Physiologist Drew Harrisberg On Everything Blood Glucose, Understanding Diabetes & Plant-Based Nutrition Fundamentals

27:04So type 2, on the other hand, is not a problem with insulin production initially. It can be later, but initially it's an issue with insulin resistance, so the action of insulin doesn't work properly. So the role of insulin is to attach to the cells of your body. It's like a key that unlocks this gateway, so glucose from the bloodstream can enter the cells of your body because that's where we need that energy to go. So when you have type 2 diabetes, you develop insulin resistance, so the insulin isn't working properly, but your pancreas is still producing insulin. But eventually, over time, they can also experience pancreatic beta cell destruction or burnout where they stop producing enough insulin.

27:44So you can become an insulin-dependent type 2 diabetic, and in pretty much all cases of type 1, you're insulin-dependent. Right. So being insulin dependent as a type two diabetic is the result of long-term chronic living with that condition that leads to that result. But it just feels like they should have separate names so that people are not confused about this. And then when I, like often now, because type two diabetes is on the rise and I don't have the statistics with me right now, but it's quite staggering. That's huge. I've got some numbers. The extent to which, yeah, people are falling prey to this disorder and the number of people that are becoming pre-diabetic, it's really a metabolic disease, which distinguishes it from a pancreatic disorder that is type one.

28:45Right, exactly. The numbers are staggering. I think globally, and these numbers are from 2021, the International Diabetes Federation, or one of those organizations put out some numbers. I think it's 537 million people globally have diabetes. 50 % are undiagnosed, 50%. So you've got this silent, insidious condition that's present amongst 50 % of those numbers. They don't even know it, which is where I think the CGM could play a role. Right, we'll get into that. We'll get into that. There's a lot of controversy around that. A lot, a lot. I'm looking for some clarity And I know you've thought a lot about that, but let's put a pin in that for the moment and just return to kind of the timeline here, which is you get diagnosed as a young person.

29:34I'm interested in what you were told the prognosis is. Now we see all kinds of people being athletic and running marathons and there's a whole type one professional cycling team where everybody, it's like there's a permissiveness or a sort of understanding that you can live an active lifestyle with this condition. Was that communicated to you at the time? Or did you think suddenly your life is over as you know it? Right. Yeah, I'd say the latter. It felt like a life sentence initially. I'm sitting in that room and the world caves in. It's just, I can't explain the feeling of life's over. I'm done.

30:14Like I have no, the future was just so grim. like the even it's hard to explain but like the color of the world changed like the saturation was like pulled out of the environment everything it was like gray um so they told me that you can still live a great life but my your life expectancy is going to go down you probably won't live as long your risk of cardiovascular disease is significantly increased the long-term complications are very frightening. And they showed me this caricature of a person who is poorly managed for multiple decades and they are blind. They're on kidney dialysis and they're missing a limb.

30:54I mean, that's what I needed to see in that moment. I mean, what a ridiculous thing to attach your future to. They said that you can exercise, but it's very dangerous and you need to learn how to do it safely. And then they said, one of the most dangerous things about type 1 diabetes is is administering the insulin and getting the dose wrong. If you overdose, it can be a life sentence, for real. You can die, seizure, coma, the list goes on. So they actually sent me home without insulin. They said, look, keep monitoring for a few days. Let's see these trends and patterns, and then we'll figure out a therapy, an insulin therapy to match your lifestyle, because everyone's a bit different.

31:33So they sent me home, and, I mean, that night was dark. I mean, I cried myself to sleep. my family were an absolute mess, especially being doctors and having an insight into this condition. They just, they knew what the potential complications were. And we all just were hoping that I wouldn't be another statistic, you know? So I had a rough night, wake up the next day and I'm like, okay, I'm going to do what the doctors told me. I'm going to track the next movements of my day and get some data of blood glucose and log my book. And, you know, I was begging for insulin therapy because I knew that it would make me feel better, that my blood glucose would come back into the normal range, that I would probably start to gain my weight back.

32:16And I just want, I was like, please give me insulin. Like I really want this. They're like, just be patient. We'll get it to you. So the next day after being diagnosed, this was the crossroads in my life. This was the game changer. So I remember eating breakfast. I ate a meal that I would eat back then. It was probably like oats and yogurt and banana or something. And I checked my blood glucose and it spiked up to 25, which is 450 in milligrams per deciliter, huge, five times normal range. And I remember seeing that number and just feeling so deflated. Like I felt terrible in my own skin already, but then just seeing that number was just another reason to sort of hate this position I was in.

32:59Anyway, I went to the gym, which is what I would usually do. And I put my glucose meter away, smashed out a workout. And for those 60 minutes, I was just in my happy space. I felt amazing. I still managed to do a good workout, full body workout, got a good sweat on for 60 minutes or so. I got out of the gym and I checked my blood glucose again expecting to see the same number because at that stage that I didn't, I didn't know that anything in your life, in the day-to-day activities of your life could influence your blood glucose, right? So I checked my blood sugar and I see that the numbers back into the normal range.

33:39So it dropped from 25 down to about five and I was blown away. I could not believe it. That was the first time that I felt this like little bit of hope. All of a sudden the color was coming back into the world around me and I felt like, hey, actually this is pretty powerful stuff. I can manage my condition potentially just by exercising. This is incredible. Right, like a little spark of agency that you could exert. What's interesting is without insulin, without the, you know, insulin being the molecule that opens the gate that allows glucose access to the cells, how does exercise provide that role in the absence of insulin?

34:20Well, this is what is so fascinating about the human body is there is another mechanism by which glucose can enter the cells of the body. I will say the caveat here is that because I was in my, they call it the honeymoon phase, which is such a ridiculous term for this phase. But when you're newly diagnosed, you may still have like three or 4 % pancreatic function at that point. So I may have been producing just a little bit of insulin, right? So small amounts, but just enough. But the other mechanism is really where the magic is. So, I mean, it's such a great question. Like, how did my blood glucose go from 25 down to 5?

34:54Like, how did that even happen? So, as we said before, insulin acts like this key that opens the gateway to the cell. But it turns out there's another mechanism, which is called non-insulin-mediated glucose uptake. It's got a few names. Contraction-mediated glucose uptake, exercise-induced glucose uptake. But essentially, the act of contracting your muscles sends this message inside of the cell to send, it's called glute for a trans, a transporter, a glucose transporter that sort of resides inside of the cell. When you contract your muscles, it sends this cascade down into that cell. And this little transporter translocates to the cell wall and acts as this gateway.

35:40So if anyone has pre-diabetes, insulin resistance, or type one, or has high blood glucose, or I mean, in everybody, in healthy people too, it's the same mechanism. So you contract your muscles and you get these glucose gateways opening up, which allows this free access for glucose to enter the cells, completely independent of insulin. So you don't have, there's no insulin cost at all in that case. It makes sense from a survival and evolutionary perspective to have this kind of backup generator, right? Like, hey, these muscles are contracting. They need glucose. Like, I don't know what's going on with the insulin over here, but like, we're gonna have to, you know, get the supply going.

36:19Yeah, exactly. So, you know, in a fight or flight situation or anything like that, where the muscles can't be dependent on wherever the insulin happens to be or not be in order to function. Exactly. And, you know, the unique thing about this mechanism is that it's site-specific. So depending on which muscle you contract is where that glute four or glucose transporter will do its work. So if you only go to the gym and do calf raises and bicep curls compared to the person who does a full body workout or training all the major muscle groups, the glute four translocation will be very different between the two.

36:54So if you have diabetes and you want to get your blood glucose under control, a full body workout is going to be a way better way to open those gateways than just isolation work, you know, doing a bro workout. So that workout that I did was just so powerful for me because it gave me this sense of responsibility or agency, as you said, but also a tool. This is my first tool that I figured out was like, I can do this. I can control my diabetes as long as I exercise every day, which became a - Right, that might be overstating the case. Very much so, which I didn't realize at the time, but I made some big errors.

37:32All I need to do is to do this, right? I made some big errors after. At some point, obviously, you get on the insulin program and all of that, and you learn how to administer it responsibly and safely. I'm sure there was a whole learning curve.

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39:26walk me through kind of the evolution of developing greater and greater agency through lifestyle choices yes with exercise but even beyond that that have kind of informed how you live with this day-to-day and sustain a healthy active lifestyle so life became a big experiment And I was already trained and accredited as an exercise physiologist. So I had this understanding of the science and I knew about how the body worked, but I'd never walked the walk as someone living with diabetes. So I began to just test everything. And at this stage as well, I was still using the glucose meter. I didn't have a CGM.

40:03I've only had this for a couple of years and I've been living with diabetes for like 12 years now. So I was doing 15 to 20 finger pricks per day, but I became obsessed with collecting the data. So I was just pricking my finger all the time. I didn't want an hour to go by without knowing what my blood glucose was. And they'd offered me this technology, but I just, I wasn't ready to wear my condition on my body. I was in hiding for the first, I want to say even a year. I did not want anyone to know that I had diabetes. I would go to the bathroom to give my insulin if I was out at a restaurant. I would never prick my finger in public.

40:43I'd go to the bathroom to do that too or go to my car or I didn't want anyone to know what I was dealing with. You know, I just, I hadn't identified with my new being and my new condition that I was going to be carrying with me for the rest of my life. And I don't want to say I felt ashamed, but I definitely felt icky about it, you know. And I know it was not my fault at all for getting it, but I wasn't ready to wear it confidently and proudly. So the first year was hard, a lot of hiding it, but a lot of self-experimentation. And I would check, you know, my blood glucose before and after certain workouts.

