How a Ketogenic Diet Can Transform Your Metabolic Health

It's difficult to have good control of your type 2 diabetes and eating lots of carbohydrates. And often what tends to happen is you eat the carbohydrates, your blood sugar goes up, and so the doctor increases the medication. And then you keep doing that, the doctor increases the medication, and ultimately your glucose is completely out of control and the doctor puts you on insulin. And then the trouble with insulin is insulin drops your blood sugar. And so sometimes you're eating carbohydrates to put your blood sugar up and having insulin to put your blood sugar down, whereas the easiest thing to do is actually not have the carbohydrates and then the blood sugar doesn't go up. go up, and then you don't need the insulin.

Hello and welcome to Beyond Diagnosis, a podcast to raise your awareness, decisions, and voice for alternative practices. If you've been diagnosed with a metabolic disorder and you prefer other options to a lifetime on medication, then this episode with Laureen Lawler-Smith, who has 40 years experience in general practice And the past 4 years has specialized in using therapeutic carbohydrate reduction to help her patients whom this approach may be beneficial. Welcome, Loreen.

Thank you so much for having me on the podcast.

It's lovely to have you here. Now, most people wouldn't know what therapeutic carbohydrate reduction is, even though it sounds quite self-explanatory, as in you're reducing Carbohydrates, I assume. But what is it exactly?

So it's reducing the carbohydrate intake in the diet to the point that you get a health benefit. So it used to be called low carbohydrate nutrition and ketogenic nutrition. And unfortunately, there were a lot of— there was a lot of baggage associated with those terms and a lot of misconceptions about what that meant. So we've recently written some guidelines for type 2 diet patients with type 2 diabetes for utilizing a reduction in their carbohydrates to improve control. And in that document, we coined the term therapeutic carbohydrate reduction to encompass any reduction in carbohydrates. The actual definition is less than 130 grams of carbohydrates per day is therapeutic carbohydrate reduction. How much carbs need to be reduced depends upon what the condition is. So a very low carbohydrate diet is also called a ketogenic diet because it could produce ketones, and that's usually less than 50 grams of carbohydrates per day. So the amount that's required depends upon what the condition is.

I said in the introduction you've been a doctor for 40 years, so why did you move into this area? What prompted that move?

So, from a personal point of view, I wasn't in good health. I was obese, I was pre-diabetic, I had fatty liver, I had sleep apnea, and I also had high levels of fats in my blood called triglycerides. And I was following the advice that I was giving all of my patients, following the advice that was in the guidelines, which is you just have to eat less and exercise more. a low-fat diet is the way to go. And the reality was that I was just getting sicker. And I'd been on and off diets all of my life, and I just put more and more weight on. And I— it just wasn't working for me. And I got to the point where I'd given up and just decided, well, this is me. I'm going to develop type 2 diabetes and all the complications. And it was a pretty depressing place to be. Then I came across low-carbohydrate nutrition and I started reducing carbohydrates in my diet. I went off to a Low Carb Down Under conference and met a dietitian there, Nicole Moore, and I transitioned from a low carbohydrate diet to a ketogenic diet. And then I lost weight, lost a considerable amount of weight. My prediabetes went away, my fatty liver went away, my sleep apnea went away, and my triglycerides returned to normal. And I was just stunned. That it was clear the advice I'd been giving my patients for 35 years was just wrong. And so then I started, I started using carbohydrate reduction with some of my patients, and I discovered that you can put type 2 diabetes into remission. Well, whoever knew that? Everybody knows that type 2 diabetes is a long-term condition, and you can't put it into remission. You can't cure it. Well, actually, you can. if you decrease the carbohydrates in the diet. And so I started using it on some of my patients and had some fantastic results. And I just decided that that's what I really wanted to do. Now, you get over a 35-year period when all you seem to be doing is trying your best to assist patients, but you're just writing more and more scripts and these people are getting sicker and sicker and you really don't see any benefit from what you're doing. pretty soul-destroying. And I think it's a reason for a lot of doctors, particularly general practitioners, to get burnt out. Whereas my job now is I work in low-carb ketogenic nutrition at Low Carb Keto Health with a dietitian and a health coach, and people get better. It blows me away. I love going to work. It's, it's just the most wonderful job I've ever had in general practice because people get better. I think one of the other things is we— you also self-select for people who are interested in lifestyle change. You know, often in a general practice setting, there are people who are ready for lifestyle change and many who aren't. And so, for example, if you're seeing someone who's suffering from type 2 diabetes and I'm saying, well, you know, we could make a big difference to this if we reduce the carbohydrates in your diet, and they're saying, well, I'm not interested, then that can be a bit frustrating. So everybody that comes to us at Low Carb Keto Health really interested in lifestyle change, we help them with lifestyle change. And in general, they feel better and their metabolic health improves, and most of them lose weight if that's what they want to do.

