Dr. David Unwin: Your waist should be less than half your height. So half of that string should go around the fattest bit of your belly. And this is a really simple test for everybody at home.

Host: I mean, it's not.

Dr. David Unwin: Yeah, you've just done it. You've passed. But fat on your belly is more worrying than fat on your legs or on your arms. And unfortunately, we've started to normalize things like the dad bot without realizing that isn't how you're supposed to be. And maybe a third of all the people in the world with type 2 diabetes don't even know they have it. But every year that you have poorly controlled type 2 diabetes, you're losing 100 days of life. And it's because people don't know the truth being fooled with the packeting and advertising.

Host: So, let's talk about the food we have on this table because this is how much sugar I would have thought was in all of these things here. Cereal, a potato, white rice, a banana, and a chocolate bar.

Dr. David Unwin: So, now I'm going to give you the correct figure. The corn flakes is 1 2 3 4 5 6 7 8. That chocolate bar is 7 and 1/2. The banana that's six. And then the potato is actually

Host: Oh my gosh.

Dr. David Unwin: And then 150 g of boiled rice is

Host: Oh, I thought rice was healthy.

Dr. David Unwin: But each of us has a number of different health futures. And what I'm interested in is how do I get you to pick a lifestyle that will get you the future you want? Because my job is about behavior change.

Host: The floor is yours.

Dr. David Unwin: All right. So, off we go. Dr. David Unwin, you were named in 2018 among the top 10 most influential doctors in the United Kingdom. Um, you've got an incredible list of accomplishments and you're held in the highest regard maybe of all the doctors I've ever had the chance to speak to by many people that I've spoken to. We were talking before we started recording about what's on your mind and what's been bothering you. And so the floor is yours. What is front of mind for you, Dr. David?

Dr. David Unwin: Well, front of mind for me is the the idea that each of us has a number of different health futures. So you have so in your future uh I don't know there could be cancer. There could uh be multiple sclerosis or there could be many futures. What I'm interested in is how do I get you to pick a lifestyle that will get you the future you want? And I think that's very difficult in the world now to know what is the best lifestyle because you've given so much conflicting advice. And the particular focus for me in terms of picking health futures is around young people because they've got the longest time to make a difference. And it's getting harder and harder and harder to make good health choices in your lifestyle. It's really hard. I'd say it's a pandemic of poor metabolic health. Yesterday in clinic, I saw two people under the age of 25 who had poorly controlled diabetes and one of them was too heavy for me actually to weigh. And this situation is completely new.

Dr. David Unwin: So when I when I was a young doctor uh and just starting off in practice, that was in 1986. Wow. A long time ago, just north of Liverpool in the practice, I'm still there now. Obesity was rare and we didn't have a single case of type 2 diabetes in anybody under 55. Not a single case. It was quite unknown. And in fact, type 2 diabetes had a different name. We've had to change the name because of the epidemic. Used to be called maturity onset diabetes. That meant old people, right? Now we call it type two diabetes because we have to include so many young people. It's really really serious because people are losing their life expectancy and I'm witnessing this. We're all sleepwalking into a metabolic disaster and the people praying the greatest price in my opinion are young people and it's a scandal and I'm hopping mad really.

Host: I want to just define that term diabetes because I think I went through a lot of my life assuming that diabetes was a disease that some people are born with and because I didn't have it, I thought I don't need to worry about that.

Dr. David Unwin: That's really important. Yeah. So, first of all, there's type 1 diabetes and type two. But before I can explain about diabetes, I need to explain about insulin. This is absolutely key to our whole discussion. So, I've already said that a high blood sugar damages your arteries. And in fact, there's work to show that a very high blood sugar damages the non-stick lining of your arteries within six hours. Really quick. It's called the glycoalix, the non-stick lining. And uh damage is occurring very quickly.

Dr. David Unwin: Insulin, the hormone insulin produced by your pancreas gland. It pushes the sugar and it pushes it out of the bloodstream inside cells where it can be used for energy for you to run around. But what if you take in uh more carbohydrate than you need to run around? Well, then that sugar is turned to fat inside cells because it's safer for you to turn that sugar into fat than it is is to have it damaging your arteries. So, I am somebody with type two diabetes. So, we can talk about me. So, I had a really heavy biscuit habit. uh I was senior partner of the practice and it's stressful and I had patients used to bring me biscuits all the time as a gift because they you know they want the doctor to be happy. So in the drawer in the top of my desk was packets and packets of biscuits. So, I'm taking in more sugar and I didn't run around and gradually my waist got bigger. And what was actually happening was as I took in more sugar than I needed to run around, my insulin was working to get rid of that sugar and it was giving me two things. One, a belly. And the other was I didn't know, but my liver was filling with fat and that's um that is very common now. So we have well it's a third of everybody in the world has fatty liver.

Dr. David Unwin: Now, the twist in the story is fatty liver interferes with the good work of insulin. So, you develop a thing called insulin resistance, which means your insulin is no longer as powerful as it was. It's beginning to become difficult for you to deal with carbohydrate and sugar because your insulin isn't working as well. And the only way to deal with that is the next twist in the story. So your pancreas has to crank up the supply. We need more insulin. This bits called the long silent scream from the liver. This is work by Professor Roy Taylor, a friend of mine at Newcastle University, and he pointed out that you you've got fatty liver for about 10 years. You don't even know. But unfortunately, this is another twist. Fat is being laid down in the pancreas gland, the very gland that your life depends upon producing insulin. And your ability to produce enough insulin collapses. And at that point, you can't regulate blood sugar anymore.

