Dhru Purohit Show - Doctor Makes His Case for the Carnivore Diet to Heal Chronic Gut Conditions and Shares What We Know and Don’t Know About High Cholesterol with Dr. Shawn Baker
Episode Date: June 24, 2024This episode is brought to you by Cozy Earth, Fatty15, and Lifeforce. With all the diets out there, determining which one is the right fit is often confusing. Today’s guest offers hope for indivi...duals who may be feeling tired, weak, or dealing with gut challenges and explains why the carnivore diet offers simplicity and reduces inflammation at the root of many of today’s diseases. Today on The Dhru Purohit Show, Dhru sits down with Dr. Shawn Baker to discuss the carnivore diet. Dr. Baker shares what the diet entails, who can benefit the most from implementing it, and the latest research on what we know and what has yet to be discovered. Dr. Baker also shares his journey to discovering the diet, why many people have seen significant healing and weight loss on the diet and common challenges found within the standard American diet. Dr. Baker gives us insight into the difficulties with the current healthcare system and shows us how personalized medicine is the future of care. Dr. Shawn Baker is the Co-Founder of Revero, an orthopedic surgeon, a leading authority on treating disease with medical nutritional therapy, an Amazon best-selling author, world champion athlete, international speaker, podcast host, and consultant. He introduced the zero-carb elimination diet to the world and wrote the best-selling book on Amazon. His personal experience with optimizing health and interacting with thousands of patients has shown powerful results in treating and reversing many chronic diseases. In this episode, Dhru and Dr. Baker dive into (audio version / Apple Subscriber version): The carnivore diet on individuals with gut challenges or autoimmune conditions (00:00:04 / 00:00:04) What does a carnivore diet entail (3:48 / 3:48) How the carnivore diet heals the gut (11:50 / 8:34) Who should try the carnivore diet (17:45 / 14:31) Dr. Baker’s journey that led him to explore the carnivore diet (20:20 / 17:03) How Dr. Baker implements the diet (34:52 / 30:00) Weight loss on diet (38:00 / 33:25) The controversy behind the diet (46:00 / 41:40) How lowering LDL isn’t the whole story (1:03:00 / 58:00) Testing to get a fuller picture of heart health (1:07:00 / 1:02:09) Key biomarkers (1:12:00 / 1:07:10) Using the ketogenic diet to treat mental health disorders (1:24:00 / 1:19:00) Prescription medications, research, and bias (1:30:00 / 1:25:30) Lessons from carnivore diet (1:40:00 / 1:35:00) Also mentioned in this episode: Revero Dr. Baker’s Telehealth company Episode with Dr. Michael Twyman and Dhru’s Cleerly results Maui Nui protein For more on Dr. Baker, follow him on Instagram, Twitter, and YouTube, or visit his website. Right now, get 30% off your Cozy Earth sheets. Just head over to cozyearth.com/dhru and use code DHRUP. Fatty15 is offering an additional 15% off its 90-day subscription Starter Kit. Go to fatty15.com/dhru and use code DHRU to replenish your C15 levels for long-term health. Right now, you can save $250 on your first diagnostic and get personalized suggestions. Optimize your longevity and track your progress; go to mylifeforce.com/dhru! Learn more about your ad choices. Visit megaphone.fm/adchoices
Transcript
Discussion (0)
Dr. Sean Baker, welcome to the podcast. You know, I'm curious, if I brought you a handful of patients as a
physician, and I said, okay, this individual is dealing with severe gut issues, this person's dealing
with an autoimmune condition that they haven't been able to get to the root of. And I said,
Doc, put these guys on a carnivore diet for 30 days. Not too dissimilar. About eight years ago,
you put yourself on a 30-day carnivore diet. What do you think would have?
happen to these individuals?
I think many of them would notice some improvement.
You know, again, I don't think this is something that every single person needs to do
or should do.
But in those particular situations, gut issues and autoimmune disease, I particularly see a lot
of improvement with that.
And I think if we look at where many diseases originate, I think the gut is clear.
You know, you think about how we interact with the external environments.
most people don't realize.
We think our skin.
Our skin is how we kind of contact the world.
And the reality is our skin is designed to keep stuff out, right?
I mean, our skin is waterproof.
We don't want things coming in.
Whereas our gut, the surface area of our gut, and most people don't realize this, but from
our mouth, our esophagus, our stomach, our intestines is all external to our body.
That's actually outside of our body.
And most people don't realize that.
And so that surface area is about the size of.
a tennis court. When you think about how much surface area is in the gut, and it's designed to
actually bring things in. If it didn't bring things in, we would starve to death, right? And it's
designed to absorb things. And that absorptive capacity is modifiable by what we put into it.
So really, the biggest interaction we have with the external environment is through our gut.
70% of our immune system is located in our gut for that very reason, because it's so
proximate to the external environment. And so that's why I think a lot of the disease things
that is influenced by our environment is largely directed through our gut.
I know he had somebody talking about indoor air pollution and lungs.
And the lungs are also a way we interact with these things, but our gut is even bigger than that.
So I would say within 30 days, people would probably start to feel better, certainly with
the gut issues.
A lot of people's guts, you know, when you stop, you know, I'll be some bold to say, stop poisoning
yourself, you know, you get better. And again, it depends on what their baseline diet is. If you, if you,
if you take somebody that's eating the standard Western diet and the standard American diet,
which is, you know, just absolute trash, they're going to clearly get better. Now, depending on what
their baseline is, it may, uh, it may or may not have as big of an impact. But clearly
many, many, many people use a carnivore diet to improve these types of issues. And that's how I
promote it. I don't print up promote it as all humans need.
to do this or we, you know, we are inherently carnivorous. It is a, I think humans exist on a
spectrum. You know, there are people that clearly to mostly meet that, all the way to people
that are fruitarians, for instance, and they still exist and they're alive. So clearly you can do
that. But I use it as a therapeutic protocol. I usually tell people three months is more realistic
to see if you're going to get a benefit. And the reason I say that is because I'd collect a data
on about 12,000 people doing this.
And we kind of said, you know, at what point did you notice significant improvements
for XYZ conditions?
And by three months, most people saw a pretty significant inflection point where they
started to see significant improvements to where they could say if it's actually working
or not.
Because I think, you know, the downside is it doesn't work.
The upside is it might potentially change that person's life significantly for the better.
There's a lot of ideas about what the carnivore diet is.
Maybe somebody read an article.
They saw a very brief video on social media.
But give our audience a sense, like, what are those individuals?
You mentioned you had 12,000 people fill out this survey as part of your community.
What are they eating on a daily basis over that period of time of like this three months?
Yeah, I mean, so I mean, as opposed to like social media is obviously a strange place.
It's entertaining.
You know, I think it's for entertainment purposes only, but you can learn some things.
And by the way, I love your content.
It's very entertaining.
Well, I think you have to.
You have to provide some entertainment so you can get people interested so they'll watch.
You can have the greatest message in the world.
You can be one of the smartest, most intelligent, insightful people.
But if your message is boring, no one's going to pay attention.
So you have to do some of that stuff just to get an audience in there.
But I think that what it's not, and you see these people eating, you know, like I'll use
a liver king as an example.
I mean, this guy's out there eating raw liver and raw testicles and acting like a caveman.
It doesn't, it's not that.
It doesn't need to be that.
I mean, it's simply people are eating whole nutritious, you know, unprocessed food.
And it happens to be animal products.
So things like, you know, and I certainly do this.
I mean, a lot of red meat, a lot of beef in particular.
I ate steaks almost pretty much every day.
Eggs are often on the menu, things like seafood.
Really, anything that really is kind of funny.
They had a face or parents is on the menu for this particular diet.
I know that would upset some people to describe it that way, but that's a reality.
Dairy products, you know, can be on the diet, although some people struggle with that.
So I think it's one of those kind of gray areas for people.
But that's basically it.
Now, some people will, like season their food, you know, these and spices and seasoning.
For some people, like an autoimmune person, that might be problematic.
But for the majority of people, let's say somebody just wants to lose 20 pounds or they're diabetic or something like that,
those things are certainly possibilities.
And it's, you know, I have a company called Rivera.
It's a digital health company.
We're nationwide.
And we don't put everybody on a strict carnivore diet.
I mean, some people need it and we'll use it in that situation.
But I think there's capacity to have some level of flexibility there and what's going to happen
long term.
Most people that will do a carnivore diet will end up doing some level of compromise down the road.
I mean, that's just a reality.
90% of the people end up.
up being, you know, when they do it, they obtain some success, and I see this all the time,
I see people say Crohn's disease. And we have a nice article ready to go that we're waiting
on the Harvard IRB to approve so we can get this published. But we get people with, say,
inflammatory bowel disease, which includes Crohn's disease or also colitis. We put them on a
carnivore diet. They heal their gut. Their symptoms get better. All their markers of inflammation go
down. They feel better than they have in years. Maybe they get off the biologic drugs that they're
on. And then over time, maybe a year later, they are able to start including other foods back in there.
And in fact, I encourage people to do that, quite honestly. I'm not religious about this diet.
I don't think it is, you know, I think that's unhelpful to be that way. And I just ultimately want
people to get as healthy as they can, whatever is sustainable for them. And I find that a lot of
people do this because they've been told that meat, particularly red meat, is so bad for us.
You know, it's killing us, it's causing heart disease and cancer and now diabetes, which,
again, the science that would indicate that is, you know, incredibly poor, unfortunately.
And that's the message that's gotten out there. And so once people do this and they experience,
they're like, well, how can something that's supposed to be so bad for me? Something I've heard
my whole life is bad for me, literally bring me to the best health I've ever been in my life.
It just doesn't make sense. And I think that's because, you know, we haven't really properly
studied that. And I think that's something that I am working tirelessly behind the scenes to get
some of these studies published. It's hard. It's hard. It's hard. I've got to
I tell you, getting funding and then getting it through, like I said, even the struggles
we're having getting it through an institutional review board.
I mean, we've got a case series of 10 people clearly with biopsy-proven, colonoscopy-proven
Crohn's disease, clear intervention of a carnivore diet, clear resolution, again, with biopsies
and colonoscopy showing diseases gone.
And the IRBs like dragging their feet, they don't want to publish it because it goes against the sort
of, I don't know, the narrative we've been sort of told to believe.
Well, we're going to get into the controversy in a little bit and how one researcher that
you've mentioned has said that the carnivore diet is so dangerous that it's unethical
that they could actually even do a study on it.
We'll get to that in a second.
But let's pull in this thread about the gut and the carnivore diet.
So is it that the carnivore diet is adding in a lot of good, maybe some things that we're missing,
or is it that the carnivore's diet is removing a lot of the bad,
the standard ultra-processed diet that so many people are eating,
or is it the combination of those both?
And can you give us some examples?
Yeah, I mean, I think it's clearly both.
I mean, you know, I think the standard diet is so bad
that any relative diet compared to that is going to be an upgrade,
whether it's a Mediterranean diet, whether it's a vegan diet,
whether it's a carnivore diet.
