Mastering Diabetes by Cyrus Khambatta and Robby Barbaro

[Member496333]

Neither would I. Fortunately, as a free-living study it's not representative of the actual results that people are able to get, in a similar way to how Virta bottoming-out at 6.2%, after a year (The 2 & 3 year bounce-back is also nor encouraging) are not representative of the results people are getting with low-carb on this very forum.

Currently, there are an increasing number of people who are achieving drug-free numbers equivalent to those that David Unwin refers to as 'in remission', while eating a diet containing anywhere between 200 and 700 grams of carbs.

Free-living studies are notoriously difficult to 'police' i.e to ensure people are doing what they are supposed to do. That's just one of the reasons I don't constantly cite the poor (comparatively-speaking) results of Virta, as though it's any worthwhile proof of just how effective a low-carb/keto diet can be for T2D. Were anyone to suggest to me on the strength of teh Virta results that low-carb was unable to bring patients into a non-diabetic range within a year, I'd point them to this forum among others, and suggest that those who were appropriately personally motivated to do so, and who had the level of ongoing community support of this forum, can trounce those numbers, and normally within half the time.

Well, the same thing is happening for those that are succeeding on the MD program. Not only do they have a whole community support structure underneath them, but the fact that they are paying to be part of that community gives them access to personalised coaching, and also provides them that extra motivation of not wanting to have wasted their money.

And just so we're clear: Barnard's program IS the MD program. Same theory; same dietary recommendations.

I have on many occasions now linked to many such progress accounts (I've done so, earlier in this thread). Yet some seem insistent that the gold-standard by which the high-carb, low-fat diet be judged is an 11-year-old free-living study. Moreover, they do so in the face of all these excellent testimonials, in what I can only see as an attempt to disinform.

Is the position that anecdotal evidence is superseded by scientific study? I'm sure Bartholomew Kay would have something to say about that, considering he places anecdotes at the top of the 'Hierarchy of evidence' Moreover, that being the case, would it be fair to dismiss the testimony of everyone on this forum, in light of Virta's findings that a low-carb intervention will bottom-out at 6.2%, over a year, and then proceed to worsen every year after?

Sure thing. I was just referring to the graph which we have all seen a hundred times but doesn’t really mean anything. Aside from the obvious problem of 7.5% A1c being very firmly diabetic, the graphic compares plant based with SAD, and since SAD is the primary driver of metabolic meltdown in the first place, it’s a bit of a hollow victory for broccoli.

 

[Goonergal]

Currently, there are an increasing number of people who are achieving drug-free numbers equivalent to those that David Unwin refers to as 'in remission', while eating a diet containing anywhere between 200 and 700 grams of carbs.

Can you point to any papers/sites detailing those results, along similar lines to those Dr Unwin has published? Thanks.

 

[Deleted member 532959]

Sure thing. I was just referring to the graph which we have all seen a hundred times but doesn’t really mean anything. Aside from the obvious problem of 7.5% A1c being very firmly diabetic, the graphic compares plant based with SAD, and since SAD is the primary driver of metabolic meltdown in the first place, it’s a bit of a hollow victory for broccoli.

Yes, we have seen that graph hundred times, but it isn't meaningless; or at least the reason we keep seeing it isn't meaningless The irony of course is that many here see PCRM as nothing but a front for veganism, and thus totally untrustworthy. Yet when it comes to trying to discount the use of a high-carb, low-fat program, and furthering the anti-vegan agenda, it suddenly becomes the indisputable gold-standard in science



I agree that 7.5% is firmly diabetic, but do you not agree that 6.2% is not non-diabetic? They really are just two different extents of science failing to demonstrate what individuals, in real-world settings are accomplishing every day. At that point, just dismiss the study. No need to declare any kind of victory, hollow or otherwise. In both cases, we can provide examples that render both studies redundant.

 

[Member496333]

Yes, we have seen that graph hundred times, but it isn't meaningless; or at least the reason we keep seeing it isn't meaningless The irony of course is that many here see PCRM as nothing but a front for veganism, and thus totally untrustworthy. Yet when it comes to trying to discount the use of a high-carb, low-fat program, and furthering the anti-vegan agenda, it suddenly becomes the indisputable gold-standard in science

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I agree that 7.5% is firmly diabetic, but do you not agree that 6.2% is not non-diabetic? They really are just two different extents of science failing to demonstrate what individuals, in real-world settings are accomplishing every day. At that point, just dismiss the study. No need to declare any kind of victory, hollow or otherwise. In both cases, we can provide examples that render both studies redundant.

