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Final proof that dietary advice for metabolic health needs to change: Wisdom Wednesdays · Hardiness with Dr Paul Taylor

• 0:09
  Speaker 1: Hey, everyone, welcome to another edition of Wisdom Wednesdays. Today
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  Speaker 1: we're going to dive into the debate that has gone
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  Speaker 1: on for far too long in the world of nutrition
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  Speaker 1: and chronic disease, and that is what diet is best
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  Speaker 1: for type two diabetes. Is it a low carb diet
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  Speaker 1: or is it, as health professionals have told us for
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  Speaker 1: thirty years, a low fat diet. Because more evidence is
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  Speaker 1: in in the form of a systematic review, and it's
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  Speaker 1: pretty clear we have to stop promoting low fat diets
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  Speaker 1: as the gold standard for managing type two diabetes. So,
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  Speaker 1: as I said, there's a major new systematic review that's
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  Speaker 1: just been published comparing low carbohydrate diets with low fat diets,
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  Speaker 1: which for decades have been targeted as the go to
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  Speaker 1: for diabetes and heart health. And I know this because
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  Speaker 1: my mum and my aunt had suffered from tatoo diabetes.
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  Speaker 1: It's rampant in our family. We know that our genes
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  Speaker 1: are pretty shiitthu surround it. And my mum has been
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  Speaker 1: told and my aunt has been told for.
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  Speaker 2: Decades to be on a low fat diet with.
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  Speaker 1: Relatively high carbohydrate but from more complex carbohydrates. Now does
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  Speaker 1: that stack up to the research. Well, this looked at
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  Speaker 1: seven randomized control trials, so the best form of evidence,
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  Speaker 1: and these trials are all involved having adults with tatoo
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  Speaker 1: diabetes or pre diabetes, and they were all put on
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  Speaker 1: a diet, or half of them in each of these
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  Speaker 1: were put on a low carb diet and half were
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  Speaker 1: put on the low fat diet. And across the board,
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  Speaker 1: low carb diets outperformed low fat diets in every meaningful way.
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  Speaker 2: Better blood sugar control.
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  Speaker 1: More weight loss, improved lipid profile, a less reliance on
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  Speaker 1: diabetes medications, which is really the key outcome here, So
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  Speaker 1: let's dive into it a little bit. What the researchers
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  Speaker 1: did was they reviewed dietary interventions ranging from very low
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  Speaker 1: carb ketogenic diets, which generally have less than ten percent
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  Speaker 1: of your total calories coming from carbs, all the way
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  Speaker 1: up to a moderate low carb diet where carbs make
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  Speaker 1: up thirty to even as as forty five percent of
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  Speaker 1: your total intake, and these that typically emphasize higher fat
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  Speaker 1: and moderate protein. Then on the flip side, the traditional
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  Speaker 1: low fat diets, they prioritize carbohydrate intake, often suggesting fifty
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  Speaker 1: to sixty percent of total calories with fat restricted to
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  Speaker 1: under ten percent.
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  Speaker 2: And here's the key.
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  Speaker 1: Many of these low fat diets are still consistent with
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  Speaker 1: mainstream dietary guidelines other than the US ones which have
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  Speaker 1: just been revised, which are going to do a podcast on.
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  Speaker 1: But this is exactly what this review calls into question.
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  Speaker 1: Across all the studies, the low carb dats, and that's
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  Speaker 1: all of them, the low carb dats consistently achieved greater
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  Speaker 1: reductions in HbA one C, which is is that more
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  Speaker 1: stable three months snapshot of your glucose. They also had
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  Speaker 1: lower fasting glucose levels, They had significantly improved triglyceride and
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  Speaker 1: HHDL or the good cholesterol levels. But even more interesting
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  Speaker 1: was that several of these studies reported that participants on
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  Speaker 1: the low carb diets were able to reduce and in
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  Speaker 1: some cases eliminate diabetes medications. And for me, that is
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  Speaker 1: the game changer. And this is so important because diabetes
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  Speaker 1: is rampant in Western societies, and the research shows that
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  Speaker 1: for everybody who knows that they've got diabetes, there's somebody
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  Speaker 1: else out there who has diabetes that doesn't actually know it,
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  Speaker 1: And having diabetes increases your risk of cardiovascular disease. It
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  Speaker 1: also very significantly increases your risk of Alzheimer's disease and
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  Speaker 1: other forms of dementia and other metabolic complications like chronic
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  Speaker 1: kidney disease and things like that. But let's think about this.
