Gary Taubes
Appearances
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
We can do this. We can treat your symptoms with drugs. You can continue to eat exactly the way you want. Or if it's type 1, you're going to eat at specific intervals, specific amounts to allow us to maximize, craft a diet to maximize efficiency of the drug therapy. And there's all these complications we know are going to ensue.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
So you're going to have an increased risk of heart disease and stroke and dementia and blindness and retinopathies. And for some of you, no matter how well you manage your blood sugar with these drugs, those complications are going to happen anyway.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
At which point, we're going to blame you. But... Right, it's the patient's fault. Or... You can do this diet. Now, what it means is no more bread, potatoes, sweets.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Yeah, which is fascinating. If you eat this way, as far as we can tell, you'll be fine. No drugs, no... complications of drugs, no needing more doses or new doses, no waiting for new drugs to come along, no dialysis. As far as we can tell, if you eat this way, you'll be fine.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And it'll probably take two or three months, you might love it immediately, it might take two or three months to get used to it, in which case, like somebody who's quit smoking, you won't miss cigarettes after a while. You will at first, you won't after a while. It's your choice. We're happy either way, because we want you to be healthy.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
But this way, chronic progressive disease, diabetic complications, more and more drugs complications of drugs this way as far as we can tell and we can't you know there are unknown unknowns here as far as we can tell if you eat this way you'll be fine yeah you choose yeah and if you do eat this way let's make sure you do it right yeah
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And if you choose the drugs, we'll make sure you're doing the right thing.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Well, they're starting to come along, but if you see how they do it... So they put out these standard of care documents and every year, every January, there'll be like eight or ten of these documents. And what they do is they revise based on what research came out in that past year. So they really have no mechanism by which to say let's just rethink this.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And then when they're revising it, the discussion of diet is inside in this document where it's sort of you can do this or you can do that or you can try this diet, we have this research for this or this research for that. They don't have any mechanism to say can we just try, let's try a different approach.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Let's divide the world up, let's say this is what can be achieved with diet and this is what can be achieved with drug therapy. And this is the complications that we know of with diets. Not many. And these are the complications we know of with drug therapy, chronic progressive disease. Many people might choose drugs. Maybe they're right.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
But we don't know how harmful that is.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Well, you can, yeah, then...
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And that's because we have this mindset that people with obesity...
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
we're not going to blame it on willpower we're not we're going to acknowledge that it's a disease now this is what oprah was saying but we're also going to assume that they won't change their diet yeah and you know it's really complicated i've read a lot of the the um you know the literature of mostly women but not entirely women with obesity um They're so confused.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
They know it's not a willpower problem.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And often these authors will say, I tried every diet, none of them worked. And I want to reach out to them and say... You didn't try the right one. Or did you... Because they always include Atkins in the list. Did it not work for you? Or are you some, but then they'll say, you know, it's just one of these books I read recently. It's, you know, I don't want to go through my life not eating a donut.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Well, I understand. I get that. I get that. But, you know, I was, I've been biased by my history as a cigarette smoker. There was a period in my life where I couldn't imagine going through my life without a cigarette. Yeah. And in fact, my next cigarette was what pulled me forward into the future. Yeah. Maybe it's an inappropriate metaphor. I'm not sure it is or not.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And a little bit of carbohydrates might prevent them from doing really well. Yeah. I think one of the points that I've made in my other books is everybody is different.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
and we definitely evolved to cope with the proteins and fats in our diet that the idea that the foods that we didn't the new foods of modern life ultra processed food that's not even food yeah i'm not wild about the term ultra processed because it's sort of like a miasma of theory of all these kind of vague things that we're going to throw in. Michael Pollan called them food-like substances.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
I prefer that. It's more to the point.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Patients do well if you don't feed them carbs. How weird is that? It's a disorder of carbamiger metabolism. Exactly. Tell them not to eat it, they do fine.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
But we didn't have time to adapt to high levels of sugar in our diet and sugary beverages in our diet. These things didn't exist. We didn't have time. I mean, I'm... diagnostic about the seed oil issue, I don't find the evidence. I mean, I can easily believe that these things are toxic, but I... The evidence is confusing for sure. There's a certain absence of human clinical trial evidence.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Yeah, it certainly should be questioned. And that's the thing, so you can propose that those are... And with the sugar and refined grains, you could see what happens when you take them out of people's lives. And we have clinical trials.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Yeah, well, so this is, you know, getting back to the history a bit. We get to the 1970s, 80s. The diabetes community, their credit, did some really ambitious clinical trials. And what they find out, in effect, is that this disease, by their treatment, is a chronic progressive disorder. It just gets worse. A famous British trial where they show they start people on...
