Cyrus Khambatta, PhD and Robby Barbaro on Thriving with Type 1 Diabetes: PYP 258

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Cyrus Khambatta and Robby Barbaro are the co-creators of Mastering Diabetes, an online program and support network for people living with all forms of the disease: type 1, type 2, type 1.5, prediabetes, and gestational diabetes.

And both have been living with type 1 diabetes, also known as insulin-dependent diabetes, for most of their lives. Type 1 can't be reversed or cured through diet and lifestyle, so they must take synthetic insulin in order to remain alive.

According to mainstream diabetes protocols, Cyrus and Robby should limit their carbohydrate intake significantly, and get the majority of their calories from proteins and fats. Certainly the last thing they should do is live on a high-fruit raw diet.

They not only live on such a diet; they thrive on it. And they've taught thousands of others with diabetes to combat the condition with a whole food, plant-based diet.

Recently, they produced a brilliant video and blog post sharing the misconceptions and myths at the heart of today's most popular and dangerous dietary fad, the ketogenic diet. (See below for the video.)

Spoiler: the ketogenic diet can achieve flatlined blood glucose levels and weight control, but at the expense of long-term health.

If you are dealing with diabetes, you're also dealing with mountains of misinformation offered by both well-meaning and self-serving sources. It's easy to get frightened or bullied into avoiding fruits and vegetables and whole grains, even though the science is abundantly clear that the real issue is insulin resistance, not high blood glucose levels. (If the last sentence made no sense to you, it will after you finish listening to our conversation.)

To help people avoid dietary disaster based on a fundamental misunderstanding of the biochemistry of insulin and glucose metabolism, Cyrus and Robby have created the Mastering Diabetes Online Summit. It's been around for a couple of years now, and has helped tens of thousands of people gain control of their diabetes and their lives.

If you or anyone you know is struggling to thrive while living with diabetes, please check it out.

In our conversation, Cyrus and Robby and I covered:

Robby:

  • getting diagnosed at age 12
  • type 1 is just an inconvenience, and won't derail your life
  • counting carbs on the Standard American Diet and getting sick (allergies, acne, plantar fasciitis, etc.)
  • experimenting with different diets (animal-based keto, plant-based keto) and feeling terrible
  • the difference between total insulin and insulin/carbohydrate efficiency ratio
  • discovering Doug Graham and the high-carb raw world
  • “the number one killer of type 1 diabetes is heart disease”
  • reducing insulin to the lowest level possible is the wrong goal

Cyrus:

  • getting diagnosed at age 22
  • a collection of auto-immune diseases (Hashimoto's, alopecia)
  • the failure of low carb diets to manage his blood sugar
  • throwing his blood glucose meter against the wall and crying – and then looking for real answers
  • eating nothing but fruits and vegetables, being terrified to go against prevailing wisdom, and cutting insulin by 40% within 7 days
  • switching from mechanical engineering to nutritional biochemistry to figure out what was going on

Both:

  • molecular mimicry and auto-immune disease
  • meeting and starting to work together
  • why keto is so popular (short-term gratification overrides long-term damage)
  • fruits don't equal sugar
  • lots of ways to reduce blood sugar, and only some of them are healthy
  • the real role of insulin (it's not the enemy)
  • empathy and positivity as strategic values
  • embracing the wisdom of our bodies
  • “type 1 diabetes is the most quantitative condition in the world”
  • how to incorporate continuous blood glucose monitoring in a useful way
  • details of the 2018 Mastering Diabetes Summit
  • and much more…

Enjoy, add your voice to the conversation via the comment box or audio recording box below, and please share – that's how we spread our message and spread our roots.

Podcast Video (with our faces smooshed by the YouTube ratio)

Talk Back

Links

Debunking the Ketogenic Diet

The 2018 Mastering Diabetes Summit

Transcript

Read the full transcript here

HOWARD: Today's show is a conversation with Cyrus Khambatta and Robby Barbaro.
They are the co-founders of Mastering Diabetes, which is a program (a coaching program
and a phenomenally popular on-line summit that is just kicking off at the end of this month),
which is why we fast tracked this episode and pushed a whole bunch of other ones down a week. Sorry everybody else, all you other fantastic guests.
We're going to have to hold our breath a little longer before we can hear from you.

Robby and Cyrus are both living with type 1 diabetes, and, I should say, thriving with type 1 diabetes. Their summit and their coaching is not just for people with type 1,
but also type 2, type 1 ½, prediabetes, gestational diabetes.
I came across their work recently. I've known about them for awhile,
but recently I watched a fantastic video presentation
debunking the ketogenic diet as a means of diabetes and blood sugar control.

And the keto diet is interesting, because it gets so many good results so quickly:
blood glucose flatlines, weight control, LDL cholesterol goes down, people feel better.
So you can really understand how people who try the keto diet become such die-hard advocates,
and why it's so hard to convince them
that what they're doing is actually going to cause harm in the longterm.
However, Cyrus, who is a nutritional biochemistry PhD,
does a masterful job in this video of explaining why what looks like good news on the front end
turns out to be very, very bad news on the back end.

So, with Cyrus the scientist, and Robby the marketer, and both of them phenomenal teachers,
they are changing a lot of lives for the better.
So I'm delighted to welcome them both. So, without further ado:
Robby Barbaro and Cyrus Khambatta, welcome to the Plant Yourself podcast.

ROBBY: We're super excited to be here. Thank you for having us.

CYRUS: Absolutely

HOWARD: Yeah, you guys are making a lot of waves with your “Mastering Diabetes” summit.
Before we get to that, and before we get to what I really want to talk about,
which is your fantastic work on the biology of the ketogenic diet,
I'd like you guys to tell me your story,
because I know in your e-mail signature you say, like, “2 guys living with type 1 diabetes”.
Who wants to go first? Who's the extrovert here?

CYRUS: Robby, why don't you go for it.

ROBBY: Sure, I'll go for it.
Ok, so I'm 29 years old right now.
I was diagnosed with type 1 diabetes over 18 years ago,
and my older brother actually has type 1 diabetes as well,
so, when I was diagnosed, my family was very familiar with it.
So, I'd actually been complaining for several weeks prior to the diagnosis that,
“Hey, Mom, I think I have diabetes just like Steve.
I'm going to the bathroom all the time. I'm thirsty all the time. Like, something's not right.”
She's like, “Ah, don't worry about it. It's no big deal. You don't have diabetes. You're going to be fine.”
So, eventually my mom was out of town, and, actually, both my mom and my dad were out of town.
It was just me and my brother at the house.
She called to check in to see how we were doing, and I said,
“Mom, I couldn't sleep last night. I was cramping all the time.”
She's like, “Ok, go upstairs.
Use your brother's blood glucose meter, and see what your blood's going on.”
So I test myself. I'm well over 400.
You're supposed to be somewhere between 70 and 120ish, and I was above 400.
So my brother, right then, he goes, “Yup, you have type 1 diabetes. Pack your bag.
You're going to be in the hospital for a couple nights.” And that was it.
That was the beginning of living with type 1 diabetes.

For everybody who doesn't know, I probably should say, type 1 is where you are insulin dependent.
So, for whatever reason, my pancreas and Cyrus' pancreas is not working properly.
The beta cells have been damaged. We do not produce sufficient insulin.
Therefore, we have to inject insulin to maintain our health and manage our blood glucose.
So, I'm living with type 1 since then, and

HOWARD: And how old were you then? Sorry.

ROBBY: So I was 12, just about to turn 13, at that time.

HOWARD: Ok.

ROBBY: And so, at that point I'm following the standard American diet.
The thing my parents always said, “Look, type 1 diabetes is just an inconvenience.
You can still do whatever you want.”
So I felt very empowered, and it didn't really, like, derail my life or anything.
But, it was the beginning journey of starting to figure out how could I take better care of myself.
So, in the beginning, I'm following the standard American diet,
just counting my carbohydrates, and things are going pretty well.

But, at that time I was still sick. I was having other problems.
I was always having allergies year round.
So, I was taking Nasonex and Claritin-D and still getting sick.
I had terrible acne, and I had plantar fasciitis, which is a really uncomfortable condition in the feet, where I had to wear these big, blue boots at night while I was sleeping,
and it was not fun to deal with.

