Dr Peter Brukner: Defeat Diabetes

Welcome to Unstress with Dr Ron Ehrlich. Well, today, we’re going to explore diabetes. We are going back to basics, see why it is such a problem, how big a problem it is, how we’ve gone with science and medicine up to this point in time, and where we can go from here.

My guest today is Dr Peter Brukner. He’s the founder of Defeat Diabetes and also not-for-profit SugarByHalf. Pete has been a guest on the podcast before. He’s a world-renowned Sports Medicine Clinician and Researcher, formerly the Chief Medical Officer for the Australian Men’s Cricket Team, and has also held similar roles at Liverpool Football Club, Melbourne and Collingwood, Australian AFL clubs, the Socceroos, the Australian soccer team, and the Australian Olympic Athletics team. Peter is currently a Professor of Sports Medicine at La Trobe University, Victoria.

Peter is just a wealth of knowledge and experience. I hope you enjoy this conversation I had with Dr Peter Brukner.

Health Podcast Highlights

Dr Peter Brukner: Defeat Diabetes Introduction

Well, today, we’re going to explore diabetes, go back to basics, see why it is such a problem, how big a problem it is, how we’ve gone with the science and medicine up to this point in time, and where we can go from here.

My guest today is Dr Peter Brukner. He’s the founder of Defeat Diabetes and also not-for-profit SugarByHalf. Pete has been a guest on the podcast before. He’s a world-renowned Sports Medicine Clinician and Researcher, formerly the Chief Medical Officer for the Australian Men’s Cricket Team, and has also held similar roles at Liverpool Football Club, Melbourne and Collingwood, Australian AFL clubs, the Socceroos, the Australian soccer team, and the Australian Olympic Athletics team. 

Peter is currently a Professor of Sports Medicine at La Trobe University, Victoria. Peter is just a wealth of knowledge and experience. I hope you enjoy this conversation I had with Dr Peter Brukner.

Podcast Transcript

Dr Ron Ehrlich: [00:00:00] I’d like to acknowledge the traditional owners of the land on which I am recording this podcast, the Gadigal people of the Eora Nation and pay my respects to their elders, past, present and emerging.

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Well, today, we’re going to explore diabetes, go back to basics, see why it is such a problem, how big a problem it is, how we’ve gone with the science and medicine up to this point in time, and where we can go from here.

My guest today is Dr Peter Brukner. He’s the founder of Defeat Diabetes and also not-for-profit SugarByHalf. Pete has been a guest on the podcast before. He’s a world-renowned Sports Medicine Clinician and Researcher, formerly the Chief Medical Officer for the Australian Men’s Cricket Team, and has also held similar roles at Liverpool Football Club, Melbourne and Collingwood, Australian AFL clubs, the Socceroos, the Australian soccer team, and the Australian Olympic Athletics team. 

Peter is currently a Professor of Sports Medicine at La Trobe University, Victoria. Peter is just a wealth of knowledge and experience. I hope you enjoy this conversation I had with Dr Peter Brukner. Welcome back to the show, Peter.

Dr Peter Brukner: [00:01:26] Great to be speaking again. That’s fantastic.

What is Diabetes and why is it such a problem?

Dr Ron Ehrlich: [00:01:30] Peter, today we’re going to talk about diabetes, and I don’t want us to assume that you know, everyone hears the word, but do they know what it means? I just wondered if we might start with what is diabetes and why is it such a problem?

Dr Peter Brukner: [00:01:47] Yeah, look, good question. And people are confused because there are different types of diabetes that you hear about. So let’s, as you said, let’s go back to basics. And basically, you know, diabetes is a disorder of your glucose metabolism. So it means that your body is unable to process glucose properly.

Now there are two main types, let’s stick to the two main types of diabetes. There are a couple of others that are a bit rare, but let’s stick to the two main ones and they’re completely different diseases. And they probably shouldn’t both be called diabetes because that confuses people, but it’s Type 1 and Type 2.

Type 1 Diabetes

Dr Peter Brukner: [00:02:23] Type 1 Diabetes is when it’s probably the more severe, you’d say, and it tends to occur when people are young. Sometimes children, sometimes young adults, you can kind of come on later, but generally when it affects young people and it’s probably an autoimmune disease in which your pancreas — your pancreas is the organ in your body that basically controls your sugar because it releases the hormone, insulin and insulin is essential. If you don’t have insulin, you die, basically. So insulin is really important.

So what happens when you, for the normal person, when you have some sugar or carbohydrates, starches, you eat that, your body breaks that or your gastrointestinal system breaks that down into glucose and your glucose is absorbed into your blood. Glucose is a very important nutrient. And to stop that or to enable that glucose to be used around the body, when the body absorbs glucose the pancreas, is an organ in your stomach, secretes a hormone called insulin. 

And insulin is the hormone that drives that sugar out of the blood into the tissues. And that’s really important because if your blood glucose gets too high, you become very, very sick. And ultimately, you know, you can’t survive. So insulin is really important to drive that sugar out of your bloodstream into the tissues where it’s used for fuel or it’s stored as fat.

