Dhru Purohit Show - Unlocking the Power of Your Mitochondria to Age in Reverse with Dr. Steven Gundry

Episode Date: April 7, 2022

This episode is brought to you by BiOptimizers, Vivobarefoot, and WHOOP.   Chances are, you’ve heard a lot of buzz about the ketogenic diet. This high-fat, low-carb approach to eating has become extremely popular in recent years for helping with everything from weight loss to cognition.   One cornerstone of the ketogenic diet is the idea that ketones are a powerful alternative fuel source for the human body. But as it turns out, ketones are not the magical fuel source they’ve been made out to be; in fact, the body cannot run on ketones and fats alone. Over the long term, a very low-carb diet can lead to muscle wasting and poor cognitive health.   Today on The Dhru Purohit Podcast, Dhru talks with Dr. Steven Gundry about the new science about what actually makes a keto diet so successful: a cellular process known as “mitochondrial uncoupling.” Dr. Gundry shares why it's the key to reversing your age and living your best, healthiest life.  In this episode, we dive into:    -Lifestyle factors that are contributing to metabolic inflexibility (3:48) -Understanding the history of ketones and what we got wrong about using them as fuel (7:33) -Mitochondrial uncoupling and how it impacts cellular aging (20:02) -Brown fat and mitochondrial uncoupling (27:12) -Why getting into ketosis is so difficult (29:04) -Traps of a keto diet (44:51) -The keys to mitochondrial uncoupling (1:05:44) -Dairy and the connection to longevity (1:29:06) -Traditional keto diet vs. Unlocking The Keto Code program (1:41:03) -Two powerful mitochondrial uncouplers (1:44:26)   Follow Dr. Gundry on Instagram @drstevengundry, and through his website, drgundry.com. Get his book, Unlocking The Keto Code, here. This episode is brought to you by BiOptimizers, Vivobarefoot, and WHOOP. Magnesium Breakthrough from BiOptimizers contains seven different forms of magnesium, all of which have different functions in the body. There isn't anything else like it on the market. BiOptimizers is offering my community 10% off, so just head over to magbreakthrough.com/dhru with code DHRU10. Vivobarefoot footwear is designed to be wide, thin, and flexible—as close to barefoot as possible. They promote your foot's natural strength and movement, allowing you to feel the ground beneath your feet. Vivobarefoot is offering 20% off your first order at vivobarefoot.com/DHRU. WHOOP is a personalized digital fitness tracker and health-coaching platform that monitors your physiology 24/7 and provides personalized recommendations based on what your body needs. For me, it's been a game-changer to optimize my sleep and improve my fitness, performance, and overall health. To get yours, go to join.whoop.com and get 15% off your membership with code DHRU15. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

The more melatonin containing foods that I'm going to get into people's diet, they're actually not eating a sleep hormone. They're actually eating an antioxidant that your mitochondria need to repair themselves. Welcome to the Drew Perot podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds and wellness, medicine, and mindset. This week's guest is Dr. Stephen Gungry, a previous guest who's been on the podcast, but today is probably my favorite episode that we've ever done with Dr. Gundy because we're talking about not only how to do keto the right way. And by the way, if you're not even interested in the topic of keto, you are 100% going to

want to listen to today's interview because we're really talking about mitochondria and how mitochondria are the key to unlocking so much potential inside of our. our body. Now, if you don't know about Dr. Gundry, he is the renowned heart surgeon and New York Times bestselling author and medical researcher. He's the author of many books, including the Plant Paradox and the longevity paradox. And his newest book, which we're talking about today, and unlocking all the concepts, it's called Unlocking the Keto Code. But again, even if you think, I have no interest in keto. I'm telling you, today's episode is going to blow your mind because a lot of what we know about keto is actually not really correct. And there's a way to do keto

and incorporate some of the benefits in it without being so restrictive. And it turns out that way of doing things may be better for your overall health. At least that's the argument that Dr. Gundry wants to make. Now, a little bit more about Dr. Gundry. After a distinguished surgical career as a professor and chairman of cardiothoracic surgery at Loma Linda University, Dr. Gondry changed his focus from surgery to exterminating modern diseases with dietary and lifestyle changes. Today, Dr. Gondry is the director and founder of the International Heart and Lung Institute, as well as the Center for Restortive Medicine in Palm Springs and Santa Barbara, California. In addition to being a practicing physician and a very busy one, Dr. Guntry is always digging

into the latest research. And you know what? I appreciate him because he's willing to admit when he got things wrong. And today, Dr. Gundry talks about a couple of things that he got wrong when it comes to keto and how it actually works in the body. By the way, a couple of the topics that we talk about today. Just a little preview before we jump into today's episode, we chat about what are some of the key foods that the longest living communities around the world eat, many of the communities in the blue zones. And surprise, surprise, it may not be some of the foods that you've heard about before. These are some new foods that Dr. Gundry has a strong argument around that are crucial to the longevity of many of these blue zones that are out there. Now, if you care about the topic

of longevity, if you care about feeling your best, today's episode, which by the way, was recorded in person at my studio in Los Angeles, which is always nice. It's so great to be able to record with a guest in person. Today's episode is absolutely for you. I hope you enjoy. Dr. Gundry, welcome back on the podcast. It's pleasure to have you here. Drew, great to see you. I want to jump right in, and I want to talk about something that is so crucial for anybody that wants to understand how to better burn fat, how to perform at their best, and that is this term that a lot more people are hearing about, and you've written about in your book, and it's called metabolic flexibility. So just to set a little bit of the lay of the land before we go into

what we got wrong with keto and what you're getting right with keto now, I want to talk about metabolic flexibility. So help us understand first, why is it so key and what are the top things that people are doing today that are causing metabolic inflexibility in their life? Yeah, so the term basically describes the ability of our mitochondria, which are the energy-producing organelles in most of our cells, to take substrates such as glucose or amino acids or free fatty acids and convert them into ATP. And most of us should have the ability of everything's working right that when glucose runs out as a fuel, we can automatically shift to using free fatty acids as a fuel to generate ATP. And it's almost, I like to use the example of a hybrid car.

When you're burning gasoline, let's call that glucose, then you're charging. the battery and then when you run out of gasoline you can immediately draw on battery power to produce power. That's critical for a properly functioning organism, a properly functioning mitochondria. The problem is, as I talk about in the book, that 50% of normal weight individuals in the United States have no metabolic flexibility. Normal weight. That goes to 88% of overweight people have no metabolic flexibility, no ability to switch from burning sugar to fat, and 99% of obese individuals have no ability to convert from burning glucose to fat. And if you think about it, if we stop eating and go to sleep, normally our glucose stores run out after about seven hours of fasting and you should automatically

every night while you're sleeping switch over to burning free fatty acids and etones and we'll talk about that in a minute to keep your brain going to keep the rest of your cells going and the scary thing is the vast majority of us have lost that ability So we're going to break down the full reasons, but just a little bit as a preview. Just a couple reasons. Top two, three reasons that you think the lifestyle factors that people have today that are contributing to this inflexibility that are there. Just a little bit of a teaser.

Okay. Well, one of the biggest lifestyle factors is that Americans tend to eat 16 hours a day almost constantly from the second we wake up to the moment we go to bed. And the beautiful work of Rafael de Cabo from the NIH that I talk about shows that if you eat fairly continuously, no matter what you're eating, you will have metabolic inflexibility no matter what foods you're eating. And so I think that's number one. Number two, as we've all talked about, our processed and ultra-processed foods have. made breaking down foods instantaneously to sugars, simple amino acids and simple fats that hit our mitochondria like rush hour here in LA and nothing moves through our mitochondria in terms

of energy production. Those I think are my two top factors. So the new book is called Unlocking the Keto Code, but I really want to emphasize here is that Even if people are listening today or watching on YouTube, even if you don't think you're interested in keto, like the foundation and the title has keto in it, but this is so central to so many aspects of health. And I guarantee people are going to find something in here that deeply relates to something that they want to make progress on in their life. So the book starts off with what we got wrong about keto.