Yes I consider 6.2 also diabetic. But my personal definition of diabetic pathology vis-à-vis T2DM is hyperinsulinemia, so I’d want to be looking at a lot more data than just HbA1c anyway. I’ve always considered it a blunt diagnostic tool. But we’re getting into the weeds now…

 

[Deleted member 532959]

Can you point to any papers/sites detailing those results, along similar lines to those Dr Unwin has published? Thanks.

It's been a while since i clicked the links myself. but here are a few random hits:

https://www.masteringdiabetes.org/how-to-achieve-a-non-diabetic-hba1c/

https://www.masteringdiabetes.org/reverse-type-2-diabetes/

https://www.masteringdiabetes.org/a1c-transformation/

https://www.masteringdiabetes.org/reverse-diabetes-bob-blackburn/

 

[Deleted member 532959]

Yes I consider 6.2 also diabetic.

So, would you agree with me that the Virta study is a poor representation of what is actually achievable with a low-carb program, and that it isn't a stretch to believe that there are currently a lot of people achieving results that far out-perform those in Barnard's official study, that do a better job of validating the program?

But my personal definition of diabetic pathology vis-à-vis T2DM is hyperinsulinemia, so I’d want to be looking at a lot more data than just HbA1c anyway. I’ve always considered it a blunt diagnostic tool. But we’re getting into the weeds now…

ok

 

[Deleted member 532959]

Well here's one story I will leave it to you to judge it success or not.

My High-Carb, Low-Fat Experiment with Type 1 Diabetes By Ginger Vieira

https://diabetesstrong.com/my-high-carb-low-fat-experiment-with-type-1-diabetes/

Edit
Bye the way this is the story of a person who actually followed the Cyrus Khambatta diet. or tried to.

Only skimmed through this, thus far. But while there are a couple of red-flags, i.e not being able to get through even a few days without cheating...oh, and the fact that amount of time would be practically useless to assess such a diet-change, I thought it was a pretty balanced article

 

[Member496333]

So, would you agree with me that the Virta study is a poor representation of what is actually achievable with a low-carb program, and that it isn't a stretch to believe that there are currently a lot of people achieving results that far out-perform those in Barnard's official study, that do a better job of validating the program?

Maybe, maybe not. In the end the only thing that really matters to me is personal results, and I know if I tied to eat 700g of carbohydrate a day my blood would set by the end of the week. Of course I have to accept the opposite may be true in others, but they will be major, major outliers. I am willing to bet 10p that if I gave a thousand diabetics a super high carb, low fat diet, 999 of them would get worse.

 

[Deleted member 532959]

Maybe, maybe not. In the end the only thing that really matters to me is personal results, and I know if I tied to eat 700g of carbohydrate a day my blood would set by the end of the week.

I suspect that just like most people your experience of carbs is within the context of a Standard Western Diet, which is, despite what many will have us believe, distinctly NOT low-fat. In most cases, the foods that many think of as carbs, are just as high if not higher in fat. The ramifications this has, in terms of health and blood-sugar aren't just cited by the likes of Barnard. Pretty sure Ted Naiman agrees with this as a toxic combination.

If it is true that carbs and fat in the blood are a chalk and cheese/water and oil type of bad combination, then prioritising one and minimising the other theoretically could help the issue. Where low-carbers clearly minimise the carbs, low-fat dieters do the diametric opposite. Is it really too hard to imagine that both could effect similar results? Especially given the success stories on both sides?

Of course I have to accept the opposite may be true in others, but they will be major, major outliers. I am willing to bet 10p that if I gave a thousand diabetics a super high carb, low fat diet, 999 of them would get worse.

And there I was, thinking we were making progress

I happen to think that both keto and low-fat are extremes; certainly enough so, that I'd regard those who make it stick (As in, year-in/year-out, with nary an hour 'off the wagon') are already outliers. But from what I have seen over the last couple of decades (I've not been behind the MD paywall, however), that those who give it everything they've got, get it done. Same with low-carbers.

However, the idea of people getting worse seems odd, especially when you consider that even in Barnard's now evidently ill-fated study patients weren't getting worse

 

[Deleted member 532959]

And a subjective precis of some of the winners and losers
https://blog.insidetracker.com/vegans-vs-non-vegans-who-is-healthier
This includes some dodgy and biassed statements regarding use of meat products.

Interesting, as I've not only heard of studied vegans coming at higher levels of testosterone than both vegetarians and omnivores, but nearly all the vegan blood-tests I've seen over the last couple of decades, levels have been well within expected and ideal ranges. This also goes for raw-vegans, and Brian Turner, who did a 30-day experiment of daily soy consumption and managing to increase his testosterone (Not scientific, but fun nonetheless)

 

[bulkbiker]

The irony of course is that many here see PCRM as nothing but a front for veganism

Because that is precisely what it is.