41:16And I would notice that depending on the type of workout, the blood glucose response was completely different. And that was the mistake I made early. I mean, it was a blessing and a curse, but you know, that pivotal moment where I did that great workout and brought me back into range in a way set me up for some failures because I saw exercise as this, as a hammer, basically. And everything was a nail. Every time the blood glucose was up, got to hammer it, right? But what I didn't realize was certain cases required a different tool and the hammer was not going to do it. I was trying to tighten screws with the hammer.

41:52You need to find other tools. So, I mean, a couple of learnings that were that depending on the intensity of the exercise, your blood glucose can actually go up. So, for the first week or two after doing that great workout, I would wake up in the morning and go for a fasted sprint session at Bondi on the soft sand. And I'd finish the session and my sugar would be up to like 20, which is the same blood glucose that it was when I ate that carbohydrate rich meal. And I was just so confused. I was like, hold on a second. I just used exercise in that case and it worked perfectly, but today it's made my sugar go up.

42:29And then I realized that caffeine, from drinking coffee can stimulate adrenaline, which also you get this glucose output. So the high-intensity sprint training, the caffeine, in a fasted state early in the morning, I was layering these two things on top of each other and causing my blood glucose to go even higher as the body has this ability to put endogenous glucose or glucose that's stored in the body into the bloodstream through the liver. So I was turning this liver tap on unknowingly in the mornings and I would wake up with a blood glucose that was normal. And after my workout, I'd be in the 20s again.

43:06So, I mean, just so many little failures and learnings along the way. Of course, nutrition. I mean, that was the next thing that I had to try to tackle. And the way I sort of fell into the nutrition side of things was I just did a simple Google search. Just being diagnosed with type 1 diabetes, what diet should I eat or something, or like how to treat or cure type 1 diabetes with diet, which obviously you can't treat or cure it. But the first thing I landed on was a paleo way of eating, which when you compare it to a standard Australian diet or a standard American diet, it's a step in the right direction.

43:44Certainly. And your diet leading up to that point was typical. Very standard. Yeah. Right. I mean, of course, health conscious, but by no means whole food focused. Like I would kind of eat a bit of everything. So I fell into this paleo way of eating and instantly some great results. My carbohydrates per day were roughly, say, 150 grams per day. So not too, too low, but just right in that sort of sweet spot. I focused on whole foods. I eliminated whole grains and legumes and dairy, but I was eating fruit and vegetables and lots of meat and eggs and chicken. Lean meats, fruit, veg, no grains and no legumes.

44:24Right. And no processed foods, obviously, and no dairy. Exactly. Yeah. So, in comparison to just a typical person's way of just mindlessly eating whatever, obviously, you're going to have amazing improvements from that. Right. And what I noticed was in the first maybe, I mean, the timeline's a little bit blurry now, but within say four weeks or so, my insulin requirements had come down quite a lot. So in the beginning, I was told by the educator to give a basal dose of insulin, which is every day you're going to give this sort of large dose that's going to sit in your bloodstream for 24 hours.

45:05That dose came down by about 50 % to 60 % after a month or so on this paleo diet. So the basal had come down and then my other insulin, the short-acting one with meals, had also come down. So per unit of insulin, I could now metabolize more glucose. which was really interesting. So again, another great tool. So I discovered exercise is this wonderful tool. Now I've got nutrition. And at this point, I felt very comfortable with where I was. I was super happy with my diabetes management. My HbA1c was great, close to normal. Not quite there yet, but very close. And you were able to put weight back on and go out and live your active of life in a pretty normal way?

45:47Yes. The weight came on rapidly and to the point where it came on a little bit too quick. I got very fluffy, very fast, which makes sense because I was essentially starving for those months because although I was eating a lot of food, it wasn't getting into the cells of my body. It was sitting in my bloodstream and I was either excreting it through the kidneys, urinating the glucose out, or it just wasn't getting, it was just building up in the bloodstream. So, you know, once you start taking insulin, which is a very anabolic hormone, you're going to gain weight extremely quickly. And I got fluffy and I was doing a lot of modeling in my early twenties.

46:20And all of a sudden this, I mean, this was a hard thing to deal with because I was getting no work now because my body had completely changed. The modeling industry loved the skinny, you know, fashion-y editorial looking body. And now I was really out of shape. and in fact there's a huge overlap with type 1 diabetes and eating disorders especially in women the stats are crazy like 30 to 40 percent of women with type 1 diabetes develop an eating disorder and i'm not surprised why you know it's well the disease the condition itself makes you like sort of hyper vigilant about what you're eating and then you're taking this on anabolic and it's creating weight gain so it's not surprising it's not surprising it's going to have that impact.

47:04A lot of women intentionally don't take their insulin so that they can lose the weight. And then you can imagine what happens there to their blood glucose. It's a slippery slope. And I've known many girls who have gone through this. It's horrible and guys, and guys. I certainly, there was a period where I also developed some disordered eating. Right, well, you're getting fluffy to use your word and you're like, well, I know how to fix that. all I have to do is cut back on this other thing. It's a lot easier than trying to regulate your dietary choices. And to add to it, if my blood glucose was in range, I would just skip meals.

47:44I would go, you know what? I'm in range. I don't want to go high. I'm so scared of these long-term complications of going high. I'm just not going to eat for like 10 hours and just stay in range longer. Then by the end of the day, I'm in a huge calorie deficit. I'm not nourishing my body with anywhere near the number of nutrients and macronutrients that I need. And then I'm going the other way. So that I dealt with that for a long time. And you know what? I did some damage for sure to my health in many ways. And again, just these little failures, I kept tripping over and figuring things out and dusting myself off.

48:17And I found my way back to a path that was really good for my health. But the first year or two was extremely difficult. So you cotton on to this paleo diet and lifestyle, and that seems to be working. Why not stick with that for the long haul? What happened? Well, I sort of immersed myself in the diabetes community online. And I became somewhat of an advocate for healthy living with type 1 diabetes. And I was talking to people on Facebook groups and Instagram and all these things. And people would ask me all the time for my opinion on certain ways of eating for diabetes. And one of the questions I kept getting asked was, what about keto?

48:58What do you think of the keto diet for type 1 diabetes? and being someone who loves the self-experimentation, I found it hard to give an answer having not tried it myself. So I thought, you know what? I'm not going to give my opinion on the keto diet until I've tried it. So I sort of dived into that. I started a keto diet and I was documenting it in real time on social media. I was posting about it on Instagram and I was waving the flag. I was an advocate. I was raving about it because the first two months, again, my insulin requirements came down even further. My insulin to carb ratio was, even though it was a very low, low carb diet, but I was taking hardly any insulin and I was keeping this beautiful, just flat line in range.

49:41Everything looked amazing. And what exactly were you eating? Like, what was the breakdown? What did that look like? So, I mean, 75 % of the calories were from fat. I definitely did a paleo-y kind of keto diet in terms of I kept a lot of whole foods, a lot of leafy greens, non-starchy vegetables, broccoli, cauliflower. I try to keep it vegetable heavy. I wanted to keep fiber in there. Right, but like completely non-glycemic vegetables. Right. Right, and when you say 70, I mean, 75 % fat. So what is that? Like you're putting coconut oil in your coffee and - I didn't go to that extent. Eating saturated fat.

50:25Like how did you consume 75 % of your calories in fat? So a lot of olive oil on salads with half an avocado, a piece of salmon, nuts and seeds on top and an egg. And then a big base of leafy greens, broccoli, cauliflower, those kinds of things. So big like salad bowls with lots of fat sources and some protein. I was consuming a lot of coconut oil, fatty meats, chicken, beef. I was eating a fair amount of saturated fat, but I would say I was doing a healthier keto diet than what you do see other people do. Right, that doesn't sound so bad. I mean, in comparison to videos you'll see online of people just literally taking a bite out of a stick of butter.

51:15And there's some wild stuff out there, right? But that's still a lot of fat, a lot of saturated fat, but had this amazing impact on your ability to really flatten that curve and manage your diabetic condition. And this is something that a lot of people with type two or any kind of metabolic disorder or just in general, people are experiencing success with in terms of how they feel. And it makes sense as to why it works. You've got this condition where glucose is something that's hard to metabolize and you're eliminating glucose from entering your bloodstream. So you're going to stay in range for longer, which also means your requirement for insulin is lower.

51:59So it just makes sense. And for about two months, it was great. And I was telling everyone about it And I was recommending it until I hit a brick wall where I noticed that every morning my fasting blood glucose was a little bit higher. It would happen day after day, week after week for a couple months. And I was very persistent. I was like, I'm going to ride this storm. I'm going to see what happens. How long were you into it when that began? So two months into the diet, I started to see my fasting blood glucose elevate. And then I stayed with it for about two months. So what was happening was my liver overnight was pushing glucose into my bloodstream.

52:40So remember I mentioned that glucose tap. That tap was on all night. And when the glucose was in my bloodstream, there was no way out. It wasn't getting into the cells of my muscles or anywhere else that it could bring my blood glucose back into the normal range. So I would increase that basal insulin, which is that background insulin. I would just give a little bit more each night until I'd find the dose that would stabilize me. But I just couldn't get it under control. So my basal was going up, my insulin, but my blood glucose wasn't coming down. So I was at this position where I felt like I was getting resistant to the insulin.