And so let's set the stage a little bit. And for those listening, again, bear with us because we're going to get in some really juicy stuff. So what did we understand and what do we think that ketosis was doing inside of the body and how it happened? And how did that start to shift a little bit through your research and findings? Yeah. So, you know, ketones have been known about since the late 1800s. They were discovered in Germany. And they were thought to be basically a byproduct of animals and humans who were starving. And they were also noted in type 1 diabetics. And they thought that these things were just excreted and wasn't, it was just a marker that they weren't very interested in. Fast forward to 1930

when the ketogenic diet, the term was actually coined at the Mayo Clinic, when it was noted that kids with seizure disorders, now this is before any anti-seizure medications, they'd have so many seizures that they wouldn't eat very much. They'd be kind of what's called post-ictal. They'd just not be very responsive. And these kids who were starving, the more they were starving, the less seizures they had. Yeah, I read about that and I was fascinated here like that, that's its origin. Yeah. And so starving kids is probably not a humane way to treat seizures, But this research prompted researchers a boss on the male clinic to say, well, wait a minute. You know, another way to produce ketones is to basically really ultra-limit carbohydrates and proteins,

which are sources of sugars and to make a diet composed of 80% fat. And when they did this with children and coined the term ketogenic diet, these kids had dramatic seizure reductions. And this was the standard of care for kids for many years until Dynelatin and Fianabarb came along. And then the diet actually pretty much died a horrible death because those of us who have kids and now grandchildren know it's really hard to deprive children and most adults of carbohydrates. And maybe we can talk about that in a little bit. So when these drugs came along, the ketogenic diet pretty much died. Fast forward to the 70s, 80s, and 90s when two big researchers, one at Boston, George Cahill, the other one at the NIH, Richard Beach, really got interested in were ketones far more important

than we thought in terms of just a starvation process? Were they designed to do something? And so both of those researchers really came upon, particularly Dr. Veach, said, I think the reason we're human is that we have the ability when we're starving, when we're going without food for a long time, we can use ketones as an alternative fuel source to keep our cells going, to produce ATP, to keep our brains going without depending on glucose. And they had some beautiful, elegant experiments that showed that if you just depended on glucose and you were starving, we can make glucose from protein, gluconeogenesis.

We would run out of all supplies of glucose in a matter of weeks. And we know, as I've talked about in the book, that a human being can literally eat nothing for 400 days plus and still be alive. And so they said, we got to be using an alternative fuel source, and they proposed it was keto. That got a lot of people interested, oh, well, this is a super fuel. And in fact, Dr. Beach made the cover of Time or Newsweek magazine because he literally felt that the natural human condition was to be continuously starving.

Now, that's, of course, not true. There's no evidence even in hunter-gatherers that starving is a continuous thing. In fact, just the opposite. When we found food, we were designed to make great use of that food and store it as fat. And we're actually known as the fat ape. We're the only great ape that's capable of storing massive amounts of fat very easily. That's another stuff. So what's really interesting, when I started, I decided to write this book because my last

book was called The Energy Paradox, and I was trying to explain how mitochondria work, why mitochondria aren't metabolically flexible, and where ketones fit into the process of improving mitochondrial efficiency. And I like other keto experts, and I've been using a ketogenic version of my program. for over 20 years in my practice. But where keto-exers got wrong is I and others said, well, being in ketosis, ketones make you an incredibly efficient fat burner, and you're going to be a fat-burning machine, you're going to turbocharge your mitochondria, and that's why ketones are so good for you.

Well, wrong. It turns out that Dact Gale's and Dr. Beech's work showed the exact opposite in human volunteers. What they found was that even at full ketosis, when we're just pumping ketones out of our liver, only 30% of our metabolic needs are met by burning ketones to make ATP. The rest is met by free fatty acids and also glucose. Here's the sucker punch, a brain which when you're starving needs ketones to kind of hold the line until it can get glucose again. Even at full ketosis, the brain only gets 60 to 70 percent of its energy needs met by ketones,

and the rest has to come from glucose. So rather than being this super fuel, because clearly it's not a super fuel, we got to look for other reasons that ketones might be happening. And that when I stumbled on it, I guess, said, oh my gosh, I'm not only wrong. I'm 180 degrees wrong about why ketones might be really beneficial. And that question through a combination of things led you to, led you back to the importance and the role that mitochondria play in all of this. Can you make that connection and explain a little bit more? Simplistically, many of us now believe that most chronic disease processes that are going to do us

in, like dementia, like cancer, like coronary artery disease, just as a few examples, are at their basis from mitochondrial dysfunction, from inability of mitochondria to work properly and efficiently. So if ketones are not this great fuel, then and mitochondria are really important to survival. In fact, if we're starving to death, if our mitochondria die, that's it. That's it. who cares about our muscles, who cares about our brain, who cares about anything else. If the mitochondria themselves die, that's the end of thing. And the problem with mitochondria is that making ATP is really hard work. And it's really damaging to the mitochondria that are making ATP.

In fact, as I talk about in the book, fun fact, you and I, every day, day make 140 pounds of ATP. And, you know, we don't eat 140 pounds of food and half of our listeners probably don't weigh 140 pounds. And yet every day we manufacture 140 pounds of ATP. And you go, wait a minute, where'd it go? Well, the answer is we spend it. We spend it as our currency to drive all cellular mechanisms.

So if ketones aren't particularly great as a fuel, and we certainly make ketones when we're starving, then what other thing might ketones do? And here's the cool thing. I stumbled upon a paper by Martin Brand, who I give a shout out. I'd never met him, who wrote a fascinating little paper in 2000, sorry. called uncoupling to survive. And we're going to talk about uncoupling, but I'll make it brief on this part. So Brand proposed that if you're starving, then mitochondria have to protect themselves at all

cost. And making energy is hard work. So mitochondria ought to protect themselves by actually making less energy, making less ATP, and actually wasting a lot of the calories that come into the electron transport chain for making ATP to protect themselves from damage. Now, at first glance, you go, boy, is that a stupid idea? Because if you're running out of calories, if you don't have anything to eat, you would think that your mitochondria would be instructed to become profoundly efficient to get every last ounce of ATP out of every last calorie because there's nothing to go around. And in fact, Brand and other people have now proven the exact opposite happen. That mitochondria waste calories.

And what he also showed, and what I show in the book, is the second thing happens. So I like to use the analogy of a dog and a dog sled. So we could hook a dog to a dog sled and the dog could pull the dog sled. He wouldn't pull it very fast and he wouldn't get very far before he got tired. What if we added five more dogs to that single dog on the dog sled and had a 16 dog sled? Well, now we're going to go a lot faster. We're going to go a lot farther. But each dog has to do a sixth of the work that that one dog had to do. The only downside is six dogs eat more food than one dog. So in a brilliant discovery, not only are mitochondria told by ketones,

signaled by ketones to not work so hard, they're also simultaneously told to divide and make more dogs pulling the dog slip, more buddies. And the cool thing about mitochondria, as you and I know, is that mitochondria contain their own DNA. And they can divide separately than when the cell divides. So with this signal, mitochondria told, don't work so hard, make more, put more people on the line, and spread the work. You'll still make the same ATP we need, but none of you guys will get damaged in the process. And when you see it in that light, you go, wow, that's actually an incredibly smart design. I would have never thought of doing that. And obviously somebody did. Now what Brand

subsequently does, he says, I know you don't believe me, but let's look at super old people. Let's look at 105-year-olds around the world, and let's look at what's happening in their mitochondria. Well, it turns out that this wasting of fuel is accomplished by opening up emergency exits in the mito club, which I talk about in the book. But simplistically, making energy is hard work. It's like a pressure cooker. Pressure cookers are really efficient, they're really good, but if the pressure gets too high, the pressure cooker explodes. Pressure cookers have a pop-off valve so that when the pressure gets too high, the steam comes

out. Mitochondria have pop-off valves, and these pop-off valves are controlled by what are called uncoupling proteins, and these proteins control popping off these valves. There's actually five of them. Lo and behold, the super old people have the most activated uncoupling proteins of anybody. And when I saw that, I went, oh, my gosh, you know, here's the secret to a long life is uncouple your mitochondria. Have them have emergency pop off valves. have them recruit other mitochondria to do the work.

And a consequence is you actually lose weight because they're doing a caloric bypass. They're throwing fuel away. Now, is this also where I've heard you talk about the oldest living communities also have a particular type of fat at higher concentrations? And that's brown fat. Can you explain what that is and what the connection of that is to what you just shared about mitochondria uncoupling in these communities? Yeah, so a lot of people know about brown fat.

Brown fat is actually called brown fat because it's so full of mitochondria, so stuffed with mitochondria, that it actually looks brown under the microscope. White fat, our traditional storage fat, is called white fat because, quite frankly, they don't have a lot of mitochondria. We know that babies have a lot of brown fat. We think it's because they need to generate a lot of heat to stay alive. But as the book shows, very healthy people have much more brown fat than non-healthy people. So it turns out that brown fat is very active, uncoupled mitochondria. And the more that they uncouple, the healthier you are in lots of ways that the book goes into. And the cool thing is you can actually convert white fat towards brown fat,

and it's called beige fat because it's actually adding more and more mitochondria into the regular fat cells and transitioning from white fat to brown fat. And interestingly enough, the way to make brown and beige fat is to send signals through the various techniques I talk about in the book to uncouple mitochondria. Now, let's do a little bit of a compare and contrast for those that are at least familiar with the keto diet, but maybe have not ventured into it themselves. They know some elements of what a more traditional keto diet would look like. Now, as you've mentioned, you've had the keto approach in part of your diets for all your programs. Right, for 20 years. And you outline it even more in detail with all the latest research and the latest foods,

some of that we'll talk about in a little bit here. But the question that I want to ask you is part of this compare and contrast is that a lot of people also would say that, hey, I'm doing keto, but they're not necessarily measuring their ketone production in the body. For the folks that have, and I've had many friends do it, not myself, one of the things that mention is that it's actually very hard to get into ketosis. Indeed it is. Even eating a little bit of carbohydrate and not eating enough fat, you actually really can't get into it.