We clearly see people that start with this sort of standard American junk food diet,
which unfortunately now, 71% of our diet in the United States now is something like that is ultra-processed
food, even higher in kids. 30% of our kids are now pre-diabetic, 25% of them are obese, which is just
insane. So moving away from that is clearly helpful. And I see that. I see a lot of people that are
critical of this diet. And I say, well, the only reason you got better is because you removed the junk food
and you, you know, you replaced it with a whole food. And I think that's part of the reason, clearly. But I get
people that were on whole food, clean diets, and yet they still improve depending on their
condition. And so I think part of it is the nutritional bioavailability. I mean, we know clearly,
I mean, here's an interesting, this is a little bit controversial because, you know, fiber has been
so lauded as this super nutrient, even though it's not essential. You know, we're supposed to eat
25 to 30 grams a day. That's what they recommend. And we look at what fiber is doing. And
observationally, epidemiologically, people that are consuming,
more fiber tend to have better outcomes. That's clear across the board. Now, I suspect that is because
it's a marker for diet quality. You know, you think about it. If I eat all this accellular
processed food, if I'm eating cakes and cookies and potato chips, I'm getting very little fiber
than diet. When I compare that to, say, someone who's eating fruits and vegetables and whole foods,
that's clearly a better diet quality. So I think that's a lot what it has to do. But interestingly,
there's a nice study from back in, I think, 1978. Interesting.
where they looked at high fiber versus low fiber diets.
And what they found was those people on a high fiber diet actually excreted, you know,
through their, through their weights products, their stool, twice as much protein,
twice as much fat, twice as much carbohydrates.
So you're actually losing nutrition, which is not a very effective way or efficient way
to nourish yourself.
But like for instance, 2018 study from Stanford showed that people that have major
depression, depressive disorder. And depression is so pervasive these days. I think something like
25% of the population is on some sort of mental, is diagnosed with some sort of mental health
disorder, which is just shocking. One in four people that we run into in the United States has a
mental health disorder, which does not bode well for happy society. And you think about every fourth
person you run into has got some sort of mental health issue. That's a problem. The odds of those
people colliding is quite high. But back to the Stanford study, people with low levels of carnitine
were statistically much higher, like three times higher to have depression. Now, where do you get
carnitine? Now, carnitine, we can manufacture some in our body. It's not essential. But if we're not
consuming it, it tends to be low. Where can you get carnitine from almost exclusively from animal products?
I think it's kind of interesting. I think asparagus has a small amount. It's like,
the only plant product we can get carnitine are one of the few. But animal products, red meat in
particular, is something that's very high in carnitine. So that's one example. We also look at things
like iron deficiency, zinc deficiency, or I just say relative deficiencies. And again, those things
are higher or more bioavailable when you eat things like meat. Again, those things have a tremendous
impact on our mental health. You know, there's just numerous of these things that are available.
The other thing is, I think that we see that insulin levels are often associated with disease states.
You know, you can literally go to any scientific search and you type in hyperinsulinemia,
which is too much insulin in the body, and literally any disease, and you're going to find an association,
whether it's cancer, dementia, diabetes, obesity, heart disease, on and on.
The list goes on and on.
And so a carnivore diet generally is pretty reliable at bringing high levels of insulin down.
So a lot of people see improvements in that.
So there's a number of things going on physiologically.
I mean, just like you would imagine.
I mean, there's so many, you know, reactions that occur in our body on a daily day.
There are millions of them.
So anything, it's kind of, you know, it's kind of interesting because everything affects everything.
You know, it's so complex.
but when you start feeding yourself good quality of nutrition, I have not seen, literally
it's been surprising.
Almost every disease I've seen someone present with has been improved by improving their
quality of nutrition, which I don't think is a controversial statement.
The controversial statement is, what do you mean by improving their nutrition?
Because some people say, oh, my God, you're eating a lot of meat and saturated fat.
That's awful.
Other people would say, hey, you're removing all the garbage.
You're providing high quality protein.
you're providing a lot of essential nutrients.
You think about why do we eat?
I mean, why are we required to eat?
I mean, a lot of people eat because they're bored or they're stressed out or they're,
the guy on the TV told them to eat.
I mean, that's why a lot of people eat for the wrong reasons.
But what do we have to do?
What do we have to obtain from nutrition?
We have to obtain essential amino acids.
There are essential fats.
We have a requirement for energy, vitamins, minerals, and then arguably water.
And a carnivore diet provides that in a very, very nice way without.
the additional things that might be potentially harmful for us.
Do you find, especially with this big community that you have behind you that's tried the
carnivore diet, do you find that most people find their way to this because they are hurting
in the sense that they're sick, their gut is messed up, something is wrong, and then they're looking
for a therapeutic solution to get better or, and maybe what percentage,
of people are coming saying, look, I feel pretty good, but I want to feel better.
Yeah, I think, and I think rightly so, the majority of people that have tried this, you know,
because you think about it, there are so many good foods out there, right?
I mean, I still get it.
I mean, I like foods.
I always like those things.
I mean, why would you give up something that provides you, you know, some level of pleasure
if you didn't have to?
I mean, most people won't make a change unless there's some level of pain.
You know, there's got to be a pain point to get people to change for most, most of the time.
Now, there's a small percentage of people to say, hey, I want to just see if I can
level up in some way in some regard. And, you know, does that help? For some of them, it does.
Some people say, had to the diet, I was already healthy. It didn't make much of a difference.
And that's why I tell people, hey, there's no reason to try it. The vast majority of people,
and I think rightly so were people that were legitimately sick. In fact, the majority of people
that do this are tend to be older people. You know, young people, you know, their 20s,
you know, like when I was in 20s, I felt pretty good. And I just imagine if I could magically
transport myself today at nearly 58 years of age back to my 20s, I wouldn't listen to me.
There's no way.
You know, go away, old man.
You don't know what you're talking about.
But I mean, it's clearly and rightly so, people that are sick that need to do this.
And I think that's what I get joy.
And as a physician, I mean, it's exciting for me to have somebody with, you know, say Crohn's
disease where they're literally going to the bathroom with bloody diarrhea 20 times a day
on the verge of getting their colon removed.
they say, hey, I want on the diet and not only do I not need surgery, but it's completely gone.
I'm completely healthy.
Or somebody who had, you know, such severe depression that they were suicidal.
And now they're like, I have a normal life.
And those things to me are so exciting.
And that's why I continue putting this message forth and being such a vocal proponent.
You know, granted, I mean, like I said, it's not the only reason way people can get healthy.
but it clearly has been uniquely beneficial or many other things have not been tried and not been
helpful set the stage a little bit with your story what was the pain that you were in that had you
try many other diets before you got to trying carnivore for 30 days and take us through your
experience of what you went through in that 30 day challenge yeah so I mean this is so when I did that
this was 2016 so we're in 2024 so eight years ago now prior to the
that, I was a, I don't know, 40, 243-year-old orthopedic surgeon. I was a very accomplished athlete.
I just won a world championship, some called the Highland Games, where you put on kilts and
throw stuff. So, I was a big, strong athlete. And I just didn't feel it. Professional rugby player.
I played professional rugby, and then I'd done high-level power. I've set some national
records in powerlifting, and I've won world championships and rowing. So I've done a lot of sports
where I've competed at a very high level.
And I remember being in my early to mid-40s
and sitting there going, you know what?
I feel old.
I don't feel very good.
And I didn't like that because I was like,
well, I'm a doctor.
I should be able to figure this out.
I'm a hardworking athlete.
I shouldn't feel this way.
And yet I did.
And so the only piece that I felt that I hadn't fully maximized
was my nutrition.
And so I was probably at that time,
290 pounds.
I mean, for perspective, I'm about 260 right now.
So about 30 pounds heavier.
Not that I was obese, but I was heavier than I probably needed to be.
I needed to be for the sports I was competing at because at 6'5, 290,
I was kind of on the smallest side for Highland Gaines.
These guys are 6, 7, 340 pounds.
You have to be very big to throw these things far.
But I didn't want to be that heavy anymore.
And I could see I was becoming metabolically unhealthy.
I mean, this is just inevitable what happens if you're that big for that long in many cases.
And so I decided I would do what I thought was the right thing at the time.
I ate a low-fat diet.
I ate a lot of vegetables.
I ate a lot of lean protein.
I worked out like a maniac, even harder than I was.
I remember I was getting up at 4 o'clock in the morning,
jumping rope 3,000 times before I had to go to work to go do surgery on people.
And then I would, at lunch in my clinic days, I'd work out during the lunch hour,
and then I'd come home at night.
I put my kids to sleep to another couple thousand jump ropes.
And I did this for about three or four months.
And I lost in the course of three months, something like 50 pounds.
And I was very lean, but I was miserable.
I was literally like hungry.
The nurses at the hospital said, hey, we like the fat Dr. Baker way better because you're
kind of an asshole.
So I was literally like, you know, starving.
I realized that that was not something I could do sustainably over the course of time.
And so I started looking at this time, I think the paleo diet was in vogue.
And so I was kind of attracted to that and I did that for about a year or two.
And I felt a little better.
And then I kind of got into the low-car literature and some of the popular media and some of the
books.
Tried that for a while.
I went on a ketogenic diet for a period of time.
And the interesting thing for me was in my career, I was doing, you know, as a surgeon,
I was doing a lot of things like knee replacements and hip replacements.
And one of the struggles we had was we had a lot of obese people that were wanting
these surgeries.
And obese people, unfortunately, are at higher risk for a number of complications, blood clots, infections, poor rehab outcomes.
And so as a community of surgeons, we all kind of got together and said, hey, we're not going to operate on people if they're above a certainty of my class without a significant attempt to have them lose weight because the complications aren't worth it.
And there was no sort of guidance.
It wasn't like, hey, do this.
It was just like, get your patients to lose weight.
We're like, I don't know how am I going to do that.
Some people sent, you know, we had a bariatric surgeon that was doing gastric bypass,
but there was no way he could keep up with the demand of the number of patients we had.
So that wasn't a realistic option.
And so I, at the time, because I was on a low-carb diet, sort of trying that with my patients.
And what I was seeing is, you know, not the majority of them wouldn't try it.
About 20% would do it.
But the ones that would do it, I found, as I would bring them back about two weeks later,
I'd say, hey, how are you doing what the diet was going on?
a high percentage of them were started telling me, hey, you know what? My knee that we're supposed to be
operating on doesn't hurt anymore. And to me, that was like, wow, that's weird, you know, because
I've got your x-ray and your knee looks like garbage. It looks like a dog's been chewing on it, right?
I mean, it's, you know, clearly you need surgery, but one of the prime indications for surgery
is pain, and they're like, they're no longer in pain. And so to me, you know, I'd done thousands of
surgeries about that time. It was more exciting to me that these people didn't need their surgery,
anymore than the fact that I get to do another operation.
And so that sort of set me on this weird course.
And I started, you know, asking the hospital, I said, hey, guys, I would like to spend,
I don't know, like one afternoon a week just kind of talking about diet, nutrition.
And the resounding no that I got was just shocking to me.
They were like, no, we're not paying you for that.
your job is basically you're telling you what my job was was to you know take people to the operating
room do surgery on them and you know consequently make a lot of money for the hospital because that's how they
be productive right be productive and make money we don't want you talking about lifestyle so that
frustrated me and I ended up you know eventually walking away from that type of stuff but but during that
journey of me being low carb I ran into this what I thought were nutty group of people just eating meat
I thought they were nuts.
I literally, because that's what you think.
They called it a zero carb diet at the time.
This was before it was even named the carnivore diet.
And I just kind of out of morbid curiosity, I was following.
I remember I was on a Facebook group, which everybody laughed at.
It was Facebook.
It's so stupid, right?
Social media again.
I remember watching these guys.
I was like, this is weird.
I was asking questions.
And, you know, I mean, some of the results they were putting up in an objective result.
They had pictures before and after.