Dr Peter Brukner: [00:04:03] Now, in Type 1 Diabetes, for some reason that we don’t really understand, the body’s sort of attacks itself and the heart of the pancreas that produces the insulin stops working. And so basically, you stop producing insulin. So it’s a very serious condition in that you don’t produce insulin, your blood glucose gets too high, and the effect is disastrous.

So Type 1 Diabetes, people with that disease, young people often need to inject insulin. So basically until insulin came on the scene 100 years ago and so people died basically when they had Type 1 Diabetes and insulin has been a lifesaver. And people now inject insulin and basically survive. So that’s Type 1 Diabetes. That’s far less common but far more serious and severe. You basically have a lifetime of injecting insulin.

Type 2 Diabetes

Dr Peter Brukner: [00:04:55] So the second type of diabetes is what we call Type 2 Diabetes, and that’s a very different disease. It tends to occur later in life and you still produce insulin but what happens is over a period of time is that your body becomes what we call resistant to the effect of that insulin. 

Now it’s a little bit like, you know, if you’re drinking alcohol, you know, the more alcohol, you know, after a period of time, you need more and more alcohol to get you drunk. It’s a little bit like the same with insulin. And if you’re producing lots of insulin, if you are eating lots of carbohydrates over a period of time, many people and there’s some genetic component to it, you know, not everyone gets it. 

But generally, people become resistant to the effect of that insulin and as a result requires more and more insulin to draw the glucose out of the bloodstream into the tissues. And ultimately, the body can’t produce enough insulin and the blood sugar rises.

So that’s really what occurs in diabetes. You have elevated blood glucose, which is called Hypoglycaemia. Now it’s interesting. I mean, back when we’re at the day, when I was in medical school and then you do a study, we used to call this disease a Mature Onset Diabetes. 

Unfortunately, sadly, they had to change the name to Type 2 because people are getting it younger and younger. This was a fairly rare sort of disease that some elderly people used to get, you know, a generation or two ago. Now we’re seeing teenagers with Type 2 Diabetes, and it’s largely because of the way we eat.

Diabetes is a disease of carbohydrate intolerance

Dr Peter Brukner: [00:06:26] So basically, how you can summarise diabetes is that diabetes is a disease of carbohydrate intolerance. Okay. In that we can’t, our bodies are unable, in Type 1 because there’s no insulin and Type 2 because we’re resistant to the insulin. But for whatever reason, our bodies don’t tolerate carbohydrates.

Now, you would think it was pretty obvious what the solution to that was. But if I asked you what has been the recommended diet for people with diabetes for the last 50 years, you’d probably say, well, the obvious thing is, you know, reduced carbohydrate, but oh no, no, no, no, no, that’s not correct. 

The recommended diet has been a low fat, high carbohydrate diet. Because of this obsession, we have with fat because I think it probably becomes, as a result of diabetes leads to cardiovascular disease, and we’ll talk about that in a minute. But and everyone’s obsessed about fat and cardiovascular disease, so people have become totally distracted and forgotten the actual reason why people become or the basic behind their diabetes is carbohydrate tolerance whether we become overwhelmed by this, by this fat thing. 

And as a result, we’ve been recommending this low fat, high starchy carbohydrate diet, which has been the worst thing you can imagine. Giving someone whose carbohydrate intolerance at a diet high in carbohydrates and when you think about it and I didn’t for many years, I have to say, you know, but when you actually think about the logic of it, it’s totally irrational. 

But because of this obsession, we’ve had over the last 30 or 40 years with fat and cholesterol. And as we discussed last time, you know, based on a lot of dodgy science and a lot of politics and power and so on, we’ve lost sight of the real problem.

Dr Peter Brukner: [00:08:25] And as a result, Diabetes and Type2 Diabetes in particular, is a massive problem in our society. I actually think it’s the biggest single health problem in Western, in this country and in western society. 

We have officially, I think the numbers are 1.2 million Australians with Type 2 Diabetes. Type 1 Diabetes, about 100 000. But Type 2 is the one I’m really focussed on. Type 2 Diabetes the official numbers are about 1.2 million. 

A feeling out there in the medical facilities that there’s probably another half a million who are out there walking around with Type 2 Diabetes that probably haven’t been diagnosed yet because often you don’t get symptoms till quite late. So that’s, you know, going on for two million people with Type 2 Diabetes.

The estimates are that there are probably another two million people suffering from what we call Pre-Diabetes, and we can talk a bit about that later. But you know, the significant proportion of those people will go on to develop Type 2 Diabetes unless like they make the changes that we’re going to talk about. So this is a huge problem. 

Now you might say, well, you know, people don’t tend to die of diabetes. You don’t hear of people dying of diabetes. But diabetes is the underlying cause because high blood sugar levels damage the arteries. And as a result, they cause damage to a whole lot of different organs.

