Vegan Diabetes Summit— Day 4, Part 1

Published 2.9.2017
This is the fifth in a series in which I am commenting on the Mastering Diabetes Online Summit, otherwise known as the Vegan Diabetes Summit. The two hosts, Cyrus Khambatta and Robby Barbaro, manage their type one diabetes (T1D) with a raw, high carb low fat diet, consisting of mostly fruit. Videos and audio recordings of the event expired today (Thursday, February 9th) at 9:00 PM Pacific time.

Please remember: I am not a nutritionist or medical professional. I am stating what these presenters claimed, mostly without any fact checking. When I know a statement is false, I say so. However, no endorsement is implied for statements presented without additional commentary or fact checking. I did not attend the final live session, and I'm going to write up the final day of testimonials.

These are not recaps, merely some notes and commentary I made while listening. There were five presentation on Day 4, and I listened to all of them. Thus I will be splitting Day 4 into two parts, just as I did Day 3.

Robert Ostfeld, MD

Dr Ostfeld's session is entitled, How to simultaneously reverse heart disease and diabetes. Spoiler alert: Eat only plants.
  • Begins by citing a study (a Neil Barnard study I think) showed that diabetes the risk of heart attack it the same as having known heart disease, though the diabetics had no known heart disease.
  • Diabetics tend to have higher blood pressure as well.
  • Says that a lot of patients have no idea about the whole food plant based diet (WFPBD), which creates an opportunity and a challenge. It’s a big (radical) change that not many will make, despite amazing results for those that do (This is for type two diabetes (T2D).
  • They show Forks over Knives in their hospital rooms. Yet when he started, the in patient meals still contained animal products. So they worked to create plant only meals. There’s one station that play the Fork over Knives on continuous loop. Plus they have the option to order plant based meals.
  • Says the film has impacted things a lot. Even in patients they don’t target will ask for the plant based meals after watching the movie.
  • Their outpatient program is larger than the inpatient. All patients get the WFPBD sales pitch.
  • Talks about Trimethylamine N-oxide (TMAO): Why is it so bad for diabetics? Higher TMAO levels are associated with higher death, higher cardiovascular disease (CVD) and higher rates of diabetes. Lots of evidence the PBD helps diabetics and CVD patients.
  • L-carnitine is what gut bugs work on to create TMAO it’s the substrate. L-carnitine is structurally similar to choline, which is in chicken, egg whites and fish and dairy. So when you eat those, the body makes TMAO.
  • Choline is essential nutrient, but it can be gotten from plants, but you also get all the phytonutrients that protect against the formation of TMAO. But here’s the thing.. what if you eat mostly plants… your gut biome would be closer to vegan, yes?
  • Neu5GC is naturally in the cells of true carnivores. They are not in human cells because we are not carnivores. True carnivores get much less cancer from eating animals. Maybe when humans eat Neu5GC we see it as foreign substance and the immune system reacts and it causes inflammation.
  • Heme iron and the body’s reaction might be part of the problem too as it creates inflammation.
  • If a T2D is on insulin, then they have to be careful, because switching to WFPBD might lower the fat in muscles, which means that as insulin sensitivity improves, then with additional insulin might push blood sugar too low— which is very dangerous. So in that case, T2Ds should not just decided to go vegan.
  • They also have to be careful with high potassium levels, which can be dangerous if the kidneys aren’t working well. It’s the exception, but this is why you have doctors. Also, if you’re on coumadin (a drug) then vitamin K levels can be dangerous. So again, just up and deciding to go vegan is not the right thing to do for everyone.
  • He encourages them to pay attention to the gum health. Promotes daily flossing. There is a association between gum disease and metabolic diseases, the connection seems to be inflammation.
  • When you have gum disease, blood vessel function can be worse. Was a study where they showed that just treating gum diseases improved blood vessel function.
  • How far do you have to go to towards being vegan see improvement? You don’t have to go vegan. Basically when a patient gets above 50% (anecdotal) is when you start to see benefits.
  • People in heart failure, he pushes harder to get them to 90% which is still not 100%. It’s a continuum. Here’s my question: What is 90% IS the apex?
  • And he mentions the necessity of vitamin B12 (which I realize is repetitive, but I'm just thrilled to hear vegans state definitively that it's mandatory!

