Show Notes

• Drew Harrisberg Website – Drew’s Daily Dose
• Dr Pran Yoganathan – Unstress Episode ‘Is the Gut the Second Brain?’
• Drew Harrisberg and Simon Hill Podcast Episode on The Proof
• Michael Mosley Unstress – Episode ‘Fast 800, Fast Exercise and Sleep’
• Nora Gedgaudas Unstress – Episode ‘Food Freedom Project’

Timestamps

• 00:00 – 02:00 – Introduction to Drew Harrisberg
• 02:01 – 08:00 – Drew’s Personal Health Journey
• 08:01 – 15:00 – Fitness Tips for Beginners
• 15:01 – 22:00 – Nutritional Advice and Meal Planning
• 22:01 – 30:00 – Overcoming Health Challenges
• 30:01 – 37:00 – Integrating Wellness into Daily Life
• 37:01 – 45:00 – Drew’s Favorite Health Resources
• 45:01 – 50:00 – Audience Q&A
• 50:01 – 52:00 – Final Thoughts and Takeaways
• 52:01 – 54:00 – Closing Remarks and Future Episodes

Drew Harrisberg on Fitness, Food, and Wellness

Dr Ron Ehrlich [00:00:00] Hello and welcome to Unstress. My name is Doctor Ron Ehrlich. Now, before I start, I would like to acknowledge the traditional custodians of the land on which I am recording this podcast. The Gadigal people of the Eora nation, who for over 65,000 years have been custodians of this land. I would like to pay my respects to their elders. Past, present and emerging. Well. Today we explore a wide range of topics we cover. Paleo. Keto. Plant based veganism. Type one diabetes, a whole range of topics. My guest is Drew Harrisberg. Now, I’ve been looking forward to getting drew on to my podcast for some time. Drew’s a exercise physiologist, a sports scientists, a diabetes educator, and most importantly, he’s a happy and healthy guy thriving with type one diabetes. Now, we talk a lot about that in this episode. He’s also an expert for functional nutrition brand Eimele, which has an essential rainbow supplement. We talk about that as well. How his world shifted when he was first diagnosed at the age of 22, when he was diagnosed with type one diabetes, quite out of the blue. And we talk about that. But after making positive changes to the way that he lives, eats, moves and approaches life, he would now readily acknowledge, as he does, that he’s healthier today than he’s ever before his diagnosis, and he regularly shares his learning to help others on his website, Drew’s Daily Dose. I hope you enjoy this conversation I had with Drew Harrisberg. Welcome to the show, drew.

Drew Harrisberg [00:01:46] Thank you for having me. Finally, we get to do this in a long time.

Dr Ron Ehrlich [00:01:49] We do, we do, we do. We’ve been talking about this for years and I guess both our busy schedules, yours more than mine, has precluded us from doing it. But here you are. And welcome. Now, listen, we we hear a lot about vegetables. It’s kind of the foundation of, you know, healthy eating. And it’s often a must in many in most diets. What are what is, what? And we’re told to eat the rainbow or what is eating the rainbow? What’s a rainbow diet and why is it good for your health?

Drew Harrisberg [00:02:20] Yeah, I think like, the public health messaging around fruit and vegetables has been something that we’ve heard about for decades and decades and decades. But I just think that the general population that good at adhering to the guidelines of fruit and veg intake, generally speaking, especially now, like the social media landscape, has almost changed people’s minds about fruit and veg. In some cases, some people think they’re actually bad for you, but I think the public health messaging has been great. It’s, you know, try to eat as many plants and fruit and vegetables as possible, but trying to eat five vegetables and two pieces of fruit per day or whatever it was, just wasn’t working. And I think a more digestible message is this idea of a rainbow diet. Meaning instead of trying to just think about your food as five vegetables, two fruit per day is a minimum. Go for colour like create a bowl of food that has so much plant diversity that it hits all the colours, essentially of the rainbow. And the idea behind it is that each unique food with a unique colour comes with different phytonutrients. So red foods have different fibre nutrients to purple foods to green foods, orange foods. So it’s just a no. I think it’s just a really nice, easy message for people. Understand, you know, you’re going to get more fibre, you’re going to get more colours, you’re gonna get more fibre nutrients. But you don’t have to just focus on specific fruit and vegetables. Just think about that rainbow creating, you know, a beautiful rainbow palatable.

Dr Ron Ehrlich [00:03:42] And how how do you how do we do that? You know, how do we up our phytonutrients intake, you know, how do how do they even benefit us? We hear about the nutrients and colours. But why are they so important?

Drew Harrisberg [00:03:54] Yeah, I think so. The fibre nutrients are basically these like, you know, compounds or chemicals in plants that occur naturally and have, you know, systemic benefits across the body for different sort of things. So again, going back to that idea of the rainbow, different fibre nutrients will play different roles within the body. I think as as a baseline understanding it’s if you if you do eat the rainbow, you’re setting yourself up for pretty good health, like as a baseline. So if you think about a diet, whether it’s a keto diet, whether it’s a paleo plant based, if the foundation is plant heavy, you’re setting yourself up for some success long term. The macronutrients may vary. Some people can do a low carb version or a high fat version, the low fat version, that to me, I’m very agnostic when it comes to the macronutrients. In some ways I just think that plant diversity, fibre, the most important things. But if you’re if you’re coming from, say, like a standard Australian doors down a Western diet and then all of a sudden up your fibre intake, you might find that you have some pretty bad digestive issues in terms of bloating and gas, which is not necessarily a sign of poor health. It may just be a sign of gut health and your ability to tolerate these new foods and fibres. So in that case, like I think people can supplement with, with different types of foods that will allow them to get these nutrients in other ways. So I’m an ambassador for a meal and they have a product, Essential rainbow. And the whole idea behind this product was for people who can’t just overnight switch to this rainbow diet and craft this perfect diet and ball and plate. You can take a daily supplement in powder. A form that will give you the, the basically the nutrients of the rainbow, in that one sort of intake. And they now have like sachets, you can take it with you on the go. So just try to make it easier to get these nutrients. But I always think go for the Whole Foods first. Lean on supplements when you need to.

Dr Ron Ehrlich [00:05:43] Yeah. No I totally agree about the Whole Foods. I remember doing a program with Professor Fred Provenza, who wrote a terrific book called nourishment, and he made a statement which kind of blew me away. And it said the humble strawberry is a good example. It has 5000 active nutrients. We only know what four or 5 or 10 of them do. But the fact that nature has packaged them all up, there’s got to be value. There’s some.

Drew Harrisberg [00:06:09] Right. And I think that’s such a good point about looking at outcomes rather than, you know, dialling in specifically on a nutrient or a micronutrient. But rather looking at what is the heart of health outcomes of eating certain dietary patterns. So like plant heavy diets have really good health outcomes long term. Whilst you know, it’s not we don’t need to be hyper focussed on every fight on nutrient in the diet, but rather just that overall pattern of eating. I think that’s the most important part of it.

Dr Ron Ehrlich [00:06:40] I think one of the interesting things about vegetables, though, because they are stationary, because they don’t move around and yet they are they need to protect themselves. There are some chemicals within vegetables that you know are potentially a problem. I mean, I know gluten gets a lot of, publicity, you know, lectins and other one, oxalates fight types for, you know, there are there are downsides too, aren’t they? Yeah.

Drew Harrisberg [00:07:09] I think that again, it’s like if we if we look at mechanisms like lectins or oxalates, whilst theoretically they may, you know, inhibit absorption of certain nutrients or they may cause some digestive upset or something like that, if you zoom out and actually look at heart or outcomes in terms of health outcomes, cardiovascular disease risk, cancer risk, diabetes, type two diabetes, generally speaking, the body of literature points to more vegetables, is actually better for long term health. And I do think that it probably difference between individuals, like some individuals are more sensitive to other foods than other people. So I would encourage people to sort of figure out what your personal thresholds off for different foods. But just like as a general guide, a plant heavy diet with vegetables and fruit is a really healthy way to eat. Even though there are these lectins, oxalate, these natural chemicals that are in the plants, it seems that they may even be like a geometric stressor. So a healthy stressor on the body that’s so low dose, like the dose makes the poison basically. So like a really high dose. Yes. Probably very bad for us, but at very low doses it actually seems to be beneficial. So, you know, it is tricky zooming in on lectins and oxalates because I think if we just look at Whole Foods, generally speaking the health outcomes are pretty good.