So, here I am. I'm managing type 1 to the best of my ability.
I'm having these other problems, following the standard American diet.
Eventually, I started learning: ok, how can I take better care of myself?
So, I tried 2 versions of the low carbohydrate diet in my journey.
I tried a animal based version - so, the Weston A. Price Foundation.
I was a member of that organization.
And then, after I learned some reasons not to consume animals,
I then moved to a plant-based, low carbohydrate diet, and I learned from Gabriel Cousins.
I was inspired by the movie, “Raw For 30 Days”.
And there's a guy in there named Curt Tyson, who was a type 1 who got amazing results.
And this was all very inspiring to me. So I started to follow a low carbohydrate diet.
(And we're going to get in...
I'm glad we're covering this now, because Cyrus is going to go into the biology later on today
with our talk about ketosis.)
But I had this experience. So, I followed a plant-based ketogenic diet for 30 days.
Like, I did it as perfect as you can.
And I ate no more than 30 grams of carbs/day, eating lots of oil, lots of nuts, and all that.
And at that point, living with type 1 diabetes,
I was taking the least amount of total insulin I have ever taken
(roughly about 10-12 total units of insulin/day).
And, if you do the numbers, it's roughly like a 3 to 1 ratio.
So, total carbohydrate to total insulin, a 3 to 1 ratio during that period.
But I was feeling terrible. I was on campus at the University of Florida. I was losing weight.
My energy was low. I had several incidences where I almost blacked out.
At this point I'm getting scared. I don't really know what to do.
I go back to a naturopath that I had worked with in the past.

HOWARD: So, wait, so you're doing this, the keto diet, under, like, medical supervision?

ROBBY: No, I was just a freshman in college at this point.

HOWARD: Oh, ok. So, you weren't part of some group who was doing it?

ROBBY: No, I was in touch with Curt Tyson. He was helpful.
I was using on-line forums and stuff like that.
I was reading. There's a book by Gabriel Cousins, like, laying out exactly what to do:
phase 1, phase 2, phase 3.
So, I was following those guidelines, but it was just me, and my doctor wasn't helping me.

HOWARD: Were you communicating with them about your symptoms?

ROBBY: Umm, you know, I guess,
I think at some point what happened is I stopped communicating with ..
I was, but at some point I stopped communicating with them when I went, I went to the naturopath,
got her opinion, and she's like, “Oh, maybe you should do chelation therapy.”
So, at this point I'm in, like, the raw food world (so, Gabriel Cousins and all that world).
There's like this whole scene of raw food people back then.

And so, I end up listening to a podcast,
where I heard Doug Graham talk about eating lots of fruits and vegetables.
And the logic really resonated with me.
So, at that point, that's when I stopped interacting and trying to get, you know,
the keto or the Gabriel Cousins feedback.
I'm like, “Ok, wait a minute, what Doug is saying resonates. I'm going to go try that.”
So, that's when I, I make that shift. So, I sign up for his coaching program. I read his book
(which Cyrus is one of the testimonials in the book, sharing his story, what happened to him).

And now, all of a sudden, I start eating all these fruits and vegetables.
So I'm eating - the first week I really eat just bananas.
The second week I eat bananas and lettace.
And I just start adding mono meals of fruit and greens. And that's how I started this journey.

And what happens is my insulin sensitivity starts going through the roof.
So, I'm now eating 600, 700, 800 grams of carbohydrate/day
and my total insulin usage is falling somewhere between like 35 and 40 units.
That's roughly what it was. So, total units go up, but insulin sensitivity is absolutely through the roof. So, now we're talking, you know - I'm eating meals where my ratio is 25 to 1, 30 to 1, 45 to 1,
you know, depending on my activity. And so this was a powerful experience.

And I'm starting to feel great. My energy is coming back. My skin's clearing.
I'm starting to just feel amazing, and that's how .. when I got excited about it.
And then now, looking back, (and we're going to go into detail. Cyrus is going to cover this.)
The importance of insulin sensitivity and why that interconnects with all the other diseases.)
So, people living with type 1 diabetes, they don't die of blood glucose problems.
The number 1 killer is heart disease.
So, you've got to understand that living a lifestyle that's good for all your tissues,
including your heart, your kidneys, is very, very important,
not just blood glucose numbers, and not just total insulin use.

So, again, in the type 1 community
there's a lot of confusion around trying to take the least amount of insulin possible.
That's not really the goal for somebody living with type 1.
The goal is to take an appropriate amount of insulin.
How much insulin did your pancreas secrete before it got damaged?
Insulin is not the enemy. It's not a problem. It's a necessary, required hormone.
You just want an adequate amount.
So, me now taking roughly between, you know, 35 or so units/day and eating a healthy diet,
that's good. That's healthy. That's where I want to be.
I don't want to be back down to taking 10 or 11 units/day
but feeling crappy and having terrible insulin sensitivity.

So, I hope that makes sense. That's my story. I don't want to take up too much time here.
Let Cyrus share his and get into the science here.

HOWARD: Ok, very cool. Yeah, Cyrus, what about you?

CYRUS: Ok, I don't actually have diabetes. I just go along for the ride. That is a joke, ok.
So, I was diagnosed with type 1 diabetes when I was 22. So, I was a senior in college.
I was going to Stanford University at the time. And, all I noticed was that I was extremely thirsty.
I was drinking, you know, upwards of a gallon, a gallon and a half of water/day.
And it felt like no matter how much water I drank, I was getting thirstier and thirstier and thirstier.
And then I was urinating 17, 18, 20 times a day. So, and I also had no energy.
So I picked up the phone and I called my sister, who is a doctor of osteopathy.
And I said, “Hey, Shanaz, these are my symptoms. What do I do?”
And she started crying immediately.
She said, “Cyrus, just drop everything you are doing. Go to the doctor right away.”
So I said, “I don't understand what's happening.”

I show up at the doctor.
They check my blood glucose, walk out of the room to go put it into a blood glucose meter,
come back 3 minutes later, and I'm pretty much passed out. I'm lying down.
I wake up. I'm like, “Ok, I'm in a doctor's office. How did I get here?
Who is that woman standing in front of me? How does she know me?”
And then I was just like, “Oh my God, I'm losing it”.
So, they take me to the hospital, and they check my blood glucose.
And kind of like Robby, who had a 400 something, my glucose was, like, 608.
So it's, like, 6 times, 7 times higher than it needed to be.
And they started giving me drip irrigation of insulin into one arm,
and then fluids into the other (saline into the other).
And, all of a sudden, things started moving in the right direction,
and I got a little bit more energy and more hydrated, and my blood glucose came down.
So, 24 hours later they discharged me from the hospital.
And they say, “Here is a prescription for insulin. Here is a blood glucose meter.
Here's a carbohydrate counting guide. Here's a bunch of syringes. Good luck.”
And I was like “What? You've got to be kidding me. This is weird.”

And prior to that I, actually, was diagnosed with 2 other autoimmune diseases.
So, the first one is Hashimoto's hypothyroidism.
And so, that basically is a decreased thyroid hormone output.
And then secondly was alopecia universalis, which is why I have no hair.
I have no eyebrows. I have no armpit hair. I've got nothing.
So, those 2 set in, and then type 1 diabetes was the icing on the cake, all within a 6 month period. So, I got really scared, really quickly, because obviously something was terribly wrong
and I didn't know what it was.

So, for the first year I listened to the doctors,
and they said low carbohydrate diet, low carbohydrate diet, low carbohydrate diet.
And they're operating under this philosophy
that carbohydrate = more insulin = a more challenging time managing your blood glucose.
Don't eat carbohydrates.
So, I said, “Sounds reasonable. You're talking to a meat eater. I eat dairy. I eat turkey burgers.
I eat, you know, fish. I like eggs. So, you're telling a meat eater to eat more meat.”
And I said, “Great, I'm going to do that” in a heartbeat.
So, it was supposed to make my blood glucose nice and controllable, but it did the opposite.
Glucose was all over the place. I mean, up, down, up, down, roller coaster everyday.
So, I was just, like, literally, like, so frustrated and so confused
that I was doing what I was supposed to do, and it wasn't working.