53:13It wasn't even working anymore, which is pretty frightening because that is the one tool that I need to keep me alive. I will literally die without it. So during the day as well, my short-acting insulin doses were going up and it just wasn't working. And there was this one day where I was actually on a photo shoot and the photographer was like, are you okay? Like, you just don't look vibrant. And it's because I was dealing with a high blood glucose that I couldn't get under control. So before the shoot, I gave a large dose of insulin, checked my blood glucose two hours later, hadn't moved. So I gave another big dose of insulin, checked again.

53:46It was not moving. So I got to this place where I was like, I think I'm actually resistant to the exogenous insulin that I'm administering, which is a pretty scary reality, right? And then that was where I kind of knew I had to shift gears. It was time to look into this, like what is going on? And this is where Simon Hill enters the conversation. Right, and what's interesting is that you are doing everything that you think is right. The conventional wisdom out there for people that are contending with this condition is that carbs are the enemy. and the best, most effective way to manage a diabetic condition is to eat a low to no carb diet to focus on fats and proteins.

54:35And this will allow you to kind of manage your blood glucose levels, which is effective until it's not, right? And I think what's pernicious and kind of beneath the surface here that we're going to get to is this idea that that's the curative path. but in reality, it's quite pernicious because all it's doing is masking your body's inability to metabolize glucose because you've never, you're not exposing your body to glucose. So you're not actually dealing with the problem, you're removing kind of the external symptomology because the minute that you do expose your body to glucose, you quickly realize like it's completely incapable of doing it.

55:20So basically you're in this persistent state or you're kind of pursuing this path blind to, kind of the reality of what's going on. And this journey that you've been on, we've talked about this on my show before with other people like Robbie and Cyrus, et cetera. There's a whole other way of looking at this that you're soon to discover by dint of our friend, Simon. Right, yeah, that's exactly right. When you can achieve, normal blood glucose levels and normal insulin requirements in the absence of carbohydrates in your diet, you're essentially just, it's a band-aid solution to a degree. It can still be a solution for some people.

56:04Because if you can maintain that long enough and you don't run into the same hurdle that I did, which it happens to a lot of people, I've gotten dozens of messages over the years, but some people can keep that up for a long time. But that is just, like you say, you're just masking these symptoms, right? Because as soon as you reintroduce the carbohydrate or that trigger, you're going to see the real identity of what's going on so whilst on the other hand if you can achieve blood glucose control that's normal with with good insulin sensitivity and normal insulin requirements in the presence of carbohydrates that is the true insulin sensitivity that is resilience and robustness right exactly exactly so you know i was i was posting online about the keto diet and type on diabetes and how to manage it and all this stuff.

56:53And Simon, he flicked me Instagram stories of a doctor who had been at a conference and delivered a talk with these lecture slides. Was it Michelle McMacken? Yes, it was. So she had been talking about a plant-based, high carbohydrate approach to managing diabetes. And I'd never heard of whole food plant-based at I didn't actually understand there was a whole movement there. To me, it was just paleo, keto or just not. That's interesting in and of itself. How would you not have even known? Didn't even know. Yeah, because there's like a whole world there. I guess that's a larger conversation about how our information silos can work at cross purposes with exposing us to different ideas.

57:43I guess if you're in the paleo or keto kind of wormhole, you're not hearing a lot about other options or alternatives. I literally had never heard of it. He sent me a message with his lecture slides and he wrote, have you considered, and he wrote WFPB. And I was like, what is that? I had to Google the acronym to even see what it meant. Did you know Simon? I knew him from around Bondi. We had mutual friends. You see him down at the beach or whatever. I'm just picturing you got like, you know. We'd cross down. I'm like working out, you know. Oh, that guy looks fit. Yeah. Like we, we, obviously we knew of each other and I knew him as the, um, the nutrition guy.

58:22And I knew, I didn't know really what his message was. Somebody, I thought he was a chef to be honest, because a friend of mine was working with him and taking some photos and I saw photos of him with food and I thought he was a chef. Anyway, he introduces me to these lecture slides and I had a look at them and I read through it and I was like, wow, so there's another way. and this way has all the carbohydrates in the diet and they're claiming that the control is as good, if not better than these other approaches. I guess being the self-experimenter that I love to be, I'm gonna have to give this a crack.

58:56That contravenes everything that we kind of hear around how to manage this condition. Carbs are the enemy. The solution can't reside in like eating a bunch of carbs to manage this. Like that doesn't make any sense at all. It does feel like mixed messaging, doesn't it? And people get really agitated and activated when you propose that as an idea. Right. I mean, look, carbohydrates, depending on the context in which you have them, can be a trigger of high blood glucose excursions. That is a fact. That is true. But what they're not telling you is that the degree of insulin sensitivity that you have will dictate whether or not you can tolerate carbohydrates.

59:40So you need to be insulin sensitive. You need your insulin to work properly. And the way to achieve good insulin sensitivity is, number one, you've got to be a healthy body weight. Body composition matters. You need a fair amount of muscle on your body because that's the glucose sink. Those are the glucose sponges that soak up the glucose. The types of fat that you eat will impact your insulin sensitivity. So if you have a very high saturated fat diet and you're eating carbohydrates, which is the standard Western diet essentially, that is a recipe for disaster. Sure. So if you add carbohydrates into that system in that context, you will see these glucose spikes and you'll blame the carbohydrate immediately because you'll just say, I ate the banana or I ate the whatever it is, the candy, and my blood glucose went up.

1:00:22But what you're failing to see in that context is if you swap those fats and replace them with unsaturated fats, lots of fiber, whole foods, that you can now tolerate those carbohydrates a lot better than in the context of high saturated fat intake. So it's really, really important to understand the different macronutrients and how they mix together and how they play. So you have a receptivity to trying this, to experimenting. And I think it's worth noting that that is not unrelated to the grace with which Simon approached you. He didn't ping you and like shame you or say you're getting it wrong or browbeat you.

1:01:06He just said, hey, maybe check this out. I think that there's something about that that is worth noting because the way that we communicate in our various dietary circles with the silos and the judgments and the owning of the other side and all that kind of stuff is not really productive at all. And I think Simon's just kind of very gentle, like, hey, man, check this out. You're a scientist. Here's the paper. I'm not telling you what to do. like, hey, maybe read this. Yeah, that's exactly it. So the way he did it was gentle. He sort of just gave me this nice little gentle nudge in the direction of now you take responsibility, you do the reading and see where you end up.

1:01:50Yeah, and I'm not attached to whether you change or do anything differently, even if you read this paper. And he didn't oversell it either. He didn't say, trust me, if you follow this diet, you'll have the best insulin sensitivity and you can manage your diabetes way better than this. He just let me do the work. And I'm glad I did the work because where I've ended up is a great place. But, you know, essentially I just decided that day that I was going to dive into becoming fully plant-based. And I was going to let go of the keto, which was the other end of the spectrum. It was quite a contrast.

1:02:24You decided that, but after experimenting though, you must have said, well, let me check it out and see if this is even effective. After reading a little bit about it, I mean, how else can you go plant-based without going fully? because I was already pretty much there because I was eating a paleo diet that was 80 % plants. I was eating a lot of plants already. But you didn't have a bowl of fruit like that sitting next to you. No, no, no. That would not be even in the house, no chance. And just remember being paleo, you're not eating whole grains or legumes. So carbs were, I wouldn't say I was fearful of them, but I was certainly not embracing them.

1:03:02And I had victimized them in certain ways myself because I'd seen, you know, sometimes I'd have these spikes and it's very easy to blame the carbohydrate. But I guess the decision to go plant-based, I was like, I'm just going to do it 100%. I could have edged their shore. I could have just slowly taken out the salmon off that plate and then swapped it with whatever, beans or – and then kept the eggs in and kept a bit of – but I just wanted to go full in to see the impacts on my blood glucose management. Because just remember, at that time, I was again in a place of turmoil where my blood glucose control wasn't great.

1:03:38At the end of that keto diet, my blood glucose control was not good. I wanted to fix it as quickly as possible. And the exposure from high saturated fat keto diet to a low saturated fat, more unsaturated fats, high carb diet, I'm going to see straight away the difference. Yeah, your numbers are going to reflect the reality pretty quickly. Right. And I was petrified of eating carbohydrates at first. I thought I was going to spike immediately. I hadn't eaten whole grains or legumes in like seven years. Seven years with no whole grains. Because that's how long I was on the paleo diet for about seven years.

1:04:16And fruit. I mean, I started to add in a lot of fruit and I accepted a couple of things. There were these two realities that I accepted and I surrendered to. Number one, I'm going to lose all my muscle because I'm not going to be eating any protein. And number two, my blood glucose is going to be very high for a number of weeks probably. That's what I thought was going to happen. And what did happen? Blew my mind. So within a few weeks, my insulin requirements and my insulin sensitivity was the best it had been in a long time. So all of a sudden, my muscles were able to soak up the glucose again that was in my bloodstream.

1:04:54My insulin requirements went down and down and down, the insulin to carbohydrate ratio, which is an indication of your sensitivity to insulin, improved beyond actually the best that it had ever been. So it was pretty good on a paleo diet, but when I removed the saturated fat and got it down to roughly 10 % of total calories, up to unsaturated fats, I could tolerate a fair amount of glucose. So that ratio was improving a lot.

1:05:25I can almost hear the outrage of the person who's listening to this, who is experiencing positive results on a keto diet. So explain how you account for that. Like, why is this happening? Because it contravenes everything that I thought was true and false when it comes to diabetes. And when I say that, we're talking about type two here as well. like the experience that you're having or the experience that you're having would not be dissimilar for somebody suffering from type two. Is that correct? Correct, yeah, very similar. The truth is you can have good diabetes management on a keto diet, that is the truth.

