Dr Rupy: The more people inhabit a preferred future, the more likely they are to make a change. And that's so powerful. The more you think I can do it. And then if you have a clinician who says, I'd love to help you, I believe you can do it, I'll support you, shall we do it? It's magic. It's absolute magic and it's great for the doctors as well. Welcome to the Doctor's Kitchen podcast. The show about food, lifestyle, medicine and how to improve your health today. I'm Dr Rupy, your host. I'm a medical doctor, I study nutrition and I'm a firm believer in the power of food and lifestyle as medicine. Join me and my expert guests where we discuss the multiple determinants of what allows you to lead your best life.
Dr Rupy: Dr David Unwin is on the podcast today with Sakina, one of the researchers here at the Doctor's Kitchen. Many of you will recognise him as the GP from Norwood surgery in Southport who is a strong advocate of lifestyle medicine and a low carb diet. Today, over a hundred of his patients have achieved drug free remission of their type two diabetes. He is the RCGP national champion for collaborative care and support planning in obesity and diabetes and the RCGP clinical expert in diabetes. His work on diabetes has been published in many journals and is pretty impressive. But Dr Unwin's work is unconventional and doesn't come without criticism from many academics who fear that a low carb strategy is not an appropriate diet long term. What I do like about Unwin's approach is the simplicity of it and how achievable it has proven to be for many of his patients. I also believe he genuinely cares about this huge problem. What I feel this conversation perhaps lacks is a deep dive into the mechanisms behind low carb diets, the applicability of it to the wider population, the pitfalls and where people can slip up. For example, I know many patients who start a low carb approach on a Monday and fall back to high sugar consumption later in the week, which is a dangerous combination of high fat, high sugar and is essentially a standard American diet. We will have to get Dr Unwin back on the podcast at some point in the future. We were limited with time on this occasion, but I'm sure you will enjoy listening to him talk about how he started getting interested in nutritional interventions and how we could start using them today. Remember, you can download the Doctor's Kitchen app for free to get access to all of our recipes, specific suggestions tailored to your health needs and new recipes added every month. We will have step by step instructions, you can share the ingredients lists and yes, we are working on an Android version too. In the meantime, you can subscribe to the Eat, Listen, Read newsletter. Every week I send you a recipe, for example, this week I sent out a broccoli, edamame bean salad with peanut and sesame dressing. It was delicious. I also sent a suggestion of what to listen to. It was a short podcast on water pollution that was done by the BBC and I send you something to read. Sometimes it can be an excerpt from Shakespeare, sometimes it's philosophy. I recently talked about René Girard's mimetic theory. I find it absolutely fascinating and I'm sure you will too. Many of you have emailed to say how much you love them because they are short, sharp snippets. Most of them are around one to two minutes long and you know exactly what you're going to get. You're going to get something to eat, something to read, something to listen to and even sometimes something to watch, plus a funny joke at the end. For now, on to my podcast.
Sakina: Thank you so much for taking the time to speak with us today. I know you had a busy day, just come out of a talk, right?
Dr David Unwin: Just calming down.
Sakina: Yeah, just calming down after a long talk. How did the talk go then?
Dr David Unwin: It was difficult to know. I ran over because I got over excited and so much I wanted to say, but lots of people came up afterwards and said, oh, it meant a lot. So I hope it was all right. My son liked it, that was very important.
Sakina: That is the most important. It's good to have support in the crowd as well.
Dr David Unwin: Yeah, he said I'd got the tone right, whatever that means. Thank you, Edward.
Sakina: Good. Well, let's start a bit about you then. After you've been treating patients with diabetes with conventional methods for a few years until you change to more integrative and lifestyle approaches. So what happened? Where did it start?