Dr Ron Ehrlich [00:08:28] Yeah. No, no I think I agree. I, I think the people that are probably most susceptible are people with autoimmune conditions. I mean, yeah, I mean, I think that’s the case. It’s a broad statement that one. But but anyway, listen, the other you mentioned macronutrients. And I think that is an interesting one because of course plant plant based diets are becoming very popular. Vegan diets are becoming very popular. And I know, I know, we did a program with gastroenterologist on yoga, Nathan, who made the point that nowadays protein requirements have actually gone up, particularly as we get older. It used to be something like 0.8 of a gram per kilogram of white. I could never work that out, so I always win 1g/kg of white. That was easy. Yeah, I’m 80, I’m 80kg. I need 80g of protein a day now, he says it’s more like 1.5 or 1.6 grams. So that’s one and a half. I would need 120g of protein a day, particularly at my age. That becomes a little bit of a challenge in an a plant based, purely plant based, plant based diet. What do you think? Yeah, I.

Drew Harrisberg [00:09:37] Think the dietary recommendations of 0.8, they came from my from my understanding of the literature. They came about as the baseline to avoid protein deficiency. So it’s not it’s we’re not talking about like optimising bone mineral density, muscle mass. It’s just like baseline nitrogen balance. It’s actually lower. But they bump it up. It’s probably 0.6 in the in the studies. But they bump it up. And I just to be sure that they cover everybody.

Dr Ron Ehrlich [00:10:04] Right.

Drew Harrisberg [00:10:04] It is too low for all the people elderly population, the anabolic response to protein is lower at a given gram to ground basis. So as you get older you probably do need more. And I actually think 1.2g/kg of protein is sort of the optimal number for somebody who’s a little bit older. If you’re looking to optimise muscle mass, bone density, if you’re an athlete. Performance. I actually think the research is pretty clear that 1.6g/kg seems to be. It seems to be the anabolic ceiling by which 1.8g or two grams per kilo doesn’t seem to benefit you that much more. So it’s like the sweet spot 1.6g per kilo. That’s what I currently. But in terms of getting that protein in a plant based diet. So I’m 85 kilos and I’m getting 1.6g/kg. So while I’m eating, let’s just call it 150g of protein a day. Sometimes more, sometimes a little bit less. But on average, about 150. I get most of my protein from whole foods sources. So legumes, tempeh, tofu. But I also I’m not opposed to supplementing with protein so that I can hit these targets. So the way I look at it is if you can hit your targets with Whole Foods plant, plant based Whole Foods, then that’s great. I mean, you can go for it, eat a plant based diet, but you may need to eat a little bit more than the recommended numbers of, say, 1.2, because plant protein is slightly less bioavailable, very small amounts, but a few percent points less bioavailable. But again, when you look at the research of, say, an omnivore diet versus plant based diet, the study is, you know, directly comparing the two diets and outcomes like muscle mass, bone density, ability to, you know, create hypertrophy in the muscles from resistance training. There seems to be almost no difference between the two diets when protein is equated. The one study that I’m thinking of, a very recent one, I think it came out last year, was looking at a omnivorous diet, a healthier version of an omnivorous diet supplemented with a white protein shake, and then a plant based diet supplemented with a I think it was a soy based protein shake outcomes where there was no difference in muscle mass, bone density, performance, strength, any of those kinds of things. So what I took away from that, and I already had known that from my experience being plant based for five years, is that you can build actually plenty of muscle in a plant based diet as long as you hit your protein targets. And if you have a hard time doing it by eating, you know, lentils and beans and chickpeas and quinoa and those kinds of things and tempeh and tofu, then just protein powder supplement is, you know, it can be a really good tool to just add to the toolkit. Some people are opposed to it because it’s processed. And but I just think in the scheme of a diet that’s, you know, 85% Whole Foods getting an extra 30g of protein a day from a powdered source that is rich in essential amino acids, really easy to digest and consume. I think it’s just for me, it’s a no brainer. It’s a beneficial.

Dr Ron Ehrlich [00:12:56] You know, I mean, I know it’s become a dirty word in public health, but meat has been with us for quite a while. And I know that like, for example, pork, lamb of lamb, beef, chicken, the lamb beef. About a third of the weight of the of the food is protein. Yeah. So, so for 100g, 30g, it will 33g protein. When it comes to lentils, it’s about 10%. So for me to hit 1.5, you know, 150g of protein a day, I would need to be eating 1.5 kilos of lentils a day. Which or other legumes? Which would really be an interesting challenge.

Drew Harrisberg [00:13:45] Yeah, challenge is the right word. It’s so. So the way that I look at it is thankfully, we don’t get all of our protein from one food source. It adds up from multiple different food sources, right? So there’s so many different legumes that you can eat and you don’t have to eat it. You know, as you say, 1.5 kilos of lentils a day to get your point is.

Dr Ron Ehrlich [00:14:04] Just just picturing.

Drew Harrisberg [00:14:06] That you do GI discomfort that would come with all of that fibre. But, it’s an interesting point you make because it actually brings up, you know, two benefits of a plant based diet from that perspective is that the protein in a plant based diet comes with fibre. And if people are already fibre deficient because a lot of people’s diets are fibre fish, they’re not eating enough plants. If they can shift some of their animal protein to plant protein, they’re going to get more fibre in the diet. So that’s a that’s a take that’s a net positive. But again like in this day and age we’re so lucky to have foods that are fortified with protein. So there’s so many plant based, you know typical plant based foods that are now very high in protein. For example, the pasta that I ate, which I actually had for dinner last night, is extremely low carb, but it’s made of beans and it’s like a, a bean based or legume based pasta, which has 44g of protein per serve. And the serving size is not that big. I think it’s only about 100, maybe 120g. So, you know, I like to lean on those foods because as you say, I could not eight kilograms of beans all day to get my protein. So I do lean on the fortified foods. There’s even breads where you can get like 30g of protein for only like four grams of carbs for two slices of bread. So they’re all great products if people want to lean on those. But if you do want to eat, say, a strictly whole food plant based diet with no, you know, bean based pastas and none of these fortified breads or pea. Milks or protein milks. Then you do have to kind of accept that it’s going to take time before you can tolerate such large amounts of these plant protein sources because of the fibre that’s coming with it.

Dr Ron Ehrlich [00:15:39] Another one that we hear a lot about is I mean, protein is one challenge. Another one is the fats. Because, you know, we talk about essential amino acids actually before we leave proteins, essential amino acids, there are 20 amino acids. And I think 8 or 9 of them we cannot make ourselves. So we have to consume them. Hence they are referred to as essential amino acids. And again, you know, coming back to that old, food meat, it’s kind of packaged up by nature for us. Well, that’s one of the challenges too, isn’t it, really, with getting the combination that allows you to get all of those 8 or 9 essential, amino acids? What do you what how do you how do you approach. Yeah.

Drew Harrisberg [00:16:26] I mean, the key word you said there is the combination. So. If so, all plans contain all of the essential amino acids, but just to varying amounts. So some so whole grains, more deficient in, say, a particular amino acid than legumes. So as long as you’re adding diversity and combining over the day, and it doesn’t have to mean one meal like you don’t have to combine grains and legumes every meal because the body can pool amino acids within the muscle. So all you, all you have to do is eat a diversity of plant based protein foods, and you’re going to get all these amino acids you need because they’re all all the essential amino acids are in all of the plants just to varying amounts. So if you only got your protein from quinoa or only got your protein from lentils, yeah, you probably run into some problems. So I’m always encouraging people to think about again, coming back to sort of the rainbow, thinking about diversity as like the king of a plant based diet. If you don’t have diversity, you can you can run into issues. And if you’re worried that you don’t have the same nutritional literacy to actually plan a, well, a well-planned, plant based diet, that’s when I lean on supplementation and then, you know, like a multivitamin. If you’re not, if you’re not planning your meals properly, if you’re not combining all of the different foods over the day, then I would lean on supplementation just to like, fill those gaps.

