Introducing Diabetes Expert Ben Zeal

Philip Pape 0:01

If you're avoiding carbs because you're afraid of blood sugar spikes , you're training fasted because someone said it burns more fat , or you think insulin is a problem , is the enemy of fat loss , but you're still dealing with energy crashes , inconsistent performance , you don't have the fat loss results you want for the effort you're putting in , then this episode is for you . Today , my guest , who has been managing type 1 diabetes for 25 years , has learned a lot about metabolism , insulin and body composition , and he is going to clarify some of those topics carb timing , insulin sensitivity , fat loss that the industry often gets wrong . So listen in tune in , because you're going to learn a ton about blood sugar , carbs and fasting that will help you focus your efforts to optimize your metabolism and finally get the results you want . Will help you focus your efforts to optimize your metabolism and finally get the results you want . Welcome to Wits and Weights , the show that helps you build a strong , healthy physique using evidence , engineering and efficiency . I'm your host , philip Pape , and today we're going to discuss how someone living with type 1 diabetes has developed strategies that are going to help you help everyone when it comes to building muscle , optimizing health . Some of these are going to be counterintuitive . Yes , we're going to get into carbs and blood sugar and some of the hot topics , because they are important .

Philip Pape 1:15

My guest is Ben Zeal , a registered dietitian , certified diabetes educator and certified strength coach , who was diagnosed with type 1 diabetes at age 7 .

Philip Pape 1:25

And rather than letting this limit him , he's built a successful practice called your Diabetes Insider and helps thousands of people with diabetes live unrestricted lives while maintaining excellent blood sugar control , which is an amazing thing , because I definitely get that sense of frustration and sometimes hopelessness from individuals who feel like their medical history and their genetics are holding them back in some way . Ben's got over 25 years of personal experience , advanced credentials in nutrition and strength training . He's tested every approach , from high carb to low carb to intermittent fasting , and it's developed a hybrid approach that optimizes muscle building and glycemic control . Developed a hybrid approach that optimizes muscle building and glycemic control . So today I think you're going to learn a lot about myths like CGMs how useful are they , how to use them , how to navigate the carb confusion based on the evidence . His tips on building muscle while managing blood sugar to help you go after gains whether you have diabetes or not . With that , ben , welcome to the show .

Ben Tzeel 2:24

I am so excited to be here and that was honestly the nicest intro anyone's ever done , so thank you .

Philip Pape 2:29

Well , I appreciate that man and it's well-deserved . We were talking before , we were recording how we connected and we haven't had someone talk about diabetes specifically on the show , especially who has lived it . There is a lifter out there . She's called the Canadian Forklift . You know Jessica Bittner , which I'd love to have .

Ben Tzeel 2:46

I don't know , I don't know . I know who she is and she's . I mean , my God , I'm like I would love to be just in remotely that stratosphere . Yeah .

Philip Pape 2:54

Yeah , yeah , no , but it's inspired because , like in our Facebook group , when I hear from clients no , mainly people who haven't worked with me yet and you'll hear that sense of like , well , because I have diabetes , I can't X , y , z and I want to bust some of those today with you . So let's get into it . Let's start with blood sugar in general , because there's some science and mechanisms behind this , how the body

Understanding Blood Sugar Fundamentals

Philip Pape 3:14

works , and I guess I would say if there's one thing everyone could understand about blood sugar , what would that be ?

Ben Tzeel 3:20

Oh man , this is such a good question too . I feel like it's tough right , because I feel like , as a person with diabetes , it's obviously a different perspective , because I'm over here thinking , well , I have to stay in range , or at least relatively in range the majority of the time , but someone without diabetes , you've got all the hysteria but the fascination with what's my glucose right now . So the biggest thing is to not overreact to the blips that you see with blood sugars , and a perfect example of this would be I one time it was probably three , four years ago went out to breakfast with one of my friends . He was a dietician as well and he doesn't have diabetes , and so I figured you know what , let's see what happens . You're wearing a CGM , you got a CGM from your healthcare provider , whoever it was . Let's compare , let's eat the same pancakes , let's see what happens .

Ben Tzeel 4:02

And it was hilarious . Of course , as a person with diabetes , I'm going to see more of a rise just because it was carbs and it was a good amount . These were chocolate chip pancakes that we didn't hold back , we had just lifted , and my blood sugar went up probably 160 , 170 . His blood sugar I absolutely I cannot make this up 94 . He went from like 85 to 94 . And he's oh my God , I went up nine points and I'm thinking , man , I would love to go up nine points eating some chocolate chip pancakes . So I think a lot of people , especially without diabetes , they see these changes in the graph like oh my goodness , my blood sugar just spiked . But you have to really put it in perspective . Was it a substantial enough spike to really warrant any sort of concern ?

Philip Pape 4:39

Yeah , no . So let's talk about that . Do people without ? So we're kind of covering two populations here , but do people have to be concerned based on the range that they sit at with a baseline , or based on the variance ? Who should even measure this ?

Ben Tzeel 4:54

Oh , it's tough . And so I think , if we're going diabetes specific first , just Google kind of , you know , parse it out Diabetes specific first , I would say it's more of the time that you are in range , right . So the standard for a Dexcom Pacific first , I would say it's more of the time that you are in range , right . So the standard for a Dexcom , which I would consider the gold standard for CGM , is typically , on default , 70 to 180 . If you tell me you're 80% , 85% in range , you're doing awesome , because as people with diabetes , you're probably not going to be 100% in range unless you're just straight up not eating or you have everything just completely perfect and all you do is diabetes in your life , which is not realistic . But for people without diabetes I would say I mean it's tough right , because yes , you want to stay in a controlled range and ideally you don't ever want to go above 130 , 140 if possible , and that would mean you ate a lot of carbs in one sitting and did not do anything to insulin sensitize yourself . So I think the biggest thing is variability matters , I think range matters , but I think time within the range , and if you don't have diabetes , the smaller the range the better , no-transcript .