That sounds amazing. And I just love it that you actually transitioned from writing scripts to feeling like you're actually helping people at a real grassroots level to change their health, you know. And I, I think one of the things that always sort Makes the hairs stand up at the back of my neck is when people say, just eat less and move more. It's simple. It's not, you know, brain science, you know, or whatever. It's just not true. That just— that may work when you're really like in your 20s or maybe still in your 30s, but there's so many reasons why someone— that won't work for someone. So when you're actually looking to determine who this approach would— who would benefit from it the most?

So everybody who comes along to see us has a complete set of blood tests done, and I'm particularly looking there for evidence of insulin resistance. So insulin resistance is a condition where your cells in your body resist the effects of insulin, and that causes glucose to be retained in your circulation. glucose can't get into your cells because the cells are resisting the effects of insulin, and that glucose gets converted into fat, and that creates a lot of the problems associated with insulin resistance, and long-term it gives type 2 diabetes. So I'm looking for signs of insulin resistance, and some of those signs might be their fasting blood sugar might be elevated, or their fasting insulin might be elevated, their average blood sugar, which is called hemoglobin A1c, might be elevated, They may have fatty liver, which is— fatty liver is a disease of insulin resistance. So that's where liver enzymes are elevated, or one of their blood fats, which are called triglycerides, may be elevated. So if any of those things occur, then almost certainly they've got some level of insulin resistance. We also use a body composition analysis machine, which is— it's a medical-grade machine, state-of-the-art, which just gives us a huge amount of information. And one of the things I'm looking for there is increased visceral fat. So visceral fat is the fat around the organs, and people with visceral fat have insulin resistance. So I'm looking for signs of insulin resistance. In our population, probably 90% of people have got some evidence of insulin resistance. In the overall population, it's at least a third of people have got insulin resistance. So I'm really looking for insulin resistance. It's these people that benefit most from carbohydrate reduction. Um, it's a bit more of a complicated answer than that because when you restrict carbohydrates down to a very low level, yes, you stop burning carbs for fuel, you start burning fat for fuel. And one of the byproducts of that are ketones. Um, and ketogenic diets can be used for all sorts of things, even when people aren't insulin resistant. So for example, ketogenic diets can be used for treating autoimmune diseases or neurological diseases or even some cancers because the ketones have such a powerful metabolic effect. Um, so I'm sorry, that's probably a very complicated answer.

No, no, I think, I think generally people know what ketones are because on social media people talk about the keto diet and they talk about, you know, going into ketogenesis, I think it is.

Yes.

Um, so I think people do are starting to understand that, you know, if you've got higher ketones means you're burning your fat, not your sugar. You know, a lot of athletes I think go into that, don't they? Um, so no, also now.

Yes, yes. Yeah.

So when we talk about— let's just go back a little bit to metabolic health. So when we're talking about metabolic health, that sort of encompasses a range of conditions. So does this approach help, like, someone— you know, we've obviously talked about insulin resistance and the diabetes, but there's also, um, Obesity, and what other conditions are in that metabolic health that this can particularly target?