Dr Ron Ehrlich [00:17:44] And is the site. And that’s I mean, that’s the protein part. And and I know B12 is another one which I think would be covered with supplementation here. And the other one would be, essential amino acids because the essential omega three, the so-called anti-inflammatory omega six being pro-inflammatory in nature, they tend to be in balance. But omega three comes in various forms, you know, the EPA, the DHA, the Ala, you know, how do we how do we get that EPA and DHA in a plant based diet?

Drew Harrisberg [00:18:20] So when it comes to the central fatty acids, if you’re leaning on whole foods, for example, flax seeds, chia seeds, hemp seeds, walnuts, you’re getting Ala. But everybody converts Ala differently. All right. So I recent did a podcast with a good friend of mine, Simon Hill, who has a podcast, The Proof. It’s a brilliant. He’s a nutritionist. We were talking about how there’s this sort of like omega, three index. You can do a test to see whether you’re a high converter or low converter of Ala and what your baseline index is. Some people convert enough Whole Foods into the EPA and they seem to be totally fine. Some people don’t. And that’s a game where I say we can lean on supplementation and I take an algae oil supplement. So if you’re a vegan, you obviously you don’t want to eat fish oil. But algae oil is the EPA in, in that form because that’s where the fish get it from the algae. So you basically going straight to the source? In fact, a meal, the company I was mentioning before, they have an omega supplement that’s algae derived, and another one called essential eight, which is also an algae based, omega three supplement. So I do think that you, you can eat a plant based diet and have perfectly fine omega profile. However, it does depend on the individual and how you convert alpha into the different form fatty acids. In which case, again, I just say like take a supplement like anyone who’s vegan B12 absolute must just to bullet-proof the diet. And I would say probably an algae oil supplement. Those two are a very good idea for anyone who’s vegan. Can you get your B12 from fortified foods? Yes, but you have to again be planning and making sure that you’re consuming those foods regularly. And if you slip up or forget, then again, just having that B12 supplement is just it just bullet points.

Dr Ron Ehrlich [00:20:08] Hmhm. You mentioned the word vegan, and I know we talked about this before you came on. Did you been a fully plant based vegan for the last, five years?

Drew Harrisberg [00:20:18] Yeah, I’d say I wouldn’t say vegan, to be honest, but plant based. Yes.

Dr Ron Ehrlich [00:20:22] Okay, okay. That’s interesting. So you would still include eggs and dairy in your diet.

Drew Harrisberg [00:20:29] What I do is at home, I’m 100% plant based. No animal products at all. But I’m not. I guess you could call it like an opportunistic omnivore. So like, for example, family gatherings, big family dinner. There’s a buffet laid out, some people, a plant based on my family, some aren’t, I, I mean, and looking at like the science, I think that a mediterranean style diet is a very healthy diet. I think that fish is is good for health outcomes. If there’s fish on the table, and I know that it’s going to end up in the bin, I won’t let that happen. I’ll eat the fish, but I don’t go out and order fish at restaurants, and I don’t cook it at home. But, you know, at these events where it’s either in the bin or, you know, I can eat it, I’m going to choose to eat it because I still I still want to have I want to be healthy for me. But I also am thinking about the planet and food waste and all these kinds of things. So for me, that’s like a been a bit of a tug of war. It’s like, am I 100% vegan or am I plant based and opportunistic? And I would say I’m probably a bit more opportunistic.

Dr Ron Ehrlich [00:21:28] Because I have, you know, there’s kind of a couple of questions and I’d be really interested to hear your response to these when I, when I go down this plant based, you know, like predominantly plant based, small, mostly vegan approach. I have a there’s a question that I just still haven’t quite, you know, got a reasonable answer for. And that is about 6 million years ago, we broke off. We separated from the chimps and the gorillas. And at that point we shared a brain, a cranial capacity of 400 cc’s. You know, that gave us a brain size. And then we were started a journey. I mean, Homo habilis was 700 cc’s erect, Homo erectus a thousand cc’s. By the time we got to anatomically modern humans, we were 1450 or 1500 cc’s, almost three times the size. Cranial capacity. How do you think that happened?

Drew Harrisberg [00:22:28] Yeah, I think I think I know where you’re going with this, so I think so. My, this is what I’m reading is that the introduction of eating cooked food. So if we have fire, we started to cook our meat. We were able to liberate nutrients that perhaps we wouldn’t before in the raw form. Which perhaps potentially I was in there 6 million years ago. But maybe the brain starts to evolve differently, having access to nutrients that we couldn’t get before. And I think that that line of thinking around evolution is interesting. It definitely I definitely am interested by it. But what I find a bit more compelling is what do we know today? And what? Because, well, I don’t know about the last 6 million years. I’m not an anthropologist or an archaeologist or anything like that. But what we do know today is that you can eat a fully plant based diet, especially if you’re not eating an entirely raw plant based diet. So I am a proponent of a cooked plant based diet because going back to what we talked about before, if you eat raw beans or raw grains, the lectins in that will cause some serious troubles. But the good thing about cooking and sprouting and fermenting and soaking is that it destroys the lectins to a sucker. There’s so little of them left that it’s insignificant. So you can pretty much destroy all of those lectins with cooking. So I think that cooking is very important. If you’re on a plant based diet and if you want to get enough protein, those protein sources need to be cooked essentially. But going back to sort of what we know today is that you can eat a fully plant based diet. You can get enough protein, and the health outcomes are really good. So there’s lots of sort of longer term literature now showing that you can live into your job, you know, up to centenarians, even if you look at the blue zones of the world, even though they’re not 100% plant based. But if we talk about plant based as like a predominant plant based diet, meaning maybe 85% or 90% of your calories coming from plants. You have less disease, live longer, healthy body weight. So I think that we we do know a lot about what we can do today. And the health outcomes are really good. But the you know, looking back through that evolutionary lens is interesting. And it definitely does raise questions. But I just go back to the outcomes that we can show today with really good long term science.

Dr Ron Ehrlich [00:24:44] Oh well I mean I think the I think the increasing brain size was a a significant I mean when we look at our impact on, on the world as 400 CCS and 1450, it’s pretty obvious. But another question that I have is also is there a is there a culture in human history that has thrived generation after generation on a vegan diet?

Drew Harrisberg [00:25:11] I don’t know about through human history, because if you look back at human history and evolution, it was an essentially there are two main things that need to happen. Survive, right? Stay alive and reproduce. But once we’re past the age of reproduction, the survival and longevity piece is no longer important. Right. So we don’t actually care. If you’re going to live to 60, 70, 80, 90, 100, if you’ve passed your genes on and you have offspring in the world and we’re keeping this, you know, moving on. So did people live a long life on an exclusively plant based diet, or were there even people eating only plants? Probably not, because it wasn’t a matter like it was a matter of survival. So it wasn’t a matter of picking and choosing how to create these diets. It was we need to survive. We need to reproduce. So if you can eat animals and catch animals, you’ve got to do it with calories as far as we can. We just need to eat when we can. But luckily for us today, we don’t have to worry about that. So in this day and age, we can formulate and plan a really well planned plant based diet where we get all the nutrients we need, all of the protein that we need to really thrive on it. And I don’t think that we need to always compare to where we came from. If what we know today is actually pretty strong evidence that it can be done in a healthful, helpful way.

Dr Ron Ehrlich [00:26:29] You know, anyway, I think there are just some challenges and actually another challenge that I see because I have five grandchildren varying in age from 2 to 8 at the moment. And, getting vegetables into them is a challenge. Right. And, and it’s interesting to look at kids development. And it’s interesting also because feeding one of the things about feeding a kid meat is that it’s kind of all packaged up there, and it’s pretty straightforward. And they’re almost like to me, kids. So this is why we do so many programs on kids health. To me, they’re the canary in the coal mine. Yeah. You know, we learn a lot from some kids and how vulnerable they are.

