[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:12.12,0:00:14.67,Default,,0000,0000,0000,,I have the best job in the world.
Dialogue: 0,0:00:14.67,0:00:15.77,Default,,0000,0000,0000,,I'm a doctor.
Dialogue: 0,0:00:15.77,0:00:18.35,Default,,0000,0000,0000,,No! Believe me that's not why.
Dialogue: 0,0:00:18.36,0:00:19.94,Default,,0000,0000,0000,,I'm an obesity doctor.
Dialogue: 0,0:00:19.94,0:00:22.72,Default,,0000,0000,0000,,I have the honor of working\Nwith the group of people
Dialogue: 0,0:00:22.73,0:00:27.49,Default,,0000,0000,0000,,subject to the last widely\Naccepted prejudice: being fat.
Dialogue: 0,0:00:27.50,0:00:31.11,Default,,0000,0000,0000,,These people have suffered a lot\Nby the time they see me:
Dialogue: 0,0:00:31.11,0:00:35.68,Default,,0000,0000,0000,,shame, guilt, blame\Nand outright discrimination.
Dialogue: 0,0:00:35.69,0:00:39.40,Default,,0000,0000,0000,,The attitude that many take,\Nincluding those in healthcare,
Dialogue: 0,0:00:39.40,0:00:42.78,Default,,0000,0000,0000,,is that these people\Nare to blame for their situation.
Dialogue: 0,0:00:42.80,0:00:46.52,Default,,0000,0000,0000,,If they could just control themselves,\Nthey wouldn't be overweight,
Dialogue: 0,0:00:46.52,0:00:48.89,Default,,0000,0000,0000,,and they are not motivated to change.
Dialogue: 0,0:00:48.89,0:00:51.89,Default,,0000,0000,0000,,Please let me tell you\Nthis is not the case.
Dialogue: 0,0:00:51.89,0:00:55.13,Default,,0000,0000,0000,,The blame, if we've got\Nto extend some here,
Dialogue: 0,0:00:55.13,0:00:56.99,Default,,0000,0000,0000,,has been with our advice.
Dialogue: 0,0:00:57.01,0:00:59.34,Default,,0000,0000,0000,,And it's time we change that.
Dialogue: 0,0:00:59.34,0:01:04.36,Default,,0000,0000,0000,,Obesity is a disease, it's not something\Ncreated by lack of character.
Dialogue: 0,0:01:04.36,0:01:08.52,Default,,0000,0000,0000,,It's a hormonal disease,\Nand there are many hormones involved.
Dialogue: 0,0:01:08.53,0:01:12.40,Default,,0000,0000,0000,,And one of the main ones\Nis a hormone called insulin.
Dialogue: 0,0:01:12.42,0:01:17.24,Default,,0000,0000,0000,,Most obese individuals\Nare resistant to this hormone, insulin.
Dialogue: 0,0:01:17.24,0:01:21.09,Default,,0000,0000,0000,,So, what does that mean exactly,\Nto be resistant to insulin?
Dialogue: 0,0:01:21.10,0:01:26.76,Default,,0000,0000,0000,,Well, insulin resistance is essentially\Na state of pre-pre-type 2 diabetes.
Dialogue: 0,0:01:26.76,0:01:31.05,Default,,0000,0000,0000,,Insulin's job is to drive glucose,\Nor blood sugar,
Dialogue: 0,0:01:31.05,0:01:33.87,Default,,0000,0000,0000,,into the cells where it can be used.
Dialogue: 0,0:01:33.90,0:01:36.96,Default,,0000,0000,0000,,In a nutshell, when someone\Nis insulin resistant,
Dialogue: 0,0:01:36.99,0:01:40.85,Default,,0000,0000,0000,,they are having trouble\Ngetting blood sugar where it needs to go,
Dialogue: 0,0:01:40.85,0:01:42.37,Default,,0000,0000,0000,,into those cells.
Dialogue: 0,0:01:42.38,0:01:45.46,Default,,0000,0000,0000,,And it just can't hang out\Nin the blood after we eat
Dialogue: 0,0:01:45.47,0:01:49.78,Default,,0000,0000,0000,,or we would all have a diabetic crisis\Nafter every meal!
Dialogue: 0,0:01:49.78,0:01:52.36,Default,,0000,0000,0000,,So, when someone is resistant to insulin,
Dialogue: 0,0:01:52.36,0:01:55.80,Default,,0000,0000,0000,,the body's response to this\Nis to just make more of it.
Dialogue: 0,0:01:55.80,0:01:58.92,Default,,0000,0000,0000,,And insulin levels will rise and rise,
Dialogue: 0,0:01:58.93,0:02:02.26,Default,,0000,0000,0000,,and for a while, years even,\Nthis is going to keep up,
Dialogue: 0,0:02:02.27,0:02:05.46,Default,,0000,0000,0000,,and blood sugar levels can remain normal.
Dialogue: 0,0:02:05.48,0:02:08.51,Default,,0000,0000,0000,,However, usually it can't keep up forever,
Dialogue: 0,0:02:08.53,0:02:11.93,Default,,0000,0000,0000,,and even those elevated levels of insulin
Dialogue: 0,0:02:11.94,0:02:15.80,Default,,0000,0000,0000,,are not enough to keep blood sugar\Nin the normal range.
Dialogue: 0,0:02:15.82,0:02:17.84,Default,,0000,0000,0000,,So it starts to rise.
Dialogue: 0,0:02:17.84,0:02:19.71,Default,,0000,0000,0000,,That's diabetes.
Dialogue: 0,0:02:19.72,0:02:21.59,Default,,0000,0000,0000,,It probably won't surprise you to hear
Dialogue: 0,0:02:21.60,0:02:26.09,Default,,0000,0000,0000,,that most of my patients\Nhave insulin resistance or diabetes.
