LIVE Q&A Panel: Diabetes Day! New Directions in Management and Care

We're having a... There we go. And we are live. Hello and welcome everyone to this incredible panel today on World Diabetes Day. I would like to start off by just to thank every single panelist that took the time to be here today. We had a short check-in, which I am now honestly not sure if we were already live or not live. So you might have heard some of these discussions while we were still getting ready and prepping, because I saw some comments coming through. But yeah, a big, big shout out and a thank you to all of you, um, for taking the time off your day. Specifically, I want to mention Dr. Madison Khaki and Denitra Davis, because it's, um, I think it's 6:00 a.m. with Denitra and it's 7:00 a.m. with Dr. Khaki. Um, here in South Africa, it's 2:00. Um, and Richard, are you the same time zone as us? What's your time there on your side?

>> It's 12:00 p.m. for me. So not too bad. I, I think I've drawn, drawn the longest draw.

>> Yes, definitely. Especially on a Friday, everyone. So, thank you so much for being here with us. And then obviously, a big thank you to our audience who's joining us. And I would really like to encourage you all to please engage, say hello, let us know where you're tuning in from. If you have any questions for anyone on the panel, please ask in the comment section. If it's a general question, you can just ask it. But if you have any specific questions to any of our panelists, um, please just make sure to mention to who you would like the question to go.

We've got an incredible diverse team here today. And as mentioned, um, today is World Diabetes Day. And before I go around and introduce our panel, I would just like to share a little something that I came across. I think it was yesterday when, when Karen, um, one of our team members, shared something. It's a post that was made on social media by one of the biggest medical aids, or also known as a medical insurance company here in South Africa, where they were asking people about myths around diabetes. And unfortunately, some of the myths that were mentioned, um, let's just say we would not necessarily agree with those. But it was also quite interesting and a bit of an awakening, a rude awakening, just to realize again all the myths that are going around with regards to diabetes, and whether that's type one or type two diabetes. And I want to mention a few of them. And I would also like to encourage our audience members if there are any myths that you have come across that you thought, "Wow, that's just crazy," or you believed it at some point, please share this with us.

So, um, in South Africa and Africa, and I think generally, often, um, when we learn about diabetes, and even if I think about how I came to learn about diabetes, you learn it from people around you, not necessarily from a medical healthcare provider. So often, people get the first information and knowledge about, um, diabet-, diabetes from the people around them. And some of the myths that came up was: "You can get diabetes through intimacy." "It's a spiritual, it's spiritually sent." And these are now specifically, um, related to Africa and South African context. "Diabetes is contagious. You have to avoid people that get it." "You have to avoid meat and fat completely." "If you don't eat enough, you will get diabetes." "Bitter foods can fix it." Um, there's so many. "Eat breakfast before 6:00 a.m. or your diabetes becomes uncontrollable." Um, there's just so many, too many to mention, but it was really just an eye-opener. And while I'm going to take time to introduce the panelists, I would really love to hear from our audience if there's any myths that they've heard.

And I am just going to start off with Dr. Hosina Kaji. Um, I feel everyone here is very well known, probably within our community already. So I'm not going to take too long to do it. But Dr. Med-, Dr. Sinaki, she's the Medical Director and Co-founder of Nutrition Network and the consulting physician for Eat Better South Africa. She is a leading voice in lifestyle-based medica-, metabolic health, and Dr. G has helped many, many people reclaim their health using simple, sustainable, and culturally appropriate interventions. She is also a lecturer on several of the Nutrition Network's trainings. We will pop a link to into the comment section if anyone is interested to learn more about that.

Then Richard, I will do you next. Uh, Richard is a globally recognized ketogenic and carnivore educator whose evidence-based approach to insulin resistance and metabolic disease has transformed lives around the world. He has worked, walked a personal journey with diabetes after being diagnosed at the age of 33, where after he managed to reverse his metabolic disease through nutrition and lifestyle and founded his company, Keto Pro. He is also one of the Burks Foundation's ambassadors. So, thank you so much for that, Richard, and thank you for being here.

Dr. Madison, I'll do you next. Um, Dr. Madison Kakley is an Assistant Professor at the Ohio State University and the founding director of the SHE Lab, that stands for Scientific Health Empowerment and Integrative Solutions. Her interdisciplinary research advances women's health by exploring the intersections of nutrition, metabolism, and hormonal physiology. With over a decade of experience, Dr. Katie leads NIH, DoD, and the Foundation-funded clinical trials focused on the therapeutic potential of ketogenic interventions for reproductive, metabolic, and mental health.

And then, uh, I will do Denitra next. Um, Denitra Davis, MED and ACE advocate, coach, and educator, and co-founder of Nutritional. Um, she has knowledge and experience with over five years in education and a personal journey of overcoming chronic, uh, illness. Denitra empowers others to heal from the inside out by bridging the gap between misinformation and metabolic truth, which also ties so, um, in with all these myths that has been going around in terms of diabetes.

And then last but not least, I would like to introduce Nicola Wire, or Nikki, as we know her. Uh, Nikki, Nikki recently joined one of our Denoon Clinic programs as a participant, arriving in a wheelchair due to severe diabetes complications. However, through lifestyle support, nutritional changes, she stood up from that wheelchair in just five weeks. She is an incredible inspiration, and so much so that she recently joined our team at Eat Better South Africa. And myself and her and the rest of the team, we were actually out and about this morning, um, at one of our local malls doing some awareness work, where we tested over 58 people, um, their blood pressure, their blood sugar, and created awareness around type 2 diabetes. And it was very interesting because even just from that, uh, interaction, we also had, um, myths and things that came up.

But anyway, now I am done talking because I know you are all here for the amazing panel. And what I'd like to do is maybe to start off, and we can just go around and you can make like popcorn. Anyone can just start and go. And I'd like to ask from you. Popcorn is not keto. Don't go and get popcorn. It's just for the metaphor. Um, I'd like to start off by asking if any of you would like to share a myth that you have heard about diabetes and might have believed at some point in your life, and then what changed for you? What made you think differently about it?

>> I'll be happy to start with a bit of an anecdotal story. So, um, when the, uh, co-director of mine, um, she went in for a blood panel and asked for fasting insulin with her general practitioner, and they said, "No, we don't run that. Why would we actually look at fasting insulin?" And she goes, "Well, there's a whole bunch of reasons. Let's start off with, you know, the type two diabetes risk or pre-diabetes." And they said that high blood sugar is actually the cause of type 2 diabetes as opposed to high insulin. So there was a whole conversation between a, a dietician and the, the general care practitioner about why she is requesting a fasted insulin panel and why they couldn't provide it for her. It was very wild. This was only a couple years ago, too.

>> Thank you so much for sharing that. And it's so interesting because I think this also came up in one of the discussions at the World Nutrition Summit around wanting to request, you know, the fasting insulin and, you know, doctors don't want to to do the test. So thank you so much for sharing that.