Drew Harrisberg [00:27:13] Yeah, I agree. I think that even though I think that the dietetics, the Dietitians Association or one of the major nutrition associations came out, that you can basically eat a healthy plant based diet at all age groups, for the course of your life. I think that when it comes to kids, it is more it’s it’s a bit more difficult. I also think that, you know, it’s hard enough for a kid to eat three pieces of fruits or vegetables, let alone the entire diet. So I don’t I can probably go on record saying this. I don’t know if it is the best idea to enforce a vegan diet on a kid. If it’s not, well, plan if you don’t know what you’re doing. Can you supplement with, you know, a nutrient like an essential rainbow supplement where you sneak it into the smoothies and you get 77 nutrients just not being there, and it tastes good. They don’t even know what’s in there. Great. You can do that. But it doesn’t mean that they have to be on a plant based diet. As a child, I think that, as you say, like meat, fish, eggs, these foods are nutrient dense. They have a lot of nutrients in them. And when you’re a growing child who’s also needs a lot of calories, I think it’s a good thing to have in there. Can you do a plant predominant omnivorous diet? Sure. Yeah, I think that’s amazing. But I just don’t know if, you know, enforcing veganism on kids is the way to go necessarily. Some people do great, though. There are families and kids who have been vacant since birth and done great. So.

Dr Ron Ehrlich [00:28:34] I don’t know. I think one of the other challenges is when we get into reproductive health, you know, in the years of reproduction that that is informs another because then you’ve got the double double whammy of a young woman or a woman with a growing young daughter or a growing foetus. And, you know, the whole story is happening there. So that’s another area that needs kind of a little bit more nuanced.

Drew Harrisberg [00:28:59] Yeah, I do agree with that. I think that there are experts in that field that, you know, way more than me. I know it is possible. I know there are absolutely people who have been vegans as as a mother who, you know, is pregnant and their child has lived basically their whole life as vegan and, perfectly healthy. But I think it requires a degree of nutritional literacy and understanding of how to formulate a healthy diet. What are the what are the key nutrients of focus? Like, you can’t just throw your hands up in the air and pretend it’s all good. Like you actually do need to focus on some key things for brain development and body, all those sorts of things. So yeah, I think if people really wanted to go down that path, I would speak to an expert who can help you to formulate that. And if you’re a kid, you know, you’re gonna run into other hurdles and barriers. Like, as you were saying, some kids just don’t want to eat the foods that you put in front of them, in which case you need ways around those those very hmhm.

Dr Ron Ehrlich [00:29:54] Now, drew, I know your background is exercise physiology, and we recently had the pleasure of, Michael Mosley joining us. And he did many programs on intermittent fasting, but also on high intensity intermittent training. And I’m just interested to know what your thoughts on that, how do we define it for those that may not be aware of it and how much is enough?

Drew Harrisberg [00:30:17] Yeah, I think this area of research is fascinating. I think it popped onto the scene. Probably, you know, a couple decades ago, and it was a big buzzword and it seems to still be a pretty big buzzword because I think the proof is in the pudding. It’s it’s very beneficial. It’s a very efficient way to improve your cardiorespiratory fitness or your VO2 max. So if we sort of take a step back and think about how to first define it. So heat or high intensity interval training is essentially hard bouts of work followed by intervals of rest. And you repeat the cycle so that the idea is that during your work period, you get your heart rate very elevated. And then in the rest period it comes down. So your ability to produce high power output efforts is better than if you just did steady state continuous training for, say, 60 minutes. Now they’re both really good. So the literature is sort of splits them off into two main areas moderate intensity continuous training or steady state training. So that’s like say 45 or 60 minutes or longer at a steady state with no rest. Just say pedalling on a bike or going for a run ride. A cardiovascular form of training first is interval style training, where you’ve got high intensity intervals or even sprint intervals, which are even more like super maximal efforts for very short periods ten to 20s, followed by multiple minutes of rest. Right now, to define whether or not you’re actually doing hit properly comes down to your heart rate. So if you are getting your heart rate above 85% of your max heart rate during the working effort, that would qualify as effective heat training. If your heart rate is not getting near 85 and it’s say, 60 or 70, you’re not going hard enough. So it’s hard and it hurts, but it’s over quick. And that’s the benefit of here, is that you get your heart rate up to this 85% of the max. You try to hold it there for not as long as you can, but there there are, there are different protocols. And then in the rest it’s going to come down. It will drop below 85% in might hold down. If you’re very fit, it’ll come down quickly to a lower heart rate. If you’re unfit, it’ll stay up around that sort of zone of 8075. So the idea is your workout is shorter, so it’s a more time efficient way to produce really good benefits. In terms of VO2 max. And VO2 max is sort of the term that’s it basically describes your ability to take in oxygen and utilise it within the body. People with high VO2 max have a really, really strong correlation with health and longevity and reductions in all cause mortality. So the better your cardiorespiratory fitness, the high over your two max, the better your odds are of living a longer life with less complications and less, disease. Right. So it’s very it’s a great way to get to that goal of improving of CO2 in less time. So if you were comparing moderate intensity continuous training to hit training, you can achieve the same VO2 max in about ten minutes less time per session on average. So it’s about.

Dr Ron Ehrlich [00:33:16] Right. Hey, you mentioned VO2 Max a couple of times and just remind us about how that’s calculated. What does VO2 Max? I mean, I know what it is, but I just like to remind our listener.

Drew Harrisberg [00:33:26] So I mean, the way you’re calculating it is actually a little bit tricky. You go into a lab and you attach a device to your face, and you’re basically breathing into a machine that’s calculating how much oxygen you’re able to take in and utilise. You can, though, you can do sort of like field based proxy tests to see whether or not you have a good VO2. And you might remember, I’m sure you did this, the beep test from school back in the day. The beep test is where you do a shuttle test. So you’re running from code to cone, and you’re listening to a track that’s basically sounding a beep. And every time you get to the cone, you have to turn around, wait for the beep, run back, and it gets quicker and quicker every, you know, minute or so. That’s sort of like a proxy way to see your VO2 max. And it’s correlated quite well with the lab tests. But essentially, like when it comes down to your hit training, like there are different there’s so many different protocols. One of the most famous is called the 4×4 protocol, which means you’re doing four minutes of hard work trying to keep your heart rate above 85%. Then you have three minutes of active rest at about 60% of your max heart rate, and you do that four times. That is a more advanced protocol. Four minutes of work is a long time to be working. There are other protocols which are one minute of work, one minute of rest for ten rounds. So that’s a little bit different. And then there’s others that are like 30s of work with a couple of minutes of rest, but the minimum dose according to the like. There was a meta analysis that came out. I think it was 2020. The minimum effective dose for hit training is 30s of work interval, accumulating five minutes of time in that heart rate zone that I was saying 85% of your map. So 25 minutes of total work at 85% of your max. That seems to be the minimum effective dose, but the optimal dose is actually with longer intervals, because it takes time to get your heart rate to 85. And then if you can keep it that for a minute, two minutes, maybe even three minutes, then you’re accumulating more time in that higher zone and it seems to be a bit better long term. So longer intervals of greater than two minutes, 2 to 4 minutes, and for up to about 15 minutes of time in that high heart rate zone. That’s sort of like the best bang for your buck.

Dr Ron Ehrlich [00:35:33] Hmhm I one of the things that I remember from hearing watching the program with Michael Mosley was when he said, 10 to 15 minutes of, high interval training, high and intense training will up your metabolism for 24 to 48 hours, whereas a ten kilometre run will do that for 6 to 8 hours. I said, wow, that’s a hell of a statement.

Drew Harrisberg [00:35:57] Yeah. It’s interesting. So okay, when we.

Dr Ron Ehrlich [00:36:00] Look at is that true, do you think that’s I mean, would you agree with.

Drew Harrisberg [00:36:04] That? It is true. In theory. So it’s called Epoc excess oxygen consumption. So when you do high intensity interval training the Epoc effect is higher, meaning that you essentially are burning more energy after the session than doing a moderate intensity continuous session, as you’re saying, sort of like a long run. But here’s where it gets a little bit tricky. You actually burn over the course of 24 hours. They look at these exact studies looking at a moderate intensity continuous training versus a heat workout. And they look at 24 hour energy consumption and they’re the same. So this seems to be a compensatory effect of when you’re doing the moderate intensity training for 6070, 80 minutes, you’re burning more total calories in that workout because you’re training for 80 minutes. Whilst a heat session may be over in 15 minutes, 16 minutes. So you’re burning less energy in the heat workout, but more in Epoc after. But the net effect is that the end up being the same. So with moderate intensity you burn less after, but you’re burning more in the workout, so over 24 hours they end up being basically the same. But that Epoc effect is real. You do have this like afterburn effect. I just don’t think it’s clinically meaningful enough to like create fat loss long term compared to moderate intensity. They seem to be pretty similar.