Dr David Unwin: So, the background is that obviously I'm an older doctor, I'm 63, and for the first 25 years of my career, I used really conventional medicine. I saw type two diabetes as a chronic deteriorating condition. So I wasn't surprised using that model that I would add drugs and more drugs and more drugs. But what did surprise me and depress me was that despite that, I very rarely saw people who looked well. So I became really disappointed in myself as a doctor. You know, you become a doctor to change the world. You become a doctor to make a difference. And it was obvious to me by the age of 55, I wasn't really making a difference and I was quite disappointed in myself. And then one patient came along and changed the whole thing. And I owe a lot to that lady. And she was a cross lady because what had happened was she had stopped taking her medication because it gave her diarrhoea as a side effect. And she'd gone on the low carb diet and discovered that she lost weight, she didn't feel hungry, she felt wonderful and her blood sugars were normal. So she was angry with me because she said I had never explained to her that bread and breakfast cereals and rice and chocolate biscuits were all sugar and that if she'd only known, she would have been doing that for 10 years. So she was quite angry with me. And the thing that really sticks in my memory is she, she said, you know, I'm even beginning to wonder whether you've got O-level biology. I was scared. I was scared because she was an angry lady and I didn't blame her. But I thought the thing to do is listen, is listen to what she has to say. And that started the low carb journey. That one patient, age 55, and I think I was fertile ground really because I knew she was right and I knew that what I'd done was a bit disappointing. And then the rest is kind of history because we started with that one patient and then built it up very rapidly.
Sakina: So it was patient led originally. So the patient brought that up and then you started looking at the research.
Dr David Unwin: Well, it's not quite like that. It was even more patient led than that because we had problems. So one of the problems was that how are you to finance a new approach in an NHS practice? We were already overstretched, no locums, no appointments. And the partners quite rightly didn't want me to do this because they said I should be seeing sick people, not doing this new fangled thing. So it was my wife actually. I was disappointed because the partners wouldn't let me do the low carb thing. And my wife said to me one day, she said, why, why are we not doing it, David? And I said, well, because we're not paid to do it. And she said, I love her to bits. And she said, David, I thought I'd married a doctor. And how many cars have we got? And you know, so why do we have to be paid to do a good thing? And she humiliated me quite rightly, but she also, she's a consultant psychologist and she offered to work for free on a Monday night. And then the practice nurse believed in it and she offered to work for free. And we started with the first 18 patients, learning with them. So it was truly collaborative because week by week we explored with low carb, swap recipes, did cookery together. And it was a great experience because it was the first time I'd really worked with patients, not alongside them, you know, not telling them what to do, but kind of learning with them. And it was a brilliant experience. I really enjoyed it. It wasn't like work at all. And those groups have gone on. We've been doing them for nine years now. Only now they're on Zoom. But I think we got into this idea of collaborating with patients, not telling them what to do. And that's very, what we do is underpinned with psychology, really. So it's good physiology, like sugar is dangerous. And then the psychology which is hope-based is very powerful and sort of collaborative.
Sakina: Well, I'd love to dive into both of these aspects, the physiology side of why low carb, what you mean by low carb, how do you define low carb, how low should we go? But also maybe some of the mechanisms behind why it has an impact. And then maybe we can talk about the psychological aspect and the implementation and the motivation.
Dr David Unwin: That works well. So I often with patients I begin with this because I want them, I want them to understand what they're doing rather than memorise it so they don't, you know, if they have to learn a leaflet, it's much better if they understand the physiology, then they can individualise it for their own lives and they're more likely to eat food they like and they're more likely to keep it up. So for me, the explanation for patients is around what insulin does. So we have to roll back a little bit earlier than that. And that is that we need blood sugar to live. With no blood sugar, you're dead. However, too much sugar in the blood damages the lining of your arteries very rapidly. And for that reason, nature has, it's a genius design where we have the hormone insulin. And insulin regulates blood sugar within a very fine margin to keep you safe. So insulin is there to control a high blood sugar. So if you eat a bowl of rice, your blood sugar goes up, that sugar has to go somewhere. And I often ask patients, where, where do you think that sugar goes? And insulin pushes sugar inside your cells. Pushes sugar inside your belly cells and you get a fatter belly. That's middle-aged spread. It pushes sugar inside your liver cells. And that is why people's liver now is often full of fat because the liver cells have to do something with that sugar