HOWARD: Did it occur to anyone that they were just telling you to do what you were already doing, more or less, like, somehow, that was going to fix it?

CYRUS: Yeah, that's a great point. I mean, the one change that I did make out of their guidance,
was to drop my carbohydrate intake more than before.
So, I ended up eating less breads and cereals and pastas and fruits.

HOWARD: So, hold the bun.

CYRUS: Exactly. Hold the bun. Bango. And so by doing that, you know,
my carbohydrate intake went down, and the proportion of fat and protein in my diet went up.
So, but your point still stands, which is I was doing effectively the same thing as before
with a little bit of a modification, and that really wasn't working.

So, about a year into this process I come home from work one day.
I check my blood glucose. (I'm excited to eat dinner. And I'm hoping that my blood glucose would be, you know, like, 110 or maybe like a 95, so that I could eat.)
Blood glucose: 288. I picked up my blood glucose meter,
and I was so pissed off that I took my blood glucose meter, and I just threw it against the wall,
and smashed it into 1,000 pieces, and I fell onto the couch, and I started crying.
And I said, “What am I doing wrong? This is ridiculous.”

So I started a personal research project to learn more about nutrition, because I didn't know anything.
And, somehow, every single door I opened up
(whether it was a personal conversation or a book or a scientific lecture),
it was plant-based diet, plant-based diet, plant-based diet.
And the universe was somehow telling me, “Hey, Cyrus, you should probably try a plant-based diet.” So, I was like, “Alright. I used to make fun of vegetarians and vegans. Let me try it out”. So I did.

And under the supervision of Doug Graham (who Robby had talked about earlier),
at a retreat, he basically showed me how to eat nothing but fruits and vegetables. That's it.
So, cold turkey, overnight, I cut out meat, I cut out dairy, I cut out fish, I cut out eggs, I cut out bacon, and I went to just literally nothing but fruits and vegetables.
And I was terrified, because the carbohydrate, you know, methodology says,
“If you eat more carbohydrate, especially if they're coming from fruit,
your insulin use is going to go through the roof.” So, I was expecting my insulin use would go up.
I started pounding carbohydrates like it was my job.
And everyday my glucose was getting lower and lower and lower,
and, therefore, my insulin use was getting lower and lower and lower.
So, within a 7 day period, I cut my insulin use by, like, 35%, 40%.
And I was like, “This feels incredible.”

So I go home, continue to make it work.
And then, I got so excited by this experiment that was happening inside of my body
that I could not explain using science,
so I started reading more books and started picking up textbooks and enrolling in classes,
and before I knew it, I was ready to do a PhD program.
So I went to UC Berkley for 5 years to study nutritional biochemistry as a PhD.
And there I was able to really learn the evidence based science about what causes diabetes,
what reverses diabetes, and how do you actually manage diabetes using your diet.

HOWARD: Hmm. What was your career trajectory before that?

CYRUS: I was an engineer, a mechanical engineer.
And I was working as an aeronautical engineer. And I didn't love it. I'll be honest with you.
So, this was kind of a welcome change. And, you know, it was a very weird set of situations, but, hey,
it turned out to be something that I'm totally passionate about now.

HOWARD: In watching your video presentation, I can sort of see the mind of an engineer.

CYRUS: Ah, nice. I like it.

HOWARD: Because, you know, one thing that I always, like, you know,
the people that I have on this show are all outliers (Right?) in some way or another.
And both of you guys, like, struggled with this condition.
And it got you both to the place where you said, “I've got to discover something for myself.”
And you work with lots of people who, I guess, arrive at that same conclusion.
But I think the fact is that most people who have any sort of condition or disease
never get to that point. What do you think it was?
CYRUS: Yeah, and, I mean, I like to think over the course of time, what I've learned is that
nutrition is something that 100% of all people will have to pay attention to at some point in their life. Right? For me and for Robby it happened at a really young age.
But, for, I'd say, the majority of people, you hear these stories of, like,
“Oh when I hit 40, man, my body changed. I just couldn't lose weight any more”.
“Oh, when I turned 60, that's when I got my heart attack”. You know?
And so there's this idea that, like, later in life something terrible is going to happen.
Then, you should think about the food you put into your body.
So, I honestly think that, you know, this whole thing was scripted, like,
I was supposed to develop type 1 diabetes, and, I don't know why, but it enabled me,
it provided me with an opportunity to change everything I was doing in my lifestyle at a young age.
And to me it's literally the greatest thing that's ever happened to me.

HOWARD: Hmm. How's the Hashimoto's and the alopecia?

CYRUS: Alopecia. Yeah.

HOWARD: You still don't have eyebrows, so..

CYRUS: That's right. Yeah, I have not grown back my hair, and I don't think I will.
And, quite honestly, I'm not actually looking forward to doing that, ‘cause I love having no hair.
Um, but one of the things that's actually starting to happen now is
I'm starting to sprout these hairs, like, on my neck and, sort of, a little bit on my face.
And, whenever a hair pops up on one side of my body,
it will pop up on the exact opposite side of my body.
So, there's a symmetry, which is just fascinating to me.

And, as far as Hashimoto's is concerned,
my thyroid hormone use was increasing, increasing, increasing.
And then I switched my diet. And then it stabilized. And then it has kind of come down.
So, I don't know of any dietary method that can fully reverse Hashimoto's hypothyroidism,
if you've been living with it for a couple of years.
So, I would love to say, yeah, you know, I reversed Hashimoto's, but I would be lying if I said that.

HOWARD: Hmm. Now, I guess, you know, when somebody has an autoimmune disease,
that it's not uncommon for there to be others that follow. Right?

CYRUS: Yeah.

HOWARD: What's your understanding of, you know ..
I guess there's lots of different potential triggers.
We don't know all that much about predicting or assessing those triggers.
But in terms of, like, once you have an autoimmune disease,
how does that affect your body in ways that could make other diseases more likely?

CYRUS: Yeah, that's a great question.
You're right in saying that autoimmune diseases tend to run in multiples.
So, people who have Hashimoto's hypothyroidism, as an example,
often express a secondary, you know, autoimmune disease,
whether that's Celiac disease or Multiple Sclerosis or something like type 1 diabetes.
You know, it kind of ranges on things that are, like, benign, like alopecia,
all the way to things that are, like, debilitating.
Um, and one of the molecular underpinnings of autoimmunity is this thing called molecular mimicry. And molecular mimicry is just a fancy, super nerd way of saying
when your immune system mounts an immune response to protein that your body manufactures.
So, in the case of type 1 diabetes, what the prevailing wisdom is right now,
is that, you know, if you're consuming a large amount of dairy, and you get casein in your diet,
there's a specific sequence of amino acids on the casein molecule
that make it such that, when that goes into your body, you can end up getting gut irritation.
And then there's sort of like holes in the tight junctions between the cells inside of your small intestine. So, this casein molecule is supposed to get completely chopped up
into either 1 or 2 or 3 amino acids, in order to, like, eventually make it into the blood stream.
But, due to inflammation in your gut, you end up with large chunks of this casein molecule
escaping into your blood. And it's not supposed to do that.
And then, as soon as it gets inside of your blood, now your immune system says,
“Hey, wait a minute. Where did that protein come from? I don't recognize that protein.”
So, your immune system mounts a response
to try and neutralize that protein, so that it doesn't cause a threat.
But, because there's a couple of - there's a sequence that's very similar
to protein that your body manufactures on the surface of beta cells,
your immune system thinks it's attacking casein, and it does.
And then it starts to attack other molecules that are very similar to casein.
And then your beta cells end up taking the hit. So, this process is called molecular mimicry,
where one molecule mimics another endogenous, human made molecule.
And then, as a result of that, you can end up mounting an immune response to your own body,
when in reality that was never supposed to happen in the first place. Does that make sense?

HOWARD: Yeah, it kind of reminds me of someone who's undergone some terrible trauma,
and, you know, let's say, a woman who was badly abused by a man.
Now every man she sees triggers a memory.
Like, your body has been traumatized by this protein escaping into the blood,
where it should never be. And now everything looks like a threat.