Dialogue: 0,0:02:26.09,0:02:29.37,Default,,0000,0000,0000,,And if you are sitting there thinking,\N"Phew, that's not me,"
Dialogue: 0,0:02:29.39,0:02:31.59,Default,,0000,0000,0000,,you actually might want to think again,
Dialogue: 0,0:02:31.60,0:02:37.84,Default,,0000,0000,0000,,because almost 50% of adult Americans\Nnow have diabetes or prediabetes.
Dialogue: 0,0:02:37.85,0:02:41.78,Default,,0000,0000,0000,,That is almost 120 million of us.
Dialogue: 0,0:02:41.80,0:02:45.75,Default,,0000,0000,0000,,But that's hardly everyone\Nwho has issues with insulin.
Dialogue: 0,0:02:45.76,0:02:47.34,Default,,0000,0000,0000,,Because as I was saying,
Dialogue: 0,0:02:47.36,0:02:51.73,Default,,0000,0000,0000,,people have elevated insulin levels\Ndue to insulin resistance
Dialogue: 0,0:02:51.74,0:02:54.34,Default,,0000,0000,0000,,for years, even decades,
Dialogue: 0,0:02:54.35,0:02:58.33,Default,,0000,0000,0000,,before the diagnosis\Nof even prediabetes is made.
Dialogue: 0,0:02:58.34,0:03:03.47,Default,,0000,0000,0000,,Plus it's been shown that 16-25%\Nof normal-weight adults
Dialogue: 0,0:03:03.49,0:03:05.77,Default,,0000,0000,0000,,are also insulin resistant.
Dialogue: 0,0:03:05.78,0:03:10.82,Default,,0000,0000,0000,,So, in case you're keeping track,\Nthis is a heck of a lot of us.
Dialogue: 0,0:03:10.82,0:03:14.46,Default,,0000,0000,0000,,So, the trouble\Nwith insulin resistance is:
Dialogue: 0,0:03:14.47,0:03:20.11,Default,,0000,0000,0000,,If it goes up, we are at great risk\Nfor developing type 2 diabetes.
Dialogue: 0,0:03:20.13,0:03:24.51,Default,,0000,0000,0000,,But also, insulin makes us hungry,
Dialogue: 0,0:03:24.53,0:03:29.28,Default,,0000,0000,0000,,and the food we eat\Nmuch more likely to be stored as fat.
Dialogue: 0,0:03:29.30,0:03:33.42,Default,,0000,0000,0000,,Insulin is our fat storage hormone.
Dialogue: 0,0:03:33.42,0:03:36.83,Default,,0000,0000,0000,,So we can start to see\Nhow it's going to be a problem
Dialogue: 0,0:03:36.86,0:03:41.54,Default,,0000,0000,0000,,for diseases like obesity\Nand metabolic issues like diabetes.
Dialogue: 0,0:03:41.55,0:03:44.77,Default,,0000,0000,0000,,But what if we traced this problem\Nback to the beginning,
Dialogue: 0,0:03:44.79,0:03:48.67,Default,,0000,0000,0000,,and we just didn't have\Nso much glucose around
Dialogue: 0,0:03:48.67,0:03:50.74,Default,,0000,0000,0000,,that insulin needed to deal with?
Dialogue: 0,0:03:50.75,0:03:53.16,Default,,0000,0000,0000,,Let's take a look at how that could be.
Dialogue: 0,0:03:53.16,0:03:54.56,Default,,0000,0000,0000,,Everything you eat
Dialogue: 0,0:03:54.57,0:03:58.26,Default,,0000,0000,0000,,is either a carbohydrate,\Na protein or a fat,
Dialogue: 0,0:03:58.27,0:04:02.88,Default,,0000,0000,0000,,and they all have very different effect\Non glucose and therefore insulin levels,
Dialogue: 0,0:04:02.90,0:04:04.66,Default,,0000,0000,0000,,as you can see on the graph.
Dialogue: 0,0:04:04.66,0:04:06.39,Default,,0000,0000,0000,,So when we eat carbohydrates,
Dialogue: 0,0:04:06.40,0:04:09.80,Default,,0000,0000,0000,,our insulin and glucose\Nare going to spike up fast.
Dialogue: 0,0:04:09.81,0:04:12.79,Default,,0000,0000,0000,,And with proteins it looks a lot better.
Dialogue: 0,0:04:12.79,0:04:16.02,Default,,0000,0000,0000,,But take a look at what happens\Nwhen we eat fat.
Dialogue: 0,0:04:16.03,0:04:19.71,Default,,0000,0000,0000,,Essentially nothing, a flat line.
Dialogue: 0,0:04:19.73,0:04:23.82,Default,,0000,0000,0000,,And, this is going to wind up\Nbeing very important.
Dialogue: 0,0:04:23.84,0:04:27.10,Default,,0000,0000,0000,,So, now I want to translate\Nthat graph for you
Dialogue: 0,0:04:27.13,0:04:29.81,Default,,0000,0000,0000,,into a real-world situation.
Dialogue: 0,0:04:29.81,0:04:31.26,Default,,0000,0000,0000,,I want you to go back
Dialogue: 0,0:04:31.26,0:04:36.79,Default,,0000,0000,0000,,and think about the last time you ate\Nan American version of Chinese food.
Dialogue: 0,0:04:36.80,0:04:40.20,Default,,0000,0000,0000,,We all know there's rules\Nassociated with this, right?
Dialogue: 0,0:04:40.22,0:04:42.86,Default,,0000,0000,0000,,And the first rule is:\NYou're going to overeat.
Dialogue: 0,0:04:42.87,0:04:45.22,Default,,0000,0000,0000,,Because the stop signal doesn't get sent
Dialogue: 0,0:04:45.25,0:04:48.24,Default,,0000,0000,0000,,until you are literally\Nbusting at the seams.
Dialogue: 0,0:04:48.26,0:04:51.71,Default,,0000,0000,0000,,Rule number two is:\NIn an hour you're starving.
Dialogue: 0,0:04:51.71,0:04:52.82,Default,,0000,0000,0000,,Why?