Dr Peter Brukner: [00:09:52] So, for example, Type 2 Diabetes is the most common cause of blindness in Australia. It’s the most common cause of kidney disease, kidney transplants, dialysis. So it’s probably implicated in most people with cardiovascular disease, with heart problems. It certainly is the most common cause of amputations and peripheral vascular disease. People’s toes and legs have to be amputated. 

And it’s very closely related with Dementia and Alzheimer’s. In fact, Alzheimer’s is sometimes called Type 3 Diabetes, such as the close relationship between the two. So, you know, the disease I’ve just mentioned, there are the biggest health problems in this country, and for many of them, the underlying cause is Type 2 Diabetes. That’s why we are so obsessed really with getting Type 2 Diabetes under control. 

Medical Education and Diet

Dr Ron Ehrlich: [00:10:41] Now it’s interesting, Peter, because you’ve mentioned eyesight, you’ve mentioned limbs. We’ve actually had on as guests like Gary Fettke and Belinda, of course. And we’ve also had James Muecke, the Australian of the Year in 2020. And you’ve just said this was something I wasn’t… And here you are. 

You know, given your position in sports medicine globally, nationally, you know, et cetera. And it wasn’t something that you were aware of, either. James had a similar story. Gary had a similar story until he became aware. What is about it? What is it about our medical education? Does it kind of mentally just cut off the basic sciences once we get onto pharmacology? That’s when we’re really studying, or surgery, we’re really studying real medicine. Is that part of the problem?

Dr Peter Brukner: [00:11:30] Yeah, I think it is. I think there are few issues, I think for start, our whole medical degree. I don’t have a single lecture on nutrition in my six years in medicine. Got one? Well, maybe I was away that day. But anyway, I don’t think I did. I can’t remember anyway. 

You know, he had biochemistry sort of stuff, you know, but not nutrition. I didn’t have an exercise. I don’t think I’d run on stress. You know, I mean, that wasn’t talked about. You know, this is a while ago, but I don’t think things have changed that much, to be honest.

And doctors, you know, we’re funny sort of people. But yeah, we’re like most people in that you stay in your comfort zone, you know, and a comfort zone for doctors is pharmacology. It’s drugs and surgery because that’s what we’re told. That’s what we’re taught. Now we’re told that is the solution. 

We know, you know, in all of that pharmacology and drugs and so on. And we’re taught that at x disease, you know, y drug. Y disease, then surgery. That’s, there are the two options. And so you stay in your comfort zone, you know, someone comes to you, and most doctors don’t feel comfortable talking about nutrition. So the easy thing is just to, you know, refer to the dietitian or refer to the dietary guidelines, which are outdated and wrong.

Dr Peter Brukner: [00:12:43] And so, you know, it’s not… I just sort of don’t, I do and don’t blame doctors, you know, I think a lot of the time we do sort of stop thinking, you know, we’re so busy and so focussed on what we’re doing day to day that we don’t actually have time to go back and then sort of think, “Well, hang on, is this right?”. 

I had a great saying once that someone said that 50% of everything you get taught in medical school turns out to be wrong. You just have to work out which 50%. And for most of us, you know, we still believe everything we’re taught in medical school is right, and it’s not the case, and things do change our… Knowledge changes.

The other thing that I’ve learnt, I guess, is through this process, you know, when I first discovered that maybe the low-fat argument was, was wrong, you know, was that we assume that all the basics of medicine are based on good, solid science and research and so on. And when I went looking for the science and the evidence for nutrition and for low fat, it just wasn’t there. 

You know, I’d always assumed that the reason the whole of Western society has been on a low-fat diet for 30 or 40 years was because of good, solid evidence science. Then when you go into it, you know, the science is either fraudulent or it’s sponsored by the sugar industry or by the food industry, and it’s really hard to diagnose.

Dr Peter Brukner: [00:14:03] And it had really I mean, I remember when I first sort of started to read about this, we’re feeling quite disturbed. You know that I was reading this book and I put it down at night thinking, “Na-dah! This could be right.” You know, we couldn’t have made such a basic mistake of this all this time. 

And yet, you know, the more you read, the more you look into it, the more you realise it. Yeah, you know, the whole advice to be obsessed about low fat and cholesterol is based on fraud and on money rather than science, which is quite scary and quite depressing in a way.

Dr Ron Ehrlich: [00:14:38] Yes. Well, I think James Muecke went through a similar experience and you know, you as well. And I think I don’t blame doctors either in the sense that people are so busy and they’re so preoccupied with what they see in front of them trying to manage it that they would rightly assume that those that are government regulation or from professional, the recommendations would have been would be something you could rely on. It’s a story that’s very easy to miss, but once you hear it, very difficult to ignore.

Dr Peter Brukner: [00:15:14] That’s right, and you’ve got to look at the consequences. You know, I mean if the advice we’ve been given was right, you know, you’d think that, well, maybe we must be getting healthier, but you know, we’re getting fatter and sicker every year. You know, obesity levels are going up. 

Type 2 Diabetes levels are going up. I mean, you know, we must be doing something wrong because if everything was right, then you know, then we’d be getting healthier and we’re actually not getting healthier.

