This transcript is brought to you thanks to the hard work of Dawn Michelle.

Welcome Jennifer to the Keto Woman podcast. How are you doing today?

Oh my God, I’m so excited. Just happy to be here. I love talking with you and I’m thrilled to be a guest.

And we’ve actually met a few times in person, so it’s nice to see you again.

It’s great to see you. I just wish I could give you a big hug.

Yes, we like hugs. Well it won’t be long. Because we will both be at Ketofest, won’t we?

Yay! I’m so excited about that, too.

Yeah, I know, me too. I suppose it is a ways away, it must be about six weeks away. But I know it’s going to come around really quickly.

I’d say seven, not that I’m watching the clock, but much to do, lots to prepare.

And exciting for me to be in America again. It’s become a bit of a regular thing for me these days. Having not been to America at all until last year, was the first time I’d ever set foot stateside. Yes. Becoming a bit regular now.

Your first Ketofest last year?

Yes. That was my first trip to the US of A.

Oh wow. Well, I’m very happy that it was a good experience. And, I was so psyched to meet you last year and then to be on your show this year. Oh my God. Yay.

We’ve been talking about it for a while, haven’t we? So, it’s nice to finally have you here sharing the web waves with me.

It’s been quite a year, actually, almost a full year since then. Thinking about everything that’s happened in my life and, just the world in general. It’s been crazy times.

Lots of changes. A lot has gone on in this year. So, on that subject, tell me a bit about you.

I am 48, I have two partners and I’ve started a low carb candy company, which, I founded actually after Ketofest last year. I was passing out some samples of my partner’s candy. He makes candied citrus peels and orange rinds and ginger and stuff. And I was passing out samples, last year to see what people thought. And everybody’s like, oh, that’s really good. So, I started a candy company and also of course I’ve been Keto for quite some time, about four and a half years now. I was a type two diabetic back in 2014. I got my diagnosis and it was really bad. I had a 12.1 A1c and started to have kidney disease. My eyes were messed up, you know, all the complications. I spent like a year trying to find, just trying different things, drugs, trying to eat a little better, but, you know, I didn’t know. Finally, I had a big wake-up call that it wasn’t working, I hit the Internet real hard found Keto and, saved my life.

How did you find Keto? Literally a Google search with your symptoms? How did you come across it?

Oh, actually, I went on Reddit. I was a Redditor and the diabetes sub-Reddit there is not entirely friendly to Keto and they’re mainly type one diabetes oriented. And they’re not strictly about Keto. But from there, some people are like, you should try Keto. And then the Keto sub-Reddit was all like, this is going to do it. You’ve got to do it. And they were right. In fact, I almost died. So I was very hesitant and fearful about trying Keto because the fear that you read on the Internet, so I went to my doctor at the time and I said, well you want me to keep increasing my dosage of these different medications? Do you want me to go on Lipitor? You have me taking Amerol and Glipizide and you say diabetes is a progressive disease on, I don’t want to see it progress anymore.

So I was thinking about trying this Keto diet. “Well, some people say it works, some people say it doesn’t. I don’t know. Yeah, if you try it, that’s all right.” So, he didn’t push it. He didn’t say it was good. He didn’t say it was bad. And so, I went, and I tried it and I was on all those medications. What do you think happened? Well, the first day that I cut out all the carbs and then the next morning I took the standard dosages of all those medications almost passed out. I think I did pass out briefly and when I could get to a blood sugar meter, it read 24. I had chills and I had to crawl, and I finally got to the phone and I talked to the doctor’s office and they’re like, oh yeah, that can be a complication. Just keep some candy on you. And you know, if you start to feel queasy like that just eat candy, it’s a problem with the Keto diet. Okay. I don’t think that’s the problem. I think the problem is with the medication. Well, if you want to cut back, you could go back to like maybe, you know, a half dose and see how that goes. Like how about a zero dose? So, I fired that doctor.

I mean, it’s crazy, isn’t it? That’s why people really need to get their doctor on-board. And the doctors need to be on-board in the first place or at least open to it because this is a great illustration of what can happen if you are on medication. You know, it actually shows just how effective this change of diet is that the medication ends up then having that such a dramatic response that it sends your blood sugar through the floor, you know, that’s actually a good validation of Keto, isn’t it? However, it could lead to potentially deadly consequences. So that’s why it’s so important to be able to work with your doctor. But to be able to do that, they have to have at least some kind of understanding, which you know, it sounded like originally when you spoke to your doctor that they did because they said they knew about it. They said Keto can help. It helps for some; it doesn’t help for others. So, I think you would be justified in thinking that they were okay with it and would have given you the guidance that you might need. If you had needed to be aware that this might be a problem when you started, that the medication was going to bring your blood sugar right down, it’d be something that you could have looked out for and managed and all the rest of it. Crazy.

I thought I was doing all the right things, consult your doctor, you know. And I did. And, it turned out that he wasn’t helpful at all, but I didn’t know that, he sounded helpful. I feel like a lot of people accept their doctors as authorities. They just do whatever the doctor says. They trust them and they don’t question, and that’s how I used to be. That ripped the scales from my eyes. And I found a doctor who views himself as my partner, and my health coach. He is an MD, but when he says something, he expects, and I do go research it and then decide for myself, if that makes sense. And take action on it or propose an alternate course of action, which I’ve done. And then he’ll research, and he’ll say whether he thinks that makes sense. So I’m not saying I have an MD or I’m an expert in stuff, but I’m an expert in my own health.

And I think that’s how it should be. And I think that’s more and more. That’s what seems to come back from pretty well everyone I speak to is this sense of empowerment and confidence that Keto low carb gives them, they get this understanding of how their body works because even if they just read the most basic of the science that goes with it, it all starts to make sense how their body’s working and they get it and they start to understand why they had the problems they had and how easy it can be to fix it or at least help whatever the issues are that they have. And that gives you a real sense of confidence to be able to then go to your doctor and let you say you’re not speaking to them as an equal. You’re not saying you have the qualifications they do, but you’re speaking to them on that kind of level where you’re the expert of you and you’re an intelligent person and you’re willing to put in the work. And when you do find the right person, and my doctor’s very similar, you get that kind of relationship where you work together. Rather than they’re just, like you said before, they’re just this authority figure that expects you to just do whatever they say.

The high priest of medicine, you walk in and it gives you three hail Mary’s and sends you home with a prescription for Ritalin or whatever. My current doctor, I love him and he’s a good guy and he loves me, you know, not in any sort of inappropriate way. But anyway, I’ll talk with him about Keto and diabetes and continuous glucose monitors and fasting all these health practices that have changed my life. And, he promotes them to his other patients, but he says that I am one of the few patients that actually does it and he feels like I’ve talked to him about how angry I am at the medical establishment for not effectively communicating to people that these practices are not just some sort of woowoo alternative with no health implications, but these are very powerful and that I feel like I might have wasted or suffered for years of my life that I didn’t have to because I didn’t know. And he said that as much as he has preached these practices to his other patients, very few of them actually adopt it.

Right. Interesting.

So, it’s kind of wasted time and then most of them are just there for a pill anyway.

Yes. That’s always going to be the problem, isn’t it? That, not everyone, I think you kind of have to be that certain kind of person, and it’s the kind of person that we tend to find in the Keto community, is that they’re sort of slightly rebellious, prepared to push back, interested in the science, interested in doing their own research, not bothered about going out there alone if needs be. Putting themselves first and leading the way.

Another problem here in the US is the way that medical billing is done. My doctor does not get paid for time he spends giving nutritional coaching. The insurance company will reimburse him for diagnostic codes, for prescribing, for performing procedures. And for a visit, he gets five minutes reimbursement and if he spends longer than that, he’s not getting paid by the insurance company, you know? He has to support the whole office with all the people that do the medical billing and the paperwork managing and appointments and stuff like that. So, if he’s wasting time talking to patients who aren’t going to actually take his advice, that hurts his whole practice.

Yes. Exactly. I remember Shawn Baker talking about the problem that he had with the hospital that he worked for and that was the same problem. He was wanting to give some nutritional advice and coaching and setting up weekly sort of drop in center type advice to give to patients who were coming in for these operations. The goal was for them not to have the operation in the first place. And, of course the hospital, the finance department freaked out at this and that’s where everything started to go wrong for a time. It’s sad isn’t it? That money basically is coming before health. And I know you talk about that the system in America and it’s different in the UK. But the frustration, I think a lot of us feel is that this way of eating could potentially save the health system. It can certainly save the NHS, which, you know, probably the biggest amount of money that flows out is to deal with type two diabetes or the associated problems that come with that. You start reversing all that, you suddenly freed up all this money to do all these other things. I mean, it just seems so obvious yet. Nope.

Completely obvious. And I’m living it and I’m trying to be an example and not horribly preachy to all my friends and family, but to inspire. It kills me that their doctors are not advocating for this. My whole family has obesity genes and diabetes genes and you can see it in action. Unfortunately, with my older relatives who are, you know, not all of them have diabetes, but a lot of them. And a lot of them are taking the approach that they can eat whatever they want and then just inject insulin to cover for it. Or, take a handful of pills, good to go, right? And they have more pills and more complications. We know how that goes, but the doctor isn’t pushing them. So, I don’t know if their doctor did push them. But they all say to me, “Oh, Jennifer, I admire what you’re doing. It’s inspirational. I wish I could do that.” Like you could, you could do that. You know, you say that, but you could.

It does seem nuts doesn’t it when you’ve got, so on one hand, you have this disease that’s progressive and there’s this path that you can take with it. On the other hand, and the choice is yours, there’s this different diet and lifestyle that you could adopt that could reverse your condition. It’s your choice. Which one are you going to take? This one involves medication, eat what you like, but it’s going to be progressive, which means it’s gonna keep getting worse. You’re going to have to keep taking more medication, and so on and so forth. Or, it’s going to be a bit more work. It’s going to be difficult to adjust to, but we can reverse it. Which one? It seems amazing that people still choose the progressive option.

It’s incredible. And then when they talk about, the things that they would have to give up, I’m like, but I know there are Keto options that would do that thing for you. You know, you have pasta. Awesome. Let me introduce you to zoodles or shirataki or these oat fiber konjac noodles that I love? Or instead of using pasta, imagine you had your sauce and sausage on a bed of Broccoli. Yum. Right? Okay. The rice, try cauliflower rice. There’s candy. I got a candy company. You don’t have to miss candy. And they’re like, well, maybe if I had your partner Will to cook for me. And I have to admit, having my partner Will to cook for me is pretty awesome. But now there’s so many companies out there providing even pre-packaged cauliflower pizza in the frozen pizza section or whatnot. You know, you don’t have to cook it all from scratch. Although I don’t think it’s that hard, I don’t do all my cooking either, so I might be kind of privileged there.

I do think it’s something that it’s a skill that is useful to have, but only basic cooking skills. Keeping it simple I think is the mainstay for everybody. Even people like me who like cooking and experimenting for the most part, I keep it simple because it’s just easier that way.

Any dinner that’s steak and a salad, is a good dinner for me.

Exactly. What’s not to like? Let’s go back a bit. I’d be interested to find out what led you to that place where you had your wakeup call with the 12.1 A1c? How did you get there? You’ve already mentioned that there’s genetic history there.

If you saw a picture of my family, you would see me, my brother, my mom, my dad, everybody. We all have the same build, what we call in Yiddish, zaftig. Do you know what that is? Puffy, to say the least. I believe that our genetic heritage, you know, is we’re perfectly well suited to living in the ghettos and surviving on nothing but cabbage and, and maybe, a Borscht for months at a time. I think we’re all very well adapted to a fasting for instance, but we’re not well adapted to living in plenty. So all of us, I wouldn’t say that we struggle with our weight because that would imply that we struggle. And for most of my life I was perfectly happy being a rotund Rubenesque. I was jolly and around 200-220 pounds. I don’t know what that is and your weird kilogram units, but larger than is healthy for me. And I was fine with that as long as I was healthy. I would go to the doctor and have my lipids and he’d say you should lose weight. But it wasn’t like I had any problems, so I ignored him. I like food.

But then I did start to have some problems with my vision where my vision was not a sharp is it should’ve been. And I went in for a checkup and he’s like, oh yeah, so your blood sugar is 320. I’m like, is that bad? And he’s like, yeah, you have diabetes. I’m like, are you sure? He’s like, I’m sure. You don’t need to retest? No, I don’t need to retest. So that began the year of trying to treat diabetes with drugs. And then just kept adding on and on and on. And then there was this one day where I had this series of unfortunate events. I was at an amusement park with my family. And there all of us were, the Kleiman genes all on parade. They had a new roller coaster. And I don’t know if you’ve been to an amusement park here where they have the safety harnesses and the fancy rides and the cages and restraints and stuff, but you have to be of a certain body size in order to fit within these safety harnesses.

That’s right, you have to, I can always remember, I’m not a fan of most of these rides that I can remember that from as a child with things I wanted to go on this, and minimum height requirement isn’t there? But then there’s also a maximum size, I guess.

Well, the newer rides because they are pushing the limits and so they have like special elaborate harnesses with different straps and cushioning and stuff. So, they actually have a test seat that you can try on to see if you will fit before you spend an hour waiting in line to go on the ride. And so, we walk up to the newest ride and it has, you know, your test seat. My dad looks at it and he doesn’t even try. My mom, no. My brother tries it and he just barely makes it. I try it and I just barely make it. So, we wait an hour to get on the ride and I get up there and it took three of the park attendants to force the harness closed over me and squish my fat into place. And that was so humiliating, and I could just see them kinda staring at me in contempt. I mean I’m probably imagining some of it, but I don’t think all of it. And you know, the other people on the ride, you know, they had to wait for these people to, to shove the harness in place over my guts. Well that was all pretty terrible and I don’t think I enjoyed the ride either.

Well, you’re not very likely to after that style, to be honest. It’s not going to happen.

No, not at all. Oh, there it was terrible. And then afterwards I had heard that my aunt who suffers from diabetes had an incident that morning where she lives alone, and she had fallen, and she was also very obese at the time. She couldn’t get up and she had to call the paramedics to come and it took a squad of six young men to get her to her feet. And I’m like, wow, so this is my genetics, this is my future. If I don’t do something, I’m going to be living alone and calling 911 to help me get to my feet until I die an early death of complications of various diseases. So, I had to do something. And wow, I’m so lucky I found Keto because, you know, one of the things we’ve talked about now is that people need not to be their own doctor, but at least be responsible for their own health. But it’s so hard because saying I reject the authority of the doctor. That’s a great first step. But then there are so many charlatans and so many different alternative health paths. And not to say that all of them are bad or all of them are good, but to be able to judge which is the right path now that you’re taking responsibility, now that I was taking responsibility for myself.

It is not an easy thing to say, this is real, this works. And this is a bunch of, woo-woo, it has marketing cache, and so it’s popular because it has an emotional appeal or whatever, but it doesn’t actually help. So, I, have a lot of scientific training. I was studying to be a PhD in mathematics and math education. And so, I had some training in reading research papers and evaluating both qualitative and quantitative research. I was able to find a lot of research backing the Keto diet, which helped me, but I can’t imagine that the average person trying to decide what’s the right health practice for them. They don’t have those resources. They’re probably just asking their friends, are going on the Internet and Googling and finding all kinds of other answers, which may or may not actually help. So, it’s difficult.

It’s tricky isn’t it? Because on one hand, especially with the recent dramatic rise in popularity of Keto, there is so much out there on the Internet and it’s all completely free. That’s one of the things I like about Keto is that it is accessible to everyone for free. You know, I mean, it hasn’t cost me anything to learn how to eat this way and I know it can do. And I know there are multiple businesses building up around it now and around the popularity of it. Businesses like yours that we’re going to talk about in a minute that are selling products to eat. There are coaching programs like the one I endorse, Kim Howerton and Carrie Brown’s program, which is fantastic. And there are all these things that you can pay money to learn about Keto if you want to, but you can also access it all for free. And that’s what I like about it is universally accessible for absolutely anyone completely for free. But there’s also the other side of that there is so much information out there, it can be really confusing to figure out which is the best path for you.

You know, Daisy, I think we kind of live in a very happy bubble actually because I think I’ve met people who have approached Keto from a less informed and less free, point of view. But where they got introduced to Keto through, for instance, Pruvit marketers or through their chiropractor who has a bunch of products, various powders and MCT oils and exogenous ketones. From that approach, it’s not a free diet, but to this approach, it’s more of a sort of a magical process of taking different potions that will make you better. And you know, the marketing hype around these things is intense.

Yes, that’s a very good point actually. And I kind of had completely forgotten about that because it’s, it’s so much something that I stay away from. I forget what a big industry it is, and of course it really does appeal to those people, that group of people that you were talking about before where your doctor was saying, he wished all his patients who Keto would have worked for, would adopt it. But it is those kinds of people who like to take a pill that are already susceptible to the exogenous ketone marketers.

One extreme or the other. You get the pill from your doctor. The people that will not venture out from their doctor’s protection and they are just going to take the pill and they don’t want to consider anything else because the doctor hasn’t said to do it. And then there’s the people who have thrown the shackles of the doctor off. But they are not scientific in their approach. So the first, and the most bloviated marketing claims out there, they’re like, well, this stuff, this is amazing, and it says, and it has these endorsements by these beautiful looking people, and, it costs a lot of money, so it’s gotta be good. Those people, you know, it’s hard to kind of separate out the facts from the fiction when you have to start evaluating these health claims that they’ve been caught in. I went to the Nourished Festival for gluten-free products, which our candy is gluten-free. And while I was there, there were several other, Keto people at this conference, including the Pruvit booth, and the Pruvit marketers. They were very enthusiastic about their product and they sounded very sincere about it. And, I hope that if they are listening that they’re not going to be offended, but their product is just completely unnecessary unless you happen to be a high-performance athlete. I don’t know. I don’t think so. I mean, obviously most high-performance athletes don’t take exaggerates ketones. So, I don’t think it’s a necessary product even for them, but certainly not for people who are just trying to lose weight.

Well, in actual fact, it goes the other way. That can actually be counterproductive if you’re trying to lose weight.

Oh, I was talking with someone actually literally yesterday about this. She said she was doing a little fast because she wanted to get her body back in a higher state of operation and she was measuring her ketones and she was 36 hours into the fast. So, she said, I took some exotic as ketones to really boost my ketones and really get deeper into the fast. I’m like, okay, you just actually completely tanked your fast because your body was producing the ketones and that means your body was taking its stored fat reserves and converting it to energy, and now you just took a whole shot of extra energy. And so, your body’s like, wow, well I got extra energy, I don’t need to produce any more ketones.

It’s actually, you just fed me, thanks, fast over.

She’s like, oh, actually that makes a ton of sense. But the Pruvit people aren’t going to say that. Sorry, Pruvit people. All right now they hate me. That’s just the mechanics of it. And you know, I understand the average consumer is not going to get deep into the science and so they’re just going to believe marketing claims.

