#161: Cyrus Khambatta - The Doctor of Making Diabetes…Disappear
Imagine being in the absolute prime of your life - 21 years old, going to school at Stanford to study Mechanical Engineering, playing sports for hours on end…and then, ABRUPTLY, it comes to a screeching halt when you are diagnosed with not one, not two, but three autoimmune diseases within a matter of months.
Today’s guest, Cyrus Khambatta, went from “soccer stud” to “chronic disease patient” in the blink of an eye when he was diagnosed with Hashimoto’s, alopecia, and Type 1 diabetes in 2002.
Determined to understand everything he could about these diagnoses, especially his diabetes, he went back to school to learn the science, earning a Ph.D. in nutritional biochemistry from UC Berkeley. In 2020, he and his business partner, Robby Barbaro, co-authored the book, Mastering Diabetes: The Revolutionary Method to Reverse Insulin Resistance Permanently in Type 1, Type 1.5, Type 2, Prediabetes, and Gestational Diabetes.
An educated person is an empowered person and that’s our goal for today - to arm you with as much knowledge, research, and hope that you can master your diabetes with a whole foods plant-based diet that, yes, includes plenty of carbohydrates and rich diversity of luscious fruit.
Rip and Cyrus Discuss:
00:00-22:00 Cyrus’s journey - How did he go from student to chronic patient in a matter of months?
22:40 Learning a new nutrition perspective from Doug Graham
27:00 Why he went back to school to find out if he was, “a freak of nature”
29:00 How can the medical establishment be so wrong with their recommendations?
33:45 Digging into the science - Let’s go!
34:50 What the heck is insulin resistance?
42:20 So, if sugar doesn’t always cause insulin resistance, what does?
53:20 What are the most dangerous fats and what effect do they have on insulin resistance?
57:19 The keto/paleo argument - why does it appear to work?
1:05:45 The Mastering Diabetes Way - Low Fat - 10-15% calories, 10-15% from protein, the rest should come from whole food, plant-based carbs
1:07:15 Plant-based, eat at least 90% of calories from whole plant foods
1:08:15 Keep your foods unprocessed or minimally processed
1:10:55 But, don’t I need fat to feed my brain?
1:14:30 Do we need a minimum amount of fat?
1:20:00 Is diabetes a disability for Cyrus?
1:23:10 What percentage of the population is affected by the different types of diabetes?
1:29:30 Why he and Robby Barbara started the Mastering Diabetes Community
1:32:10 Is Alzheimers now Type3 diabetes?
1:35:00 The importance of daily movement and exercise
1:42:50 What is the Hegsted equation?
1:47:10 Cyrus’s thoughts on the Glycemic Index
1:53:00 What about gluten?
1:57:00 Is he a fan of caffeine?
2:01:45 What does Cyrus eat in a day?
2:04:22 What is the worst thing about having Type 1 Diabetes?
2:04:04 What is the best thing about having Type 1 Diabetes?
2:08:00 Join the Mastering Diabetes Challenge!
Cyrus Khambatta may have a Ph.D., but today he’s here to help you master your diabetes.
Order Mastering Diabetes
Ten Things You’ll Learn from the book, Mastering Diabetes:
Get your best A1c in the next 3 months and maintain it for years
Reverse insulin resistance permanently and feel the best you’ve felt in years
Eat more and weigh less for the rest of your life
Lower your cholesterol, blood pressure, and triglycerides using food as medicine
Get full control of your blood glucose for the first time in years
Avoid the long-term chronic disease risks of low-carbohydrate and ketogenic diets
Eat carbohydrate-rich food and overcome nasty food cravings
Make 30 delicious and satisfying recipes that meet (and exceed) your nutrition needs
Easily implement intermittent fasting for increased insulin sensitivity
Know exactly how to move your body for incredible blood glucose control
And much, much more...
Episode Resources
Join the Mastering Diabetes Challenge
Order the Mastering Diabetes Book
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Rip Esselstyn:
If you want to shake things up and get out of whatever kind of rut that you might be in, I want to personally invite you to join us at camp. Stop kidding yourself. It's actually in Sedona, Arizona, October 10th to the 15th. This is our last retreat of 2022, and you'll be joining 80 other people that are looking to dive deep into the plant-strong lifestyle, and have more fun than you've had since you were in camp as a kid. We're talking bountiful amounts of plant-strong buffets, world class lectures, bonfires, stargazing, movie nights, talent show nights, hiking, yoga, pickle ball. This is one week you will never, ever forget. Just go to plantstrong.com. Click on Sedona. We got about three slots available. I hope to see you there.
Cyrus Khambatta:
My goal is to go through the process of living with diabetes so that I can learn everything I possibly can about it and help as many people as possible. I do believe that that is what I was put on this planet for, and I strongly believe that. Now, if I did not have diabetes, I would be eating the same diet, most likely, that I ate when I was 20 years old prior to being diagnosed. And trust me, that diet was not awesome. It was not healthy. So that diet likely would've led to other chronic diseases. I may have developed hypertension, I may have high cholesterol, I may become overweight. I may developed the same standard American condition that so many other Americans are living with, right?
So being diagnosed with diabetes was actually a gateway for me to be able to enter into the world of health and study and break it all the way down to its building blocks, and then build it all the way back up and try and figure out what the heck true health actually is. And in that process, I'm healthier. I'm easily 10 times healthier than I was back in the day.
Rip Esselstyn:
I'm Rep Esselstyn and welcome to the Plantstrong Podcast. The mission at Plantstrong is to further the advancement of all things within the plant-based movement. We advocate for the scientifically proven benefits of plant-based living and envision a world that universally understands, promotes and prescribes plants as a solution to empowering your health, enhancing your performance, restoring the environment, and becoming better guardians to the animals we share this planet with. We welcome you wherever you are on your plan, strong journey. And I hope that you enjoy the show.
Imagine if you will, being in the absolute prime of your life. 21 years old, going to school at Stanford University to study mechanical engineering, playing sports for hours on end. And then it all comes to a screeching halt when you're diagnosed with not one, not two, but three autoimmune diseases, all within a matter of months. My guest today, Cyrus Khambatta, went from soccer stud to chronic disease patient when he was diagnosed with Hashimoto's, alopecia and type one diabetes in 2002. For a period of time, he followed his doctor's orders with regard to diet, but he was determined to understand everything that he could about these diagnoses, especially the diabetes. He took agency of his own health and went back to school to learn the science behind the disease, earning a PhD in nutritional biochemistry from the University of California Berkeley.
Today, class is in session because Cyrus and I dig deep into the science. What exactly is insulin resistance? What is the difference between the different types of diabetes? Can you have too little fat in your diet? What happens when you take the low carb approach? And what treatments are best for long term health? My friend, Dr. Michael Clapper has called the low carb paleo diets, a physiological parlor trick. And today you learn why from the co-author and co-founder of Mastering Diabetes, Cyrus. An educated person, is an empowered person. And that's our goal for today. To arm you with as much knowledge, research, and hope so that you can master your diabetes with a whole foods, plant-based diet. That yes, includes plenty of carbohydrates and a decadent diversity of luscious fruit. He may have a PhD, but today he's here to help you master diabetes.
Cyrus, what's up?
Cyrus Khambatta:
What's up my man? How you doing? How you doing?
Rip Esselstyn:
I'm good. I've been missing you.
Cyrus Khambatta:
Man. I miss you. I miss you every day. It's funny because we've been spending some time together here in Austin, and every time I come visit you, I'm like, man, I should live there. I should hang out with Rip every single day.
Rip Esselstyn:
I know you had the chance.
Cyrus Khambatta:
I know. I blew it, didn't I?
Rip Esselstyn:
Yep, located down to the, what is it? Is it the Sunshine State.
Cyrus Khambatta:
Yeah. Sunshine State in Florida. Yeah. My wife and I just moved to St. Petersburg, which is, man, this place is incredible.It's hot every day and there's a beach nearby, so I'm pretty happy camper.
Rip Esselstyn:
Woo hoo hoo. Well, thank you for coming on the Plantstrong podcast. I've been meaning to have you on three and a half years now, and it finally came to fruition, so this is a good day for me.
Cyrus Khambatta:
I'm glad I made you wait so long. It's like I was playing hard to get here, huh?
Rip Esselstyn:
You have been. So, I really with you today, I want to talk about diabetes. Because you know what you and Robbie have done with Mastering Diabetes is, to me, nothing sort of absolutely phenomenal. Giving people the tools and the resources and the knowledge to really master a disease that the CDC has labeled as a full blown pandemic. And it is. It's taking down people and shortening their lives and in many cases, crippling them unnecessarily. And so I want to dig in with you on Mastering Diabetes, which of course is the title of the book that you and Robbie came out with. What was this like 2019, 2018?
Cyrus Khambatta:
It was actually two weeks before the pandemic. Wow. So we're looking at February 18th 2020, right before the world changed very quickly.
Rip Esselstyn:
How was that book tour for you?
Cyrus Khambatta:
It was actually really fun. I mean, we didn't do a physical book tour, but we were doing a virtual book tour by getting on a ton of podcasts and coordinating with a lot of affiliate companies that they could try and get the word out to their audiences. I mean, I loved it, honestly, because the content that's in that book is something that has literally been in my head for the better part of a decade. And so writing the book was just an exercise in getting it out of my head and putting it on a piece of paper and writing it in a way where it could actually change people's lives.
And so it was really fun experience to not only write the book, but then also be able to talk about the book. And then the best part was that when people were getting the book and we got feedback from it, I mean, people were saying that their lives were changed forever. And I'm not sure it gets better than that, honestly. That's like, that's why I get up in the morning and that's why I do what I do.
Rip Esselstyn:
Yeah, yeah. I can relate. So 10 years, all this information that's in the book has been swirling around in your head, and now you've got it down in this book. What makes you such a relevant person to tell people how to master diabetes? So why you, as opposed to somebody else?
Cyrus Khambatta:
That's a great question. So the reason is because if we go backwards in time, back to the year 2002, that's when my life changed fundamentally within a very short period of time and then positioned me on the track towards health and diabetes. So what happened was that I was going to undergraduate, I was a senior at Stanford University, 2002, studying mechanical engineering, and I just wanted to graduate with a degree and then move on with my life. But I was diagnosed in November of that year with type one diabetes, and I didn't know anything about health at that point in my life. I was, all I knew was that I just felt very strange. I was extremely thirsty. And I mean Rip, I can't even tell you the type of thirst that I experienced. It was so, it was unbelievable because I would be sitting at my desk and I would be trying to study for finals, and I was like, "Man, I'm pretty thirsty."
So I would drink a 16 ounce glass of water in five seconds, and I'd put it down, and then 10 seconds later I was like, "I think I got thirstier." And then I would repeat that and I put it down, and then five minutes later I was like, "Man, did I just get thirstier again?" And then I would just repeat this over and over and over again. So on a given day, I was drinking between one and one and a half gallons of water. And because of that, I was urinating frequently. So I would go to the bathroom every half an hour, like clock work. And as a result of that, I was flushing a lot of electrolytes. So just a lot of water in, a lot of water out. And then when I tried to go to sleep, I was so electrolyte depleted that my muscles began to cramp. So you know that feeling when you're lying in bed and all of a sudden your hamstring cramps and it's extremely painful?
Rip Esselstyn:
Not fun.
Cyrus Khambatta:
And you do everything you can to try and get rid of that tension that built up inside of your hamstring. Well, that would happen in my left hamstring. So then I would manipulate my body to try and relieve that tension. And then in the process, my right butt cheek would cramp, and then as a result of that, my right calf would cramp and then my abs would cramp. And then before I know my shoulder would cramp. And there were literally moments where I was lying in bed and I was in full body rigor mortis, and I was like, "This is unbelievable what is happening to me?" so I ended up going to the hospital and, or sorry, I went to the health clinic, and at the health clinic, they basically-
Rip Esselstyn:
Is this at Stanford or is this at UC Berkeley?
Cyrus Khambatta:
This is at Stanford. This is at Stanford. So I actually picked up the phone and I called my sister, and she's a doctor of osteopathy in family practice. And I explained my symptomatology to her and she was like, "Cyrus, drop everything that you're doing right now. Go straight to the health center because you're explaining that you have type one diabetes." And I was like, "Shanaaz, what are you talking about? Type one diabetes? I don't even know what that means." But the only association that I had in my head was that diabetes was about old people and cake. That's it. And I was like, "Okay, so what am I supposed to do?" So she goes, "Go straight to the health center, call me when you get there." So I go to the health center, I check myself in, a nurse treats me, she takes a finger stick of blood glucose and walks into another room to go put it into a blood glucose meter and comes back about, I don't know, two minutes later.
And I had already fallen asleep, so I was passed out on the table inside of her office, and she walks into the office again and she goes, "How did you get here?" And I was like, "I walked." And she's like, "We need to take you to the hospital right now." And I was like, "Is this an emergency situation?" She's like, "Absolutely, we got to go." So I ended up getting transported to the hospital, and when I was there, they monitored my blood glucose over the course of the next 24 hours. They gave me IV insulin into one arm. And then they gave me fluids into the other arm to try and get me more hydrated, first of all, because I was actually dehydrated and secondarily, to bring my blood glucose down. And over the course of 24 hours, they said to me, "Cyrus, not only do you have type one diabetes and your pancreas no longer secretes a sufficient amount of insulin, but you also have two other autoimmune conditions."
The other ones are called Hashimoto's hypothyroidism, which had been developing over the course of the previous six months, but it wasn't officially diagnosed until that moment. And then the third one was this thing called alopecia universalis, which is, you can see I have no eyebrows, I have no hair, I have complete total hair loss, and I used to have hair. So there's three autoimmune conditions that set in within a six month period. And here I am, a 22 year old guy trying to play soccer or hit on women, go to parties. And all of a sudden, that was my life. So I turned into a chronic disease patient instantly, and it was a tough pill to swallow. So to answer your question, how did that turn into what I am today? That set me on a course to try and figure out-
Rip Esselstyn:
Before you continue, let me ask you this. So you got diagnosed with the three autoimmune diseases in one fell swoop?
