Insulin Resistance and Pre-Diabetes in Women: Using Nutrition & Fasting to Reverse the Cycle Before It’s Too Late with guest Matty Lansdown

About this Episode

What’s the difference between pre-diabetes and diabetes? Just how serious is insulin resistance? What strategies and methods can we use at home to control our blood sugar? Nutritionist Matty Lansdown, host of the “How to Not Get Sick and Die” podcast, joins Dr. Amy and Sandy today to share his knowledge and advice on eating for optimum health. From managing stress and boosting focus to losing weight and preventing so many of the diseases and health issues that can come from poor nutrition, you’ll learn the role that nutrient-rich foods—and junk foods—play in how you look, think, and feel. Whether you’re looking for tips on losing or maintaining weight or just want to be ‘in the know’ on the latest from the scientific and medical community regarding our current understanding of nutrition, tune in this insightful conversation. 

About Matty Lansdown

Matty is a scientist and nutritionist with more than 10 years of experience and a background working in the health system. Firstly, in a nutritional epigenetics lab servicing elite athletes and also working as a part of a disease-research team within hospitals. In addition to working with clients (especially moms) who want to lose weight without counting calories, he hosts the “How to Not Get Sick and Die” podcast, which has become one of the top-rated health podcasts in Australia and the top 2% of podcasts worldwide.

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Read the transcript for this episode:

Dr. Amy Moore: Hi, and welcome to this episode of Brainy Moms, brought to you today by learning our LearningRx brain training centers. I’m your host, Dr. Dr. Amy Moore, coming to you today from a very snowy Colorado Springs, Colorado, and I am joined by my co-host, Sandy Zamalis, coming to us from across the country in Stanton, Virginia. Hi Sandy.

Sandy Zamalis: Hello.

Dr. Amy Moore: I feel like I haven’t talked with you in a really long time on air, so I’m excited to share this episode with you.

Sandy Zamalis: I’m glad to be back.

Dr. Amy Moore: Yeah. And so we’re super excited to welcome back our guest, Matty Lansdown. Let me tell you a little bit about Matty. He’s a scientist, functional nutritionist, international speaker, and a health coach who specializes in weight loss and self-confidence for professional women and busy moms. Matty hosts the podcast, “How to Not Get Sick and Die,” where he delivers free weekly insights on health, nutrition, and human optimization offering the latest advice on how your diet and lifestyle can directly affect your energy focus, self-confidence, and overall wellbeing. Listeners, you may remember Matty’s episode from last fall where we talked about diets and weight loss and a bunch of other uncomfortable topics related to food.

Well, we’ve invited him back to make us uncomfortable all over again today, by talking about a really huge health topic that has an impact on a lot of people, and that is insulin resistance and pre-diabetes, and why it’s a problem, why we all need to care and what we can do about it. Welcome back to our show.

Matty Lansdown: Amy, thanks for such a fantastic intro and it’s so lovely to meet you too, Sandy.

Sandy Zamalis: Well, like I said, I’ve been listening to you all day and prep for today, so I feel like we’ve been talking like old friends for the last 12 hours, so …

Matty Lansdown: Well, let’s just continue the conversation.

Dr. Amy Moore: Absolutely. So, okay, I, I know that this might not seem like a topic that’s relevant to every mom listening, but the CDC has said that one in three adults in the United States has pre-diabetes. One in three. That statistic blows my mind.

Matty Lansdown: Yeah.

Dr. Amy Moore: Like absolutely blows my mind. And so there’s an issue happening here and we need to talk about it, and so let’s talk about it.

Matty Lansdown: Yeah, it’s a huge issue. It’s one in four in Australia, and they’re predicting within the next 10 years it’ll be one in 10 humans on the planet. And it’s like, where did this come from? Because it’s literally happened in a generation. If we go back to 1990, it was very rare to find it was—as an adult with this situation or even a kid. And now it’s really normal in children as well. Which before just a generation ago, it was unheard of in children. It was, you know, adult-onset diabetes was the phrase, and the terminology used in diagnosing, then it just became diabetes because so many people had it and then it was child onset and now it’s just, diabetes for everybody! And so it’s, yeah, it’s like what has happened in this generation of food consumption, life, health wellness that has led to this situation? Because it’s like, it’s terrifying. It’s one in three and obviously that number’s just progressively moving in a direction that’s possibly gonna be one in two. And then we’ve gotta think of all of the other health issues that are also, you know, improve, increasing in their numbers. Cancer, we’re almost that one in two people have cancer, so if we think one in two will have cancer and then one in three will have diabetes, there’s a heap of people that have both, right? And so, and that’s just two. There’s loads of other things, blood pressure, pressure, cholesterol, heart attacks, atherosclerosis. And so it’s like, whoa, this is really kind of terrifying to think of what the future might hold. And so, and so from my experience, one of the big causes of getting to this place with so many people suffering from this is just a massive misunderstanding about what diabetes is, how to treat it, and what causes it. And that’s one of the, the problems with sort of Western medicine is that it often manages symptoms, which is a useful tool, but it also doesn’t go one step further to be like, what caused this problem? And how can we change that cause so that we can live many years into the future without the repeated problem occurring?

Dr. Amy Moore: Yeah. Okay. So I think before we talk about why we’re seeing this influx, I think we really just wanna talk first about why we should care. Like, why should we be afraid of it? I know that my husband is a surgical nurse and he assists with amputations weekly. Weekly from diabetics.

Matty Lansdown: Yeah.

Dr. Amy Moore: And not necessarily uncontrolled diabetes either. Right? And so when I hear these stories, well, first of all, let me say, I was diagnosed with pre-diabetes and insulin resistance right before Christmas, and that’s all that started spinning in my brain were the stories that my husband has said about, “Oh, well we had to remove, you know, three toes today from this 38-year-old woman who wasn’t even overweight. Yeah. Right? And so anyway, it, it terrified me. And it should, because losing a limb or losing toes isn’t the only impact that insulin resistance pre-diabetes and diabetes can have on your entire system. Right? I mean, there are a bunch of bad things that can happen to us. So talk about that.

