We’re living in fascinating times when it comes to nutrition science – especially if you’re a follower of Functional Medicine. And if you’re a horse owner navigating Equine Metabolic Syndrome (EMS), insulin resistance, or the dreaded spring grass season, you’ll know how frustrating it is to feel like you’re constantly firefighting. Too fat, too cresty, too footy.

So when one of my favourite IFM mentors (Institute of Functional Medicine) – Dr Mark Hyman - recently dropped a podcast titled “Reversing Diabetes Naturally: The Science Big Medicine Ignored,” I got very excited – because, as always, the crossovers to equine health are impossible to ignore. In fact, they’re positively galloping.

The core message - it’s not about fat. It’s about carbs

The central theme? Insulin resistance – both in people and ponies – isn’t driven by dietary fat or protein. It’s driven by an overconsumption of refined carbohydrates, processed sugars, and what Dr. Hyman calls “food-like substances.”

More accurately, it’s not just about carbs in isolation – it’s about the type, the load, and the metabolic context. In both humans and horses, it’s the combination of refined inputs, reduced movement, and compromised metabolic flexibility that creates the problem.

Sound familiar?

Our modern horse feeds – especially the shiny commercial mixes – are the equine version of this. High in starch, cereals, molasses, and low in fibre or any real nutrition. And yet, for years we’ve been taught to stick to low-calorie “lite” feeds while meanwhile, obesity, EMS, and laminitis cases are rising fast.

And yet… The science is increasingly pointing us in a different direction.

Diet as medicine – literally

Dr. Hyman and colleagues shared how carbohydrate restriction and ketogenic diets are now being used to reverse Type 2 Diabetes in humans – yes, reverse. Not just manage with medication.

In one clinical trial, people with advanced Type 2 Diabetes came off insulin, reversed their blood sugar issues, and normalised their metabolic markers – just by changing what they ate.

And the crux of it? “If you don’t take the toxin, you don’t need the antidote.”

In other words – remove the cause, and the symptoms go away. A radical idea in conventional circles, but not to those of us in the natural health space – because this is foundational functional medicine. Treat the terrain, not just the symptom.

So, what does this mean for our horses?

Let’s be clear – we’re not putting our ponies on keto, nor are we filling their feedbowls with sloshes of liquid oil. Horses are herbivores, and their metabolism works differently to ours. But the parallels are still powerful:

• EMS is a disorder of carbohydrate metabolism.
• Horses with insulin resistance are carbohydrate intolerant.
• Feeding high-starch, sugar-laced, cereal-based diets keeps their metabolism under constant stress.
• This stress increases inflammatory markers, strains the liver, and hammers the pancreas.

We’re also learning more about the role of the gut microbiome and cellular energy metabolism in this picture – how the hindgut, liver, and muscle cells communicate in regulating insulin sensitivity. It’s not one pathway, but a network.

The solution? A low-starch, high-fibre, forage-based diet supported with functional nutrition. And the thing is – we all know this! And yet we still buy those cheap, heavily processed, junk-filled bags at our feed merchants.

It’s not radical. It’s returning to what horses evolved to eat – simple, fibrous plants with a diverse range of nutrients and a slower sugar release. Add in herbal allies, targeted mineral support, and nutrients that support cellular energy pathways, and we’re starting to address not just the symptoms, but the underlying metabolic conversation.

Repeating patterns, missed conversations

One thing that stood out in the podcast was the failure of traditional medicine to have the adult conversation. Major trials showed that weight loss alone didn’t fix diabetes – yet the system kept doubling down on the same broken advice. Which totally sounds familiar in the horse world.

We keep seeing advice like:

• “Just restrict turnout.”
• “Use a muzzle.” Out of my three EMS's, only Cookie would keep her muzzle on - Murf would literally cry within minutes and I felt so bad that I took it off. As for MacAttack, well you can guess... he had it off within seconds, usually hung from a very high branch so I couldn't reach it.
• “Add this safe-for-laminitics feed.” Which is actually mostly about profit - a "Safe for Laminitics" stamp on a feedbag usually means palms have been crossed with silver to lure worried customers to buy their product. And yet if you check the sugar content you'll see it's often over 7% - including molasses-free beet which still carries a sugar-reside of 7%.

All while ignoring the metabolic why behind the problem. And just like humans, our horses are often stuck on this blood sugar rollercoaster, never truly resolving the root cause.

From chronic to reversible?

One line from the podcast hit me fair and square - “It’s only a chronic progressive disease if you keep feeding the toxin.”

What if EMS and insulin resistance in horses don’t have to be lifelong labels? What if, with the right feeding approach, lifestyle support, and functional nutrition, we could bring these horses back into balance – not overnight, not magically, but systematically?

At EquiNatural, that’s our north star. It’s why we do what we do. And full disclosure – after a decade of struggling with my connie, Murf, where he only had to look at green grass and the crest, pulses, and hot footy hooves would all say a big “Hello!”, I got him to where he was able to go out comfortably on grass, 24/7, for his last 10-years.

Let’s keep the conversation going

This blog isn’t about giving medical advice - it’s about nudging the needle of awareness. If the science is shifting in human health, we should be taking notes in equine health too – especially when so little funding is directed toward equine metabolic research.

Metabolic mayhem isn’t just a human epidemic – I saw it back in 2001 when I first got Murf - and we still see it year in, year out in our fields, on our yards, and in the feet of our beloved ponies. And they need us to do better.

Thankfully, we can. Nourish wisely, strip back the unnecessary, and trust in nature’s blueprint.

Your horse’s cells are listening.