Cyrus Khambatta:
Correct.
Rip Esselstyn:
So the alopecia, was that something, was your hair starting to fall out or how did you get diagnosed with that?
Cyrus Khambatta:
Yeah, that was a great question. My hair was actually starting to fall out at that point. So what was happening is that my head of hair, I would end up with small bald spots that would appear on the left front side, and then it would go to the back middle. And there were these sort of bald spots that were appearing, not only on my head, but then I would also get a couple of bald spots on my chest. And I also had some bald spots on my legs, and I couldn't really exactly figure out what that was or why that was happening. And funny enough, a friend of mine, who was a very good friend of mine from high school, had come over to dinner one night and he took a look at me and he goes, "Cyrus, I don't want you to take this wrong way, but you look weird."
I was like, "All right, I know. I know exactly what you're talking about." He's like, "Here's what we're going to do. You're going to finish your food, we're going to go to CVS. I'm going to get a Bic razor and some shaving cream, and I'm going to shave all of your head so that you don't look as weird anymore. How do you feel about that?" And I was like, "Let's do it." So we went and got the razor, we came back, he shaved my head, half an hour later, I had zero hair on my head. And then funny enough, within the next 24 hours, all the remaining hair that was on my chest and on my legs and on my arms, gone, fell away.
Rip Esselstyn:
Followed the way of the head.
Cyrus Khambatta:
Yeah, seriously. I mean, I still don't fully understand exactly how that happened, but within, if I call it 24, 48 hours, I went from being, having hair to being completely hairless.
Rip Esselstyn:
So has anything changed as far as alopecia, as far as you're concerned, since Jada Pinkett Smith and that whole ordeal with her letting the world know that she's got it and it's a thing?
Cyrus Khambatta:
It was funny. I was actually expecting there to be a lot of conversation about alopecia and what causes it and who has it, and how's it different from men versus women and receiving a lot of messages from it. It was crickets. Yeah, I mean, maybe in the world of alopecia, there's a huge conversation happening right now, but I'm not really involved in that world. So from my perspective, nothing really has changed significantly, other than watching a very entertaining 30 seconds on television.
Rip Esselstyn:
So when you're in airports or parties, does anybody, little kids ever say, "Oh, why are you so bald?" Or is it, there's so many bald people now and they probably can't really notice your eyebrows and your eyelashes and all that stuff. The fact that, and the fact that you're 40 or over, and at this point you have no hair sticking out of your ears.
Cyrus Khambatta:
Which is a superpower actually. Well, what young kids do who, when I'm playing with them, a lot of times they'll look at me and they'll be like, "You don't have any eyebrows." And I'm like, "You're right. I don't have any eyebrows." "What happened? What happened to your eyebrows? Did you lose them? Did you burn them?" And then I have to go and explain to them, but for the most part, I don't know, People have told me that they don't really know that I don't have eyebrows until weeks or months go by. And then all of a sudden they're like, "Huh, you don't have eyebrows. That's kind of crazy." But then if you go onto our YouTube channel for mastering diabetes, and you read the comments, a lot of the comments are about my eyebrows or my lack of eyebrows, and people tell me I look like a weirdo and that they're not going to listen to somebody who doesn't have any eyebrows. And that my eyebrows fell off because I ate too many mangoes. And it's just like, it's just a circus, but it kind of depends on which audience you ask.
Rip Esselstyn:
All right, so let's get back. So why you? You get diagnosed and then what's your next move?
Cyrus Khambatta:
Okay, so get diagnosed. And then the doctors at that time told me, they said, "Listen, we can't really give you any recommendations, any health recommendations for reversing alopecia or for reversing Hashimoto's hypothyroidism, because you know what? We don't really know. But when it comes to managing type one diabetes, you can eat a low carbohydrate diet. Because if you do that, then that'll keep, that'll do two things. There's two promises. Number one, it will keep your blood glucose low. And number two, it will keep your insulin use low. So if you hit a low carbohydrate diet, your blood glucose will become very controllable and your insulin use will stay nice and low. Do that." And I said, fine. Sounds like a plan. So at the age of 22, they told me to eat more milk, more cheese, more red meat, more white meat, more peanut butter, more bacon, more dairy products, you name it. So I ate all that stuff.
Rip Esselstyn:
And did you like eating all that stuff?
Cyrus Khambatta:
I loved eating all that stuff when I was that age. I mean, I looked forward to it, honestly, because I kind of grew up on that food, plus some vegetables here and there. So it wasn't that big of a deal for me. In fact, I kind of liked the diagnosis, to be perfectly honest. But then things started to change pretty rapidly. So about three months in, four months in, somewhere around there, I recognized that it was really hard for me to exercise. That was the first thing that became a little bit strange. And what would happen is that-
Rip Esselstyn:
And is exercise something that has, up to this point in your life, been important for you?
Cyrus Khambatta:
Oh man. I mean, I started moving my body when I was four years old, three years old, and my mom was, she would enroll me in every sport. So I literally grew up from the time I was like, before I could even remember, baseball, soccer, swimming, running, hiking, basketball, you name it, everything that, that was my currency. That's how I spent a lot of my time, was just moving my body. Probably very similar to you growing up as a young active athlete. So all throughout high school I played soccer and then I began lifting weights, and that just became a staple of who I was and what I did.
So I get to college and I'm trying to continue to do the same thing, and all of a sudden I recognize that something is wrong. My body just does not feel the way that it had felt previously. I felt slower. I felt I wasn't overweight, I felt slower, I just felt more lethargic. And I recognize that my recovery from exercise was horrendous. So as an example, I would go play one soccer game that last about 90 minutes long. And under normal circumstances, I would be able to recover from that soccer game within about 24 hours. I'd be sore, my legs would be tight, I'd stretch, I'd drink some water, everything would be fine. Then I could go and I'd play again 24 hours later. But in this scenario, when I was first diagnosed with diet type one diabetes, it would take me four days to recover from one game of soccer. And if you're an avid athlete, four days is unacceptable. Absolutely unacceptable. You just can't get the volume of exercise you want in. You're not going to make strength gains, you're not going to make endurance gains. It's just not going to happen.
So I would sit on the couch regularly, the second day after exercise, and I was like, "Oh my God, why do my hamstrings hurt so much? Why is my chest tight? I didn't even use my chest while I was playing soccer. What the heck is going on?" So that was happening. In addition to that, my blood glucose became a roller coaster, again, the promise was that my glucose would become controllable. But in reality, if you looked at my blood glucose meter, it was a random number generator. I mean, my glucose was just this saw tooth pattern of up, down, up, down, up, down, up, down, all day long, every day, for months on end.
And as a result of that, when your blood glucose goes high, not only does it make you feel pretty low energy and just kind of get on your nerves, but you have to inject a lot of insulin to lower your blood glucose. So inadvertently, my insulin use began to creep up over the course of time. So by the time I hit my one year marker, eating a low carbohydrate diet, living with type one diabetes, my insulin use had doubled. I started out at 25 units of insulin per day. There were certain days where I was injecting 50 to 55 units of insulin per day, but despite the fact that I was eating a low carbohydrate diet, so nothing that the low carbohydrate promises or the low carbohydrate world had told me, was actually coming true. So at that point I was like, "You know what? I got to find something different. I don't know what I'm going to do. I'm just going to find something."
Rip Esselstyn:
But did you go back to the doctors that had prescribed this and say, "Hey, this isn't working. I mean, am I an anomaly here? Or the prescription that you've given me is messed up here."?
Cyrus Khambatta:
Very good question. So the truth is that when I was working with an endocrinologist at that time, and whenever I would try and talk about diet, it was like the conversation just didn't go anywhere. Because as you know, doctors don't really understand nutrition. So if you start to ask a doctor about, well, what's the difference between a turkey burger and a red meat? And should I eat potato buns or should I eat potatoes, or should I eat hot dog buns, whatnot. Yeah, they don't know the answers to those questions. So the thing that my doctors were concerned with, is downloading the data from my blood glucose meter and then giving me a prescription for a different type of insulin, that was their entire focus. So the conversation about nutrition was just kind of like, if I would bring something up, it was just gone. I wouldn't even get into response.
Rip Esselstyn:
So their focus was very myopic?
Cyrus Khambatta:
Extremely myopic.
Rip Esselstyn:
They weren't looking holistically at the no full equation here. And the most important part of the equation, which is, what are you putting in your mouth?
Cyrus Khambatta:
Exactly. And I mean, I would venture to say that in today's world, things haven't changed that much, to be perfectly honest. Because-
Rip Esselstyn:
20 years later.
Cyrus Khambatta:
20 years later, 20 years later. I mean, I talk to people with diabetes left and I hear the same story from people over and over and over again, about my internal medicine doctor said this, and my PCP said this, and my endocrinologist said this. And the answer is always a low carbohydrate diet. "Eat low carbs. Carbs are bad for you, don't eat carbs, you're allergic to carbs." Blah, blah, blah, blah, blah. And I got the same advice. But yet, not only did it not work for me, I'm also seeing in 1000s and 1000s of patients and clients over the course of time that it's happening to them too.
...glucose uncontrollable, insulin uses going up, oral medications going up, becoming more overweight, more hypertensive, higher cholesterol, more brain fog, worse skin, and the list goes on.
Rip Esselstyn:
So who introduced you to a smarter path?
Cyrus Khambatta:
So I was living in San Francisco at the time, and I had some friends who just happened to be more, they happened to be eating, I believe it was a 100% plant-based diet, and it was just out of pure coincidence. So I was talking to them, I was like, "Why would you do that and what are you gaining from it? And would it work for somebody with diabetes? Yes or no?" And so one of my friends said, "Hey, Cyrus, you should talk to this guy named Doug Graham." Doug Graham is, he's-
Speaker 1:
80/10/10, right?
Cyrus Khambatta:
Exactly. "He's a very smart guy. You should pick up the phone and call him or send him an email." So I did. And when I talked to Doug, I basically said, "Hey, Doug, listen, I have type one diabetes. This is my experience eating a low carbohydrate diet. It's not working for me. I'm an athlete. Can you make me feel like a normal human being?" And he was on the other side of the phone, and he laughed and he was like, "Cyrus, you have no idea what's about to happen to you. I'm hosting a sports retreat in Colorado in three weeks. Why don't you show up and come hang out with me for a week and I'll show you everything and it'll flip your world upside down?" And I said, "Great, let's do it." So I went to go hang out with him for a week at his retreat, and while we were there, he showed me how to do literally the exact opposite of what I was doing.
So I was eating a relatively animal product heavy diet, and it was higher in fat and protein and low in carbohydrate. He told me how to switch over to a 100% plant-based diet, that was a raw food diet, that was 80% or more from carbohydrate energy, and then approximately 10% from fat and 10% from protein. And lower my, I'm sorry, eat nothing but whole foods and basically get rid of all animal products, period. End of story. And so I was like, "Great. I mean, I don't know what this is going to do to me, but I'm just going to have this willing suspension of disbelief that this might work. Let's see what happens." And Doug said, "Great, just watch and learn." So what I recognized was that within the first 24 hours of being under his supervision and his guidance, my blood glucose values began to fall fast.
So like I was saying, I normally would have this saw tooth curve where I would hit 200s and 300s on a daily basis, which is, normal blood glucose is supposed to be approximately 100, call it somewhere between 70 and 130 and try and keep it there within that range all day long, every day. My glucose going into this was in the high 100s, 200s, sometimes 300s. And within 24 hours of being under his guidance, my blood glucose fell down into the low 100s, and sometimes it fell even below the threshold for hypoglycemia, down beneath 70. And so I would have to suspend my basal insulin on my insulin pump and then just try and eat more food, eat more food, and more food. So if we fast forward over the course of seven days, I walked away from that retreat having gone from eating 125 grams of carbohydrate on average per day before the retreat, to 650 grams of carbohydrate per day at the end of the seven days.
Rip Esselstyn:
Fivefold increase.
Cyrus Khambatta:
Fivefold increase, right there, fivefold increase within seven days. And you would think if the low carbohydrate methodology was true, if it worked, if had a solid biological and physiological reasoning behind it, then if I five folded my carbohydrate intake, I should have at least five folded my insulin use. Because that's what the low carbohydrate world tells you, that more carbs equals more insulin equals more weight gain equals more cholesterol equals more inflammation in many tissues. So I was expecting to use more insulin, but I had a fivefold increase in my carbohydrate intake and my insulin use fell by 40%.
Rip Esselstyn:
Incredible.
Cyrus Khambatta:
So I, being five times as much carbohydrate energy for 40% less insulin. And when that happened, I was like, "Doug, what the hell is happening to me?" And Doug said, Cyrus, he explained a lot of the biology to me. And then from that moment onwards, I said, you know what? I'm going to go study this stuff because I really want to understand the biological, the actual biochemistry underlying what is happening inside of me. So I put myself back to graduate school. Sorry, go ahead.
Rip Esselstyn:
No, no. So I was going to say, so you wanted it, So where did that lead you? What school and what degree?
Cyrus Khambatta:
Yeah. So then at that point, I said, This is really fascinating. For two years, I just lived this lifestyle and I returned back to athletics and I became extremely active. And I got on my bicycle and I rode my bike 16,000 miles on the first year and beyond. Then I decided that I wanted to put a PhD level education behind this. So I went to UC Berkeley, and I studied there for five years. And I got a PhD in nutritional biochemistry, so that I could answer one question and one question only. And that one question was, am I a freak of nature? That's literally all I wanted to know was what's happening inside of me, am I some weird genetic anomaly? Or is what's happening inside of me also applicable to other people, with either type one or type two or prediabetes? That's what I wanted to know.
