Master Your Hypertension With Lifestyle Medicine

Introduction and Robbyu2019s Background 0:00

Welcome back to the Reverse Hypertension Naturally Summit. I'm Dr. Laurie Marbas and today I'm excited to welcome an old friend Robby Barbaro from Mastering Diabetes. How are you today? I'm so happy to be here. Thanks for having me. Well, I think it'll be wonderful because you have a unique story and me, we can just jump right in. And let's talk about kind of like your your past quickly and then how you evolved into managing diabetes. And I know you have a special emphasis also with hypertension and some things that you guys offer.

So let's start there. Yeah. I mean, I, I love sharing my story just because how much it's inspired me to reach others and, and share this information and that really the connection between insulin resistance and high blood pressure. Right. It's one of the like the central note of so many things are connected to the insulin resistance. And that's the magic of what we do at mass and diabetes. So how do we get started? Well, let's go back to the beginning. I was diagnosed with type one diabetes when I was 12 years old.

So that was 24 years ago. It's a pretty recently I celebrated my 24 year anniversary of living with type one. And, you know, at the time I was following the same American Diet. My parents wanted to make sure that we had the best medical care possible. So we were living in Saint Cloud, Minnesota, and they said, okay, we're going to drive to Rochester, we're going to take you to the Mayo Clinic and we're going to make sure you have the best medical team. And we would go there was like a whole event.

We would stay at a hotel. We would see an endocrinologist, a nutritionist, a psychologist, his whole team trying to help us out. And in no conversation did anybody say anything about insulin resistance. Nothing. And that is such a missed opportunity. I think even for people diagnosed with type one with isn't it isn't caused by insulin resistance, right? So there's different types of diabetes. Type one diabetes is an autoimmune condition and so is type 1.5. All right. That's how much it's crazy how many people are getting diagnosed type 1.5 these days or misdiagnosis type two.

when they have type 1.5. So a side note here, if you're listening to this show and you are underweight and your blood glucose levels are abnormal, that is the time to work with a qualified medical professional and see what is your c-peptide level. Are there any antibodies present and really get to the bottom of this? But back to the story here. So type one diabetes autoimmune condition, so it's not caused by insulin resistance, whereas pre-diabetes, type two diabetes, that is a precursor. You cannot have one of those conditions unless you have

Type 1 Diabetes, Insulin Sensitivity, and C-Peptide 2:53

exacerbated your insulin resistance. You've developed you've really gone quite far on the spectrum of insulin resistance. You have to have it. So even if you're living with type one, you just get diagnosed and you go in to your regular doctor. It would be nice if they would bring up this topic of, Hey, you know what, if you make some lifestyle changes, you can become more insulin sensitive. And the fact that you are now using insulin actually makes it really easy for you to assess your level of insulin sensitivity.

It's kind of like a a real benefit, almost a gift that Cyrus and I have with the work that we do is that we have that third variable that you need to have in order to understand your insulin sensitivity. Anybody listening to this, you can test your blood glucose levels and you can count the amount of carbohydrates you're consuming, but you don't know on a meal by meal basis, how much insulin is your pancreas secreting to keep your blood glucose at any given level that you're seeing? You don't have that data. You can go get fasting insulin test.

That's pretty helpful, but it doesn't tell the whole story. So people living with insulin dependent diabetes type one, type 1.5, even insulin dependent type two, we have this piece of data that tells us instantaneously meal by meal what decisions are making insulin work more efficiently. So I've had my c-peptide tested. It's less than 0.01. So C-Peptide is produced in a 1 to 1 ratio with insulin. So it's a great indicator of how much insulin is your pancreas secreting. I'm effectively producing none.

I'm I'm producing an undetectable amount. So when I eat a meal and I my body needs to metabolize some carbohydrate, the insulin I inject is the only insulin work. So when I see that I'm needing less insulin for more carbohydrate, I know that those lifestyle decisions that led to that, that's improvements on sensitivity. And that was the experience that I had and science had. We had these experiences separately and then we met. We're like, Wow, like we're kind of like the same on so many levels. Like let's, let's explore working together.