>> Well, althious, right? The myth I'm going to talk about is that di-, diabetes is chronic and progressive. And I learned that as a medical student. I learned that, um, in, I first did another fellowship and then I moved to this specialtity, uh, which was internal medicine. And throughout my training from the best, really amazing endocrinologists, never once did I ever experience even reducing medication, even reducing medication. Never once did I experience that as in successfully, "Wow, I have managed to get off this," until I came across, you know, over a decade ago, the science that Puff Loops was talking about, um, and he, he credits to Dr. Jeff and Volk and Eric Westman's book that made him shift, um, his point of view. And then when, as you know, Jana, but those of you who don't know, when I tried to establish that protocol in the public hospital that I worked in, um, desperately trying to apply the science, you know, practically, and we founded, I finally had a chance in my maternity leave to found, co-found Eat Better South Africa. And we went to the poorest communities. The poorest communities. Here's another myth: "That this is a rich man's diet." Boom. Boom. Gone. And within two weeks, I was reducing anti-hypertensives. I mean, leave the, the diabetes anti-hypertensives. And we were reducing medication and consistently do so within a six-week period. Um, I mean, that, that blew my mind as a clinician, and it continues to blow my mind that I experience my dream. You know, you think you're only going to experience your dream, you're going to work for it. I'm experiencing it in real time in weeks, seeing that success in patient healthcare.

>> Thank you so much for sharing that.

>> I'm going to jump in and add on to that. No, I, I, I was talking with a, a student the other day who was basically came up and said that we have a lot of nutrition lecturers that are rebutting this use for ketones and ketosis and, and especially in type two diabetes. And I was like, "Okay, let's, let's take it down to the basics. Let's say that you are out and you are actually starving. And this is what, you know, a lot of people lean their, their ketogenic research on is this previous starvation ketosis, right?" Was like, "So, what is your body doing when you're starving essentially?" Well, we're producing ketones because we're breaking down fatty acids. I'm like, "Yeah, absolutely." So, your body says that when you are out of anything that you can put into your body, it has a way to save you, and that is through ketones. If they were harmful, that would not be your body's way to continue to keep you alive. And it was like a, just an eye-opening moment. But the same thing, the dogma here in regards to low carbohydrate diets is it's incredible. Um, it's almost demonized to a point. It's very silly. And you can see just the, the, the pleotropic effects of just falling into ketosis, even acutely. Even acutely. And, um, some people will still refuse to ignore the, the evidence.

>> Yes.

>> Yes. Denitra.

>> Yeah. Yeah, I was just going to add on that the myth that I believed for so long is that type 2 diabetes runs in my family, that it's in the genes.

>> If someone in your family had it, then it's avoid-, avoidable that you will have it as well. So that was a big myth that I, um, believed. But what I later learned is that it really is, um, an association but not causation. So I often am saying that, you know, this is not genetics, it's dietetics, right? It's really that we've had the same diet, we've eaten the same way, we've had the same type of habits. And so now we see the same type of illness, but it's not in the genes. And so that was liberating for me because diabetes does run in my family. Those habits run in my family. But being able to change that trajectory with the right knowledge and the right information. I was diagnosed with pre-diabetes, and I often say to people, "Don't let the 'pre' fool you," right? Because we'll be tricked into thinking because we have been diagnosed with pre-diabetes that we indeed, in fact, because it's in our family, then it's the path for us. And so that was a big myth for me to, um, for me to get free from that thought process. And so now I live in neither one of those spaces. Um, and I try to help other people not live in those spaces just because someone before them, um, suffered with diabetes.

>> And if I could just add to that, Denitra, um, you know, this idea of, I mean, we call it the loaded gun theory, you know, the, and not just with epigenetics, but you have a loaded gun. Are you going to pull the trigger? And, you know, teaching patients that it's they make the choice to pull the trigger. Sometimes they don't. It's most of the time they don't. It's what they've been fed. Now, in recent times, from even in, um, in utero, it's what they've already been primed with. But you actually need to pull the trigger somehow. And what's really important for those of you who are listening, I mean, we all know this and we've experienced this, but there is this level of complacency with people that I see, patients, family members, and just the broader community where people who are obviously not healthy, firstly go to the doctor to have the health check, and they run on the treadmill and they go, "Oh, and they're, they're obese or they're overweight." But the doctor says, "No, you're healthy." And they go, "Oh, I'm great. My heart's great. The doctor gave me a, a clean bill of health." Um, but they also, there's this complacency about, "It runs in my family. I'm going to get it anyway. What's the point?" And I just want to say to those of you who are listening who have loved ones or who know people with diabetes, or you're suffering. I've heard from patients that diabetes is extremely painful, um, painful as in inflammation and just general body pain. But know that it is reversible and really, really quickly. It's simple. It's not easy because it takes a massive mindset shift, but it is a simple solution.

>> Yeah, thank you. That's another, another myth I think busted right there in terms of diabetes being a chronic, uh, condition and you cannot get better. Nikki.

>> I also believed that, uh, I used to believe actually, like, uh, once you are diagnosed with diabetes, it comes as a death sentence. So we used to believe that once I have diabetes, then the next thing is I'm going to migrate. And then, um, we also believe that, uh, diabetes is worse than being HIV positive because that's what they say. They say it's reversible, it's irreversible, and there is no treatment toward that. So it comes like, when I got diagnosed with type 2 diabetes, I was afraid. Honestly, I thought the next thing is I'm going to get thinner and die maybe in a few months. So, it's just that, uh, there is no enough education out there that we need to know more about sugar. It's something that is silent, and we tend to ignore the truth about type 2 diabetes.

>> Thank you, Nik. Richard.

[clears throat]

