Mark Bell's Power Project - Power Project EP. 186 - Layne Norton vs Paul Saladino

Episode Date: February 26, 2019

In today’s episode, Dr. Layne Norton and Dr. Paul Saladino are both athletes and professionals in the nutrition realm. They are here to debate on the topic of Flexible Dieting vs. the Carnivore Diet... as a way to maximize health and/or body composition. Dr. Layne Norton is a bodybuilding/figure/physique coach and a proponent of flexible dieting as a way to guide his clients as well as himself nutritionally. He claimed his pro card at the age of 24, and is a professional powerlifter who set the raw squat record in 2015 IPF World Championships of 668lbs/303kg at 93kg. Layne obtained his PhD in Nutritional Sciences at the University of Illinois in 2010. Dr. Paul Saladino is a medical doctor specializing in functional medicine and psychiatry. He obtained his M.D. at the University of Arizona with a focus on Integrative Medicine. He most recently completed his training through the Institute for Functional Medicine and is a certified functional medicine practitioner (IFMCP). He is passionate about correcting the roots of disease and exploring WHY such systems are out of balance, often focusing on the gut, chronic inflammation, and nutritional biochemistry. ➢SHOP NOW: https://markbellslingshot.com/ Enter Discount code, "POWERPROJECT" at checkout and receive 15% off all Sling Shots Find the Podcast on all platforms: ➢Subscribe Rate & Review on iTunes: https://itunes.apple.com/us/podcast/mark-bells-power-project/id1341346059?mt=2 ➢Listen on Spotify: https://open.spotify.com/show/4YQE02jPOboQrltVoAD8bp ➢Listen on Stitcher: https://www.stitcher.com/podcast/mark-bells-power-project?refid=stpr ➢Listen on Google Play: https://play.google.com/music/m/Izf6a3gudzyn66kf364qx34cctq?t=Mark_Bells_Power_Project ➢Listen on SoundCloud: https://soundcloud.com/markbellspowerproject  FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell ➢ Snapchat: marksmellybell Follow The Power Project Podcast ➢ Instagram: https://www.instagram.com/MarkBellsPowerProject Follow Nsima Inyang ➢ Instagram: https://www.instagram.com/thenattyprofessor/  Podcast Produced by Andrew Zaragoza ➢ Instagram: https://www.instagram.com/iamandrewz

Transcript
Discussion (0)
Starting point is 00:00:00 So what is going down today, Mr. Mark Bale? Well, you know, first of all, welcome to Mark Bell's Power Project. I'm your big fat host. At least, I guess, formerly used to be bigger and fatter. And, you know, today we got Dr. Lane Norton on the show. We got Paul Saladino on the show. Paul is a carnivore diet guy and Lane Norton, many people already know as the kind of flexible dieting guru. And I'm looking forward to a good debate. Should be really interesting to see what these guys have to say. What are you interested with
Starting point is 00:00:41 this, Nsema? Yeah, I'm really curious to see, first off, how maybe the carnivore diet would impact performance. Because something cool or interesting about the way, like, how much protein Paul intakes, he's eating like 300 plus grams of protein a day, right? And, like, from Lane's side, he's, from the flexible dieting approach, we, or they generally eat much less protein each day so i'd like to see how both of them like would not argue but talk about how it affect like the high level athletes performance and then if people watch a lot of paul's content he's really into like the mood and psychiatric effects of the carnivore diet which he's noticed a lot of benefit for himself he's noticed a lot of benefit for the people he works with. Um, and even like I've noticed as I have like gone, like even lower carb, et cetera, I generally have a pretty even mood. Um, but I have noticed a
Starting point is 00:01:37 pretty good benefit from that. So I wonder if, I don't know if there's been any research done on that. Maybe it's the ketosis aspect of it. Cause we talked a lot about that on here, but yeah, it'd be interesting to see how they both talk about that. If, um, if there's any type of like, I don't know,
Starting point is 00:01:53 agreement or disagreement there. Yeah. I feel like for myself personally, I feel like carbs can kind of slow me down and they can kind of, they can change my mood quite a bit. And when I say carbs, I'm mainly talking about the good stuff. I'm mainly talking about like pizza, donut, cookies, things like that.
Starting point is 00:02:08 I noticed to be a little bit more even keel when I have potatoes and rice and, and things like that. It doesn't seem to, doesn't seem to harm me in any way. And it seems to help enhance a performance. So I guess sometimes the question is like, why, you know, okay. Carnivore diet sounds like a great idea. Um, but if you don't have like stomach issues with some other foods, maybe it makes sense because sometimes these guys end up, uh, getting pretty far into the weeds, whether it's carnivore
Starting point is 00:02:35 diet or vegetarian diet, you end up having the supplement a lot. You end up having, you know, you got a lot of vitamins and weird shakes and different things that you start doing and different, uh, maybe you start, uh, you know, you got a lot of vitamins and weird shakes and different things that you start doing and different, uh, maybe you start, uh, you know, making smoothies and all kinds of weird stuff to try to get those extra nutrients. And it's like, well, why do we have to make this so hard? Can't I just like eat an apple? Can I just eat some carbs? You know, it might be, it might work out.
Starting point is 00:02:59 Okay. So interested to see what these guys have to say. Let's, uh, get them on the horn here, Andrew. You got a horn? No, this podcast machine didn't come with one of those horns. So maybe it's an upgrade we can get later. What's going on, ladies and gentlemen? Here we go.
Starting point is 00:03:33 What up, fellas? Hey, it's Lane Norton. What's up, buddy? Hey, it's Jack Dutton and Mark Bell. What's going on? Yeah, why is this guy so jacked? He claims he's an Addy professor, but I don't know. We all know.
Starting point is 00:03:52 He's just low dosing it, bro. He's just low dosing it. I know, I read it online. Microdosing, I heard. Microdosing. Just picograms. It's just picograms. Oh, God. Hey, while we have you in front of us thus far.
Starting point is 00:04:07 There we go. We got Paul on there now as well. So let's kind of kick this off a little bit by starting out with you, Lane. And let's ask you this question. Can you hear us, Paul? Yeah, I'm here. There we go. Okay.
Starting point is 00:04:24 So, Lane, if you wouldn't mind kind of starting this out by uh you know i know uh paul is a proponent of the carnivore diet and you're a proponent of many different styles of diets and along with uh being i would say an expert material expert when it comes to flexible dieting having done it yourself and having helped and coached so many people over the years. Lane, would you mind kind of kicking this off by starting out by saying, if any, what do you think the benefits might be to a carnivore diet? Oh, get me to take the opposing stand already. Um, well, I think, uh, I think that for some people, uh, meat is difficult to overconsume, especially if you're using, uh, leaner sources of meat.
Starting point is 00:05:13 Um, and though, and so you see a lot of, um, people who are able to drop weight and therefore they get healthier just from losing weight. Uh, I saw that Paul, uh, he posts a lot of anecdote on his, uh, Instagram. And so I just, just want to put it out there that let's keep track of how much anecdote gets used versus research. Uh, and he posted the, um, the levels of inflammatory markers for, I believe it was a client or something like that. And they dropped on the carnivore diet. They also lost a significant amount of body weight. And there was a meta-analysis done by NOUD in 2014 and another one in 2017.
Starting point is 00:05:59 I can't remember the name of the researcher, so I apologize in advance. I can't remember the name of the researcher, so I apologize in advance. They've all showed that regardless of type of diet, that you could explain almost 95% to 99% of the health benefits of different diets simply from the weight loss. So if you lose weight, you get healthier. I mean, even look at the – if you want to use anecdote, look at the Twinkie diet professor, Mark Howe. So Mark Howe went on an 1800 calorie per day diet where he got all of his carbohydrate sources from junk food. All his carbohydrate and fats were from junk food. And he did drink a few protein shakes a day and he took a fiber supplement. All of his blood markers improved because he lost 27 pounds. His LDL got better. His HDL got better.
Starting point is 00:06:46 His trisomyglycerides got better. His insulin sensitivity improved. Now, some people, especially low-carbohydrate components, would say that would be impossible. There's no way you can do that eating so many refined carbohydrates, but it happened. And you see this in the literature as well. There was a study done looking at low sugar versus high sugar,
Starting point is 00:07:02 and they found that when they lost the same amount of weight, same health benefits. So what I will say is that if you've tried other diets and carnivore allows you to create a calorie deficit and stick to that calorie deficit, and it's something that you find easy, and then if you can sustain it and you're not able to sustain other diets, then it probably is the best diet for you. can sustain it and you're not able to sustain other diets, then it probably is the best diet for you. I'm not a real big fan of some of the extreme claims that are getting thrown around and I think quite frankly are borderline dangerous. That's my objection. I was funded by the meat, dairy and egg industry, those who paid for my studies. If anybody has a bias here,
Starting point is 00:07:45 it should be me. I never thought I would, I actually posted the story the other day because there was a guy who was saying that egg whites make you fat. And in the story, when I talked about it, I said that you just watch, there will be people who say vegetables are bad for you. And here we are. So I'm glad to see that my prophecy has come true. Paul, what are some of your thoughts, Paul, on flexible dieting, if you think it has any benefits, and then you can also certainly rebuttal on some of that. Yeah. So I think that I would agree with Lane that there are benefits to weight loss. And indeed, when we see people lose weight, we do see inflammatory markers improve. And I would argue that that is probably due to the benefits
Starting point is 00:08:34 of caloric restriction. If we think about caloric restriction, many of the molecules that are being studied at this point and are a lot of hype, I would say, in the popular press, being studied at this point and are a lot of hype, I would say, in the popular press, specifically resveratrol, mimic mechanisms that mimic caloric restriction genetically and epigenetically. And so I think that there's no argument that there are benefits to caloric restriction. The question in my mind is, are there some ways of eating which are easier to attain greater satiety and therefore easier to create a calorically restricted state or an isocaloric state in which weight can be maintained than others? And I think this gets into the sort of the carbohydrate insulin
Starting point is 00:09:25 model, which surely Lane will debate and we can talk about that. But from my perspective, a low carbohydrate or carnivorous diet is incredibly satiating. And at the risk of being accused of anecdote, I will point to a large survey that was done on Twitter. People could look. I think that the Twitter account is Nathan equals one. There is a large survey there just between keto and carnivore. And I think the results were overwhelmingly that a carnivorous diet is more satiating. And I think that people could also argue that a ketogenic diet or a low-carbohydrate diet is more satiating relative to a flexible diet or a low-carbohydrate diet is more satiating relative
Starting point is 00:10:05 to a flexible diet or a diet that has more carbohydrates. And we can point to studies, again, that would indicate that there are some benefits there. Specifically, I would point to the study from David Ludwig, which I will note for people. The title of the study is, hold on, it's coming up. It is a study in which they, the title of the study is the effects of a low carbohydrate diet on energy expenditure during weight loss maintenance. It's a randomized trial, and they used 164 adults. They had three dietary groups, a high, a moderate, and a low-carbohydrate diet for 20 weeks. The high, moderate, and low-carbohydrate diets were 60, 40, and 20% respectively. And the interesting thing about the study is that it's 20 weeks. Many of the studies that have involved low-carbohydrate diets have been much shorter and then subsequently criticized for lack of an adjustment period or a fat adaptation period.
Starting point is 00:11:15 So when they did this study, what was interesting, what they found was that the people on the low-carbohydrate diet actually burned more calories. They used doubly labeled water. The diets were isocaloric and the protein was kept standard between the different diets. So I think that the idea here is that the macronutrients that we select to make our calories in can affect satiety and can subsequently affect the calories out. I would not disagree with a calories in calories out model. I would not disagree that caloric restriction is beneficial or that weight loss has benefits. I would disagree that, um, that the majority of the benefits, or perhaps I might split hairs about a 95% benefit
Starting point is 00:11:58 regarding weight loss. We can talk about that, but I think that weight loss has clearly been shown to be beneficial. How we achieve the weight loss, I think, is different. I think that if we adjust the macros to achieve weight loss a certain way, it may be easier. And I think that that would be what I would say about flexible dieting, that I think that though Lane may counter with studies that show that people functionally or in controlled settings, weight with different types of... Anyone who has tried a carnivorous diet or anyone who has actually tried a ketogenic diet would absolutely say that those are more satiating and easier to lose weight.
Starting point is 00:12:35 So that's what I would say to that. That's just not true. That's anecdote and that's selection bias. There's people... Dom D'Agostino's sister, he said gained 30 pounds on the ketogenic diet because she overate on fat. So now do some people find it that way?
Starting point is 00:12:53 Absolutely. I will agree with you on the point that macronutrient selection can absolutely affect energy expenditure. Higher protein, higher fiber diets have been shown to have differential effects on energy expenditure. In fact, protein and fiber are about the same in terms of a TF of about 25 to 30 percent. Carbohydrate, about 6 to 8 percent.
Starting point is 00:13:14 Fat, about 2 to 3 percent. So, yes, it does. Now, I'm so glad you brought up Ludwig's study because this is one of my favorite studies because it is a display and how if you torture the data enough you can get it to show what you want it to show so first off doubly labeled water has never been validated for a low carbohydrate diet and in fact in animals they consistently show that when they use doubly labeled water in a low carbohydrate diet versus a high carbohydrate diet that the doubling level water method overestimates energy expenditure. The other thing I really want to touch on is the fact, well, there's two things I want to touch on. The first is they said that total daily energy
Starting point is 00:13:56 expenditure was, I think it was like 400 calories per day higher in the group that was on low carbohydrate versus high carbohydrate. And then the moderate was kind of in the group that was on low carbohydrate versus high carbohydrate. And then the moderate was kind of in the middle. So they show this total daily energy expenditure. But if you actually read the paper and look at the data a little bit deeper, they didn't show differences in basal metabolic rate. And they wore accelerometers and didn't show differences in physical movement. So where is that 400 calories coming from? That doesn't make sense. You can argue it's neat, but again, they're wearing accelerometers.
Starting point is 00:14:36 It should pick up difference in daily movement. So that is a data artifact. And in fact, they also changed. So those groups were blinded, doubly blinded, when it started. And after there was a series of experiments done, Kevin Hall talks about this. And after the groups became unblinded to the researchers, they changed how they made comparisons for their analysis. The traditional way you do it is a comparison to baseline, the beginning of the study.
Starting point is 00:15:08 They started making comparisons to the end of the weight loss phase. So when they did that, they saw differences with the doubling label water method. When you go back and rerun the data, and researchers did this as criticism, when you go back and rerun the data and compare it to baseline,
Starting point is 00:15:25 which by the way, is exactly how they loaded up in their proposal and then changed it later and how they did it in like seven out of eight experiments, I want to say, when you go back and run it that way, there's no difference. So unless 400 calories is coming out of some magical energy system that we don't know about, that's not the case. And even if it was, there are 33 other experiments or 32 other experiments that are examining weight loss and energy expenditure based on diet composition. And when you combine those studies into a meta-analysis that was done, they show virtually no difference in weight loss or energy expenditure. And in fact, they show a small favoritism towards a fat-restricted group. Now, I will agree with Paul in what he's saying. Like 26 grams of fat per day, extra fat loss with fat restriction.