So, you know, I think we really need to… And what it’s done is it’s made me a bit of a sort of a sceptic. I think, you know, I sort of now question everything which is probably not a good thing. But I really spent half my time now reading trying to get to the bottom of everything that we’re taught. And it’s quite scary that some of the stuff you come up with, which really isn’t there. 

And then if you stick your head up and suggest that maybe what you know, you get shut down by the establishment. I mean, you look at Gary Fettke and […] in South Africa and we’ve all been, you know, we all have people try to sort of take us down when we suggested that, you know, the current sort of status quo might be wrong and that that’s scary too. 

You’re not allowed to challenge anything these days. And I think there’s the problem is there’s a lot of vested interests in maintaining the status quo. You know, some of the pharmaceutical industry and the food industry are doing very well. Thank you very much. They don’t want things to change.

Dr Ron Ehrlich: [00:16:42] You know, I think this is part of the problem that two basic things like food and health care have become commodities…

Dr Peter Brukner: [00:16:50] Yeah, absolutely, and commercialised…

Defeat Diabetes

Dr Ron Ehrlich: [00:16:52] …And in a market-driven world, a market-driven economy. They’re big commodities, they’re big commodities, and that’s not going to be surrendered. But you, we, you know, Defeat Diabetes is an attempt, a serious attempt in an independently serious attempt. Tell us about Defeat Diabetes.

Dr Peter Brukner: [00:17:11] Well, I guess, yeah, I’ve always been, you know, since I’ve sort of gone down this track, I’d be worried about Type 2 Diabetes. And as I said, the numbers are going up and the effects of it are this is massive in our society. And sort of can I keep waiting for someone to do something about it? You know, there seems to be an obvious solution. And ultimately, you know, no one was doing anything about it, you know, and I think because of all those influences that we mentioned. 

And I observe that both in the UK and the US, they had been online programmes that promoted a restricted carbohydrate diet and exercise and other things that had been remarkably successful because traditionally what we’ve been taught about Type 2 Diabetes is that it is a chronic progressive disease. 

So, you know, you go along to your doctor, Ron, and you know, it’s, “Oh look, you know, just got some bad news for you. You’ve got Type 2 Diabetes.” And then you say, “Well, what can I do about it?” And he sort of shrugged his shoulders, says, “Well, there’s not really much you can do, we’ll give you some drugs that help a little bit of that. But you know, you’ve got to learn to live with it and you’ll get all the consequences of it.”.

Well, you know, that’s very depressing. I mean, it just doesn’t give people hope at all. It doesn’t give doctors hope, doesn’t give patients hope. But now there is accumulated evidence that restricting your carbohydrate intake can actually dramatically improve diabetes control and in fact, it can put diabetes into remission. 

Now we’re taught that that’s not possible, but the evidence overseas is that these programmes, these low carb programmes, as they’re referred to, have about a 50% remission rate. So you people get off their medication and no longer are diagnosed with diabetes, so their blood sugar levels come down to normal.

Dr Peter Brukner: [00:18:56] Now that you know, that is incredible there are no drugs that can do that. There’s no other, you know, a form of treatment, maybe bariatric surgery can do that, but that’s pretty radical. So, you know, here’s a relatively simple way of putting your diabetes Type 2 Diabetes into remission. So there they are. 

I’ve been observing those two programmes in the UK and the US. And initially, my thought was, well, maybe we could licence the UK one to Australia, and we tried to do that and didn’t work out for a whole lot of different reasons.

So sort of a year or so ago, I bit the bullet and got a couple of colleagues involved. We decided, well, we’d write our own programme, an Australian based programme. So it’s Australian. We determined that it would be completely evidence-based. So everything we did would be backed up by the latest science and it would be, you know, by Australians for Australia. You know, as I often say, we’re talking about Vegemite, not Marmite, you know. And the important things are that.

Dr Peter Brukner: [00:19:51] We put together an app-based programme. Ultimately, we’ll put out a web-based programme as well. But we initially started with an app-based programme. We called it Defeat Diabetes. And in that programme, there is a whole bunch of what we have 13 lessons along the way, really, and these lessons consist of videos and articles and action plans, quizzes. 

We’ve got meal plans, we’ve got recipes, we’ve got cooking demonstrations and so on. And it’s really, you know, the one-stop-shop, if you like the rap for everything about diabetes, it gives you the background information to try and understand why we’re doing what we’re doing, but also gives you the practical information right down to recipes and meal plans about how you can get on top of this.

And we launched the app in January, and it’s a subscription app. You get a 14-day free trial and then you can sign up for various lengths of time. For instance, 12 months is $99, so it’s less than $2 a week. So, you know, it’s about half a cafe latte, I think per week to give you the information you need for your diabetes. And the response has been terrific.

 And there just recently we surveyed our first group of people who subscribe to the app, and we looked at the results after three months. We had 62% of those people put their diabetes into remission, which was even better than that of states.