They had, you know, lab values.
before and after it piqued my curiosity enough to where I tried it myself because I was already kind of in this low carb
state of mind and this is like I said 2016 and I remember I had a small following on Twitter I had like
3,000 followers and most of them were like medical types and things like that people that were interested
in kind of low carb nutrition I said hey I'm going to try this all meat diet for 30 days clearly I'm going to
die at the end of this but what's going to kill me I remember I ran a poll I said is it going to be my heart's
going to clog up my, I'm going to die of scurvy, or my colon's going to fall out from lack of
fiber, right? We kind of had a laugh with that. So I did it for 30 days. And, you know, the first
seven, eight days, I felt kind of not great. I didn't feel bad, but wasn't great. I remember
I had some mild headaches. Probably I was dehydrated in retrospect. But by about two, three weeks
in, I was like, well, I feel pretty good. And I was strangely satisfied with just.
just eating steak and eggs, which I thought was weird.
Because, you know, in the past, I was, I like to eat.
You know, you can imagine.
You don't get to be a 300-pound human without liking to eat.
And I was a guy that would go, you know, I go to a restaurant.
I said, let's get two or three appetizers.
Maybe I'll have two or three entrees.
And, oh, I can't decide between the red velvet cake and the cheesecake.
Hell, just give me both, right?
I mean, that had been my way of eating for years.
Because I spent, you know, 25 years weighing 280 pounds as a big, strong athlete.
So I could eat, I could put away a lot of food.
And this time, I was like, you know what?
I'm pretty satisfied with this.
I'm not even hungry, which was to me kind of revolutionary because I was like, I'm not
constantly thinking about food.
So I did that for 30 days.
It felt really good.
And then I said, well, the experiment's over.
I'm going to go back to my regular healthy, um, I'm never a diet.
And I did that.
And within 24 hours, I remember my guts started feeling bad.
I started getting some back pain, and I just didn't feel as good.
And I was like, you know what, all things being considered, I'd rather feel good.
I don't really care about, you know, the fact that this diet is strange, weird.
I'd just rather feel like I feel good.
And within two months, I remember, I'd had really bad quadriceps tendonitis,
semi-right quadriceps.
I remember I was squating.
I was doing a 500-pound squat one time, and I felt a little tear like I partially tore my tendon.
And that had bothered me for 10 years.
I couldn't sit like this for a long period of time because my knee would always hurt.
it would prohibit me from training sometimes because it was too painful.
And as an orthopedic surgeon, I know how to treat tendonitis or how we're supposed to treat tendonitis.
I knew all the little tips and tricks and I had tried all those things.
It never went away.
So I'd kind of resigned myself as someone who was approaching 50 years of age at that time.
I think it was 40.
No, I was already 50 at that point.
That's just being 50.
That's what being old is like, right?
I see it all the time.
It's normal.
Two months after that, it went away.
And it's never come back since, which is kind of cool to me.
So that really got me thinking.
And then I noticed that I was competing.
As I mentioned, I was doing this kind of rowing, this crazy sport, this competitive
rolling where you just get on a rowing machine and push as hard as you possibly can for a set period of time or distance.
And I was already at a level where I was setting American records on that at 49 for the 40 plus age group.
So I turned 50 and I was on this diet.
And within about four or five months, my power.
output went up by something like 10%, which is at that level is kind of unheard of. It's like
taking Usain Bolt going from 9-5 to 9-2. I mean, it was like a huge leap in power,
which again was also very shocking to me. So at that point, I was pretty impressed with my results.
And so somehow I convinced 100 people online at time on Twitter to try it for 90 days. And we actually
collected data. I called this the, because everybody was saying, well, it's just n equals one. It's
It's fine for you, but it's not applicable to the population.
So I said, well, let's get a bunch of people out here and call this n equals many.
Instead of n equals one, it was n equals many.
Got 100 people to do it for 90 days.
And we actually built a little website to track the data.
And what we found was that among those hundred people, the average weight loss was about 14 kilos, so about 30 pounds.
They lost about eight centimeters on their waist.
Their average heart rate, the resting heart rate went down by 10 beats per men.
it. And then everything's subjective, sleep, digestive health, mental health, you know, joint health,
sexual health, everything got better. So I thought that this is really, really kind of interesting and
weird. You know, I was like, I wouldn't have expected that. And so this is probably September of
2017 at this point. And then I think at that point, Joe Rogan picked it up and kind of message me,
hey, would you like to come on this show and talk about it?
And at that point, I was like, yeah, I didn't realize how influential he was at the time.
Because I didn't really pay attention to podcasts and stuff.
So I kind of drove up to his place in Woodland Hills at the time and just kind of hopped in there and had a discussion.
And then all of a sudden, you know, obviously it kind of gets a little bit overblown.
And then all of a sudden, I had a lot of people start asking me question and following me.
I had a lot of vegans that didn't like me at that point.
I remember all of a sudden I'm like the Hitler to the vegans.
It was funny how that transpired so quickly.
And all I'm doing is saying, hey, look, this is my observation.
I'm seeing people get healthy eating as crazy, all-meat diet.
And I think it's fascinating and interesting and kind of cool stuff.
And I'm excited about it.
But a lot of people didn't like it, apparently.
So that's, you know, and so now we're some seven years later.
And I've been just astounded by the thousands, 10,000,
probably into the hundreds of thousands of people now that have tried it.
with in many cases very, very positive results, which I think is, I think it's just cool.
I think it's fun to see that.
You know, you've shared that you're not religious about the carnivore diet, right?
You're advocating that there's this strong therapeutic approach that you've seen in hundreds,
now thousands of individuals, and you want people to pay attention to it and maybe question
some of the assumptions that they had about various athletes.
of why they thought the carnivore diet or even just meat in general is dangerous.
Now, with all that being said, you've also been very public that 95%, 90, 95% of your diet is pretty much beef.
And I actually don't even know if you add salt to it or if you don't add salt to it.
Do you add salt?
I do.
You have a little salt.
Yeah, it tastes better.
Occasionally you'll have some eggs, right?
You'll have some other proteins inside of there as well.
But beef is the main one.
from the outside, somebody could look at that and say, wow, that seems like very strict.
How have you decided to practice the carnivore diet in that version that you're doing right now?
Yeah, I mean, it's something that I don't think a lot about nutrition anymore.
It's kind of weird in a sense that I don't really, you know, because in the past it was, you know,
you spend so much time thinking about food, you eat lunch, what am I going to have for dinner?
You think about new recipes and new restaurants and you think about how much time and effort
is put into feeding yourself.
And so that's something that I don't even really think about anymore.
It's like, yeah, I don't have a steak.
It's not even a question for me.
It's like how many?
Maybe that's the biggest decision point I have at this point.
But I, you know, a lot of people, well, that sounds so boring.
I mean, literally for me, I enjoy every meal.
It's not like I'm sitting down to eat a plate of, you know, some, I don't know,
what would be so like cauliflower.
If I'd eat plain cauliflower, can you mind?
I don't know how do people do this.
raw cauliflower with anything on that it tastes like sawdust to me but but yeah I mean my diet is is
generally beef based I'd say for sure it waxes and wanes a little bit sometimes you know like if I go
out of town and it's not available I'll eat eggs I'll eat fish I'll eat some dairy products and
things like that every once in a while like I said I'll have a piece of cake you know I'm just like
eff it I'll have a piece of cake it's not it's not to me it's not like I said it's not a religion now
generally I don't want that stuff, which is really cool because it's like, you know,
it's not that I don't get to eat that stuff. I'll eat whatever I want whenever I want to.
It's just I don't really want to, which I think is very liberating because a lot of people say,
oh, it's so restrictive, but to me it's more freeing because I literally don't feel compelled
to eat all this, you know, quite honestly, garbage that's out there. I just don't desire it,
which in many people find that to be incredibly freeing. You know, we have this new sort of
thing these new drugs out there, these OZemex, GLP1 agonists, where people think, for the first time,
I don't feel literally like I have to eat this stuff because we have such a problem with, you know,
I think this is a real issue, food addiction. I think there's, you know, clearly people with
eating disorders, whether it's binge eating disorder, night eating disorder, or just food addiction,
which is estimated to affect about 14% of the population. And, you know, these people are constantly
sort of controlled by food and their cravings. And when that goes away, it is incredibly, incredibly
liberating. And so that's how I feel. I just don't, I don't really worry much about nutrition.
I know, I know, you know, if you think about every animal on the planet, how many of them
are walking around with apps telling them what to eat? I mean, we see people in it, we're like,
oh, I need to, you know, get my macros or, you know, add up my micronutrients or they're on some
sort of crazy plan. And maybe they're tracking themselves. And maybe they're tracking themselves.
with some sort of tracking device.
And no other animal on the planet does that or needs to do that.
And I think humans shouldn't be any different.
I mean, there should be a diet where you don't have to think much about it.
We're just eat until you're good.
And I literally eat until I'm full and I don't eat again until I'm full again.
And it maintains me in what I think is a reasonably good level of help.
I want to talk about weight loss for a second.
You mentioned that a bunch of the people in your community,
the average weight loss when individuals went on this 30-day program.
So it was like 14 pounds?
14 kilos.
14 kilos.
So about 30 pounds.
Wow, that's a lot.
Right.
What is it about the carnivore diet that you think is playing such a significant role
in those individuals that have weight to lose and primarily like the reshaping of their body
composition?
Because it sounds like they're probably, you know, keeping their muscle, maybe in some
cases adding some muscle but losing some fat, is it that they're getting so much protein and protein
is so satiating or is it that they're just not getting this ultra-processed foods, which are so
addictive that cause you to eat more of them? Or is it some combination of those and something else?
Yeah, I think both those things are important. I, you know, again, with the ultra-processed food,
we know that consumptive ultra-processed food literally rewires our brain to desire more of it.
And I think the food engineers know this.
And I think they've known that for decades now.
I actually had a gal who was employed as a food chemist.
And she set her job.
And she worked for one of these major food corporations for like 30 years was to make food
as addictive as possible.
And she felt really bad about it.
She felt horrible about it because she realized that she's been part of this horrible thing
that's really destroyed much of our population's health.
But when you think about, you know, you point out satiety, and that's an important concept
because this is how these GLP1 drugs work, for instance, in many ways.
It is very satiety-provoking in a sense that the way I tell people, you know, like people
ask me, well, how much should I eat?
Well, I say, eat enough, eat enough beef or steak and eggs so that you don't want a cupcake
or a pizza or whatever, whatever that problem food might be.
And the people will do that, they'll often find that they become so satiated.
And you are right that, you know, the protein is typically higher than most diets.
If you're on a bodybuilding diet, you may be kind of equivalent.
You know, the average American consumes between 12 and 16 percent of their calories come from protein.
I think that's not enough for most people.
I think that's the problem with that is it drives you to consume other foods.
So a carnivore diet, typically 20 to 40 percent protein for most people, depending how they practice it.
Protein itself is metabolically more challenging to break down in energy.
So about 20, up to 25 percent of our protein calories are just thermically used up just to process it.
So that's clearly part of what's going on there.
As we talked about, like for instance, with beef things that stimulate GLP1 naturally in our body,
protein does, mono-unsaturated fat, which most people don't realize beef is the biggest fat in beef
is actually mono-unsaturated fat.
We hear about how, because we always hear about the saturated fat, but it's there,
but it's actually the second most prevalent fat in beef.
So I think the mono-insaturated fat, the protein from beef provides this significant satiety
benefit to where a lot of people will find that they're not hungry.
They don't eat as much.
And that can be a problem.
A lot of people under eat on the diet.
And they end up run on into problems with not being able to consume enough.
And so that's an issue that some people have.
So I think that's going on.