1:06:17You can also do a keto diet that is healthier than the one that you see, like you say, on social media of a guy eating a stick of butter, pouring coconut oil and butter into his coffee and eating bacon and eggs all day and a carnivore-style keto diet. You can eat a high-fiber, whole food-based ketogenic diet, and you can achieve good diabetes management for a long time. But some people don't as well, right? So different individuals are going to react differently to certain diets. And even in the case of those people that can keep that keto diet up for a long time, when they decide to reintroduce carbohydrates, even if it's just on a cheeky weekend or every now and then, the ability to tolerate glucose goes down.

1:07:01And it happens in healthy people. It happens in people with type 2, type 1. That is just how the human body works, is your tolerance for glucose goes down when you are fully eliminated from the diet and you increase your saturated fat. So it's just nice for people to know that there is another solution. You don't have to, like some people will stick to this keto diet for years or decades, but they feel like a slave to their diet. And they feel like they have to follow that way of eating because it is treating their condition without even knowing about this other solution. So I don't want to tell anyone what to eat, but I just want to say there is another way that you can do this.

1:07:35And if you do remove saturated fat or at least limit it to about 10 % of total calories, you can regain that insulin sensitivity. Your carbohydrate tolerance will go up and you can eat the fruit, you can eat the banana, you can eat the grains, and you're not always going to see this spike in your blood glucose. But you also seem to be achieving the goal, which is to be in a situation where your body can tolerate the carbohydrates, that you have that robustness that is lacking on a keto diet because you're just avoiding that exposure. Yeah. I think a lot of people with type 2 diabetes in particular, they go on a low-carb diet, remove carbohydrates from the system, and they say that they have achieved remission or even reversal.

1:08:24They think they've reversed it because they come off the medication, their blood glucose goes back to normal, they wake up in the morning, their fasting glucose is normal, their postprandial or post-meal glucose is normal, the A1C goes down, They may come off insulin if they were dependent on it for a while because they might still have some pancreatic beta cells that are working. And then they think, I've done it. And then all of a sudden, they add back the carbohydrates and it shows up again. So you've got to understand that, again, the absence of carbs from the diet are going to show you a blood glucose and insulin picture that may not represent the true robustness of the system like you mentioned.

1:09:04whilst in the presence of glucose. If you can handle glucose, you can handle carbohydrates and achieve the same numbers as the people who are completely eliminating the carbohydrates, to me, that is the true step. Yeah, yeah. Then you're in not just remission, you're in a journey of reversal. I mean, is that overstating the case? It's not. It can absolutely happen. If you have type 2 diabetes, you can't reverse type 1. I'll just say that now. Once you've got type 1, at this stage, there's no cure. You cannot reverse it. But if you have type 2 diabetes and you can tolerate carbohydrates, you have completely normal blood glucose, your pancreas is still working, you've got the beta cells, that would be reversal.

1:09:45So you can reverse type 2 in certain cases. If your beta cell function is burnt out and you don't produce insulin, that's a different story. Now you can't really reverse it. That's where staying on a low-carb diet long-term can work for people because they don't produce insulin. so keeping glucose out of the system you can keep them in range for longer right so you adopt this plant-based whole food plant-based approach like how quickly before you started to uh you know perceive these results and realize that you were on to something pretty powerful maybe two weeks in my numbers were back to normal i mean two that sounds like even when i think about it now, that's very fast.

1:10:28I couldn't believe how quickly it happened. And then it just slowly sort of plateaued in terms of the gains. It wasn't just linear and it sort of plateaued a little bit and I was able to maintain that. I'm five years in now and I'm maintaining the same instant sensitivity. I'm eating hundreds of grams of carbohydrates. I didn't wither away and lose all my muscle. I was very happy with my gym performance and my sporting performance and and how I feel and just the whole list. I was very, very nervous about a few things there. And thankfully I was wrong. Right, your ability to build lean muscle mass and be the fit kind of exercising fiend that you are.

1:11:12Right, to maintain my strength and still, you have this vision of you're gonna be frail and your bones are gonna turn to dust and you're not gonna be, it's just not the case. It's so wild. I mean, I had Robbie Bavaro and Cyrus, the Mastering Diabetes guys on the podcast. Robbie is basically a fruitarian. Like he just eats fruit all day long and he's managing his type one diabetes. And he was very transparent about all his numbers. And that just blows people's minds. Like the comments on the YouTube of that are like bananas. Like people just can't believe it. they think he's lying, you know, because it's like, what?

1:11:55Fruit is the thing you're supposed to avoid. You're supposed to avoid all these sugars. And here he is like doing the exact opposite. Like, how can this possibly be true? And the guy has like more energy than anybody I've ever met. It's incredible. He literally eats upwards of a thousand grams of carbohydrate in a day. Some of his meals have like 300 grams of carbs just in a bowl of fruit. And again, If people are wondering how is this even possible because so-and-so told me that fruit is terrible for diabetes and spikes their blood glucose, he's so sensitive to insulin. The insulin is working so well because his saturated fat intake is extremely low and he's a healthy body weight.

1:12:33That's a huge part of it and that's something we haven't really spoken about. But people with type 2 diabetes, if you're trying to reverse your type 2 diabetes, the number one thing is weight loss. And a lot of the studies show that there's sort of this key number of about 15 kilograms of weight loss can achieve a reversal or omission of this type 2 diabetes. So that's why, again, if you start a keto diet and you lose all this weight and all of a sudden your type 2 diabetes seem to be going away, a lot of it may be attributed to the weight loss. So that's, again, I'm not completely excluding these other dietary patterns if they can help people achieve weight loss.

1:13:16Let's call it fat loss. Let's be a bit more specific because you don't want to lose muscle. We want to hold on. Muscle is very precious. Muscle is the sink or the sponge that soaks up the glucose. So we want to hold on to as much of that as possible. It's not just an aesthetics thing. It's quite important for many aspects of health. But then losing body fat, that 15 kilograms for some reason is a number that people can achieve some really good results if they hit that. And in addition to just this fear around carbohydrates is a whole ideology around grains that you had to sort of deprogram yourself from.

1:13:50So talk a little bit about introducing grains back, whole grains, we should say, back into your diet and the impact of that. Yeah, I definitely demonized grains for many, many years. I thought that they caused inflammation, ruined your gut health, would elevate your blood glucose levels. and it's because I was reading a lot of these paleo blogosphere style of you know the rhetoric there is that whole grains are you know they have lectins and poisons that are trying to kill you and you know all this stuff and I definitely fell for it in the beginning because it's a compelling story it's a lot sexier than the the current story of the whole food plant-based one it just you know as you mentioned before it seems to not get the same limelight as these really appealing carnivore, grains are trying to kill you, plants are trying to kill you, that sort of storytelling?

1:14:41Well, those stories are very reductive and they're often delivered in a package that comes with a developed torso and a lot of sort of conviction, right? Like, we can get into that. Like, it is interesting that the plant-based message doesn't track in the same way because it's missing that kind of,

1:15:09it's not all tied up in an alpha bow that is appealing to a young male, I guess I should say. I mean, there are many developed torsos in the plant-based world that are promoting the message, but as you say, even in spite of that, it still doesn't quite get the spotlight that I think it deserves. And I think a lot of it is to do with that alpha male rise of the liver king, the carnival craze of like the hunter, right? Right, there's a whole story around masculinity and a search for identity and the connection between that hunter kind of paleo primal, what does it mean to be a man that connects with a certain dietary affiliation that involves a lot of animal protein.

1:15:59And when you strip that away and you're talking about whole food plant-based, it just sounds beta, soy boy, you know, it's just a harder narrative. How to say. You know, it's just not gonna, it's not gonna track, you know, in an Instagram reel or in a TikTok in the same way, which is problematic and is a longer conversation around like how you storytell and how you communicate. But you as, you know, look, you're an incredibly fit dude. You came to this after your exploration in good faith in the paleo community and the keto community and discovered this plant-based way of eating. And not only has it helped you manage your diabetes, it's fueled your active lifestyle and you've become this sort of proponent, sort of an unlikely proponent of a way of living that is more sustainable, healthier long-term without the compromises that some would have you believe are part and parcel of eliminating animal products from your diet.

1:17:05And when I made the transition to the plant-based diet, I've got to be honest, the animal ethics side of it was not my focus because I was very, very determined to manage my diabetes, get those numbers under control, try to maintain my physique the best way I could. I wasn't thinking about the planet or the animals. I've got to be honest. But as you dive into, you know, research and reading and documentaries and just the community, you get exposed to those other two pillars that now anchor me potentially more than the health side of this diet. Because I think a diet attached to values and ethics is much easier to maintain long-term whilst a diet attached to a little bit more vanity and you know vanity and uh weight loss and aesthetics yeah it's harder to maintain long-term so the animal side of things for me is absolutely huge i mean i always considered myself an animal lover and i remember i got a i was when i was paleo i was like making a chicken broth and i had like the chicken carcass i cooked up all the meat and I had all the bones left over and I was boiling it down and, you know, videoing and put on social media.