Matty Lansdown: Yeah, so many things and it’s so when you get, when we’re in the category of like insulin resistance, pre-diabetes, it usually takes about 13 years of that to become full-blown diabetes. So, what, that’s actually good news in my mind because it tells me that the body is actually trying over such a long period of time to mitigate and fight against what’s going on.

It’s that again, we’re not, we’re not dealing with the cause and so in a lot of situations we find out that we are pre something. And I worked in a cancer hospital for seven years and we would always tell people like, you’re pre-cancerous. Come back when you’ve got full-blown cancer. And it’s like, hang on. What? Like, we can’t do anything for you until the problem’s big enough. And so I think that’s awful, an awful strategy to health and wellness. And so it’s the same when we’re, you know, working with doctors when we talk about pre-diabetes or insulin resistance, it’s like often it’s just acknowledged and no guidance is given. And that’s not necessarily the fault of the doctor. They have very limited education when it comes to nutrition, which, you know, is something I believe should be changed because we often go to our doctors for nutrition advice because poor nutrition causes so many health issues. But that’s the world that we live in. So we have to go out on our own and do research and listen to podcasts like this and read books. And so, amputations are one of the biggest things as you’ve just described, Amy, that happens as a result of having high blood sugar, high insulin levels for a long period of time, people go blind. That’s a common part of diabetes as well. Blindness, which is, you know, it’s terrifying. You don’t wanna, you wanna lose your sight. And, and the thing is too, is that when we get into the management of diabetes or even get really close to being fully diabetic and we might be prescribed insulin, is that if we really understand what’s going on with diabetes, we also understand that prescribing insulin actually fuels the fire, which is a problem. So what happens with diabetes is that basically we get to a state where there’s so much sugar in the blood from our diet, from the things consumed throughout that day, throughout that week, that the amount of insulin that is released, and the reason insulin is released is because blood sugar is toxic if it’s not removed fast enough, which is why these bad things happen to different organs, and parts of our body. And so the insulin comes out and it’s kind of like the chaperone. It comes out and says, “Oh, hey. Hey, sugar, we need to go into the cells because you’re actually really dangerous out here.” It’s kind of like the security guard or the bouncer at the, you know, the bar. And there’s like a really crazy drunk guy that’s outside being dangerous and he’s like, we need to come in here to keep you safe. Right? So that’s basically what insulin is doing. It’s taking the sugar outta the blood because it’s toxic to the body if it’s there too long and putting it into the cells. And what happens when we get pre-diabetic and insulin resistant is there’s already too much in the cell. So there’s already too many drunk guys in the bar we can’t fit anymore in. And so what the, what the pancreas does in order to try and mitigate that is it just hires more bouncers. It just increases the amount of insulin that’s then in the blood. So if you think about. We’re, if we’re putting more insulin in via injections, we’re not actually solving the blood sugar problem. We’re just meaning we are pushing more blood sugar into the cells. And if you think about what blood sugar into the cells is, that’s fat storage. And so there’s a strong relationship with taking insulin and becoming obese, right? There’s a very strong relationship between those two things. It’s like you might not even be overweight at all. Go on insulin. Five, 10 years later, you’re 20, 30, 40, 50, a hundred pounds bigger. And that’s because you’re not actually dealing with the sugar supply, which is the issue that caused the high insulin to begin with. And so we just get to a place where the pancreas gets burnt out. It’s like, “Whoa, we’ve just been trying to put so much sugar into the, into all of the cells for so long. We keep going up and up and up and up.” Those systems just burn out. And so the toxic sugar ends up being damaging to your eyes, to your limbs, to the blood supply, to the arteries, which then leads to all of the other problems, which is why amputations happen because this toxic blood sits in the limbs for so long that it starts damaging all the capillaries and the arteries and then the like the toes or the fingers or the hands start to rot. And it’s just like this awful cascade of events. So once we start understanding the relationship between our diet, sugar, and insulin, we can start understanding that like, “Oh, okay. So if I reduce the sugar in my diet, my pancreas will reduce the amount of insulin that it produces, and therefore we’ll be able to start, stop putting stuff in storage and be less toxic.” And we can slowly, slowly, slowly start to reverse this cycle. It’ll take a few years, but we can, we can actually reverse it.

Dr. Amy Moore: Yeah, I heard you use an analogy when you were talking about insulin resistance about instead of the bar and the bouncer you talked about like the Japanese train and having to—can you tell that? Because I just, I was so amused by that, but it was, it really helped me understand.

Matty Lansdown: Yeah, so anybody that’s seen, uh, like a video or been to Japan or seen a video of the people getting on trains, they literally hire people to stand on the platform and push as many people into the trains as they could possibly fit. And so it’s the same idea. Yeah. With ourselves, it’s like we’re just trying to stuff as much sugar into the cell as possible, and that insulin is effectively the persons that’s been hired to stand on the platform and say, “Nope, we can fit another 10 people in here. Watch this.”

Dr. Amy Moore: Yeah, I love that.

Sandy Zamalis: I was sharing with Amy before we started that. This is such an interesting topic for me because my dad passed away from kidney-related illness, so his kidneys failed and that was the whole train wreck that you described a minute ago. And then my niece was diagnosed with type one and I have an uncle who had diabetes and it’s kind of rampant in my family.

So we talk about this topic all the time. But with that said, you know, when my dad got sick, that was a surprise to us because he was never diagnosed with diabetes. So what demographic is the most impacted by insulin resistance because sometimes it can sneak up on you.