I think the fact that it is, despite what some people might say,
it is incredibly gentle on the gut.
You think about how we're designed as human beings.
I mean, our gastric pH is literally 1.5, 1 to 1.5.
that is more acidic than a lion's gut, believe it or not.
A lion runs around two to three.
It's on par with scavenging animals, so like vultures and hyenas and things like that.
And the thought evolutionary was that early hominids were actually scavengers.
And because we would find maybe a lion had killed a zebra and they leave about, on average,
there's studies in Africa that show that a lion will leave about 25 kilos of meat behind after they're done.
So humans went through there, probably picked off.
the scraps that have been sitting out for who knows how many hours, they obviously would have been
contaminated with bacteria. And so we had to develop a very acidic gut to deal with that. And so
there's all this talk about the microbiome and how important that is, but you don't need a microbiome
literally to digest meat because it's all absorbed before it even gets to the microbiome. So it's
interesting. A lot of people are trying to dial in their microbiome through probiotics and prebiotics and
pro prebiotics and all these things because, what,
we're seeing is this fermentation that's occurring by the microbiome. But, you know, so you have to,
so in order for you to effectively consume all this plant food, the microbiome has to be dialed in
or you have problems. You have digestive problems. You don't need that for meat. In fact,
there are people, so the most compelling argument I can make for this, and there's, well,
there's a couple, but there are people out there that don't have a colon, right? Because you hear
about your microbiome lives in your colon and it, it ferments all this food. It's really important.
and you get these short-chain fatty acids like uteric acid.
Well, why is it that people that don't even have a colon,
you know, the lost their colon due to diverticulitis or colon cancer or Crohn's disease
can live a normal full life to normal life expectancy without even having a microbe
because you don't really need it.
Humans have, like if we compare a human to other primates, like for instance,
a gorilla can get something like 60% of its calories from the,
the fermentation of fiber in its gut. A chimpanzee can get like 45%. Humans can get around 4%. So we have a
very diminished capacity to absorb calories from things like fiber. It's like a tiny amount. Like some
people estimate, maybe at most 200 calories a day. And that's clearly not enough to run a human
being. So it's kind of how we're designed from a hardware standpoint. You know, if we want to use like
the variable microbiome as a software package. We're hardwired to consume meat. We can do it very easily,
very efficiently. And in the context of all species that have ever been on Earth, so every animal
that has either swam, flown, or walked on Earth, something like 85% of them have been carnivorous.
Why? Because it's an easier. It's a more efficient way to digest and absorb nutrition.
You think about if I were going to build a brick house and I had a pile of bricks over here and I had some straw and mud over here, it'd be more efficient to use the bricks that are already formed.
And that's the same analogy to animal, you know, if I'm made up of animal cells, right, and all the components that make up that.
And I need that to continue to maintain that, to grow that.
The easiest way to get that would be to consume direct animal cells.
Rather than consuming the straw in the mud, I just want to.
to consume the bricks. And that's why it's much more efficient that way. So it's a more efficient way
of eating. You know, as food prices go up, and this is interesting, you know, how many of us have
experienced a time where we go, we want to be super healthy and we go buy all this organic fruits and
vegetables, we put them in our fridge. And then two days later, you pull the strawberries out and they're
all covered in mold. You got to throw them away, right? It says, oh, man, that's a waste of money.
And then, as I pointed out earlier, all that fiber that you're consuming, much of the nutrition
actually ends up being flushed down the toilet.
So you're literally like wasting money consuming all this stuff.
Whereas with meat, you're absorbing, almost all of it gets absorbed.
So it's more efficient.
And in fact, many people end up, they find out themselves eating way less on this diet.
They actually end up spending less money because people know,
oh, that's meat is so expensive and so on and so forth.
And true, it is relative to cereal.
I mean, but cereal is literally devoid of nutrition.
That's why I've got a fortified.
You know, that's why we have these fortified cereals
because they're so nutritionally devoid.
And the fortification, you know,
isn't even absorbed to the degree that we think they are.
So anyway, you know, there's people that are listening
and they're like, I like this guy.
He is making sense.
Like, okay, this doesn't sound like crazy.
Help our audience understand,
because a lot of them are not in this world
of maybe being super aware of the carnivore diet.
Maybe they've heard of it a little bit.
why is it that the carnivore diet ends up being one of the most controversial diets that are out there?
And secondarily, I mentioned this earlier, why is it that some researchers or at least one researcher at Stanford University said that the diet is so controversial, it's so unethical that we can't even run a study to see if it works or if it doesn't work.
Give an overview of that.
Well, again, obviously, it goes counter to everything we've heard about for the last 50, 60, 70 years in nutrition.
If we go back to the origins of, say, the American Dietetics Association, this goes back to 1917.
Most people don't know.
It was founded by a woman named Lena Cooper and one other person.
And Lena was a staunch Seventh-day Adventist and Seventh-day Adventist religiously are kind of vegetarian.
They just don't like red meat.
They think it's, they think red meat leads to.
sexual deviancy, masturbation and lust and adultery.
And this goes back to guys like John Harvey Kellogg and, you know, these folks that
believed that meat was one of the drivers of sinfulness.
And so we have that baked into the origins of nutrition.
And then we couple that with, you know, what happened when Dwight D. Eisenhower,
President Eisenhower had his heart attack back in the 1950s.
And so they were looking for a reason.
And that's where they came with this diet heart hypothesis.
So we've been sort of immersed in this belief that meat is the enemy in many ways.
And there are a lot of associational studies out there.
Like, for instance, Harvard University just did one earlier this year saying that, you know,
the consumption of red meat was associated with like a 62% increase in the risk of diabetes.
And the problem with that study, as there are many, is they said, well, you know, we're going to call red meat.
Lazzania is red meat and sandwiches are red meat and McDonald's hamburgers are red meat.
And we're not going to account for how much sugar was consumed.
And oh, by the way, obesity is not going to be something we control for.
It's like we're picking out obese people and saying they're more likely to have diabetes and blaming it on the red meat.
Well, I said, well, it's because red meat makes you fat.
And, you know, I'm sitting here saying, well, wait a minute, I got people that go on red meat diet and they lose 200 pounds.
It doesn't make you fat.
You know, it's the overconsumption of whatever that tends to do that.
But I mean, as far as like, you know, Professor Chris Gardner at Stanford, you know, he says it's unethical to study this diet.
You know, and I'm like, well, right now there are literally hundreds of thousands of people are doing it.
I think it's unethical not to study it, in my view.
So we've got that sort of interesting thing, you know, because there's people that are
so convinced that they are correct without, you know, it's, you know, it's one of these things
where kind of this, you know, trust the science thing that we went through. And it's just like,
if you say you trust the science, you can't question the science. It's not very scientific.
And so this is something that is very much threatening to people because they, they have built
careers saying that I know that I'm right or I'm mostly right. And all of a sudden you have
something that says, you're completely wrong. That's offensive to a lot of people.
people. And they don't want to, they don't even want to acknowledge that in a way. But you can't,
you know, it's interesting. There's this sort of, you've heard the term evidence-based medicine,
I'm sure. And does anyone know where that comes from? Well, interestingly, that came from a guy by the
name of Professor Gordon Guyatt. Now, Gordon is a professor at McMaster's University in Canada.
And back in the early 1990s, he was a internal medicine residency director at that institution. And he was
frustrated that the way medicine was being practiced was that guys were saying, well, I don't know,
my patients seemed to do better when I do this. And there was no real science behind that in sort of
developing, you know, the way we think about things. And so he came up with this concept called
evidence-based medicine, which he actually coined that term back in 1991. There's a paper by him
that you can find. And his entire career since that time has been, how do we evaluate the strength of
evidence. Is this a good study? Is it a bad study? What can we learn from this?
Because quite honestly, a lot of studies out there are kind of worthless. I mean, in fact,
probably most of them are, to be honest. And he was involved in a huge study in 2019,
looking at Red Meat. He was a senior author. It was 14 other authors from around the world.
And they basically said, the evidence that shows that Red Meat causes heart disease,
cancer, or any other disease is so weak and so,
poorly done that it is basically something we can literally ignore. You can continue to eat as much meat
as you want. That's what we know at this point. And I think that's, I think that's a fair assessment
of what we really know. I mean, you can point to, I can certainly pull up studies that will show
you that red meat is beneficial in this regard. It doesn't cause these things as can many people
show studies that show the opposite. But the reality is we just don't know. And I get people asking me,
well, well, is this going to shorten your life? And I'm like, I have no.
idea. I have no idea and I don't think anybody does. And I think this is, you know, to me,
this is sort of almost arrogant in a way to say that the Mediterranean diet is going to make me
live to 100 or the vegan diet or even the carnivore diet. I think that's wrong because we have
no way of really knowing that, no way of testing that. So at best, you're speculating. And so what I am
more concerned about, and I've said this over and over again, I mean, clearly I'm 100% certain that
I'm wrong about something. I just know that. I mean, there's no way I'm not. I mean,
but what I do know and what I see every day is I can take someone who's sick and suffering
and I can provide an intervention, perhaps a carnivore diet, and I can make them so they're
no longer sick and suffering. And I think that is so incredibly important and powerful.
Rather than worrying about am I going to get heart disease, you know, five years prematurely,
or am I going to die of cancer, or am I not going to make it to 100, which I think is all just
guess work and not particularly, you know, the farther you get away from today and tomorrow,
the less accurate you are. I mean, you know, the weatherman can't predict the weather in five years.
I mean, there's just no way, right? I mean, they're lucky if they get it right tomorrow in many cases.
So it's the same thing with medicine and anything else. So again, if we focus on as physicians and
healthcare providers of actually doing what we're supposed to do, it's taking someone sick and
getting them better rather than, you know, maybe putting them on some drug for the rest of their life
in order to prevent something. Who knows what it is? I mean, I think the health care system,
and I'm going off on a tangent here, but I think the health care system is incredibly
poorly incentivized. I mean, we have this just really perverse system at this point, you know,
where patient well-being is almost an afterthought at this point. I mean, if it's not profitable,
you think about the drug companies. If it's not, you think about the drug companies. If it's
profitable they're never going to develop it you know there was an interesting you know
Goldman Sachs did a really nice sort of study on is it profitable to cure a disease
and they came out resoundingly with the answer is no it's not it's literally not profitable to
cure disease and so that's kind of where we're we're at you know with the health care system
in the pharmaceutical industry you know i was asking you why is it so controversial you gave a great
overview. I'd love to pull on some of those threads that you mentioned. You know, the primary
researcher you mentioned, I forgot his last name. Chris Gardner. Chris Gardner. He was also,
if anybody is familiar with the Netflix documentary, the twins study where they took twins.
They had one of the twins follow a vegan diet. They had the other group of twins follow essentially
like an omnivore-ish, you know, diet. They didn't control for calories. They just kind of let people
ate whatever they want.
And not only, the paper was published.
Again, these are researchers from Stanford.
And the Netflix documentary, you know, came around around the same time.
And the big sort of caption from that study and the documentary was, look how much
healthier the vegan diet is because these, the individuals, the twins, again, twins
because they have the same genetics on each side, they lowered their LDL cholesterol.
And that's often the argument that you're hearing.
from individuals who are in the evidence-based camp
and also individuals that are in the plant-based or vegan camp,
which is, hey, we know from these large observational studies
that LDL is associated over time with arthrosis,
heart disease, the number one killer of men and women that's out there.
So anything that we can do to lower the LDL of individuals
is going to be a beneficial thing.
Now, I'd like you to talk about, like,
why is that not the complete story around LDL from your perspective?