and they turn it into fat. And that is why a quarter of the entire developed world have a fatty liver. But the next really important thing to understand is that a fatty liver interferes with the effectiveness of insulin. So your insulin doesn't work as well anymore and you can't regulate your blood sugar. And you're seeing that, you can see how that becomes diabetes. You can't regulate your blood sugar because insulin doesn't work. There's a next step to this as well. It's a double whammy. The pancreas, the very gland that produces insulin, also fills with fat and can't produce insulin. So that is how towards the end stages of diabetes, you're struggling even to produce insulin. The good news, the important good news is that all of this can be reversed. So if you cut the carbs, then your liver empties the fat out quite rapidly. Your insulin sensitivity comes back, the fat leaves the pancreas and you produce insulin more normally again. And that is how, that's the physiology of remission of diabetes. And Roy Taylor at Newcastle University did all of the studies on that where he actually showed the fat leaving the liver and the pancreas. So that helps my patients understand that too much sugar leads to fat in the liver and leads to diabetes. And so the next logical question is how do they know where sugar comes from? And so obviously they know quite a lot of it already. But the next point is that starch is concentrated sugar. So it's nature's way of storing sugar. So that means that all starchy foods are as it were concentrated sugar. So that's bread, rice, breakfast cereals, potatoes, all these things. And so for instance, a small bowl of rice, 150 grams of boiled rice, digests down into the equivalent of 10 teaspoons of sugar. So if you have type two diabetes, a bowl of rice is a kind of disaster. You need to eat something else. And I'm helping my patients understand what could you eat that you'd enjoy instead of rice? Loads of green veg, perhaps. What foods don't put up your blood sugar? Meat, fish, eggs, cheese, loads of green veg again. So that that's the basis of the low carb diet where you're trying to avoid overloading yourself on sugar because in a way, think of type two diabetes in a way is a disease of carbohydrate intolerance. You can't really deal with it. So having diabetes means that sugar is sort of toxic to you because your insulin isn't working properly. There's another point of physiology that's really important. We are a genius dual fuel engine. We can burn two fuels, sugar or fat. Fat is a very good fuel. Per gram, there's more calories in it than sugar. So it's a very good fuel. But insulin has a final trick. Insulin prevents you from being able to burn fat. So if you keep eating small amounts of carb through the day, you can't burn your own fat reserves. And when you go low carb, the commonest thing that patients tell me is that they're not hungry. And they're not hungry because suddenly they can burn their fat. And that means they can do intermittent fasting if they want or Ramadan can be completely changed for them as an experience because they can fast and they're not as hungry. So insulin is a really complicated hormone and understanding it if you have type two diabetes is is is really worthwhile.
Sakina: Thank you for taking us through that physiology. That's very interesting to understand the mechanisms behind why low carb works. I know you've presented some findings right at this conference from a study that you've done. Could you tell us more about the findings?
Dr David Unwin: So, I think, I mean at the beginning we had some surprises because, so I, remember I had never seen remission of type two diabetes. And so that is a blood sugar that's in the normal or in the pre-diabetic or normal range. So blood sugar that's not in the diabetic range without using drugs. And so there was the first lady and then very rapidly lots more came along and we were astonished. And we've kept data on this from the very beginning. And in our practice, we've now got 117 patients who are drug-free diabetes remission, 117. And that represents 52% of all the people who've chosen to go low carb. But better than that, it represents over 20% of the entire diabetic register of an NHS practice. So this is proof of concept at least that it can be done. And in our practice, I think another good piece of evidence is that we're saving about £68,000 per year on the drug budget. So that there's two things. We're seeing drug-free diabetes remission almost on a weekly basis with spending less money on drugs. And this is very hopeful because it means what if we could reuse some of the drug budget for lifestyle medicine? You know, are we, this is part of the beyond pills campaign that the Royal College of Medicine have started up. Well, are we using all that money on the drug budget well? I'm not sure we are because we're saving that amount of money. At the moment, the tragedy is that all our savings go back to the Treasury and we don't have that money to run what we are doing. So we are funding this in the practice ourselves, but we believe in it and it's a joyous thing to do. It's great fun.
Sakina: Another thing that you've been talking about in this talk is salt versus not versus, but the fact that processed food are often high in salt and that's why we've been talking about their detrimental effect on heart health and cardiovascular health. But processed food are also high in sugar, added sugar. And so could it be that added sugars are the ones that are detrimental for heart health? And that's something you've been looking into.
