toast test

Brian Mowll's Avatar

Brian Mowll

16 Sep, 2013 08:19 PM

Dr. Rosedale,

I've been following your work for almost 10 years and have always been interested in learning more about the toast test. You mentioned in the toast test interview that you learned a lot about insulin while in Asheville, NC - what makes it go up and what makes it go down. And you described the hyperinsulinemic boy with the "half piece of toast". Have you done this test enough times to have "standardized" a response? I would love to use this or something like it for my IR/T2D patients with a 2 hour glucose/insulin challenge, but I'm not sure what is a normal vs. abnormal response. Could you provide some insight as to what we should use to challenge (e.g. what type of bread, how many grams of bread, how many grams of starch/fiber/sugar, etc.), and a normal response range vs abnormal response range? Obviously, I am not using this to create a diagnosis and we are not submitting to insurance, this is a functional assessment of glucose tolerance and insulin response. Thanks. Dr. Brian Mowll

  1. Support Staff 1 Posted by Fiona on 30 Sep, 2013 02:18 AM

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    Dear Dr. Mowll,

    First of all, it is so refreshing to hear from another doctor that is really keeping up to date on better ways to treat their patients. Dr. Ron is amazing in what he has done for his T2 (that never stay that way for long) patients, and many others as well. Dr. Ron has been traveling a lot and trying to finish a book so I have not been able to get your an answer to your question as yet. I know he does not do the toast test on everyone, after all these years he looks at them, their labs, and just has that inert ability to know what is going on. I will continue to try to get a answer for your from Dr. Ron. In the mean time, we get asked all the time for doctor referrals, and as Dr. Ron does not see patients anymore would be great to have other doctors that treat in the same way. This is your website correct? Just one question for you, are any of your patients on statins?

    Also we are actually going to be launching Dr. Ron's supplements again as so many patients have been asking constantly the last 5 years they have not been available. We will be working out a whole sale rate for other doctors, or an affilate compensation as well for directed traffic.

    Hope all is well.

  2. 2 Posted by Brian Mowll on 30 Sep, 2013 03:16 PM

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    The website for my private practice is

    However, I have just launched a new initiative to reverse the diabetes
    train wreck that is hitting our nation and world. We are starting a
    community-based, integrative chain of diabetes centers called SweetLife
    Diabetes Health Centers.

    The first one is launching in mid-October. The website is

    I would love to check out Dr. Ron's supplements and if he is interested, I
    would be honored to include him as a part of our Medical Advisory Board,
    since he has already advised me so much through his books, podcasts,
    articles, and interviews.

    Could you look at our website and check with Dr. Ron to see if he would be
    willing to sit on our board? There is no time required. It is mainly an
    advisory role which can be as much or as little as Ron wants (I know he is
    super busy!).

    Thanks for the response and I look forward to hearing back from you.

    Dr. Brian Mowll

  3. Support Staff 3 Posted by Fiona on 30 Sep, 2013 08:00 PM

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    Dear Dr. Mowll,

    That is wonderful news! Will be centers be promoting a Rosedale type diet? Dr. Ron has been honored to have been asked to sit on many boards but when we dig a little deeper often the programs were not ones that Dr. Ron would be associated with. So we would need to know a little more, and to find out how this could work for both Dr. Ron and the group. As you know it is his life's work and had made great strides. Dr. Ron is currently launching more critical information about mTOR which is very exciting and important to get out to those that are needlessly suffering.

    Many thanks,


  4. 4 Posted by Brian Mowll on 30 Sep, 2013 08:11 PM

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    The Rosedale Diet is required reading for all clinicians at SweetLife! We
    use a low carb, moderate protein, high (healthy) fat approach emphasizing
    olive oil, fats from cold water fish, avocado, nuts and seeds, and medium
    chain triglycerides from coconut. Our focus is on controlling insulin and
    leptin and healing the cell membrane to allow better hormone signaling and
    improved glycemic response.

    I've attached a document describing our Core Diabetes eating plan.