And while I was at grad school, my mind was blown even more than Doug had blown my mind. And I began to realize that there is literally 100 years of scientific evidence, dating back to 1920, that clearly documents the relationship between carbohydrate, fat, protein, and insulin requirements. And the long and short of it is that the low carbohydrate world wants you to believe that carbohydrates are bad for you, and carbohydrates lead to increased chronic disease. But the scientific research shows the exact opposite. That when you eat whole food carbohydrates coming from fruits and starchy vegetables and legumes and whole grains, and you increase the proportion of those foods inside of your diet, your chronic disease risk comes down. The amount of insulin resistance inside of your body, which we can geek out on a little bit here, goes down, your blood glucose control becomes better, and all of a sudden life becomes way easier.
Rip Esselstyn:
How is it that in 2022, if we've had now over a 100 years of scientific research that has shown that a high carbohydrate, low fat, whole food plant-based diet is the answer, how could we have it so wrong? How could the medical establishment be so upside down? And how many people are walking around with diabetes right now, either type one or type two or 1.5 or gestational, that are doing the incorrect protocol and are in this state of wondering, just like you were, "What is wrong with me"? It sounds like a miserable existence.
Cyrus Khambatta:
Yeah, it is really not a fun place to be. It really is not. So to answer your question, how is it that we're a 100 years from the beginning of the research and we're still getting it wrong? I'll say two things. Number one, the medical institution and the pharmaceutical industry are extremely powerful machines, and they are intertwined with one another. When doctors go to medical school, they don't learn anything about food. They learn everything there is to know about how to diagnose and how to treat disease, mainly through the use of pharmaceutical medication. So the conversation about diet and plant-based diet doesn't really factor into their education at all. And then as a result of that, when people go to the doctor, they don't really learn about food. Food isn't taught in school. And so most people are walking around completely ignorant about what food can actually do for them and how it can influence their risk for chronic disease, many chronic diseases.
Number two, if you were to ask your dad the same question, right? "Esselstyn, why is it that the eating a low fat, plant-based whole food diet can truly reverse atherosclerosis and coronary artery disease and cardiovascular disease in general, but yet the cardiology world doesn't want to believe it, doesn't understand it, still prescribes statin medications, blood pressure, medications, and unnecessary interventions at times? What would he say to that?
Rip Esselstyn:
Yeah, I mean, I think it'd be the exact same answer. And it's sad state of affairs that we're letting these huge, powerful industries, and also in many ways, egos and business. What's the quote that? It's something like, if a cardiologist is faced with telling somebody, you know what? You can totally take care of this heart disease, but it's going to require sweet potatoes, steel cut oats, green leafies, and all this other stuff. Or he can say, "You know what? Nobody ever eats that way. Instead, what I would recommend is let's give you a stent. If you get any more blockages, you can just come back. We can play surgical whack-a-mole, put in another 3, 4, 5, however many we need." So to me, he's letting his 50,000 or 75,000 procedure cloud his judgment.
Cyrus Khambatta:
There's no question about it. There's no question about it. And another thing that I think is also factoring into this equation is that in the world in which we live today, social media has become a sort of very, whatever. It's all over the place. So whether you like it or not, your life is influenced by social media. And what I have learned by paying attention to what people post on Instagram and Facebook and TikTok and beyond, is that a lot of what's circulated on social media platforms is not about the science. There are very few people who can actually comprehend the science, because it takes a lot of time and a lot of energy and a lot of focus to be able to read a scientific paper in detail and truly understand who were the subjects, what period of time, why was it done this way, What are the results mean? What does the conclusion, what can be done in the future, and what is the takeaway message? But on social media, what people do is they talk about their feelings.
Cyrus Khambatta:
Social media, what people do is they talk about their feelings. They talk about what they think is the right answer, and how this felt to me when I did it. And so what people are communicating is purely emotional, or mainly emotional, and emotion has a place in this world of lifestyle medicine. But it is not the truth, because the truth comes from the scientific world. But only a fraction of people have the opportunity to be able to actually understand that and relay it to the actual general public.
Rip Esselstyn:
Cyrus, let's dive into the science. I think this is a perfect segue for us. For example, one of the things that I don't think... If we were to ask a hundred people on the street, what is insulin resistance, or even probably a lot of people that have type two diabetes, they probably couldn't give us a really good answer. And so I think it's fundamentally important that we discuss insulin resistance and what exactly it is. And as you state on the cover of your book, the revolutionary method to reverse insulin resistance permanently in Type 1, 1.5, 2, prediabetes and gestational diabetes.
Cyrus Khambatta:
Correct.
Rip Esselstyn:
Because if I was looking at that, I'd say, "Cyrus, I know for a fact that you cannot reverse Type 1 diabetes."
Cyrus Khambatta:
Correct.
Rip Esselstyn:
Because your pancreas is no longer generating those insulin cells.
Cyrus Khambatta:
Correct.
Rip Esselstyn:
So, talk to me. What am I missing?
Cyrus Khambatta:
Okay. So here we go. The name of the game is insulin resistance, just like you mentioned. And the reason why we focus 100% of our energy and on our education on understanding and talking about insulin resistance, is because it is the uniting factor or the puzzle piece that connects the entire diabetes world. The diabetes world has multiple different types of diabetes. You get Type 1, Type 1.5, they're both autoimmune conditions which are non-reversible. Type 1 affects mainly people who are less than 30 years old. Type 1.5 affects people who are older than 30 years old. It has a slower onset and doesn't lead to full insulin dependence. So those two are autoimmune conditions.
Then you have prediabetes, Type 2 diabetes and gestational diabetes. All three of those are lifestyle-induced versions of diabetes. They have a small genetic precursor, but are mainly influenced by the activity that you do or do not perform, the amount of alcohol that you do or do not drink, the type of food that you are eating, and beyond. So we have five different classes or five different flavors of diabetes, if you will. And the simplest way to connect all of them together is to talk about the underlying condition, that it influences your blood glucose control across all five of those, and that is called insulin resistance. So what insulin resistance is at its root is it is a condition which can be created inside of your muscle and inside of your liver, primarily by the consumption of a diet that is high in saturated fat.
Rip Esselstyn:
Now, when you say your muscle, do you mean all the cells in our muscles? What do you mean by muscle?
Cyrus Khambatta:
Yes. You have what's called skeletal muscle. Skeletal muscle is all over your body. You have hundreds of muscles that span everywhere from your shoulders to your chest, to your triceps, to your biceps, to your forearms, to your abdomen, to your lower back, to your quadriceps, your hamstrings, your calf muscles, you name it. All throughout your body. You've got large muscles, you've got small muscles, you got everything in between. Each one of those muscles is composed of billions of cells. And billions with a B, sometimes potentially even trillions, depending on how large the muscle is.
And those cells are critically important for a number of overall physiological function. And the ability of those muscle cells to be able to operate in an optimal manner is critical to life, absolutely critical to life. And I'm not talking about people who are going to be an Olympic athlete, or somebody who is even a very active individual. I'm talking about just your average individual who may or may not be working out, who may or may not be performing any activity. The function of those muscle cells is critically important for your chronic disease risk. So that's number one.
Number two, your liver. Your liver is the hardest working organ in your entire body. I would say, arguably, that your liver works harder than your brain. That's a very controversial statement, but the point is that your liver can perform more functions, it has a more diverse range of metabolic functions than any other tissue in your body. Your liver can manufacture and store many different carbohydrate, fat and protein molecules. It is involved in cholesterol metabolism. It's involved in the production of urea. It detoxifies pharmaceutical drugs that you consume. It produces hormones that are going into your blood. It communicates with your adrenal gland. It influences your sex drive, and beyond. So there are many aspects of liver function that are absolutely critical to normal physiological function. And insulin resistance happens to impact both of those tissues, your muscle and your liver, and it gets both of them into a state of dysfunction that can then increase your risk for prediabetes, Type 2 diabetes and gestational diabetes. And also make your blood glucose control very hard and very challenging in Type 1 and 1.5.
So the question really becomes, what the heck is insulin resistance and what causes it? If you go on the internet and you type in insulin resistance and you try and figure out what it is, most of the information that you'll find on social media, again, is not about truth, it's not about science, it's not about education. It's about feeling, it's about opinions. The stuff that you'll find on social media will tell you that carbohydrate causes insulin resistance. That sugar causes insulin resistance. And the truth is that some of that is true, can be true, but in very, very specific physiological situations. The truth is that insulin resistance is most easily induced and most repeatably induced in animals, and I say animals because that includes humans plus also other mammals, is easily induced in all mammals using a diet that is high in fat.
So let's transport backwards in time. Let's go back to 2007, when I first began my graduate degree. My professor at the time said, "Cyrus, I'm going to give you a project for the next five years. And the project is to understand every single aspect of insulin resistance. I want you to learn what causes it, how to induce it in laboratory mice and in laboratory rats, and then how you can rescue insulin sensitivity using either intermittent fasting, calorie restriction or movement." So this is a really fascinating topic, and there's a thousand different rabbit holes that you can get caught in. My first homework assignment was to try and figure out how do I create insulin resistance in laboratory mice and laboratory rats? What am I going to do? And what my head was saying is just feed them a diet that's got a lot of sugar in it, Cyrus. Feed them fructose... What's that?
Rip Esselstyn:
I said right.
Cyrus Khambatta:
Feed them either artificial sweeteners or fructose or high fructose corn syrup. And when I looked into the research to try and figure out how insulin resistance was induced in laboratory animals, the answer was totally different. The answer was very different. The answer was feed them a diet that is high in saturated fat, for a minimum of eight weeks. If you do that, animals will become insulin resistant. And it's very, very repeatable, extremely easy to measure, extremely easy to perform.
Rip Esselstyn:
So is this leading you to believe now that, wow, it's not about the sugar, it's about the fat?
Cyrus Khambatta:
It's not about the sugar, it's the fat. But here's the thing. This is 2007. Go backwards four more years, to when I transitioned to a plant-based diet, 2003. I had already had that experience myself, because I transitioned to eating a diet that was much higher in carbohydrate energy. And as a result of that I ate more carbohydrate and I had less fat. And all of a sudden my life improved dramatically. My insulin use came down, my blood glucose came down. So I knew that, intuitively. And then the research confirmed that. And then it confirmed it over and over and over and over and over again. And I saw this repeated in, not only mice and rats, but I also saw it in human studies. I also saw it in rabbit studies. I also saw it in studies involving dogs. It was the same thing. Because this is a mammalian... What's the word I'm looking for, it's a mammalian physiological mechanism, that you can induce insulin resistance by eating a diet that contains excess saturated fat.
So here's how this works. Fat in food is locked up in a molecule known as triglyceride. Triglyceride is just the storage form of fatty acids inside of mammals, and inside of fruits and vegetables and plant material. So triglyceride is how fat exists primarily in the natural world. If you consume triglyceride inside of a food that contains a significant amount of fat, like let's say you're consuming red meat, or you consume cheese, or maybe even an avocado, or maybe you have some olive oil. All of those foods tend to be fat rich, and they contain triglycerides. So you consume the triglyceride, it travels into your mouth, it goes down your esophagus, it gets inside of your stomach. Inside of your stomach is an acid chamber, where the walls of your stomach are secreting hydrochloric acid into the lumen, and they're basically using that as a mechanism to try and get access to the food and start to unfold it.
So primarily protein is denatured and unfolded from its three dimensional structure and linearized inside of your stomach. At that point the partially digested food material, called chyme, ends up transitioning into your small intestine. Your small intestine is a magical, magical organ, because inside of your small intestine that's where the bulk of nutrient digestion and absorption happens. In your small intestine there are digestive enzymes that are secreted by your liver and your pancreas and your gallbladder, and your small intestine itself. And that cocktail of enzymes has a very specific function. And that is these enzymes go and they effectively attack the food that you are eating, or that you just ate. And their purpose is to try and take this food and take it from its large macro molecules and cut them into individual pieces, and then take those individual pieces and absorb them through the walls of your small intestine and put them into your blood.
So when it comes to triglyceride, the triglyceride is basically cut. The reason it's called triglyceride is because there are three fatty acid molecules attached to a glycerol. So you have a glycerol backbone plus three fatty acids. And the digestive enzymes hydrolyze or cut the glycerol from the three fatty acids, and then those three fatty acids are then transported into your lymph system. And then in your lymph system there then eventually dumped into your blood. And then once they're inside of your blood they are then packaged into these things called chylomicron particles. There's some funky words that we use in the biology world, but the idea here is these chylomicron particles are these little spaceships. And they're spaceships that contain a bunch of cargo. And there are billions of them in circulation inside of your blood at any moment in time.
So right after a fat-rich meal, these chylomicrons are loaded with the cargo of fatty acids. And these fatty acids circulate in chylomicrons. And their goal is to get to a tissue so that the fatty acids can be unloaded into a tissue. Now, if I could design the human body, or if I could design mammals from the ground up, what I would do is I would make it so that those chylomicron particles only really have access to one tissue. And that one tissue is called fat tissue, or adipose tissue. Because if those chylomicron particles went only to the fat tissue and delivered their cargo into the fat tissue, that would actually be physiologically safe. Because your fat tissue is actually a very safe place to keep fatty acids. It's designed both mechanically and enzymatically to be able to take up large amounts of fat, when present, and then store that fat and lock it up in a triglyceride one more time, and keep it until it doesn't need it anymore, then it can cut it and deliver to other tissues.
But here's the problem. When those chylomicrons are loaded with their fatty acid cargo and they circulate, they not only deliver fat to the fat tissue, which is again the safe place to put it, but they also deliver the excess to your liver, and they also deliver the excess to your muscle. So now you have fatty acids that are basically getting partitioned into one of three tissues. Your adipose tissue, number one, and then your muscle and your liver is number two and number three.
Rip Esselstyn:
Does it get partitioned into the liver and the muscles after the adipose tissue has kind of been maxed out, or not necessarily?