Yeah, and again, I'll be very clear.
This is from my perspective.
Because if you talk to the average cardiologist, most physicians will say, yeah, lowering
LDL is a good idea for most people.
And I think for most people, it's probably not a bad idea, to be honest.
And so when you use that as a primary outcome metric, and again, that, anytime we're
using biomarkers, whether it's LDL, whether it's blood glucose, whether it's, you know, serum,
potassium or whatever you want to put in there, it's not a clinical endpoint that's often meaningful.
You know, and so I think, you know, just back to that Netflix documentary, the other thing that
was probably of interest is the people that went on the plant base that clearly lost muscle
or failed to put on as much, much, much, as much muscle, which to me is a clinically important
marker, you know, when we're talking about various markers of disease.
LDL cholesterol or total cholesterol or APOB or however you want to just divide it up or think about it
is clearly a risk factor for cardiovascular disease in my mind, you know, based on the evidence I've seen.
But I do think it's a dependent variable.
And I think there's emerging evidence and certainly some evidence has already been published that shows that.
You know, for instance, there's a huge study that Mortensen did in 2022 look out of Denmark
where they showed that people that had high LDL cholesterol versus low LDL.
cholesterol had no difference in outcomes with regard to cardiovascular disease like heart attack,
strokes, need for revascularization, if they had a CAC score, which is a calcium score of zero,
which means that there is another dependent variable. And what would drive a high CAC score? Well,
things like diabetes, things like smoking, things like chronic inflammation, hypertension. So I think
you have to look at it globally. And I think, you know, it's lazy medicine just to
focus on one variable and say, hey, you come in with high cholesterol in my clinic, you're going to leave with a script.
I mean, that's a product really of the health care system again.
When physicians have five, ten, 12-minute visits, I mean, they don't have time to take a comprehensive look at what's going on.
They base everything on a lab value. You get that. And, you know, it's becoming more and more of that.
In fact, medicine is going to increasingly as providers are replaced by AI algorithms, you're going to see a lot.
less and less physician interface.
Because drug companies would just love to get all the drugs in your hands, and we'll see that.
But with regard to LDL, as you know, Matt Budoff, who's a cardiologist here in UCLA,
is working on a particular study that looked at people with very, very high cholesterol.
We're talking total cholesterol of 7, 800 points, LDL cholesterol, 5, 6, 700,
five years at least in that period of time, all on a sort of,
a higher fat ketogenic diet.
And what they found on their baseline data after five years was that they were at no increased,
they had no increased level of plaque in their arteries and someone who had low cholesterol
with the same level of health.
So that's interesting.
You know, that data study that I had mentioned found that 60% of the people that had
familial hyper-collestrial email, that's this genetic high cholesterol,
those people did not have advanced heart disease.
compared to anybody else. So there's, obviously, I use the analogy if I wanted to start a fire.
And what do I need to start a fire? Well, I need something to burn, some wood, right?
I need an oxygen-rich environment, and I need a spark. And if I don't have any one of those three things,
the fire doesn't happen. So I can have all the logs in the world, but if there's no oxygen
and no spark, it's just going to sit there, right? So I kind of look at that as that is your LDL
cholesterol, is that it's the wood, but if you don't have the fire, if you don't have the oxygen-rich
environment, then it may not do anything. And so, again, I think more and more data is pointing that
way that it's a dependent variable. I think where there's more to come, you know, particularly as Matt
Budoff and hopefully other people replicate his work, that we can see that because I don't, you know,
I'm not interested in having a heart attack, you know. And as someone who I don't have really high
cholesterol. I mean, I know there's some people that do that. And I think here's another interesting
bit of information. So there was a great meta-analysis. It was just published in January this year,
by going to have Adrian Sotomoda out of Minorite Tech. He was previously, he was a PhD from Oxford.
They did 41 randomized control trials, and they did a meta-analysis on that and said,
what is driving high cholesterol in these people in a low-carb state? And overwhelmingly, what they
found was it was if they were very lean. If they were obese, they didn't have high cholesterol.
If they were very, very lean, though, they had high cholesterol, which fits into something called
the lipid energy model. I think maybe if you had Dave Feldman on here, you guys talked about it.
So it clearly lines up with that. I mean, we see, for instance, like certain drugs, like there's
these drug classes called SGLT2 inhibitors. Basically, what happens is they're diabetic drugs,
and you end up peeing off all the glucose. So it makes you,
get rid of all your glucose, and it lowers the risk of heart disease. But guess what else it does?
It raises your LDL cholesterol. And despite the fact that it raises your LDL cholesterol, your heart disease risk goes down.
So again, there's a lot of the things that are at play here. And to say it's just all black and white and just a knee-jerk reaction, everybody on, everybody that has high LDL needs to be on a drug is probably harming some percentage of the population.
You know, certainly, I mean, because, you know, the average doctor visit, this is a problem.
Doctors are used to dealing with sick people, and most of the data we have are on sick people
that have heart disease.
What about somebody who's healthy and fit and physically active and doesn't have diabetes
or pre-diabetes or, you know, chronic inflammation or hypertension?
Are they acting a little bit differently?
I think the answer is yes.
But again, studies are forthcoming on this.
I don't want to push too hard on that.
So I tell people, if you have high cholesterol and you're on a low carb diet, a ketogenic diet,
a carnivore diet, you shouldn't ignore it.
You should get some more information, maybe get some imaging, maybe get some sequential imaging
where you check it, you know, year one, year three, and see where you're going in that direction
so it can help you make decisions.
Well, I'm somebody that fell into that camp.
I've had higher LDL, higher APOB.
I think my APOB at the highest was like 190 when I tested it a few years ago.
and then I made some dietary changes and still it was elevated so I got and I searched a little bit
and through a friend I ended up connecting with a cardiologist Dr. Michael Twyman I don't know if you've heard
his name before yeah I've interviewed him yeah yeah it's a great guy he's been on this podcast a couple
times and through that process and especially me falling into the camp of being Indian South Asian
in America we have the highest risk of any ethnic minority of having heart disease there's literally
center at Stanford University called the South Asian Heart Disease Center that's, you know,
dedicated to like researching this, all the Indians that live up there in the tech money and the
donations. And they've had all these different theories. Is it genetics? Do we have smaller arteries?
Is it this? But it's very clear now, since that Institute's founding, there's a lot more awareness
that especially for Indian South Asians who tend to be undermuscled, skinny fat, have insulin
resistance that those things all play in a role. Not that these other things may not have a
factor, genetics, et cetera, but the lifestyle components being very sedentary play a major role.
So I got some imaging done because LDL, APOB, these are all guesses and their proxies.
So I got advanced a CCTA scan done. I got a particular one done. It's an AI imaging scan,
the clearly scan.
Yeah, familiar with it.
And the results came back, and I was a little bit nervous about what it was going to say.
And it showed that I had incredibly clean vascular health.
In fact, Dr. Twyman told me that it's the cleanest for anybody in my age group that he's
seen for a male.
I think he's seen a female.
And I even went to a vegan cardiologist to get a second opinion, Dr. Joel Khan,
who I think you know.
I know Joel.
He had been referred to me.
I've known Joel through a few different, you know, groups that I'm part of in the industry.
And somebody said, you know, well, you should show it to Joe as well, too, because, you know,
Joe has seen more clearlys than a lot of people that are out there.
And he told me that it was the second cleanest that he's seen next to his own.
I guess he puts a lot of attention into that.
So he was bragging a little bit about that, which, which great.
You know, I'm happy for anybody who has a good cleary scan.
So that left me feeling that even though my APOB was high and even though,
So my LDL has been high because I'm a hyper-reabsorber.
I got some further genetic testing done.
I don't have familial hyper-cholestromania, but I'm a hyper-reabsorber of cholesterol.
So there could be reasons why my body is just producing or keeping more of that sort of lipids
in the system.
But it put a lot of my concerns to rest that I generally eat very clean.
I've been on a mission as a former recovering sort of vegetarian and vegan growing up to
add lean muscle mass to work out more, to improve and up the protein intake in my diet now.
And I felt that largely I was heading in the right direction, but there was these individuals I would say
from just seeing my LDL, my OPB, that, hey, I'm worried.
But now getting some of that imaging done, and, you know, unfortunately, this is out of pocket.
You know, I think my test cost about $2,000 than the interpretation.
So it's not accessible to everybody, but that price will come down over a period of time.
and it goes back to this idea that you have, which is we're going to be guessing a lot less.
And instead, we're going to have more, especially when it comes to heart health, we're going to have
better and more available imaging that's going to tell people the individual answer to,
is their diet healthy for them and are they heading in the right direction?
And I think that I just wanted to share that personal testimonial because, number one,
I'm excited about what's coming down the pipeline.
And number two, my APOB, I haven't been testing it for,
I didn't know about it. And a lot of my clinicians that I was working with it didn't know about it
prior to about like eight years ago. So I don't have data on it, you know, seven years ago and further than
that, eight years ago and further than that. But I feel like that'd be a long enough time of having it
that we should see, you know, some advanced plaque, soft plaque and hard plaque buildup. And of course,
I'll continue to monitor it over time. Have you gotten some of this imaging done yourself?
You've mentioned you've had high cholesterol, high LDL. I don't know if you've know your APOB number.
Have you gotten some of this imaging and what has it told you about your own health?
Yeah, I got a, well, I got a coronate scan a few years ago.
It was zero.
So, so, I mean, again, it's not as precise as the clearly or CT angiography.
But, you know, my, again, my, I'm not as lean.
I mean, my BMI is, I'm obese by BMI.
I mean, obviously I've got a lot of muscle mass on me, but so I don't tend to run as high
of an LDL cholesterol as some others do.
now. If I get leaner, and it was kind of interesting, I did a real interesting experiment back
about two months ago where I checked my total cholesterol at a certain point, and it was 154, which is
low. I mean, it's like most cardiologists would be happy at that number. And then I fasted
for like 18 more hours and I exercise. And I rechecked it and it went up from 154 to 345 in under
18 hours, which shows you how dynamic these numbers. So that's to your point, why are we guessing
what numbers it can fluctuate dramatically over the course of even, you know, 24 hours? So,
you know, I, like I said, I had my imaging done with the CAC score, which was zero. You know,
I look at my V-O-2 max. I basically put up, you know, for my age, world-class numbers of VO-2 max,
which is another proxy for cardiovascular function. Because
As you pointed out, and I think rightly so, we want to look at things that actually matter over time.
You know, like if my LDL can change 200 points in 24 hours, you know what?
Can't change that much in 24 hours is how much fat I have on my body.
You know, I mean, it's just like these are things that actually are, to me, more clinically useful.
I mean, I think literally a simple measuring tape where you can take a waste of height measurement
provides you more information on a person than a slew of laps can in many cases.
So there's some things that we sort of over-rely on these labs which change.
Like even, for instance, vitamin D, most people don't know this, but vitamin D can vary 30% throughout the day.
It's like, I'm worried about my vitamin D's link below.
What times do you take it?
So when you know how much diurnal variability is in a particular lab, you start to say, well, how important is that if it can change so much.
So I like things like that imaging you had that clearly is a great study.
I think blood pressure can be a pretty reasonable metric if it's measured correctly.
I think body composition is huge, as you point out, in India where there are more diabetics
and people with cardiovascular disease in large any place in the world.
I mean, they just, they're the most populous country in the world right now.
They've surpassed China recently.
So you've got that.
And as you know, in India, 30% of the population is vegetarian.
And even the ones that eat meat don't eat that much.
just like five kilos a year.