Ben Tzeel 6:13

Go without food for a second . What can you do outside of food to get your body in a prime position to be able to absorb the carbs and the sugar that's within the blood , right ? And so , of course , there's two main ways the body can do it . There's insulin , right , of course , and then there's also with physical activity , using the calcium channels . You can basically do the same mechanism but not have insulin involved . So people like oh , if I take a walk after I eat , my blood sugar doesn't go as high because you've now started allowing your muscle to take up that glucose from the blood without doing anything else , and so that's what I typically refer to . So if I tell people hey , you're very active ,

Insulin Sensitivity and Physical Activity

Ben Tzeel 6:48

you're walking , you're lifting , whatever you might be doing , that's going to put you in a prime position to have a little more variability and wiggle room , so your number may not spike as high depending on what types of carbs you're eating . So that's typically my primary way , I would say , from an insulin sensitivity standpoint .

Philip Pape 7:07

Nailed it . There we go Cool , nice . So walking and lifting and muscle are some of the phrases you mentioned , and there's confusion around how that works . So I often use colloquial language here , for two reasons . One is hey , I don't know all the science at any one time out of my head , and number two is that's what people understand as analogies , right ? So the idea that the bigger your muscles , the more they can hold and store in terms of glucose , as well as the more active you are , the more you shuttle those nutrients . You talked about calcium channels , so maybe break it down when you walk . Just in that moment , what is happening ?

Ben Tzeel 7:36

So basically , in a nutshell , just imagine that there's these gates , right , and you have to have a certain molecule attached to a gate , and there's four gates or a combination lock , whichever one's easier for you to imagine , and basically you just have to turn the lock to have each of the things in the code go , you know , get open , and once you do one , two , three , four , boom , it's open and the glucose can come in . So it's that simple and at that point , because you're walking and you're in motion , these gates will stay open , they'll continue sucking up glucose into the cell , pulling it out of the blood , and that allows your blood sugar to either not rise as high or , you know , in the case of someone whose blood sugar might be already high at baseline , to bring it down .

Philip Pape 8:13

Awesome . And does being sedentary have an amplifying negative effect ? And by that I mean , is it simply ? This is an important question , right ? Is it simply not giving you the benefit of walking , or is it amplifying the worsening of that effect of not using insulin ?

Ben Tzeel 8:28

Oh man , I love these questions . These are the things that I always wish people ask , but I never get asked . So I think it's . I think it's both right .

Ben Tzeel 8:35

I think if somebody's body is used to a certain amount of activity at baseline and I've seen this in myself , I've seen this with patients all the time where , let let's say , your body's used to 8000 steps per day and today you just decided to hang out , have a lazy day , Netflix , whatever you are going to see that negative impact because your body is already used to a certain baseline and you're not even close to approaching that .

Ben Tzeel 8:56

So you might notice insulin resistance just because you're not moving , compared to your norm . So I think there's that aspect of things where you're not giving your body what it wants . You start walking , your insulin sensitivity goes back , your blood sugar goes right back in the range . It is absolutely unreal how specific that is and I've seen it with myself and many , many , many people . But I also think just that baseline in general , if you're not moving , it's not doing you any favors and that doesn't mean you need to be in perpetual motion on a treadmill or a walking pad , but I think your body really appreciates . Our bodies are meant to move right . Our body needs to stay in motion .

Philip Pape 9:28

Loves to move , loves to lift , loves to be functional and active in the world . And so , when you think of someone with diabetes like yourself , I've heard the claim and maybe it's true , right that the walking after meals is as effective , or more than metformin right Than a diabetes medication . What are your thoughts on that ? Like , how can diabetics actually can they manage to an extent where they can limit or eliminate some of their pharmacology from their lifestyle ? How important is all this for that ?

Ben Tzeel 9:54

Well , I would joke that I'm married to a pharmacist but I'm not the pharmacist so I can't answer completely right . But what I would say is , from an efficacy standpoint , walking after meals or really any sort of light activity post meal can do absolute wonders . You just can't expect it to do all of the heavy lifting metaphorically of the medication . So , for example , if someone's on insulin or if I'm on insulin and I go out to dinner and I know okay , I had a ton of carbs , I'm going to walk after this meal , it will definitely blunt the ability for my blood sugar to keep rising . But then if I walk for 10 or 15 minutes when I stop moving , if my blood sugar was going to keep going , it's going to keep going up , like it's not just going to completely stop and oh , everything's perfect now , but also it depends on the duration you're walking and a bunch of other factors .

Philip Pape 10:36

That's good to know . So it's a matter of degrees and again , that reinforces why you need to measure that when it's a concern for you and when it's not . It sounds like just being active and lifting could probably be enough . I mean , I don't measure my , I've never measured my blood glucose and I don't plan to because you know , I kind of understand the science that you're talking about

Training for Better Blood Sugar Control

Philip Pape 10:54

and I've had guests on who are big advocates for it and one of the reasons they say it's helpful for non-diabetics maybe is to see the results of your food balancing right , like when you balance your macros , or having enough protein , fats along with the carbs . How important is food balance and blood sugar management from that perspective ?

Ben Tzeel 11:14

I would say food balance , diabetes or not , food balance is going to be imperative . And , like you're saying right , if somebody's hey , my macros are being hit and I'm one of the people who's more liberal I don't care how you do it , as long as you do it . You can break the protein up and you know certain amounts , whatever fits in your life . But if you want intermittent fast , go for it . You want to be lower carb , go for it . If you hit your numbers , you hit your numbers .

Ben Tzeel 11:35

But from a blood sugar standpoint , I will say having fat and protein at meals will help with not spiking quite as high as you possibly could . But on on the flip side , there's people who and I don't advocate for this way of eating but there's people in diabetes land who will basically just eat carbs , nothing else , just carbs . No , basically no fat , basically no protein , and their blood sugars are just fine because there's no potential for anything to slow down digestion , anything to induce insulin resistance . So there's these different camps and within diabetes land too , you get the people on the low carb side . So I think everyone always asks what's the best way to eat with it , and I don't think there's necessarily a perfect method or we would all do it , but on the flip side , I think that from a food standpoint , you have to have balance within it , otherwise you're going to spike more than you want to .