Cyrus Khambatta:
Actually, the truth be told is that it depends on a number of circulating biomarkers and hormones.
Rip Esselstyn:
Okay. But it just seems to me like this miracle, of our bodies, it doesn't seem like it would be flawed. Everything seems to be like it is for a reason, a good reason. So maybe the flaw isn't in these spaceships and where they're delivering stuff, maybe the flaw is in the excessive amount of food we're eating.
Cyrus Khambatta:
That's exactly right. It's not a flaw in the organism's creation, or in the way that it's designed, it's a flaw in the fact that we are consuming excess saturated fat, which puts pressure on this process, and then causes this process to go awry. So you're absolutely right, from that perspective. So to answer your previous question, the priority is, yes, put as much fatty acids into adipose tissue as possible, as top priority. And then, number two, the excess or the overflow ends up getting partitioned into your liver, into your muscle. So if you're eating a diet that contains a significant amount of saturated fat, then the amount of fatty acid that goes inside of your liver and muscle will go up over the course of time.
Now, here's the problem. When saturated fat gets inside of your liver and gets inside of your muscle, that is okay in small quantities. Your liver and your muscle, inside of each cell, inside of what are called the hepatocytes, which are the liver cells, and then the myocytes, which are the muscle cells, they have the enzymatic machinery to be able to uptake saturated fat in small quantities and store it in this thing called a lipid droplet. The lipid droplet is literally this little globule of fat that's intracellular, that is used as an energy source for that cell. It's literally like a backup fuel mechanism. And that cell can use that as energy and burn it for ATP and then perform useful cellular work. But the problem is that when you're consuming a diet that has a lot of saturated fat, then you force those myocytes and you force those hepatocytes to accumulate excess saturated fat beyond their design.
And as a result of that, that lipid droplet starts to grow a little bit larger than it was designed for, and gets to grow over the course of time. Now, the problem is that when that lipid droplet grows, one of the primary dysfunctions that happens inside of the cell is that the cell begins to block the action of insulin. Now, why the heck would the cell do that?
Rip Esselstyn:
So there's resistance.
Cyrus Khambatta:
There's resistance. Because from the cell's perspective, the cell is sitting there and it's being given excess saturated fatty acids that it didn't necessarily ask for, nor was it designed to store. But it can't really block that from coming in, because there's excess fatty acids floating in the blood in the chylomicron particles, that were there because the person, the host, ate a large amount of saturated fat. So these fatty acid molecules get inside of the liver, inside of the muscle, beyond the design. And then these liver and muscle cells are like, what am I supposed to do? How do I block this stuff from coming in? So they slow down the ability of insulin to do its job. Because insulin is the single most powerful anabolic hormone in mammals. Anabolic basically means synthesis, or to manufacture, to create.
Insulin is the single most powerful hormone that promotes number one, fuel storage, and number two cell growth. So if you're trying to store more fuel, or you're trying to grow a cell, the way that you would do it is by allowing that cell to communicate very well with insulin. So what these cells do is they basically go like, oh crap, there's too much stuff coming inside of me. Tell insulin to go away, decrease your ability to communicate with insulin. And by doing that, then when insulin comes and knocks on the door and says, "Hey, knock, knock, there's some glucose in the blood. There's some fatty acids in the blood. There's some amino acids in the blood. Do you want to take it up?" Those cells are like, "I'm not listening to you anymore, insulin. You already put a bunch of stuff inside of me. I got to get rid of this stuff first, go away."
And so, as a result of that the next time that you eat something that's carbohydrate-rich, let it be a banana or a bowl of rice or a bowl of quinoa or a potato, the carbohydrate molecules that are inside of that food get broken down into glucose. The glucose wants to get access to your liver and muscle, the exact same cells that already accumulated excess saturated fat. So the glucose comes to the door of the cell and the glucose is like, "Hey insulin, tell this cell I'm here." So insulin goes, "Knock, knock. Hey, liver cell. Knock, knock. Muscle cell, there's glucose in the blood, would you take it up right now?" And both of those respond by saying, "Sorry, I'm not listening to you right now. I got a bunch of stuff. Let me get rid of this stuff first. Leave that glucose in the blood."
So what ends up happening is there's a traffic jam of glucose inside of your blood, and a traffic jam of insulin inside of your blood. So insulin cannot signal to the liver and muscle as effectively, and glucose cannot enter the liver or muscle as effectively. So you end up with what's called hyperglycemia, which is excess glucose in your blood. And then, number two, hyperinsulinemia, which is excess insulin in your blood. So classic insulin resistance is when you go to the doctor and the doctor takes a whole panel of different biomarkers and they find out that your fasting glucose is high. That's hyperglycemia. And if they do measure your insulin level are likely to find that your fasting insulin is also high. And that right there tells you that there's a traffic jam inside of your liver and muscle. Fix that problem, and fix it first.
Rip Esselstyn:
Isn't that interesting? And so that is why there's so much confusion around people thinking it's a sugar issue, when the fact of the matter is it is an excessive fat issue. And you keep saying saturated fat.
Cyrus Khambatta:
Correct.
Rip Esselstyn:
Does it have to be saturated fat? Or does monounsaturated fat, or even enough polyunsaturated fat, could they do the same thing?
Cyrus Khambatta:
Yeah. Good question. Basically, you can think of there as being three different types of fat. There's trans fat, which is like a hydrogenated fat that it results from a hydrogenation process that humans invented. Small amounts of trans fat are actually present inside of the natural world, but in microscopic quantities. Trans fat is very, very dangerous, that can actually harm endothelial cells and increase the atherosclerotic process and increase your LDL cholesterol. So you don't want that stuff. Number two, there's unsaturated fatty acids. And unsaturated fatty acids are the ones that you talked about, the MUFAs and the PUFAs, the monounsaturated fatty acids, and the polyunsaturated fatty acids. Those are considered unsaturated because from a chemical perspective they don't have a full array of hydrogen molecules. Don't worry about the biology. But those molecules are actually bent. They are bent molecules. So from a structural perspective they're not linear.
And that makes a big difference because bent fatty acids, when they get inside of the cellular architecture, are not used for energy, they are used for other purposes. So the actual three-dimensional structure of that molecule makes it so that instead of burning that for ATP and trying to get energy out of it, those monounsaturated, polyunsaturated fatty acids are used for other purposes. They're used for membrane fluidity inside of the fluid membrane on the outside of the cell. Or even membrane fluidity on the actual organelles themselves inside of the cell. Some of them are slightly more pro-inflammatory, some of them are slightly more anti-inflammatory, but the idea here is they have a different function altogether. And so when I'm talking about excess accumulation of fatty acids I'm talking primarily saturated fat. Because the saturated fat molecules are linear and they are used for energy. Those are the molecules that are stored inside of your adipose tissue, and your liver and your muscle, and can be broken down and they can yield ATP, which is useful energy for cells to use to operate on.
Rip Esselstyn:
Do you know why it is that fat, unlike glucose, doesn't need an insulin escort into the cells, and it can just go right in there whenever it seems like it wants to? It's unfair, Cyrus.
Cyrus Khambatta:
It is. It is. You're asking such a good question. It's such a good question. And truth be told, I don't know the answer to that question. I will be the first person to tell you. I don't know the answer. But you hit it on the head here, which is that when fatty acids are present in those chylomicron particles, and those chylomicron particles knock on the door of the liver and the muscle and they're like, "Hey, knock, knock, I got some fatty acids here for you." Those fatty acids can get inside of the liver and muscle cells, effectively without being blocked. They don't need an insulin to come along with it. They don't need some other molecule to act as an escort or a signal for them to get inside.
So when there's more saturated fat inside of your blood, then that means that there's going to be more saturated fat inside of your liver and inside of your muscle. Why? I don't know. I really don't know the answer to that. But the mechanism of transport of those fatty acids inside, using these things called fatty acid transport proteins in the membrane, makes it so that it's literally just a diffusion process, meaning that when there's more in the blood, then it ends up diffusing into the tissues and getting transported into the tissues so the tissues end up soaking it up.
Rip Esselstyn:
We could talk for three hours about insulin resistance. It's just kind of nutty how it's just a wormhole.
Cyrus Khambatta:
We could.
Rip Esselstyn:
But I want to talk about a lot of other things while I have you here. But before we move on from insulin resistance, let me ask you this. The keto and the paleo people that are suggesting that... I am hearing an echo there... Suggesting a low carbohydrate diet. They're never, ever testing in a true form to see if you're insulin resistant. So could you explain that?
Cyrus Khambatta:
Yeah. It's a really subtle point, but a very important point. In the research what you will find is that studies that investigate what is the effect of a low carbohydrate diet on people living with either prediabetes or Type 2 diabetes, you'll find a similar story from most research, which is that when you feed someone with prediabetes Type 2 diabetes, AKA somebody with insulin resistance, a low carbohydrate diet, number one, their blood glucose will come down. Number two, they will lose weight. Number three, their fasting insulin level will come down. And number four, their A1C level will come down. Their A1C being a marker, a measure of three month average blood glucose concentrations. I'll repeat that. You eat a low carbohydrate diet, fasting glucose comes down, fasting insulin comes down, A1C comes down, and weight loss happens.
So if you put all those together and you monitor people over the course of a two month period, three month period, six month period, what you're likely to find is that at the end of that intervention those people are healthier. They lost weight. Their A1C came down. Their fasting glucose is down and their fasting insulin is down. It's a challenging situation, because a low carbohydrate diet leads to these short-term results. And these short-term results, on a piece of paper make you look healthier. In conjunction with that, often people recognize that their blood pressure comes down, and they oftentimes report that they have a lot more energy. And a lot of this can be just explained literally by nothing more than weight loss.
So rather than saying, "I lost weight, in addition to all these things," think about it this way. You eat a low carbohydrate diet. A low carbohydrate diet is a rapid weight loss tool. By losing weight, then all those other biomarkers start to fall in line. By losing weight your A1C comes down. By losing weight your fasting glucose comes down. By losing weight your fasting insulin comes down. By losing weight you end up with lower blood pressure. So if you put weight loss as the first domino in a chain of other dominoes down the road, you'll find out that weight loss is actually the reason why so many other things improved.
Now, here's the kicker. Those people are improving all those other biomarkers, but they're actually becoming more insulin resistant.
Rip Esselstyn:
At the same time.
Cyrus Khambatta:
They're becoming simultaneously. They're getting improved biomarkers, but yet they're becoming more insulin resistant. Because as I told you earlier, insulin resistance is a function of the total amount of fat that you're eating. And ketogenic diets are extremely high fat diets, between 70% and 80% on average.
So how is it that somebody's getting more insulin resistant, but yet their biomarkers are improving? And the answer is because a low carbohydrate diet is literally a glucose suppressing tool. That's the way that I like to think about it. When you eat a ketogenic diet you are playing the carbohydrate avoidance game. You are not eating potatoes. You are not eating whole grains. You are not eating starchy vegetables. You are not eating fruits. You're eating red meat, white meat, dairy products, fish, chicken, peanut butter, olive oil, and the like. So by doing that, by not putting carbohydrate energy into your mouth, you are never challenging, you are never knocking on the door of the pancreas. Being like, "Hey pancreas, go manufacture insulin and go make that insulin, do something inside of the liver and muscle." And as a result of that, you shut down the glucose economy, if you will.
So you've suppressed the glucose economy and you've turned up the fatty acid economy. So now your liver, your muscle, plus the lipoprotein particles inside of your blood are all operating in the currency of fatty acids. And when they're operating in the currency of fatty acids, and carbohydrate metabolism is told to just go sit by the wayside, then great, things look good on a piece of paper, and your glucose is nice and low. But the minute that you take somebody who's eating a ketogenic diet, the minute you feed them one banana, one potato, something small, a small amount of carbohydrate, call it 25 grams, maybe 30 grams of carbohydrate, they're in such an insulin resistant state that the glucose molecules from those carbohydrates inside of that food are practically unmetabolizable. Because insulin can't really get those glucose molecules inside of their liver and muscle. And as a result of that, if you follow them over the course of the next two hours, their glucose, sky high. 200, 300 and beyond.
Rip Esselstyn:
Okay. So if it works, it almost seems like, as Dr. Clapper says, a physiological parlor trick of sorts, to make you look like you've solved your insulin resistance, when the reality is a potato or a banana or something like this causes it to skyrocket. And now you can point to that as the issue, when in fact you're telling me the issue, it's not the sugar that's in these whole plant-based foods, it's the fact that we have been just bombarding our cells and our liver and our muscles with all this fat. And now we are full blown insulin resistant. It is severe. Going back to when you were doing something similar at 22. But you didn't feel good. And was this not working for you? Because I think you were getting, what was it, you said the chainsaw effect or the rip saw-
Cyrus Khambatta:
The saw tooth effect.
Rip Esselstyn:
The saw tooth effect.
Cyrus Khambatta:
Yeah. Okay. That's a good question. Your question is basically, if what you're saying is that when people eat a ketogenic diet their glucose comes down and they look better on a piece of paper, and they've suppressed the carbohydrate economy, then how come that didn't happen in you? And the answer is very straightforward. I didn't eat a ketogenic diet. I was eating a general low carbohydrate diet. And a general low carbohydrate diet, if you look in the research, there's literally no definition for a general low carbohydrate diet. But it basically means that you're trying to limit your carbohydrate intake to somewhere between 75 grams per day, upwards of 200 grams per day. All of that is housed under the low carbohydrate umbrella.
Rip Esselstyn:
Good point. And now that I think about it, truly, there may have been some keto books way back, but I don't think the keto thing became a thing until like 2014, 2015. Before that it was all paleo.
Cyrus Khambatta:
Exactly right. So prior to keto, it was paleo. Prior to paleo it was like the Zone and the South Beach Diet, which were not really keto, they were just low carbohydrate-ish. Prior to that it was Atkins. So Atkins was the original popular ketogenic program back in the 90s that everybody was talking about as being the best thing since sliced bread.
