<p class="p1"><span class="s1"><a href="https://peterattiamd.com/sarahhallberg/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220403-pod-sarahhallberg&utm_content=220403-pod-sarahhallberg-podfeed"> View the Show Notes Page for This Episode</a></span></p> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220403-pod-sarahhallberg&utm_content=220403-pod-sarahhallberg-podfeed"> Become a Member to Receive Exclusive Content</a></span></p> <p class="p2"><strong>Episode Description:</strong></p> <p class="p2">Today's episode of The Drive is a rebroadcast of the conversation with Sarah Hallberg (released on May 17th, 2021). It's with great sadness that we report that Sarah recently lost her battle with lung cancer, and as such we've decided to republish her episode to honor her amazing work in challenging the status quo in the treatment of metabolic disease.</p> <p class="p2">Sarah Hallberg was the Medical Director at Virta Health and a physician who spent nearly two decades treating patients with obesity and type 2 diabetes. In the first half of this episode, Sarah discusses how she became a huge believer in the efficacy of carbohydrate restriction for the treatment of type 2 diabetes through her research and clinical experience. Sarah challenges the common beliefs about the role of dietary fat and carbohydrate on the plasma makeup of fatty acids and triglycerides. She also expresses the importance of understanding early predictors of metabolic illness—highlighting one particular fatty acid as the most important early predictor—before finishing with a discussion about how doctors might be able to personalize patients' metabolic management in the future. In the second half of this episode, Sarah tells the personal story of her own lung cancer diagnosis. She talks about dealing with her grief, deciding to continue her work while prioritizing her family, and how she devised a plan to extend her survival as long as possible. </p> <p class="p2"><strong>We discuss:</strong></p> <ul class="ul1"> <li class="li2">How Sarah discovered the profound impact of carbohydrate restriction for reversing obesity and type 2 diabetes [2:00];</li> <li class="li2">Prediabetes and metabolic syndrome: prevalence, early signs, and the importance of treating early [14:45];</li> <li class="li2">Overview of fatty acids, how they are metabolized, and understanding what you see in a standard blood panel [28:00];</li> <li class="li2">The relationship between diet composition and metabolic markers [34:00];</li> <li class="li2">Why palmitoleic acid is such an important biomarker [47:00];</li> <li class="li2">The best early indicators of metabolic disease [58:45];</li> <li class="li2">Personalized management of metabolic illness [1:05:45];</li> <li class="li2">Sarah's cancer diagnosis and the beginning of her journey [1:14:00];</li> <li class="li2">The emotional impact of a devastating diagnosis [1:26:00];</li> <li class="li2">Sarah's plan to extend survival [1:35:30];</li> <li class="li2">Sarah's aggressive treatment plan [1:46:15];</li> <li class="li2">Life-threatening complications and the return of her cancer [1:57:45];</li> <li class="li2">Sarah's reflections on her approach to life with chronic cancer and balancing her time [2:09:45]; and</li> <li class="li2">More.</li> </ul> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220403-pod-sarahhallberg&utm_content=220403-pod-sarahhallberg-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></span></p> <p class="p2">Connect With Peter on <a href="https://twitter.com/PeterAttiaMD"><span class="s3">Twitter</span></a>, <a href="https://www.instagram.com/peterattiamd/"><span class="s3">Instagram</span></a>, <a href="https://www.facebook.com/peterattiamd/"><span class="s3">Facebook</span></a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg"><span class="s3">YouTube</span></a></p>
Actionable Insights
1. Reverse Type 2 Diabetes
Implement very low carbohydrate restriction to reverse type 2 diabetes, achieve normal blood sugar, and reduce medication dependence, as demonstrated by clinical experience and trials.
2. Be a Relentless Self-Advocate
Actively and persistently advocate for yourself within the healthcare system, especially when cancer recurs, to ensure necessary tests (like biopsies for genomic profiling) are performed to access appropriate treatments and clinical trials.
Address the ‘sleep, exercise, nutrition trifecta’ and manage cortisol levels, as these fundamental interventions significantly reduce the risk of chronic diseases like heart disease, cancer, and Alzheimer’s.
Be hypervigilant about any elevation in blood sugar, and consider monitoring palmitoleic acid (POA) and triglycerides as early indicators of insulin resistance, even if traditional blood sugar levels appear normal, to intervene proactively.
5. Understand Insulin’s Risks
Recognize that insulin is not a benign medication; aim to reduce insulin requirements as much as possible, as a significant reduction in dosage indicates improved health outcomes and reduced negative effects of hyperinsulinemia.
6. Challenge Medical Dogma
Continuously research and challenge existing medical beliefs and guidelines, even if it causes cognitive dissonance, to ensure that health practices are founded on the best available science and to question misleading common ideas like ‘you are what you eat’.
7. Determine Carb Tolerance
Identify your individual carbohydrate tolerance for personalized nutrition, as consuming carbohydrates above this threshold can lead to increased palmitoleic acid (POA) levels, indicating metabolic stress.
8. Treat Obesity Without Bias
Healthcare providers should approach patients struggling with obesity without bias, understanding that obesity is often a consequence of underlying disease processes rather than a personal failing.
9. Choose to Live Actively
Actively choose to live fully and with purpose, rather than succumbing to self-pity or despair, as this positive choice benefits both yourself and your loved ones, even when facing a terminal diagnosis.
10. Be Honest with Children
Communicate serious health diagnoses honestly and transparently with children, as consistent truthfulness can prevent anxiety and build trust, even if the information is difficult.
11. Seek Multiple Expert Opinions
Actively seek multiple expert opinions and explore all available treatment options, especially for complex illnesses like cancer, acknowledging that this often requires significant resources and privilege.
12. Manage Chronic Symptoms
Develop strategies to manage chronic symptoms like nausea and fatigue to maintain an active life and continue pursuing important work and personal commitments, improvising as needed.
Transform anger and negative emotions stemming from illness or injustice into productive action and purpose, rather than allowing them to lead to despair or inaction.
14. Prepare for Healthcare Costs
Be aware and prepared for potentially significant out-of-pocket healthcare costs, even with insurance, especially for complex and long-term illnesses like cancer, as these can amount to tens of thousands of dollars.
15. Model Resilience for Family
Model resilience for your children and loved ones by demonstrating how to cope with life’s stressors and adversities without being defeated, showing them how to live fully despite challenges.
Use personal experiences with illness, especially when privileged, to advocate for health equity and address systemic disparities in care, extending advocacy beyond your immediate situation.
17. Don’t Dismiss Severe Symptoms
Do not dismiss or rationalize away severe symptoms; seek immediate medical attention when experiencing significant health deterioration, even if you are tempted to attribute it to minor causes.
18. Accept Changed Life Plans
Practice acceptance for changed life plans and dreams due to illness, while holding onto core, non-negotiable roles and relationships, such as being a parent.
19. Educate Against Skepticism
Proactively educate and provide evidence to address potential resistance or skepticism when introducing unconventional but evidence-based approaches in healthcare, such as carbohydrate restriction.
20. Offer Carb Restriction Option
Physicians should offer carbohydrate restriction as a treatment option for all patients with metabolic disease, based on its demonstrated efficacy in improving health outcomes.