Dr David Unwin: It's a great question. Well, I worried about that for years because there was a problem in the first, in myself actually, I was one of the first. I noticed that when I went low carb, I actually noticed two things. One was I'm a runner and I needed more salt in my diet because I was getting muscle cramps at night, really bad ones, causing me to wake my wife up by shouting because the pain was that bad. So the other one was that my blood pressure went really low. I hadn't had normal blood pressure for a decade and my blood pressure went low. So that seemed really odd. I was so intrigued because all of the patients were noticing the same that they were having to have more salt and yet the blood pressure was improving. And that took me about four years to try and find out what was going on. And eventually I teamed up with a professor of cardiology, Professor Brady from Glasgow University, because we actually published the work on blood pressure. And apparently we've known for nearly a hundred years that insulin causes renal sodium retention. What this means is that if you have a high carb diet, that's means there's a lot of insulin to deal with the carbs. That insulin stops you from weeing out the salt. The insulin causes you to retain salt. And if you retain salt, fluid follows it. And the combination of fluid and salt puts up your blood pressure. And we've known that since 1933. And with monotonous regularity from then, studies have shown that insulin is an integral part of essential hypertension. And we need to factor that in. And again, my own patients do very, very well and they come off medication for their blood pressure because it improves so much. So that's the role. I think I like to say we blamed salt for what the sugar did, really, because the sugar caused you to retain the salt. And if you think about it, is it likely that we were designed to die young because we lived by the seaside and ate fish? It's not kind of likely that, is it? I'm a great believer in evolution. And then if that actually happened, all the people that lived at the seaside would die, wouldn't they? All that salt. So actually we were designed to regulate salt and wee it out if we had too much. But whoever designed us never anticipated the modern food environment of high carbohydrate. We were designed in a low carbohydrate environment. Caveman could not possibly have come across Doritos, cornflakes, all these things. The best he could manage was berries in autumn and a few roots. There was really very little carbohydrate. That's our design. That's our design. So I hope that's answered your question.
Sakina: Yeah, so that goes against a lot of public health recommendations that we've been. So how do you feel about that? What would critics say about this new approach? And how do you respond?
Dr David Unwin: They would, I suppose, yeah, they would worry, they would worry that the salt was going to put up the blood pressure. And that's exactly why I've kept careful data from the very beginning because I was worried about that too. And so my first point was, well, for my patients, the blood pressure has improved significantly, systolic and diastolic. So I hope people would think at least for my patients, it seems okay. But then what you've actually got is some far bigger studies from all over the world that were in today's presentation, which showed that actually it's generally known that insulin is an integral part of essential hypertension. And we need to factor that in. And again, my own patients do very, very well and they come off medication and that's what they like. I think I, that's also why I measure so carefully other factors for cardiovascular risk. That's why I'm measuring the lipid profiles and the weight and the waist circumference, but all of them seem to improve. So personally, I am not worried because I've been doing it since 2012 was the very beginning and the results get better and better rather than worse and worse.
Sakina: So you have those sugar infographics that were published in NICE before.
Dr David Unwin: So the sugar infographics were originally published in the Journal of Insulin Resistance because we wanted to publish how they're calculated and how is it done and put it through peer review, which is still there. So the original paper is still there. And then I won, I was shortlisted for a NICE award. Um, because NICE felt that the infographics were so useful for people wondering what to eat. And then a national newspaper decided, not to say, that NICE should never have supported me. And so they pursued NICE. NICE became frightened and dropped. So they, they, so I was shortlisted for a prize and then our work was endorsed, so I was able to put the NICE approve. And this national newspaper pursued NICE and then NICE got scared and withdrew support. But I still was shortlisted for the award and the infographics are, they've been translated into 14 languages, downloaded millions of times. And for any listeners that are interested, if you just Google PHC, which is a UK charity, PHC Unwin and sugar, it'll take you straight to the infographics there. And there are eight of them in all these languages. And there's no copyright, so they're free. So that made me very unhappy, but other papers, I was really supported by the Daily Mail and the Daily Express. So it was, I, I, when I look back now, it wasn't so bad because then all of a sudden loads of people said, no, it's brilliant, it's really good. And other papers were really supportive. Oh, and the food programme, I went on Radio 4 and the food programme. So maybe, you know, it's controversial.
Sakina: Some of the people are saying that it didn't count for individual differences, but that's the complexity of communicating complex scientific concepts without being able to apply them to individual people. So how do you handle that complexity?