So insulin resistance is a diabolical condition which increases the incidence of all sorts of diseases. So from a symptom point of view, if you have insulin resistance, you tend to be hungry all of the time. So what your body responds— if the cells aren't responding to the insulin, your body responds by making more insulin. When your insulin is elevated, you're in fat storage mode. And so you're hungry all the time, you crave carbohydrates, you feel really tired, you don't want to exercise. And when you try and lose weight by restricting calories, it doesn't work because insulin blocks the enzyme you need to break down your own body fat. So from a symptom point of view, hungry all the time, tired, can't lose weight. Insulin resistance in the brain is associated with brain fog because if you've got insulin resistance in the brain, glucose has trouble entering brain cells and they don't function so well. So that's what a symptom of someone who is insulin resistant would look like. It can also affect mood, and depression and anxiety is much more common in people with insulin resistance. And then from a diagnosis point of view, we've got fatty liver, we've got high triglycerides in the blood, overweight or obesity, sleep apnea, which, which is a result of overweight or obesity, As time goes by with insulin resistance, over 15 to 20 years you'll develop type 2 diabetes. But insulin resistance also increases the risk of various forms of cancer— breast cancer, prostate cancer, colon cancer— all much more common in people with insulin resistance. So it's really diabolical that it's, uh, it can start off quite subtly and it can end up with, you know, serious long-term consequences, potentially life-threatening consequences.

What I'm hearing is, is more like the insulin resistance is the root cause for all these other conditions under the umbrella of metabolic disease. Is that correct?

Absolutely. I mean, I didn't forget— I mentioned— didn't mention heart attack and stroke are much more common in people with insulin resistance. The number one cause of dementia is in fact insulin resistance. So if you have type 2 diabetes, your risk of Alzheimer's disease is trebled. So it is— it— the biggest problem we have in our society, health problem, is in fact insulin resistance. It affects a huge number of people and has just lots and lots of consequences.

And do you believe that this insulin, the spike in this insulin resistance, especially in modern day, is due to our refined carbohydrates? Or is it just that you— is it also because Metabolically, you are genetically wired that way?

I think it's a combination of things. I think, you know, having high insulin has been a mechanism whereby we've survived from an evolutionary perspective. You know, from an evolutionary perspective, we're hunter-gatherers. You know, we've largely eaten animal products. And I always say to people, if you don't believe that, if I send you out into the wilderness of Australia now and you tried to feed yourself, if you didn't catch animals or insects, you wouldn't survive. The agricultural revolution's only 11,000 years ago, and that's when we started growing significant quantities of crops. So if you're a hunter-gatherer and you come across some carbohydrates— so for example, you come across a fruit tree full of fruit— it's very much to your advantage to hang about and eat as much fruit as you possibly can. So the fructose in the fruit puts up your insulin. When insulin is high, you're in fat storage mode. You're hungry all the time. You can't stop eating. And I always reflect to people, that if I put a bunch of grapes in front of you, you could just stop at one. And the reason you can't stop at one is not willpower, it's biology. You know, your body wants you to access those carbohydrates to put on weight. And so this has been a mechanism where we ensured our survival. So when there's carbohydrates available, you get a kick of insulin and it makes you eat more carbohydrates, you put on weight, and then when winter comes or there's not enough prey about for you to catch, you're going to survive. So it's, it's a mechanism which has been with us for 2.5 million years, but unfortunately it's been hijacked by our modern environment. I think there's a number of things to think about. I think firstly is, you know, processed food, which often are high in carbohydrates. But I think if you have a look at the number of ingredients that are in foods these days, most of them, you know, weren't around 10 years ago, let alone 20 years ago. I think there is a clear association between eating processed food and carbohydrate— sorry, insulin resistance. We've got the Australian Dietary Guidelines, which came in 1980. And you probably remember the pyramid, which had all those carbohydrates down the bottom of the pyramid—

Absolutely.

—with fat at the top. So we're told that we need to eat carbohydrates 3 times a day, 5 times a day. But there's other things as well. So there's some evidence that some contaminants in the environment— so air pollution, plastics, pesticides, herbicides. There's some evidence that all of those things may be hormone disruptors and contribute to this increasing incidence of insulin resistance. So it's multifactorial, really.

It's huge. It's a huge area, and also I think an area that can be a bit confusing for people, because my husband is a type 2 diabetic and his brother is a type 1. Or actually, he told me that you could only be born with type 1. Is that true? Just to debunk some theories or misconceptions.

So type 1 is an autoimmune disease where something triggers your immune system to attack your pancreas. So it tends to come on in younger people, but it can come on in older people, whereas type 2 is directly as a result of insulin resistance. So what happens with the insulin resistance is your body's doing its best it can to actually manage the fact that glucose is being trapped circulation because it can't get into cells. And eventually your body loses control and your blood sugar goes up. So they're actually opposite. So type 1 diabetes, your immune system attacks your pancreas, your pancreas doesn't produce insulin, you've got a lack of insulin. With type 2 diabetes, you're producing plenty of insulin, it's just your body's not responding to it. So they're very different diseases.

