Realfoodology - Raw Milk, Animal-Based Diets, + The Cholesterol Myth | Paul Saladino

Episode Date: February 25, 2025

234:  I am excited to welcome Paul Saladino to the podcast, as this conversation was long overdue. We recorded while we were both in Washington, D.C., for the Make America Healthy Again ball, and I��m so excited to share it with you. Paul is a wealth of knowledge when it comes to nutrition and preventative health, and I’ve been following his work for years.   In this episode, we take a deep dive into cholesterol myths, the role of saturated fat, and how metabolic dysfunction—not cholesterol—is the real issue. Paul shares a fascinating analogy that helped me fully grasp these concepts. We also discuss the benefits of an animal-based diet, the history and controversy around raw milk, and the broader implications of nutrition policy and education.   Topics Discussed:   Raw vs. pasteurized milk   The role of saturated fat in health   Cholesterol myths and metabolic dysfunction   Pharma companies, statins, and LDL levels   Meat consumption and heart disease   Fasting insulin and ancestral diets   Food deserts and nutrition policy   Calorie counting and eating disorders   Stay tuned for part two!!!  Sponsored By MANUKORA  Go to Manukora.com/REALFOODOLOGY to get $25 off the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook!  LMNT Get your free Sample Pack with any LMNT drink mix purchase at drinklmnt.com/realfoodology Our Place Use code REALFOODOLOGY for 10% off at fromourplace.com BIOptimizers  For an exclusive offer go to bioptimizers.com/realfoodology and use promo code REALFOODOLOGY  Paleovalley Save at 15% at paleovalley.com/realfoodology and use code REALFOODOLOGY Graza Head to Graza.co and use REALFOODOLOGY to get 10% off of TRIO which includes Sizzle, Frizzle and Drizzle, and get to cookin’ your next chef-quality meal! Timestamps: 00:00:00 - Introduction  00:03:01 - Raw vs pasteurized milk  00:10:01 - Issues with sterile milk & history of raw milk  00:13:51 - The milk we give to babies  00:16:05 - Saturated fat is good for you 00:20:40 - Cholesterol misinformation & metabolic dysfunction  00:28:21 -  Pharma companies, statins, & LDL levels   00:34:52 - Meat consumption & heart issues  00:37:02 - Fasting insulin & ancestral diets  00:40:21 - Food deserts  00:43:22 - MAHA & policy change  00:46:27 - Nutrition & education 00:50:31 - Calorie counting & eating disorders  Check Out Paul: Website Instagram Youtube Check Out Courtney: LEAVE US A VOICE MESSAGE Check Out My new FREE Grocery Guide! @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Produced By: Drake Peterson

On today's episode of the Real Foodology podcast. There are so many nutrients in red meat that improve your fertility, your mental clarity, your strength, your resilience to injury, right? Like you need red meat. Hello, friends. Welcome back to another episode of the Real Foodology podcast. Today's guest, Paul Saladino. He's also known as the Carnivore MD, but he's not carnivore anymore.

He's what he calls animal based. I just have to say this was an amazing conversation. Paul and I were both in DC at the same time because we went to the Make America Healthy Again Ball around the inauguration. And we have become friends because we got connected through our mutual friend, Cali memes recently. And we decided to record a podcast, which I feel is long overdue. I have been following his account for a long time. And I think he's amazing. He is a wealth of knowledge. He's an MD who went through the traditional training and he came out on the other side and he realized that what he was doing was

not really truly helping patients. So he revamped everything. He went and he got more education and went online and started teaching everybody how to eat and take care of themselves from a preventative lens. We talk a lot about cholesterol in this episode and I think the analogy that he made was so fascinating and it really helped me fully understand the nuances in all of this. So we talked a lot about that. We talked about animal-based diet. We talked about, I give some updates around Hector Psoriasis because he has since gone animal-based and we've gotten a lot of advice from Paul over the last month or so. And I give you

a full update on Hector Psoriasis and it's pretty exciting. So you're definitely not going to want to miss this episode. I hope that you enjoy it. I really loved it. So if you want to take a moment to rate and review the podcast, it means so much to me. It really does help this show a lot. And I just appreciate your support so much. I wish I could hug you all. Thank you so much for listening. This was a long episode, so we split this into two parts. This is part one, so tune in next week for part two. I'm a huge fan of Manuka honey. In fact, I've taken it for years because of its antibacterial and antiviral properties. It's rich, creamy, and honestly the most delicious honey I've

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and you can even scan a QR code to see the results for yourself. Now it's easier than ever to try Manucora honey honey. Head to ManuCora.com slash realfoodology to get $25 off the starter kit. That's M-A-N-U-K-O-R-A dot com slash realfoodology for $25 off your starter kit. This episode of Real Foodology is brought to you by Grazza, my new favorite olive oil. It's single origin, which means that it's only one olive from one region, no mysterious blends. That means a traceable fresher product without mixing in any lower grade or unknown oils. It comes in super fun squeeze and spray bottles. So there's no more

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-♪ Paul, thank you so much for coming on today. I'm glad we made it work. It's good to be here. I know. We're currently in D.C. for the inauguration, and we were scrambling to try to find a studio, which we could not, so we're making do in his Airbnb. We made it work. We're looking at the Potomac River frozen over right now over there. I know. It's crazy to be here. Okay. So when you and I first met, you were pouring me a

glass of raw milk into a wine glass at a very nice restaurant. In Phoenix. Yep. Which was very on brand for you. Yes. So I just want to go into it. Why are you such a proponent for raw milk? Well, it's funny because I got so much shit for that pose people were saying it was staged and it just wasn't stage Did you? Yeah, it was absolutely absolutely not staged. I go everywhere with raw milk. I just showed you in my Airbnb here Oh, yeah, I saw it. We can put this we can get b-roll for the for the podcast

I mean we have I have five gallons of raw milk, which is more than I'm gonna need This is my family brought me this because they live in DC. But so raw milk is interesting to me for a lot of reasons, but it's an interesting animal food. So it's an animal food, number one. So milk is healthy for humans, calcium, vitamins, choline. And when you look at raw milk versus pasteurized milk, the difference is the heating process. And milk is kind of an interesting fragile food, but it's shared across mammals, right? So anything with mammary glands makes milk, presumably. That's how it works, whether it's a dog or a dolphin or a human, right? I always think of that scene in Meet the Fockers where he's like, I have nipples, Greg, can

you milk me? Yeah, right? Yeah. Yeah. Female species, right? Females of the mammalian species make milk. For the longest time, I thought milk is for baby cows. It's not for humans.