Dr Ron Ehrlich: [00:21:22] This is the condition that many doctors and we’ve had. I had Rob Szabo on as a guest too, and you and Rod Tayler with we’ve done a whole low carb story here, but that Rob is one of those doctors who was a doctor diagnosed with Type 2 Diabetes and felt mortified that he knew the status quo as there is no cure. We just have to manage. And within 48 hours, Rob turned it around, to his surprise. Absolutely. 

And I think you, although you didn’t go die, you weren’t diabetic. But I know you lost quite a bit of weight, you know, over a relatively short period of time. It’s interesting without going into the biochemistry, the terms glucose and sugar and carbohydrates often get mixed up. I think it might be worth just reminding our listeners were actually telling them for the first time why carbohydrates affect blood sugar.

Why do carbohydrates affect blood sugar?

Dr Peter Brukner: [00:22:22] Yeah. Okay. Very good question. So basically, carbohydrates, there are two main types of carbohydrates. Sugars. OK, so I think we’re all pretty familiar with that with sugars, sucrose, table sugar, which consists of a molecule of glucose and a molecule of fructose. And so that’s part of the story. Sugars are all carbohydrates, and I think most people get the fact that, you know, too much sugar is not very, not very good for you. 

The tricky thing is that there’s so much hidden sugar, you know, we all sort of realise, okay, you can’t put three teaspoons of sugar into a coffee or whatever or put too much sugar on. And we know that Coca-Cola and things like that are full of sugar, but it’s all a hidden source of sugar. So basically all pretty much all processed foods. So all packaged and canned foods have added sugar because the food industry has gotten used to the taste of sweetness. 

So probably about 80% of processed food has added sugar. So even things that, you know, are promoted as being healthy, you know, like breakfast cereals and fruit yoghurt and bread and muesli bars and barbecue sauce and all these sort of things are full of sugar. And that’s what people don’t really understand. So, so sugars are a one part of the story.

The other part of the story is is the category called Starches. So they’re, you know, potato, rice, pasta, that sort of an actual thing and those what a starch is, that’s also a carbohydrate. The starch is just a whole bunch of glucose molecules stuck together. So you ingest a starch, your body breaks at your gastrointestinal system, breaks down that starch into its constituent molecules, which is just glucose, and it’s absorbed into the bloodstream as glucose, so exactly the same as having sugar. It’s absorbed in the same form as in glucose. 

Now the only difference is it takes a bit longer because it takes time to break it down, whereas you know you have a glass of coke and you immediately get a rise in blood sugar, whereas if you have a potato, it takes a little bit longer. But what people don’t understand is that these starches are basically just sugar molecules or glucose molecules stuck together.

Dr Peter Brukner: [00:24:40] So between the sugars and the starches, that’s the majority of our diet. You know the modern diet all still processed packaged foods and so on. So, you know, reducing carbohydrates involves reducing both the sugars and the starches. And that’s really what we’re about with our dietary recommendations and restricting the carbohydrate intake so reducing the amount of sugar, so, you know, soft drinks, fruit drinks, fruit juices, flavoured milk, a lot of drinks that have full of sugar. And then there’s all that, all the different foods that are full of sugar.

So if you basically, you know, stick to see to real food, so what we recommend is sticking to real foods are meat and fish and fruit and veg and dairy and eggs. All the things that I’ve been told are bad for you. If you are actually a lot better than what’s been replacing them and then the sugars and starches. 

So it’s really a matter of getting back to, you know, if you eat real food, then your carbohydrate intake is going to be restrictive and you’ll be eating lots of healthy proteins than fat. The first thing you notice when that happens is you stop being so hungry, especially carbohydrates make you hungry. Fats and proteins fill you up. And you know, I used it probably three meals and three snacks a day. You know, you’d have your cereal for breakfast and you know…

Dr Ron Ehrlich: [00:26:10] …that’s what we’re taught to do. We would try to keep the blood sugar level even. And in fact, it’s a wonderful model for selling food.

Dr Peter Brukner: [00:26:17] Yeah, of course, it is. Yeah, the cereal industry has convinced us that breakfast is the most important meal of the day. There’s absolutely no science for that, but everyone believes it because, you know, we’re gullible. And you know, the food industry is they are the most brilliantly clever marketing people in the world. You know you look at breakfast cereals. 

I mean, you know this zero five in sugar, it’s about till they are, you know, and yet, you know, little Johnny’s walking down the aisle with his mom and, “Mama! Mama! Mama! I want that one that is brightly coloured. You know..” And they’re so clever the way they do these things, you know, and they and they say, “Oh, no added sugar. Oh, why is it? That’s healthy, you know?” No added sugar. 

Yeah, but all the sugar is in the cereal or in whatever it is. And so it’s very, very clever in that. And they just taking us for a ride that, you know, the consequences are disastrous because we’re getting fatter and sicker and it’s really hard to take them on.

Dr Ron Ehrlich: [00:27:19] When we do hear about low carb, you know, low carb means different things to different people. When you’re being told by the authorities that your recommended daily intake should be about 300 grams of carb. Well, I think it is, Peter. I think it’s about 310 grams of carbohydrate a day, and people don’t really know what that means. We’ll get to that in a moment. 