And so many people who think that they're doing a traditional keto diet, they're actually very hardly in ketosis or not producing that many ketones. Any thoughts about that? Yeah, that's absolutely true. And, you know, we've measured blood ketone levels in all of our patients, fasting. And it's fascinating. And I talk about a woman in the book, Miranda, who's not a real name, but she had been on a traditional high-fat keto diet for two years under medical supervision. And she kept gaining weight, as actually a number of keto dieters do. And so she came to me and we

did her initial blood work. And number one, she was not producing any ketiator. And number two, she had insulin resistance. She had pre-diabetes. She had metabolic inflexibility. She had metabolic syndrome. And she was actually apoplectic. She said, what do you mean? That's impossible.

You know, I've been eating this high-fat diet for two years. And what do you mean I'm not making ketones? I don't know. Here's the evidence. And so she said, well, why not? Well, so here's the cruel gut punch. Again, 50% of normal weight people cannot shift from burning fat as a fuel to burning glucose as a fuel. 88% of overweight people can't shift to get to burning fat as a fuel.

99% of obese people can't do it. Why? It's actually, it's a cool design. And once you understand the design, then it's easy to make a fix. So the design is insulin, and most people now know about insulin, insulin takes the primarily sugars and proteins that you eat, and it acts as a salesperson. And it sells that sugar and protein to primarily our muscle cells. It says, hey, guys, this person just ate some great stuff. Open the door.

I want to sell you this stuff. Well, for most of us, our cells are full. They've had plenty to eat. And they go, now, couldn't eat another bite. It looks delicious, but please, really, I don't want any. Well, insulin has to get rid of this stuff. So insulin recruits a bunch of its friends and tries to shove this into the muscle cells. And the muscle cells resist that effort and says, no, there's no.

There's no place here. Well, insulin says, okay, you're going to thank me someday. I'm going to take all these extra calories, and I'm going to store them as fat. Because one of these days the famine will arrive and, you know, you'll thank me for storing all this as fat. So insulin turns on an enzyme called lipoprotein lipase to convert all this stuff we eat into fat. So far so good. Now, fat and fat cells has to be released, has to be removed from fat cells by another enzyme. And that enzyme is hormone sensitive lipase.

Drew, hmm, what hormone would hormone sensitive lipase be sensitive to? Insulin? Insulin. Why? Why? Because if you're eating and trying to store fat, the last thing you would want to do is pull fat out of storage. That'd be dumb. One guy carrying it in and one guy carrying it out. So when insulin is present, hormone sensitive lipase is blocked. It's not turned on. And sadly, the vast majority of us, and certainly the vast majority of people I see in my practice, have an elevated insulin level. So when they go on a ketogenic diet and they stop eating carbohydrates and they limit their proteins and eat a lot of fat, that stuff is still stuck. The fat is stuck in the fat cells because insulin takes actually a long time to fall for

most people. And it's literally like water, water everywhere and not a drop to drink. And so you could do a ketogenic diet, but until your insulin level fall, you're done for in terms of actually generating ketones in the traditional high-fat diet. The other sad thing is, like you noticed, one little, oh heck, you know, I'll have a handful of berries that won't break ketosis, or, you know, I'll have four ounces of wine, that won't break ketosis, or what the heck, I'm going to have a low carb bar with five net. carbs and that's enough for most people who have an elevated insulin level to fail.

Compared to somebody who doesn't and when you're talking about it, you're talking about fasting insulin and measuring that in patients. Correct. Yeah. And could you share just some numbers just for the people that are listening, you know, we've been writing a lot about this, we've been doing episodes about it. What would be an example of this woman that you were sharing earlier? What would her fasting insulin be that, you know, or a range? Yeah. That would be considered to be elevated. And then where do you want people to be when it comes? comes to those optimal numbers. That's a great question.

So Miranda's number was 16, which, you know, most of us would argue is, you know, a severely high insulin level. I mean, I see people with fasting insulin levels of 30, 40, and 50, believe it or not. Luckily, labs are getting smarter and smarter about showing a range. I'll give you a rather hilarious example. The Cleveland Heart Lab, which is now owned by Quest, their upper range. of a normal insulin level is 26. Wow. Now I would argue and Mark might argue too that where the Cleveland Clinic is located, normal people might have an insulin level of 26 because of the way

their diet and lifestyle is. We now use Boston Heart as one of our labs and Boston Heart used to say that under 10 is a normal insulin level. But now, Boston Heart is going, hey, guys, we were wrong about this. Five to ten is moderate insulin resistance. And you better get your insulin below five if you know what's good for you. Personally, when I started embarking on my journey, you know, 25 years ago, even though I was running 30 miles a week going in the gym one hour a day, eating a healthy low fat diet. My, and I was 70 pounds overweight, despite doing all this, my fasting insulin level was 16.

And I went, son of a gun, no wonder I can't lose weight. You know, doing all this crazy stuff, I was just storing everything I ate as fat and I couldn't go get it. I couldn't unlock it. And what do you say now to your patients that are coming to you when they say, okay, hey, you know, this patient of yours was, I think you said, 16. Yeah. What is the number that they, you know, quote unquote, should be shooting for?

Well, you know, in my practice, I really want people to get to five and below. We start rejoicing when we go under 10 because now we know we're making progress. I'll give you a great example from yesterday. I have a woman who's from San Diego. We are talking off camera about San Diego. and very successful one young in her 40s. She's obese. She tells me she goes to Pilates every day.

You know, she works out and she keeps gaining weight. Well, I've been working with her for a couple years, and I only see her, unfortunately, about once a year. So we saw her last summer, and her insulin level had gotten down to five. And she was making great progress. She was losing weight. She was happy.

This time she came back, and she's up 15 pounds. And she said, I don't get it. I eat like a bird. You can ask my husband, I eat like a bird. And, you know, all I do is gain weight. And I said, well, let's look at the numbers. Your triglycerides a year ago, which is a pretty good, accurate indication of how many sugars and starches you're consuming. was 50.

I'm a really mean person. I want triglycerides to be 30 to 50 in my patient. The normal level is up to 150, but I'm mean. Her triglycerides were 50 last year. They're now 99. So they doubled. Her insulin last year was four, and now it's nine. And then when we calculated her insulin resistance score, which is Homa IR,

are, she had no insulin resistance a year ago, and now she's positive for insulin resistance. Wow. So I said, well, the news is you may be eating like a bird, but this bird has been eating a lot more starches and carbohydrates than the bird last year. The hummingbird. And now she's taking all that, and she's now with insulin signaling it to store fat. And she said, and I go, look, you are. are a perfect example of this in motion.

You're now trying to swim upstream because with your insulin level high, you've blocked hormone-sensitive lipase and you turned on lipoprotein lipase. So everything you eat as a bird is being stored as fat. I think it's such a crucial point for people for many multiple of reasons. Number one, they don't really hear unless they're diabetic, they don't really hear their doctor talking about insulin. No. Number two, very few people get their insulin on their blood report.

Correct. In fact, I would say that I don't know what the numbers would be actually, but when I talk to my friends and tell them, you know, they're asking me like, what blood tests should they get? Just big picture and what's missing and what to go ask their doctor for. I'll see like, you know, almost 60, 70 percent don't have their fasting insulin listed on their blood report. I don't know what it's like when, you know, you're actually the doctor who's doing these tests.

Well, here's the worst. I have third-year family practice residents that rotate through my clinic for a month at a time. These are the third year, so they're about to go into practice. This is their last year of training. Not a single one of them has ever heard of a fasting insulin level. Wow. Not a single one. And when they see, you know, in my clinic how it's used, they're going, what the heck?

you know, why haven't I been taught this? And I've said on many shows, if I had one blood test to predict someone's fate, it would be a fasting insulin level. If I only got one, you know, if you had $8 and give me a blood test, it's a fasting insulin level. It's that important. Because getting back to your original talk, this is a measure of metabolic flexibility. And with every passing year, we know if you don't have metabolic flexibility, you are going to participate in disease processes that you do not want to participate in. So how we got down this line of talking about fasting insulin, which again, so key for everybody who's listening, you know, ask your doctor for it, read up on it. We have a bunch of links and articles that are there. You know, you have to advocate for your health and obviously pick up this book, you know, unlocking the keto code because Dr. Gundry goes into it further over here.

but how we got down this channel is that we were saying that ketosis is very hard to get into. Correct. And especially there are people who, if they haven't addressed their elevated level of insulin and their insulin resistance, that actually ketosis could be putting them into worse off health in some instances. They could gain more weight. They could have more problems. They could not feel great.