Starting point is 00:16:26 I don't even really worry about that because that's not that much. And it's pales in comparison to what is sustainable for the individual because that is the most important thing. What is sustainable for an individual? Again, if somebody says, hey, Lane, I tried every diet out there, and carnivore was just easy for me, and I know I can stick to it, and it and sustainable, knock yourself out. That's awesome. I don't understand why we have to go from that to you should only eat meat, vegetables are bad, fiber is bad, and low carb is magic. I don't
Starting point is 00:16:59 see why we have to make that argument. Paul, how'd you become friends with Lane Norton here? Oh no, you're going to die, Lane. Oh my God. He's ate broccoli. How did this come to be, this matchup here? This came to be because of a post that I did about fiber. So I would, I would like nothing more than to go down the fiber rabbit hole and discuss why fiber may not be the best thing for humans in general. So I did a post about fiber on, on Instagram and Mark reposted it on his, on his Instagram and then someone tagged Lane and then Lane and I had a discussion about that briefly over that over that post um what i would say in quick response to what lane was just saying about the ludwig study is that i think that this is a tricky thing and that at this point we are
Starting point is 00:18:01 getting into like these nuances of data and it's very hard to say I mean has this research science that's what I do so I know yeah so has there been an errata published to the study I mean have they answered to these claims has there been more analysis to suggest this is incorrect I mean this is this quite a quite a quite a criticism of the study. I would, if you're interested in that, I would read Kevin Hall's response to that. And I think it is,
Starting point is 00:18:32 I believe it is low carbohydrate. You know what, I'm going to butcher it. So I'll actually look it up. Well, if I get a free minute to look it up, and then I'll tell you. But there is a response from Kevin Hall. So if you just search Kevin Hall response Ludwig study, it should come up on Google. And they kind of break it down as those criticisms. I don't know if Ludwig has responded.
Starting point is 00:19:01 I think it's been about two months since he put that out, so he may have, and I may not just see it yet. Okay. Okay. I think that the, what I would say, hopefully I can make an overarching argument here as we get into the carnivore space. And I think that before I talk about fiber, I just like to, would give, I would like to give people a basic thesis around carnivore. I think that what Lane is saying is interesting that if carnivore works for some people, that's great. Why do we need to get into the discussion about vegetables being bad and fiber being bad? I think that's sort of the meat, you know, that's a horrible pun. I'm sorry I used it. But that is the issue. That is the crux of the issue around why carnivory is something to be considered by humans and why it is something
Starting point is 00:19:40 to debate or think about at this point. And so I would like to offer a little bit of a thesis around the carnivore argument. What I would say about the carnivore diet and what I will hopefully be able to illustrate or what I will try to illustrate as we go through these different points is that a carnivorous diet, that is the way I would define a carnivorous diet, is a diet that consists of eating an animal nose to tail. It's been called a whole foods animal-based diet rather than just muscle meat. And a diet that is eating an animal nose to tail provides all the nutrients needed for a human without harmful plant compounds. And that is kind of the crux of the argument around carnivore. And I think that would be sort of the first point that Lane and I can discuss, is that there are many harmful nutrients in plants, and a carnivorous diet seeks to remove those.
Starting point is 00:20:31 It seeks to find the group of foods that humans are perhaps evolved to eat most efficiently, most readily, with the highest nutrient density, to focus on those foods without the anti-nutrients, without the harmful aspects of plant foods. If we go into the harmful aspects of plant foods, we're looking at anti-nutrients, we're looking at digestive enzyme inhibitors, we're looking at specific plant pesticides, we're looking at things like fiber. So at that point, we can go into the fiber with a few more ideas here. So I would say that there are different types of carnivores in nature. And this gets into a little bit of an evolutionary kind of side road. I won't take us too far down that road. But there
Starting point is 00:21:11 are obligate and facultative carnivores. And facultative carnivores can eat some plant products and obligate carnivores really get sick when they eat plants. And so if you look at the acidity of human stomachs, if you look at the, these are sort of evolutionary arguments, if you look at the acidity of human stomachs, if you look at the, these are sort of evolutionary arguments, if you look at the acidity of human stomachs, if you look at the actual layout of a human digestive tract, it's interesting that the acidity of a human stomach mimics that of other scavenger animals. And our digestive tracts look more like that of facultative carnivores like wolves or even obligate carnivores like tigers. Again, these are sort of evolutionary arguments. They don't hold a whole lot of water. But the idea is that these foods may in fact be the ideal foods. Some humans may be able to tolerate some plant foods, but there is this argument that perhaps the plant foods are just survival food and that we can eat them if we need to in times of starvation, but that evolutionarily the animal foods are probably the ideal foods for people. And that for some people, the plant foods can be very harmful. And there is a difference,
Starting point is 00:22:14 I would say, between, at the risk of, you know, going back to what we were saying earlier, there's a difference between, you know, anecdote and actual, anecdote and actual data that we're gathering in a clinical sense. To say that you can't use anecdote is to basically eliminate all clinical observation. I'm a clinician. I'm a physician. So this is what I see in clinical observations. And until these clinical observations get categorized and get codified into larger studies, we call them case studies. But I would argue that anecdotes are valuable, and we can't ignore them. Now, it may be an anecdote that says, oh, this vegan had an improvement in their IBD, and this carnivore had an improvement in their IBD or inflammatory
Starting point is 00:22:54 bowel disease. But I think those are both valuable, because as a physician, as a clinician, I think it's very important to look at what works for people. And so I think that to carte blanche, eliminate all anecdotes, is to eliminate a lot of clinical data. So I would object to that. And I would say, yeah, we can say this is anecdotal evidence. But I believe Jeff Bezos says, when your anecdotes don't agree with your data, you need to examine your data. Seeing things, and it's not systemically you're observing the data, there's something going on here. We can't just say anecdotes don't matter because anecdotes are stories. Anecdotes are individuals who've had their lives changed by this diet. And no, it doesn't create a scientific code which we can all follow without questioning it.
Starting point is 00:23:35 But that's what we're doing here is we're questioning that. So with that in mind, I would just add that to the discussion. So at that point, I would say, let's talk about fiber. So the study that actually triggered the whole discussion on Instagram was a study which showed that by quartile, there was an increasing incidence of diverticulosis as people ate more fiber. And this is an interesting thing because for years there has been a suspicion, or at least in the popular literature, in the popular perspective, the idea that fiber prevents diverticulosis. But that doesn't seem to be the case when you look at Asian populations and
Starting point is 00:24:24 certainly when you look at studies like this. So the name of the study is A High Fiber Diet Does Not Protect Against Asymptomatic Diverticulosis, published in Gastroenterology in 2012. And by quartile, they found an increasing risk of diverticulosis by increasing fiber based on food frequency questionnaires. So admittedly, this is a type of epidemiology where they do colonoscopy, and they look back and they ask people how much fiber they ate. So, and then they also looked at the amount of bowel movements people were having. And they found that people with less bowel movements per week, less than seven, less than seven beautiful poops had less diverticulosis than people who had greater than 15. So this sort of throws a wrench
Starting point is 00:25:03 in the whole equation. This sort of throws a wrench in the whole theory that fiber is A, protective against diverticulosis, and raises the idea that we don't really understand what's going on with diverticulosis. We can talk about sort of what people think may be causing diverticulosis, but fiber in A may be not protective against diverticulosis and may actually be causing diverticulosis in some populations, which is what we started arguing about. There is much more to talk about with fiber, but I'll at least offer that and see what Lane has to say about it. Ready to go.
Starting point is 00:25:34 Cool. No one poops more than Lane Norton, by the way. That is also true. No diverticulitis. Do you have diverticulosis? So just to move back, because you did ask me,
Starting point is 00:25:51 the name of the response from Kevin Hall is no significant effect of dietary carbohydrate versus fat on the reduction in total energy expenditure during maintenance of lost weight, a secondary analysis. And that's available online.
Starting point is 00:26:07 I didn't see a response from Ludwig. I looked for it, didn't see it, but that doesn't mean it's not out there. I just didn't see it when I did a quick glance. So I just wanted to, because you asked. Okay, so there's a lot to unpack there. The first thing I want to say is I'm not against anecdote. I'm going to say is I'm not against anecdote. I'm not. I don't want to make that argument because anecdote is the first the face of research that has been conducted. And I'm not going to poo-poo on correlation data either because I did some reading about
Starting point is 00:26:53 diverticulitis and, I mean, I've read in grad school. It was not my area of expertise. But what we can say is we don't really know what causes diverticulitis. I don't give a damn. What's that? Diverticulitis or diverticulosis. We need to differentiate them. Yeah, we need to differentiate them. So we don't really know what causes either of them.
Starting point is 00:27:23 The thing that you have to be careful with, and again, this is not me trying to dismiss correlation data People who eat more fiber also are going to eat more more things that are gonna May have a tendency to eat more things like seeds Beans these sorts of things have been known to aggravate these conditions or possibly cause them We We don't know if they cause them. The problem with making that association is that when we don't know what causes it, it may be that it's just this particular thing that aggravates a condition that was genetic or was caused by something else and then this is the thing that triggers it further. Because we do know if somebody has a flora, you don't eat high fiber during that.
Starting point is 00:28:05 You eat a low residue diet. Now, regardless of that, that's only one condition. Now, it was the condition I was supposed to comment on, but I was seeing an overall trend of anti-fiber amongst the carnivore community. And that's just one condition. If we are not meant to eat fiber, fiber is bad for us. You mentioned anti-nutrients, and that's true. There are, I mean, fiber binds to cholesterol.
Starting point is 00:28:34 It can bind to iron. It can bind to other things. And that's why it's probably important for some people to make sure you eat a balanced diet where you do have some red meat. So you're getting some iron, those sorts of things. to make sure you eat a balanced diet where you do have some red meat. So you're getting some iron, those sorts of things.
Starting point is 00:28:47 I really tried to disprove myself on this because I would rather disprove myself than have somebody else disprove what I believe because nobody likes to look bad. So I went through a lot of the fiber data and it's just really consistent. Now you've only got really cohort studies, unless you're looking at studies in like constipation or those sorts of things
Starting point is 00:29:11 where you can see a benefit to fiber and double blind, double blind control trials. It reduces all cause mortality. Every 10 gram increment of fiber intake in terms of cardiovascular disease, cancer, especially colon cancer, bladder cancer. And then if you get into some of the nutrients that are in fiber containing foods like sulforaphane and lycopenes and those sorts of things, I mean, sulforaphane in particular found in broccoli sprouts has some really
Starting point is 00:29:43 powerful anti-carcinogenic effects. And I think it's really, really, really, really a bad idea to suggest eliminating fiber. Now, if there is somebody who has a specific condition where fiber aggravates that, yes. But that's like saying, you know what? Nobody should drink dairy because some people have lactose intolerance. That doesn't make any sense. No, people who have lactose intolerance should not drink dairy or eat dairy. But it doesn't mean it's bad for everybody.
Starting point is 00:30:21 And this is the same thing with fiber. And one thing that I was really concerned about that I saw a couple of claims made was the anecdotes about depression, that meat is somehow improving depression symptoms. I've done literature on this. There's not a lot out there, but there was one meta-analysis of 21 studies from 10 countries that actually found that meat, higher meat intake was associated with increased incidence of depression and increased intake of fruits, veggies, and whole grains, fish, olive oil, and dairy were associated with a decreased incidence of depression.
Starting point is 00:30:57 Now, I'm not saying meat causes people to be depressed. I want to be very careful about that. That's not what I'm saying. I want to be very careful about that. That's not what I'm saying. However, if a meat-based diet was a cure or a treatment for depression, what we would not expect to see is people who have a higher incidence of meat intake have higher levels of depression. We wouldn't expect to see that.
Starting point is 00:31:20 And again, when I dug into this further on depression, what you find is with regards to their diets, you just see an overall unhealthy lifestyle. Okay? So when they lose weight, if people lose weight on a carnivore diet, it would not shock me if their depression symptoms got better. That would not shock me in the slightest. better. That would not shock me in the slightest. But making claims that meat can help with depression, that there are specific things in meat or something about a meat-based diet, I think that's very dangerous. And quite frankly, I think it's irresponsible, to be honest. Okay. I would love to answer some of those points. We covered a lot there. So let's talk, let's go back to fiber. I will answer all of those points,
Starting point is 00:32:10 but I think it's important for people to understand the difference between diverticulosis and diverticulitis. Let's define what diverticulosis is. Diverticulosis is outpouching, outpouching of the mucosal layer through the outpouching of the submucosal layer through the mucosal layers of the colon, creating these diverticulum, these sort of pockets, right? That is a precursor lesion to diverticulitis, which is a closed off pus pocket of the diverticulum where there's an infective process. Now, the problem with diverticulosis, the outpouching of the submucosal through the mucosal layers, is these can bleed and cause very significant
Starting point is 00:32:45 lower GI bleeding, and these can also lead to the diverticulitis. Now, after the age of 50, the incidence of diverticulitis is quite common. It's a very large number. It's above 60% of the age, fully after the age of 50. So diverticulitis is very common. 20 people with diverticulitis,
Starting point is 00:33:04 and diverticulitis can be a really big issue for people. It can be a major stomach infection. It can cause the need for antibiotics. It can cause diverticular rupture. It can cause sepsis. It can cause the need for actual laparotomy and surgery on the gut. So the morbidity associated with this is significant. Now, let's review some of the data on fiber and diverticulosis. So this is the outpatching of the colon. So we talked about that one study, which was the first one, where by quartile, people who ate more fiber had more diverticulosis. That's the outpatching. What's interesting about this is that people who eat more fiber are generally people who have
Starting point is 00:33:41 healthier behaviors. So there's really no mechanism that I think you can explain more diverticulosis with a healthier lifestyle. It's like a reverse healthy user bias. Lane mentions people might be more likely to consume seeds and beans, but those are not risk factors for diverticulosis. Those are risk factors for diverticulitis. Seeds are, not beans. Seeds are risk factors for diverticulitis because they actually occlude the aperture of diverticulum and cause it to become a walled-off space where bacteria can grow. So people eating more fiber are going to have healthier lifestyles, so you can't apply a healthy user bias to this study. So there's really no mechanism that I can understand why people eating more fiber would get more diverticulosis unless those were correlated. Again, this is correlational data. We can't say for sure, but it's hard to keep even wrap your head around. Now, if we explore more of the literature on fiber, I think this is really interesting. And the reason I will talk about this in such detail is because I think this
Starting point is 00:34:38 is one of the major issues around plants. The other is polyphenols, and we can talk about sulforaphane and all that stuff later. But when you remove fiber from people's diets, you do see an improvement in constipation. There are interventional trials in people with constipation, gas, and bloating who have had full removal of fiber, and they find complete resolution, as in 100% resolution of some symptoms. Of the symptoms in the study. No, Lane, in this study, which I will show you, the entire cohort that had fiber removed had full resolution of their symptoms. So what's going on there? I mean, this defies conventional wisdom. The name of the study is Stopping or Reducing Dietary Fiber Intake Reduces Constipation and
Starting point is 00:35:22 Its Associated Symptoms. It's published in 2012 in the World Journal of Gastroenterology. And the group in which fiber intake was reduced to zero had complete resolution of symptoms. That is bloating, zero, constipation, zero, straining of the stool, zero percent. So the removal of fiber completely removed constipation in those people. Removal of fiber completely removed constipation in those people. Furthermore, there's a study stopping or reducing dietary fiber induces constipation and associated syndromes. That's the same one. This is the one I want to note here.
Starting point is 00:35:54 Constipation and low fiber diet are not associated with diverticulosis. So this is interesting as well. There's the other side of the coin here. In people who are constipated and on a low fiber diet, they don't have diverticulosis. So we have the idea that A, increased fiber increases diverticulosis potentially. I can't make that complete, that's a correlation, not a direct causality. So the increased fiber is correlated with increased diverticulosis. Low fiber is not associated with diverticulosis and constipation is not associated with diverticulosis. The pathology of this outpouching of the submucasal layer through the mucosa is quite complex.