But when we’re talking about, well, now let’s talk about that because I think one of the things that’s important is for people to spend a week of their lives measuring the food that they eat and recording what their carbohydrate intake is. So you need to look at the labels and pick up sugar, pick up carbohydrate content, et cetera. But you’d also need to weigh some food and work out what the carb, I guess there’s a carb.. Is there a carb counter on Defeat Diabetes?

Dr Peter Brukner: [00:28:12] I know there are lots of carb counters out there, though. There are apps and websites and so on that, you can count your calories. But basically, you know, if you’re having is the standard Aussie diet, lots of processed food, I mean, you’re going to be up there 253 grams of carbohydrates a day, you know, I mean, you’ve only got to have how about a normal bottle of 600 or a bottle of coconut and you’ve got 64 grams of sugar or something? 

I mean, it’s just, you know, the majority of people by the time they finish breakfast are probably at about 150 grams of carbs, you know, to have a glass of fruit juice and a bowl of cereal and a fruit yoghurt toasted to you with a cup of sugar. I mean, they’re 150 grams of sugar every bit of time.

Low carbohydrate

Dr Ron Ehrlich: [00:28:58] Yeah, and they’ll be hungry. They’ll be hungry, ready to have another snack at morning. What is low carb? What do you how do you define low carb?

Dr Peter Brukner: [00:29:07] Well, I mean it basically, most people would consider probably under 120 grams of carbs a day is as low carb and then °n low carb. And then you get down into what the ketogenic, the keto-type diet that people might have heard of. You know, that’s down to sort of 30 or 50 grams of carbs a day. 

So there’s various grades. And the way I look at it is that everyone has an ideal amount of carbs that they should be having, and it really depends on where you are in that sort of insulin resistance if you are young and fit and healthy and you have insulin sensitive and so on you can have you 120, 150 grams of carbs a day and you know, you’ll be OK.

But if on the other hand, you’re the only overweight or you’ve got Type 2 Diabetes or prediabetes or metabolic syndrome or hypertension or something like that, you should be getting down towards the sort of, you know, 30 to 50 grams of carbs a day, at least in the short term to get your metabolic health under control and then you can just slack it off a little bit and you’ll find the right amount because your or about the study and you’ll feel good and your blood sugar will be fine and so on. 

And so that’s what I did, you know, I guess I went to, you know, pretty hard for three months and, you know, I didn’t measure my carbs, but I just didn’t have any carbs, really. I would just eat, you know, lots of sort of eggs and bacon and avocado for breakfast and dinner to be made official, you know, vegetables at the I’d have a few berries and a bit of cream and some nuts and so on. 

And so I was probably down to the 30 or 40 grams of carbs a day and did that for three months, lost 13 kilograms of weights, resolved. All my metabolic issues went from being pre-diabetic with a fatty liver to absolutely normal. And then after that, I just gradually introduced a few a bit more fruits a day occasional salad, bread or something or a bit of dark chocolate or whatever.

Dr Peter Brukner: [00:31:02] And then I’ve sort of found my right amount which is, I guess, is probably about 70 or 80 grams of carbs a day that keeps my blood sugar and my wife’s and me feeling good, you know, because one of the other things is, you know, we focus a lot on your weight and your blood sugar and so on. But it’s also how you feel, you know? Yes, you just feel so much better when you’re on this, you know, restricting your carbohydrate and so on. 

You sleep better, you exercise better, you concentrate better. You know, it all sounds a little bit too good to be true. And to be honest, I thought it was too good to be true to start with. I was sceptical and cynical as anyone else about this when I first heard about it. And that was only because a colleague of mine who I respect a lot […] in South Africa was so adamant that it was a lie. I thought, “Oh, I need to look into this more.” And even though I read a lot, I was quite convinced about it. I was still sceptical til I had the experience myself.

In three months, I’d had a thing called fatty liver, which is a sign of prediabetes. It’s a disease where you basically get fat infiltration into your liver. And I had that for 10 years and had blood tests every couple of years that you do, check-up, your blood sugar, you got fatty liver. And I didn’t really know what fatty liver was. I sort of ignored it and I figured I was on a low-fat diet. I’ll be alright, you know, typical doctor. 

I’m looking after myself very well. And after three months of changing my diet, my fatty liver completely disappeared. Liver function, back to normal. From my normal ever since I had it for 10 years. Maybe even before that, that was as far back as my blood taste went. So, you know, in the space of three months, maybe even less, because I only measured it at the end of the three months, I’d resolve this, this health issue that I’d had for 10 years, and that’s what blew me away.

Dr Peter Brukner: [00:32:48] You know, I just could not believe that that seemed like diet, you know when drugs weren’t what help that that diet would do that. And it is real. It’s a life-changing experience for me when I sit in, as it has been for you and for many others, I think, you know, and once you’ve been through it, you never go back. 