That’s right. And it is, when you look at the science behind it and you start. I have a very logical brain and I have to understand how something works before I can buy into it. And when you start picking these claims apart is when you start realizing there’s something dodgy going on. And it’s not to say that there aren’t potential really useful applications for exogenous ketones. I’ve recommended them to my uncle, for example, who has early onset Alzheimer’s, perfect candidate for exogenous ketones in my opinion. And there are others. But if weight loss is your goal, stay away from them. Save your money, spend it on steak and bacon.

The interesting thing about the marketing and health auras and taking an emotional approach to health. I think it is the intuitive way that most of us operate and some of us are more rational. I’m not saying rational is better, but because rational can get trapped too. We can make things over-complicated and we can get stuck trying to evaluate different courses of action and fail to take any action. Sometimes we have to rely on our feelings. But often our feelings will lead us to the flashy over marketed solutions that seem emotionally appealing but are not the right ones.

Difficult balance to try and figure out. Tell me about, you obviously adopted this way of eating and for some people and I’m not sure how I would cope in that situation. I live on my own so I can do what I want in my house and have what foods I like in the house and all the rest of it. I’m not sure if I could cope if I lived with someone who was a carb eater. I’m not sure how I’d deal with that. I know people find a way, but you are quite lucky, I think. You managed to get your team on-board and they found their own benefits from it. Is that right?

Well, not right away. My partner Will, did start cooking Keto for me right away because he was very supportive and is very supportive. But my partner Gloria, she, while being emotionally supportive, she loved her carbs and it was actually a big sacrifice for Will. He was cooking Keto for me, but he was still having carbs himself. And he was going through a phase at the time where he was perfecting his artisan bread skills. And let me tell you, I think he caused my diabetes. I’m sorry, Will. Will, you, there? You caused my diabetes. He just would pull this perfectly amazing loaf of sourdough out of the oven and offer me a hot slice of this crusty, amazing smelling bread with butter. Oh, just thinking about it. I mean, there is no Keto equivalent, unfortunately.

That’s impossible to resist, isn’t it? I do understand that. That’s where I was saying, if I had that in front of me, I’m not sure how I’d cope.

And oh, he’s making these pretzels and bagels and he was just really getting into it. Fortunately, he stopped making those and he would still make fried potatoes or whatnot for him and Gloria. But I could resist those, under the threat of looming death. Death is a great motivator and, avoiding death. Once it became apparent to me that eating carbs and paying attention to my blood sugar, it was very apparent. You know, even the supposedly to heart-healthy oatmeal that my first doctor had advocated would spike my blood sugar and there it would be up the 200-300 range again.

It’s a very good way actually, isn’t it? Bringing things like that home. It’s one of the reasons why I say that it is useful to get a meter just to do that, to test different foods cause I’ve done the same thing. I had the exact same result with oatmeal. I used to love the steel cut oats. You know, these are super healthy, and I used to eat all the time. I can remember having a conversation with my sister who also used to like having oatmeal for breakfast and she used to say, the thing is, you know you have this thing that’s supposed to be really good for you and is supposed to be really filling, but I just tend to feel sleepy and I’m really hungry mid-morning after having it. Of course, now we know exactly why that is, it’s because of the massive spike and then slumping in blood sugar.

I’ve been surprised by a number of foods, and butternut squash. I made some soup with it and as soon as I tasted it, it tasted so sweet. So, I thought, right, I’m going to test my blood sugar response to this. And it went even higher than oatmeal. So that’s where it’s just really worth testing different things, especially if they are your favorite things. And then you have this black and white data in front of you. You can’t argue with that. You can’t argue and potentially play down how you felt, which is really easy to do when it’s balanced with something that you’re really craving. You can really play down those other things. But when you’ve got that data, black and white in front of you, that’s shown you exactly what’s happened to your blood sugar and you combine that with how you feel and then it makes it a little bit easier to balance those scales in the right direction I think.

Absolutely, having that feedback loop is the only way I think that people learn to change their behavior. You know, just somebody telling you, oh, you shouldn’t do that. Well, okay, yeah, probably they’re right. But, being able to experiment and do something and see the results of that, is so powerful. So, I’ve been wearing a continuous glucose monitor (CGM).

I would love to try out those.

For about a year and a half now, ever since they became available for type two diabetics. Not that I take any drugs or anything. So, my doctor’s like, well, you know, if you want it, I’ll prescribe it for ya. Cause he’s my health partner. But he’s like, I don’t know why you need it. You know, it’s not going to tell you any information. Like you need drugs, cause you don’t. I’m like, it’s going to tell me stuff. And it really has. It’s fascinating to see how different foods react. And even though I’ve pretty much cured my insulin resistance at this point, and I have experimented by having a carb meal or a piece of chocolate made with real sugar. I can see it spike and then I can see it go down again. And that makes me so happy to see because wow, you know, back when I was still fighting the insulin resistance, I would go up and it would stay up.

That’s the problem, isn’t it? Has anything surprised you? So, you’ve obviously had this data for a long period of time. Have there been things in there that you would never have expected to either spike it high or maybe drop it low, and not even necessarily food? I know some people react to things like coffee. Or have you seen maybe things like stress or sleep impacting it? I mean that’s where it must be so fascinating. Just having that continuous, being able to monitor it all the time. You can see the results of so many different things.

It’s really has provided a level of insight into my metabolism that I had zero insight, or a very tiny insight into before. One thing that I can say that is hugely important to understand is that when you’re using a little blood glucose meter where you do the finger prick, you are getting one readout, one tiny piece of information. And compare it to a continuous glucose monitor. It’s like you’re looking into a room, a dark room, completely dark room and you flick the light switch for a second compared to just turning the light on.

Yeah. So much you can miss.

Huge. So, when people say like, Oh, I’m going to test my reaction to coffee. I’m going to take a read out before and a read out after. My experience with the continuous glucose monitor, it tells me that a hundred percent, those two readings are basically meaningless because there’s a natural fluctuation. There’s other stuff going on depending on the time of day, your circadian rhythm, heat, stress, sleep, other foods you might’ve eaten in the past 12 or even 36 hours. And just your general state of health too. So, depending on your body’s general state. Like I can see where my body is in a general, like kind of unstressed, very relaxed, healthy state for a couple of weeks at a time. And then I can see my baseline blood glucose is in the 80s. But then I can absolutely see where maybe my sleep isn’t as good because I’ve been traveling, or work stress is going on. And then my baseline glucose is going to be 90s or even up around 100. And my reaction to foods is different. No, somebody can’t just do like, I’m going to see how I react to coffee and take two readings. That’s not going to tell you anything. Or people say, I tested my reaction to this sweetener allulose and I did this thing and I took two readings and now I know it spiked me 15 points. That’s just noise. For one thing, those little, readers have a variation of 10 to 15 points anyway. Even if you took two readings in quick succession using the same finger, even the same drop of blood, you get variation and then to think that you’re going to learn something.

Yeah, you can still learn something. I mean, I know whenever I test foods, I do the baseline before I start and then I’ll do three afterwards. I tend to do one at 30 minutes, one at 60 and one at 90 or two hours, I think I do. It’s going to tell you something. It’s going to show you that general trajectory. But, but yes, what I’m fascinated about is to see all those nuances and particularly the impact of things like stress and sleep because everyone always looks directly at the food. It’s a common thing, isn’t it? When people are stalled, when they’re having problems with losing weight and it’s always about the food and they can be saying things like, I’m doing everything right and I don’t understand why am I not losing weight or why have I gained weight this week? And, and it’s only when you look at all the other things that really can have a dramatic effect. So it’s interesting that you say that you have seen that, you have seen the impact that it has on your blood sugar so that we can then infer from that that it’s going to have an impact on say, weight loss, if that was what you were tracking from something like stress or lack of sleep.

I think so. I think it’s the causal chain based on all the science that I understand is you’ll have generally raised cortisol levels and that increases your insulin resistance and your general insulin levels, which will lock the fat within your fat cells so you’ll feel less energetic overall and not burn as much energy and have less access to your fat stores and, you know, the whole cascade. So, I think it is clear that stress and lack of sleep has a huge impact.

So is there anything that surprised you during the time you’ve been monitoring? Is there anything that you wouldn’t have expected to impact the way it has that you’ve seen pop up on those charts?

One thing I would say is that if you are exposed to heat at all, don’t take blood sugar readings and expect to get something meaningful, Because if you get in a hot bath or a sauna or something like that, your blood sugar is going to shoot up like 50-60 points. I think it’s universal. I’ve read that, everyone has this response, but nobody knows about it. So, you go sunbathing or something like that, your body gets hot, it’s gonna release blood glucose, and then once you get cool again drops right back. But to see the magnitude of these swings, you wouldn’t expect it. Also exercise. Exercise is very, very interesting. If you just think like, well I’m going to exercise and so my muscles are going to burn glucose and my glucose is going to drop. Yeah. Not really. Yes, in the total energy sense because you obviously are burning energy and so the energy has to come from somewhere, but your body also responds to stress by releasing glycogen, so your muscles have more energy to burn and it’s always a moving target.

So, your body’s going to release depending on the, the stimuli you get like a really intense lifting session. I go out there and I’m really giving it my all, my body’s going to respond by releasing a ton of glycogen, blood glucose, so I have that energy. Because it’s like, well, you’re doing something seriously intense, I’m going to give you a ton of energy. So, you’ll actually see on the CGM a spike. And then because generally lifting is not a sustained exercise, then you know, maybe you don’t burn that right off. So, you see the spike and it’s not exactly a a crash right away, but a sustained exercise that is intense. Like, sometimes I’ll hit the treadmill as hard as I can and then I kind of oscillate. So, I’m releasing, burning, releasing, burning. And these swings are pretty large until you see it.

And I think once everybody has CGMs accessible to them, like as part of the Apple Watch or fitbit or something like that, I think people are going to be responding to these by maybe structuring their workouts so that they, you know, that you can have a glycogen workout. Where your aim is to exhaust your glycogen. Or maybe you don’t want to exhaust your glycogen because you’re prepping for a race the next day or something like that. But you’ll be able to finely tune what you’re doing with your body and see how your body’s responding to the stress.

Wow. That’s fascinating. It makes me want to try it. I’d be looking at it, I’d be like testing everything. I did see what impact it had.

Definitely.

Oh yes, that spike was such and such.

I also wear an Oura ring. So, I can measure how my sleep, you know, it gives you sleep scores and stress level scores and stuff like that. So, I can also see and correlate. And it absolutely does correlate with what I see on the CGM in terms of general stress levels.

Ah, interesting. So, another thing I’d like to see, but then I’d also probably be a little bit dismayed by the results I’m going to sleep with. My sleep is less than perfect.

Well, it gives you the tools to measure, you know, how your sleep is, and then you try different things to experiment to improve your sleep.

That’s true. Actually. And that goes back to what we were saying before. It’s hard to deny what’s going on if you’ve got the data in front of you.

Exactly. It’s important to measure. Measure, and then respond.

This transcript is brought to you thanks to the hard work of Cheryl Meyers.

Welcome Jackie to the Ketowoman podcast. How are you doing today?

I’m very well Daisy. Thank you for having me. It’s a real pleasure.

It was lovely to meet you in person. You are another one of the lovely ladies I’ve met at the PHC conference the other weekend. It was great, wasn’t it?

It was great. Although, as I don’t know if you remember, my son had called me in the middle of the night to take him to the hospital and so I was a bit sleep deprived and kept dozing off, but I really enjoyed it.

Oh gosh. Yes. I remember now. I’d forgotten that you had great dramas, didn’t you? Really bad timing.

Yeah, I was. So looking forward to the conference, you know, had been booked it about six months before now, five months before and I was really looking forward to it. So that night, sitting in, sitting in the hospital is that they go, these things happen.

They do often in opportune moments. What was your best bit, what was your favorite takeaway from the conference?

I loved Dr Robert Lustig. I thought Zoë Harcombe’s was really good. And really interesting considering that she isn’t Keto, but how she was saying that you don’t have to have carbohydrates. I thought they were all very good. I was even really impressed with the president of the Royal College of GPs and that looking forward to how AI is going to interact with our health and how we deal with things going forward.

Absolutely. I must admit, when I, when I was looking at the lineup, I was thinking that his presentation might be a bit dry, but actually like you say it was really great, wasn’t he? He was. He was very entertaining. I really enjoyed his presentation.

Definitely and I think it definitely got me thinking about how AI is going to interface with our lives. We already see it a little bit with Alexa, but that’s taken it even a step further and how people might start recognizing issues before they even get to a major level.

I must admit, I’m very tentative about allowing an Alexa into my house. I don’t have one. Although I did, did have a very entertaining interlude at my sister’s house. My brother in law had been online and he’d found out these different things you can do and you can ask Alexa to fart and she has this whole catalog of farts and we were being Brits and liking toilet humor, we were very much entertained, to the point of yes, tears of laughter. So if anyone’s got an Alexa, ask her to show you an array of her farts. It very entertaining.

I have to try that later.

It’s very funny if you find that kind of thing funny, which obviously I do and my family does too, so yes, that was very amusing. Let’s get onto the matter at hand, which is you. So Jackie, tell me a bit about you.

I’ve done various things throughout my life, jumping from one thing to another. I’ve never really stuck with things very much and I was thinking that I’ve always considered myself quite healthy, but it’s only in the last year that I realized that I probably wasn’t as healthy as I thought I was. I’ve always been overweight from probably nine or 10 years old. I felt overweight. Now when I look back at the photos, I just think you look lovely. What was wrong with that? But obviously compared to some of my peers, I was overweight and my dad was overweight. My granddad used to have the nickname Cannon because he was so overweight. And I just grew up with that belief and I took after my dad, so I took after his side of the family.

So I grew up with the belief that I was going to be fat and of course that translates into being fat anyway. Then when I was 17, I had a, they didn’t know what was going on–it had been going on for years and I’d been in and out of hospital, not hospital, but the doctors trying to find out what it was. And they thought I had something wrong with my kidneys. And when they did a scan, they then thought I was pregnant and I was only 17. So they took me into the hospital–where I’d never even met the gynecologist– came in and operated on me and afterwards found out I had a tumor the size of a football.

Wow.

And they removed one and a half ovaries and my appendix at the same time. Now at that time I was nearly 18 I was still in hospital on my 18th birthday. I didn’t understand the consequences of what was going on. It was only later when I was in my thirties when I got married and my dad stood up to give a speech that I realized the impact it had on the whole family at that time, but I was completely oblivious. Now I realize that that operation in itself probably led to the ongoing weight gain that I experienced in my late teens and early twenties. Then around, I was probably about 27 at the time, I was living in Majorca. I had just, what a one off to start with was a headache. Like I’ve never known before. I ended up in bed for five days and someone had to look after me cause I was living on my own at the time and from then on I started to get migraines very regularly and paracetamol wouldn’t do anything. I was on really strong pills for my headache and I was taking those pills. They reckoned you should take one or two a month. And I was taking on average nine a month.

Wow.

Probably getting headaches every other day and I couldn’t function without the pills. I was just, and when I took the pills, it would knock me out for a couple of hours. I had to just go and lay down. I couldn’t do anything because the side effects were so bad. Then I got married in my thirties and couldn’t have kids–not realizing at the time that I’d lost one and a half ovaries. So it’s not surprising really. After two rounds of IVF, um, managed to conceive twins who are now 16 and just doing their GCSEs. Over the last, well up until 2017 and for the few years before that I’d been in a situation which was quite stressful and I was often working at night, usually once a week. But there was a period of time before that when I was doing quite a lot of night shifts and they work 12 hour night shifts.

It was in my own business, but for staffing reasons, I had to step in and I didn’t realize at the time how that was influencing me. So from February 2016 to May 2017, I put on something like 23 pounds over the year. So my weight had gone up really quickly, but I hadn’t really noticed it because you just don’t do you. And it was at that time that I was listening to a podcast that recommended a book and the book was Gretchen Rubin’s “Better Than Before”. And in the book, Gretchen Rubin said about another book, which was Gary Taubes, “Why We Get Fat”. I was listening to the book on Audible. So the following month when my credit came up, I thought I wasn’t in the mood for dieting. I’d tried lots of times before, all through my teens, and I’d got to the point where diets don’t work. I was also telling myself, I know what to do. You have to eat less and move more.

Of course. That’s what we’re told, isn’t it, by pretty well everyone.

Yeah, absolutely. I just figured that I wasn’t any good at it and I was a failure and I would go to bed every night and I would say to myself, tomorrow’s going to be different.

Why is that? I find I’m exactly the same. I have this massive boost of motivation in the evenings and it tends to manifest well with all sorts of things, but it’s that those lists of things you’ve got to do, and I often walk around my house, looking at all the jobs that need doing and think, yes, I do that and I’ll do that. Why is it you have that real peak of motivation before you go to bed, but when you wake up the next day, somehow, it’s all disappeared.

Is it because you’ve had, you feel like you’re such a failure during the day because you haven’t done what you said you’re going to do. And so you go to bed thinking “Tomorrow’s going to be different.”

I don’t know, but it really seems to be a pattern. I wonder if something that popped into my mind then was perhaps it’s that you can think like this because you’re not going to do anything about it right now. And there’s some kind of, because you know you’re going to sleep, that there’s some kind of cutoff. I don’t know, but it’s weird. It’s just when you said that, it just immediately resonated with me because it’s something I do so, so often.

And I did that for a long, long time. And particularly around diet and food and just telling myself I was going to eat less. I was going to move more. And then I’d wake up the next day and nothing had changed. I think that leads you to a place of feeling like a failure and like it’s all your fault and you’re useless. And even at that time, I knew wheat was addictive. I’d read, “Wheat Belly” by William Davis. And so I knew wheat was addictive. I knew the effect it was having on my brain, but I just couldn’t stop eating it. I’d seem to be eating more and more as time was going on. And I know now that stress was an influence as well.

Yes. I just wanted to pick up on that actually–just going back a little bit, when you mentioned about that it was a very stressful period of your life, but also the fact that you were having to do night shifts and you had that period of quite rapid weight gain. And do you put that down to one or either or both of those things with hindsight?

I think what I’ve learned on my Keto journey is that it probably did have a huge influence, both the stress and the working at night was most probably influencing my insulin levels. Now when I was working at night, I was taking my own supper with me, which was usually something like roast chicken and a salad and my own homemade dressing. And once I eaten that I didn’t eat for the rest of the night. So it wasn’t as if I was snacking all night. So I was keeping up fairly good food times, but my whole circadian rhythm was probably just thrown out of balance. And it would take me a few days to get over it and then it would be back to Sunday again. I’m back doing the night shift again and then we’d start the week again. And that went on for well over a year, maybe longer that I was doing that.

Hmm. Interesting. So often people assume that it’s all to do with the food or you know, at least the majority of the change that they think they need to make is the food, it’s what everyone goes to first and it’s what throws a lot of people, I think, when they’re saying, but I’m doing everything right. I’m following all the rules–yet I’m not losing weight or I’m gaining weight. And they don’t look at all the other things that are going on that can actually have a massive, massive impact.