Philip Pape 12:19

Okay , and then to extend that , very interesting , you talk about the like only carb approach . I feel bad for those guys because , as much as I love carbs , I got to have my protein when you're lifting . But it does bring up the restriction in the extreme camps and the reasons people do diets which are often , I'll say , flawed , and I it saddens me because if you're going to do something , it should be intentional for a purpose , and if you're doing it for the wrong purpose , then you're just shooting yourself in the foot . The big one is just cutting carbs for X , y , z , right . Cutting carbs to lose weight ? No , that's energy balance . Cutting carbs because we think it's going to cause more fat storage , that's a whole topic about , again , insulin sensitivity and the flawed hypothesis related to fat burning versus glucose . It's just two energy systems that you know . It all balances out . What are your thoughts then on someone on diabetes who doesn't quite understand this and is afraid of carbs ? What are your thoughts on that ?

Ben Tzeel 13:11

So my first thing is I give them an ice cream sundae . No , I'm totally kidding , but my thing with that is here's a pizza . First of all , pizza is like the biggest nightmare for most people with diabetes . We fix it , but something I would say is somebody who's nervous . It happens all the time because you get this dysfunctional relationship with food , because everyone says you can't have this , you can't have this , you can't have this , which does not serve anybody .

Ben Tzeel 13:32

I'm always trying to figure out . My team's always trying to figure out where does this come from ? Where does this stem from ? Was it one bad incident ? Was it one care provider early on in your diabetes career ?

Ben Tzeel 13:40

If we're going to call it that , that may have led you astray . And then , from there , how can we challenge this ? Because I'm not asking you to eat a whole pizza , but we also can't have you concerned about a bowl of Cheetos that's next to you because you're concerned about what it's going to do to your blood sugar . So at the end of the day , it's going to be hey . How can we get you to slowly break out of this comfort zone ? If it's something that you're interested , that will work for your blood sugar management ? Because , to a degree . Are carbs needed ? We could debate that and that's a fun . I love that topic in general but you don't necessarily need carbs if you live with diabetes . But a lot of people feel better , and so to me I'm like , if you can have a less restrictive life , you already have enough things going on with diabetes . Let's make it less restrictive but also be able to still balance your blood sugar . I don't see any problem with it . So slow , steady exposure , I think , will be what ultimately saves it .

Philip Pape 14:26

Yeah , and that sounds sustainable to me . Um , so then let's tie this all back to lifting , which we alluded to a little bit , but one of my favorite topics , uh , specifically your approach to training that makes the most sense for building muscle from a blood management perspective . And if the answer is look just any training approach that's effective to build muscle and strength is is all you need . But where I'm going with this is there's some , I understand , there's some science around blood sugar management , insulin sensitivity , with the training session itself , the , the stimulus , recovery , adaptation , inflammation , post-training and then the fact that you have this tissue on your frame and like is it more important to focus on neuromuscular strength versus hypertrophy ? You know like I'm giving you a lot here , but it's also a blank canvas , so go for it .

Ben Tzeel 15:14

Oh man , these are like the types of questions that make me wish that I had stuck with the PhD I was doing for a while . I was doing that before I became a dietician . I was like I'm going to go get a PhD and only study diabetes and macronutrient composition and body composition , and I would have been doing exactly what you're describing . And then I was like I'm going to be a dietician , I like people . So , that being said , with all of these questions , I would say from a training perspective , it all kind of folds into itself right , because , like you said , having more muscle at baseline ideally means more insulin sensitivity , easier for the muscle to have the ability to bring glucose into the cell . Everybody is happier that way . But at the same time , from a training perspective , if you train at all , there's potentially up to a 72-hour window of increased insulin sensitivity , depending on your level of training .

Ben Tzeel 15:56

Now , someone like me I've trained for I don't know more than half my life , so at that point I'm probably not getting a 72-hour boost , I'm probably getting it closer to a 24-hour boost , but it's still something .

Ben Tzeel 16:06

So my first step is for most people they're not doing anything . Hey , let's get you started working out with something that you like . I don't really care what it is , preferably there's resistance training a few times a week , but as you really start getting getting into the weeds , how can we get you from a hypertrophy standpoint and then some of the muscular endurance standpoint ? I think a combination of those two . It doesn't have to be perfect , doesn't be any sort of , you know , linear , undulating periodization , but something of that nature where we can get both . We get the best of both worlds , where , hey , there's going to be muscle on your frame but also you have the ability , if you decide to go , you know , do some sort of crazy 20 rep set , you can still get through it and still get the benefits from an insulin sensitivity standpoint , cause for hours later you're going to be especially the first 12 hours you're going to be more sensitive .

Philip Pape 16:48

Nice and are you an advocate of bulking cutting ? You know you prefer people to stay at maintenance and do it slowly . Does it matter ? Like it's preference ?

Ben Tzeel 16:55

I think it matters where your blood sugar control is . First , because in my mind I don't really want you doing anything crazy until I know your numbers are not going to look like the Rocky Mountains , because otherwise , at the end of the day , you know when your blood sugar is higher , everything's just is more dysfunctional because your blood literally moves slower to the body . It's like syrup instead of normal blood flow . So that's not going to help you with recovery . And then with low blood sugars you can't train . So if your blood sugar is constantly bouncing , we got to stabilize that first . Ideally , if somebody's eating too little and their metabolic rate is slow , fix that at the same time . Then say , okay , now let's go , body comp , let's go .

Fasted Training: Benefits and Trade-offs

Philip Pape 17:28

Yeah , I'm a big advocate of that as well Priming your body for success in a maintenance mode where you're not stressing it out with these other things . So once you've got that in place , tying it back to carbs , do you find people does it make a difference when folks like really throw in the carbs into their diet and they're trying to build muscle , or do you find that it's very personal ?