And so I have been following a low fat plant based health food diet for 18 years now, and I will consume well over 700 grams of total carbohydrate. Carbohydrate per day on a consistent basis. That's gone up even a little bit since I started to train for Ironman races. I did three Ironman races in 2023 and that has, you know, improvements on and simply because of the endurance training. But the amount of insulin I need to metabolize that carbohydrate energy, like most people's minds, don't even think, when is that really possible?

I will inject a physiologically normal amount of insulin these days. Now that I'm using an insulin pump and Omnipod 5, I will inject somewhere between like 24-28 units of insulin for upwards of 700 grams of carbohydrates per day. A healthy, normal pancreas is going to secrete somewhere between 25 and 50 units per day. Right. It's going to change on your age, your gender, your height, your activity. But that's the ballpark range. And so I'm eating way more carbohydrate than even a low carb person might eat in a week or even a month, sometimes in one day.

And I'm using a physiologically normal amount of insulin. So I'm really experiencing this high level of intense sensitivity I've been doing this for many years. I'm like, Is there research on this? So I go and look into the journals and lo and behold, there have been papers published. I'm using a high carbohydrate diet to improve insulin sensitivity. As early as 1926 and insulin was discovered in 1921, the first use in humans in 1922. So as soon as we really knew about insulin, there were researchers looking into this and seeing decade after decade the exact same thing with nothing to the contrary.

Not that there has not been a single study that was a truly low fat, less than 15% of total calories coming from fat that I have ever seen, where those human beings didn't see an improvement in insulin sensitivity. I haven't seen that paper published yet. If somebody has one, I would love to see it sent to me. So I have this experience and I'm like, Wow, okay. Now the research is showing the same thing and I really have this realization that, wait a minute, we have over 100 million people in the U.S.

living with some form of prediabetes or type two diabetes. And that condition in the vast majority of cases can be completely reversed if you reverse insulin resistance. And so we start doing this work Saturday night in 2017, we came together and started mastering diabetes and we have been able to help so many people. And what's been fascinating for, you know, your audience here today is type two diabetes pre-diabetes. Even those who come to us with uncontrolled type one, type 1.5, usually they have some extra weight and usually they also have high blood pressure.

Number of people that I speak to that are coming to us on diabetes meds, blood pressure meds and cholesterol meds is extremely high. It's it's the it's the majority. And so people come into the program, they start following this low fat plant based off of diet with a single focus. We try and keep our program really simple and help people do it step by step, because overwhelmed is one of the biggest problems when it comes to lifestyle change. So it's okay, we're going to keep this simple. We're going to do this step by step, and we're only going to focus on one thing make lifestyle choices to make insulin work more efficiently, whether that's the insulin that your pancreas is still secreting, whether that's seeing some that you're injecting because you need to inject some

High-Carb Plant-Based Diet and Research on Insulin Resistance 8:53

whatever it is, let's just focus on making that work as efficiently as possible and that's some of the magic that makes us a little bit different from a lot of various programs out there. Is this is this really singular focus and a willingness and a commitment to believe in people, believe in you listening to this, that you can do it. Like a lot of times people go to their doctor and they have these conditions and they like, oh, here's your medication, because they, they might know that lifestyle medicine is the right path, but they just don't even say anything because they don't believe the patient will do it. Well, we do.

And we have there are so many things that you can do, like you can do the basics. And then sometimes you got to go a little further and we'll help you do that. Right. Whether it's, you know, recalibrating, you know, how much maybe you need a little bit more fruit. And believe it or not, more fruit and a little bit more raw fruit and some more greens in a lot of cases can help people take things to the next level. It's so funny. Just today I was reading a post in We have like this free Facebook group and some person they were doing well and they c-peptide that was like a little bit low.

And then they eventually said, You know what, I'm just going to go like full arm and do like 100% off with it and see what happens. And they finally got some extraordinary results. Now, I'm not saying that everybody has to take it that far, but we will help you make adjustments along the way to see what do you have to do to really reach your goals. And sometimes what do you have to do to make the most of a small amount of insulin production, which is sometimes if you've had type two for so long, your pancreas is so exhausted that we might need to go another level.