So it's not a, even in the households that eat,
it's like a small, well, you know better.
It's like a once a week, maybe minimal thing for many people.
And yet they have tremendous levels of diabetes and heart disease.
So you gotta ask a question, why is that?
Why do we have so many people with heart disease that barely eat much meat?
And yet we're gonna blame it on that here.
You know, what I like about your approach, Sean,
is that you're saying very clearly on your end,
there's certain things that you don't know.
So it's very clear that these observational studies show that over the long haul,
and if you take somebody like a Peter Attia or a Simon Hill,
who's been on this podcast before,
they'll say, listen,
over the long haul,
you are gambling by having your LDL higher or your APOB higher.
And do you really want to put yourself at risk?
and based on all the data that we have out there from these observational studies.
Now, if I understand correctly, and you correct me if I'm wrong, I'm just recapping for our audience,
you're not throwing that out.
You're saying, yeah, these large observational studies do show that.
Now, a couple things are, you know, are those individuals that have high LDL?
Are they healthy?
No, it's the general population, and most of the general population is unhealthy.
So they also have insulin resistance.
they're obese often or overweight.
They have other factors that are there.
Now, sometimes I've heard these individuals say,
well, a lot of that is controlled for,
and I'm not smart enough to know the answer around that.
But then further, you're saying that if we actually look at a population
that is truly healthy, and if we use maybe more some of this,
more advanced imaging, we actually don't know the answer to,
is that a problem over time?
And then more importantly, if you do lower your LDL extremely low or your total cholesterol
extremely low or your APOB, is there something that you're potentially sacrificing?
Can you talk about that for a second?
What do you think could be sacrificed if people continue on this threat of going very extreme
of wanting to lower their lipids to the lowest level possible?
Yeah, it's interesting.
There are advocates out there that will say they want their LDL cholesterol like 20,
which is what a newborn infant is born with.
Now, mind you, a newborn infant hasn't eaten anything yet.
So it's like this is the only time in our life.
There's interesting studies that looking at breastfeeding infants,
and they look at their total cholesterol,
and within 13 weeks, the average infant who breastfeeds will have a total cholesterol
between 180 and 250.
So high, relatively high, much higher than these people would want you to have,
probably double why that.
And so why is that?
Are we saying now that breastfeeding is?
dangerous for human beings, perhaps.
I mean, it's kind of one of those interesting things.
I mean, again, if we're talking about associations, we know that low cholesterol is associated
with higher rates of, or can be associated with higher rates of depression, violent behavior,
suicide, infection, some types of cancer.
So there are some perhaps long-term issues around dementia.
So there are potential problems.
Now, people will point to certain studies and say, well, we've excluded that.
again, most of those are industry-funded studies which have, you know, a clear conflict of interest
there. When you have a drug manufacturer tells you that our studies show this drug is safe and effective
over the long term, you can almost always rely on those guys to over-promise and under-deliver.
I mean, that historically is what happens. So you tend to not to be conspiratorial here,
but I mean, I think there's some of that going on. And I think that if, for instance,
and I, you know, I tell people, look, you know, you got to do it's right for you. If you have
you know, because I talk to people all the time. I interview people almost on a daily basis where
it's like they've had some awful, awful disease. Maybe they've had MS, you know, multiple sclerosis and
they're bedbound. And now they've been on this higher fat, maybe a carnivore diet. And now their
their MS plaques are going away. They are now able to participate in life. Maybe they got their
job back. To them, when I asked them, what about if your risk for heart disease is increased?
what do you say to that? They said, you know what? I would rather risk that than go back to where I
was. As physicians, you can't just make the decision for people. They have to be able to decide
what makes sense to them. And certainly you can offer that some people like if they don't want to
change your diet, because a lot of people like, I like, I like my diet, I don't want to change it.
I was on a whatever diet you want me to be on a cardboard-based, you know, low-fat diet.
And I didn't feel good.
I didn't do well.
I had gut issues and so on and so forth.
And so for those people, they're not going to go back to that.
They're not going to make the lifestyle alterations because they feel so much better.
You might offer them some sort of lipid lowering therapy, whether it's a statin,
whether it's, you know, PCSK9 inhibor as a Tim Bean or any of these other, you know, ZDIA,
any of these other drugs out there.
And I think, you know, I'd certainly tell people that's an option for you if you want to do that.
Now, assuming there's no side effects that you don't have issues with that, many people do
have the side effects. Many people just patently don't want to be on these drugs for every reason.
They don't trust the pharmaceutical industry. They don't like the fact that they have to be on drugs.
They don't like the fact that they're dependent on someone else for their health. I mean, this is one of
the nice things about diet in general. It's like you can you can kind of wean yourself off the
dependency of the health care system because when you are literally diagnosed with a chronic disease,
let's say you're diabetic and you need a doctor to refill your, you know, whatever, your metformin or any other
drugs that you might be on, you become disempowered in many ways because you are now dependent upon
some other individual if they feel like it or if they decide to or if they deem it's necessary to
provide you this drug, whereas if you get away from that and you're like, look, I've got within my
own capabilities, I can change my lifestyle, I can eat a certain way, I can dial in my sleep,
I can not be sedentary, I can exercise, I can maybe find a supplement or something like that,
then you become empowered, which is a lot of people don't.
want to give that up. I know this is kind of a little wandering a little bit, but I think that
with regard to, and I'll say it again, with LDL cholesterol, I think most people out there
it's a significant risk factor for. And, you know, if you're talking about population level health,
yeah, it probably makes sense. I mean, well, interestingly, we have on a population brought our
average total cholesterol down from around 220 to 200 over the last 30 or 40 years. And the instance
the disease has not decreased.
I mean, cardiovascular disease has not gone down.
Now, cardiovascular mortality has gone down because we've gotten better at treating it.
Of course, it was the confounder of smoking.
Back in 1954, 45% of American smoke.
Today, it's around 13%.
So you can't ignore that factor.
And then going back to Dwight D. Eisenhower, you know, when he had his heart attack,
well, it must have been the fat, but he was smoking three packs a day.
And they kind of, this is back in the 50s when they thought smoking was still healthy for us.
So it's kind of one of those things that there's a lot of moving parts here.
You know, a lot of folks that are listening today, and even you and me individually in our
own health journey, we're trying to make the right decisions for our own health.
And every week we're getting exposed to new information every day in many instances.
You mentioned you had Dr. Michael Twyman on.
He's the cardiologist that I work with.
I've interviewed him.
And I've been very transparent with my audience that I'm trying to make the right
decision at looking at all these things.
and from what I've understood and sort of internalized from his content is that, okay, you have
shots on goal, let's say APOB and these particulates, which play a role in cardiovascular disease,
atherosclerosis, and more importantly than that, in his sort of explanation, is our endothelial health.
How strong is the endothelial health?
How strong is the endothelial function, which is a byproduct of, are you producing enough?
nitric oxide, because that plays a huge role into it.
Are you avoiding the main things that damage the endothelium, things that oxidize it?
Are you avoiding being exposed to chronically bad air, which largely comes from indoor air,
off-gassing, smoking, things like that?
Are you living a sedentary lifestyle and not producing enough nitric oxide?
Are you drinking and, you know, smoking a lot?
Are you doing these things that are damaging the endothelium that would allow these particulates to sort of get wedged in and then plaque to be built around them?
So diet is one component because we're looking at the total amount of lipids that are there, which seem to be playing some role.
But then there's also the endothelium.
Is that your understanding as well too?
Or do you have any comments on that?
Yeah, sure.
So, I mean, and that's a good analogy because you've got shots on goal and you got the goalkeeper, right?
And if you've got a good goalkeeper, maybe those shots don't get through.
And so I think that obviously like anything, you know, like a hormone and a receptor,
you have to have both to have the effect.
There's obviously the proteoglycan content.
So there's little proteoglycons that can reach out and grab and help us to endocytose some of those cholesterol molecules.
And so that proteoglycan is affected by hyperglycine.
It's affected by hypertension in those types.
type of thing. So again, it's, it's even at the most basic level, there are multiple factors that go
into that. And so to your point, you know, let's say I have the cleanest diet in the world,
but I'm still exposed to environmental toxins through the air, right? I'm still exposed to maybe
chronic sleep issues or something. So there's other things you have to dial in. So if you're going to
quote unquote roll the dice with, I'm on this low carb, carnivore ketogenic diet and run with
high LDL cholesterol, which, you know, that's up to you if you want to do that.
Have you dialed in those other factors, too, because you may still be at higher risk due to
compromise endothelium from indoor air pollution or chronic stress or, and stress, I think,
is underplayed on how incredibly important it is with regard to the development of cardiovascularies.
And some people would estimate maybe even 30% of our risk is associated with chronic stress.
And some people, how do you mitigate that?
Let's say you live in an awful situation.
Let's say you live in a, you know, a crime-ridden, impoverished area.
You know, so there's other factors here that you have to take into account when you're
going to, quote, unquote, roll that dice.
And so I tell people, I'm comfortable in my own health decisions, what I want to do,
but I'm not going to make it for you.
I think you need to be, you know, aware of what your overall picture is.
Because I know enough about myself to where I'm saying, hey, I'm comfortable with this.
but I'm not going to make that decision for somebody else.
The same way, I'm not going to tell somebody you need to be on a medication,
you need to lower your drugs in all cases.
Because, again, as you mentioned, there are other reasons where that might be a net detriment.
You know, like I said, if we just talk about lifestyle measures,
let's say, I know if I ate a low-fat cardboard diet, I'd have lower LDL cholesterol today than I would,
if I didn't.
However, I might have more gut issues, I might have more inflammation, I might have more joint
issues, my quality of life might be worse. And it's not a trade-off that I'm willing to have. I mean,
ultimately, none of us are getting out of here alive. At some point, we're all dead. And it's like,
well, I remember I had this, I had this discussion with this one vegan doctor one time. And I said,
and he was talking about the potential risk of a meat based out, you know, yeah, your mom are
more likely to have heart disease or cancer or something like that. And I said, well, what do you
think vegans are dying of? And he looked at me, well, I mean, it was on, it was on Twitter. So he kind of
pause and he said, I think it's like skiing.
accidents. I was like, you've got, come on, man. Skiing accidents. So I actually looked it up,
and there's some data on this so-called Epic Oxford City where they had, it's in the sub-tables
where you can look at it, you can find it. And the number one cause of death among vegans and
vegetarians is heart disease and cancer, just like everybody else. So, you know, one way they,
I think they had a little more cancer and a little less heart disease. So what would you rather
die? I know it's a morbid topic. I'm like, honestly, I wouldn't mind dropping dead of a heart attack
at, you know, 90, you know, just boom like that, if I had to. Now, again, you want to live as long as
possible. You ask, you know, like you ask somebody, like I've seen in my life, I've had the
opportunity to meet a lot of 100-year-olds. And most of them, I was like, I don't want to live
to be 100 if that's the situation. Because in my experience, it was all these literally
demented old ladies in a diaper with a broken hip. And I'm like, that's what 100 is. I'm good. I don't
need that now. Obviously, if you start seeing robust vigorous, because this is, you know,
I know a lot of people are interested in longevity and all these various longevity gurus.
And I think it's a great sort of place to be because you don't get a money back.
There's no money, money back guarantees. There's no accountability. It's like, yeah, you do my,
you know, whatever, take my supplements or my expensive program and you're going to live longer.
It's like, well, how do you know that? So when we have 120-year-old people walking around that are
vigorous and jacked and tan and getting after it, I'll start paying attention to that.