Dr Ron Ehrlich [00:37:20] And remind me if you said it Epoc stands for.

Drew Harrisberg [00:37:23] Excess post oxygen Post-exercise oxygen consumption. So it’s basically explaining the your your entire system is working overtime to clear the metabolites of that workout. And it does it by, you know using oxygen essentially. So you’re you’re you’re setting your body up to obviously our bodies want to be in homeostasis. Right. You do this heat workout and all of a sudden you’ve got all of these metabolites and By-Products of the training that built up. Then in the next, say, 24 hours, your body is working to clear it and bring you back to homeostasis. And that’s what sort of epoch it’s.

Dr Ron Ehrlich [00:38:00] Interesting. Another public health message that I know we hear a lot about, and it rolls off the tongue very easily because it makes it seems to be so logical, a bit like fat makes you fat. Is calories in, calories out. You know, the reason we are fat is because we put too many calories in and there’s not enough calories going out. Which what do you think? What do you think of that as a. Yeah, I think as a public health.

Drew Harrisberg [00:38:26] I think that message is like, if you think where it comes from is the laws of thermodynamics. So people will say you cannot violate the laws of thermodynamics. It’s an energy and energy. Out. Calories in, calories out. I think it can be. Well, I think it is true. I think it can be just a misleading way of thinking about it, because some people will will say to you, but I’m not eating that much that many calories. Like, I promise you, I’m only eating thousand calories a day and I’m gaining weight. I’m getting fat so it can’t be calories in, calories out. So what I would say is, in that case, a better framing of it is energy stored versus energy burnt. Because yes, that person is only eating a thousand calories, but for some reason their body is storing more calories than they burn. So I think that that calories in, calories out, energy and energy out. It is true as a law of thermodynamics, but I just think that the way it’s packaged isn’t very digestible for people because they’re like, I’m not even eating that much. But I think that at the end of day, if you are gaining weight at some point you have to be storing more than you’re burning. I think that that I think everyone would agree on. Whether you think calories in, calories out is true or not. If you’re storing more than you’re burning, you’re going to gain weight, even if that means that the calories in part of the equation is very small, like a thousand calories a day is very, very small. It just means that the calories out is not exceeding the calories in. That’s the sort of way that I think about it. I’d love what do you I’d love to hear your thoughts on that. You know the.

Dr Ron Ehrlich [00:39:54] Well, I think this thermodynamic law is great in a closed system. I don’t know that the human body necessarily just fits into that simple mode. And I, I think it’s kind of led to a lot of, you know, I got to I can I got to do more exercise which, which we all agree we’ve got to do, you know, we need to move more. But it’s just it just seems to be a little bit oversimplistic and hasn’t seemed to work terribly well.

Drew Harrisberg [00:40:23] So the calories out part or the expenditure part exercise is one way, but it’s actually not. It’s it’s not. I mean, I’m an exercise physiologist. I think exercise is unbelievably healthy and it’s amazing. Yeah. But as a fat loss tool, it’s actually not that strong of a lever to pull. The best lever you can pull is to affect the other part of the equation, which is the in calorie count. So in standard Western diet or standard American diet, the calories in is just in the thousands of calories. It’s just building up building up. And the expenditure is very low. If you try to out eat those calories coming in by exercising it, you’d be running all day like it’s just it’s so hard to burn a thousand calories, but it’s so easy to not eat the thousand calories in many cases. It’s also very easy to eat thousand calories in many cases, right? But my point is, the ease of eating a thousand calories in this environment is a piece of genetic environment that we live in, in this modern world to to out exercise the ease of eating those thousand calories. You got to be working out for hours every day. And it’s just people on here. It’s just not going to happen.

Dr Ron Ehrlich [00:41:28] Yeah, I thought the other thing that I felt was wrong was this preoccupation with calories, calories, the calories, the calories. There are different sorts of calories. For example, if you eat fat, a lot of fat, healthy fats, then it’s a bit like putting. This is, one of our guests that I’ve had frequently on is Norah Gigalitres. And Norah’s analogy is your metabolism is like a fire. And if you put a log, a big log on the fire, as in you eat a healthy fat that is going to burn all day and you’re not going to be hungry. And yes, that is that is how one way of going the other is to go on a low fat approach and a high carb approach because you’re hungry and you can’t eat. You’re sitting in front of the fire constantly throwing Kindle on to it. But in, in the in the process accumulating the calories in. So I think this is this is why the calories in calories out kind of reduces things to macronutrient idea. Whereas I think there’s something about a low carb approach versus a low calorie approach that is more sustainable. Yeah. What do you think?

Drew Harrisberg [00:42:44] Yeah, I think that whether it’s low carb or low fat, whether it, as you say, like for example, protein has a higher thermic effect than fat, right? So when you eat protein, 20% of the calories that you take into 100 calories on your plate of protein may only end up as 80 calories in your body. So there’s this effect. We are losing some of those calories in in metabolising. So not all. You can’t say all foods are equal calorie. All calories are equal because calorie is a unit of energy or unit of heat. So that’s that that we know. But where the calories come from will be a bit different. So the calories on your plate don’t always end up exactly as what it is in your body, because they have different thermic effects. High fibre foods have a higher thermic effect than, say, drinking pure oil, right? It’s very low thermic effect. It’s you just eat it. It’s liquid calories or soft drink say liquid calories coming in low. So make a. You’re not getting that look like loss of calories in the digestion of it. I do think that the comparison of low carb to low fat is is interesting. I’ve been very successful on both. I was paleo low carb for seven years and I did it to manage my type one diabetes. And then I went plant based, high carb, low fat, not low fat. I don’t actually think that a low fat diet is that healthy for us. I think that a good baseline of for me, it’s probably I’d say I’m getting, say, 30 to 40% of my calories from fats. In Whole Foods, you know, forms olive oil, walnuts, nuts and seeds, avocado, those kinds of things. Soy products, tempeh, tofu. But I think that having fat in the diet is very important. No one. No one. I don’t think anyone really can deny that at this stage. I think it’s pretty clear that it’s good for you. Look at Mediterranean style diets, whether it’s rich in nuts or olive oil or fish seem to be very healthy and good for for people. But I think that when you look at low carb as low fat, there are people that respond really well to low carb diets, and there’s people that respond really well to low fat diets. And what it comes down to really is the individual who is eating the diet because, Christopher Gardner did that study. I’m sure you’re aware of it. Where they put it was a very healthy, omnivorous diet versus a very healthy plant based diet. So not like a vegan diet with, like, fake meats and all that kind of thing. Whole food, plant based diet, omnivorous diet. Comparing the two. From memory. And I’ll have to dig up the study. Go back to it. I’m pretty sure it was icicle out caloric, or at least the macronutrients were match. Certain macronutrients would match, but very similar diets. And they were looking at adherence rates and what the outcomes were in these people. And they it was a crossover design. So you do both diets. Some people do great low carb, some people do great low fat. But overall they seem to be pretty much the same in terms of weight management over time. But body composition. So body fat, lean mass, all of these things seem to be very, very similar over time, depending on what you could stick to the best. Again, I think the individual approach is very important. You know, some people just do. Some people can be on keto diet for years, others can’t even do it for a couple of months. So it just depends on on the individual and what you can.

Dr Ron Ehrlich [00:45:55] Well, I can imagine, drew knowing how qualified and obsessed obsessed with health you are. You know, you would be an example of someone who gives a great deal of thought to the combinations of foods that you put in in your mouth. You mentioned, plant based meats. And I must say, I recently went to a restaurant with a friend who was a group of us, and they use vegetarian, and we actually ordered plant based meat, which I never, ever would do. And I just did it out of interest, and I was shocked to see how much, like, pork or beef or chicken they, they were. And it just struck me that this has got to be the ultra of ultra processed foods, plant based meats. What are your thoughts on that? Yeah, I.

