How To Use Food To Transform Your Health, Reverse Type 2 Diabetes & Improve Your Mood with Dr David Unwin #611
Dr. David Unwin, an NHS GP, shares how he reversed his own Type 2 Diabetes and helped over 150 patients achieve drug-free remission using food and lifestyle. He discusses early signs of poor metabolic health like fatigue, belly fat, and brain fog, emphasizing reducing starchy carbohydrates.
Deep Dive Analysis
26 Topic Outline
Early Signs of Poor Metabolic Health
Dr. Unwin's Personal Health Transformation
Pivotal Influences: A Patient and His Wife
Normalizing Chronic Ill Health and Diet's Role
Empowering Patients with Type 2 Diabetes
Understanding Teaspoon of Sugar Equivalents
Informed Consent and Medical Ethics
Practical Low-Carb Eating and Keto-Flu
Ketogenic Diet: Addressing Misconceptions
Real-World Diabetes Remission Data
Cardiovascular and Kidney Health Improvements
How High Blood Sugar Damages the Body
Dr. Unwin's Past and Present Diet
Diverse Paths to Diabetes Remission
Physiology of Liver Fat and Insulin Resistance
Metabolic Health for Already Healthy Individuals
Challenges in Medical Practice: Guidelines and Curiosity
Gender and Age Differences in Low-Carb Outcomes
The Reality of Ultra-Processed Food Addiction
Avoiding 'Cheat Days' for Long-Term Success
Addressing the Root Cause of Metabolic Dysfunction
Family's Journey to a Low-Carb Lifestyle
Affordable Low-Carb Eating and Resources
Redesigning Healthcare for Prevention
Crucial Blood Tests for Early Metabolic Health
Final Advice and Resources for Listeners
8 Key Concepts
Metabolic Health Continuum
Metabolic health is not an on/off state but a spectrum, with type 2 diabetes being the end stage of years of metabolic dysfunction. Early symptoms like fatigue, belly fat, brain fog, and low mood are often signs of underlying insulin resistance.
Teaspoon of Sugar Equivalents
A method developed by Dr. Unwin to help patients understand the sugar load of commonly eaten foods by converting their glycemic load into an equivalent number of teaspoons of sugar. For example, 150g of boiled rice is approximately equivalent to 10 teaspoons of sugar.
Dual Fuel Engine (Human Body)
The human body is designed to burn either sugar (from carbohydrates) or fat for energy. A diet high in carbohydrates keeps insulin levels elevated, which prevents the body from efficiently burning its own stored fat.
Ketosis
A healthy metabolic state where the body, due to very low carbohydrate intake (typically under 50g/day), produces ketones from fat to use as its primary fuel source. This is distinct from ketoacidosis, a dangerous condition often associated with Type 1 diabetes.
Insulin Resistance
A condition where the body's cells become less responsive to insulin, forcing the pancreas to produce increasingly more insulin to maintain normal blood sugar levels. This can lead to chronically elevated insulin (hyperinsulinemia) and eventually progress to type 2 diabetes.
Hyperinsulinemia
Chronically high levels of insulin in the blood, often a precursor to type 2 diabetes. This elevated insulin is the body's attempt to overcome insulin resistance but can itself cause damage and promote further fat storage, particularly in the liver and pancreas.
Long Silent Scream from the Liver
A metaphor describing the 10 years or more during which excess sugar from a high-carbohydrate diet is converted into fat and stored in the liver. This accumulation of liver fat is a primary driver of insulin resistance and the progression towards type 2 diabetes.
Ultra-Processed Food Addiction
A condition where individuals continue to consume ultra-processed foods despite knowing they harm their health, often experiencing intense cravings and an inability to stop. Research indicates this affects a significant portion of the population and is strongly linked to type 2 diabetes risk.
10 Questions Answered
Early signs often include tiredness (especially after meals), increased belly size (waist circumference more than half your height), brain fog, low mood, and elevated blood tests like fatty liver or high triglycerides.
Yes, type 2 diabetes can be put into drug-free remission, even after years of medication, through significant lifestyle changes, particularly dietary interventions like a low-carbohydrate approach.
By reducing carbohydrate intake, blood sugar levels decrease, which in turn lowers insulin levels. Lower insulin allows the body to burn stored fat, including fat in the liver and pancreas, which are key contributors to insulin resistance and type 2 diabetes.