Dialogue: 0,0:04:52.83,0:04:57.43,Default,,0000,0000,0000,,Well, because the rice in that meal\Ncaused glucose and insulin to skyrocket,
Dialogue: 0,0:04:57.44,0:05:01.53,Default,,0000,0000,0000,,which triggered hunger,\Nfat storage and cravings.
Dialogue: 0,0:05:01.54,0:05:04.78,Default,,0000,0000,0000,,So, if you are insulin\Nresistant to begin with,
Dialogue: 0,0:05:04.81,0:05:07.59,Default,,0000,0000,0000,,and your insulin levels\Nare already higher,
Dialogue: 0,0:05:07.60,0:05:10.57,Default,,0000,0000,0000,,you really are hungrier all the time.
Dialogue: 0,0:05:10.59,0:05:12.51,Default,,0000,0000,0000,,And we have this setup:
Dialogue: 0,0:05:12.52,0:05:16.26,Default,,0000,0000,0000,,Eat carbs, your glucose goes up,\Nyour insulin goes up,
Dialogue: 0,0:05:16.27,0:05:19.30,Default,,0000,0000,0000,,and you have hunger and fat storage.
Dialogue: 0,0:05:19.33,0:05:22.92,Default,,0000,0000,0000,,So, how do we recommend\Nto these people to eat,
Dialogue: 0,0:05:22.92,0:05:27.34,Default,,0000,0000,0000,,because it seems like that would be\Nreally important, and it is.
Dialogue: 0,0:05:27.34,0:05:29.91,Default,,0000,0000,0000,,Let's focus just on type 2 diabetes,
Dialogue: 0,0:05:29.95,0:05:34.66,Default,,0000,0000,0000,,because the general recommendations\Nare to tell patients with type 2 diabetes
Dialogue: 0,0:05:34.68,0:05:39.96,Default,,0000,0000,0000,,to consume 40 to 65 grams\Nof carbohydrates per meal,
Dialogue: 0,0:05:39.97,0:05:42.07,Default,,0000,0000,0000,,plus more at snacks.
Dialogue: 0,0:05:42.08,0:05:44.96,Default,,0000,0000,0000,,Trust me on this, that's a lot of carbs.
Dialogue: 0,0:05:44.96,0:05:47.82,Default,,0000,0000,0000,,And remember what's going to happen\Nto glucose and insulin,
Dialogue: 0,0:05:47.82,0:05:48.99,Default,,0000,0000,0000,,blood sugar and insulin,
Dialogue: 0,0:05:49.01,0:05:50.46,Default,,0000,0000,0000,,when we eat them?
Dialogue: 0,0:05:50.48,0:05:53.58,Default,,0000,0000,0000,,Yes, we are essentially recommending
Dialogue: 0,0:05:53.58,0:05:57.90,Default,,0000,0000,0000,,that they eat exactly\Nwhat's causing their problem.
Dialogue: 0,0:05:57.90,0:05:59.40,Default,,0000,0000,0000,,Sound crazy?
Dialogue: 0,0:05:59.42,0:06:01.65,Default,,0000,0000,0000,,It really, really is.
Dialogue: 0,0:06:01.66,0:06:07.19,Default,,0000,0000,0000,,Because, at its root, diabetes\Nis a state of carbohydrate toxicity.
Dialogue: 0,0:06:07.19,0:06:10.41,Default,,0000,0000,0000,,We can't get the blood sugar\Ninto the cells,
Dialogue: 0,0:06:10.41,0:06:12.84,Default,,0000,0000,0000,,and that causes a problem\Nin the short term.
Dialogue: 0,0:06:12.85,0:06:16.64,Default,,0000,0000,0000,,But the long-term consequences\Nare even greater.
Dialogue: 0,0:06:16.65,0:06:21.77,Default,,0000,0000,0000,,And insulin resistance is essentially\Na state of carbohydrate intolerance.
Dialogue: 0,0:06:21.79,0:06:27.80,Default,,0000,0000,0000,,So why, oh why, do we want to continue\Nto recommend to people to eat them?
Dialogue: 0,0:06:27.81,0:06:30.77,Default,,0000,0000,0000,,The American Diabetes\NAssociation guidelines
Dialogue: 0,0:06:30.78,0:06:34.27,Default,,0000,0000,0000,,specifically state that there is\Ninconclusive evidence
Dialogue: 0,0:06:34.28,0:06:37.51,Default,,0000,0000,0000,,to recommend\Na specific carbohydrate limit.
Dialogue: 0,0:06:37.52,0:06:41.25,Default,,0000,0000,0000,,But those guidelines go right on\Nto say what we all know:
Dialogue: 0,0:06:41.27,0:06:47.17,Default,,0000,0000,0000,,Our carbohydrate intake is the single,\Nbiggest factor in blood sugar levels,
Dialogue: 0,0:06:47.17,0:06:50.76,Default,,0000,0000,0000,,and therefore need for medication.
Dialogue: 0,0:06:50.76,0:06:53.04,Default,,0000,0000,0000,,These guidelines then go on to say:
Dialogue: 0,0:06:53.04,0:06:56.77,Default,,0000,0000,0000,,Hey look, if you are taking\Ncertain diabetic medications,
Dialogue: 0,0:06:56.81,0:07:02.02,Default,,0000,0000,0000,,you actually have to eat carbs,\Notherwise your blood sugar can go too low.
Dialogue: 0,0:07:02.03,0:07:03.63,Default,,0000,0000,0000,,Okay, so let's take a look
Dialogue: 0,0:07:03.64,0:07:07.16,Default,,0000,0000,0000,,at the vicious cycle\Nthat that advice just set up.