CYRUS: Bingo. Exactly.
Yes, that's actually a really good way to think about it.
And, you know, when it comes to type 1 diabetes, does that mean that, like,
I drank too much milk as a kid? Well, maybe.
You know, there's also viruses that can predispose you to an autoimmune reaction.
So, you know, there's no –
It's almost impossible to say, “Well, Robby got type 1 diabetes because of _____,
or Cyrus got it because of _____.”
But, you know, those are the prevailing ideas here. And there's a lot of research to back up all those - this whole idea of molecular mimicry.

HOWARD: Gotcha. So, Robby, how about you? So, you're –
I don't know what else you do for a living. I know you're a professional. Help me here.

CYRUS: Howard, I do one thing. I do diabetes.

HOWARD: Alright. So, I wasn't sure whether it was your day job, or just your Friday afternoon.
So, when did you decide that this was going to be your thing?

ROBBY: So, I've been very passionate about spreading the low-fat,
plant-based, whole-food message, really, since the beginning of getting into this.
And so, it was in college that I really dug into it.
It changed my life. And I changed my major so I could have some time to focus on this on the side.
And then, straight out of college ..
In college I started a non-profit organization. I made videos on YouTube.
I was selling tropical produce in Florida. So, I was really passionate about it.

And then, my first job, my only other job after college: I worked at Forks Over Knives.
So, I'm really good friends with Brian Wendel,
who was the creator, the founder, the mastermind behind Forks Over Knives.
And we actually met at a Doug Graham health event. That's how we first met.
So, Brian will always say that, you know,
me and Doug had a little bit of impact on how he sees nutrition
and the wholistic perspective that is taught at Forks Over Knives.
So, I spent about 6 years there with Forks Over Knives from the beginning,
sort of being Brian's right hand person. And he had the vision.
He, you know, made all the deals, and then I was responsible for getting things done.
So, I spent a lot of time there just learning and enjoying the business side of sharing this message, but also having the opportunity to connect with the experts and read a lot of their material,
and help publish articles on the blog and testimonials and recipes,
and really had a chance to get to know, really, you know, the key players in this community.
So that was a really great education for me.

And, even in college I was passionate about ..
I've always been sort of like a leader and a coach just by nature. So, even in college
I would coach people a little bit, while working with Forks Over Knives on the side.
I coached people a little bit, and eventually Cyrus and I merged forces.
And the 2 of us together are a heck of a lot stronger than apart. So, we love what we do.
We do Mastering Diabetes full time.

HOWARD: Nice, and how did you guys meet?

ROBBY: So, at first I knew of Cyrus, because he was in that book.
And there was articles of him on .. There was a website called “Organic Athlete”.
I think they did a profile on Cyrus. And there was pictures of him just looking ripped and fit,
and talking about how this diet had improved his life.
And so, I knew of Cyrus, but we hadn't been in touch
until we did a lecture together in San Francisco area.
We did a lecture where we had people come, and they got some food, and we both gave a talk.
And that was really fun. And we started to talk, and we're, “Hey, what are you up to?
What are you doing?” And Cyrus was talking about his coaching practice and what I was doing,
and, sort of, our vision and our goals, and that was the beginning of us working together.

We started out with a small group coaching program that we did together.
And now, we continue to do that,
but we also have a large group coaching program that is very affordable and accessible
for people all over the world. So we're really passionate about that work.
As far as getting into the nitty-gritty, like, it's something we're really, really passionate about.
So, when I was at Forks Over Knives,
we did such a great job of publishing amazing content and inspiring stories,
and we were moving into creating food products that people can use and make this accessible,
and a meal planner to make it easier to, you know, prepare and then execute the lifestyle.
But in regards to the nitty-gritty nuances of a person being like
“This is the medication I'm taking. These are my blood glucose readings. This is what's going on. Like, how do I, how do I – what do I do at the airport? Like, this is my problem in this moment.
You know, how can you help me?” And that's the way we work in our coaching practice.
Like, every little nuance of what does it take for you, in your situation, your nuanced details,
to execute this lifestyle. That's what we do through our coaching program.
And it's literally, like .. It's affordable. It's $29/month, and we answer questions within 24 hours.
We are literally there with people everyday, every step of the way.
And we're just super passionate about it.

HOWARD: Cool. So, I'm curious what you guys saw in each other or in the collaboration
that was stronger? Because each of you has a great story.
Each of you is clearly well-versed, articulate, passionate, inspiring.
Like, what was it that you said, “Oh, we could be stronger together?”
What did each of you see that got complemented?

CYRUS: That's actually a great question.
I would say, you know (I'll speak from my perspective here),
I like to think of myself as, like, the science professor. You know, like, I'll get stuck in the weeds,
like, really getting into the molecular level details of evidence based science, because I love to do it.
And then I developed a coaching practice to try and help people, you know,
make modifications of their lifestyles for maximum success.

And, when I met Robby, what I realized, I was like, “Oh my God, this guy is a marketing machine.
This guy has a really good social media following. He's got a great personality. He's super inspiring.” And so we're like, “Hey, hold on a second. What if we were to combine forces,
and then we'd have both, you know, like, more reach to the outside world.”
But, then we also have, you know, the science background.
And then, as we decided to, you know, start joining forces, within a very short period of time,
we both realized that the sum was greater than, you know, the addition of the parts.
And so, it's been really, really, really fun to work together
and to really develop a coaching practice together
that has now influenced, affected more than 2,000 people's lives.

HOWARD: Hmm

ROBBY: Yeah, I mean I could just go on a long list of amazing things about Cyrus.
But, I mean, there's no doubt, I mean, I think Cyrus is so smart. I mean this guy is just wicked smart. His ability to read studies and understand them quickly and efficiently,
and then summarize them in a way that people can understand, is really beautiful.
And so (I don't know if you mentioned it or not on the show),
but his undergrad was from Stanford in mechanical engineering.
And then he goes to UC Berkeley to get a PhD (just really, really smart, well educated,
but also can bring that to people). So, that's been super fun to have that aspect of our company.
He’s like our chief medical officer, basically.

Um, but in addition to that just, I mean, his experience.
So, Cyrus had been doing this diet for I think, you know, 12 or 13 years when we joined forces.
I think I was doing it for probably 8 or 9 at that point. Um, and knowing he knew our passion for fruit. So, Cyrus had also had the experience of doing years and years
of following a fruit and vegetable diet.
(So, that's not just what we teach. We teach people
the whole gamut of eating, you know: beans, and whole grains, and all that stuff. That's essential.)
But the passion for teaching people that you can have large volumes of fruit, whole fruit,
as a person living with diabetes, and that reverses insulin resistance, is super important.
So, the fact that we're on the same page there is priceless.

And just, you know, we have fun together, our personality ..
We spent all day together on the computer working on things.
And our team is growing now, which is super fun.
But just the willingness to work hard and focus on this.
Like, the amount of time we've put in to build what we have so far is remarkable.
So, when you have somebody who you see is dedicated and doing that, that's also priceless.
So, when we put 2 really hard working people, smart, put them together, it's pretty powerful.

HOWARD: That's great. So, I want to talk about
the Mastering Diabetes Summit that you guys have coming up,
but I want to frame it in a way that I'm very curious about.
And you may .. (Feel free to, like, reject this framing entirely.) But, it's like, I see you guys,
and you're like the next generation of plant-based avatars, and educators, and inspirers.
And I think that there's a way in which the older generation
(which I sort of consider myself on the trailing edge of),
but, you know, the people who really made this a thing: Colin Campbell, Esselstyn, Neal Barnard
(you know, the people who we keep seeing at the big Veg Fest and the events),
there's a way in which, um, they, I think, have trouble getting additional traction.
And I'm wondering if you see that? If you see that there's a role for you that's different
(as sort of digital natives, as millennials-ish, um),
that you're bringing a different sensibility, and whether the summit reflects any of that?

CYRUS: Ok, so let me take a stab at this one. First of all, um, how dare you call me a millennial.

ROBBY: Ha, ha, ha

CYRUS: Uh, I think the reason that we seem to be getting traction with the diabetes community, or at least I ..

HOWARD: It's because you look so young. I don't know. I didn't realize you were 70.
You really don't look ..

CYRUS: Yeah, it's because I don't smoke, so I appreciate it.