For individuals with insulin resistance or type 2 diabetes, these starchy or sugary carbohydrates can significantly raise blood sugar, as they break down into sugar in the body. Dr. Unwin uses 'teaspoon of sugar equivalents' to illustrate this impact.
Ketosis is a healthy metabolic state where the body burns fat for fuel, producing ketones, often achieved through a very low-carb diet. Ketoacidosis is a dangerous, severe medical condition, typically seen in Type 1 diabetes, where the body produces dangerously high levels of ketones due to a lack of insulin.
Dr. Unwin's practice data shows that patients on a low-carb diet experienced improvements in every single marker of cardiovascular risk (cholesterol, HDL, triglycerides, blood pressure) and also improved kidney function.
Yes, Dr. Unwin and his wife believe ultra-processed food addiction is real, characterized by intelligent people consuming foods they know harm their health and experiencing cravings. Research suggests a significant portion of the population, especially those with type 2 diabetes, may be food addicts.
While some ingredients might seem pricier, patients often find that by honestly accounting for money spent on junk food (crisps, fizzy drinks, pizzas, snacks), the overall budget for a low-carb diet can be comparable. Utilizing resources like frozen produce, cheaper protein sources (mince, chicken thighs), and free apps with budget recipes can help.
Fasting insulin is highlighted as a transformative test that could identify insulin resistance years before type 2 diabetes is diagnosed, allowing for earlier intervention. However, it is not routinely available in the NHS.
Suggestions include taxing ultra-processed foods and subsidizing locally produced whole foods, implementing planning restrictions on fast-food outlets, and providing longer, paid consultations (e.g., 30 minutes) for doctors to discuss the pros and cons of lifelong medications with patients.
19 Actionable Insights
1. Consult Doctor on Medication
If you are currently on medication for diabetes or other conditions, consult your doctor before making massive changes to your diet, especially dramatically cutting carbohydrates, as medication doses may need adjustment to prevent adverse effects like hypoglycemia.
2. Reduce Starchy Carbs for Health
If you have metabolic dysregulation, type 2 diabetes, or pre-diabetes, reducing starchy carbohydrates (like bread, rice, potatoes, pasta) can dramatically improve blood sugar control and potentially lead to drug-free remission, as these foods break down into sugar.
3. Identify Blood Sugar Spiking Foods
Pay close attention to what you eat and how it affects your blood sugar. Identify specific foods that cause your blood sugar to spike and make a conscious effort to eat something else instead.
4. Check Your Belly Size
Measure your belly size as an early indicator of metabolic health. If your belly circumference is more than half your height, it may signal a problem with insulin resistance.
5. Recognize Metabolic Health Signs
Be aware of symptoms like tiredness (especially after meals), increased belly fat, brain fog, unexplained sleepiness, low mood, frettiness, circular thinking, fatty liver, or high triglycerides, as these can be early indicators of insulin resistance.
6. Prioritize Protein, Veg, Healthy Fats
Base your meals on protein sources like fish, chicken, eggs, or red meat. Add loads of green vegetables and healthy fats such as butter, olive oil, or full-fat mayonnaise to create a nutrient-dense diet.
7. Understand Food Sugar Equivalents
Be aware that many commonly eaten foods, even those perceived as healthy, have high sugar equivalents (e.g., 150g boiled rice ≈ 10 tsp sugar, a large baked potato ≈ 9 tsp sugar, a banana ≈ 5-6 tsp sugar). This knowledge helps in making informed dietary choices.
8. Explore Ketogenic Diet
For those with metabolic issues, adopting a ketogenic diet (under 50 grams of carbohydrates per day) can help lower insulin levels, enabling the body to burn fat for fuel, which can lead to significant health improvements.
9. Prepare for Keto Flu
When transitioning to a low-carb diet, be prepared for a temporary period of feeling unwell, sometimes called ‘keto flu,’ which can last up to a week as your liver’s enzyme balance adjusts to burning fat instead of sugar.
10. Identify Food Addiction
Reflect on your relationship with food; if you find yourself doing things you know harm your health (e.g., secret eating, intense cravings, inability to stop certain foods despite negative consequences), you may be experiencing food addiction.
11. Avoid ‘Cheat Days’ if Addicted
If you identify with food addiction, avoid ‘cheat days’ or occasional indulgences, as even a small amount of a trigger food can lead to intense cravings, rebound anxiety, depression, and a loss of control over your eating habits.