I mean, because if you feel so much better, so much more energy. And you know, the only problem is you need a new wardrobe because you know, you lose so much weight, you know, to get all your clothes. But I figured that was a small price to pay.

So, you know, I think it’s just a no brainer, but. And we’re seeing that with people who are doing the programme on the app. You know, I mean, every day I’m getting, you know, a message or something on the Facebook group and saying, “You’ve changed my life, I can’t believe why didn’t I know about this before, et cetera, et cetera.” You know, so that’s very, you know, rewarding when things like that happen.

I mean, no one ever told me, I’d change your life, and I said no of the regular order, the old age. But you know, it’s very rewarding on that. And, you know, we just want to get the message out there to as many people as possible because it is a massive issue.

Dr Peter Brukner: [00:34:00] The other thing, Ron, is it, you know, people say, Oh, I’m okay, I’ll be on my blood sugar was fine, I’ll be alright.” But you don’t develop Type 2 Diabetes overnight. You know, it’s somebody that takes 10 15 years, probably of the slot gradually becoming resistant to insulin. 

And till a point where you actually go bang, you know your blood sugars are too high. But that happens over a period of time and much better to get, you know, to prevent it happening and to wait till it does happen because we know the consequences of high blood sugar are disastrous and all those diseases we talked about before. And if we can prevent that, you know, it’s our whole medical paradigm is wrong. 

You know that we’ve talked about before that we wait until people are sick and then we throw drugs at them and surgery and everything like that. It’s just crazy, you know, it just does not make any sense at all when if we get, you know, we get the other things right in your diet rather than exercise right, we get stress right. You know, we don’t we’re not going to get to these situations. We don’t need drugs, you know, but that’s not good for the pharmaceutical industry.

How to access the Defeat Diabetes app

Dr Ron Ehrlich: [00:35:03] You know, it is such a huge problem. And to hear you articulate it in this way and to offer such a solution as to Defeat Diabetes is… And that’s why I’ve been very, very keen to support it. And how should be, remind us how people can access this?

Dr Peter Brukner: [00:35:24] OK, well, there’s these two ways really can go straight to the App Store or the Google Play as an Android and Apple version, just click on the app Defeat Diabetes app. As I said, you get a 14-day free trial, so plenty of time to look through it and see whether you want to continue, or you can just sign up straight away. As I said, there’s one month, three months and 12 months, the options. The 12-month option is, you know, it’s only $2 a week. It’s very easy.

And then when that happens, you become part of a Facebook group. You get emails every week, you get new recipes, you get new videos. You know, where you become part of a community and alike, you know, like-minded community people who are trying to sort of improve their health and just, you know, fantastic. Just being on the Facebook group here, all these great suggestions and people’s experiences and ideas and recipes. And you know, it’s great.

Dr Peter Brukner: [00:36:21] So alternatively, if you want to find out a bit more about it before you dive into the app, you can go to Defeat Diabetes website, which is just defeatdiabetes.com.au and have a wander around there and you’ll find out a lot more about it. You’ll see some sample videos and articles and so on and learn a lot more. And on that also, we also have all the evidence behind it all in case you want to get into the science of it all. So now that your options go straight to the app or the App Store and download the app, or you can actually go to the website and log on from there. So there are two options, hopefully, you know you’ll have a good result.

Dr Ron Ehrlich: [00:36:59] Well, Peter, thank you so much not only for these amazing initiatives and the needed initiative but thank you also for joining us today and sharing that with us.

Dr Peter Brukner: [00:37:10] My pleasure. Thanks for having me.


Dr Ron Ehrlich: [00:37:14] Isn’t it interesting to talk to people like Peter Brukner? I mean, Peter’s position in Sports globally is what he’s a world leader, and yet he was not aware that the advice that is put forward by the organisations over the last 30 or 40 years, he just assumed it was there. It was evidence-based. Evidence-based. 

I’ve made a note of this, this was a Healthy Bite we’ve done about Evidence-Based Medicine or Evidence-Based Marketing, but it bears repeating because the word evidence-based is said to absolve anybody of any other things. Once you’ve said the words, Oh, this is evidence-based on repeated use that as well. But, you know, independent, evidence-based is the key.

When you say evidence-based, it’s like the holy grail of everything you say after that. And the problem is that there’s a very big difference between evidence-based medicine and evidence-based marketing. And part of the problem with the science in medicine is that at least 70% of the science in medicine is paid for by commercial interests, who, it needs to be said, also have a conflict of interest.

Dr Ron Ehrlich: [00:38:36] And another guest on this podcast, Dr Andrew Saul, once said good health may make sense, but it doesn’t make dollars. Well, it doesn’t make dollars for the food industry, and it doesn’t make dollars for the pharmaceutical industry. And when they are sponsoring research and they have the power to lobby professional organisations and government bodies and regulatory bodies to develop public health policies, which, if the evidence is anything to go by, hasn’t been terribly successful. 