So, the reason why I think people with diabetes tend to resonate with our messages is like multiple.

Number 1: we both have diabetes.
You know, we absolutely love Michael Greger.
And we absolutely love Dean Ornish and Neal Barnard. And those guys are unbelievably smart.
But the fact that they don't actually have diabetes is something that kind of creates a little bit of a wall between somebody living with diabetes and them.
It's sort of like, “Alright, I understand that you're smart, but you don't know what I'm going through.
You don't know. You don't feel it. Right? You don't see it everyday.” So, that's number 1.

And then number 2:
uh, the fact that we can talk about it from a very scientific perspective
and teach people the biology of diabetes that they never learned.
And in so doing, we explain a lot of the symptomology of living with either type 1 or type 1 ½,
or prediabetes and type 2, and we can explain to them,
“Oh, the reason why your fasting blood glucose is high in the morning is because ____.
The reason why you've been unable to lose weight over the course of time is because ____.”
And when we talk about it in that respect, from a very scientific perspective, people are like,
“Oh, wow. These guys understand me. They totally understand”. Right?

And, so, I think a combination of the 2 of those is really helping out.
And people really trust that we are going to lead them in the right direction.
And as soon as somebody gives us their trust, that's when we go into full steam ahead and say, “Alright, we're going to deliver.” And we're going to make sure that we provide this person
with an incredible experience, so that they also, over the course of time,
are likely to recommend someone else to the program,
because they had such an awesome experience themselves.
So, we appreciate you, you know, referring to us as the next generation.
We like to think that, but, you know, we're trying to stay humble at the same time.

HOWARD: Ha, ha, Robby, what are your thoughts?

ROBBY: Um, yeah, I mean, I think ..

HOWARD: You're not insulted if I call you a millennial, right?

ROBBY: No, that's totally fine. That's cool with me.
Ha, ha, um, you know, yeah, first off, I appreciate all the kind words there.
And I think, you know, I mean, the success of the summit .. I get what you're saying about, you know, maybe, you know, some of the other luminaries are having a hard time reaching new people.
That may or may not be true, but I will say, like, just in regard to the success of the summit,
the reason that event is so successful and so amazing,
actually comes down to the experts themselves
(like, the people that we have chosen to interview and that have agreed to be interviewed).
The information is so solid and makes so much sense and is so congruent
when you're hearing it from this expert and that expert, and it's all tying together,
saying the same conclusion each and every time.
And they're citing studies, and they're well read, and they have, well, great education,
and they all have experience with their actual practice. They're physicians.
Um, it's just really powerful. So, it's been really fun to interview them, get to know them more,
and bring that information to more people. So, I think that is the key of why it's successful,
to be honest with you.

HOWARD: Do you guys feel like .. like so, I imagine, like, you scan facebook feeds
and you see all the popular stuff about keto. And I know that you responded to it in that video.
And like, when I ever see this stuff, you know, very often I just want to, like, draw a circle on the wall
where I can just bang my head for awhile.
And my first impulse is often, to be very snarky and combative.
And I actually did that for about 5 years until I just got tired of it.
And I'm wondering if you guys were more, sort of, more strategic about having a positive message
or of being less combative, or, like,
how do you think about your role as being in an argument and still..?
ROBBY: I just want to.. I want to comment on that real quick,
and then I'll let Cyrus give his response as well.

The thing is, see, the particular nuanced situation, in the world of diabetes,
if a person follows the ketogenic diet properly,
they get the exact results that Cyrus laid out in the ketogenic article and the video,
which is that you can see flatline blood glucose.
You can stop taking diabetes medications, if you're following this diet properly.
So, I completely understand where the people on the internet are coming from
(these people commenting out there). It is incredibly confusing. You go to these websites,
and you see the ketogenic people with before and after pictures that are incredible,
and this person saying, “I got off my medications. My A1C is 4.9”.

Like, we get why people are confused, and that's why, you know,
we put so much time into putting that together and teaching people the nuance
of why is that happening and why is that not actually ok.
So, my answer to your question is, I understand and I empathize with them.
And there's so many nuances in the diabetes world
that I just see that as an opportunity for us to provide more education.
And, in a nice kind way, that just opening up a door to be educated, because
we can teach them and have them understand. And that can be a really powerful moment for them.

CYRUS: Absolutely, and, you know, one of the things that I see all the time is that,
just like Robby was saying, in the ketogenic community, or I should say, in the world of diabetes
the one thing that most people with diabetes are fixated on
(and this sort of includes medical professionals as well),
is blood glucose, blood glucose, blood glucose, or I should say blood sugar, blood sugar, blood sugar. Right? That's what people are always, like, just hell bent on getting down. Right?
So, you know, regardless of what you're doing right now,
if your only goal in life is to decrease your blood glucose, well, there's a number of ways you can do it. I mean, there's a lot of ways. Right?
Number 1: You can exercise like a madman. You can perform 4 hours of exercise every single day. Your glucose is going to come down.
You can do intermittent fasting every single day. You can do an 18 hour intermittent fast.
Your glucose will come down.
You can adopt a ketogenic diet (where you're basically avoiding foods that are carbohydrate rich). Your glucose will come down.
You can lose weight. Your glucose will come down.
You can also adopt a plant-based diet that is low in fat, and your glucose will come down.

So, what, the reason why people get so, kind of like, flustered about this whole process
is because, when you adopt a ketogenic diet, and you're basically avoiding fruits,
you're avoiding potatoes, starchy vegetables, bread, cereals, pastas, legumes,
and you're eating things that are, you know, mainly animal based products,
whether they're meat, fish, eggs, bacon, chicken, things like that, you get results,
and you get them fast, like, very quickly. Within weeks you can be losing 2, 3, 4, 5, 10 pounds.
Your blood glucose can normalize very quickly. Your A1C value can drop very quickly.
You can start to reduce your LDL cholesterol and, therefore, your risk for heart disease.
All that stuff is, like, very quick. And in the world in which we live today,
we're, sort of, very encouraged by instant gratification.

And so, if I walked up to you, Howard, and I said, “Hey, listen. You're overweight. I want you..”,
or like, “I'm going to try and help you lose weight, and I can get you to lose 30 pounds
in the next 2 months.” Right? “And all you've got to do is (you know) follow my advice.”
If you really want to lose 30 pounds, then you're going to be like,
“Ok, great. I don't care. I'm going to do it. I’m going to do it.”
Because you're focused on the short term benefits.
But, in so doing, you forget to think about what's going to happen to me 5 years down the road. What's going to happen to me 10 years down the road? Right?
Is what I'm doing right now to lose 30 pounds going to negatively impact my health
10 years down the road? And, if the answer is, “yes”, then you have to know that.
You absolutely have to know that going into it. Right?
But if the answer is “no” (what you're doing right now is actually safe for you,
not only in the short term, but also in the long term), then great. That's a long term strategy.

So, what we do, and, you know, what a lot of the research that I've done, clearly shows,
is that the ketogenic diet provides incredible short term benefits,
but in the long term you end up actually increasing your risk for chronic disease,
including cancer, including hypertension, including high cholesterol, including coronary artery disease, including atherosclerosis, including cognitive decline (or Alzheimer's disease).
And so, if you're adopting a ketogenic diet and it's working to control your blood glucose,
but 2 years down the road or 5 years down the road or 20 years down the road
you now have a whole host of other chronic diseases
that now are more important than the diabetes that you tried to solve earlier,
then you have yourself in a pickle.

And that's where low-fat, plant-based, whole food nutrition comes into play.
Because it's both a short term and a long term solution. But yet people just don't know that. Right? And people are again, they're sort of focused on like, “Well, wait a minute. I can't eat bananas.
Don't tell me I can eat bananas. I can't eat potatoes. That's all sugar. Right? Sugar's bad for me. Sugar's going to make me fat. Sugar's going to increase my risk for diabetes.”
But yet, we're using the wrong terminology, because fruits don't equal sugar.
It's the wrong word you use. And, if you actually understand the science,
you'll realize that it will work to lower your blood glucose and A1C in the short term.
And your risk for chronic disease 5 years down the road is going to be nullified.
And that's the beauty of it.