Their lipids could be out of control. Yep. And again, that could be directly related to this metabolic health access. So now is that connecting the dots between the two of those, are you basically saying that, you know, following a program like yours and really understanding all these things in context and mitochondrial and coupling as the mechanism to get there, that when you are bringing your insulin in line, when you're bringing your metabolic health in line and your labs are reflecting that, then you can take advantage of ketones and their real purpose. of being a signaling molecule for a health for the better. Yeah. Yeah. And again,

60% of people who try a ketogenic diet leave at the end of a month before an end of the month, 60%. And so much of that is because you normally, if you can release fat from fat cells, you can burn free fatty acids as a fuel very well. and you sadly have to have free fatty acids to create ketones in the liver. Now we have a work around that that we'll talk about in a minute. But unless you're releasing free fatty acids, you can't produce ketones in your liver. And your brain has to have ketones temporarily when you're taking away glucose.

And so it's no wonder that so many people, you know, they get brain fog, They get headaches, their athletic performance plummets, and they go, pf, this isn't for me. And we've seen people, you know, hardcore take a month to drop their insulin levels, you know, back to where they'll actually start releasing fat from fatso. So it's, that's the frustrating thing about most people, you know, attempting a ketogenic diet. it's no wonder they feel awful because their mitochondria are literally sputtering to a stop because they don't have any fuel to work with. There's also some other dangers that you've written about, you know, traps, I would say,

rather, that people find himself in. And one of them is, I'll pull up the list here because I bookmarked it inside of the book, is I believe that one of them was relying too heavily on animal protein as a, a way to get your fat intake up to that level that a ketogenic diet often requires. So can you talk about that a little bit? Yeah, I am not against animal protein. I call myself a veg aquarium. I eat mostly plants, and then I eat primarily wild shellfish and sometimes fish on the weekend.

So I'm a veg aquarium. So during the week, you're... Yeah, pretty much plant-based. Pretty much plant-based. Yeah. Minus dairy. Yeah, so, yeah, we'll talk about dairy in a minute. We'll talk about dairy in a minute, but I just wanted to clarify there because I know you are really championing and for good reason, all this latest research that's out there about dairy, but specific types of dairy, which we'll come back to it.

Yeah, we'll come back to that because that's actually one of the exciting parts of the book. Yeah, I thought it was like a shining star inside of this book. And it should have prompted my wake-up call when I was a professor at Loma Linda University for most of my career. And for those of people who don't know, Loma Linda is the only blue zone in the United States. The university is run by the Adventist Church, and they're primarily vegetarians, a number of vegans. But when I first went to Loma Linda back in the late 80s, I met with the dieticians because I noticed that the food in the cafeteria, which was vegetarian, was really heavily

fat-based. 50% of the calories in the cafeteria was fat, and it was primarily milk fats. And what kind of foods would you see, just like, for example? Well, so, I mean, for instance, we had these hilarious things. They were called mystery meats. Most of them were actually based on texturized vegetable protein, TVP. And you could make a shrimp out of TVP. I've eaten a few of those in my days. Yeah.

In fact, can I do a quick aside? Yeah. My longtime partner, who's unfortunately now deceased, Leonard Bailey, we always had a Christmas party, which was usually at a hotel. And we had Adventist-approved foods and, you know, vegetarian foods. And Len came back from the serving line and he's popping shrimp into his mouth. And he turns to his wife, he says, you know, honey, they're getting better and better at this. These taste exactly like real shrimp.

She looked and she said, man, you idiot, those are real shrimp. The other ones are next door. Oh, I'm sorry. I didn't mean to. Oh, no. Yeah. But, yeah, so, I mean, we had a Wham sandwich, which was a fake chicken patty with cheese on it covered with a fried egg. And that was a Wham sandwich.

And we had Wham, which was fake spam. And it was just loaded with fat. And I went, you're killing everybody. Well, Leonard did I know, wait a minute, this is the longest living people in the United States. What do they know that I should know? But it took me a number of years to learn what they knew. So the way that we got there, we were talking about animal protein. So animal protein is a list of kind of like the don'ts and some of the traps that people get into

when they're doing a traditional keto diet, which would actually lead into like the dues of your program and your protocol. Yeah. One of the most interesting, my first book was called Dr. Gundry's Diet Evolution. And it came out in the mid-2000s. And random house had bought my book. And they had done all the South Beach Diet books and all the Adkins books. And they bought my book because I figured out a few things that they had missed.

I had the pleasure of meeting Dr. Atkins' ghostwriter and also Dr. Atkins had nurse. And as most everyone knows, Dr. Atkins died young. And when he died, he was actually obese. He was an obese man. And he made, I think, a fundamental mistake. He started out as a high fat doctor. And he really wanted people to limit their protein, limit their carbohydrates, and eat a lot of fat.

And he got into such trouble with the American Medical Association that, I mean, he's a cardiologist, that he morphed into a high protein doctor. And I, to this day, believe that he didn't know at that time that protein, we have no storage system for protein except for muscles and cellular repair. But we do not waste calories. So if we're eating a lot of protein, we convert it into sugar via gluconeogenesis. Why? Because we have a storage system for sugar. It's called fat. And you could watch him transition from actually a very lean individual getting fatter and fatter as he morphed. from a high fat doctor to a high protein doctor.

And I think that was, and I see this in my patients who use, you know, a high protein ketogenic diet, they don't get into ketosis. Their insulin levels stay high. And we, at least in my practice, see these people really raise their insulin-like growth factor, one, IGF-1, which to me is still our best measurement of, of how you're going to do in the long haul in terms of longevity and good health. And, I mean, didn't he also die under kind of like, it was a little bit of like funny circumstances.

Funny circumstances. Yeah, he had actually developed a cardiomyopathy. But I think the press release or whatever. He slipped on the ice. He slipped on the ice and hit his head. But the autopsy showed, number one, he was obese and number two, that he did have coronary disease. Yeah.

Yeah. So the takeaway from that as part of this and also a lot of people that do the traditional keto diet, and often the ones that I see that end up having the worst time are the ones who have both high fat and they're eating like high protein. And actually, they're not even doing keto in the first place and they're still eating carbohydrates because they think that it's about eating a lot of cheese and eating a lot of bacon. Yep. And so they're not really doing, they're not getting anything right when they're going down the journey

of doing keto. No, and in fact, you know, I have a number of patients and good for them because I learned from them, I'll have a number of patients say, hey, you know, I'm going to do, I'm going to do a hardcore carnivore diet, a hardcore keto carnivore diet. And, you know, I'm, you know, I'll see you in three months and, you know, let's look. And a lot of these people, quite frankly, they feel great. And they're- I had a friend just this morning in my men's group. He's been doing carnivore for about a month, just something that he ventured into himself. And he said, I'm feeling fantastic right now. Yeah. And, you know, some people accuse me of being the father of the

carnivore diet because the carnivore diet removes lectins. Right. They talk about lectins and that. I don't need to be the father of that. But it may be that that's true. And I think that's why initially a lot of people do feel so much better because they're removing lectin-contained foods. But- And they're probably balancing their blood sugar. Correct. Yeah, exactly. But what happens is to all of these people. I now have three in the last six months who have embarked on them. Within three months, all three of them say, man, I'm feeling great, this is great, I really feel good. There are markers of vascular inflammation, which used to be perfect, go through the roof. There are markers for oxidized cholesterol, which used to be perfect, go through the roof, and markers for vessel

flexibility, there's a saying in longevity, that you're only as young as your blood vessels are flexible. They stiffen up. What would that marker be for vessel flexibility? Like if somebody was interested in looking into that? Yeah, so they want to look at ADMA and SDMA. Okay, got it. The marker for vessel stiffness is called the plaque test, PLAC. I was actually the consultant for the company that designed it. But the fascinating thing is, so they're feeling great. And their cholesterols are through the roof, all three of these guys. They're feeling great. And then I show them this. And they go, but, but I said, well, look, you're the, you're the swimmer in the water from jaws in the, in the nice, clear ocean. And she's paddling along. And she doesn't know

that there's a great white shark with its jaws agape about to eat her. And I said, look, I'm showing you your great white shark. Are you sure you want to continue this? And actually all three of them said, okay, I'm backing off. I'll see in three months and let's see. All three, the great white shark disappeared in three months. Wow. Now, I go into that, why?

Because on these ultra-low fiber diets, whether it's a carnivore diet, whether it's a high-fat diet, you're depriving your microbiome, the friendly bacteria in your gut, the foods that they absolutely need to eat to produce what are called post-biotic compounds. So you need to give them prebiotic fiber. So the probiotics, the friendly bacteria, can make postbiotics. And the postbiotics are actually what promote vessel flexibility. In fact, the Nobel Prize for Medicine a few years ago was the discovery of nitric oxide, which is a postbiotic. Buterate, and everybody knows how great butyrate is for lots of reasons,

but buterate from postbiotic is a postbiotic. And so these people have deprived the most probably important organ in their body, their microbiome, of the stuff the microbiome needs to eat to stay alive. And we can watch it on blood tests. Powerful. Before we walk through a few of the key things that are there as part of unlocking that keto code, right, and playing a direct role in that mitochondrial, uncoupling, which leads to all these benefits in our life. I heard you in another interview

to talk a little bit about kind of like the evolutionary history of mitochondria. And you'd share the story about 60,000 years ago, at least based on the latest evidence and stuff that we have right now, and the human species being windled down to quite a few number of people. Can you talk a little bit about that and why that's important to understand in the context of mitochondria and what makes human beings exactly who they are today? As you know, And hopefully a lot of readers know, we think that two billion years ago, a cell decided to engulf a bacteria. And rather than eating the bacteria, so I'm very much like Jonah and the whale, the bacteria said, hey, I got a deal for you. Don't kill me.