So it wasn't that easy to find that. But if we had to go backwards in time and you were to say, "Hey, Cyrus, you're going to eat a ketogenic diet in order to suppress your glucose and insulin," I would've been like, "No, there's no way." Because, intuitively, a ketogenic diet, my brain just won't do it. I just can't do it. And I knew that that was not a recipe for ideal health, but yet the low carbohydrate thing that I was doing, wasn't like full-blown keto. And for some reason I could justify that, when in reality I learned that that was actually a pretty bad idea too.
Rip Esselstyn:
I like that we're talking about fat. I want to talk about fat a little bit longer here. So on the Mastering Diabetes green light, yellow light, red light program, which indicates to people which foods you can eat. Green, unlimited amounts of, right?
Cyrus Khambatta:
Yeah.
Rip Esselstyn:
Yellow, you want to be cautious. Red, let's let's put the brakes on these guys. What percent fat are we talking about when you say a low fat, whole food plant-based diet?
Cyrus Khambatta:
Great call. Great call. Okay. When we say low fat plant-based whole food diet, all three of those terms mean something. Low fat has a very specific definition, plant-based has a very specific definition, and whole food has a very specific definition.
Rip Esselstyn:
Talk to me about all three.
Cyrus Khambatta:
Okay. Low fat means 10% to 15% of your diet contains fat. 10% to 15% of your diet... Sorry, let me back up. 10% to 15% of the total calories that you're consuming on a daily basis should come from fat.
Cyrus Khambatta:
... on a daily basis should come from fat, 10 to 15% of the total calories you're consuming on a daily basis should come from protein, and the remainder, which is between 70 and 80% of your calories, should come from carbohydrate. Okay? So you can call it a low fat, you can call it low fat, low protein, you can call it high carbohydrate. I don't care what you call it, it Doesn't really matter. The point is that we're looking at either somewhere between like 70/15/15 or 80/10.10.
Rip Esselstyn:
Yeah. Okay. Yep. Then plant-based, whole food?
Cyrus Khambatta:
Okay. So that's low fat. Plant-based. Plant-based is this umbrella term that basically means eat a lot of plant material, eat as much plant material as you possibly can. If you choose to be 100% vegan and eliminate all animal products, by all means, I'll give you high five. I think it's a great decision. But if you say, "Cyrus, I don't want to do that. I still want to eat some eggs. I still want to have a little bit cheese. I still want to eat a turkey burger here and there. I want to have a red meat here and there," my answer to you is, "Listen, I'm not the food police. You do whatever you want to do. I'm going to educate you," and at that point, you're the one that decides what you want.
So if you're going to eat a plant-based diet, I would say eat at least a minimum of 90% of all your calories that come from plant material. Okay? Fruits, vegetables, legumes, whole grains, herbs and spices, mushrooms, leafy green vegetables. Get your nutrition and your calories from there. If you have the occasional animal based product, that's on you.
Rip Esselstyn:
Yeah. What about whole foods?
Cyrus Khambatta:
Okay. Whole foods either completely unprocessed or minimally processed. Okay? So if you were to walk out into a jungle, or you were to walk out into the forest and try and live for a week with no food on you, what would you eat? Okay? You'd probably eat the stuff that you could find. You'd look for things that are growing on trees. You'd look for things that are growing on bushes. You might, I don't know, might try digging something up underneath the ground, or you might try and hunt something. Okay? If you did try and hunt something, the truth is that number one, hunting is real hard and number two, if you did manage to kill something and eat it, it would only provide you with a small amount of calories and you would spend the bulk of your time trying to find other food because you'd realize that the cost benefit analysis is not in your favor.
So hunting is extremely hard, but gathering and collecting would be a lot easier. So point being, in the world in which we live today, it's really easy to go get a bunch of convenience foods and it's also really easy to go get a bunch of meat and dairy products that you find in the grocery store because they're subsidized and they're relatively inexpensive. But what we tell you to do is eat as much whole plant material as possible. Whole meaning you picked it from a tree, it sat on a shelf and you put it into your mouth and it required zero cooking, zero grinding, zero smoothie-ing, zero blending, nothing. A perfect example. All fruit. You don't have to do anything to fruit. You just open it up and you eat it and it's good. Okay? Minimal processing would be things like legumes, okay? You take legumes, whether it beans, lentils, or peas, and sometimes you got to cook them, okay?
So that's considered processing, but it's minimal processing and it doesn't require any refining process. Refining being extraction of certain ingredients and leaving other ingredients behind. So at all points in time, if you are eating a low fat diet that is primarily plant based and as whole as possible, otherwise known as AWAP, as whole as possible, then you are going to likely find that your overall chronic disease burden or your overall chronic disease risk goes down very quickly. If you can continue that over the course of time and make it a sustainable collection of habits, then you're likely to dramatically improve your quality of life and maybe even improve your longevity into the future.
Rip Esselstyn:
So do you have people ever ask you, "Hey, Cyrus ..." So that's a pretty low fat diet. I mean, most Americans are probably consuming, I don't know, 35 to 60% of their calories from fat. It's one of the reasons why there's so much diabetes, but our brains, my man, are 60% fat. So I need fat to feed my brain fat? I mean, what's your answer to that?
Cyrus Khambatta:
Okay, here's my answer to that. My answer is don't confuse structure with function. Okay? People do this all the time. Okay? I'm going to give you an analogy. Your car. Your car is made of metal and glass and rubber, okay? But that's the infrastructure of your car. What do you put in your car to make it run? You put fuel in your car, you put unleaded gasoline or diesel gasoline or you put electricity.
Rip Esselstyn:
Not put metal and glass and plastic.
Cyrus Khambatta:
Right. You're not going to go to the lumber yard or you're not going to go to the scrap metal yard and find a bunch of scrap metal, be like, "Hey, Toyota, how come you're not running off of this stuff?" Doesn't matter. The structure is built of certain material and the function is different because the function requires unleaded gasoline in order to move. Same thing with your brain. Your brain is primarily fatty acids and cholesterol. We know this is fatty acid, it's cholesterol, and it's nervous tissue bundled into this massive supercomputer. Just because your brain is primarily composed of fatty acids and cholesterol does not mean that your brain feeds on fatty acids and/or cholesterol.
From a physiological perspective, your brain has one preferred fuel and that one preferred fuel is glucose. The people in the ketogenic world love to debate this ad nauseam and tell you that ketone bodies are the most effective fuel for your brain, blah, blah, blah, blah. But the truth is that if you open any physiological textbook and you read it, it will show you over and over and over again that your brain prefers glucose. Your brain has all the enzymatic machinery and the physiological function to use glucose as your primary fuel source and there's so many backup mechanisms inside of your liver and inside of your muscle to ensure that your brain gets an adequate supply of glucose at all times and that is, without question, the most powerful fuel for your brain.
Rip Esselstyn:
I think where there's a little bit of confusion is because you hear that with growing infants, they need a certain amount of fat in their diet until they're about two years of age. But after that, I mean, your 10 to 15% is all you need, right?
Cyrus Khambatta:
That's a true statement. So breast milk is a perfect example of how the nutritional content of the ... Sorry. The nutritional content of breast milk changes over the course of time as the child develops and gets older. It's fascinating. So somehow the mother's breast recognizes the age of the child and then alters its composition of fatty acids and protein and carbohydrate in order to meet that child's nutritional requirements. It's mind boggling.
Rip Esselstyn:
It is. I know that the fat and carbohydrate change. Does the protein change? Because my understanding is mother's breast milk is about 4.8% protein.
Cyrus Khambatta:
Okay. So I don't know the actual numbers off the top of my head, but I do believe the protein content does change over the course of time. It might not be as large of a swing in magnitude as carbohydrate and fat is, but I do believe the protein requirements change slightly.
Rip Esselstyn:
Yeah. We'll have to look into that.
Cyrus Khambatta:
Yeah, for sure. We can super geek on that.
Rip Esselstyn:
I'm trying to dive into fat here. So what about fatty ... So all these vitamins like A, D, K that are fat soluble, do we need a minimal amount of fat in our diets to basically allow our bodies to absorb those vitamins? Is there any myth around the fact that, "Oh, if you're vegan, you're not getting enough fat, you're not going to be able to absorb those fat soluble vitamins."
Cyrus Khambatta:
Yeah, exactly. So the fat soluble vitamins are basically A, D, E, and K. The conversation in the world of social media and beyond is that in order to absorb a sufficient amount of A, D, E, and K, the fat content of your diet has to be medium to high, otherwise you're not going to get enough and things are going to go wrong.
Rip Esselstyn:
What do you say to that?
Cyrus Khambatta:
What's that?
Rip Esselstyn:
What do you say to that?
Cyrus Khambatta:
The truth is, if you look in the research, that's not what the research says. Okay? So betacarotene is an example. Okay? Betacarotene is a fat soluble vitamin that you can absorb. Betacarotene in large quantities is very bioavailable with as little as five grams of fat per day in children. Okay? We're not talking large amounts. So again, this idea that you have to have a medium fat diet or high fat diet in order to get a sufficient amount of that, from a mathematical perspective, that's not true. Okay? Other studies in children have shown that 2.4 grams of fat per meal or as much as 21 grams of fat per day is sufficient for optimal absorption and utilization of vitamin A.
Rip Esselstyn:
And that's nothing.
Cyrus Khambatta:
That's nothing. That's a very small amount. Right? So what we're saying-
Rip Esselstyn:
For the listeners that are like, "Well, what does 21 grams of fat look like?" Can you put that into perspective for us?
Cyrus Khambatta:
For sure. Okay. So 21 grams of fat, Let's actually pull up, because I don't know these numbers off the top of my head. I'm going to open Google right here.
Rip Esselstyn:
Yeah, let's do it.
Cyrus Khambatta:
Ask me that question one more time in a second.
Rip Esselstyn:
Yeah, I will. But I'm just thinking, and for example, let me think. Like oats. I know that oats are about 18% fat, right? But a serving size, 18% fat, 18% carbohydrates, and the remaining is coming from carbohydrates. But I would like to know if I have a bowl of oatmeal in the morning, let's say a cup or two cups of oatmeal in the morning, how many grams of fat am I getting from that oatmeal?
Cyrus Khambatta:
Okay, perfect. So to answer any one of these questions here about specific foods, all you have to do is download ... Our preferred app is called Chronometer. You can also get MyFitnessPal, you can get any number of different apps here that have the USDA nutrient database inside of it. Then you can basically just say, "Hey, how much does one cup of oats yield me?" Right? So I'm looking at Chronometer right now on my screen, and I see that one cup of oats gives you 55 grams of carbohydrate.
Rip Esselstyn:
55? Yeah.
Cyrus Khambatta:
55 grams of carbohydrate, which is awesome and 5.3 grams of fat.
Rip Esselstyn:
5.3.
Cyrus Khambatta:
5.3 grams of fat. So basically 10 to one ratio, 11 to one ratio of carbohydrate to fat, right? So what we were talking about earlier is we said in children, as much as 2.5 grams of fat per meal, or as much as 21 grams of fat per day is enough for sufficient betacarotene absorption and utilization. So it really doesn't take that much. If we took a look at avocado as an example, this is another popular food that people love to consume.
Rip Esselstyn:
Is that a yellow light food or a red light on Mastering Diabetes?
Cyrus Khambatta:
It is a yellow light food because it's a higher fat plant food. We don't say you can't eat it by any stretch imagination. Go ahead and eat it, but just realize that when you consume avocados, it easily contributes to your total fat content throughout the day and over the course of time can make you more insulin resistant without you even knowing it.
Rip Esselstyn:
Right. So you don't want people to abuse that.
Cyrus Khambatta:
Exactly. A little bit goes a long way, let's put it that way. Okay. Perfect example. One avocado. Okay? One medium avocado, which I realize is not an objective measurement, but...
Rip Esselstyn:
Let me guess.
Cyrus Khambatta:
Go.
Rip Esselstyn:
I am going to say it's probably about 1,000 calories a pound. One medium is probably ... So it's 500 calories. Of that, 80% of it is fat. So if I got 500 calories, 80%, let's just say is ... let me say 400. So is it 40?
Cyrus Khambatta:
So you're thinking about 40 grams of fat per avocado?
Rip Esselstyn:
Yeah, but that seems like too much. Is it 20?
Cyrus Khambatta:
Yeah, cut it in half.
Rip Esselstyn:
20?
Cyrus Khambatta:
21, 20. Right? Your math was very close, except it has 225 calories instead of 500.
Rip Esselstyn:
All right. That's where I blew it then.
Cyrus Khambatta:
Yeah, that's right. So point being is that one avocado yields you approximately 20 grams of fat and gives you approximately 12 grams of carbohydrate energy. Okay? So what we suggest to people is you got to have about 10 to 15% of your calories from fat for the day in order to maintain optimal insulin sensitivity today and into the future. That translates into approximately 25 to 30 grams of fat per day. So it's not really that much, but the truth is that when you're eating a lot of fruits, a lot of starchy vegetables, a lot of whole grains, and a lot of legumes, then your total fat content is low, defacto, because that's the macronutrient distribution of those foods. It's just that simple.
If you're eating those foods, your macronutrient profile will be approximately 70/15/15 or maybe even 80/10/10. So you don't have to try. If you want to add some fattier foods into your diet, okay, go for it, not a problem. But just like we said, a little bit can go a long way.
Rip Esselstyn:
Do you feel like diabetes for you is a disability?
Cyrus Khambatta:
No. Diabetes is a superpower. I'm not even joking.
Rip Esselstyn:
I love it.