Ben Tzeel 17:48

I find it tends to be more energy balance focus and protein focus . But what I will say is , from a carb perspective , if you're trying to lift heavier , of course you and I both know it's going to be like rocket fuel . So you tell someone who's eating 80 grams of carbs per day oh hey , we're , we're going to slowly up at . Oh , now you're at 160 . And suddenly they're deadlifting more than they've ever done and they're feeling amazing . That's probably just a function of the carbs , but from a carb standpoint I don't really feel like it's 100% necessary , like I've done .

Ben Tzeel 18:13

Like you mentioned earlier in the intro , I've gone all the way down to 40 grams of carbs per day . I think I was eating 3,300 at maintenance and I was still lifting heavy and it was rough but I could still do it . And then , on the flip side , I've gone all the way up to close to 500 per day and it was great . Lifting was great . My blood sugars , on the other hand , not as amazing . At the time I was also in college , so different conversation , but it's definitely possible .

Philip Pape 18:35

Yeah , it's good to understand that the experimentation you went through itself is the missing piece for a lot of folks , in my opinion , in that , like I think of clients who start with me , and I think of one in particular who was afraid of carbs and wanted to work with me just to eat more carbs . He doesn't have diabetes , but my answer to a question would be a question like why don't you try it and let me know ? Because at the end of the day , that's all you can tell . So it sounds like when you get the blood sugar managed properly , when you're eating in a balanced way , when you've got some reasonable targets for your performance , for your activity , you can then start to tweak the dials right and push one way or the other and see , and that sounds like a nice , safe approach to do it , even if you are a little bit fearful at first , because you've proved to yourself right through the data where you're at . So what kind of data , what kind of metrics do you like to track ?

Ben Tzeel 19:23

So , of course , blood sugars right . For most , most of the people that come to our practice , they have a continuous glucose monitor or they have some way to measure their blood sugar consistent . So that's that's going to be imperative because , again , everything in my world and our world , you know , branches out from that . But I would say total macros are going to be massive as well . And especially , you know the calories and the protein . And , for our sake , we look at the carbs simply as a function of how do they relate to the blood sugars ? Because , again , if someone comes in and they're eating 400 carbs a day , I'm not going to suddenly cut them to 200 . I'm not going to increase it either .

Ben Tzeel 19:53

I want to get an idea of okay , if we have this here , are your numbers any more steady now that you're paying closer attention ? And then , from a training perspective , okay , how many days per week are you training ? What's your intensity of your training ? I like when people track the numbers . Not everybody does . Everyone's got a different commitment to activity and you know this only too well . But if I can get that data too , I love it . We'll look at labs , we'll look at the whole picture as much as we can , but typically from a diabetes standpoint , can we look at the food ? Can we look at the blood sugars ? How do they interlink ? And then , ultimately , what decisions can we make based on this ?

Philip Pape 20:24

Cool and you mentioned labs . So what ? What are you looking at there for blood work ?

Ben Tzeel 20:27

So of course , a1c cause that's going to be technically the you know the average of the blood sugar over the last three months a little more complicated , but generally the gist that one's going to be a big one . We do like thyroid because for two reasons . One , and especially in type one diabetes land , where it's almost like a buy one , get one free for autoimmune disorders , thyroid tends to be one of the ones that goes , and so we like to keep just an eye on that to ensure that that's not getting out of hand . And you know we don't prescribe but we'll tell people . Hey , we see this . Maybe consider talking to your doc about this , your endocrinologist or PCP , whoever those Two of the big ones .

Ben Tzeel 20:57

We'll look at the CBC , cmp , all the lipids , just to make sure everything's behaving itself , and every now and then there's something that's off , but it's nothing typically wild . And for some of the men , especially as men get older , we do like to look at the testosterone , similar with women . We'll look at the estrogen because that can have a pretty big impact on blood sugar as well , especially as those levels start to decline .

Philip Pape 21:18

Yeah , yeah , makes total sense . So then , like with the A1C , another thought that came to mind is the correlation between that and what are the biggest factors ? Right , and I know , just simply managing your weight and body fat . You know , people are always surprised to learn how much of an impact that does have . Independent of everything else . What are your thoughts on , like , the two or three biggest hitters for A1C ?

Ben Tzeel 21:37

I would say the first one for A1C , I think far and away is is your ? If you're on insulin , is your dosing on point ? If you're not on insulin , is your medication on point ? Because without that , at baseline right , you're going to be already behind the eight ball . And I don't care if someone's the best carb counter in the world , if your insulin to carb ratio is wrong , it's not going to matter . Your blood sugar is going to be all over the place . So that you know dosing mixed with carb counting and , technically , protein and fat counting , that's always far and away number one .

Ben Tzeel 22:03

I would say number two would be the activity side of things , because with that I remember vividly , there was one patient usually trains like four or five days a week and he , for whatever reason , for two weeks just didn't train . His blood sugar average went up 15 points just from not training . Ate the same , everything else the same , just went up 15 points , which in A1C world that's going to be almost a half a point or a little more than half . That's a substantial difference , especially from a long-term complication risk . So that's going to always be number two . And then number three for A1C believe it or not , stress , stress will wreck you , absolutely wreck you .

Philip Pape 22:36

Yeah , you mentioned stress . Isn't that the common denominator with everything , literally ? You mentioned stress . Isn't that the common denominator with everything Like even um ? I just recorded an episode about chronic inflammation and how , like , the biggest drivers are related to lifestyle . I mean , visceral fat is a driver , but , like you know , you and I talked about being sedentary and not having that blood flow and how that affects insulin sensitivity and blood sugar . Well , that's also stress . That's lifestyle . It's all interrelated and yet it's one of the things that it's not sexy to talk about . Right ? Sleep and stress . We all need more sleep and less stress . So , speaking of stress , I think about things that stress our body . Right , one of those is a calorie deficit , but another would be potentially fasted training . I'm curious of your thoughts about fasted training . Yeah , yeah , just go .