Starting point is 00:36:30 It doesn't seem to be a pressure issue, which you might imagine. It's probably an inflammatory issue. And if you look at the actual pathology of these lesions, there's lymphocytic infiltration into the diverticulum, suggesting that there's probably even an autoimmune issue going on there. There's like a submucosal inflammation creating the diverticulosis. So it's an interesting equation that, in fact, fiber is not protective against diverticulosis. It may even be correlated with it. Now, so that's the diverticulosis issue. In diverticulitis, there's actually a questionable benefit to fiber. I know Lane had mentioned when we were discussing this on Instagram that there were some meta-analyses that suggested that diverticulitis, there was improvement with fiber. But those studies are quite mixed, and there's not a clear
Starting point is 00:37:13 indication that a high-fiber diet is beneficial in diverticulitis acutely. And in fact, this is a study, a systematic review of high- high fiber dietary therapy and diverticular disease the conclusion uh high quality evidence for a high fiber diet in the treatment of diverticular disease is lacking most recommendations are based on inconsistent level two and mostly level three evidence so the idea is that we don't even know how to treat diverticulitis usually it's bowel rest we don't give people more fiber when they have diverticulitis. Those people are in the hospital, they're puking, they're acutely sick, they're septic potentially, we're giving them antibiotics. So if there's no benefit for fiber and diverticulosis, there's potential harm or association. There's no benefit
Starting point is 00:37:56 for fiber and constipation. There's potential benefit in an interventional trial to constipation, bloating, gas, with removal of fiber, then we see this real trend that like, what is fiber even good for? And we can answer that. But let me just continue a little more because Lane mentioned cancer. So if we look at the adenoma, so colonic adenoma are pre-cancerous lesions. There are two types that occur in the colon. There are villus adenomas and tubular adenomas. There are also tubular villus adenomas. If we look at the data for fiber and adenoma recurrence, it's quite, it's kind of a, it's a bummer. We wish fiber helped with adenoma recurrence.
Starting point is 00:38:34 2007 Journal of Cancer Epidemiological Biomarkers Prevention, the Polyp Prevention Trial Continued Follow-Up Study. The title of this is No Effect to a Low-Fat, High-Fiber, High-Fruit and Vegetable Diet on Adenoma Recurrence Eight Years After Randomization. So the study failed to show any effect of a low-fat, high-fiber, high-fruit and vegetable eating pattern on adenoma recurrence, which means those patterns, which are high-fruit, high-vegetable, no benefit in adenoma recurrence. People were eating high fiber, low fat, high vegetable, adenomas come back at the same rate. That means precancerous lesions recur
Starting point is 00:39:10 at the same rate now, okay? Now, furthermore, another study, no benefit in colorectal cancer recurrence in women. The list is incredibly long. There's a study, no benefit, addition of a cereal supplement in adenoma recurrence. No benefit, lack of high-fiber, low-fiber diet, another one in adenoma recurrence. Furthermore, associated increase occurrence when combined with esphagula, which is like psyllium, so that's metamucil. And so in this trial, people, they did an intervention where they gave people metamucil, and they actually saw an increase in the recurrence of tubular adenomas in the colon. At this point, we're saying, okay, look, fiber doesn't help with diverticulosis. It might even be associated. It doesn't help with adenomas. It doesn't help with colon cancer. It might even be associated with increased adenoma.
Starting point is 00:40:08 So the cancer argument, what? You're throwing your hands up, Lane. This 2000. I'm looking at meta-analyses. The meta-analyses are very, very clear. Lancet, 2000. You're talking about adenoma recurrence. I'm talking about overall incidence of cancer in meta-analysis. Okay. Hundreds of studies and tens of thousands of people. You're talking about isolated incidents. You're using isolated studies. Let's talk about it.
Starting point is 00:40:36 Let's talk about it. You are citing epidemiology, and I am looking at— Which you just used as well. I'm looking at smaller studies that don't have the healthy user bias. What you are citing, Lane, which I will address, is the idea any of the studies that show that reduction in all-cause mortality are, I would say, they are impossibly invalidated by healthy user bias, which we should cite for people. invalidated by healthy user bias, which we should cite for people, right? Now, what Lane is citing are large meta-analyses which show that as people eat more fiber, there are better cardiovascular outcomes. However, healthy user bias is something that is impossible to control for in these studies. Healthy user bias is the idea that people have been told to eat fiber. People that eat more fiber
Starting point is 00:41:21 are generally people who exercise more, smoke less, get more exercise, are out in the sun more. They have healthier behaviors. They're higher socioeconomic status. They're more likely to listen to other recommendations from their physician. So the problem is that healthy user bias is the main problem that confounds all of these epidemiologic studies, Lane. We cannot look at a meta-analysis of people with fiber and say for every 10 grams, there's a decrease in cardiovascular outcomes. That is
Starting point is 00:41:49 absolutely healthy because that's what it shows. That's healthy user bias. You can't say that that is actually a valid correlation because the reverse is also true. All of those studies that don't agree with your bias, but individual studies that agree with your bias are totally fine. that don't agree with your bias, but individual studies that agree with your bias are totally fine. Well, the thing is that when there are conflicting studies, we have to consider, are there a larger healthy user bias effect? Is there a larger healthy user bias happening? How do you explain the lack of benefit in a cereal supplement, the lack of benefit on a high fiber, low fat diet, the lack of benefits? What? That's an isolated fiber source in a specific circumstance. The other thing is,
Starting point is 00:42:35 I have an interesting story for you. So yes, there can be healthy user bias. Absolutely. In fact, years ago, when a bunch of anti-meat papers came out. I argued for meat. And if you look at the data, meat is associated with colon cancer. There's a lot of association with colon cancer. When you actually, people who eat meat tend to eat less fiber. Or people who eat higher meat tend to eat less fiber. One of the corrections you can do in the data is go back and correct for that difference in fiber intake.
Starting point is 00:43:05 And what you see is when you correct for that, a lot of the association of meat with cancer, with colon cancer, goes away. If fiber was causative for that, why would you see that? I'm not saying fiber is causative. But you just did. No, I'm saying fiber doesn't benefit. I'm saying fiber doesn't benefit. I'm saying fiber doesn't benefit. Dr. I would disagree with that.
Starting point is 00:43:26 Dr. I'm saying there's a lack of benefit. This other study, this is the New England Journal of Medicine. I mean, these are New England Journal of Medicine studies, dietary fiber and risk of colorectal cancer and adenoma in women, right? Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer and adenoma. What I am saying is that fiber has no benefit in adenoma recurrence, no benefit in colorectal cancer and adenoma. What I am saying is that fiber has no benefit in adenoma recurrence, no benefit in colorectal cancer, right? Potentially harmful
Starting point is 00:43:51 in the study where they added metamucil, which is a sphagula. Well, metamucil is psyllium, but sphagula is in the same family. Now, that effect of harm was mitigated when they added calcium. We can talk about calcium in the gut as well. But generally, calcium in the gut has been found to be protective against colon cancer. That's a whole separate idea. But what I'm saying is that there is no benefit to fiber in colon cancer. What you are saying is that the data around meat and fiber, when normalized for the absence of fiber, showed no significant association. That doesn't mean that fiber is protective or that meat is causing it. And what I'm not arguing, I'm not arguing that fiber is causing cancer. I'm arguing
Starting point is 00:44:28 that there's no benefit. I see fiber as basically useless filler. You could get the same thing by eating toilet paper, which is basically what it is, right? And I think that, you know, if people want to eat fiber, if they want to eat toilet paper, if they want to eat Metamucil, they can fill their gut up, but there's no benefit to that. And the misleading part here is around the healthy use in large medical analyses, stating that people who are eating more fiber are healthier. There were a few things you said before that I'd like to address so we don't lose them as well, if I may. So you also mentioned mentioned the idea that that mean depression so this is pretty close to my heart and I think that we should not gloss over this this is again I would
Starting point is 00:45:16 argue strongly healthy user bias people that eat more meat are people who are doing less healthy behaviors we cannot cannot control for this. We cannot control for the idea that people who are eating more meat are smoking more, exercising less, in the sun less, are doing less overall healthy behaviors. This does not mean that vegetables are healthy. It does not mean that meat is causing depression. That's absurd. These are not really useful. These are not useful studies. I'm not using a trick here. The studies that don't agree with you are very useful. The healthy user bias is so strong, we have to dissect it out carefully. Now, you said that if meat were curing depression or meat were helping depression, that we would
Starting point is 00:46:00 not see this correlation. I would argue that is completely false. That's completely wrong. Because people that eat more meat, that is nothing like a carnivorous diet. As I mentioned earlier, and perhaps I can elaborate on this, a carnivorous diet is about the idea that perhaps humans evolved to eat meat as the primary food, that plants can be survival food, but have many anti-nutrients which may be causing issues. We can't look at any diet or any series of diets or any survey of people who are eating more meat and saying that
Starting point is 00:46:28 that is like a carnivorous diet because that is nothing like a carnivorous diet. There's nothing like a carnivorous diet about eating meat plus plants. What we're talking about here is the idea that eating meats without plants may remove these plant toxins and that that the removal of the plant toxins may in fact be what is so beneficial for people. And I would, we will argue for that, I'm sure later ad nauseum. All right. But the meat itself being healing, sure. You can make an argument that meat is very nutrient dense. It has much higher and more bioavailable nutrients. I don't think you would disagree with that.
Starting point is 00:47:00 And that the meat in an animal, if you eat nose to tail, you can't just eat the animal meat. You can't just eat the muscle meat. You have to eat the whole animal. It can provide all the nutrients that a human needs. So there's really no benefit to vegetables would be my argument. And what we are arguing now is around the fiber issue. And I am saying there's no benefit to fiber. There's potentially harm in a few studies where they're adding Metamucil. So there's no benefit to fiber there. Now, if we look further at the fiber, people might say there's this whole argument that I would like to address quickly. Rhonda Patrick has talked about this. This is very much discussed in a popular press, the idea that you need fiber because of gut diversity or because
Starting point is 00:47:42 of the mucus layer in the gut. So these, I would say, are not supported. There's no evidence that you actually need fiber for diversity in the gut or a mucus layer or a healthy epithelial barrier in the gastrointestinal tract. So there is a study that I will point to which shows that fiber did actually not increase the alpha diversity in a population. So this is an interventional trial. This is not an anecdote, but I will add to it that in my own experience and an experience of clients and people that I've worked with, fiber does not increase alpha diversity and people who are checking the carnivorous diet actually have seen an increase.
Starting point is 00:48:24 Again, it's anecdotes, small numbers, an increase again it's anecdotal small numbers but um i think it's still valuable so this study is dietary fiber intervention on gut microbiota composition in healthy adults systematic review and meta-analysis 2018 american journal of clinical nutrition says dietary fiber intervention particularly involving fructans galacto oligosaccharides um does not lead to an increase in alpha diversity, which is the overall diversity in any one ecological system, right? So there's no evidence that fiber increases diversity of the gut. Can I comment on that just real quick? Because there's a lot of things and I don't want to forget anything. But those are just two types of fiber. And in fact, those two in particular tend to cause, especially in people
Starting point is 00:49:07 with FODMAPs, these are two big triggers here. Absolutely. Yeah. I agree. I think that that's kind of isolating two sources of fiber and making a conclusion based on that is a little bit strong. Go ahead. Well, I'm saying that with that, in that study, there was no benefit to alpha diversity with those fibers being added. Well, I think we need more studies on this. Paul, what about the idea, you know, Lane mentioned this earlier of, you know, fiber, it can, it has the ability, I believe, to connect to some things and to pull some stuff out of our body, basically. What about this idea that fiber is heart healthy and can help with cholesterol? Like you see it on the boxes of cereal and you see it on oatmeal and stuff like that.
Starting point is 00:49:53 It's got a little heart on it and it's supposed to help lower our bad cholesterol. So I think that that gets into a very murky area. We can certainly talk about lipids. I would love to i would point to a trial from the european journal of clinical nutrition in 2006 it's a randomized controlled trial of dietary fiber intake on serum lipids the conclusion is our study does not support the hypothesis that water soluble fiber intake from oat bran reduces total and ldl cholesterol in study participants with a normal serum cholesterol. So the idea is that any reduction in LDL with fiber is going to be meager. If you look at
Starting point is 00:50:35 other studies with LDL reduction, they are on the realm of five milligrams per deciliter. I don't think anybody's done a study where they're looking at particle number LDL reduction in fiber. But there's never been a trial that I'm aware of where fiber can reduce LDL in the blood by anything more than five to eight milligrams per deciliter, which I think most in medicine would argue is a fairly insignificant reduction. At the risk of going into the LDL or the lipid rabbit hole, which we probably should give a whole section of the discussion to, I will say that LDL reduction alone is a very poor prognostic marker in the absence of knowledge of HDL, triglycerides, other inflammatory markers, insulin resistance, fasting insulin, etc. So there have been, you know, that's a highly debated issue, whether lowering LDL alone has any cardiovascular effect.
Starting point is 00:51:26 But people love to lower LDL in clinical practice and imagine that it's going to help them with cardiovascular outcomes. And I think that the benefits are mixed. If there's any benefit, it's incredibly meager in that respect with fiber. with fiber. Lane, what are some of your thoughts, Lane, on, you know, we hear a lot, we hear people talk a lot about, you know, getting on these lower carb diets and insulin, and I've heard you be pretty passionate about this in the past. What are some of your thoughts on insulin? Because it does seem to be kind of a misunderstood thing. People just think if they're going to eat carbs, sometimes people freak out and think they're going to all of a sudden get fat. Yeah, good question. I do want to address, I'm sorry, Mark.
Starting point is 00:52:11 Go for it, yeah, absolutely. First off, I want to acknowledge that if you have very high cholesterol, usually familial hypercholesterolemia, adding fiber isn't going to do a whole lot for you in terms of bringing that down. He is right. You can modify about the max is about 10% through diet or in terms of the composition of your diet. I'm not arguing that, but that doesn't mean there's not a beneficial effect. Again, this is why we look at the entirety of the diet. I think that going so far as to say that ldl doesn't matter i
Starting point is 00:52:46 think is i didn't say ldl doesn't matter okay all right well i don't want to mischaracterize um i think what you could say is saturated fat and ldl probably don't matter as much as we may have thought they did back in the 70s, but they still matter. One other thing I wanted to bring up, you talk about the trial where they saw that higher fiber had a higher amount of defecation and bowel movements and a higher incidence of diverticulosis. But then you said another trial where they decreased fiber and it relieved constipation. So it's kind of like that's kind of speaking out of both sides of your mouth. Either fiber decreases bowel movements or it increases bowel movements.