When I started looking at the literature, it's fascinating. Just looking at the literature of dairy and dairy fat, there is so much literature suggesting benefits. Whether you're looking at dairy fats like C15, which is an odd chain fatty acid. C15 is pentadecanoic acid, but it occurs in butter, it occurs in cheese, and it occurs in milk. So dairy fats across mammalian species look to be healthy for humans. It doesn't have to be human milk.

Obviously breast milk is amazing for babies, and what mom eats affects the composition of her milk. So we can get to that as well because there's an interesting story about infant formula and how it's illegal in the United States to make infant formula without seed oils, but we'll save that for a minute. We should talk about that. Yeah. But there's so many valuable components in dairy in general.

Immunoglobulins, lactoferrin, lactoglobulin, there are so many valuable immunologic components, vitamins, minerals, and then these unique fats like C15, which is pentadecanoic acid. Specifically with C15, that fat has been studied and shown to protect us against lipid peroxide induced cell death, which is called ferroptosis. I know we're getting technical pretty quickly. I'll try and back it up. I love it.

No, it's good. But it's so interesting to me that across animal foods, whether it's meat or dairy, there are unique benefits to eating cow's milk or camel's milk, mammalian milk versus quote an almond milk. And so as I went deeper down the rabbit hole, I started eating, okay, butter is healthy for humans because of stearic acid, which is an 18 carbon saturated fat. It also has C15 in it. So C15 is protective.

The literature is very clear, at least observationally. There's a very strong association between the consumption of dairy fats and better outcomes in terms of cardiovascular health and leanness. And then, so you get cheese, you get butter, but then you get to like raw milk and you think, okay, raw milk is milk from cows or other mammalian species that has not been pasteurized. There's a big pushback right now against raw milk. People like Matt Walsh, who I'm sure came out. I was surprised by that. I'm sure he was here this weekend.

Yeah, he is. Came out and did semi-satirical posts or just actually critical posts on X saying, why are you drinking milk riddled with E. coli and listeria when you could just be drinking milk that's pasteurized. And so the assumption there, the inference is that pasteurized milk and raw milk are basically the same nutritionally and that raw milk is just pasteurized milk with a bunch of bacteria in it. And it's just not that simple. Unfortunately, when you heat mammalian milk, mammalian milk seems to be one of the more

fragile things that we have in terms of animal foods. You can heat butter, it doesn't really get that damaged. We cook steaks and hamburgers and they're still apparently good for humans to eat. But when you heat milk, you appear to change the conformation of the whey protein. So I used to think raw milk was better than pasteurized milk because of the probiotics. And yes, raw milk does have many more orders of magnitude more probiotic, symbiotic organisms in it which come from the cow or from, in the case of humans, from a mother's breast, which breast milk is not sterile either.

And so I used to think it was the probiotics in the milk. And that may play a role in terms of shaping the gut microbiome of humans when we drink raw versus pasteurized milk. But there's also an interesting body of literature suggesting that the whey protein in raw cow's milk in this case is immunologically valuable for humans. It seems to program our immune system in a certain way. And that's really interesting. That's fascinating.

So these are studies like the Gabriella study and others which are similar. They're observational. But what they show is that kids who grow up on or off farms drinking raw milk have lower rates of asthma, eczema and allergies. This is called this atopic triad. This hits home for me because that's what I grew up with. I grew up right here outside in DC, right? So we're in Arlington right now. I grew up in Vienna 20 minutes away. I had asthma. I had to take an inhaler. I had eczema, which I struggled with my whole life. And that was ultimately the reason that I went down the

sort of carnivore animal-based rabbit hole and I had seasonal allergies. And kids somehow seem to benefit from cross-species exposure to mammalian milk. That's really interesting to me. That's really interesting. And then you start to look at the literature and there's just, there are many studies that are just kind of silenced and never talked about showing unique benefits to raw versus pasteurized milk. So what's the problem with pasteurized milk?

You sort of heat the proteins in milk, that whey protein probably changes conformation and you lose potentially the immunologic benefits or pasteurized milk maybe immunologically stimulating to people could cause eczema, could cause allergies or could cause other autoimmune things. A lot of people I know get bad immunologic autoimmune reactions from a pasteurized milk.

The other thing that happens with pasteurized milk is you do lose all those bacteria. You have essentially a quote sterile product, but that's not always what we want. As we know, there is no such thing as sterility. Our skin, our mouth, our nose, every piece of our body, every crack and crevice is teeming with bacteria. We don't want to just sterilize the whole thing. This is the fallacy around antibacterial soaps. As soon as you wash your hands with an antibacterial soap, all of this skin microbiome just comes

back onto your hands. And you can actually cause disruption of the normal balance in the flora of a human skin, mouth, nose, whatever. And your immune system. Yeah. It's all connected. And so we probably don't want to be drinking a sterile milk. And the problems with a sterile milk are that there are no microbial components to prevent overgrowth of pathological things.

So there are certain microbes that do make humans sick, listeria, certain strains of E. coli. Not every E strain of E. coli is pathogenic. And so when Matt Walsh says raw milk is riddled with E. coli and listeria, he's actually so far off base he doesn't really realize it because the reason raw milk is, one of the reasons raw milk is probably safer than pasteurized milk when done correctly, when done in a clean way, is that there are, let's just say, hundreds of thousands, millions, billions of colony forming units of organisms in the raw milk that are symbiotic, that are preventing overgrowth

of the really bad bacteria. Even if you got a little bit of Listeria into your raw milk, unless it's a mass of contamination at scale, which is sort of a systems issue in the way you produce the raw milk, that Listeria is much less likely to grow because there are millions, billions of other bacteria and viruses and organisms that keep it in check. This is the magic and this different perspective that we're learning as humans with the gut microbiome or any other microbial environment. It's not about sterility. It's about having the right organisms there to keep everybody else in check.