Dean Ornish MD

In last year's Fat Summit, Ornish's presentation was one of my favorites. Hyman tried to challenge him on the merits, and Ornish knew the research completely, including studies with results that seemed to be in opposition to he teachings. Hyman's own understanding of the science was nowhere near as complete or deep. In this presentation, Ornish was facing much friendlier questioning, and frankly it was not as interesting.

  • Connection between diabetes and heart disease: the main complication to diabetes is heart disease.
  • His points are ones I've heard him present before.
  • He uses the clogged sink analogy for diabetes, and wants to turn off the faucet (particularly for T2D) but can it apply to T1D. Works better in T2, but it helps T1 too— because once you have an autoimmune disease, you need to do what you can to limit the damage.
  • Ornish does a high level (detail sparse) data dump, and Khambatta lets him do it. But I learned more when Hyman was challenged him.
  • RE: ketosis and ketogenic diets: Says that it’s always easier to believe what you want to believe. Atkins/keto/paleo are all the same. The problem is that there’s an element of truth. Avoid refined carbs is good, but the issue is what you replace them with.
  • Need to get past low carb vs low fat because it might be all about where do you get your protein.
  • Age didn’t matter in his studies.. it’s only about how much you change your life…
  • Can you have too low fat? Says that's hard to do if you’re getting enough calories.
  • Wrote a book The Spectrum.
  • Fear is not a sustainable emotion. Being lonely and unloved is worse than eating bad.
  • Lots of ways to numb and distract ourselves. It’s important to have people who love you.
  • How does all this change physiology? Back in the day, stress was mostly acute, now it’s chronic.
  • How you interact with stress is key, and having support makes a difference.
  • Chronic hostility his the worst emotion and causes the most heart disease.

Susan Levine MS RD

Title: Is feeding kids dairy abuse? I didn't expect to get through this one, given the title, but it turned out to be the webinar version of clickbait. She was a bit more reasonable that the title would suggest.

  • Going over some of the same ground on gestational diabetes. Dairy and meat are bad and increase risk.
  • Women just pitches veganism to are concerned about B12 and healthy fats.
  • Don’t need dairy for Ca. and Dairy is very high in sat fat. Most Americans sat fat is ingested as dairy, specifically cheese.
  • And we go through the heme iron vs non-heme iron issue again.
  • Heme iron is absorbed better than non-heme iron, and there is such a thing as too much iron. Some vegans wind up iron deficient though, especially if they only eat fruit.
  • Supplementing iron is dumb idea, but if you don’t eat beans and greens you might have to. And prenatal vitamins are packed with iron as it is.
  • Says if eating plants, you get the correct omega 3 to omega 6 ratio. If you eat too much 6, then the body can’t transform 3 to the forms it means.
  • Pregnancy isn’t the time to be messing around with omega fat ratios.
  • If diagnosed with gestational diabetes, can not cure it at this point. All you can do is try to control it with diet. Don’t look to reverse, you are managing it.
  • She thinks gestational looks like T1, even though really it’s like T2. Like T1 in that cure is not the goal, control is.
  • Morning sickness is your body saying avoid animal products? No. It’s not. Populations that don’t eat a lot of animal products don’t have morning sickness— is this true? Morning sickness is not affected by diet. It’s individual.
  • Vegan kids do better? Depends on if they supplement properly. (Not what she said) No mention of B12 yet. She says it’s safe, she’s using vegan and vegetarian are not the same and FINALLY she mentions B12 and that it MUST be supplemented on a vegan diet.
  • They discuss why people are resistant to push veganism. They refuse to discuss the need for supplementation. Sure, there is big money in the dairy and meat, but the bottom line is that a healthy diet should not leave you in need of supplementation, and veganism does. The refusal to deal straight up with this issue is ridiculous. Also, they are overstating the science on the benefits. It is not true that any amount of animal product is detrimental. Too much animal products can be unhealthy. They conflating not eating well with eating animal products and that is simply not the case.

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