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  Speaker 1: This is a diet that not only improves blood sugar,
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  Speaker 1: but can reverse the course of diabetes enough to reduce
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  Speaker 1: medication or to get off it completely. That is a
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  Speaker 1: massive shift in the way that we approach chronic disease.
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  Speaker 1: So let's dive into a couple of these studies because
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  Speaker 1: it's quite interesting to look at them. One of the
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  Speaker 1: large trial was by researcher called Doran's and colleagues, and
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  Speaker 1: they had people following a low carb diet. They found
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  Speaker 1: that they had significant reductions in HbA once and lost
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  Speaker 1: about six kilograms in six months. The fasting glucose levels
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  Speaker 1: dropped by over ten milligrams per desci liter and that's
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  Speaker 1: the American values. That's not a small shift. It is cleaningly,
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  Speaker 1: clinically sorry, meaningful. And then another study and the researchers
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  Speaker 1: were salslow at all participants on.
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  Speaker 2: A very low carb diet.
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  Speaker 1: Here they saw and that was a very low carb
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  Speaker 1: ketogenic diet. Not only did they have greater reductions in
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  Speaker 1: HbA one C than those on a moderate carb diet,
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  Speaker 1: but they also lost nearly eight kilograms more of weight
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  Speaker 1: and had a significant reduction in medication use. So it
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  Speaker 1: seems that lower carbs were even better. In Teatal's study,
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  Speaker 1: both low carb and high carb groups lost a similar
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  Speaker 1: amount of weight, but only the low carb group showed
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  Speaker 1: better glucose control, had better triglyceride levels, and reduced medication use.
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  Speaker 1: So even though the low fat diet lost weight, they
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  Speaker 1: didn't have any metabolic benefits. So it's the metabolic benefits
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  Speaker 1: that are really key, and that comes from changing the
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  Speaker 1: macronutrient composition of your diet. Now, low corp dits don't
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  Speaker 1: just help you to lose fat. They help your body
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  Speaker 1: to work better. They stabilize your blood sugar, They reduce
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  Speaker 1: inflammation because we know that high blood sugar is a
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  Speaker 1: massive driver of systemic inflammation. These lower corp dits even
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  Speaker 1: improve your cholesterol profile, which people have criticized, you know,
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  Speaker 1: saying that that's one of the problems with them, right,
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  Speaker 1: and they give people, many people the chance to get
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  Speaker 1: off the blood sugar roller coaster.
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  Speaker 2: But this is where things get really important.
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  Speaker 1: Despite these outcomes, low fat diets are still being widely recommended,
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  Speaker 1: both in clinical settings and in public health campaigns, which
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  Speaker 1: for me is complete, delately bonkers. We have been told
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  Speaker 1: for decades that decay to heart health and diabetes is
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  Speaker 1: cutting fat, and its horseshit.
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  Speaker 2: It was based on.
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  Speaker 1: Outdated, very poor quality epidemiological studies where they just follow
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  Speaker 1: people for a number of years, and we know that
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  Speaker 1: that's really poor way to design studies.
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  Speaker 2: And what we now know.
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  Speaker 1: Is that when you cut fat and replace it with carbohydrates,
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  Speaker 1: you actually make metabolic health worse. It's like trying to
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  Speaker 1: fix a fire by throwing petrol on it.
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  Speaker 2: So we also know that this is a bigger picture, right.
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  Speaker 1: A diet high and refined carbohydrates is one of the
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  Speaker 1: core drivers of metabolic disease. And this systematic review gives
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  Speaker 1: us really solid, high quality, randomized control evidence to support
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  Speaker 1: the idea that carbohydrate restriction is more effective than low
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  Speaker 1: fat eating and in managing and even reversing type two diabetes.
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  Speaker 1: So why hasn't the world caught up with this yet? Well,
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  Speaker 1: part of it is just inertia. Public health guidelines are
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  Speaker 1: very slow to change, and a big part of This
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  Speaker 1: is bias. Many dieticians and doctors were trained under the
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  Speaker 1: low fat paradigm, and it's very hard to unlearn what
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  Speaker 1: you've been taught for years, particularly if you've been telling
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  Speaker 1: people to do stuff for years.
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  Speaker 2: We have that confirmation bias, and you tend.
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  Speaker 1: To then seek out the studies that support your view
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  Speaker 1: and ignore or minimize the studies.
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  Speaker 2: That don't support the review.