Right? And that's okay. There's there's different degrees of commitment to lifestyle change and consistency. And and we're going to help meet you where, where you're at. So anyways, we're doing this for all these years, Dr. Morris. And we also start running some in-person retreats. All right. So people come down. We did some in California, we did some in Costa Rica that people come they fly in the they fly in on Thursday, Thursday or Friday. The retreat starts Friday nights. We feed them dinner on Friday night.

And our meals are super simple. So at these retreats, we would only do buffet style of single ingredients. Okay, so you would just like there's like a for breakfast, you have a big bowl of mangoes, a big bowl, papaya, a big bowl lettuce, a big bowl of spinach, maybe some some beans and stuff like that. Some very simple options at each meal dinner, we would have, you know, like kosher squash. We would have some some quinoa, some beans, stuff like that. Right. So you have all these individual ingredients.

You put a sauce on top if you want. And people were lowering their blood pressure. So fast that they had to reduce their medication. So people are there for Friday, Saturday, Sunday. We should have breakfast on Monday. Some people Saturday, Sunday, we had a medical doctor on staff for all these retreats and they would need to talk to the medical doctor and reduce their blood pressure medication like that quickly, because at the retreat, this is the perfect example of us like stacking together. Everything we really know of that can help you improve in something.

Seriously, the diet is like really, really optimal and clean. We're having you move your body twice a day. We're encouraging everybody to go to bed early and get some sleep because you can wake up the next day, you're going to learn a lot. You're going to be active. So we're stacking all this stuff together. We have community, we have good energy, we have support. Hopefully you're not getting a less stressful environment because we tried to create that for you. And, and, and people are low in their blood pressure like that fast.

It's it's fascinating. And of course, inside our coaching program, again, people are not here like eating certain foods or doing some certain thing, you know, specifically for blood pressure. They're just reversing it. Some resistance. And it's the reduction in diabetes meds, classrooms, blood pressure rise. It's all coming together. And I mean, Dr. Roberts, we've sent a lot of patients to you over the years. And I mean, do you I mean, what do you see in the people who are following the and diabetes map?

No, absolutely. I think let's see the first one must have been 2018 or something. It's been a significant number of folks and people working with them and they do very well. Right. So they reverse the diabetes or we find that they were diagnosed inappropriately with type two and it was actually take one and a half and it's a very nuanced diagnosis. It's a fascinating you'll see a definitely some characteristics that are across the board. But yes, the insulin resistance is a big thing. I I've done deep, deep dives on this resistance.

Diabetes is my favorite thing to work with. And so, you know, just to kind of highlight what you're speaking to when you think about insulin resistance

Mastering Diabetes, Blood Pressure, and Retreat Results 14:04

and hypertension, there's a few things that we want to keep in mind. Simple excuse me, first of all, you'll see in some resistance there's a sympathetic nervous system activation, right? So that will raise your blood pressure. We have impaired nitric oxide production, which again is very important for vasodilation. We have the sodium retention and fluid imbalance which causes hypertension. We have inflammation. We have the obesity and there's hormones from the particular fat. Storage is not being utilized very well.

There's vascular changes. There's the kidney is sending out messengers to raise the blood pressure. So there is so many things tied around into resistance and hypertension that it's a really important thing to point out. And so, yeah, a low carb, low fat, high carbohydrate. Also, the plant based diet is definitely the way to go. But it also speaks to you have another product that I utilize with patients as well, and that's the Amla product. And we talk a little bit about that and what that is exactly.

I love to tell the story about this. Okay. So the one that I can see every day, this is behind this course on the green. It's a tea, right? And so when Cyrus and I first started running our program in 2017 together and we started growing, a lot of people, we would have some people that if things just seem to be a little bit more stubborn, you know, as they could be, they were really compliant. They were doing things, they were getting really good results. But there was just like this final end result of like they kind of get their buggers just a little bit lower, their blood pressure still a little bit high, but cholesterol's just not budging in the way we wanted to.