Cyrus Khambatta:
We literally have a podcast episode called Why Diabetes is My Superpower. I'll tell you this, and I'm not just saying this for marketing purposes or anything, I truly do believe this. I was given diabetes for a reason. Okay? I am a puppet. My goal is to go through the process of living with diabetes so that I can learn everything I possibly can about it and help as many people as possible. I do believe that that is what I was put on this planet for and I strongly believe that. Now, if I did not have diabetes, I would be eating the same diet, most likely, that I ate when I was 20 years old prior to being diagnosed and, trust me, that diet was not awesome. It was not healthy. So that diet likely would've led to other chronic diseases. I may have developed hypertension, I may have high cholesterol, I may become overweight, I may develop the same standard American condition that so many other Americans are living with.
So being diagnosed with diabetes was actually a gateway for me to be able to enter into the world of health and study and break it all the way down to its building blocks, and then build it all the way back up and try and figure out what the heck true health actually is. In that process, I'm healthier. I'm easily 10 times healthier than I was back in the day, without question. No questions asked. What allows me to go to sleep at night and wake up in the morning and feel good about myself and my life is that I'm trying to help out as many people as possible so that they can also get the same results, if not better results, by doing something very similar to what I've done.
Rip Esselstyn:
So you are so grateful that you got type one diabetes?
Cyrus Khambatta:
Yes. I am truly grateful, and I love living with type one diabetes. Not only that, people ask me, they're like, "Hey, man, when artificial pancreas come around, are you going to get one? When you can get a beta cell transplant and it can last you for the rest of your life, are you going to get that? When there's a cure to type one diabetes, you going to get that?" My answer is probably not. I have no desire. I literally have no desire. I don't actually want type one diabetes to go away. I think I want to have type one diabetes till the day I die because it is fascinating and I'm always learning new things and it helps me stay accountable to my lifestyle and it helps me help other people at the same time.
Rip Esselstyn:
Yeah. Well, having spent several days with you and Robbie living at our house for a couple days and watching how you guys eat and how you monitor your blood glucose levels, it's incredible to me how it also is a disease ... it keeps you on your toes and you can't ... maybe type two's different, but with type one, which I think we should let everybody know, that type one affects what percent of the population.
Cyrus Khambatta:
Yeah, good question. Type one affects a total of between two and four million people in the United States alone, and there's 350 million people. So what's the math on that?
Rip Esselstyn:
I think I've heard it's like 3%.
Cyrus Khambatta:
Sure. Single digital percentage. Yes.
Rip Esselstyn:
Type two represents what? 80% of the diabetes that's out there?
Cyrus Khambatta:
Type two represents ... Sorry. Prediabetes and type two together represent 92% of the diabetes population. So a majority.
Rip Esselstyn:
Okay. Anyway, getting the privilege to see how you and Robbie live with type one diabetes, it's something else and it makes me not for one second take for granted that I have this ability where my body can register exactly what's going on and generate the perfect amount of insulin and all this stuff. You guys, you're taking shots and your bolus and your long acting insulin, your short acting insulin. It's ever present and so many people I think that are living with type one and type two almost view it as a monster. Why? Why me? I love the way you guys are trying to reframe the whole conversation in that diabetes is you, you are diabetes, and this can be a really great gift.
Cyrus Khambatta:
Yes. So I'm glad you brought that up actually, because to a certain extent, it is a full-time job. There's no question about that and you can't really let your guard down, because if you do, then you can make a mistake. Speaking of mistakes, when I was hanging out at your place, I'll be very open and honest about this. I was hanging out of your place, I woke up one morning and my blood glucose was lower than it should have been, right? I woke up in a hypoglycemic state because I made a mistake from the night before, and I gave myself the normal amount of long acting insulin, but it turns out I was so insulin sensitive from hanging out with you and getting in the swimming pool and going to the gym and using our bodies all the time-
Rip Esselstyn:
Pickle ball. Don't forget the pickle ball.
Cyrus Khambatta:
And the pickle ball. As a result of that, my blood glucose was low the next morning and you saw it. I was trying to have a conversation with you and I made absolutely no sense and you turned to me and you were like, "Cyrus, come downstairs with me right now. We're going to the kitchen," and you started feeding me dates and mangoes and I started eating it and was like, "What is going on?" Then you told me, "Your blood glucose is low," and I started to recognize that when my blood glucose became normal, and then I was like, "Oh my God, thank you for helping out." So I am not infallible. I make mistakes here and there. There's no question about it. The goal when living with pre-diabetes and type two diabetes is to eat a diet, a nutrient dense, plant-based, low fat, whole food diet and use that as your primary chronic disease reversal tool.
It reverses prediabetes and a lot of other comorbidities that come along for the ride. Same thing with type two diabetes. Now, if you're living with type one diabetes, the idea is to use that same diet or that same lifestyle to control your blood glucose with precision and make it such that your blood glucose variability is very low, your A1C value is very low, and the quality of your life is extremely high. The last thing I'll say about this is that people with type one diabetes when they are first diagnosed are scared. They're scared because they go from being a normal individual to somebody who has to inject insulin multiple times per day, every single time they eat and monitoring their blood glucose 24 hours a day. It's not easy to do. Okay?
In addition to that, medical professionals often inadvertently scare people even more without knowing it because they tell people things like, "Well, if you have type one diabetes, your lifespans going to be cut by 10 years right off the bat. So just subtract 10 years off the end of your life," and you're like, "What? I just lost 10 years off my life? Are you kidding me?" Then they tell you things like, "Well, you're going to have to go on a statin medication at some point in your life. You're going to have to go on blood pressure medication at some point in your life. You might develop retinopathy in your eyes. You might develop nephropathy inside of your kidneys. You might get a limb amputated over the course of time," and you're like, "What is going on?"
So they tell you these things because statistically speaking, that's what happens to people with type one diabetes. If you have type one diabetes and you look in the data, you'll find out that people who have that and people who generally eat a low carbohydrate diet end up with a whole collection of ancillary problems down the road. So they scare you into believing that that's just a byproduct of type one when in reality it's not. It's a byproduct of type one that is poorly managed using primarily pharmaceutical medications in a low nutrient quality diet. If instead you're living with type one diabetes and you maximize your nutrient density and eat as plant based as possible, then you can minimize the risk of any of those other future chronic diseases from even setting in, you can kiss them goodbye in most situations, and you can maximize the quality of your life. That's the message.
Rip Esselstyn:
What I realized too, being around you and Robbie for three days, was, like you said, this can almost be a full-time job that you got to stay on top of, right?
Cyrus Khambatta:
Yes.
Rip Esselstyn:
So I want you to talk for a second about the community that you and Robbie have formed over the last several years that allows people with type one, type two, 1.5, you name it, and you can get the coaching and the attention that you need to totally master this disease so you don't have to get afflicted with the ancillary, the retinopathy, the neuropathy, amputation of limbs, the kidney failure, going on a statin medication, all the things you just talked about that are really almost, it seems, unavoidable if you don't transition to a whole food plant based diet.
Cyrus Khambatta:
Yes. Okay. Thank you for bringing this up because when I was first diagnosed with diabetes and I was going through the process for the first, call it, decade of living with type one, trying to figure it out and learn the research and optimize my own health, I began to realize that I felt like an island. I didn't really know that many other people who lived in one type one, after many years of living with type one diabetes. I certainly didn't know people who were living with type one diabetes and were happy. I'll tell you that, because the world of type one is filled with a bunch of people who have suboptimal health and a lot of people, just like you mentioned earlier, a lot of people complain about the fact that they are developing other health conditions over the course of time. It's not their fault, but that's just what happens, right?
So as I was going through this process, I was like, "Man, why is there not an uplifting and inspirational community of people who are going through the process of living with all forms of diabetes to together that can help one another out and that are acting on credible scientific information? Okay. I'm not interested in your opinion. I'm not interested in your emotions about what you think is the right opinion. I mean, I am, but what I'm interested in is the science. So let's create a scientific basis and then add a community on top of that. That's what Mastering Diabetes is. So we created the scientific basis that forms the Mastering Diabetes method. The Mastering Diabetes method has four components; a low fat, plant-based/whole food diet, daily activity, intermittent fasting when necessary, and the fourth thing is daily documentation of all the habits that you're doing and what effect they have on your blood glucose.
If you follow the method exactly the way that we describe, your life with diabetes can improve tenfold and in most situations, we see that people living with prediabetes type two and gestational diabetes, they kiss it goodbye. It just literally disappears. Some people it could take two months and some people can take six months and some people it takes three years. It depends on your habits, it depends on your disease history. But the idea here is that when you target the root, which is insulin resistance, and you get rid of that insulin resistance, you become insulin sensitive, you develop a superpower that even your non-diabetic friends don't have. When you develop that superpower, not only does diabetes fade away into the background, but so does high blood pressure, so does high cholesterol, so does the early signs of dementia, so does cardiovascular disease, so does obesity, and the list goes on.
Rip Esselstyn:
I've even heard, Cyrus, that Alzheimer's is like type three diabetes. Have you ever heard anything like that?
Cyrus Khambatta:
Absolutely. That's exactly what it's being coined as in today's world.
Rip Esselstyn:
Can you speak to that for a sec?
Cyrus Khambatta:
For sure. So Dean and Ayesha Sherzai, who are very good friends of mine and good friends of yours, are the world's experts in understanding the causes and the effects of what they call vascular dementia and Alzheimer's disease. One of the things that their research has brought to light that they've educated me on ad nauseam is the fact that dementia has classically been thought of as an inevitable consequence of some type of genetic issue. So it's either a genetic issue that you inherited from your parents or it's the accumulation of these mysterious plaque molecules that somehow make their way into neurons inside of your brain that just decrease your cognitive ability and make it so that you end up with dementia and then your life kind of fades away into the background.
The truth is that dementia and Alzheimer's disease are strongly influenced by what you eat, and they're strongly influenced by what you eat early in life. So even though they generally set in in people who are 60, 70, 80 and beyond, what you're eating as a 20 year old matters. What you're eating as a 30 year old matters because it is setting the stage for what's happening inside of your brain that may take many, many, many years to develop that could turn into a dementia or Alzheimer's state in the future. So type three diabetes is the term for Alzheimer's disease in today's world because the cellular mechanism of cognitive decline inside of your brain in Alzheimer's disease is insulin resistance of your brain.
It is fascinating. So the story that we told earlier is insulin resistance inside of your liver and inside of your muscle. Everything about eating that triglyceride molecule and insulin knocking on the door and not being able to get glucose in, that is a true statement. None of that is up for debate. But insulin resistance can affect your brain, and when it affects your brain for a long period of time, it can then progress into dementia, which can then progress into Alzheimer's disease. Once you're at that state, it can be very challenging to try and recover. I don't even know if it's possible at this point. So the name of the game when it comes to dementia and Alzheimer's disease is prevent, prevent, prevent. That's what you can do today so that you can avoid the transition to type three diabetes into the future.
Rip Esselstyn:
Okay. Thank you. You also mentioned two other pillars of the Mastering Diabetes formula. You mentioned exercise and you mentioned intermittent fasting. Can you talk to me about those two things and how they're related to, I guess, mastering insulin resistance?
Cyrus Khambatta:
For sure. Do you have another six hours maybe?
Rip Esselstyn:
Well, obviously I want you to do this in a way that is time sensitive.
Cyrus Khambatta:
Yeah. You're like, "30 seconds, go." Okay. So you're right. Daily movement and intermittent fasting are two pillars of the four pillar Mastering Diabetes method. Daily movement is the first. Okay, so daily movement is very effective because movement stimulates insulin sensitivity. We could talk for hours about exactly what's happening inside of your muscle tissue when you move and how that influences insulin glucose to behave inside of your muscle. It's a fascinating story, but it would take literally multiple hours to go through. The most important thing that I want people to take away from this is when it comes to movement. When you move your musculature, whether it's through endurance exercise or resistance exercise or some combination of the two of those, whether it's by getting in the swimming pool and trying to keep up with rip, which is, trust me, ladies and gentlemen, impossible. I've tried it, it doesn't work. Or whether you're going to the gym and you're trying to do a resistance class and just trying to move with resistance based movement.
Rip Esselstyn:
Trust me, I've tried that with Cyrus and it's impossible.
Cyrus Khambatta:
Regardless of the type of exercise you're performing, exercise, what it does is it mechanically forces your muscle tissue to expand and contract hundreds, if not thousands, of times within a given session. So that mechanical work that's being performed by muscle tissues requires energy. So the energy has to come from somewhere. The energy that your muscles used at the beginning parts of exercise come from the thing that it's already storing. It has two fuel tanks. Number one, glycogen, which is a stored form of glucose, and number two, the lipid droplets we talked about earlier, the triglyceride that's actually inside of your muscle tissue.
So higher intensity exercises uses more glycogen, more glucose, lower intensity exercises in general use more fatty acids. But point being, those are the two fuel storage warehouses that are built into your muscle tissue, and that's a good thing because then those muscles will have energy to be able to use during exercise.
Now, when you are done with exercise, this is where the magic happens. When you're done with exercise, you have to refuel those fuel tanks. Okay? You got to put more glucose back into the glycogen granule. You got to put more fatty acids back into that lipid storage depot. Okay? The beauty is that you can get glucose inside of your muscle tissue, either for free with zero insulin or for a drastically reduced amount of insulin. Okay? That's the key. So under normal circumstances, if it would take, let's say, five units of insulin to get a bunch of glucose into your musculature and store it properly, after exercise, that five units of insulin could come down to something like three or maybe even two and a half.
Rip Esselstyn:
It's so fascinating because when I look back on my triathlon career and after a hard exercise session, we always heard about this golden window of about 20 to 30 minutes when after exercise, you want to eat a nice amount of carbohydrates so that you can store as much glycogen as you can in that window of time after exercise. So anyway, even in healthy people without insulin resistance, it sounds like there's some benefits as well.