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  Speaker 1: But the science has clearly moved in a different direction,
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  Speaker 1: and that's why it's definitely time for health professionals to
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  Speaker 1: shift to the new narrative where low carbohydrates shouldn't be
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  Speaker 1: tided as an alternative. So some of the diabetes sites
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  Speaker 1: will say how you can do this? They should be
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  Speaker 1: this is the thing that you should do. This is
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  Speaker 1: the thing that is most proven to actually get you
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  Speaker 1: off the diabetes medication and fix your metabolism. Now, there's
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  Speaker 1: a little nuance behind this, right, and it.
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  Speaker 2: Is a small nuance.
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  Speaker 1: So we know, and I've known this for years, that
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  Speaker 1: there are some people about one in eight to one
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  Speaker 1: in ten of the population that have a variant of
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  Speaker 1: a particular gene, and this is called the apo A
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  Speaker 1: two gene. The apple lipperprotein A two gene. So you
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  Speaker 1: probably heard me talk about before the apoe E four gene,
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  Speaker 1: and that's linked to Alzheimer's disease, and this is a
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  Speaker 1: slightly different gene. It's involved in a part of its
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  Speaker 1: role is in fat metabolism, and we know that people
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  Speaker 1: with a certain variants called this c C genotype, they
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  Speaker 1: have a higher risk when they consume high amounts of
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  Speaker 1: saturated fat.
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  Speaker 2: They have a higher risk.
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  Speaker 1: Of insulin resistance and glucose metabolism in response to that
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  Speaker 1: saturated fat. But this is only in finding about ten
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  Speaker 1: to twelve percent of the population, and this is why
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  Speaker 1: some people might go on a high fat diet, So
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  Speaker 1: this isn't particularly low carb. If they're eating lots of
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  Speaker 1: saturated fat, they may find that their blood glucose and
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  Speaker 1: their insulin levels get worse. But the vast majority of
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  Speaker 1: people eighty five to ninety percent don't have that variant,
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  Speaker 1: and even with reasonably high amounts of saturated fat, which
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  Speaker 1: by the way, is not the thing that's promoted in
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  Speaker 1: a low carb diet. It's saying, you know, just just
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  Speaker 1: eat more fat and have adequate amount of protein. That
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  Speaker 1: fat doesn't have to be particularly saturated fat. So if
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  Speaker 1: you're concerned about that, or if you've had your genes
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  Speaker 1: tested and you know you've got this cc alletal of
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  Speaker 1: the ApoA two, then just keeping your saturated fat to
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  Speaker 1: about ten percent will soarch you out.
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  Speaker 2: But other than that, for the rest of.
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  Speaker 1: The people, in the vast majority of the people, it's
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  Speaker 1: clear that if you have glucose problems or type two
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  Speaker 1: diabetes or pre diabetes, the best thing that you can
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  Speaker 1: possibly do is shift on to a low carbohydrate diet,
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  Speaker 1: and if you can tolerate a very low carbohydrate diet,
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  Speaker 1: because that will be a quicker fix for your metabolism.
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  Speaker 1: And remember, it's not just about diabetes. It's about all
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  Speaker 1: of the complications that go along with the diabetes, such
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  Speaker 1: as caronic kidney disease, increased risk of heart disease, increase
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  Speaker 1: risk of Alzheimer's disease and other forms of dementia, and
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  Speaker 1: a number of other different health conditions. So this is
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  Speaker 1: really about cutting back on the ultra process carbs, especially sugar, bread, pasta, rice,
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  Speaker 1: breakfast cereals, fruit juice, all of that, and swap those
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  Speaker 1: out for whole unprocessed mood for sorry and meat, fish, eggs,
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  Speaker 1: not seeds, vegetables, and then healthy fats are good fats
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  Speaker 1: like olive oil and avocado.
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  Speaker 2: But again, unless you know you've.
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  Speaker 1: Got that variant of that particular gene, you don't need
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  Speaker 1: to be scarred of a little bit of saturated fat.
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  Speaker 1: And the other thing here is this can also act
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  Speaker 1: as primary prevention.
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  Speaker 2: And it's good to see.
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  Speaker 1: And I'm just giving a teaser for my next one
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  Speaker 1: that the American Dietary Guidelines have eventually started talking about
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  Speaker 1: eating real food and not promoting all of this ultra
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  Speaker 1: process shit that they have been for many, many decades.
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  Speaker 2: But that's for another week down the track.
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  Speaker 1: In the interim, low carbohydrate is the way to go
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  Speaker 1: if you have blood sugar issues or you're concerned about
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  Speaker 1: blood sugar issues and all of the other associated health issues.
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  Speaker 2: Catch you next time.