Dialogue: 0,0:07:07.19,0:07:11.22,Default,,0000,0000,0000,,So it's: Eat carbs so you have\Nto take medicine,
Dialogue: 0,0:07:11.22,0:07:12.74,Default,,0000,0000,0000,,then you have to eat more carbs
Dialogue: 0,0:07:12.75,0:07:15.37,Default,,0000,0000,0000,,so you avoid the side-effect\Nof those medications,
Dialogue: 0,0:07:15.38,0:07:18.56,Default,,0000,0000,0000,,and around and around we go.
Dialogue: 0,0:07:18.58,0:07:22.90,Default,,0000,0000,0000,,Even worse is that nowhere\Nin the ADA guidelines
Dialogue: 0,0:07:22.91,0:07:26.52,Default,,0000,0000,0000,,is the goal of reversing type 2 diabetes.
Dialogue: 0,0:07:26.52,0:07:28.32,Default,,0000,0000,0000,,This needs to be changed,
Dialogue: 0,0:07:28.34,0:07:35.34,Default,,0000,0000,0000,,because type 2 diabetes can be reversed,\Nin many, if not most, situations,
Dialogue: 0,0:07:35.34,0:07:37.51,Default,,0000,0000,0000,,especially if we start early.
Dialogue: 0,0:07:37.51,0:07:40.81,Default,,0000,0000,0000,,Not only do we need\Nto let people know this,
Dialogue: 0,0:07:40.82,0:07:47.18,Default,,0000,0000,0000,,but we have to start giving them\Nthe practical advice so they can do this.
Dialogue: 0,0:07:47.24,0:07:48.87,Default,,0000,0000,0000,,Consider carbs.
Dialogue: 0,0:07:48.89,0:07:52.53,Default,,0000,0000,0000,,First, here's a shocker for you:\NWe don't need them.
Dialogue: 0,0:07:52.55,0:07:58.35,Default,,0000,0000,0000,,Seriously! Our minimum daily requirement\Nfor carbohydrates is zero.
Dialogue: 0,0:07:58.36,0:08:01.72,Default,,0000,0000,0000,,We have essential amino acids,\Nthose are proteins,
Dialogue: 0,0:08:01.72,0:08:03.17,Default,,0000,0000,0000,,essential fatty acids,
Dialogue: 0,0:08:03.18,0:08:05.66,Default,,0000,0000,0000,,but, nope, no essential carb.
Dialogue: 0,0:08:05.68,0:08:07.06,Default,,0000,0000,0000,,A nutrient is essential
Dialogue: 0,0:08:07.06,0:08:13.27,Default,,0000,0000,0000,,if we have to have it to function,\Nand we can't make it from something else.
Dialogue: 0,0:08:13.30,0:08:16.40,Default,,0000,0000,0000,,We make glucose,\Nplenty of it, all the time,
Dialogue: 0,0:08:16.44,0:08:18.65,Default,,0000,0000,0000,,it's called gluconeogenesis.
Dialogue: 0,0:08:18.67,0:08:20.71,Default,,0000,0000,0000,,So, we don't need them,
Dialogue: 0,0:08:20.72,0:08:23.58,Default,,0000,0000,0000,,the overconsumption of them\Nis making us very sick,
Dialogue: 0,0:08:23.62,0:08:26.22,Default,,0000,0000,0000,,yet we are continuing\Nto recommend to patients
Dialogue: 0,0:08:26.22,0:08:28.99,Default,,0000,0000,0000,,to consume close to, if not more than,
Dialogue: 0,0:08:29.01,0:08:33.60,Default,,0000,0000,0000,,half of their total energy intake\Nevery day from them.
Dialogue: 0,0:08:33.62,0:08:35.52,Default,,0000,0000,0000,,It doesn't make sense.
Dialogue: 0,0:08:35.52,0:08:37.47,Default,,0000,0000,0000,,Let's talk about what does.
Dialogue: 0,0:08:37.47,0:08:39.91,Default,,0000,0000,0000,,Cutting carbs, a lot.
Dialogue: 0,0:08:39.92,0:08:42.28,Default,,0000,0000,0000,,Yes, in my clinic we teach patients
Dialogue: 0,0:08:42.29,0:08:45.64,Default,,0000,0000,0000,,to eat with carbs\Nas the minority of their intake,
Dialogue: 0,0:08:45.64,0:08:47.48,Default,,0000,0000,0000,,not the majority.
Dialogue: 0,0:08:47.50,0:08:49.12,Default,,0000,0000,0000,,So, how does that work?
Dialogue: 0,0:08:49.14,0:08:51.91,Default,,0000,0000,0000,,Well, when our patients\Ndecrease their carbs
Dialogue: 0,0:08:51.92,0:08:55.84,Default,,0000,0000,0000,,their glucose goes down,\Nand they don't need as much insulin.
Dialogue: 0,0:08:55.84,0:08:59.23,Default,,0000,0000,0000,,So those insulin levels drop, and fast.
Dialogue: 0,0:08:59.24,0:09:00.77,Default,,0000,0000,0000,,And this is very important,
Dialogue: 0,0:09:00.78,0:09:02.18,Default,,0000,0000,0000,,because a study
Dialogue: 0,0:09:02.18,0:09:06.06,Default,,0000,0000,0000,,looking at our National Health\Nand Nutrition Examination Survey data,
Dialogue: 0,0:09:06.06,0:09:07.80,Default,,0000,0000,0000,,better known as NHANES,
Dialogue: 0,0:09:07.80,0:09:10.90,Default,,0000,0000,0000,,showed that the single,\Nbiggest risk factor
Dialogue: 0,0:09:10.90,0:09:12.64,Default,,0000,0000,0000,,for coronary artery disease
Dialogue: 0,0:09:12.64,0:09:15.11,Default,,0000,0000,0000,,is insulin resistance.
Dialogue: 0,0:09:15.12,0:09:20.27,Default,,0000,0000,0000,,It is responsible\Nfor a whopping 42% of heart attacks.