    In addition to Dr. Ron, I follow Richard K Bernstein from New York, who
    advocates a similar approach. My views are much more aligned with Dr. Ron,
    however, particularly regarding supplementation.

    Thanks again for reaching out.

    Dr. Brian Mowll

  5. 5 Posted by Brian Mowll on 08 Oct, 2013 03:17 PM

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    Hi. Just wanted to see if you were able to follow up on this.


    Dr. Mowll

  6. 6 Posted by Brian Mowll on 24 Oct, 2013 02:43 PM

    Brian Mowll's Avatar


    I was wondering if you could pass along a message to Dr. Rosedale for me:

    Dear Ron,

    I have followed you for many years and have a question for you.

    My practice is almost entire type 2 diabetes and metabolic syndrome and we
    get excellent results using a similar approach to what you describe in your
    book, articles, and podcasts.

    However, I have one area that we cannot seem to correct that shows up in
    about 20% of our patients. The pattern is in patients not on insulin whose
    blood glucose level is regulated before bed (<100), but rises sharply in
    the morning to 140+ upon rising.

    I've tried testing and addressing cortisol levels and that does not seem to
    be consistently related. I've also looked at urinary epinephrine
    metabolite testing without much correlation. I have found no consistent
    relationship with sleep apnea or poor sleep habits either.

    This seems to be unrelated to food, and my only remaining assumption is
    that the liver is over producing (dumping) glucose in the morning.

    Have you seen this and do you have any useful strategies for helping to
    correct this morning blood glucose spike?

    Thanks for your help.


    Dr. Brian Mowll
    [email blocked]

    The information in this email is not intended as and does not substitute
    for medical advice - the information presented is for patient education
    only. Please consult your primary care physician or hospital for any
    medical emergency.

  7. Support Staff 7 Posted by Ken on 25 Oct, 2013 10:24 AM

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    Greetings Dr. Brian

    While you are waiting on a reply I have a 2 part question.

    In your practice have you experienced the following with your patients?

    • (1) flaccid paralysis in leg(s) due to lack of sufficient potassium

    • (2) edema in leg(s) due to lack of sufficient protein

    I am asking as a lay-person ...

    Much appreciated

    Ken Smith, Farmington, Mo.

    BTW Thought I might add that I am not seeking medical advice, just a yes or no -- Thanx

  8. Support Staff 8 Posted by Dr. Rosedale on 12 Nov, 2013 02:45 AM

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    Hi Brian,
    Actually, this is quite common and is something I expect and look for if someone is following the diet properly. Evening blood sugars generally reflect the how well one is following the diet and the before breakfast blood sugar reflects how much the liver has manufactured, and that is determined by the liver sensitivity to insulin and the hypothalamus's sensitivity to leptin. Both of these regulate gluconeogenesis, so your thought about the liver dumping glucose in the morning is correct. If one continues to follow the diet, the liver becomes more sensitive to insulin and as the hypothalamus becomes more sensitive to leptin, gluconeogenesis will reduce . Improving the sensitivity of the liver to insulin can often take several months and sometimes a bit longer. If one has considerable visceral adiposity this might have to burn off somewhat to physically improve the blood flow of insulin into the liver.
    I appreciate your fine question.

  9. Support Staff 9 Posted by Dr. Rosedale on 12 Nov, 2013 02:46 AM

    Dr. Rosedale's Avatar

    Thank you Ken as well for all your support and being a wonderful example to others. Keep up the great work!

  10. Support Staff 10 Posted by Dr. Rosedale on 12 Nov, 2013 11:46 PM

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    I noticed on your diet recommendations that you allow 50-100 net carbs per day. It may be especially useful in those that are having trouble lowering their morning blood sugars, to keep their carb intake to the lower portion of that range, and perhaps even lower. Also, and perhaps even more importantly, they need to adhere to a maximum protein recommendation (on average approximately 1g protein/ kilogram lean mass/per day) that is especially relevant to reduce gluconeogenesis at night. Regarding carbohydrates and why 100 grams of carbs may be high; you can see the finale to a fine debate on this topic;

    Keep up the good work.

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