And the other thing that you did bring up when you said about, I wanted to ask, when you brought up about the pyramid. I think a lot of our listeners, a lot of the audience, it's confusing. You listen to the Diabetic Association and they say to— well, they've said to my husband, etc., eat a lot of carbs, just make sure they're, you know, brown rice, not white rice, or wholemeal bread instead of white bread. And they don't really talk about restricting the carbohydrates as much, or they say eat some protein with your carbohydrate. But you're not— doesn't sound like you're an advocate for that.

I think that the way to control type 2, in fact both of them, is to limit your carbohydrate intake. So base your diet around protein and fats. I think one of the things that I'd encourage everybody, either with insulin resistance or with type 2 diabetes, to do is to get a continuous glucose monitor and wear it for a couple of weeks. So you can get them online, some chemists sell them. And the advantage of that is if you have a continuous glucose monitor on, you can see what you're eating does to your blood sugar. And if you try and keep your blood sugar between 4 and 8, you'll find out that brown rice will put you above 8, and wholemeal bread will put you above 8. You'll discover what it is. It's about exploring your own body, really, and just questioning your own body and saying, okay, how can we keep my blood sugar under control? So I think it's a fallacy that you can eat lots of carbohydrates. And have good control of your— well, it's difficult to have good control of your type 2 diabetes and eating lots of carbohydrates. And often what tends to happen is you eat the carbohydrates, your blood sugar goes up, and so the doctor increases the medication. And then you keep doing that, the doctor increases the medication. Ultimately, your glucose is completely out of control and the doctor puts you on insulin. And then the trouble with insulin is insulin drops your blood sugar. And so sometimes you're eating carbohydrates to put your blood sugar up and having insulin to put your blood sugar down, whereas the easiest thing to do is actually not have the carbohydrates, and then the blood sugar doesn't go up, and then you don't need the insulin. The standard way we manage type 2 diabetes in Australia is, um, I think it's problematic because, you know, that's the way I used to manage type 2 diabetics. And I can say to you, I always used to say, you've got type 2 diabetes, and unfortunately this is a chronic long-term condition, and no matter what you do, you are going to get worse and worse, and you're going to end up on more and more medications. Ultimately, you end up on insulin. Now, how is it saying that to a person? I mean, that's terrible.

It's terrible.

Whereas I can say to them, okay, you've got type 2 diabetes, you are intolerant to carbohydrates. We need to limit your carbohydrates to control your blood sugar. We need to develop a diet that you love to eat, which satisfies your needs, which is low in carbohydrates. Um, and that's what we aim to do. That's what we, we do in the clinic, is try and get people on a, on a plan that they don't need medication. Um, and it blows you away when you see someone with poorly controlled type 2 diabetes and they change their— they drop their carbohydrates in their diet. In 3 months, they actually don't have diabetes.

Can you actually, instead of always just managing it, can you reverse it with this?

You can. Um, the earlier you, you start decreasing carbohydrates, the better you are, because one of the things that happens is, uh, in response to the insulin resistance, your pancreas churns out lots and lots and lots of insulin. And over a period of years, your pancreas will get burnt out and it won't be able to produce the same amount of insulin. So in general, if we get someone within the first, you know, say 5 years of having type 2 diabetes, we can put that into reversal. So that their blood sugars are normal, their insulin is normal. If someone's had it for 20 years, then we could certainly improve their control dramatically, but sometimes we don't get to the point of them being in remission. Sometimes we've just reduced their medication and improved their control significantly, but not necessarily put them into remission.

For the people who have diabetes and preventative, there's a difference between keto amount of carbohydrates and just a low-carb diet. So this is a 2-part question, like what's the difference in the amount of carbohydrates for each? And if someone was in a prevention mode, what would you suggest the amount of carbohydrates they eat? And if they're a diabetic type 2, how much would they eat? What's the difference between keto and low carb? And then prevention, and you actually do have diabetes.