Ben Tzeel 23:19

As I sit here , literally having training , trained , fasted , right before we're talking right now .

Philip Pape 23:24

OK so .

Ben Tzeel 23:25

I personally do it . Some people love it , some people hate it . The reason I do it is twofold right , I don't have any insulin on board from any sort of boluses , which in my world , just makes life slightly simpler . So I don't have to worry about my blood sugar potentially falling off a cliff . And I don't have to worry about my blood sugar potentially falling off a cliff and I don't have to worry about any food in my system for that . Some people don't like it because oh , there should be something in your system before .

Ben Tzeel 23:45

For me it's like from a muscle standpoint too . I know there's the potential for breakdown . I know there's ways to mitigate that . I just see as the tradeoff . I'm like , if I still hit my targets more down the average person , yes , but if it's , it's kind of in my mind it's like SPF 30 , where you block 98% of the sun , or SPF 70 block 99 . It's like is that little teeny 1% difference going to really make that big a difference ? If my numbers are happier , which is going to make everything better in the longterm , I'll take the happier blood sugars . But I think it's . It's totally viable . Some people if their blood sugar still crashed , then they need to have a concern with that , but we'll work through it . But I I personally do it and I love it .

Philip Pape 24:24

Cool , so you do it for blood sugar purposes .

Ben Tzeel 24:27

Mainly blood sugar . Also just convenience , like I like just having it done , then I can do what I want to do . Cool .

Philip Pape 24:32

Which is with intention , with purpose , like I think that's the main theme , is that people are thinking I should do fasted training because it's better for fat loss or something , and I and I think that that doesn't work . And also you , like you said you're you've got to look at the the cons and they're actually insignificant , like we know now from protein , recent protein research , that you could distribute it just about however you want and it's like like a couple percent difference right In outcomes . You know , and you it sounds like you've been training a long time so you've like got a big baseline , et cetera , et cetera . So yeah , I just wanted to get that out for people . It's like sure you can do it if it's convenient . It's like intermittent fasting , like the main reason you do that is it's probably convenient for you and maybe it helps you control your calories , right . Like it's not autophagy and longevity and all that stuff . Do you agree ?

Ben Tzeel 25:16

I'm going to laugh and say this too . I also intermittent fast and I only do it because I like eating two larger meals . I do not care about everything else . Like , that's just how I like to do it , and from an esophageal everything . If there's a little benefit , cool . But I'm not doing it because , oh , it'll .

Philip Pape 25:29

You know for sure , help me live eight minutes longer per day , like no , it's just , you know , if you like it , like it , you know carnivore , keto , this and the other . I'm like look , if you like meat and liver and eggs as your diet , you love it . You think you can do that the rest of your life . You feel great , you perform , you're not worried about the consequences of not having fiber . You know whatever , uh , go for it , right , like it's not . I'm not here to tell you what to do or what not to do , but rather to say that don't let others fearmonger you into thinking you have to do this . It's like the two opposites . What is your biggest boogeyman right now that we haven't touched on in the industry ?

Ben Tzeel 26:09

Oh geez . I mean , besides carnivore which I don't even think carnivore is a problem I just don't think most people can stick to it for longer than three weeks . Yeah , that's the main thing . Yeah , Okay , glp ones Not even a question . Okay , okay , I don't think that's even a question . I think because it's everywhere , it's pervasive and it's it's fine . But I think a lot of people view them in a really skewed way , diabetes or not . Continue .

Philip Pape 26:31

Tell me more when you say cause I yeah , no , we're probably on the same page with this , the nuance , but yeah , let me hear it .

Ben Tzeel 26:37

So with it I mean the irony is they were initially developed for people

GLP-1 Medications: Uses and Misconceptions

Ben Tzeel 26:40

with diabetes right , and for people with diabetes they can do amazing work and I'm grateful that they exist . But then , when it became old , they can help with weight loss . Everyone just assumes I'm going to take this thing , it'll be fine , and then I'll lose all this weight . And I mean the studies you've seen on the study show that once you get off of it , if you don't change anything , you're you're done for . You're just going to gain it all back .

Ben Tzeel 26:59

And I tell people I'm like it's just , it's basically a manufactured calorie deficit because you're feeling disgusting so you don't want to eat anything . It's like you could do the same thing . You know you want to track and put in a little effort , but I always will say if you want to use it and I've had patients use them with amazing success and I think they're incredible If they're used as a springboard if you do everything else with them , if you do the nutrition side , if you do the exercise side and then from a blood sugar standpoint in our population , if you do the blood sugar have that on point it will work incredibly . I've had people lose well over 100 pounds and they're amazing , but the key is to not have it . So you're so reliant on them that the moment that they're out of the picture , you're completely SOL . That's the problem , and I think so many people just want to use them as this crutch and say it's the magic answer , and in that case it's not .

Philip Pape 27:40

Yeah , okay , I 100% agree . I mean , that's what it comes down to . It's like and I know you referred to your holy trinity , I think , right , nutrition , training , blood sugar , and I guess for me , without thinking as much about the blood sugar , for nine diabetics it's like nutrition , training and lifestyle . Same idea . The whole thing is use it as a tool to help with the potentially gene-related appetite dysfunction you have with your brains , which we know is a real thing and it's exacerbated based on your history , and then do the lifestyle and then come off of it . And I also have worked with clients who , like on terzapatide , which is one of the more powerful ones who say like look , I am doing a lot of the things , but now I'm worried that when I come off , you know I'm just going to start gaining all the weight back and I think there's like a titration method for that . So , given that you work with diabetic population who's probably taking the original Ozempic right , like the OG for diabetes , how do you work with them to come off of that as a strategy ?