But more to the MD programme have you tried it yet?

You seem very pro yet every time you have been asked what you are doing to put your own T2 into remission you usually clam up or say "not yet".

 

[bulkbiker]

that even in Barnard's now evidently ill-fated study patients weren't getting worse

Err yes they were that's why the HbA1c line starts to go up again.. that is a worsening of their previous just bad levels.

 

[Goonergal]

It's been a while since i clicked the links myself. but here are a few random hits:

https://www.masteringdiabetes.org/how-to-achieve-a-non-diabetic-hba1c/

https://www.masteringdiabetes.org/reverse-type-2-diabetes/

https://www.masteringdiabetes.org/a1c-transformation/

https://www.masteringdiabetes.org/reverse-diabetes-bob-blackburn/

Those are all n=1 stories, which are great and have their place, but that wasn’t what I asked for. These links have been shared to death, I’m after some data.

 

[Deleted member 532959]

Because that is precisely what it is.

But more to the MD programme have you tried it yet?

You seem very pro yet every time you have been asked what you are doing to put your own T2 into remission you usually clam up or say "not yet".

No! The two things are intertwined, but the PCRM model is based fundamentally on real-world health results. That doesn't mean all is fine 'n' dandy. As a vegan, for various reasons, i don't support them.

My own results are unclear, currently. I have very few strips at the moment, and the last time I ordered them they were held up for weeks in customs. As such, I'm not even measuring daily. Last time I checked, a few days ago FBG was 180 (Down from 200-and something), and 5 kilos lost (Currently weigh less than I have in 7 years, and 7 kilos lighter than I was at diagnosis, four years ago).

However, I'm not currently following the MD or any program. I am just eating less of any foods that I want. The only qualifier is that they're vegan. I'm currently considering increasing the current quantity of junk-food I'm eating and more closely monitoring throughout November (This presumes I get more interim strips). Nothing certain, though

 

[Deleted member 532959]

Err yes they were that's why the HbA1c line starts to go up again.. that is a worsening of their previous just bad levels.

That's not what I mean. If Barnard's plan was potentially impossible, there would never have been any initial drop. But I'd again draw your attention to Virta's study which not only failed to reach non-diabetic range, but also has bounced back upwards.

Perhaps low-carb is just not effective for the Virta participants

 

[Deleted member 532959]

Those are all n=1 stories, which are great and have their place, but that wasn’t what I asked for. These links have been shared to death, I’m after some data.

Actually, you asked me to papers, but also sites. I pointed you to their site. And their account contain data point, albeit limited. It is still data

Can you explain to me why these examples aren't worthy of consideration?

 

[Oldvatr]

Those are all n=1 stories, which are great and have their place, but that wasn’t what I asked for. These links have been shared to death, I’m after some data.

I also seek evidence that is independamtly derived, and all beating my betes sources so far have been from sites with vested interest. At least with this site, it is open to the public, and so we notice a distinct lack of claims being made for High Carb type diets, except where insulin treatment applies. There is also a dearth of proper studies in the archives regarding the claims for these diets. That is why we are slow to applaud when these posts appear. There is a limit to the glossy promo videos we can absorb. Bring some verifiable evidence that is properly constituted, then we can discuss it. The OP video does not float my boat.

 

[Oldvatr]

That's not what I mean. If Barnard's plan was potentially impossible, there would never have been any initial drop. But I'd again draw your attention to Virta's study which not only failed to reach non-diabetic range, but also has bounced back upwards.

Perhaps low-carb is just not effective for the Virta participants

Not true (from where I stand anyhow)
https://www.virtahealth.com/outcomes

Edit to add: if I break my rule and link to a site with vested interest, then I get this:
https://www.diabetes.co.uk/news/201...hba1c-in-type-2-diabetes-review-99114687.html

Backed up by the science
https://pubmed.ncbi.nlm.nih.gov/30007275/

 

[NicoleC1971]

Thanks



Actually, Denise used to be a raw-vegan. We used to be on the same raw-vegan forums, over a decade ago. She is one of a handful of people who pass my litmus test for trustworthiness. It's not necessarily that I agree with all her stances, it's that she will at least attempt to pursue the truth, even when it ends up contradicting her previously-held positions. Even better, she then cops to it and publicly retracts or corrects herself

She is bereft of the hubris, dogmatic-thinking, reductionism, motivated-reasoning and confirmation-bias that plagues the current nutrition-sphere (That includes from the majority of vegan doctors and gurus). To me this is both the gold-standard and the bare minimum we should be willing to accept.