Yeah, agreed. And it’s taken me until probably earlier this year to recognize that it’s not just about what I’m eating. It’s other things as well.

I’ve taken you off track a little bit. So going back, you started to discover some interesting books via podcasts. Let’s go back to that and what you started learning from. If I could have a pound for every time someone mentions Gary Taubes, I’d be a rich woman. It has to be, I think the most cited book on this podcast that people talk about. That was really the turning point for them.

Yeah, and I think it was just that understanding of calories in, calories out don’t matter. Fat is not the thing that we have to be scared of. We want to be avoiding carbohydrates as much as possible and the vegetable oils and just going back before that, when I was listening to the Gretchen Rubin book, I was telling myself, oh, I can’t do this. I’ll be useless. I’m no good. I can’t keep anything up. But I still went ahead and bought the book. So obviously part of me, although I didn’t want to diet, part of me was thinking I’ll listen to it and see what I think. It just all made so much sense. Previously I’d been thinking about the best way to go would be to have a vegetarian diet, but I wasn’t–I had tried that in the past, but it wasn’t very good because I love my meat too much and I was thinking I needed to get back to that.

And then this book was sort of talking to me in the sense of, you can eat meat and you can have butter. I love butter. The things I absolutely adored. My favorite foods, which is bread, potatoes and pasta are the ones that I shouldn’t be eating. So I just thought I’m going to cut that out. And I didn’t read anything more or do anything else other than read that book. And I cut out potatoes, pasta, bread or wheat, biscuits, cakes. I just cut that straight out. And I said to my husband, because he does all the cooking, I said, I don’t want potatoes anymore. Can you replace my potatoes with another green vegetable or another vegetable? I didn’t even say green vegetable. And for the next six months that’s what I did. But I didn’t realize I was eating loads of peas, loads of meat and loads of corn, um, corn on the cob over that following six months. And I still managed to lose probably about a stone, maybe just after just over a stone–17 pounds, I think in that six months until I felt ready to investigate a bit more and I bought Jimmy Moore’s book, “Keto Clarity.” Then I started to understand more about the ketogenic diet, so I started to make some changes to what I was eating, so I cut out the peas and cut out the corn and replaced those with green leafy vegetables. That’s when I started to see a change and I started to incorporate some intermittent fasting by, the first thing I did was not eat after my dinner, although I didn’t do it very often since I’d been on the low carb. I’d started to eat cheese at about 11 o’clock at night or something like that, so I cut that out.

I’m a late night snacker, too. I’m a devil for that.

Well, I never used to be, but then I started doing it because I could. I can eat cheese, so I’ll eat it. From January last year, January ’18, I cut out anything after my supper and went through to the morning. Then I found that eating in the morning wasn’t sitting well with me and I didn’t feel great eating and I was eating quite a lot eggs and bacon as Jimmy Moore recommends and avocado and sour cream and I was feeling quite yucky so I just cut that out completely as well and went through till lunchtime. And that’s my day to day regimen is to have my supper and then nothing till lunch. I do do some network meetings where they, it’s a breakfast meeting and they have breakfast and it’s really hard sitting there watching other people eat. So I quite often will have some egg and bacon but most days I don’t have breakfast.

From there I started listening to Jimmy Moore’s podcasts, from there I’ve found other podcasts, and I’ve been listening to lots of them all the time really and making different changes. So back in January I tried carnivore and did that for a couple of weeks but was really missing vegetables. I was even craving, which I’m never usually bothers me. I was even craving fruit at that time. So I only did it for two weeks cause I thought I can’t do this long term. And then when we were at the PHC conference the other week, I met a lady called Christina who said two weeks is not really enough and you need to give it a bit longer. So I thought, okay, I can try that again. So now I’m doing a sort of lighter version of carnivore where I’m just eating meat and fish and butter, 85% chocolate and occasionally some nuts. And most evenings I will put some nut butter on my chocolate. But other than that I’m sticking to carnivore and eggs. Of course.

Yes. I suppose you’d more call it just that, you know, really just the real drilling down on the carbs I guess. Um, I think quite a lot of us sort of jump to carnivore when we’re thinking of that because it’s, I don’t know about you, but it’s this, like you just, you just kind of need a name for something. But what you’re really saying is just that you’re really drilling down those carbs as low as you can comfortably go. But still including some things in your diet that keep you happy doing that.

Yes, definitely isn’t no carbs at all. I’ve still been having some olives as well, occasionally.

That’s an interesting thing that came to mind when you were speaking earlier and I’d be interested in your perspective on this and whether you agree. It’s going back to when you were talking about listening to the Gary Taubes book and before that talking about how you just felt a failure a lot of the time because you couldn’t do what you thought you were supposed to be doing, whether it be eating vegetarian diet and/or the whole eat less, move more like we’re all told and instead of automatically assuming that what we’re being told is wrong, we feel that we’re failing at it. And I wonder if there’s part of us in there and it’s, it’s thinking about the Gretchen Rubin’s tendencies and I, I don’t know what tendency you are, but I’m a rebel tendency and I’ve always felt this sort of inner part of me rebelling and fighting against what I’m being told I’m supposed to be doing. 

And I wonder if there’s a part of us, because we’re intelligent humans, we’re intelligent women. We shouldn’t blame ourselves first and foremost and assume that we’re the failure. We should be thinking, well perhaps it’s what we’re being told. And I wonder whether so many of us have this massive light bulb moment when we read something like Gary Taubes who is saying, and the phrase that is often picked out in these kind of books is when they say, “It’s not your fault, you’re not doing anything wrong.” It’s what you’ve been told and this system that you’re trying to squeeze yourself into, that’s never gonna work for you. And I wonder if, if that’s why it really resonates so much with us where when you were saying, and I’ve heard so many other people saying, it all suddenly made sense, you know, because there’s the science that goes with it and everything suddenly makes sense. It’s logical. Whereas before, I wonder if there is a part of us inside, although it’s not shouting loud enough, that was saying, you know, hold on a minute, none of this makes sense. Why are you doing it? And so sort of pushed against it. I don’t know. I don’t know how you feel about that, but I think maybe that’s part of the issue that I used to have.

It might be part of it and I was always, I sort of flip between rebel and obliger.

Right. That’s definitely a flip one extreme to the other.

Yeah, and in all these psychometric testing, I never fit in one box neatly. I’m always a bit of something, a bit of one and a bit of another.

Oh, absolutely. And I think she really just talks about your dominant tendency doesn’t she? We’re all made up of different parts, but she certainly found that most people tend to fall predominantly in one, one tendency with overlaps of other ones.

I sort of flip between both of them and just going back further, I never bought into the low fat products. I would have full fat yogurt, I wasn’t a great yogurt eater anyway, but you know, whatever there could be low fat of, I would always have the full fat version and I would always have butter. I’ve never had margarine–if you go to what we used to say was a cafe, I would say no butter because I knew it was margarine and I’d rather have no butter than margarine. But even that over time we’ve become so brainwashed into what the government are telling us, not so much school when I was at school, but just everybody, especially the young people growing up now, they still have an influence on us as to what we should and shouldn’t be eating and how we should be moving so much more. And I think with Gary Taubes’s book, I think that the one thing that really stuck out with me was even if you exercise an hour a day, every day, every year, you have to do even more just to maintain your weight where it was. So it’s not definitely isn’t about calories in and calories out because you have to increase that exercise year on year to just maintain where you are. I think that was very prominent. 

And I think at the time I was also still scared of the fat issue, of eating the fat. I love the idea of it, and maybe the reason it resonates so much with us is because that’s our natural way of eating. We would have come through thousands or millions of years of eating meat and eating fat and it’s only in the last 40 years that we’ve stopped doing that as much. But maybe that is our natural tendency and that’s why it feels so right to do this. And so at that point when I had sort of been doing the low carb thing for about three or four weeks, maybe, probably three weeks, and I was on holiday with my friends in Spain and my friend is a nurse and she said she was doing the low carb and that they’re now recommending it to diabetics as a way of controlling their diabetes. And I was asking her, but is it safe? Is it okay? It didn’t feel it still, there was still that part of me, that brainwashed part of me that felt it wasn’t okay to do low carb. And I am so glad that I had that conversation with her because I think if I had an, I might have just gone back to eating carbs and gone back to that belief that we need so many carbs that we have to have carbs. So I’m so grateful to my friend for, you know, just reiterating that. And, and I think at that point it was still hard, but it was easier and easier to eat the fat and leave out the carbs.

So remind me, you’ve been Keto low carb for, for how long now? Getting on for that must be getting on for a couple of years?

It’s two years now. It was the end of May. I did the low carb with the peas and the corn version for about six months. And then in January ’18 was when I started to dial it down. And really, you know, I ordered my ketone meter, started to check my ketones and it still took me a good few months to get those ketones up to more than 0.5 or 0.4. It took quite a lot of work and a lot of dialing down and a lot of titrating. I’ve always been a big eater. I used to worry, if I’d go out, I used to worry that they wouldn’t be enough food and that I might be hungry and I used to eat loads. It took time for me to recognize, even just tell myself if I’m hungry later I can eat more, and I had to keep doing that and saying it’s okay. You don’t just have to have your one meal. If you’re hungry later you can eat more. And that was really a massive thing for me because I was so used to eating my lunch and my dinner. I never used to snack a lot between meals–I used to eat loads and it took me a long time to sort of dial down the portions to be satisfied without overeating.

Yes. It’s interesting isn’t it? What you’re used to. I was exactly the same before I had weight loss surgery and I would say, I’m a good few years out of weight loss surgery now and I can eat, I would say the amount that an average person eats, but I used to eat a huge amount and it’s funny when you keep saying things that sort of send these bells off in my head thinking, Gosh, yes, I used to do that too. And it was, there was that kind of panic wasn’t there, that panic of thinking that there might not be enough food, that you weren’t going to feel satisfied and that you were going to need more and I wonder how much that’s actually relating to food and whether it’s some kind of other emotional need or something because logically it doesn’t really make much sense does it? We get to do that, especially as you were saying with you starting to do some intermittent fasting and what I always find that is most interesting when you do do that, you really get to see what real hunger is. The difference between that real stomach growling, ravenous hunger and then when you do eat you don’t find that you can eat that much before you’re satisfied and it’s, I just find it interesting, the whole concept of hunger.

I don’t think I ever really got hungry before. I don’t think I allowed myself to get hungry. And even now I still will tend to have my lunch around lunchtime and my supper at suppertime probably irrespective of whether I’m hungry or not.

Creatures of habit aren’t we?

Part of it is habit and part of it is the social aspect. So lunch I will mostly have with my mum, so it’s a time for me to be with her so she’s not on her own and then in the evening it’s with the boys and we will tend to watch something on TV and that’s become part of the social network of how I eat. But outside of those times I don’t usually eat. I might have a little little bit of chocolate after my lunch. I might have occasionally a few nuts if I want to in the afternoon. Sometimes I’m just craving something to eat. But for the most part, I will just have my lunch and my supper.

Yes. I think a lot of people seem to fall into the two meal a day category, don’t they? I would say, oh, I know it’s a bit of a generalization here, but most people I know who are Keto tend to fall into that group. The two meal a day.

Yeah. I don’t know. It’s easy. I do do the occasional–I’ll go through from one suppertime to another. I do do on a Thursday night, I go to taekwondo, so I will probably go from the Wednesday night through to the Friday lunchtime. Do you know what I love is the freedom to not worry about food. To know that if I don’t eat all day to day, I will be fine.

Yeah. You’re not going to pass out.

I’m not going to pass out. I’m not gonna get a headache. I’m not going to get the jitters. Which would have happened beforehand. If I went past lunchtime, I would end up with the jitters and I would have a headache and a migraine and it’d probably last for a few days. I always made sure I ate, but now I always walk around with things in my bag. I’ve always got two or three bags of one ounce of nuts and I was generally got a bar of 85% chocolate and I know that if I’m really hungry I can eat that and I can still go all day without touching it. Even though it’s there and it’s beside me and I’ve got it with me, I don’t actually need it. I think that brings so much freedom to the way you live now. Way I live now.

You mentioned that it’s just reminded me about when you were talking about the migraines that you had and there are two questions, really, one that would you attribute to your change of diet, which you attribute the easing of the migraines to that, but also what did you notice? What were the big changes you noticed? Obviously when you went from how you were eating before and you went through that period where you lowered your carbs but you weren’t keto and you mentioned how you lost weight, but then when you went to keto and you started measuring your ketones and, and so on and so forth. But what kind of changes did you notice from transitioning between those stages? Because I know I too had a period where I was quite sort of, well, moderate to low carb I guess. And there were definitely improvements from a weight loss point of view, but it wasn’t until I dialed down to keto levels that I started seeing changes to things like my migraines and depression and things like that. So I’d just be interested to hear from you what the changes were that you noticed with those different periods.

Just going back to the migraines, they had been changing over the years. So, from when I was pregnant, I still had them through my pregnancy, but afterwards they eased a bit and they weren’t as bad as they used to be. And then with time, that has got even better. And I, I even got to the point where I would stop taking the sumatriptan pills I was taking.

Oh, is that what you were taking? When you mentioned the tablets that you were only supposed to take a few a month and you were taking them a lot more? Is that what you were referring to?

Yeah.

Oh, well you would be horrified then that the point I got to, and this is where I realized something had to change, where my migraines so bad and that’s what I took as well. There’s a whole group aren’t there called triptans, which they use to treat migraines and it’s to do with, changes the flow of blood doesn’t it? I can never remember whether it opens up or constricts the blood flow, but it does one or the other and that’s supposed to be how it works.

I think it’s constrict, yeah.

I can never remember. In my worst months I was getting migraines half of every month, so I was taking, that’s probably about 15 tablets a month. That’s what I was taking. And I got to the point where, and I’m sure you’re probably familiar with the whole concept of rebound headaches and migraines and that you actually start getting headaches or migraines because of the tablets that you’re taking. And so it just becomes this vicious cycle. And I can remember reading a really interesting book about it and they said, at some point you have to break that. And the only way you can break that cycle is to stop taking the medication. And that’s why I did.

And somebody years and years ago said to me, she had migraines and she said she stopped taking the pills, but it just seemed inconceivable to me to stop taking them.

Yeah. Because how can you function with the migraine?

Exactly. Once I came out of the pregnancy, and so even before I went low carb, I probably had a couple of years where I did, for the most part, I did stop taking them. And if I had a headache, I would just grit my teeth through it. And it would often be three days where I felt lousy and nine times out of 10 I would not take a pill, but then I would have the occasional one, which would make me very sick in my stomach. And at that point I would need to take the pills. So I was down from nine or 10 a month to maybe one or two a year.

Wow. Big change.

Once I went low carb, that sort of continued. But when I started keto, I started to actually get more migraines than I had been previously. But I haven’t had one for ages now. And I’m wondering if now sitting here right this minute, thinking back, maybe it was the electrolytes, because now when I feel a headache or any sign of a headache coming, I will go and eat some salt or make myself a drink of water with salt and low salt in. And so I’ve managed to keep it at bay. So maybe in those early days when I was getting migraines, maybe it was an electrolyte imbalance.

Quite possibly. It’s with that transition phase, isn’t it? When your body’s adjusting to the new fuel, I guess, is literally what it is–everything goes a little bit sideways, as far as things like that go, especially if you’re vulnerable to headaches. I found the same thing when when I was doing my carnivore challenge that I was getting at a lot of headaches. I got a tremor in my eye and as soon as I started taking magnesium, that really helped actually. So similar thing. What changes did you start to see then when you were fully into keto and were in ketosis that you no doubt saw on your ketone meter. What changes for the better did you notice, if any?

So I think the main thing was, which completely astounds me, even now, probably around April last year, I decided to exercise–

Of your own volition?

Of my own volition. Somebody in a group that I belonged to was mentioning about Joe Wicks, the body coach. So I started doing his absolute beginner video. I’d put it on, and I’d do that about three times a week. And then in June last year, two people said to me in the space of about 10 days that they were doing the Couch to 5k, I don’t know, you did it as well. And I thought, well I might give that a go. So I did and I couldn’t get to the 5k but I could run eventually for the 30 minutes.

Oh, well done. Did you actually get to week nine? I’m a shocker. I got to week eight, which you believe before I stopped and I haven’t taken it back up again. Um, but did you actually get to the end of the program then?

I did and I got to the end of the program and I kept it going.

Wow.

Until October. So then back in August I thought I might go back to taekwondo. I’d done it a little bit beforehand, but hadn’t done it about three years. So I went back to taekwondo. Then in October, while sparring, I damaged my toe, my big toe, and the nurse had said to me, don’t do anything. So then I stopped running and I didn’t do anything for about five weeks. And then I started the couch to 5k again and thought, right, this time I’m going to try and go faster, faster, but I wasn’t doing very well. And then back in January, I started again on week one again, I thought, right, I’m going to start again. And now I do it and I’ve done about three park runs so far, but I’ve done it with the couch to 5k. So I do my walking bit and the running bit in the walking and the running bit. But since then I’ve just been running and I’ve been extending my mileage. So I’m up to about 2.4 miles that I can run without stopping. But very slowly. And then recently this week, I’ve just thought, well, I don’t have to just run for 2.4 miles. If I’ve only got 10 minutes, I could just run for 10 minutes. And so that’s what I’ve been doing as well. And just giving myself a bit less of a hard time, but trying to do something a bit more regularly.

Mm. Yeah, I was going to ask you actually if you had a a park run near you, you know when you talk about going to a taekwondo class, it just struck me that you might be the kind of person that likes to go and do an organized type of exercise, if you like. And especially doing it with other people. I know a lot of people really get a lot out of park run.

I think I’m doing it to push myself. I don’t think I need to go. We’ve got quite a long drive so, and we live on the top of a hill with no pavements and cars going past very quickly. So running on the road is not really advisable. So I tend to just run up and down the drive. So getting to the park makes it just a bit different and it’s also pushing me to aim for that three mile or 5k goal really. So I’ve been pushing myself a bit harder and I think other changes, well I just, I don’t know about you but I just feel, I tell people I feel amazing. I feel like I’ve never ever felt before in my life. And somebody said to me a little while ago, you probably just don’t remember what you did feel like when you were younger. But actually I do because leading up to that operation when I was 17 I’d been ill for years before that. I felt something hard in my stomach and my mom said go to the doctor and I didn’t like doctors so I wouldn’t go. And it had been going on for years and I used to come home from school in the middle of the day because they’d send me home because I was in so much pain in my side. It was usually around my period time. And what they reckoned afterwards was at the time of my period, everything would, the tumor would push on some of my vein, um, yeah, probably veins and arteries and all sorts of things in roundabout about my kidney area and that was causing all the pain. So I never felt great. I always was, always felt overweight and I never felt great. And then afterwards I was probably going through a hormonal change. This probably similar to menopause, if not, not exactly, but you can sort of imagine that having all your ovaries ripped out, and Gary Taubes does mention in the book about rats where they take out their ovaries and how the body totally changes. So I never felt great, but I never felt that bad that I thought there was anything wrong. It just became, this is me, this is who I am, and I’m a person that can’t follow through. I’m a person that can’t do things, you know, I’m not consistent. I can’t keep up new habits. And since going keto, and particularly in this last six or eight months, I’ve come to recognize that that wasn’t true. What it was was what I was eating or how I was living. Probably eating was stopping me from being the person I am today because I feel different.