>> 100%. Look, the biggest, biggest thing for me, which I've realized more recently, I think within, within our community, we understand the carbohydrates are sugar. And you'd be surprised how many people within or outside our community are not aware that carbohydrates are sugar. So they'll look at the back of a packet and they'll say, "Well, it contains maybe 50 grams of carbohydrate, but only 2 grams of sugar." And that's a fallacy. Each and every one of those carbohydrates will sugar. So I think it's, for me, it's disconcerting that the back of a nutritional packet has these two different variances. I think carbohydrates and sugar are one and the same. The amount of cl-, so I work with clients from all walks of life, type two diabetes, um, cancer, Alzheimer's, up all the way up to athletic performance, and people with hormonal problems, and so on and so forth. It shocks me still how many people come to see me and think that they are doing the right thing, type 2 diabetes, and they think that they're eating a healthy meal for breakfast: a bowl of muesli with a chopped-up banana, maybe some berries. So it's not just enough to have a bowl of sugar, but they're adding sugar to their sugar. And then, you know, it's, it's a quasonant at 11, and then maybe some tuna and rice, uh, for lunch, and so on and so forth. Each and every one of these breaks down into sugar. And, um, it's, yeah, that's the biggest, the biggest myth I think within, within this area for me. And obviously, the fear of of animal proteins, red meat in particular, the most nutrient-dense food on the planet. It's not the protein that's the problem. And it's not the saturated fats found within that's the problem. These are compounds which are essential for life. And, you know, we mention genetics and and epigenetics. These are quite literally the compounds that build every cell within the body. And if we were to look at each cell as a percentage, only 1 to 2% of that cell is is polysaccharide. The remainder, minus the water, predominates protein and fats. Um, and as you guys mentioned, you know, epigenetics. I come from a family of sick people. I was incredibly sick myself. Um, clinically obese, type 2 diabetic. I suffered with chronic fatigue, depression, anxiety, arthritic pains daily, debilitating migraines that would make me blind, for which I was on three different medications. Used to be covered in acne, teeth problems, you name it. IBS, I, I, I [laughter] had it all. Um, my lifestyle, I thought was was healthy. You know, I consumed my brown rice and my brown bread and my muesli and my cereal. And so I, I ate off the food pyramid, the eat well plate. And the harder I tried, the sicker that I became. And my, my dad died at the age of 62, morbidly obese. And, and as you guys saw during the presentation a number of weeks ago at the World Nutrition Summit, I was, um, I was heading that way. I was clinically obese and incredibly unwell. And I always put it down to, to genetics. Does it just run in my family? But this is a fallacy. We can control, we can't change our genetics, but we can express it differently through something called epigenetics. We can express it differently, um, via the activation of certain pathways and compounds, HDAs and hats, for example. I won't get into the science too much today, but these, the benefits of epigenetics are elicited through good quality proteins and quite literally the overconsumption of the carbohydrate compounds, particularly grains, which is the first thing that I recommend anybody remove. By the way, um, they have huge impacts on causing cltogenesis, quite literally breaking and damaging the DNA, inhibiting the body's ability to take good quality photocopies of that DNA. Um, and we, we mentioned insulin and and sugar, carbohydrate. Do you know the first thing that I would say to, uh, a client that comes to see me? I don't teach, I don't teach low carb. I don't teach keto. I don't teach carnivore. I teach real nutrition. And the first thing that I teach them is how damaging grains are to the body. We know about gluten and gliadin, but grains also contain other proteins called wheat germaglutin, which will quite literally poke holes in the gut. They'll bind to the epithelial cells lining of the gut and they'll poke holes in the gut, causing intestinal permeability. This is the root cause of all autoimmune disease. When you explain this to somebody, then it's, it's easy for them to, to make the switch. But it also contributes to, uh, insulin problems, blood glucose problems, and, and fat storage problems because these are lectins, the carbohydrate-binding proteins that will bind to the insulin receptor. And they will signal the body to store five times more fat than that elicitation action of insulin alone. And we mentioned calories. We talk about calories reduced. This is nothing to do with a calorie. Doesn't really exist, at least in the context that we believe it to. Um, and to put this in context, when I was clinically obese and type 2 diabetic, I was consuming around 2,700 calorie equivalent a day. Now I consume between 4 to 6,000 and I'm single figure body fat. It's, it's not the, the calorie that's the problem. And we can, we can get into this if, if anybody has any questions that they want to pop into the chat. But the issue with these compounds, the grains, is that intestinal permeability and it's ability to bind to the insulin receptor, further driving that, that insulin resistance as we know it, and that fat storage. So for me, understanding the carbohydrates and sugar, and in modern life, the, as a majority, the biggest consumption comes from grains. So, the first piece of advice I would give somebody if they're looking to help combat, um, type 2 diabetes is remove the grains. The carbohydrates for me don't come in until week three, believe it or not. And we can get into those other, those other, um, uh, ports of call, but removing the grains, I think that is the single biggest lever that we can do, and understanding that all carbohydrates are sugar.

>> Thank you so much for that, Richard. And I, I, I can kind of also just support what you were saying in terms of this morning when we were in the local shopping center, you know, creating awareness around World Type, uh, Diabetes Day. Um, what we did, one of our tables, we set out different types of food, um, and then we had little sachets and we spooned the number of teaspoons of sugar in each one of those products and we set it out and we wrote on it nicely. And I think that has drawn so much attention from, um, passerbys in terms of, "Wait, there's sugar in that? Wait, there's sugar in that?" Um, so much so that one person actually went, did his shopping, came back and asked me to go through his shopping bags and to help, uh, understand and see. And like he's like, "Okay, I got the healthy bread, right?" Um, and then me showing him, helping him to calculate, and I go like, "Well, there's almost four teaspoons of sugar in one slice of bread." "I got the healthy granola," you know, doing the math and explaining that. So, a lot about this is, is around education. And, um, I mean, something else that came up, and I think maybe that's something we should talk about a little, is around, is it expensive to follow a healthy diet? Um, I know I've got some strong opinions around it. Uh, but it's not for me to share that right now. I think I would like to hear from you, and maybe, particularly Nikki, uh, from your experience as well, in terms of the Eat Better South Africa programs and Nutri-, like, how do you navigate that, I almost want to say critique or defense, um, which we've heard numerous times this morning as well, like, "Oh, I can't eat this, I can't eat that, I can't afford it." What, what's your thoughts on that?

>> So I encountered one patient yesterday who asked me the same question. So she was like, "I already bought my groceries, so what do I have to do?" So I was like, "Okay, you know, um, you just have to sit down and put everything down. Now, like, let's say you want to do your groceries for a week or maybe for two weeks, instead of buying the grains, rather buy something like, you go to the local stores. We also have the cheaper ones here in South Africa. So you can just, some go to Boxer or you can go to Shoprite. And then instead of buying your pup, just rather buy maybe bones, because it's cheaper. And also you can buy the chicken feet, which is also healthy for you and it's cheaper as well." So I also have the same experience when I was not feeling well. I basically was, it was just like one person income in the family. So we just had to make some adjustments like that. So, um, it was effective for us. So instead of buying that 10 kg of rice and that 10 kg of p and that 10 kg of flour, we had to buy like the cheaper meat, the, the bones, the cow feet, and, uh, the offal, which was very good for us as well. So it's not expensive to live better and to eat better than is it expensive to eat all your cars? Because you still have to go to the clinics, you have to visit the hospitals more often. So I do encourage most of my clients that whenever you want to buy, you just have to check which one is better for you. Either to be a patient or you want to stay away from the clinic.

>> [laughter]

>> Hey, I just wanted to add to that. That was amazing, Nikki. You summed that up so perfect. Um, so here in the US, one of the thing, the challenges that I run into is that we are what we call a meat and three or two. What does that mean? That means that you have a meat and you have side items. You have vegetables on the side. And so, you know, we've been taught you need a starch, you need a green vegetable, and you need meat. And so one of the things that I've started to do is help people understand is it's not ex-, expensive to feed this way now because you've removed the sides that are causing the issue. So if you've been eating a meat with three vegetables or three side items, you know, we call them vegetables, but they may include a macaroni and cheese. That may include potatoes, and then you have a green vegetable. So if you're taking those things away, you've saved already, right? Just by taking those away. Even with my son, chatting with him about, um, a burger, right? You can have the burger patties. You can go to a place and just order burger patties. You know, I often say that a bun is a utensil. Why are we eating utensils? The only reason why we eat a bun is the grease off of our fingers, right? So why are we eating that? And so it's much cheaper to go to a place and let's get the patty. So just making what I call these ingredient switches changes also what you're spending and you get more bang for your buck. And then also, my one of my favorite terms coming into this community is being satiated. So when you reach satiety, you're not going to be as hungry and ravenous where you feel like you need to be a grazer all day. So therein lies savings already. I mean, if you're just eating a ribeye a day, you can't go wrong with that, right? And you saved on all the sides. So for me, that was a learning experience for me to understand that I didn't need a side item. What was on the side of my beef is some fat, right?

>> Beef.