1:18:19And someone slipped into my DMs and said, you know, you're an abuser. You want to know where that chicken came from? Watch this. And then I got into this dialogue with this person. I'm saying, no, no, trust me, I love animals. I really, I love animals. You're wrong about me. You don't know me. I didn't know me. I was so, I was contradicting. I was a hypocrite because I told myself I loved animals and I did. but I was eating some of them. I loved my dog, but I was eating the other animals who feel the same pain as my dog, suffering the same way as my dog and arguably are as intelligent as my dog.

1:18:55So I just didn't, I didn't see it until I started eating a plant-based diet for health, got exposed to these other two pillars. And then before I knew it, I saw some things that you just can't unsee. And yeah, I mean, that holds me now, holds me together. Yeah, my journey was not dissimilar. It started from a kind of vanity and health perspective. I didn't feel good. I didn't like the way that I looked. And the ethics and the kind of environmental considerations came much later, but now are much more, they're on a parody with the, you know, it's like, it's a lifestyle that checks all the boxes, right?

1:19:36You can be more gentle on the planet. It's more compassionate towards our animal friends. It's actually in the best interest of our health. Like it's almost as if nature designed it that way. You know what I mean? And it's interesting to kind of be on the receiving end of all the mental gymnastics that go into rationalizing and these other choices like, oh, actually, if you eat meat, you're part of the solution. And the way to save the planet is more pasture, more cattle pastures, et cetera, that really don't hold up under close scrutiny, which is a whole other podcast. I don't wanna go too far down that rabbit hole, but I think it gets confusing in the influencer space

1:20:32for people who are in a position to be easily kind of massaged or manipulated away from the truth. Oh yeah, absolutely. You see it now more than ever. I think that narrative has grown a lot. And I think people use it as an excuse. I know a lot of, like, let's be honest, most alpha men who are eating meat today aren't hunting it themselves. They are paying somebody to kill the animal for them. In what world does that make you a man, to pay for this industry to exist so that you can eat meat? I just don't see that as a masculine characteristic. I mean, I feel like, I feel more of a man now choosing not to partake in something that goes against my values.

1:21:14To me, that is a stronger move than to go, hey, I'm only gonna eat meat, but I'm gonna make sure that that person grows the animal, feeds the animal and kills the animal for me. I just, you know. It's more masculine and takes more courage to take a hard ethical stand that contravenes a socially acceptable behavior and to do it out of compassion for the souls that can't speak for themselves. like to be a caretaker, to be a protector. But that is a harder, once again, like a harder narrative to spin. But I think it's people like yourself who hold themselves out as an example, that's how you kind of create change in this narrative.

1:22:06And I think the era of, activism is a tricky thing. Like you need all kinds, You need people who are on the far edge and uncompromising and speaking truth to power. And then you have people like Simon who are a little bit more gentle. And all those different voices have different ways of connecting with people. But I found, much like Simon, that a lot of the sort of tools used by the animal rights and vegan community not to work for me and I think are failing in general. And it's much better to be an example, like a healthy, vibrant living example of this lifestyle to attract people who are curious about that and to allow them in without judgment to have a dialogue about what that might look like for them.

1:23:05That seems it's a slower change I think, but I think more effective. I think the sort of more aggressive advocacy, like the example is the guy who sent me the message saying, you tortured that chicken, blah, blah, blah. Right, that doesn't make you - Didn't work for me. That's not gonna make you feel like you wanna make that change. Right, it wasn't productive. It's gonna make you defensive. Correct, and I decided - Entrench you in that, yeah. Yeah, I decided not to be that guy going forward, even though I want to say that to so many people and I know it's true. What's true is not as important as what is productive.

1:23:41if you want to move the needle. Talk a little bit about overcoming your fear of suddenly sort of dying on the vine. Like if you're going to eat only plant-based protein, well, that protein is inferior and it's certainly going to be substandard compared to the way that I was eating before. Like how have you, you know, how has your fitness changed or your gains, you know, have they been compromised? Like how does, what does that look like? The first couple of weeks and months, I did feel a bit different. I think I lost a little bit of weight though, because naturally when you adopt a whole food plant-based diet, because the calorie density of the diet is so low, you are probably going to lose some weight, which is pretty awesome if you're somebody who's overweight and wants to lose weight in a way that's kind of effortless in that you can eat large volumes of food and not have to count your calories and worry too much about it.

1:24:36So I lost a little bit of weight and I did feel a little bit weaker in the beginning. And that's when I started messaging Simon. I'm like, mate, I need your help here. The muscle's going. I feel a bit weak. And I wasn't pretending everything was perfect straight away. And he said, look, you need to eat more calories. What are your protein? What are you eating at the moment? And I'd never, ever had tofu or tempeh ever in my life. So he introduced me to those two foods, which are now a staple of my diet. I eat soy foods every single day. Another myth that we can bust another time. But I had to learn what were the protein replacements to make in my diet.

1:25:12If I was taking out fatty cuts of meat and steak and chicken, eggs, fish, what am I going to add back in? And Simon helped me to develop sort of not a meal plan, but understand how to manufacture that bowl every time I sat down to eat. Like what are you going to put in that bowl that's going to give you all the nutrients and the protein and the macronutrients that you need to still perform, play sport, build muscle. And I've gained probably a few kilos of what I like to think is lean muscle. I definitely didn't just blow up. Tofu, tempeh, beans, lentils, and the like. And protein supplement. What about all the lectins?

1:25:54They're everywhere. Are they destroying? Are you toxic from all the lectins? Well, it turns out it's easier to destroy lectins than it is for lectins to destroy you. Okay. And all you gotta do is cook them or soak them or both, and you're gonna pretty much remove most of them. Right, nobody's eating raw beans. Well, I don't know many people know. So, you know, the idea, this whole lectin, I mean, whatever. It's a whole other, like, yeah, but it's worth spending a minute to bust that myth. I know. Because there are a lot of people who are afraid of lectins. Yeah. I mean, the way Simon put it to me - There's one person who's responsible for that.

1:26:34Isn't that incredible though? Like hats off to that marketing team. That one person just completely changed the diet of tens of millions of people with one book. I don't even want to name him. We don't need to get airtime. Okay. But Simon explained to me, he goes, look, lectins are destroyed when you cook them. If you look at epidemiological studies of the longest living populations with the least amount of chronic disease, they eat arguably the most lectins. You know, beans are a staple of their diet. So, and just to tie it back into diabetes, those same populations, who Dan Bittner calls the blue zones, right?

1:27:11Yep. Not only do they eat a lot of beans and lectins, they have quite a high carbohydrate diet and they have the lowest amount of type 2 diabetes because their body weight, they're a healthy body weight, they're active, they move a lot, they've got wonderful bonds and connections with family and community. They enjoy their life, enjoy what they eat. And the last thing on their mind is, are those carbohydrates gonna make me fat or are they gonna cause diabetes? It's just, we invented this problem because people wanna point the finger at something to blame for the way they feel today. And it's always very reductive.

1:27:46It's like, this is the one thing that you need to remove or whatever. And I appreciate the nuance and the complexity with which you describe your condition, like saying it's not just any one of these things. And if you do that, yes, this will happen, but then you have to worry about this. Like our physiology is complicated. Diabetes is complicated. Nutrition is super complicated. And anybody who tells you this is the solution that fits all and you just have to do this one thing or remove this one thing, I would be very wary of. Yeah, that's the red flag. If somebody has the solution to a problem that you didn't even know was a problem, So they probably invented the problem and then sell you the solution.

1:28:29You know to probably look for other people to bounce some ideas off. That's a problem. Which leads us to CGMs. So let's spend a few minutes talking about this. Obviously, CGM, a continuous glucose monitor, is a life or death, very important piece of technology that's instrumental to any diabetic's life in order to simply survive, right? but you have to be monitoring your levels all the time. It's crucial, but we're in a very interesting moment in which we're seeing the pioneering, the innovation of all kinds of technology that's connecting the everyday person with what's happening in their body in real time, whether it's your whoop strap or your aura ring.

1:29:18And now these companies where you could do blood work and they give you in-depth analysis around that. And of course, an added piece here is the CGM for the first time ever being available to everyday people through various companies. And this allows anyone to wear one and to monitor their own blood glucose in real time. There's an argument that this is a good thing because anything that connects a person to what their body is doing is knowledge and knowledge is power. But there are also many people in the diabetes community who are upset about this and are concerned about what this means, right?

1:30:10So talk me through like your philosophy on this because I'm actually trying to figure out where I stand on all of it. I am too, to be honest. I've given this a lot of thought, obviously as somebody who wears a CGM as you mentioned for purposes that relate to keeping me alive it is a little bit funny seeing people wearing them on the streets who essentially don't need it it's more of a want it's more of a fashion accessory or a badge of honour to show how much they care about investing in their health which is something to commend in some ways if you care about your health that much that you're willing to wear a device that was invented for people with diabetes, you've got to sort of take your hat off and say, okay, well, you obviously care about your health, good on you.

1:30:55But whilst knowledge is power, if you don't understand or know how to interpret the data that you're collecting, I believe it's kind of useless. And I think that people are falling into the trap of wearing a CGM to collect data without knowing exactly what it means or what caused certain fluctuations in their blood glucose levels and then again pointing the finger at something that may not be the actual cause of that issue. And I'm seeing CGMs as a way for people to justify low-carb diets or keto diets. Again, it's not giving you that whole picture. It's only telling you what the symptoms are, which are those little fluctuations in blood glucose, but it's not telling you about your insulin sensitivity.