HOWARD: So, before we started recording, we talked about, you know,
that, basically, the keto community doesn't understand basic biology.

CYRUS: Right.

HOWARD: And, but there are people in the keto community with PhD's.
Like, they're not all, you know, gym bros. Right?

CYRUS: Right.

HOWARD: So what's, you know - someone just texted me, like,
literally 3 minutes before we got on this Skype call together. He's like, “Alright, what about this?”
And he sent me a picture of a book cover called, “Fight Cancer with a Ketogenic Diet”.
And so, like, this is a, you know, a PhD who wrote the book. There's studies.
What .. Can you explain in terms that I could understand,
like, what's .. if diabetes is not about blood sugar, what is it about?
CYRUS: Ok. Great question. So, um, diabetes is about ..
the reason that you develop prediabetes or type 2 diabetes
is because you developed another condition first. And that condition is called insulin resistance.
So, in other words, you cannot develop prediabetes or type 2 diabetes
without first developing insulin resistance. So, it's the precursor and it's a required precursor.
The question is ..

HOWARD: Ok, yeah. So, what's insulin?

CYRUS: So, what's insulin? Ok, what's insulin and what's insulin resistance? Ok.
Here's the crash course in insulin biology.
Insulin is a hormone that your pancreas, that the beta cells in your pancreas manufacture
in order to help you properly metabolize your food -- period, end of story.
Now, when you eat food (whether that food is carbohydrate rich, like potatoes or quinoa,
or whether it's carbohydrate poor, like a piece of steak, ok), insulin is required
in order to metabolize the carbohydrate, the fat, and the protein that are present in those foods.
It just so turns out that the most potent trigger, or the most potent signal for insulin in your body
is glucose, which comes from carbohydrate. Ok? So, in other words, when you eat foods
that are higher in carbohydrate, that's a more potent signal for insulin to be secreted
than if you're eating things that contain mainly fat and protein. Ok?
So, that's the sort of like, the reason why insulin exists.

Now, insulin's job is, once it gets secreted from the beta cells into your blood,
it circulates in your blood, and it knocks on the door of your liver,
and it knocks on the door of your muscle and in tissues all throughout your body,
and it says, “Hey, knock, knock, I have some glucose for you in the blood.
Would you like to take it up?”
And so, cells have an opportunity to say, “Ok, great. Sure. Hey, thanks for notifying me. Great.”
And then they open a door, and then they allow the glucose to come in.
So, cells that are insulin sensitive, they'll hear the knock.
They will recognize insulin when it gets to the cell surface,
and they'll say, “Oh, hey, look. There's some glucose. Ok, great.”
And then it will enable glucose to come into the cell using a whole bunch of different mechanisms.

Now, if a cell is insulin resistant, then, when insulin comes to the door and it says,
“Hey, knock knock. I got this glucose. Do you want to take it up?”
the cell, basically, either cannot hear insulin knocking in the first place or the cell responds by saying, “Un uh, not your turn. I don't want any glucose. And the reason I don't want any glucose
is because I already have a whole bunch of other stuff inside of me.”
And that other stuff is dietary fat.

So, if you're eating a diet that's got a significant proportion of dietary fat,
and you're eating things like meat, and cheese, and olive oil, and coconut oil, and eggs, and bacon, (mainly animal products), over the course of time
the dietary fat from those foods ends up getting partitioned into tissues all throughout your body.

So, some of it goes into your adipose tissue or your fat tissue.
So, you end up storing a little bit in your cheeks and in your neck.
You get some in your, you know, in the back of your tricep. You get some in your butt.
You get some in your abdomen. Um, and if all of the fat ended up in your adipose tissue, great,
no problem. Problem solved. Diabetes does not exist.
But the problem is that some of those, those fat molecules, those triglycerides,
they don't go into your adipose tissue. They go into your muscle. And they go into your liver.
And that's where the problem starts.
Because your muscle and liver have a very small capacity for fat storage.
And when you're eating a diet that's high in fat,
and you're constantly eating fat rich foods for breakfast and lunch and dinner everyday
for months to years, you end up overwhelming your liver and your muscle with too much fat.
And so they don't really have an option. They end up taking on a little bit of fat now,
and then a little bit more, and then a little bit more, and then a little bit more.
And over the course of time, now you actually have fat deposited inside of muscles
all throughout your body (literally in your shoulders, in your chest, in your quadraceps,
in your calf muscle).

And so, then, the very next moment, when you go and eat a banana -
You have a banana. It gets broken down into glucose.
The glucose says, “Hey, insulin, I need your help.”
Insulin goes, “Knock, knock, calf muscle. Would you like this glucose? I have it.”
And the calf muscle responds by saying, “Un uh. I got all this fat. I got to get rid of this stuff first.” And so, as a result of that, it rejects insulin, and it rejects glucose, and it leaves it in your blood.

And 2 hours later you check your blood glucose,
and you go, “That's weird. I just ate 1 banana and now my blood glucose is at 345.
You see, bananas are bad for me. I can't eat anything that contains carbohydrate,
because every time I do, my blood glucose goes through the roof.”

So that's the sort of like, that's the process that most people with diabetes end up going through.
So, you know, we get brain washed into believing that the banana is the one to blame,
the potato is the one to blame, 'cause these are carbohydrate rich,
and your glucose goes through the roof, and now you've got a problem.
But, in reality, those are not the foods that actually caused insulin resistance to begin with.

What you've got to do is reverse insulin resistance. Let's get rid of that problem all together.
(And now, when you eat a banana, it's fine. The glucose is controlled.)
So, the way to reverse insulin resistance, is to go back and say, “Well, what caused it?”
It's the excess accumulation of fatty acids over the course of time.
So, let's minimize your fat intake in your diet. Let's eat a lot of plant rich foods,
and, in so doing, your muscle and your liver have an opportunity
to start burning all of this fat they've accumulated over the course of months to years.
And then, as a result of that, the next time you eat a banana,
you hear the “knock, knock”, and they go, “Hey, cool. Glucose is here. Come on inside.”
And then, now your blood glucose is much more controlled. Does that make sense?

HOWARD: I think so. So let me .. I'll show you how classy I am, with this metaphor.
It sort of reminds me of like, you're having a party and someone goes to use your guest bathroom
and takes a huge dump and blocks up your toilet,
and now the solution, (the keto solution), is to take away all the drinks
so that the toilet doesn't overflow, (so people will pee less for the duration of the party)
as opposed to taking a plunger and clearing out the blockage in the first place.

CYRUS: Wow, that's actually.. Ha ha.
Yeah, so you're playing the role of, like, bathroom avoidance. Right?
In the ketogenic world where it's like, let's minimize the drinks so people don't go to the bathroom
vs no, no, no, no, no, the problem is not that people are going to the bathroom.
The problem is that the toilet is clogged. Let's unclog this toilet.

HOWARD: Oh, cool.

CYRUS: Yeah, really. I'm going to start using that when I talk to people.

ROBBY: Super classy.

HOWARD: Yeah, right. Ha, ha. That's why I work alone.

CYRUS: Ha, ha, ha.
So, you know, to go back to what you were saying, you know, like, what is the problem?
And the problem is that in the world of ketogenic
(you know, ketogenic educators and the authors and, you know, the scientific researchers),
yeah, they have great credentials. They're PhD's. They're doctors.
They're very, very smart people. They really are.
But yet in this process of, like, trying to translate the benefits of ketogenic diets
and low-carbohydrate diets, they twist their words. And they don't know that they're doing it.
They're not trying to be deceiving. But what they'll do is
they'll say things like, “Oh, well, insulin is your fat storage hormone.
And any time there's any insulin secretion in your body, that's going to make you store more fat”.
And, technically speaking, that is a true statement,
but if and only if you are already living in an insulin resistant state. Right?
If you're not insulin resistant to begin with, then insulin is not your fat storage hormone at all. Right? So, again, they're sort of like, “Oh, let me use that, and just use that statement
to justify why insulin is bad and you should never eat anything containing carbohydrate.”

HOWARD: Right. So, it sounds like you guys are coming at this from a wholistic perspective.
From a, you know, sort of a T. Colin Campbell, Doug Graham version of wholism,
where maybe the person .. You know, if you didn't know that plungers existed, then, you know,
rationing drinks would make sense.