And I'll make energy for you. I'll make ATP for you in a far more efficient way than you can do it yourself in exchange for giving me a nice place to live and feeding me. Deal? Apparently it was a match made in heaven because all what are called eukaryotic cells, all higher forms of life are based on these engulfed bacteria that became mitochondria. Now, what's fascinating is that mitochondria are only contributed from the female. The female egg contains mitochondria. The male sperm does not. So all mitochondria come along the female line.

So mitochondria are actually genetically, they're like bacteria. And again, as I mentioned, they have their own DNA. And it's separate from the nucleus. each mitochondria can grow in divide. What's really interesting is we can follow in human ancestry mitochondrial DNA, and we can trace lineage based on the mitochondrial DNA. And about 60,000 years ago, it looks like there was a tremendous road jam out of Africa. And at least with mitochondrial DNA, it appears that there was one surviving female and maybe a few guys. Why?

And she's called mitochondrial Eve because every one of us, we can trace our mitochondria back to this single female about 60,000 years ago. Why that's important going along the same line is our microbiome is inherited from our mother at birth, actually even before birth. We now know that the microbiome seeds the placenta and the microbiome actually is in the fetus before the baby is even born. And there's a lot of exciting evidence that the microbiome in the placenta of the fetus determines your immunologic fate.

May even determine the fate of autism, but that's all another subject. Getting back to that. So we get our microbiome from our mother. because she took a crap on us as we came out the birth canal. We know that kids who get cesarean section, their microbiome was screwed up for at least six months. They actually carry a skin microbiome, which you don't want. Long story short, we now think, thanks to the work of Marvinides from Paris, that the microbiome

talks to their sisters, the mitochondria, with a language. that has now been discovered called postbiotic. And the microbiome literally tells the mitochondria what to do, what to be worried about. Is there problems that they've seen? Is there trouble in the engine room? And so that cross talk is so critical to our mitochondrial function and well-being that to deprive the sisterhood down below of what they need to survive is literally doing

a kill punch to our mitochondria. In fact, you said it that they text back and forth through this communication. And is that like these gut microbial metabolites? Is that the... Yeah, yeah. So there are both, they're gaseous messengers, gasso messengers. they again when Marvinette is a chairman of a microbiome meeting that I presented every year. And about 10 years ago, he said, I'm telling you that, you know, the gut microbiomes talk to the mitochondria.

And I go, oh, come on. And he said, I'm telling you, it happens. And I said, well, how do you know? He says, they're text messages. And one of these days we're going to discover the text message. And those text messages were discovered as postbiotics. So hydrogen gas is a text message. Methane gas is a text message.

Carbon dioxide is a text message. Buterate is a test message. Acetate, acetic acid is a text message. And they send messages between each other to do certain things. And that actually is what gets into, there are whole lots of messengers that actually tell mitochondria to protect themselves and to waste energy and waste calories and actually spiff them up. And that's what's so amazing. Just as one example that I used before, interesting Japanese study looked at people with Parkinson's disease.

and they compared people's gut microbiome with Parkinson's versus normals. The people with Parkinson's disease did not have hydrogen gas producing microbes in their gut, whereas the other folks did. And so they said, huh, what if we gave people with Parkinson's hydrogen water, hydrogen dissolved in water? and lo and behold, their Parkinson's symptoms diminished, showing that this silly gas, you know, which was in the Hindenburg, was actually a critical communication system that actually improved mitochondrial help.

I mean, who knew? Well, Marvinides knew. It's all super fascinating. And for the person who's listening, and they're understanding these pillars, they understand these stories and naturally for everybody who's listening it's great now how do I get the benefits how can I duplicate just like you gave the dog sled analogy it's harder for one dog to pull sled and maybe even can't but if you had six or 20 dogs yeah now of a sudden

they can all pull the sled together and you can get to your destination in that same way as you've outlined mitochondria uncoupling and duplicating a number and wasting calories is an important part of us getting the benefits in our life and it relates to longevity. It relates to feeling better, feeling younger, and all the whole host of reducing chronic diseases, et cetera, et cetera. So you've listed a few keys that are there. I'd love to walk through and highlight a couple of them. And the first one that you have is intermittent fasting or time control eating.

We've done a lot of episodes on this topic, but tell us about your take or twist that's important for people to know in the context of the new book. Yeah, so number one, because most people don't have metabolic flexibility, most people, when they stop eating or try to extend the time that they don't eat until their first meal, they can't really get to that point because they can't release fats from fat stores. So what I propose in this book is, look, I want to hold your hand. and I want to get you to a point where you comfortably only eat from six to eight hours during the day.

And what does that look like? Well, I'd like to get you to the place where you eat lunch as breakfast at around noon or 11 o'clock. And then we'll finish dinner at seven or eight o'clock at night. And that'll give us a six to eight hour eating window. Can I ask one clarifying question about that? So you've talked a little bit about Walter Longo and some of his work and research. One of the things that he's notable for on talking about is that, you know, the communities and the societies where people eat breakfast seem to live longer than the ones who skip.

So that doesn't have to be a huge breakfast, but eating a little bit because our brain requires sort of energy for focus, for this. So is it a societal reason? Well, one, what do you think about that and his conversations in there? And two, is it because of societal reasons that you're sort of pushing that timeline backwards to make sure that people can eat dinner? Because dinner typically is a social thing? Yeah.

When I was writing the energy paradox, I really wanted to have people eat breakfast and eat lunch and then skip dinner. And I've tried it in the past with patients. I've tried it in past with myself. and if I was going to design the perfect way to do that, that's probably what I would do. But unfortunately, societal reasons, it's completely impractical. My wife and I mainly see each other at dinner. We both have jobs.

And the idea that, you know, we'd come home and then stare at each other and not do anything. and most people have families with kids. And so you start looking at the literature of where breakfast came from. And first of all, a hundred gatherers don't eat breakfast. There's no storage system. They eat breakfast. They break their fast, 10, 11 o'clock in the morning when they find something. You look at the history of breakfast.

It actually breakfast started with the Industrial Revolution in England. And men were sent to factories early in the morning. There were no lunch breaks. There were no breaks. And they would come home wait at night. So the wives would feed them a breakfast before they left. And the next time they would eat would be after sundown. They actually followed a Ramadan diet, which as I've written about, is actually very effective.

Fast forward to the early 1900s when the Kellogg's Corn Flakes Company made a deal with the United Fruit Company, a maker of chiquita banana, that they would put a coupon for a box of chiquita bananas in a box of Kellogg's cornflakes, and then they paid physicians to tell people that not only was breakfast the most important meal of the day, but you should top it with a banana to get potassium. And bananas aren't a great source of potassium. So this whole mindset of breakfast being the most important meal the day is really a very modern concept from the late 1800s. For sure.

Yeah. And I think also Volta Longer was talking about like not people eating this big American industrialized breakfast, but rather like it might be a little bit of prosciutto, some cheese, other things that. Right. Somebody might have, and it might be more around like 10 a.m. or whatever, but not necessarily waiting until lunch in America is usually 1230, 1 o'clock, sometimes 2. You have a meeting, you skip lunch, and it starts later.

And to Volter's credit, and I give him credit in the book, recently he's shown that if you eat a primarily nut bar, and it's called the fast bar, that it will not take you out of ketosis. And I've used that trick, actually in my program, of having people who really need some help getting towards noon, just have a handful of nuts. Or, as we'll talk about in a minute, hopefully, have some MCT oil. Or have a piece of goat or sheep cheese or have some goat yogurt or sheep yogurt. And you won't break your fast for a really fascinating reason. You know, you work with people from all different backgrounds, shapes and sizes. and everything like that as patients, one of the conversations that's been pretty prevalent

and been integrated in a lot of practitioners' sort of recommendations is that do there need to be different fasting recommendations for women in their prime fertility years? Absolutely. And do you at all tweak your intermittent fasting approach for those, for exactly that, women in their prime fertility years? Yeah. And I actually work with a lot of women athletes who can't get. get pregnant. And it's fascinating that they have a very low, you know, body fat percentage. And

we have a, women have a fantastic sensing apparatus. You have to have adequate fat stores to go nine months without eating to actually pop an egg out to risk an egg getting fertilized. and so you have to have fat stores that if the famine happened tomorrow and you're pregnant, you can carry that baby to term. The best example is orangutans. Orangetans during fruit season, gain 7 to 8 pounds of weight in fat, eating fruit. Keep remembering that eating fruit makes you fat, but that's another story. But all great apes store fruit as fat.