1:31:36It doesn't tell you about do you have fat building up in cells that it shouldn't be, which means that insulin isn't working properly. It doesn't tell you that stuff. So, you know, people, the problem is people are demonizing foods off the back of CGM use. It's happening. They're eating a carbohydrate thing. See, look at that. There's my blood glucose spike. It was because of X. Yeah, it gamifies the whole thing where the goal is to flatten that thing as much as possible. Right. which is gonna lead you to making dietary choices that might not have the best long-term results, right? Right. Without that education piece.

1:32:16I think the education piece is super important and I'm not sure that it's quite in place. The contrary opinion would be like, listen, I wore one for two weeks and I learned a lot. Like I had no idea that this food did this or when I don't sleep well, for example, that was something that I learned after playing around with it for a little bit, like, holy shit, when I'm not rested, it's all over the place. That was something I didn't realize or fully appreciate. Or certain foods are acting in a way that I wouldn't have expected. Like when I eat a banana, it does spike higher than I would have thought.

1:32:55Like, okay, I can file that away. I'm not gonna make a big deal about it, but it's a data point. But the importance of that data point is only in correlation to a whole other world of understanding and nuance that really isn't part and parcel of what that whole thing is about right now. And is that data point clinically meaningful? Right. That's the thing that I'm – Who cares? Right. And there's a kind of a weird shaming, oh, I had this spike. That's bad. Right. Is it bad? We don't know. What we do know is there's studies looking at HbA1c, which is that average three-month glucose level, in normal healthy people, over thousands and thousands of people, big epidemiological studies and even randomized studies.

1:33:40But there's a clear inflection point. It's like a hockey stick. So the idea that the flatter the better means you're going to have less health complications, less chronic disease, you're going to live longer. I'm not convinced that is true right now today. especially looking at this inflection point at around, I think it's about 5.5%, the HbA1c. Whether your A1c is 4.1 or 5.5, your risk for chronic disease is pretty much the same. But when it starts to go outside of that normal range, then you're going to see some complications and your risk might increase. So if you're wearing CGM because you're gamifying and you want to be the flatter the better, I'm not convinced that that is an evidence-based approach.

1:34:21And I'm not convinced that those spikes, quote unquote spikes that you're seeing are clinically meaningful or even relevant in your overall health? Right. Well, I think one of the problems is that the people that are signing up to wear a CGM are not the people who actually would benefit from having one because we're in, as we mentioned earlier, like there's a massive rise in metabolic disease right now. Like there are so many people who are either pre-diabetic or inching ever so closely towards that who would benefit from understanding how haywire their glucose regulation is. But those are not the biohackers.

1:35:07The biohackers are probably fine, right? Like they don't have to worry about it. But to the extent that there could be a better way to deploy these CGMs as a tool in the toolbox of stemming the rise of type two diabetes and prediabetes because by 2030, something like 50 % of Americans are expected to suffer from this. Like this is a massive problem, right? And here's something that could kind of help people earlier as they're nearing that to understand that they're at risk. I think there's a benefit there. Definitely. Secondarily, you have on the far other end of the spectrum, elite athletes who are using super sapiens and really understanding how nutrition impacts performance.

1:35:54And they're able to extract really valuable data, especially in the endurance space. How do you get through an Ironman in high humidity and hydrate and keep your glucose stable? All that kind of stuff I think is interesting at the cutting edge of athletics. But that's a whole other world, right? That's different from what we're talking about. So I see your point and I think it's very valid. The other question I had is, cause I've heard this, cause I've talked about CGMs on the podcast before and people from the diabetes community who get sort of agitated about that have led me to believe, like, is there like a shortage of these?

1:36:37I mean, certainly like if there's only so many CGMs and there are people for whom wearing one of these is life or death, I would rather those people have them than the biohackers out there who are just noodling around with it. And there's an expense thing too. Like how does that work in? If more people are using them, do we reach a certain scale where they become cheaper and more affordable to the people that need them? Or is there a scarcity of these devices altogether that make it important that we be conscious of that if we're going to try to play around with one? Rich, I don't know the answer to that.

1:37:12I understand that some people who have diabetes may not be able to get their hands on them because, like you say, they're attached to the arm of somebody who's a gym goer who just wants to use it as a fat loss tool, which I don't believe it is. I haven't seen, I don't know anyone who doesn't have a CGM because there's a shortage of them. In Australia, it's subsidized. So the government pays the bulk majority of that fee. It only came into use, I think it was maybe a year ago now or less, actually just a few months, where it used to be like$5 ,000 a year to have one and now it costs maybe$10 a sensor.

1:37:48So it's much, much cheaper. So it's affordable now for people with diabetes in Australia. I don't know about in the US. I have heard that though, that people can't get their hands on them. But then the other argument, as you mentioned, is the supply demand and if you can increase the scale, does it become cheaper for everybody? but I just don't know that these companies producing them are there yet to create. Well, if we look at the price of insulin, we can predict how that might play out. But just going back to one other utility that I can see a CGM working is, imagine if we put a CGM on the people who are high risk, right?

1:38:30So you go to your doctor, your doctor sees that you're high risk, maybe it's for family history or it's to do with your BMI or waist circumference or whatever other metabolic conditions you have, you might even have diabetes unknowingly. And we could diagnose a large amount of people with diabetes just by using the CGMs, right? Because a lot of the people who are undiagnosed aren't visiting their doctor. They're not tracking any data whatsoever. So they're walking around with diabetes, not knowing it, which is a silent killer, essentially, increasing your risk of cardiovascular disease and all these other metabolic issues.

1:39:01But if CGMs were accessible and cheap and everyone wore one, then we're probably gonna diagnose millions and millions. Yeah, and there is something about seeing it on your screen right after you eat something like, wait, you mean when I do that, this happens? Like I didn't know that. That creates a connection with your body and also provides that sense of agency. Like, oh, but when I do this, then this happens. Like, oh, cool. Like you become much more engaged with yourself. and that can then lead you down a path of being more engaged in other areas. Like once you experience a certain positive result, then you're encouraged and motivated to explore further.

1:39:46Yeah, it's a kind of wearing like a step tracker. I mean, that simple data input of how many steps did I do today may make you go to the gym and might make you choose a healthier meal. It snowballs. So yeah, I mean, there are cases where I can see it being very beneficial. I just worry that we might be misusing it at the moment. I'm not sure that. I'm not going to stamp. Yeah, no, I understand that. And like I said, I do think that there is a lot of room for improvement in the education piece because it isn't as simple as like keep it flat. No, definitely not. It's not that simple. It's very complicated.

1:40:24But the other thing is like if you're only doing finger pricks, like I was for many, many years before I had the courage to wear a device, And I say courage because I didn't want to have this physical device attached to me 24-7 that represented my condition. So I was doing these finger pricks every single day, but you're only getting a little snapshot of this very dynamic system that's in flux all the time. So if I did a finger prick at 10 a.m. and the next one I did was at 3 p.m., I have no idea what happened in between those hours. Did my blood glucose rise very high and come down? Did it stay flat?

1:40:58Did it go low and come back? You just don't know. So the data that you get from the CGM, as you say, you pick up your phone and you can see in real time these little dots in graph form. You can see the trends and patterns. You can learn at this time of day, naturally my blood glucose goes up because in the morning you've got cortisol flowing and your blood glucose will kind of rise. And at this time of day, it naturally goes down and you learn so much in real time. So that is the beauty of the technology. It's amazing technology. One of the other things I learned using it is how my body responds to different versions of time-restricted eating and intermittent fasting.

1:41:37And I went through a period where I was kind of doing this one meal a day and I would eat like a big dinner, but I would do it late at night. And then watching what would happen to my blood glucose over the period of when I was sleeping was like very surprising. What did it do? Well, it would just, it would like drop and then it would like spike at like two in the morning. And that was typically when I would like wake up, you know, it was, and I was like, wow, this is like wreaking havoc on me. Like I wouldn't have thought that. And I sense have realized like, oh, actually when I eat smaller meals throughout the day, I have better results.

1:42:12I have more restful sleep. I don't have this, you know, strange looking graph that happens in the middle of the night. And I could feel it, but being able to match what I was experiencing with those data points, helped convince me that I needed to do things a little bit differently. That's very interesting. I mean, that's a phenomenon that happens to people with type one a lot, is if you have a very large dinner close to bed, especially if it's packed with a lot of fat, because that slows down gastric emptying. So the rate at which the food leaves your digestive system, enters the bloodstream and carbohydrates, right?

1:42:49So you basically, you're slamming your foot on the brakes. You've got all this food in your stomach waiting to digest. And then like six hours later, it starts to enter your bloodstream. And you can have these massive spikes like six hours later. The classic example for people with type 1 is a pizza. It's just the one food that I don't know anyone who's figured it out because it's got a lot of cheese, saturated fat, refined carbohydrates, big serve. You eat that, six hours later, your blood glucose spikes. And by that time, the insulin that you gave for the meal is long gone out of the system.

1:43:21So it's this mismatch between the rate of glucose entering the system and the rate of which your insulin is working. Now it's gone. So I never thought about that though in people without diabetes. And I'm actually really surprised that that's the case. I would not have predicted that. I would have thought that your pancreas would handle that naturally. Now you're scaring me. No, no, no, no, no. I'm not saying anything. I'm not diagnosing anything right here. But yeah, it's very interesting. Well, I don't do that anymore. but I'm interested in whether you've played around with, as an experimenter with intermittent fasting or time-restricted eating and how that kind of operates as a type one.