CYRUS: Yeah.

HOWARD: Robby, what's your sense of like, you know, from “Forks Over Knives”
and from working with T. Colin? Like, is it just widening the lens?

ROBBY: Yeah. You're exactly right in saying that we come at this from the wholism perspective.
I know you worked on that book. And that way of thinking is very much the way we approach this. And we actually do this. We very much focus on (the actual diet that we teach) is about whole foods. So it's very, very much, “Hey, we'd very much rather see you eat brown rice than brown rice pasta.
We'd rather see you eat beans than bean pasta.” Because these nuances matter,
especially in the beginning of somebody reversing insulin resistance.
So, yes, we are very, very much on to that perspective. And, it's very simple. Like, we teach ..
It's very, very simple, very logical. And, you know,
the understanding of just embracing the incredible wisdom of our body.
Like, we have trillions of cells doing trillions of actions every second, everyday,
so far beyond our comprehension. And to just focus on eating whole foods
and letting nature run its course, is very logical, and something we definitely teach people.
HOWARD: Hmm. Do you have people who resist that at some sort of emotional level?
Because, like, if I have type 2 diabetes or heart disease, I could understand,
“Ok, my body has wisdom, and I've been abusing it, so I can try to reverse it.”
But if someone has type 1 diabetes, do you find that people come in, like, feeling, like, pre-betrayed?

CYRUS: Pre-betrayed, meaning .. ? Who has betrayed them?

HOWARD: Like, their body. Like, you know, you didn't cause your type 1 diabetes.
People, when they understand, like, they can say,
“Well, my habits caused my heart disease, my high cholesterol, my type 2 diabetes.”
But type 1 diabetes was just, sort of, fate or God or my body or the universe.
Is it harder, do you find, for people with an autoimmune disease that they've had since very young
to embrace the wisdom of their body?

CYRUS: That's a great question. Um, I would almost say it's kind of a hit or miss.
So, in reality we actually see there's sort of, like, a fundamental difference
in the way that a person with type 1 diabetes in our program thinks
vs a person with, you know, type 2 diabetes may think.

And, yeah, the people with prediabetes and type 2 diabetes,
they kind of come to a certain point where they have ownership.
And they're like, “Well, I guess I'm the one that caused this problem.
Now I'm going to be the one that has to reverse this problem.” Right?
But at the same time, you know, habits take awhile to rewrite.
And so, even if you come to the recognition that, like, yeah,
maybe I'm the one that, you know, created this problem over the course of time, you know,
it's going to take time and effort to rewrite those habits. Right?

Vs somebody who's living with type 1 diabetes.
The overwhelming majority of people with type 1 diabetes,
they want nothing more than just to get rid of it. They're like, “Cure me. Get rid of it. Like, I'm out. Like, I don't want anything to do with this stuff. Like, stem cell therapy? Fine.
Uh, you know, islet cell transplant? Fine. Like, just get this out of me.” Right?

But then there's a portion of the population, kind of similar to Robby and I,
who, we're sort of like, “You know what. It's not our fault. We don't know what caused it.
We stopped asking that question a long time ago. But, I'm ready to make a change.
And just tell me what to do. Just tell me what to do, and I'll make the changes.”

And, a lot of the times we find that people with type 1 diabetes
actually can make changes a little bit quicker,
because they don't have this long history of, you know,
habits that may have caused a metabolic problem in the first place.
Does that make sense?

HOWARD: Yeah, both you guys, it sounds like you saw the light in your late teens, early 20's. Right? You didn't have an additional 30 years of dietary dogma and bad habits.

CYRUS: That's exactly right, exactly right. Yeah, so there's like, because there's less time,
it's easier to make some change. And, you know, people with type 1 diabetes, they do ..

It's the single most quantitative health condition in the world.
There's nothing, there's no other condition that requires as much measurement
and as much, sort of like, number finageling as living with type 1 diabetes.
You've got to measure your blood glucose.
Some people choose to figure out exactly how much they're eating, and then, you know,
do a little bit of math and find out how much insulin I've got to give myself.
And then you've got to wait a certain amount of time. And, you know,
there's a little bit of, like, documentation and rigidity required.

But, if you're willing to do that, then you get to a point where you're like,
“Hey, cool. Like, this system works. This is awesome. Actually I'm having a good time.”
And, so, because of that, you, kind of, have to decide at some point along the way
that you're willing to put in the effort. And if you're willing to put in the effort,
then you can get to a point where it goes from medium effort to high effort.
And then, as a result of high effort, it goes down to low effort,
where you're like, “Cool, now I'm on cruise control. I sit in control. I got this handled.”

HOWARD: Mmm, yeah.
And it reminds me a little bit of the promise of, you know, continuous glucose monitoring.

CYRUS: Yes.

HOWARD: But it feels psychologically very different.

CYRUS: Well, yeah. Those continuous glucose monitors are a tool.
Like, Robby is a perfect example. He uses a continuous glucose monitor to check his glucose,
and he wants a 5 minute update every 5 minutes. He looks on his phone, “Ok, what am I now? What am I now? What am I now?” And I see that, and it works beautifully for him.
But, my God, I tried getting on a CGM and I threw the thing out the window,
because it was just like, it was too much information for my brain, and I just didn't care that much.

HOWARD: So, if I'm in a room with you and a monitor, I should duck a lot?

ROBBY: Well, I love the CGM. And not because I check it all the time,
but because the data you get from it is very useful in optimizing your lifestyle.
So, it's not required, but it is a nice tool. There's no doubt.
And I do, um, I do have to check my blood glucose a little bit less frequently, which I like.
And it is actually, for a lot of people that are, you know, just getting into this,
or maybe type 1's who live by themselves, it really is a beautiful tool.
Especially for when you're sleeping, it can beep and wake you up, if you're going low.
And it can help people optimize their blood glucose during the night, if they want to.
It can beep and tell you you're going a little bit higher. You can make a correction
and sort of learn from that, and hopefully, get to the point where you don't need to do that any more. But, it's a good tool.

But like Cyrus said, it's got to be used appropriately.
You can get too neurotic about it. You can overreact. CGM's have a 15 minute delay.
So, about what it's saying, is not what your blood glucose is right now.
It's what it was 15 minutes ago. It's really, it's about the trends.
So, I mean, I could give a whole lecture on the nuances (for somebody living with type 1)
on how to use it properly.
But, I will say, I use a Dexcom. I love the Dexcom. I'm about to partner with them
on one of their new products. It's great. So, there's other tools coming out,
which we're aware of and working on too.
So, we're always about advocating whatever the best is on the market.

HOWARD: Gotcha. So, before we close with the details of the summit,
I'm curious, do you guys have a book in you?

CYRUS: It's on its way, actually.
We're in the process of actually writing a book right now, so I'm actually glad you asked that.

HOWARD: Good.

CYRUS: Because you're .. Yeah, you're the, you're the .. What do .. How do you refer to yourself?
You're a co-author or you're a ..?

HOWARD: Um, well I, yeah, it's a negotiated title. So whatever, I mean,
I've been a contributing author.

CYRUS: Contributing author. There you go. Yeah, so ..

HOWARD: You guys are coauthors?

CYRUS: We would be coauthors. Yeah, that's exactly right.

HOWARD: Cool. When will it be out?

CYRUS: We're looking to get it out by, probably, realistically, the beginning of 2020.
So it's like, you know, a little more than a year from now.
And we're really going to try and put in a lot of, like, hard work
to turn this into a masterpiece so that, you know .. We would like it
so that anybody can pick up this book and just be like, “Oh, look, this is the solution right here.
I just got to just do this.” Right? And then we invented the coaching program
because sometimes the solution, it can be a little complicated and maybe there's questions
along the way and maybe you're looking for support and a community of other people to do it with. And then, therefore, you can read the book, and then you can also
participate in the coaching program. And then, boom, now you've got what you need.

HOWARD: Right right. 'Cause it sounds like the 2 of you had very, sort of,
different emotional reactions to the disease. Sort of, you know, I guess Robby,
from having a brother and from having a certain relation like, “This is not such a big deal.
I can do anything I want”, vs you, Cyrus. It sounds like it, kind of, hit you harder.