It’s lovely to hear when people say they feel amazing. I mean, you know, what more could you ask really?

And I’m still not great because I still get a tired slump in the afternoon and I haven’t quite worked out why that is. But other than that, I’ve been able to introduce new habits. Previously I was having problems with my gums and I would have to go to the hygienist every three months and more recently she said, I don’t need to see you for six months because I’ve started flossing and brushing with the interdental brushes, which I would never have managed to be consistent in keeping that up previously. And I think that as well as avoiding all the sugars and the carbs has helped my dental health.

There’s interesting, right when you mentioned about having that afternoon slump because obviously you’ve experimented a lot with your diet. So I mean it strikes me that it’s not what you’re eating that’s impacting that. Something that jumped to mind was, and I can’t for the life of me remember which one of the Rangan Chatterjee podcasts it was, because there’s been a few that I’ve listened to recently that have had a lot of overlap with sleep and with circadian rhythms and things like that. So I can’t remember exactly which one it was, but one of them was talking about how we have transitioned, evolved over time as a human race, but also how we evolve from birth and as we grow up between different patterns of sleeping and they were talking about, I think do they call it the bi-phasic? That sounds logical because that’s too, but this sleeping in either sleeping in two blocks of time when it was quite normal–and babies and very young children do this, but we also used to do it apparently quite a lot, however many years ago–where we’d sleep for a block of time and then actually have a period of time in the middle of the night where we might get up and talk to each other or whatever and then go back to sleep.

Interesting enough, I did that for a few months when I worked on a kibbutz and because of the way we socialized in the hours we worked, we started very early. I slept in two blocks of four and actually felt very good on that, but the point I was going to make to you that might be worth trying, I don’t know if it would fit into your lifestyle and it might have been, thinking about it, it might’ve been the Matthew Walker podcast. He has his book about sleep and the importance of it and the different patterns and they talk about as long as you have the whole period that you need to have all the different phases of sleep, which for most people is 90 minutes so you get that entire sleep cycle. He was saying a lot of people benefit greatly from having a nap or sleep during the day.

It’s quite important that you have it before, I think the cutoff point was about 3:00 PM or you’ll struggle getting to sleep and that will cause problems, but a lot of people really benefit from having a sleep cycle length nap in the afternoon and I remember my grandmother, it was always absolutely part of her routine and she set her alarm after lunch. She had her nap and then you know away she went for the rest of the day. I just wondered if it’s worth experimenting with something like that. Maybe your body is telling you that you need that rest at a certain point in the afternoon.

It could be. It also relates with the Spanish siesta time as well. What I’ve found that I’ve been doing is I’ve been going to pick my boys up from school and getting, aiming to get there about 10 minutes early and then I just sleep for about 10 minutes in the car. And that 10 minutes makes a big difference to the rest of the day for me.

Interesting.

What I’ve been doing is trying to get my circadian rhythms in balance by going out in the daylight as early as possible without any glasses or contact lenses and then going to bed a bit earlier at night. Also, I’ve been wearing blue blocking glasses, not all the time in the evening when I’m watching the TV, but definitely when I’m in bed reading my Kindle and if I get up in the night, I quite often put those on. So I’ve really been focusing on my sleep hygiene as well and trying to dial that down. But that’s been a recent thing over the last three or four months I’ve been working on.

And you mentioned to me you’ve been playing around with the “Miracle Morning” concept of getting up early, is that right?

Yes.

It’s another book that I’ve read and had great, great promises to myself at night that I would do. And weirdly enough, actually the week it took to read, I would read it as I was going to bed and I was actually waking up at six o’clock in the morning. It was most bizarre, not that I did anything with it. This is um, you’ll see this is a bit of a recurring pattern with me, but by all accounts you have actually been putting it into practice.

I have, you gave me that recommendation a couple of months ago and I had it on my wishlist on Audible. So I downloaded it on Monday, listened to all the way through and then listened to all the way through again, this time bookmarking certain areas of the book. And so I think Wednesday morning was my first day. Now I normally get up at six o’clock in the morning. So I got up at five to five and I was the 10 minutes of everything, which for the listeners are Silence–so meditating for 10 minutes, Affirmations for 10 minutes, Visualization for 10 minutes–I’m not very good at visualizing things that are not yet, but I’m working on it. And the E is exercise, the R, he says SAVERS–the R is reading and the S is scribing or journaling. So I have been doing that. Over the weekend, I was up late on Friday night and Saturday night, so I didn’t get up early, but I still had time to take that hour and a bit of time to do that. So I have done it for six whole days now.

Wow. And what are you feeling about it?

I’m feeling–I think it’s adding to my confidence and my confidence has been growing over the last 18 months. It’s been adding to my confidence of I can install new habits. I don’t know how long this is going to last because I’m sort of person that would do it for a couple of weeks and then stop. But something feels different inside this time. Something feels like I might actually do this and carry on with it. I bought another book, by Emily Fletcher called “Stress Less, Accomplish More”, which I’ve been reading this week and it just, it’s given me more of an outline of how to meditate and giving a bit of a leeway around meditation. So I’ve quite enjoyed that book. Today was the first day that I’ve put her session into my miracle morning. So we’re going to see how that goes. I have to report back to you on that.

Yes, you absolutely will, okay. I find this with a few people, I might recommend something. They actually go out and do it–other than me who reads the book and doesn’t do it. So I will be, I will be fascinated. I love this recurring theme of a building of confidence and it’s something I really feel strongly about that keto seems to have this empowering this, this gives people, their sense of empowerment. It seems to happen over and over again that people gain confidence because they suddenly start figuring out, I guess, how their body works, why their body works the way it does, start gaining control of food maybe where they’ve thought they haven’t had any control of it before. It just seems to be an overriding thing that comes up again and again, particularly with women. I feel that just a sense of empowerment and confidence.

I think before, I felt I was controlled by food, that food had some sort of power over me. Whereas now I know that I’m in control and I can choose to eat something and I can choose not to eat something. I can choose to eat off of what we would consider a ketogenic diet or I can choose not to. That control is very, not only liberating, it gives you back your power. But also I think that the carbohydrates, particularly the wheat, affects our brain to the point where we don’t feel like we can do anything. And that then influences out over our whole lives. And we then quite often you were talking about depression, I think was I depressed? I don’t know. But I was very lethargic and couldn’t be bothered. And I think that freedom from that also allows you to do other things and feel good about other things. And like for me, as I said, it’s like I’ve never felt before in my life. So it’s just amazing.

Another thing that seems to happen with a lot of people, we get rather evangelical about it and want to want to spread the word. We, we are running out of time here a bit, but I would really like to hear about your plans for that because I know you have several things in the offing where you’ve, I believe you’ve already started with some things. You have some YouTube videos, and whatnot, don’t you? But you have some plans for, for spreading the word and helping other people. Tell us a bit about that.

Back in April last year, I started a website and a YouTube channel and I was just doing a weekly update of what was going on for me and that was taking up quite a lot of time as well as doing everything else I was doing. So I did leave that go a little bit to the wayside and I was very evangelical about it and I was telling everybody whether they would listen or not. It was just, Ah, you’ve got to do this. I’ve managed to dial that back down and try and bite my tongue a bit, and not say too much, too often, but sometimes it comes out. But I was having a conversation and I’ve met Louise Reynolds a couple of times for coffee since she’s working in the UK and she’s only up the road from me. It was just a comment that she made and I thought, actually, this is something I really want to do. I think people talk about their passion and living life on purpose. And I never knew what that was before, but this really feels like it’s the right thing for me to do. I already have a Facebook group and I am going to be doing some coaching and I have been, I have started coaching a couple of people recently, so I’m going to be doing some coaching and I’m going to be starting my own podcast, British podcast and all things coming up in the future.

Fantastic. And what’s it going to be called? Because I rather liked it.

Oh, you did? Okay. It’s called Fabulously Keto.

I love that. It makes me think of AbFab, which all ties into the whole Brit thing, doesn’t it?

Yes. And Louise actually did actually mention to me AbFab, but the domain had already gone—AbFab Keto had already gone, so I stuck with Fabulously Keto. So I think for me, I’m aiming this at over forties because I look on Facebook groups, on Keto Facebook groups, and I see lots of, particularly women losing lots of weight very quickly, but men as well. And that hasn’t been the case for me. And it’s been a very slow process. I’m probably down to about 53 pounds I’ve lost so far, but it’s been very slow and very plodding. And I think that’s because once you either start to go into your menopause or you’re in it or you come out the other side, things in your body are working very differently. And even though it might not be exactly the same for men, I think the older the body gets than it does have a different effect on your body. So fabulously Keto is aimed at the over forties. And it’s not that I must have this weight loss and I must have it by next week, but it’s about an understanding that we’re here and it’s about health.

And I think that is really key. And I heard a great quote the other week that says we have two lives and our second life begins when we realize we only have one.

I like that.

And I thought, yeah, and I think I’ve got to that point a couple of years ago where I am now on a completely different trajectory. So that my first half century or just over was on one trajectory and my second half century is going to be on a different trajectory and I want to get to that point where I get to, I decided about 10 years ago, I wanted to get to 107. Well, I want to get to 107 now being able to do the things that I’m doing at 55 and not be sat in a chair in a home waiting for my sons to come and visit me, who probably won’t want to do that.

Wow.

I want to be able to enjoy them and see their kids grow up.

I love that. I’m going to repeat that. I think for the end quote–that ties in very well. Talking of quotes and tips, we’ve come to that point in the show where we’d like to hear from you what would be your top tip?

I listen to your top tips and I always said that my top tip would be your why. And for me it started out about weight loss but very quickly became about health. And I know so many people have said that over the time. And I think it is really important because that’s the thing that keeps you on track and keeps you choosing and making the right choices. And as I said, my why is now to get to 107 and be able to do that with great health and maybe even still be running and to see my kids grow up because I’m 40 years older than they are and I want to see them grow up and I want to see them have children of their own. I just want to add in another little tip that I think has been a key for me. And that is I don’t feel like I’m on diet. I feel like this is the way I eat and this is the way I choose to eat. But if I choose not to eat this way, then that’s fine. But it’s a choice and it’s not something I just throw all caution to the wind and say I’m not doing this anymore. So I will sometimes choose to have something which is non-keto and it might be a whole meal, it might be a holiday, it might be a whole day. But I know and I set in my mind that is my time span. So it might be the meal, it might be the day, it might be two weeks and I will then choose to get back on to the way of life because I’m not on diet and I haven’t fallen off. It’s been a choice. And I think I always say to my kids, you have to do well at school so that you can have a choice of what you do. And that’s what I feel like I’ve got now is I’ve got choice. And I would say to anybody, don’t think about being on the wagon or off the wagon. It’s about choosing to eat the way you want to eat and choosing not to at certain times.

Yes, I love that perspective. It changes it doesn’t it from this thing that you’re shackled by something that you’re restricted by that has these constraints and boundaries to just flipping that on its head and it being your choice. So automatically all those, all those boundaries just disappear because it’s your choice. You have complete freedom in what you do.

Yeah, and last year when I was on holiday, my choice was I’m going to eat bread and I’m going to have chips if I want to. And in reality when the bread came up at the dinner table, if it didn’t look that good, I would just say to myself, do I want to eat off plan for this bread that doesn’t look that great? And the answer would be no. So I wouldn’t have it. And if the chips look like they come out of a packet, then I wouldn’t have them because it’s then choosing is this worth eating off plan for? And quite often the answer is no. And so you end up sticking to the plan anyway.

Yeah, that’s right. That’s, that’s one of my rules actually. I think it’s one of the things that is, I’m going to go out there and say impossible to ketofy and that is chips or French fries for our American cousins. We’re not talking about crisps, which is what we call chips. Your chips are our crisps and our chips are your French fries. But yes, it’s something that I just don’t think that you can get that hit with keto, but my rule is I will not have them in the house, but if I’m out at a restaurant and it’s on the menu choice that I want or I feel like having them, I see them going out to another table and they look like amazing chips, then it is something that I will have in that context, in that situation. And I’m the same as you. I’m very picky. So if they, if they don’t look like they’re very nice, well then, I’m not going to bother. If they look like real knockout chips then I’ll have them. But what is interesting to me is that I won’t eat them all. So they will come and I’ll have some and I’ll enjoy them and I’ll probably leave at least two-thirds of what ends up on my plate, which I never would have done before. So I do think there are some, uh, I called it a rule, didn’t I? But like you say, let’s use your perspective. It’s a decision. It’s a decision for me that, that I make in a certain context and it works. It might not work for somebody else, but it works for me.

Mm. And I’ve had you say you’re an abstainer. Well, I’ve worked out, I’m a moderator so I can have something occasionally and then straight away get back to it. I don’t have that. I must eat the whole–even beforehand, if I had a bar of chocolate, I would eat one or two squares. I’d be quite okay with that. I wouldn’t have to eat the whole lot. I give myself a little bit of flexibility, but the rest of the time I’m so strict with myself that I can have that leeway if I need to.

Yes. And there is a scale because I am definitely an abstainer, but I can set up these rules for myself. If I had potatoes in my house, I would not be able to moderate them. No way. But I can selectively have them sometimes when I’m out at a restaurant. So it’s interesting isn’t it? How in certain conditions I can be a moderator, but there’s a very narrow window of when that works. Overall, I’m an abstainer, but I do think keto or whichever of eating that you find works really well for you can empower you to make some of those decisions and have them work well for you.

Yeah, definitely find liberation there.

Well, wonderful, fabulous. I should say. Seems fitting to use while I’m talking to you. It has been truly fabulous talking to you today and it was fabulous also to meet you in person and enjoy the conference with you. I think it’s, it’s always nice to share something like that with somebody else, isn’t it?

Yeah, it was really good. It was really good to meet you because I felt like I’ve known you for a long time, but you probably not the same because I get to hear you every week and you don’t get to hear me every week.

You’ve got me in your ear holes every week. What it’s going to be the other way around soon and I shall get to hear you and your podcast. I very much look forward to that.

Okay. I think it will be launching in September.

Fantastic. Well, what we’ll do is we’ll update the show notes and I’ll put out something on social media to remind people so that they can find you when it comes out. I wish you all the best with that. Good luck.

Thank you very much. Thank you for having me.

And I have to ask you, are those peacocks in the background that I keep hearing?

Yes. Sorry about that. They are peacocks.

First of all, I thought it might be a cat and then I thought, oh no, that’s a peacock, isn’t it?

Yes.

They’re yours presumably, are they?

No, they just arrived and they sometimes visit our house and sometimes they’re next door. I think at the moment they’re next door somewhere, but this is their screeching time of year.

Oh, it’s a particular type of year, isn’t it? They don’t do it all year?

No. It seems to be now around the springtime and then the rest of the year they’re fairly quiet.

Well, that’s merciful because they are rather noisy, aren’t they? Beautiful birds.

And they do it at night and early in the morning.

Oh goodness me. What a joy. Not! Well, thank you very much, Jackie. It’s been a great pleasure.

Thank you Daisy. It’s been lovely talking to you.

This transcript is brought to you thanks to the hard work of Trish Roberts.

Welcome Siobhan and Dave to the Keto Woman podcast. How are you doing today?

Great. Thank you for having us.

Very excited and happy.

And how are you feeling about the conference? We’re nearly at an end and I’m starting to feel a bit deflated. Getting a bit sad about leaving everyone. What have been your best bits?

Oh my goodness. For me it was getting a chance to see…. I’ve really been impressed with the advancement on, especially the cardiology front. Brett Scher and Nadir Ali are cardiologists that are really breaking ground and addressing a lot of these tough topics head on. And I’m really glad to see that. I really enjoyed Paul Mason’s presentation as well. And again, I’m kind of biased, but I feel like it’s a very critical question that a lot of people have. In many respects sort of the one key question because as far as being concerned in terms of mortality in the ketogenic diet… I mean, people aren’t worried about keto rash or cramps in their legs as much as they are of, if they’re going to die of heart disease. And so I’m glad there was a lot of focus here on it and they were really good talks.

Yeah. One thing I’ve been really excited about this time was just the level of excitement and hope. Not only in Low Carb Denver, but also CarnivoryCon. There’s a lot of developing stuff, a lot of people talking about just getting healthier. One thing in particular that I enjoy is just the level of excitement from the doctors because one thing that Brett has talked about in the past is doctor burnout, where they’re trying and they’re trying and they’re trying, and it’s the same for the patients. Like nothing they’re doing is working, and it just hits them hard. And to see care providers and doctors and coaches and stuff, just happy and excited to be able to help people is just exciting.

I’ve been speaking to quite a few Type 1’s, and they were really excited about that presentation yesterday as well with Nadia Ali and Brett Scher. They really seemed to get a lot from that.

Well Type 1 is especially challenging because I feel like the science is so strong for a ketogenic diet with Type 1s. There could be a case – and I believe somebody was doing a fairly good job of this – I think it was Sarah Hallberg who was saying, there are these three different ways to address diabetes and that she was speaking more to diabetes Type 2. For Type 1… I try not to be a specific diet advocate, but in particular for Type 1, it’s kind of comparable to epilepsy in that you really should find a way to manage bringing down total carbohydrates because of how much you know. You know how much insulin you’re going to need to manage it, and your body has an enormous challenge in trying to regulate it. And so for me that’s not as close of a call.

Yeah. Especially because lately more and more we’re finding type ones that are transitioning into Type 2s. Like their dietary management is just so poor that they’re becoming insulin resistant, which is just complication on top of complication, and it has to be really difficult for them.

So you two are both known for doing crazy experiments. What have you been up to lately?

Gosh, where to begin? I guess if I were to say what the last set of experiments are, they were to do carnivore. And one thing I didn’t get a chance to talk about in the presentations, but I feel like it’s kind of a little more appropriate for a podcast….for all of the kinds of experiments I’ve done and for the controversy they’ve garnered, nothing came close to my mentioning I was going to do a carnivore experiment. I got a whole lot of people both jumping in on the positive and negative side. It had enormous attention and this I found to be pretty odd because my ketogenic diet, I’m normally having close to 75 to 80% animal based products.

So getting all the way to 100% I thought would be, to use the euphemism, a nothing burger. Probably it would feel like keto to me. Probably no one would care. I couldn’t have been more wrong about that. Not only was there a lot of pushback on the outside, but I was thinking, gosh, I hope there really is going to be good data given there’s not…given how much I’m having to put up with to make this happen. And sure enough, I found that if I went on carnivore I did in fact see a lot of effects that really kind of blew me away. As you know, a lot of the data I just go and get it myself. That’s the value of N of one, is when you’re the N, you get to find out how much things people have been telling you really pan out.