1:43:59Yeah, absolutely. I've played around with everything at this point, I think. The fasting is a really good tool. I find it, you know, it makes it a lot easier. If you're in range, if your blood glucose is in range and then you aren't adding these inputs to the system, it can be easy to stay in range. the problem that I was running into was similar to you. I was eating meals that were too big. I was so hungry by the time it was time to break the fast that I was overeating the volume of the meal, which delays the gastric emptying. And then there was that mismatch, as I mentioned, between the insulin and the glucose.

1:44:33But I think I just need to learn to sort of scale back the size of the meals. And it's definitely a good tool. It can absolutely work. And some people just aren't hungry in the morning. I like to train fasted. I don't want to eat a big meal before I train. So it works practically for lots of people to fast until you're hungry. It makes sense. But you haven't found like a specific protocol that works for you. I haven't. I mean, I haven't played around with it that much, but for me, when I do the fast, I backload my calorie intake. So I'll fast in the morning and eat more from sort of noon onwards.

1:45:10But I know people who do the opposite and they front load their calories and they get some pretty good results with that. So I think that it definitely does matter the protocol that you choose and what time you decide to do your fast first, your eating window. I haven't tried the front loading yet. So maybe you're enticing me to do another experiment. The front loading. Yeah. It's like, I just, I don't want to wake up in the morning and eat a bunch of food. I want to go out and train right away. If I'm training really hard, I can't always do a fasted workout session in the in the morning, because that will impair my ability to do it the next day and the next day and the next day.

1:45:47You're always like, you're eating not for that session, but you're kind of eating for the following day in order to recover and repair. But in general, if I'm not training super hard, yeah, like just get out and get it done first thing. Is that including - Rather than eating a huge meal, right? When I wake up in the morning, like I just never want to do it. But you don't have to do it that way. What you could do is do your fasted workout. So what time would you do that workout? It's early? Seven. Seven, right. So seven or eight in the morning, you do your workout, you're home by nine, 10. That's when your eating window can begin.

1:46:17So it's like a post-meal breakfast. You can do that sort of maybe it's 10 till four, I don't know, it's 10 till whatever. That could be your eating window. But again, if you love food and you don't have metabolic issues and you don't need to be adding all these tools into your life, then perhaps you don't have to do it. Yeah, it's what's in vogue right now. Like what is your protocol? Right, right. You know what I mean? My protocol is enjoying my life. Which kind of brings us to, I wanna spend the last part of our conversation talking about good practices for just eating a healthy whole food plant-based diet.

1:46:57Like we talked a little bit about the protein, but common misconceptions or confusions around things like omega-3s and vitamin D and B12. like how are you making sure that you're not deficient? Like how do you think about these things in terms of not only how you function as a fit active person, but also long-term? Like how are you eating to sidestep, to not only manage your diabetes, but also sidestep heart disease, which is a risk factor for your condition and to prevent cognitive decline and all the other kind of downstream things that we need to be thinking about sooner rather than later? The way that I've constructed my dietary pattern is the front of mind for me, the most important thing, the most important principle is diversity, plant diversity.

1:47:52I need to try to get as many different unique plants in there as possible because they all come with unique nutrients. Some have protein, some have carbs, some have fat. I just need diversity there and also for gut health. If you're just sticking to three or four vegetables, I would argue that your microbiome health is probably not as robust. The Tim Spector 30 plants a week. Right. Which should be really easy actually. Like if you're actually eating a robust, diverse whole food plant-based diet, you're probably getting 30 different plants a day. I would say so. Yeah, I think I could do that in a meal sometimes even.

1:48:26So plant diversity is key. When I'm making that plate or bowl, I'm thinking of the three macronutrients. But I will say that I have to think about those because I'm living with diabetes. So every time I make a meal, I have to eye off that plate and understand how many grams of carbohydrate are in the meal, how many grams of protein, how many grams of fat. Because the interplay between those three macros will influence the dose of insulin that I have to give. And it took me years of learning how to understand what's in the foods and counting the carbohydrates, you know, because I would, in the beginning, I would have a food scale.

1:49:00I would weigh every single ingredient that went in. I'd plug it into an app. It would spit out the information regarding the macros and the calories, and then I would give my insulin dose. Thankfully, now I'm at the point where I can just look at it and understand what to do. But I want to try get 30 grams of protein per main meal, and I get that from tofu, tempeh, legumes, beans, chickpeas, lentils, some nuts and seeds. I'm trying to eat carbohydrates at all my meals as well, and I like to get it from whole grains. and then a big, big base. This is where the volume comes. I can get my volume that fills me up from the lower calorie density, nutrient-dense, leafy greens, cruciferous, non-starchy vegetables.

1:49:50If you stick to that and you eat three meals a day, you're pretty much going to be good. But if you really want to bulletproof it, I'll take a protein supplement after workouts just because I enjoy it. I actually like the flavors and I can make a smoothie or, you know, like a sort of like protein ice cream or something. And that's the enjoyment. That's the enjoying life factor that you just mentioned. Like for me that people say, oh, it's processed and I don't care. I like the way – I like the taste. It's not bad for you. And it helps me hit my protein targets. So you're getting maybe an extra 30 grams.

1:50:23So you're looking at, I don't know, 100, 120 grams a day? 120 to 150 sometimes. It depends. sometimes I'll have two scoops over a day or I'll have an extra serve of tempeh. So I'm not counting and I'm not being granular, but roughly 30 per main meal, maybe a snack and maybe that protein shake gets me approximately 1.5 grams of protein per kilo of body weight, roughly. And how do you think about omega-3s, DHA, DHEA? There's a lot of discussion around that and whether you can adequately meet your body's requirements on a plant-based diet. look i i try to get it from food as much as i can i eat a lot of whole flax meal hemp seeds chia seeds um but i also take a supplement to again bulletproof those those nutrients and i'm not afraid to take an essential it's called essential aid it's one i like to take it's got you know simon's uh oh meal yeah yeah so i take that every day it's got b12 vitamin d algae oils for those, instead of fish oil, you take the algae oil, same thing.

1:51:30And yeah, that's my daily dose. I just take that and I bulletproof my diet and I do blood work very frequently and I have no issues. I'm healthy. And when people come to you and say, tell me about your diet or, you know, how are you doing what you're doing? What are some of the misconceptions around not only eating plant-based as a type 1 diabetic, but just life as a T1 diabetic in general, and also being this kind of fit person who likes to train? What are some of the things you would like to not necessarily correct the record, but sort of misconceptions out there around how you're eating and how you're living?

1:52:15Well, I mean, the main misconceptions are, and most people have seen these floating around on the internet, is that you need to eat animals to get your protein, which you don't. So people's major concern is where am I going to get my protein? Is there enough protein in plants? Yes, there is. Spoiler alert. What about all those carbohydrates? Isn't it too high in carbs? And this is a fair point that people make is what if they want to do a low-carb version of a plant-based diet? That's getting a little tricky now. And I think that if you're going to do a plant-based diet, you've got to be willing to surrender in certain aspects of your life and say, you know what?

1:52:53Perhaps I need to amend my relationship with carbohydrates and adopt this dietary pattern instead of trying to make my dietary pattern meet my carbohydrate goals. You mean like a keto plant-based? Right. It can be done. But a lot of the protein sources that you get from plants come with carbohydrates. So I think it's tricky. I haven't tried it and that's one experiment I don't really want to try right now. But some people want to try to do that version and it's possible. But I really think that, I think we need to like zoom out a little bit and look long-term. What do you want to achieve long-term?

1:53:26If you want to achieve a diet that is attached to values and ethics, a diet that makes you feel satiated and full, that contains all the nutrients you need, that you can build muscle and you can still reduce your risk of chronic disease, reduce your risk of developing cardiovascular disease, our biggest killer, then the plant-based diet is ticking all of those boxes and some people might find that they can't stick to it that you know they have digestive discomfort or it's just not for them well then you can do an 85 plant-based diet and get a lot of the probably all of the benefits to be honest other than the ethical side and environmental perhaps but most of the health benefits come from going 85 plant-based I would say and I think that there is research to support that so So yeah, you don't have to go 100%, but maybe you start at 80, 85, and you nudge your way to 100.

1:54:17And some people will be surprised at how kind of easy it is to do once you're in the groove. What are some ways of getting people started with that? I mean, there are certain people, it sounds like you just were like, okay, I'm in, and you just snap your fingers and you're all in overnight. I had a similar kind of way of getting into it. Most people are not like that. You know, like, how do I dip my toe in this? how do I break up with some of my favorite foods that I feel powerless to put behind? How do you embark upon this journey in a way that you're focused on creating new sustainable habits that will last you the test of time and not just get you through a 30-day experiment?

1:55:01I think going back to what we spoke about before is if you can attach your dietary change to something a lot deeper than just vanity or aesthetics and you think about ethics or environment or something a little bit stronger. If you have a pull towards that, it's going to be easier to do it. But I think understanding the swaps you've got to make. So maybe it starts with reducing the portion size of the animal product on your plate. You don't have to eliminate it entirely, but just reduce it and then maybe the 50 % reduction that you've taken away, you put in with beans or tofu or tempeh or something plant-based.

1:55:37So you're still getting the protein dose you need. Half of it may be coming from plant protein, the other half from animal protein. And then slowly you can just nudge towards the plant protein over time, adding new vegetables and fruits and trying new things. Like, you know, I hadn't eaten fruit, like a diversity of fruit in many, many, many years. And you forget how bloody good fruit is. Like it's really delicious. And there are so many different types. It's not just apples and oranges. Like take a leaf out of Robbie's book. Go to a market and fall in love with the variety. I mean, that guy has, you know, a weird like romantic obsession.