So as soon as you start burning fat, you'll produce ketones, um, and they will appear in your system. In order to have a significant amount of ketones in your system, you probably need to have less than 50 grams of carbs a day. For someone who wants to prevent getting type 2 diabetes, you'd start at less than 130 grams of carbs a day, which is just the traditional definition of Uh, low carb. How much you need to restrict carbs really depends upon how metabolically unhealthy you are. So for example, for myself, in order to maintain my normal blood sugars, because I had insulin resistance for a long period of time and I was on the verge of getting diabetes when I started my low carbohydrate diet, I need to stick with less than 20 grams of carbs a day, which is in the ketogenic range. Other people who've just been diagnosed with type 2 diabetes, you know, may get by with less than 70 or less than 50. So I'll sort of summarize it. So what we tend to do is we say to people, let's go keto to start off with. Let's go less than 20 grams of carbs a day. Let's get you to where you want to go, and whether that's improve your symptoms, lose weight, or become metabolically healthier. And when you get there, we're going to work out how many grams of carbs you can have. So everybody's got— each individual has got a carbohydrate threshold. So what we tend to do is say, let's start at 20. So next week you're having 30 grams of carbs per day. How are you feeling? Do you still feel well, or all of a sudden you're starting to be hungry again, or you're putting on weight? And then the following week we'll go 40, and the following week we'll go 50. And eventually you'll get to the point you know that you've triggered off the metabolic evil twin, because all of a sudden you're starving hungry all the time, and you can't stop eating, and you want to eat carbs, and you feel exhausted, and you, you know, you want to sleep and you start putting on weight and, you know, okay, I'm over the threshold, I need to back off. And we also complement that with blood tests as well. Just again, you know, we can see, you know, whether your parameters, your blood parameters start going off. So it's a matter of, this is what we do. You don't have to do it this way, but keto to start off with, get where you want to be, and then add back carbs until we know how many carbs you can have. An alternative approach is just say, let's start with less than 75. And let's do that for a month and see where we're at. And if we're getting the gains we want with less than 75, well, that's great. And if we're not, we can drop them. So you could do it either way.

Yeah, it sounds, it sounds incredibly individualized. And because of that, not to go alone, like to really seek out someone like you who's an expert in this, because a lot of people just self-diagnose or self-medicate by themselves, as in I'm just going to drop my carbs to this and see how I go. But it sounds very specific in the amount of carbs and how you should actually do it?

It is very specific, and I think there's a couple of issues to talk about. I think the first thing is that there are a lot of fallacies out there about ketogenic, low, very low carbohydrate ketogenic diets. People think you have to pour fat all over everything, um, and you don't. Um, it's not about, um, low carb, high fat. It's about really, um, uh, prioritize protein So the first thing on your plate should be protein, and we're going low carb, and we're adjusting the fat intake to get where we want to go. So as I say, the fallacy of people go on a ketogenic diet and they get up in the morning, have a bulletproof coffee, which has got butter and cream and MCT oil, and then they wonder why they're not losing weight or they've got diarrhea. So there's some fallacies out there, and I think it's really helpful if you speak to someone who knows what they're talking about. So that's the first issue. The second issue is you do need to be a little bit careful if you're on various medications if you suddenly drop your carbs and drop your insulin. So for example, a lot of high blood pressure is caused by insulin resistance, and if we— insulin causes retention of salt and water in your kidneys, puts your blood pressure up. If you're on blood pressure medication and you suddenly go low carb, often your blood pressure can drop and it can drop quite low. So if you're on blood pressure medication, you just need to be careful of that. And the other thing is if you're on any agent that decreases your blood sugar, then you may find the combination of a low carbohydrate diet and that medication might be too much and you might get low blood sugar. Again, what we might need to do is just adjust your medication before you go on low carb. Again, particularly people on medication need to think about it and maybe take some advice, but for everybody else, I think there are so many fallacies out there and so many gurus on the internet who spout off all sorts of things that aren't necessarily backed by science. So one of the organizations I'm on the board of, the Australasian Metabolic Health Society, and we're a group of health professionals, doctors, health coaches, dietitians, nutritionists who are committed to the science of therapeutic carbohydrate reduction. And, you know, our role is in educating other health professionals most of us are listed on a website called Low Carb Down Under. So Low Carb Down Under has a list of practitioners around Australia who practice low carbohydrate medicine and have a reasonable reputation. So that's another source to go to if you want to get some professional help.