Matty Lansdown: Yeah, that, that’s a really good question because I remember as a teenager I was really into sport and, and doing different things, and so I remember distinctly the first marathon runner that was diagnosed publicly and it was on the news and it was like, “What?!” It was the first realization that somebody that wasn’t overweight and that was actually deemed as, you know, super healthy was actually diagnosed. And so that, as we sort of touched on briefly, it’s not necessarily proportional to body weight or body image. We can actually have people that are visibly skinny, that are, that are diagnosed with diabetes. And so the demographic, well, we’re getting to a point where all demographics are vulnerable to this because fundamentally it’s an access to food issue. Which is most cheap food is, and therefore lower socioeconomic people are probably more susceptible. However, the privilege and abundance that maybe all of us here have accessibility to equally is full of sugar and unhelpful carbohydrates and that type of thing. So it’s pretty much across the board with a bit of a leaning to the lower socio demographics because the other thing about unhelpful foods that are high in sugar, high in refined grains and carbohydrates is that they’re exceptionally cheap.

And so when people go to the supermarket, obviously they’re trying to make, you know, get as much bang for their buck when they spend. And so all the things that go into the shopping cart, everything’s in a bag, a box, or a can. It’s heavily processed. It’s often had the protein removed. And all of this, these synthetic chemicals and, and sugars added into it for flavor and experience and craving. And there’s a whole other layer of the conversation where companies put people’s heads in MRI machines to study their addiction response to their foods so they can make their foods more addictive. And so we’re just on this cycle of being addicted to foods that are not nutritionally fulfilling, but we crave more of. Which are just all sugar, fills the blood up with sugar we eat too often because we’re not getting enough protein and it’s just this cycle. And so I—and especially, we’re moving towards one in three people having it. Like it’s across the board, like everyone, whether you have abundant access to food and you can choose whatever you like, still plenty of sugar and carbohydrates that are unhelpful. And if you’re restricted by finance, then you’re almost restricted to an exclusive carbohydrate diet, unfortunately.

Dr. Amy Moore: Yeah, so interesting that PCOS, polycystic ovarian syndrome, is frequently associated with insulin resistance. And I know in my thirties I had PCOS. I was diagnosed with, with insulin resistance at the same time and handed my prescription for Metformin or Glucophage. I was given zero education from my physician at the time about what that mean. Just “Here’s your prescription.” Right? And so why do we see those two associated and what do we need to do instead of just taking our prescription for metformin to the pharmacy?

Matty Lansdown: Yeah, that’s a really good question. And it’s not often that people draw those parallels because the way that I describe PCOS is literally diabetes of the ovaries.

So diabetes is toxic because it’s sugar in the blood and the blood is everywhere. Literally, it’s one of the diseases that affects every single organ limb, every layer of your entire being that the blood goes toxic blood sugar can damage. And so it’s exactly the same for ovaries. So PCOS is often an an early sign of like, “Well, we’ve got diabetes in this area of the body.”

It’s possible that in the future it’s gonna expand if we don’t make any changes. And so, and I’ve actually had, I’ve worked with a number of women that we’ve been able to take them completely off Metformin, focusing on what would otherwise be classified as maybe a diabetic diet and trying to reverse that. So, every organ in the body can be negatively affected. You can have cirrhosis of the liver, you can have, you know, the kidneys fall apart because the filtering they do of the sugar get those systems just get so burnt out because they’re doing so much work all of the time and they never have a break. Which is why I guess intimate fasting is a useful tool for many people as well to give some of their organs that are so burnt out, like the pancreas and the kidneys, a bit of a breather to recover and be like, all right, we’ve actually got a few hours off here. We can sort of focus on fixing ourselves before we go back to whatever’s coming in the next meal. So it’s the same with PCOS. It’s yeah, it’s essentially diabetes of the ovaries.

Dr. Amy Moore: Fascinating. I have never heard it described like that, but it makes so much sense because it was kind of a chicken or the egg scenario in my mind. Does the PCOS cause the insulin resistance or is it the other way around? And so what I’m hearing you say is the, I mean the blood sugar issue is creating it.

Matty Lansdown: Yeah. Yeah.

Dr. Amy Moore: Okay. So going back to your analogy, and you can use either the bouncer in the bar or the train analogy, whichever one you like best. Talk to us a little bit about what happens when we’re eating constantly and why reducing the number of times we eat during the day can actually be beneficial or intermittent fasting, or just make that connection for us in that visual.

Matty Lansdown: Yeah, sure. So basically when we’re eating all of the time our, so if we think about our gut, and I refer to it as gums to bum. So that whole system of gums to bum, if that’s switched on all of the time, that’s a significant portion of your body that’s working, that’s having to do work that’s requiring blood supply, enzymes, acids, all of the resources that you’ve got in your body. Which, and a really clear indication of your body doing that is if you think about when you finish Thanksgiving dinner or Christmas dinner and you basically wanna pass out. It’s because your gastrointestinal system is doing all of the work on this massive amount of food.