CYRUS: For sure.

HOWARD: You know, I have a friend, Joshua Turner,
who was on this podcast a couple of months ago, who is a type 1 diabetic, grew up in Louisiana,
the only type 1 diabetic he knew,
and felt incredibly alienated from everyone and everything from the age of 11.
So the idea of a community in which just, you know, just people knowing ..
can understand your story and your struggle, even if they're not offering a whit of useful advice,
still feels like it's a huge benefit.
CYRUS: 100%. Yeah, and you know, I think I'm also similar in the sense that
I never thought that I needed, you know, a community of other people living with type 1,
because I was like, “Ah, don't worry. I have it under control.
Like, what can a community possibly provide me that I can't provide for myself?”
But then, having been part of a community now, leading the community, creating the community,
it's like, man, we look at these stories in facebook and I'm just like, “Oh my God. This is unbelievable. People are changing so quickly. They're so optimistic about it. And they're coming to the rescue.
They're coming to support one another. And that's my favorite part of the whole thing.
They, literally, are there to be like, “Hey listen. I've gone through this. Let me help you out.”
And as soon as I see that, I'm just like, “God, this is so fun. This is such a cool thing.”

HOWARD: Right. And when you see someone .. When I see the people in my program
who make that switch to becoming, like, next generation teachers, I know they've got it.
Like, that's when I know they're successful, when they take on that role of passing it on.

CYRUS: That's exactly right. Yeah, you hit it on the head. Right.
'Cause they’re like, “Now I have the ownership, I have the knowledge,
I have the confidence to be able to talk about this and help somebody else out.”
And I also find that there's .. a lot of people have this sort of, it's almost like a moral obligation, like,
“I benefitted from this. I see the light, and it's making me healthier.
Now, like, there's nobody telling me that I have to go help someone else.
And there's nobody, you know, forcing me to have to, like, come to the rescue of someone else.”
They just do it out of the goodness of their own heart. And I love seeing that, because you're like, “Hey, cool. Thank you for helping out. You know, that person in need is really grateful
even if they haven't told you right now.”

HOWARD: Yeah, well, I mean, it's, you know, in terms of longevity.
Like, assigning positive meaning to the shit that happens to us is probably, you know,
right up there with a plant-based diet. In terms of, like, looking at both of you.
You could say, “Oh, what a bad deal of the, you know, what a bad hand I was dealt.”
And both of you are like, “Yeah, this gives my life the meaning that it has.”
God knows, again, you might be, you know,
building nuclear submarines or something totally miserable or ..

CYRUS: Ha ha

HOWARD: Right? You know, you could be doing, you know,
social media for some company that sells, you know, GI Joes.

CYRUS: Ha ha, yeah. It's absolutely true. There's a meaning in there.
If you can make positive change out of a previously, you know, adverse situation,
it's, man, it just feels so good. It really does.

HOWARD: Alright, let's close by telling people about the summit, and who should ..
Is it only for type 1 diabetics,
or is it for type 2's, 1 ½'s, prediabetics, friends, family, interested humans?

ROBBY: Yeah, so the summit is for anybody living with diabetes,
anybody interested in learning more about diabetes,
anybody who has a family member who's living with diabetes and wants to really, truly
understand the underlying biology, and then the solution for how can you move forward.
So, people living with prediabetes, type 2: how can you do everything you can
to get rid of this condition.
People living with type 1, type 1.5: how can you really get in the driver's seat
and control your health destiny beyond just diabetes numbers,
but, of course, getting great diabetes numbers as well.
So, it's for everybody.

HOWARD: Gotcha. And aside from you guys, who else,
who are the marquee speakers that will get people excited.

CYRUS: Yeah, we've got all kinds of people in here. So, we got people like
Dean Ornish, Dr. Neal Barnard, Dr. Michael Greger. Last year we had Dr. Klapper.
Robby, help me out. Who else have we got?

ROBBY: David Katz (I don't know if you said that already), Rob Ostfeld, Chef AJ.
And we have each person giving a certain different topic.
We have Chef AJ covering, you know, a lot of things, but mainly on calorie density.
We have Rob Ostfeld going deep on, you know, some cardiovascular issues.
You have Dean Ornish talking about, you know, heart disease.
You have, um, who else? I mean, it's a lot. It's hard to remember.
We also have Eric Adams. We have some very entertaining people in here.
He has an incredible story, and he was a very eloquent speaker.
We have some testimonials.
We have Marc Ramirez, Adam Sud, talking about the psychological components.
We have Michelle McMacken, an amazing expert covering a lot on insulin resistance,
Susan Levin talking about things for families and kids.
It's really, yeah, nothing was left uncovered and not addressed in this year's summit. So ..
It's free. We're really excited about that.

HOWARD: Great. So, what do people need to know in order to find out more and sign up?

CYRUS: So, what you do is you go to “masteringdiabetes.org/summit”,
or you can just go to “masteringdiabetes.org” and then in the very top there's a nav bar
and you just click on “summit”, and it will take you right there. So, we are putting together ..
basically, the summit goes live on the 28th of March, which is not too long from now.
So, we're in the process of putting together .. this is our second summit.
And last year we attracted something like 26,000 people from around the world to participate,
and this year we're hoping we can get it up to 40,000, maybe 50,000 people,
and really start to educate lots and lots of people.

One thing (I don't know if Robby mentioned this,)
but we are also translating this entire summit into Spanish.
And we are creating a Spanish language coaching program,
because the Latino population living with diabetes is growing
potentially at an even faster rate than it is in the English speaking world.
So, we put in countless hours in order to package this information
so it's understandable to somebody who doesn't speak English very well,
or maybe it's not their native language.
And we're going to be running both of those summits simultaneously.
So, we're very excited.

Go to “masteringdiabetes.org/summit” and then
just enter your email address somewhere on the page,
and then we will notify you everyday for 7 days. There's 5 new speakers become available.
So you can listen to things about, you know, what causes diabetes in the first place,
and then it's how do you solve diabetes,
and then how do you deal with the emotional aspects of diabetes,
and let's listen to some success stories. So .. It's like a whole sequence of information.
And the feedback that we've gotten from a lot of people who participated in the summit last year,
it just blew our minds. So, it's actually the best part of our job.

HOWARD: Cool, And now is that interview based, or presentation based?

CYRUS: It is interview based. So, we schedule interviews with all these professionals,
and we get anywhere from like a 30 minute to a, you know, 50 minute long interview with them.
And we try and tackle, like, very specific topics, because someone like Garth Davis is an example.
He's an expert on the evidence based research underlying protein.
What's the deal with animal protein? What's the deal with plant protein? Are they equal?
So, we really, like, you know, get his expertise on that.
And then, when it comes to someone like, you know, Dr. Neal Barnard
will talk about something related to insulin resistance and cheese, as an example. So, you know,
we have a lot of, like, really phenomenal presenters and the interviews are well worth it.

HOWARD: Awesome. So, I will have to get this fast tracked on the podcast.
So, I apologize to everyone else I've interviewed the last 12 weeks.
I'm pushing you back so we can get this out in time that people can sign up for the summit.

ROBBY: That's awesome.

HOWARD: It was so great to talk to, to meet you guys, to talk to you,
to feel your energy and your passion and the clarity of what you're up to.

ROBBY: So, thank you so much. It's really great to be on this show and
we have to get you on our podcast.

HOWARD: Ok. Twist my arm. So, yeah, cool. I'd love to.

ROBBY: Yeah, let's do it.

CYRUS: No question. Yeah, Howard, thank you so much for the opportunity to be here today.
It's like, you know, I've read a lot of the books that you've written, and, you know, you're just like, you're so eloquent in the way that you can really describe complex topics, and, you know
(if I haven't said so already), I really appreciate all the work that you do
and continuing to spread the message of plant-based nutrition. It's so needed. It's so valuable.
And I appreciate all the effort you put in.

HOWARD: Aw. thank you, brothers. It's great to be on your team.

ROBBY: Yeah, that's exactly right. It's a team effort here.

HOWARD: All right. Well, thanks a lot. Good luck,
and I hope everybody goes and checks out the Mastering Diabetes Summit.

Download the transcript of this conversation here.

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