And in the case of carnivore, I really can’t say there were a number of symptoms. I would say both advantages and symptoms that turned out to be worthy of mentioning. A lot of them most of your followers probably already know. My appetite was much more satiated and in fact I just thought less about food. I didn’t think about planning for food and so forth. And that was very liberating. A little less time in the bathroom…make of that which you will. I really found that I enjoyed meat a lot more specifically when meat was my main target; which was good. That said…

You think it would potentially be the opposite..that you get bored with it?

As I was about to say, that said, I haven’t done a really long-term carnivore experiment, but in both that first one I did and in a second one that I did just recently, I do get bored of food choices. But it seems as if it’s in the process of subsiding before it is, that I end up ending the experiment. So it could very well be that if I were doing carnivore for say, three months, that I would actually find, oh, okay, I’m really getting into animal products only. It’s working out for me.

Yeah. And that’s actually exactly what I found. I’ve been doing carnivore for almost a year and a half I think – since October 2017 – and I definitely found… I thought I would get bored going in, but it was the exact opposite. My excitement for food went from absolutely zero to just excited about every single meal. Happy while eating. Satisfied after the ambiguity and appetite I was experiencing with keto went away. It’s absolutely clear when I’m hungry and when I’m not. And after all this time, am I bored? No, absolutely not. It’s more enjoyment than I’ve ever experienced from food. Ever.

I actually want to prod you into what really should be the experiment you should talk about because it is one of your most recent experiments and it relates to carnivore. It’s your raw week.

Yeah, so I’ve been having a…I think it’s a pre-existing issue with low folate, and I think it’s pre-existing because even in my Standard American Diet days, I was having symptoms of numbness and tingling in my fingers. And actually right before I started keto, I had a numbness and tingling in my toe that was not going away. And that was actually a big motivator for keto because like in my head it was like diabetes or something. But obviously that wasn’t it. I was also experiencing shortness of breath, even just like sitting and doing nothing like we’re doing right now, it would just be like breathing normally, but feeling like there’s just not enough oxygen. And eventually I got tested, B12 and folate, and folate was like rock bottom, like 2.8. Normally low carbers I see like levels of 10. So clearly that’s pretty abnormal, especially because there’s research indicating that with low carb diets folate goes up, even with the same intake. Amber discussed at CarnivoryCon that this relates to gut bacteria and things like that.

And I decided to try supplementing for a while. So I did that while I was out of the country for three months and the symptoms did subside, but I wanted to see if I could find some other way to fix the issue. And I was like, hey, if you cook meat, you lose water content and folate is a water soluble vitamin, so if I just don’t cook it, maybe I’ll get more folate that way. It was just a random thought. So I decided to do a full week of raw meat only, and I was doing that while at Amber’s house before the conference. So it was like raw chuck roast, raw beef heart. Not really any organs then, except for the heart, because I didn’t want that to confound. I just recently got my labs back and my folate was 18. Granted, that could be still coming down from the supplementation even though I’d stopped it several weeks before that.

But this is definitely something I want to look at further because if that’s all I need to do to fix it…

Can you tell them what the reference range is?

So the reference range I think is like under 3 is a clinical deficiency, and then up to, I think it’s like above 28. Just say it’s above 28 and you’re out of range.

And your prior tests?

My prior test was 2.8, and then 3.1 for another one, and then it went out of range when I was supplementing. And now it’s 18. So it’s very interesting. And while I was eating raw, I experienced something very similar at the beginning of carnivore, where when eating pork I was getting like this feeling of just absolute happiness and excitement while eating…like a borderline euphoria. And that eventually faded over time. And that’s why I was eating pork so much. It’s actually something I’m kind of known for on social media.

Pork and cream cheese.

Pork and cream cheese was my go to. But I was getting the same feeling with raw meat and in my head it’s like, maybe there’s something in here I need. It’s not very scientific, but it’s something I want to pay attention to because it’s not ignorable for sure.

Well, it’s using your first and most important meter. Because I can never say this enough times, for as much as we like to experiment and measure methodically, the one meter you should never lose touch with is, how you feel. Never. And I think that if you’re feeling good around the clock…and I always put it that way, as in 24/7 you’re just generally feeling good. Not having rushes. Not having feeling good briefly, and then having a crash. But if you’re feeling good around the clock, that’s very valuable information and you want to be very mindful of what you’re doing and how this came about.

And presumably you’ve seen an improvement in those things.

Yeah, like the symptoms haven’t come back. Nothing. No tingling or shortness of breath. I’ve been running all over the place and been fine. And so it’s definitely something I want to continue. Although I do have another experiment coming up that will be not as fun. I want to dig a little deeper into lipoprotein(a) because I did some fasting, and then high calorie, and then baseline diet, high calorie, and it seemed to be tracking with fat intake. So I want to explore that a little bit more. Probably as soon as I get back home. And that’ll be with a high carb, low fat diet.

Yuck.

I agree. Especially because… I mean to be honest I don’t like plants that much regardless of what they are. It’s just soul sucking to eat them. But I really, really want the data.

That’s going to be a real shock to your system surely, after all this time.

Yeah. I want to give it a good length of time just to make sure there’s not any transition, so it’ll probably be multiple weeks paying very close attention to how I feel. Because when I was following the Standard American Diet, I had depression and it was pretty bad. So that is one thing that I’m concerned about, and I’ll have my parents on standby, like warning them ahead of time, watch out for anything. Please let me know if I’m acting weird and I’ll just stop because that’s not anything I’m messing around with.

And as we would advise to anybody else considering N of 1s, you always want to be prepared to cancel an experiment if it’s not working.

Absolutely. There is nothing shameful in that. Absolutely nothing. You have to take care of yourself first and foremost.

And on that note, while I was doing the white bread and processed meat experiment, which was also a high carb, low fat diet, and my continuous glucose monitor was just constantly showing me the alps, if you will. I was very irritable. It was probably one of the most difficult times that I’ve had as far as maintaining control of my emotion. And Siobhan would joke toward the end – though not entirely joking.

I was not joking.

That she might have to take time off soon if I was going to continue the experiment too much longer. So if I’m experiencing the same thing on the other side, I’ll let you know.

Yeah, I would appreciate that.

It’s a challenge though because in approaching an experiment like this, you do want to do your best to keep your own biases in check. So I intend to every time I do an experiment, even if I’m going out of keto, to try to experiment with something like this, I try to maintain the best outlook for what the experiment could be, and not let anything trip me up. And I will say, there are experiments where I’ve had carbs and not fat, and it did not have a negative impact on my mood. This last one was one of them. And of course, I’m going to be hoping the same for you as well.

Yeah. And one thing I’m going to do to try and mitigate that…because the problem with lipoprotein(a) is it’s an acute phase reactant, meaning if there’s inflammation it goes higher. So I’m actually trying to go out of my way to avoid that. And one of the ways I’ll be doing that is going with the whole food based approach. So it’ll be a very simple sweet potato, lean meat type of thing. And I’m hoping that’ll help mitigate part of the mood issue, because I think part of that was largely due to insulin resistance and things like that. So hopefully that’ll help and I can coast through easy and just be bored, and that’ll be the worst of it.

And do you think the kind of carbs you had in this experiment where you were feeling irritable, played a part?

Oh yes. Michael Eades did a really great presentation not too long from that, to really emphasize, how a food is processed can matter for how it impacts your system. And he was going into not just your insulin, but also a number of other factors. I certainly have speculated on for some time when I like to call speed of entry…how fast things that you’re consuming, food stuffs that you’re consuming, can get into the vascular system. And particularly we’ve found a lot of ways through refinement that I speculate, can kind of trick our enterocytes to some degree. As I say over and over again, we’ve had a lot of practice as a species with protein, fat and very fibrous carbs. This is sort of a brand new paradigm where we’ve actually found ways to get, say, glucose inside of our bloodstream within minutes.

That just wasn’t really that possible before, not at these scales, right? And given that, it doesn’t surprise me that I’ve now done – in one year’s time – I’ve now done four different experiments that had to do with carbohydrates. First one being the skittles experiment from last year. Then I did the weight gain experiment where as the standard American diet. Then I did the white bread and processed meat experiment. And then a very recent one was the added dextrose experiment. All four of them have character to themselves in both how I was feeling about it. What I saw for the difference in my continuous glucose monitor and aftermaths.

And ironically of all of those experiments, the shortest of them was the added dextrose experiment. It was only four days long. It was a total of 75 grams of dextrose added to each meal. So a total of 225 per day. It was the highest my glucometer had ever gone. And afterwards I had cravings like I had never had post any other experiment. I actually really wanted sweets. So I had a whole bunch of keto junk food, but I kept trying to figure out a way to just get my head space out of it. It wasn’t until I went into the second version of the carnivore experiment that I was really able to reset. These things really weigh on me as to how much other people may be dealing with the same things. And I do believe, again, it’s not just carbs, it’s the nature of those particular things that I was eating.

Yeah, I agree. I was about to bring that up. We do see anecdotally that some people who are consuming liquid fats habitually – not just bulletproof coffee, but I’ve also seen an example of bone broth with butter melted into it – they can sometimes come back with really weird lab results, or weight stalls, or weight gains, and for the lab results it tends to be high triglycerides and it’s like I’m following really strict keto, but my triglycerides are really high. I don’t know what’s going on. And it’s on our list for people who have high triglycerides on low carb, are you consuming liquid fats? And I think it’s the same issue. It’s the speed of entry that’s the problem.

Yeah, there’s definitely something in that. I mean it makes sense logically as well, doesn’t it?

Well, I mean I think the best way to think of it is we’re having a conversation all the time. Our digestive tract is having a conversation that’s spoken in hormones, spoken through signals through the vagas nerve. These are practiced over 2.5 million years, right? And for Homo sapiens, we’re talking what, 200,000 years, I want to say. This is very long. It’s very common. There are all sorts of refinement that’s happened for how that system works, and now we’re throwing that all up in the air entirely. And so the signalling things like your leptin response, probably the dosage that was actually in your vascular system at the point where that was getting activated was so much smaller than it is on the Standard American Diet. So, so much more is inside, and that’s why people could have cycles where it’s not just a hypoglycemic but also hyperglycemic. I doubt any of our ancestors were dealing with this.

Yeah. And I just want to clarify that I don’t think this is a problem for everyone, but I definitely do think it is a potential problem because while I was losing weight, I was drinking the bulletproof coffee. And so it’s not everyone for sure, but I do think it’s important for people to realize that if they’re having issues, it’s something to think about because it can just be helpful to know what could be contributing to potential problems and then they can kind of figure it out and go from there.

And let me just add, I think one of the worst excuses to be having liquid or refined forms of fat is that you’re trying to “fill your macros”. Oftentimes people are trying to hit a percentage that they’ve heard is the keto percentage. I’m happy for family and friends to get into things like keto treats in the beginning to get into things like bulletproof coffee if they find that it satiates them away from carbohydrates to some extent. But I actually get a little bit frustrated with them if I feel like they could have a coffee that isn’t bulletproof and it’s not something that they necessarily need to have and they feel that they need to add it in order to hit their fat macros for the day. If you’re trying to add energy for the purpose of meeting these macros, I highly discourage it.

I agree. And people finding ways to add things like MCT oil just because they’ve heard they should be adding it. But for what reason?  It always comes down to these real whole unprocessed foods and if you stick to those in majority, it’s very difficult to go wrong, isn’t it?

Well, I do want to nitpick a little because I actually do take issue to the whole process debate, because there are plenty of processed foods that we eat that are perfectly healthy.

That’s very true. Bacon…

Cheese and salami and stuff like that. I think what I would like people to focus on is the metabolic effect of what we’re eating and the better we can understand that process, the better we know… I don’t react well to this. I react well to this. I can have bulletproof coffee be perfectly fine. Everything looks good. I feel good. I’m full from that. And then some people have the complete opposite reaction. And so I think that’s what I try and focus on is the effect of what we’re eating. Because what else would you care about in the end?

It gets back to whether you have a problem or not.

Yeah, exactly.

If you’re having fat shakes and fat bombs and you’re still running record marathons and so forth, then you probably aren’t listening to this part of the advice anyway, right? And I’m not going to tell that person, oh, you’re wrecking your life. If you’re happy 24/7 – getting back to that first meter – and you don’t seem to have any issues with your personal goals. You know, your weight’s at the right weight and you don’t have any stalling. You don’t have any disease states that’s arising. Whatever you’re doing is probably good. Probably is. That said, if you want my top list of suspects. If you find that your weight’s stalled. If you find that you’re not feeling good, I start with how fast are you getting food into your body? Because that is stored energy ultimately and your own hormonal system to be able to turn on those regulators like leptin to be able to tell you you’re done, that’s got to happen soon enough for you to then limit the amount of food that you’re eating.

Yeah, and I think this would actually apply to carnivore as well because I’ve noticed that people seem to sometimes think that because I follow a carnivorous diet, I’m recommending it to other people. And sometimes I think if there’s evidence behind something they’re experiencing, and carnivore could potentially help based off of anecdotal data that we have, I’ll mention it, but a lot of the time I don’t. And I think that’s because if you can eat plants and be happy and feel healthy and feel energetic and great – why would I tell you to do anything else? That’s just silly. Obviously you can try it and see if you feel even better, but then if you do that and find, whatever, I miss my vegetables then go eat them.

And you mentioned you were getting quite a lot of pushback and extreme reactions to carnivore experiments. Was it along those lines or something different?

Yeah, so some people even within the keto community, some big wigs for that matter. Some would say that it’s unsustainable environmentally. Some would say that actually there’s still a number of issues with nutritional completion. Certainly there are a lot who are concerned, even eating nose to tail, that you don’t get enough nutrients. All of these things, again, me being an N of 1, I like to go get my own data. I like to go see for myself. I know that I am going to be getting very wide spectrum testing and so I’ll have a fairly good idea of what I feel like the data’s going to look like, even if it’s just in the short term. And that I’m going to find more meaningful than what anybody tells me, truly. Because a lot of times, even what I’m telling myself turns out to be wrong, the blood work is the most important.

Oatmeal was an interesting topic in your CarnivoryCon presentation.

Yeah. So that presentation focused a lot on an area that I’d been excited to explore because I was considering – and truly I still am considering – I would like to do a plant based diet for around four to six weeks because I feel like that would give it the best shot. And if I went for that period of time, I need to figure out what diet I could eat that I would feel was nutritionally complete enough. And, believe it or not, I landed on Michael Greger’s Daily Dozen which I was showing in my presentation. It actually came pretty close to hitting all the stuff that I wanted to hit. But amino acids was pretty tough. And even with all of the different samples that I had put together, I found that oatmeal was really the primary source of the amino acids I was looking for. So then it was like, okay, well maybe I can just pump up oatmeal in particular, and then I found that it needed to be at least a pound and a half dry. So a pound and a half dry, which means…

I’d struggle with that. Just eating it consistently.

Yeah, so before adding water….Right, it’s like its so much oatmeal. And where I was going with that whole talk was that, amino acid composition – like if we were to take each of us and enzymatically break us apart to where we just have this bucket of the mixed amino acids, there’s around 23 of them associated with the human body. Well we’re pretty close to the other animals who are making a lot of the same proteins from the same amino acids, that I was basically pointing out that amino acids are kind of like the toner for our proteins that proportionality speaking, it makes sense why it is that those would end up being comparable to each other.

Whereas if you go to the plant kingdom, how surprised could you be that there’d be some amino acids that would be highly lacking while others were way over the top, right? And that’s what I found is that sure enough, while I was checking out, just trying carnivore, a nine ounce ribeye steak covered all my amino acids. A nine ounce chicken breast covered all my amino acids. Salmon, all my amino acids. It was crazy. And the other food compilation I put together – there was a dozen – really took about a pound and three quarters and didn’t quite get me there either.

To lower the tone of it…it’s no surprise that there’s a difference in toilet activity really. When you come down to it, the more nutrient dense it gets for your needs, the less waste there’s going to be. Whereas if you got to bulk it up with pounds and pounds of carbs…

Yeah, to be sure I’m going to… I have two very good vegan friends who I spoke of in the conference. What they would want to say is, well, okay, sure; but how much environmentally did it take to make that cow or to make that chicken and so forth. These are all, I think, valid things to bring up as long as it’s within that sphere. I think you’ve got to still separate though the two. You’ve got to talk about the topic of nutrition and it should stand on its own for nutrition. I lauded those people in the vegan movement who are trying to move towards more nutrition completion because I think it’s something that we should all be striving for. Again, if I had a vegan friend, just like Siobhan was saying, if they’re all into plants for that matter and they’re meeting their nutritional needs, why would I tell him to do anything differently if they’re happy?

I think you mentioned this in the presentation. The point is if you’re going to do it that way and I’m the same. If you want to do it that way, that’s fine. It takes a lot more work and effort, and being methodical about it, and working out exactly what you need to eat, and the variety of what you need to eat, to get those things you need. Whereas it’s a lot easier just to throw a steak in the pan.

It’s actually a really massive gap. Again, I really want to be even handed about it, but I would just love if there was a lazy nutritionally complete vegan diet that’s whole foods plant based. Because I really think I would have already been doing it by now. I would’ve just started acclimating to whatever that was, but I wasn’t able to find a way to reach the vitamins, the minerals and the amino acid completiveness that I was seeking. And I didn’t even need it to be perfect. I just needed to be close enough to where I could say I did a good shot at doing a plant based diet and here’s what it looked like. Not that I was going to change any minds in either sides of the movement, but because I want really good information. I wanted to see, hey, what does Dave Feldman look like on a nutritionally complete plant based diet?

And as I told my wife, I think I could pull it off if I just had a vegan cook in the house. And by the way, I’m not totally ruling that out. If it eventually gets to the point where I can rope somebody in to make all my vegan meals to be able to make it to that level, then I would do it. But as far as like me planning it, cooking it on my own, no. Yes, it’s just, its way easier to throw a ribeye steak onto the grill. I don’t have to do that much more past that point. It’s kind of daunting.

Yeah. I can actually back that up because I first heard Amber discuss carnivore at that first Ketofest where I met Dave actually. And after that I started… I was already working a full time job and then pretty much all of my free time after work was studying, helping Dave, talking to Dave, figuring out all this stuff, and so anywhere I could cut out time that I didn’t need to be spending, I was doing that. And that’s a large reason of why I started carnivore in the first place because it’s like, picking these vegetables of what I want to eat and cooking them and preparing them and chopping them, while I could just throw, you know, mostly pork on a baking sheet, stick it in the oven, heat up some cream cheese and eat it, and then be done in like 15 minutes. It’s just no comparison. And understandably though other people do enjoy cooking. Like my dad enjoys cooking. I’m not one of those people.