So the orangutan, the female orangutan doesn't go into heat until after she's gained that 7 to 8 pounds, and then she pops her egg out. And so I see so many females in my practice, if I can forcibly make them gain 10 pounds, the next thing I go, hey, thanks, I'm pregnant. And in fact, many of these women stop ovulating. And I just actually had a young lady, an athlete, a couple of weeks ago. And she said, you know, it's really weird, you know, I'm only 35 years old and I'm in menopause. And I go, what do you mean? And she said, well, I am at a period in a year now. And, you know, I've been using, you know, a ketogenic fasting diet.

I really limit, you know, my eating window. And so I do female hormones on everybody and male hormones on male. And I said, well, that's interesting. You're not in menopause. Your follicle stimulating hormone is incredibly low. And if you were in menopause, it'd be incredibly high. And you're still producing estrogen, but it's not much. I said, you're not in menopause.

You've told your body to stop popping out eggs because you're a bad risk. And she said, really? And I said, what's right here? And she said, well, that's good news. You know, I thought I was in menopause. I said, no. So if you don't want to get pregnant, then this is a perfect option for you and no problem. She's 35. She has two kids and she's a, oh, I just thought I was a menopause. But this was a perfect example. Yeah, you see it a lot. I had a girlfriend many years ago who was, you know, vegan for years, but was a low fat vegan and stopped having her period. And when she finally started having and, um, and, and, kind of discover the world of flow living, which is an author out of New York, Alyssa Vitti, and she started including eggs in her diet and other things that were beneficial. She still was

vegetarian, but she was having eggs and things. Boom, immediately started to get her period back, which just shows you the power of not removing fats from your diet. That's true. That's true. So how would you adjust your eating window for anybody who's a woman again in their prime fertility years who wants to step into the keto program that you've aligned. Well, the good news is, or the bad news is, the vast majority of us in the United States are metabolically inflexible, and so many people are pre-diabetics without knowing it. And so many women are going to enter pregnancy with two hands tied behind their back. because we see so much diabetes of pregnancy now.

And I can tell you that this puts your baby and not only you, under extreme risk. So for women who are overweight or obese, absolutely, let's get you on an intermittent fasting program. Let's get your insulin levels down. let's uncouple your mitochondria, let's get you metabolically flexible, and then you'll be ready. It's like training for anything else. And then if you're on the flip side, because you have a lot of people that come to you that

have actually been eating very healthy for years. And maybe they're fasting insulin is not in the right area. Maybe their sugar is a little bit high, but you look at them, they're maybe even look a little underweight. Right. Right. So for those individuals, would you say, that, okay, let's not focus on necessarily the traditional time-restricted eating window.

Right. Let's just dial in the rest of the factors that are there. Exactly. And we see, like the woman who starts my book, this woman, once we kind of dialed in all these uncoupling compounds that she was eating, the weight kept falling off of her. And even though she was no longer eating a traditional ketogenic diet. And for her, believe it or not, she got to be a real carbohydrate-eating fiend as long as they were the right carbohydrates. And so she was really happy with my ketogenic version of her diet.

That's great because that's a super important thing for people who are listening. Again, if you've had one belief of what keto is, I think you're going to really like this program because there's a lot of foods that you can have that previously you didn't think that you could have before. Let's go into the next one. Key number two, and that is polyphenols, which you've been known to talk about for quite some time. What is important for the listeners to know about polyphenols in the context of mitochondrial uncoupling?

Okay, that's a great question. Let me answer it in two ways. One of the most startling discoveries was in World War I. Munition factory workers in France and Germany were noted to be profiling. loundly skinny, no matter how much they ate, and they always seem to be running a low-grade temperature. And nobody kind of put it all together until the late 20s, when they discovered one of the compounds in munitions manufacturer, is a compound called 2-4-dinitrophenol. Fenol, hear that word?

and it's called DNP. And some clever researchers at Stanford University in 1930 said, son of a gun, DNP was making these factory workers really skinny. And they couldn't gain weight. What if we gave it to people as a prescription as a weight loss drug? And lo and behold, they did. And there were over 100,000 prescriptions for DNP written in the United States alone. And it was a miracle.

If you took a little bit of DNP, you would lose a pound a week. If you took a lot of DMP, you could lose five pounds a week. Five pounds a week. That's a miracle, weight loss drug. Well, not so fast. These people started running temperatures. They started having thyroid issues. They developed cataracts, and this was before cataract surgery.

And I like to joke, it'd be great to see how you look in that skinny dress, but you can't see yourself. Right, this cataract covering your eyes. And people started dying. And so the FDA, newly formed FDA, is one of its first act banned DNP for sale in the United States in 1938. But DnP lived on, and when it turns out the electron transport chain was discovered or proposed by Sir Peter Mitchell, it turns out that DnP was the first mitochondrial uncoupler that was discovered. And it worked by literally having mitochondria waste calories. and in the process of wasting calories, it actually generated heat. Now, the downside was that this particular uncoupler

didn't tell mitochondria to make more of themselves. And so you'd have them waste so much ATP that the end result was death. DnP still actually has a lot of interest. There are many companies working on forums of DMP that would be manageable. and there's a whole body of research that's fascinating. But that gets to the question of polyphenols, more than one phenol.

So we know phenol rings are capable of uncoupling mitochondria. So polyphenols, we associate with plants, with very colorful pigments in plants. The colors we see in leaves as the leaves turn yellow and gold and orange and red and, and even maroon in the fall are the polyphenols in those leaves that have been hidden by the green of chlorophyll. So plants have their own mitochondria to produce energy, and they're called chloroplasts. And interestingly enough, their mitochondria work exactly opposite of ours. They take sunlight, photons from sunlight, combine them with carbon dioxide, and produce oxygen and glucose. So exactly the opposite.

Plants need sunlight, but the chloroplasts are damaged by sunlight. Just like we need oxygen in our mitochondria, but mitochondria are damaged by oxygen. oxygen radicals, free radicals, reactive oxygen species, all part of the damaging effect of oxygen. So plants protect themselves from the damage of sunlight by producing polyphenols. And those polyphenols uncouple their mitochondria to protect them from the damage of sunlight or other stressors. When we eat plant polyphenols, number one, we don't absorb them very well, but our bacteria love them. They're actually a prebiotic fiber.

And the bacteria convert those polyphenols into bioactive mitochondrial uncoplers, which explains why, for instance, like a Mediterranean diet, where there's a rainbow. of different polyphenols in the diet from olive oil to red wine to fruits and vegetables you name it they're actually benefiting from the mediterranean diet by the uncoupling ability of polyphenol it's actually pretty cool it's fascinating yeah so you know every time i say this i start singing the circle of life from the lion king uh because you know the the lion king's talking to his son and the you He says, oh, yeah, you know, we eat the plants and then we die and we feed the plants and blah, blah, blah. I can hear it saying.

Yeah. Let's hit a couple more. I know we were about a little bit more than an hour into the interview, but I feel like these areas that you've mentioned are just so key that a lot of people are just not familiar with them. So dietary fiber, you know, what is it about dietary fiber that is so central to that communication, again, between our gut bacteria and our, and our, in our mitochondria. Yeah. So, you know, we've known for some time that, you know, dietary fiber is important for our bowel movements, but we really didn't realize that soluble dietary fiber is the main food for gut bacteria.

And rather than the fiber being what we saw coming out of our rear ends was actually these got bacteria eating the fiber and growing and dividing and making lots of other baby bacteria. So the vast majority of what comes out our rare end is actually bacteria that should be fed on fiber. And, you know, Terry Walls, who's become a good friend, she thinks that, you know, when you look into the toilet, you better see a giant coiled snake looking back at you. And, you know, she has little, you know, giant turd dolls on her, on her counter. Like a little poop emoji? Yeah, and she's absolutely right.

And that actually explains why when you go on a ketogenic diet or even high protein diet, all of a sudden the caliber of your stool and the frequency of your stool often goes down dramatically. Because the vast majority of what you should be pooping out is actually bacteria that have eaten what you've been feeding them. And again, the more we feed them, what they want to eat, they'll produce these postbiotic gases and short-chain fatty acids like butyrate. The cool thing about buterate is we now know that colon cells, the colonocytes, have to have butyrate to stay alive. That is their fuel source.

They don't want oxygen. There is no oxygen in the colon. They don't need blood supply. They actually have to have butyrate. And that's why people on a high fiber diet tend to have less colon cancer than people on a low fiber diet because their colonocytes are happy and don't go through any changes. The other cool thing is that about 10% of all butyrate is released, not used by the colon and enters our circulation, where it uncouples mitochondria, surprise, surprise. And it also is a inhibitor of one of the main mechanisms of cancer cell proliferation, which are called histone decarboxylases.

Don't remember this. So buterate is also the substrate for beta-hydroxybutyrate, which is the main ketone that supplies energy to our brain, B.HB. and you can buy BHB supplements like I talk about in the book. So buterate is a biggie, and we get it from fermentation. Now, the really other fun fact is another product of fermentation is acetate, acetic acid. Most people know acetic acid as vinegar. And it turns out that acetic acid is also a really good mitochondrial and coupler.