I wish I could share your optimism about evolving understanding. I see nothing but devolution. And while I will never suggest that refined foods are the key to health, I've seen nothing so far that convinces me of the detrimental effects of the inclusion of a certain amount of process (even ultra-processed foods.

Of course, this is for each individual to decide. i'm certainly not making any recommendations.



Hmmm...That litmus-test I mentioned earlier...Lustig gets nowhere near

I do, however, give him credit for making the exception for whole fruit, to be viewed as distinct from the rest of his crusade against sugar.



The whole Paleo backstory started out as a badly-researched idea, and depending on the day or the orator, has only declined since then. At this point, it is mere fantasy, but without the fun of the cosplay. Well, except for this guy

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You are right that we did eat carbs to varying extents. We know this due to the extra amylase (as distinct from out distant ape cousins) that humans developed. in fact, so ubiquitous was starch-eating (We currently have evidence of cooked starches going back 175,000 years), that the animals that evolved alongside us also developed this increase in amylase:

https://www.futurity.org/starch-amylase-mammal-saliva-2062422-2/

And yes, you are absolutely right that there has never been any vegans within our entire history/evolution. Just as with those who pursue long-term keto or so-called carnivore diets, veganism is a human construct, made only possible by our modern world (even then, that depends on various factors).
My own veganism is not predicated on any false notions of evolution, nor even on any 100% surety of healthfulness. Up until this point, my own experience and that of others (To include long-term, older-generation and from-birth vegans) leaves me quietly confident, though I try to keep an open mind



There are absolutely going to be people who aren't able to tolerate certain foods, and those who have really deadly allergies to others. Ruling out extreme sensitivities, it seems like the body is capable of becoming accustomed to all manner of foods. It's unlikely we'd have survived our evolution without such abilities.

And I happen to get all my bread, pasta and rice from a supermarket. So there's that



Not going there



I don't think any one diet works for everybody. Even if it has the potential to do so, the menu has to be something the participant has to be at least slightly interested in following.



Honeymoon period? Are you suggesting that at some point it's just going to stop working for him? if so, how long would you predict...and why?

As for eating fruit, here's one of Robby's WIEIAD vids. He's been eating like this for about 15 years, I believe. Of course, I can see why very few people will want to do what he is doing (and to be clear this is not what the MD program recommends), but I'm sharing for a different perspective:

Thanks for sharing your opinions. I can't imagine being vegan but do know my step mum feels much better without meat and cheese although she is still overweight though has no health issues. Dairy seemed to make her joints worse!
At the same time as reading Denise Minger's book I also read Leia Keith's book The Vegetarian Myth (a vegan apostate) and Michael Polan's one too although you could reverse his conclusion in her case: Eat food, not too much, mainly plants!
As for this type 1 guy who takes no insulin, I am speculating as to why this could be. As a type 1 I have to take at minimum a basal dose of insulin because in the absence of endogenous insulin to suppress it , my liver will pump out glucose. Hence my speculation that he is making a little insulin of his own! Dr Bernstein (type 1 specialist) advocates a ketogenic diet for newly diagnosed to prolong the life of the beta cells for as long as possible.
My own insulin supplies dwindled to nothing circa 1981 and my blood glucose got to over 31 yesterday without eating a thing (a pump tubing issue) but I suppose like you I am rather attached to my way of eating and not willing to give it up.

 

[StewM]

Thanks for sharing your opinions. I can't imagine being vegan but do know my step mum feels much better without meat and cheese although she is still overweight though has no health issues. Dairy seemed to make her joints worse!
At the same time as reading Denise Minger's book I also read Leia Keith's book The Vegetarian Myth (a vegan apostate) and Michael Polan's one too although you could reverse his conclusion in her case: Eat food, not too much, mainly plants!
As for this type 1 guy who takes no insulin, I am speculating as to why this could be. As a type 1 I have to take at minimum a basal dose of insulin because in the absence of endogenous insulin to suppress it , my liver will pump out glucose. Hence my speculation that he is making a little insulin of his own! Dr Bernstein (type 1 specialist) advocates a ketogenic diet for newly diagnosed to prolong the life of the beta cells for as long as possible.
My own insulin supplies dwindled to nothing circa 1981 and my blood glucose got to over 31 yesterday without eating a thing (a pump tubing issue) but I suppose like you I am rather attached to my way of eating and not willing to give it up.

Yeah I had a look at the studies and the main source seemed to be a study which found that a 6 year old had sent type 1 into remission via a Gluten-free Diet.

The study called for further research, which as far as I can tell never happened, which limits discussion around it severely.

The study shows a solid series of tests were conducted to confirm the Type 1 diagnosis despite the most logical explanation being that the patient was misdiagnosed.