Dr David Unwin: I think that's such a great problem, question. So we know that people's response to carbohydrate varies. And actually, I mean, the best way to sort that out if you've money is a thing called a Freestyle Libre, which gives you 24-hour monitoring of your blood sugar, and then you'd know. But you know, most of my patients can't afford a Freestyle Libre, so I have to try and help them with general advice. And I stick to it that for most people with type two diabetes, eating cornflakes, eating loads of bread, eating rice, for most people. So it may be that the bowl of rice for some people is nine teaspoons and others is 10 and others 12. But it's very rare that I meet somebody with type two diabetes who can eat a bowl of rice and it do nothing. So of course, as we, as we learn, individualising is great because then you get a chance of both mixing what do I enjoy eating with what's safe. So I'm great. But until we can prescribe in the NHS something like a Freestyle Libre for type two diabetes, which I am forbidden from doing at the moment, the amount of individualising we can do on the NHS is very small. And meanwhile, the infographics are a good general rule. Of course, people could just do their blood sugar, couldn't they? They could just prick their finger. And if you just check your blood sugar an hour after whatever food, you can do that. I did that, but it's painful. So in the end, I actually bought a Freestyle Libre for myself, went on Twitter, and we had a sort of Twitter vote, what do you want Dr Unwin to go on, eat a bowl of porridge? And then I would put on what happened, a doubling. Eat a banana, put my blood sugar, this kind of thing. So you make a good point and I think there is a future behind this, but at the moment there is no finance for it.
Sakina: For listeners, maybe you can tell us what those infographics represent. We'll have the link, but what they represent and what the glycaemic index is.
Dr David Unwin: So the, that's a good point. So what, just going back to starch produces a lot of sugar. So what, what I discovered was that my patients didn't really understand glucose or grams. So the, you've heard of the low GI diet. Well, that's talking about glycaemic index. So carbohydrates vary in how sugary they are. So the carbohydrate from cornflakes is different in how sugary it is to the carbohydrate from rice, which is why we have the glycaemic index. But already listeners are beginning to wonder what I'm on about. So I found with my patients that it was helpful for them to have it interpreted how sugary a portion of food is in terms of something they do understand, which is a teaspoon of sugar. So the infographics list all sorts of different foods in terms of teaspoons of sugar, approximately, to give you an idea what might be a good dietary choice and what might be a very bad one. So give you another example. My mother, 86, has type two diabetes. She thought raisins were a really good food because it's part of her five a day. Well, a small pack of raisins is somewhere well over 10 teaspoons of sugar. So it's not a good for my mother. Whereas, you know, if she ate raspberries, that wouldn't be as bad. So the infographics are there to help you understand the relative sugariness of different foods and to improve your diet.
Sakina: So that brings us to the psychological side of it and the implementation side of it. So how, how can people with type two diabetes maintain a low carb and a low sugar diet in the long term? Do you have any tips for motivation?
Dr David Unwin: I think it's broader than that as well. I think it's both people with type two diabetes and also clinicians, you know, wondering how can I help my clients or patients. And so we're now going into the realms of what my wife, Jen Unwin, has taught me. So she's a consultant psychologist and she's spent her life exploring the role of hope in chronic disease. And she would tell you that hope is great for cancer, great for high blood pressure, ischaemic heart disease and so many other things. And it's key to behaviour change. So I used to nag people without hooking them first. So I, I think if you have diabetes, most people are a little bit worried about what might, what might happen to me. So the idea that you could really improve your diabetic control, we know, you see, that diabetic, the quality of diabetic control is actually linked to mortality. People with good diabetic control live longer. So most of my patients are very interested in that. So this is the first thing, trying to find out what it is, what are the hopes that my patients have. And I've got another tip for you. So many people talk about weight loss. So I'm trying to find out, I'm saying, what are you hoping for? If this approach works well for you, how would we know what's going to happen? And lots of people would tell me weight loss. And the trick there is to say, you see, weight loss isn't really a goal. It's a surrogate goal. So I'm saying, what difference would weight loss make to you? And then you're getting right into people's genuine hopes. And I get told all sorts of things. So I get told, then I could wear fashionable clothing. I get told, maybe I could breathe better if I wasn't so heavy. Or somebody the other day said, it'd be fun to be able to do my own shoelaces because I can't bend over. And you see, the more people imagine a preferred future, the idea that you're wearing fashionable clothing and then you could look in the mirror again and you'd love showing your relatives. The more people inhabit a preferred future, the more likely they are to make a change. And that's so powerful. The more you think I can do it. And then if you have a clinician who says, I'd love to help you, I believe you can do it, I'll support you, shall we do it? It's magic. It's absolute magic and it's great for the doctors as well because I love doing that. And who wouldn't? Who wouldn't? And then, you know, the next thing is noticing because what, what helps behaviour change is feedback. So if you think about the maintenance of behaviour change, how do we help people keep on the straight and narrow? And the important thing about that is feedback. So it may be that you're going to measure your waist circumference and that goes down and but you keep an eye on it. It may be that it's haemoglobin A1c, it may be your skin condition. So all sorts of different things are giving you feedback on how you're doing. And we encourage our patients and clients to notice how things are going because if you're doing well, maybe you should do more of it. Or maybe you could notice when were good days and bad days. What did you eat on the bad days? Should you eat less of that? There's a lot more to that and you could think about having my wife on the podcast because she understands or I could do another one very because it's complicated and we've published it. It's called the GRIN model. All of this is published in the Journal of Holistic Medicine. And if you Google, if you Google GRIN and Unwin, there's an open access paper on exactly the nuts and bolts of that.