So this is what's interesting about raw versus pasteurized milk. The trouble is that historically raw milk gets a bad rap because it went from being something that was only available on farms in the late 1800s to being something that people wanted in cities in the early 1900s and they didn't have the right cleanliness standards. They were milking cows in dirty conditions, feeding them the spent grains of alcohol fermentation which is called swill. And then you get a milk which caused a lot of, let's just say, infectious disease.

So that's not what you want. But now more and more producers are able to produce raw milk, which is challenging in a clean way. And if we can do that, we actually get humans this sort of historically valuable food that is really under attack today. So it's a really interesting sort of, I think, lightning rod. You know, it's a very divisive issue. I think one of the most asked questions that I get in my DMs is what cookware do I use?

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Users report better digestion, increased energy, and faster muscle recovery, plus no more feeling bloated and sluggish after meals, which is exactly what you don't need when you're trying to stick to those New Year's fitness goals. For an exclusive offer, go to bioptimizers.com slash real foodology and use promo code real foodology. It is so divisive. I mean, I get people DMing me about it all the time. Now, I personally, I don't really like milk very much. Like when I was little, my mom would tell me stories all the time

that I would throw my bottle over the crib because she just said, I never liked milk. And I remember as a kid, I was always like that. I was always rejecting it when I was little. And so now as an adult, I just don't particularly love the taste of it. Like I'm not against raw milk. In fact, hearing all of that makes me want to drink it more. We'll drink it.

I know, I'm going to have to have more. And I will say, when I had a sip of that at the dinner, when we met, I was like, oh my gosh, I've never had milk like this before. You liked it? I did, it tasted a lot better than any milk I've ever had. What were you drinking as a child? This wasn't-

Well, I'm sure it was pasteurized milk. Right, you weren't throwing a bottle of breast milk away. Oh, no, no, no. This was after you were done breastfeeding or when your parents were mixing it, right? Yes, when it was like actual milk. Yeah, because I was breastfed until, I don't know, a year and a half or something. And then after that, she said that I would literally like, she would put me in for a nap with a bottle of milk and she said that I would throw it over the, over the crib.

And it was probably, who knows what kind of milk she was giving you. When I was growing up here in Virginia, my parents, my dad is a doctor, we would get skim milk. So skim milk is all of the milk fat removed. And 60 to 70% of the immunologically active components are found in the fatty portion of the milk. That's like when you get real milk, when you get raw milk, it's not homogenized either. So you can see the cream on top.

And this became like a trend on social media recently. People were just going crazy. Well, that's the way milk is supposed to be. There's supposed to be cream on top and that cream is rich and it's kind of carnal in some ways. It's the kind of thing my father as a traditionally trained internist in the 1980s thought that's bad for you. That causes high cholesterol.

That increases cardiovascular disease. The data suggests the complete opposite. And so I was drinking skim milk, which is just the watered down garbage pasteurized milk and if they do have a 2% milk, which was like a treat in my house, normal milk is around 3.7, 3.9% fat. So 2% is about half fat, whole milk is about 4% fat and skim milk is probably less than half a percent fat in the milk. If we were drinking 2%, they homogenize it.

They have a system where they have to like blend it all together, which isn't really the way milk is supposed to be either. Yeah. Oh, the whole low fat movement ruined so much of our food landscape and including the milk. I want to talk about this. So you mentioned something called C15. You've also mentioned saturated fat, which is another one that people go insane about. It's so divisive. Why is saturated fat a good form of fat for us if it comes

from animal-based products? And what are your thoughts around fat in general? So, fat is so interesting, right? Because we can talk about seed oils. We'll get to polyunsaturated fats. But just so people understand, a fat is a long chain of carbons with a carboxylic acid on the end, right? So, it's just a long chain of carbons with a carboxylic acid on the end, right? So it's just a long chain of carbons and a saturated fat means that in that long chain of carbons There are no double bonds between the carbons. That's a saturated fat because every carbon has It's full of hydrogen. So it's really saturated with hydrogens and unsaturated fat means that there's at least one double bond between the carbons There's an unsaturation point meaning there's at least one hydrogen bond because every carbon is bound to hydrogens to fill all of the orbitals in the carbon atom. And if it's an 18-carbon fat or if it's 18 long, then there's 18 carbons,

so C18 with zero double bonds is a stearic acid. I'm having flashbacks of my biochemistry classes right now. But it's important. This is what Ritz real. No, it's good. Yeah, yeah. And C15 is 15 carbons. So if you have 15 carbons saturated fat, that is pentadecanoic acid.

Most of the fats that you and I learned about in our training were even chain fatty acids. C12, C14, meristic acid, lauric acid, C16 is palmitic acid, C18 is stearic acid, then you go to longer chain fats or that's the saturated fats. Or we're learning about C18 with one double bond, which is a monounsaturated fat called oleic acid. C18 with two double bonds is linoleic acid, not to be confused with linoleic acid, which is alpha-linoleic acid, which is an omega-3. That's a different one.

It has more alpha-linolenic acid, has more double bonds, and it's an omega-3 versus an omega-6. The omega-3 versus omega-6 designation has to do with where the first double bond is from the end of the molecule. So that's just, it's all nomenclature from organic chemistry, but saturated fats, they're not inherently bad. They've just gotten a bad rap. They're in animal fats.

So if you look at butter, for instance, it's probably 55 to 60% saturated fats. It's a mix of palmitic acid, stearic acid. Like I said, there's some pentadecanoic acid, that odd chain versus an even chain fat in there. And there's a few other saturated fats. And the rest of the fat in butter is mostly oleic acid, which is the monounsaturated fat found in olive oil. Monounsaturated fats make up about 75% of olive oil.

