The Empowering Neurologist – David Perlmutter, MD and Dr. Sarah Hallberg

On today’s program, you’ll discover that diabetes may be reversible by means of nutritional interventions. My guest is Dr. Sarah Hallberg, a strong proponent of a very low-carbohydrate approach, not just for diabetes, but for weight loss and even for the improvement of cardiometabolic risk markers. With her organization, Virta Health, she just released a landmark study on this very subject.

Dr. Hallberg once gave a terrific TEDx talk that’s worth watching after our interview. She’s the medical director and founder of the Indiana University-Arnett Health Medical Weight Loss Program and will discuss her ongoing research on today’s episode of the Empowering Neurologist.

  • Melissa

    Please use the terms type 1 and type 2 diabetes when sharing. There is a significant difference and can be confusing to people who don’t understand the difference. Type one is not yet reversible but we remain hopeful that someday it will. Thank you

  • rubagreta

    The day is coming when the ADA finally crumbles and admits its advice for all diabetics has been horrible for decades.

    Thanks to the hard work of people like Dr. Hallberg, I, who am just “Google educated” and “YouTube educated,” know the proper nutritional advise for those diagnosed with pre-Type 2 diabetes, and it means no medication.

    Most MD’s and dietitians and nutritionists? They know nothing.

  • Leigh Cassidy

    Hello, I have been a type 1 diabetic for over 40 years. I have worked in the bush for 30 years and dealt with it via insulin and nutrition. For the last 11 years I have been facilitating Ortho-Bionomy to particularly address my whole system with regards to health. I do not believe it is “only” any particular aspect such as mental, physical, emotional or spiritual that needs changing, but a composite of the human.
    I am not on my third week of fruit only, and have had several days of 6.2 averages on my glucometer, and am feeling better than ever. Insulin resistance my need to be re-booted completely in all aspects, which is what i have done, as fruit uses its on ATPs to feed the system.
    It is fascinating.
    Insulin is not the only answer, fruits are not the issue. When I am done using insulin, will be reintegration. From 40 units daily to 6 at this moment, for my 6.2 average, is getting there.
    Definition of sugar is interesting. Good talk, thank you

    • Alice Ihde

      I didn’t understand what you said. Would you pease clarify? You’re eating all fruits to reset your insulin?

  • Gela K

    I love Dr. Hallberg’s work. What a beacon of light she and YOU are in this dark era of ‘modern’ medicine. Keep up the great work.

    • David Perlmutter

      Thanks for watching our discussion!

  • Alice Ihde

    My endocrinologist said NOT to eat fat, even fatty meats, like brisket! Does this work because of being in ketosis? Isn’t this very hard on the body?

  • maria

    I notice the main stream media now reports that diabetes can be put into remission by a very low-cal diet and exercise in 4 months. (Read this in the National Post – I live in Canada – yesterday.) It does not yet seem to be mainstream news that diabetes can be put into remission by a very low-carb diet and exercise. The low-carb approach strikes me as an easier way to go, and I assume there are other benefits to low-carb as well.

    • Kate

      A very low calories diet (800kcals) per day was devised by Dr RoyTaylor of Newcastle University about 4 years ago, which successfully reversed type 2 diabetes in 12 weeks by means of weight loss. This was not well reported. The diet is based on 4 meal replacement shakes of approx 200 kcals each, which are not ‘high protein’ or ‘ low carb’ but nutritionally balanced. The diet works but may not prevent weight regain if the initial behaviours and eating patterns which led to a diagnosis of diabetes in the first place are resumed when the diet ends. It may be that the diet period of 12 weeks is too short or that individual needs vary depending on how much weight needs to be lost or other factors not taken into account.

  • Mitzi Andersen

    Thank you for this marvelous interview on both sides. My husband, who ran many ultra-marathons over several years, has Alzheimer’s in consequence of recommended carbo-loading which continued when an injury caused him to stop running. His habitual intake of carbohydrates did not stop then and he developed type 2 and, then, type 3 diabetes and, hence. Alzheimer’s. Having listened to Dr Perlmutter’s dietary and other recommendations during and after the online series, Awakening from Alzheimer’s, I was able to assist my husband to improve his condition so that the effects of his Alzheimer’s have considerably reduced. Unfortunately, the doctors I have met here in South Africa are not yet aware of these developments so I am working on my own, which is difficult. I sometimes have to face skepticism, so this program will assist me to convince the unconverted.