Ben Tzeel 28:32

And so the fun thing it's the two things I'll say . One is for Manjaro . For whatever reason , it just seems like it works better . Again , I've never taken it personally , but I've seen in the , in the probably three dozen people we've had who are on it , it always seems like Manjaro skews a better result . So Zempix kind of there calms the noise , but that's just . I forgot to mention that before .

Ben Tzeel 28:49

So I want to make sure .

Ben Tzeel 28:50

I said that , but from a from a titrating off standpoint , my biggest thing is making sure , from a metabolism standpoint , if we can make sure that you are eating an amount that's still reasonable .

Ben Tzeel 28:59

Maybe you're in a deficit , ideally you're still in a deficit , but then we can slowly start to rebuild it back up and have them say , hey , I can know I can hit these targets every single day . I can hit these targets every single day . Then I have confidence that , as I need to reverse diet , if I choose to reverse diet and I want to eat more , I'm going to do so in a slow and controlled manner , because otherwise that's exactly what's going from a hunger standpoint , is going to go nuts and they're going to eat a bunch of more food than they're used to and the weight's going to come back , so it really just becomes hey , can we get you in a position where , as the doctor , I don't do any of the titration right , but as the doctor starts to bring it down , how can we make sure everything else in your life is set up for success ?

Philip Pape 29:43

So you don't have to stress fail-safes in place yeah , it's a good way to put it , Fail-safes and the titration and kind of increasing the calories or even going to maybe a little bit more aggressively over maintenance as you do it . Whatever strategy makes sense for folks , so that once the appetite kicks in you're actually eating enough , that appetite's not as much a concern versus continuing in a dieting phase as you come off , because that's definitely going to be challenging .

Ben Tzeel 30:05

Not only is it going to be hellish , but then , if you're able to change the frame and say , hey , you are likely going to be eating a little bit more , your appetite's going to come back . How can we use this to our advantage ? Are we going to go into maybe a more of a strength building phase , if you're able to get the mindset shift with that too ?

Philip Pape 30:25

I think it can do amazing things , but someone has to be ready for that point , or otherwise they're going to absolutely fail , totally agree . All right , I'm switching it up a little bit here because insulin pumps are an area that I know nothing about . I've known diabetes . I've seen the various technology . I always thought it was kind of interesting how they work and how

Understanding Insulin Pumps and Technology

Philip Pape 30:35

they've evolved over time . But I guess the question is just maybe tell us a little bit about how it works . But also , do you know , do you take breaks from using it ? How does that affect the blood sugar management with the other strategies that you work on ?

Ben Tzeel 30:48

Oh man , I was going to say I've been on a pump on and off , but mostly on since 2002 , which is kind of crazy . So I've I've seen the evolution of a pump where you have to do all the math yourself and plug in everything to a pump where it does a lot of the work for you not everything , but a lot of it for you and can make your life a lot easier . So , in a nutshell , you know someone without a pump . You have type one diabetes or you're insulin dependent . You're taking an injection every time you eat , you're taking some sort of basal insulin , long acting , that will last the entire day . What a pump will do is it'll just be constantly giving you teeny little amounts 24 , seven to function as that basal and every time you eat a meal you dial up and say , hey , I want to eat a meal , this is 30 grams of carbs . Boom , you take your dose and now you go eat and you're fine . So it makes life a lot simpler because you're taking fewer injections as long as the pump is working and there's algorithms now that can make life a lot easier . Oh , it sees , your blood sugar is going up a little bit . Here's a little bit insulin for you , so you don't have to actively correct it . So from a simplicity standpoint , it can help a lot . It also can shut your insulin down if it notices you're trending down . So for a lot of parents with kids , super , super helpful with these algorithms , for a lot of people that make life easier . It's amazing .

Ben Tzeel 31:51

But I would say a couple of things that people get hung up on is they expect it to do everything for them , which it's not going to .

Ben Tzeel 31:56

You still have to have some sort of active managing role .

Ben Tzeel 31:58

But when the sites don't work like I'm on an Omnipod right now , which is the wireless one and when the sites don't work you're not getting insulin or you're not getting as much as you think you're getting , so suddenly you could eat a meal it's the same meal you eat every day but if you're not getting the amount of insulin you thought , your blood sugar is shooting up and there's no real way to bring it down until you replace that site or take an injection . So that's one of the big I'm going to call it cautionary but one of the big things that people have to realize is you have to have a backup plan for that , and there are times where I've gotten frustrated because I've had this for almost 26 years . I have scar tissue , so sometimes I run into issues of sight . So that's when I'll take a break , like you're alluding to , where I'll say I'm going to go on injections for a few days , or for a few weeks or a few months , depending how frustrated I am , and then I can always come back .

Philip Pape 32:42

Cool man , Thanks for explaining that . Yeah , I wasn't 100% sure how they worked and wanted the audience to understand , and it's just another tool that you've got to be aware of , obviously as part of the strategy for managing the blood sugar . So kind of related or maybe not related , but I think you've said that diabetes can be a strength rather than a limitation . I'd love to hear your thoughts on what you mean by that can be a strength rather than a limitation .

Allan 33:04

I'd love to hear your thoughts on what you mean by that . Hi , my name is Alan and I just want to give a shout out to Philip , pape of Wits and Weights for being a huge part of the foundation for my continued health and well-being . Philip exemplifies a nutrition coach who demonstrates how much he cares . Philip works tirelessly and with dedication to provide coaching , support and major content for us to use . He creates a practical approach from research and Philip empowers all of us to use food as quality for our health . He is skilled in how to assess and direct nutrition . Philip creates a community full of wisdom , support and camaraderie . In summary , philip Pate is the real deal . He knows how to assess and direct nutrition and he continues to steer me in the right direction . Thank you , philip .

Ben Tzeel 33:55

So I think what was really tough was I was diagnosed at seven , right ? So you're seven , you want to just make friends and have fun , live a second grade life , right ? And you're not paying attention to this thing . And I kept getting told no , no , no , no , no . You can't get strong , you can't play sports , you can't lift , you can't have the cupcakes with your friends and it got really frustrating .