Just different fats are just mixes of polyunsaturated fats, monounsaturated fats and saturated fats. Even butter has a little bit of polyunsaturated fat, but it's a small, small amount. So linoleic acid is maybe 1% of butter, whereas it's 15 to 20% of olive oil, it's 25% of canola oil, it's 55% of grapeseed oil or soybean oil. And so we have this mix of different oils, different fats that make up the different oils. So saturated fat gets a bad rap, probably going all the way back to 1950s with Ansel Keyes and the seven countries study and the diet heart hypothesis. And broadly the diet heart hypothesis is the notion that saturated fat raises cholesterol

and more cholesterol causes heart disease. And now we know that if you really look at the data, saturated fat doesn't really have a strong association with heart disease that's consistent at all. Ansel Keys' data was really cherry-picked. He picked seven countries where you could correlate saturated fat in the diet with the incidence of cardiovascular disease or the serum cholesterol. But when you really look across Europe, there are so many countries that don't follow the trend, that don't work in his model, he just conveniently left those out. What we do know about saturated fat is that in, I would say, 60 to 70% of people, one

certain type of saturated fat, palmitic acid, does raise LDL cholesterol. And this is where things start to get really interesting. Steric acid doesn't really raise LDL cholesterol. Maristic and lauric acid, which are the saturated fats that are common in coconut oil, don't really raise serum cholesterol. And by serum cholesterol, we're talking about LDL cholesterol. Sometimes synonymous with ApoB containing lipoproteins, we'll just say LDL for the sake of discussion in this podcast. That's the one that gets a bad rap. We can talk about why that's not

an issue in my mind, but really there's only one saturated fat that does it, palmitic acid, and that's found in most animal fats, and that's why it can raise cholesterol. Now, then you get into like the 1950s, 1960s, the American Heart Association, and this notion that is very hard to kind of reverse in people's minds that more cholesterol in the blood equals more heart disease. And that's a very interesting thing. Even to this day, there are many very intelligent doctors and people in the medicine space who will die on the hill, which is called the lipid hypothesis, saying that more cholesterol is a risk factor, is a strong risk factor for cardiovascular disease.

So I would say high level, and we can go down there if you want to go into the rabbit hole, I would say high level. When you really look at that data carefully, I don't think it holds up to scrutiny. And I think that things that we have been doing evolutionarily as humans, like eating animal fats, are not... It doesn't make any sense for them to cause heart disease, right? Just historically, let's rewind the clock. In 1900, 99% of the fat that we were eating was animal fat.

Tallow, which is rendered beef fat, lard from pigs that were mostly pastured and not fed corn and soy. Butter. And the milk fat. lard from pigs that were mostly pastured and not fed corn and soy. Butter. Butter and seed oils. Milk fat. Seed oils were not even a thing. Rates of heart disease, vanishingly low in 1900, vanishingly low. So if saturated fat is causing heart disease, why is there no historical correlation there?

The problem, just to paint the picture broadly for people, and again, we can get more into this in a moment, I think the problem here is that, and there are studies to corroborate this assertion, the majority of people today are insulin resistant, have metabolic dysfunction. There's a study that came out probably five or six years ago suggesting that 86% of Americans had at least one risk factor for metabolic dysfunction. And a more recent study suggests that the number is as high as 93%. You've heard the statistics. 70 plus percent of Americans are obese or overweight.

Diabetes rates, like formally diagnosed diabetes, probably over 43% of Americans, childhood obesity is climbing. I would argue that 70 plus to maybe 90% of Americans have some degree of pre-diabetes, this metabolic dysfunction cascade or this metabolic dysfunction timeline, this metabolic dysfunction... What am I looking for here? This metabolic dysfunction, let's just say- Like they're on the track for it. Yeah.

It's just this metabolic dysfunction spectrum, right? And we're just not formally diagnosing them with diabetes. So what we have is a situation where when everyone is metabolically unwell, it may look like heart disease is associated with higher levels of LDL because I think LDL cholesterol itself, which is this lipoprotein that carries cholesterol and triglycerides in our blood, it is involved in the causal cascade of atherosclerosis. I don't believe there's evidence to suggest that it is causal, that it is the proximate cause, right?

So this is interesting. So right over here, the people looking on the video can't see this. There's a fireplace, right? Dr. Justin Marchegiani Yeah. Dr. Jon Sefcik So you need wood to make a fire. You can't have a fire without wood. We know that you need ApoB-containing lipoproteins to generate atheromatous plaque in the human arteries.

You can't get atheromatous plaque without ApoB-containing lipoproteins. But just like with wood and fire, wood doesn't cause a fire. We're sitting here and there's dry wood right there and there's no fire in the fireplace, right? What do we need to make a fire? I have to walk over there and take a spark and light the wood. So the spark in this analogy is the proximate cause. So when we're talking about atherosclerosis, there's a difference between the spark and

the wood. So if you're in a situation where there are lots of sparks, and I would argue that the spark in the case of atherosclerosis, cardiovascular disease, is metabolic dysfunction, is insulin resistance. So if you're in a situation where there are lots of sparks, if you are a human that is insulin resistant, then yes, if for instance, I don't know how to, if there were a bunch of firecrackers around the fireplace right now, and I was lighting off firecrackers all the time,

then yeah, having more wood over there would result in more fires. Does that make sense? Yeah, yeah, yeah. If you have more sparks, then you're, and you have more wood, you're gonna have more fires. Yep.

But if you don't have sparks, you can have a lot of wood and not have any fires. And in the case of wood, the analogy actually continues to work. Wood is valuable, right? Wood can be used to make a house. I can use wood to make furniture. And in the human body, LDL is the wood and the sparks are metabolic dysfunction. So without the metabolic dysfunction, I would continue to argue against the people who espouse

the lipid hypothesis that without the sparks, wood is valuable. So wood is the LDL cholesterol. And we know that LDL cholesterol moves components around the human body. It moves precursors, hormone precursors, it moves cell membrane components. LDL cholesterol and ApoB containing lipoproteins in general, really all lipoproteins participate in the immune response. So when you have a virus or a bacteria in your bloodstream or in your body, these lipoproteins participate in the immune response. So when you have a virus or a bacteria in your bloodstream or in your body, these lipoproteins

disrupt something called quorum sensing. Quorum sensing is the communication between the pathogenic bacteria. So lipoproteins are part of the immune system and so they serve a valuable role. So wood is valuable. Wood makes furniture. Wood makes houses. You don't necessarily want to get rid of all the wood and wood isn't the culprit, it's the sparks. So the problem here, this is a very long-winded answer to your question about saturated fat. In most humans,

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Plus its low acidity makes it gentle on your gut. This coffee is also tested for mycotoxins and mold so it's as pure as it gets. If you're ready to make the switch, go to paleovalley.com slash realfoodology for 15% off your first order and experience a coffee that nourishes your body and mind every single day. The way that you just described that was genius and it really helped me understand. Does that make sense? Because I really went around.