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Diet only and then they add one drug and then they go and they see how many of the patients diagnosed with type 2 diabetes can stick with one drug, monotherapy, and the answer is like 10%. So as time goes on, you keep on having to add drugs to keep the blood sugar under control. They do these, we said a cord and a... I forget the other names of the other two trials.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Looking at intensive insulin therapy and they find that it does more harm than good at the very best. And then they do this huge look ahead trial, $200 million to demonstrate that if you lose weight, you'll reduce diabetic complications. It's a fundamental pillar of thinking with diabetes. Just get your patients to lose weight. They'll be fine. Yeah.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
and they get them to lose weight and it doesn't make a damn bit of difference. The trial was ended for futility, a $200 million trial and a great quote in the New York Times from a Harvard diabetes specialist named David Nathan who says, we have to have an adult conversation about this. And they never do.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
No, they lost weight and they didn't get better. The idea was you lose weight, you'll have fewer complications, you'll reduce heart disease, you'll reduce strokes, you'll reduce mortality from this disease. It didn't make any difference.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Well, it could have been because of how they lost weight. And in fact, back around 2003, when I first heard about this trial from one of the principal investigators, I was in a conference, he invited me to talk in Houston. I remember saying to him, look, are you doing a low carb arm? Just do a low-carb arm. Make it not just low-calorie, low-fat, fruits, vegetables, whole grains, the usual story.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Mediterranean diet, right. Well, this was pre-Mediterranean. I mean, this was just classic low-fat. But in low-fat, they're also saying you're eating fruits, vegetables, whole grains, cut back on meat, exercise. No, they never crossed their mind to do a low-carb diet because that was still considered quackish.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
As the diabetes community keeps learning about how ineffective their treatments are and how their belief system is falling apart on top of them and not having an adult conversation about it, which is maybe we're making some mistakes here.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Other physicians coping with this increased obesity in their patients are confronted with patients who don't take their advice and instead like buy Atkins Diet Revolution book and lose 40 pounds on Atkins. Yeah. And a few of these doctors are open-minded enough, Eric Westman and David Ludwig, they say, I'm going to look into this. I'm going to actually do a clinical trial.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
So they start doing clinical trials. There's a big study at the Philadelphia VA. And there, the woman named Linda Stern is frustrated by how much, her inability to help her patients. So she literally goes to like a Brentano's bookstore and she sits down in the diet section, starts reading diets.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
You know, it's not, not, not, not. They definitely don't get grades, good grades for this in med school. Anyways, I think she found protein power. Yeah, that's right. The Eads, Michael Eads.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
She tries it on herself, and they're effortless to lose weight, so they put together a clinical trial, and this is a Veterans Administration Hospital, so there are a lot of vets, they're not just obese, they have metabolic syndrome and type 2 diabetes, and instead of cutting them out of the trial, as you would, you know, the inclusion criteria in a pharmaceutical trial is going to say, we're going to not take these patients because they're ill.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
She says, since this is so associated with obesity, let's do it. And not only do these patients lose a lot of weight on the diet, but their type 2 diabetes gets better on this high-fat, low-carb, small protein-powered diet. So you start getting this groundswell, this movement of doctors who are reading these articles in the literature. And... saying, look, diet really seems to help.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
They don't know this deeper history, although Eric Westman at Duke is looking into it. It's just patients do well if you don't feed them carbs. How weird is that? It's a disorder of carbamiger metabolism. Tell them not to eat it, they do fine.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
So Steve Finney and Jeff Volek, too. Steve is a PhD nutritionist who trained at MIT and is out at UC Davis. And he had studied ketogenic diets. And Jeff Volek is an exercise physiology PhD, then at the University of Connecticut. And they start working together. Publishing on this and they helped start this company, Virta Health. I remember Steve's idea, I think it was.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
We could just convince insurance companies and employers that they could save money. Diabetes is an expensive disorder. It's costing them $12,000, $15,000 a year in medical bills. If they could save 80% of that by getting these people on a diet, wouldn't they want to do that? So they'd become the clients, not the patients.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