Cyrus Khambatta:
Absolutely. So you're right, even in healthy individuals. So you're a perfect example. You don't have diabetes, we don't want you to ever have it. So the amount of work that your beta cells have to perform in order to manufacture insulin goes down because your muscles just don't need as much insulin. So you're able to store the same amount of glucose for less insulin, for like 40 to 50, sometimes even more of a reduction in insulin use. That's a good thing because you are sensitizing your muscle tissue to insulin. So less insulin does the same amount of work. Okay? So when it comes to exercise, the reason why we tell people to use their body on a daily basis is because when you use your body and you use it consistently, you are constantly stimulating insulin sensitivity in your musculature, and that allows glucose to easily enter your muscle tissue and get out of your blood. And that keeps your blood glucose low. That's a good thing.
Rip Esselstyn:
Are you as shredded or more shredded today than you were when you were 22, in 2022?
Cyrus Khambatta:
In 2022?
Rip Esselstyn:
Not 22, 2002.
Cyrus Khambatta:
2002. No, no, no. Sorry. I am more shredded, if you will, I have more muscle mass, so I have more endurance, more strength, more power today than I had when I was 22 years old, without question.
Rip Esselstyn:
Can you show me those guns?
Cyrus Khambatta:
These guns right here. You can't really see it in this lighting, but maybe you can.
Rip Esselstyn:
Oh, I can see them.
Cyrus Khambatta:
Maybe a little right here. I mean, I enjoy working out with you because when I try and get in the sun... I mean, Rip, you're a gold medal... Sorry. No, no, no, no. Not gold medal. You have a world record in the 200-meter backstroke, if I'm not mistaken. Is that right?
Rip Esselstyn:
That's right. That's right.
Cyrus Khambatta:
Okay. I have firsthand experience trying to get in the pool and do anything with Rip, and I gave up after about 30 seconds because this man is a complete machine and watching you swim is like pure art. This guy is a freaking fish in the water. It's unbelievable. But the beauty here is that you have trained every muscle in your body and your brain to operate at peak performance to be able to be as efficient as you possibly can in the water. And watching that is just pure art, but it's also a perfect example of you don't even recognize what's happening inside of your muscle tissue after the fact.
I mean, we're describing one biological mechanism that has to do with glucose and insulin, but there are hundreds of biological mechanisms that are happening simultaneously before, during and after exercise that are fascinating. But as far as chronic disease prevention is concerned by being active in the swimming pool and by being active in the gym and by moving your body and going on walks, and running, and hiking, biking, and swimming and doing whatever you want to do, you can keep your muscle tissue extremely sensitive to insulin. And that over the course of many days, months, and years is going to lead to a dramatic reduction in chronic disease risk.
Rip Esselstyn:
So with the people that are part of your Mastering Diabetes community, do you tell them, get out and move two to three times a day? Do you have a certain prescription for it?
Cyrus Khambatta:
It's so easy. 30 minutes per day. That's it. That's the only real requirement. So 30 minutes per day, use your body and try and exercise at a point where you can't sing your favorite Whitney Houston song. And you also can't have a conversation with somebody because if you can do either one of those, then you're not working hard enough. You're not breathing hard enough. Okay? So if you can do that and you can do that for once a time, you can take that 30-minutes and do it in one session, or you can break it up into three 10-minute sessions or two 15-minute sessions, I don't really care. But point being is, get that movement in. And that in addition to a low fat plant based whole food diet will sensitize your muscle more than you can even predict.
Rip Esselstyn:
I want to ask you about intermittent fasting. I want you to talk to me about that for a sec. Again, it doesn't have to be an hour or two hours, but before we do, I want to say something and I meant to mention this when we were talking about fat, but I found this to be extremely interesting and that there's something called the Hegsted equation. I'm sure you know it well. And maybe you could tell us about it.
Cyrus Khambatta:
Sure. So the Hegsted equation?
Rip Esselstyn:
Because I thought that saturated fat, I knew what it did for insulin resistance. I knew that it contributed to atherosclerosis, but it also does something else. So go ahead.
Cyrus Khambatta:
Yeah. Okay. So the Hegsted equation is a mathematical equation that describes the relationship between saturated fat in your diet and your cholesterol level in your blood. It is fascinating. So this researcher named... I don't know what his first name was. We'll call him Samuel.
Rip Esselstyn:
Samuel Hegsted.
Cyrus Khambatta:
Samuel Hegsted. Okay. So he recognized over the course of his career as he was trying to understand more about cholesterol metabolism in particular, what influences your cholesterol level inside of your blood? Okay. Does eating cholesterol influence your cholesterol level? Does eating carbohydrate influence your cholesterol level? Does eating saturated fat? Does eating unsaturated fat? You tell me. So he did a whole collection of experiments.
So what he found over the course of his career is that the relationship between saturated fat and cholesterol was the strongest. And that if you wanted to increase your cholesterol level in your blood, nobody wants to do that, but let's say you wanted to do that, the simplest way to get that done would be to go eat saturated fat. Not even eating cholesterol, which is fascinating.
Rip Esselstyn:
It is.
Cyrus Khambatta:
Because the rhetoric is, "Oh, you want higher cholesterol? Go eat more cholesterol. You want lower cholesterol? Reduce your cholesterol intake." But the truth is that Hegsted said, "No, no, no. If you want less cholesterol in your blood, you got to reduce your saturated fat intake."
Rip Esselstyn:
So I read this when I was reading your book and I found that to be so fascinating. But, Cyrus, here's the thing, where do we find predominantly saturated fat. And where is cholesterol only found?
Cyrus Khambatta:
Okay. Truth be told, cholesterol is found both in animal products and plant products. People keep on saying like cholesterol is only found in animals.
Rip Esselstyn:
Not much in plants, right?
Cyrus Khambatta:
Correct. It's found in 1/100 the concentration in plant products as it is in animal products. Anything that's physiologically relevant, foods that contain a significant amount of cholesterol come from the animal world. Any animal based product you can think of whether it's white meat, red meat, fish, chicken, poultry. It could be eggs, bacon, dairy products, milk. All of that. All of that contains cholesterol. It turns out that saturated fat and cholesterol tend to travel together. They tend to be in the same foods in similar concentrations. And as a result of that foods that are high in cholesterol tend to also be high in saturated fat and vice versa when it comes from the animal world.
In the plant based world, if you eat a food that's higher in saturated fat as an example like olive oil. Most people think that olive oil has no saturated fat. That's not a true statement. It contains a significant amount of saturated fat. Coconut oil is an even perfect example. Coconut oil is predominantly saturated fat, but there is zero cholesterol.
Rip Esselstyn:
91% baby.
Cyrus Khambatta:
How much?
Rip Esselstyn:
91%.
Cyrus Khambatta:
91% saturated fat, but zero cholesterol. Or effectively zero cholesterol.
Rip Esselstyn:
Right. So cholesterol and saturated fat are BFFs.
Cyrus Khambatta:
Yes, they are absolutely BFFs. That's a great way to think about it. Now, if anybody's interested, go look up the Hegsted equation. It's called H-E-G-S-T-E-D. And this is literally a mathematical model, mathematical equation that specifically it'll predict how the saturated fat in your diet and the cholesterol in your blood are related to one another. And you can map it out on a piece of paper and you can figure out a way to actually lower your cholesterol just by reducing your saturated fat content.
Rip Esselstyn:
All right. I've made a game day decision here.
Cyrus Khambatta:
Do it.
Rip Esselstyn:
On the move. And that is, I don't want to talk about intermittent fasting because that's something I'd love to actually say for another day with you.
Cyrus Khambatta:
Cool.
Rip Esselstyn:
And some other things. But before we leave and I let you get back to your family, I would love to ask you a couple more questions that don't require as lengthy of an explanation or answer. So the first one is I'm assuming it won't, and that is, I think so many people today are worried about what's the glycemic index or number of this fruit or vegetable or whatever, or thing that I'm eating. Do you guys buy into the glycemic index? And if so, why? And if not, why not?
Cyrus Khambatta:
Okay. Great question. The answer is we don't. The glycemic index only really matters when you're already insulin resistant. Okay?
Rip Esselstyn:
Wow.
Cyrus Khambatta:
If you're not insulin resistant, the glycemic index doesn't really matter.
Rip Esselstyn:
That is so important. Can you say that one more time?
Cyrus Khambatta:
Yeah. The glycemic index only really matters when you're already living with insulin resistance. If you are not insulin resistant, then the glycemic index doesn't really matter.
Rip Esselstyn:
Oh my god.
Cyrus Khambatta:
Does that make sense? Do you want me to repeat it?
Rip Esselstyn:
Yeah. Let's say that I am not insulin resistant, so I don't have to worry about how much sugar... We're talking about sugar, right, when we say glycemic index?
Cyrus Khambatta:
Yeah. So really what you're talking about is basically the glycemic index measures how the speed or how quickly a food will raise your blood glucose level. It's literally a measure of velocity. Let's put it that way. So it measures the speed at which a given food will raise your blood glucose level. And the foods that are highest on the glycemic index are actually... Truth be told, it's pure glucose. Okay. It's at a hundred or dextrous, we'll call it. Okay?
Foods that are considered low glycemic have a rating of 55 or less on this scale. Medium glycemic is basically 56 to 69. And then high glycemic is basically 70 and above. Okay? Now, here's the kicker. The glycemic index is basically meant to be something that's useful for people. So I can take a look at a piece of food and be like, "Oh, okay. That's either low, medium or high. I want to try and eat either medium or low, as much as possible and try and avoid or eliminate all high glycemic foods."
But here's the problem. The glycemic index is a measurement of one food in isolation at any given moment in time. Okay? How many times do you eat a meal that contains one food and one food only? Does that happen?
Rip Esselstyn:
Very rarely.
Cyrus Khambatta:
Very rarely. Okay. The food that you eat is put into a thing called a meal and a meal usually contains multiple different foods at the same time. You might have a little bit of rice with some potatoes. And then in addition to that, some green beans, okay? That's multiple foods acting at the same time. So the glycemic index of any one of those foods is effectively diluted by the other foods that are also present in that meal. That's point number one. Number two, the glycemic index is also, it changes in a given food depending on the temperature at which the food is eaten, depending on how it was cooked, depending on how ripe it is, and depending on the variety of the food itself.
So there's so many things that factor into the actual true glycemic index of a food that because of that, it's really hard to just look on the internet and be like, "Oh, I'm eating this red potato. What is the glycemic index of it?" Because that doesn't take into account. Is it baked? Is it fried? Does it have oil on it? Was it prepared, and then cooled?" Because that matters. Right? Is it chopped up? Is it blended or is it not blended? All of these things matter. So as a result of that, the glycemic index is just like it's too confusing. The first thing I said was that the glycemic index only really matters if you're insulin resistant. And the reason we say that, the reason this is a true statement is because if you are insulin resistant, what that means is that you have low carbohydrate tolerance. The ability of your digestive system to tolerate carbohydrate is very low because of this excess stored saturated fat inside of your liver and muscle and the traffic jam that has resulted.
So in that state, if you try and add foods that are higher on the glycemic index, good luck. It's not going to work. Your glucose will go high. There's no question about it. So the way to eat foods that are higher on the glycemic index is to first become insulin sensitive. You have to do that first. Don't put the cart before the horse. Make sure that you become insulin sensitive first. If you do that, then you can eat higher glycemic index foods to your heart's content assuming that they're whole foods. And then you don't have to worry about that scale in any way.
Rip Esselstyn:
Yeah. And now you're like you and Robby eating 400 to 500 grams of carbohydrates a day.
Cyrus Khambatta:
More, 700 plus.
Rip Esselstyn:
700.
Cyrus Khambatta:
700.
Rip Esselstyn:
Sorry about that.
Cyrus Khambatta:
No worries.
Rip Esselstyn:
That's right. That's right. Five, 6X what you were doing when you were 22 in 2002.
Cyrus Khambatta:
Right. And the truth is that a lot of the carbohydrates that we eat tend to be higher on the glycemic index scale. Right? We're talking about things like mangoes, and dates, and bananas. And most people with diabetes, they can't even look at those foods because those foods are going to raise their blood glucose. Again, the reason is because they're already insulin resistant. But if they became insulin sensitive, then they could eat those foods and they could eat them in large quantities. That glucose would say nice and stable and life would be totally different.
Rip Esselstyn:
So the moral of the story here is get to the root causation of everything by eating the way we're talking about here. And then you can kiss goodbye, the glycemic index and all these other things.
Cyrus Khambatta:
That's exactly right.
Rip Esselstyn:
Yeah. All right. You good for two more questions?
Cyrus Khambatta:
Let's do it.
Rip Esselstyn:
All right. What are your thoughts on gluten? And I'm talking specifically for people with diabetes. Should they stay away from gluten or it doesn't matter or once you're insulin sensitive... Again,? Does it unlock the key and now we can do what we want. What do you think?
Cyrus Khambatta:
Okay. So gluten has become a pretty large conversation in the world of health overall today, both for people with diabetes and people who don't have diabetes. There's a condition called celiac disease, which is basically an autoimmune gluten intolerance. If you have celiac disease, by all means, do not touch gluten. Okay? Gluten comes from four primary sources, wheat, barley, rye, and spelt. Those are the four places where you're most likely to find gluten. So if you have celiac, don't touch those foods by any stretch, imagination.
A lot of people have to be very careful about eating food that was processed in a facility that also contained gluten, right? It's like, it's pretty gnarly. Celiac affects 2% of the population or less. Okay? 98% of the population does not have celiac, does not actually have a frank gluten intolerance. Okay? So that is a good thing. And that means that if you don't have a gluten intolerance or you haven't been diagnosed with celiac disease, then you're in the majority of the population and that's a good thing.
Now, again, if you eat a plant-based diet, it is actually very simple to either have a small amount of gluten or to actually be gluten free because if you eat a plant-based diet, but you just don't eat wheat products, which is not that hard to do, if you don't have barley in your diet, which is not that hard to do, I don't eat barley. Okay?
Rip Esselstyn:
I don't eat rye.
Cyrus Khambatta:
If you don't eat rye and you don't eat spelt, then defacto, you're pretty much gluten free at that point.