I got a little off track, but. No, no, no. That was really good. Well, and I always come back to this too. I learned this through another doctor that was on my podcast maybe two years ago. The pharmaceutical companies keep lowering the numbers for your cholesterol because the lower that it is, the sooner they're allowed to get you on a statin, and they can push that through through the doctor's office.

I just have always been, you know, I'm classically trained. I was on the dietetic track. I ultimately didn't go for my RD, but I still have my Master's of Science in nutrition, and I was classically trained in the old, what do you call that, like if you want to call it narrative or paradigm. Yes, paradigm for that. And then I more recently have been reading a lot, and actually my own doctor was telling me, because we've been seeing my LDL go up a little bit because I've been eating more red meat.

Of course, it happens in humans. It's normal. Than I've ever had. What's your LDL now? Do you know the number? I'll have to tell you afterwards and I'll do it in the intro so people are curious. It's not even that crazy high. It's like barely above the average, which I mean, again, the average is coming from

a sick population too. And they're moving it down. I'll just say for people to know this, I didn't mean to interrupt you. Mine is around, my LDL is around 130 now. Okay. When I was strict carnivore, it went up to like 300, 350. And we can talk about the differences between a ketogenic metabolism versus a mixed metabolism. I eat a lot of carbohydrates now, but my LDL is around 130 now, maybe 140.

But yes, if I were eating, and this gets really, this gets into the seed oil rabbit hole. If I were eating seed oils, if I were eating more olive oil and avocados and less butter and ghee and tallow and animal fats on steak, and believe me, those latter fats, I believe are healthy, then I could lower my LDL. But I do not believe that would lower my cardiovascular risk. And we can talk about why certain oils lower the LDL and certain oils raise it, but I don't think it has to do with cardiovascular risk. And we can talk about why certain oils lower the LDL and certain oils raise it, but I don't think it has to do with cardiovascular risk because seed oils actually lower your LDL.

And they probably do this because they cause oxidative damage to the LDL particle within the liver. This is ferroptosis, this programmed cell death, but LDL is not a cell. But there is evidence in animal models that when you have more polyunsaturated fats, the APO-B containing lipoproteins in the liver actually get degraded because of oxidative stress. So you produce less LDL because you're damaging the LDL particles in the liver. They don't actually go into the blood.

There's a number of reasons that seed oils consumption might lower LDL, none of which are likely to lower your cardiovascular risk, all of which probably indicate a higher cardiovascular risk. So it's just this very, this is like a Gordian knot. This is a very complex human physiology that I think has been oversimplified for decades based on bad misinterpreted science starting starting with Antelkis propagated by the American Heart Association probably after the equivalent of the $25 million donation from Procter & Gamble in the 1940s, which got the AHA going. Immediately after that, the AHA starts recommending avoiding animal fats, focusing on polyunsaturated fats. Procter & Gamble was making polyunsaturated

seed oils, remember, in the 1940s. So there's a whole history of possible collusion. We've seen it before in terms of nutrition and medicine and pharma. This is the same story over and over, but for whatever reason, we've really been brainwashed. And even on the street today, if I talked to people, if I said, is a steak bad for your heart, nine out of 10 people would tell me yes. And I would say, what is it based on? They'd say, well, I heard it on the news. And it's like, this is the phrase-

Or my doctor told me. Yes. And it's like, this is the phrase- Or my doctor told me. Yes. And it's like a lie often repeated becomes the truth. And so what is the truth and what is the lie? I always go back to historical evolutionary frameworks. And I think when I'm with the Hadza in Tanzania, I spent time with them a few years ago, they're not cutting the meat off, they're not cutting the fat off the steak. They're eating as much fat as they possibly can.

These guys don't have rates of heart disease that are high at all. You can look at hunter gatherer cultures that have high amounts of saturated fat in their diet from animal foods. They don't have heart disease. 1900, humans, we didn't have heart disease as Americans. We were eating tons of tallows. So this can't, it doesn't all gel. Something is wrong.

And I think we're just thinking about the whole equation wrong. So that's the very, very long-winded answer to your question, which is a great question. Why is saturated fat so vilified? Why are we afraid of milk? Why are we afraid of butter? Because it raises our cholesterol. And we wrongly believe that cholesterol is causal in atherosclerosis because we are a very sick population who have a lot of sparks.

And so if you have more of the necessary intermediates in the atherosclerosis cascade, yeah, you might have more atherosclerosis. And if you take someone who is metabolically unwell, I'll just say this and then I'll pause and we can kind of unpack all that. If you take someone who is metabolically unwell with diabetes and you lower their cholesterol, you will lower their risk of heart disease, but you're not getting to the proximate cause, which is their metabolic dysfunction, right? So you can lower their cholesterol and you will lower the rates of heart disease.

Interesting questions remain about whether you cause other problems downstream, right? Because we know that when you lower someone's cholesterol with a statin, for instance, there does seem to be a signal for increased rates of Alzheimer's, dementia, and other issues, maybe even worsening diabetes. So the drugs are not perfect. And the question is, if you're doing this, are you actually going to help them live longer? You can't just look at cardiovascular mortality. You have to look at all cause mortality.

Say you lower someone's LDL, you might decrease the risk of dying from cardiovascular disease. Do you increase the risk of dying from cancer, an immunological surveillance problem because you don't have as much LDL cholesterol or lipoproteins necessary to do the immune surveillance? Do you increase the risk of dying from dementia because we know that some statins cross the blood-brain barrier and the brain has its own supply of cholesterol that it makes there. So there are all sorts of issues. When I see someone that's diabetic, I want to fix the root cause, the metabolic dysfunction. The LDL is not the root cause of their cardiovascular disease.