Now, if we break that up into a normal day, we’re essentially using that same amount of energy, but across the entire day because we’re eating. And actually, a study, it’s 2021 study now, but it was that they discovered that in America in this study, that the average American was eating six to 11 times a day. And so when we are eating that often, we are not actually switching off this massive system that requires so many resources in order for us to be able to digest the food, pull the nutrition out of it, and do all the things that our gut is meant to do. And so when we’ve got that system sucking our resources, we have brain fog, we can’t focus on things, it’s more difficult to do activities and movement and go to the gym and yoga and that kind of thing. It’s really difficult to manage our emotions and the way we react or the way that we might navigate difficult situations or stress because just simply our system is using the resources elsewhere. And so what we need to do in an ideal world and ideally we’re in an ideal world ‘cause we’re in the Western world. And so what we need to do is start reducing the amount of times that we eat. So we all went through that chapter of like the eighties and nineties where it was eat six times a day to keep your metabolism up. And so we know now that that is, that was, that that advice was built on the idea of maintaining somebody’s metabolism. Because the belief was, if you let your metabolism drop, you wouldn’t keep it up. Which in theory is a good theory, but unfortunately, we’ve seen the world over the last generation become sicker, more obese, more diabetes, more cancer. And so we know now from that that that’s not really great advice. And so what we need to do is go back to maybe what we were doing in like the fifties and before that. And if you ever see a photo of people on the beach or in the fifties or the sixties or the seventies, it’s really difficult to find a photo of a group of people and there’s an overweight person. And so they’re often, often when we look at our photos of our parents back in the day or our grandparents we’re like, “Whoa! You’re chiseled, Grandpa! Like, you look really good!” And for us in this generation, that’s not gonna be a thing because we have so much food going into our bodies all of the time. And so from there we need to start sort of scaling back our meals. But the thing is, if you just scale back at your meals, your meal frequency, without changing the contents of the meal, you’re gonna fall back into the same patterns because currently those meals are causing cravings and leading to you wanting the next meal. So when we eat the first time of the day, basically our blood sugar goes up because we’ve just introduced sugar to the body. The insulin comes out and it puts it in storage. From there, it should go back down to baseline. And one of the interesting things about the advice that we are given, in the context of having diabetes or managing our blood sugar, is it’s like, “carry lollies or chocolates with you. As soon as you feel a little bit faint or a little bit wobbly, have a chocolate or have a jelly bean and we’ll get the insulin and blood sugar back up.” In my mind, we’re actually trying to default to the wrong side of the threshold where we need to—we need to get used to actually getting on the other side of feeling faint and feeling those wobbles. And yes, that does mean that there’s gonna be a couple of weeks of readjustment and managing that transition, but we actually want to get used to the other end of the spectrum, which is that, “my blood sugar’s low and that’s a good thing. Because insulin is low and that’s a good thing.” And so we only want those spikes to happen when we’ve actually got food in the system. And so we wanna reduce the amount of times that we do that. Not necessarily to zero. We don’t necessarily wanna water fast for the rest of our life ‘cause that’s got a hundred percent death rate. So let’s not do that. But we need to start putting space in between these. And as well, it’s important to acknowledge that trying to put space in the beginning. Don’t just rip out all of your snacks overnight. Because in three or four days you’ll be like, “Oh my God, my cravings are like, I’m so hungry, I miss all of this food.” We need to do a thing I call “one tweak a week,” which is we need to make one small change and then we need the body to adapt to that. And we need another small change and the body to adapt to that. And sure it’s not sexy and amazing on a clickbaity sales title, but we have to do it over a long period of time so that you don’t feel faint, so that you are not overwhelmed, so that you don’t dive headfirst into a pizza because you have had all of the good stuff ripped out of your life. Like we need to do it really slowly over time so we can reverse this.

Because if you remember I said takes 13 years for us to develop that full diabetes diagnosis anyway, so we need to—we’ve walked up the problem mountain and we’re at the top and it took 13 years to walk up. So, we actually need to walk down slowly rather than jump off the cliff.

Sandy Zamalis: So, my niece is type one, so like we’re constantly checking hypo versus hyper glycemic for her. And that’s a whole different ballgame from what you’re describing where you really don’t wanna be low. Lows are bad too for people with type one. So I wanted to make sure we put that out in the podcast.

Matty Lansdown: Yes, thank you.

Sandy Zamalis: But when we’re talking type two or pre-diabetic, when we still have control over those highs and lows, I know for me, you know, I always thought like we’re supposed to keep it even, right? Like you’re trying to avoid the big spikes. Way up, way down. But we can keep it even, which I think in my head was why you’re supposed to eat like every two hours or something like, so you don’t, you avoid those spikes. So what does it look like, from what you’re describing when you’re trying to retrain your system into how to eat and when to eat and how often, what does that look like for your clients or what do you advise?

Matty Lansdown: Yeah, thanks so much for clarifying. This whole conversation is definitely about type two diabetes mellitus, for sure. Type one is very different. Very different. So basically what I would start for most people is that everyone I’ve ever worked with diabetes or not, overweight or not, there seems to be a common thing across the Western world, which is that there’s a deficiency in protein. And this comes from simply the original food pyramid in 1977 with the biggest suggestion on there was grains, rices, cereals. And so we’ve gone, you know, almost two generations of people that have been advised to focus on carbohydrate-rich foods. And there’s a load of reasons for that as to why that came to be. There’s another rabbit hole. Matty-ruins-everything episode. But basically we we’re at a place now where, you know, cereal for breakfast is normal, a muffin and coffee for morning tea is normal. A sandwich or a focaccia or a roll for lunch is normal. Then everybody has their 3 p.m. slump and that’s created because of all the decisions we just made. And so we have the slump and so we go to the cafe. We might get a cake or a croissant or something. And then we go home. We swing on the door of the fridge before dinner, as soon as we walk in the door.

And so we’ve got all of these hits. And if you, if you listen to all the foods I mentioned, they’re all refined carbohydrates. And sure there might be some protein in the middle, but if we think from a business perspective that it actually costs 10 times the amount to farm protein, and therefore for businesses that sell food, it also costs more for them to acquire protein.

So from a business perspective, it makes sense that we have a reduction in protein in a lot of the things that we’re selling, which you could also argue the big plant-based movement is actually like a, we don’t have to sell, you know, farm-grown protein anymore cause it’s too expensive. Anyway, another day. So the—but the point is here that we’re just so used to consuming six times a day at least, carbohydrate-rich foods. And so the blood sugar and insulin is going up and down, up and down, up and down to the point it just stays stuck, which is when we’ve got diabetes, right? We’re just stuck at the top. And when we’re—the other thing is when we’ve got high insulin, and if we haven’t eaten recently, it causes cravings because the insulin needs a job to do. It’s like, “Hey, I’m here to get rid of the blood sugar, but you haven’t eaten for two hours.” Like we—and that literally drives cravings. So what we need to do is we need to look at protein in the diet. And so it’s important to know, and this is like this will change people’s diets, what you put in first will be what you crave for the rest of the day.