Dr. David Unwin: Well, I can tell you that the people with pre-diabetes in my practice north of Liverpool, 93% of them will get a completely normal blood sugar if they go low carb. Okay, how about we wait for the 10 years and until you've got type 2 diabetes and then you go low carb, at that point I've got a 73% chance of you having a normal blood sugar. Let's wait another few years because you don't want to give up bread and you don't want to give up chips and pizza... you only stand a 50% chance. So really it's a stitch in time.

Dr. David Unwin: But there is there's something better than the glycemic index and that's called the glycemic load. The glycemic load takes portions of food and predicts how will that portion of food actually affect your blood sugar. So, the density you're all you're looking at the density of sugar in it as well. So, that's why the glycemic load is better.

Dr. David Unwin: The first powerful woman was a lady I'd known for over 10 years. She and her husband had poorly controlled diabetes. The lady, well, let's call her Mrs. Jones. She marches in and uh she said to me, "You think you're going to tell me off, don't you, Dr. Enwin? Well, I've got news for you. I'm going to tell you off." She said, "When you do my blood tests, you will find that my blood glucose is completely normal despite not taking your metformin."

Dr. David Unwin: And she said, "I'm wondering if you're actually qualified as a doctor because in the last 10 years, did you ever once tell me that bread was sugar or breakfast cereals were sugar?" I had to learn online uh that bread is sugar, that rice is sugar, that breakfast cereals are sugar, and when I cut those foods, I don't need your metformin now. And she said, "This is school boy biology. You should have learned that when you were 16." I was dead scared because every word she said was true. It was the first case of drug-free type 2 diabetes I had ever seen. I was ashamed, really ashamed.

Dr. David Unwin: Jen, she is a clinical health psychologist. She said, "You have to read this book about the low a low carbohydrate approach to um insulin resistance to type 2 diabetes." She said, "David, why why are you sort of failing? Why don't you do one thing before you retire? Why don't you and me go on this diet for see if some patients would volunteer and do it with us?" And I mentioned it to the partners and they said, "No." They felt it was a bit self-indulgent. So we found 18 volunteers amongst the patients and then Jen and I. We started meeting every Monday night talking about low carb.

Dr. David Unwin: And then the magic begins. The results. The first thing I saw was the liver function improving. I got people who I thought they'd had abnormal liver function for 10 years and suddenly within weeks the liver function was improving often by a third or 50%. Then the weight started falling off people. The first one was people said, "Are you hungry?" Because I'm not. And my belly went away. Next thing was I noticed I had high blood pressure for years. When I took my blood pressure, it was low normal.

Dr. David Unwin: I have a good way so we have to think of starchy carbs as actually glucose molecules holding hands and then digestion comes along and breaks down they're they're not holding hands anymore and they become free sugar again. Starch is soon to be sugar. glucose holding hands. And when it holds hands, it's not sweet. But then when you digest it exactly it's no longer holding hands.

Dr. David Unwin: Even a small slice of brown bread is about 3 teaspoon of sugar. If you're young and you take a lot of exercise and your insulin's really good, then maybe brown bread is is okay. If you're like me though with insulin resistance there it would have to be low carb bread.

Dr. David Unwin: She would say about 14% of the population has some aspects of ultraprocessed food addiction. I need to understand what's going on. I find that my husband is getting up at 4 in the morning and eating bread out of the fridge. She started putting detergent, liquid detergent on any bread that goes in the bin. But he still eats it. He's getting up at 4 in the morning, rumaging through the bin to eat the bread with the detergent on. So then she says, "I spray bleach on the bread and leave the can of bleach by the bin." What I've described to you is addiction.

Dr. David Unwin: What I did for him in the end, he needed everything. So, low carb. Then I got him using a continuous glucose monitor so that he would get feedback immediately. And on top of that, I gave him a low dose of the new GLP-1 drugs. The ampic helped reduce the noise the cravings in his head.

Dr. David Unwin: So, what we've just did, we had the goals G. Then we had your resources R. Then we had increments. What things had you done? Little things on the way. And then finally, I invited you to notice and reflect. And that spells grin. And that's Jen's published grin model.

Host: A massive French study found that drinking just 100 mil of sugary drinks per day... is associated with a almost 20% increased risk of overall cancer. Chronic hyperinsulinemia... can inhibit aptosis the natural process where damaged or cancerous cells self-destruct.

Dr. David Unwin: Lifespan is hanging out there as sort of stuttering along, but health span is going down in the UK. People are now spending roughly up to 23 years at the end of their lives with poor health and in sickness. Every taxpayer in England pays an extra £7,000 tax per year for the consequences of ultraprocessed food.

Dr. David Unwin: My gut reaction is to try and use diet. But one of them is magnesium. It's very very difficult to get enough magnesium in your diet without supplementation. If you tend to be a bit constipated, magnesium citrate is very good. If your bowels are not a problem and particularly if you're wanting better sleep or mood, magnesium glycinate or thriionate is actually crosses the blood brain barrier.

Dr. David Unwin: Each of us see yourself as an experiment. Don't be frightened of experimenting. But if you're going to experiment, notice, measure something. I think continuous glucose monitors because you're getting individualizing right there.

Host: If humanity organized to make contact with a more intelligent species, who should represent humanity and why?

Dr. David Unwin: What about David Atenburgh? He's 100 years old and he spent so long um thinking about the planet and wouldn't he be a wonderful ambassador. I think the aliens would really like him.