Yeah, thank you so much for that. It will be invaluable to many people researching this because they're— like you said, there are so many different opinions out there. And I was going to ask you about You know, debunking some of these myths, which you just have, which is fantastic because so many people shy away from it because they believe what's on social media and they think it's incredibly hard on the liver. They say don't do a keto diet because it's too stressful for the liver. But I suppose it'd be stressful for the liver if you're getting up and having all that fatty bacon and a fatty sausage and eggs and everything for your breakfast, like so many say to have.

So it's not the fat so much that stresses your liver. Uh, sorry, it's not the fat you eat that stresses your liver. It's the fat that gets put in your liver because you've got insulin resistance. It's that excess glucose in your blood, which has to be converted to fat, which actually goes into your liver. So the absolute majority, I'd suggest more than 9 out of 10 people, their liver function improves dramatically on a low carbohydrate diet. Um, it's, it's the carbohydrates that your liver doesn't like, doesn't, um, isn't happy about. The rest of it tolerates it quite well. So a ketogenic, low-carb diet, ketogenic diet is safe for your liver, it's safe for your kidneys. Uh, you know, the function's only going to improve if you reduce your carbohydrates.

Great to know, and it's great to hear it from a professional like yourself who's done a lot of research. Like you say, it's very science-backed because, like, like we say on social media, you know, there is such a, um, for and against. And it is confusing for people, and that's why I love it when a professional like you comes on and debunks these myths and actually gives people some solid advice on what truly happens. You also take a very holistic approach, so can you tell us what you do there, who else that you work with?

The first part of our holistic approach is that we're not just about treating symptoms and we're not just about treating diseases, we're about treating people. And so it's very important that the person in front of me is driving the agenda, so that whatever we're doing is meeting their needs. So, for example, someone might come in and their number one goal is to lose weight. Someone else might come in and their number one goal is to reverse their type two diabetes. But we also use increasing evidence with ketogenic diets in terms of mental health. So someone might come in and their number one thing is they. you know, wanting to have an improvement in their mental health. So again, it's just really important where I'm working with the person's goals, not my goals, not things I'm imposing on top of them, but with their goals. And to that end, we have— I work with a dietitian. I encourage all of the people that I see to see a dietitian as well. And we also work with health coaches. And our best program is when you combine the 3 because, you know, I can give information, the medical information, and Nicole can give the dietary information. But a lot of this a lot of this change is about mindset. It's about how you organize your day, how you organize yourself, how you manage your cravings, how you manage the people around you who are trying to undermine you. And having a health coach is just often that little missing link. And sometimes when people are struggling to make headway, adding in a health coach can really help with that. We also have an online Facebook community for people to communicate with each other. And I think peer support's really important as well. I think a lot of times when you're out there and you're not feeling well, you feel like you're all by yourself and there's nobody else in your situation. I think it's really helpful to have people who are also experiencing some of the things you're experiencing and facing some of the challenges you're facing as well with the lifestyle change.

Yes, absolutely. Community is number one. I think it's so important, especially like what you mentioned about if you have a family member or anyone who doesn't agree with what you're doing and they try to undermine you know, your success by saying, you know, that's ridiculous, it doesn't work, you're gonna harm yourself. You know, I have family members who say just a little bit of everything, you know, but a little bit of everything might work for one person, but a little bit of everything may not work for you. So just having that support of other people is, you know, um, very important. So Can reducing carbohydrates have a big impact on our gut health and the inflammation in our body?

There's really good evidence that, um, basically your gut might— your microbiome is what you eat. So whatever it— so whatever you're eating, the bacteria that thrive on what you're eating are the ones that are going to be in your gut. So if you change your diet significantly, your gut microbiome is going to change. Low carbohydrate diets, but in particular ketogenic diets, completely change the gut microbiome, and they change it to a, a much healthier balance. Ketones themselves, uh, are anti-inflammatory. They suppress the major inflammatory pathway in the body. And a healthy gut microbiome also produces ketones, um, which are anti-inflammatory in the gut. Yeah, it changes your microbiome quite dramatically. And sometimes some of the, the symptoms you get when you transition can just be your gut microbiome adjusting.

Interesting about that. And also the inflammation, because a lot of people say that All disease starts with inflammation.