Dialogue: 0,0:09:20.30,0:09:23.48,Default,,0000,0000,0000,,Low-carb intervention works so fast
Dialogue: 0,0:09:23.50,0:09:28.07,Default,,0000,0000,0000,,that we can literally pull people off\Nof hundreds of units of insulin
Dialogue: 0,0:09:28.11,0:09:30.11,Default,,0000,0000,0000,,in days to weeks.
Dialogue: 0,0:09:30.12,0:09:32.79,Default,,0000,0000,0000,,One of my favorite stories\Nis a very recent one.
Dialogue: 0,0:09:32.81,0:09:37.70,Default,,0000,0000,0000,,A young gal, but who had an almost\N20-year history of type 2 diabetes,
Dialogue: 0,0:09:37.72,0:09:41.21,Default,,0000,0000,0000,,came in when a physician from another\Nclinic told her she was just sick,
Dialogue: 0,0:09:41.22,0:09:43.19,Default,,0000,0000,0000,,and she'd probably get used to it.
Dialogue: 0,0:09:43.19,0:09:45.95,Default,,0000,0000,0000,,Her diabetes was way out of control.
Dialogue: 0,0:09:45.96,0:09:49.84,Default,,0000,0000,0000,,This despite the fact that she\Nwas on multiple medications,
Dialogue: 0,0:09:49.84,0:09:54.22,Default,,0000,0000,0000,,including almost 300 units of insulin,
Dialogue: 0,0:09:54.22,0:10:00.09,Default,,0000,0000,0000,,that was being injected into her\Ncontinuously every day via a pump.
Dialogue: 0,0:10:00.09,0:10:03.32,Default,,0000,0000,0000,,All of this, remember,\Nblood sugar still out of control.
Dialogue: 0,0:10:03.36,0:10:07.41,Default,,0000,0000,0000,,So we put her on a low-carb diet,\Nand now let's fast-forward four months.
Dialogue: 0,0:10:07.41,0:10:11.98,Default,,0000,0000,0000,,She lost weight, yes,\Nbut, better than that, sick no more.
Dialogue: 0,0:10:11.98,0:10:16.11,Default,,0000,0000,0000,,Her blood sugar levels\Nwere now normal all of the time.
Dialogue: 0,0:10:16.12,0:10:20.63,Default,,0000,0000,0000,,This on, get this, no diabetes medication.
Dialogue: 0,0:10:20.65,0:10:22.89,Default,,0000,0000,0000,,Gone was the 300 units of insulin,
Dialogue: 0,0:10:22.90,0:10:24.62,Default,,0000,0000,0000,,no more insulin pump,
Dialogue: 0,0:10:24.62,0:10:28.46,Default,,0000,0000,0000,,no more pricking her finger\Nmultiple times each day,
Dialogue: 0,0:10:28.48,0:10:32.02,Default,,0000,0000,0000,,gone, all of it, no more diabetes.
Dialogue: 0,0:10:32.02,0:10:36.61,Default,,0000,0000,0000,,One of the greatest joys of my job\Nis to be able to tell a patient like this
Dialogue: 0,0:10:36.64,0:10:39.05,Default,,0000,0000,0000,,that they no longer have diabetes,
Dialogue: 0,0:10:39.06,0:10:42.29,Default,,0000,0000,0000,,and we ceremoniously take it off\Ntheir problem list together.
Dialogue: 0,0:10:42.32,0:10:45.33,Default,,0000,0000,0000,,So, are they cured, is this a miracle?
Dialogue: 0,0:10:45.33,0:10:48.01,Default,,0000,0000,0000,,We'll leave that grandstanding\Nto Doctor Oz.
Dialogue: 0,0:10:48.03,0:10:50.50,Default,,0000,0000,0000,,Cured would imply that it can't come back.
Dialogue: 0,0:10:50.52,0:10:54.10,Default,,0000,0000,0000,,And if they start eating\Nexcessive carbs again, it will.
Dialogue: 0,0:10:54.13,0:10:58.80,Default,,0000,0000,0000,,So no not cured, but they don't have\Ndiabetes any longer.
Dialogue: 0,0:10:58.80,0:11:04.53,Default,,0000,0000,0000,,It's resolved, and it can stay that way\Nas long as we keep away the cause.
Dialogue: 0,0:11:04.56,0:11:07.74,Default,,0000,0000,0000,,So, what does this look like then?\NHow does somebody eat this way?
Dialogue: 0,0:11:07.77,0:11:10.07,Default,,0000,0000,0000,,Well, first, let me tell you\Nwhat it's not.
Dialogue: 0,0:11:10.09,0:11:15.24,Default,,0000,0000,0000,,Low-carb is not zero carb,\Nand it is not high protein.
Dialogue: 0,0:11:15.27,0:11:18.10,Default,,0000,0000,0000,,These are common criticism\Nthat are so frustrating
Dialogue: 0,0:11:18.12,0:11:20.27,Default,,0000,0000,0000,,because they are not true.
Dialogue: 0,0:11:20.28,0:11:23.30,Default,,0000,0000,0000,,Next, if we take the carbs out,\Nwhat are we going to put in?
Dialogue: 0,0:11:23.32,0:11:25.80,Default,,0000,0000,0000,,Because, remember,\Nthere's only three macronutrients:
Dialogue: 0,0:11:25.83,0:11:28.05,Default,,0000,0000,0000,,if one goes down, one has to go up.
Dialogue: 0,0:11:28.06,0:11:32.31,Default,,0000,0000,0000,,My patients eat fat, and a lot of it.
Dialogue: 0,0:11:32.32,0:11:35.50,Default,,0000,0000,0000,,"What!?" you say. What's going\Nto happen when you eat fat?
Dialogue: 0,0:11:35.52,0:11:37.89,Default,,0000,0000,0000,,Well, let me tell you, you're\Ngoing to be happy,
Dialogue: 0,0:11:37.91,0:11:41.70,Default,,0000,0000,0000,,because fat tastes great,\Nand it is incredibly satisfying.