Nor me.

Not even close.

No, I must admit, I’m not overly tempted by vegan, but I can remember when I interviewed Carrie Diulus, and she made it sound really interesting and tasty. But the effort that goes into it, and for me in France, just the lack of availability of ingredients, if I was to do vegan keto, it would be so boring.

I know. If I could make things that were three ingredients and as fewer steps as possible, that’s what I want.

Now, Carrie if you’re listening, if you cook for me and Dave, we will come over, have a little vegan keto retreat, get blood work all together.

100%.

It’d be fun.

Carrie Diulus, by the way, is one of my favorite people in the keto movement. And she actually has a tough job because she is vegan – vegan keto – so she’s kind of straddling two worlds that are at battle with each other. And God bless her, she’s doing such good work, and not just for Type 1 diabetics – she’s Type 1 diabetic – but also for those people who are emerging who want to do a vegan diet, that’s ketogenic.

Absolutely. I have utmost respect for her approach and what interested me was that she landed there through self-experimentation via carnivore actually, and found that vegan keto was how her body felt the best.

Yes. And I think that’s a valuable lesson to take away. Because once again, if you’re really good scientist, you’ve got to keep from falling into your own biases. And so I would hope that if I had a family member that was in the same spot and I had them trying carnivore as the multiple removal diet, and they were still having problems, so we could figure out if they were the next Carrie Diulus, and move them over to vegan. Because whatever works is what we want to hope you can find, but part of that is remaining open minded the whole time.

Yeah. I just want people to be happy and healthy and that’s all I really care about.

What about coffee?

Coffee’s a fun topic for us. First of all, I should just say that it’s been annoying to me only from a studying aspect, as in it kind of came on to my radar really, and I want to say maybe a year and a half ago, but very loosely. And one of the experiments that haunted us a bit – actually, you weren’t as involved at that time, but you did know her, was a gal by the name of Brenda Zorn who I’m sure you know well. She had gone on a steak only diet before carnivore was even as big as it is now. And there was a lot of battling and a lot of internet rancor about it. But while she was on it, one month later she got her blood work, and her triglycerides are sky high. They were 500 and she didn’t have those kinds of triglycerides before being on keto.

Well, I tried to reassure her that probably it was temporary. Because at those levels, if you’re metabolically healthy, you can probably correct them quickly – that’s a lot of what this research shows. But sure enough it ended up tapering down. The only other thing she was having than steaks, was coffee. And ironically I asked her if at the beginning of the experiment if she could actually go without the coffee for lack of confounders, and she said there was just no way. And then brought up lots of euphemisms of things that would happen to me if I tried to make her. So that was the very first time it kind of came onto the radar. And the reason I started asking on occasion whenever somebody would come with high trigs and it didn’t make sense. And by it didn’t make sense is, we do expect people who when they go on a low carb or a carnivore diet, that typically triglycerides will be low in HDL will be high. Triglycerides being low, like say under a hundred would be ideal, but at least under 120 or 130, and HDL being high, typically 50 or above.

Now when triglycerides end up being above 150, but HDL is also high, let’s say 50, 60, 70. That’s curious. And we have two suspects when that happens. The most common one is they didn’t actually do a fully fasted blood test. We recommend that that you fast for 12 hours or more, preferably 12 to 14 hours is the nice spot we would like you to be in. Water only. No coffee. Now if they’ve done that – if in fact they definitely fasted for that period – our next question is do you drink coffee? And if they drink coffee, then our next suspect is that it could be a coffee sensitivity which we have seen with a number of carnivores. Not the majority of them. Don’t throw anything at your iPod right now, but a fraction of them do appear to have high triglycerides. We had somebody – Sean Brennan – who actually did a very extensive N of 1, showcasing this with himself that looks very compelling.

He was trying different types of coffee while intermittently having no coffee and when he had no coffee, his triglycerides were low. When he had coffee his triglycerides are high. Whether it was filtered or not, French press or even decaf.

So it’s the coffee itself. It’s not the caffeine.

That’s what we think. I mean to be sure it’s an N of 1 – as always, we like to get reproduction by other people who may have this coffee sensitivity to see what it looks like. And to be fair, our original No of 1 ended up coming back, ended up doing a very extensive experiment and it didn’t work the second time around.

So Brenda actually did a… I believe it was a six week experiment where she did a baseline test just eating her normal diet, coffee included. Then she included coffee for two weeks. So steak only, coffee, normal amount of exercise, not within a couple of days leading into the test, but otherwise. And then she did no coffee and we didn’t see the same triglyceride increase. But CarnivoryCon gave me some additional ideas because they were talking about phytotoxin – toxins found in plants and I’m wondering maybe it has something to do with gut permeability. I don’t think we really have any idea at this point. It’s definitely interesting though and definitely would like to see more people trying it out if they’re curious. If they suspect it, it’s pretty easy to test. Usually what people end up doing is they just subtract coffee for two weeks, go water only, and then retest and then they’ll come back and see it dropped from like 296 to under 100.

It’s really a remarkably high number of people that we see correct their surprisingly high triglycerides by either making sure that they’re at least 12 hours water only fasted, and/or eliminating coffee for like say 7 to 10 days. We usually like to say 10 days if possible. And that suggests there may be some phenomenon here. I do, by the way, have some new ideas I have to talk to you about, particularly since I’ve kind of come to realize a couple of other things since Michael Eades talk that may be relevant.

Hmmm…mysterious.

Yeah, we’ll talk.

They’re looking at each other secretively. I would hazard a guess though that if you found you got some pushback from carnivore, the pushback you’re likely to get from suggesting people give up coffee, it’s going to go off the charts.

You have no idea. I always feel like I have to hold my hands up in defence as any objects are going to be flown my way. You know what’s fascinating to me, is coffee I feel like is one of those quiet addictions. People don’t realize just how addicted they are until you’re even just suggesting that they go without it. And then there’s almost like a visceral reaction people get. This is the worst part…anecdotally speaking, the people who seem to have the coffee sensitivity anecdotally seem to be the ones who are the most attached to coffee.

I can see the logic in that though.

Yeah. It does make me wonder if you look a little deeper, one of the fascinating things you find out about is it’s an adenosine aggravator. But that typically is talked about as far as the brain goes, not so much as to what would be happening in the vascular system. Which is why I kind of assumed it wasn’t really that big of a deal. There really hasn’t been a lot of presentations and some work sent my way that has me like… I feel like I could spend a week just on looking at how coffee affects the human body. It turns out there’s really a lot of things it can impact. So all of these things have me quite curious.

Yeah, and to note, I don’t have this reaction, and Dave has asked me before…would you be willing to go without coffee? And I was like, yeah, sure, whatever.

But you’ll do anything it seems.

But she doesn’t have a coffee sensitivity, that’s her point.

I would be thrilled if I did because then I could just test it, test it, test it, test it, test it, test it, over and over and over until I could figure out what it was.

Then probably give it up.

Neither Dave nor I have figured it out. And it’s worth mentioning we don’t know if there’s an increased risk from this rise in triglycerides – we just don’t have the data on it. And so really I think it’s up to the individual, but it is worth noting, I’ve never actually seen a case of something that increases fasting triglycerides that is anything that you want to have around.

But what’s good for the goose is good for the gander. We don’t want to make the statement that we know for sure that this could be problematic. All things considered, I just say I don’t feel comfortable with it.

Yeah, and that’s kind of what we go with. People have to decide for themselves if they’re comfortable with it or not. And it’s just part of being honest here.

I’m interested in the behavioral side of it. After talking to Amber about how much liquid I intake, and I know a lot of that is just habit. I’ll have a coffee and then I’ll go make another coffee, and another coffee, and then my tea for the rest of the time. And I’ve been interested in doing a carnivore experiment again – really strict meat, eggs, salt. That’s it. But extending that out to just water – meat, eggs, salt, water – just to see…because having tried it before, the more restrictive you get with the food – as you’ve noticed – your appetite goes down and cravings go down, and all that stuff. I’m just interested to see…I don’t dislike water at all, but I don’t think I’ll have the same behavioral issues as I do with coffee and tea. I think I’ll only drink it when I need to – when I’m thirsty.

I definitely do still drink water out of habit, but I also drink other things. And I actually have tried to go water only before, but the first time I did end up successfully quitting diet soda, which is fantastic for me.

Same here.

Not because I have seen any hard evidence on any harm, but I didn’t like the feeling of being addicted to it. But going water only the first time resulted in really severe carb cravings, which I’ve never actually had before. And it got so severe, I was like texting Dave, like nearly in tears, like what do I do? And his response was to go have a cup of coffee if it’s that bad.

And it changed it, right?

Yeah, immediately after I had that cup of coffee, the carb cravings were gone and it wasn’t even like, oh, a carrot. It was like I was at the store and it was like, they sell donuts, you should buy like five donuts and just binge eat all of them. It’s like, what the heck is going on? So it’s very clear that coffee does have an effect on me and I don’t know what it is. It wasn’t that I was under eating, I was eating more than normal just to try and keep this stuff at bay. And then I actually tried again recently because I had heard on the Carnivore Cast – if you’ve ever listened to it – Amber had been talking about how she had had withdrawal symptoms and she supplemented with L-Tyrosine, which is a type of amino acid. I was like, all right, I’ll try this again, I’ll see if I can induce the cravings again and then do a clean break where I add the coffee back in, and then try a break again with adding the L-Tyrosine, and see if I can get rid of it.

I stopped after three days but only because it was making me really hungry, and I was also simultaneously trying to work on my presentation for CarnivoryCon and I was like, I’m not doing this right now, I just don’t have the head space for eating more than I usually do as well as trying to work on this presentation. So I’ll definitely come back to that. It’s not at the top of my priority list, but mostly just because I have like six other experiments I have ahead of that.

But I do actually want to express this. This is another observation of patterns that I certainly see a lot. It seems people are chronic soda drinkers are typically not the big coffee drinkers, and vice versa. A lot of people I know would say, oh yeah, you know what? I only drink water Dave. I mean, except for coffee. But it’s almost like a throwaway line. And this is where I find the visceral reaction that I do. And I’m like, oh, well why don’t you try just doing water only and cutting out the coffee, and then sit up straight. There’s an alarmed look as though, oh no, no, no, I can’t. Okay, well then you know, you haven’t quite hit water only, and it’s okay, you still have an attraction to coffee. It’s almost as intensive as what my prior sweetened drink attraction was.

I was a chronic soda drinker my whole life. Truly tried – this isn’t hyperbole – probably six times in the last five years to really give up soda. And that includes after I went keto and I was having diet soda. My cravings for sweetened solids went down, but my cravings for sweetened drinks didn’t. And I kept wondering how much of that was truly habit. Sure enough, while it could be a podcast of its own, and I’m sure Siobhan’s tired of hearing me talk about it, but it’s an area of great fascination for me. I finally figured out what I need to do in order to accomplish going to water only. So now every beverage I have is water. Full stop. Since May 1st of last year. So I’ll probably come up to a year pretty soon actually.

Yeah. And this is actually something I’ve talked about a lot with Dave because I had the same exact experience of trying to quit soda, trying to quit soda, trying to quit diet soda after I went keto, and it was like nothing would work. It was like this horrible addiction and I really didn’t like it. And so he went water only and I was like, okay, maybe that’ll work for me. And even though I didn’t keep the coffee out and stick with water only permanently, it did work to quit the diet soda, which I consider a huge win. And the funny thing for me is I don’t have the same addiction reaction to coffee. I don’t have the same addiction reaction to sparkling water or whatever.

So I’m mostly okay with keeping those in for the short term. And it’s just fascinating how different the response is because if I go to a coffee shop and it turns out they’re closed, it’s like, yeah, whatever, I’ll just go do something else. But with the diet soda, it was like this visceral disappointment at not being able to have it, and then the anticipation, and then the satisfaction. And then shortly after that, the anticipation again.

Panic if there aren’t enough left in the fridge and it’s a Sunday and you can’t buy anymore.

Yeah. I really would love to figure out what that is because I don’t think it’s necessarily the sweetener. I don’t think it’s necessarily the carbonation.

There’s some kind of a fix effect.

Yeah, definitely.

There’s some kind of a key satisfaction that does seem to be quantitative in nature. During the time…people also knew me before I started the water only challenge, that I would obsess about the subject a lot and really break it down. I even got to the point where I would kind of break it out into what the phases of joy were. So, for example, at the point where I knew I was going to go get one, I had a reward effect just in knowing that I was going to go get one. And that oftentimes felt like the biggest effect of all. That now the plan was in place, I would say, be walking across the street to the grocery store and, oh, it was just going to taste so good. And that had a euphoria all on its own before me even having one sip of it. And then as I drank it, I oftentimes wouldn’t drink it all at once, like chug it. It would be kind of a nursing it, sipping it slowly, et cetera.

And then there was sort of an aftermath. An aftermath that seemed for me to last about two hours. Around two hours of almost as if I was still sipping on it. But it’s a fresh memory of joy and therefore there was this kind of euphoria in the aftermath. And that to me was something that I found to be so fascinating because here you are, you’re having an experience that you could say stretches out over two and a half, three hours from this one drink. From this one 20 ounce bottle.

I’ve always found with that, but with other sweet things. I remember it with ice cream – was that anticipation and that climb, that mounting up to the top. That actually when I started eating it, I realized I was back on the way down. That high point was actually before it even went in my mouth I found.

I think that happens a lot of times especially with things you’ve determined that you’re going to cheat. Like if you were going to break a commitment. The excitement of breaking the commitment is almost greater than when you’re breaking the commitment. Like you’re almost in the process of eating this food. You’re like, you know, I didn’t really need to eat this even though this is off my diet, and I decided to do this, right? But I try to bring this up for people to kind of realize it. If right now I were attempting you with a donut, and you really didn’t want the donut, and I was like, this is great donut. Telling you we’re all going to have one, and you really felt like you wanted to have one, and then you went, all right. And at that point you committed to going ahead and cheating. You’re like, you sure you’re going to…

And in that moment you’re getting excited about it, and then I go, no I was just kidding, I’m not going to let you have that donut, I’m going to be mindful. I’m going to be careful. You would actually feel this kind of frustration and resentment towards it, as opposed to relief that I just now prevented you from breaking your commitment. That’s what’s so fascinating to me is I think that a lot of that initial joy is relief from indecision. You were being tempted with something that you weren’t so committed to that you could ignore it, and you were sitting there teetering for so long that it took that moment where you said, okay, I’m going to go ahead and commit to this direction – it’s just the easier one – that you actually felt a release.

Is that part of what you were saying…you said the only thing that worked – with repeatedly trying to give up the soda, and then the diet soda – was the only thing that worked…just going to water only.

Yes. So I will unpack this for a second just because you’re curious. Basically every time I tried to quit I had that which I would replace it with. So either I had say sparkling ice, which was another kind of sweetened drink or sweetened tea that I’d sweetened with stevia or just club soda. I’d rationalize, okay, well you know, its sparkling fizzy water, so I’ll still feel somewhat entertained. But there was a problem with every single time I did this; my head space was still applying the attempt to go seek this out. To seek out these other replacement beverages. And therefore, even if I was drinking more water, it didn’t change that the water was disappointing because I could have been having the club soda. And so then I would still be…we’d be going to different restaurants and I would care whether or not they could serve a club soda or not.

And let’s say I go there and I said, could I get club soda? And no, we don’t actually have club soda, would you just like water? And I’d like, yeah. But I’d be disappointed. So what I needed to do was I needed to find a way to remove beverages as a source of joy. Only when I could do that could I remove them as a source of disappointment. So that sounds almost too easy to accomplish. But that’s exactly what happens. And I like to use smoking as an analogy. You don’t smoke, right?

I used to.

Oh, you used to smoke. Okay. So when you’d gone a long period of time without smoking, it’s not so much that you would think, oh, this inhale is a wasted inhale. I could be inhaling smoke, right? But on some very tiny level…actually kind of is, because you had a bodily function that you now apply to the source of joy, right? Well, if you think about it, drinking is a bodily function that’s being applied to a source of joy because we now have drinks that make it entertaining. I needed to change my drinking to be just like my breathing. So if it’s not a source of joy, it’s not a source of disappointment. It just is.

Yeah. And I wanted to make a point because the big problem with me is it would result in this cycle. For me, eating is a huge source of joy and excitement and pleasure and it’s all good. But after I’ve eaten, that’s it. I’m not hungry anymore. It stops there. It doesn’t turn into this cycle of eating and excitement like what I had before. And it was actually a rule that I had very early on into keto which is, if something was resulting…if I ate something immediately after eating that thing, if I just wanted more of it, it was out. Immediately. Not allowed in my diet. And so that included fruit of any kind, even low carb, berries, nuts and stuff like that. And it’s just because if something is hijacking my appetite like that, or my mind like that, I didn’t want it anywhere near me. Like I think you’ve mentioned before, there are moderators and abstainers. I’m a hardcore abstainer. If I can’t moderate, you don’t deserve to be anywhere near me. And so the diet soda was definitely the hardest of those. But really satisfying.

In my opinion, there are very few actual moderators. I think most people in order to truly quit something, need to completely cut it out. And to Siobhan’s point, I’ve actually given this advice before myself in that, if I find I will eat something – not that I can eat something or even that I desire to eat something, but that I will – then that is something I need to be mindful of. What is it that activates me to go ahead and eat something when I’m not hungry? So by the same token, I would say the same thing with beverages. What gets you to drink something when you’re not thirsty? Because a lot of the soda I was drinking, I wasn’t drinking when I was thirsty.

Exactly it. That’s what I was thinking. That was my instinctive feeling that just taking it down to water; I would only drink it when I actually needed it

And that was always the pitch to myself long before I was into keto and nutrition or any of that, going all the way back to my twenties I kept thinking, if there’s one habit that I could feel confident was a net health gain, I’m pretty sure that it would be to just drink water only. That anything I’d be drinking that wasn’t water was probably worse for me on balance. Even if it was a “vitamin water”. Probably anything that I could get from a beverage, I’d be better served getting from food. So if I could just flip a switch…and I had actually said this to Siobhan before I pulled this off…if I could flip a switch and just drink only water, that’s what I’d like to do. And so I’m so happy to have found that actually it’s easier than it’s ever been. Each month it actually gets easier than the month before. It’s like, great, now I don’t even think about it.

And it’s so fascinating because this seems to be – this type of cyclical reaction to things seems to be – very individual because I’ve heard people having the same struggle with dairy, and I was like, hey, maybe that’s me. I’ll quit dairy for a month and see. But even before that I would have cheese in the fridge for like a month, and I just wouldn’t touch it except for an occasional meal. And then after that I was like, I don’t want any more of this. And I did go a whole month without dairy and I was like, this is nothing. I don’t even care. Even after that I didn’t really go back to eating that much dairy. So, for me that’s a non-issue, but then for other people they’re like, I can’t have cheese in the house. I can’t have it anywhere near me because I’ll just eat it even if I’m not hungry.