  • Mike Keyes

    She’s 90% correct. The cells don’t become insulin resistant. The insulin gets modified.
    By dietary poisoning.

  • Perch David


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  • Kate

    Dr Hallberg’s enthusiasm is infectious. Her willingness to stick her head above the parapet and highlight her own profession’s ‘wilful ignorance’ about a dietary cause and failed treatment of the type 2 diabetes epidemic in the interests of disease maintenance and product sales of e.g. metformin, statins, etc is admirable. But there is nothing new here: at least two decades ago, Dr Mercola for example, stressed that the main role of insulin is fat storage. Why? Perhaps (in evolutionary terms) in order to ensure survival of the species in times of food scarcity. As Dr Perlemutter pointed out, present day food abundance (in the Western world at least) is at odds with our genetic predisposition. Epidemics of chronic diseases point to a failure to adapt especially in those of us who have inherited a ‘thrifty gene’. But it can’t be just about sugar and grains per se. These were around when I was a child but there was no diabetes epidemic. Most people had defined waists and a healthy waist/hip ratio indicating a normal insulin/cortisol response. Something – or many things must have changed.

    Dr Hallberg’s presentation reminded me of the parable of the blind men and the elephant, which none had ever seen. One man swore it was a creature with a long wiggly tail, another that it had large flappy ears, yet another that it had a thick trunk. All were convinced they were right. They were of course, but they were missing the bigger picture. The diabetes epidemic must surely be part of something bigger and we should perhaps look at all the facets of modern life re chronic diseases to find lasting solutions.

    In his latest book, Dr Pizzorno describes in detail the role played by toxic compounds in a polluted world in approximately one third of cases of diagnosed diabetes and other diseases. Other functional medicine writers have examined the issue of leptin resistance as well as insulin resistance, so it might not be a good idea to tell diabetics to ‘eat when hungry’ as there may be leptin and ghrelin as well as insulin resistance. The timing of meals appears crucial to allow glycogen to be used up and release of triglycerides from fat storage to begin. The roles played by cortisol, adrenalin, stress, sitting too much and sleeping disorders (to name a few) re blood sugar dysregulation are significant; we have not even touched upon issues such as food addiction, food intolerances, agricultural practices, processed junk foods that harm human health and NFLD. The increasing problem of non alcoholic fatty liver disease from consuming non fibrous sources of fructose and its effects on insulin seem to be traceable to more than just carbs alone.

    As for excess calorie consumption, please don’t tell me this is not an important consideration. It is not the only consideration but the type and amount of calories consumed are not mutually exclusive factors in controlling insulin production. Both are surely relevant. Overeating for your needs on regular basis messes up both hormonal and mitochondrial health. We know that regular exercise helps maintain insulin sensitivity and this is probably better defined as ‘regularly moving throughout the day’ as we were designed to do.

    If Dr Hallberg’s experiments can reverse type 2 diabetes in the long term simply by restricting grains and sugars alone, which I assume is what is meant by ‘carbs’, then this will be an achievement to celebrate. It would be interesting to know if the beta cells of the pancreas, once destroyed, can be regenerated.

  • Carole

    Wonderful and so informative…..both you, and Dr. Hallberg are most certainly ‘beacons of light and hope’. Really enjoyed and benefited from this talk……thank you both.

    • David Perlmutter

      Thanks for watching Carole. Glad to know you enjoyed!

  • Lana Logan Harper

    I’m actually a patient of Dr. Halberg’s. She advocates for me – a 5% carb/20%protein/75% fat load per day. I’m never hungry and feel great – blood numbers are great.

    I’m also a fan of Dr. Perlmutter; I am confused about the carb load he recommends per day – filling my plate 3/4 full of vegetables each meal will not keep me within the 5% carb allowance for the day. How do I reconcile this difference?

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