Dialogue: 0,0:11:41.72,0:11:43.64,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:11:43.64,0:11:45.80,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:11:45.80,0:11:49.04,Default,,0000,0000,0000,,But, remember, fat\Nis the only macronutrient
Dialogue: 0,0:11:49.05,0:11:53.29,Default,,0000,0000,0000,,that's going to keep our glucose -\Nblood sugar - and insulin levels low,
Dialogue: 0,0:11:53.29,0:11:55.91,Default,,0000,0000,0000,,and that is so important.
Dialogue: 0,0:11:56.66,0:12:00.94,Default,,0000,0000,0000,,So, I want you to now hear\Nmy simple rules for eating.
Dialogue: 0,0:12:00.94,0:12:04.31,Default,,0000,0000,0000,,These rules, you have to remember,\Nare even going to be more important
Dialogue: 0,0:12:04.33,0:12:07.50,Default,,0000,0000,0000,,if you are one of the tens\Nof millions of Americans
Dialogue: 0,0:12:07.54,0:12:10.14,Default,,0000,0000,0000,,who have trouble with insulin levels.
Dialogue: 0,0:12:10.16,0:12:13.95,Default,,0000,0000,0000,,Rule number one: If it says light, low fat\Nor fat-free, stays in grocery store.
Dialogue: 0,0:12:14.19,0:12:17.40,Default,,0000,0000,0000,,because they took the fat out,\Nthey put carbs and chemicals in.
Dialogue: 0,0:12:17.40,0:12:19.48,Default,,0000,0000,0000,,Rule number two: Eat food.
Dialogue: 0,0:12:19.48,0:12:22.20,Default,,0000,0000,0000,,The most important rule\Nin low-carb nutrition:
Dialogue: 0,0:12:22.21,0:12:24.12,Default,,0000,0000,0000,,Real food does not come in a box,
Dialogue: 0,0:12:24.12,0:12:26.77,Default,,0000,0000,0000,,and no-one should have to tell you\Nreal food is natural.
Dialogue: 0,0:12:26.78,0:12:28.98,Default,,0000,0000,0000,,You should know that when you look at it.
Dialogue: 0,0:12:29.00,0:12:31.98,Default,,0000,0000,0000,,Don't eat anything you don't like.
Dialogue: 0,0:12:31.100,0:12:34.56,Default,,0000,0000,0000,,And eat when you're hungry;\Ndon't eat when you're not,
Dialogue: 0,0:12:34.57,0:12:36.68,Default,,0000,0000,0000,,no matter what the clock says.
Dialogue: 0,0:12:36.70,0:12:40.24,Default,,0000,0000,0000,,And number five is a simple way\Nto remember what we want to avoid.
Dialogue: 0,0:12:40.62,0:12:45.40,Default,,0000,0000,0000,,No GPS: no grains,\Nno potatoes and no sugar.
Dialogue: 0,0:12:45.40,0:12:47.71,Default,,0000,0000,0000,,That last one is a biggie,\Nright, no grains?
Dialogue: 0,0:12:47.71,0:12:49.02,Default,,0000,0000,0000,,Na, no grains.
Dialogue: 0,0:12:49.04,0:12:50.37,Default,,0000,0000,0000,,But we have to have them.
Dialogue: 0,0:12:50.37,0:12:52.15,Default,,0000,0000,0000,,Nope, they're a carb.
Dialogue: 0,0:12:52.17,0:12:54.13,Default,,0000,0000,0000,,But whole grains are so good for us.
Dialogue: 0,0:12:54.15,0:12:57.74,Default,,0000,0000,0000,,Well, first of all, there are actually\Nvery few foods out there
Dialogue: 0,0:12:57.74,0:13:00.58,Default,,0000,0000,0000,,that are truly whole grain\Neven when they say they are.
Dialogue: 0,0:13:00.59,0:13:03.24,Default,,0000,0000,0000,,Most foods that purport themselves\Nto be wholegrain
Dialogue: 0,0:13:03.24,0:13:06.43,Default,,0000,0000,0000,,are highly processed\Nand the fiber benefit ruined.
Dialogue: 0,0:13:06.45,0:13:09.06,Default,,0000,0000,0000,,Or they're coming\Nwith highly refined flour,
Dialogue: 0,0:13:09.06,0:13:10.77,Default,,0000,0000,0000,,usually both of these things.
Dialogue: 0,0:13:10.77,0:13:13.51,Default,,0000,0000,0000,,So if you are one of the truly\Ninsulin-sensitive people,
Dialogue: 0,0:13:13.51,0:13:15.81,Default,,0000,0000,0000,,you can eat real, whole grain.
Dialogue: 0,0:13:15.82,0:13:20.57,Default,,0000,0000,0000,,But if you're in the enormous slice\Nof our population with insulin issues,
Dialogue: 0,0:13:20.58,0:13:22.88,Default,,0000,0000,0000,,it's making things worse.
Dialogue: 0,0:13:23.45,0:13:26.32,Default,,0000,0000,0000,,So what if you are one\Nof the real insulin-sensitive people?
Dialogue: 0,0:13:26.33,0:13:27.71,Default,,0000,0000,0000,,Can you still eat this way?
Dialogue: 0,0:13:27.74,0:13:30.20,Default,,0000,0000,0000,,Yes! I am a great example.
Dialogue: 0,0:13:30.22,0:13:33.16,Default,,0000,0000,0000,,Over a year ago I decided\NI would cut my carbs
Dialogue: 0,0:13:33.20,0:13:35.83,Default,,0000,0000,0000,,as low as I recommend\Nto my diabetic patients.
Dialogue: 0,0:13:35.85,0:13:39.43,Default,,0000,0000,0000,,Now, it's not mandatory for my health\Nlike it is for theirs;
Dialogue: 0,0:13:39.45,0:13:42.27,Default,,0000,0000,0000,,I'm not insulin resistant,\Nso would this be a problem?
Dialogue: 0,0:13:42.29,0:13:44.38,Default,,0000,0000,0000,,No! That's just the thing.