>> Yes. You know, and if I go there, you know, maybe some scal-, maybe some butter. But, you know, again, here in the US, I often remind people that if you go to a fine steak restaurant in the US, steaks are sold a la carte because they have all the nutrients that you need. Um, so there's not a need for a side. I believe that, you know, we added sides from being greedy. I used to like them a lot, but now my sides have changed drastically. Just give me fat in the beef and I'm good.

>> I just [clears throat] wanted to add that as a point for saving, um, on this way of eating.

>> I'd like,

>> Oh, you, you jump in. You go ahead, Richard.

>> Are you sure?

>> Yeah, sure.

>> Thank you. Look, just from my, my point of view, I used to spend an awful lot of money on takeaway. You know, I would spend for convenience. I believed that it was a saving of my time, um, I believed that it was quicker to, to nip to the local fast food restaurant, um, than it was to actually cook a steak. And, uh, I, I couldn't have been further from the truth. But I used to spend an awful lot of money. Now, one takeaway for me used to cost, I like to eat, so it used to cost around £30. £30 will probably pay for half a week's worth of food for me now. Uh, [snorts] my total bill, um, in my local butcher is anywhere between £50 to £70 a week. Uh, and it was £150. And the reason that I've saved so much money is that I've, I've come away from buying those takeaways. Uh, I shop, I buy in bulk. So I go to my local butcher. Um, you can buy very high quality animal proteins at a very low price. You don't have to buy the sirloins and, and the ribeyes. And I know that particularly from the states, you know, it's, it's, um, it's, it's ribeye all the way, isn't it? And I love ribeye. It's too expensive for me. I don't, I very rarely buy a ribeye unless I'm out. Now, what I buy is a lot of ground beef or minced meat. Incredibly cheap. But also, there's another cut that I'm sure you guys are all familiar with called chuck. Now, chuck is the end of the ribeye. It's not as aesthetically pleasing. It's [snorts] very fatty and it's incredibly cheap. It's known as stewing steak, but I love to pan-fry. So I pop this into my pan. I don't add any fats when cooking any longer, 'cause I, I don't need to. There's, there's plenty of fats within the chuck. I'll add a little bit of water. I'll put onto a low temperature and I'll cover it with, with a lid so it creates its own little environment and I'll let that cook for 10, maybe 12 minutes, and it's the nicest piece of meat that I have ever tasted. I would genuinely pick that over any other cut, uh, on the market, and it's around a third of the price in the UK, at least, of of ribeye. Um, so there are cheaper means and organ meats. Organ meats, incredibly cheap. Now, if you, if you don't like organ meats, because they can be very strong, incredibly nutrient-dense, you can ask your local butcher to mince in some of these organ meats with maybe a five to 95% mix or 10 to 90% mix with, with the mince meat or the ground beef, and the organ meats, and you can barely taste the organ meats, if at all. Incredibly nutrient-dense. Now, many people say to me, "Do you get bored of of eating the same thing every day?" My diet predominates beef and lamb. Now, lamb, I know from the state side, as you guys can attest, it, it's grass-fed beef, isn't it? Um, but this is because you guys don't have access readily, at least, to, to lamb. Now, lamb is, in my opinion, even more nutrient-dense still because it's, it's, it's always grass-fed, at least predominantly compared to, to beef. The B vitamin profile is superior. Um, the amino acid profile is higher in glycine, which is incredibly beneficial for the production of collagen, and it helps us balance what's called the glycine to methionine ratio, which we can get into if you guys like. And it's also very high in omega-3s, 10 times higher omega-3 in lamb fat compared to beef. Uh, lamb is incredibly beneficial and it's known as land salmon because of its high omega-3 content. So I predominate beef and lamb. I do eat outside of just beef and lamb. I do eat eggs also occasionally, although I have reduced these ever so slightly. Um, I do eat chicken,

>> [snorts]

>> uh, and pork, and all these other things, but I predominate beef and lamb. But for me, I never get bored of eating a fatty cut of, of beef or a nice fatty cut of lamb or some crispy chicken skin. It's the nicest thing to me that, that I can ever imagine. And I think we, we are, we are indoctrinated into this way of thinking from a young age, as you say, you know, with the meat, uh, and two or three pieces of, of vegetables. Um, my, my beef or my lamb is quite literally with a side serving of more meat, meat with more meat. And that's not to say that you can't eat vegetables, by the way. There are some which are, um, are far lower in carbohydrates. Um, there's a link on my website, which is a free link to a shopping list, which highlights all of the lowest, um, carbohydrate, um, vegetables available. And there are some which are very low in, on the toxicity scale also. Things like avocado and, and lettuce and cucumber and olives are very, very low on toxicity, very low in carbohydrate. But there's a whole host of, of lower carbohydrate vegetables that you can use and fruits if, if you're living a ketogenic or low carb lifestyle. But I never get bored of eating meat. I never get bored of eating meat. [laughter]

>> Thank you, Richard. Um, I mean, here in South Africa, lamb and ma are quite popular. So, in Africa, we say a sculper, it's just like a lamb chop on the b-, which is like a barbecue. It's very, very nice. Um, I would like to ask Dr. Madison Kley a question. In terms of women's health and women in general, does diabetes, pre-diabetes, diabetes, insulin resistance, does that affect women differently? And does it have a different effect on their health than it has on men?

>> If you were to ask the Gen Pop and/or, uh, medical personnel over here, they would say no. Off the rip, right? You know, they have the same cookie-cutter response on what they do for pre-diabetes and diabetes. And it is absolutely different because, because the cycle that that women go through routinely, and this, the cycle of life, it's all metabolically influenced. So once you have the tipping stone that kind of falls off the wagon, everything else falls off too. So you have hormones that are affecting your, uh, your metabolism, metabolism that is affecting your hormones, and, and things are just thrown off. So androgens increase with, with insulin resistance, and all of these other things that could have really been mitigated early, early on. So a lot of times with the reproductive issues, women don't get diagnosed until we are at PCOS or infertility or something along the lines of where something is going wrong in my cycle. There's not enough, um, I guess communication. There's not enough cross-talk. There's not even enough research done for women to know off the rip when something is wrong. Like, you should be able, I know every cycle is different, but you should be able to in yourself say, "Uh, I think I'm a little late this month," or "This is different than normal." And being different than normal is still normal out in the, the clinical, any, any information that they're getting. It's, it's incredibly, incredibly wild. Um, in terms of the phasic changes, even for somebody who doesn't have a normal regular menstrual cycle, they still have ebbs and flows of hormones, right? So, there are certain, certain phases that we are better fat metabolizers. We are, we prefer that, and we don't realize that even, even if we eat a high carbohydrate diet. So, kind of looping back to the last question too about like, what's more expensive? Um, in a lot of the times, we use this one paper that was in 2020. I was trying to find it here, but I was looking at, um, a single family, um, looking at a mixed diet versus low carb, and it said a mixed diet was like $43 a day, where, uh, low carb, I'm, I'm speaking, I'm paraphrasing here, but the low carb was $50 or something. And we actually have to cite that every time in our IRBs, but that is if everybody were to eat the same exact meal every single day. Maybe that's great for rich, but like, not everybody does that, right? It's going to ebb and flow. Also, you're going to have days where you're a little bit more hungry, where your workouts change your caloric need, where your, as a woman, your phase changes your caloric need. Um, but in terms of, uh, of hormonal considerations, I'm so glad to see here in the United States that endocrinologists and, um, and general practitioners, OBs, are all working together. Um, realizing that the story is very common and very connected between every, all of those systems. It is definitely way, way, way, uh, beyond its, where our pace should be in terms of women's health. But I guess scratching the surface is something, baby steps we'll take.