And lo and behold, who would have guessed that, that apple cider vinegar or balsamic vinegar works its wonders, not in some mystical, magical way, but as being active mitochondrial uncooplers. Wow. And on that note, because we just recently did an episode on this with the glucose goddess, you know, white vinegar also plays a role, right? Yeah. Balances blood sugar, other things. Balsamic vinegar, you got to be a little bit mindful. You want to have it in the context of things. It's easy to overdo it because it typically would elevate your glucose, but it has other beneficial properties, as you're mentioning as well.

It's super fascinating once you go down this whole area. Well, we've covered a lot, and there's a few other areas, but we've got to save some gems for people to get into the book, you know, and a reason to get the book, which is fantastic, by the way. But I want to talk about dairy. Yeah. I want to talk about dairy. And this is really one of the stars that have come out of the book.

and I'd like you to talk about a little bit of what your research has shown you about the blue zones and how pivotal role dairy, but a particular type of dairy, plays in what you think could be contributing to their longevity. Yeah, you know, I first began scratching my head about the benefits of dairy when I was at Lomelinda because it went against, you know, my teaching of a low-fat diet as being beneficial for heart health. And you actually look at the Framingham Heart Study, and you'll find that there are some interesting long chain carbon fats, ultra-long fats that come from dairy, that the presence in the blood in the Framingham Heart Study, which is the longest ongoing heart study, I think it's a third

generation, the people who had these dairy fats in their blood, actually, even though their cholesterols were high, had the longest lifespan with the least diseases. And then you go, well, that's interesting. That goes against the party line. You know, my philosophy is always question conventional wisdom. Even if it's your own. Even if it's my own. That's correct. As I say in my book, so then there was a famous book, the food editor for Vogue, Jeffrey Steingarten, had a couple interesting books. First book was The man who ate everything. And he had a whole chapter on cheese. And the chapter was entitled, Why Aren't the French Dead? And he expounded on the fact that the French eat more cheese than basically anybody in the world besides the Swiss. And yet they have

some of the lowest heart disease in the world. And a lot of it has been attributed to the French paradox of drinking red wine. And oh, by the way, red wine is an uncoupler as well. But when the new research started coming out about certain molecules in chi, and then I went back and looked at the blue zones because, sorry, I'm the only nutritionist who's ever lived in a blue zone, so I guess I ought to be interested in blue zones. So, and, you know, I know, I know. I know. I know. Dan Butner, who wrote the Blue Zones, and I appreciate his research. But when you look at the Blue zones and look at their bean and grain consumption, things fall apart. For instance, Okinawa, the Okinawans, 85% of their diet is a purple sweet potato. They-

By calorie, by volume? By calorie. By calorie. They only eat about, they only get about 5% of their calories from rice, and it's white rice, not brown rice. They don't eat tofu, and they have miso and nato. So the idea that they're a blue zone because they're eating beans and rice, sorry, it doesn't work. Why the purple sweet potato? It's full of polyphenols, anthocyanins. So they have long life because number one, they're eating a ton of fiber from those purple sweet potatoes, is feeding their gut microbiome, and they're, uncoupling the mitochondria. Okay, so let's go to some of the other blue zones. Let's go to Sardinia and let's go to the Nagoyan Peninsula of Costa Rica. Hotbeds of eating beans and grains.

Well, not so fast. The longevity Sardinians live up from the top of the mountain. They are compared to the people who live down by the Mediterranean Sea. The folks down at the Mediterranean don't have longevity, only the people up at the top of the mountain. What's different? They're goat and sheep herders. And it turns out that goat and sheep milk have 30% of their calories as medium chain triglycerase. So inadvertently or whatever, because of where they live, they're actively uncoupling their mitochondria, whereas the folks down below don't get their benefit because they're not goat cheaper.

There's also a really cool membrane protein globule in milk products that is phenomenal for uncoupling mitochondria that I talk about in the book as well. Okay, let's go to the Nagorian Peninsula. Can I mention one more thing about the Sardinians is that my business partner who you know very well, Dr. Mark Hyman, he went and spent a week and there's a group of young ladies. who sort of organize these trips where you can go and go spend time with them and live in the homes of these individuals, these centenarians. And they were, you know, a sheep herder. And they also were taking them outside on like a walk with the sheep. And they were taking the, the, I think it was,

I think it was sheep and maybe some goats. And they were having them eat certain shrubs and eat this rosemary and do this and do that. And kind of like instructing the goats on like what to have. And they were saying that this is like a pre-seasoning for our cheese. But of course, as we know, there's tons of beneficial polyphenols that are in those herbs. So you have the double whammy of this high quality cheese or yogurt, whatever they end up making. But built in polyphenols that the animal has synthesized now, and I'm sure is somehow impacting the milk. Yeah, you know, that was actually one of the discoveries of the Swiss guards at the Vatican. The Swiss guards actually come from really a few villages.

in the highest Swiss Alps. And they actually only eat two things. They eat freshly baked bread and huge slabs of cheese. And the cows are only fed on alpine pastures. And the French government did a study years ago, looking at the various polyphenol components of these pasture, high pasture-raised cows in their cheese and milk, versus the cows that were down in the lowlands and found this phenomenal difference in bio-available polyphenols.

So, yeah, so these traditional herders have learned all that. So now we go to the Nagoya Peninsula. And what makes them so unique? Everybody in Costa Rica eats corn and beans. So what? The Nagayan Peninsula are sheep and goat herders. and they have goat and sheep yogurts and goat and sheep cheese, and that's the differentiating factor.

And a paper that it didn't include in the book, you can actually show that head-to-head, it's the goat cheese consumption that fights against the ill effects of the corn and bean in their diet. So finally, let's go to Crete, Icaria. Their diet, they are goat and sheep herders, Plus, they eat a huge amount of something I got interested in years ago. Persolene.

Persolane is that little weed that everybody's got growing in the sidewalk. Portulacca or Moss Rose is Persoline, by the way. And they eat a huge amount of persling. Well, perslane is loaded with alpha-linolinic acid, ALA. And as the Leonhardt Diet study showed, giving people alpha-linolinic, acid in their diet, in short-chain omega-3 fat, actually was the difference in the survival rate of the Leonhardt diet against a low-fat American Heart Association diet. And the study was stopped as unethical to continue with a low-fat diet because the results

were so good. And those researchers, as I pointed out in the book, the only difference in the outcome of the two groups who had better heart health was the amount of alpha linoleonic acid in their blood. As I show, just so happens that this short chain omega-3 fat is really good at uncoupling mitochondria in the walls of your blood vessels. So the takeaway powerful, right? And so one of the takeaways is, and this is something that I've been experimenting with over the last like year, is that it seems to be that even for people who thought that

that dairy was not, you know, that perfect food and, you know, not something that we want to be including. Well, there's a couple of nuances to that. Number one, traditional cow's milk may not be that beneficial. Correct. Right? And you're not saying for people to go out there and have that. It has no benefit.

Has no benefit. And it has a lot of negative that I've written about before. Yeah. And so most, you know, people that are also contemporaries of yours would also agree. and yet we can distinguish and say that this sheep and goat's milk that's made, and my preferred form is goat kefir, if I do a lot of goats cheese, like if I kind of go a little ham and take the whole thing, you know, a little slice, like little carve out of the cut of the cheese,

which would probably be about like five or six slices. I still have a little bit of a reaction. I get a little bit of a reaction to that, but I have goat kefir, which you can find at Whole Foods and a lot of places and natural food stores. I think the brand is called Redmond's, no affiliation or Redlands or something like that. And I do fantastic on it. I'm satisfied. I feel fueled for the day.

I have it in the morning with a little bit of put some cacao nibs on there. And sometimes I'll put in a little bit of nuts, macadamian nuts, which you talk about inside of the book here, maybe some walnuts. I try to soak those as well, and I feel great on them. So, yeah, and I talk about this. So, yeah, I think the goat of all of this, the greatest of all time, is the finding that goat and sheep milk have these beneficial, modified, medium chain, fricelisides. You're right that a lot of my really tough autoimmune disease patients, and my practice, has morphed to the 70% autoimmune patients who aren't getting better elsewhere. A lot of these people, and we do them sensitive to the various components of dairy,

a lot of them are sensitive to not only casein A1, which is in American dairy, but also casein A2, which is present in goat and sheep. Interestingly, a lot of people, if you ferment that dairy, the fermentation breaks those casein molecules. into easier to handle molecules. So your observation is probably 100% correct. So I think it's well worth trying adding goat and sheep products into the diet

for multiple reasons that I spell out of the book. My wife and I now have made it a practice of having a piece of goat or sheep cheese before dinner with some raw pistachios. And I go into why you ought to eat raw pistachio. Who knew they were the biggest source of melatonin of all time? Yeah. And you have this whole breakdown of why melaton is important.

And it's much more than sleep. It's not a sleep hormone. Right. Which you've talked about in a few other interviews. So a few people, Google around, you'll see you talking about that. Well, I'm not sure we had the full time to be able to go into that here because there's still a couple more things that I want to get a chance to go into. Sure.