But until then, I'm kind of like, let's fix it here and now.
We have a hard enough time with that.
You know, if you just walk around, you know, the streets of L.A., you'll just see how many sick
people with chronic disease or it's mental health or obvious clear physical health.
It is an enormous problem.
You know, you mentioned the here and now.
And I think one of the most exciting things in the space of carnivore, keto, low carb,
that's happened in the last like especially three years has been this explosion of some of the
world's top psychiatrist Harvard, Stanford, these other institutions that are literally
reversing severe mental health conditions bipolar disorder, type two bipolar disorder, severe
schizophrenia. And not just in young people, older people too, severe depression.
anorexia, severe anorexia, and they're largely doing it through diet.
And some of these doctors have gone so far to say, like Dr. Georgia Ede at Harvard,
who's been running a lot of these studies and working with patients saying that meat is actually
a superfood.
And it's one of the most important parts of their protocol to help patients heal.
When you look from the outside and you know some of these people, how excited are you about
this conversation that's happening specifically for these dietary interventions for mental health?
Yeah, I mean, it's tremendous.
And it's one of the more common because mental health has become so, mental health disorders
have become so pervasive.
It's one of the more common things I see get better.
And you're absolutely right.
Schizophrenia, depression, you know, bipolar disorder.
I've seen Tourette's syndrome.
My goodness.
I've seen PTSD, all these things that I've been seeing for years.
And one of the problems is, you know, we've always talked about low-carb diets in the context
of weight loss and diabetes primarily.
But I'm like, there's so much more here.
In fact, I would be so bold as to say that good nutrition will affect every single disease
process out there.
I think, I mean, it always makes sense to me because somebody will ask me, what about
this disease?
I say my pat response is improving nutrition is always going to be a good idea.
I don't care what it is, whether it's end-states cancer or demand.
if you can improve that person in nutrition, you're going to see some benefit.
And, you know, let's just extend this over even to addiction.
I see people with alcoholism, with tobacco addiction, with drug addiction, go on one of these diets
and literally they say, I lost a desire to smoke cigarettes.
I lost a desire to drink alcohol.
So I think nutrition, you know, and an old saying is, you know, food is medicine.
There's a really a lot of truth to that.
And the fact that, you know, Georgia Eads and others that have been talking about,
I've known Georgia for, gosh, eight or nine years now, talking about this stuff in a more sort of open way.
Because even five years ago, if you talked about the fact that nutrition impacted depression,
people would get angry about it.
Oh, you don't know my trauma.
It's all about trauma and nutrition is not going to have a role there.
Well, I mean, the brain is an organ like the heart is, like the heart is,
like the liver is, like the kidneys are, they're all affected by nutrition.
And if you're not nourishing your brain correctly, it's not surprising that you have these,
these issues. And so it's exciting to see. I'm really, really hopeful I know like the
Bazuki family, you know, metabolic minds, I mean, Jamizuki and her husband, I mean, they,
that video game roleblocks, they're billionaires and their son, I think Matt was diagnosed with
severe bipolar disorder. He put it in remission with a ketogenic diet.
So I think we're going to see more, more sort of directed that way, hopefully more research,
but hopefully more clinicians that will get on board with us.
And I think this is part of the problem with the health care system in general is when I was
practicing orthopedics, I mean, I would line up, you know, I get my morning schedule.
I have 50 patients to see.
50 patients in an 8-hour clinic, not to mention I have to see my PA's patients too if they
brought somebody ahead of question.
So I'm seeing maybe 60, 65 patients in a day.
You can't provide good health care doing that.
And that's just how the system's set up.
And so if we can have a system set up where we can facilitate the utilization of these
natures, rather than just writing prescription, because it's so easy to write a prescription,
they've got that so streamlined and so automatic.
I mean, it's built into the EMRs here, hit that button.
I mean, it's going to be literally what we're going to see with health care in my view,
and my prediction is you're going to have people that will interact with some sort of terminal.
It won't even be a doctor.
They might be able to stick their finger and get a blood sample.
That will be analyzed very rapidly.
A diagnosis will be made, and a Amazon drone will drop a drug off at your house later that afternoon.
I think that's where health care is going in a lot of ways.
And we already see that, you know, there's a lot of these drugs you can get over on the Internet.
So that's going to happen.
And the physicians will be in the background, maybe signing off.
Maybe one physician will do this on maybe 5,000 people a week or something like that, some ridiculous number.
And what you're talking about, the nutrition side requires, unfortunately, a lot of time and a lot of support.
And I think that's what we lack in health care.
We put all this money into technology and the latest drug.
And yet what may provide even more benefit is just actually getting people, you know, on the right lifestyle, with the right nutrition, with the right level of support.
And that's, you know, like I said, our company, Rivera is done.
And that's why I said it up.
I'm so frustrated with, even if I want to do the right thing, I have nowhere to turn.
I can't do it.
I can't, you know, like I said, my hospital is actively saying, don't do that because we lose money.
So to turn that around and provide the resources for people to actually get that type of care is real important.
Because, you know, with our thing, we have a physician that oversees it, oversees the care.
But we have a coach talking to that person every single day in many cases.
And that's, for some people, that's what's needed, you know, particularly somebody that's really struggling with implementing this stuff.
And gosh, I mean, if I, you know, I don't know if you know who Callie Means is, but I know he has a company where he's actually, you know, enabling people to write food as a prescription, right, true medicine.
So I think that's, I think there's going to be a dichotomy.
I think there's going to be some people that just give me the drugs and I don't need the doctor in the way because a lot of people, you know, you go on these little, you know, doctor.
rating things. And some of the people really are excited and give high marks for doctors that are
very responsible of getting them drugs really quickly. I don't have to wait for my refill. My doctor
always gives me a refill. And that's a good doctor. And I'm like, man, I think it would be better
if your doctor can get you off the drugs. That would be real cool. But no, there's people that are
just, you know, like I said, you see these little memes where you got, you know, pills and surgery
and the lines out the door and you got one person saying diet and license on and no one's at his
counter. So I think that's going to change. So I think enough people are becoming frustrated with
the clear, really lack of results. I mean, you know, you think about how many drugs are there for
these chronic diseases. The more drugs there are, the diseases never go away. It's not like we put
these diseases, you know, where they don't exist anymore. They're more prevalent. The more diabetes
drugs there are, the more diabetics we have, which is kind of disturbing. You know, something on that
note, have you heard or ever read the book, Sickening?
It's John Abrams.
I'm familiar with John Abrams's work.
I've seen a couple of these interviews.
I have not read his book, though.
One of the core opening lines in the book is a super inconvenient truth that most people,
let alone their primary care doctor knows about, so your own doctor doesn't know about this,
is that whenever we hear that a drug had peer review and research and a panel looking at it,
the peer review team that actually reviewed that drug never got access to the actual data.
Right.
They only saw a summary, a sanitized summary of the data on that drug from the drug company itself.
Right, because it's proprietary data.
They don't want to share that, right?
All the study data is proprietary, including with the jab that we all went through and were being,
you know, told to take.
And when you understand that, you can understand how is it that something like a drug like
Vioxx could get out there for 10 years and lead to an excess of 50,000 additional deaths
before it was ended up taking off the market is because drug companies have an incentive
to put out their version of the story even to the peer reviewers.
And the peer reviewers tried to push back at a certain point in time.
All the journals got together and said, we need to change this.
We need access to the raw data.
And unfortunately, right after they published their open letter, a few months later,
September 11th happened, and the whole national conversation was focused on something else
and terrorism.
And the issue just kind of got swept under the rug.
And ever since then, it's never really been brought up, except for in a few circles where
people would look at it and say, that's conspiratorial. What are you talking about? All these journals
and doctors and researchers have our best interest at heart. And we have to understand that they have
their selves, their executive team and their shareholders best interest at heart. That doesn't
mean that there aren't good people that are there, but the incentives are designed to tell a
particular story. So there's shouldn't be surprised when we find out that certain drugs that we thought
were safe or didn't have certain side effects come out and end up having,
major issues or don't end up working as well as lifestyle.
Many drugs don't actually have to be tested against lifestyle interventions.
So what happens when you actually look at lifestyle interventions?
Well, lifestyle interventions, the diabetes prevention trial, which is another study that
was government funded that John Abrams talks about in his book, he showed that when you
compared metformin, just being on that.
to having a study set that was on metformin and dietary and lifestyle changes,
and then just dietary and lifestyle changes with the appropriate coaching that was there,
the population that did the best when it came to type 2 diabetes was the group that got
the education and the support and made the dietary changes.
So in that instance, when doctors are presented with the full data,
they can actually see that, no, patients actually want to make these changes.
They just don't have the support, and obviously that's a bigger conversation of how we need to change health care.
But unfortunately, a lot of doctors are left with the message because they just get the sanitized data from the drug companies that patients don't want to do any work.
They just want the magic pill.
And so just give them this drug that will make everything better.
Yeah.
And it's, you know, as you probably are aware, I mean, it's like these journals, these medical journals, I mean, something like 40% of their incomes comes from the drug company buying their reprints, you know, they're preprints so they can hand out to the doctors.
So it's even the journals themselves are, you know, Marsha Engel, who sat on the, was a chief editor at New England Journal of Medicine for so many years, basically said, I can no longer in good conscience support this because I know it's basically it's, it's such bad corruption in that whole system. There's a famous quote of her talking about. I wrote that in my book actually. I don't remember the exact quote right now, but that's kind of where it comes from. And so, yeah, I mean, we've got, I think I think I saw stat where we're since,
2010, something like 14,000 FDA approved safe and effective drugs have been pulled from the market.
That's a high number, 14,000 of them, you know, and that's all these drugs that are, you know,
one of the, I saw a funny little meme, somebody put any drug that's making billions of dollars will always be safe and effective.
And I think that's true.
I mean, like, but I used to prescribe Viox.
It was a good, it worked with inflammation with people's knee.
It literally worked pretty well.
But, I mean, again, the company withheld the data.
that they knew that it was causing excess cardiovascular disease.
So that was something that they clearly knew about.
And these companies, you know, they'll make their 10, 20, 50, maybe in the case of things like statins,
trillion dollars.
And then at some point, when enough people are harmed and when physicians actually realize that there's actually harming enough people,
when enough people die, it gets pulled from the market.
and they pay, you know, some slap on the wrist, $2 billion fine, which is, you know, pocket change for these companies.
So it's kind of an interesting, sad situation that we have.
So, I mean, and I'll see that with, I think with these GLP1 drugs that are out there, we're going to see something similar.
You know, they'll make whatever, hundreds of billions of dollars.
And then eventually they'll have to, you know, shift it, change, it going to the next drug.
Oh, that one didn't work very well, but guess what this new one?
And it's just like, I don't if you remember the Charlie Brown, the Peanuts cartoon,
every year Lucy would put the football out there and pull it from Charlie Brown, and every year he'd fall for it.
It's like the same thing.
We just keep falling for the same thing over and over company.
These, you know, these drugs have been fined guilty of clear fraud are still back in action.
They're still out there, you know, just no one goes to jail.
They pay some slap on the wrist fine, and they keep, you know, as is.
because our whole system is basically the politicians are basically, you know, being,
I mean, for every single member, a sitting member of Congress,
there are three federal lobbyists that are lobbying these guys.
Think how much power they have. It's crazy.
With all that being said, you know, you have a telemedicine company, right?
And I'm sure there's still some times you guys will bring in some prescription drugs.
You might have people on testosterone.