>> But if I could just jump in on the, on the cost, because it's such a big one for me, and so many important points have already been made, but I want to say that a huge, you know, a, a very, very poor, indigent community is going to find it really, you know, it, it, there is a cost to food. And so when we're looking at some of the communities that Eat Better South Africa serves, or just out in the world at the moment, there are a lot of people struggling to make ends meet. Then yes, it may be difficult to eat healthy. But at the same time, it's more about what you remove than what you add in. So the reason that people are sick is because of the pro-inflammatory components of these ultra-processed diets. Now, for some people, all they can afford is what the food stamp allows them, or what, you know, whatever they get from people. And so, you know, that's, that's something that we need to acknowledge. Um, we had a meeting yesterday, uh, talking about the role, you know, like the meals that children are being fed, um, at school. We had somebody, Bitten Johnson, shared about how a mother was reported because she sent butter, um, with her child because she didn't want the child to be given margarine. So we live in a weird, a crazy system, and we really need to do things like this to speak out against the system. So that's really important. So the first thing I wanted to make note of is inflammation, and we don't speak enough about, uh, polyunsaturated fats, seed oils, the ultra-processed seed oils. A lot of these health products, it'll say, and I, I see this all the time. I, when we stop at a, a garage or something like that, if we're traveling, there's almost nothing that my family can buy. You see a big bar that says "Protein," and you flip it over, and it is full of toxic substances. But people are so pro-protein at the moment that that's the marketing that's trying to push that. But in terms of the cost, it's about eating real food. Like, you know, Rich gave all of these amazing examples of being cost-effective. And, you know, keeping, putting, I always try to sneak in liver any which way I can, u-, because my son totally hates the taste. So all of those things, you don't have to buy keto. Please don't, like, go looking for, "I want the keto pasta," and it's not a, a swap. It's not a, like a, a clean swap. "Oh, I eat pasta for supper, so now I'm going to eat keto pasta." No, it's a different way of eating. And I want to say that, um, once you start eating to satiate, and you're eating what your body needs, you no longer feel hungry. Number one, um, and, and so your time between meals increases. So instead of eating six, seven times a day, you're eating twice a day. Some people eat once a day and they're thriving. And on top of that, your, um, taste buds change very, very drastically. So you appreciate the taste of the steak and the salt and the butter and maybe a bit of rosemary, and there's not much more that you need to add, right? So you don't need the condiments and, you know, the drinks because you feel like you're spoiling yourself. You really feel spoiled, right? Because you can finally taste food. Then let's talk about the cost of preparing. You boil a pot of rice, it takes so much electricity and time. A pot of pasta, all of these things. Whereas, um, cooking, you know, a piece of fish or a steak or frying an egg, those are really, really quick. So for time-strapped people, you're working long days, you come home, you do not really need to meal prep. You can literally buy and within five minutes, you've got your food ready. And then the other thing is that we eat, we eat too much. We're too complacent. We, we just eat a lot. We're used to eating a lot. So if you're just aware of, you know, it's not about primarily, it's not about portion control, but you, you portion control yourself because you're satiated, so you don't have to eat so much. I've got so many notes here. It doesn't have to be organic. Um, we've got people who, um, have reversed autoimmune diseases, you know, just looking at eating carnivore, and they, they couldn't afford to eat organic cuts. They just ate whatever they could afford, and they reversed their autoimmune diseases. Um, and then let's talk about fasting. You know, fasting is a great health tool. And so, if you have this much money and you really want, you don't want to live with the long-term costs of diabetes, there's short-term and long-term expense. Then consider implementing fasting as a tool so that you've actually got a whole day or however many days that you're, you're drinking water and you're making sure that you're having your salt and your electrolytes and maybe bone broth. Bones are almost free. Um, and tallow from the bones, that's free. You can go to the butcher, get the thing, make your own tallow like they did in the old days. There's so many ways. So speak to us, drop us a line, and check in if you're not sure how. Eat Better South Africa does this and shows people how to implement this. One last thing is when we did the EP Better, the very first, um, um, EP Better, uh, at in Ocean View, and we were very interested in how much people were spending and whether it was more than they were normally spending. And people were either spending slightly less or they were spending exactly what they normally spend because the community came together and people were on this WhatsApp group saying, "Oh guys, um, there's this place has a special," or people buying in bulk and sharing, and people weren't buying the chips and the biscuits and the, all the other things because they didn't need it anymore.

>> Exactly, Dr. That is so true. And I, you also kind of touched on it. You spoke about women and you spoke about mothers, and I want to tie that into the importance of women's health and women's understanding of type 2 diabetes, of, you know, proper nutrition for our bodies because often women are the main, um, person in the house that's doing most of the cooking, that's doing the feeding of the family, that's doing the shopping. And, um, and yet they are so often overlooked. And I, Uh, Dr. Katie, I think it was you that, that at some point explained, and maybe it was a previous live or discussion that we had, about how as you get closer to your menses, your fat burning actually goes up. Is that correct? Do I remember correctly? Because, because I was thinking about Richie mentioning, you know, how you tend to eat the same thing, and generally speaking, um, I'm very boring in that regard. Okay. And the same when, like, when people ask me if I want to go for coffee, I'm like, "I'll go, but I only drink water." I'm very boring, but I'll come for the company. Right. So I, as a rule, almost every day I have my six eggs, and I have like, we also, we eat a lot of chicken, um, in our house, but it's the same thing. And people ask me, "But aren't you getting bored?" And I'm like, "No," 'cause, you know, it's, it's like, personally, like you mentioned, it's like, you just get so used to it. Also, when you have that mind shift around, "I'm eating for fuel. I'm eating for health. I'm not eating for pleasure and entertainment." Um, which I think is so often why a lot of people do go for the junk food. Why we do go sit in front of the TV at 9:00 p.m. at night. So it's having that mind change. Yet, which was so interesting, um, for me, kind of coming out of this conversation, yet a certain type, time during my cycle, I would start to crave other foods, and then yes, then I become bored with what I eat every single day. And that is not necessarily true, um, you know, for, for, for everyone, or for men, as an example. So, um, yeah.

I don't know. Yeah. Yeah, I'll go ahead and take off with this, but first I want to get I I even though, yes, most of the time, I guess stereotypically women are the shoppers, my husband is a wonderful shopper and a wonderful cook. It's so great that he does keto, but he will find all of the meat deals ever. So, if anybody wants [laughter] wants to figure out how to coupon correctly, he's the best coupon lady. He's going to hate me after this, but and finds wonderful meat. So, he does the cooking, but he has done he's cooked keto since honestly since we've been together. So over a decade now.