You know, putting this all together, right, is really what your program is all about. So if we look at that and we contrast that, your program with all these aspects of a higher fiber diet, these polyphenol rich fruits, contrast a day in the life of a traditional keto, which may not even be ketogenic. You might not even be producing ketones. You could be causing a lot of damage that's there to the Gundry unlocking the keto code program. Just walk me through a day of both of those and kind of compare in contrast, right, like what the morning white look like or the afternoon or the eating. You know, just look at those two things side by side. Yeah. So, well, we're talking about boredom on one hand.

I mean, you can only eat so many slabs of bacon covered with cheddar cheese. You can only have so many hamburgers smothered with cheddar cheese, which, by the way, is the wrong form of cheese. And you can have only so many ribby steaks or, you know, a pound of butter. Go ahead, folks. try to eat a pound of butter. It's really hard. Or, you know, cream cheese everything or fat bombs, everything. And it really starts to get old. The other thing I think is scary in a lot of the traditional keto diets, and I've written about this before, a lot of them use a ton of different artificial sweet. And problem with these high fat diet. Like erythritol, xylitol, things like that.

Those are not quite so bad, but you look at the keto bars, tons of them have sucralose. Superlose. Okay. Interesting. And one packet of sucralose, Duke University, showed, destroys half your microbiome. One packet. It's like an antibiotic. Yeah, it's like an antibiotic.

It's like, holy cow, who knew? And so a lot of these keto drinks have sucralose. A lot of these keto products have sucralose. And so you've got to be really aware of that. Number two, in the book, there's really good evidence that these long chain fatty acids actually increase your insulin resistance, the exact opposite of what you want. And so I see so many people, you know, like Miranda in the book, she's so frustrated and she's following all the rules.

She's eating all these fats. She's having fat bombs. And she's, you know, loading up on these wrong cheeses. and she's getting fatter and fatter and fatter. Contrast that with, okay, I'm going to hold your hand and one hour a week, we're going to move our breakfast. So if you're used to eating breakfast at seven this week, let's eat at eight. Take the weekend off.

There's a beautiful study out of Chicago that shows if you concentrate on intermittent fasting during the week and take the weekend off, it does not impact long-term results, number one, but it also makes those people far more compliant. Because what I'm trying to give people is a program that you can live with literally and figuratively. And a traditional ketogenic diet is not a program that you can live with literally and figuratively. Powerful, powerful information.

Let's end on just like, you know, just like we talked about dairy, right? A few other foods that you put in the column of powerful mitochondrial uncouplers that people might have been sleeping on a little bit, or maybe they have it a little bit here and there, but they could consider including it more regularly in their diet. Give us like two or three more. Well, it turns out that olive oil has some of the most cool polyphenols that uncouple mitochondria. And olive oil is actually a rich source of melatonin. And we won't get into that today, but melatonin is one of only two antioxidants that are active in mitochondria.

And I think that comes as a shock when people read it in the book that you could swallow all the antioxidants in the world, vitamin E, vitamin C. And they're not going to ever do anything to protect your mitochondria. Only two antioxidants are active in mitochondria. melatonin. I mean, who knew the sleep hormone and glutathione. And those are the only two. So if you start looking at blue zones and Mediterranean diets, you find rich melatonin rich foods. And the richest one is actually pistachios by far. But red wine has it, coffee has it, tea has it, melatonin. And so the more I can get melatonin, mushrooms are loaded with melatonin. The more melatonin containing foods that I'm going to get into people's diet, they're actually not eating a sleep hormone, they're actually

eating an antioxidant that your mitochondria need to repair themselves. And in food form, it's going to operate much differently than synthetic melatonin, which most people are used to and would be taking to try to make themselves drowsy later on night. And as I argue in the, it's fascinating. I didn't, we cut this from the book too. We know that, well, this part we have in the book, we know that shift workers have much higher incidence of chronic diseases, whether it's diabetes, whether it's cancer. And we know now that the circadian rhythm is disrupted.

But what we're beginning to understand is that melatonin is not the sleep hormone, but it's the hormone that comes out during sleep when your mitochondria should actively be repairing themselves. And melatonin is actually what causes that prepare to happen. What's really interesting is that cancer cells do not actively grow and divide during sleep. They grow and divide during wakepower. And why? Because it looks like melatonin is one of the strongest suppressors.

of cancer growth ever, and I allude to why it works in the book as a teaser. That's fantastic. Super, super interesting. So, okay, olive oil. We already talked about goat and sheep's cheese, and you talked about pistachios and them having one of the highest form of melatonin inside of there. And just, you know, you mentioned MCT a few times, and a lot of people are familiar with MCT.

I guess one clarifying question I would ask is that for people who are, trying to hedge their bets against the cholesterol sort of hypothesis and lipids and other stuff, if they wanted to potentially be getting their MCTs from like goat kefir in the example that I was sharing, instead of taking isolated MCT oil, would you be okay with that and would you be fine with your patient if they came to and share that that? Hey, that's something that I want to try. Yeah, absolutely. But the nice thing about MCT is, oils. First of all, MCTs are not absorbed like any other fat. They're absorbed directly through the wall of the gut. They go directly to the liver, and they're directly converted into ketone.

And the beauty of that is you could eat a high carbohydrate breakfast and have MCT oil with it, and you'll create ketones, even though you ate a ton of carbohydrate. The other beauty is, even though you can't get to all that fat that you've stored, MCT oil can get you to make ketones while your insulin is still high. So it's the perfect crutch to get through the misery of trying to get your insulin levels down. So we do see in some women, they're very sensitive to liquid MCT, they get upset stomachs, they get diarrhea. Right.

So you've got to start really slow. Why do you think that is more the case with women? Because I've noticed that with my sisters. Sometimes my mom has had that in the past. And it's like, all right, maybe that's not for you. Yeah, I really don't know. But I found in my practice that if we ask women to use powdered MCT, they do much better. And there's a lot of powdered MCT creamers out on the market now that they do really quite well with powered MCT.

They do great with, you know, goat kifere or goat yogurt or sheep yogurt. or piece of sheep cheese. So there's a lot of ways to get these compounds in diet. But again, if four out of the five blue zones are using cheese or goat and sheep products as a mainstay of their diet and the fourth blue zone is using polyphenols and fiber in their diet, maybe we ought to reassess what makes a blue zone a blue zone. Could you imagine a new, I don't even know if it was a study, but rather more of a survey, I guess, of these populations that does that? What would it take to do that?

Like, if we needed to revisit the blue zones and relook at that, are the blue zones really even still active anymore? Most of them aren't. Yeah. They're kind of like eating the Western diets and other things like that. In fact, believe it or not, the original and only description of the Okinawan diet was done by the U.S. Armed Forces in 1947 when we occupied them after World War II. It's the only, and you can actually Google it, it's the only description of the actual original Okinawan diet. Wow.

Yeah. And they were so poor that literally all they had was a sweet potato. And that's, you know, who knew that that was their lifeline in so many ways. Dr. Gundry, this is fascinating and I really appreciate you writing this book and continuing your message from the longevity paradox and also just noting where, hey, these are some areas that I didn't get quite right or these are some areas where I might have been a little bit wrong? Because I think that that is the gray area and the nuance that if we can all step into that, regardless of what dietary philosophy people come from, then we'll probably ultimately all arrive to some common trends and themes.

And then people can personalize it based on their lifestyle and their approach. Yeah, I think it's a very important point. What this book points out is that there are a lot of varying diets that have some interesting successes. But if you start breaking those diets apart, you'll notice that there's a commonality in that a ton of those diets have mitochondrial uncoupling foods as a highlight of their diet in one way or another. So it's actually a very unifying book. So rather than, oh, I'm in this camp and I'm in this camp. It's like, guess what? The camps are all joined by the presence of polyphenol foods and uncoupling.

The book is out there unlocking the keto code, the revolutionary new science of keto that offers more benefits without the deprivation. I think that's the key. I have a lot of people that have tried keto and then usually stop because it just gets tiring and it's not enjoyable. Even, again, I think there's a lot of really interesting things out of the carnivore. diet and probably the people who are doing it best are the full nose to tail individuals that are exploring that but even still you hear I was listening to an interview with a you know a champion of you know one of the keto diets sorry carnivore diets and you were saying you know the reason I got off of that and started including more vegetables and other things

again deprivation right you want to be able to do something that you can enjoy nothing wrong with trying something here and there but what's something that you can live with and your program and protocol is exactly that it's something that people can live with So please check out the show notes for the link to the book. It's on Amazon, your local bookstore, all the places that are out there. Anywhere else that you want to send our audience to? Well, they can come visit me at Dr. Gundry.com, my supplement and food company, Gundrymd.com.

Got two YouTube channels come to the Dr. Gundry podcast. We have great guests like Mark Hyman and other fine folks. So. And, yeah. wherever you find me on the internet. I hope I pop up and wave at you. Beautiful. Well, thank you so much for coming back on the podcast. Appreciate you. Thanks, Drew. Appreciate it. Awesome. Fantastic. That covered a lot of ground. Good. Yeah. How long did we buy? Oh, that'll be a good YouTube show.

That'll be a good one. Before you run.