Rip Esselstyn:
Just make sure your oats aren't contaminated. Right? They're gluten free.
Cyrus Khambatta:
That's exactly right. So the truth is that when people talk about eating a gluten-free diet and people struggle with it and people go, "Oh God, it's so hard. You don't understand. I have to buy all these products that are gluten free and I have to be a detective everywhere I go." A lot of the times, I'm just thinking to myself, "I think you're over complicating this. I think you could just get away with eating a plant-based diet that doesn't contain wheat, barley, spelt or rye. And you would be effectively gluten free. And again, this is paramount to what we've been talking about, whole food, whole food, whole food.
If you eat packaged and processed products that come from the freezer section or the refrigerated section in your grocery store, then you have to be a detective about whether it contains gluten or not. If you go to the produce section and you pick up an apple 100% guarantee, there's no gluten in it. If you pick up a potato, 100% guarantee there's no gluten in it. So I just want people to recognize that gluten insensitivity is no joke. There's no question about it. I'm not trying to demean that in any way, shape or form or diminish that. But if you want to eat a low gluten diet, by all means, it's very doable. And if you don't want to eat a gluten diet, or low gluten diet, then you can also do that as well. You can include wheat, barley, spelt, or rye inside of a plant-based regimen.
Rip Esselstyn:
And I got to say, again, when you get to see firsthand, how you and Robby live this life and how clean it is and how literally whole food plant-based it is like little to never do I see you guys eating anything out of a package? If it's a can, yeah, it's a can of beans, right? No salted kidney beans, lentil beans, whatever. What did we make for your airplane trip? I think it was chickpeas, right?
Cyrus Khambatta:
It was chickpeas. The cheesy chickpeas.
Rip Esselstyn:
That's right. But it is incredibly whole food plant-based and clean. Caffeine. Talk to me for a second about caffeine, coffee, teas. Are you a fan? Not a fan? What do you think?
Cyrus Khambatta:
Yeah. So I've done a fair amount of reading here to try and figure out if there's a connection between is caffeine good for you, bad for you? Is it smart? Is it not smart? Because as you've probably seen, there's a lot of research that demonstrates that coffee in particular is actually beneficial for long-term health. I've even seen some articles that say people who consume three to five cups of coffee per day may live longer than their non-coffee drinking counterparts. And I'm just like bonkers. I don't understand that research to be perfectly honest.
But here's the thing. I don't have any qualms necessarily against drinking caffeine. So personally, I don't use caffeine. I don't need caffeine. I don't want caffeine. I honestly don't think caffeine affects me because when I drink green tea, which is a relatively decent amount of caffeine, I can go to sleep within 15 minutes and I can stay asleep for hours at a time. So I don't think caffeine actually affects me in a way that it affects a lot of other people. Point being, this is not about me. This is about human health.
Caffeinated beverages can... We've found empirically that people who consume caffeine early in the morning have stranger blood glucose phenomenon later in the day. Okay? So if you drink caffeine in the morning, especially if it comes from coffee, then chances are somewhere in the middle of the afternoon, your glucose might be doing some weird things and it might be hard to piece that puzzle together.
That's just a pure observation. I don't have any research to back that up, okay? If you choose to have caffeine in your diet, my answer is go for it. You can totally do that. That's on you. And there's no problem with that. But I would recommend that if you constructed a diet where you didn't need caffeine, that would be an optimal solution. So the reason you're drinking caffeine in the first place is because caffeine is a neurological stimulant that gets your brain to be in a more active state.
And the biological mechanism of that is long and complicated, but it effectively enables, what is it? Cyclic AMP to be more active inside of your brain at all times. And that's a good thing. Okay? So the point is that if you need caffeine in order to be awake, then I would say in the same way that we're going on the root cause of diabetes to figure out what's the problem, go to the root cause and try and figure out why do you need caffeine?
If you need caffeine in order to stay awake, my answer would be to you, maybe there's some other aspect of your lifestyle that's not ideal. Maybe your diet could be more whole food plant based. Maybe you could be doing a little bit more exercise. Maybe you are experiencing a significant amount of stress. You might want to reduce that. Okay? So I would say, try and figure out what's the real source of the need for caffeine. And if there is a real problem, that's causing you to be excessively tired or chronically tired at all times, solve that problem first.
Rip Esselstyn:
So you don't think it has anything to do with me being up till 1:30 AM watching Stranger Things?
Cyrus Khambatta:
Absolutely nothing to do with that.
Rip Esselstyn:
Good to know.
Cyrus Khambatta:
That's a great show by the way.
Rip Esselstyn:
Laughter...Woo. Yeah it is.
Cyrus Khambatta:
But I would say that if you were watching the Die Hard trilogy over and over and over again, then that could definitely get you pretty tired because that is just adrenaline pumping at all time and I get exhausted from watching it.
Rip Esselstyn:
No, I hear you loud and clear there. I've never been a coffee drinker, never touched the stuff. And I find the best way for me to wake up in the morning is just hit the swimming pool.
Cyrus Khambatta:
Yeah, exactly.
Rip Esselstyn:
And exercise.
Cyrus Khambatta:
So what happens to you when you exercise first thing in the morning? What does it do for you later in the morning or later in the day?
Rip Esselstyn:
Oh, man. Well-
Cyrus Khambatta:
Cognitively?
Rip Esselstyn:
It grounds me for the day. I am pumped up. I'm on fire. I typically eat shortly thereafter and then I'm good. I'm good until usually two or three and then maybe I'll go and I'll do some pull-ups or something like that if I feel myself starting to fade a little bit. And then I'm good again. I guess it's my caffeine, right?
Cyrus Khambatta:
Yeah. Exercise is your caffeine. That's brilliant. That's brilliant. My caffeine tends to be mangoes or dates. Right?
Rip Esselstyn:
Yeah.
Cyrus Khambatta:
And what I have noticed too, is that the moment I started consuming more fruit in my diet in particular, not just plant-based material, but fruit, my energy levels took a noticeable increase, noticeable increase.
Rip Esselstyn:
So let me ask you this because right now it's probably about 5:00 of your time in the afternoon.
Cyrus Khambatta:
Yep.
Rip Esselstyn:
How many pieces of fruit would you say you've had already today?
Cyrus Khambatta:
Okay. So total number of fruits. So Robby is actually in town and we're hanging out in person. So between Robby, and Kylie, and myself, and then also Indigo, who's now nine months old, we are eating an abnormally high amount of fruit. But that's a good thing. So today in particular I've probably eaten, without exaggeration, I've probably eaten eight mangoes, five bananas and a handful of strawberries.
So it's that eight plus five, plus a handful of strawberries. Call it like 15 pieces of fruit up until now. We haven't had dinner yet and that's probably going to have another four to five pieces of fruit in it, as well.
Rip Esselstyn:
And then what else have you eaten besides fruit today?
Cyrus Khambatta:
Okay. What else have I eaten? Before this, I was eating a bowl of chickpeas. Surprise, surprise. For those of you who don't know, I am obsessed with chickpeas. And so I eat those every single day without fail. And then addition to that, I also will eat potatoes. I also generally eat some vegetables, some non-starchy vegetables for dinner time. That includes things like zucchini and/or cauliflower and/or broccoli because I love those foods. Sometimes I'll throw in some tomatoes. Sometimes there's some cucumber in there and then some leafy greens as well.
So the bulk of my calories comes from fruits, and chickpeas, and potatoes. That's where I get calories from. And then the rest of the stuff is just there for nutrient value. And just because it's crunchy and tasty, and easy to eat.
Rip Esselstyn:
I'm telling you, everybody, that's listening, you got to witness. You got to see it firsthand to believe it. And you will never look at a mango or a banana or a strawberry, a chickpea the same way again. After having you guys stay at our house for three days, we now can't get enough of those things. It's incredible the influence that you had, not only on me, but also the whole family and the kids. It was really dynamic.
Cyrus Khambatta:
So now Cole, and Sophie, and Hope are all...
Rip Esselstyn:
We're mangoholics. Can't get enough. I want to ask you just two more questions, really short kind of quick ones and then I'm going to let you get back to the mangoes. What is the worst thing about you having type 1 diabetes?
Cyrus Khambatta:
Great question. The worst thing about having type 1 diabetes is that exactly what you witnessed in person. If I become too insulin sensitive because I'm super active and I don't actively back off on the amount of basal insulin I give myself at nighttime, I can drive myself pretty darn dangerously low in the middle of the night. That's not a good thing. There has been some times when we were living back in San Francisco where I was so low in the middle of the night that Kylie woke up and she had to pour some honey into my mouth in order for me to not pass out. Terrible experiences. Not fun emergency situations. Can't go to the hospital. Don't want to deal with that.
So I have to be extremely militant about exactly how much basal insulin is going inside of me. And it's always a balance between how much activity have I had. Did I eat enough calories? How much dinner did I eat? Did I miss dinner for whatever reason? It's this long sophisticated calculation in my head. Point being, when it doesn't go right, it's terrible. When it goes right, it's beautiful.
Rip Esselstyn:
So the thing about that, that to me would be scary is, let's say you're on the road and you're in a hotel room and you're all by yourself. Do you have any kind of redundancy set in place where somebody checks on you or a phone call or something because otherwise if that got too low and you can't have your wits about you enough to open the door and go out, it seems like you're in trouble.
Cyrus Khambatta:
Yeah. You're sitting duck. And the answer is so they have continuous glucose monitors or CGMs that have alarms on them. So if your blood glucose does go low, it'll wake you up. That would be a useful tool for sure. I just don't happen to have one on me right now. Another option is that sometimes when you start to go into that hypoglycemia threshold, my brain will wake me up. It'll literally cut my dream short and I'll pop awake. I'll usually recognize that something is wrong because I'm extremely fidgety. And I'll have thoughts that are darting all throughout my head, I can't make sense of anything. And then I usually make these kind of rapid movements.
So I've trained myself to recognize when that's happening to pick up a banana. That's hopefully not too far away and stick it in my mouth or take two or three of them and then just relax and wait. So in an ideal world, there would be somebody waiting there for me, but that's not always practical.
Rip Esselstyn:
Yeah. Okay. And what is the best thing about living with type 1 diabetes?
Cyrus Khambatta:
The best thing about living with type 1 diabetes is that it is the greatest excuse to eat the healthiest diet that you can possibly eat. It is literally the best excuse to become the healthiest version of yourself. Let's put it this way. You don't have a choice. You don't have a choice. If you don't take care of yourself, if you don't maximize your insulin sensitivity, if you don't control your blood glucose with precision, the consequences can be very dire. So if you take the responsibility, which I do and I take it to heart, it has transformed me into being the healthiest version of myself. I'm healthier today than I've ever been in my life. And I don't plan on stopping anytime soon.
Rip Esselstyn:
I love it. I love it. Tell me, anything that's going on with you, the Mastering Diabetes community that we should be aware of, that we can participate in for our listeners?
Cyrus Khambatta:
Yeah. There's two things I would say. Number one is that we recently launched a challenge and the challenge is awesome because there's a lot of people who are interested in getting involved in the Mastering Diabetes method, but they're nervous because they're not sure if they can eat bananas and mangoes and potatoes. And so we've constructed a challenge which is a six week long challenge that teaches people exactly. We literally will hold your hand and show you exactly what to do over the course of six weeks.
We'll give you a meal plan. We'll give you grocery list. We'll give you exercises. We'll give you an accountability coach. And that way you can go through the entire process handheld without exception. And you'll get to a point within the first two to three to four weeks where you're going to be like, "Oh my Lord, this is definitely working." The challenge, you can participate in that by going to masteringdiabetes.org/challenge.
The second thing is that in November of every year we have a blood sugar... It's a blood sugar transformation summit. Okay? So the blood sugar transformation summit is really, really fun. We ask a lot of speakers to come in. World's experts on diabetes and we interview them and we provide this information for free. It's a really fun opportunity for tens of thousands of people to join in and learn a lot about diabetes and what they can do to maximize their health.
So look out for that. Just join our mailing list. Go to masteringdiabetes.org, get on our mailing list and you'll hear about that. And come November, it's going to be an explosion of really fun information. It's always a great event for everyone who participates.
Rip Esselstyn:
Cyrus, you're a beautiful man. You're doing beautiful, incredible work. And I feel so fortunate and lucky that our paths have crossed and we become such great friends. So thank you for that.
Cyrus Khambatta:
I fully agree. Thank you, Rip. I mean, I can't even tell you how much I enjoy hanging out with you in person and online. You are doing such a phenomenal service to the world of plant-based nutrition and to people who really need this information through packaged products that they can easily buy the grocery store, through education, through in-person events. I mean, you are a force for good and I hope one day to be as good as you. So I'm trying and hoping.
Rip Esselstyn:
We're just trying to be BFFs kind of like that cholesterol and saturated fat, but the healthiest versions.
Cyrus Khambatta:
That's right. I think we are BFFs, but haven't really admitted it online until right now.
Rip Esselstyn:
Woo. Hey, hit me up with a PLANTSTRONG fist, my man.
Cyrus Khambatta:
Boom. There it is.
Rip Esselstyn:
Boom. All right. Hey man, I'll see you the next time you're in Austin.
Cyrus Khambatta:
You got to a deal. Thanks, my brother.
Rip Esselstyn:
To learn more about Cyrus and Robby's Mastering Diabetes book and programs, visit www.masteringdiabetes.org. Of course, we'll link it all up in the show notes at plantstrongpodcast.com. Until next week, keep it real and always keep it PLANTSTRONG.
The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, Ami Mackey, Patrick Gavin and Wade Clark. This season is dedicated to all of those courageous truth seekers who weren't afraid to look through the lens with clear vision and hold firm to a higher truth. Most notably, my parents, Dr. Caldwell B. Esselstyn, Jr. and Ann Crile Esselstyn. Thanks for listening.