Um but in terms of the cycle so yeah actually we were seeing in a study with women who were a a mixed diet right they were doing resting metabolic rate tests and I know everybody on the panel knows what that is but for those of you who don't we're basically measuring um at rest they get come in fast or fasted um and we're seeing essentially how many calories that they're burning at rest. We were finding that in the ludial phase and Jana this is probably why you're like I feel like I'm craving more things in the ludial phase so right before menes the body is essentially preparing to hold on to an egg right the idea is to prepare for pregnancy it's preparing to hold on to the egg and the actual need for energy so the calories that you're burning increases so we're increasing during that time um but we're also seeing an RQ drop so the respiratory quotient which alludes to us being better at fat fat burning in that moment in time. And this was all a change from menes. So we're using menes as the baseline uh because of the the reset in terms of estrogen and testosterone and progesterone at the at the beginning of the menes. So day one the men's phase is what we're uh I guess comparing everything to. In the ludial phase we saw an increase in the caloric need um and a decrease in RQ which meant more fat burning.

Now, in the ludial phase, right before a minty starts, right before the period starts, you see all of the the Instagram clips or gifts or whatever they're called of like somebody throwing chocolate at their wife and like running for the bed, right? Um, and that's that's the dogma we've had for a while. And it's because of the increase in hunger. It's the increase in body heat. All of things that are about to change because we're about to, as blatant as I can say it, rip a part of our body out for a couple days, right? So that takes preparation to get to that car wreck knowing that it's coming. Um so with with that we've had this this experience or I guess again the dogma and the um the normaly around here's your chocolate here's your carbs eat this quick it'll make you feel better because you're tired. Yes, there is a there is the ability for quick energy for carbs, but if you are hyperfocusing on that all the time, we're going to see that quick energy start to deplete because of our insulin resistance and all the effects of that. Um, but in terms of just the the the adaptation process or I guess the transition between the menes and um switching back between being more fat burning versus being more carbs, this information isn't out there. you'll see bits and pieces of the story like there is not one paper that puts it all together. It's somebody who says yeah we saw a decreased IQ in the ludial phase but then somebody else who mentions finally the increase in carbohydrate metabolism because of estrogen. So trying to put this whole map together is a bit of a pain in the butt especially for women who are trying to figure it out right now. Um, but I can and will say that ketones all the way around, whether you are in in an ovulatory state where we know that we can utilize glucose a little bit better, utilize carbs a little bit better or in a uh in the ludal phase where we're a little bit more lipolytic, ketones are helpful. We're we're absolutely helpful. We can still utilize carbs. Carbs are indogenously made, right? We have gluconioenesis for a reason. We do not actually have to eat it in our diet. It is not an essential macronutrient. So if our body already knows how to regulate and make it, we should probably we should probably listen to our body. Rod's been doing this for a hot minute, right? And so being in ketosis helps with all of those other effects, too. The brain fog in the luial phase, the bloating, the inflammation, the lackluster energy, um the cramping, all of these things ketones can actually have a direct or indirect pathway and fix for.

Hey, I wanted to just hop on. You dropped a word that I want to just bring out is insulin resistance. I think sometimes when we come to this conversation and today being world diabetes, there are people somewhere saying this has nothing to do with me because all my numbers are good. All my numbers are fine. I'm not diabetic. Right? Even if they have a pre-diabetic diagnosis, again, I'll say that don't let the prefool you. And so you mentioned so many things related to women's reproductive health that are missed because they're not diagnosed as diabetic, but what they miss is they are insulin resistant and no one's having that conversation. And so we're treating all of these things separately rather than acknowledging that your sugar and insulin levels are impacting the other challenges that you're having. I remember you articulating that so lovely when we were at the World Nutrition Summit just really diving in deep, right? And I think that's a misnomer. So I want to say that loud and clear that we need to know our labs. Yes, an A1C is only usually, especially in the US for me and my understanding is only tied to being pre-diabetic or diabetic, but you have to dial back and ask for a fasting insulin. That tells the whole story. And A1C without a fasting insulin is just a part of the story. And what I'm finding is women in particular are having hyctomies as a solution for what regulating insulin could fix and no one is having that conversation. We had it at the World Nutrition Summit, but that conversation is not happening. And so I'm working with women and I'm seeing over and over and over again that they are being diagnosed with fibroids and their solution is surgery to have a hysterctomy. And so I just want to keep highlighting that today. I don't know when we're ever going to have um insulin resistant day, but this is it, right? is that what we're really dealing with is diabetes is just one reaction is what I call it to insulin resistance. There are many more reactions to insulin resistance, high blood pressure. People are missing it. So, they think this conversation isn't for them because they don't have this culminating um diagnosis. I often say that pre-diabetes is not a pre um diagnosis. It's really a culminating, right? It took you 10 years to build up to being diagnosed as pre-diabet pre-diabetic, but there were many other things that were missed before that diagnosis that we should definitely continue to bring into this conversation. So, thank you uh Dr. Thank you for bringing that in because I was over here like, "Okay, we got >> No, I I I love I love that you that you're you're standing for this."

One of the I guess a little talking point just to send everybody home with um if you have high insulin or if you're if you're not even if you're not if you don't see high insulin in your labs, but you're like, I know that there there might be something off, look at sex hormone binding globbulin. If that is inhibited, that is a feature of high insulin. A high insulin will inhibit SHBG or uh in the ovaries, it will high insulin will go and tell the ovaries to increase their production of testosterone. Look at all of these. So, not your fasting insulin is is necessary. All of these other things, if you're like, I I might have an issue. This could be a problem. Go check those out, too. Yes, it's a pain in the butt to get those paid for by insurance, but it's it's necessary. your future reproductive health and also post reproduction, right? Parmenopause and menopause, everything that we go through right now will affect how our symptomologies are later in life too. So prepare yourself now so that you have a wonderful quality of life later.