Ben Tzeel 34:18

And so over the years at first I was I'd run into resistance , but I started realizing that the resilience standpoint I think it really builds a lot of resilience and it forces you to build a lot of resilience .

Ben Tzeel 34:27

And also thinking about it from just a health standpoint , from you know , if you're looking at it as a positive , you're way more in tune with your health than the average person . Like somebody you know in a conversation who's listening to this is probably already in tune with lifting and working out and food , but someone who's not , you know , relative to that , you're way more . You have to be more in tune . I have to know everything that's going on in my body . I have to be paying attention to my sleep . There's 40 plus factors that can impact your blood sugar at any given moment . I need to be paying attention to these things . So , while it takes up a lot of bandwidth , I feel like from a longevity standpoint as long as blood sugars are maintained , I think in a really weird way this is keeping me on my toes and more accountable , because you get real immediate feedback if you're not paying attention .

Philip Pape 35:07

Yeah , yeah , To the point where it threatens your very physiology and your life . I imagine you know not to find a point on it . So then , based on that , what you've learned and kind of the insights you've had , are there a couple of big lessons that you like to share with folks , whether they are dealing with diabetes or not , for training , nutrition , whatever , and it could be mindset , could be psychology you've taken away from that experience .

Ben Tzeel 35:29

I think one

Diabetes as a Strength, Not Limitation

Ben Tzeel 35:30

huge thing I've seen again with myself with patients is you have to everyone has to understand , from a consistency standpoint , you're not gonna just explode to perfection right away .

Ben Tzeel 35:40

And so with your blood sugars right , if you're like my , numbers are way higher than they should be , you can't expect in two weeks your blood sugars are going to be perfect . If you're trying to lose 50 pounds , you didn't take two weeks to , you know , gain the 50 pounds . You're probably not going to take two weeks to lose it . So I think , just keeping expectations tempered and enjoying the ride along the way it's with life in general , lifting and lifting pretty moderate , heavy to heavy , a good amount of time , typically solves a lot of problems that otherwise would you know , would be very nasty . So I've just , the more I've done it , I've like , oh , I got into this when I was 14 . Like I really love lifting , I don't think I understood the benefit at the time and the significance you start when you're 14 for aesthetics and for sports , but realizing as a lifelong thing this is massive for people with diabetes .

Philip Pape 36:32

Yeah , and I would extend that to say it is massive for everyone , because that message is the message I try to share on every podcast I go on and I'm surprised sometimes when I talk to a health coach who's like , well , I don't really lift weight , like you're missing out on the biggest piece of the pie in my opinion . So you know , I love what you said about . You know , you can't explode to perfection . We are not just a society , but as a species we want to get things solved . Like once we know we have a goal , we want to go after it , we want to get it solved and we're like you know how do we make that happen as quickly as possible ? And so when you combine that with realistic expectations like it's going to take time and enjoying the ride , meaning you know what you could still get dopamine hits and short-term wins . Anyway , if you're smart about , like , constructing the process the right way , it can all work out .

Philip Pape 37:17

I was talking to Nick Delgadillo . He's the CEO of Starting Strength Gyms and he was talking about how , like , new lifters will get that self-motivation once they start seeing the results come fast , especially when you're you know , you're squatting three times a week and weight's going up every time , but then after a certain period of time it starts to get really hard and the progress starts to slow down and you can't just necessarily be a lifter for its own sake , right , you have to kind of parlay that into maybe a sport or something you enjoy or whatever . And I joked because I said , well , I actually do love lifting and some people just love it for its own sake . He's like cool , you're the easiest person to coach , aren't you ? What are your thoughts on that in terms of people who don't lift regularly and are listening , being consistent , getting in the gym , thinking it's not something for me or I don't like it ? How do I get to like it ? You know those things . How do I start ? How do I be consistent ? How do I become a lifter for life ?

Ben Tzeel 38:08

I think , and I think for some people I've talked to especially , they're even nervous about the gym , right , because there's , oh my God , everyone's going to be watching me and looking . When nobody actually cares and I think they'll be nice and supportive , but if they're in their heads I'll be like let's get you started with something at home . You know , you can get a couple of resistance bands you can get , you can use your body weight and you can do a lot with just those two things . But you know , then you add in , you know , a couple of little weights and then , when you're comfortable , hey , let me go into the gym and let me make it a twice a week thing . I'm going twice a week for half an hour . I's add that third day , let's add that fourth day , let's extend it by 10 minutes .

Ben Tzeel 38:43

Suddenly you look back and a year from now , you just went

Building Consistency with Lifting

Ben Tzeel 38:46

from I'm barely squeaking in there twice a week for 30 minutes to I'm here four times a week for an hour . And as you start to see those games like you were alluding to , people start to see that and they're like I want to keep seeing these games , I want to see this progress . I see the changes in my body , and that's , I feel like , how people tend to at least from what I've seen fall in love with . It is they see the progress , but then also they don't realize until they look back whoa , I'm here way more than I'd ever thought I would be .

Philip Pape 39:10

For sure . Take the action , get the result , get the motivation and make sure to look back what's happened in the before and after you have to , and I'm bad at that myself .

Ben Tzeel 39:26

There are times where I'm like , wow , I just didn't . And I'm like , oh , but I was supposed to do that , and so that's a problem that I've worked on all the time where I'm like I need to give myself some credit . But to that point right . I vividly remember to one patient where she started out eating 40 grams of protein a day and she thought that was a lot , and a year later she was at 150 grams , just plowing , and she was like I ate 150 grams of protein every day . I'm like , yeah , remember when you could only eat 40 ? And she's like , how did I live ? I was like , great , great question . Only you can answer that .

Philip Pape 39:45

Exactly .

Ben Tzeel 39:46

But that's , I think , a way to kind of summarize that part where you don't realize how much you've done until you look back and say , wow , that was awesome .