And so the first thing that you put in your mouth in the morning is where you need to start. It’s before the coffee, before everything. It’s like we need to put protein in first. And yet, I know it’s weird. Steak for breakfast is very strange, but actually——

Sandy Zamalis: I think that’s sounds delicious.

Matty Lansdown: Yeah. I do it all the time. I love it. I love it. I love it. But we need to put protein in first and not protein powders. Like we need, like—which are useful and got their utility. But if we’re really trying to—we’re talking about people that got diabetes or pre-diabetes or really trying to reverse the situation, we wanna put real whole real food protein sources in steak, chicken, you know, that kind of thing in the morning as the first thing, or whenever you break the fast.

Sandy Zamalis: What about eggs? I know eggs has been like, you know, the, you know, the one ingredient that has hit every single fad diet of either it’s terrible cuz it’s too high in cholesterol or it’s great. Are eggs, a good source of protein?

Matty Lansdown: Yeah, I think they’re fantastic. I think eggs are totally fantastic and yeah, they’ve gone terrible, great. Terrible, great. Terrible, great. And I think we could have another podcast talking about cholesterol, because I think that’s also like diabetes being miscategorized. I often describe cholesterol as blaming the firefighters for being at the fire. Cholesterol like is 80 to 90% of your cholesterol is created by the liver. If you pull it outta the diet, the liver will up-regulate it. If you add heaps into the diet, your liver will down-regulate it. So I’ve watched my grandmother for my entire life talk about cholesterol and pick food off the table and be like, I can’t have this. I’ve gotta have this. And she’s never solved her cholesterol problem ever.

Her numbers have never changed despite taking all the statins. And it’s important to note too: Statins are the highest-grossing drug of all time. They’ve made a trillion dollars. A trillion. So yeah, don’t, no need to worry about cholesterol eating steak for breakfast, in my personal opinion.

Dr. Amy Moore: I would love to have you back to talk about cholesterol ‘cause we’re, my husband and I, are big fans of Malcolm Kendrick and the Great Cholesterol Con and Peter Atilla and yeah, we’re on board there with not being afraid of a little cholesterol.

Matty Lansdown: Yes.

Dr. Amy Moore: And that there are other risk factors that we have to look at, when we’re——

Sandy Zamalis: Well, the brain cholesterol, right?

Dr. Amy Moore: Absolutely. Every in your body needs cholesterol. Absolutely. Okay, so I wanna go back just a little bit and clarify what is happening. All right, so like, let’s use your train analogy of you’re stuffing all the blood sugar into the cells. The insulin guy is, that’s his job to stuff all the blood sugar into the cells. And so if we wait to eat, that gives our body time for the insulin to get rid of some of the glucose in the cells, right?

Matty Lansdown: Yeah.

Dr. Amy Moore But if we keep eating, then it doesn’t have time to do that. Right? So then it just backs up. It just makes the line on the on the train platform longer

Matty Lansdown: Yes. And the line on the train platform becomes toxic.

Dr. Amy Moore: Ah. Right.

Matty Lansdown: Because those customers that didn’t get on the train get angry, they start yelling, they start just ruining the joint. And that’s basically what happens with the blood sugar being toxic, which is why it can put people into comas and lead to blindness and all of these things. Because it can’t stay in the blood for long.

Dr. Amy Moore: So it has to be in the cells before it can be eradicated from the body. It can’t just float around freely.

Matty Lansdown: Yeah, the glucose should be put into the cells in order to be used as energy in order to be stored as fat. Because like having stored body fat is not a bad thing, it’s just about the amount of it. So yeah, we obviously want to eat these things for energy, but we also get energy from fats and from protein and different things. It’s hard to get energy from protein, but we can still do it. And the body and the liver can actually make energy and turn fat back into sugar. In situations where it needs it as well, which is what happens when we are fasting. So even when the platform is totally empty, we can actually pull some people out of the trains if we need to, which is our fat stores. So it’s accessible in the other direction too. But only if we’ve got allowed enough space between meals. And I guess the time that most people would do that is when they’re asleep, that that process would start happening. We’d start reducing the pressure on the cell. The insulin levels could go down, the pancreas could actually stop releasing insulin for a change because it’s been doing it for so many years. And that’s what we want. We want these fluctuations of on and off and our body to be able to go back and forth because that it’s kind of like a—if you think about it as a lever or a lever. It’s like if that lever being rusted on one side and not it’s, it’s meant to come back, but we can’t pull it back because it’s been stuck in insulin release for constant blood sugar supply through the diet, eating 10 times a day for 20 years, and it’s just stuck. And so it takes a little bit to loosen it and to unrust it and slowly pull it back the other way. And then we should be doing that between our meals.

Dr. Amy Moore: So talk to us about keto and your thoughts on the keto diet for kind of reversing insulin resistance and pre-diabetes or trying to hold it at bay. What are your thoughts on that?