Starting point is 00:53:38 I think if you look at the data, if you take people who have gut issues, people who are FODMAP sensitive, these sorts of things, and you do an elimination diet and you take fiber out because that trial he referenced, they had them eliminate fiber for two weeks. And then they had them add it back into a tolerable level. So if you're talking about people who have GI problems where it's probably autoimmune, like he said, then eliminating fiber in an elimination-style diet and then slowly adding it back in to a tolerable level probably is a good idea. But I think if you're just talking about that as, hey, they cut out fiber completely, it sounds like they cut it out forever and they just never had any problems. But that's not what the trial was now mark your question about insulin i'm finally going to get to it i apologize um i think that it would be a mischaracterization to say that insulin plays no role in obesity i think insulin does play a role in obesity and uh overall health insofar as how it relates to overall
Starting point is 00:54:46 caloric consumption. If we look at, Paul mentioned the carbohydrate insulin model of obesity. The carbohydrate insulin model of obesity basically says that, and it was proposed by Ludwig, that we don't get fat because we overeat. We overeat because we are fat. Basically, that because we have high insulin from high carbohydrate intake, that decreases lipolysis and traps our storage, our stores, like free fatty acids, inside of adipose tissue, and they are inaccessible. like free fatty acids inside of adipose tissue and they are inaccessible and thus we feel hungry and we're starving because we can't access those and so we overeat and that's why we get fat
Starting point is 00:55:34 let me break a few things down as to why steven goyanet wrote a great for for the lay person an article about this, kind of why this probably is not correct. And the first thing I'd point to is the trials where they, again, this is about all the world studies, not free living. So we're not talking about sustainability. We're not talking about that stuff. We're just talking about physiology.
Starting point is 00:56:05 They fed a ketogenic diet versus a non-ketogenic diet. Actually, it was a very high carb diet. It was like over 300 grams of carbs. Same calories. Saw an overall reduction of 20% for the day, for the overall area under the curve, I believe, for insulin. They saw no differences in fat loss. Actually, they saw just a little bit more fat loss in the low-fat group, I believe. Again, if insulin was driving obesity, if we had a 20% difference in insulin for the day, we would expect to see differences in fat loss.
Starting point is 00:56:38 Further, there is a drug out there, and I can't remember the name of it now, but it's a GLP-1 mimetic, which basically, GLP-1 is a gut hormone that increases insulin. When they give this drug, it increases insulin. It also causes weight loss. So if insulin was a main driver of obesity, if we gave a drug that increased insulin, regardless of anything else, we should, now I'm not saying insulin causes weight loss, okay? Obviously, this drug is doing something else. But we would expect to see weight gain, if anything, but we don't see that. Finally, there was a study done with – it was actually done by Lohling,
Starting point is 00:57:19 Mendelian randomization. Basically, different genetic types. And people who secrete high insulin versus low insulin. And BMI. So what you would expect is that if insulin was driving obesity, you would expect there to be a very strong association between your natural levels of insulin that you secrete, and the genes that are responsible for that and obesity and BMI. They saw basically that study showed that insulin could explain
Starting point is 00:57:54 anywhere from 1% to 10% of obesity, of fat gain, meaning 90% to 99% was not explained by insulin. So I don't want to say that insulin has no effect. It may have an effect, but only in the context of caloric surplus versus deficit. Further, the one other thing, the idea that insulin traps fat stores and makes them inaccessible, kind of the chicken or the egg argument. We get fat because we eat too much or we eat too much because we get fat. People who are overweight
Starting point is 00:58:32 and have metabolic type syndrome have higher levels of circulating free fatty acids. And further, when they give drugs that block lipolysis, but put people on calorie deficits, they don't see that it impairs fat loss. They've done those trials. So that kind of breaks down every aspect of the carbohydrate-insulin model. That is not to say that low-carbohydrate diets don't have a place in the treatment of obesity.
Starting point is 00:59:01 They absolutely do. Some people do very, very well on a low-carbohydrate diet. Mark, I mean, you personally said that's what you felt like you could stick to and was sustainable for you, and you enjoyed that. That is a perfectly reasonable explanation as to why to do a low-carbohydrate diet. Absolutely. But kind of the demonization of insulin as the main driver of obesity has largely been debunked. demonization of insulin as the main driver of obesity has largely been debunked. Lane, what are your thoughts on lifting and a carnivore diet? I mean, I don't know if you've ever even, I don't know if you've ever tried it personally, but like, what are some of your
Starting point is 00:59:34 thoughts on something like that? I think for most lifters, it's probably not going to impede them that much, to be honest with you. I mean, in terms of performance, you're not eating carbohydrate, but you're having a lot of protein, so you can make a lot of glucose from gluconeogenesis. Does a powerlifter need carbohydrates to be like a little bit more full or even like a bodybuilder maybe or something? What are your thoughts? I think you would be at a disadvantage bodybuilding wise, just from the perspective of glycogen and even like things like diet breaks and leptin and whatnot but um if you're talking about like performance for a power lifter um that's tough i think maybe in a volume block where you're having much higher
Starting point is 01:00:21 reps and you're you're approaching kind of a lactate threshold sort of thing where you're having much higher reps and you're approaching kind of a lactate threshold sort of thing, where you're really creating a lot of metabolic byproduct accumulation, I think maybe then you might see some differences. But in terms of lifting a one rep max, I don't think it would probably matter if you were adapted to it. So, yeah, I don't see it being a huge downside for powerlifters. So see there, I am not beholden to any one side. I was in a debate one time about the ketogenic diet. That was on the opposite side. And somebody said, well, we know it negatively affects endurance performance.
Starting point is 01:01:00 And I said, well, I don't think that's true, actually. But no, I don't think it would be a big downside for a power lifter I think you probably placebo is very powerful too so just because it's placebo doesn't mean it doesn't work so if you feel really good on something and you feel really positive about it it probably will work pretty well. I mean, there was this, I think I can't, I'm going to butcher the study, but they gave, they took people who had reported allergy issues. Every single person in the study got a sugar pill and they told every single person, this is going to help your allergies. It's a, it's a a drug not only did almost all of them report that
Starting point is 01:01:46 their allergy issues got better by physiological measurements oh almost half of them did get better so literally that's how powerful the mind is so again that's why i'm not beholden to any one diet i mean hell you can flexible diet and still do a ketogenic diet. You can track your macros and do it. It just means that you're obviously on many carbohydrates, but within those parameters, you can have whatever you want. I think for the most part, find a diet that you can stick to that you enjoy. I'll end it there.
Starting point is 01:02:23 I'm getting kind of long-winded, so I don't want to take too long. I want to that you enjoy. And, you know, yeah, I'll end it there. I'm getting kind of long-winded, so I don't want to take too long. I want to give Paul a chance to talk. What you got there in SEMA? What would you like me to comment on? I don't think that the – I think with regard to insulin, you know, Lane was talking a lot about insulin, and I think Stephen Gayenet has written a lot of interesting things as well.
Starting point is 01:02:51 And I think that the issues around insulin levels and obesity are complex, and it's not clear. And I think that it's far from clear that the carbohydrate-insulin model of obesity is proven. But I think that the most, from my perspective, the most important issues I see around insulin are insulin resistance. And that has to do with leptin resistance and inflammation. And I would kind of swing it back to carnivore arguments and say that insulin resistance is something that we can certainly track on a carnivorous diet.
Starting point is 01:03:28 And I think that one of the things that I should be careful of in this debate is the conflation of ketogenic diets and carnivorous diet. I kind of let that slide a little bit in the beginning. You know, Lane mentioned that Dom D'Agostino's sister had gained weight on a ketogenic diet. And I think that I should be careful. When I associate them, I would only associate them in the sense that a carnivorous diet is ketogenic. But I think that when people are eating a ketogenic diet with plants, that is a completely different animal than a carnivorous diet without plants.
Starting point is 01:04:00 And as we've seen from our small survey on Twitter, a carnivorous diet is more satiating than a ketogenic diet. But I think that with regard to insulin, what we are really looking at from my perspective that is most relevant is insulin sensitivity. And I think that we can make a strong argument that a carnivorous diet is very good for insulin sensitivity. We can talk about that. We can talk about ketosis. We can talk about activation of the genes involved in insulin sensitization, which mimic caloric restriction with ketosis. There's a whole thing we can go into there. But I would say that on a carnivorous diet, there is a huge amount of evidence that you are extremely insulin sensitive. Now, there is one caveat there that depending how you're going to measure the insulin sensitivity, I would ask Lane what his fasting insulin is on a mixed diet.
Starting point is 01:05:00 My fasting insulin? My fasting insulin runs about 90. Your fasting insulin is 90? Insulin, sorry. Fasting glucose. I apologize. I actually don't remember what my fasting insulin was. I know it was right smack dab in the middle of what's global. I can't remember the exact number. Right. Well, the problem, so the thing is this, right? If we're actually looking to quantify insulin resistance, the range is, of insulin is from four to about 24. But most people would agree that that range is very poor and that most people we want to see around four for their insulin. So if an
Starting point is 01:05:37 insulin is in the middle of the range, I would argue that there is perhaps some insulin insensitivity there. I can't say without looking at more of Lane's markers. But what we will see on a carnivorous diet, by anecdote and by research, if you're talking about zero carbohydrates, is that fasting insulin goes way down. It's often below four. Now, why does this matter? Insulin sensitivity correlates with many of the atherogenic profiles of lipids. Looking back into that conversation,
Starting point is 01:06:06 and insulin sensitivity is probably the single greatest risk factor or the single greatest determinant of the progression of atherosclerosis in the setting of LDL and many other sort of conditions. This insulin sensitivity is a huge, huge thing. Now, how do we measure it? We measure it, fasting insulin is probably the best measure unless you're doing uh insulin tolerance test or excuse me a glucose tolerance test which is going to be a little bit more of an involved process but in terms of day-to-day laboratory measures we want the fasting insulin and i would argue that from my perspective the most relevant piece of insulin is what is the insulin sensitivity and someone on a carnivorous diet uh is to have a very high level of insulin sensitivity.
Starting point is 01:06:47 And that someone on a mixed diet, I would argue, or even a ketogenic diet, depending how much and what types of foods they're eating, could have much worse insulin sensitivity. In that setting, I think things get a little bit confusing. So going back to LDL, let's talk about that a little bit. Let's talk about lipids. So I think that one of the things that people see or people get worried about on a carnivorous diet is an increase in LDL. It doesn't happen to everyone. It happens to some people. And the point I would make there is that the LDL number in milligrams per deciliter is a very poor predictor of cardiovascular outcomes. We know that from Framingham data. And then if we actually stratify cardiovascular risk by high and low, or I would say, I should say high and low HDL,
Starting point is 01:07:39 in the low HDL group, rising LDL is a risk factor, but in the high HDL group, it is not. And that is a recharacterization of the data from Framingham from 2011. And so there is this context for lipids, and there's context for LDL within the setting of insulin resistance. I would argue that HDL number, HDL triglyceride ratios are all the context which give us a sense of insulin sensitivity. We can also look at things like small dense LDL, oxidized LDL, oxidized LDL-HDL ratio, oxidized LDL total cholesterol ratio. And what we see clinically through many anecdotes, through many lab tests, is that people on a carnivorous diet may have high LDL. They may even have an elevated LDL particle number, perhaps above 1200 or 1300 animal per liter, but they have ratios of
Starting point is 01:08:31 oxidized LDL to HDL, ratios of oxidized LDL to total cholesterol, HDL to triglyceride ratios that are very favorable. And so I would argue this gets into a whole other realm of differential LDL phenotypes. But I would say that carnivorous diet, my thesis around this would be that carnivorous diet is actually a better lipid profile than a mixed diet in terms of insulin sensitivity measured by fasting insulin, HDL number, triglyceride number, HDL-triglyceride ratio, HDL-total cholesterol ratio, and small LDL, oxidized LDL-total cholesterol. So I would be curious about some of your labs, Lane, like what your HDL is, what your triglycerides are, what your oxidized LDL is, what your LDL particle number is on a mixed diet. So we're just comparing anecdote now? Or can I talk about data?
Starting point is 01:09:27 I think that I'm curious, your show. Okay. Well, my CRP was almost undetectable. It was extremely low. What was it? Uh, like 0.1? You measured it once. Sorry? You measured it once. I measured it once, yes. Okay.
Starting point is 01:09:48 Okay. HbA1c was 5.2, I believe. And my LDL, I've always run a little bit high on the total cholesterol. My HDL was 63, so it was pretty high. And I think my LDL, I want to say, was on the high side of normal. And I can't remember the exact number. Triglycerides. Sorry? Or triglycerides.
Starting point is 01:10:17 Triglycerides were low. They were like, if I knew we were going to compare anecdotes, I would have brought this data. I think they were like in the 40s. They were low. And oxidized LDL or any of those measures, you ever check that? We didn't measure those. I would just say that I think it's valuable that we test ourselves. I mean, I'm happy to hear the data that you're having, that you're showing,
Starting point is 01:10:42 and I can present some data suggesting that oxidized LDL to HDL and triglyceride ratios or total cholesterol ratios are probably the best predictors of this stuff. But I think that if we're not testing ourselves and we don't know this data, I don't know how we can really substantiate what's going on. Well, I've tried to test ourselves. And I've always run a little bit high total cholesterol, and that's probably from the family. So even when I was 15 years old, I had to get blood work done for i was taking um an acne medication called accutane
Starting point is 01:11:09 and every time i've ever gone in i've been over 200 total cholesterol it's always been that way um and but it's only about i think i'm barely over the cutoff and i didn't see the point of uh trying to go on statins now. What's interesting is when I had blood work done when I was competing back in 2010, my total cholesterol was down to like 170. It was much lower. My LDL was lower. I mean, again, the caloric restriction and I was eating over 200 grams of carbohydrate
Starting point is 01:11:42 a day. I want to bring up a point about insulin sensitivity and context. I'm glad you brought that up. How you define insulin sensitivity matters because you can actually argue that the ketogenic diet or a meat only diet is worse for insulin sensitivity if you define it by an oral glucose tolerance test. Only if that oral glucose tolerance test is administered immediately. What you see in that setting is that.
Starting point is 01:12:09 Agreed, but I'm saying. So this is the nuance, and I will not let you off the hook with that one. No, I'm. Great freeze frame. rate of free stream. That is sensitive after being on a low or zero carbohydrate diet. You cannot say that a zero carbohydrate diet is not insulin sensitive. That is false. Are you done?
Starting point is 01:12:38 Yeah. Okay. I'm just saying, you were talking about different ways of defining it. And again, I'm putting out there I mean if you look at I've got Sean Baker's blood work pulled up here his HBA1C was 6.3 his blood glucose was 126 fasting I mean again this is all contextual dependent right I agree with you that taking one marker and running away with it is probably a bad idea.
Starting point is 01:13:08 You're looking at an overall profile, which I think, again, is a good idea. And I don't doubt that somebody can improve their blood markers on a carnivore diet if they're losing weight. I'd like to see this data where if they
Starting point is 01:13:24 maintain... This is what needs to be done. If somebody stays in maintenance and changes from a mixed profile to a carnivore diet, do we see these benefits? Because that's the real question. Because we do know weight loss has a significant benefit. And again, I'm not trying to argue that carnivore is going to kill you. That's not what I'm arguing. What I'm arguing against is this kind of zealot-based position that it's like an anti-vegan, it's like vegan reactionism that we've been told our whole lives the vegan diet is better for us and we should eat plant-based and all these sorts of things.
Starting point is 01:14:04 lives the vegan diet is better for us and we should eat plant-based and all these sorts of things and so the knee jerk of that is plants fucking blow and let's just completely get them out of the diet i mean nuance and context is extremely important if somebody has diverticulosis or diverticulitis or some kind of inflammatory bowel disorder where fiber causes them problems, absolutely they should admit or limit fiber. But we can't just dismiss every single meta-analysis, and we're talking about dozens of meta-analysis, and just say, oh, well, it's the healthy person profile. But use a poll on fucking Twitter that doesn't, oh, that doesn't have selection bias? Come on. The Twitter poll was about carnivore versus keto satiety.