And I really wonder, is this a different physiological reaction to the food? Is it a psychological reaction to the food. Is it both? I’m really curious what drives that? Because it does seem to be pretty individual.

It comes back a lot to addiction I think. Abstaining, moderating and just those emotional reactions to food or drinks. What’s next on the cards for experiments? Siobhan, you mentioned high carb, low fat.

Sweet potato and lean meat. Not Looking forward to it, but hopefully the data is good. I have a whole ton I want to do after that. Pork with L-Carnitine because I’ve seen a drop in Lipoprotein(a) with beef. And then maybe some more fasting experiments. I want to get a cardio check, which is a home cholesterol meter and do some fasting with day to day or even hour by hour readings. Just lots of fun stuff.

And how long have you got to torture yourself with the high carb?

I think probably two or three weeks just to give it a fair amount.

I look forward to watching that one. What about you Dave?

Well, so there are two experiments. One that’s the top secret experiment that Siobhan knows about, but I think it’s less likely it’ll be in the very near future. There’s one that I would like to do that I may be able to pull off even within a week or two, of total time of the experiment – which is I’d like to do my baseline and then the intervention be the addition of insoluble fiber. So I’d like to see what that would do with my blood work. Obviously there’s lots of speculation on that. But all of that said, I’m very reluctantly coming to grips with the fact that I am human, and that apparently I may need to de-emphasize my experimenting for a little while because there are some larger responsibilities that are coming onto the scientific front with some bigger players. And I guess I could…this may be the first podcast I mention this…I may have a book coming out in the near future.

How exciting.

Yes. My hope is it will be sometime late summer, or the fall. We’ll see because me being me, I’m sure I’ll be obsessively editing it a lot.

I know all about obsessive editing.

And I better be one of the first ones to get a signed copy.

Oh, I think you’ve got an in.

So perhaps you could leave us with a top tip.

I think for mine, it would be to pay really close attention to yourself. You know, if something is changing your behavior in a way that you’re uncomfortable with, it might be something to think about. And unfortunately that does include coffee for some people, not everyone, but also food habits. People, just try and pay attention to yourself and see what sort of impact things in your life are having, because you never know what sort of impact removing it could have. How about you Dave?

I’m going to extend my invitation that I gave at the talk today, which is that I really want anybody listening who likes the work we’re doing to consider being one more contributor. Don’t underestimate your contribution to also be a citizen scientist, because as I said in the room, every one of us is. Every one of us are conducting an N of 1 experiment and we actually are pretty interested in how the outcome of that experiment goes. Well you may learn something quite valuable that can help you out, but why not go ahead and help out everybody else as well.

Good point. And where do we need to go to do that?

Cholesterolcode.com is of course the site we manage and we put up a lot of our materials there. We do also invite people to come to the Cholesterol Code Facebook group -a lot of people are networking there. And of course for those who are Lean Mass Hyper Responder – having LDL of 200 or more; HDL of 80 or more; Triglycerides of 70 or less or thereabouts – may want to strongly consider a special Facebook group we have for Lean Mass Hyper Responders.

Fantastic. Thank you very much for sharing your time with me. It’s been a great pleasure, especially to do it with you here in the same room, face to face, and to have shared this wonderful conference with you both. As well as CarnivoryCon of course, which was amazing, wasn’t it?

Yes, it was. Thank you for having us.

Yeah, wonderful. Thank you.

Thank you.

This transcript is brought to you thanks to the hard work of Cheryl Meyers.

Welcome Bec to the Keto Woman podcast. How are you doing today?

I’m doing really well. Thank you Daisy. Thanks for having me.

Loving the conference?

It’s awesome. I’m learning so, so much, my brain is full.

Mine too. It’s, it feels like there’s a little bit of space there left to maybe squeeze some more knowledge in, but I was just saying earlier before we started, I sometimes feel have this sort of limit to how much you can stuff in, in a limited period of time. But you made the comment and I think that’s absolutely true that they’ve got a really nice pace with different presentations going on that that just stops you having that overload effect.

I agree. I think that they’ve balanced the high level public health content with the getting down into the weeds with the technical stuff really well. So you can come through a technical presentation and just have a little bit of a break and zoom out and take on something that’s a bit more big picture. I really like the way they’ve balanced that.

Yeah, me too. So tell us a bit about you.

I am 35 years old. I’ve had Type 1 diabetes since I was 17. I’ve been eating low carb for about 17 and a half years. So seven or eight months post diagnosis, I switched to a low carb diet and have been Keto since about 2012 when I started experimenting with a Ketogenic approach for endurance exercise. I’m also the CEO and one of the founders of the Type 1 diabetes family center in Perth, in Western Australia. And that’s a facility and service of which I’m immensely proud. 

We’re now supporting more than a thousand people impacted by Type 1 diabetes in our state. And we very much have an holistic and food first approach to diabetes management encompassing not only nutrition, certainly, but insulin therapy, being versed up on all the tools, the technical tools and devices that you can use to manage diabetes, but also mental wellness, peer support and very much that wraparound social support element that I think is needed for a life well lived with a chronic disease like diabetes.

I think it’s really important to take that holistic approach.

Absolutely. And I think that we’ve had a very medical model of care for Type 1 diabetes that’s really focused on insulin therapy and insulin delivery devices. And I feel that zooming out and looking at all the different pillars of good diabetes care and good health and nutrition, exercise, mental support, and indeed family support. That’s why we called ourselves the Type 1 diabetes family center as far as I’m concerned, Type 1 diabetes is a team sport. Every person in a family is impacted by a diagnosis, and every person needs to be knowledgeable, compassionate to the person living with diabetes but also to themselves because it is a long journey and it can go on a lot of different directions and the family center is there to help people through that.

And it’s great this working together with the patient and their family, which is really important, but with the medical care they’re getting. I was talking to Belinda Lennerz earlier and she was saying that there’s often this mismatch between the patient and the practitioner they’re working with and that they’re quite often feeling really alone because they’re going out on a bit of a limb getting involved in this way of eating and then not feeling supported. So it’s really nice to hear that there are more practices at least embracing this approach even if they can’t necessarily promote it, but it sounds like you’re able to take it more to that level to actually promote it and suggested as a way of eating and a lifestyle to adopt that’s really going to help manage the lifestyle for the Type 1 diabetic in question.

Yes, we are, we believe that a low carbohydrate approach should be on the table as one of the first line therapies in relation to Type 1 diabetes management. Obviously it’s always going to be adjunct to good insulin therapy. However, we’re not afraid to talk about it. We feel that it is not that controversial. It’s just eating real food. And it is certainly central to our approach to care. If patients want to come in and talk about it, then we’ll have the conversation because at the family center, we believe that people with Type 1 should be supported to transition to or maintain a low carbohydrate approach with solid dietetic support. They need to be meeting their micronutrients, they need to be meeting their energy requirements. And I think that not everybody does it well alone. And if we’re able to provide them that clinical support, then that’s what we’re here to do.

We are not necessarily leading with it. We lead with the holistic approach that I think the patient-centered approach is really what we’re about, in that when patients come into the family center, the first question they’re asked is what are your goals? And we really work with those because if somebody comes in and, HbA1c isn’t their goal and it’s not their focus, but perhaps weight management or exercise or managing hypos is, then we’ve got to go in building a relationship on what they need, rather than necessarily going away and say, well HbA1c is the marker of good diabetes management. That doesn’t necessarily serve them. So, that’s what we do.

And what are the most common concerns that people have when they come to you? The primary concerns, the things that are impacting their lives in the most negative way that they’re trying to fix or find strategies to help, you know. What are the most common problems that people are asking for help?

In relation to diet and Type 1 diabetes or more generally?

I suppose generally, because you take that holistic approach in just managing their Type 1 diabetes. What are the biggest issues that they have that really impact living a quote/ unquote normal life?

Before we opened the family center, we ran a whole series of focus groups asking parents of kids with Type 1 and adolescents and young people with Type 1 what they needed. And the theme that came through most strongly was connection. They said to us, we feel isolated. We feel alone. We feel unsupported and underserved by not only the medical community but by the community at large. People don’t understand our disease. It’s invisible, which is in some ways a blessing and in some ways a curse, because the general community doesn’t see it, doesn’t understand it. And the power of connection is transformative. And that’s why we have very much led with a peer support approach. 

We’ve set up online communities that are thriving with parents of kids with Type 1 and now adults, and they’re running through closed Facebook groups. And as you’re known as someone participating in the social media world in relation to Keto and this way of eating, it’s just a live dynamic community. And so we’ve set those up. We have hundreds of engagements every day through our online communities and we also have a lot of face to face connection and events. So that’s how we have tried to build a community in Western Australia, our own people with Type 1, because we want to make sure that people don’t have to live that lonely road, and that they, they can feel connected. And I think the value of connection is not only in the sense of not feeling isolated and alone, it’s also the information exchange that happens when you’re part of a bigger community, the hive brain that you can tap into of hundreds of people that have experienced what you’re experiencing and can offer insight and advice and knowledge. I think there’s huge value in that as well.

That’s a really big difference, isn’t it? I can remember when I had my first weight loss surgery and I was just completely isolated and just couldn’t do it, wasn’t getting good information from the bariatric team and there was just nowhere to access the information until I started finding online groups, you know, and that surgery didn’t go well, but when I had the revision surgery, I had access to all these online groups and the difference was incredible. Being able to make contact with people who are going through, have been through the same thing. It’s just worlds apart from dealing with the theory of it from someone who hasn’t experienced it. It’s just so much more reassuring to be able to, to talk to your peers in that situation isn’t it?

It absolutely is and we’ve made that central to the philosophy at the family center in that nearly every member of our team is personally impacted by Type 1 so it goes all the way through to the people. I truly believe that people with Type 1 diabetes should be working in diabetes organizations because there is that sense of, again, connection. You can drop your shoulders when you walk into the family center because everybody there gets it and that ocean deep compassion, that’s the stuff. That’s the stuff that changes the trajectory of people’s Type 1 diabetes management that helps them come to terms with it, to make peace with it because they see others who are living with it and working well with it. And I think that’s what we aim to create.

I’d be really interested to hear more about your personal experience about when you got your diagnosis. What led up to that? What led up to you know, you obviously realized that something was going wrong, there was a problem, but I’d just be interested to hear more about that.

It was interesting. It came off the back of it very, very stressful year. I had finished my final year exams and I was the goody two shoes over achiever at high school who was the captain of everything. And I had, I believe that maybe that lead in of that sort of eight to 12 months of high stress in my final year at school, was possibly one of the triggers of my diabetes diagnosis, which was in April the following year. So I got a really unwell over a series of, you know, short months and lost a lot of weight. I think I lost 12, 14 kilos over a couple of months. Started—the thirst is just indescribable, and I remember I would wake up through the night and probably I drank the worst thing I possibly could have drank. I still couldn’t, I couldn’t even go near a glass of it today. And that was apple and guava juice. I went through liters of the stuff! And indeed I remember being at a wedding, and that night I was so thirsty, I drank five carafes of lemonade. I mean, and I, I remember the fellow I was with thinking, what is wrong with this girl? 

And I was just making my sugar level higher and higher and higher and getting thirstier and thirstier. I had every symptom in the book, blurry vision, sores that wouldn’t heal, leg cramps—and finally my mom dragged me to the doctor. I had, she had made several appointments for me, which I had canceled cause I hate going to the doctor. And I went to see my GP who did a finger stick. And, actually no, he did a blood draw and I got a phone call the next day and I’ll never forget his voice. He said, ‘Rebecca, you have diabetes.’ And it was his very final sentence. And my heart sank. I didn’t really know what that meant, but I knew it was bad. And he basically said, get to the hospital asap. And I went there and I was diagnosed and it was just this whirlwind of three or four days. I was admitted. I was given my first insulin injection, which made me feel instantly better, which was wonderful. 

But then I was given the education and I will never forget again, they gave an brought in an orange and a needle and they made me practice learning how to inject with the orange because it’s the same sort of texture as flesh, apparently. So I injected a number of times and then they gave me a fresh needle and said, okay, now it’s your turn. And that was it. That was the start of five to seven injections of insulin every day. I think on calculation I’ve probably had around 45,000 injections in my life. It was the start of eight to 10 blood glucose finger pricks every day. And it was the beginning of the counting, the endless counting of carbohydrates, fats and proteins, plugging that into complex insulin to carbohydrate ratios, which change in my body four to five times a day. The string theory that you have to do to manage insulin dose calculations. And I guess the beginning of that fear, which lasted in a very intense way for the first eight months, of administering a hormone that is so powerful, it will kill me if I get the dose wrong in what back then was in really quite large amounts and had me afraid to take a walk around the block.

That’s incredible.

Or to go to sleep or any of those things that are normal life we should be able to do without thinking. And that was the beginning of my journey towards finding a solution.

Yeah. So what advice were you given when it comes to diet?

Eat according to the Australian guide to healthy eating, which was, you know, 8 to 12 serves of starchy vegetables and grain based carbohydrates every day. Limit fat, lots of fruit and I did, I dutifully did that for the first eight months. It was cereal and toast for breakfast. I had sandwiches for lunch, I had fruit for snacks. I had pasta for dinner and every meal, my blood glucose surged high and then crushed low because insulin is a woefully blunt tool. Synthetic insulin in any case, it is not even close to the sensitivity of a physiological insulin response. So I was trying to deal with these tsunamis of glucose charging into my system with, you know, great big wads of exogenously delivered artificial insulin and a lot of guesswork.

That’s what strikes me—that the calculations are just fraught with danger because they can only be guesstimates at best.

They are. And I think that we’re given this advice as people with Type 1 that here is this thing called the insulin to carbohydrate ratio. And if you count your carbs accurately and you weigh them and you’d do the ratio, then your dose is going to be good. And I really genuinely think that many members of the medical profession believe that works. It’s not sound science, it’s much more art than it is science because there are so many factors that influence not only the carbohydrates and the rate at which they’re absorbed into our system, but also how fast insulin is absorbed. I know from years of practice that if I put my needle in my stomach it’s going to work a lot faster than if I put it into my arm. And if I put it into my bum, it’s going to work in a different way altogether. 

And so even just the basic where you put your needle in is going to impact how fast the insulin works. And then there are myriad other factors around absorption of tissues at the site, you know, how active you’ve been. I think wonderful Adam Brown has isolated 42 factors that impact blood glucose and a lot of them are food and obviously insulin related. But it is, it is just such a complex beast, and the advice that you’re given that here’s the formula, go forth and conquer. It just falls flat. And yet I think so many people, it raises this false hope that “We’ve got, we’ve got a tool, we have a formula,” and it just doesn’t work like that.

There are just variables at every level, every turn. But yet you’re being told that this is quite an accurate linear equation that you should be able to master. So if things aren’t going quite right, which I imagine is probably the norm or certainly not going right all the time, the logical conclusion of that is well, I must be doing it wrong.

Absolutely. And there, I think the feeling of I am a failure is a very familiar feeling for people with Type 1, because you know, we’re set up to hope and believe that with the formulas and with the counting, you know, we’ve got this control over diabetes and that doesn’t work. And then when we go in to see practitioners around it who aren’t compassionate to the daily experience of living with Type 1, it can feel like you’re a naughty kid being dragged in front of the principal. You know, they’re there. I remember going in to see my endocrinologist and he would flip through my diet, my book, you know, there’s apps for this stuff now, but I used to write down all blood sugar levels and, and I might have fantastic control for weeks, but then he’d flipped back and he’d point to the hypo that I had on the 7th of April, which is months before, and he said, what happened here? And the whole appointment many times would be zero in on something that went wrong and reverse engineering that. And so there is never a sense—well there wasn’t in my experience—it wasn’t a sense of congratulating me or celebrating me for the things I did right. It was more around, okay, how do we hone in on the risks and that and the stuff that I didn’t do right. 

And I think the hard thing about Type 1 is that it’s all on me. All of those calculations, all of the discipline around food, around exercise, around managing those myriad factors, it’s all on me to manage. There’s no other thing I can blame. And so when it goes wrong, it does feel like my fault. And that can be a really hard thing to deal with. And learning more recently around self-compassion, and building that resilience and, and compassionate self-talk and behavior has been a really important piece for me and a relatively new thing. But we have to be compassionate to ourselves because there’s a lot of management that goes into diabetes at any given moment. 25% of my brain space is taken up with calculations.

Got to allow some room for other things. What triggered, led you to start looking for something else? A different way of managing all this?

There wasn’t a particular incident. I just woke up one morning and said, I can’t live like this, I’ve had enough. I there has to be another way. And I think I went, it wasn’t Google then, I went online and found the Dr. Bernstein “Diabetes Solution.” I wish I could remember the search terms that I plugged in to find that, but I saved up, I was working in a video store as a student at the time and I was earning $11 an hour and I had to save up, I think it was about $68 to buy this book and pay for the shipping. And it took weeks to come from America. There was no Amazon or Book Depository then. And I read it, I devoured it and it made so much sense in indeed I had already been restricting carbohydrate in the lead in to getting this book because I just couldn’t cope with the high, the feeling of my high blood sugar. And then reading that was very much validation. 

So I took those high level principles I felt much more confident about it and implemented them into my life. And almost immediately everything changed. My insulin dose has dropped by 75%, and they still remain very, very low. So my error margins dropped significantly because I wasn’t, dosing myself with industrial doses of insulin anymore. My hypos became mild instead of completely brain frying, you know, shaking, sweating, terrifying things. And everything became so much easier. My roller coaster blood glucose levels smoothed out and I have maintained that way of eating, with a few blips, admittedly, for the last 17 and a half years and maintained A1Cs in the low fives and high fours. I think my highest A1C ever was 6.6 for the majority of that time. It has completely changed my trajectory, with this disease and my ability to live a rich and full and active life with it.

Yeah, and I can just sense that switch from despair and I just can’t do this anymore to one of hope and potential of happiness and normality.

Absolutely. And people say, Oh wow, but isn’t eating low carb hard? I think it might take a bit of discipline. I find it extremely easy now, and a bit of creativity in the kitchen.

It takes some discipline to start with.

Yeah, I agree. It takes, you know, build your knowledge base, get committed, be disciplined around navigating your food choices and you know, get creative. Although it’s getting easier and easier now. It wasn’t easy then because they were no low carb conversations happening. I was very much out in the wild. But it is something that we can do and we can thrive with. And you’re absolutely right. Once you have that foundation and that base laid around the confidence and the skills to eat low carb and navigate food, then it becomes so much easier and life does feel more hopeful.

I was at a party last night, Pamela Zorn had laid out a wonderful array of food and we were just laughing, you know, joking saying this, this way of eating is so onerous. There were two or three different kinds of crackers, there was a delicious smoked salmon dip. She’d made cultured butter, cultured truffle butter, poppers, prime rib, smoked chicken.

Where was my invitation?