Matty Lansdown: Yeah, I think we’re at a point in the nutrition world and the Instagram world where keto, the word keto has been hijacked by marketers everywhere. I’m in a very healthy city. Melbourne’s got lots of health stores and now everything’s a keto friendly. It’s really not. It’s really not. It’s just the market. Like keto cookies are not a good idea. They’re just cookies. Like, and that’s okay. It’s okay to eat cookies. But, you know, I just think the word keto has been totally hijacked. But if we talk about it in its clinical nutrition setting, I think it’s a really good tool for people that need a rapid response. It’s a very good therapeutic tool in a cancer setting, also a diabetes setting and a number of other diagnostic situations. But it’s really good because we basically we reverse that situation of the blood sugar rapidly. However, it does mean that there’s a thing called “the keto flu.” And that is all of the wobbles and the fainting and all of that stuff happens really full on and it doesn’t feel good. So I sort of, I lean more towards the generally low carb but progressively over time so we can kind of slowly walk into that space. However, I’ve had, you know, cancer patients that are like, I really need to do something today because I’m on my third relapse and like I’ve decided that nutrition might be helpful. And so, you know, some extreme situations require rapid ketosis. But I think it’s a good diet. Clinically, it shouldn’t be done forever. I think the reality is that we live in a world where carbohydrates are accessible, and unless you are one of those evil wizards that can never eat a carbohydrate again, then you’re a human. And so we’ve got a factor in your body’s ability to do that because going too long without consuming carbohydrate can lead to a thing called carbohydrate resistance. And you have literally one piece of bread and you want to take a nap for three days because your body is like, it’s effectively that lever, we’ve rusted it in the other direction. So yeah, I think a healthy person, or when we progress towards health, we should be—it’s called metabolic flexibility. We go between burning fat, burning sugar, burning fat, burning sugar, and we just go back and forth. And intermittent fasting allows us to do that. So I think keto is good. The general aim should be low carb, I believe, especially for women. There’s a lot of good research and a lot of books that have been written about the benefit, hormonally speaking, and especially the transition through perimenopause with carbohydrates. So for the women that I work with, it might technically be like maybe we start with a keto breakfast, but dinner always includes some carbohydrates like we all, every single day. Because it’s just so important to nurture those hormones and the stress response. And most people have been living long, stressful lives with kids and jobs and that kind of thing. So there’s, it’s a multi-dimensional kind of answer, I guess to, you know, each individual. But as a standalone, the keto is a good place to start. But I’m always thinking about the psychology of it because you can jump into keto and have a fantastic weight loss diabetic reversal situation, but if you haven’t dealt with your behaviors and your emotions that drive—that originally drove the snacking habit that you had in the beginning, then it’ll just be another yo-yo diet you go on. I’ve spoken to so many people and worked with so many people that have jumped into my emotional eating program because they’re like, “I know how to do it. I’ve lost the same amount of weight 15 times over the last 30 years.” Right? And so we also have to manage the psychology. So jumping in, that’s why I’m big on one tweak a week, because if we jump in rapidly, yeah, we’ll feel great for two weeks, but there’ll be all of these parts of ourselves, emotionally and psychologically that are like, I don’t feel safe. This is strange. Where’s the chocolate? The chocolate gave me comfort. Whatever the story is, you know? And so I think it’s, yeah, a good practitioner is managing the psychology of the situation and the diet.

Dr. Amy Moore: So for those people who are all-or-nothing, black-and-white thinkers and are ready to jump in, in order to have that metabolic flexibility that you were talking about, let’s say you wanna go all in with keto, you can push through that keto flu for that week. How long would you recommend staying on keto before you take a break? And then how long should that break be before you go back on keto?

Matty Lansdown: Yeah, so as a really general answer, so everyone’s metabolism and body and life is different. And so I’ve worked with people where we can do it six days a week, and then we have one day where it’s like, you know, we go out for brunch and have carbohydrates kind of thing. I’ve worked with people that can do it for three months before they need to throw a bit of a curve ball into the mix. So it really is up to the individual. I mean, generally I think one to two, three months is, is pretty good. But it’s really important that we cycle back and include, you know, carbohydrates again. But once we’re there and once we’re starting to really see the results we want, we wanna move back to basically a daily situation of, you know, maybe you wake up, you’re in a fasted state, so naturally you’ll be a bit more ketotic in the morning, which is how we should all wake up assuming that we don’t have our body full of sugar from the night before. And then so we all should wake up into ketosis. And then if we eat protein and fat, or even just protein for breakfast, we should stay in ketosis for most of the day. And then when we come to dinnertime, we pick carbohydrates that we know work for our body, work for our digestion, and don’t totally knock us out. I notice from working with people over the last few years that sweet potato is often a trigger food. So when we include it in dinner, it’s delicious and amazing, and it’s a vegetable, but it’s one of the foods that actually triggers then the hunt for chocolate or the hunt for ice cream. So we have to identify those carbohydrates in our diet. So, I think, yeah, initially, we need to figure out for you what works. It might be up to three months, it might be one month, it might be a couple of weeks before we need to cycle back. The other thing to remember is that the human body is an adaptation machine, which is amazing because otherwise we’d all be 1 billion kilograms, because we would never have adapted to the diet that we’re on. So the same thing happens in the other direction. It’s that when we go between diets, we adapt to the diet, and that’s what everybody knows as the plateau, the really frustrating weight-loss plateau. And so that’s actually your body’s intelligence trying to keep the reserves here for some devastating famine that’s coming. So, the same thing’s gonna happen on keto. You’re gonna have a plateau. Your body will adapt to it. So it’s the same reason we need to cycle back and forth and the more often we can cycle back and forth, generally speaking, the more we’ll keep the adaptation mechanism guessing and not adapting. So we’ll continue to sort of find the benefits. The unsexy thing about that is that there’s some weight loss and there’s a little bit of weight gain. There’s a bit of weight loss, there’s a little bit, but we progressively moved down over time.

Sandy Zamalis: I’m one of those people where like, I’ll forget to eat. Right? That which, you know, is not necessarily fasting when you forget to eat.

Dr. Amy Moore: Cause it wasn’t intentional, right?

Sandy Zamalis: Right. But I also—

Dr. Amy Moore: You can count it, Sandy! You can count it! God fasted for the last 12 hours.