Dialogue: 0,0:13:44.41,0:13:46.70,Default,,0000,0000,0000,,Unless you have\Nan exceedingly rare syndrome,
Dialogue: 0,0:13:46.72,0:13:49.08,Default,,0000,0000,0000,,then cutting carbs\Nis going to be good for you,
Dialogue: 0,0:13:49.13,0:13:51.77,Default,,0000,0000,0000,,even if it's not necessary.
Dialogue: 0,0:13:51.78,0:13:55.88,Default,,0000,0000,0000,,I want to show you a couple of pictures\Nof my radical food.
Dialogue: 0,0:13:55.88,0:13:58.51,Default,,0000,0000,0000,,So, this is a common breakfast\Nin my house.
Dialogue: 0,0:13:58.52,0:14:00.80,Default,,0000,0000,0000,,So does it look like\NI just broke my own rule?
Dialogue: 0,0:14:00.82,0:14:04.82,Default,,0000,0000,0000,,I didn't because this muffin\Nis made with coconut flour.
Dialogue: 0,0:14:04.82,0:14:06.81,Default,,0000,0000,0000,,I bake all the time still.
Dialogue: 0,0:14:06.81,0:14:11.53,Default,,0000,0000,0000,,I just use non-grain-based flours:\Ncoconut, almond, hazelnut, flax.
Dialogue: 0,0:14:11.53,0:14:13.31,Default,,0000,0000,0000,,They make delicious things.
Dialogue: 0,0:14:13.36,0:14:16.90,Default,,0000,0000,0000,,And this is a typical dinner in my house\Nwith a typical starch.
Dialogue: 0,0:14:16.93,0:14:19.52,Default,,0000,0000,0000,,That would be the sautéed mushrooms.
Dialogue: 0,0:14:19.57,0:14:25.01,Default,,0000,0000,0000,,No, my patients and I eat delightful food\Nall of the time and enjoy it.
Dialogue: 0,0:14:25.01,0:14:27.01,Default,,0000,0000,0000,,But what about the research on this?
Dialogue: 0,0:14:27.02,0:14:29.95,Default,,0000,0000,0000,,I mean is this just anecdotal\Nevidence now from my clinic?
Dialogue: 0,0:14:29.96,0:14:31.03,Default,,0000,0000,0000,,No!
Dialogue: 0,0:14:31.04,0:14:33.66,Default,,0000,0000,0000,,There are dozens of\Nrandomized controlled trials
Dialogue: 0,0:14:33.66,0:14:35.41,Default,,0000,0000,0000,,looking at low-carb intervention
Dialogue: 0,0:14:35.42,0:14:39.72,Default,,0000,0000,0000,,for things like diabetes,\Ncardiovascular risk factors, obesity.
Dialogue: 0,0:14:39.75,0:14:41.95,Default,,0000,0000,0000,,They're consistent. It works!
Dialogue: 0,0:14:41.100,0:14:45.23,Default,,0000,0000,0000,,There are even a large number\Nof studies showing
Dialogue: 0,0:14:45.24,0:14:48.90,Default,,0000,0000,0000,,that low-carb nutrition\Ndecreases inflammatory markers,
Dialogue: 0,0:14:48.93,0:14:53.21,Default,,0000,0000,0000,,which is making it really exciting\Nfor diseases like cancer.
Dialogue: 0,0:14:53.24,0:14:56.33,Default,,0000,0000,0000,,We just finished a study in our clinic.
Dialogue: 0,0:14:56.34,0:14:57.66,Default,,0000,0000,0000,,And what we did is,
Dialogue: 0,0:14:57.67,0:15:00.28,Default,,0000,0000,0000,,we took 50 type 2 diabetic patients
Dialogue: 0,0:15:00.30,0:15:03.69,Default,,0000,0000,0000,,that were treated with\Nour low-carb-high-fat-based program,
Dialogue: 0,0:15:03.69,0:15:05.67,Default,,0000,0000,0000,,and we compared them to 50 patients
Dialogue: 0,0:15:05.68,0:15:08.17,Default,,0000,0000,0000,,who were treated with the ADA guidelines.
Dialogue: 0,0:15:08.17,0:15:09.38,Default,,0000,0000,0000,,And after six months,
Dialogue: 0,0:15:09.39,0:15:12.67,Default,,0000,0000,0000,,not only did we find\Na significant metabolic advantage
Dialogue: 0,0:15:12.68,0:15:13.97,Default,,0000,0000,0000,,for the low-carb group,
Dialogue: 0,0:15:13.99,0:15:18.89,Default,,0000,0000,0000,,but, and let's face it, this is important,\Na huge cost savings.
Dialogue: 0,0:15:18.91,0:15:24.27,Default,,0000,0000,0000,,Our analysis showed that our patients\Ncould save over $2,000 a year
Dialogue: 0,0:15:24.30,0:15:28.13,Default,,0000,0000,0000,,just on the diabetes meds\Nthey were no longer taking.
Dialogue: 0,0:15:28.16,0:15:30.22,Default,,0000,0000,0000,,Just think how fast that adds up.
Dialogue: 0,0:15:30.25,0:15:32.02,Default,,0000,0000,0000,,We are in a diabetes epidemic now
Dialogue: 0,0:15:32.03,0:15:36.19,Default,,0000,0000,0000,,that we are spending\N$250 billion a year on in this country.
Dialogue: 0,0:15:36.83,0:15:38.49,Default,,0000,0000,0000,,So, I want to show you a slide now
Dialogue: 0,0:15:38.50,0:15:42.45,Default,,0000,0000,0000,,that demonstrates where\Nthose savings are coming from.
Dialogue: 0,0:15:42.46,0:15:45.63,Default,,0000,0000,0000,,So this is looking\Njust at the insulin difference
Dialogue: 0,0:15:45.65,0:15:47.76,Default,,0000,0000,0000,,in the two groups after six months.