12. Consider Intermittent Fasting
Once your body becomes a ‘fat burner’ (e.g., through a low-carb diet), you may find you are less hungry and can comfortably eat less frequently, such as skipping breakfast and eating only once or twice a day.
13. Exercise in Fasted State
If your body is trained to burn fat, you can often exercise in a fasted state (e.g., running in the morning before eating) without needing to consume food beforehand, as your body will efficiently use stored fat for energy.
14. Use Continuous Glucose Monitor
If accessible, consider using a continuous glucose monitor (CGM) to gain real-time insights into how different foods and activities affect your blood sugar levels, empowering you to make personalized dietary adjustments.
15. Vegan/Plant-Based Low-Carb
If you prefer a plant-based or vegan diet, it is possible to follow a low-carb approach by being clever with food choices and finding suitable recipes, such as those available on resources like D-Life India.
16. Low-Carb on a Budget
To manage costs, be honest about current spending on junk food, which often equals the cost of healthier options. Utilize resources like the free Freshwell app for budget-friendly low-carb recipes and meal planning, and choose cheaper options like frozen fish or mince.
17. Learn Low-Carb Cooking
Invest time in learning how to cook delicious low-carb meals using alternative ingredients like almond flour or gram flour for baking and pancakes, ensuring you don’t feel deprived and can enjoy a varied diet.
18. Cultivate Health Curiosity
Cultivate curiosity about your own health and what works for you. If you observe improvements or unexpected wellness, explore the reasons behind them to further personalize and optimize your health strategies.
19. Avoid ‘Perpetual Autumn’ Eating
Recognize that the modern food environment, with constant access to high-carbohydrate foods, mimics a ‘perpetual autumn,’ leading to continuous fat storage without the natural periods of scarcity our ancestors experienced.
8 Key Quotes
If only you had told me that it wasn't just sugar I should be avoiding, but the starchy carbohydrates that break down into sugar, I could have had better health years ago.
Patient to Dr. Unwin
I'm 67 now, and I run regularly, which would have been impossible when I was a younger man... I can out-sprint my grandchildren.
Dr. David Unwin
What we've got is we have a changed environment in the world which I believe a lot of it is dietary but there's other things as well acting on possible genetic triggers. But those triggers don't have to go off.
Dr. David Unwin
It's a progressive, chronic, irreversible condition, which is just not true.
Dr. David Unwin
If you have a spike of blood sugar, you damage the non-stick lining of your arteries, the glycocalyx is damaged within six hours.
Dr. David Unwin
Your body will do whatever it can to keep your blood sugar in a very tightly controlled range because it's dangerous.
Dr. Rangan Chatterjee
I think we're confusing guidelines with they are not rules that must be obeyed, they're not tram lines, they're guidelines.
Dr. David Unwin
You continue to take something that you know is harming your health and that if you don't have it you get cravings, yeah it's the very basis of addiction.
Dr. David Unwin
2 Protocols
Dr. Unwin's Approach for Newly Diagnosed Type 2 Diabetes Patients
Dr. David Unwin- Explain the blood test results (e.g., high hemoglobin A1c) and that insulin is not working properly.
- Present two alternatives: lifelong medication or lifestyle change, emphasizing patient choice for a collaborative approach.
- If lifestyle change is chosen, educate on foods that significantly raise blood sugar.
- Encourage patients to identify specific foods spiking their blood glucose (e.g., using a continuous glucose monitor if available).
- Recommend a nutrient-dense diet: increase protein, avoid carbohydrates, and include healthy fats (butter, full-fat dairy) and plenty of green vegetables.
- Teach about 'teaspoon of sugar equivalents' for common foods to aid understanding of carbohydrate impact.
- Monitor progress and adjust as needed, noting that many will experience less hunger and significant health improvements.
Family Transition to Low-Carb (Dr. Unwin's Family)
Dr. David Unwin- Parents (Dr. Unwin and wife) adopted low-carb first, initially causing friction with teenagers.
- Compromise by initially designating a 'carbohydrate corner' for kids' preferred foods.
- Shifted to making protein and green vegetables mandatory for everyone, with optional carbs (like rice or oven chips) that teenagers had to prepare themselves.
- Wife (Jen) focused on creating delicious low-carb alternatives for treats like birthday cakes (almond flour), pancakes (gram flour), and ice cream (blended cream with frozen raspberries).
- Leveraged children's vanity and competitive spirit (boys wanting to be 'hench,' daughter wanting clear skin, sons trying to outrun dad) as motivation for them to adopt the diet.