Starting point is 01:14:46 I know. We're not using a Twitter poll to illustrate diverticulosis outcomes. I know, Paul. I'm making a point. What I would say to that is that I appreciate the dangers of zealotry, and I would hope to not present any of this data in an overly zealous way. And I would hope to present this data from the perspective of the idea that a carnivorous diet is not something that should be dismissed, that we should examine it as beneficial in some context, and we need to do more examination of it. And I think that within the popular culture,
Starting point is 01:15:26 we need to do more examination of it. And I think that within the popular culture, there is a backlash against meat. There's a backlash against the absence of fiber. There's a backlash against meat causing cancer, which I would love to dig into with you. And there's a backlash against the absence of polyphenols. And I think that there are too many pieces of this evidence. There is too much evidence in favor of the idea that perhaps these things are not beneficial for us, potentially harmful, and that many people could be helped by a carnivorous diet, that we should not ignore this. Now, what much of that does come from anecdote, I will admit to you, if you look at meatheals.com, some of these things, this is how I got originally interested in it, because I'm a clinician. I am in the final few months of my residency in psychiatry. And I will tell you that it sucks seeing people who have
Starting point is 01:16:10 recalcitrant depression or anxiety and they don't get better. And I think that what we're seeing is quite remarkable. The idea that removal of plants can help some of these recalcitrant people is just, it's incredible. And I think that this is where the argument comes like, okay, so if removal of plants can help these people, we need to study this. Like what is going on here? Is it, is it that there are anti-nutrients? Is it that there are inflammatory things in plants? Is it that there are potentially toxic chemicals in plants that are causing this? Because what I would say regarding psychiatric disease specifically is that I think there is a very strong growing awareness that much psychiatric disease is actually autoimmune in nature.
Starting point is 01:16:49 It's inflammatory. It's neuroinflammatory. And that we need to look for things that have mechanisms against autoimmunity and neuroinflammation. And what we're seeing here is that perhaps the removal of these foods can be very beneficial for these people. And again, every hypothesis begins with anecdote. So can I, Mark? Go for it. Sorry, me and Mark are trolling each other suddenly.
Starting point is 01:17:21 Paul, I think that I'm going to come back around to something here. I don't think I have ever said that the carnivore diet is shit and no one should do it. I don't believe those words have ever come out of my mouth or I've ever typed them. So I don't want to be characterized as that being my position. I'm not saying you were doing that, but I think some people will take it that way. Again, and I do think it is important to question fundamental beliefs. I do. recommending to people things that at best may not work or sorry, not at best,
Starting point is 01:18:08 may not work but also may do harm. Again, I would expect to see differences in, trying to figure out how I'm going to frame this, you cannot
Starting point is 01:18:24 just dismiss the analyses. Another point I wanted to bring up that I'm going to frame this. You cannot just dismiss the meta-analyses. Another point I wanted to bring up that I did not bring up was the production of short-chain fatty acids in the gut from fiber production. I would love to talk about it. Please, let's talk about it. Perfect. Beneficial effects on insulin sensitivity and a whole host of other markers, obesity, those sorts of things. We don't know a lot about the gut microbiome. We know if you change your diet, it changes the gut microbiome.
Starting point is 01:18:52 Those are some of the things we know. There's been some short-term studies that have seen that if you have high saturated fat intake, those can actually lead to production of compounds in the gut that may be toxic to some gut microbiota. Again- Like what? We don't know whether be dangerous. What compounds are you referring to? What study is that? What compounds are you referring to and what study is that that any saturated fat could hurt gut microbiota in some way? Good question. I'm going to see if I can find it for you.
Starting point is 01:19:26 May I comment on saturated short-chain fatty acids? Yep, go ahead. So short-chain fatty acids in the gut are a corollary argument to the argument that is postulated around fiber or carbohydrates being necessary to feed bacteria or else the mucus layer in the gut will be degraded. So I would like, I can address both of those. So the short chain fatty acid argument in the gut is interesting. I presume you're referring to butyrate. What short chain fatty acids are you referring to? Butyrate's one of them, yeah. Are there any others? Because there are also short chain fatty acids produced from the ingestion of amino acids. So if we're looking at short-chain fatty acids in the gut, there are butyrate, propionate, and isobutyrate.
Starting point is 01:20:16 Now, isobutyrate is actually a short-chain fatty acid that can also act as a fuel for colonocytes, and that is produced in the setting of protein administration. So amino acids can also be used to make short-chain fatty acids. Ultimately, short-chain fatty acids are argued to be beneficial as fuel for the colonic epithelial cells. Now, in the setting of a ketogenic diet, and I will use the term ketogenic loosely, I should say in the setting of a carnivorous diet, ketones are circulating in the body and in the blood, and those ketones can be used directly by the gut epithelium for fuel. So the question is, I think that the short-chain fatty acid argument is a little bit confusing and not fully fleshed out because you can make
Starting point is 01:21:02 short-chain fatty acids on a carnivorous diet. You make different short chain fatty acids than you do from carbohydrates. You make isobutyric acid rather than butyric acid and circulating ketones can also act as fuel for the colonic epithelial cells. So I don't see any problem in a carnivorous diet for colonic epithelial cells. I'll also comment. I said it's not fleshed out because people are saying short-chain fatty acids are needed for gut epithelium and you can't make butyrate. My argument is that there are plenty of other short-chain fatty acids that you can. I am fleshing it out right now. Watch me flesh it out. Ketones can be used.
Starting point is 01:21:40 I was just commenting on obesity and also insulin and glucose control as well. Sorry, go ahead. Yeah. So the study, let's just note this for people because I think it'll be interesting. The study that people discuss when they are criticizing the idea that carbohydrates are needed for a gut mucus layer is often quoted. It was quoted by Rhonda Patrick on Joe Rogan. It's quoted by Stephen Gundry. And it's widely misunderstood. So the title of the study is A Dietary Fiber-Deprived Gut Microbiota Degrades the Colonic Mucus Barrier and Enhances Pathogen Susceptibility. The title sounds pretty bad. It's from Cell in 2016. But if you read the paper, the problem is this. This is done in
Starting point is 01:22:27 notobiotic mice. So these are mice that are raised without a gut microbiome, and they are infused with what they call a synthetic human gut microbiota composed of 14 species of bacteria that are carbohydrate-dependent and carbohydrate-liking bacteria. So this model, I would take issue with the model here and say that, first of all, they're using it. It's in mice. What model would you have used? I think that for this, we need to use a human model and there's no way to replicate a human microbiome in a mouse necessarily. So this is a pretty tricky- How would you show the study?
Starting point is 01:23:03 I think we need to have better models for leaky gut because what they're actually looking at here is mucus barrier integrity, actually epithelial and mucus barrier integrity at the gut. We can go into that if people want to talk about leaky gut and the idea of tight junction opening and colonic or GI epithelial hyperpermeability, but we don't have great models for that. We don't have great metrics. All I'm saying is that I think the validity of the study is questionable in the fact that they are using notobiotic mice with a synthetic human microbiome with 14 species that are carbohydrate loving. And then they take the carbohydrate liking bacteria and they deprive it of carbohydrates in the mice. What do they see? They see reduction of the mucus layer, but they note in the paper that there is no associated histopathologic difference. So that to me is quite an issue. Like they're saying that the mucus gets smaller in this synthetic microbiome that is deprived of carbohydrate, but there's no histopathologic changes in these animals, suggesting what is the actual, what's the hoopla?
Starting point is 01:24:17 The reason I point this out is because I want people to know where all of this sort of this talk about needing fiber, needing carbohydrates for a mucus barrier comes from. I think there's no evidence to support this in real life. And what we see in clinical practice, again, it's anecdote, is that people who deprive fiber, who deprive carbohydrates, or I should say people who don't eat fiber or carbohydrates, still have a gut microbiome. There are still bacteria in the gut. Tested myself, tested other people. We've looked at diversity of people. They're still there. The gut bacteria are there. They're still in the proper populations. The diversity can even increase. And we don't actually see problems with mucosal or epithelial barrier integrity in these people. So I would say that the short chain fatty acid argument really doesn't hold a lot of water for me, nor does this argument that you need
Starting point is 01:25:08 carbohydrates or fiber to create a healthy mucus layer. So I want to understand your position. So because the studies have shortcomings, we should dismiss them? have shortcomings, we should dismiss them. Because the studies have shortcomings, we should not preach them like they are canon, as people are doing. Okay. So I think the first thing I want to talk about with regards to that is the definition of the word need. Okay. Definition of the word meet? Need. Need. You need fiber.
Starting point is 01:25:49 You need carbohydrate. That sort of thing. I don't think you need fiber or carbohydrate, depending on what you term need. Do I think you're going to fall over dead tomorrow if you don't eat fiber or carbohydrate? No. Tuesday?
Starting point is 01:26:07 No. Next week? No. Next Tuesday? No. Next week? No. Next month? No. Next year? No. Decades? I mean, that's, again, it's impossible to do a double blind placebo controlled study on this. That sounds like a, that's a total, that's a hypothesis, right? And I don't know what you're basing that on. Sure, sure. Everything is a hypothesis. Right, but what are you basing that hypothesis on? That you may, what you're basing that on. Sure, sure. You're guessing. Well, everything is a hypothesis because nothing is a hypothesis. Right. But what are you basing that hypothesis on that you may- Meta-analysis. What are you basing the hypothesis that fiber may be needed long-term on?
Starting point is 01:26:31 What evidence do we have to suggest that that may be the case? No, no, no, no. What I'm saying is if you, again, look at the meta-analyses that you're about to dismiss that I'm going to cite- The healthy user bias ones that are irrevocably damned by healthy user bias? Yeah, those. Okay, keep going. Yeah, but are superseded by Twitter.
Starting point is 01:26:50 So those studies, when you look at the fact that you have consistency, I mean, again, this isn't like, okay, it's a rogue study or a rogue meta-analysis or a rogue couple of meta-analyses. It's very consistent. And so when you look at that, when you look at what tends to make up all those things, when you start to control various co-founders, fiber seems to have a protective effect on cardiovascular disease and cancer. I disagree. Okay. Well,. I disagree. Okay. Well, you can disagree. I'm not going to sit here and recommend that people omit fiber. Am I going to sit here and tell people that they need fiber to live?
Starting point is 01:27:36 No, because you don't. The human body is extraordinarily resilient. Just like you probably don't need meat to live. But do I think eating meat is a good idea absolutely i think meat's great i eat more meat than is recommended by the american dietetic association so again i think context is important i mean i can i can go through and we can dismiss every single study that's ever been made if we pick out enough points. Again, hang on, hang on. I appreciate your patience.
Starting point is 01:28:14 So we can go to any study and we can go back and forth about why we need to dismiss it. I don't think any study should be dismissed. to dismiss it. I don't think any study should be dismissed. I think we need to look at how it's designed, what it's examining, and we need to look at the overall context of what does the overall data say, which is why I default to meta-analyses because they are the gold standard for looking at what the overall arching theme of the data says. You're right. There's a lot of things we don't know. But what we do know is that people who eat higher fiber tend to die older. We do know that.
Starting point is 01:28:56 Okay. And that's even with them controlling some co-founders as well. I'll comment on that, yeah. Okay. Well, healthy user bias. Okay. Well, healthy user bias. Okay. Well, maybe. But that's the data we have.
Starting point is 01:29:21 And if you want to place your value on anecdote, and again, if somebody has a GI issue, specific circumstance, everything is tools in a tool belt. And I think it's very important to never just toss out a tool. Everything is tools in a tool belt. And I think it's very important to never just toss out a tool. Everything is tools in a tool belt. Now, I'll use my screwdriver a lot more than I use my power drill. But I still get my power drill if I need it. So it doesn't surprise me that some people with extreme GI problems do really well on what's essentially an elimination diet. That doesn't surprise me. But that doesn't mean that everybody should do that.
Starting point is 01:29:57 So I hear you. I think that I'm hoping we can move on to some other issues around plants, because I would like to further discuss some of the dangerous characteristics of plants rather than continue to debate which types of studies we're going to use. But I think that I hear you appealing to the hierarchy of evidence around meta-analyses, and I will say that meta-analyses of epidemiology are still epidemiology, and that a collection of that are subject to healthy user bias is still subject to healthy user bias. I think that if you have a collection of studies that are all confounded by the idea that people who eat more fiber have other healthy behaviors, then they're all going to show the same thing,
Starting point is 01:30:37 right? And what I'm pointing out is that there are many studies that show the reverse, that there are studies with fiber that show increased diverticulosis. There are studies that show no improvement in colon cancer. There are studies that show no improvement with fiber supplements, no improvement with vegetables. And there are studies that show negative outcomes with esphagola, which is like psyllium. There are studies which show no real improvement with lipids. There are studies which show no real improvement with satiety. There are studies which show some improvement with satiety. What I'm saying is that there is no evidence that fiber is beneficial at all. If you are appealing to epidemiology around the studies that show that
Starting point is 01:31:19 fiber has better outcomes long-term, I would say that people should study the behaviors that people in those studies do who eat more fiber and do more of those things. And ultimately, I think you're right. We shouldn't disregard those studies, but when we can come up with a reasonable hypothesis for why that may be and why a bias may be present, we need to consider that as well. And that is why I think, I mean, obviously, am arguing, I'm arguing for a carnivorous diet. And I am saying that there is that you cannot, I would say that in my opinion, and we'll let everyone listen to this aside, epidemiology studies that are, uh, probably confounded by
Starting point is 01:31:57 healthy user bias around fiber and outcomes are not strong enough to make me think that it's important to include in the diet. And then furthermore, there's all these other issues which may have problems. And then there's the other issue that clinically what we see, and you're noting this is true, anecdotally, for many people with GI issues, removal of fiber is a miracle cure. So if people are listening to this and they have constipation or diarrhea, I said miracle cure and you're freaking out. It's very beneficial. I'm so triggered right now. What's's that i'm so triggered right now uh don't worry uh we can uh we can have a session afterward um the uh i mean clinically what we see if people are listening to this and they have constipation bloating gas like try removing fiber and watch what happens people have small intestinal bacterial overgrowth remove fiber and watch what happens it will resolve these are these things resolve without
Starting point is 01:32:51 fiber and that is a clinical that is a clinical piece of information that is anecdotal but it is clinical data that we cannot ignore and that is something that i'm saying about fiber i think that we have beat fiber to death however however. Let's move on to something else. Let's talk about- My girlfriend is in the other room over there. We know that if she eats less than 15 grams of fiber a day, she can't shit. That is in the context- There's my anecdote.
Starting point is 01:33:19 There's your anecdote. Okay. Yeah. I mean, she gets constipated. That is in the context of a mixed diet, right? Okay. Not in the context of a carnivorous diet. Fiber elimination only works if you're eating only meat. Okay. I'm kind of – all right.
Starting point is 01:33:39 And if you're going to dismiss epidemiology, you probably shouldn't have started off the debate with an epidemiology reference, just for future reference for debates. I'm not dismissing epidemiology. I'm saying that when we are using epidemiology, we should look for bias and look for things that may be wrong. You're always going to find it because it's always there. That's an inherent law of study. It's just always bias.
Starting point is 01:33:56 That doesn't mean you ignore it, Blaine. I agree. Hey, Paul, I'd be curious because if being a listener, that's, I didn't want to cut you guys off because you guys, there's a lot of good stuff going on here, but I'd be curious because if I was someone listening in, I know Paul, you would say it's not a pure carnivorous diet. So fiber apparently isn't necessarily absolutely necessary, right? Is what you're saying. But at the same time, why wouldn't I just go eat meat, go carnivorous, but also keep a little bit of fiber in my diet and not totally get rid of it? What would be the use of absolutely getting rid of all fiber whatsoever?