1:56:11Like durian, you know, like it's like, what is the fetishization that certain people have with durian? Like Doug Evans is the same way. It's so funny. I'm like, you guys should just get married or get a room. Like it's weird. It is bizarre. I mean, I don't understand it. I'm not that way inclined, but yeah, they have romanticized that relationship for sure. I mean, Robbie knows the names of fruits that I've never heard of. You know, he shows us on Instagram like this strange looking thing. Where people, normal people have bookshelves. He has like shelves and he puts all his fruit on there. I mean, it's like, yeah.

1:56:45Yeah, but I guess, look, you got to fall in love with the food you're eating. You got to enjoy it. That's sustainable, you know? And if it's healthy food, that's even better. I mean, a lot of people fall in love with foods that aren't so good for them. So I think if you're going to move the needle, you've got to be willing to experiment. You've got to be willing to try new foods, make it taste good. This is the thing. If it tastes shit, you're not going to eat it. And a lot of people tend to say, oh, tofu, yuck, it's so bland. Yeah, marinate it. Make it, whatever you do to your chicken, you can use the same thing for your tofu.

1:57:17Or use the tofu as the canvas and, you know, make it tasty. Find recipes online. You know, there's so many great plant-based recipes and homemade dressings and sauces. And you've got to find a way to actually make it taste good. I think that's an important one because it's really easy to eat some boring meals and go, no, it wasn't for me. Yeah, because you had boring meals. Make them enjoyable. Yeah, I think you have to make it fun and not make it so pressurized and adhere to some kind of perfectionist ideal such that when you have a weak moment or you lapse into some old kind of habit that doesn't serve you, it's like, okay, that's fine.

1:58:00and just get back to what's the next best choice. Totally. How can I find new recipes and turn it into something that ignites your curiosity and doesn't feel like heavy and burdensome? Yeah, I agree. And I think that it's easier now than it ever has been. If you go on social media and you follow a few people who have amazing recipes and they teach you how to do it from scratch, I mean, there is definitely the side of it that people don't talk about enough is sort of like culinary skills, like actually learning how to cook is quite important because, I mean, even in Bondi, there's a shortage of plant-based restaurants.

1:58:40I mean, there's a handful of them, but not all restaurants are gonna have a plant-based option. So a lot of your eating is probably gonna be done at home, which is probably healthier for you anyway, because you know what you're putting in the food. So you gotta get those skills and learn how to cook. That's probably another good place to - Yeah, you do all your cooking. I do a lot of it. Yeah, so what happens when you go out to eat? and like how do you manage like the social aspect of the whole thing? Because I feel like that's really the Achilles heel. People don't wanna be problematic in social settings.

1:59:10They don't wanna be in situations where like they are making other people uncomfortable because they have a certain way of eating and it just becomes tricky and complicated. Yeah, the social aspect is very interesting because I mean, for me, it's actually double-edged because on one hand - Your life depends on it. Like this is your job, right? Right, right. But also - It's different. You have an excuse that everyone is gonna be like, cool. And I hate that. I hate leaning on diabetes as the excuse, which is easy to do when I go out. It's like, oh guys, you know, I have to eat this because my diabetes, it's an easy thing to do, but I try my best not to do it.

1:59:53And I told myself from day one, I will, I know it's not my fault I have it, but it's my responsibility to manage it and I'm never going to use it as an excuse because I want to empower myself to do whatever the hell I want to do in this world. And if I'm leaning on it, even once as a crutch, it's just going to trickle into other things in my life and I don't want that to be an excuse. So, you know what, you've just got to own it. So when I go out with friends and, you know, we finished rugby season once and we went to a pub here in Bondi and all the boys ordered burgers and chips and steak and stuff and I, you know, really quietly pulled the waitress aside and I said, Thank you.

2:00:26hey actually I don't eat meat have you got anything on the menu that's vegan or plant-based? And she's like, yeah, we'll whip something up for you. Anyway, all the food comes out, all these burgers line up the table, and then I get this like rainbow bowl, like this Buddha bowl, most beautiful looking thing. And the boys all look at me and they go, hey, that looks really good. I didn't see that on the menu. And I'm like, yeah, I just asked, you know, for the way she said, I wonder if we can get some. So, I mean, look, if you can just own it and be willing to, I was willing for them to say the comments, whatever, of our soy boy, whatever they wanted to say.

2:01:01I owned it, I held my ground, I enjoyed my meal, and it turns out that they wanted to taste it too. Yeah, I love that, that's cool. Well, I just think that you're a really powerful example of this lifestyle, young, vibrant, living with type one diabetes, but not in a way that it's inhibiting you in any meaningful way. And the fact that you have, in good faith, lived these other lifestyles and have kind of arrived here and this is a sustainable solution that's working for you is amazing. And I think that that gives you a certain resonance, you know, when you talk about it, that that's really powerful.

2:01:42I appreciate that. Yeah, man. So I appreciate you coming to talk to me today. You have this website, Drew's Daily Dose. You've got all kinds of resources there for anybody who's curious about how you do, what you do. You've got these five pillars. We talked about nutrition and exercise, but there's mindfulness and we talked about managing blood glucose and all of that. But you have lots of tools and resources and kind of a whole protocol. Yeah. I mean, one part of the story that I didn't mention was after being diagnosed, I went back to uni and got a degree as a diabetes educator because I thought, I'm in the perfect position to educate people.

2:02:21I've got this family of doctors. I'm educated. I'm an exercise physiologist. I'm a diabetes educator. I'm living with diabetes. How could I not share this information? So Drew's Daily Dose was my way of sort of figuring out a protocol, that five pillar protocol to help people. And I was consulting a lot online and doing coaching and one-on-ones, but now I'm at the point where I really want to reach way more people at once. And Simon and I have got some really fun ideas for some online courses that we want to start generating around certain niche groups and diabetes obviously being a huge part of it.

2:02:53And I just released, you know, after 12 years of doing all this social media stuff or whatever it is, I just released my first like training program, like an online training program, you know, resistance training for strength and hypertrophy, cardio, zone two, I know you love your zone two, zone five, all like evidence-based protocols. and an e-book with, you know, it's like 16 ,000 words, 50 pages, you know, explaining the state of the evidence in terms of you want to gain muscle and build muscle, build strength and improve your cardiovascular fitness for health and longevity. This was my way of distilling all of that into this e-book with like videos of every exercise and eight week programs.

2:03:33And so I just, I actually just only released that a couple of weeks ago. So. Yeah, that's pretty cool, exciting.

2:03:42And really interesting. I mean, we could have done a whole podcast on endurance training, strength training, HIIT, high intensity, all of that. Like I know that you and Simon have spoken at length about that on various podcasts. So you have plenty more to share. There's so much. Again, if you find yourself in Los Angeles. Yeah, so if you're digging on Drew and his message, Like I said, there's at least 12 conversations between you and Simon on the proof and your website. Lots of stuff out there for you to kind of learn more and dig a little bit deeper. Is there anywhere else that you want to direct people?

2:04:19You know, I'm active on Instagram. That's the only social media account I've got, Drew's Daily Dose. And Simon and I are running some retreats now, actually. Oh, yeah. Did you just do the Bali one? It's in October. It's coming up. Yeah, coming up in October. Is it sold out? We might be opening a second week. So there's definitely space and we plan to make that the best week ever. And I know you just did one, right? Yeah, yeah, yeah, in Italy. A little bit different than the one that you're doing, but it looked cool. I was checking it out and the location looks insane. Beautiful location, world-class surfing wave right out the front of the resort.

2:04:53We're going to make it very education heavy as Simon and I love our science and education. Yeah, everyone's getting blood work. Right, everyone's getting blood work. Probably going to get DEXA scans as well. and we want to make it not just a week but like an ongoing protocol and we'll still check in with people and stay on top of their blood work and all of their goals and build a community in person and online and just keep it going. I mean, look, this is Simon's. He's done all the hard work. I'm definitely – I came on as the exercise physiologist but he's so generous that he's, you know, taking me along for the ride.

2:05:25So I'm just so grateful in so many ways for him. I mean, we're here in his studio, Waves Bondi. He got me on this plant-based diet. We're doing these retreats together. We're in his studio. Yeah, I mean, he's an unbelievable person. Like when I was here in January, I mean, he just hooked me up and is so open and like you said, generous with what he has. He's a really extraordinary person. Great. I'm very grateful to have him in my life. Me too. And he brought us together in his home. That's right. Shout out to Simon, of course. I don't know when this podcast is gonna go up, but it'll probably be sold out by that time.

2:06:04But if not, go to theproof.com. There's a whole kind of landing page there with more information on that. And this was cool, man. Thank you. Thank you so much. I can't believe we did this here in Bondi. It's quite surreal for me. I'm a little jet lag. I hope I didn't come off too incoherent, but I just let you talk the whole time. You seemed very awake. Excellent. Thank you, Drew. Thank you so much. Peace.

2:06:32That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page at richroll.com, where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change, and The Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com. If you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify, and on YouTube and leave a review and or comment.

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2:07:54Portraits by Davey Greenberg Graphic and social media assets Courtesy of Daniel Solis Thank you Georgia Whaley for copywriting And website management And of course our theme music was created by Tyler Pyatt, Trapper Pyatt And Harry Mathis Appreciate the love, love the support See you back here soon Peace, plants Namaste

2:08:26Thank you.