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Rest Day

Many in the CrossFit and medical communities are mourning the loss of Dr. Sarah Hallberg, who passed away late last month following a long battle with lung cancer.

Dr. Hallberg was a vanguard thinker in the fields of obesity and diabetes management and prevention. When Hallberg realized her training — first as an exercise physiologist and later as a primary care physician — had not equipped her to help her patients in the way she wanted, she didn’t give up. Instead, she worked harder to find a way to help.

After serving eight years in primary health care, Hallberg left her practice to dig into the scientific literature on obesity. Her research and passion opened onto a new career path for her, leading her to head an obesity study at Indiana University, deliver a TED Talk at Purdue, and become the Medical Director at Virta Health before joining the CrossFit Health circuit to share her research on carb-restrictive diets in the treatment and reversal of Type 2 diabetes.

Hallberg was committed to finding effective, sustainable, and preventive measures for treating diabetes — alternatives to traditional methods involving insulin and other drugs. She focused on empowering physicians to do more than write prescriptions and helping patients take control of their health.

If you would like to help continue Hallberg’s work, please consider contributing to the GoFundMe page organized by fellow CrossFit Health contributor Nina Teicholz. Proceeds will go toward creating educational resources related to the treatment and reversal of Type 2 diabetes.

Comments on 220414

16 Comments

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Chris Sinagoga
April 14th, 2022 at 6:37 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Just watched this again, and even better the second time around. Also kind of ominous how she made the hypothetical scenario about 50% of people catching an infectious disease.

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Kristan Clever
April 14th, 2022 at 5:52 pm
Commented on: 220414

re-watched her discussion with Peter Attia MD.

what a fighter.

may we all remember her and may her legacy continue.

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Katina Thornton
April 14th, 2022 at 11:42 am
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

The world has lost a brilliant, probing mind. It's up to all of us to continue her mission and identify how we are part of the problem and what we can do to improve the situation.

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Jason Mateer
April 14th, 2022 at 8:23 am
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

This was great to watch, delivered with great energy and passion and with a message so straight forward and non-complex that there will be continued success in Dr Hallberg's work. The world has lost a true gem in her passing. Long live her legacy.

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Chris Sinagoga
April 14th, 2022 at 2:42 am
Commented on: 220414

Dr. Hallberg's video was literally next on my list as I'm going back and rewatching the Messpert archives. Sad to hear about this.

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Matthieu Dubreucq
January 30th, 2020 at 12:22 am
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Great simple explanation. Especially like the fact she wants to educate the patients so they can make the best choice to reverse (or improve) their condition.

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Terence Kealey
June 16th, 2019 at 12:55 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

As recently as 2009 Vivian Fonseca, the editor-in-chief of the American Diabetes Association’s journal Diabetes Care, could open an article in his journal with the words “Type 2 diabetes is a progressive disease …” Dr Sarah Hallberg, of the Indiana University Weight Loss Program, believes that ain’t necessary so.


Before 1977–before the Federal government first advised the people of America to eat more carbohydrate and less fat–patients with diabetes were given sane and sensible dietary advice: type 2 diabetes is a disease of carbohydrate intolerance, so patients were advised to avoid carbohydrates. Those were the days of special diabetic foods such as low-sugar jams, but such foods are no longer much marketed, because type 2 diabetics have in recent decades been told to treat fat, not sugar or carbohydrate, as the enemy.


The war on fat was declared by Ancel Keys (1904-2004), a physiologist from Minnesota, who argued that because atherosclerotic plaques are full of cholesterol and other fats, people should avoid fatty and cholesterol-rich foods. And his argument was urgent because the US suffered, after the war, from an epidemic of heart attacks. And since diabetics, too, are prone to cardiovascular disease, they too were steered away from low-carbohydrate foods to low-fat foods.


Which Sarah Hallberg finds ridiculous. As she protests, type 2 diabetes is a disease of carbohydrate intolerance, and if patients suffer from an increase in heart attacks and strokes, perhaps their high levels of glucose and insulin are driving the synthesis of abnormal fats by the liver. And perhaps, in turn, the abnormal fats are then deposited within the arterial walls.


She’s of course right, and in her recent work she’s shown that putting type 2 diabetics on low-carbohydrate diets not only lowers their blood sugar and HbA1c levels, it also helps restore their blood lipid patterns to near-normality. Type 2 diabetes, it transpires, is not a progressive disease: it can be reversed.


Dr Hallberg is not the only person to have made this discovery, and perhaps the best book on the subject is Dr David Cavan’s 2014 book Reverse Your Diabetes, which shows how low-carbohydrate diets can indeed reverse your diabetes. But though Sarah Hallberg is not alone, she may be the best advocate for the new story. She’s a great communicator.

