Mastering Diabetes by Cyrus Khambatta and Robby Barbaro

Its low fat, high carb according to their sales literature
Low-fat, plant-based, whole-food nutrition
Learn the science behind eating nutrient-dense, carbohydrate-rich food to reverse insulin resistance.

Surely their scientists know that insulin resistance is rare in T1 D but they imply this diet will solve problems for all diabetics. Er?

A 2% drop in HbA1c is hardly mind blowing. It's a 22 mmol/mol drop. And 20 lb weight loss is less than the 15 kg of Newcastle. It's 1.4 stones so significant, but Roy Taylor needs the full 15 kg to claim remission.

Oldvatr said:

Its low fat, high carb according to their sales literature
Low-fat, plant-based, whole-food nutrition
Learn the science behind eating nutrient-dense, carbohydrate-rich food to reverse insulin resistance.

Surely their scientists know that insulin resistance is rare in T1 D but they imply this diet will solve problems for all diabetics. Er?

A 2% drop in HbA1c is hardly mind blowing. It's a 1.6 mmol/mol drop. And 20 lb weight loss is less than the 15 kg of Newcastle. It's 1.4 stones so significant, but Roy Taylor needs the full 15 kg to claim remission.

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I really can't understand why it is being suggested as good for type 2 diabetics. Any ideas please?

Going back to my previous posting on nutrients, it would seem that they do not use any fortified products at all. I have difficulty in seeing what they use for protein too. They use some seeds and legumes, but no nuts Small amount of animal product is allowed if you really feel inclined, but it works better if vegan.
No avacado.no coconut, no palm oil or seed oils or olive oil so no Omega fats at all. No lipid sources or cholesterol sources to provide our bodies with the basic building blocks for cell maintenance. Our brains need some fat so our bodies will have to invent some instead. This is not IMO a healthy diet plan.

They say it is necessary to measure your baseline IR level frequently to decide when to use Low GI or Hi GI foods and vary according to your IR level. Er????

Here is an interview with one of the authors
https://diabetesstrong.com/mastering-diabetes/

as I suspected - no attempt to mix and match plants to ensure proper nutrition. They go by what it looks like and tastes like. No mention of B12 deficiency in their introduction. Possibly a footnote on the diet plan?

EllieM said:

Well, if you are making your own food from scratch rather than buying premade meals from a supermarket, you miss out on a whole load of added sugar?

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It is still very high in carbs, and non insulin users can't compensate for that.

HSSS said:

is this 2% actually meaning two dcct points eg from 9% to 7%.

I’m trying to locate any evidence for their claims. Anyone found any in their media?

https://www.masteringdiabetes.org/

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Yup. USA HbA1c is DCCT, we in UK are mmol/mol. They claim full science backing it up, but I suspect that since they reference McDougall, then it may be what he used in his book. ADVENT -2 and Harvard Nurses Study. Or it could be Forks over Knives that also used McDougal. Michael Greger also referenced bases his plans on the same source.

Here are their science references
https://www.masteringdiabetes.org/bookinfo/

Oldvatr said:

A 2% drop in HbA1c is hardly mind blowing. It's a 1.6 mmol/mol drop.

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HbA1c 7% = 53 mmol/mol
HbA1c 5% =31 mmol/mol
A drop of 22 mmol/mol

The idea of this diet for T1s & T2s is to reduce insulin resistance and is supposedly good for reducing complication risks. Low fat equals low colesteral so that helps weight loss, cardiovascular and heart health. I am 35yrs T1 and enjoyed this course. I am also vegan already so that helped massively and ignited my interest to begin with. The recipes are very simple. Nothing very complicated at all. Some of the ingredients are not recognisable but google is always helpful for this. Not a good course if you can't live without meats and fats! My colesteral has gone down considerably and generally feel very healthy from this food.

I always followed a low fat diet in the past as we were told that was healthy. Since becoming T2 and changing to a low carb high fat diet my total cholesterol has dropped by 2.0 points. Therefore I disagree that fat causes high cholesterol in my case.

HSSS said:

I understand the premise of their regime is that the cause of t2 diabetes and insulin resistance is fat and that it gets taken up by the cells and blocks glucose receptors in those cells and to eat the “goods” carbs.

What experience does anyone have, what are the “good or bad” points? Where is the argument strong and well evidenced? Where does it fall down?

For clarity I haven’t yet read or much about it, I’m just exploring the concept. Much as I did low carb before ploughing deeper into the science etc.

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Hey, I actually do eat vegan - sorry everyone - and I've listened to a few episodes of the podcast from those guys so here's my two cents. I largely agree that their approach falls into the category of vegan people making unsupported health claims (aka. "vegan propaganda").

The plans good point is that it largely pushes people towards eating whole foods promoting general health. The plans bad point is that it implies that veganism is necessary to eat a generally healthy diet. It's obviously not. A vegan diet can be healthy, so can a omnivorous diet, both can also be unhealthy.

When it comes to living a non-diabetic life, a vegan diet requires more attention to address some deficiencies. If you were thinking of eating vegan, I'd recommend you do some googling of the supplements you might want to take. Anemia convinces nobody that you're healthy.