The problem then becomes that the paradigm bleeds over into you and I. People will say, Courtney, you can't eat red meat because your cardiovascular disease risk is going to go up. Whereas the flip side is you're a female. There are so many nutrients in red meat that improve your fertility, your mental clarity, your strength, your resilience to injury, right? You need red meat as much as anyone and your doctor is saying don't do that.

He or she is not realizing you're metabolically healthy. There's no increase to your cardiovascular disease risk here. Yes. Okay, so my question is let's say that there's someone, well, I'll give a perfect example. My fiance's dad had a horrible heart attack like a week ago. Okay, I'm sorry to hear that. Thank God he's okay. He had a 100% blockage.

Very scary. I would argue, I have not seen his numbers, so I'm just fully hypothesizing here, but I would argue that I think he's probably metabolically not healthy. 100%. I would bet a million dollars. Yes. His fasting insulin is 10 or 12 or 15,

and we can talk about fasting insulin. And he's also of Mexican descent, which we know diabetes, it runs a lot more in that demographic. They probably have a genetic predisposition. Doesn't mean he's gonna get it. Yeah, yeah. But he's more predisposed for it.

He's probably eating seed oils. He's probably eating processed food. I'm just assuming. Yeah, yeah. So we've been doing like a whole overhaul with him. Thankfully, they got the seed oils out a while ago because we've been working on him for a while with all of this. But there's a lot of processed food consumption.

So my question is, if you know that they are already at risk because they're metabolically unhealthy, would you say that maybe right off the bat you don't push more meat consumption? Is there maybe a period there where maybe you bring down the blood sugar and the inflammation and then, or is it not going to matter? No, I don't think it matters because red meat isn't causing any of the problems, right? If you're addressing, you need to address his metabolic dysfunction. I the way I believe the way you address his metabolic dysfunction is by cleaning up the diet. Hands down.

And so the problem here is that I would be willing to also bet that his doctor has never actually looked at his metabolic health. Maybe since he had a heart attack, they did a fasting glucose. But I'd be willing to bet nobody's looked at his fasting insulin. And a lot of times the fasting glucose is not elevated. And unless he's wearing a continuous glucose monitor and you can see sort of the 24 hour trend of his glucose levels, they're not going to see it with just a glucose. But all his doctor has to do is get a $30 blood test called a fasting insulin. That's all he has to do. And this doctor has to understand how to interpret it,

you know, because if the fasting insulin is less than five micro IU per ML, they're insulin resistant. But the normal range for fasting insulin goes up to 24 micro IU. And so as doctors, I was never taught about fasting insulin. This single blood test would change the landscape of health in our country.

The United States government could subsidize the blood test and every doctor, if they knew how to interpret the blood test, would understand, your soon to be father-in-law is insulin resistant. Oh, he's pre-diabetic. Oh, what's causing that? Now we have to address that. And the answer, I believe, is not metformin, right? It's not ozempic. It's what is he eating that is causing him to be metabolically unwell because he didn't

just get diabetic. Diabetic is not a genetic. It's not in your genes entirely. The predisposition is there. But this is another problem with Western medicine. His doctor is probably going to say, well, you're Mexican-American. You're just going to be diabetic based on your genetics. This is the problem with all of it.

We're so blind to basically the total perspective, the idea that we're just blind to lifestyle in medicine and in dietetics. You saw this too. We just don't understand how much what our patients are eating and how their living affects their metabolic health. It's crazy. I went to medical school in Tucson, Arizona and the Pima Indians are native to that area of Arizona.

They have one of the highest rates of diabetes in the world. It's like 60 to 70 percent, right? But if you look back a few generations at pictures of Pima Indians, they're fit. They're ripped and they're skinny. What happened, right? They stopped eating their evolutionarily consistent diet. You go back 300 years and you can put pictures of this in the podcast for people to see. Look at Pima Indians from the 1800s.

They look like healthy humans. And now they're incredibly obese and incredibly diabetic. They have a predisposition to diabetes. We all have these chinks in our armor. We all have these predispositions. My weakness is eczema and allergy. Yours might be, who knows, right? Mine is actually eczema too.

I never had asthma, but yeah, eczema was a big one for me. We all manifest chronic illness differently, but we all swim in the same dirty water. So that's why I think Western medicine can't figure this out because as a doctor you're thinking, well, this patient has autoimmune thyroiditis. They have Hashimoto's. This patient has rheumatoid arthritis. This patient has psoriasis. This patient has diabetes.

This person has lupus. They're all the same thing. It's all the same thing and it's all fixable in the same way. And yet Western medicine says, there are 10,000 diagnoses for which I have 35,000 drugs. Look at me. How cool am I? And that's how pharma works, right? It's just like you name a disease and then you give a drug.

And so yeah, I think your father-in-law is likely getting a narrative that is not going to serve him well. But hopefully this type of thing and you and your fiance can guide him in that way. We've been doing that actually. He just went home to visit him and he completely just threw everything away in his pantry, took them on a grocery trip and they were FaceTiming me like, what do we buy here? What kind of yogurt do we buy? And I was telling them, because they were trying to buy the low fat yogurt that had

sugar in it. And it was like plain, full fat, like organic, like the cleanest one you can find, like things like that. I mean, the other issue is like where they live, like the cleanest one you can find, things like that. I mean, the other issue is where they live, some of this stuff is harder to find, you know? Which we're going to talk about. Let's talk about food deserts, and I want to talk about sugar too, so we can go wherever you want.

You and I actually spoke on the phone about this recently, and it's interesting because you brought up the Indians, and there's a lot of conversation around how Indians on reservations are getting really high numbers of diabetes, and a lot of it has to do with the food deserts, and there's this whole conversation that's happening right now online. I'm getting attacked a lot for registered dietitians because they're getting it from their nutrition, from their schools, from their education,

that's coming from big food, I believe. And let me just be very clear, I'm not saying that I don't think that accessibility is an issue. I absolutely think accessibility is an issue. But I also believe that we are making it more, the conversation has become so conflated that now we're just saying that people have no control whatsoever.