>> Yeah, 100%. >> Can I can I just quickly jump on that? It's um I think you you guys have all made um a very important uh observation in regards to to fasting insulin. Um and and you're right, you know, Denitra, you mentioned about blood glucose being measured over a number of years and you could be in a a normal state because insulin behind the scene is working over time to keep that blood glucose low. This is why fasted insulin is so important. But if we look at um and we're talking terminologies with this uh insulin resistance and so on. We don't have an insulin problem. It's not a problem with with insulin. The the reason that the insulin uh is is hindered in its ability to send the glucose into the cell is because the cell is too full. So it's a protective mechanism. So in order to send sugar into the cell um most of it is transferred in through a transporter called a glute 4 transporter which sits on the surface of the cell. Now when the cell becomes toxic or close to becoming toxic too full so the cell has grown because there's so much glucose in there or fat then this this uh glute for transporter transllocates into the cell. This is what prevents the the um the storage. So we increase insulin to force this and so on and so forth. And then we look at diabetes drugs like metformin and so on and so forth and these force the transllocation of that transporter back to the surface which the cell doesn't want to do. So it it's not a case of we have an insulin problem. We have enough insulin. The issue even though we've tested in the insulin comes back to the glucose. So the answer to this is simple. We need to reduce the amount of glucose that we're consuming. So it's it's not an insulin problem. It's too much sugar. And by sugar I mean carbohydrate. When we take a step back and look at it from a simple perspective, this is a quick fix. And all you guys Dr. Cena has just mentioned you know incredible um resolutions of people with type 2 diabetes and we see this in as little as two weeks. Um you know Dedra me mentioned earlier that you know we are uh or was it Nikki I think mentioned that when we are told we have diabetes that it's a death sentence and it's it's irreversible. We can quite literally reverse this in as little as 2 weeks by reducing the amount of carbohydrate. Uh and Dr. Cena mentioned seed oils. Seed oils are very high in an oxidized omega6 called linoleic acid. We're told that these are heart healthy. These are the these are the opposite to heart healthy. And there's one one uh condition that you need to search uh in order to to prove yourself prove positive that this is correct. And it's a condition called cyto sterilemia. Cytosterilemia is a genetically inherited condition in which the body can't remove the toxic omega6. um our body fights hard and works hard to remove the the vegetable oils but in this condition they accumulate and it leads to early onset cardiovascular disease. So it's proof positive that these seed oils are detrimental. The halflife for these uh these toxic omega sixes especially the linoleic acid is is is two years. What you consume today is causing damage for another two years. It damages the liver, inhibits the liver's ability to to to work. The liver is an incred it's the most import one of the most important organs within the body. The amount that it does in the body, we that's something we could just discuss for probably two days straight. It's it's an incredibly important organ. And when we inhibit the ability of the liver to work, everything else downstream is affected. So, you know, coming back to the grains, high in carbohydrate, high in lectins. Number two on the list for me is the seed oils. If there's only two things that you can do or take away from from this call today, it's to to remove or heavily reduce the grains and seed oils. And you're going you're going to see a huge a huge improvement in regards to this. And just one other thing, myself really quickly, Dr. Aena mentioned about quality of of nutrients. And this is critically important because when you consume these fake foods, these franken foods, which is pretty much everything in the supermarket, remember there's only two aisles in the supermarket which contain real food. That's the meat and fish aisle and the vegetable aisle. And I I no longer shop in the vegetable aisle because I'm I'm I'm now living a carnivore lifestyle. But that is through a series of incremental changes. But two aisles. Everything else are fake foods. Franken foods full of man-made toxic chemicals to keep you addicted uh and which make you incredibly unwell and it's very difficult to to choose the products which are devoid of these seed oils but you can you can find them but these compounds contain things like phytic acid and lectins which block the absorption of the nutrients that are potentially found within. So it's not enough just to eat some meat. You know, if you eat that with your bread or your pasta or your rice, the phytic acid in the lectins are enough to block the absorption of essential co-actors like zinc, iron, and magnesium by as much as 100%. Which basically means that many of the nutrients that you're obtaining from the animal proteins, even though you're consuming them, they may not be absorbed. Now this is critically important because these co-actors are used in the production of our neurotransmitters. So the neurotransmitters are made in the gut or 95% of them are made in the gut. These go on these are things like dopamine and serotonin and epinephrine and so on and so forth. So if we don't produce these neurotransmitters, this leads to anxiety and depression and craving. So now we reach for more of the sugary compounds to to elicit our dopamine and serotonin responses each and every time downregulating the receptor and increasing our requirement for more sugar and more sugar and more sugar. And interestingly these grains and many vegetables also are sprayed with a herbicide called glyphosate which everyone on the panel is familiar with. This compound will block the second step in a pathway called the shikamate pathway. Now if you were to ask chat GPT and I think I asked this actually in in the nutrition conference recently. If you were to ask chat GPT does the shikimate pathway exist in the human body it will tell you it does not. And then I challenge you to say well you were incorrect because the shikimate pathway exists in the bacteria in the gut and and chat GPT will come back and say apologies you are absolutely correct. Now the shikamate pathway allows us to create our aromatic amino acids. Tryptophan, tyrrosine, felonaline. These are the the precursors that go on to make our neurotransmitters. So think about this logically. The grains that we're consuming the glyphosate and the lectins and fitates. But the glyphosate is is blocking the second step in this pathway which now basically means that we're unable to make 95% of our neurotransmitters. Now we see a massive increase in depression and anxiety which I've suffered with severe mental health issues. I could not leave my house a number of years ago and that was a fact. My life was spent living in boxes. I lived in my box and the only time that I would leave my box was to jump into my metal box to drive to a big box. My place of work.

>> I was just wondering I see a couple of questions that are coming through if we're going to do some of the questions here. >> Yes. So that's the question if you guys have a couple of minutes more to stay. >> Let's get into the questions. >> Yeah, because we had one hour. So I guess it depends. I don't want to uh use too much of everyone's time. I want to be really mindful about it. But one comment I quickly want to touch on and I know we've spoken a lot about the conference. I'll ask our media team to put the link in the comments. if you weren't able to make the conference or see the conference, you can still access the content from the conference and see all of these amazing people's um presentations. Uh but one of the comments that I want to say and maybe Denitra if you want to show us your t-shirt because people were commenting on us three of us wearing the same shirt today and maybe Denitra, do you want to read to people what it says? >> Yes, it says type 2 diabetes. It's a star rating, one star rating. I would say zero stars, but then somebody would think it's five stars. And it says that it's way too expensive, hard to manage, and didn't come with instructions. Would not recommend. And so I picked this up while in Cape Town, South Africa. I see Nikki's wearing hers as well. So yes, I'm sporting this today for attention. I hope they get attention like who's wearing a type two diabetes shirt. >> Yeah. No, I think these shirts are great. Um, so I want to go to to I think I'm going to ask one question because there's many and I at this point I feel like we should have made it two hours and then I think okay wait we'll invite each of you back again because each and every one of you brings such a incredible like application for like nutrition intervention for um for betterment of health and specifically related to diabetes. But this question came from Karen and I think you know we talk a lot about nutrition and whether it's a keto diet or a carnivore diet and we've got actually so many questions about uh the carnivore diet Richard. So we'll definitely be getting you on soon to answer all of them. Um, and we have all of these discussions within I want to say our community, right? So our community here, our community on Facebook. Um, but the question is, how do we continue to get this message out? Listening to all the media today around diabetes day, it's all the same story. Eat small meals, whole grains, fiber, etc., etc. What can we as a community, and I say we, us here on the panel, but also like as the broader community, the listeners, what can we do to get the message out there? So one of the things that I'll say is that I as a teacher I try to stay away from labels. So you mentioned you know keto carnivore. What's really happening is we are removing sugar from our diet is essentially what's happening. I often have to say to people when you take all meat out of your diet all you're eating is sugar. Right? And people say that everything changes to sugar. Meat doesn't change to sugar. And so the idea is that you're decreasing your sugar. So the message and how we continue to move this message is helping people understand that we are making them sugar aare. We've become more sugar aare and we're changing how much sugar we're putting in our diet under the umbrella of being healthy. mentioned earlier like what a breakfast typically could look like is, you know, for us a bowl of oatmeal, wheat, toast, fruit, and juice. That's all sugar, but somehow we've been taught that that's healthy. And so when you remove all of that and have some bacon and eggs, now you're not eating sugar and you're satiated. So I think that's a good way to keep reinforcing this message. And I think Dr. Hina also said like this is not about what you put in. It's really what you take away that's impacting your body and and you know converting to sugar in your body that's unnecessary non-essential as you mentioned early earlier.