We'll go after the payers, the insurers, the Kaisers and Blue Shields of the world. And they create this company. They get this brilliant CEO, Sammy Inconin, who was a world-class Stanford MBA, made millions creating the website. I always forget whether it was Trulia or one of the real estate websites. And it's a world-class triathlete.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
who was diagnosed with prediabetes yeah despite having come in first in his age group in the iron man triathlon yeah and sammy goes to steve and jeff for advice on how to treat the prediabetes and also how he wants to this is sammy and kenny wants to row to hawaii from san francisco to hawaii with his wife meredith and he thinks they could do it with like a fun on a ketogenic diet.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Jeff and Steve can coach him and they start talking about this idea and they start this company Virta Health. Meanwhile, by the way, Sammy and Meredith do row to Hawaii and they break the record and they don't need any carbohydrates on the whole trip. I think it's 24 miles.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Not only that, Sammy believed that a low-fat diet was the healthiest way to eat. He had been told that. And Sammy is, I think he's Norwegian. And as he put it, not that being Norwegian matters, but if he's Finnish, I apologize. Yeah. Somebody tells him not to eat fat, he doesn't eat fat. The man has an extraordinary strength of will and then he's diagnosed with prediabetes.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
So there's something wrong. This is a common phenomenon that happens to many people in our world. You're doing what's supposed to be the right thing and it doesn't work for you. And then you do the wrong thing, which in this case is low-carb, high-fat ketogenic animal diet. And you get better and you say, wait a minute, if it's wrong for me, maybe it's wrong for a lot of people, if not everybody.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
So they start this company, Virta Health. They realize they need a clinical trial to convince... And they meet Sarah Hallberg, who is a physician in Indiana, an amazing woman to whom the book is dedicated, who has been asked to run an obesity clinic at Indiana Health and has to learn everything she can about obesity.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And she starts reading all the literature and she goes down the rabbit hole and she experiences this... based on Jell-O revelation. And she realized that the only people who seem to be who seem to be effectively getting their patients to lose weight are these people like Westman who are advocating for these Atkins low-carb keto diets.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And so she goes and spends time with Westman, she goes and starts advocating for this at her obesity clinic and she meets Jeff and Steve and they put together a clinical trial where they're going to randomize people with type 2 diabetes to either this nutritional ketosis keto with... smartphones and personal coaching and telemedicine.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
Yeah, because you're going to have to adjust medication. If you stop eating the toxin, you're going to have to lower the dose of the antidote. And it's either that or the American Diabetes Association standard of care which is drug therapy. And they do the trial and after a few years they report one-year results and after three years they report two-year results.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And for patients who comply with the diet they seem to put this progressive chronic disease into remission. So it's not a progressive chronic disease. No. It's only a progressive chronic disease if you're eating the toxin.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
If you're not eating the toxin, you don't manifest the symptoms. And it's not the ideal clinical trial. Yeah. There's all kinds of problems with it. it wasn't randomized, actually I probably said randomized and I should not, they let patients choose whether they wanted the diet or the ADA standard of care.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
But even with those constraints it demonstrated beyond a shadow of a doubt that a disorder which is considered chronic and progressive is not necessarily chronic and progressive and that the defining factor is the diet, again whether you eat the toxin.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
And so by the end of the book, I mean, again, this book does not advocate. It's a dense, historical, critical... Yeah, it's like a mystery novel. And a mystery novel.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
I think it's a very good book. The question is imagine a scenario where everybody, every physician was taught not just the proper drug therapy but how effective this dietary therapy was. Because there have always been two levers to pull to keep blood sugar under control. There's diet or drugs. Until 1921 we only had diet and for patients with type 2 diabetes it was effective. Yeah.
The Dr. Hyman Show
Reversing Diabetes Naturally: The Science Big Medicine Ignored
don't eat these foods you'll be fine yeah once we had drugs you had two lovers and the idea was use the drugs give the drugs you know we're going to say that diet is integral the cornerstone of therapy but we're going to pay lip service to it because we got the drugs what if confronted with a new patient you give them the diagnosis you have type 2 diabetes or type 1 diabetes and you say look