The most, most diseases start with inflammation. And again, that's one of the things we see. We see people who come in, they've got joint— so they come in, they want to lose weight, or they've got diabetes, and they go on a, in this instance, a ketogenic diet. And they come back 2 weeks later and they say, all of my joint pain has gone, it's all gone. And sometimes we have people who actually don't— they lose interest in the whatever else it is. They start a very low carbohydrate diet because It controls their pain. And again, there's good data in the literature about that as well.

Would that help people with arthritis, for example?

Completely. Not everybody, but the majority of people. I know I sell— I sound like I'm selling snake oil here. It just seems like what I do just fixes everything, and it's not. That's not entirely true. But for the majority of people, they just feel so much better.

I've actually— I actually know people who have gone on a low carbohydrate Even though my son is a high-level athlete and he does eat carbs, and they say he needs carbs because he burns them. But I know people who have gone on a low-carb diet and all of a sudden their energy goes through the roof. Like people say, like athletes, you need the carbs to burn for energy, etc. But then you get people who are not athletes, you come off the carbs They've been tired and all of a sudden they've got all this energy and they, like you were saying before, they sleep better and the energy. Is it the sugar that's making you? It's the sugar that's making you tired, is it?

It's a couple of things. I think having high insulin levels will make you tired and sleepy. So if you've got insulin resistance, your insulin levels are high, it'll make you tired and sleepy. But I think for a lot of people also, they get eating a lot of carbs, they can get reactive hypoglycemia. So they eat carbs, their blood sugar goes up, and then it your body overresponds. And then your blood sugar crashes. So, you know, for example, for me, um, in general practice, when I was unwell, you wouldn't want to be my 2 o'clock patient because I'd eat lunch between 1 and 2, and at 2 o'clock it was all I could do to stay awake. So I think sometimes that tiredness can be the reactive hypoglycemia.

Oh, that's interesting. That— so that's that what they commonly call the, the 3 PM slump?

Yes, yes.

So that 3 PM slump is not something that you should just douse with coffee. You should actually be listening to it because it's your body telling you something.

No, sorry, not everybody gets it. I was going to say, even if you haven't got type 2 diabetes, it can be really instructive to get a continuous glucose monitor on because you can actually watch what happens and you can see when you're feeling tired, is your blood sugar drop low? So, you know, I think they're fantastic things for everybody just to have a trial. I mean, it's $100 for 2 weeks, it's fairly expensive, but it's a really good tool for educating yourself about what's happening in your body.

Yeah, it is. And that's the key, isn't it? Is for us to start becoming more aware of what's happening in our body, listening to our symptoms, you know, taking note of when do I feel sleepy, how have I woken up in the morning, do I have pain in the morning when I go to walk, all the rest of it. This has been so incredibly informative, and I really do hope our listeners do take, you know, all the key points that you've pointed out and start becoming a little bit more confident around reducing their carbohydrates. That there is actually— before we go, there is one more myth I would like to debunk. And people say it's okay to have carbohydrates as long as you have it with protein, it's not going to affect your insulin.

So protein will slow down the absorption of the carbohydrates, but if you're eating lots of carbs, uh, your blood sugar is still going to go up.

So tell us, Loreen, What is one action someone can do today to further, you know, better their metabolic health?

I think for the majority of us, we are— well, first, number one, stop eating processed food. You know, eat real food. If your grandma wouldn't recognize it as food, it's not food. So just try and minimize the amount of processed food you're consuming. I think that's the number one thing. I think the number two thing is just have a look at, you know, how many carbs you're consuming and consider whether it is impacting your health at all. I mean, for really young people, you know, they're not insulin resistant. And for the, for the older people who don't have insulin resistance, you can eat lots of carbs and it's not going to impact you. Processed food, not so. But, but for the majority of people, if you do decrease your carbs, you will feel better and you'll be metabolically healthier.

Great advice to finish it. And for our listeners, if anybody would like to contact Lorene or find out more information, All of the details will be in the show notes, so do look there and do contact her. Thank you so much for coming on. It's been a pleasure. Yeah, it's been a pleasure talking to you. Thank you so much for having me on. I would love to know what was the biggest insight or aha moment you got from this interview so you can now speak up, take action, and make informed decisions for your health.