Sandy Zamalis: So the funny part to me, like I’ve never been able to wrap my brain around intermittent fasting because I, like you just described it, that’s me. Like when I do that, I feel like I end up gaining weight. It’s like my body’s like, “Hold up, she’s starving! Gotta hold on!” So every morsel. And I do better when I’m doing something like a paleo or a keto or, but I’m eating, you know, in normal, you know, healthy increments throughout the day without any big, long pause. Do you have any recommendations for that? I know that’s all in my head about the “Hold on!” but that’s what it feels like to me.

Matty Lansdown: No, no. It’s not in your head at all. There’s definitely some people that benefit from maintaining. So I find that most people, when we start looking at what their eating schedule looks like, they’re approximately 12/12. And what that means is that they’ve got about 12 hours of fasting and they have their first coffee and breakfast at approximately 7 a.m. They have dinner at 7 p.m. and it’s approximately 12/12. And so some people, like if we try and do 16/8, say, so 16 hours of fasting, that might just throw them out completely. And so one of the best things that we can do for people just like you, Sandy, is maintain what works for you. But it’s really about the nutrition quality and then removing the snacks in between. So there’s only three reasons that we should ever need a snack. One, our diet’s deficient in protein, and the other two, which are kind of the same, is that we’re emotionally eating or we’ve got a sugar addiction. And so, yeah, which is like the reason the diabetes exists basically. And so, so we have to, yeah, still do the 12/12 or whatever it is for you, if that feels like it holds good structure and health and wellness and, and benefits in your life. And then it’s just about focusing on how can I get the most out of this meal? What do I need to put into it? And where are the other meals or snacks in my day that I can pull out? Because we can have little dips into that fasting window, which is technically what we should do between breakfast and lunch and lunch and dinner. It should be a dip into that fasted state, which instead of a dip into overwhelming hunger, which is something that we’ve often programmed into ourselves by the food choices we’ve made.

Dr. Amy Moore: You said no snacks. Is that what I heard you say? No snacks?

Matty Lansdown: Yeah, so, but you wanna start with, with removing one at a time. So, and that’s the idea is that we’re trying to get as much of the fasting benefit as we can without moving the structure that an individual finds beneficial. So instead of eating, four or five or six times a day, it’s like, no, we’re gonna commit to three times a day. Or for some people two, I eat, I eat pretty much two times a day. And there’s just nothing in between. And so if we get the nutrition right and we’re also able to manage any emotions that come up that would drive sugar cravings, then it’s actually no problem. We get all the benefits from the fasting and actually as the deeper we get into the fasting, the more focused we are, the more efficient. But this is, this is obviously after, you know, we’ve dealt with all of the stuff in the beginning. This is sort of getting into that more optimal state at the other end of the process.

Sandy Zamalis: So Amy and I are coffee addicts. So my question was to go back to the breakfast question that you had set up right, where you’re like, have your coffee and your morning breakfast. My Achilles heel is that I’ll have my coffee alone and then that can—without any kind of protein at all. And then that just throws me off for, and then I’m not hungry because I just had, you know, two cups of coffee.

Dr. Amy Moore: What Sandy isn’t saying is that she sweetens her coffee.

Sandy Zamalis: I do that too.

Dr. Amy Moore: I just put heavy cream in my coffee so that it kind of mimics that fasting state.

Matty Lansdown: Mm-hmm. Yeah. So I mean …

Dr. Amy Moore: (laughing) I’m not trying to one-up you, Sandy. I’m sorry. That was terrible.

Sandy Zamalis: (laughing) I’ll own it.

Matty Lansdown: It’s normal. It’s normal, right? That’s why we’re talking about it, is that we’ve gotta figure out what’s going on here right?

Sandy Zamalis: I will say before you, just to finish up, my husband does the same thing and he does just black coffee, and he’ll do the same thing. Like it’ll just override his metabolism. He won’t eat until way later. But I can’t think that that’s good. Sorry, Matty. Go for it.

Matty Lansdown: Yeah. Well, I mean, first and foremost it’s like, what is good and it’s gonna look different for everybody, right? And that’s the kind of frustrating thing. It’s like when everybody listening wants a definitive answer, and then Matty’s like, “Well, it depends on you.” And like, and it’s like, “Oh, that, that wasn’t the answer I wanted.” And the reality is that if we’re gonna get your health and wellness right, and you’re in a situation that’s problematic, you really want a customized approach because there’s some bad stuff that possibly eventuates if we don’t get that right. So good looks different for everybody, but there’s also, in the fasting world, there’s clean and dirty fasting. And so dirty fasting is the idea that we don’t raise our blood sugar, so we still put foods in. There might be zero calorie or whatever. The calorie number is irrelevant. If you’re putting nutrition into your body, it has an impact. It doesn’t matter how many calories are in it. So if you’re putting coffee in and it’s a zero calorie coffee or a zero calorie drink, it doesn’t matter. Your gut has to switch on and it has to transfer that nutrient from the gut into the blood. So that’s—we’re ending the fast there. But it’s called a dirty fast because we’re basically not spiking insulin. So that’s the dirty fast and you can still classify yourself as fasting. I’m more of a purist because I think there are so many more benefits than just managing our blood sugar. However, I think a dirty fast is a good transition because we can get a lot of gut health and immune benefits and brain health benefits from actually keeping ourself in a properly fasted state. Because as soon as we put that zero-calorie drink in, the fast is technically over. The system has switched on, we’ve gotta do some work. Or we’ve taken some supplements or something or medications the gut has to switch on. So all the benefits that we were getting in our gastrointestinal tract have been stopped for now.