And so, okay, you know, let's do some research on this. And we stumbled across a video from Dr. Michael Greger talking about Indian gooseberries. And he was discussing some research on the topic. So, of course, we go we dig into this research and we're like, this is really intriguing. So we would then say, Hey, guys, this do an experiment, this like buy some of this, put it in your smoothies and see what happens. And lo and behold, people got great results and we were like, Wow, this is crazy. But the problem is it's not very palatable, like to just buy it.

It doesn't really taste good. So. Cyrus in his, you know, Ph.D. background here is like, I'm going to solve this. And he ends up going to some some shops in San Francisco like some like herbalist people. And he starts talking to them and starts thinking about what can we mix this with to make it taste good so people can consume it. Armadale basis and get it in their body consistently, which is the key factor here is that you've got to use it consistently, just like you got to have your diet consistent, you got to have your movement consistent, like just doing one thing in some bursts is not going to help solve any health problems.

So like how are we going to do this consistently? So the first thing he came up with was, let's combine it with oolong green tea, which has a whole nother range of scientific papers discussing the benefits around that. So that was the first product that was created. It was just amla Indian gooseberries, the powder can with oolong green tea combined and boom, there you have it. Okay, so we start getting that in the hands of people and they start consuming it regularly just as a tea. And we couldn't believe the testimonials that were coming in.

I mean, it's crazy. So this if you've none of you have heard about this fruit, it's called the Indian Gooseberry. And it is the most antioxidant, rich, whole food on the planet. There's no whole food that has more antioxidants than Amla. Barry's also known as Indian gooseberries. But the problem is the reason you don't see them at the grocery store, they don't see them like in a container next to the blueberries and Blackberries is because they're very bitter. They they just you're not going to enjoy the berry itself.

It's going to be hard to find. You can go look for it at some Indian markets and I encourage you to do that so you can just try it and see. But really the easiest way to get it in your body is through this tea. And then we also turned it into a coffee for people who are coffee drinkers, we want to serve people wherever they're at and whatever they enjoy to get this in their body consistently. I don't drink caffeine, so this one's caffeine free. There's also a couple other options that are caffeine free, but it's incredibly powerful.

And so I'm just going to read a couple people who wrote their story to us. Somebody says, this is Mrs. G. On January 25th, 2024. She says, I have been drinking amla green tea hibiscus consistently one or two daily for four months to include restricting my sodium intake.

Amla Tea, Medicinal Plants, and Consistency 18:58

I have been able to stop taking my blood pressure medication and maintain my blood pressure below the numbers. When taking medication, I feel wonderful and I believe consistency is the key. So that's a great story. And I want to highlight there. Dr. Marcus The key is so people who are picking this up are also getting recipes from us, they're getting lifestyle tips, right? And so it's a combination of both. Please don't mistake us in saying, Oh, wow, just like put this little just so you know, it is a tiny scoop, right?

So I'll show it to you, I guess just this little scooper, that's it. Like, don't think this is some miracle pill, all right? We're not. We're not telling you that this is a miracle. Just drink this tea. All sudden, your life is going to be fantastic and your boyfriend is going to be fixed. Now, there is research with demonstrating the benefits of people who just added the certain amount of Indian gooseberries. But we know that to truly get the overall results, you have to combine medicinal plants with a whole food diet.

You have to address the costs. You can't just try and cover up the problem with some sort of even if it's a natural pill, even if it's a natural medicinal plant, that's not what we do here. Right. You have to address the cause, your cause of high blood pressure. You're cause of type two diabetes. Wasn't a lack of Indian gooseberry. It's just like it's not a lack of metformin. Right? Right, right. But this stuff can help this. And that's another thing about what we do. A massive diabetes, which I'm super passionate about, is like a lot sometimes, you know, we get like criticism out there, almost all of us of our diets are restrictive or it's it's like to to say, look, we are helping people who have a metabolic illness, like you dug yourself into a hole.