Starting point is 01:34:41 Because, so this gets into the idea of a carnivorous diet, right? In order to eat a carnivorous diet, right? In order to eat a carnivorous diet, you're going to eliminate all fiber. And that's the idea that to understand what a carnivorous diet is, you have to do a carnivorous diet, right? A carnivorous diet is not eating meat and vegetables. And this gets into something which we haven't talked at all about, which is the large body of data around potentially toxic and clearly toxic compounds in plants. So the idea around a carnivorous diet is that removing plants is a benefit because of all of the negative things in plants, all the toxins, all the digestive enzyme inhibitors, et cetera,
Starting point is 01:35:21 et cetera, which we should probably elaborate on. The removal of fiber is one of the side effects of that. And what we are illustrating over the last amount of time is the fact that in my perspective, the removal of fiber, not harmful in any way, shape or form for people. And in some clinical conditions, quite helpful. Does that make sense? Does that answer your question? It makes sense. So, I mean, then what about the, what are the toxic and dangerous effects of these, you know, some vegetables, et cetera, that you haven't talked about yet? Like, is there, can we go deeper on that? Yeah, we can absolutely go deeper. And then we can talk about toxic compounds in meat.
Starting point is 01:35:57 I would love to talk about that. We should definitely talk about both. We should talk about both. So I will note that before you cook it, Lane, meat doesn't have any toxic compounds that I'm aware of, but we can debate that. Okay, we'll debate it. Let's talk about heme iron. I would love to talk about heme iron, but first let's talk about plants. But can be converted to a carcinogenic compound. Go ahead. Yep. Only in the context of calcium deficiency in rats and nitroso compounds from
Starting point is 01:36:28 nitrates. But we'll talk about that. I think that heme iron is a fantastic thing for people who want to actually absorb iron and use it to make red blood cells so we can live. So let's talk about plant toxins, right? Let's talk about how toxic plants are. Now, the overarching perspective here is, I think, quite interesting from the perspective of evolution. Plants do not exist to feed humans. Plants have their own agenda. This is anthropomorphization, but indulge me. Plants exist to move their DNA forward evolutionarily.
Starting point is 01:36:55 They do not exist to feed humans. Kale doesn't give a shit. Are animals different than that? Animals are completely the same as that. But plants are looking out for themselves. Plants can't move. They can't defend themselves. So what they have done is evolve myriad, myriad pesticides and toxins to defend against rodents,
Starting point is 01:37:14 insects, herbivores, and other people or humans or whoever wants to eat them. Now, this list is long. It is exhaustive. The first thing I would do is refer people to an article from Bruce Ames, who was actually Rhonda Patrick's mentor when she was in graduate school, I believe. And the title of this article is Dietary Pesticides 99.9% All Natural. What Bruce Ames notes in this article is that plants have so many toxins that have never been characterized and that have either been shown to be harmful in rodents or just never even looked at to be characterized in humans. And
Starting point is 01:37:55 that the majority of what we take in, in terms of pesticides, are from plants. There are thousands. And if you look at the biochemical complexity of plants, it's incredible. It's just, it's overwhelming. There's a chart on the second page, 49 natural pesticides and metabolites found in cabbage, 49 molecules. How many of them are characterized in humans? Three. We don't even know what these molecules do.
Starting point is 01:38:19 The idea is that plants are evolving chemicals, which are meant to hurt animals which consume them or else the plant would get consumed if this were willy wonka's chocolate factory and you could just run around eating whatever you want and it all tasted great and i guess the metaphor is breaking down because it all has sugar but let me just finish the thought i mean if plants were like you know candy cane lollipops and you could just go eat them all there would be no plants left on the earth right plants have to be in this constant warfare with with herbivores and with animals that eat them and so plants have tons and tons of pesticides they're not characterized we don't know what they do the first one on this list let's just talk about this one because it goes back to what
Starting point is 01:38:56 lane was saying about sulforaphane which i would love to talk about glucosinolates this is in cabbage so table 49 natural pesticides pesticides and metabolites found in cabbage. The first one is glucosinolates. Glucosinolates are like glucoraphanin, which is the precursor to sulforaphane. So the way that sulforaphane gets made is when my rosenase in the plant combines with sulforaphane when the plant is chewed. Sulforaphane does not exist in plants in a native form because if we look at the biochemistry, it is too oxidatively active. So fluorophane would cause oxidative damage to the plant and probably kill the plant if it were active in the plant.
Starting point is 01:39:32 So it's in a glucoraphanin form, myrosinase-activated. This is how glucosinolates work. They get activated by myrosinase in the chewing of the plant. This is an evolutionary mechanism saying, I'm a piece of kale, I'm a brassicant vegetable, whether it's kale, broccoli, brussel sprouts, cauliflower, those are all hybridized. But basically, the oldest brassica vegetable, a plant is sitting there, an animal comes along and chews it, the myrosinase combines with the glucosinolate, and what do you get? You get an active plant pesticide, which is oxidatively
Starting point is 01:40:00 active. We throw around these terms a lot, and I think as we get into these plant pesticides, we are going to get deep into this rabbit hole. So I'll explain this to people. There's oxidation and reduction. Loss of electrons is oxidation. Gain of electrons is reduction. So we're talking about oxidation and reduction. We're talking about oxidative stress. We're talking about movement of electrons between molecules. There are many of these molecules which create oxidative stress, meaning they are transiting electrons around. That's basically what it's doing. Life is the movement of electrons. We're moving electron currency. And so what happens with these plant pesticides is that they are oxidative stressors. They go into our bodies
Starting point is 01:40:34 and they provide oxidative stress. Sulforaphane is a great example of this. It's been essentially hailed as like the greatest thing, right? Monty Patrick promotes it, but how does it work? There is a large misunderstanding that sulforaphane is used in human biochemistry somehow or gets into our circulation. None of those things happen. When we eat glucosinolates, whether it's sulforaphane or another glucoraphanin
Starting point is 01:40:58 after it's been transformed by myrosinase, there's a number of them here on this page, those are immediately detoxified by the body. The body doesn't want these. We do not use these molecules in human biochemistry at all. We immediately detoxify them through phase one and phase two detoxification in the liver, and they are excreted. The only potential benefit to these compounds is hormesis, which is a philosophical idea that potentially a small amount of a toxin could result in increased enzymatic systems like the NRF2 system and increased glutathione. So what's been shown around sulforaphane is that
Starting point is 01:41:33 when you ingest some sulforaphane, you may get induction of NRF2 and you may get increased glutathione. Glutathione is an endogenous antioxidant. That is something we make on our own. So sulforaphane is not doing anything in the human body that we cannot do on our own. There are other things which can be hormetics and also increase glutathione. So forafane has no unique mechanism and we know it has toxic effects. What are the toxic effects of the glucosinolates? For instance, they are scavengers of iodine. They're called goitrogens. If you eat enough broccoli sprouts, you will become, you can easily become iodine deficient're called goitrogens. If you eat enough broccoli sprouts, you can easily become iodine deficient. So there's this idea, like this is what the plant is doing. It wants
Starting point is 01:42:11 to inhibit iodine absorption in your gut. It's going to bind up the iodine. You're not going to have enough. And the plant is preventing the animal from reproducing. So this is an example that I'm illustrating around this. There are many of these compounds. This is just the glucosinolates. Also in the cabbage, cyanides, which gets into the cyanogenic glycosides, terpenes, and phenols, which have been shown to cause cancer in lab animals. So there are so many of these compounds in plants. In a high doses. Absolutely. Have they been studied in humans? No. We don't even look at these in humans. We don't know what these are doing. We don't even know what these, this is my argument. We don't
Starting point is 01:42:43 know what these plant molecules are doing to our DNA. They can be damaging our DNA, they can be causing XX oxidative stress, and I will show you a paper in which they removed plant flavonoids and people had improved markers of oxidative stress. So the idea is that these plants can be creating too much oxidative stress at some level if we believe in hormesis, which we will talk about further, hopefully, which is the idea that a small amount of a toxin could be beneficial by increasing glutathione, we can definitely get too much. You can definitely get too much sulforaphane. You can definitely get too much resveratrol. You can definitely get too much of these compounds. And the idea is like, if you can do all this on your own, and they're
Starting point is 01:43:21 also inhibiting the absorption of iodine, and we don't know what many of these compounds are doing, where's the net benefit of this? It's just not clear. There's never been a long-term study, and it's probably impossible to do, around, we could probably do it with sulforaphane, but all these other molecules and plants. But the idea, evolutionarily, is that these are not friendly pesticides. This is what plants are trying to do. They're trying to prevent us from eating them. So that's the overarching idea around plant pesticides. There are multiple other types of toxins in plants, which we can go into oxalates, phytic acid, tannins. There are so many of these, which can be harmful. There's phytoalexins, there's digestive enzyme inhibitors,
Starting point is 01:44:04 cyanogenic glycosides, like I said. It's huge. The list is huge. And there's some evidence that these can actually be directly harmful to humans. So the idea is that plants don't give a shit about humans. They're basically trying to kill anyone. Plants don't want you to eat them. They don't want us to eat them.
Starting point is 01:44:19 They never want us to eat them. If we can tolerate them, which may be genetic variability between humans, then perhaps we can tolerate a small amount. But ultimately, the question is, is there any net benefit? I would argue no. And there's probably a net detriment, which is the idea around a carnivorous diet. How do you feel when you remove all the plants? How do you feel when you remove all of these anti-nutrients and toxic compounds? What do you think, Lane?
Starting point is 01:44:41 I think all this discussion of feelings is's so important um well i think file markers look you know i mean let's you want to you want to you want an objective end point sure let's how's your insulin sensitivity how's your neuroinflammation let's check your il6 let's check your microglial activation in your brain sure let's do all that. Okay. Feel your feelings, Lane. Feel your feelings. Sure. I'm happy to get my blood work done. So first thing, it's a very interesting argument of a defense mechanism. I feel like it would bear more weight if humankind wasn't not continuing to grow and prosper and reproduce over the course of millennia. Hang on, you got a really long diatribe, so let me do my thing.
Starting point is 01:45:34 Animals, bro, don't want us to eat them either. So, again, animals care about themselves. And if you look at animals that have effective defense systems that are involved in, be it poisoning or those sorts of things, it's a very quick response. Like you eat it and you die. It's not something that, oh, us plants, well, they ate me, but you know what? They're going to stop eating us in about 70 years. Oh, well, that didn't work. Maybe in 10,000 millennia they'll be able to stop eating us because we're slowly, slowly poisoning them. That seems like a really poor evolutionary mechanism, to be honest with you.
Starting point is 01:46:25 The other thing I would like to talk about is, I spend a lot of time pointing out specific compounds in these plants that when you put them on petri dishes, when you put them in really high doses, you can cause problems. First off, that I know of, no pesticides have been able to... No natural pesticides have been shown up in plants in amounts that actually cause problems in humans. I can't believe that. But polyaromatic hydrocarbons, heterocyclic amines, and e-myer has all been shown to contribute to carcinogenesis.
Starting point is 01:46:55 Love to talk about it. Again, now, God, I never thought I would have to take a semi-anti-meat position. So weird. So I don't want to say that meat is going to give you cancer. I think if you eat a lot of charred meat, it's probably a really bad idea. I think if you eat meat cooked at high temperatures, it's a bad idea because they have increased formation of these products, which have been shown that they do damage your DNA, and they contribute to carcinogenesis.
Starting point is 01:47:27 And even in, you mentioned that meat does not have, when it's uncooked, does not have any carcinogenic compounds in it. But that's not true if you consider the meta-analyses, oh my god, meta-analyses, looking at heme iron and the progression of cancer. Now, I want to be very clear. Heme iron is the most absorbable form of iron. That's a benefit. Okay? That's a checkmark in the heme iron box.
Starting point is 01:47:56 And I think one of the things I really try to emphasize to people is this very uncomfortable fact. Here's my feelings, I feel to be true, that there probably isn't one best diet for everybody. I know that's a crazy thing to say, but there probably isn't, if there's one for heart disease, it might be worse for cancer. If there's one diet that's better for diverticulitis,
Starting point is 01:48:22 it might be worse for heart disease. We don't, the fact is – I would disagree with that. What's that? I would disagree with that. Okay. Well, you can't. So thinking that there's going to be one diet that's just going to fix all of our problems
Starting point is 01:48:38 and be perfect for everything I think is fool's errand. Do I think there are specific circumstances when an elimination diet, even, I don't know, I think you can get the benefits from carnivore by doing some other things as well. But sure, do I think an all meat diet can have some benefits? Sure.
Starting point is 01:48:57 But you can't say that there's absolutely no downside to eating meat because that's just not true based on the data. Okay, well, we can talk. I would love, we should enumerate the things that you think are the downs the data uh okay well we can talk i would love we should enumerate the things that you think are the downsides to eating meat and we can address those rather than making the okay let's hear your spiel on cyanobacteria colons uh heterocyclic amines and emire okay yeah yeah great i'd love to talk about it so i think that that's
Starting point is 01:49:19 that's basically like no one is forcing anyone to char their meat, right? Agreed, agreed. But cooked at high temperatures, too. That is completely able to be mitigated by sous vide, by the way that you cook your meat. That is totally avoidable. It's important to note that high temperatures will cause formation of some of these compounds as well as if you're not charred. Right, right. So the study that I looked at for heterocyclic amines, heterocyclic aromatic amine intake increases colorectal adenoma risk. Finding some perspective European cohort study. I am not arguing that
Starting point is 01:49:55 charred meat or HCAs or polycyclic aromatic hydrocarbons are healthy, right? But I would argue that our body, A, has an ability to deal with these through the same pathway that we deal with other things which can be hormetics so heterocyclic amines polycyclic aromatic hydrocarbons also activate nrf2 pathway so these act through the same mechanism that potential plant hormetics activate so our body has the ability to use these to upregulate NRF2, to detoxify. You can methylate them and get rid of them. Now, in this study, what was interesting was that the only significant association in adenoma was for strongly or extremely browned meat. So there is a clear level here. I think that you can cook your meat at high temperature
Starting point is 01:50:43 for a small amount of time. Should you char every steak? No. Should you eat a bunch of burned meat? No, this is not a good idea. But there is a clear dose response curve here, and it's only in the highest levels that the adenoma trend was statistically significant in this study. So I would say, number one, think about how you're cooking your meat. Do sous vide. Don't cook it in a pan for a long time. Don't do a lot of browning or burning. Just be about it right this is completely avoidable and then secondarily know that your body has mechanisms to deal with these we've probably been having some heterocyclic amines polycyclic aromatic hydrocarbons for all of our evolution and we have mechanisms in fact the same mechanisms that we use for hermetic mechanisms uh for hermesis around other things
Starting point is 01:51:24 that are toxic the n NRF2 pathway. So those mechanisms work for me, just not for plants. Well, it's a different argument, right? So what I was saying with that was that we can detoxify some of those things, but broccoli sprouts is just giving you a bunch of toxins. What you are saying is that heterocyclic amine is toxic. And what I am saying is that sulforaphane is a toxin and that we have the ability to deal with small amounts of both of them.
Starting point is 01:51:44 They are detoxified through the same mechanism as the NRF2 pathway in the liver, right? They are both toxins. We get exposed to some, but you can choose to not get exposed to any sulforaphane. Why does sulforaphane not show up as a risk factor for cancer when they analyze these studies? If you want to get into all the sulforaphane literature, we can get into that, but I'll finish with these first, right? Okay. Happy to look at that stuff. So the thing is this, heterocyclic amine, polycyclic amine, hydrocarbons, think about how you cook your meat. Just think about how you cook your meat.