And it really pisses me off. Yeah, so I was actually researching this and the food deserts are interesting. So food deserts for people that don't know are just areas of the country where it's hard to get access to single ingredient foods. There are a lot of grocery stores or places where you go to buy food and they don't even have fruits and vegetables. They might have meat, but it's mostly processed meat or sausages or something, but they don't

have a lot of single ingredient meat and they don't have a lot of single ingredient fruit and vegetables. Or also another one that I've read too is that if people are not close to a grocery store and they're going to like their local 7-eleven to get you know the little oranges and bananas that are there. I mean they have barely any produce there. Yeah. And so the reason most of these food deserts exist and this is actually pretty sad is consumer choice.

That these supermarkets used to sell fruits and vegetables and nobody bought them and The reason most of these food deserts exist, and this is actually pretty sad, is consumer choice. These supermarkets used to sell fruits and vegetables and nobody bought them. And so they stopped selling them. Which is, I think that's an indictment of the food system. And it's saying, wait, if you're providing people food that is so addictive and so hyperpalliable that they no longer want to eat the foods that humans have eaten throughout our evolution, you've basically made drugs illegal. You've basically created fake legal drugs and food

so that humans have been reduced to just like, all we're gonna do is eat a Snickers and Cheetos and Takis and Coke. That's crazy. Like we need, at that level, I would argue there needs to be some government oversight. It's hard to walk it back. You can't close Pandora's box, but I mean, this is crazy. Like we need, at that level, I would argue there needs to be some government oversight. It's hard to walk it back. You can't close Pandora's box.

But I mean, this is crazy. When consumer choice is driving food deserts, we have a major problem. Well, and people are, we're now seeing signs of people being, they are very, they're highly addicted to these foods. I just read an article that was, I forgot what they named it. They're trying to name some new thing around hyper or ultra processed foods where it's an addiction and if you take the foods away from them, they start showing irritability. Of course.

All these, you know, they're literally having withdrawals. And it makes sense. Showing food withdrawal is real. And it makes sense why when I go online or you go online and you know, we say Oreos, they're not good for you or Dor Doritos, and we get just destroyed. I'm like, oh, we're going after their drugs. Yeah, people push back. Yeah, and they get, don't take it away from me.

I mean, it's crazy. It has become a full-blown addiction, and I think they're illegal drugs. So my question is then, what do we do about this? Because there is also that concern that with the government, in my opinion, it's like everything the government touches. I mean look at the what we were just talking about with heart disease and just the whole narrative around that. It's like anything the government touches I feel like just goes completely corrupted.

So how do we find the middle ground in this? Well now, I mean we're here in DC for the inauguration, you know. You and I are both very hopeful that you know that regardless of Republican Democrat, that this administration will bring people into office at the level of the FDA, the level of the USDA, the level of CMS, the level of the NIH, the level of Health and Human Services with Bobby Kennedy, that can begin to make meaningful change. This is our hope because if you look at the problem, it's clearly connected with the government.

I mean, the FDA is completely corrupt, receiving 47% of its funding from pharma. This is wild. USDA guidelines community, 19 out of 20 members have ties to pharma and food industry. Of course, none of this is going to change. At a governmental top-down level, hopefully we'll see some reform. I've been talking to some of my friends about this, and we've had conversations with other folks that we're talking to at these events for the Make America Healthy Again movement, and just kind of asking questions like, what can you do? Some of the coolest ideas I've heard are around HSAs, health savings accounts. I would love to see those almost have no cap, have pre-tax money that you can use to spend

on healthy interventions. And then I would love to see HSA availability expanded. So I tweeted about this the other day. If you can use food stamp funding to buy junk food and soda, HSAs should be able to be used to buy single ingredient meat and produce. So if you could put aside, say you could put aside $20,000 a year and you could spend that money on meat, chicken, fish, eggs, milk, and vegetables and fruit. That would be amazing for Americans.

Then you'd actually incentivize people to buy healthy food. And then if you similarly actually do the right thing and stop the use of food stamps, the SNAP funding to buy absolutely ultra processed foods, you've really begun to change it from a governmental level. And look, but we have to, and I think, from my perspective, we have to incentivize good habits and disincentivize bad habits. I mean, cigarettes have a huge tax. How much is a pack of cigarettes today?

$12? I don't know. I buy them every once in a while just to make videos with them and I feel so guilty. Like I'm a bad boy. I'm buying cigarettes. I'm walking out of a store with Marlboro's. I've done this and I feel so guilty like I'm a bad boy. I'm buying cigarettes. I'm walking out of a store with Marlboro's. I've done this and I'm like, You're like, what if someone sees it?

Yeah, like this is so bad. I kind of like smell it and I'm thinking like, I don't know. I have no desire to smoke it but I'm like, this is bad. That's so funny. It's so funny. I feel guilty about it but I buy them and I'm like, $12? This is crazy. That is crazy. So, you know, cigarettes are $12 but Coca-Cola is $2.50 for a liter. And you can get it on food stamps. So you can get it from taxpayer funding.

You can't buy cigarettes with food stamps. Exactly. So I think there does need to be something, some regulation around that. I also do think too, and you and I have been doing this for years, education, education, like people need to know. That's what we do. That's bottom up. Exactly.

People need to know because it is so shocking to me that there's so many people. My father-in-law is a perfect example of this. He thought he was eating well. He thinks that he's doing pretty well and he thinks that he's eating pretty healthy. Obviously there's habits that he's like, I know I need to change, but a majority of Americans are eating what their doctors are telling them is healthy. And they're telling them to do low fat milk, low fat dairy, avoid the steak.

They're telling them all the opposite. Almost the wrong things. Of what we should be doing. Yeah, it's okay if it's low fat. We're still like 30 years old. That's what we've been telling you for 30 years. I know. And the other thing that we're telling people,

and this is insidious, is calories. Yes. And the calories model, I think, might be a PsiOP. Because if you only count calories, you can lose weight, but you will become less healthy over time because you will become nutrient deficient, and I guarantee you will cheat and you will binge. It is so difficult for a human to be in calorie prison. Counting calories without attending to food quality is the worst way to lose weight. Oh, and you're in a prison. You're in a calorie prison. Counting calories without attending to food quality is the worst way to lose weight.