Dialogue: 0,0:15:47.76,0:15:49.28,Default,,0000,0000,0000,,And what we can see is
Dialogue: 0,0:15:49.30,0:15:52.57,Default,,0000,0000,0000,,that the low-carb group\Nwas able to decrease their insulin
Dialogue: 0,0:15:52.58,0:15:55.48,Default,,0000,0000,0000,,by almost 500 units a day.
Dialogue: 0,0:15:55.51,0:15:57.52,Default,,0000,0000,0000,,Whereas in the ADA treated group,
Dialogue: 0,0:15:57.53,0:16:01.99,Default,,0000,0000,0000,,they had to increase their insulin\Nby almost 350 units a day.
Dialogue: 0,0:16:01.100,0:16:03.31,Default,,0000,0000,0000,,Two important things.
Dialogue: 0,0:16:03.31,0:16:06.51,Default,,0000,0000,0000,,Number one: Insulin is expensive.
Dialogue: 0,0:16:06.53,0:16:12.17,Default,,0000,0000,0000,,And number two: Not all the people\Nin this study were even on insulin,
Dialogue: 0,0:16:12.20,0:16:15.40,Default,,0000,0000,0000,,which makes these results\Neven more impressive.
Dialogue: 0,0:16:15.41,0:16:18.63,Default,,0000,0000,0000,,But what I would say is\Nthat this graph really represents
Dialogue: 0,0:16:18.65,0:16:21.82,Default,,0000,0000,0000,,two different approaches\Nto treating this disease.
Dialogue: 0,0:16:21.84,0:16:25.73,Default,,0000,0000,0000,,The first, our group,\Nwith the goal of reversing disease,
Dialogue: 0,0:16:25.75,0:16:27.74,Default,,0000,0000,0000,,meaning they need less medicine.
Dialogue: 0,0:16:27.74,0:16:32.13,Default,,0000,0000,0000,,And the second group, which very clearly\Naligns with the ADA guidelines,
Dialogue: 0,0:16:32.14,0:16:35.78,Default,,0000,0000,0000,,which state that diabetes\Nis a progressive disease,
Dialogue: 0,0:16:35.78,0:16:38.36,Default,,0000,0000,0000,,requiring more medicine over time.
Dialogue: 0,0:16:38.38,0:16:42.22,Default,,0000,0000,0000,,Progressive unless we take away the cause.
Dialogue: 0,0:16:42.25,0:16:43.77,Default,,0000,0000,0000,,So, what's the problem then?
Dialogue: 0,0:16:43.77,0:16:47.01,Default,,0000,0000,0000,,Why is this not everywhere?\NWhy isn't low carb the norm?
Dialogue: 0,0:16:47.03,0:16:48.45,Default,,0000,0000,0000,,There's two big reasons.
Dialogue: 0,0:16:48.48,0:16:53.00,Default,,0000,0000,0000,,Number one: status quo.\NIt is hard to break.
Dialogue: 0,0:16:53.04,0:16:55.29,Default,,0000,0000,0000,,There are many agendas involved.
Dialogue: 0,0:16:55.32,0:16:59.56,Default,,0000,0000,0000,,We got this notion that low fat\Nwas the way to go decades ago.
Dialogue: 0,0:16:59.59,0:17:01.32,Default,,0000,0000,0000,,But a recent study just came out
Dialogue: 0,0:17:01.32,0:17:04.67,Default,,0000,0000,0000,,showing that there was\Nzero randomized control evidence
Dialogue: 0,0:17:04.68,0:17:08.33,Default,,0000,0000,0000,,to recommend to Americans\Nto remove the fat from our diet.
Dialogue: 0,0:17:08.34,0:17:10.93,Default,,0000,0000,0000,,And that's how the carbs got added in.
Dialogue: 0,0:17:10.94,0:17:16.13,Default,,0000,0000,0000,,It was essentially a huge experiment\Non millions of people,
Dialogue: 0,0:17:16.16,0:17:18.63,Default,,0000,0000,0000,,and it failed miserably.
Dialogue: 0,0:17:18.65,0:17:21.49,Default,,0000,0000,0000,,The second reason we don't\Nsee it everywhere is money.
Dialogue: 0,0:17:21.51,0:17:25.74,Default,,0000,0000,0000,,Don't be fooled, there's a lot of money\Nto be made from keeping you sick.
Dialogue: 0,0:17:25.76,0:17:28.92,Default,,0000,0000,0000,,And what we see is,\Nwith these specialty guideline panels,
Dialogue: 0,0:17:28.94,0:17:32.68,Default,,0000,0000,0000,,they are stacked\Nwith conflict of interest.
Dialogue: 0,0:17:32.69,0:17:38.96,Default,,0000,0000,0000,,So, the solution to the diabetes epidemic\Nin my clinic is exceedingly clear:
Dialogue: 0,0:17:38.98,0:17:43.85,Default,,0000,0000,0000,,Stop using medicine to treat food.
Dialogue: 0,0:17:43.86,0:17:48.19,Default,,0000,0000,0000,,And for a disease\Nwhose root cause is carbohydrates,
Dialogue: 0,0:17:48.19,0:17:51.42,Default,,0000,0000,0000,,take away the carbohydrates,\Nor at least cut them,
Dialogue: 0,0:17:51.44,0:17:54.83,Default,,0000,0000,0000,,so we can remember\Nwhat we used to know.
Dialogue: 0,0:17:54.83,0:17:56.44,Default,,0000,0000,0000,,We knew it a long time ago,
Dialogue: 0,0:17:56.44,0:17:58.64,Default,,0000,0000,0000,,this was said thousands of years ago,
Dialogue: 0,0:17:58.65,0:18:02.71,Default,,0000,0000,0000,,and we need, in this day and age,\Nto get back to that notion.
Dialogue: 0,0:18:02.74,0:18:04.22,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:18:04.23,0:18:06.93,Default,,0000,0000,0000,,(Applause)