Is so hard. How can anyone think eating that is onerous in any way? Yes, the transition is difficult because apart from anything else, you know, most people are just fighting that carb addiction. But once you’re through that and you can just revel in so many things that we’ve been told for so long are bad because they’re full of fat, but they’re delicious.

Yes, yes.

But you’re a swimmer, a competitive swimmer.

That’s right.

Tell us about that and how that all the implications of that with the Type 1.

I love swimming. I’ve been swimming since I was a kid. And I’ll dial back a little bit into sort of transitioning across into Keto because it has been, I had to take a long hiatus from swimming until I really got Keto right, because for various reasons there were difficulties, technical difficulties around testing my blood glucose in the water. But also the transition across to Keto in 2012 was around endurance exercise. Generally. I was doing long distance mountain bike racing at that point and triathlon and the conversation around ketogenic diets and becoming fat adapted sort of came across my radar with Steve Phinney and Jeff Volek’s book, “The Art and Science of Low Carbohydrate Performance.” And that really changed my thinking around how I could become a better endurance athlete by becoming completely fat adapted.

At that point I’d probably been low carb, and eating above the Keto threshold. When I read that book, I dropped my carbohydrate considerably and change my macronutrient ratio and found myself racing around mountain bike courses with a big smile on my face and endless energy. And that really helped me feel safe and confident to come back to swimming because I felt having watched my blood glucose stay completely stable while I raced and trained on land, I felt confident that I could get back in the water. And at that point, because I was not able to test my blood, I could still trust that it was going to stay stable. So that was really the push that I needed and certainly wanted to be able to get back into swimming. And I have since gone on and done the Rottnest channel swim twice now, which is a 20 kilometer swim to an island off Perth.

We’ve got a few big plans to do a double crossing next year. So that would be a pretty major achievement that I’d really love to tackle. But we do a huge amount of training, so squad sessions, sessions in the river, sessions in the ocean every week in the lead up to these races. And yeah, fueling it with a ketogenic approach. It’s quite remarkable when I see my swimming friends who are taking on carbohydrates every 20 minutes while we’re training and gel shots and we’re having to drop drink bottles with PowerAde right up and down the beach when we do our long sets and they all remark, you know, how do you do this without any fuel? And I think I’ve got enough fuel in my left bum cheek to swim to Madagascar and it feels wonderful and very freeing to not only be able to feel like I have an endless source of slow burn energy, not have to eat because—eating while swimming, I don’t know if you’ve ever tried it. It’s not an easy thing to do—

I can’t imagine it would be, no.

—when you’ve got a salty tongue and you’re tried to ingest something while you’re treading water because you’re not allowed to hang onto a boat that’s against the race rules. It’s, it’s not a fun thing, you know? And I’ve got mates that ate peanut butter sandwiches and all sorts of ridiculous things out there and they’re great. I’d rather just keep swimming, thanks. But also finally to trust that I can, my blood glucose is going to say stable. That’s the holy grail of exercise formulas for someone with Type 1. So it’s something that ketogenic diet has very much enabled me to do and, and to do well, which I’m really happy about.

I can still remember my mum used to drum into me that I wasn’t allowed to swim until at least an hour after I’d eaten. So I think I’d constantly have that voice in my head. Well, you can’t possibly eat and be swimming at the same time.

You’d have to take a little rest, a siesta floating on your back. I don’t actually understand.

I don’t know where that has come from either. But it was just something that was this really strict rule.

Yeah, I’ve heard that too as a kid. So I don’t know about that.

Presumably then you must have seen quite a difference with the practicalities of how you were organizing that your swim before and after Keto. It sounds like you’re not having to take on any fuel at all, you know, in the competition swimming or do you have to take on some?

I could very easily do it completely fasted. I guess the only reason why I need or I would refuel during a long race is if I get a bit hungry or to lift my spirit. Because if you’re face down in murky green water for hours and hours on end with no one to talk to you and just inside your own head, sometimes it’s nice to take a break and having something nice to eat is, or take on board is just something to do. I think the other reason why I might take some nutrition in is to keep me warm and that does actually really help. Yeah, there’s no real need for it. I can run on ketones and feel like I’ve got perfectly stable energy levels throughout long swims.

But you did need it before, pre-keto?

Pre-keto, I was doing a little bit of swimming, but I think that at that point I had a lot less knowledge and the skills weren’t there in relation to how I manage diabetes and I wasn’t doing particularly well, which made me sort of avoid swimming to a certain extent, the testing regimen was a lot more onerous. Now I wear a Freestyle Libre, which is the little sensor I can put the receiver in a waterproof phone bag and just scan myself in the water so I’m totally self-sufficient. Then I’d have to stop and dry my fingers and get warm and test my blood and it was just fairly onerous to do. So I think that combination of the technology and the ketogenic approach is really just allowed me to do swimming with the freedom that I want to do it with without having to constantly think about or be anxious about blood sugar levels and how I’m going to test them next.

I remember Richard Morris telling me about the practicalities. You have to have the insulin you potentially need floating out there, accessible for you to use when you need it?

Yes. So, when I race, I have a paddler, a support paddler and he would have my hydration, nutrition, insulin or preprepped, my glucose monitor in the Libre. And when we stop to do a blood sugar test, he will throw me Libre. I can’t touch the boat. I’ve got to tread water, scan. If I made insulin, he’s got the pens, he has to throw that to me. It’s got a float on it so that it doesn’t sink because I can’t even be passed something because that would be a disqualification. I have practiced treading water and injecting insulin. It’s not as difficult as you might think with a pen in particular. And yeah. So all of those transitions have to be practiced before race day to make sure that we’re doing it right. I’m not going to be disqualified and I can do all the diabetes management tasks that I need to do.

What’s the distance? How long are you talking about with these races and the time that it takes?

We would do 10 kilometer swims regularly on the weekends and the distance for the race, this recent one’s 19.7 kilometers. So what’s that? About 12 and a half miles, I think. The first time I did it was horrific. It took nearly 10 hours. I got stuck in a horrible current and I swam over the same rock for about two hours, at one point I think it was soul destroying.

I was going to say, that sounds like the ultimate in frustration.

It was awful and I was seasick and I didn’t know that I got seasick until about 10 k’s in, when I started being sick and my heart just sank because I thought, oh my gosh, I’ve got a long way to go. If the only thing that’s going to fix me at this point, because I can’t keep anything down, is being on land and I have 10 kilometers to swim. So that took me six hours, that last 10 k’s of that race because of the current issue. And because I had to stop every 15 minutes to puke. But if not for keto at that point, if I had of been a carb dependent athlete and I needed to have nutrition going in every 15 or 20 minutes, that would have been my swim over, you know—and I trained for six months for this race. 

But the fact that I didn’t have to take anything on board as I was being sick, that was something that I was thinking far out, I’m so glad that I’ve adapted to this approach because I just don’t need to have the fuel. It’s awful vomiting, but I can get through that. The second time I did it, which was last week, it took me seven hours. So I took three hours off my PB, which I’m really happy with. You don’t do that every day. And it was a brilliant swim, I had a great time. I had a tiny little bit too much long acting insulin on board, which I started to really wear in the last couple of hours of the race. So I did need to take some glucose on to counteract that. But again, first 14 k’s was a breeze. I had half a YoPRO yogurt, which was three grams of carbs just so that I could take some medication on board at the 10 k mark and more sea sickness tablets. And that was all I would have needed if not for that tiny little bit too much insulin. So I felt a lot better through that race.

So you’re out there apart from your support team, you’re out there on your own. Multiple people are racing but yeah. So all on your own

Yeah, the Rottnest Channel Swim is an iconic event in WA [Western Australia], they have about two and a half thousand participants, not all solos. There’s about 300 odd solos that attempt to do it each year and the rest of doing it in duos and teams. So it’s a busy race. It thins out a bit in the middle, but very congested at the start and the finish, I don’t think I would swim to Rottnest just on my own. I like the safety in numbers concept as you may know, WA is also the shark attack capital of the world at the moment. So I think that I’m, I’m happy to be in the mix there, but it’s a lovely swim. You can see the bottom the whole way. And it really is a stunning environment.

You’ve mentioned a few times how things were when you were first diagnosed and the technical advances in things that are available to you to help you manage and monitor this. Perhaps you could just share a little bit about the change that you’ve seen over the years that you’ve been dealing with this.

When I was first diagnosed, it was obviously a blood glucose monitor. That’s the only technology that was out then. And I used that for many years. Indeed, I still do when I had to take breaks from the Libre or CGM. And obviously that’s evolved to continuous glucose monitoring and the Libre Flash glucose monitoring devices. I think both of them have been absolute game changers in Type 1 diabetes care. Unfortunately they’re not as affordable as they need to be for the Type 1 community. And that’s something that they’re suddenly changing to a certain extent in Australia. They are now federally subsidized for people under 21 and fingers crossed that they subsidize them for adults as well. But the visibility of blood glucose levels is something that when we work with people at the family center, the lights go on when they see the blood glucose surge that happens after they eat carbohydrate.

It’s instant. When I was diagnosed, and indeed even now, the advice, I still hear that people are told this, I was actively discouraged from testing my glucose after meals. I was told test before, so before breakfast, eat your breakfast and then don’t test again until before lunch. And of course in the meantime, my blood glucose would have gone up to 15, 17, 20—and it would come back down very nicely into range and I might be 5.6 before lunch, but meanwhile I spent three hours with my blood sugar level out of range.

What was the reasoning for that then? It doesn’t seem to make any sense—you would’ve thought you’d need to know what was going on in-between?

Well, the rationale would be it’s going to happen anyway. And if you know about it, you want to correct it with more insulin and if you correct it with more insulin and you end up in a hypo because there’s going to land in the safe range, it be all right.

That is obviously that linear equation, again, that doesn’t exist…

Well it just disregarded the three hours after every meal that I would spend outside of range. And if I didn’t know about it then I couldn’t even act on it. And at that point, the only, apart from reducing carbohydrate, I could change the time I took my insulin, take it a little earlier. So it married up with the carbohydrate curve perhaps as a mitigating strategy. But I wasn’t even given access to that information. And it took me becoming an overzealous blood glucose tester to the point where I had to have letters written by my doctor to the National Diabetes Services Scheme, justifying why I needed so many blood glucose test strips because people thought, I think they thought I was selling them on the black market or something. Because I was doing 20 tests a day cause I just needed to understand.

So CGM—now people, it’s visible. You know, we’ve got 288 glucose readings a day and it’s just sensational information. And I think that people really have the tools now to be able to act on that and change their management strategies to adapt their food and their insulin therapy due to better manage diabetes. That’s glucose monitoring technology. Obviously the insulin pumps have come a long way. I don’t use one, but I see their benefits particularly in children. Kids need that flexibility I think around being able to manage insulin and basal rates according to their very sporadic levels of activity. I think as adults we can be a little bit more structured about activity choices. Whereas kids, I think, you know, type Type 1 diabetes already feels like a straightjacket if they can run and play when they feel like running and playing and we can just drop their basal rates, I think that’s fantastic. 

The other thing I think the benefit is micro bolusing. The pumps give the ability to bolus and indeed run basal rates at much more sensitively fine-tuned doses than you can get with a syringe or a pen. There are real benefits to the pump. That said, there are also the downside. Wearable technology has mechanical issues, you know, pump fat failures, bubbles in the line. All the things that happen that come along with pumps that people need to think about as does CGM. It’s very intrusive if you’ve got a phone or a device alarming at you all the time, especially if you’re trying to run really tight thresholds, you will hear alarms often. It will interrupt your day and your sleep and your thinking. And that’s one of the pieces that I think that we don’t do very well in Type 1 diabetes care is prepare people for the psychological burden of the wearable devices. The very active wearing a piece of space junk our kids call it on our bodies and getting the questions and the curiosity from the community at large and have to explain diabetes over and over again. That can become a real drag. So there’s light and shade around technology, and I think we have to be really careful in the way we talk about it because in our diabetes community pumps are almost incentivized. I hear this thing of when we get to the pump, like when we graduate to a pump,

Yeah, this is the goal for everybody.

Yeah. And a pump is just a glorified insulin delivery device. You know, it might be snazzy, but it isn’t going to change the fact that you’re still making all the decisions. We do have closed loop technology that is just starting to be released, which was really exciting. So that means a continuous glucose monitor is talking to the pump and automatically adjusting basal rates. The person still has to think, they still have to do meal announcements in exercise announcements. So they’re actively managing those variables.

Yet the tendency is to think that it’s all just going to be automated and they can, the worry goes away because the responsibility is taken on by these interacting machines that are just going to manage it all for them.

Indeed. And that plays out both in the community at large, where people, every time there’s a big news article, Oh closed loop technology, somebody rings me up and goes, they’ve got an artificial pancreas now—your problems are all solved. And you know, that’s absolutely not the case. And then within the Type 1 community, when we see the research plays out, when you put people on pumps, their A1Cs in the first 12 months often going up because they themselves think, ah, I’m on a pump now, it’s all automated. And so, and that’s a bit of a hard reality when they realize, Whoa, actually I still have to do the inputs. I choose not to use a pump primarily because there are no pumps that are waterproof. So that’s a little bit of a struggle for me. But also because I’ve found a really great regimen with the insulins that I use and I feel like if it ain’t broke, don’t fix it.

Interestingly, I have a retro thing going on with the insulin that I use. So when I was first diagnosed, there wasn’t any rapid acting insulin. I was put onto regular human insulin, which is now considered so old school, you know, pharmacies don’t stock it. When I asked my GP for it, he looked at me like I had grown a second head. You know, why do you want this old insulin, over the years, over the time I progressed to the newer analog insulins for a period of time there. But I’ve since come back to using R, the regular insulin, in the last few years because it’s remarkable in how the time action profile and the peak of R insulin marries up with a protein glucose spike that I get. So protein spikes my glucose after four to five hours and that is exactly the time when R peaks. So, it’s really interesting that you know, we can actually look to the older insulin technology and find it useful in this new way of eating.

That is interesting. I found it interesting as well what Jake Kushner was saying about how potentially these automated systems with the insulin pump, how it potentially could work particularly well if you were eating low carb because you had, the blood glucose ranges were moving in a much tighter band.

Yes. And the increases are not as sharp. So if you’re eating a mostly protein and fat based diet, you’ll have sort of these mild peaks and that’s something that the pump can keep up with so that the pump can actually automatically adjust a basal rate rather than requiring a big bolus of insulin in order to keep up with that protein and fat curve. And I think that, I mean that is really the ultimate hands-off diabetes management. I mean, you’re not actually having to actively put meal announcements or food announcements into that pump, which is almost, I mean, I hate to say the word cure, but it’s certainly lightens that mental burden, which is one of the hardest things to bear with diabetes.

Yeah. So it feels like, instead of having to do that micromanaging throughout the day, if you more macro manage, pun intended, I guess, with your overall diet. And look at focusing on that. But that’s not having to look at the details all the time. I can see that being quite freeing. Obviously you’ve still got to carry on paying attention, but you’re managing it with more broad brush strokes and maybe this technology and equipment could take care of those finer details.

Absolutely.

It can free you up a little bit more for day to day living.

That’s the ultimate application for the closed loop system. And indeed are you familiar with the We Are Not Waiting movement?

No.

The We Are Not Waiting movement created a technology initially called Nightscout. It’s open source. It’s created by citizen scientists, mums and dads and people with Type 1 diabetes around kitchen tables around the world where they hacked continuous glucose monitors and firstly worked out a way to bounce the information to phones for remote monitoring. Awesome. Especially for parents. The next step has been the development of the open artificial pancreas system and the loop system. So these are again hacked systems where people are essentially running the closed loop type technology and have been for a number of years now well before the companies have released it. I have a friend at home, Kyle Masterman, who is a sensational athlete, low carber and he’s running an open APS and he has messaged me a number of times and says, I haven’t given myself a bolus all week.

And the system is just running in the background and managing things for him, and it’s giving him these micro boluses of insulin as he eats a big protein meal, you see the insulin start to catch up and his blood sugar level is insanely good. The thing I think the system hasn’t quite adapted to, is exercise yet, and that’s the next piece. But the idea that the food variable and the insulin variable can run in the background. That is awesome.

Yeah, I think that sending the same way when we haven’t spoken too much on that, but the tendency is just to look at food. But it sounds like looking at your activity level is hugely important.

I’ve worked out over years of experimentation than any exercise that spikes my heart rate over about one 80 beats per minute is going to raise my blood sugar level. So I actually need to take insulin in order to do high intensity interval training or spin class or anything where I’m going to do sprints. That’s so counterintuitive. I need insulin to exercise. Hang on a minute. The other thing that causes my blood sugar level to go up is glycolytic exercise, like lifting. Then the opposite effect happens if I’m doing longer, slower endurance stuff. If I’ve got the formula in my basal insulin dose right, and keeping in mind that I inject that, you know, I’ve got, I’m committed for 16 to 18 hours of a certain activity level once I do that. So sometimes it’s seven o’clock in the morning, I take a certain dose and I do a different activity than I anticipated in the evening. And sometimes you can get that wrong, but if I’ve got my basal conditions right, then my blood sugar level with endurance exercise normally stay stable.

If I’ve got it wrong, sometimes it will drop off a little. So that seems to play out as a general assumption for most people with Type 1. High intensity—blood glucose spike, low intensity—blood glucose is stable or drop. And bringing that into play is really important. , because when you’re dosing insulin, you’re not only dosing on what you’re about to eat, you’re also thinking how much activity have I done in the last three to 24 hours and how much activity do I anticipate doing probably in the next three to eight hours. And so as you say, you’re bringing in another set of variables, the duration, the time, and the intensity of activity or another few variables if you want to really drill down into it that you have to consider.

It sounds like you have to be super organized and good at planning.

Absolutely. I think that’s something that diabetes has taught me. It’s not my strong suit, but amongst a whole lot of other lessons, being a good planner. And I think almost to the extent where that too for a while it took over my life about planning and routine and I would become very anxious if my routine was interrupted and started to try and build a little bit more, I guess being able to be a little bit more relaxed about changes to the plan has been again, a more recent project.

Well, I could go on talking to you for hours. We’re being ushered and nagged by—interesting enough, the room needs to be set up for an exercise and movement session. I like to round off the podcast with a top tip, which can be anything you like, but I think maybe it would be nice to give your top advice for somebody who’s just been diagnosed with Type 1.

Connect with community. Clinicians took me some of the way—the community took me the rest of the way. If you have access through online groups or face to face support, other people who are walking a mile in your shoes, the information exchange, the support and understanding that you will get is the key to not only understanding diabetes well, but making peace with diabetes. And I feel that that community is transformative. It’s absolutely essential.

Well, thank you so much. It’s been a great pleasure for me and really interesting. I’ve been fortunate enough to be able to interview a few of you who have Type 1 or involved with Type 1 and it’s been very interesting and an education for me and hopefully will be for the listeners as well. So thank you so much. It’s been a great pleasure.

Thanks for taking an interest in people with Type 1. It’s important to us and thank you to all your listeners for being interested also.