Drew Harrisberg [00:46:43] Think they have their place depending on on the individual. I think that if you’re somebody who is an ethical vegan and you stopped eating meat because of the ethics, but not because of the flavour, yeah, I mean, at the end of the day, like a lot of people are vegan, but they still love the taste of beef, pork, bacon, cheese, eggs, all of these things. Then I think that having something for those people to eat is good, because again, if we go back to imagine, imagine a guy that’s 85% whole foods rich in fruits and vegetables, eating the rainbow, nuts and seeds, huge diversity. And then 5% of the diet is, say, a plant based meat product, you know, once or twice a week. I just think that that long term, I don’t think that you’re going to see a huge difference between the person that eats a, you know, one piece of plant based meat once a week versus the person who is strictly whole foods. I think that the foundation of that 85% big base of Rainbow Foods is what makes people healthy. And there’s even studies looking at red meat intake and the way that when it’s paired with a diet that is rich in fruits and vegetables, it can offset some of the potential negative effects of high red meat intake. So we know that fruits and veggies are protective. So I think that like even if it is a processed version of, of meat or plant of fake meat, whatever you want to call it, I just think within the context of that kind of plant heavy diet, I don’t see it as a huge problem. Personally, I don’t tend to eat those products or lean on them too often. I think they can taste really good, and they can trick you to thinking you’re actually eating meat, which is quite nice. Oh, yeah. But I think, like, again, if we go back to that, say protein, the protein part of the earlier conversation, if you transition to a vegan or plant based diet. You are trying to build your tolerance, but you’re struggling to eat enough protein. And a plant based alternative is a good way for you to get at least that baseline of essential amino acids to at least hit, let’s say, the 0.8 to 1g particular bodyweight. Then again, it’s just a tool that you can lean on. Should you eat it three times a day, every day? Probably not. But I think that every now and then I think it’s it can be extremely.

Dr Ron Ehrlich [00:48:51] You know, I can’t help but feel that to well-meaning vegans, becoming the unwitting footsoldiers of an old ultra processed food industry with the meat, you know, plant based meats. And I know that meats, our demonised red meat, is seen to be pro-inflammatory. But I know, and we’ve done many, many programs on this. It’s not it’s there is a big difference between industrialised meat production, which I totally agree with. The the most ardent vegan I would agree with is unconscionable. What is bad for the animal is bad for us and bad for the planet. But the corollary is also true what is good for the animal is good for us and good for the planet. But that’s a whole other discussion. Listen, I just want to finish up, you know, well, we all lead busy lives, right? And, what would be some tips for maintaining wellness, you know, for us at all, trying to lead a busy life. But, you know, give us some four, three, four, five tips on on how to improve our wellness.

Drew Harrisberg [00:49:55] Okay. I think we actually, we we covered a couple of them. Yeah. I think that reframing, our mindset away from to focus on macronutrients, you know, becoming too tribal in. Is it low carb is a keto is a high fat is a plant based. And just think about diversity of of plants. I think that that rainbow idea is something that will serve a lot of people. So try to get as many colours and diversity of plants in your diet. I think it’s good for gut health. I think it’s good for getting more fibre in all of these unique foreign nutrients. Then obviously the movement pace is is huge. So being an exercise physiologist, I, I understand the benefits of exercise, but I like to frame it outside of the calorie conversation or the body weight conversation. Primary benefits of exercise for me, related to bone density, muscle mass, the ability for, you know, to improve insulin sensitivity, to tolerate glucose better, to improve your heart health through, say, like high intensity, high intensity interval training. So if people whether you’re whether you’re a good, healthy body weight or not, I think that exercise needs to be a pillar of of or let’s let’s not even call it exercise. Let’s call it movement because it’s more gentle movement. It could be playing tennis, surfing, golf, going to the gym with the structured program, whatever it is. Just having movement as a lot of every single day is non-negotiable. I think that we just have to be on our feet more, lifting heavy things, moving our bodies, getting a heart rate up. I think that’s just like, think about and it doesn’t matter how you do that. You can do that any way you want. That’s amazing. Non-negotiable.

Dr Ron Ehrlich [00:51:34] Yeah. No, no, that’s the basic and and very important. So drew, I know that at the age of 2022, I think you were and you just finished your, your degree in exercise physiology, ironically, you know, you get this diagnosis. It was quite a shock. Tell us about it. Tell tell us what that diagnosis was.

Drew Harrisberg [00:51:56] Yeah. So at the age of about 22, I finished university. I had my degree as well. I had my sports science degree. I was actually in the process of getting accredited as an exercise physiologist, when when I found out about this. But I got diagnosed with type one diabetes, which is an autoimmune condition where the immune system destroys the cells of the pancreas that that are responsible for producing insulin. So as a result, if you have type one diabetes, you have to administer insulin from outside of the body. So multiple daily injections or an insulin pump or an automated insulin delivery system, type two diabetes difference between type one and type two is type two is not autoimmune. The the pancreas in the beginning works perfectly fine. It can produce plenty of insulin. In fact, in most cases, it produces too much instant hyperinsulinemia. But over time. Due to insulin resistance, meaning the instance is just not working properly. And the pancreas, the beta cell function starts to deteriorate. People with type two diabetes can actually need insulin as well from outside of the body. Insulin dependent type two. So the main difference is autoimmune. The other one is more genetics and lifestyle factors. So being overweight or obese can be a risk factor for type two diabetes. there are some dietary elements and sedentary behaviour and those kinds of things. But they both fall under this umbrella of hyperglycaemia. So diabetes basically just means high blood glucose. But the way that the two manifest are very different.

Dr Ron Ehrlich [00:53:21] Hmhm. And you must have gone through this a million times in your head. What do you think the trigger was? What? What brought this on?

Drew Harrisberg [00:53:30] Yeah. Oh, I’ve thought about this many times. You know, getting diagnosed at 22, especially during that time of my life, I was I felt like I was in, you know, the prime of my life. Life was too good to be true. Everything was was great. And then out of nowhere, I got this diagnosis. I mean, there’s this genetic predisposition. Could be a part of it. I don’t know if I carry certain genes that predispose me to type one diabetes. There may be environmental triggers that can create this autoimmune sort of attack or auto immune response to occur. There are lots of theories around the environmental stuff, but it’s so hard to pinpoint exactly what it could have been. It may have been some kind of virus. It could be a gut microbiome change or shift or dysbiosis or something in the microbiome. There’s lots of theories. Back in the day, it doesn’t even matter anymore because once the pancreatic beta cells are destroyed, it’s sort of that’s that’s it. You’re type one diabetes for life, while type two is a little bit different. If you can reverse the insulin resistance, you can reverse the type two diabetes. That’s only if the if you haven’t been living with type two diabetes for too long, because over time the pancreas can actually lose its ability to function properly. So if you catch type two diabetes early and then you lose a significant percentage of body weight, you clear some of that insulin resistance. You can reverse the condition, but if your pancreas is sort of burnt out, it may be too late and you might have to rely on medication and things like that.

Dr Ron Ehrlich [00:54:55] So what was some of the symptoms that drove this, you know, that alerted you to to it? How much of a warning did you get?

Drew Harrisberg [00:55:02] So the signs and symptoms are very clear and obvious when you know what you’re looking for. But at the time, I didn’t know what was going on. So rapid weight loss was the first thing I sort of really figured out was that I was, you know, in just a few weeks, I’d lost ten, 12. I think 15 kilos was the most weight I lost over the. Wow. So that’s excluding being diagnosed. Exhaustion and tiredness couldn’t keep my eyes open. Falling asleep, driving to to work and, you know, falling asleep all the time. Very thirsty during the day. Drinking water, waking up in the night to drink, needing to pee all day and waking up multiple times throughout the night to go to the toilet. So those are sort of the main signs and symptoms. And and again, if you don’t know what they are, you can just you just think that that’s kind of normal. Like, you just sort of justify feeling thirsty and you need to go to the toilet, but when it becomes abnormal in terms of the frequency, then you should probably get checked. And a blood test was all it took to sort of figure this out.

Dr Ron Ehrlich [00:55:56] Wow. So from beginning to end of onset of symptoms and diagnosis, how long did that take you to establish that?