>> So if I could just quickly say how could you change this? Let's take it to Tik Tok because Tik Tok changes the world doesn't it? [laughter] And what take take what to Tik Tok? Take the the patients stories because that's you know I almost want to say wait for those people who make the laws to get diabetes because then they'll realize that all the stupid advice doesn't work. It feels like the doctors and the healthare workers and the change makers who a lot of them who have completely changed I mean to changed the way he thought because he developed diabetes. So it's those and that's what I've seen with my colleagues. It's when they become morbidly obese so they get sick and they don't know how or they have bowel issues and they don't know why and they start to consider carnivore and then they get um you know improvement. So it's it's it's that and then of course I have to punt for nutrition network. I'm wearing my nutrition network shirt proudly today. Just give me one moment to get our textbook. So continue with the robust science. This textbook was created because we know that people trust textbooks. It is incredible. It has got it was either I think it was a Japanese clinician um he he was able to save his license by using the science from this particular was a Chinese uh doctor from this particular book. Um and whether you're a a doctor, any kind of healthare worker or a lay person, we've got a course for you um at nutrition network. This is why we have we continue to create these modules because we are behind the robust science root cause medicine and the way to do it is to change it's um you know Bon Johnson and all of our clinicians talk about uh this sorry the starfish one starfish it matters to you know you know the story about the starfish it matters to the starfish so it's a ripple effect of one person at a time changing one family at a time changes a whole generation. Um, and it's just to just continue and to be brave and to share and to learn because when you're challenged, you have to be able to say, "Oo, I don't know why, but I'll go and find out." You don't have to have all the answers. You just have to know that the either is science to support it or we need to continue to research and back what we're saying up with science. And also the other thing is here at Eat Beta South Africa we started with what we call the operation noise. So we started at Don Clinic and we on the 31st of October we had a wellness day at the clinic which we included a staff. So we had to start with the health care professionals as well because it also starts with them. So it's um surprising to know that um there is also limited knowledge with our doctors and nurses as well. So um sorry to say but um but uh what I found out that is uh it's been the second week and the numbers are doing well. Like on the first day, there were some of the staff that had uh high sugar, but they were on duty. And um when they started the 30-day green list challenge, they first week, the other one came with good comments. She was like, "She's happy with how it has changed. Her waist has reduced, her weight is reduced, and she's feeling more happy and energetic." And so this is what we want to do like we try with the first we start with the stuff and then we go with the patients. So also um I think 2 days ago another doctor referred a patient to me and then also our dietician she also referred a patient to me who has diabetes and um when she started the program was like on 29.5 and going with time last week when I saw her it was on 16.4 four. So you can see the changes within less than a week. It it is something that we need to do. If we start educating our clinic staff, our doctors, try and encourage them on how they can help the patients with the diet and all that. It it is something that that will help the community as well.

>> I agree. And I'm going to jump on to the sharing the Tik Tok. I think we need take dogs and we need them to go to kids. >> Honestly, this is this where it start. You know, the the um food that they're given in schools, the nutrition direction that that kids are given sometimes sets them up for failure. You know, we see obesity and children and they have one meal a day technically with their parents. A lot of them are doing breakfast and lunch at school and then dinner at home, but then they end up with obesity and the doctors are basically pointing the finger at the parents. And yes, that is an issue, too. But let's talk about school nutrition first. And because the influence of all of the social media and um these gifts or whatever they're called moving forward, I'm dating myself. um that that needs to be something that is more directed towards them so they understand that fat it should not be scary. They hear it as one word when you know you're heavy set and you have fat on your body and then they're like I have to eat it too. That doesn't set a very good precedent. So try trying to change that. Maybe we we start saying atapose tissue from a very young age. Well that person has a lot of atapose as opposed to that person's fat. It really doesn't help when they're trying to um to to go through the normal normaly of middle school and high school being like, "Yeah, I'm going to go ahead and eat fat in front of all of these people who might turn around and make fun, poke fun, what have you." They're very influential at that age. So, yeah, back to the Tik Toks. I literally have seen more done on Tik Tok than I think. [laughter] No offense, Frontiers, but Frontiers. I just also want to mention and I put them in the chat um as we're talking about spreading this message. We were um privileged to watch the animal movie while we were in Cape Town. We got a chance to see the animal movie. So, I put the link in the chat to encourage people to watch that. And then there's also a movement right now, a documentary that's coming out called Healing Humanity that's with Carrie Man that's coming out as well. And so the trailers are available and they're spreading this same message and showing how people have reversed diabetes in such a short time. So, um, I just threw those in the chat as a way to continue to spread the message and get it out. And if any of you want to teach me about Tik Tok, I'm ready to learn. Oh, looks like we've lost Jana.

>> But um >> u I I don't know whether she's been kicked off, but maybe Nikki, do you want to say anything to close? >> Okay. Thank you everyone for joining us and thanks to our panelist Rich. I really loved your fat presentation. It's topnotch [laughter] and um thank you so much. Uh hopefully we'll see each other on the next show. >> Awesome. Thanks everybody. >> Thank you all. >> Sorry everyone. >> I'm back. I got cut off. Sorry guys for a moment. I just saw something went wrong and I'm like clearly because I'm not in the room anymore. But thank you. [laughter] I I because I was wanting to just thank Denitra for sharing all those resources and I didn't I want to know if Richard if maybe you did mention if there's anything you wanted to add just as like a closing. What do you think we can do more to get the message out there? >> Look, I I think you guys have nailed it. And I think each and every one of us, you know, we're all trying to do these things. We're all the pebbles in the ponds, you know, as uh [snorts] as Dr. Ina mentioned you know it's one of us will see the benefit and with me I came up against lots of resistance from friends and family but eventually it stands the test of time they continued to become sicker and sicker and I was continued to become healthier and now that ripple effect has finally taken effect and these people are now changing you know their um their views on on food and health and wellbeing. So it's just just be be yourself, you know, be that person, be that pebble in the pond and um and create those ripples. And as Dr. Cena mentioned, Tik Tok, you know, social media is incredibly important. Um I'm very active on social. Uh but much of my content unfortunately is um is blocked uh for obvious reasons, but it's um yeah, those I post daily. I'm live also every Sunday on YouTube for free for an hour for live Q&A in regards to any health questions. We usually get a few hundred people live on on the call there. Um so any free advice that you guys are looking for, feel free to to jump on a 700 p.m. UK time every Sunday. Um but yeah, just I think you're all doing an incredible job. It's incredibly inspiring and I just love being part of the community because it just listening to to you guys speak about your journey and parting words of wisdom, you know, it's it's very much a community of learning and supporting and I'm very proud to be a part of that. So, thank you.

>> Thank you so much everyone. Thank you Denitra, Richard, Dr. Sena, Dr. Kley and Nikki for joining us today. I know we went way over time. Um, but thank you so much for getting up early or um, offering up your Friday afternoon. Um, there's so many valuable things I think that came out of this conversation today. And I would also like to thank our audience and apologize that we didn't get to all of the questions. Um, we will definitely invite all of our speakers back so we get can get into them. And I would like to encourage everyone to maybe share this video or maybe one of us I want to say like anyone else on this panel go and look at their social media. Go share some of their videos because like social media is king, right? And maybe we should all go do a nice little Tik Tok after this. I would love to see it. [laughter] So I challenge you all. Let's go and do it. Let's go change the world. I hope everyone has a fantastic day further and thank you for all the incredible work that you do.