Sakina: Amazing. I'm taking notes of that and we'll put them in the description as well. So for people with type two diabetes who would be interested in trying a low carb diet, for example, and see if it works for them, would it be something they would do with a professional or would it be something to try by themselves? And if so, how low?
Dr David Unwin: I think that, so I'm so glad you said that. I think we have to give a little health warning here that this isn't about giving advice to people who are other doctors' patients. We're giving general information. And for particularly for people who are on prescribed medication, as I've explained, this approach might improve your blood pressure, so you might need that medication may need to be changed. Or if you're on medication for diabetes, you would need to do this alongside, it's not for me to interfere with other doctors' patients. However, there are sources of information. So a podcast like this, it's about giving information, not advice. That's so important. So for people thinking, well, where could I find out more? There's different things. So you could go to the resource page of the charity that we set up, the Public Health Collaboration. On that resource page is a diet sheet, frequently asked questions. There is actually an app. So a young, doctors all over the world are doing this. And many of them come to me to learn. And there's a great bunch of young doctors at the Freshwell practice and they've developed a free app. And it's free. So there's an app that can be downloaded to work alongside your doctor because maybe the doctor hasn't got time. So they, these young doctors have used my teaspoons of sugar equivalent, they've tested it and given it to the world as a free gift. Isn't that amazing? And then if you explore, I think Diet Doctor is an amazing website. That's actually run by another GP, a Swedish GP, a friend of mine, Andreas, and that's full of recipes and loads and loads of information. Then I've got another suggestion. One of the particular problems with diabetes is people from India, Pakistan, Asia. And there is an amazing website called D-Life India, which is really delicious recipes for low carb, particularly for vegetarian and some vegans. So there's lots and lots of information out there for people who are interested. I'd also, I could go on and on. I'd also recommend Jason Fung, consultant nephrologist from Canada, has written a good book called The Diabetes Code. David Cavan, a consultant endocrinologist in the UK, has written another very good book on diabetes remission. What else? Oh, I can mention anything I like, can't I? Yeah. Another story, quick story. So in the early days, an Italian chef contacted me to say, this is amazing. I've just reversed my diabetes. I think you need help though. Could we do a joint project? Because you've taught me how to reverse my diabetes and transform my life, but I understand tasty food. So it's Giancarlo Caldesi. And he and his wife have done, I think it's now six low carb recipe books, which are amazing. And it's all about, you don't need to compromise. You want to enjoy food, but it be healthy. And so the whole idea of these recipe books, three of them have been serialised in the Daily Mail, very popular. So you can search Caldesi recipe books on Amazon. I wrote the scientific introduction as an explanation so people would understand. I did that, it's important you know I don't get paid for anything. And if I am paid, I donate the money to the PHC. So I did this scientific introduction in exchange for a donation. And Jen put her psychology in that those recipe books. So each recipe book has physiology, psychology, delicious recipes. So I suppose I should give them a little blow, shouldn't I? Yeah.
Sakina: Amazing. Thank you so much for your time today. It was very interesting and it's good that we were able to go through the physiology, psychology and the more complex complexities, sorry, of communicating science as well. So thank you so much.
Dr David Unwin: You're very welcome.
Dr Rupy: Thank you so much for listening to this week's episode. I feel that we need to do another episode with Dr Unwin because there is a lot more to unpack with a low carb diet, a low carb lifestyle and making this achievable for the majority of people for whom it is appropriate. I definitely think there is merit here as is exemplified by the many studies demonstrating that low carb interventions can reverse type two diabetes. There are many other ways in which we can do it too. Remember to check out the app on the app store, just look for the Doctor's Kitchen, subscribe to the Eat, Listen, Read newsletter that goes out every single week and I will see you here next time.