Drew Harrisberg [00:56:03] Well, I actually think that my active lifestyle and the exercise I was doing was keeping me sort of out of hospital for probably months. So I think I would have been unknowingly protecting myself from getting the diagnosis for about six months. Well, because the weight loss was rapid, but I sort of held it for six months, so it took me a long, long time before I actually figured out I should get a blood test and see what’s going on. And I also think that, like the journey, the dietary journey that I’ve gone on since then is really quite interesting because, you know, I got diagnosed and the first thing I did was look for answers. I wanted to know, how can I best manage my blood glucose levels? And at that point, I didn’t know you couldn’t reverse it. But in my head, I was like, I want to find a way that’s just reverse this and go back to normal. But the first thing I did was I actually went on a low carb, whole food paleo diet. So I eliminated grains and legumes and dairy, but I ate, fruit, vegetables, nuts and seeds, fish eggs, you know, all the typical paleo sort of diet. And I was very strict with it, and it was a great management tool in the beginning, especially, as, you know, I got my insulin requirements down. My blood glucose was nice and stable. I had I had great diabetes management on a paleo diet. Then I transitioned to a little bit more extreme on the low carb diet. And I went to the keto diet. And for the first couple of months, it was fantastic. Again, my blood glucose management was excellent, very flatlined, stable blood glucose, pretty low insulin requirements. But two months in on the keto diet, I started to run into some some hurdles which. I was sort of in denial about. I couldn’t understand how this was happening, but. Basically, I was waking up in the mornings and my fasting blood glucose was slowly elevating every every day, at week upon week upon week for a couple of months until. So what would happen is I wake up in the morning, my blood glucose would be higher than the day before, and then I would wait a couple of days and see if it would normalise. Because diabetes is tricky since there could be stress. Sleep could be so many things that’s causing that it wouldn’t normalise or in fact would keep creeping up this fasting blood glucose. So I started to get more insulin at night. My basal insulin, which is this background insulin dose that essentially is meant to keep you in range overnight, does what your pancreas would do is sort of like, imagine the pancreas overnight is drip feeding insulin to keep you in this tight blood glucose range. So I would give extra basal insulin to try to counter that high blood glucose and was working. So I give more insulin more instead. And the trend continued where I’d give more insulin, but my blood glucose would still be higher and higher over time. So I was a little bit confused about what was going on there. And then I also noticed that a meal times, even if I ate the smallest amount of carbohydrates, the amount of insulin I needed to tolerate those carbohydrates was getting more and more. So my instant sensitivity was going the other way as well. And I was just perplexed by which is what led me to go on the plant based diet. So basically, I went paleo to keto, and then I went to the other extreme to a plant based diet with lots of carbohydrates. And now my insulin sensitivity is, you know, the best it’s ever been. I can tolerate more glucose for a given unit of insulin than I could ever before. Which just goes to show you that there are so many different tools you can use to manage diabetes, like whether you want to do a low carb approach or you want to do keto or plant based. Figuring out what works for you is part of this journey. You know, and maybe more than one thing can work for you at different times of your life. And, I’m obviously plant based five years now, really super happy with the results. My diabetes management never been better. But I did have success with, you know, the spectrum of macronutrients.

Dr Ron Ehrlich [00:59:43] But you now, I guess success is measured in how often you need to inject. Is that have you or the blood glucose level? How do you measure success?

Drew Harrisberg [00:59:53] I measure success by number one, my time in range. So I wear a continuous glucose monitor. And I have a all of this data gets sent to my phone. And I can see in real time the response to meals. And then it all these great background analytics of what is the like, what percentage of time is in range in the range that I’ve set? And it’s over 90%, which is for type one diabetes. That’s like a I’m very proud of that. I think the yeah. Like the aim like an endocrinologist or diabetes educator would say, hey, if you can get to 70%, that’s fantastic. So being 90 and sometimes 100% like I’ll occasionally I’ll have like a 2 or 3 day stretch of 100% and I’ll just be celebrating that little win. But yeah, like roughly 85 to 90% of my time in range. That’s number one. The HBA one C, which is your average blood glucose over three months. That’s another measure of success, so to speak. Average blood glucose level. You know, it’s like there was times where, when I felt like I was really quite insulin resistant during, like, the back end of the keto diet, where my average blood glucose was actually probably 7.7 or even getting towards eight. And, like I would be trying to correct during the day with more insulin and it was just wasn’t moving. So the incident wasn’t it wasn’t working. My body wasn’t very receptive to the signal of insulin. So, yeah, I mean, like average glucose, HBA once a time in range number of injections is an interesting one because that was a sort of like my badge of honour when I was low carb. I was like, I only needed a couple of injections a day and very low total insulin. But now I actually use insulin to carb ratio as something that I’m more proud of in terms of how insulin sensitive am I really if if one unit of insulin can allow me to eat 20 to 30g of carbs? For me that’s a really good measure of of insulin sensitivity. Was before when I felt like I was in in less insulin sensitive shape. It was like one unit of insulin for 5 or 6g of carbs. So I’ve my response to insulin is something that I think is also really important.

Dr Ron Ehrlich [01:01:56] And how often are you injecting or does one inject on the average as a type one diabetic.

Drew Harrisberg [01:02:02] It can be a lot. So I always have one background dose of insulin which is sort of last for 24 hours. So I do that in the evenings. Some people split that into a morning and an evening. So 12 hours apart. So there’s 1 or 2 injections there. And then there’s every injection with with meals depending on if they’re very low carb I won’t inject for certain meals. But assuming they contain any reasonable amount of carbohydrates it requires injection. So that would be three meals a day. So already at five. And then sometimes like a snack, maybe that’ll be a six injection. And then if for whatever reason my blood glucose is high I have to give correction doses. So could be six, seven, sometimes eight injections in a day. And this is been 13 years now. So do the math now.

Dr Ron Ehrlich [01:02:48] Yeah, yeah. And and you know, we hear a lot. I mean, this whole expression of low carb means so many different things to so many different people. I mean, at the, the Atkins, initial dose is 20g of carb a day. I think it goes up to a higher maintenance dose. You know, when you talk to nutrition dietitians who say you could be on three, 400g of carbs a day? No, no. Hang on. That’s normal. So low carb is 200g a day. That’s not low carb. No, but to a nutritionist, it is. What is? What is your what? You must. You’ve obviously analysed this what you went. And on a plant based diet what’s your average carbohydrate intake a day.

Drew Harrisberg [01:03:32] So when I was I’ll go I’ll take you through the journey. So when I was paleo it was probably 130g max to be honest. Some days probably 9100 somewhere around that, let’s.

Dr Ron Ehrlich [01:03:41] Say you were doing you were doing a lot of exercise.

Drew Harrisberg [01:03:43] They weren’t you. I was doing a lot of exercise. So yeah, that’s right. My exercise doesn’t really change that much over the years. The only thing I’ve really played around with is the dietary pattern. But yeah, paleo diet is, let’s say 90 to 130g of carbohydrate a day. Keto was significantly lower. That was a lot, probably less than 20g a day, I’d say maybe less than 30g a day. And I kept that up for about four months. And then plant based, I slowly transitioned my way to a higher carb version of it. I actually started on a lower carb, plant based diet because I wasn’t ready to just introduce will be carbohydrates. The conditions I was under, I felt like I was already had lost some insulin sensitivity. I couldn’t tolerate glucose very well at the end of the keto phase. So I was like, I’ll just slowly do it. But it came back quick. Within a couple of weeks, my glucose tolerance was sort of back to normal, and then it sort of improved. But this is something that, you know, even people who are staunch keto advocates know that you lose glucose tolerance. You know, you’re just you’re changing the the kind of like the currency that you’re trading in. Like when you’re a keto diet, you’re great at storing and burning fat. They’re on a plant based diet or high carb diet. You’re better at using glucose. So it’s just like different pick pick which one, you know. But now I’m eating probably 250 to 350, maybe, maybe 400g of carbs if that. I think that would be a huge carb day for me. I think on average, to be honest, like 250.

Dr Ron Ehrlich [01:05:08] Wow. Okay. But well, that would still be considered high carb in a lot of people’s.

Drew Harrisberg [01:05:13] Yeah. For me that’s like that’s a significant amount.

Dr Ron Ehrlich [01:05:16] Yeah, yeah. But but the proof for you is in literally and in the stats in the numbers. Right. And and and I think this continuous glucose monitor which you just showed is on the back of your arm, I mean for you it is that they were permanently.