You're going to have to take some steps to get out of the hole like you're in a different position. Then the 22 year old that hasn't been eating well but isn't on any medications, doesn't have type two diabetes, isn't £50 overweight, isn't taking a blood pressure medication or cholesterol medication. It's like you're in a different spot. So we serve the people who are ready to dig themselves out of that hole. And what you want to do when it comes to your maintenance program and how you want to adjust that totally up to you.

But let's talk about that in two or three years, once you've you've really fixed the whole you dig yourself into. So we're really passionate about what this does. It's also it's a habit like we when you make it part of your morning, it's a way to kick start your day of like, okay, you know what? I'm going to make all the decisions. You know, I had my tea, I had my traditional plants for the day because there's also a bunch of other plants in these. So for example, the Hibiscus version also has ginger, cinnamon, minced leaf and obviously hibiscus, right?

So medicinal plants are powerful. Start your day with some medicinal plants and let that be the setting, the tone. Okay. You're going to make that better decision at lunch today, right. And and always know it's step by step. It's not black and white. Right. It's not like, oh, my gosh, has to be perfect. Like get rid of that. Like get going. Start taking steps in the right direction. You are going to it's going to become easier over time and know that you will falter. You will make mistakes, that nobody has a straight line to perfect health, everything being fixed.

It's going to be up, up and down, up and down. But you trajectory is going to be up and get started. So I kind of like how you hinted around, like it's not a perfect trajectory. Can you speak to some of the stumbling blocks that you see people maybe come across as they're trying to engage in these healthier lifestyle choices and then how they actually you know, the ones that are successful overcome them because I think that's a very powerful statement. Absolutely. For sure. Okay. So the first one that comes to mind is that when people first start eating a plant based food diet, one of the most common mistakes is not eating enough food because the calorie density is so much lower than what you're used to eating.

And so you a lot of people, they also they have a little bit of fear of eating carbohydrate rich foods. So having a big bowl of quinoa and beans and potatoes and brown rice and fruit, having a big bowl is scary. So maybe they'll start with like a smaller bowl, which is okay, but just know that that is not going to have enough calories. It's certainly not going to have the same amount of calories you are consuming prior, especially if you come in trying to emphasize salads like, Oh, I'm going to do this healthy diet, so I'm definitely going to include more salads, I'm going to eat more carrots, I'm going to eat more lettuce and I'm going to eat more tomatoes and peppers.

That's great. But those foods are super low in calories and they're quite bulky, which in the beginning could be a problem. So you really got to find a balance. Like it's beneficial that you're lowering your calorie dense and you're eating these filling foods. But there's a place where there's like a sweet spot and a sweet spot is somewhere around like 400, 500 ish calories per pound. And believe it or not, that's where starchy vegetables end up landing. And that's where some of the most calorie dense fruits end up landing.

So things like plantains, bananas may support some of those foods. Those could be more satisfying fruits as well. But the bottom line is, it is a valuable exercise to use in nutrition, logging software. Our favorite software is chronometer. There's many others you can use, whichever one you want and everyone you use consistently. And we're not recommending that you log your food forever

Common Mistakes and Practical Lifestyle Tips 24:58

because it can be painstaking, annoying and frustrating, but definitely do it in the beginning. As a learning experience. It's going to illuminate what you're going to be doing for the next the rest of your life. And it's a very valuable exercise, so make sure you're consuming big enough portions of plant based foods and you're consuming the right foods that are nutrient dense and calorie providing. Okay, you got you have to find that balance. And these days it's pretty simple, right? If you if you follow the recipes that are provided by pretty much any plant based expert, you can follow our recipes on our website.

They're free there. We have more on Instagram. We have them on a meal plan. It's very easy to find recipes these days. You can even ask Chad for recipes if you wanted to, believe it or not. Does a great job. Okay, so definitely focus on that. That's one mistake. Another mistake I see people doing is they try to do intermittent fasting and the cravings are just like too much, too much. So I'm like green is actually a fantastic way. T Somebody consuming a beverage that has a little bit of flavor, a little bit of nutrients can be a great way to help you successfully do some intermittent fasting.