So I’m a very much like want to clean fast to get all the body benefits, but the dirty fast is a good transition in between. And so the other thing too is, often what I find is reverse dieting is needed. And what I mean by that is that people have adapted their life over many years to drinking the coffee in the morning. And so as soon as we do add in any nutrition, then they need—then they start gaining weight and they’re like, “Oh my God! What’s going on? Like, I’m going back to just drinking a coffee.” They wouldn’t have talked to me in the beginning if just drinking the coffee produced the body that they were happy with, right? So we actually need to do some uncomfortable reverse dieting, which is basically training the body back into a normal frequency of nutrition before we can go back the other way. A lot of bodybuilders do reverse dieting, but also, if you’re the kind of person that has been smashing the gym, eating salads that are predominantly spinach leaves and not much else, and you’re like, “Why aren’t I losing weight?” You’ve adapted your current body to a really limited nutrition supply. And so then whenever you go back to normal, add some other meals in, you are gaining weight. And how frustrating because you’re doing all of this to lose weight. So we have to reverse diet that person in order to train their body, to trust the nutrition supply, to not grab onto every molecule that comes into their body desperately and put into storage before we can actually then go back in the other direction. And it’s a commitment over time. But again, these problems weren’t created overnight. So we actually have to think, “Well, it took me 20 years to get here. It’s probably at least gonna take me one to walk down the other side of the mountain.”

Dr. Amy Moore: Yeah. Okay. Sandy, we need to take a break, let you read a word from our sponsor, and then when we come back—I can’t believe we’ve already been talking almost an hour—we need to let Matty tell our listeners how they can find him, how they can work with him, all of that good stuff when we come back.

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Dr. Amy Moore: And we are back talking to the amazing Matty Lansdown about insulin resistance and prediabetes, and a little bit of intermittent fasting and keto and all the stuff that everybody’s uncomfortable hearing but needs to know. Matty, talk to us about how our listeners can find more of you.

Matty Lansdown: Yeah, sure. So I also have a podcast and Amy’s been on the podcast with a fantastic episode. It’s called ‘How to Not Get Sick and Die.’ We’re very to the point. So come and hang out there. We try and make all of the health and wellness things fun and laughable, and entertaining. Also my website, And I also have a Facebook group called The Healthy Mums Collective. So if you’re a mom and you’re wanting to manage your emotional eating or lose weight or gut health or any of that kind of stuff, or anything we’ve been talking about today, we’ve had lots of diabetics through, come and join the group and answer the questions and let’s hang out.

Dr. Amy Moore: And then do you do one-on-one coaching too?

Matty Lansdown: Yeah. Yep. So I’ve got group programs and one-on-one programs. So, yeah, feel free to come through any of those mediums and chat with me. And if you need support and help or it you’ve got diabetes and you wanna know what to do, like yeah, feel free to reach out.

Dr. Amy Moore: And where can we find you on social media?

Matty Lansdown: Well, I just started another Instagram, so I’m Matty.Lansdown and there’s no posts there. And I think I’ve got three followers and one of them is my mom, so that’s pretty exciting. So I did have an Instagram account that got de-platformed, another rabbit hole for another day, but feel free to follow me there. And aside from that, yeah, just the Facebook group, Healthy Mums Collective.

Dr. Amy Moore: All right, fantastic. Is there anything that you wanna leave us with that you haven’t gotten to say?

Matty Lansdown: Oh, well, I’ve got 250 podcast episodes, so I have a lot to say, but … I’m just grateful for this opportunity. I appreciate your time, Sandy and Amy and I love hanging out and it’s, you know, just feels like we’re kind of old friends, which is nice. And so, yeah, I’m grateful to be here and everybody that’s listening, thanks for hanging out and putting up with me.

Dr. Amy Moore: Oh, it’s been great. I’m so excited that you came back and talked to us about something that was personal to both of us and. You know, we like to, we like to talk about topics that will reach the most amount of people who need to hear it, but then we also want people to know that we’re in the trenches too, right? Like, we’re in there, we understand this plight, you know, we’re struggling with this kind of stuff too and so it makes it that much sweeter, right, to bring it to our listeners.

Matty Lansdown: I think it’s easy for people to, that listen to podcasts and look at, you know, people that are doing this kind of work as, you know, these god-like creatures. And it’s like, no, we’re all just humans having human experiences and we struggle to, and we’ve got challenges as well. So, it’s good to be able to connect with people and say, “Hey, we’re humans. You are humans. Like, let’s just figure this out together.”

Dr. Amy Moore: Absolutely. And we didn’t, we didn’t talk about your history on this episode because you, you talked about it in our last episode, but I mean, you struggled too, right? Like you came into this entire field of nutrition because you wanted to get healthy yourself. Right? And so, yeah, you get it.

Matty Lansdown: Totally. Totally. Yeah. It was a combination of my own stuff with emotional eating and trauma and that kind of thing, but also working in the cancer hospital and seeing also diabetic patients, Alzheimer’s patients, all these patients just being managed, not being pointed in the direction of fixing the cause, which is, yeah, it was the real motivator for the name of the podcast. It’s like actually How to Not Get Sick and Die is pretty easy. Come and listen to my podcast.

Dr. Amy Moore: Well, we invited you on this podcast because I loved the name of your podcast, so I’m like, I gotta meet this guy. So, and look where we are today.

Matty Lansdown: Here we are.

Dr. Amy Moore: Absolutely. So listeners, thank you so much for being with us today. If you liked our show, we would love it if you would leave us a five-star rating or and review on Apple Podcasts or wherever you get your podcasts. If you would like to be on our show, you can visit us at our new website, You can find us on every social media channel at The Brainy Moms. So, go there and follow. Wherever that is. Also, you can find Sandy on TikTok at, she is The Brain Trainer Lady and she has an amazing following with lots of cool videos so that you can learn how to get help for struggling cognition learning at any age. So look, until next time, we know that you’re busy moms. And we’re busy moms, so we’re out.