Starting point is 01:52:11 Be smart. Do sous vide. You can avoid these. Now what I would say about heme iron is that, as you noted, heme iron is really, really beneficial for people. And the problems around heme iron are, again, that's exactly the same study that's been done with meat, right? So if you have meat, you're going to be getting heme iron. So I'm saying, again, and this is this thing, this is healthy user bias. People that have
Starting point is 01:52:35 more healthy, people that have more meat consumption, have more heme iron, have less of these healthy behaviors. If we look at the chemistry of heme iron, however, it seems that heme iron is most problematic when it's in conjunction with the N-nitroso compounds. And heme iron is only carcinogenic in calcium deficient rats, right? In actual intervention studies, again, they're in rodents, but the study which I will show you is they feed the rats a calcium deficient diet. Um, and that is the only people that is the only population of, um, animals in which they see, um, this issue with heme iron. So we know that heme iron is beneficial. We need some of this, absolutely need some of this, but we can't, you know, we can't just say it's, it's carcinogenic. Heme iron is clearly not carcinogenic by itself. I mean, it's iron, right?
Starting point is 01:53:27 It's iron in a certain reduction status that is beneficial for humans because they absorb it very well. But in animals, it's only been shown when they deplete the calcium or when they associate it with other carcinogenic and nitroso compounds, which are the nitrates. Again, this is the stuff that is found in bacon. And we can talk all about nitrates. Nitrates are used as preserving agents. It's not found in bacon until you cure it with the nitrates or you add celery. Nitrates are very prominently found in plants. And we can totally talk about how consumption of lots of nitrates from plants might be a bad thing as well. But N-nitroso compounds come from nitrates.
Starting point is 01:54:05 They are not endogenously found in meat. So I would, again, I would counter your argument and say, before you cook the meat, there is nothing that has been shown to be dangerous for humans in it, right? And we can go through, oh, saturated fat, oh, this or that. But that is what I would posit, is that uncooked meat, no toxic compounds Plants, thousands of toxic compounds, potentially more or less uncharacterized. You said that animals don't want of plants being clearly toxic. I would argue with that directly, citing oxalates, which we know are toxic and are in many foods, right? Oxalates are a two-carbon unit that have been found to be accumulating in breast and thyroid tissue. 85% of people over the age of 50 have oxalate crystals in the thyroid gland and breast tissue they're known to cause kidney stones they're in almonds brassica vegetables rhubarb beets they're everywhere they serve no they serve no purpose
Starting point is 01:55:14 in the human body they are frankly toxic so the elimination of oxalates is like that's just a plant toxin right there's others too there's phytic acid phytic acid is a molecule that plants use to chelate divalent cations where are all the vegetarians falling over dead though what's that why why do all why are there no vegetarians like no vegetarians falling over dead this is where we're looking at the outcome what is the metric that you're measuring is it morbidity is mortality or is it calcium oxalate kidney stones is it these we have like what is your what is your metric in the blood like if we i would love to see a study where they looked at oxalate kidney stones? What is your metric in the blood? I would love to see a study where they looked at oxalate levels in vegetarians, where they looked at oxalate accumulation, where they looked at joint pain in vegetarians,
Starting point is 01:55:53 where they look at calcium oxalate kidney stones in vegetarians and stratified it by oxalates. I don't think anyone debates that oxalates in the diet contribute to calcium oxalate kidney stones, Lane. I think this is a clear thing, and there's no use for this this is a toxin in plant some people can handle it better than others there are polymorphisms and how we detoxify it but the idea is there's plenty of compounds in meat that we have no use for that doesn't wait what fact that there's good things in meat but meat compounds don't accumulate in a pathogenic way like a kidney stone orization. The oxalates is a hole in the rabbit hole and people have associated them with all sorts of problematic issues, joint pain. You can get calcium oxalate, arthropathy. I mean, there's, there's all sorts of issues with oxalates.
Starting point is 01:56:34 There are, and I would argue that there are tons of things in meat that we use. And I, I don't know, I mean, is there anything in meat that we don't use? I'm actually not sure about that. I don't think there's anything in meat that I'm aware of that accumulates like oxalates accumulate, right? And there are other, there are plenty of other examples of plant pesticides and plant toxins, right? Let's look at cyanogenic glycosides. These are found in the edible parts of plants like apples, apricots, cherries, peaches, plums, and the seeds of fruits. And they are known to be problematic. People have died from eating these. It's in cassava root. There's tons of these things.
Starting point is 01:57:08 And they can release cyanide, which is a mitochondrial toxin. It inhibits one of the complexes of the mitochondrial respiratory chain. So plants are putting toxic things in their seeds. Why is it that vegetarians do not have a significantly shorter lifespan, and in fact, in some studies, show them to have longer lifespans than non-vegetarians? Now, full disclosure, full disclosure, I don't believe veganism is the optimal way to health. Okay? I'm not arguing that.
Starting point is 01:57:41 I think it's good to eat meat and consume animal products. But if that's the case, why aren't we seeing drastic differences in lifespan? I think that the problem here is that you're looking at- Health user bias? Absolutely. Absolutely. I mean, you know it, man. It's vegetarians, dude. Who goes vegetarian? People that have been told, I mean, people that do all these other healthy things. It's completely completely confounded show me individual case studies this is the difference this is how i think about as a clinician like i want to see a vegetarian i want to see their labs i want to see their inflammatory markers i want to see their oxalate levels i want to see their micronutrients and again this is hard to study but i'm saying that at a scientific level we know this
Starting point is 01:58:18 to be true this is not debated but there are these toxic compounds in plants, cyanogen and glycosides, et cetera. Let's, okay, let's look at pepper, for instance. Would you say decreased disease incidence? Anyway, go ahead. If it was truly toxic, you would see this show up in the literature. You would see it show up in the literature. It definitely shows up in the literature, but we haven't done large studies. In isolated cell lines and high doses. Not necessarily. Not seeing it show up in meaningful literature. I'm sorry, that's the wrong way to use that. Physiological outcome literature. Who's studying it? Who's even looking for it in medicine? Apparently people, you're citing studies, so people are. But there, you know, I don't even, how would anyone even study? What would they even do?
Starting point is 01:59:05 Like say, oh, this person has more of this phytoalexin. Like we're not even thinking about these things. I hope that people will start to think about it in the future and we can test for that or look at the levels. And I would love to dialogue a little bit how we can design some trials. Or metabolomics. I mean, you know, like perhaps. So lemons, let's look at sorolins, for instance.
Starting point is 01:59:24 Sorolins are in citrus fruit. Some people have such a strong reaction to this that they get burned. They get actual photosensitization and burned in the sun when they eat sorolins. Now, there is genetic variability in terms of And some people break out when they have casein, so don't eat casein. Well, I'm not a fan of dairy either. So yeah, absolutely. I would say if people are breaking out with casein, I mean, what do you want to talk about? Like, let's talk about immunology. Let's talk about the fact that that is a meaningful outcome.
Starting point is 01:59:48 You can't ignore that. Somebody breaks out when they have casein, you can't say, you don't think that's an immunologic reaction to casein? Like there's something going on there. In an individual. And immunology is so complex and you can mount an immunological response to anything if you you
Starting point is 02:00:07 can pick out almost any food and find somebody that will have some kind of response to it and i would argue you should never consume that food well everybody should never consume that food no i agree with you there but i think that for people one of the utilities of a carnivorous diet is it eliminates all the plants right and i when i'm arguing is that for people, one of the utilities of a carnivorous diet is it eliminates all the plants, right? And what I'm arguing is that for people with medical issues, I see things as a physician on a very individual level. I will admit that because I see patients, I see faces, I see stories. I see people who have diseases that don't get better. And you think, wow, what's going on here? We don't understand this in medicine. So we have to push the conversation forward. We can't just look at it at a population level and say, none of these are a problem because nobody's dropping dead.
Starting point is 02:00:47 There's a lot of science behind this and there's gathering anecdote. There's gathering movement around people saying this is problematic. And what I'm trying to do is show the science behind it, show the theory, show the things that are going on, show what's going on with these plants and say, this may be what's going on here. We don't actually know why this is beneficial. But what I'm saying is there's a lot of evidence that there are plenty of dangerous things in plants and that plants don't want us eating them. Sorrelins, like I was saying, with citrus fruit, people definitely get reactions to that. They get burning from the sun. I mean, like just from eating lemons or citrus fruits. If you look online, so there is an article. So go to wikipedia and you look at the list of poisonous
Starting point is 02:01:25 plants it's long or um there's a european society um that released an article that i'll tell people about here where they court where they looked at all the poisonous plants and there are so many there's nothing like this in animals right there's a complete divide just theoretically just ideologically. If you look at animals, and again, maybe a puffer fish is an exception, but by and large, there's nothing like this in animals. And there are thousands of plants that are so toxic to humans. And then what about subclinical toxicity? That's the way I see it, is this subclinical toxicity. Difficult to study, but real in terms of like what i see do we know i would argue that
Starting point is 02:02:07 it is i think it's something you can't ignore right we need to find out because when someone you know gets sick it's like what is going to fit how are we going to fix them that's where it drives home when someone you know gets your your your reductions your your You're saying, because what happens is people get sick. And I have people in my family who have had cancer. You know, when people get sick or something bad happens, or we know it's in Palestine, when somebody gets injured, we always look for a reason. Why did this happen? The fact of the matter is, it's probably not one reason. People say, well, that person, they worked in a factory, or they had diet drinks, or they did this, or leans too far forward on his squats, and that's why his back got injured.
Starting point is 02:03:03 There's a lot of nuance. And going back and trying to draw what caused something in an individual, it's just a crapshoot. It's an absolute crapshoot. Now, hang on. That's medicine. That's what doctors do. And you know what? I'm going to a different subject, but the orthopedic who repaired my pec tear 10 years
Starting point is 02:03:29 ago, I said, what can I do to make this not happen again? He goes, we don't even know what causes this stuff. We really have no idea. We don't know what causes a lot of stuff. This is why meta-analysis are so important because you have your own bias of what caused you to form a condition, a disease, whatever. And like for example, we take somebody who say gets on the carnivore diet, right? Since we're using it, they lose 30 pounds. Awesome. All their blood markers improve. Awesome. And they say,
Starting point is 02:04:06 yeah, it was those plants that was causing me to be fat or not fat. It was those plants that causing me to have high inflammation. Well, no, you lost 30 pounds and now your inflammatory markers went down. Maybe it was the plants. How do you know? Paul, with, uh, that's an individual Paul with, uh, with you, um, having, you know, with you seeing so many people over the years and promoting the carnivore diet, have you seen anything negative come back from people eating meat? Some people have a hard time digesting it. Some people get sick from it. Some people have a bowel problem, stomach issues, anything like that?
Starting point is 02:04:42 Definitely. Definitely. There's definitely an adaptation period. And anyone that's going to do a carnivorous diet will hear about that when they're thinking about it. But yeah, and it's usually short term. Generally, what I have seen is incredibly positive and really encouraging. And I'm going to feel my feelings here for a second and let people know. So what I see in medicine in, you know, probably 15 years in medicine, because I was a PA in cardiology before I went back to medical school. And then, and now at the end of my four year residency is that Western medicine doesn't really work that well. We're really, really good at
Starting point is 02:05:17 correcting things acutely. And we are really bad at figuring out the root cause of things. And people on, on Lane's Instagram have attacked me for being associated with functional medicine. And all I would say to people is that functional medicine is root cause medicine. I went to medical school. I went to residency. I'm a real doctor.
Starting point is 02:05:36 And I just give a shit about what's causing a problem. And most of Western medicine is preoccupied with how to treat the symptoms. And so what's so cool about these discussions is that we're starting to at least entertain ideas about what is causing something to happen. Now, am I saying that plants are causing everything? No. Am I saying that it's worth investigating? Absolutely. That's exactly what I'm saying, is that we need to entertain the idea that perhaps humans are carnivorous and do better without plants for all these reasons we've talked about. We can keep going down to many, many rabbit holes. But that's what I'm saying, because we need
Starting point is 02:06:16 answers in medicine. We need to know what is causing some of these things. And we need to stop. I think that if we, my retort to Lane would be that if we look at meta-analyses, that doesn't give us an idea of what's actually causing something. It talks about population norms, and it's too Lane was criticizing me for this earlier, calling me irresponsible. And you can correct me if I'm wrong, Lane, for recommending this diet to people within the practice. But that's my intention, is to say, is this safe? And is it doable for people? And will it be helpful? The first thing is, is it safe?
Starting point is 02:06:58 I don't want to hurt people with this diet, which is why it's important for me to look at lipids and look at fiber and look at these other issues around meat, heterocyclic amines, polycyclic aromatic hydrocarbons, potential causes of cancer with heme iron, which I don't agree with, et cetera, et cetera. But then the next step is like, okay, I think it's safe and it's doable and it's viable and you're not going to get a nutritional deficiency. And so if it helps someone, that's incredible. And that's something we should study because that is one person who is not going to get helped by the medical system, who is going to continue on their biologic for ulcerative colitis, or who is going to continue on their anti-inflammatory medication for joint pain, or who is going to continue on
Starting point is 02:07:36 to not get relief from SIBO. And so that's what strikes me as a physician is that in so many cases, this can be very helpful. In answer to your question, Mark, yes, absolutely. When people transition to a full meat diet, and I should say a carnivorous diet, because I clarified at the beginning that it's important to think of this as a full animal diet, not just meat, that they're going to have adaptations. They're going to have adaptations in bile salt adaptation, probably, and bile salt absorption, excuse me, because there are more bile salts that are produced when you eat large amounts of fat and meat lane may want to talk about secondary bile salts. I'm happy to talk about that as well. Um, but the increased bile salts on a carnivorous diet are often not
Starting point is 02:08:16 absorbed well in the small intestine of people in the beginning, and they do get loose stool. And so people do an adjustment, but, and then they go through a ketosis transition, but generally they are much, they are better later on. Does that answer your question, Mark? It does. Uh, speaking of stool, uh, to show you guys how much Paul gives a shit, he actually sent me his stool sample. Yeah. I was quite shocked to say the least, but, uh, there were somehow prebiotic fibers in that stool, wasn't there? least but uh there were somehow prebiotic fibers in that stool wasn't there there were there what i sent you mark was a section of a stool test that i did myself i've done two over the course yeah that's right i said you literally give a shit yeah i i do give a shit man i do give a shit i i absolutely give a shit and i've posted on my social media multiple times that I'm super
Starting point is 02:09:05 serious about understanding the biology behind this and looking at blood work, looking at my own blood work, looking at carnivorous client blood work to understand what's going on at a pretty granular level to say, is there a problem here? What are we looking at? Because it's valuable to me. And maybe we'll find that this isn't the way to do it or that we were wrong in our hypothesis but i'm not there yet i actually am very excited about it as you can tell so but yeah i sent i sent a portion of a gi test that i did to mark and it wasn't an actual picture of my stool although um that's next yeah right that could be that could be next um just to show you how there's still some of my stool of super training. Oh, yeah, for sure.