And I would say some people, they try and maybe go overboard with intermittent fasting. That's another problem sometimes. So I would say incorporated in a slow, steady, consistent way. Let's see, what's another mistake I see people making? I think, you know, I just keep on going back to number one. Dr. Marbas, like the fear. The fear of eating carbohydrates is unbelievable. And this goes in like the night. People aren't eating enough fruit, then they're not eating enough potatoes. They're just like, you've got to have calorie providing, you know, what we call green light for put food into green light, yellow light and red light.

And there's there's we list them in that as that got an order right to the first four categories are intentionally the first four because they're calorie providing it's fruits it's starchy vegetables it is legumes and it's intact whole grains. You've got to have a proper portion of those with greens and non-starchy vegetables at every meal. You know, that's another mistake. Let me let me cover that one, Dr. Marbas. So people with blood glucose challenges. Okay, in the beginning when you're very insulin resistance, okay, you will see spikes.

There's no question you're you're not going to solve this problem in one day or two days. You could see improvement and see they're going in the right direction. But you're not solving it. You're not like completely turning this around 180 degrees that fast. So you have to learn how to eat your way, eat and move your way out of insulin resistance in a steady way. And one of the the like you're going to have bug spikes how you can blunt them and make them you know less frustrating is including greens and non-starchy vegetables at every meal.

Every meal. I have greens with my breakfast. And that's how you tastebuds change your tastebuds. Absolutely change. And arugula is like one of the best tasting foods on the planet. For me, it's unbelievable. I have a regular with almost everything. I just love it. I also love spinach. I love romaine lettuce. There's so many great greens, but in our recipes we will take care of that for you. Kind of to think about it because we've already proportioned out how many greens and non-starchy vegetables should be in that serving, but nonetheless greens and non-starchy vegetables every meal, especially in the beginning.

Then you should also eat at a reasonable pace. Okay. When again, this is this is a nuance specific details for people who are struggling with also blood glucose challenges, which I assume are a lot of people who are coming here to learn about high blood pressure. These things come together. So when you're insulin resistance, you got to give your body a little grace. You don't you don't just start eating that meal like as fast as possible. If you're eating meals right now in 8 minutes, bump it up to 12.

Right. Like that little difference is going to make it if you're eating out, you think your lunch break is only 15 minutes. Okay, fine. Then you will do what you probably you probably finish the meal sometimes in six or seven, bumping up to 14. Right. Like, like any small increment and just just the, the mental shift of the mindset. Okay, I'm going to start chewing my food. I'm going to take it gracefully. I'm going to maybe say some gratitude before this. You know, like really just bringing that attention to your meal is definitely going to help blunt blood glucose spikes is no question.

And then moving your body after a meal is spectacular for people have blood glucose challenges moving your body any time of day, any amount. Especially any amount. That's more than you've been doing previously. Like you're moving in the right direction is always beneficial. So if you're like, Oh, I can't do that anymore, but I can do it before, great, do that. But for people with blog post challenges, the best thing you can do is move your body after and it doesn't need to be intense just walking.

We seen this in the research we've seen in our clients and as a person living with type one. Again, I have all these fun experiments every single day, every time I eat food, I know that if I'm walking after a meal, I have to adjust that carbohydrate insulin. Rachel I have to take less insulin or I have to eat a snack every single time is no exception. Like, it's just like that's a fun thing about it's some resistance, it's so objective, it's so repeatable. It's, it's unbelievable. So that's another mistake that I think it's easy to correct.

And hopefully you love your meals so much that you enjoy spreading them out a little bit more. No, I think that's fantastic. This is going from being mindless to mindful and movement in what you're eating and your meals. And I think that people also find that they're more present in other parts of their lives, which is always a wonderful way to live. So I think this is a super way to end our conversation. So thank you so much, Robby, for sharing with us today your story and all the work that you're doing to help people find health and wellness.

We appreciate you. Thank you so much. So happy to be here. And I hope everybody listening. You're really inspired to take action and enjoy all the speakers. Thank you.