Drew Harrisberg [01:05:31] Yeah. So every ten days I’ll change sensors. But it requires a new sensor to be put in. So you can’t really use it. But yeah, I’ve been using it probably for a few years now with maybe 3 or 4 days off in those years.

Dr Ron Ehrlich [01:05:46] So it’s it must have it must have revolutionised your testing. I mean, this pinprick testing that is interesting. I mean, I actually think a continuous glucose monitor for everybody for a two week period is a great learning experience to see how what you eat affects your blood sugar levels.

Drew Harrisberg [01:06:04] Yeah. You can like there’s so much data that you get from it that it can be overwhelming and people can get get obsessed with these numbers. And I think like a two week experiment, there are there are places for it, especially in populations that are at risk of diabetes or insulin resistance or pre-diabetes, that if you just threw a CGM on everyone with prediabetes, or at least on the spectrum of developing it, you’re going to probably diagnose a lot of undiagnosed cases, which could be really good. But I do think there are a lot of people who are having perfectly healthy responses to meals are pathologizing those responses because they’re trying to, like, keep it so flat, like it’s normal to have fluctuations in blood glucose, especially if they go up and come back down, you know, within an hour or two if they’re elevated for three, four, five hours. And obviously that’s that’s a bit of a problem. But, that just comes to education behind CGM use and learning. Not only does dieting influence blood glucose, sleep levels, stress levels, sleep quality and quantity, there’s so many factors. So that’s the part that I think that these software companies need to nail in on is what are the other factors that influence blood glucose control? Because there are many.

Dr Ron Ehrlich [01:07:16] But it’s a whole issue around these personal tracking devices anyway that we can become so preoccupied with it. I mean, I know for a period of time I was wearing an aura ring and, my wife would ask me in the morning, how did I sleep? And I couldn’t didn’t want to answer until I checked it out and she forbade me. She said, I don’t want to hear the stats. I just want to hear how you slept. And we can become a bit preoccupied and it can become stressful.

Drew Harrisberg [01:07:43] Right? Like, it’s almost like stressing about not sleeping. Maybe worse than just the bad night’s sleep. I also do that. I’ve got, I check my sleep every week, but every every morning when I wake up, I look at the sleep stats. But I’m also trying to correlate how I feel. So first I wake up and I think I actually feel really fresh today. I feel energetic, I’m ready to go to the gym. Let’s check the stats. And then if they correlated, it’s like, yep, I knew it. Sometimes they’re not. And then when it’s when they’re not correlated. The question is which one do you listen to? Do you listen to you how you feel or do you listen to the data. You know?

Dr Ron Ehrlich [01:08:17] Yeah. Well, I think I think for you who are monitoring as a type one diabetic. The kind of monitoring that comes certainly from the glucose monitor is, is almost a no brainer. The the fact that you’ve added in all these other devices is another story.

Drew Harrisberg [01:08:33] Yeah. True. That is true.

Dr Ron Ehrlich [01:08:34] I just want to finish up with one thing. Taking a step back from your role in health, your background as an exercise physiologist, because we’re all on a health journey through life in this modern world. What do you think the biggest challenge is for us as individuals on that journey?

Drew Harrisberg [01:08:50] I think the environment where I really think that the way the world is moving, it’s becoming easier and easier to be sedentary. So sitting down for long periods. Not having to. There’s no necessity to move like they used to be. So it’s so easy to just sit down all day, operate off a phone or computer, eat, you know, mindlessly an influx of calories that you don’t care where it’s coming from, whether it’s ultra processed or whatever. It’s just too easy to not move it off and essentially just create poor health outcomes over time. And I think it’s it’s it’s the environment we’re living in. So we need to have these daily practices to sort of offset the world we live in. Like if you look at the blue zones, these five zones of the world with the most centenarians, these people are living into the hundreds with the least amount of disease, healthy body weight, very functional, physically able, you know, bodies, their environment is set up for longevity week. We it’s up to us to sort of essentially hack our environment, to kind of mimic what they’re doing. They’re growing their own vegetables, they’re gardening. They’re you know, they’re doing the physical labour. They’re not getting someone else to do all those things for them. They’re building, they’re fixing, they’re eating not too many calories. I know we spoke about that, but like, we’re not overeating. We’re not in that in they’re not in an obesity genic environment where there’s calories are just for men. They’re able to maintain a really healthy body weight. The their bone density is good. They’ve got strong joints and muscles. So I think that for for everyone at home and who’s sort of listening, it’s like, how can we create our own little micro environment that mimics something that you would say in the blue zone. That, you know, includes all those things. I was just explaining.

Dr Ron Ehrlich [01:10:36] Well drew, that’s a great note for us to finish on. And thank you so much for joining us today. We will, of course, have links to your site. I know you’re prolific on your on your postings and all the information that you share with people. So thank you so much for sharing.

Drew Harrisberg [01:10:50] Time.

Dr Ron Ehrlich [01:10:50] With us today.

Drew Harrisberg [01:10:50] I’m so glad we done. Thank you so much for having me.

Dr Ron Ehrlich [01:10:53] Well, it is interesting, isn’t it, to hear someone who has gone through all these different, diets from paleo to keto to, low carb to, plant based and who is constantly monitored monitoring his blood sugar level and lands on a plant based approach to, his diet, which is fascinating and obviously important and highlights how personalised, nutrition is and I must say, Drew Drew’s Daily Dose, which is his website and Instagram that he he has quite a following. He he shares all those insights and learnings. But he’s a very he’s well-educated and he’s well motivated. And he is monitoring and combining his foods regularly and obviously doing it to great, benefit. I do ask that question, though, of people who are, essentially vegan and I think they’re important questions to ask. Because something special did happen 6 million years ago when we broke off from the chimps and the gorillas and, we started our journey first as Australopithecus, because when we were gorillas and chimpanzees, our brain capacity was 400 cc’s. When we went on to become Australopithecus, we got to around 600 when we were Homo habilis, about a thousand CCS or 700 CCS, Homo erectus, a thousand cc. So our brains were getting bigger. And one would have to ask why, until we landed on anatomically modern humans around 300,000 years ago, with a brain capacity, cranial capacity of 1450 or 1500 cc’s. Now, my question is, how did that happen? And it’s a rhetorical question as far as I’m concerned, because I think the answer comes in a nutrient dense diet. And, this is a really interesting, one it’s why studying human evolution, I believe, and learning from, from our ancestors is so important. We have much to learn there about what constitutes a nutrient dense diet and importantly, essential nutrients. The we have 20 amino acids, of which nine are essential. We cannot make them ourselves. So we need to consume them. And meat happens to be a very, concentrated way of doing that, as well as B12, which is another great challenge that you other drew identified. And also omega three essential fatty acids, EPA, DHA ally. And there’s no question that I like, omega three essential fatty acids, there in walnuts and other seeds and nuts. I think the challenge is to get the DHEA and the EPA, and yes, you can do that if you combine. Well, but, an essential fatty acids and essential amino acids are important. And that is why I asked the question about brain development. But the other one is also, is there a society that has thrived generation after generation on a vegan diet? And as far as I know, there isn’t. Animals or animal products have been part of our human journey for millions of years. And as my one of my mentors, Alan Savoury, says, don’t blame the racehorse as a mate, but blame the race. The way the resource is managed, as in industrial factory farmed meat, which I believe is unconscionable. It’s unethical, it’s cruel, and what is not good for the animal is not good for us to consume and is not good for the planet. But the opposite is true. What is good for the animal is good for us, and it’s good for the planet. So, all very interesting, I think, though fascinating, to see somebody like true, who, as I said, is monitoring his blood sugar very, very closely and is obviously very, in tune with not only his own, body chemistry, how he’s feeling, but how to combine foods effectively and making it work for him. I thought it was a fascinating conversation. We’ll have links to Drew’s Daily Dose, on the show notes, I would encourage you also to join our unstressed health community. Some great resources there, some great programs about exploring stress, the five stressful program of exploring the five pillars of health. To build resilience and focusing on mindset through positive intelligence and identifying your saboteurs, all on our unstressed health platform. I hope this finds you well. Until next time. This is Doctor Ron Erlich. Hey! 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.