Starting point is 02:09:49 But what that showed was that I still had all of the families of bacteria you would expect to be present in a normal gut, right? So you're looking at bifidobacterium, you're looking at lactobacillus, you're looking at clostridium, you're looking at enterococcus, you're looking at bacteroidetes, formicides ratio. So you're looking at all of these phyla bacteria and they're all still there. So I think that people imagine like, oh, you need carbohydrates to fuel gut flora. And that's just not the case. And that goes back to our previous discussion, which I won't belabor. But yeah, I've not seen any evidence and there are no published studies of this, but if anything, let's just, let's do some studies about this, or perhaps in my practice, I can continue to correlate data and then publish it on patients who are doing this
Starting point is 02:10:34 sort of thing and looking at gut flora and it'll represent some sort of a survey or a case series. But yeah, the gut flora are still there. My stool still looks beautiful without any fiber. Mr. Lane Norton, are you going out to Columbus, Ohio? I'll be there. Oh, cool. And what booth will you be at? Number 552. And you have a book that came out kind of recently.
Starting point is 02:10:57 Where can people, what's the book about and where can people check it out? I love that you're willing to give me a pimpology, Mark. But let me just say, I'll be brief, 30 seconds. I want to emphasize, I don't think that Paul is a bad guy or trying to make people sick or anything like that. We disagree on some fundamental things. But I do think he cares. I think he cares a lot. Otherwise, he wouldn't be on this thing.
Starting point is 02:11:24 I just am very cautious before recommending drastic dietary changes. And there's a lot of things we don't know, like you said, which is why I default to the pinnacle of empirical evidence and the meta-analyses. Now, listen, I've changed my mind on stuff over the years. on stuff over the years, if we start to get data out that says, hey, these people maintain their weight, they switch from a mixed diet to a carnivore diet, and all of a sudden look at their blood markers, they're kicking butt, well, then I'm going to take notice. But until that happens, I'm going to remain skeptical, and I'm going to default to the highest level of empirical evidence. So, all right, now, pimpology.
Starting point is 02:12:03 So I will be at booth 552 uh i have a new book out fat loss forever it's in right now up until now it's only been available as an ebook uh at how to lose fat forever.com 400 pages basically breaks down research i lose fat keep it off if you're at the arnold we will actually have hard copies of that book also my complete contest prep guide my first book as well as my girlfriend holly's contest prep recipe guide which is delicious low calorie recipes and we'll be selling some clothing so if you're out of the arnold uh come by our booth buy our shit booth 552 if you're out at the Arnold, uh, come by our booth, buy our shit booth 552. If you don't want to buy our shit, that's cool too. Come by, um, take a picture or don't, uh,
Starting point is 02:12:50 debate me about the carnivore diet, whatever you want to do. And I hope to see a lot of you guys there. Where can people find you, Paul? And what do you got coming up next? So, um, I'm on Instagram at Paul Saladino MD. I am on Twitter at MD Saladino. I am on YouTube. I've got a channel where I've done a number of videos about my experiences with the carnivorous diet, talking about some of my blood work. I think the most comprehensive compendium of data regarding my blood work is on Instagram. I have a website, which is paulsaladinomd.com. Right now I'm in Seattle and I'm moving to San Diego in June to move the private practice there. I see patients, people can reach out to me. My email is paulsaladinomd at gmail.com. And I'm actually in the process of writing a book. So that's exciting. And people can look for that in the future. I will be sure to send Lane an autographed copy. This question is this question is for both of you.
Starting point is 02:13:56 This question is for both of you. Who in the fuck is Ludwig? You can take it. Do you want to take it or should I? You can take it. David Ludwig is the originator of the carbohydrate insulin model of obesity and a researcher at Harvard University. Very, very cool. He did a lot of the original kind of development of that hypothesis and some of the studies that have been done afterwards. And I want to be clear, when I criticize his work or the interpretation of the work, I'm not dismissing him as a scientist. I'm not saying it's bad research. I think everything
Starting point is 02:14:30 needs to be taken in context. And, um, I'm just because I disagree with the conclusion doesn't mean I think he's a bad person or anything like that. I think both of you guys are studs. I really thank you both for being on the show. Thank you so much for taking the time. Wow, look at those pipes. Lane, how's your back healing up? It looks like you've been – whoa, there we go. It looks like he's got a little bit more of a tan going there. I'm not tan, much to Holly's chagrin.
Starting point is 02:15:00 That feels great, man. I just squatted 520 for a triple pain-free today. Damn, that's great, man. I just squatted a five 20 for a triple paint free today. Damn. That's awesome. Good. Not long way, long way to go to get back to nationals, but, uh, feeling good. Feeling good. That's fantastic. Thank you guys again for your time. It's really, really appreciated and, uh, hope to hear from you guys soon. Cool. Thanks Mark. Catch you guys later. Thanks for coming on lane. I appreciate it. Thanks Paul. Nice meeting you. We'll meet in Lane. I appreciate it. Thanks Paul. Nice team meeting you. Good to meet you. We'll meet in person.
Starting point is 02:15:27 I'm sure at some point. A lot of steak and broccoli. You can have all my broccoli. All right, cool. Wow. I just learned that I'm really stupid. You know,
Starting point is 02:15:41 I mean, it took a lot longer than I thought for me to come to that conclusion, but I found out I'm really dumb. I didn't know what those guys were talking about the whole time. Yeah, I got lost a bunch of times. But what I wanted to say before we called them was when we had Sean Baker on, he's not, I mean, maybe he is, but he's not somebody that's going to throw studies at you. He's not going to throw too much. He just, you know, he just knows his shit but with paul like i knew for sure he was going to have a lot of a lot of studies up his sleeve a
Starting point is 02:16:10 lot of stuff that he's able to cite and it was pretty cool it was like uh it was uh i don't want to say it was um lane's kryptonite or anything but it was like hey here's a taste of your own medicine yeah thing you know and and it got lane fired up that was pretty cool yeah. Yeah. The healthy user bias, the healthy user bias that Paul continued to mention, like kind of just helps you understand that if honestly, okay, if you get a little bit more activity, you start being more active in the gym, you clean up your diet a little bit, whether it be going carnivore going, you know, vegan going keto, like you have good habits in terms of your food, then you're going to improve either way. So it like, it kind of makes that simple.
Starting point is 02:16:47 Now, the big thing is, should you totally get rid of vegetables and fiber, et cetera, which honestly I really hope does get researched more so that we can really, I know, see how beneficial it is. It is really scary though, that like, like studies can be so skewed, right? Yeah. You know, you can just, if somebody could say, hey, there's a problem in this like school district and, you know, we consider this to be a big problem.
Starting point is 02:17:11 Someone can run a study and pick the five best students and be like, there's actually no problem. Like we did this test, right? And you can kind of get whatever reading you're searching for. And I think that's ultimately what happens when it comes to nutrition, comes to supplementation. Somebody wants to find that creatine works.
Starting point is 02:17:30 You know, somebody wants to find that glutamine is going to be this magical thing, but creatine and fish oil and whether it's vegetables or meat or any of these things have, have not necessarily been things that have single-handedly changed people's lives. It's like a combination of things. And, uh, I think to kind of go along the lines of a little bit, what Lane said is, you know, these people that are, and, and Paul, I think they both actually said it back and forth. Uh, these people that are, are being studied that are eating these vegetables that are
Starting point is 02:18:03 eating these higher levels of fiber. Maybe you should pick the two or three things, two or three healthy habits that they have and, and do that. Yeah. And not, and the food, the food part of it, obviously that, that is a huge part of it, but these people are probably meditating. They're probably doing something active every single day. They're, they're taking time to also slow down occasionally.
Starting point is 02:18:25 They're, they probably plan their day. They're, they're taking time to also slow down. Occasionally they're, they probably plan their day. They're probably a little less stressed and probably in general, since the time they were young, they probably have always just eaten a little bit better than most. I'd say like with individuals that really do want to try carnivore, you should make sure to like, look up Paul's information, the information that he does have on his channel,
Starting point is 02:18:42 because there's a lot of, I guess, probably wrong ways to go about trying to do the carnivore diet that would have you not feeling very like that, that well, for example, even paying attention to your macronutrients, like Paul was talking about, making sure that you have enough fats in terms of energy so that you can actually work out. You feel good because if you're just having a lot of protein and minimal fat, right, you're sooner or later, you're going to start being like, Oh, carnivore doesn't work, but maybe you're just not eating enough fat in your diet.
Starting point is 02:19:06 Yeah. Maybe you're eating steaks that are too lean. And he's talked about that before on our podcast where he said that he added fat to stuff. Like he would put a butter on there or cook stuff in beef tallow, which is basically beef fat. Yeah. And that's even with like ribeye cuts, right? Like he still said that that's just not enough fat.
Starting point is 02:19:22 So when he said that, I'm like, oh, damn, I thought like I was doing good by eating ribeyes, but he's like, no, you need to add more. It's also very interesting to me. And I was, even though they were so different and even though they were like, they got into like some almost like fights going on there for a little bit, I was hearing similar stuff, but I don't think they were hearing it because they were ready to make their next point. And I kind of, uh, what I gathered from the whole thing really was this is that, and, uh, this has been proven before. And I wish I could remember what it's actually called, but, um, they've done studies on people where they've had people consuming like a mixed diet where people are having carbohydrates in their diet. And they showed that there was a value to having a bite extra like vitamin C in your diet.
Starting point is 02:20:09 And they showed that in the absence of carbohydrates, I'm probably butchering all this information by the way, but in the absence of carbohydrates, the vitamin C wasn't needed as much. And so, and so I think what's happening and what I've heard these two guys say is that when you're on a carnivorous diet where you're consuming a lot of meat and then also eating the animal from, what did he say, nose to tail or tail to nose? When you're eating the entire animal, that you probably don't really necessarily need a lot of other stuff because you're probably getting everything that you need from the meat. need a lot of other stuff because you're probably getting everything that you need from the meat. Now, if you're somebody that's on a mixed diet or you, uh, let's even say we'll just consider any other diet being a mixed diet, because that would be a mixed diet. It would mean that you're mixing in other stuff.
Starting point is 02:20:56 So even if you just on the weekend decided to like let loose or just had a cheat meal here or there, maybe you need a little bit of fiber. Maybe you need some fruit, maybe you need a little bit of fiber. Maybe you need some fruit. Maybe you need some vegetables. So that's where I would say, I agree with all the stuff that Paul said. I think that he has a lot of really valid points. I don't think he's trying to poison the people that he's working with. I think he's, you know, just trying to help people.
Starting point is 02:21:20 Um, and I myself have done a carnivore diet. I myself have just eaten meat for periods of time. Uh, I liked a lot of it, but I also have kind of recognized like that is a way of doing things. There's other ways of doing things. And for me, a carnivore diet is just too difficult to do all the time. I'll probably always go back to it. I really do enjoy a lot of, uh, aspects of it, but whether you're on a carnivore
Starting point is 02:21:46 diet or whether you're following flexible dieting or whatever the program is that you're following, just make sure that you're sticking and actually adhering to it and actually giving it a good try, a good shot for a while. If you try it and it's like, it's clearly not working, your stomach's always bothering you, your, your energy levels in the gym suck. I mean, you can just grade yourself on a scale of one to 10 on how you're feeling with some different things. Grade how you feel at jujitsu.
Starting point is 02:22:10 Grade how you feel in the gym. And then also pay attention to your gut. Like if you're taking dumps 40 times a day and that's not normal for you, something bad is going wrong in your system. So that's some of my advice and that's some of what I took from today's podcast. Yeah. And you know, a lot of you are trying, listening to this and you're trying to lose weight, let's say on a carnivore diet or any diet. I did watch some of Paul's
Starting point is 02:22:34 content and he did mention that he, he does pay attention to how much he actually eats of this food. So whether you're going carnivore or any diet, a lot of people are trying to lose body fat and weight. It's a good idea to track what your intake is. So at least you can just understand it. I'm not saying track your food every single day and take a food scale everywhere you go, but you could potentially be in a caloric surplus on a carnivore diet and notice you're not losing any weight or any fat. It's not because the diet isn't working. It's because you were actually just eating way too much food. So, I mean, neither of them went into that here because that wasn't the subject, but from a pure application standpoint, because that's what a lot of us simpletons are looking
Starting point is 02:23:09 at. Yeah. I want to get ripped. I want to get ripped. Right. You know, whether you're a carnivore, whether you're keto, whether you're, you know, you moderate carb, higher carb, make sure that you're in a caloric deficit with whatever diet you're doing, because that in the end of the day, that caloric deficit is going to be the thing that's going to allow you to get leaner, lose body fat and get that body that you're probably looking for. And it's real easy to get confused on all this stuff. And as I've mentioned many times here, it's mentioned in my book, you don't want to just start out in a caloric deficit unless you've dieted before.
Starting point is 02:23:39 Yeah. If you, if you've been on diets before and you've handled them pretty well, then don't go and jump into a caloric deficit. First thing you need to get used to is the food. So if you're going to try a carnivore diet, first of all, make sure that you like meat because it's going to get boring real fast. Maybe think of some different ways that you can prepare it so that you don't get too bored from it as well. But get used to the food first and then start to think about, oh, maybe I could fast a little bit. Maybe I could cut calories back a little bit here and there.
Starting point is 02:24:06 And that's how you're going to have long-term success. If you're trying to play the short game and you're like, I want to lose, you know, 20 pounds before the summer and it's already June. Well, you know, that's going to be hard. And the rebound off of that might be tough, right? So when you're trying to get a fast result, a lot of times you'll have a fast rebound as well. And we want to try to play the long game here. We want to try to get used to the food, then start to maybe have some sort of caloric restraint or a restriction. Um, what I noticed from the carnivore diet personally, what I really liked about it was the simplicity of how black and
Starting point is 02:24:40 white everything was. And it was like, I was either eating, uh, I was either eating meat or I was fasting and I used the combination of the two. So there really wasn't, there wasn't a lot of gray area. I did have, um, I did mix in some liver and some heart and some, a couple other things, and they were convenient to mix in it. What this was not hard. None of it was gross. It sounds gross. I know it sounds gross. I know it sounds disgusting. I know it sounds like I'm a fucking savage over here, but it was very easy to mix in. I actually just cooked it in with my ground beef. Didn't notice a flavor difference and it was, I was totally fine with it. The other thing I had was bone broth, but it was very simple for me. I
Starting point is 02:25:22 would, I would go and I'd fast for 16 to 18 hours on most days. I'd go home and I'd eat meat and I would kind of like relax for a little bit and I'd be like, I'm still hungry. And I would crush some more meat. And I was able to end most of my days with, uh, you know, taking in a nice portion of food. It felt really good. So it worked really well for me and I recommend it, you know, give it, give it a try, give it a shot and definitely fall, follow along with a lot of the, uh, recommendations that, uh, Paul had. Yeah. I need to learn how to sous vide my meat. Yeah. Yeah. That, that shit's really good. Anything else, Andrew? No, that's everything, man. It was, uh, that was good. They went at it. Ah, it was fantastic. I'm, I'm really, uh, excited, really excited for people to hear that one.
Starting point is 02:26:05 Yeah. I'm excited for Paul because he creak crushed it I think. He did great. Again not taking anything away from Lane but people in
Starting point is 02:26:13 this space know Lane right? People that follow us know Lane. The same crowd doesn't know Paul. They will now. Yeah.
Starting point is 02:26:20 Yeah he like M&M'd it right there. He got his chance and he didn't he didn't throw up all over his t-shirt. All right. That's all the time we got. Strength is never weak this week. This is never strength. I'm at Mark Smelly Bell on Instagram and this is at the natty professor on Instagram. All right, guys. Thank you so much. Catch you guys later.

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