When it comes to living a diabetic life, the only real difference you're likely to notice is that you'd maybe struggle to eat low carb on a vegan diet. A well balanced vegan diet is pretty high in carbs (mine sure is). But, you can achieve great A1Cs with a low carb diet or a high-carb diet, that comes down to food planning and insulin management. It's up to you on where you stand on that topic.

EllieM said:

Thanks for your interesting and informative post which I mostly agree with. It sounds like this diet can work well for T1s if they want it to. Like the others, I am sceptical as its benefits for T2s, though. (As you are young and on insulin I am assuming you are T1? I know, I shouldn't assume).

I would be very interested to know whether this diet can be made to work for T2s. (My son is vegan and 3 out of his 4 grandparents are T2.)

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Hey, yeah I'm T1. I wouldn't have any experience of living as a T2 and being vegan. I think the authors argument are that if you eat lots of carbs (healthy ones) you train you're body to be sensitive to them and so as a T1D you'd need less insulin per meal and as a T2D you'd tackle insulin resistance.

What people have refered to as the vegan propaganda is the implication that veganism (i.e., zero meat etc.) is whats improving insulin sensitivity whereas it may actually just be a healthier diet in general (i.e., containing some amount of healthy meats).

Of course, I'm certainly not here advocating meat eating, my views on diet are probably fairly self-evident. But I also think that those who make non-factual health claims probably end up harming their own cause for short-term gains (probably in book sales).

Doug88 said:

I think the authors argument are that if you eat lots of carbs (healthy ones) you train you're body to be sensitive to them and so as a T1D you'd need less insulin per meal and as a T2D you'd tackle insulin resistance.

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What's the basis for this particular argument? Do they have data/studies that show this will happen?

I also presume you'd be training your body to be LESS sensitive to these carbs because if you were more sensitive your Blood Sugar would spike higher (requiring more Insulin to compensate)? Unless I'm misunderstanding what you mean by sensitive.

HSSS said:

@Doug88
thanks for the considered reply. I can see that eating whole foods of both animal and non animal varieties is a healthier way of eating than a junk food diet and will probably give benefits either way over a highly processed diet. As someone who already struggles to absorb some nutrients and is close to anaemic I can’t see this approach working for me on that basis alone. Nor as a type 2 is there the option of managing levels with insulin. That is a one way street to deterioration and complications from increasing insulin resistance for us. All the history shows that medication alone, even with reasonable bgl achieved, does not avoid this hence the reason type 2 is known as progressive under a medicated model of the last 50 yrs.

It is this claim for improving IR in type 2 in the presence of higher carbs - of whatever source, as the carbohydrate itself is all the same even if the packaging/skin it comes in is more healthful - that totally baffles me entirely.

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I think that the argument for the high carb diets is that they have to be ultra low fat, and this is what provides the protections, certainly it was the argument used to justify the WFPB diets. However, large sacle studies and some meta analyses have established that the association between all cause mortality and dietary fat intake is that the ultra low fat diet has a higher risk of adverse outcome than even the high fat intake diets.

I am reminded of a study performed on post mortem records of patients who succumbed to cardio events, which showed tht those with a low level cholesterol were more prevalent for this outcome. Other studies have also recently shown that having cholesterol levels too low also increases all cause mortality risks.

The links to these studies have been posted and discussed many times in this forum

obtom said:

The idea of this diet for T1s & T2s is to reduce insulin resistance and is supposedly good for reducing complication risks. Low fat equals low colesteral so that helps weight loss, cardiovascular and heart health. I am 35yrs T1 and enjoyed this course. I am also vegan already so that helped massively and ignited my interest to begin with. The recipes are very simple. Nothing very complicated at all. Some of the ingredients are not recognisable but google is always helpful for this. Not a good course if you can't live without meats and fats! My colesteral has gone down considerably and generally feel very healthy from this food.

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Actually low dietary fat does not equate to low blood cholesterol. Our liver manufactuers ALL the cholesterol we use in the blood and does this by stripping out bits from incoming cholesterol or by creating cholesterol from scratch. The human cholesterol has its own electrochemical signalling system that the incoming cholesterol does not, and so the incoming cholesterol is incompatible with what we need. There is no direct relationship between what you eat and what we circulate.

StewM said:

What's the basis for this particular argument? Do they have data/studies that show this will happen?

I also presume you'd be training your body to be LESS sensitive to these carbs because if you were more sensitive your Blood Sugar would spike higher (requiring more Insulin to compensate)? Unless I'm misunderstanding what you mean by sensitive.

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Hey thanks. Firstly, yeah as I said somewhere above, my impression of the book is that its not very well evidenced at all.

On "sensitivity" question, I was trying to say that the authors were claiming that eating more healthy foods that were high in carbs would lead to you having a higher carb/insulin ratio - so yeah that would be increasing ... eh... insulin sensitivity (not carb sensitivity - coming from Ayrshire, my English isn't that great).

But yeah, I'm not claiming that any of this is actually true - just that I think that is the basis for what the authors are claiming.

obtom said:

Low fat equals low colesteral

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You may benefit from looking at recent research into this. Low fat does not equal low cholesterol.