Oh, it's so… and you're in a prison. You're in a calorie prison. You can lose weight eating 1,500 calories of donuts per day, but believe me, you will break out of that prison and when you do, you will go crazy. And this is the other thing about calorie restriction that doesn't work is you get adaptive thermogenesis. So, and there is a solution here which we'll get to in a moment, but when you restrict calories your thyroid turns down the thermostat on your body.

And so you end up in this race to the bottom and this is what you see with shows like Biggest Loser. The statistics suggest that 86 to 90 plus percent of people on the show gain back all the weight they lose plus more because the body goes into like panic mode. You're starving. The only way to fix that is with food quality. This is what's so fascinating to me and I've been trying to speak about this, but it's a very difficult thing for me to talk about eloquently.

If you increase food quality, satiety comes naturally without even thinking about calories. Look, I fully believe that if you go in there and you drink all the raw milk in my fridge, you could probably gain weight. But most people are not going to do that. If you just eat butter, you could gain weight. But you're going to hit a satiety threshold with single ingredient foods, milk, butter for most people, even honey for me, fruit, steak. I'll get to a point, and I don't know if you've had this experience, I take one bite

and I feel like that's good. And I get the second, or I get the 35th bite halfway in my mouth. No and I don't know if you've had this experience, I take one bite and I feel like that's good. And I get the second, or I get the, you know, the 35th bite halfway in my mouth. No, I don't want it. Yes, I'm the same exact way. I'm not even hungry. I'm the same exact way. And I can do that with things like honey. I'll take a spoonful of honey or I'll put honey in my milk and I think that's good.

And I'm like, don't want anymore. I'll do it with an apple, an orange, with raw milk. It's satiety thresholds are built in to single ingredient foods. You don't even really have to think about calories. You can if you want. I think it helps to think about macros. I think it's important for humans to know how much protein they're getting and get it from good bioavailable sources like animal meat.

I think it's important for people to understand the balance of fats in their diet, where they're coming from, how many polyunsaturated fats versus saturated fats, where their carbohydrate sources are coming from, all that matters. But once you have a general outline, I don't think about calories ever in a day. I think about protein, and then I think about I'm hungry, and that's it. And once I get enough protein for the day, and that's easy, I'm just eating whatever I want. And the only foods I'm eating are single ingredient foods most of the time. Or if I'm eating a non-single ingredient food,

like for instance, you know, like air dried steak, right? These are gifts for you, by the way. Because I know that you're gonna be at the inauguration and you're not gonna have time. So this is obviously, this is my company, full disclosure, but all of the ingredients on the label are things my great-grandmother would recognize. Grass-fed beef, apple cider vinegar,

which is organic, and salt. That's it. So if you're gonna eat a food with an ingredient label, that's your great-grandmother recognized the ingredients. It's that simple. It's really simple. It's that simple. And same as you, I have this natural satiety

and threshold that I just hit now, and I don't have to think anything about calories. When I was younger, before I knew all of this, I was doing, I'm horrified about this, I was doing the SlimFast bars and the, I mean, it's like I look back and the sad thing is that I was mentally struggling so much with it too because I was trying to think like, okay, if I have this small amount of calories and then by the end of the day I was just like, I'm so hungry.

You cannot stay in calorie prison. You just can't do it. And so then, and then I would be thinking about it all day and it just and when I Started eating the way that I eat now. I do not I mean I have the healthiest relationship I've ever had in my entire life with food This is why I get so frustrated too because there's this Subset of our DS that are going online saying that if you eat the way that we do that you're gonna develop an eating disorder It's the biggest thing from the truth. So maddening because I've never had a more healthy relationship with food in my

entire life. I don't think about it. I eat when I'm hungry, I stop when I'm full, I prioritize whole, real foods. Does that mean I never eat like a chip or something? No, but it's rare for me. And if I do, it's something that's made in avocado oil, it's organic. Like I would never buy or eat like Doritos or Oreos or something. But yeah.

I think the fallacy here is that you can be healthy without restricting at any level with your food. In the dietetics community, I hear these sort of like truisms like all foods fit. Bullshit. All foods do not fit. Like shut your mouth. They're also talking about things that I don't even consider to be food. Yeah. All things are not food and all foods do not fit. Like shut your mouth. They're also talking about things that I don't even consider to be food. Yeah, all things are not food and all foods do not fit.

Like the simple fact of the matter is that to be a healthy human, you must have discipline with regard to some aspect of your diet. Yes. And so you and I choose to have discipline with regard to food quality. And I think that's the best choice a human can make. Because if you choose to eat high quality foods, and we've defined those, but I'll define it for people in case they don't understand. Single ingredient foods or foods with labels that your great grandmother would recognize,

eat meat, eat plants, that's fine. Most people listening to the podcast know that I'm in the animal based sphere. I don't eat vegetables. We can talk about that. If you guys want to eat vegetables, knock yourself out, but eat plants, eat meat, eat foods that your great grandmother would recognize. That's high quality food. If that is the way you apply discipline, you don't have to think about calories and you

get to eat things like butter, raw milk with honey, steak. Tell me how that's limiting yourself. I mean, I don't eat Doritos, but and so yes, you can also apply discipline in terms of fasting or time restricted feeding or calories, but I think all of those strategies fail or don't have the best return long term. I think the best return is just eating higher quality food, and then you get to eat all the foods that humans have traditionally eaten and enjoy them. And I don't feel restricted. Exactly.

I don't feel restricted. I never even think about it. I'm not sitting over here being like, oh my God, I'm dying for Dorito. That has never happened to me. So yeah, I just, the notion that it's restrictive to me is insane because also, you know, you go back like 50 years and this is how everyone ate. It's so crazy to me. It's so simple.

Thank you so much for listening to the Real Foodology podcast. This is a Wellness Loud production produced by Drake Peterson and mixed by Mike Fry. Theme song is by Georgie. You can watch the full video version of this podcast inside the Spotify app or on YouTube. As always, you can leave us a voicemail by clicking the link in our bio. And if you like this episode, please rate and review on your podcast app.

For more shows by my team, go to WellnessLoud.com. See you next time. The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and doesn't constitute a provider-patient relationship. I am a nutritionist, but I am not your nutritionist. As always, talk to your doctor or your health team first.