Philip Pape 39:53

For sure . Always good to have some mindset psychology on the show , because that's what a lot of times people struggle with , not just the nuts and bolts and the information . So we've addressed some fear mongering , we've addressed some myths , we've addressed blood sugar management . Speaking of blood sugar , I guess you and I talked before we recorded about some of the hot , spicy topics . I guess what would be something that's , I guess , on the dangerous side that is being promoted by the gurus and the fitfluencers related to blood sugar , that they just totally get it wrong and it could actually hurt people maybe .

Ben Tzeel 40:23

Man , that is a good one , because I feel like a lot of them everybody still talks about you know , oh , when you're done working out , you better have this massive insulin spike . So you better spike your blood sugar with all these carbs and , like I wouldn't even say it's necessarily dangerous , it's been around since I started lifting no-transcript . Probably not going to work for me . You don't need to actually do that . From what I've seen in the research has shown you don't really have to do that either , but I haven't seen tons of craziness . I'm sure there is . I also don't always go looking for it , which is probably for my own sanity's sake , because I see enough stuff about nasty blood sugars and how to cure your diabetes and getting told that you can eat random things . So I see enough of that and I'm like I don't want to fill my brain with more trash .

Philip Pape 41:18

All right , I get that man . Yeah , I wish I could just like get rid of social media altogether and just delete it all and there's days I'm like could I live off the grid , would it be fun ?

Ben Tzeel 41:28

And then I'm like , no , I'm like two days , I want to see what people are doing .

Philip Pape 41:30

Exactly All right . So then let's go more moderate approach . I alluded to fiber once , I think , talking about carnivore . What role does it play in blood sugar control ? Is it necessary Because some people say , well , it's not essential , just like carbs aren't essential ? What are your thoughts on fiber ?

Ben Tzeel 41:44

I don't know if I'd go so far to say necessary , but I would say doing two things . One would be slowing down the potential blood sugar spike . So you eat a meal and if your blood sugar would have gone I'm just going to throw out arbitrary numbers If it would have gone to 180 , if you've got a good amount of fiber , maybe you're only going to 140 just because it slows digestion so much . I think and I don't have all of the fun super in-depth data on this , but I do know from a gut health perspective there's a lot of links with gut health and blood sugars and the microbiome and the different possibilities of if your microbiome's off , your blood sugar control could get worse . That's , I think , the bigger thing with fiber is . I think there's a lot of impact on the gut that people don't pay attention to .

Philip Pape 42:24

Yeah , I agree , and it's . I don't think there are any very many people who are educated enough or expert enough to convey the full answer , but , um , there is someone . Oh man , what's his name ? Justin Cottle . Do you know Justin Cottle ? He's , he's a . He is an anatomy researcher . Uh , he worked at the anatomy lab . It's the big one . I forget the name he's . He's also a YouTuber now .

Philip Pape 42:46

Really nice guy , actually remind me a lot of him Cause he's . He's very nuanced . You

Final Thoughts on Fiber and Gut Health

Philip Pape 42:50

know , positive guy , doesn't want to like fear monger , any of this stuff and he'll give you a really good explanation of the whole , uh , digestive tract and like how fiber affects the microbiota and how diverse sources of fiber and different even eating different apples on different days , you know the different pectins from the different skins will feed that bacteria and we just don't know . So I worry that someone eating carnivore 20 years from now will they have some effect that we haven't been able to study yet because of the length . But you know , we know having fiber has positive outcomes . So I don't know what having no fiber , what the outcome is going to be , is the question .

Ben Tzeel 43:24

Yeah , I don't know if I want to know , honestly , because even in , like the keto people , at least they're getting fiber . It may be crazy amounts that might be manufactured , but it's something .

Philip Pape 43:33

For sure , for sure , all right , man . Well , with all of this stuff , is there anything that we didn't cover ? Anything you wished I would have asked , and then what would your answer be ?

Ben Tzeel 43:42

Man , honestly it's one of the most fun in-depth ones I've gotten to do in a long time , so I'm feeling like we covered a lot of stuff . I don't want to overdo it , Cool man .

Philip Pape 43:52

No , that works . That works . I think you covered all the main points . Where do you want people to look yourself up and learn more about this ?

Ben Tzeel 43:58

I would say if people are interested , diabetes or not , my team and I are able to work with you , know people from all walks of life who want that nutritional insight , especially in relation to blood sugars , but at man of zeal on Instagram and Tik TOK . So M a N O F T Z E E L . And then your diabetes insidercom is the place for you know what our team does . We've got free stuff on there . We've got tons of different freebies , opt-ins and knowledge for you to be able to learn more about diabetes and make your life better .

Philip Pape 44:25

And there's a podcast too , right .

Ben Tzeel 44:27

There is a podcast , the your Diabetes Insider podcast , very cleverly named so that one's a lot of fun if you want to hear some more real , raw rants and fun nuanced diabetes knowledge .

Philip Pape 44:36

For sure , yeah , so we'll throw those in the show notes . Manofzeal at IG . That's with the silent T in there Yourdiabetesinsidercom and yourdiabetesinsiderdiabetes . I'm sorry , I flipped them . Which is the domain ? The domain is .

Ben Tzeel 44:50

Oh , yourdiabetesinsidercom and then yourdiabetesinsiderpodcast . Okay , okay , so super original on the podcast no no no , that's good .

Philip Pape 44:57

I switched the podcast name , All right , man . Well , yeah , no , it's been a lot of fun . Ben , I appreciate your approach to all of this and I like that people have , you know , the flexibility no matter whether they're on the diabetes or not to really kind of eat and train in a lot of different ways , as long as they're doing it and living an active lifestyle right . Just not for blood sugar alone , but just just to thrive . So thank you so much for sharing that message .

Ben Tzeel 45:19

I'm just grateful that I got to chat with you and hopefully educate some people , diabetes or not , that you know it doesn't have to restrict your life .

Philip Pape 45:26

Awesome . So great for having you on . Thanks for coming on .

Ben Tzeel 45:29

Thank you .