You might have people in some instances as you're balancing out their health.
you might bring in a statin or statin-like, you know, drug that is helping them decide, you know,
if they want to roll the dice in one direction or not.
I've been very transparent with my audience, even though I have virtually no soft plaque
and no hard plaque in my clearly scan, and we'll link to it in the show notes below,
my cardiologist walking us through that and everything.
I've decided that I don't want to have, even though I'm doing all the lifestyle stuff,
long-term high APOB the way that it is.
so I decided to start on a Zetabyte, right? So I think both you and I would say that there are some
great drugs that are out there and people should have individual choice of whether or not they want to
participate it. And there are some, you know, people that are genuinely trying to make things that
move society in the right direction. Of course, antibiotics, you know, helped society, probably the most,
out of any drugs, antibiotics helped the most. And that was obviously life-saving for us as a species.
So always like to put stuff in context, which I know you're really good at doing.
You know, I want to come back to the carnivore diet as we're winding down here for a second.
You know, at the beginning of the interview, you mentioned that the vast majority of people
that find themselves in this position where they're looking at what some people would say is a very
extreme diet from the outside. And by all measures, it is very extreme compared to the ultra-processed
food standard American diet, but by design, because it works. They're looking for a therapeutic
intervention to help them with severe eczema, severe gut issues, autoimmune conditions,
and as we mentioned, in many cases, severe mental health issues that are there.
Some of our audience is going to find themselves nodding their head along and saying,
you know what, I'm in that camp.
Maybe I need to do a little bit more research and maybe I need to subscribe to your channel,
which they definitely should.
We'll have the link below.
For the other group of people that are saying that, sure, you know, there's some things that I want
tweak. I might have a little bit more joint pain or I might have a little bit of belly fat that I
want to do. I want to do a little bit of body recomposition. What are some lessons or themes they can
learn from the carnivore diet? If you say one, two, and three, takeaways that if they're not ready
or they don't feel like they need to go on as quote unquote extreme of a dietary intervention,
because their health issues aren't that bad, what are a few lessons that they can learn from the
carnivore diet that they can incorporate. Yeah. So I think that protein is quite important. I think that's
whatever, you know, even if you're on a vegan deck, guys don't listen to the guys to say don't need a lot of
protein because that's just a disaster. Which is less and less every year. You have less and less
vegans I feel every year are advocating for the low protein. Right, right. Even, you know,
even Dr. Gart Davis, who I debated recently, wrote a book called Proteinaholic where he was demonizing
protein. He says, you know, I've kind of walked that back a little bit. So I think he's even really as, as a guy who's
now in his 50s, it's like it is incredibly important to retain lean functional mass.
I think, you know, I think that's something that I'm really, you know, interested in.
I'll be talking about a lot more as time goes by.
I think that, you know, not constantly eating is important.
I think, you know, in my view, the fact that we eat from 7 a.m. to 10 p.m., you know,
three meals a day plus three or four snacks a day is a disaster for us metabolically.
So I think, you know, maybe perhaps some level.
of intermittent fasting for some people. I know there's people that are critics to say,
well, it's all about calorie restriction. Well, whatever gets you there so you don't overconsume
energy, whether it's protein or fat, or sorry, carbohydrates are fat, that's incredibly important.
I think that, you know, gosh, just avoid the ultra-processed stuff. I know there's people
that say, well, you know, protein powder is ultra-processed and so on and so forth. But I mean,
generally, if you generally cut out ultra-process foods from your diet, you're going to do better.
most people are going to do that. Now, the problem is, what are you replacing it with? I mean,
I have found that it is really hard to be successful on a diet where, number one, you don't like the
food, or number two, you're hungry all the time. That's just not sustainable over the long haul.
So you've got to find something that you enjoy, that nourishes you properly, and, you know,
keeps you relatively satiated. Otherwise, you're just going to be in there eating, you know,
Ben and Jerry's and Oreo cookies. And that's just not,
appropriate. I think obviously alcohol is not a health food. I mean, obviously minimize that.
People ask me, what's the best alcohol? And I said, well, what's the best, what's the best bat
to hit yourself over the head with? It's a kind of just no matter. It's still a problem.
I think that, you know, just other lessons that I think, I think it's not, I think the important
thing, like I said the other day, the most, the best nutritional advice I could give somebody
is to get stronger. And I know that's kind of counterintuitive, but I'm like,
you think about that, what do you mean by that? Well, eat in a way that's going to allow you
to feel good to where you can get out there and do the things that are necessary, the strength training.
So protein is important, non-inflammatory foods, and you can figure it out yourself.
Here's an interesting sort of observation. Many have gone to bed. We wake up the next morning and we're like,
oh, my, you know, my elbow is really hurt. I wonder what I did if I slept on it wrong or maybe it was
that, you know, that tennis game I played three days ago. Well, maybe it was a chocolate cake you had for dessert last night.
If you start thinking about how food impacts you in ways outside of, you know, my stomach's rumbling.
I mean, there are so many ways that a meal can actually impact this that we don't even associate with.
I mean, I clearly see people all the time that go off a diet and all of a sudden, all their joint pain will come back.
That's real.
I used to dismiss that.
When I remember I was, you know, seeing some lady in my clinic as an orthopedic surgeon and she said, you know, every time I eat gluten, my knee hurts, I thought she was crazy.
I thought he was crazy lady.
I'll just kind of yell.
Let me just look in your knee with a scope.
We'll figure this out.
It turns out there's a lot of truth to that.
There's a lot of things going on that actually impact us.
And our diet impacts us in much more ways than we think.
So pay attention to that stuff.
I think that as far as, you know, finding something that, you know, is easy.
I mean, the thing about a carnivore diet is it's so simple.
You don't have to think.
I mean, it's like it's so easy my dog could do it.
My dogs do it, by the way.
I mean, it's, you know, nutrition should not be hard.
And if you find yourself constantly obsessing and calculating about your diet, rethink where you're at.
It shouldn't be that hard.
It should be very, fairly intuitive.
It should be fairly easy.
You don't have to eat gazillion foods.
I mean, and, you know, think about in the context of the time we've been on Earth, it's only recently.
I mean, you see some of these food recommendations.
where it's like you need a little of this and a little of this and a little of this to have a complete diet.
I'm like, those things don't even grow on the same continent.
How would have that even been humanly possible prior to modern refrigeration and transportation?
So it's like nutrition can be a lot simpler than it is.
And you can kind of think about, you know, obviously there's some genetic differences in all of us.
You know, if you live in the tropics, you have more access to stuff.
But if you live in like my ancestry is northern Europe, I mean, there's not a lot of mangoes growing
around in Northern Europe, it wouldn't have been accessible to me.
So I think it's something to realize that, one, animal products are incredibly beneficial.
They're more efficient.
They provide tremendous nutrition.
Most people don't realize this is a nice study by Stefan Van Vleet out of Utah State,
formerly out of Duke.
Meat has all kinds of phytonutrients in it, which most people don't realize that.
It's got something like 70,000 unique nutritional compounds.
in beef.
And so some of them are polyphenols and tannins
and all these various, quote unquote, healthy plant companies.
So they're actually in meat.
So it's kind of interesting.
I'm a huge believer in that.
I've been like snacking on these like Maui-Newie beef sticks
from this like wild venison.
Have you tried those before?
I have, yeah, when I was there,
I was in Hawaii for a talk a few years ago.
That company was actually there.
Yeah, those are great.
I love that like the deer eat wild
and we can get access to that.
Obviously, there's a growing movement of regenerative.
of agriculture where the cows and other animals are eating a lot of different things. So I'm a big
believer. Final question here. Do you think that you were born to be one of the leaders in the
carnivore movement because your dad traumatized you by sneaking onions and vegetables into your meatloaf?
And so you were so traumatized as a young kid and you hated vegetables so much that this was the
only path that was there for you. Yeah, that's a funny story. I remember my dad and it was kind of funny
when I asked about that years and years later because I would sit at the table and, you know,
my parents were like, you're not getting up to you finish your meal, don't waste food.
So I would sit there and I hated onions with a pat.
I still do, unfortunately.
And they were in there and I'm sitting down there eating this, well, not, basically not eating,
staring at this cold piece of meatloaf that had been there for like three hours.
And my dad was just like, you know, just eat this stuff.
And what's the problem?
I said, I don't like onions.
He goes, well, you can't even taste them.
And I said, well, dad, if you can't taste them, why'd you put him in there?
And he was like, well, shut up, kid.
And then I asked him years later about that.
And he goes, you know, I didn't really like vegetables either, but I just felt that you had
to eat them.
That's why I forced you to do that.
So maybe that's why.
No, I think it's kind of funny.
I would have never in my life predicted.
You know, if you had asked me 10 years ago, I'd be this crazy diet, write a diet book
and be an advocate for this crazy wacko, bizarre diet, never in a million years.
I would have ever thought that.
I mean, it's just not who I was.
but it's kind of funny how life takes you in these different directions.
I've had kind of a really, you know, circuitous route through life,
which has been taking some fun detours.
But maybe that was it.
Maybe that's why I mean, I literally don't like vegetables,
so that makes it easier for me.
But yeah, I guess I was born to do this perhaps in that way
or traumatizing to doing it.
Well, the thing I appreciate you about you is that, you know,
you're very clear you don't like vegetables,
but you're not saying that everybody else out there has to stop eating this.
I actually really do like vegetables, not generally completely raw by themselves in large amounts.
It's usually with a little bit of butter, oil, salt, other ways to make them palatable.
But I enjoy vegetables.
I do like onions, although my wife doesn't like me eating onions.
But I really appreciate that.
You know, I mentioned to you that we've never really done an episode with just one individual on the carnivore diet,
largely because I feel that I have a little bit of stewardship with my audience that I'm not excited about having somebody on that's telling them that, you know,
broccoli or eating a little bit of spinach here and there is going to kill them. And I felt like when I
found your content a few years ago and have seen the way you communicate about it, it just felt really
balanced, but you still are firm in your beliefs and you're willing to share those beliefs. So
Dr. Sean Baker, I want to thank you for coming on the podcast. How can people follow you? And also,
you know, who's a good fit for this telemedicine company that you have? Yeah. So, so the company's
called Rivera, R-E-V-E-R-O.com. And so we're licensed at all 50 states. And we currently are treating
anybody with cardiomomomat disease, so obesity, diabetes, hypertension, metabolic syndrome,
autoimmune conditions, inflammatory conditions. That's where our focus is right now. We'll probably
expand. I'd like to see us expand into mental health in the next few years. But for now, that's
where we're at. So anybody that fits that description that wants a doctor that is not afraid to
let you eat meat for one and will work with you.
that need support because our coaches do a wonderful job with that of reaching out and,
you know, in many cases, contacting you every single day.
As far as where I'm located, I have a YouTube channel as well, Sean Baker, M-D.
I'm on Instagram at Sean, so it's S-H-A-W-N, Baker, B-A-K-E-R, and then the number 1967,
which is when I was born.
And then I'm on Twitter at S-Baker-M-D.
So those are the major places you can find me.
Amazing.
Well, they'll get educational content, some snarky content too in a fun way.
You'll laugh a little bit, you know.
But I want to acknowledge you and appreciate you for doing all the work you're doing
to advocate for people who are hurting at the end of the day.
You are a physician.
You see people who are hurting.
You're trying to give them options and solutions.
Some of them that have worked for you, a lot of them that work for also your community.
And I want to acknowledge you for being on that journey.
And, of course, for coming on a podcast today.
Well, Drew, thanks for having me on and let me share with your audience.
Hi, everyone, Drew here.
Two quick things.
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