If you plot the incidence of obesity and Type 2, which used to be called late-onset, it’s not late-onset anymore, Type 2 Diabetes. It is actually hitting upwards and it has done ever since the dietary guidelines have been promoted so widely.

Now it’s worth noting also, this figure: 4 grams of sugar or carbohydrate is a teaspoon of sugar, so four grams of sugar or carbohydrates is a teaspoon of sugar. And then there’s the fibre component of carbohydrates we need to consider as well. So that is why when you are going down this path, I actually do think it’s a worthwhile exercise for a week of your life to just look at labels and keep a little note of how many carbohydrates you’re consuming. Even for a day or two, it will be, I know, an eye-opener.

For example, if you have to use, as Peter said, if you have a juice or a smoothie bowl of cereal, some yoghurt, it’s quite likely that by the end of that meal, you may have already consumed 100 to 120 grams of carbohydrates or sugar that use those two words almost interchangeably. I know there are complex carbohydrates which break down slower, and that’s a good thing. 

But just focus on your carbohydrate and sugar intake in a 24 hour period, and I thought it was interesting to note what is a reasonable level, Peter said, “If you were fit and healthy and doing a lot of exercises, 120 150 grams of carbohydrate a day wouldn’t be a problem.”

Dr Ron Ehrlich: [00:40:54] Personally, I at my age and my stage in life feel that a very sustainable level of carbohydrate on a daily basis is around 70 to 80 grams. I totally agree with Peter on that one. But if you have just been diagnosed with Type 2 Diabetes and you want to bring that back under control, then for a period of time, who knows how long that will be? It will certainly be for at least a couple of months, but maybe you’ll feel so good you’ll want to continue that on for longer.

A carbohydrate level of 20 to 30 grams of carbohydrate a day will bring that back under control. Will it put you into remission? Well, the science says 50 to 60% of the time it probably will, which is a hell of a lot better. Then there is no cure for Type 2 Diabetes. We just have to learn to manage it for the rest of our life.

Now, I’d refer you back to an episode we did with Dr Rob Szabo. In fact, I did a whole lot of episodes about low carb living with Dr Rob Szabo, who was a doctor in his late 30s, fit and healthy, who was shocked to be diagnosed. I know Rob won’t mind me mentioning this, was shocked to be diagnosed with Type 2 Diabetes and was had been advising his own patients of exactly what Peter Brukner has just said. There’s no cure. We just have to manage. 

And then he stumbled upon a low carb option and literally. And this was for I think he was in his late 30s at the time, literally turned around his health in about 48 hours. To his surprise, to his shock, to his great relief and to the benefit of him the rest of his life.

Dr Ron Ehrlich: [00:42:36] So, so don’t let your doctor tell you that there is no evidence to support X, Y or Z. You know, this is another thing that I think you also need to be aware of, and that is when a doctor says or a so-called expert says there’s no evidence to support that, what they should really be saying is “I haven’t read the evidence to support that.” And between those two statements, there is a world of difference.

The episode we have done with psychologist Julia Rucklidge was very insightful for me, she said, “We need, as people, but as practitioners to be sceptical but curious.” And that really stuck with me. It’s important for us to be sceptical but curious, but at what point do most medical practitioners curiosity kick in? And I would argue it is at the point in their education when they studied pathology, the study of disease and pharmacology, and surgery, how to manage those diseases. 

And from there, they’re very curious and thought, Well, they should remember that in the first few years of medical or health practitioners, health practitioners degrees, we studied the basic science of anatomy, biochemistry and physiology and histology, the study of cells, the study of biochemistry, what goes on in those cells, the study of physiology, how all those cells and systems within our body interact to keep us healthy. And if our curiosity came back a few years to the very beginning of our training, then that would be a wonderful place for medical practitioners to be sceptical but curious. But when someone says to you, there is no evidence to support it.

Dr Ron Ehrlich: [00:44:31] Well, here’s a statistic I’ve heard there is so much evidence out there at the moment that it takes something like 600 hours a week to keep up. Now, consider resigning 168 hours in a week and you sleep for a third of that. So it’s not possible to keep up with all of the research. 

So I always preface what I don’t know is I’m very pleased to. I’m very open to admitting there’s an awful lot I don’t know. In fact, the more you learn, the more you realise you don’t know. And I’m learning a lot and I’m realising, I don’t know a lot, which is exciting for me. I find that empowering. So anyway, I digress.

Log on, find out about Defeat Diabetes. It is an independent, evidence-based, independent, evidence-based, and therein lies a big difference as well. An evidence-based approach to this big and growing problem, which doesn’t just affect diabetes, it sets you up for every other comorbidity and complication of this pandemic and every other disease you can think of. 

Anyway, we’ll have links to Defeat Diabetes. I’d recommend you go on there and log on and subscribe and become part of that community. I am very proud and pleased to be a supporter of that. I have made a commercial commitment to it without any suggestion that that will make a financial return at all not interested. 

I’ve often said the change has to come from the ground up and I’m putting my money where my mouth is quite literally, and I think it’s well worth you .logging on and supporting this as well. Hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well.


This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.