live this.
[00:21:15] We were on this path, right? And then I had my dad to look at and say, OK, well, he's already there. Well, now he's off all his he's off 13 medications in the last six months. Right. He's lost 60 plus pounds. He's no longer a diabetic. Right. But he was at the point where he was on into one hundred plus units of insulin a day. What do you think his quality of life was like? Well, I know it was crap. I know he had headaches. I know his energy was, you know, down the drain. Like sleep was an issue like just, you know, mood swings even. I know I suffered from some of that in my mid thirties, you know, from from the insulin spikes and then some resistance that I had. So the encouraging thing here is that we have now with this one hundred years of looking back to see kind of where we've lost our way. And one of the motivating factors that you and I have talked about, Tommy, is the fact that from a financial standpoint, this is an epidemic. Like, you know, we're talking about billions of dollars to not even see improvement. So those costs are only going to go up being obese, having diabetes, et cetera.
[00:22:19] So when you and I started this, we're like, let's turn on the microphones and tell our story. Well, what we didn't realize is that maybe in the in the beginning it was like, all right, I want to tell the story because I want to help people like us. But what I'm realizing is that the diabetes epidemic, because of its relationship to other health metrics and poor health outcomes, could literally transform the health, not just here in the United States, but of the country. And now I'm even more motivated than I was 12 months ago, tossing around the idea of talking into a microphone with you like everybody at least needs to hear this. And even if this is just the first step into the rabbit hole, like just thinking about it differently rather than treating the symptom, getting to the underlying cause and actually taking the responsibility back into your own hands rather than relying on pharmacology and technology. Let's go back to the old the old guard, so to speak, and just look through the lens that maybe there is another way and be open open to it, because you can always go on the medication. But let's never let you get there in the first place.
[00:23:23] Right. You don't have to go down that path, even if a lot of people kind of were led down the right the wrong direction. It doesn't it doesn't have to continue. Right. Like we can we can make a turn. We can make an exit off off the highway at any point right now.
[00:23:40] Right. And it's it's I don't see I mean, I see it being an uphill battle. Right. Because you've got, you know, the pharmaceutical companies, you've got the medical institutions. The medical field is being consolidated like hospitalist groups and the small little doctor's office, you know, especially here in Houston, is going away out in the rural areas. Yeah, of course, you'll have the local family, doc, that kind of does everything from. You know, possibly saving a horse's life one day to delivering a baby the next, if you're out like in the middle of nowhere, and they did it for a bushel of corn, too, right? Right. Right. That's still exists. But in where we are seeing that going away. So the consolidation, in my opinion, being in clinical practice and then being on also the insurance side of things is it's almost gotten out of control. Right, in terms of looking at cost here in the United States, too. So we're up against that. Then we're up against the the convenience and ease and engineering, chemical engineering of our food supply. Right. Right. So we're really stressing our willpower. Our system seems to be a little backwards. And then trying to figure out this information on your own is extremely overwhelming. So where do we start? Well, we start with the basics. Controlling your insulin response is really simple, and that's why we believe fasting is the number one place to start. If you have weight loss, resistance, you've done the Yo-Yo you've put on and lost that 20 to 40 pounds. You've got one hundred pounds to lose. You know your prediabetic. Yes, reducing carbohydrates. It's going to be a huge part in that. But also increasing that time in between your meals is going to accelerate that healing process.
[00:25:19] Yeah, that's going to be the only thing the only way that your body is going to be able to drop the insulin levels low enough to to give the cells time to recalibrate and to become more insulin sensitive. And so and if you're if you're having trouble because you feel like you're on an island, you're you're alone with it or you don't have somebody else to talk to you about, about fasting or insulin friendly lifestyles, then that's why we started a free community on Facebook. Right. Like doing the community and get involved with the conversation. You'll see a lot of really, really cool, inspiring stories. People really kind of, you know, putting their lives out there a little bit and sharing them and giving some good feedback and and just just a great community that's growing.
[00:26:05] Yeah. And if you're on Facebook, that's just just search fasting for life community. And then there's a couple of questions. You answer the questions. Well, let's admit you into the group and then it's a it's a it's a small community because we've just started out doing this right. So we've had, you know, a much greater impact. And how many people have heard the podcast, but only it's such a small percentage, even though it's probably dozens a week at this point. Now, replying to emails and Facebook messages and comments on our our podcast posts and all that, but being in the group will get you in an area where there's like minded people and there's a bunch of fasting groups out there, you know, fasting groups that have hundreds of thousands of people there on Facebook. I believe that we're doing something a little bit differently in that we want to keep it conversational. We want to keep it intentional. Meaning, if you have a question, go to the group. If you if you're not seeing the answer or getting the support you need, then reach out to us. Info at the fasting for life dotcom info at the fasting for life dotcom. And then the last place you could is we are going to be doing eight of these challenges this year. So we've committed to doing eight of the ten day fasting, guided fasting ramp up challenges.
[00:27:22] Right. And we're about to start one here on the twenty eighth. I know you guys have been hearing a lot about the challenges recently. We just did an our podcast about the year in review of like we didn't expect full transparency. I did not expect to do more than one or two challenges last year, but the results in the demand in the waiting list has been just incredible. So it's like, OK, well, if this is a way to get people results and wins, then we're just going to keep doing it. So I know you've heard a lot about the fasting. We're in the middle of one right now. If you guys have interest in it, then shoot us a message. Let us know. We're also going to be really working on getting some more tools into your hands over the first quarter this year. We're not really of. Yeah, some guides and some some resources and digital resources and stuff as well. So the challenge is always kind of our home base right now because that's where we get to interact with 30, 40, 50 people at a time and we get to see the transformation take place. So just really cool stuff. And please, please, please, if you have not yet, go and add yourself to the fasting for life community. And we hope to continue to provide value and add support there as well.
[00:28:37] Yeah, absolutely. Cool. All right. Tell me anything else. I think we kind of. I think we got that one hope.
[00:28:45] I think that's I think that's a really good one. I think the conversation is going to continue on that and. I just I love the perspective. I just love the fact that we can we can kind of see where we came from and where we're going and make some corrections along the way, too. And we didn't talk about fasting until the very end. Right. Well, we'll put the link for the article and for the Facebook community in the show notes as well.
[00:29:09] Cool. Yep. Yep. So if you're wondering where to go, we want you to have an action step. Go to the Facebook community. If you're already there and you haven't gotten our Fast Start guide yet, go to our website, download the Fast Start guide that'll show you how to put one meal a day eating windows into your day to day life. Super simple. At six steps, we walk you through exactly what to do and how to do it. You've got questions. Reach out to me, as always. Thank you, sir. We'll talk soon. Thank you, everybody.
[00:29:39] So you've heard today's episode and you may be wondering where do I start? Head on over to be fasting for life dotcom and sign up for our newsletter where you'll receive fasting tips and strategies to maximize results and fit fasting into your day to day life.
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