Unexpectedly, we now have not one but two competing techniques for reversing type 2 diabetes, Sarah Hallberg’s low-carbohydrate diet and Roy Taylor’s low-calorie diet: Dr Taylor has shown that the insulin-secreting cells of the pancreas are disabled by abdominal fat, and when he puts his patients on diets of only 800 or so calories a day, they eventually lose enough abdominal fat to rescue their insulin secretion.


Interestingly, Roy Taylor’s clinical findings are similar to Sarah Hallberg’s, in that he can reverse diabetes in about two thirds of patients, with the best results being found amongst the more recently-diagnosed folk. Future research will probably integrate Hallberg’s and Taylor’s work into one combined pathophysiological narrative, but for now let us rejoice that, in a single decade, at least two separate approaches have confounded the depressing fatalism that ruled the field as recently as 2009.


Dr Hallberg is now extending her studies beyond a year or two, to discover for how long patients can maintain low-carbohydrate diets and to discover for how long diabetes can be maintained in remission. My guess is that they can both be maintained indefinitely, because we don’t need to eat carbohydrates. They are not essential foods.


During the 19th century, Ignaz Semmelweis in Vienna was driven literally mad by his failure to persuade his obstetric colleagues to wash their hands before, rather than after, they internally examined women during the delivery of their babies–even though such examinations with unwashed hands led, on a horrific and easily-measurable number of occasions, to the deaths of women from puerperal fever or infection. But on failing to persuade his colleagues, Semmelweis was, infamously, reduced to prowling their wards, denouncing them to their faces as murderers.


Dr Hallberg has, however, avoided this trap. Even though she is bewildered by the survival of Ancel Keys’s low-fat idea, she recognizes her carbohydrate-endorsing colleagues as good people, anxious to do good, who have simply been misled by a flawed hypothesis, and she approaches them courteously and with respect. Moreover, she is clearly winning them over, because she has one insuperable force on her side, namely the empirical observations of good science.


Sarah Hallberg is a rare person who saw through the failings of the low-fat high-carbohydrate story: she recognizes diabetes as a disease of carbohydrate intolerance. But she also possesses the diplomatic skills to convert the opposition. She will prevail in ways poor Semmelweis did not.

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Cliff Lightfoot
June 15th, 2019 at 8:08 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

It is interesting that crossfit has had recent blogs vilifying modern medical research, yet has linked this study (and private company). As a fellow physician, I urge readers to take what they read/hear on the internet as opinion. Do your own research, present this study to your doctor, and have a conversation with him or her about your care.

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Chris Sinagoga
June 7th, 2019 at 5:28 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Great presentation/Q&A


Sounds like CrossFit can be not only the swim coach, but the lifeguard too.

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Allison Autrey
June 6th, 2019 at 8:46 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Great talk! So much great information but especially like where she makes the analogy about how the diabetes epidemic would be approached/attacked much differently if the epidemic was an infections disease one. What would happen if 52% of the population had an infections disease? Powerful statement

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Michael Shaleen
June 6th, 2019 at 6:33 pm
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Love the focus and efforts to help 'every day' people!!

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Mars Leroux
June 6th, 2019 at 3:03 am
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

There are also some evidence that suggests a Carb restricted dieet combined with Creatine supplementation may extend the life span of cancer patients.

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Dan Palenchar
July 10th, 2019 at 6:36 pm

Mars, the addition of Creatine is interesting here. Do you have any resources you can share? Carbohydrate restriction, given the high glucose utilization of cancer cells, makes mechanistic sense and I've seen studies on this. I've not heard of adding creatine supplementation, and am wondering what the mechanism might be. Are the possible benefits of creatine supplementation dependent on and/or additive to those of carbohydrate restriction alone? Would love to hear your thoughts, or see any evidence you're aware of.

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Russ Greene
June 6th, 2019 at 2:52 am
Commented on: Dr. Sarah Hallberg on Carb Restriction as a Sustainable Diabetes Treatment

Great talk, but if Dr. Hallberg is waiting for NIH to come around, she might have to wait forever.


NIH is fully invested in old carbs plus drugs paradigm, in the intellectual and financial sense:

https://www.sciencemag.org/news/2018/06/us-lawmakers-want-nih-and-cdc-foundations-say-more-about-donors

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Russ Greene
June 6th, 2019 at 2:53 am

*in the, not "old.

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Richard Feinman
July 26th, 2019 at 11:30 am

They seemed to have now latched onto the DASH diet. Very sad.

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